从独尊医术到兼重德艺——传统良医论的历史演进

From Paying Supreme Tribute to Medical Skills to Balancing Morality and Skills—The Evolvement of Traditional Concept of Good Doctors

春秋战国时期,"良医"已成为一个比较流行的概念。考察多种典籍的有关记载可知,当时良医纯粹是基于医术的精良而作出的判断。传统医学名著中最早论及医德的,是成书于西汉的《黄帝内经》。张仲景所著《伤寒杂病论》的"自序"则是一篇具有很高价值的医德文献。晋代杨泉首次明确地将医德内涵纳入良医概念,实现了传统良医论从独尊医术到兼重德艺的嬗变。其后,唐代孙思邈对良医概念的道德内涵作了进一步的扩充,而明代陈实功的"医家五戒"、"医家十要"以高度概括的语言系统地总结了祖国传统医德规范,被西方学者推崇为世界最早成文的医学道德法典。

During the periods of Spring and Autumn as well as Warring States, ＂ Good Doctors＂ had been a popular notion. According to many ancient books and records, the concept of ＂ Good Doctors＂ was a sheer judgment on the basis of excellent medical skills. The Yellow Emperor＇s Canon of Internal Medicine （ Huangdi Neijing） in Western Han was the first book referring medical ethics among traditional medical classics, while ＂the author＇s preface＂ to Treatise on Febrile and Miscellaneous Diseases （ Shanghan Zabing Lun） by Zhang Zhongjing was a valuable literature on medical morality. Later on, Yang Quan in Jin Dynasty firstly and explicitly put the nature of medical morality into ＂ Good Doctors＂ concept, finishing the evolvement of traditional ＂ Good doctors＂ concept. Thereafter, Sun Simiao in Tang Dynasty expanded the moral connotation of the concept, while Chen Shigong summarized our traditional medical ethics by highly general words such as ＂ Five Medical Commandments＂ and ＂ Ten Medical Demands＂, which were praised by western scholars as the earliest statute book on medical ethics in the world.