西医东渐：神经衰弱的中国化研究

【作者】 赵丽；

【导师】 张松智；

【作者基本信息】 曲阜师范大学 ， 中国近现代史， 2025， 硕士

【摘要】 “神经衰弱”是美国医生乔治·比尔德于1869年提出,在十余年内成为一种经常被识别和广泛定义的美国功能性神经症。后该诊断跨越大西洋,传播到欧洲,与当地已有的关于神经系统的研究一起,在欧洲流行起来。神经衰弱在美洲和欧洲的全盛时期一直持续到20世纪初的头十年,第一次世界大战后因该诊断本身概念过于笼统等方面的原因逐渐被其他的诊断所代替。在神经衰弱诊断逐渐被西方国家弃之不用的同时,由于该诊断与文明之间的关联,中国的传统观念以及近代中国的医疗条件和动荡的社会现实等方面的原因,神经衰弱诊断逐渐传入中国并迅速被国人接受。近代国人的精神状态面临着一系列的困扰。而“神经衰弱”这一诊断的引入,一方面,为人们解释了长期困扰自身的一些精神和身体上的不适,让许多人仿佛找到了问题的根源,那些时常感到疲惫、焦虑、失眠的人,突然有了一个可以归结的病症名称;另一方面,它也引发了社会各界的广泛讨论,医学界开始深入研究神经衰弱的成因和治疗方法,试图为深受其苦的国人提供有效的解决方案。在病因论方面,主要有“性”“遗传”“日常不良习惯”“脑”“社会环境”等方面的归因;在治疗方式上,预防之外,常采取如:“感情疗法”“安静疗法”“暗示疗法”“作业疗法”“隔离疗法”等精神疗法或采用如:“水治疗法”“电气疗法”“按摩疗法”等身体疗法,此外,当病情过重时,也需要借助相关药物来加以治疗。神经衰弱相关的知识与疗法是由西方传入中国的,主要渠道是通俗性书刊的出版,它们就词语的翻译及治疗方法等方面进行了介绍。在这个过程中,“英美派”和“德日派”对这一诊断的认识侧重点存在诸多分歧,在疾病认知方面,“德日派”侧重于强调生理、生物学因素等在神经衰弱发病中的作用,而“英美派”更倾向于从心理、社会因素的角度去理解神经衰弱;在治疗方法的选择上,“德日派”倾向采用物理治疗和药物治疗相结合的方式,而“英美派”则更偏向于注重心理治疗和行为干预。广大的药商和患者在该诊断的建构过程中也扮演着重要角色,药商出于利益的需求,往往利用不用的表现形式和宣传手段,加剧民众的焦虑心理,而医药广告的刊登数量的变化也可以看出民众对药品的认可程度。神经衰弱诊断对近代国人有着重要的影响,诸多知识分子都受神经衰弱的困扰,以顾颉刚为例,幼年的启蒙教育,学生时代的不良习惯,中年的事业忙碌、家庭变故及情感经历等均使其病情反反复复,而在择医经历上可以看出既有西方医疗知识的影响,但同时也有中国传统医疗观念的影子,呈现出一定的中国本土化特色,为观察近代神经衰弱诊断的中国化的相关情况提供了一个缩影。更多还原

【Abstract】 The term "neurasthenia" was coined by American physician George Beard in 1869,and within a decade or so became a frequently recognized and widely defined functional neurosis in the United States.The diagnosis later crossed the Atlantic and spread to Europe,where it became popular along with existing local research on the nervous system.The heyday of neurasthenia in the Americas and Europe lasted until the first decade of the early twentieth century,when it was gradually replaced by other diagnoses after the First World War for reasons such as the overly generalized concept of the diagnosis itself.While the diagnosis of neurasthenia was gradually abandoned by the West,the diagnosis of neurasthenia was gradually introduced into China and rapidly accepted by the people of the country due to the association between the diagnosis and civilization,traditional Chinese concepts,and the medical conditions and turbulent social realities of modern China.In recent times,the mental state of the country is facing a series of disturbances.The introduction of the diagnosis of "neurasthenia”.On the one hand,for people to explain the long-term plague of some of their own mental and physical discomfort,so that many people seem to find the root of the problem,those who often feel tired,anxious,insomnia,suddenly have a disease that can be attributed to the name of the disease;On the other hand,it also triggered a wide range of discussions in all walks of life,the medical profession began to study the causes and treatments of neurasthenia in depth,trying to provide effective solutions for the people of the country who suffer from it.In terms of etiology,the main attributions include "sex","genetics","daily bad habits","brain","social environment",etc.In terms of treatment methods,apart from prevention,mental therapies such as "emotional therapy","quiet therapy","suggestion therapy","occupational therapy","isolation therapy",etc.are often adopted,or physical therapies such as "hydrotherapy","electrical therapy","massage therapy",etc.are used.Besides,when the condition is too severe,relevant drugs are also needed for treatment.The knowledge and treatment of neurasthenia were introduced into China from the West,mainly through the publication of popular books and periodicals,which introduced the translation of words and treatment methods.In this process,there are many differences between the Anglo-American school and the German-Japanese school in understanding this diagnosis.In terms of disease cognition,the German-Japanese school emphasizes the role of physiological and biological factors in the pathogenesis of neurasthenia,while the Anglo-American school prefers to understand neurasthenia from the perspective of psychological and social factors.In the choice of treatment methods,"German and Japanese" tend to use the combination of physical therapy and drug therapy,while "Anglo-American" is more inclined to pay attention to psychological treatment and behavioral intervention.The majority of drug manufacturers and patients also play an important role in the construction of the diagnosis.Drug manufacturers often use different forms of expression and publicity to increase people’s anxiety due to the needs of interests,and the changes in the number of medical advertisements can also show people’s recognition of drugs.The diagnosis of neurasthenia has an important impact on modern Chinese people,many intellectuals are troubled by neurasthenia,take Gu Jiegang as an example,the enlightenment education in childhood,the bad habits of students,the busy career in middle age,family changes and emotional experience,etc.,all make his illness repeated,and the influence of Western medical knowledge can be seen in the medical selection experience.But at the same time,there are also the shadow of traditional Chinese medical concepts,showing certain Chinese localization characteristics,which provides a microcosm for observing the relevant situation of the sinicization of modern neurasthenia diagnosis.更多还原