古典妊娠醫書中的“安胎”、“養胎”與“辟殺”

The Fetal Sedative, Nurturing and Exorcism in the Medical Gestation Texts of Middle China

宋錦秀(Jin-Shiu Sung)

《婦女與兩性學刊》 8期 (1997/04) Pp. 77-113

https://doi.org/10.6255/JWGS.1997.8.77

摘要

本文基本上是由臺灣的田野工作出發，以人類學「民族誌式」的觀點，嘗試切入中國傳統醫學與文化的領域，闡明中醫古典妊娠論述內涵，廓清田野與文獻傳統之知識關聯的一項史學研究。質言之，本文企圖透過女科醫學典籍與資料的爬梳，分由證治、養生、禁忌等三大範疇，試將臺灣民間傳統安胎策略與隋、唐、宋三代妊娠女科的知識體系，做了一個貫時限的聯繫，並藉而建構了「古典」妊娠論述的基本內涵及其論題所在。
筆者指出，古典妊娠知識大抵不脫兩大基本論題；一是以「妊娠疾病」之證論與方治爲主題的「妊娠安胎」論述，而「安胎」之論，早自先秦、兩漢以來即爲女科傳統所重，無疑亦是古典妊娠論述的第一個論題。其二是以北齊至隋、唐時期發展成熟的「逐月養胎」爲核心命題，並且與「胚胎說」、「胎教說」暨其他養胎禁忌互爲從屬與涵蘊體系的「妊娠養胎」論述；其論述旨趣明顯已由先秦、兩漢以來著重療癒或控制妊娠疾病的「安胎」層次，提昇至積極調攝身心健康、保母衛兒的「養胎」層次，由此，並推衍出了許多養胎禁忌的廣泛論述。相對而觀，妊娠養胎論述中較爲狹義的「禁忌」範疇，舉如，有關「胎殺」的「將息避忌法門」及信仰等等，則是遲至南宋時期，甚或晚至南宋嘉熙元年(1237 A.D.)《婦人大全良方》成書前後，方才逐漸發展出來的。

關鍵字

性別與儀式 ； 古典女科 ； 安胎 ； 養胎 ； 辟殺

並列摘要

Starting from the perspective of fieldwork in Taiwan, this essay intends to pursue a historical analysis that combines 'ethnographic' data and Middle Chinese texts pertaining to medical gestation to examine the relationship between Chinese medicine and culture. In traditional gynecology, the medical texts can be classified into three main categories: symptoms & therapy, regimen, and taboos. This essay tries to make a dynamic relationship between Taiwan traditional strategies of fetal sedative and gynecological knowledge systems in Middle China-from Sui & T'ang Dynasties to Sung Dynasty--in order to construct the primary meanings and 'classical' discourses of pregnancy.
I argue that there are two fundamental themes in the classical knowledge of pregnancy. One is the theme of fetal sedative (an t'ai), and its discourse is focused on symptoms and prescriptions pertaining to pregnancy 'disorders'. Moreover, fetal sedative is clearly the first theme in classical discourses of pregnancy, whose importance in Chinese gynecology has been strssed since the Pre-Qing &Hang Dynasties. The second is the theme of fetal nurturing (yang t'ai), which focuses on the thesis of 'zhu yue yang t'ai' (fetal nurturing monthly during the gestation),which has been developed to perfection the Northern Chi to Sui & T'ang Dynasties. This theme also involves the subordinate fields of related theories of fetation, fetal education (t'ai chiao) and other taboo subjects. As a whole, the theme of fetal nurturing has advanced to a point of maintaining a condition of 'balance' within mothers-to-be, instead of focusing on curing and reducing 'disorders', and thus has given rise to broad discourses on taboo. By comparison, relevant discourses within the category of taboo, such as exorcism devices and beliefs concerning 't'ai sha' etc., have gradually developed to perfection until Southern Sung Dynasty, and appear late in classical works such as Fu-jen ta-chun liang fang (Complete Good Prescription for Women), which was published in 1237 A.D.

並列關鍵字

gender & ritual gynecology of Middle China (ku ten nu-k'o) ； fetal sedative (an t'ai) ； fetal nurturing (yang t'ai) ； exorcism (bi sha)