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论菩萨龙树眼科论著的文本与语境位置。

On textual and contextual position of the ophthalmological treatise of bodhisattva nāgārjuna.

作者信息

Kim Seongsu, Kang Sungyong

机构信息

Institute of Humanities, Seoul National University, Seoul, KOREA.

出版信息

Uisahak. 2013 Apr;22(1):217-74. doi: 10.13081/kjmh.2013.22.217.

Abstract

Medical knowledge in India began to be introduced to China in earliest from the Later Han Dynasty period to the times of Wei-Qin and South & North Dynasties. This is proved by many Buddhist medical books appeared in those days. Of the contents of Indian medicine, the theory of four major elements affected Chinese medicine more than did the theory of body fluids. Based on the theory of four major elements that was began to be introduced in Fú shuō fú yī jīng, an attempt to establish a new medical system was made in Zhŏu hòu băi yīfāng written by Táo Hóng-jĭng and Sūn Sī-miăo who tried to develop etiology further but could not achieve any great outcomes. Unlike the foregoing situation, Indian medicine aroused a large echo in China in the field of ophthalmology with ophthalmological knowledge mentioned in Suśrutasa hitā and 'Jīnzhēn-shù'(cataract couching) introduced as a surgical treatment of cataract. The Suśrutasa hitā which is one of the three major texts of Indian medicine contains additional information on surgical operations not introduced in the Carakasa hitā. The technique of cataract surgery was particularly popular in the Tang and Song dynasty periods in China under the name Lóng shù pú sà yăn lùn(The Ophthalmological Treatise of Bodhisattva Nāgārjuna) or Lóng shù lùn and was even designated as a subject to educate medical officers. While the original text of Lóng shù pú sà yăn lùn was not handed down, the first testimony that show the trace of the introduction of this text into China was the Tiān zhú jīng lùn yăn mentioned in Wài tái mì yào(Arcane Essential from the Imperial Library) written by Wang Tao. Long shàng dào ren who was mentioned as the compiler of the book is assumed to be Lóng shù. Although Tiān zhú jīng lùn yăn introduced anatomical knowledge about the eyeball that could have not been in the traditional Chinese medicine, this book has only limited quantity of information in this regard. Thereafter, Tài píng shèng huì fāng (Holy Prescriptions for Universal Relief) compiled by a national agency at the beginning of the Song Dynasty period introduced Lóng shù pú sà yăn lùn without clear indication of the reference. Contemporary with this book, many ophthalmological books such as Mì chuán yăn kē lóng mù lùn(Longmu's Ophthalmology Secretly Handed Down) were published. As Chinese culture was spreading out into surrounding countries, medical knowledge was also introduced to Korean peninsula and Japan. The ophthalmological knowledge contained in Lóng shù pú sà yăn lùn was also reflected and some parts of it were introduced in I shin bō in Japan. Based on the policy decision of King Sejong, the fourth king of Joseon Dynasty, large scaled promoting projects of medical knowledge was established. It is notable that the Ui bang ryu chwi compiled as a result of the synthesis of the medical treatises available at that time initiated by King Sejong contained a considerable part of Lóng shù pú sà yăn lùn in reedited form that had already passed into oblivion in China. The intellectuals in Joseon Dynasty who participated in the compilation of Ui bang ryu chwi not only indicated that Lóng shù pú sà yăn lùn was a medical text published in the times of Wei-Qin and South & North Dynasties in China but also clearly indicated the textual reference and left the original text for later generation without modifying the contents. According to the Ui bang ryu chwi, the Lóng shù pú sà yăn lùn indicated that the core causes of eye diseases were heat, winds, and three body fluids(trido a) and contained the analyses of symptoms, related treatments, and several analyses of wrong treatments. In addition, Lóng shù pú sà yăn lùn explained diverse eye diseases through more than 30 medical treatments. In particular, this book accurately described golden needle acupuncture for treatment of a Nèi-zhàng understood to be cataract. Therefore, this book is a significant textual record in the history of ophthalmological medicine in East Asia. Along with the golden needle acupuncture which is a method of removing the crystalline lens in which white turbidity occurred by stabbing the eyeball with a needle, traces of Indian medicine that had been already lost in China were clearly indicated in Lóng shù pú sà yăn lùn kept in the Ui bang ryu chwi. In particular, the book indicates that the eyes were directly correlated with the brain and that to treat the internal disorder, treating the brain that lost stability due to heat and bodily wind was indispensable; these are the traces of Indian influence. This textual source demonstrates a case of knowledge exchange in field of medicine with concrete cases of the encounter and clash between the standpoints of understanding human body.

摘要

印度医学知识最早在东汉时期至魏晋南北朝时期开始传入中国,这一点在当时出现的诸多佛教医学典籍中得到了证实。在印度医学的内容中,四大元素理论对中医的影响超过了体液理论。基于《佛说佛医经》中开始引入的四大元素理论,陶弘景和孙思邈在《肘后备急方》中试图建立一种新的医学体系,他们试图进一步发展病因学,但未能取得显著成果。与上述情况不同的是,印度医学在眼科领域在中国引起了较大反响,《妙闻集》中提到的眼科知识以及“金针术”(白内障摘除术)作为白内障的外科治疗方法被引入。作为印度医学三大主要典籍之一的《妙闻集》包含了《阇罗迦集》中未介绍的外科手术的额外信息。白内障手术技术在中国唐宋时期特别流行,名为《龙树菩萨眼论》或《龙树论》,甚至被指定为培训医官的科目。虽然《龙树菩萨眼论》的原文没有流传下来,但最早显示该文本传入中国痕迹的是王焘所著《外台秘要》中提到的《天竺经论眼》。书中提到的该书编纂者“龙上道人”被认为就是龙树。尽管《天竺经论眼》介绍了传统中医中可能没有的关于眼球的解剖知识,但这本书在这方面的信息有限。此后,宋朝初期国家机构编纂的《太平圣惠方》在未明确注明参考文献的情况下引入了《龙树菩萨眼论》。与这本书同时期,许多眼科书籍如《秘传眼科龙木论》等出版。随着中国文化向周边国家传播,医学知识也被引入朝鲜半岛和日本。《龙树菩萨眼论》中包含的眼科知识也有所体现,其部分内容被引入日本的《医心方》。基于朝鲜王朝第四代国王世宗的政策决定,开展了大规模的医学知识推广项目。值得注意的是,世宗发起综合当时可用医学论著而编纂的《医方类聚》包含了大量以重新编辑形式呈现的《龙树菩萨眼论》内容,而该书在中国已失传。参与编纂《医方类聚》的朝鲜王朝知识分子不仅指出《龙树菩萨眼论》是中国魏晋南北朝时期出版的医学典籍,还明确注明了文献出处并保留原文内容供后人参考。根据《医方类聚》,《龙树菩萨眼论》指出眼病的核心病因是热、风以及三种体液(trido a),并包含了症状分析、相关治疗方法以及对错误治疗的若干分析。此外,《龙树菩萨眼论》通过30多种医学疗法解释了各种眼病。特别是,这本书准确描述了用于治疗被认为是白内障的内障的金针针灸法。因此,这本书是东亚眼科医学史上的重要文献记录。除了用针刺眼球去除出现白色浑浊的晶状体的金针针灸法外,保存在《医方类聚》中的《龙树菩萨眼论》还清晰地显示了在中国已经失传的印度医学痕迹。特别是,这本书指出眼睛与大脑直接相关,治疗内部疾病时,治疗因热和身体之风而失去平衡的大脑是必不可少的;这些都是印度影响的痕迹。这一文献来源通过人体理解观点的相遇和冲突的具体案例展示了医学领域的知识交流情况。

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