求人不如求己－明清時期自學入醫者的動機、行醫與評價

就醫療史研究而言，儒醫與世醫最受矚目，但對於自學入醫者之研究，甚為不足，為彌補這一空白，本文對明清時期自學入醫者作深入考察，第一部分指出他們學醫的十四類動機；第二部分探討他們學醫的過程，例如他們看過哪些書籍、如何克服閱讀和理解困難等；第三部分探討他們行醫歷程與後人之評價。作為結論，本文指出，即使醫療的話語權掌握在士人與文獻紀錄者手中，但醫者口碑與地位始終由開放的市場決定，沒有哪一類醫者必然佔上風。

關鍵字

自學入醫者；學醫動機；醫學書單；執業行醫；評價

並列摘要

Studies of Ming-Qing Chinese medical history have largely focused on ruyi, literally, ＂Confucian doctors＂, and on shiyi, literally. ＂doctors by family training＂. This article, however, focuses on ＂self-made doctors＂, i.e., those who embarked on the medical profession out of their own initiatives. Part One of the article lists fourteen types of motivations for the self-made doctors to embark on the medical profession. Part Two explores the processes of their studies, looking into issues such as what kind of books they read, and how they overcame difficulties in comprehending the medical texts. Part Three examines the professional lives and reputations of these ＂self-made doctors.＂ The article concludes with the observation that although the literati and book owners had a monopoly over the discursive power of the medical profession, the reputation and status of the doctors were decided by an open market. Compared with other groups of doctors, the ＂self-made doctors＂ were not disadvantaged.