A Social History of the Medical Thoughts and Practice of Confucian Physicians in the Yuan and Ming Dynasties------Zhu Zhenheng and the Danxi School.

摘要

This thesis aims to explain how Confucian physicians constructed the medical thoughts and practice. A Confucian physician is supposed to be a well-educated gentleman and a master of the medical classics. From the 12th century on, Confucian physicians gradually became a new identity of the orthodox doctors, while the Taoists, shamans, midwives and surgical practitioners all became the "others". At the same time, among the Confucian Physicians, different schools appeared. The Danxi School was a group of disciples following Zhu Zhenheng (1282-1358) from the 14th to 15th centuries in Jiangnan. Zhu was a gentleman from Wuzhou, who was treated as an ideal model of "Confucian physicians" through the whole Ming dynasty.;The first three chapters focus on the medical thoughts of Confucian phycians. Chapter One studies on the body of the "Southerners". People living in the territory of Southern Song identified themselves as the "Southerners". This identity was strengthened by the unequal racial policy under the Mongol reign. It motivated the Jiangnan literati to appeal for a medical knowledge body specifically for the "Southerners", which would focus on treating the ailments caused by the "southern" environment and dietary habits. Chapter Two explores the concept of "fire". In the Song dynasty, "fire" is an element of the prevalent cosmological theory of "the five circulatory phases and the six seasonal influences". However, in Liu Wansu (1132-1208)'s innovative interpretation, the concept of "fire" was internalized into the body structure. Zhu Zhenheng inherited this concept of bodily "fire" and developed the theory of "yang is always in excess, yin is always deficient", which was later strictly followed by the Danxi School. Chapter Three investigates the disease of "laozhai". According to the Taoist interpretation, the disease of "laozhai" was due to the ancestor's sin. However, Confucian physicians developed a new meaning in the context of Danxi's "yin is deficient" body. Demons were gradually excluded from the etiology of the Danxi School.;Chapter Four and Five study on the practice of Confucian physicians. The Danxi School didn't have consensus on how to treat the "yin is deficient" disease. Therefore, the therapy of "nourishing yin" was quite differential in individual practices. However, it is certain that Confucian physicians tended to use herbs to treat patients who declared themselves suffering from demons. Religious rituals of expelling demons were excluded from their clinical practice. However, Confucian physicians didn't refuse to use some unusual herbal remedies such as the placenta, or moxibustion that might function as Taoist rituals of expelling demons.;Chapter Six and Seven analyze the rise and fall of the Danxi School. The reason why Zhu became a powerful medical master lies not only in his medical thoughts or skills but in his social activities. He was very active in the lineage organization and local administration. In the local society, Zhu gained the power and fame as an authoritative Confucian gentleman, though he had never received any governmental position. After the death of Zhu, his disciples achieved successful careers as professional doctors in Suzhou. Later when the Ming Empire was established in Nanjing, most of Danxi's disciples went into the Imperial Medical Service. After the 1450s, Zhu Zhenheng became a best-selling author and a symbol of the popular medicine. The popularity of his works eventually destroyed the structure of the master-disciple relationship in the Danxi School. The Danxi School gradually disappeared. In the end, because the mid-Qing physicians preferred ancient masters such as Zhang Zhongjing (fl. 168-196) to the modern, vulgar Danxi, the Danxi School and their medical master faded away from the mainstream medicine.