從朱震亨到丹溪學派──元明儒醫和醫學學派的社會史考察

From Zhu Zhenheng to the Danxi School: A Social History of the Confucian Physician and Medical School in Late Imperial China

元代醫者朱震亨（1281-1358）及其身後之丹溪學派是明清直至當代醫史編纂論述的重心之一。本文立足社會史的視角，利用地方志、族譜、文人贈序等多種史料，細緻地重構了朱震亨從一個在地方社會擁有俠、儒、醫多面形象的士人上升為明清後世儒醫偶像和丹溪學派始祖的歷史過程。本文第一節致力於重現朱震亨在地方社會的形象與角色，其人早年尚俠，後在婺州濃厚的理學傳統熏陶下轉向「求道」之路：一方面研究「小道」醫學，另一方面積極組織當地「朱氏宗族」的祖先祭祀活動。第二節考察了元末明初號稱為丹溪傳人的醫者群體。雖然此群體並無一致的醫學理念，但醫者們以授受醫學知識建立縱向師徒關係，同時亦有同鄉、姻親的橫向聯繫，最重要的是共同尊奉丹溪為醫學之師。自十四至十五世紀中期，此醫者群體的活動軌跡從婺州擴展至江南地域的中心蘇州以至新建明王朝的太醫院，構成了朱震亨從一介地方醫者躍居明清儒醫偶像的社會基礎。第三節探討儒醫朱震亨形象最終的確立與丹溪學派的形成。本文發現，十五世紀中期以後，原本以師徒關係維繫之醫者網絡逐漸模糊，以釐清「真正」的丹溪知識及金元醫學知識系譜為目的之文本撰寫與出版取而代之成為比附朱震亨最主要的方式，形成了後世所認定之學派面貌。經由商業書坊的營銷出版，這些比附丹溪的文本廣泛流傳，並以聲稱認同同一文本理念的「學派」風格深刻影響了明清醫學知識的生產與實踐。

This paper addresses the most prominent late imperial Chinese “Confucian physician”, Zhu Zhenheng (1281-1358), from a social history perspective, investigating how a local physician in Southern China arose to be a nationally acknowledged authority on medicine between the thirteenth and sixteenth centuries. Although Zhu and his “Danxi” school had been intensively explored by previous scholarship, this paper’s contribution lies in its meticulous reconstruction of the forming of “Danxi” mastership in scholarly medicine as a century-long historical process situated in changing social and political context of local Jiangnan (Yangzi Delta) region. Firstly, it unveils Zhu’s image as a powerful social and cultural authority in his hometown Wuzhou, by highlighting his leading participation in ancestral sacrifice activities of local families under the surname of “Zhu”, in tax revenue collection and judicial negotiation with local government, and in other “public” affairs. Secondly, it traces the expansion of this network of physicians, who identified themselves as Zhu’s medical disciples, from local Yangzi Delta to the Imperial Medical Bureau of the newly established Ming power. This evolving network, enhanced by the “master-disciple” connection, facilitated the social foundation of Danxi’s rise as the national master on medicine. Thirdly, it argues after the mid-fifteenth century, the idea of being a disciple of the Danxi school shifted from making personal connection with Zhu’s medical descendants to interpreting Zhu’s idea through textual production, which focused on a certain public and scholarly debate on “authentic” principle of “Danxi”. Enhanced by a flourishing commercial publishing industry from the late fifteenth century onward, this new scholarly style of textual production finally consolidated the “Danxi” school in late imperial Chinese medical tradition.