清朝医药法制研究
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摘要
清朝是中国社会发生重大转折的时期。清朝医药法制体系内容丰富,涉及领域广泛,形式灵活多样,既继承了前朝法令又有所创新,新政后制定的各项医药条例直接影响着民国时期的医药法律。
清朝医药法制体系较为散乱。清朝前期医药法律散见于《大清律例》、《大清会典》和诏令、礼治法则中。清末医药法律存在于《大清新刑律》、《违警律》和各类防疫、检疫条例中。清朝医药法律涵盖面广,涉及食品卫生、药品管理、医疗质量管理、防疫、检疫、公共卫生等诸多领域。其全面性为中国历代封建医药法制体系之冠,然各法令间缺乏有机联系,尚未形成现代意义的法制系统,仅仅能被视为法律体系。从法律内容考察,清朝医药法律的内容充斥集权、礼治思想,以维护皇权、父权为核心思想。清朝前期医药法令的着眼点在于维护统治阶级的医药权益和保持社会劳动生产力;清朝后期的医药法令虽然在形式上更为关注民生,但是其出发点不外乎缓和社会矛盾以巩固封建统治。从社会意义考察,清朝医药法律是当时社会、经济、医学、法律等领域状况的综合体现。清朝前期以“参汉酌金”作为立法原则,建立其一套以传统医学、法学为理论基础,成文法为主体,习惯法作补充的适应封建小农经济的医药法律体系。清朝后期的医药法律以西方相关法律为模板,除维护封建统治者利益之外,对民生、民权也给予了一定程度的关注,同时还带有浓厚的殖民地法律色彩。
总体而言,清朝医药法律有以下几个特点。
一、医药法制形态多变
清朝医药法制体系的一大特点是变迁迅速,其根源在于满清王朝社会形态的多次巨变。天命元年(1616)努尔哈赤创立后金政权。后金政权有浓厚的氏族社会特点。就法制体系而言,后金统治者虽然在某些方面借鉴了其他民族的经验,但是总体而言还是非常简陋,正如《大清律辑注·序言》所谓“太祖、太宗创业东方,民淳法简,大辟之外,惟有鞭笞”。此时后金政权并未确立成文的医药法令,医药法制体系由氏族习惯维系。顺治元年(1644),清兵入关,清王朝正式建立。汉族文化的熏陶使清朝统治者的意识形态由氏族意识迅速转变为封建意识。这一阶段清朝统治者为了治理国家,继承了汉族法制经验创设成文法典《大清律》,同时修纂了具有行政法典意义的《大清会典》。《大清律》和《大清会典》中涉及医药事务的律令与唐、宋、明相较没有实质性变化。这意味着清朝医药法治体系由氏族法律体系演进为封建法制体系。道光二十年(1840)鸦片战争暴发,中国沦为半封建半殖民地社会,西方法律文化也由此通过各种渠道侵入中国社会。此阶段清朝医药法令借鉴西法,多有创新,客观讲是清朝医药法制史上的一次巨大进步,对民国医药法律体系影响很大,但不可避免地带有有浓厚的殖民地法律色彩。
二、“参汉酌金”为立法原则
满族统治者入主中原后意识到要管理好以汉族为主体的国家必须大量借鉴汉族法制经验,同时也认为应当保持自身的民族特色,因此确立了“参汉酌金”的立法指导思想。“参汉”是指参考汉族经验,“酌金”是指保留满族特色。清朝医药法令亦受此影响。《大清律例》载医药法条七款。分别为“造御膳有误”罪、“合御药有误”、“庸医杀伤人命”罪、“医家诈伪图财”罪、“私刨人参”罪、“军人替役”罪、“擅售毒药”罪。其中“造御膳有误”罪、“合御药有误”、“庸医杀伤人命”罪、“医家诈伪图财”罪、“擅售毒药”罪五条均为沿袭《大明律》相关规定,罪名设置、惩罚措施等方面几乎没有变化。“私刨人参”罪为《大清律例》新设,“军人替役”罪较前朝规定有了较大的不同,是满族民族特色的体现。禁止私刨人参旨在保护满族特有的药物资源以保证皇室用药需求,同时也惩治了侵犯清朝前代帝后寝陵的行为。满族统治者对军队建设相当重视,故此设立“军人替役”罪以惩治混入军队的庸医,保证军事医疗质量。
清朝统治者大幅沿袭前朝法令,既继承了经验,也延续了前朝历代医药法制体系的不足,即漠视民间医疗医药问题。卷帙浩繁的《大清律例》和《大清会典》中涉及民间医疗医药的法令寥寥无几。其原因在于统治阶层保守的政治哲学。为私权益而进行诉讼,在统治者看来不外是“细事”争端,缺乏应有的重视。他们追求的是息讼、无讼。“无讼”不仅是官僚们的价值取向,也在群众中具有广泛的影响,如果发生争执则寄希望于纲常的德化作用和族长邻右的调处功能,很少诉讼于官府。这也是我国二千余年封建历史上医药法制体系少有突破性发展的原因之一。
三、医药法令充斥集权、礼治思想
自汉朝“废黜百家独尊儒术”后,儒家礼治思想被历代王朝确定为不容质疑的治国法则。清朝医药法令也不可避免地充斥着礼治风气,具体表现是行为后果因当事人身份不同而异。“合御药有误”、“庸医杀伤人命”罪都是为惩治庸医而设。但“合御药有误”的受害者是贵族统治者,因此被列入“大不敬”的范畴,属于“十恶”之一,即使没有造成严重后果相关医工也要受到杖刑,监管官员亦会受到牵连,“减医人厨子罪二等”处理。相较而言,对民间医疗事故责任人的处罚要轻得多。“庸医杀伤人命”罪规定:“凡庸医为人用药针刺误不如本方,因而致死者,……以过失杀人论(依律收赎给付其家)”。民间致死人命的医疗事故最终多会以赔偿的方式了结,而御医出现失误至少要受到杖刑的严惩,同罪不同罚,封建礼治思想体现得淋漓尽致。
封建社会是集权社会。集权御用思想也体现在清朝医药法制体系中。清朝医药法令多是为保证帝王医疗质量而定。《大清律例》和《大清会典》均载有大量御用医疗行政法律条款,相关人员分工细致,监管严格,责权明确,以保障皇室成员的用药安全和医疗质量为指导思想和工作重心,成为清朝成文医药法令的主体。御医的行为受到多层监管,动辄得咎。规制民间医疗医药的法令则极为粗疏,涵盖面也较窄。可见清朝医药法令确如黄宗羲所言,是“一家之法”而非“天下之法”,由此可见集权御用是清朝医药法制的根本点。
四、习惯法是发挥重要作用
前文已述,清朝成文法典对民间医疗医药领域关注不足。同时清朝统治者法律思想保守,《大清律》制成后被认定不可变更,否则就是违背祖制大逆不道。因此《大清律》制定后至清末新政开始前,各级官吏惮于增删条文,医药领域的法制空白只能由习惯法填补。
习惯法是人们公认并视为具有法律约束力的一些习惯、惯例和通行的做法。清朝医药法制体系中习惯法占有极其重要的位置。清朝绝大多数调整民事医药法律关系的行为规范均以“习惯”作为表现形式,统治者又以诏令的形式加以认可,形成了清朝医药习惯法。总结清朝文献发现,上升为习惯的医药习惯主要有两项:“颁医济民”和“侍亲奉药”。“颁医济民”是指国家在遇到自然灾害和疫病流行时以帝王的名义选派医官为民疗病并向民间派发免费药品。“颁医济民”的习惯并非起于清朝,史料记载汉朝就有“民疾疫者,空舍邸第,为置医药”的传统,历朝历代多沿袭之。文献研究表明,清朝统治者定都北京后很好地践行了“颁医济民”的习惯,几乎每一次疫病暴发后均有遣医派药的行为,这表明“颁医济民”已具有了习惯法地位。“侍亲奉药”是指亲长在患病之时子女必须亲身侍奉医药。子女奉药侍亲多能得到各级官员的褒奖。怠于奉药侍亲者除了受到舆论谴责外还会被归入“不孝”的范畴,这是《大清律》确定的“十恶”之一,将受到法律的严惩。清朝皇家贵族在“侍亲奉药”一事上多能身体力行,以为表率,《清实录》对此记录颇多。道德规劝、法律约束、帝王表率这三方面力量综合作用,使“侍亲奉药”也具有了习惯法效力。
五、清末医药法令殖民地色彩浓厚
中国沦为半殖民地社会后,在殖民列强以放弃领事裁判权为诱饵,诱使清政府以西方法律为模板修订清律。清政府在这种刺激下也决定“参酌各国法律”,修订现行律例“务期中外通行”。新政后清朝统治者模仿西方,创制了一系列医药新法律。《大清新刑律》、《违警律》均设专章规定医药法令。东三省暴发鼠疫后,清政府制定各级防疫条例十五件,涉及交通管制、消毒、尸体处置、公共场所医药管理多个领域。清朝各地的公共医药、检疫、防疫律令都有所创设或完善,是中国防疫法制的发轫。上述条例多是于日俄等列强国家“协商”制定,参照西方各国成熟法律制定,因此立法质量大有进步,立法程序也更为合理。但是因为列强干扰,这些条例中也存在着极度缺乏民族自尊的现象,如“东清铁路通知限制传染病传染规条”规定“华工不准乘坐快车、邮政车……华工不准入海滨省,欲入后贝加尔省者须在满洲里站验病五日放行……华商亦遵守以上各条章程,惟较华工不同者,若在交界站、满洲里站严明无病,准其入海滨省及后贝加尔省”。对“华工”乘坐交通工具、住宿等事项严加限制,却未对外籍人员类似行为加以规范,对具有买办性质的“华商”则给与介于“华工”和外籍人员之间的待遇。又如“铁道遮断交通之措置法”规定“西伯利及南满搭客入关者,但有西医证书,关不再留验”,以拥有“西医证书”作为免于留验条件体现一种盲目媚外的心态。
细究清朝卫生法制经验教训则可得出下述结论:一、国家必须端正对待医学及医生的态度;二、国家必须改善医药法令赖以生存的法律环境与法律土壤;三、卫生法制体系应当是一个开放、包容的体系,允许必要的创新和因此带来的失败和局部利益的损失;四、医药律令必须也必将会符合医学和社会医疗环境的现实状况。
The Qing dynasty is last feudal empire in China history. The medical law of Qing dynasty, which also touch the medical law system of the public of China, is abundant and flexible. It is the continuator of traditional Chinese law as the same as the originator in the Chinese medical law history.
The medical law of Qing dynasty is relative disheveled. The medical law of prophase Qing dynasty indwell, , decrees and custom. The medical law of second half Qing dynasty indwell , and epidemic prevention rules. Although the medical law of Qing dynasty is richest medical law system in Chinese feudal society, it is not an organic whole. The matter of the medical law of Qing dynasty is full of feudalism and Confucianism. The medical law of prophase Qing dynasty emphasized the medical benefit of the potentate and the development of society productivity. Although the medical law of second half Qing dynasty pay attention to the medical benefit of plebeian, but the core is not changed. The medical law of Qing dynasty is the embodiment of the polity, the macro-economy, the jurisprudence and the medicine of the Qing dynasty.
Qing dynasty Chinese medicine legal system is more scattered. Early Qing Dynasty Chinese medicine contained in the law, "the Qing Law," "will be the Qing Code" and Dahir, courtesy of governance rules. Law exists in the late Qing Dynasty Chinese medicine "clean the law", "breach of police rules" and various kinds of epidemic prevention, quarantine regulations. Qing law covers a wide range of traditional Chinese medicine, involving food hygiene, medicine management, medical quality management, vaccination, quarantine, public health, and many other areas. China for its comprehensive medical history of feudal the highest legal system, but the lack of organic links between the Act, has not yet formed the modern sense of the legal system, only be regarded as a legal system. From the legal content of inspection, the Qing dynasty Chinese medicine centralized filled with the contents of the law, governance at the thought, to maintain imperial power, as the core of patriarchal ideology. Early Qing Dynasty Chinese Medicine Act is to maintain the focus of the ruling class of medicine to maintain social rights and labour productivity of the late Qing Dynasty Chinese medicine in the form of decrees. Although more concerned about people's livelihood, but it is starting point just easing social conflicts so as to consolidate feudal rule. From the social significance of inspection, the Qing dynasty Chinese medicine is legal at the time of social, economic, medical, legal and other fields of the comprehensive situation. Early Qing Dynasty "Han discretion of the Senate" as the legislative principles, to establish a set of its traditional medicine, law for the theoretical foundation for the main statutory, customary law to add to the small-feudal legal system of medicine. The late Qing Dynasty Chinese medicine to Western law-related laws as a template, in addition to safeguarding the interests of the feudal rulers, the people's livelihood, the Citizens has also given a certain degree of concern, and also with a strong color of colonial laws.
Overall, the Qing dynasty Chinese medicine laws have the following characteristics.
1. the rule of law form of Chinese medicine volatile
Qing dynasty Chinese medicine legal system is a major feature of changing rapidly, its roots in the Qing dynasty the many changes in social patterns. On the legal system, the rulers, after the creation of the regime, is still very rudimentary, as the "big Qinglv series of Notes·preamble" so-called "Dynasty, Taizong Venture East, the Sun Mr Law, the production, only flogging ". At this point after the regime has not established written decree medicine, Chinese medicine from the legal system used to maintain the clan. Shunzhi first year (1644), Qingbingruguan, formally established the Qing Dynasty. Han culture of the Qing dynasty rulers nurtured by the ideology of the clan awareness of the rapidly changing for the feudal ideology. To this stage of the Qing dynasty rulers to rule the country, inherited the experience of the creation of the Han rule of law written Code "Qinglv," Tsay repair at the same time with the significance of the Code "will be the Qing Code." "Qinglv" and "Code of the Qing will be" involved in the affairs of Chinese medicine and rules Tang, Song and Ming compared with no substantial change. This means that the rule of law in the Qing Dynasty Chinese medicine from the clan system for the evolution of the legal system of feudal legal system. Daoguang 20 years (1840) outbreak of the Opium War, China became a half-feuda-half-colonial-society, Western culture has this law through various channels penetrated Chinese society. This stage of the Qing dynasty Chinese medicine reference western Act, more innovative, objective Qing dynasty Chinese medicine stresses the rule of law is a history of tremendous progress, the impact of the legal system in medicine great, but inevitably there is a strong color of colonial laws.
2. "Han discretion of the Senate" for the legislative principles
After the Manchu rulers of the Central Plains into good management to be conscious of the Han nationality as the main countries must learn from the Han large number of legal experience, but also that the nation should maintain its own characteristics and therefore established the "Han discretion of the Senate" legislation guiding ideology. "Shen Han" refers to refer to the Han experience, "the discretion" means to retain Manchu characteristics. Qing dynasty Chinese Medicine Act was also affected by this. "Qing Law" were "rigged Yushan is wrong" crimes, "a Royal medicine is wrong", "Yong Yi destruction of life" crimes, "pseudo-medical home bluff fiscal plans" crimes, "private plane ginseng" crimes, "the military service for the" crime "trespassing The sale of poison "crimes. The "Yushan made an error" crimes, "a Royal medicine is wrong", "Yong Yi destruction of life" crimes, "pseudo-medical home bluff fiscal plans" crimes "unauthorised sale of poison" the crime of five are followed "Minglv" relevant provisions, Count of settings, such as punitive measures and almost no change. "Ginseng private plane," the crime as "the Qing Law" new "soldiers for the easement" over the crime of the former provisions have been greatly different, is the embodiment of the Manchu ethnic characteristics. Ginseng prohibit private plane to protect the Manchu-specific drug treatment resources to ensure that the Royal demand, but also to punish violations of the Qing Dynasty Tombs previous Dihou sleep behavior. Manchu rulers of the armed forces attach considerable importance to the building, it set up a "military personnel for service" to punish the crime of mixing with the army Yongyi, military medical quality assurance.
Former rulers of the Qing Dynasty followed sharp Act, inherited both experience and continuity of the previous history of inadequate medical legal system, which is ignoring civil medicine medical problems. Juanzhi voluminous, "the Qing Law" and "Code of the Qing will be" involved in the civil law very few medical rules. The reason is that the ruling class conservative political philosophy. For the interests of private litigation, the rulers seem nothing more than a "small matter" of disputes, lack of due attention. They are seeking the interest of First Instance, no defendants. "No court" is not only the value orientation of bureaucrats, is also a broad masses of the impact, if a dispute is pinning hopes on the Gangchang the role of Germany and the sheikhs of the mediating function of the right neighborhood, very few officials in the litigation. This is also China's 2,000 years of feudal history of medicine breakthrough in the legal system rarely one of the reasons why.
3. medicine Act full centralization of power, governance at the thought.
Since the Han Dynasty "Only 100 deposed Confucianism," the Confucian thinking of governance at the previous dynasty was identified as the unquestionable principle of governing the country. Qing dynasty Chinese Medicine Act also inevitably full of governance at the atmosphere, is the concrete manifestation of the consequences as a result of the parties vary. "A Royal medicine is wrong", "Yong Yi destruction of life" crimes are designed to punish Yongyi. But "there are a Royal drug misuse" of the victims are noble ruler, was included in the "Taibu Jing" areas, are "Shie" one, even if no serious medical consequences related to the subject of criminal punishment, regulatory officials Will be affected, "by cooks who admitted the crime of second-class" treatment. In contrast, the civil malpractice liability of punishment is much more to light. "Yongyi destruction of life" crimes: "Where Yongyi well as the misuse of acupuncture treatment, and thus to death, to manslaughter on (by law to pay their ransom home)." People killed and more medical blunders eventually will end the way of compensation, but at least Yuyi errors are subject to criminal punishment and severely punished, with different crimes of impunity, at the rule of feudal thinking embodied most vividly.
Feudal society is centralized community. Centralization of power, QC, also reflected in the thinking of the Qing dynasty Chinese medicine in the legal system. Qing dynasty Chinese Medicine Act is to ensure that more health care quality may be the emperor. "Qing Law" and "Code of the Qing would" contain a large number of medical, QC, the legal provisions related to personnel and meticulous division of labor, strict supervision, the right to select clear, in order to protect members of the royal family of drug safety and medical quality as the guiding ideology and The focus of work, written into the Qing dynasty Chinese medicine the main Act. Yuyi the conduct of multi-storey supervision, often in the blame. Regulation of private medical medicine Act is extremely careless, coverage is also narrower. This shows that the Qing dynasty Chinese Medicine Act is as Huang Zongxi said, is "one of the law" rather than "the world of law," This shows that centralization of power, QC, the Qing dynasty Chinese medicine is the rule of law and the fundamental point.
4. customary law is an important role to play
Qian Wenyi reference to the Qing Dynasty written code of civil medical attention less than the medical field. At the same time the Qing dynasty rulers of conservative legal thinking, "Qinglv" was made that can not be changed, otherwise the system is contrary to the ancestral Danibudao. Therefore "Qinglv" to Qingmoxinzheng enacted before the start of officials at all levels in the additions and deletions Dan provisions, the legal gaps in the field of medicine can only be filled by customary law.
People customary law is recognized as legally binding and some of the habits, practices and general practice []. Qing dynasty Chinese medicine in the common law legal system takes up an extremely important position. The vast majority of the Qing Dynasty Chinese medicine adjustment civil legal relations are in the code of conduct "habit" as a form of expression, Dahir rulers again in the form of recognition, formed the Qing dynasty Chinese medicine customary law. Documents found summing up the Qing dynasty, will rise to the habits of Chinese medicine mainly used to have two: "Chi-ming received treatment" and "pro-Bong-paternity." "Ji received medical people" refers to countries in the face of natural disasters and epidemic disease, in the name of the emperor to send medical officer for the treatment of civil and distributed free medicines. "Ji-min received treatment" is not the habit of starting from the Qing Dynasty, the Han dynasty historical records are "people Jiyi, Didi empty homes, home for the Chinese medicine" tradition, history and more followed in Li Zhao. Literature Research shows that the rulers of the Qing Dynasty in its capital Beijing after a good practice the "Chi-ming received treatment," the habit, almost every time after the outbreak of the disease have sent doctors to send medicine, this shows that "economic received medical people" have a The status of customary law. "Bong paternity pro-drug" refers to pro-long illness at a time when children must personally serve traditional Chinese medicine. Children Bong-paternity can be more pro-government officials at all levels of recognition. Dai Yu Feng, in addition to pro-drug paternity condemned by public opinion, will be classified as "Buxiao" areas, this is "Qinglv" OK "Shie" one of the law will be severely punished. Royal nobles in the Qing Dynasty, "Shi Feng pro-drug," the more able to personally think that setting an example, "Record-" quite a lot of this record. Moral advice, legal constraint, the emperor set an example in these three areas combined forces, "Shi Feng pro-drug" also has the effect of customary law.
5. the late Qing Dynasty Chinese Medicine Act colonial strong
China became a semi-colonial society, the colonial powers to give up consular jurisdiction as bait, the Qing government to induce the West to amend the law as a template Qinglv. The Qing government in this stimulation also decided to "light of national laws", to amend the existing law, "the Treasury of Chinese and foreign access". After the Qing dynasty rulers of the New Deal to imitate the West, creating a series of new legal medicine. "Clean the law", "breach of police rules" There will be a special chapter provides medicine Act. Northeast outbreak of plague, the Qing government at all levels enacted Prevention of Disease Ordinance 15, traffic control, disinfection and disposal of the bodies, public places medical management in many fields. Qing Dynasty around the public medicine, quarantine, vaccination rules have been created or improved, China's epidemic prevention is the rule of law Faren. Most of the Russo-Japanese and other foreign powers in the country "consultations" develop, in the light of the legal development of mature western countries, greatly improved the quality of legislation, the legislative process is more reasonable. However, because of interference by foreign powers, which also exists in the extreme lack of national self-esteem, such as "Chinese Eastern Railway informed the restrictions on the transmission of infectious diseases," provides that "laborersnot allowed to take the express train, postal vehicles......no access to the waterfrontlaborers Province, to After the Baikal province in Manchuria stations will berequired to post-mortem on the 5th of release...... also abide by Chineseentrepreneurs all over the Constitution, but different than the laborers, if the junction points, Manzhouli station strict disease-free, quasi-Riviera Province and its after-Baikal Province ". "Laborers" on transport, accommodation and other matters in strict restrictions on foreign nationals not to regulate similar acts, the comprador nature of the "Chinese entrepreneurs" are given between "laborers" and foreigners between the treatment. Also, "Railway traffic interdictions of Cuozhi law" provides that "Xi Boli and southern Manchuria passengers entry, but Western medicine certificate, the Commissioner no longer Liu Yan," to have "Western medicine certificate" as a condition of Liu Yan from a blind Meiwai mentality.
Through careful study, the Qing legal system health lessons can be drawn the following conclusions: First, the state must correct treatment of medical doctors and the attitude of the Second, the state must improve for the survival of Chinese Medicine Act legal environment and the law of soil; three, public health legal system should be An open, inclusive system that allows the necessary innovation and therefore the failure of local interests and the loss of four, medicine law will also need to be consistent with the medical and social reality of the medical environment.
清朝医药法制体系较为散乱。清朝前期医药法律散见于《大清律例》、《大清会典》和诏令、礼治法则中。清末医药法律存在于《大清新刑律》、《违警律》和各类防疫、检疫条例中。清朝医药法律涵盖面广,涉及食品卫生、药品管理、医疗质量管理、防疫、检疫、公共卫生等诸多领域。其全面性为中国历代封建医药法制体系之冠,然各法令间缺乏有机联系,尚未形成现代意义的法制系统,仅仅能被视为法律体系。从法律内容考察,清朝医药法律的内容充斥集权、礼治思想,以维护皇权、父权为核心思想。清朝前期医药法令的着眼点在于维护统治阶级的医药权益和保持社会劳动生产力;清朝后期的医药法令虽然在形式上更为关注民生,但是其出发点不外乎缓和社会矛盾以巩固封建统治。从社会意义考察,清朝医药法律是当时社会、经济、医学、法律等领域状况的综合体现。清朝前期以“参汉酌金”作为立法原则,建立其一套以传统医学、法学为理论基础,成文法为主体,习惯法作补充的适应封建小农经济的医药法律体系。清朝后期的医药法律以西方相关法律为模板,除维护封建统治者利益之外,对民生、民权也给予了一定程度的关注,同时还带有浓厚的殖民地法律色彩。
总体而言,清朝医药法律有以下几个特点。
一、医药法制形态多变
清朝医药法制体系的一大特点是变迁迅速,其根源在于满清王朝社会形态的多次巨变。天命元年(1616)努尔哈赤创立后金政权。后金政权有浓厚的氏族社会特点。就法制体系而言,后金统治者虽然在某些方面借鉴了其他民族的经验,但是总体而言还是非常简陋,正如《大清律辑注·序言》所谓“太祖、太宗创业东方,民淳法简,大辟之外,惟有鞭笞”。此时后金政权并未确立成文的医药法令,医药法制体系由氏族习惯维系。顺治元年(1644),清兵入关,清王朝正式建立。汉族文化的熏陶使清朝统治者的意识形态由氏族意识迅速转变为封建意识。这一阶段清朝统治者为了治理国家,继承了汉族法制经验创设成文法典《大清律》,同时修纂了具有行政法典意义的《大清会典》。《大清律》和《大清会典》中涉及医药事务的律令与唐、宋、明相较没有实质性变化。这意味着清朝医药法治体系由氏族法律体系演进为封建法制体系。道光二十年(1840)鸦片战争暴发,中国沦为半封建半殖民地社会,西方法律文化也由此通过各种渠道侵入中国社会。此阶段清朝医药法令借鉴西法,多有创新,客观讲是清朝医药法制史上的一次巨大进步,对民国医药法律体系影响很大,但不可避免地带有有浓厚的殖民地法律色彩。
二、“参汉酌金”为立法原则
满族统治者入主中原后意识到要管理好以汉族为主体的国家必须大量借鉴汉族法制经验,同时也认为应当保持自身的民族特色,因此确立了“参汉酌金”的立法指导思想。“参汉”是指参考汉族经验,“酌金”是指保留满族特色。清朝医药法令亦受此影响。《大清律例》载医药法条七款。分别为“造御膳有误”罪、“合御药有误”、“庸医杀伤人命”罪、“医家诈伪图财”罪、“私刨人参”罪、“军人替役”罪、“擅售毒药”罪。其中“造御膳有误”罪、“合御药有误”、“庸医杀伤人命”罪、“医家诈伪图财”罪、“擅售毒药”罪五条均为沿袭《大明律》相关规定,罪名设置、惩罚措施等方面几乎没有变化。“私刨人参”罪为《大清律例》新设,“军人替役”罪较前朝规定有了较大的不同,是满族民族特色的体现。禁止私刨人参旨在保护满族特有的药物资源以保证皇室用药需求,同时也惩治了侵犯清朝前代帝后寝陵的行为。满族统治者对军队建设相当重视,故此设立“军人替役”罪以惩治混入军队的庸医,保证军事医疗质量。
清朝统治者大幅沿袭前朝法令,既继承了经验,也延续了前朝历代医药法制体系的不足,即漠视民间医疗医药问题。卷帙浩繁的《大清律例》和《大清会典》中涉及民间医疗医药的法令寥寥无几。其原因在于统治阶层保守的政治哲学。为私权益而进行诉讼,在统治者看来不外是“细事”争端,缺乏应有的重视。他们追求的是息讼、无讼。“无讼”不仅是官僚们的价值取向,也在群众中具有广泛的影响,如果发生争执则寄希望于纲常的德化作用和族长邻右的调处功能,很少诉讼于官府。这也是我国二千余年封建历史上医药法制体系少有突破性发展的原因之一。
三、医药法令充斥集权、礼治思想
自汉朝“废黜百家独尊儒术”后,儒家礼治思想被历代王朝确定为不容质疑的治国法则。清朝医药法令也不可避免地充斥着礼治风气,具体表现是行为后果因当事人身份不同而异。“合御药有误”、“庸医杀伤人命”罪都是为惩治庸医而设。但“合御药有误”的受害者是贵族统治者,因此被列入“大不敬”的范畴,属于“十恶”之一,即使没有造成严重后果相关医工也要受到杖刑,监管官员亦会受到牵连,“减医人厨子罪二等”处理。相较而言,对民间医疗事故责任人的处罚要轻得多。“庸医杀伤人命”罪规定:“凡庸医为人用药针刺误不如本方,因而致死者,……以过失杀人论(依律收赎给付其家)”。民间致死人命的医疗事故最终多会以赔偿的方式了结,而御医出现失误至少要受到杖刑的严惩,同罪不同罚,封建礼治思想体现得淋漓尽致。
封建社会是集权社会。集权御用思想也体现在清朝医药法制体系中。清朝医药法令多是为保证帝王医疗质量而定。《大清律例》和《大清会典》均载有大量御用医疗行政法律条款,相关人员分工细致,监管严格,责权明确,以保障皇室成员的用药安全和医疗质量为指导思想和工作重心,成为清朝成文医药法令的主体。御医的行为受到多层监管,动辄得咎。规制民间医疗医药的法令则极为粗疏,涵盖面也较窄。可见清朝医药法令确如黄宗羲所言,是“一家之法”而非“天下之法”,由此可见集权御用是清朝医药法制的根本点。
四、习惯法是发挥重要作用
前文已述,清朝成文法典对民间医疗医药领域关注不足。同时清朝统治者法律思想保守,《大清律》制成后被认定不可变更,否则就是违背祖制大逆不道。因此《大清律》制定后至清末新政开始前,各级官吏惮于增删条文,医药领域的法制空白只能由习惯法填补。
习惯法是人们公认并视为具有法律约束力的一些习惯、惯例和通行的做法。清朝医药法制体系中习惯法占有极其重要的位置。清朝绝大多数调整民事医药法律关系的行为规范均以“习惯”作为表现形式,统治者又以诏令的形式加以认可,形成了清朝医药习惯法。总结清朝文献发现,上升为习惯的医药习惯主要有两项:“颁医济民”和“侍亲奉药”。“颁医济民”是指国家在遇到自然灾害和疫病流行时以帝王的名义选派医官为民疗病并向民间派发免费药品。“颁医济民”的习惯并非起于清朝,史料记载汉朝就有“民疾疫者,空舍邸第,为置医药”的传统,历朝历代多沿袭之。文献研究表明,清朝统治者定都北京后很好地践行了“颁医济民”的习惯,几乎每一次疫病暴发后均有遣医派药的行为,这表明“颁医济民”已具有了习惯法地位。“侍亲奉药”是指亲长在患病之时子女必须亲身侍奉医药。子女奉药侍亲多能得到各级官员的褒奖。怠于奉药侍亲者除了受到舆论谴责外还会被归入“不孝”的范畴,这是《大清律》确定的“十恶”之一,将受到法律的严惩。清朝皇家贵族在“侍亲奉药”一事上多能身体力行,以为表率,《清实录》对此记录颇多。道德规劝、法律约束、帝王表率这三方面力量综合作用,使“侍亲奉药”也具有了习惯法效力。
五、清末医药法令殖民地色彩浓厚
中国沦为半殖民地社会后,在殖民列强以放弃领事裁判权为诱饵,诱使清政府以西方法律为模板修订清律。清政府在这种刺激下也决定“参酌各国法律”,修订现行律例“务期中外通行”。新政后清朝统治者模仿西方,创制了一系列医药新法律。《大清新刑律》、《违警律》均设专章规定医药法令。东三省暴发鼠疫后,清政府制定各级防疫条例十五件,涉及交通管制、消毒、尸体处置、公共场所医药管理多个领域。清朝各地的公共医药、检疫、防疫律令都有所创设或完善,是中国防疫法制的发轫。上述条例多是于日俄等列强国家“协商”制定,参照西方各国成熟法律制定,因此立法质量大有进步,立法程序也更为合理。但是因为列强干扰,这些条例中也存在着极度缺乏民族自尊的现象,如“东清铁路通知限制传染病传染规条”规定“华工不准乘坐快车、邮政车……华工不准入海滨省,欲入后贝加尔省者须在满洲里站验病五日放行……华商亦遵守以上各条章程,惟较华工不同者,若在交界站、满洲里站严明无病,准其入海滨省及后贝加尔省”。对“华工”乘坐交通工具、住宿等事项严加限制,却未对外籍人员类似行为加以规范,对具有买办性质的“华商”则给与介于“华工”和外籍人员之间的待遇。又如“铁道遮断交通之措置法”规定“西伯利及南满搭客入关者,但有西医证书,关不再留验”,以拥有“西医证书”作为免于留验条件体现一种盲目媚外的心态。
细究清朝卫生法制经验教训则可得出下述结论:一、国家必须端正对待医学及医生的态度;二、国家必须改善医药法令赖以生存的法律环境与法律土壤;三、卫生法制体系应当是一个开放、包容的体系,允许必要的创新和因此带来的失败和局部利益的损失;四、医药律令必须也必将会符合医学和社会医疗环境的现实状况。
The Qing dynasty is last feudal empire in China history. The medical law of Qing dynasty, which also touch the medical law system of the public of China, is abundant and flexible. It is the continuator of traditional Chinese law as the same as the originator in the Chinese medical law history.
The medical law of Qing dynasty is relative disheveled. The medical law of prophase Qing dynasty indwell
Qing dynasty Chinese medicine legal system is more scattered. Early Qing Dynasty Chinese medicine contained in the law, "the Qing Law," "will be the Qing Code" and Dahir, courtesy of governance rules. Law exists in the late Qing Dynasty Chinese medicine "clean the law", "breach of police rules" and various kinds of epidemic prevention, quarantine regulations. Qing law covers a wide range of traditional Chinese medicine, involving food hygiene, medicine management, medical quality management, vaccination, quarantine, public health, and many other areas. China for its comprehensive medical history of feudal the highest legal system, but the lack of organic links between the Act, has not yet formed the modern sense of the legal system, only be regarded as a legal system. From the legal content of inspection, the Qing dynasty Chinese medicine centralized filled with the contents of the law, governance at the thought, to maintain imperial power, as the core of patriarchal ideology. Early Qing Dynasty Chinese Medicine Act is to maintain the focus of the ruling class of medicine to maintain social rights and labour productivity of the late Qing Dynasty Chinese medicine in the form of decrees. Although more concerned about people's livelihood, but it is starting point just easing social conflicts so as to consolidate feudal rule. From the social significance of inspection, the Qing dynasty Chinese medicine is legal at the time of social, economic, medical, legal and other fields of the comprehensive situation. Early Qing Dynasty "Han discretion of the Senate" as the legislative principles, to establish a set of its traditional medicine, law for the theoretical foundation for the main statutory, customary law to add to the small-feudal legal system of medicine. The late Qing Dynasty Chinese medicine to Western law-related laws as a template, in addition to safeguarding the interests of the feudal rulers, the people's livelihood, the Citizens has also given a certain degree of concern, and also with a strong color of colonial laws.
Overall, the Qing dynasty Chinese medicine laws have the following characteristics.
1. the rule of law form of Chinese medicine volatile
Qing dynasty Chinese medicine legal system is a major feature of changing rapidly, its roots in the Qing dynasty the many changes in social patterns. On the legal system, the rulers, after the creation of the regime, is still very rudimentary, as the "big Qinglv series of Notes·preamble" so-called "Dynasty, Taizong Venture East, the Sun Mr Law, the production, only flogging ". At this point after the regime has not established written decree medicine, Chinese medicine from the legal system used to maintain the clan. Shunzhi first year (1644), Qingbingruguan, formally established the Qing Dynasty. Han culture of the Qing dynasty rulers nurtured by the ideology of the clan awareness of the rapidly changing for the feudal ideology. To this stage of the Qing dynasty rulers to rule the country, inherited the experience of the creation of the Han rule of law written Code "Qinglv," Tsay repair at the same time with the significance of the Code "will be the Qing Code." "Qinglv" and "Code of the Qing will be" involved in the affairs of Chinese medicine and rules Tang, Song and Ming compared with no substantial change. This means that the rule of law in the Qing Dynasty Chinese medicine from the clan system for the evolution of the legal system of feudal legal system. Daoguang 20 years (1840) outbreak of the Opium War, China became a half-feuda-half-colonial-society, Western culture has this law through various channels penetrated Chinese society. This stage of the Qing dynasty Chinese medicine reference western Act, more innovative, objective Qing dynasty Chinese medicine stresses the rule of law is a history of tremendous progress, the impact of the legal system in medicine great, but inevitably there is a strong color of colonial laws.
2. "Han discretion of the Senate" for the legislative principles
After the Manchu rulers of the Central Plains into good management to be conscious of the Han nationality as the main countries must learn from the Han large number of legal experience, but also that the nation should maintain its own characteristics and therefore established the "Han discretion of the Senate" legislation guiding ideology. "Shen Han" refers to refer to the Han experience, "the discretion" means to retain Manchu characteristics. Qing dynasty Chinese Medicine Act was also affected by this. "Qing Law" were "rigged Yushan is wrong" crimes, "a Royal medicine is wrong", "Yong Yi destruction of life" crimes, "pseudo-medical home bluff fiscal plans" crimes, "private plane ginseng" crimes, "the military service for the" crime "trespassing The sale of poison "crimes. The "Yushan made an error" crimes, "a Royal medicine is wrong", "Yong Yi destruction of life" crimes, "pseudo-medical home bluff fiscal plans" crimes "unauthorised sale of poison" the crime of five are followed "Minglv" relevant provisions, Count of settings, such as punitive measures and almost no change. "Ginseng private plane," the crime as "the Qing Law" new "soldiers for the easement" over the crime of the former provisions have been greatly different, is the embodiment of the Manchu ethnic characteristics. Ginseng prohibit private plane to protect the Manchu-specific drug treatment resources to ensure that the Royal demand, but also to punish violations of the Qing Dynasty Tombs previous Dihou sleep behavior. Manchu rulers of the armed forces attach considerable importance to the building, it set up a "military personnel for service" to punish the crime of mixing with the army Yongyi, military medical quality assurance.
Former rulers of the Qing Dynasty followed sharp Act, inherited both experience and continuity of the previous history of inadequate medical legal system, which is ignoring civil medicine medical problems. Juanzhi voluminous, "the Qing Law" and "Code of the Qing will be" involved in the civil law very few medical rules. The reason is that the ruling class conservative political philosophy. For the interests of private litigation, the rulers seem nothing more than a "small matter" of disputes, lack of due attention. They are seeking the interest of First Instance, no defendants. "No court" is not only the value orientation of bureaucrats, is also a broad masses of the impact, if a dispute is pinning hopes on the Gangchang the role of Germany and the sheikhs of the mediating function of the right neighborhood, very few officials in the litigation. This is also China's 2,000 years of feudal history of medicine breakthrough in the legal system rarely one of the reasons why.
3. medicine Act full centralization of power, governance at the thought.
Since the Han Dynasty "Only 100 deposed Confucianism," the Confucian thinking of governance at the previous dynasty was identified as the unquestionable principle of governing the country. Qing dynasty Chinese Medicine Act also inevitably full of governance at the atmosphere, is the concrete manifestation of the consequences as a result of the parties vary. "A Royal medicine is wrong", "Yong Yi destruction of life" crimes are designed to punish Yongyi. But "there are a Royal drug misuse" of the victims are noble ruler, was included in the "Taibu Jing" areas, are "Shie" one, even if no serious medical consequences related to the subject of criminal punishment, regulatory officials Will be affected, "by cooks who admitted the crime of second-class" treatment. In contrast, the civil malpractice liability of punishment is much more to light. "Yongyi destruction of life" crimes: "Where Yongyi well as the misuse of acupuncture treatment, and thus to death, to manslaughter on (by law to pay their ransom home)." People killed and more medical blunders eventually will end the way of compensation, but at least Yuyi errors are subject to criminal punishment and severely punished, with different crimes of impunity, at the rule of feudal thinking embodied most vividly.
Feudal society is centralized community. Centralization of power, QC, also reflected in the thinking of the Qing dynasty Chinese medicine in the legal system. Qing dynasty Chinese Medicine Act is to ensure that more health care quality may be the emperor. "Qing Law" and "Code of the Qing would" contain a large number of medical, QC, the legal provisions related to personnel and meticulous division of labor, strict supervision, the right to select clear, in order to protect members of the royal family of drug safety and medical quality as the guiding ideology and The focus of work, written into the Qing dynasty Chinese medicine the main Act. Yuyi the conduct of multi-storey supervision, often in the blame. Regulation of private medical medicine Act is extremely careless, coverage is also narrower. This shows that the Qing dynasty Chinese Medicine Act is as Huang Zongxi said, is "one of the law" rather than "the world of law," This shows that centralization of power, QC, the Qing dynasty Chinese medicine is the rule of law and the fundamental point.
4. customary law is an important role to play
Qian Wenyi reference to the Qing Dynasty written code of civil medical attention less than the medical field. At the same time the Qing dynasty rulers of conservative legal thinking, "Qinglv" was made that can not be changed, otherwise the system is contrary to the ancestral Danibudao. Therefore "Qinglv" to Qingmoxinzheng enacted before the start of officials at all levels in the additions and deletions Dan provisions, the legal gaps in the field of medicine can only be filled by customary law.
People customary law is recognized as legally binding and some of the habits, practices and general practice []. Qing dynasty Chinese medicine in the common law legal system takes up an extremely important position. The vast majority of the Qing Dynasty Chinese medicine adjustment civil legal relations are in the code of conduct "habit" as a form of expression, Dahir rulers again in the form of recognition, formed the Qing dynasty Chinese medicine customary law. Documents found summing up the Qing dynasty, will rise to the habits of Chinese medicine mainly used to have two: "Chi-ming received treatment" and "pro-Bong-paternity." "Ji received medical people" refers to countries in the face of natural disasters and epidemic disease, in the name of the emperor to send medical officer for the treatment of civil and distributed free medicines. "Ji-min received treatment" is not the habit of starting from the Qing Dynasty, the Han dynasty historical records are "people Jiyi, Didi empty homes, home for the Chinese medicine" tradition, history and more followed in Li Zhao. Literature Research shows that the rulers of the Qing Dynasty in its capital Beijing after a good practice the "Chi-ming received treatment," the habit, almost every time after the outbreak of the disease have sent doctors to send medicine, this shows that "economic received medical people" have a The status of customary law. "Bong paternity pro-drug" refers to pro-long illness at a time when children must personally serve traditional Chinese medicine. Children Bong-paternity can be more pro-government officials at all levels of recognition. Dai Yu Feng, in addition to pro-drug paternity condemned by public opinion, will be classified as "Buxiao" areas, this is "Qinglv" OK "Shie" one of the law will be severely punished. Royal nobles in the Qing Dynasty, "Shi Feng pro-drug," the more able to personally think that setting an example, "Record-" quite a lot of this record. Moral advice, legal constraint, the emperor set an example in these three areas combined forces, "Shi Feng pro-drug" also has the effect of customary law.
5. the late Qing Dynasty Chinese Medicine Act colonial strong
China became a semi-colonial society, the colonial powers to give up consular jurisdiction as bait, the Qing government to induce the West to amend the law as a template Qinglv. The Qing government in this stimulation also decided to "light of national laws", to amend the existing law, "the Treasury of Chinese and foreign access". After the Qing dynasty rulers of the New Deal to imitate the West, creating a series of new legal medicine. "Clean the law", "breach of police rules" There will be a special chapter provides medicine Act. Northeast outbreak of plague, the Qing government at all levels enacted Prevention of Disease Ordinance 15, traffic control, disinfection and disposal of the bodies, public places medical management in many fields. Qing Dynasty around the public medicine, quarantine, vaccination rules have been created or improved, China's epidemic prevention is the rule of law Faren. Most of the Russo-Japanese and other foreign powers in the country "consultations" develop, in the light of the legal development of mature western countries, greatly improved the quality of legislation, the legislative process is more reasonable. However, because of interference by foreign powers, which also exists in the extreme lack of national self-esteem, such as "Chinese Eastern Railway informed the restrictions on the transmission of infectious diseases," provides that "laborersnot allowed to take the express train, postal vehicles......no access to the waterfrontlaborers Province, to After the Baikal province in Manchuria stations will berequired to post-mortem on the 5th of release...... also abide by Chineseentrepreneurs all over the Constitution, but different than the laborers, if the junction points, Manzhouli station strict disease-free, quasi-Riviera Province and its after-Baikal Province ". "Laborers" on transport, accommodation and other matters in strict restrictions on foreign nationals not to regulate similar acts, the comprador nature of the "Chinese entrepreneurs" are given between "laborers" and foreigners between the treatment. Also, "Railway traffic interdictions of Cuozhi law" provides that "Xi Boli and southern Manchuria passengers entry, but Western medicine certificate, the Commissioner no longer Liu Yan," to have "Western medicine certificate" as a condition of Liu Yan from a blind Meiwai mentality.
Through careful study, the Qing legal system health lessons can be drawn the following conclusions: First, the state must correct treatment of medical doctors and the attitude of the Second, the state must improve for the survival of Chinese Medicine Act legal environment and the law of soil; three, public health legal system should be An open, inclusive system that allows the necessary innovation and therefore the failure of local interests and the loss of four, medicine law will also need to be consistent with the medical and social reality of the medical environment.
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