健康的道德經濟──德貞論中國人的生活習慣和衛生

Moral Economy and Health: John Dudgeon on Hygiene in China

倫敦傳道會在一八六三年派到中國的蘇格蘭醫療傳教士德貞，是十九世紀最勤於研究中國衛生狀況的西方醫師之一。德貞曾任中國海關醫療勤務的北京醫官，也獲聘為同文館醫學與生理學教席。他在中國的行醫生涯將近四十年，對中國人的生活習慣和健康情況有許多觀察和探討。這段期間來華西方醫師大多對中國社會風俗與衛生狀況持負面看法，和當時英國醫學對東方人衛生狀況的主流評價一致。德貞卻大不相同。他讚揚中國人的健康情形和生活習俗，甚至宣稱中國傳統生活方式在衛生上遠優於當時歐洲都會的現代生活，值得歐洲人學習效法。本文分析德貞對中國衛生狀況的觀察和評論，指出他和他的海關同僚在中國觀察到西方公共衛生學說難以解釋的異常現象，促使他反思英國公共衛生運動的侷限。本文也探討十九世紀晚期蘇格蘭出現的社會、經濟與公共衛生問題，如何影響德貞對中國生活方式和社會文化的評價。此外，本文指出德貞回歸歐洲十八世紀新古典醫學的理論傳統，以文明病的概念來解釋他的醫學觀察，並且闡明蘇格蘭長老教會神學思想如何形塑德貞關於道德經濟、政治經濟與衛生保健之間關係的看法。透過探討德貞迥異於當時英國公共衛生運動的論點，本文進而分析大英帝國中心的醫學理論和海外醫師的邊陲經驗的互動與張力。

John Dudgeon was one of the most prolific European writers on the hygienic conditions of China in the nineteenth century. A Scottish medical man dispatched to China by the London Missionary Society in 1863, he served as Medical Officer to Chinese Imperial Maritime Customs in Beijing and became Professor of Anatomy and Physiology at the Interpreters College. During his long medical career in China, he wrote extensively on the diet, dress, residences and social customs of the Chinese, in terms of their implications for health. At the time, western medical men in China were highly critical of the sanitary conditions of Chinese towns and the personal hygiene of the Chinese people. However, Dudgeon held the unconventional view that the Chinese lifestyle was far more salubrious than that of the Europeans and that the environmental conditions in Chinese cities were superior to those in their European counterparts. Dudgeon even argued that Europeans ought to emulate Chinese customs and hygiene practices. His position with regard to these issues was diametrically opposed to that of contemporary British medicine, which generally viewed native customs in Asia with disdain. This paper argues that Dudgeon was prompted to scrutinize the shortcomings of public health measures in Britain by his medical observations in China. Deteriorating economic conditions and heightened social tensions in Scotland in the late nineteenth century also contributed to Dudgeon's critical reflections on the metropolitan culture and lifestyle prevalent in Europe. In addition, this article addresses the link between Dudgeon's concept of moral economy and Scottish Presbyterianism. It is the contention of this work that a detailed analysis of Dudgeon's eccentric medical ideas will reveal the interplay and tension between metropolitan medical theories and the overseas experiences of British medical men on the periphery of the Empire.