In the 18th century, Xu Lingtai (徐靈胎) and Yoshimasu Todo (吉益東洞) were medical revolutionaries. They emphasized researches about synthesis of formulae, efficacy of medication and observation and then classification of clinical phenomena, so they assumed a modern scientific character. But, there were clear differences between their academic thoughts. In this paper, we examine the causes of difference in three fields, i.e. traditional culture, viewpoints of talented people and academic personality. The first, difference was due to traditional culture. Chinese medicine has a long history and heavy traditional culture. Yin-Yang (陰陽) theory, Five Phase(五行) theory, Viscera and Bowels (臟腑) theory and Meridian and Collateral (經絡) theory stemmed from everyday practice, and Chinese people learn these theories from experience and observation. From the standpoint of Chinese people, particularly scholarly doctors [儒醫] such as Xu Lingtai, it was easy to debate medical theories. In contrast, Japanese traditional culture didn't have as long a history as China. Thus as a necessity, it was harder to disseminate traditional Chinese medicine theories in Japan. Yoshimasu Todo simplified it by cutting out the superfluous traditional Chinese medicine theory, so at that time it must have been shocking to the Japanese medical world's trends. The second, difference was due to viewpoints of talented experts. From the standpoint of Xu Lingtai, above all, medicine is just a learning, only a kind of technique, even more not a means of living. Xu Lingtai was concerned with the appearance of very talented experts such as 'great man' (偉人), and 'exceptional man' (奇士) who carried out medical research. Instead of cultivating a few talented people, Yoshimasu Todo tried to produce a large number of clinicians quickly who could treat ordinary people. The third was due to personality difference. As Xu Lingtai threw away Confucianism and studied medicine in his youth, although he had a critical attitude, he was always mild-mannered. Yoshimasu Todo always had a clearly critical and rebellious nature. Personality influenced their literary spirit and learning style, so although both advocated reactionism, the academic thought of Xu Lingtai was reformative and mild, while that of Yoshimasu Todo was revolutionary and fierce. Xu Lingtai and Yoshimasu Todo had considerably similar research domains and academic thought, so it is proper for them both to serve as examples for making a comparative study of medical history in China and Japan in 18th century.

徐灵胎与吉益东洞都是十八世纪的医学革命家。他俩重视方证与药物效能的研究，重视临床现象的观察和分类研究，具有明显的近代科学色彩。但是，两人在学术上的差异也是明显的，关于其原因，本文主要从各自的文化传统、人才观、学术个性三个方面加以探讨。第一，关于文化传统。中国医学历史悠久，有着深厚的文化传统。阴阳五行学说，脏腑经络学说等，无不来源于生活实践，来源于中国人自身的感受和体察。对中国人来说，尤其是对如徐灵胎那样的儒医来说，谈论医理更是游刃有余。而日本文化没有中国文化那样悠久的历史，具有浓厚中国文化味的中医理论必然给在日本的传播和普及出现障碍。吉益东洞删繁就简的做法，正是当时日本医学界思潮冲击下的必然反应。第二，关于人才观。在徐灵胎的眼里，医学首先是一门学问，而不仅仅是一种技术，更不是谋生的手段。他最关心的是所谓“伟人”,“奇士”般的从事医学研究的高级人才的大量出现。吉益东洞的传道的目的，不是要培养高级医学人才，而是要迅速地育成大批为市民阶层服务的临床医生。第三，关于人格魅力。徐灵胎早年鄙薄科举，弃儒攻医，虽有叛逆心理，但不失儒雅温良之气，而吉益东洞则有明显的叛逆性和反抗性。两人的人格对其文风学风也有影响。两人均倡导复古，但徐灵胎是改良式的，吉益东洞则是革命式的，一则和缓，一则激烈。由于徐灵胎与吉益东洞具有十分接近的研究领域和相似的学术思想，将两人作为18世纪中日两国医学史比较研究的范例，是比较适合的。