生活化与专业化的较量——中国明清时期的自我治疗现象研究。

IF 0.1 4区 哲学 0 ASIAN STUDIES Korean Journal of Medical History Pub Date : 2022-04-01 DOI:10.13081/kjmh.2022.31.93
Xiaoyan Dong
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引用次数: 0

摘要

人们理所当然地认为,就医的日益普及和医学的不断发展是人类文明进步的重要体现。一般来说,医疗技术的进步和医疗资源的丰富意味着自我治疗的现象减少了。然而,这项对中国医学史的研究发现,从文人官僚到偏远山区的普通民众,寻求自我治疗一直是各个社会阶层的人们的共同选择,尤其是在中国明清时期。尤其是在查阅医学书籍、地方志、家谱、笔记和选集等史料时,可以看到这样的记录。尽管明清时期的医术比以前更加发达,当地的医疗资源也更加丰富,但从偏远地区的普通人到文人、官员等精英群体,人们在自己或家人生病时,往往将自我治疗视为一种基本选择,不管他们是否有能力或机会拖延治疗。本文旨在探究这一看似矛盾的现象背后的逻辑和根源。因此,这项研究首先提出了一个问题:是什么导致了这种看似矛盾的现象?针对这个问题,本研究证实了以下几点:首先,低门槛和高回报驱使不同学历的人进入医学行业,而好医生很难找到;因此,自我治疗并不比其他选择更糟糕。其次,在明清时期,儒家医生倾向于写更多实用的处方,这给许多人提供了提高自己医学知识的机会,也为自我治疗提供了极大的便利。第三,自明代中期以来,高昂的医疗费用给普通人寻求专业医疗带来了严重困难,因此他们在生病时尽量自救,本研究进一步发现,造成这一现象的深层原因在于传统医疗日常生活方式的高度与相应的医疗专业化和专业化程度的低之间的不协调。那么,这就引出了另一个问题:这种不协调是历史规范还是某个历史阶段的产物?本文认为,明清时期,在宏观趋势上,二者呈现出竞争关系。然而,在更广阔、更微观的时空背景下,这种竞争关系有效吗?特别是在当前,慢性非传染性疾病正成为对人类健康的最大威胁。随着医疗技术的专业化发展,医疗生活方式的趋势也成为填补高度权威医疗的空白,承担起自身健康责任的合理途径。这种医学专业化和生活方式似乎是并行发展的。因此,可以得出结论,二者之间的不和谐只是某个历史时期的产物。最后,这项研究提出了另一个相关的问题:医疗生活和专业化并行发展背后的社会和文化含义是什么?这是一个有待于今后研究的问题。
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The Contest between Life-Oriented and Specialization : A Study on the Self-treatment Phenomenon in Ming and Qing Dynasties in China.

It is natural for people to think that the increasing popularity of seeking medical treatment and the continuous development of medicine are the important embodiment of the progress of human civilization. Generally speaking, the progress of medical technology and the abundance of medical resources mean that the phenomenon of self-treatment is reduced. However, this study of Chinese medical history found that it had always been a common choice to seek self-treatment for people in all social classes, from literati and bureaucrats to ordinary people in remote mountainous areas, especially during the Ming and Qing Dynasties in China. Such records can be seen especially when looking through historical materials such as medical books, local chronicles, genealogies, notes, and anthologies. Although medical skills in Ming-Qing era were more developed than previous eras and the local medical resources were more abundant, from ordinary people in remote areas to elite groups such as literati and officials, people often regarded self-treatment as a basic choice when they or their family members fell ill, no matter whether they had the ability or the opportunity to delay medical treatment. This article aims to explore the logic and root behind this seemingly contradictory phenomenon. Therefore, this research first raises the question: what accounted for this seemingly contradictory phenomenon? In response to this question, this study confirms the following: Firstly, low barriers to entry and high rewards drove people of varying qualifications into the medical profession, and good doctors were hard to find; thus, self-treatment was no worse than the alternatives. Secondly, in the Ming-Qing dynasties, Confucian physicians tended to write more practical prescriptions, which gave many people the opportunity to improve their own medical knowledge and provided great convenience for self-treatment. Thirdly, since the mid-Ming Dynasty, the high medical cost had caused serious difficulties for ordinary people to seek professional medical care, so they tried their best to save themselves when they fell ill. On this basis, this study further found that the deeper reason for this phenomenon lies in the incoordination between the high degree of daily life style of traditional medical treatment and the corresponding low degree of medical specialization and professionalism. Then, this leads to another question: is this incongruity a historical norm or a product of a certain historical stage? This article argues that during the Ming-Qing era, in the macro trend, the two showed a competitive relationship. However, in the context of a broader and more microscopic time and space, is this competitive relationship valid? Especially at present, chronic non-communicable diseases are becoming the biggest threat to human health. With the professional development of medical technology, the trend of medical life-style has also become a reasonable way to fill the gap from highly authoritative medical treatment and take on the responsibilities of their own health. This kind of medical specialization and life-style seems to be developing in parallel. Therefore, it can be concluded that the dissonance between the two is only the product of a certain historical period. Finally, this study raises another relevant question: what are the social and cultural implications behind the parallel development of medical life and specialization? This is a question to be answered in future research on the topic.

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来源期刊
CiteScore
0.20
自引率
0.00%
发文量
11
审稿时长
8 weeks
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