A History Lived With Epidemics: Moments of Crisis That Shaped Civilizations
Among the many ways to describe the human journey, the Korean phrase “Saeng-Ro-Byeong-Sa”—birth, aging, sickness, and death—encapsulates the essence of life. Of these, “sickness” is not merely a personal affliction; it has the power to impact entire communities and reshape the fate of nations. Epidemics, in particular, have demonstrated their capacity to alter the course of history, and human civilization has evolved through its long struggle against them.
The Origins and Spread of Epidemics
In ancient times, the concept of microorganisms was unknown, and epidemics were often seen as divine punishment or natural disasters. For example, Samguk Sagi, Korea’s oldest surviving chronicle, records that in 15 BCE (the 4th year of King Onjo of Baekje), a devastating famine was followed by the outbreak of an epidemic. With no acquired immunity, newly introduced diseases were often far more lethal—especially in isolated societies encountering foreign pathogens for the first time.
These outbreaks were typically fueled by contact with outsiders through war, migration, or trade. In the Silla period, for instance, conscripted laborers gathering in the capital facilitated the spread of infectious diseases. Extreme weather events like droughts and harsh winters further weakened the population, increasing their vulnerability to illness.
Epidemics During the Three Kingdoms Period
Samguk Sagi details various epidemic outbreaks in Goguryeo, Baekje, and Silla, with the most detailed records found in Silla’s history. Outbreaks were most common during winter and spring—seasons associated with famine and cold-related hardships.
Rather than internal conflicts, contact with foreign powers—especially China—played a larger role in the spread of diseases. After Baekje's fall in 660 CE, a significant epidemic hit Silla. Similarly, disease spread through Goguryeo following the collapse of the Northern Wei dynasty. These illnesses were even transmitted to Japan, where smallpox and other infectious diseases became endemic.
How People Responded to Disease
In ancient times, lacking effective medical treatments, people interpreted disease as divine punishment. One poignant account describes a man named Hyangdeok, who cut flesh from his own body to feed and nurse his ailing mother—highlighting the desperate measures taken in the face of medical helplessness.
People turned to religion, praying to healing deities like Yaksa-bul (Medicine Buddha) or relying on herbal remedies and folk medicine. Silla was among the first to establish formal medical education, training physicians at the state level. While royals received specialized care, commoners typically relied on isolation or flight to escape contagion.
Disease in the Goryeo and Joseon Dynasties
Medical documentation improved during the Goryeo period, allowing historians to identify specific diseases such as jiljin, onyŏk, and jangyŏk. Even kings were not spared—King Yejong and King Injong are believed to have died from infectious diseases.
In the Joseon dynasty, epidemic records became even more detailed. The Annals of the Joseon Dynasty document epidemics in over 160 separate years. In the 18th century alone, several outbreaks killed hundreds of thousands annually. The consequences of these diseases extended far beyond health—triggering population decline, economic stagnation, and social unrest. The cholera epidemic that swept through Asia was particularly devastating in Joseon Korea.
Religious and Cultural Responses to Disease in Joseon
People of the time attributed disease to malevolent spirits or ancestral curses. To appease these forces, they held rituals or shamanistic ceremonies. Particularly feared illnesses like smallpox and measles were referred to as Mama and treated with reverence. When royals recovered from such diseases, celebratory ceremonies were held in the palace. Among the common people, rituals such as baesong-gut (shamanic appeasement rites) were performed to calm the spirits believed to bring disease.
The Rise of Medical Solutions to Epidemics
By the late 18th century, variolation (an early form of smallpox inoculation) began to spread, paving the way for modern vaccination. The introduction of Edward Jenner’s cowpox-based smallpox vaccine (the “Jennerian method”) marked a turning point in disease prevention. In Korea, physician Ji Seok-yeong introduced the smallpox vaccine in 1885, leading to widespread adoption and a significant reduction in mortality.
The Ever-Present Threat of Epidemics
Even in the modern era, with all its medical advancements, epidemics remain a constant threat. From the Spanish Flu to SARS and avian influenza, humanity continues to grapple with evolving pathogens. While vaccines and public health systems form our first line of defense, history reminds us that epidemics are not merely medical issues. They have deeply influenced the social, cultural, political, and even spiritual landscapes of societies.
Understanding the historical impact of infectious diseases helps us better prepare for future challenges—not only through science but also through awareness, resilience, and collective action.
