医疗史视野下的晚明“红丸案”——以医病关系为中心的探索

A Research on The Red Pill Case in the Late Ming Dynasty in the View of Medical History——Focus on Physician-patient Relationship

晚明时期的"红丸案"历来被视为疑云笼罩的宫闱阴谋,但若从医病关系的角度分析,则能解读出大量社会文化信息。"红丸案"中出现了太医院御医、御药房宦官与外廷群臣三类医者,他们与身为病患的明光宗的种种互动,反映出宫廷这一医疗空间是多种势力角逐的场所,内部存在错综复杂、彼此纠结且不断变动的权力关系。崔文升、李可灼先后为光宗用药,分别体现着明中期以来宦官医疗权力的膨胀与外廷群臣对参与皇帝医疗进程的积极态度。皇帝在政治上至高无上的权力也使得以他为病患的医病关系极不平等,导致"红丸案"中的明光宗对其医疗进程的干预几近随心所欲。但他在无形间也受到宫廷医疗空间内部权力关系变动的制约,并最终影响到了自身的治疗效果。明代几位因用药"失误"而死的皇帝,相关事故或都能照此解读。

The Red Pill Case which occurred in the late Ming Dynastyhad long been seen as a suspicious palace intrigue.However,we could also acquire plenty of social and cultural information in the perspective of physician-patient relationship.There were three types of physicians in this case,including royal physicians from imperial academy of medicine,eunuchs from the imperial pharmacy,and courtiers from imperial government.Their interactions with T’aich’ang emperor reflected the court as a medical space was a place where many factions competed each other for power.In this place,the power relationship was considerably complicate,entangled and everlastingly changing.The prescribing forT’ai-ch’ang emperorfrom CuiWensheng and Li Kezhuo respectively represented the strengthened medical power of eunuch since middle Ming Dynasty and the positive attitude of the courtier to interfere the emperor’s healing process.The supreme power of the emperor in politics also made physician-patient relationship in which the emperor played the role of patient became extremely unequal.This circumstance led T’ai-ch’ang emperornearly arbitrarily intervened his healing process.However,he was still restricted by the alteration of power relationship in the court medical space,which finally influenced his healing effect.There were several emperors died of prescribing"mistakes"in Ming Dynasty.Perhaps we could reanalyze all of these medical accidents through this conclusion.