“儒醫”概念的文化與政治意蘊

The Cultural and Political Implications of "Literati-Physicians" (Ruyi) of the Song Dynasty

Abstract

LANGUAGE NOTE | Document text in Chinese; abstract also in English.

雖然中國歷史上儒者行醫是比較普遍的現象，但“儒醫”作為專有名詞出現是北宋時期。後世學者多在其文化意義上闡發這概念的社會學和倫理學意義，強調儒醫在知識結構和價值取向方面的特徵。本文對《宋會要輯稿》所輯錄北宋官方文件中“儒醫”一詞的前後語境及相關政策設計思路進行了考查，認為北宋官方提出“儒醫”概念，是在醫學社會發展需要和醫學社會地位低的雙重壓力下而採取的政策選擇，其目的是通過制度設計和文化正名的方式吸引儒生加入以加強醫學行業，同時也借此整合醫學，將醫學更好地統一於儒家的王政體系之中。

The earliest definition of ruyi (Confucian physicians or literati-physicians) referred to the literati the imperial court intended to recruit for its Taiyiju, the Imperial Medical Services. The concept of ruyi emerged and gained popularity during the Song period, after which the Confucian physician occupied a unique position between the literatus and physician in the social hierarchy. From an institutional perspective, the official Hanlin Medical Institute functioned as a special medical service department whose major responsibility was to take care of the imperial family. The Imperial Medical Services, which had initially been under the jurisdiction of the Hanlin Artisans Institute, became part of the Guozijian, the Directorate of Education in the Song period, due to imperial sponsorship. This essay contends that the process of the “Confucianization of medical doctors” initiated by the court elevated the social position of physicians, making them members of the Confucian political system.

Based on the Chinese historical work the Song Huiyao Jigao (Song Dynasty Manuscript Compendium), this essay discusses the cultural and political implications of literati-physicians during the Song Dynasty. It argues that although Confucian literati-physicians viewed themselves as the elite group in the realm of medical skills, the social dilemma of their “middle” social position was evident in the medical histories written during the period. The term ruyi is understood in three ways: (1) practical/medical skills; (2) the Confucian methodologies adopted in studying medicine; and (3) the Confucian ethical codes. Literati-physicians were expected to go beyond their professional boundaries and attain a social status parallel to the Confucian literati who passed through the thorny gate of the civil service examinations.

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