Medical Localization

In the Ming and Qing dynasty, the booming economy and advanced culture facilitated the development of Chinese medicine in south China and many regional schools of medicine came into beings, such as Wumen School, Xin'an School, Qiantang School and Linnan School. Wumen (Wuzhong) is the ancient name of Suzhou while Xin'an is the ancient name of Huizhou. And they were both located to the south of Yangtze River. Geographically speaking, the two cities were seated next to each other. But Wumen was plain while Xin'an upland so that they formed their different school of medicine—Wumen School and Xin'an School, and two schools were both very famous at that time. The present paper chose these two schools as the research object, viewed the ancient doctors as a whole and tried to discuss the development of school, progress of medicine and their relationship to the environment from eco-social history point of view, adopting the methods of history, bibliography and comparison. It is hoped that this paper may rekindle the attention to the environment of Chinese medicine development and provide the evidence to the culture of modern Chinese doctors.This paper was discussed from six parts.1. The formation of regional Wuzhong and Xin'an Schools had their social, academic and regional reasons. The social basis for the emerge of these two schools were the flourishing of medicine in Song and Yuan dynasty, the economic development of Ming and Qing dynasty and the shift of medicinal and culture center to the south of china. At that time, Suzhou ranked the first in both economic and culture development in china, and it was the center of national economy and culture having a large population. So the emergence of Wuzhong School was one century earlier than that of Xin'an School. The Xin'an School rose from the middle of Ming dynasty with the development of business activity at Huizhou, which stimulated the progress of economy and the demands for medicine. By investigating the population of doctors in these two cities, the author found the population of Wuzhong School was larger than that of Xin'an School while the Xin'an School had the larger proportion of doctors to the whole population.2. Reasons for persons who chose a doctor as his career: The inherit of medicine was from teacher to pupil and from generation to generation at both places, and the doctors were mainly persons who failed in learning Confucius or due to disease troubling. The differences between the two places were: Wuzhong School emerged earlier and had more hereditary doctors; while doctors at Xin'an School mainly learned their skills from doctors inside or outside the city, or they became doctors because their fathers were attacked by diseases. The inheriting style and hereditary physician system in Ming dynasty were closely related to the popularity of family-teaching in Ming and Qing dynasty, which was the mirror of both political and social factors. The reasons for the person who chose a doctor as his career were the dual actions of civil service examination system of old china and principles of filial piety of the Confucian. The differences between the two schools were related to the backwardness of economic and medical science at Huizhou, while the influence of Mr. Cheng and Zhu's Philosophy and Generational institution were other important factors.3. The composition of doctors at each School: the two Schools'doctors were mainly Confucius doctors, hereditary doctors, King's honorary physicians (KHP) and doctor officials. But the features of Wuzhong School manifested by a larger population, a higher social status, multiple hereditary doctors and KHP mainly showed up in the early and middle period of Ming dynasty; while Xin'an School showed as KHP mainly in Qing dynasty had a lower social status, and very few hereditary doctors, which were contradictory to the condition of Wuzhong School. This might be related to the early emergence of Wuzhong medicine and the hereditary doctor's system. Viewing from the native place of doctors at these two schools, the author found that most doctors at Wuzhong School were native doctors while those at Xin'an School were composed mainly of native doctors and hundreds of doctors from other places who lived here later. This might be due to the differences of geographical, natural and economic conditions at the two places.4. Education and social status: The doctors at both Wuzhong and Xin'an Schools achieved upstanding culture, medical education and moral cultivation. They were the doctors who always kept the thoughts of helping the sick people in their minds, and devoted to their medical duties. This can be seen from the"yitie"and"bian'e". The common people and officials living at Wuzhong and Xin'an showed their identification and respect to these doctors. So the social status of these doctors was determined by their medical ethics and skills, not regulated by the ruler.5. The difference of interactivity and living between Wuzhong and Xin'an doctors led to one-way flow of social interaction, which means it mainly showed that the doctors of Huizhou moved to and lived at Suzhou. Academically, doctors from both cities studied and promoted each other in the fields of epidemic and typhoid fever study. In livelihood, doctors of Wuzhong lived a more leisurely or even wilder life while doctors of Xin'an led a relatively law-abiding life. This might be due to the common action of multiple factors, such as economy and cultures at both cities.6. The doctors of Wuzhong and Xin'an had something in common, judging from academic features and achievements, but they each had their own academic propensity. Doctors of Wuzhong School had many original opinions on epidemic and typhoid fever researches, and they were also innovative on diagnosis and treatment of surgical disease and miscellaneous disorders. While doctors of Xin'an school conducted many researches on Cannon of Internal Medicine and originated the collation of typhoid fever books. They also had original creation on laryngology and carried out many researches on smallpox eruption in pediatrics. They were enthusiastic in the popularization of medical science at the same time. The doctors of Xin'an School prevailed in theoretical creation, while the doctors of Wuzhong School prevailed in therapeutic creation, which aimed directly at clinical application. These were closely related to the geographical and natural environment and social conditions of the two cities. For example, pandemic of epidemic diseases in Suzhou city drove the researches on epidemic disease in Wuzhong area, while the poor environment and remote location at Huizhou prompted many people chose doctors as their job and the popularization of medical science. Meanwhile the different social academic environment was also the important cause for the different academic tendency of the two Schools.Above all, the medical regionalization of Wuzhong and Xin'an came as the result of social environment and geographical factors in Ming and Qing dynasty. The common and different things in path of being a doctor, the composition of School, the education and social status, the social influence, interaction and variance of Wuzhong and Xin'an doctors had their own reasons. The discussion on these questions will guide the development of modern TCM and the training of Chinese doctors.