本文主要从西学东渐的社会背景出发，讨论20世纪上半期，西医在中国传播的历史因素、传播方式、传播主体，以及西医传播对近代中国社会的影响。全文共分五部分内容。 第一，西医初入中国是一个主动传入的过程，对近代中国传统医疗制度及观念的产生了巨大的冲击，也为西医进一步传播作了铺垫。19世纪初，传教士借医传道于中国，教会医疗在融入中国社会的漫长过程中，虽历经波折，但其先进的制度体系、技术水平以及教会医师所体现的人文关怀，逐渐赢得了许多中国人的认同。西方近代医院制度被移植到中国，对中国传统的医疗格局产生巨大冲击，中国人的医疗观念开始有所改变。 第二，西医之所以能在近代中国广泛传播，是多种社会条件和驱动共同作用的结果。进入20世纪以后，西医逐步由传入发展到传播阶段，这种转变是在许多社会因素共同作用的条件下产生的。首先在新文化动动的倡导及政府政策的支持下，西学大量涌入中国，西医也在这样的条件大传播开来。其次是外国传教士与中国留学生所组成的社会群体，成为西医在中国的传播的重要主体。再次是一些医学会、药学会、护士会、卫生会的成立，及与西医相关的译著的出版和刊物发行，推动了西医文化的进一步传播。所有这些因素的共同作用，成为西医在近代中国广泛传播的社会驱动力。 第三，西医教育成为20世纪以后西医传播主要方式和途径。西医教育与西医传播是相互推动的，西医传播促成了近代医学教育的形成，西医教育又使西医传播更加广泛和系统。中国医学教育从师徒传承的方式，发展到学校式医学教育；从最初的主要由教会办学到后来逐渐收归国有、国家自办医学教育；从开办高等教育到发展中等医学教育及开办医师培训班等多层次医学教育。最终，西医教育朝着多种类、多层次化方向发展，使西医的传播更为广泛和系统。从这些转变中，分析和探讨西医教育事业起步以后的主要成就、基本经验与历史教训。 第四，西医传播发展到一定程度，导致新兴的西医职业群体逐步形成，而西医群体形成以后，成为近代中国西医传播是重要主体。西医群体是西医在近代中国传播的产物，在西医制度的影响下，中国有了西医选拔和认定制度，医生经历了职业化的演变过程；中国医师与传统医士的区别，反映西医职业群体的形成及其较高的社会地位，也反映出西医在整个医疗事业中地位的形成。20世纪初中国的西医群体的数量相对较少，分布不均，表明近代中国西医的发展水平还非常有限。反过来，而西医群体的形成，又极大地推动了西医在近代中国的传播，新兴的西医群体已成为西医在近代中国传播的重要主体。 第五，西医在近代中国的传播日益扩大，中西医之间的学术论争愈演愈烈，西医在论争中彰显优势，并在社会实践中体现其文化取向。20世纪20—30年代，西医的地位日益上升，发起了废止中医运动，不仅对传统医学产生了极大的冲击，也推动了近代中国新的医学理论和医学派别产生。西医传播最终要在近代化发展趋势中，体现医学的伦理观和社会化倾向。 最后，20世纪上半期，西医在中国形成系统、确立地位、并广泛传播，不仅得益于西学东渐的历史背景，还得益于当时政府的政策和人力、财力的支持，是客观条件与主观因素共同作用的结果。西医传播对近代中国的医学制度、教育体系、乃至整个社会都影响深远，其中也有许多值得深思的地方。如在强调西医传播推动了中国医学的近代化的同时，需要理解西医学的科学性与民族性的关系，合理地分析、利用西医传播的优势，使其与其它学科的发展相调协，才能推动西医事业的可持续发展。 关键词：西医，传播，影响，近代中国

 This article embarks from the social context of western learning to the east in early 20〓 century, to discuss the dissemination and the social influence of Western medicine in modern China. The full text is divided five chapters. The first chapter, in the late Qing dynasty, Western medicine was introduced and new style hospitals were set up firstly in China. I mainly introduced the start of Western medicine and the transformation of traditional medical service space, and from which the impact arisen on medical service pattern influence in the 19th. The missionary proselytized taking advantage of the medicine in China, taught the medical service to integrate the Chinese society in a long process, although has been through repeatedly the twists and turns, but its advanced institutional framework, the technical level as well as humanities concerned which doctor manifests, had won Chinese's approval gradually. The Chinese tradition's medical pattern and the medicine system had had the significant transformation----Western modern hospital system was transplanted to China, modern public health cause also would be launched, and the Chinese people gradually changed the attitude to the Western medicine. The second chapter, I introduced social driving that actuated the western medicine spreading in modern China. The western learning massively emerged in “wusi” period, and western medicine is no exception. Foreign missionaries and Chinese students studying in Western medicine became the main body of spreading western medicine in China. There were some medical societies, the pharmaceutical society, and related translation's publication and the distribution of publication, promoted the western medicine culture further dissemination. This entire factor's combined action becomes the social driving of western medicine widespread dissemination in modern China. The third chapter, I introduced the beginning of western medicine education and its main achievement, experience and lessons. The dissemination of western medicine promoted the formation of modern medicine education, TCM education developed from inherit method to the school type; from mainly ran by the foreign church to the nationalization gradually. We managed ourselves medical education and set up higher education, and then develop secondary medicine education and physician training class, and so on. The western medicine education developed at multi-level and educated various types talented person in medical profession, which further promoted the western medicine's dissemination and developing. The fourth chapter, I analyzed doctors evolution of professionalism through examining the changes of doctor selection system; from the distinction between modern doctors and traditional medical workers, reflected the formation and the social position of western medicine professional community; Through analyzed the quantity and the distribution condition of modern doctor, reflected the level of the modern medical service in modern China. I stressed the modern doctor groups take an irreplaceable role on the spreading of western medicine culture; we must simultaneously strengthen the doctor's moral education, improve their entire quality. The fifth chapter, beginning with Ideology and culture context of modern China, to analyze the impact on TCM and the social ponder arisen from the disseminating of western medicine. With the western medicine expanding day by day, some supporters initiated abolishing TCM event, which caused the struggles between traditional Chinese and Western Medicine. This chapter focuses on the effect of people from Western medicine in modern China(such as the change of people' ideas, including the understanding and yearning for the science, idea of Cooperation of Chinese and Western medicine being formed), from which reflected the development orientation of western medicine in modern China. Finally, understands the relations between scientific nature and national characteristic nature in the medicine domain. Mainly emphasized the Western medicine, although comes from West at the first, is non-native product, but Western medicine' “invasion”, not only promoted Chinese medicine modernizing, but also gave us much medicine education experience, it took a great role in improving our medicine education level. Simultaneously the coexisting situation of multiple medicine culture and education patterns had also formed under the dissimilar condition and background. So, in order to promote the further spread of western medicine, we should step up research and analysis on the TCM and western medicine, strengthen academic standards, and reduce the power rivalry, as far as possible to avoid their own negative factors to facilitate the healthy development of medicine. KEY WORD : Western Medicine, Dissemination, Influence, Modern China