西洋醫生與華人醫藥──以在華基督教醫療傳教士為中心 (1825-1916)

Western Doctors and Chinese Medicine: Protestant Medical Missionaries in China (1825-1916)

一般認為在十九世紀以降中西文化的交往過程中，西洋醫學進入中土最為成功，對中國當地社會影響也最大，並將之歸結於其在外科手術方面較華人當地大夫的領先和優越。然而，被以往研究忽略的一面，是這些西洋醫生並非只診治外科手術病人，為了拓展診所和醫院的影響，他們每天還要診治大量非外科手術的病人。在不同的社會文化環境裏，這些外來者如何贏得華人病家的信任，就是一個需要重新探討的問題。從此時歐美醫學的發展來看，以化學、生物化學和實驗室為標誌的醫學革命尚未開始，那些在中國內陸開辦診所和醫院的西洋醫生們在非外科手術疾病的診療技藝方面，尤其是在常見的間歇性發熱和一些地方性疾病治療過程中，與華人當地醫藥並無太大差距；再加上西藥進口和運輸費用昂貴，置身內陸省份而得之不易，以及華人病家更熟悉和更相信當地醫生的經驗良方，致使他們不得不較多關注和利用了華人當地醫藥，並收到相當的療效和贏得了民眾的普遍信任。因此，關於近代西方醫學成功進入中土的故事，除了在外科手術方面的擅長之外，其中也有一批西洋外來醫生對當地華人醫療經驗的參照和援借，並進而涉及中西兩種不同醫療文化體系之間的「選擇」、「轉譯」、「溝通」與「合作」的多元歷史演化。

It is generally believed that, among the cultural exchanges which took place between China and the West beginning in the 19th century, Western medicine made the most successful entrance into China and had the most remarkable impact on Chinese society at the time. This was due mainly to the superiority of Western surgery over surgical techniques adopted by indigenous medical practitioners. Unfortunately, previous studies have ignored the fact that Western doctors not only diagnosed and treated surgery patients, in order to expand the influence of clinics and hospitals, they also had to diagnose and treat large numbers of non-surgical patients every day. Consequently, we must reinvestigate the ways in which foreign doctors secured the trust of indigenous patients in a social and cultural environment different from their own. At that time, the European and American medical revolution, which was marked by developments in chemistry, bio-chemistry, and laboratories, had not yet begun, and, in terms of non-surgical treatments and skills, especially regarding the treatment of intermittent fevers and other local maladies, there was no major difference between Western doctors who ran clinics and hospitals in inland China and indigenous doctors. In addition, Western medicines were difficult to obtain in inland provinces due to high import and transport costs, and indigenous patients were more familiar with, and, thus, more willing to trust, indigenous medical treatments and prescriptions. As a result, Western doctors had to pay greater attention to and more widely utilize indigenous medicines, a process which proved quite effective and won the general trust of indigenous patients. Therefore, aside from the dominance of Western surgery in China, during the successful introduction of modern Western medicine into that country, Western doctors also referenced and borrowed from indigenous medical experiences. This phenomenon involved a diverse historical evolution process in which medical and cultural systems from China and the West “made choices,” “translated,” “communicated,” and “cooperated.”