Do doctors have a high social status in Qin Dynasty?

The social status of doctors varied according to different societies, and it was influenced and constrained by the social economy, politics, culture and ideology at that time, which largely depended on the social system, the dominant ideology of the society, especially the ruler's attitude towards medicine and doctors. Changes in the social status of doctors have an important impact on the development of medicine. This paper attempts to illustrate the changes in the social status of doctors in ancient China from the above aspects, and then explore and analyze its impact on the development of Chinese medicine, in the hope that we can today to history as a mirror, from which we can draw lessons.

I. Xia - Western Zhou

In the early human class society, before the development of medicine, due to the limitations of the development of productive forces, people's scientific understanding of nature is insufficient, and the means of resistance is very limited, and thus for a variety of ailments have to mainly beg for help from the gods, so this period is the witch doctor dominated the history of the status and prevalence of witchcraft. status and witchcraft prevalent historical stage. However, witch doctors were not full-time doctors and still belonged to the category of "witch".

During this period, witchcraft was prevalent, and the air of mysticism shrouded the whole society like a mist. As a witch specializing in prayers and sacrifices, he acted on behalf of the interests of the slave-owning class, and influenced the affairs of the state through the activities of divining good and bad luck and making sacrifices, forming a kind of special political power, and had a very prominent position in the society. In the long-term prayer and sacrificial activities, some of them absorbed certain medical experience and knowledge of the people, and with the gesture of being able to communicate with ghosts and gods, cured people in a superstitious way, giving a mysterious coat to medical activities and creating the illusion of mixing medicine and witchcraft, and this part of the witch, the so-called witch doctor, was the forerunner of the early doctors. In the absence of a full-time doctor at that time, witch doctors played a leading role in the medical activities of the whole society.

While witch doctors in this period mainly appeared in society as witches rather than doctors, they were, after all, the early intellectuals of human society, who could, by virtue of their social status and the cultural knowledge they possessed, centralize and mystify the initial medical activities and knowledge, and record some effective medical experiences and medicines and organize them to systematize them, so that they could be used for the medical treatment of later generations. Later generations of medicine were able to detach themselves from witchcraft and embark on the path of independent development. Such as "ancient witch book" of the "Classic of Mountains and Seas", as the basis for the practice of ancient sorcerers, is a classic of witchcraft [1], the book recorded a large number of pharmacological knowledge, accurately describes some of the origin of drugs, performance, utility; Changsha Mawangdui unearthed the "fifty-two diseases," is so far the most ancient medical prescription book found in China, the book has the most ancient medical prescription book. The "52 Disease Formulas" unearthed in Mawangdui, Changsha, is the most ancient book of medical formulas found in China so far, in which there are quite a number of formulas used by witch doctors to cure diseases; and there are even more records about diseases in the well-known oracle bones. It is inconceivable that the knowledge of medicine in the ancient times could have been passed on to future generations without the systematic organization of medical and pharmacological knowledge by witch doctors and recorded in the Shanhaijing and other related documents. Under the conditions at that time, this duty of witch doctors was also irreplaceable by others. We should recognize the positive impact of witch doctors on the development of medicine on the one hand, and not to be generalized to the negative.

II. Spring and Autumn Period - Pre-Han Period

During the Spring and Autumn Period and the Warring States Period, China's society was undergoing a change from slavery to feudalism. Due to the increase in productivity and the development of natural science and technology, coupled with the further expansion of the social division of labor, all walks of life increasingly tend to specialize, medicine began to separate from sorcery, the emergence of a number of full-time doctors in the community to help the world. The "Zhouli" the "witch" in the "Spring and Autumn great Zongbo" officials, while the physician belongs to the "heavenly official Tsukazai" jurisdiction. From then on, medicine and witchcraft were separated.

This period of doctors and Yin (Western) Zhou period of witch doctors under the cloak of mystery than, in the political life of the country has not played an important role, the status has declined. However, because of the "learning in the government" at that time, knowledge was mainly monopolized by the aristocratic ruling class, the status of the intellectuals engaged in medicine - doctors was naturally different from that of the ordinary people at that time, and belonged to the "scholar" class, which had a very high status in society. The status of doctors, who were engaged in medicine, was naturally different from that of ordinary people at that time, and belonged to the class of "scholar", which still had a considerable status in the society [2] and was valued by the society. For example, when the doctor Bian Magpie went to Guo, the king of Guo welcomed him at the middle gate of the palace and called him "Mr."; and when he passed through Qi, Marquis Huan of Qi treated him as an honored guest. At that time, even Confucius, the founder of Confucianism, had a high regard for the profession of doctor, saying, "A man without constancy cannot be a witch doctor.

The social status of doctors is difficult to compare with the early witch doctors, but medicine has embarked on the road of independent development, free from the shackles of witchcraft, doctors do not have to cover up as witch doctors but can be engaged in medical activities openly and honestly, to sum up their experience, and to improve the theory. In addition, because of the vassal states for their own rule needs, actively recruiting, recruiting all kinds of talents, doctors at that time as a class of Shi, also by the courtesy of the monarchs of the countries, the activities are relatively free, such as magpie traveled around the countries, had to Qi, Zhao, Guo, Qin, Zhou and other countries to practice medicine, and according to the needs of the masses around the world to do different specialties of the doctor; Qin doctor doctor doctor slow and doctor and had to the State of Jin for the Jin Jing Duke, Jin Ping Duke respectively! The doctors of Qin State, Doctor Slow and Doctor Wo, went to Jin State to treat the diseases of Duke Jing and Duke Ping of Jin. Due to the political division of the feudal lords in this period, the culture of all the sons, a hundred schools of thought, with a strong atmosphere of academic democracy, the free flow of doctors, on the one hand, can make the people of various countries in the disease can get the maximum treatment, while due to the frequent wars and epidemics, but also to the various belligerent countries to the doctors to provide a wide range of talent, enriching the breadth of their clinical practices On the other hand, the free flow of doctors was also conducive to the exchange and improvement of medicine, and doctors were not confined to one side, especially to the economically and culturally developed vassal states, so that they could absorb the most advanced ideas and technologies and refer to them in the field of medicine, which facilitated the development and progress of medicine. The philosophical ideas of Chinese medicine, such as yin and yang and the five elements, were applied to the theory of Chinese medicine during this period and guided clinical practice.

During the Qin Dynasty, Emperor Shi Huangdi, in pursuit of immortality, favored the Fongshi (at this time the Fongshi, including doctors), the burning of books and Confucianism, "the world dared to have a collection of Poetry, the Book, a hundred languages, Sydney at the first, the Lieutenant of the miscellaneous burned; ... do not go to the book of medicine, divination and planting of trees". The book of medicine is not in the list of burning, so that medicine in this cultural catastrophe to avoid unnecessary losses, but also to enable the continued healthy development of medicine.

The early Western Han Dynasty, due to the impact of the peasant wars at the end of the Qin Dynasty and the wars of the Chu and Han Dynasties, the productive forces of society were greatly damaged, in order to restore the development of social production, the rulers had to implement the policy of rest and recuperation with the people. In order to stabilize the stability of the countryside, the government paid great attention to the protection of infants, old-age pension and stabilization of people's livelihood, and the social status of doctors increased accordingly. The court often summoned private doctors to consult about medicine and its efficacy. Emperor Wen of the Han Dynasty summoned Chun Yu Yi, a famous doctor of the time, and asked him in detail about his study of medicine as well as the specific details of diagnosing and treating diseases and bringing up disciples, to which he replied one by one. Sima Qian recorded all these in the "Records of the Grand Historian" (史记?). The magpie Cangong Liezhuan", leaving the earliest surviving medical case in China - "diagnosis book".

Three, the middle of the Western Han Dynasty - Tang and Five Dynasties

The middle of the Western Han Dynasty was a period of consolidation and development of feudal society. Due to the development of the feudal economy, coupled with the rulers, especially during the period of Emperor Wu of Han Dynasty unprecedented economic and political policies of agriculture and business restrictions on labor, the order of feudal society, "the scholar-peasant-industry-industry" of the four people of the order of the period has also been stereotyped. Since Confucius first private school, academic culture began to move down to the people, after hundreds of years of development, to this point, "learning in the government" monopoly has been completely broken, ordinary people can also be more access to knowledge, doctors due to the technical nature of the medical knowledge has also been completely to "work" view, medical science and technology. "view, the medical profession is categorized as square technology and so on ("Han Shu? Art and Literature"). Doctors from the original Shi class and into the "work" class, the status can not be said to have declined. What is more important in this period is that the situation of the hundred schools of thought was broken, and Confucianism gained a unique position. Emperor Wu of the Han Dynasty accepted Dong Zhongshu's proposal of "dismissing the hundred schools of thought and respecting only the Confucians" and guided the politics by the Confucian ideology of unification, and designated the five Confucian classics as the Poetry, the Book, the Rites, the Book of Changes and the Spring and Autumn Annals, which were required reading for the feudal scholars. Officials were selected mainly from Confucian students, and Confucianism gradually developed, with Confucianism becoming the orthodoxy of feudal society for the next 2,000 years.

Confucianism emphasizes humanistic and ethical knowledge, while belittling science and technology. Confucianism believes that "cultivating one's body, keeping the family in order, ruling the country, and leveling the world" is the most important thing in life. To intellectuals, "ruling the country and leveling the world" is even more important, so they should "learn from the best" and become officials after reading books. For intellectuals, to become an official is the only right way, while others are regarded as side roads, and what they learn is unified within the scope of Confucian classics. The "rule of man" was the first and the "rule of things" was the last; "emphasizing the way and not the tools" belittled natural science and technology, and knowledge with scientific cognitive value, such as medicine, was considered to be "small arts", "square technology", "medical divination and phantom, all square technology". Doctors, as a profession, were also discriminated against, as were other professions of a laborious nature, and the social status of doctors fell considerably from what it was before.

The consequence of this is bound to be that people are ashamed of practicing medicine, and even ashamed of it, so that many intellectuals in the possibility of engaging in medicine in view of the social pressures and psychological impact, and to the practice of medicine, which will inevitably lead to the loss of medicine in the inheritance of the development of many talented people; in addition, it is also easy to make a lot of the rulers of discrimination against the medical profession, and even the destruction of the medical profession, and thus also affect the normal development of medical science and technology to some degree. Normal development. For example, Hua Tuo, a famous doctor in the Eastern Han Dynasty, even when his medical skills were excellent and famous, he still regretted his own practice of medicine, and he was "well-versed in several sutras", "but he was a scholar, and he saw his career as a doctor, and he often regretted his own practice of medicine." Later, Xun Yu's unwillingness to be Cao Cao's doctor offended the ruler, who put him on trial and sent him to prison. When Xun Yu pleaded for Hua Tuo with the words "Tuo's skill is real work, people's lives are at stake, it is appropriate to contain the forgiveness of", who knows that this ruler who has a reputation in history of "only talent is promoted" and valuing talents even said: "Do not worry, the world when the rodent is no longer there! !" Eventually, a generation of famous doctors were brutally killed, resulting in its writings have not been passed down to the world, the ancient surgical prescription - "Ma Bo San" has also been lost, so that future generations of medical practitioners y regret. At the same time another famous doctor Zhang Zhongjing, the development of Chinese medicine has made immortal contributions, and then the so-called history of the word was not recorded, "the theorist pushed for the medicine of Central Asia Saint, and (Southern Song Dynasty) Fan Ye, "the book of the Han Dynasty" is not for Zhongjing biography, is why the gentleman has regret." [4] From this, we can also imagine the social status of doctors at that time.

The period of the two Jin Dynasty and the North and South Dynasties had many scholarly masters of medicine and the emergence of a number of gate medical family, but a considerable part of them are only medical knowledge as a tool for their own life, most of them are not willing to use it to treat the majority of ordinary patients. For example, Yin Hao, a scholar of the Eastern Jin Dynasty, was the leader of the Qing dynasty, and he was a good scholar of the internal canon and the scriptures. But he refused to see a doctor for the lower level staff, once a lower level staff of the mother has a disease, ask him to medical treatment, to kowtow to blood in order to be for it. After he had cured the patient, he burned his own prescription, fearing that he would be regarded as a medical doctor again. This shows that at that time, the scholarly scholar's study of medicine, as much as possible for their own purposes and refused to do for others, but also reflects the status of the medical doctor was not very high [5].

More noteworthy is the Tang Dynasty. On the one hand, the Tang dynasty to improve the Sui dynasty's imperial examination system, widely open the door of the career, so that the intellectuals tend to be like overdrive, sundial, head of the poor, in order to seek a position; on the other hand, most of the supreme ruler of the Tang dynasty like poetry and literature, and then influence to the Confucian students, the scholar-class, the Tang dynasty, the extreme prosperity of literature and art is not unrelated to this. However, most of them did not take medicine seriously, and even scorned it, "All push steps, divination, phrenology, medicine, and skill, are all skills, ... small people can be ... so the former saints did not think to teach." [6] At that time, Han Yu, a literary master, said more frankly, "Witch doctors and musicians, the people of a hundred works, the gentleman is not tooth." Tang dynasty medical practitioner Sun Simiao originally known as the world of literature, very talented, learning medicine, history books after he was categorized as "square technology" category, and not into the Confucian, Zhu Xi very sorry, sigh, said "Simiao for the Tang famous scholar, because of the knowledge of the medical relegated to the stream of technology, pity! [7] only this doctor into the "another book" one, it is enough to make many would have been willing to start from the doctor's Confucianism. No wonder the Song Dynasty medical doctor Gao Baoheng lamented: "Pity that the Tang order to list of medicine, pay the stream of the implementation of technology, and Mr. Recommended Kun rare" [8]. It is because of this discriminatory attitude of the ruling class, the doctor's low social status, so that the social atmosphere was "the court and the public are ashamed of the name of the medical profession, and teach their children to recite a short text, the construction of a small policy, in order to get out of the way, the art of healing, Que and the discussion of the" [9]. This also led to this period of medical talents in terms of quantity, academic attainments and the influence of later generations, can not be compared with other areas of science and culture at the same time, the same day, which can not help but cause people to think y.

Four, Song - Yuan

The important change in the politics of the Song Dynasty is the development of the civil rule, attaching importance to the cultivation and selection of scribes, the social status of the intellectuals than successive generations greatly improved. During this period, the supreme ruler was quite interested in medicine and attached great importance to it. For example, at least five of the nine emperors of the Northern Song Dynasty were familiar with medicine. Song Taizu himself studied medicine, had personally for his brother Zhao Guangyi moxibustion back [10]; Song Taizong Zhao Guangyi before he ascended to the throne, that is, pay attention to the medical profession, hiding more than a thousand famous prescription. And after the emperor that mobilized the medical officials compiled 100 volumes of the book, given the name "Taiping Shenghui Fang", and the imperial preface [11]. Song Zhenzong, Song Huizong, etc. had also personally for the medical book for the preface, and Song Huizong also in the name of personal (actually medical officer on behalf of the kitchen) to write and promulgate the book of "Sheng Ji Jing" [12]. In the Northern Song Dynasty 167 years of history, there are 10 large-scale central official engraved medical books, each time there is one or more important medical monographs, and become a medical book of fine. Song dynasty in the implementation of the imperial examination to select officials at the same time, also attaches importance to the selection and employment of medical officers, has led to a period of medical officer post salary redundancy. Later generations of doctors "doctor", "Langzhong" name that originated in this period. Modern medical historian Xie Guan said: "China's successive governments attach importance to medicine, no more than the Song."

Because of the ruler's emphasis on medicine and advocate, the literati to know the doctor through the doctor became the fashion, "Confucian doctors" is the name of this period appeared. The social status of the doctor has greatly improved, people do not know the medical practice of medicine for the shame of the lowly, but instead of medicine for the benevolent arts, the Confucian thing. "Medical country medical people, its reasoning is also", "not a good prime minister, then a good doctor", a large number of Confucian infiltration of the field of medicine, the emergence of generations of Confucian doctors, so that the quality of the medical team has been significantly improved, and to promote the updating of the knowledge structure of the medical staff and the efficiency of medical research

The Chinese government's policy of "one country, two systems" has been a major factor in the development of medical theory and in the improvement of clinical experience.

Mongolian rulers for the rule of the need for medicine is also quite important. Xianzong (Mongkol) to the throne, Zhiyao into the see, the emperor even asked Confucianism is like medicine [13]. This is a side reflection of the status of medicine at that time. "other to the art of talking about things are always tested, and to the medical work, was the light favored by a lot of people." [14] in the process of unification of the whole country, Mongolia soldiers attacked the city, the massacre is extremely tragic, but the only not kill artisans and captured as slaves, the doctor also regarded as the same artisanal art, get to avoid death. Yuan Shizu to Yuan thirteen years in February, the pacification of Jiangnan, the edict had ordered the search for "the previous generation of sages, noble Confucianism, medicine, monks, Taoism, divination, astronomical calendar, and the mountains and forests of hidden celebrities" [15], for the service of the ruling class, the doctor is also in the list of the use of. Yuan unified the country, the implementation of cruel racial discrimination and class oppression, the people of all races are divided into four classes, the Han Chinese, the South resides in the last two classes; in the community and the people according to the occupation is divided into ten classes, that is, a government official, two mandarins, three monks, the four Taoist, the five medical, six workers, seven hunting, eight craftsmen, nine Confucian, ten beggars [16]. Doctors are in the fifth place, above the Confucians, "but at that time, there are many differences, Ambrose no customization, its origin in the school, there is a state school, ... there is medicine" [17], doctors can also be selected at any time for the officials, which can also be seen at the time of the doctor's social status; on the other hand, also reflect the On the other hand, it also reflected the status of intellectuals in the Yuan Dynasty. In the early Yuan Dynasty, the imperial examination system was once abolished, up to nearly eighty years, the majority of scholars have no door, and because of the change in social status, a considerable part of them will turn to the "benevolence" known as medicine to go. The increase in the number of intellectuals specializing in medicine led to the development and consolidation of Confucian medicine, and influenced later generations.

Fifth, Ming - Qing (before the Opium War)

Ming and Qing dynasties are the last two dynasties of China's feudal society, is the decline of feudal society. The feudal ruling class to maintain its decadent dominance, political, ideological and cultural authoritarianism unprecedentedly strengthened and reached extremism. In order to strengthen the ideological control, a series of means were adopted in culture and academics to restrain people's words and deeds. During this period, the imperial examination system was more complete, with the eight-legged essay to get a scholar, the examination is specialized in the four books and five sutras, and the readers also study the sutras based on this. This rigid academic tradition at the time of countless of the best scholars adsorbed in their own, wasting their talent and energy; and "deviate from the scriptures", a little thought "is not in line with the sacred teachings of the scriptures," the ruler that is given to their personal and even family to a light and the body, the heavy will be extinguished! The ruler gave his personal and even family to punish him severely. "Artists, not to the path of morality" ("Ming History"), such as medicine and other scientific knowledge and technology, are all regarded as "strange skills and tricks", "small ways" and to limit and combat. The

The Ming Dynasty inherited the Yuan Dynasty's craftsman system. Yuan dynasty medical household quite favored by the rulers, can be fully exempt from miscellaneous service, only pay the annual package of silver three two for the use of the doctor [18]; and the Ming dynasty medical household in addition to exempt a part of the miscellaneous service, the main service and taxes and food can not be exempted [19]. Another example is the medical position of the hospital, the highest level of the Yuan dynasty for the second grade; the highest level of the hospital in the Ming dynasty in the founding of the country was reduced to the third grade, and later reduced to the fifth grade [20]. The Qing Dynasty basically inherited the Ming hospital system, the discriminatory attitude towards medicine is more than the Ming Dynasty, such as the order: "the Imperial Hospital Acupuncture and Moxibustion Section, with a permanent stop", so that the development of acupuncture and moxibustion therapy is hindered to a certain extent; the Qing dynasty Jiangxi governor Pei Ruidu has submitted: "...the highest rank in the Yuan Dynasty, the highest rank in the Ming Dynasty was reduced to the third grade, and later reduced to the fifth grade [20]. ... medical divination and astrology, often fake its art to confuse the people, although not a cult, but also when severely punished." And the Yongzheng Emperor at the time, "the deep Jiazhi", the attitude of the medical doctors can be seen [21].

This period, many medical doctors are not the original initiative or voluntary from the doctor, mostly because of the study of the scriptures to take the road to the career path was frustrated and was forced to devote themselves to medicine, even the most famous Ming Dynasty medicine Li Shizhen is no exception. His father, Li Yanwen, was a famous local doctor, but because of the low social status of doctors at that time, he did not want Li Shizhen to take medicine as a profession again, and he wanted Li Shizhen to take the imperial examination to enter the career path. At the age of 14, Li Shizhen passed the examination, and then he failed in three attempts to pass the examination, and at the age of 23, he had to give up the examination and decided to study medicine with his father.

Some of the dignitaries in society at that time, "the arrogance of the gas, service doctor as a mandarin, contempt for the doctor as a worker, the family has a patient, and then urged to be adjusted, and the right to life and death of the responsibility of the "[22], so that the social status of medical practitioners do not have respect for the medical practitioner himself and his family members in order to practice medicine inferiority complex, and even their own medical as deep as a taboo. Such as the Qing dynasty famous medical doctor Xue Xue, specializing in the treatment of dampness and heat disease, wrote the "dampness and heat" and other medical books, the development of warm disease has made great contributions to the development of China's medical history also has an important position. However, after his death, his grandson wrote an epitaph for him, summarizing the life of his ancestor, but there was "not a word about medicine", instead, he was placed in the stream of science. Yuan Mei, a famous writer at that time, was outraged when he read the epitaph, thinking that he was "willing to give up the miraculous in order to be stinking and corrupted", and wrote an article specifically to refute this. Imagine in such a drilling study to go to the thought of the dominant career and the low social status of the doctor for the people to despise the environment, and how many outstanding intellectuals to take the initiative to engage in medicine? Even if engaged in medicine, people also mostly as a family breadwinner, their own survival of a skill, very few can it as a discipline to see. All these, the development of medicine undoubtedly has a negative impact.