中央研究院歷史語言研究所集刊
第七十七本，第三分
出版日期：民國九十五年九月
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明清的人痘法──
地域流佈、知識傳播與疫苗生產
邱仲麟
本文考察明清人痘法普及的歷程，並討論這個過程中知識傳播、疫苗產銷的概
況，及人痘接種所存在的地域性、階層性。據先前學者考證，明朝隆慶年間(1567-
1572)，人痘法出現於安徽寧國，但經過本文探究，起源於江西的可能性更大。這種
預防天花的方式出現後，主要流行於江西、湖廣、安徽、江蘇、浙江、福建與廣東
等地。直至一六七○年代，才有醫者至北京為上階層種痘。康熙十七年(1678)，康
熙皇帝將人痘法引進宮中，成為皇室認可的醫療技術。不久之後，朝廷將人痘法傳
往蒙古等地。但在整個傳播過程中，朝廷並未勒令地方官全面推行此一療法，故人
痘法的傳播主要依靠士人與醫者。人痘法傳播的初期，種痘知識仰賴傳抄，技術並
不公開。至康熙五十二年(1713)，種痘法首次出現於出版的醫書內，乾隆六年
(1741)才有專談種痘的醫書出版。次年(1742)，種痘法被納入御醫所編的《醫宗
金鑑》中，種痘知識亦隨著這部欽定的醫書不斷再版而流傳。爾後，也有其他種痘
書刊行，人痘法遂普及於世。在疫苗的製造方面，安徽寧國與浙江德清是比較著名
的中心。其次，也有一些專門製造疫苗的醫家。除了向外人購買之外，不少醫者也
自行研製。由於疫苗成為有利可圖的醫藥商品，市場上甚至出現許多贗品，造成不
少後遺症。整體而言，在十九世紀初，人痘接種雖已相當普遍，但種者仍以上階層
居多，且有南盛北弱的情況。
關鍵詞：人痘法江西康熙皇帝出版疫苗
中央研究院歷史語言研究所
邱仲麟
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oduction
Chung-linCh’iu
ThisarticleinvestigatesthepopularizationofsmallpoxinoculationsduringtheMing
andQingDynastiesanddiscussestheprocessesofknowledgedissemination,bacterin
production,andmarketing,aswellastheregionalandsocialaspectsofsmallpox
inoculation.Accordingtoearlierscholars,smallpoxinoculationbeganinNingguo,Anhui,
between1567and1572.However,asthisstudydemonstrates,itishighlypossiblethat
smallpoxinoculationoriginatedintheJiangxiregion.Followingthediscoverythat
smallpoxinoculationprotectspeoplefromsmallpox,thetechniquespreadthroughoutthe
Jiangxi,Huguang,Anhui,Jiangsu,Zhejiang,Fujian,andGuangdongregions.Notuntilthe
1670sdidphysiciansarriveinBeijingtoinoculatetheupper-classcommunity.In1678,
EmperorKangxiintroducedsmallpoxinoculationtothePalace,anditbecamearoyally
approvedmedicaltechnique.Shortlythereafter,theCourttransferredthistechniqueto
Mongoliaandthesurroundingregions.Localofficials,however,wereneverorderedbythe
Courttoactuallyperformorpromotetheinoculationprocedure,soitwasmainly
disseminatedbyscholarsandphysicians.Intheearlystagesoftheinoculation’s
dissemination,onlyhandwrittenknowledgewascirculated;thetechniquesthemselveswere
notmadepublic.In1713,theinoculationprocedurefirstappearedinprintedmedicalbooks.
In1741,medicalbooksdedicatedtosmallpoxinoculationbegantobepublished.In1742,
royalphysiciansincludedtheprocedureintheirversionoftheYizongJinjian,andthe
knowledgewaswidelycirculatedbythisroyallyapprovedandcontinuallyreprintedbook.
Soonthereafter,moreandmoremedicalbooksoninoculationwerepublished,and
smallpoxinoculationbecameincreasinglywidespread.Ningguo,Anhui,andDeqing,
Zhejiang,werefamousmanufacturingcentersforthebacterin,althoughsomeprivate
clinicsalsospecializedinproducingthebacterin.Inadditiontopurchasingthebacterin,
manyphysiciansalsodevelopedtheirownversions.Sincethisbacterinwasaprofitable
medicalproduct,therewerenumerousfakeproductsonthemarket,whichresultedin
SmallpoxInoculationinMing-QingChina:
RegionalSpread,KnowledgeDissemination,
andBacterinPr
InstituteofHistoryandPhilology,AcademiaSinica
明清的人痘法──地域流佈、知識傳播與疫苗生產
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variousaftereffects.Inthebeginningofthe19thcentury,smallpoxinoculationwaswidely
available,yetonlytheupper-classwasinoculated.Smallpoxinoculationwasmuchmore
prevalentinthesouthofChinathaninthenorth.
Keywords:smallpoxinoculation,Jiangxi,EmperorKangxi,publish,bacterin
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