不就男醫：清末民初的傳道醫學中的性別身體政治

本文以在中國的西洋傳教醫療為例，探討在帝國主義擴張的脈絡下，醫者與求醫者的身體性別政治。本文首先指出，帝國擴張與性別政治之間的關係，特別是中國的性別規範如何成就了西洋女傳教醫師的東方事業。不僅女醫前往中國的背景反映了（西方）性別政治，西洋女醫也與中國社會的性別政治，有著協商互動的關係。由於此一歷史中，有男有女，階級有高也有低，有中國人也有外國人，我們可以深入追究一些重要的問題，其中包括在中國既有的性別身體規範之下，西醫與中國婦女接觸，如何受到性別、階級、文化背景的影響，而疾病與其所牽涉的身體部份又扮演了什麼樣的角色。透過這個歷史的分析與詮釋，我們可以看到，在一個醫療權威有待建立且醫療化有限的歷史脈絡裡，醫療實踐是眾多的社會實踐的一種，且需要處處與社會文化中既有的規範協商，甚至讓步。同時，我們也可以看到婦女對於不同身體部位的疾病，有不同的態度。最後，我們不必然要將性別規範或是所謂的禮教視為是女性的困境，輕易地將女性視為是受害者，甚至西式中國女醫的興起正是在此一歷史情境的產物，而當理解到歷史中多重權力關係所編識出的複雜性。

關鍵字

傳教醫療；帝國主義；性別與身體

並列摘要

This paper examines the gender and body politics of the social encounter between Chinese women and Western medicine from the 1870s to the 1920s. Basing my analysis on the reports of American medical missionary men and women who practiced medicine in China, I focus on the ways in which Western medical missionary practice was shaped by the gender of the participants on both sides of the encounter, together with the nature of the patients' illnesses. According to the American mission literature, particularly the kind that aimed at promoting medical missionary women, Chinese women were often victims of heathen social customs. One of the most commonly proffered examples was Chinese women's concerns over modesty, which kept them from seeing male physicians even if the illness was life-threatening. However, while this was more or less true for women of the higher classes, not all Chinese women observed such a strict rule of propriety, as evidenced by the numerous medical missionary men's reports about the considerable number of women patients (usually poor) whom they treated. Moreover, Chinese men patients in general did not necessarily prefer male doctors or attempt to avoid Western medical missionary women, who could in this period see both men and women patients. Since the gender of medical missionary men (and Chinese medical men) posed problems for respectable Chinese women patients, mission leaders thought Western medicine could reach these bodies more effectively through medical missionary women. However, Chinese women as patients were not the only group whose propriety had to be maintained, Chinese women as physicians were also subject to such regulations; more often than not, they avoided seeing men patients. Other factors such as the patient's marital status, age, and the nature of her illness also contributed to the ways in which she sought medical attention. Nationality, gender, social status, and level of desperation (or a fundamental need for medical help) were all factors that shaped missionary medical practice. The relationship between the gendered body, class, Western incursion, medical need, and missionizing becomes clearer when we examine so-called ”heathen social customs” such as Chinese women's concerns of modesty, a particularly polyvalent site of social politics and meanings. As Western medicine established its status in China at the advent of China's colonial modernity in the twentieth century, a fundamental change in matters regarding gender and body politics took place. Respectable women patients now, without worrying about losing status, sought medical men's services for general illnesses, and Chinese women physicians could also receive men patients.