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One of the common yet questionable questions for medical historians is “How was and is Korean medicine different from that of China?” Queries of this sort often invite us to the medical discourses “Hyangyak (鄕藥, Local Medicinals)” and “Tongŭi (東醫, Eastern Medicine),” which were presented in pre-modern Korea. Scholars with a nationalist bent have asserted that the emergence of those discourses showcased the historical processes of having built up Korean specificity in medicine, getting away from the medicine of China. By contrast, those with a diffusionist bent countered that those discourses were in effect all about the historical processes of having accommodated or adjusted the advanced medical knowledge, originating from China (the center), to Korea (the local). Both of these standpoints are, in essence, based upon the so-called center-periphery non-symmetrical frame—surely an imperialist as well as modernist architecture—within which medical knowledge uni-directionally flows from the a priori center to the a priori local. Historical sources, however, point to quite a different landscape: counter-commonsensically, it was not parochial specificity but Confucian as well as medical universalism (set in local contexts) that Korean doctors and scholars had sought by employing the geopolitical terms Hyangyak and Tongŭi. This obviously leads us to look more carefully into the agency, agenda, tools, strategies, and solutions of the historical actors concerned, as well as into how medical projects work in what socio-political context. The discourses Hyangyak and Tongŭi could, I point out, be better understood in terms of the shaping process of an ethical identity of the literati, government decision dynamics between the policies of people-saving and nation-building, appropriation of what was considered as the cultural center, and cultural rearrangement of what medical tradition or practice was all about.