作为医学故事的病例记录:宋代中国的医学叙事:宋代医生对自己医术的叙述 - 徐树伟(1080-1154)

Asaf Goldschmidt
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引用次数: 0

摘要

研究或讲授中医史的重点往往是中医的基本理论,以及中医对人体、生理、病理和治疗的认识。换句话说,我们通常倾向于阅读和分析经典医典和与治疗相关的文献,包括方剂学和本草纲目。然而,只关注这些资料为我们提供了片面的中医介绍。这些研究只展示了医生为了将其理论或实践知识传授给读者而撰写的内容。然而,这些原始资料缺乏包括医疗在内的脚踏实地的临床知识,例如,现代医学院校的临床查房就体现了这一点。换句话说,我们传统上对医典和医方的关注几乎没有提供任何临床知识,给我们留下了片面的叙述,忽略了医学和治疗在实际中是如何进行的。本文主要从历史角度探讨医学的后一个方面。本文利用可追溯到宋代的文字和影像资料,根据医生、病人家属和旁观者记录的病例,描绘了医生与病人(包括其家属)之间的临床接触。通过这些病例记录或病例故事,我们可以从临床角度和社会互动角度来叙述医患之间的互动。也就是说,我们可以利用这些病例叙述来说明诊断和治疗的过程,同时与患者家属进行互动。我还将讨论对医疗过程的视觉描述,为宋代医学的叙述提供另一个视角。病例记录和描绘医疗过程的绘画是中国原始资料在叙述医学方面潜力的典范。
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Case Records as Medical Stories: Narrating Medicine in Song-Dynasty China: A Song-dynasty Doctor’s Narration of His own Medicine – Xu Shuwei (1080-1154)
The focus in studying or teaching the history of Chinese medicine is often on the doctrines underlying it and on its perception of the body, physiology, pathology, and its treatment. In other words, we often tend to focus on reading and analysing the classical canons and therapy-related texts including formularies and materia medica collections. However, focusing on these sources provides us with a one-sided presentation of Chinese medicine. These studies only show what physicians wrote in order to pass down their knowledge, either theoretical or practical, to their readership. However, these primary sources lack the clinical down-to-earth know-how that encompasses medical treatment, which are represented, for instance, in the clinical rounds of modern medical schools. In other words, our traditional focus on the medical canons and formularies provides almost no clinical knowledge, leaving us with a one-sided narrative that ignores how medicine and healing are actually practiced in the field. This paper focuses on the latter aspect of medicine from a historical perspective. Using written and visual sources dating to the Song dynasty, the paper depicts the clinical encounter between doctors and patients including their families based on case records recorded by a physician, members of the patient’s family, and bystanders. This array of case records or case stories will enable us to narrate the interaction between physicians and patients both from the clinical perspective and from the social interaction. Namely, we can use these case narratives to illustrate the process of diagnosis and treatment all while interacting with members of the patient’s family. I will also discuss visual depictions of the medical encounter to provide another perspective for narrating medicine during the Song dynasty. Medical case records and paintings depicting medical encounter are exemplary of the potential of Chinese primary sources for narrative medicine.
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