Postdoctoral Fellow, Institute of Modern History, Academia Sinica.
Uisahak. 2023 Apr;32(1):321-353. doi: 10.13081/kjmh.2023.32.321.
This study aimed to confirm what kind of medical treatment was given to criminals by the local governments in Qing China and the role of the government doctors in charge of the criminals' medical care. Using local administrative and historical materials, I explore the procedures and methods of medical treatment and explain the treatment processes for criminals. The findings demonstrate that, although different from modern ideals, in premodern China under the emperor's rule, there were provisions for ailing criminals to receive medical treatment. In the Qing era, the execution of actual punishments worked as a keynote of judicial policy, and the number of criminals managed by local government offices was larger than before. The government doctors took charge of the criminals' medical treatment, but it seems that their position in the Qing era was not popular due to low salaries and psychological resistance to treating guilty criminals. Moreover, the government doctors dispatched to treat criminals were required to play an additional role. They had to testify that there were no other causes of death other than disease, which demonstrates that the government doctor played a role in determining whether the death was a crime. However, their treatment practices for criminals demonstrate the use of traditional medicine from the Tang and Song era onwards. There are two reasons for this. First, unlike the private market, there was no economic incentives for doctors to use new medicines and prescriptions. Second, because of the fear of being reprimanded for the death of the criminal, using classical prescriptions was a way for doctors to defend the adequacy of their medical practice. From an institutional perspective, medical care for criminals through government doctors was guaranteed during the Qing era. However, government doctors were not selected for their medical competence, nor were they provided with adequate incentives to practice good medical care. Even some government doctors devoted themselves to medical care, the quality of care was not systematically guaranteed. This provides evidence of the poor medical environment surrounding criminals in premodern China.
本研究旨在确认清政府对罪犯实施的何种医疗以及负责罪犯医疗的政府医生所扮演的角色。利用地方行政和历史资料，我探讨了医疗的程序和方法，并解释了罪犯的治疗过程。研究结果表明，尽管与现代理念不同，但在帝制下的近代中国，存在为患病罪犯提供治疗的规定。在清代，实际刑罚的执行是司法政策的基调，而且由地方政府机构管理的罪犯人数比以前更多。政府医生负责罪犯的医疗，但由于工资低和对治疗有罪罪犯的心理抵触，他们在清代的地位似乎并不受欢迎。此外，被派去治疗罪犯的政府医生还需要承担额外的角色。他们必须证明罪犯的死亡除了疾病没有其他原因，这表明政府医生在确定死亡是否是犯罪方面发挥了作用。然而，他们对罪犯的治疗实践体现了从唐宋以来的传统医学。这有两个原因。首先，与私人市场不同，医生没有使用新药和处方的经济激励。其次，由于担心因罪犯死亡而受到斥责，使用经典处方是医生为其医疗实践充足性辩护的一种方式。从制度角度来看，清代通过政府医生为罪犯提供了医疗保障。然而，政府医生的选拔并非基于医疗能力，也没有提供充分的激励来实施良好的医疗。即使一些政府医生致力于医疗服务，护理质量也没有得到系统的保证。这为近代中国罪犯所处的恶劣医疗环境提供了证据。
