The characteristics and main contents of ancient Chinese medical ethics

Generally speaking, the characteristics of ancient Chinese ethics tradition are: morality and politics are closely integrated and serve the patriarchal hierarchy; moral law Legalization, legal moralization; focusing on the unity of medical ethics and medical skills, the combination of medical ethics norms and medical ethics practice; emphasizing the moral cultivation of the subject; emphasizing the unity of nature and man, harmonious interpersonal relationships, and paying attention to the golden mean; deeply influenced by Confucianism, Confucianism Ethics and morals play a dominant role in ancient Chinese medical ethics.

Specifically, my country's ancient medical ethics has the following main contents:

1. The "noble" thought of respecting and valuing life

my country's first medical classic "Huangdi Neijing" says: "The sky covers the earth, and all things are ready, and nothing is more precious than human beings." The chapters "Shu Wu Guo Lun" and "Zheng Si Lu Lun" in "Nei Jing·Su Xiang" also mention that doctors should Avoid five faults and four faults, and warn doctors to analyze the cause of the disease from pathological and psychological aspects, so as to cure the patient's disease. Sun Simiao's famous saying of the Tang Dynasty, "Human life is of the utmost importance, and a thousand pieces of gold are valuable. If one party can help, virtue exceeds this" further illustrates the importance of attaching importance to the preciousness of life and medical ethics.

2. The purpose of practicing medicine is "medicine is a benevolent skill"

"Medicine is a benevolent skill" means that medicine is a profession that implements benevolence. It is the benevolence and righteousness of Confucianism and the essence of medicine. The perfect combination. Our country's Confucian culture has always emphasized the need to "predict Confucian principles" and "only then can one know medical principles." "Confucian medicine" represents the result of the close integration of general ethics and medicine. Ren is the core of both general ethics and medical ethics. "Mencius: King Hui of Liang, Part 1" states: "There is no harm, this is the art of benevolence." Doctors in the past dynasties have regarded "medicine is the art of benevolence" as the purpose of practicing medicine and as the basic principle of medical ethics. Sun Simiao, a famous doctor in the Tang Dynasty, emphasized that doctors must "first have a heart of great compassion and be willing to save the suffering of souls". Gong Tingxian of the Ming Dynasty said in the "Ten Essentials of a Medical Practitioner" in "Rejuvenation from All Diseases": "First, keep a benevolent heart,... Second, understand Confucianism and Taoism,... Third, understand pulse,... Fourth, recognize the cause of the disease,... Ten, do not focus on profit." . In the "Five Precepts and Ten Essentials for Physicians" in Chen Shigong's "Surgical Authenticity" of the Ming Dynasty, he proposed that the first "essential" is: first understand Confucian principles, and then understand medical principles. The proposition that "medicine is a skill of benevolence" still has important practical significance even today. It reminds medicine to adhere to people-centeredness at all times, to combine "benevolence" and "medicine", and to cooperate between doctors and patients.

3. The principle of "universal equality" in practicing medicine

Ancient doctors started from the moral concepts of "benevolence saves people" and "medicine is a benevolent skill", emphasizing that patients should be treated equally, " "Everyone is equal" and "He is dedicated to rescue". Sun Simiao proposed: As a doctor, "if someone comes to seek help in illness, he should not ask whether he is rich or poor, whether he is young or old, whether he is close or good friends, whether he is Chinese or barbarian, stupid or wise, and all are treated as close relatives." Ming Dynasty The doctor Min Zicheng was kind and good at giving, and he never tired of answering the beggars. Doctor Zhao Mengbi went hundreds of miles away to meet people's urgent needs, knocking on the door in the middle of the night, and no one answered. Even when he was seventy or eighty years old, he "still saved people in the past." Zhu Danxi was one of the four great doctors in the Jin and Yuan Dynasties. When he was practicing medicine, "everyone was waiting for him with illness from all directions, and there was no empty day". The teacher "went there immediately, even if it rained or snowed on the road, it would not stop." The servant complained of pain, and the master said to him: "The sick person is as old as a year, and he wants to take care of himself?" Although it is hundreds of miles away, there is nothing to worry about. "Doctors in the Song Dynasty treated diseases and saved people, "regardless of their rank, they will always visit him." Liu Mian, a famous doctor in the late Yuan and early Ming Dynasty, served as an imperial physician during his lifetime of medical practice. , taking "treating everyone equally, regardless of high or low" as their creed. He often said, "I will not be greedy for the wealth of the rich, and I will not be tired of the poor." In a strictly hierarchical feudal society, people's moral status was hierarchical. The excellent medical style of ancient Chinese doctors who advocated the doctor-patient relationship of treating patients as relatives is very valuable.

4. Morality that emphasizes justice over profit

It is said that during the "Three Kingdoms" period, Dong Feng, a famous doctor in Jiangxi Province, lived in seclusion in Mount Lu. For those who recovered from serious illness, five apricot trees were planted, and for those with mild illness, one. Over the course of several years, more than 100,000 apricot trees were planted, and they grew into forests. The apricots harvested every year were used to support poor people seeking medical treatment. The story of "spring is warm in the apricot forest" is still circulated in the medical community to praise the virtues of doctors. Pan Wenyuan, a doctor in the Ming Dynasty, had excellent medical skills and never thought of remuneration when practicing medicine. Although he has been practicing medicine for 30 years, he is still so poor that he has almost no land. After his death, local people packed the streets to pay his respects to his funeral to express their condolences and eternal memory. The anecdote of "Spring is warm in the apricot grove" and the legend of "empty streets" represent the typical moral values ??of ancient my country that valued justice over profit.

5. Incorruptible and upright medical practice

There are numerous examples of incorruptible and upright doctors in ancient my country. For example, the medical book "General Micro-Essays on Prescriptions for Pediatric Health" emphasizes that doctors must have good conduct and an upright medical style. Chen Shigong of the Ming Dynasty stipulated in the second precept of the "Five Precepts" in the "Five Precepts and Ten Essentials for Physicians": Anyone who treats women, nuns, monks, etc., must wait for an attendant to be nearby, and then enter the room for examination. If there is no companion, do not look at yourself. Zhang Gao recorded in "Yishuo": "He Cheng, a physician during the Xuanhe period of the Northern Song Dynasty, once diagnosed and treated a scholar who had been ill for many years and could not be cured by a hundred treatments. His wife was sold out because her husband was ill for a long time, and she had no money. I am willing to give you my body as a reward. He Cheng immediately said seriously: "Why do you say this, Madam? But don't worry, it's for the sake of treatment. Don't use this as a slander!" The scholar finally recovered under He Cheng's careful treatment! Be healed. He Cheng's noble moral sentiments have been praised from generation to generation.

6. Respect the modesty of colleagues

Sun Simiao discussed the relationship between doctors and colleagues in his famous book "The Great Doctor's Sincerity": "A husband is a doctor, and he must not He talks a lot, talks about right and wrong, talks about people, shows off his reputation, undermines other doctors, and is proud of his own virtue. "Chen Shigong's "Five Precepts and Ten Keys for Physicians" recommends: "Everyone who shares the same path in the countryside... …Respect him when he is a senior, teach him by scholars, give in to him when he is proud, and recommend him when he is inferior." His colleague Fan Fengyi wrote in the preface of "Surgical Authenticity": "My colleague Chen Shigong has always been magnanimous. Benevolence and lack of restraint reflect the mutual respect among colleagues and the virtue of being open-minded and eager to learn. "Zhu Zhenheng (also known as Zhu Danxi), the founder of the Yangyin sect among the four great masters of the Jin and Yuan Dynasties, once treated a woman suffering from tuberculosis, and she was about to recover. But there are two red spots on his cheeks. Zhu Danxi had no other way to treat the disease, so he wrote a letter to the patient's family asking Ge Kejiu from Jiangsu Province for treatment. Sure enough, the patient was completely cured. These examples are deeply touching and thought-provoking.

7. Pay attention to moral self-discipline and cultivation

As my country's first medical classic, "The Yellow Emperor's Internal Classic" marks the initial formation of the motherland's medical theoretical system and is the foundation of my country's medicine and medical ethics. Important early treatises on education. Sun Simiao, as a "great sincere doctor" praised by doctors of all ages, attached great importance to moral self-discipline and cultivation. He studied medicine due to illness in his youth and devoted his life to medical research. The emperors of the Sui and Tang Dynasties called him to serve as an official many times, but he refused and dedicated his life to curing diseases for the people. In order to relieve the pain of leprosy patients, he actually took more than 600 leprosy patients to live in the deep mountains and old forests. He was not afraid of infection, took care of them personally, and carefully treated them. More than 60 people attended. He is highly respected and is known as "Master Sun" and "King of Medicine". Yang Quan of the Jin Dynasty said in "The Theory of Physics": "Doctors cannot be trusted unless they are benevolent people; if they are not smart and rational, they cannot be trusted; if they are not honest and sincere, they cannot be trusted." That is to say, when appointing doctors in ancient times, they must be Choose people with good moral character. Another famous saying related to this by Lin Bu of the Northern Song Dynasty in his "Province the Mind: On Medicine" is "A person with constant virtue cannot practice medicine." "Doctors are the difference between life and death..." This famous saying is still widely recited today. Yu Chang, a famous doctor in the Qing Dynasty, in his famous book "Medical Law", in addition to greatly enriching and improving the medical ethics evaluation theory of traditional medical ethics, another important contribution he made to medical ethics was that he initiated self-reflection by doctors in the cultivation of medical ethics. , he hopes that there will be a "self-litigation doctor" in the world.

8. Devotion to the medical profession

Many ancient doctors had the spirit of not fearing power, not seeking fame and fortune, not caring about personal gains and losses, and dedicating themselves to the cause of medicine and the people. In the feudal society, the status of Chinese doctors was very low, and they were often included in the "three religions and nine streams". They were in the same category as fortune tellers and feng shui, and were called "medical horoscopes". But in order to save people, they gave up their official positions and became people's doctors. Fan Zhongyan in the Song Dynasty said, "If you don't want to be a good prime minister, you would rather be a good doctor." Hua Tuo, a famous doctor in the Eastern Han Dynasty, had great medical skills, but he was indifferent to fame and fortune. He gave up his official position three times in his life and insisted on practicing medicine among the people. "Compendium of Materia Medica" written by Li Shizhen in the Ming Dynasty is an unprecedented masterpiece of pharmacology in my country. The book contains 1.9 million words, 52 volumes, 1,892 kinds of medicines, and 11,096 prescriptions. He spent 27 years, read more than 800 books, interviewed people from all over the world, and revised his manuscript three times. He systematically summarized my country's rich experience in medicine before the 16th century and made important contributions to the development of medicine in my country. Huangfu Mi of the Jin Dynasty had a poor family and worked in farming since he was a child. At the age of 20, he set out to study hard. At the age of 42, he became hemiplegic and deaf due to rheumatism. At the age of 54, he suffered a serious illness due to taking Hanshisan for medical treatment and almost died. However, he did not give up school because of his poor health, but instead devoted himself to the research of acupuncture. After years of unremitting efforts, the masterpiece of acupuncture science "Yellow Emperor's Three Acupuncture Classics A and B" was finally written. This book is the earliest existing monograph on acupuncture in my country. It systematically expounds the theoretical knowledge of acupuncture and lays a solid foundation for the development of acupuncture. He is called the ancestor of acupuncture by future generations.

As an ancient civilization with a long history in the world, my country’s ancient medical ethics is extremely rich in content. The above introduction is only its main content or tradition. These excellent contents or traditions are still worthy of our inheritance and continuous development based on the characteristics of the times. It should be pointed out that ancient Chinese medical ethics also had its historical and class limitations. Mainly manifested in two aspects: First, it is influenced by feudal patriarchal thoughts and hierarchical concepts and some feudal superstitious thoughts. For example, feudal moral concepts such as "Three Obediences and Four Virtues" and "Three Cardinal Guidelines and Five Constant Virtues" restricted women's medical treatment by certain rules and regulations. For example, Li Muyan's "Introduction to Medicine·Standards for Practicing Medicine" in the Ming Dynasty said: "When diagnosing a woman, she must first ask her close relatives to inquire about the syndrome, color, tongue, and diet, and then do whatever they want, or if the syndrome is serious, they need to be diagnosed in a bed under a separate tent. Otherwise, if the symptoms are mild and the patient is treated behind a curtain, his hands must be covered with gauze. If it is inconvenient for poor families, the doctor will wear gauze on his own. "① In addition, the "loyalty", "filial piety", "benevolence" and "benevolence" of the feudal ruling class. Ethical concepts such as "righteousness" and "propriety" also have a negative impact on medical ethics. For example, "the hair and skin of the body are received from parents and dare not be damaged." Autopsy is regarded as an unfilial, unkind, and unjust act and is banned, which seriously hinders the progress of autopsy research in my country. Among the requirements for medical ethics in ancient my country, there are many manifestations of the feudal patriarchal hierarchy in Confucianism. For example, it is recorded in "Book of Rites: Quli": "If the king is sick and drinks medicine, his ministers will taste it first; if a relative is sick and drinks medicine, his son will taste it first.

"This is a manifestation of the feudal patriarchal hierarchical concept of "king, minister, father and son". Secondly, although ancient my country's medical ethics has a relatively complete discussion of medical ethics standards, it lacks a more systematic ethical theory.