이 논문은 조선 후기 대표적인 지식인인 정약용(1762~1836)의 방역 활동과 이를 뒷받침한 사상을 탐구한다. 정약용은 자신과 가족의 개인적 차원, 더 나아가 그의 시대가 부딪친 끔찍한 전염병에 대해 맞섰다. 이런 여러 개인사가 관료로서, 지식인으로서, 의학자로서 역병에 대처한 정약용의 행적과 무관하지는 않을 것이다. 그렇지만 모든 조선 사람이 똑같은 역병의 위협 속에 살았으므로 꼭 정약용만이 역병에 대해 남다른 특별한 행적을 보였으리라 기대할 수는 없는 노릇이다. 정약용이 조선 후기 가장 대단한 인물이었으므로 혹시 방역 분야까지도미쳤을지 모를 그의 미덕을 일부러 찾아 칭송하려는 연구가 아니라면, 그의 행적은 질병과 의료의 일상생활사적인 측면을 짚는 사례의 제시로서 만족해야 할 것이다. 이 논문은 방역과 관련된 정약용의 행적과사상이 단순한 일상생활사 차원을 넘어 존재했기에 그것을 본격적으로 탐구하고자 한다. 그리하여 정약용은 자기 또는 그의 시대가 부딪친 방역에 대한 실천과 구상을, 때로는 의학자로서 수준 높게, 때로는관료로서 체계적으로, 궁극적으로는 경세가로서 자신의 전체 사상과연관 지어 극복하고자 했음을 보이고자 한다. 정약용이 『여유당전서』 에 남긴 방대한 내용 전체를 보면, 방역, 의학, 기술 등에 관한 조각 내용과 이를 아우른 사상적 편린이 여기저기 흩어져 나타난다. 또 그것은 20대부터 70세 임종 때까지 지속된 특징을 보인다. 또 그것은 나이가 들면서 수정, 발전, 종합하는 모습을 띤다. 역사적 접근을 취하는 이 글은 그가 남긴 여러 저작에 편재하는 전염병 의학과 방역 관련 기록을 네 부분으로 나누어 살핀다. 그것은 첫째, 1800년 유배 이전 『마과회통麻科會通』(1797)에 결집된 마진麻疹(홍역과 유사 질병) 연구, 둘째, 1789년 이후 임종 무렵까지 지속된 종두법에 대한 관심, 셋째, 1797~1798년 곡산부의 수령으로서 펼친 방역 활동과 이를 바탕으로 한 『목민심서』·『경세유표』에서의 제도화 구상, 넷째, 그의 전염병 의학과 방역 활동의 유교 사상적 체계화 등과 같다.

This paper explores the epidemic prevention and control activities and underlying ideology of Jeong Yak-yong(丁若鏞, 1762~1836), a representative intellectual of the latter half of the Joseon Dynasty(朝 鮮 王朝, 1392~1910). He stood against terrible contagious diseases faced by himself and his family on a personal level and, furthermore, his era itself. At times on an advanced level as a medical scholar, at other times systematically as a government official, and, ultimately, as a governor, he sought to overcome the crises by linking his entire ideology. As has already been elucidated to a considerable degree by earlier research, Jeong Yak-yong’s activities as a medical scholar are shown by his authorship of the A Comprehensive Guide to Treating Measles (Magwa hoetong, 『麻科會通』) in 1797 on the basis of examinations of both measles(紅疫, hongyeok) and all other ailments with similar symptoms, his establishment of a unique brand of the study of measles(麻疹學), his compilation of the first Korean text on smallpox vaccination(種痘法) in 1800, and his exploration of cowpox vaccination(牛痘法) around the 1830s. This paper demonstrates that his brand of the study of measles stemmed from an ambition to reconstruct the entire study of measles, which still did not have clear medical theories and treatment methods, and brought about the independence of the discipline from the age-old tradition of the study of smallpox(痘疹學). As for his introduction of variolation(人 痘法), this paper reexamines the established theory, received even today, that has been created on the basis of his records. In other words, the established theory that “Jeong Yak-yong discussed technical problems regarding variolation together with Bak Jega( 朴齊家, 1750~1805) in 1800 and Bak Je-ga subsequently informed traditional Korean physician Yi Jong-in(李鍾仁, 1756~1823) of the method, after which smallpox variolation spread throughout Joseon” relies solely on Jeong Yak-yong’s statements, and Yi Jong-in’s claim that, after obtaining information on smallpox variolation from Bak Je-ga in 1798, he figured out the method on his own and practiced and disseminated it before 1800, too, must be equally heeded. This judgment stems from the disparity between the smallpox variolation technique presented by Jeong Yak-yong and that practiced by Yi Jong-in throughout his career. As for Jeong Yak-yong’s possession of a book on cowpox vaccination, this paper positively evaluates the fact that, though he could have been suspected of a link to Western learning(西學: mainly Roman Catholicism here though encompassing Western theoretical and technical learning), he nevertheless transmitted some of the contents to a close associate and sought to leave the work to posterity even at the price of deleting contents related to the West. Because full-fledged research on Jeong Yag-yong’s epidemic prevention and control activities has yet to be conducted even today, this paper sets out to shed light on them in earnest. These activities included: his prevention and control of a cold disease(寒疾, hanjil: presumably the inf luenza) during 1797~1798 as the district magistrate(府使, busa) of Goksan(谷山); his performance of diagnosis and examination in Gangjin(康津), the location of his exile, amidst the spread of a warm epidemic disease(瘟 疫, onyeok: presumably the influenza or a typhoid disease) during 1814~1815 after finding prescriptions for highly efficacious treatment; and his attempts to obtain prescriptions from China through the use of his international network and to disseminate them during the 1821 epidemic of the leg-paralyzing epidemic disease(麻脚瘟, magagon; cholera), a hitherto unknown pestilence, after the lifting of his banishment and his return to his home village. Furthermore, this paper demonstrates that Jeong Yak-yong’s medicine and epidemic prevention and control activities were intricately systematic in terms of both institutions and ideology. In the Admonitions on Governing the People(Mongmin simseo, 『牧民心書』), a work from his late years, he presents a model of epidemic prevention and control activities to be performed in provincial counties and prefectures(郡 縣, gunhyeon) as among the indispensable tasks of provincial magistrates. This was so that, going beyond a level where provincial epidemic prevention and control levels were determined according to the capacity of individual provincial magistrates, epidemic prevention and control activities would be performed on the basis of established laws and manuals, and these activities resemble those of modern states. Finally, this paper elucidates that Jeong Yagyong’s medical and institutional searches with respect to contagious diseases were more broadly based on or constitutive of his views of technology and monarchism. It demonstrates the formation of a consistent ideological structure among his ideas: he defined medicine as one of the five arts buttressing the country together with farmers’ agricultural technology, women’s spinning and weaving technology, army’s arms manufacturing technology, and “hundred artisans’”(百工, technologies: i. e., artisans’ civil engineering, architectural, shipbuilding, and handicraft technologies); he saw these technologies as sources of the nation’s wealth and power and therefore urged the state’s efforts to attain technological advances; and he grasped them as the keys to monarchical rule. Considering that no one in Korea had developed such discussions so systematically before him, Jeong Yak-yong’s responses, where medicine, systems, and ideology were organically intertwined, are especially noteworthy.

epidemics, A Comprehensive Guide to Treating Measles(Magwa hoetong, 『麻科會通』), smallpox vaccination, infectious disease control, perspective on technology.