從隋唐時期的「咒禁」科，兩宋時期的「書禁」科，到元明時期的「祝由」科，這種帶有宗教色彩的咒術療法，在官方醫學中傳衍一千年左右，卻在明穆宗隆慶五年(1571)被廢，而且，從此之後「祝由」始終不見恢復設科，其中緣由，不得不探。針對廢除祝由科此事，絕大多數的中國醫學史論著，或是避而不談，或是將時間斷定為清代，或是含混其詞。但也有人認為廢科的「遠因」為祝由醫療「與正統醫學長期衝突」，可惜的是，此說舉證太少，流於臆測。因此，本文便以傳統文獻為核心史料，歸納各種論述，依時代先後，敘述「醫學社群」對於「祝由」療法的評價與態度，據以探討其意見是否真的影響祝由科的廢除。根據本文的探討來看，由於有《黃帝內經》的權威性依據，加上若干傑出醫者的發揮與倡導，從祝由科被納入官方醫學體系起一直到被廢除，千年之間，醫學社群內部的醫者及其外圍的士人，不斷發表頌揚、肯定的言論，並進行療效和治療機制的論述。其次，透過教科書的編纂和醫學教育，官方也不斷培育出祝由科醫師，提供病者的醫療需求。此外，即使在廢科之後，三百多年間，表達肯定、支持祝由科的醫者和士人仍然不絕如縷。少數嚴厲批判與拒斥祝由科的言論，都只見於廢科之後，其餘抱持模稜兩可者，其時代也大多在晚明及清代，而且，都是以士人的意見為主。總之，中國傳統醫學社群對於祝由科的主流意見，基本上是肯定與支持，因此，祝由科的廢除不能歸因於「與正統醫學長期衝突」。

From the zhoujin (咒禁) division of study of the Sui and Tang dynasties to the shujin (書禁) of the Song dynasty and the zhuyou (祝由) of the Yuan and Ming dynasties, such religiously infused incantation cures were passed on through the official medical field for about a thousand years. However, zhuyou was abolished during the Ming dynasty in 1571, and never again resurfaced in established medicine. The reasons for this necessitate exploration. Regarding the matter of zhuyou’s abolition, the overwhelming majority of Chinese medical history scholars either avoid speaking of it, or conclude their study at the Qing dynasty, or are vague on the subject. But there are also some who believe the underlying cause of zhuyou’s abolition was “a long-term clash with orthodox medicine.” However, the evidence offered to support this argument is too little or based on speculation. Therefore, this article uses traditional documents, drawing on various treatises from successive eras to deduce an account of the attitudes and assessments of the “medical community” toward zhuyou treatment. Based on this investigation, it can be determined whether its opinions truly had an impact on the abolition of zhuyou. This articles argues, on the basis of the authoritative Inner Canon of the Yellow Emperor as well as the opinions and advocacy of a number of distinguished physicians, that during the thousand-year span between zhuyou’s admittance into the official medical orthodoxy until its abolition, both physicians within the medical community and outside scholars continuously expressed praise and affirmation for it, writing treatises on its healing effects and treatment mechanism. Furthermore, through inclusion in textbooks and medical education, the government also continuously trained zhuyou medical practitioners to meet patient demand. Despite its being abolished, over three hundred years later there were still physicians and scholars who expressed certainty and support for zhuyou. In addition to those supporters, after the abolition there was a minority harshly criticizing and rejecting zhuyou, while the remainder stayed ambiguous. These criticisms emerged mostly in the late Ming to Qing dynasties, and were primarily the opinions of scholars. In short, the mainstream opinion of Chinese traditional medical communities toward zhuyou was basically affirmation and support. Therefore, abolition of zhuyou cannot be attributed to “a long-term clash with orthodox medicine.”

祝由 ;咒術 ;醫學 ;醫者 ;士人

zhuyou; incantation; medicine; healer; scholar