中国近代医疗史研究的几个关键词

杨念群
中国人民大学

本文不打算从狭义的专门史角度探讨“医疗史”研究，而是把“医疗史”视为现代政治史演变的一个组成部分。其基本思路是：现代政治不仅是行政体制运作的问题，也是通过医疗实践对每个“个人身体”在日常生活中进行塑造的问题；从中西医冲突的角度可以窥见近代政治对国人身体进行的规训与惩戒。如何克服“东亚病夫”的自卑感，并同时达致最终的民族自觉？也许是中国近代最重要的主题之一，西洋外科手术的传入引发的是一场“身体”革命，当西医传教士的第一把手术刀切入中国人的身体时，一个“现代性的事件”就发生了！

“医疗化身体”所处的位置还必然和“医疗空间”的重新安排有关，要明了此点，就必须对“政治空间”的涵义重新加以界定，特别是要考虑“医疗空间”的渗透与“地方”民众生活之间形成了复杂的调适与冲突的关系，解读这种关系是理解现代政治在基层实践的关键和起点。

西式“医疗空间”逐渐在中国合法化的过程实际上也是一个如何使之“制度化”的过程，这种制度化也是现代医疗资源从城市向乡村的扩散过程，是对“地方感觉”与“地方性知识”的塑造过程。地方性资源对这种强制传播也同时实施了抵抗，尽管这种抵抗并不成功。只有把这些复杂的因素统统考虑在内，才能更加贴近实际的历史进程。也只有处理好了这些复杂因素之间的关系，才能理解现代革命为什么会演变为跨区域的风暴。

Key Terms in the Study of Modern Chinese Medical History

YANG, Nianqun
Renmin University of China

This essay is not intended to study “medical history” in a narrow sense, but, instead, it regards“medicalhistory” as an integral part of the evolution of modern politics.  Modern politics is much broader than the administrative functioning of institutions, but is related to the shaping of the “individual body” through medical practice in the everyday life.  Through the debates between Chinese and Western medical approaches, we can discover that Chinese modern politics has disciplined and punished the Chinese “bodies.”How are we to overcome the sense of inferiority as “sick man of East Asia” and achieve national confidence in the end? It may have been one of the chief topics in modern China. The introduction of western surgery to China had brought a “body” revolution in China. When the first scalpel was used in a Chinese body, an“event of modernity”occurred.

The position of the “medicalized body” is naturally related to the re-position of “medical space.”In order to make this clear, one has to redefine the “political space,” especiallyin reconsidering the accommodation and the conflict between the penetration of “medical space” and the “local” civil life. To interpret this relationship is the key and the starting point to understanding modern politics practiced in grassroots society.

Western “medical space” has gradually become acceptable in China. This is in fact a process of “institutionalization,” whichexpands the modern medical resources from the cities to the villages. This process also shapes the “sense of place” and the “knowledge of place.”The local resources have resisted such imposing transmission of urban resources, although the resistance has not been successful. Only when we take into consideration these complicated elements can we become closer to the actual historical process. In the same light, when we settle the relations of these complicated elements, we may understand why a modern revolution has been transformed into a storm that has crossed the boundaries.