摘 要 2005 8 2005 12 11
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167 A Study on Medical Related Problems of the Medical Diagnoses and Treatment Practices of Female Patients Based on the Recorded Medical Case Studies of the Ming Dynasty Tsai, Chen Chun ** Venerable Huei Kai *** Abstract The main purpose of this study is to provide the enhanced understanding in learning about the medical practices in social environment during the Ming Dynasty by researching and studying the reported case studies in medical historic books due to the gender difference and its derivative causes. Through the existing medical cases ** *** The preliminary conception for this essay came in August 2005, and after some revisions, the essay was eventually presented in the 5th Conference on Theoretical Construction of Modern Life-and-Death Studies held by the Department of Life-and-Death Studies of Nanhua University on Dec. 10 11, 2005, and was further revised subsequently. We do appreciate the correction and suggestion by two anonymous reviewers. Lecturer of Department of Life-and-Death Studies, Nanhua University, chiayi, Taiwan. Associate Professor of Department of Life-and-Death Studies, Nanhua University, chiayi, Taiwan.
168 recorded in books of the Ming Dynasty, this paper examines the autobiography written by medical doctors and the conversations between the medical doctors and patients or between the doctor and patients' family members in order to further understand the embarrassment and difficult challenges due to the recorded fourconstraint limitations and the relatively restricted exposure of the female patients. The characteristics of the medical treatment practices, in their social environment under once prevailing medical practices of the Ming Dynasty, are researched and studied in the following outlined summary: First of all, limited by the constraints of the social environment, female physicians were only exclusively practicing in the residence accommodating females and birth rooms; female physicians were also facing the negative images imposed by the male-dominant society; and nevertheless it cannot be neglected that their pre-existing conditions and practicing experiences had still provided other in-service physicians with abundant educationable knowledge. Secondly, the medical consultation and communication had to be performed through a female patient's family or close relative. Most patients could not make a request or ask a question directly; they were passively recognized as patients without voices; female patients were feeling embarrassed in requesting a medical service due to their concern over the confidential privacy which could delay their chances to cure their diseases and could eventually cause their unavoidable death. Third, physicians had their bias opinions over females on the basis of their knowledge of the female physiology and psychology. They assumed that females were easily to get agonized, depressed, emotionally weak and unstable. Most descriptions regarding female patients, according to the medical case studies, were neither objective nor friendly. Fourth, according to the recorded case studies and the registered medical treatment history, not all the socialized restrictions between males and females were followed up closely when
169 the females were undertaking the medical treatments. It deserves our attention that a few surgical-related cases, including the treatment of breast cancer, mastitis and vaginal examination, exposed many helpful medical contexts and their meanings. Although female medical diagnoses and treatment practices put the barrier between the working physicians and patients due to the strengthening forms from the socialized gender restrictions between males and females, however, the infrastructure of the medical research development was greatly revived and improved by the striking life-seeking survival from the ordinary individuals and the revolutionized process in breaking up the sociallyrestricted practicing rules and judgments. Key words: medical reference books of the Ming Dynasty, female patients, female physician, voice of patient, medical treatment, medical case studies
170 壹 前 言 Charlotte Furth 1 2 1 Charlotte Furth 2 Charlotte Furth Ming-Qing Medicine and the Construction of Gender, 2 1994.6. Charlotte Furth. Women as Healers in the Ming Dynasty China. Yung Sik Kim, Francesca Bray. Current Perspectives in the History of Science in East
171 960 1665 3 1600 1850 4 5 3 4 5 Asia. Seoul National University Press, 1999, 467-477. Charlotte Furth, A flourish Yin: Gender in China s Medical History, 960-1665. Berkely and Los Angeles: University of California Press 1999. Charlotte Furth, Blood, Body and Gender: Medical Images of the Female Condition in China, 1600 1850, Chinese Science 7 (1986), pp.43-66. Charlotte Furth, Concepts of Pregnancy, Childbirth, and Infancy in Ch'ing
172 6 Cass, Victoria 7 8 Dynasty China, Journal of Asian Studies 46.1 (Feb.1987), pp.7-32. 6 Angela Ki Che Leung, Women Practicing Medicine in Pre-modern China, paper presented at the conference New Direction in the Study of Chinese Women, 1000-1800. Leidon, 1996.9. 12-13. In Harriet T.Zurndorfer ed., Chinese Women in the Imperial Past: New Perspectives (leiden: Brill, 1999), pp.101-134 7 Cass, Victoria. Female Healers in the Ming and the Lodge of Ritual and Ceremony, Journal of the American Oriental Society, 106:1(1986). 8 2002
173 9 10 貳 診 療 女 性 遭 遇 望 聞 問 切 四 診 合 參 的 困 境 11 9 Yi-li Wu, Transmitted Secrets: The Doctors of the Lower Yangzi Region and Popular Gynecology in Late Imperial China (Ph.D. dissertation. Yale Unversity, 1998). 10 ZHENG Jin-sheng. Female Workers in Ancient China. Yung Sik Kim Francesca Bray. Current Perspectives in the History of Science in East Asia. Seoul National University Press, 1999, 460-466. 11 264 1996 179b
174 1573 1620 1640 12 13 12 1979 1211 3b 13
175 14 14 1992 3819
176 15 16 15 16 1999 461
177 1563 1640 17 17 1999 1339
178 參 空 間 的 限 制 一 閨 閫 產 房 為 男 性 醫 者 的 禁 地
179 18 1555 1636 19 18 1979 55 19 2002 285-286
180 20 二 活 動 於 女 性 生 活 空 間 的 傑 出 的 女 性 醫 者 21 22 23 24 20 2002 21 1b-2a 22 1a 23 32 1999 833 24 768
181 25 26 三 女 性 生 活 空 間 中 醫 術 不 足 的 女 性 醫 者 27 25 17 1999 943 26 949 27 1989 21
182 28 29 30 28 764 29 4104 30 3853
183 31 媪 32 33 34 31 3843 32 3853 33 3847 34 3853
184 35 四 男 性 醫 者 對 女 性 生 產 提 出 的 補 救 方 法 36 37 38 35 1985 533-534 36 1981 959 37 1999 168 38 1357
185 39 1438-1517 1549 1613 40 41 42 43 44 39 963 40 1999 1957 41 42 3847 43 44 1997 352
186 45 1536 1618 46 47 肆 問 診 的 限 制 45 46 47 1982 58 1971 290-291 3826
187 1487 1559 一 問 診 時, 多 數 女 性 患 者 的 聲 音 不 見 了
188 48 154 158 82 203 98 41 41 10 398 402 190 48 736
189 49 11 50 92 51 161 52 10 53 28 54 49 50 51 52 53 54 765 740 759 815 739 746
190 31 55 二 少 數 病 案 有 女 性 患 者 的 聲 音 56 55 56 747 738
191 87 57 57 797
192 58 58 75
193 癧 59 三 女 性 因 禁 忌 話 題 而 諱 疾 忌 醫 者 多 59 91
194 60 61 62 63 60 帯 61 62 202 63
195 64 64 203
196 伍 男 性 醫 者 對 女 性 患 者 同 理 與 認 知 上 的 偏 頗 65 疴 66 67 68 65 66 67 68 3819 3848 4091 1339
197 69 70 69 70 2003 921
198 71 歳 72 71 72 2003 24
199 69 歳 6 歳 43 32 38 73 73
200 陸 社 會 階 級 差 異 對 女 性 診 療 所 產 生 的 現 象
201 74 75 151 74 59-60 75
202 76 31 18 76 774
203 77 柒 結 語 77 86
204
205
206
207 Charlotte Furth. Women as Healers in the Ming Dynasty China. Yung Sik Kim, Francesca Bray. Current Perspectives in the History of Science in East Asia. Seoul National University Press, 1999, 467-477. Charlotte Furth, A flourish Yin: Gender in China s Medical History, 960-1665. Berkely and Los Angeles: University of California Press 1999. Charlotte Furth, Blood, Body and Gender: Medical Images of the Female Condition in China, 1600~1850, Chinese Science 7 (1986), pp.43-66. Charlotte Furth, Concepts of Pregnancy, Childbirth, and Infancy in Ch ing Dynasty China, Journal of Asian Studies 46.1 (Feb.1987), pp.7-32. Angela Ki Che Leung, Women Practicing Medicine in Pre-modern China, paper presented at the conference New Direction in the Study of Chinese Women, 1000-1800. Leidon, 1996.9.12-13. In Harriet T.Zurndorfer ed., Chinese Women in the Imperial Past: New Perspectives (leiden: Brill, 1999), pp.101-134. Cass, Victoria. Female Healers in the Ming and the Lodge of Ritual and Ceremony, Journal of the American Oriental Society, 106:1(1986). Yi-li Wu, Transmitted Secrets: The Doctors of the Lower Yangzi Region and Popular Gynecology in Late Imperial China (Ph.D. dissertation. Yale Unversity, 1998). ZHENG Jin-sheng. Female Workers in Ancient China. Yung Sik Kim Francesca Bray. Current Perspectives in the History of Science in East Asia. Seoul National University Press, 1999, 460-466.