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[关于针灸疗法确立的研究]

[The study on the establishment of acupuncture].

作者信息

Jung Woojin

机构信息

Department of Philosophy, College of Humanities Hoegi-Dong, Dongdaemun-Gu, Seoul 130-701, Korea.

出版信息

Uisahak. 2011 Dec 31;20(2):463-92.

PMID:22343703
Abstract

In ancient china, four famous literatures, Huang Di Nei Jing, Nan Jing, Ben Cao, Shang Han Lun appeared, which made the foundation of oriental medicine. Huang Di Nei Jing, the book of acupuncture, is the most essential literature among these four litertures. So the question asking the identity of oriental medicine can be turned into the question about the identity of acupuncture. The investigation into origin will not be the only way to study of identity but one of the most attractive means. So we can answer with the study of origin to the question about identity. Acupuncture is comprised of theories like jing mai, qi xue and technical factors like moxibustion, bian which is like present operating knife. To trace the origin of acupuncture, we must investigate not only technical factors but also theories. But it will be impossible to trace every theories underlying the acupuncture in this small thesis. This is the reason that I restricted my attention to the principle of preventive medicine, regimen. Before the excavation of Mawangdui, the belief that acupuncture started long ago before Han period had been generally accepted. But there was not any proof proving the presence of acupuncture in the excavated literatures representing the Han period medicine. This fact announced that we must draw the time of establishment of acupuncture back after the Mawangdui literature buried in B.C. 168. But we can find the proof of the presence of acupuncture just before B.C. 168 in Shiji written by Si Mi Qian. Through these facts and inferences that we got until now, we can reach a conclusion that acupuncture would have appeared around 190-176 when Chun Yu Yi was practicing as a doctor. As you know, in the Mawangdui literature, what was associated with jing mai was moxibustion. But at the same time, moxibustion was being used just as the experience medicine technique without theory. So the moxibustion would has been about to be associated with jing mai theory in Mawangdui period. The word zhen jiu, the acupuncture and moxibustion, means there was a way to reconcile two techniques. It was by assuming bu and handing xie over to acupuncture that moxa can coexist with acupuncture. bian is used for infection treatment more than bloodletting tool in ancient china. but there is a bridge between acupuncture with bian. Acupuncture inherited its appearance from bian. It is generally believed that blood-letting is commonly developed in the classic east and west medicine. But the blood-letting could be harmonious with the old chinese belief that vitality must be retained in the body? No. The blood-letting is not generally practiced in ancient china. We can scarcely find the evidence of blood-letting in the ancient literature now in hand except Huang Di Nei Jing. Blood-Letting widened its territory in ancient chinese medicine with the help of the medical version of wuweierwubuwei principle which means 'not do anything, then everything does'. But soon lost its territory. Even in the Huang Di Nei Jing, We can find its disappearance. What is the reason? For its disharmony with chinese life idea, 'not lose essence'. Acupuncture replaced the blood-letting. It was the response of the ancient chinese healers to the regimen spirit and harmonious with chinese life view. Regimen spirit, the medical version of 'wuweierwubuwei' does not pursue cure after being ill but defense before disease. Acupuncture, meeting the demands of time, appeared in pre-han period as the association with jingmai theory which may be developed in regimen field, inheritence of moxa's esperience, and the shape of bian.

摘要

在中国古代,出现了四部著名的文献,即《黄帝内经》《难经》《本草纲目》《伤寒论》,它们奠定了东方医学的基础。《黄帝内经》作为针灸之书,是这四部文献中最为重要的一部。所以,探寻东方医学的身份问题,就可以转化为关于针灸身份的问题。对起源的探究并非研究身份的唯一途径,但却是最具吸引力的方式之一。因此,我们可以通过对起源的研究来回答关于身份的问题。针灸由经脉、气血等理论以及艾灸、砭(类似于现代手术刀)等技术因素构成。要追溯针灸的起源,我们不仅要研究技术因素,还要研究理论。但在这篇小论文中,不可能追溯针灸背后的每一种理论。这就是我将注意力限制在预防医学原则——养生之上的原因。在马王堆出土之前,人们普遍认为针灸在汉代之前就已存在很久。但在代表汉代医学的出土文献中,没有任何证据证明针灸的存在。这一事实表明,我们必须将针灸的形成时间追溯到公元前168年埋葬马王堆文献之后。但在司马迁所著的《史记》中,我们可以找到公元前168年之前针灸存在的证据。通过这些事实以及我们目前所得到的推断,我们可以得出结论,针灸大约出现在淳于意行医的公元前190 - 176年左右。如你所知,在马王堆文献中,与经脉相关的是艾灸。但与此同时,艾灸只是作为一种经验医学技术被使用,并无理论依据。所以在马王堆时期,艾灸即将与经脉理论相结合。“针灸”一词意味着有一种方法可以调和这两种技术。通过将补法赋予针灸,艾灸才能与针灸共存。在古代中国,砭更多地用于感染治疗而非放血工具,但它与针灸之间存在联系。针灸的外形继承自砭。人们普遍认为放血疗法在经典的东西方医学中都有发展。但放血疗法能与中国古代认为必须保持体内元气的观念相契合吗?答案是否定的。在古代中国,放血疗法并不普遍。除了《黄帝内经》,我们在现有的古代文献中几乎找不到放血疗法的证据。放血疗法借助“无为而无不为”的医学理念在中国古代医学中得以拓展,但很快就失去了其地位。即使在《黄帝内经》中,我们也能看到它的消失。原因是什么呢?因为它与中国的生活观念“不失精”不相容。针灸取代了放血疗法。这是中国古代医者对养生理念的回应,与中国的生活观念相契合。养生理念,即医学版的“无为而无不为”,并非追求患病后的治愈,而是疾病前的防御。针灸顺应时代需求,在汉代之前出现,它与可能在养生领域发展起来的经脉理论相关联,继承了艾灸的经验,并且具有砭的外形。

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