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崔汉绮关于《心医论》的论述及其对中医和西医的批判:以与徐敬德哲学的关系为中心

Choe Han-gi's Discourse on Singi and His Criticism on Chinese Medicine and Western Medicine: Focusing on the Relationship with Seo Gyeong-deok's Philosophy.

作者信息

Cho Sung-San

机构信息

Department of History, Sungkyunkwan University, Korea.

出版信息

Uisahak. 2019 Aug;28(2):373-426. doi: 10.13081/kjmh.2019.28.373.

Abstract

This study examines how Choe Han-gi (1803-1879) developed his medical discourse which integrated the concepts of traditional Chinese medicine with modern Western anatomy, based on the philosophy of Seo Gyeong-deok (1489-1546), a scholar of the Neo-Confucianism of Joseon (1392-1910). Seo emphasized gi (C. qi, vital, material force) rather than yi (C. li, the principle of things) as a way of understanding the world. Since Choe's early academic interests pertained to Neo-Confucianism, it is reasonable to examine his philosophy in this context. Similar to Seo, Choe assumed that the most essential component of the world was the intrinsic and mysterious gi. Although Seo spoke of gi as a damil cheongheo ji gi (the gi which is profound, uniform, clear, invisible, and empty), Choe preferred to use the word singi (C. shenqi, the intrinsic, invisible, and mysterious gi). He believed that the earth, moon, and stars operated through the action of singi and that all creatures could only exist by relying on it. Singi was the most important premise in Choe's medical discourse, a fact demonstrating that although he could be very critical of traditional Chinese medicine, his perspective was part of that tradition. He believed that singi integrated and operated the entire human body and that it perceived external objects. He also emphasized the role of hyeongjil (C. xingzhi, a visible object with a form and quality; here it means all human bodies). This was the medium through which singi could appear in reality. Choe thought that singi could not reveal itself in reality without hyeongjil, and that hyeongjil became a dead thing without singi. His perception of the role of hyeongjil was expressed in his interest in modern Western anatomy, an interest that complemented his focus on singi. In light of his understanding of the singi-hyeongjil relationship, Choe criticized both modern Western anatomy and traditional Chinese medicine. He thought that modern Western anatomy lacked awareness of singi and that traditional Chinese medicine lacked accurate knowledge of human anatomy. Although he was not completely sympathetic toward any forms of medicine, he was open to ideas from both Western and Chinese medicine. Choe could not accept Western anatomy as fully as Japanese intellectuals did. The study of anatomy in Japan had developed in relation to the idea of Ancient Learning (C. guxue), which denied such theories of systematic correspondence as Yin and Yang and the Five Elements (C. yinyang wuxing) and tended to focus on the action of hyeongjil itself. Because Choe accepted modern Western anatomy without accepting Ancient Learning, his perspective was unique in the history of East Asian anatomy. From a medical history perspective, how does Choi Han-gi's medical discourse distinguish itself from other medical discourses, and what are its characteristics? In addition to other explanations, focusing on the political imagination associated with medicine can help illuminate the differences between the medical discourse of Choe and those of others. Discussion of medicine and the human body was tied to political thought, manifesting the political imagination of the society in which that discussion took place. The development of Western and Japanese anatomy reflected a vertical and hierarchical political order, exemplified by the belief that the brain was the center of the body. However, Choe doubted that organs like the brain or heart dominated the body. In his view, the singi ruled the body; it was not a specific organ, and it was equally inherent in all people. His political thought also emphasized the horizontal and equal order among people. His view of singi simultaneously influenced both his perspective on medicine and his perspective on society. Choe Han-gi's belief in this horizontal and equal political order was inherent in his singi-centered medical discourse.

摘要

本研究考察了崔汉绮(1803 - 1879)如何基于朝鲜(1392 - 1910)新儒家学者徐敬德(1489 - 1546)的哲学,发展出将中医概念与现代西方解剖学概念相结合的医学论述。徐敬德强调以气(中国哲学中的“气”, vital, material force)而非理(中国哲学中的“理”,the principle of things)作为理解世界的方式。由于崔汉绮早期的学术兴趣与新儒家思想相关,在这种背景下审视他的哲学是合理的。与徐敬德相似,崔汉绮认为世界最本质的成分是内在且神秘的气。尽管徐敬德将气描述为“湛一清虚之气”(深邃、统一、清晰、无形且虚空的气),崔汉绮更倾向使用“神气”(中国哲学中的“神气”,the intrinsic, invisible, and mysterious qi)一词。他相信地球、月亮和星星通过神气的作用运行,所有生物只能依靠它而存在。神气是崔汉绮医学论述中最重要的前提,这一事实表明,尽管他可能对传统中医非常挑剔,但他的观点仍是该传统的一部分。他认为神气整合并运作整个人体,且能感知外部物体。他还强调了形质(中国哲学中的“形质”,a visible object with a form and quality;这里指所有人的身体)的作用。这是神气能够在现实中显现的媒介。崔汉绮认为,没有形质,神气无法在现实中展现自身,而没有神气,形质就会变成死物。他对形质作用的认识体现在他对现代西方解剖学的兴趣上,这种兴趣补充了他对神气的关注。鉴于他对神气 - 形质关系的理解,崔汉绮既批评现代西方解剖学,也批评传统中医。他认为现代西方解剖学缺乏对神气的认识,而传统中医缺乏对人体解剖的准确知识。尽管他并非完全认同任何一种医学形式,但他对中西医的思想都持开放态度。崔汉绮不像日本知识分子那样完全接受西方解剖学。日本的解剖学研究是与古学(中国哲学中的“古学”)思想相关发展起来的,古学否认阴阳五行等系统对应理论,倾向于关注形质本身的作用。因为崔汉绮接受现代西方解剖学但不接受古学,所以他的观点在东亚解剖学史上是独特的。从医学史的角度来看,崔汉绮的医学论述如何与其他医学论述区分开来,其特点是什么?除了其他解释外,关注与医学相关的政治想象有助于阐明崔汉绮的医学论述与其他人的医学论述之间的差异。关于医学和人体的讨论与政治思想相关联,体现了进行该讨论的社会的政治想象。西方和日本解剖学的发展反映了一种垂直和等级分明的政治秩序,以大脑是身体中心的观念为例。然而,崔汉绮怀疑像大脑或心脏这样的器官主导身体。在他看来,神气统治身体;它不是某个特定器官,且所有人都同样内在地拥有它。他的政治思想还强调人与人之间的横向平等秩序。他对神气的看法同时影响了他对医学的观点和对社会的观点。崔汉绮对这种横向平等政治秩序的信念蕴含在他以神气为中心的医学论述中。

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