明代醫學研究——以“醫學教育”及“醫德”為中心

The Medicine Education of Ming Dynasty–the Focus on Morality and Medical Ethics

中國傳統醫學在明代，承接宋元以來的發展，醫學派別已然確立，並更一進步發展出新學與新說。明代視醫家為世業專官，因此醫者多為世醫承繼，醫者的學養多來自於父祖的傳授。在中央更設有專屬的醫療教育機構——太醫院，選優秀之醫家子弟就讀教習，學成考核後派至各處服務。明代在醫學教育上除承繼金元將醫學分科，並輔以專業醫書如《內經》、《難經》、《脈訣》等傳授醫家子弟，並經由考試以考核醫家是否適任，對醫家之要求是以世業專官為主，並要有恆，更要博極群書，通曉病理。但在明科舉制度的限制及社會經濟發展的影響下，明代醫家中有不少是“棄儒從醫”之儒生，他們習醫之後，便極易將所學之儒道與醫道相結合，其中不少醫家倡“醫儒同道”，除彰顯濟世救人之心外，亦是對自我的期許。而“醫德”的提出則是此一觀念的具體展現，藉由“醫德”的提倡，以矯醫家沽名釣譽或貪利輕義之弊。相對於此，明代醫家對於病家亦提出勸導。醫德的發揚為儒道影響醫家的具體事證。本文擬就以此為中心，就明代醫學中之“醫學教育”與“醫德”為主進行研究。

Traditional Chinese medicine in Ming dynasty had made great advancement, especially on medical education. There are several features about medicine in Ming dynasty, for example, morality and moral integrity and Doctor's Ten Admonish Rules ...etc. Some important contributions to the field of Chinese medicine had been made at that time. This article will discuss some aspects about medical education of Ming dynasty, focus on morality and moral integrity. What is the meaning of morality and moral integrity? Who controlled the power of medical education? What was the meaning of the ''Confucian Scholar Doctor''? What was the meaning of ''Transferring from being a Confucian scholar to become a physician'' and ''A Hereditary Doctor''? Why did they do this? What kind of position were the Ming dynasty doctors in? How many years had they studied medicine and been trained to become physicians? What characters did they have? When a young man determined to learn medical skills, what could he do? What kind of social class origin or family background should they have? In addition, how did the civilians view them? Were most of the physicians in Ming dynasty outstanding? Through the research on the medical education at that time, we can realize the remarkable effort made by the physicians in that dynasty. Their influence on the medical education system had established new rules in the field of Chinese medicine. Chinese people owe them great gratitude because they tried to set up the dignity and mode a respectable image for physicians.