現存北京第一歷史檔案館之清宮醫藥檔案相當完整地保存了清代中葉以後宮廷的醫 事活動。其主體係總數多達約四萬件的御醫的診療記錄「脈案」，被視為傳統醫學經驗的寶 庫。脈案自一九九○年整理出版後即廣受高度重視，數年來已有多篇醫、史學論文根據其內 容發表。本文意在評介該檔案的內容、整理概況、並反省到目前為止的學者利用情形。全文 共分四個部份。首先介紹並檢討檔案的整理情形與現狀。就檔案原貌與出版檔案之間的差異 做了較詳細的校訂，並在史料上儘可能提供補救的方法，第二部份說明這些醫藥檔公文書， 了解其成為檔案前的職務特性與角色將有助於解讀其內容。進而以此為基礎，在第三部份討 論歷來學者間對於脈案可信度的兩極化評價及其原因。最後，本文藉由史料比對的方式，具 體說明脈案作為史料的價值與限制。因此，除了作為醫學史與宮廷史的史料外，清宮脈案的 研究也提醒學者即使是對於所謂第一手的檔案史料也應抱持審慎懷疑的態度。

　　　　　In this article I describe the Ch'ing palace medical archives in the First Historical Archives with illustrations drawn from the archives collection as well as relevant historical materials. This article is intended to be a general and practical guide for those desiring an illustrated survey of how to utilize these archives for various research interests. Also it is going to critically discuss the scholarly utilization of these archives. This article consists of four parts: it begins with introducing and discussing the current status and the filing policies of the medical archives. At this part I detail the differences between the original and the published version of the medical archives, and provide sources complementary to the issues. At the second part I explain that the medical archives were originally bureaucratic documents. It would be helpful to clarify their functions and roles before conducting researches based on these archives. Accordingly at the third part I show the historians' polar opposites toward the verity of the contents in the archives and discuss the reasons. Finally I compare the archival records and relevant sources to concretely explain the value of the medical archives and their limitation. Therefore, other than being useful to medical history and the history of imperial family, this study also reminds scholars of critically useing archival sources.