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李寿姬的《医术漫笔》与18世纪朝鲜王朝中下级医官的职业身份

YI Suki's Yŏksimanpil and the Professional Identity of a Chung'in Medical Official in Eighteenth Century Chosŏn Korea.

作者信息

Yi Kiebok

机构信息

Program in History and Philosophy of Science, College of Natural Sciences, Seoul National University, Seoul, KOREA.

出版信息

Uisahak. 2013 Aug;22(2):483-528. doi: 10.13081/kjmh.2013.22.483.

Abstract

About one hundred years after the publication of Tongŭibogam (1613), a physician at the court YI Suki (1664-?) wrote a medical manuscript titled Yŏksimanpil (Miscellaneous Jottings on Medical Experiences and Tests, 1734). As indicated in its title, Yŏksimanpil was a medical essay composed of 130 medical case histories, drawing on what YI Suki himself had experienced in his medical practices. This paper examines the messages YI Suki in Yŏksimanpil tried to address to his fellow Korean doctors, and by doing so illuminates an aspect of the medicine in the late Chosŏn period. The argument goes that YI Suki wrote Yŏksimanpil as a vehicle for promulgating his professional identity as a bureaucratic physician who belonged to the network of the chung'in technical officials-a group of government technical functionaries in late Chosŏn Korea. Throughout the late Chosŏn period, the chung'in technical officials had been discriminated, institutionally and socioculturally, against the yangban literati, while their promotion to honored higher positions was blocked. It was in the late 17th and early 18th century that a group of chung'in officials tried to secure their sociocultural places for their professional activity, thus bringing to light their social and professional identity in Chosŏn society. A member of the network of the chung'in technical officials in the early 18th century, YI Suki was in an effort to position himself as a doctor somewhere between the medical tradition and the Confucian literary tradition. In these sociocultural contexts, we can see more clearly what YI Suki tried to speak of in his book and the historical meaning of the medical writing Yŏksimanpil. First, the way he practiced medicine was testing and confirming what the received medical textbooks had asserted (Chŭnghŏmkobang). This style of practicing medicine could be viewed as a reflection of the comprehensivity trait of bureaucratic court physicians network YI Suki belonged to. Also this type of practice has the implication that YI Suki himself was a well-versed practitioner following the medical textual tradition, which was closely associated with the medical officials network. The emergence of the practice Chŭnghŏmkobang could be better understood in the backdrop of over 100 years of maturation process of Tongŭibogam in the clinical practices. Second, he formulated the professional identity of physicians only in terms of medical proficiency without recourse to the Confucian literary tradition. In other words, in promoting the social status of medicine, he did not resort to Confucian morality. He instead emphasized his dexterity or resourcefulness in dealing with millions of ever-changing diseases (Imsikwŏnbyŏn ). Conceivably, this way of characterizing his own medical practice-by way of strongly combining the textual tradition and the experiential tradition while keeping distance with the Confucian literary tradition-reflected the complexity of the ambivalent identity of the technical chung'in officials, especially in regard to Confucianism, between Confucian physicians and hereditary doctors. All in all, YI Suki presented himself as an ideal image of the physician, which arguably reflected the sociocultural and academic context of the network of the chung'in technical officials in early 18th century Chosŏn Korea.

摘要

在《东医宝鉴》(1613年)出版大约一百年后,宫廷御医李寿基(1664年 - ?)撰写了一部医学手稿《医事漫笔》(《医学经验与试验杂记》,1734年)。正如其标题所示,《医事漫笔》是一篇由130个医案组成的医学文章,取材于李寿基自己在医疗实践中的经历。本文考察了李寿基在《医事漫笔》中试图向韩国同行传达的信息,并借此阐明朝鲜后期医学的一个方面。论点是,李寿基撰写《医事漫笔》是为了宣扬他作为一名属于中人技术官员网络的官僚御医的职业身份,中人技术官员是朝鲜后期的一群政府技术官员。在整个朝鲜后期,中人技术官员在制度和社会文化层面上受到两班文人的歧视,同时他们晋升到更高尊位的道路也被阻断。正是在17世纪末和18世纪初,一群中人官员试图为他们的职业活动确保社会文化地位,从而在朝鲜社会中彰显他们的社会和职业身份。作为18世纪初中人技术官员网络的一员,李寿基努力将自己定位为介于医学传统和儒家文学传统之间的医生。在这些社会文化背景下,我们可以更清楚地看到李寿基在他的书中试图表达的内容以及医学著作《医事漫笔》的历史意义。首先,他的行医方式是检验和确认已有的医学教科书所断言的内容(《证治准绳》)。这种行医风格可以被视为李寿基所属的官僚宫廷御医网络的综合性特征的一种反映。而且这种行医方式还意味着李寿基本人是一位精通医学文本传统的从业者,这与医学官员网络密切相关。《证治准绳》这种行医方式的出现,在《东医宝鉴》在临床实践中经过一百多年的成熟过程这一背景下可以得到更好的理解。其次,他仅依据医学熟练程度来界定医生的职业身份,而不借助儒家文学传统。换句话说,在提升医学的社会地位时,他没有诉诸儒家道德。相反,他强调自己在应对千变万化的疾病(“因病制变”)时的灵巧或机智。可以想象,这种通过强烈结合文本传统和经验传统同时与儒家文学传统保持距离来描述自己医疗实践的方式,反映了技术中人官员矛盾身份的复杂性,特别是在儒家方面,体现在儒家医生和世袭医生之间。总而言之,李寿基展现了自己作为理想医生的形象,这可以说是反映了18世纪初朝鲜中人技术官员网络的社会文化和学术背景。

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