1、中央研究院歷史語言研究所集刊 第七十七本，第三分 出版日期：民國九十五年九月 -401- 宋、明之際的醫史與儒醫 祝平一*本文考察儒醫的身分認同與其對文本知識的態度如何表現在宋、明之際的醫史書寫上。宋代的醫史比附佛、道的宗教傳統，而醫學知識仍和宗教傳統關係密切。明代的醫史轉而比附儒學傳統，以為建立醫家統緒的模範。醫史書寫的變遷，和儒醫群體在醫療場域興起有關。儒醫之名起於宋，到了明代儒醫已漸次成為醫療市場中的顯貴。然而儒醫缺乏一定的通過儀式來確定成員的身分，因此所謂的儒醫並沒有固定的疆界，擺盪在社會聲望的標籤和具體的社會群體之間。聲稱儒醫的醫者一面要應對醫者作為伎流的污名；一面又要誇示其他醫者。
2、儒醫便以界定醫學正典和道統、區隔不同文本間的地位，以文本的階層界定醫者層級、壟斷醫療知識和倫理價值，並透過醫史的寫作和醫學社群中其他的成員區隔。藉著和儒者傳統相提並論，他們以儒醫的標籤區隔其他的醫者。儒醫的名號雖有助於他們誇示其他的醫者，卻無法在現實上拉近他們和士人的社會鴻溝。比附雖成為儒醫誇耀鄰近社群的策略，卻也同時反應出他們無法向上提昇的社會窘境。從宋到明醫史中所折射出來的正是醫療群體與知識變遷的歷史。 關鍵詞：醫學社群 文本知 儒醫 宗教與醫 醫史 *中央研究院歷史語言研究所 宋、明之際的醫史與儒醫 -449- Narrations of Histories of Medicine fr
3、om the Song to the Ming and the Rise of the Confucian Physician Ping-yi Chu Institute of History and Philology, Academia Sinica This article studies the representations of Confucian physicians and their attitudes towards textual knowledge in medical histories written between the Song and Ming dynast
4、ies. The Confucian physician, a new social category that emerged in the Song dynasty, occupied a position between the literatus and the physician in the social hierarchy. Confucian physicians viewed themselves as the elite group in the realm of medicine. However, the social dilemma of the “middle” p
5、osition of the Confucian physician is evident in the medical histories written during this period. These texts emphasize the importance of textual knowledge as the sole avenue to the art of medicine and construct genealogies of physicians parallel to that of the Confucian tradition. The medical hist
6、ories produced during the Ming departed from previous modes of historical narratives, mostly religious, which compared physicians with eminent practitioners in the Taoist and Buddhist traditions. The social strategy of mimicking Confucianism enabled Confucian physicians to distinguish themselves fro
7、m other physicians but was not enough to prevent others from eroding their professional boundaries, reading medical texts, and despising them as specialists. This mimicking strategy, though it distinguished Confucian physicians from other doctors, revealed that these elite physicians were unable to achieve the social status of literati who had passed through the thorny gate of the civil service examinations. Keywords: Confucian physician, medical history, textual knowledge, experience, historiography of medicine
