The earliest definition of ruyi (Confucian physicians or literati-physicians) referred to the literati the imperial court intended to recruit for its Taiyiju, the Imperial Medical Services. The concept of ruyi emerged and gained popularity during the Song period, after which the Confucian physician occupied a unique position between the literatus and physician in the social hierarchy. From an institutional perspective, the official Hanlin Medical Institute functioned as a special medical service department whose major responsibility was to take care of the imperial family. The Imperial Medical Services, which had initially been under the jurisdiction of the Hanlin Artisans Institute, became part of the Guozijian, the Directorate of Education in the Song period, due to imperial sponsorship. This essay contends that the process of the “Confucianization of medical doctors” initiated by the court elevated the social position of physicians, making them members of the Confucian political system.
Based on the Chinese historical work the Song Huiyao Jigao (Song Dynasty Manuscript Compendium), this essay discusses the cultural and political implications of literati-physicians during the Song Dynasty. It argues that although Confucian literati-physicians viewed themselves as the elite group in the realm of medical skills, the social dilemma of their “middle” social position was evident in the medical histories written during the period. The term ruyi is understood in three ways: (1) practical/medical skills; (2) the Confucian methodologies adopted in studying medicine; and (3) the Confucian ethical codes. Literati-physicians were expected to go beyond their professional boundaries and attain a social status parallel to the Confucian literati who passed through the thorny gate of the civil service examinations.