「鼠疫」傳統醫學古籍中鼠疫病名之沿革

目的：鼠疫為齧齒目動物與人類共通的疾病，其主要是依靠跳蚤將鼠疫桿菌（Yersinia pestis）傳遞至不同個體間，其歷史非常悠久，多次影響人類文明發展，而中國多次的瘟疫中，部分與鼠疫有關，然「鼠疫」一詞出現要追溯到1891年吳存甫的《治鼠疫法》，而在這之前，傳統醫學又是如何稱呼這種疾病？本文希望透過典籍回溯，了解傳統醫學對鼠疫病名之沿革。方法：本文對於「鼠疫」病名的篩選將分成兩個方法在傳統醫學典籍中尋找，第一是直接搜尋與鼠有關聯的病名，並搭配其症狀是否有符合現代鼠疫；第二則是直接透過鼠疫常見的症狀對應典籍中有類似症狀的病名分析；找出這些名詞後，我們也會對比西醫名詞傳入後，西醫對傳統醫學的影響。結果：從歷代典籍中，我們發現有鼠一詞的病名包含鼠，且有可能是鼠疫的過去病名的有「鼠瘻」等；而症狀尚來判斷的話，我們認為「疙瘩瘟」、「大頭瘟」、「探頸瘟」、「核瘟」這些病症都包含了頸部腫大或是身體有明顯腫塊的症狀，這些症狀可對應腺鼠疫產生的淋巴結紅腫結塊，所以我們認為這些病名雖然沒有直接提及老鼠或是其致病原，但有可能是鼠疫的古病名。18世紀末19世紀初，華南鼠疫的流行也帶動清末的中國及日治的台灣，中西醫的交流，西醫的病名Plague被翻成百斯篤、ペスト、魄司脫在兩岸之間流傳，但隨著「鼠疫」一詞的出現，結合現在微生物學的觀察，讓中西醫對鼠疫一詞的成述一致化，變成現在所熟知的鼠疫。結論：「鼠疫」不論在東西兩方都是令人恐懼的傳染病，在對其傳染源不明的年代，傳統醫家們使用其外在症狀來做為其病名的來源，而到人們逐漸發現治病源可能來自老鼠時，才出現「鼠疫」一詞，並結合鼠疫桿菌（Yersinia pestis）的發現，將傳統醫學和現代醫學的名詞一致化。

關鍵字

鼠疫；瘟疫；疙瘩瘟；耶爾辛桿菌（Yersinia pestis）

並列摘要

Objective: Plague is a common disease between rodents and humans. It mainly relies on fleas to transmit the pathogen, Yersinia pestis to different individuals. It has a very long history and has affected the development of human civilization numerous times. However, there have been many plagues in China's history, some of which are related to the Plague itself. However, the appearance of the term ＂plague＂ dates back to Wu Cunfu's ＂Plastic Plague Law＂ in 1891. The study aims to explore the history of Plague in Chinese medicine by referring to and study the classics. Methods: We screen the disease name ＂Plague＂ in the Classics of Traditional Chinese medicine with two research methods. We first search the disease names related to rats and whether the symptoms are consistent with modern plague directly. We also search through the common symptoms of plague corresponding to the analysis of disease name with similar symptoms in the classics. After identifying these terms, we then compare the influence of Western medicine on Chinese medicine after the introduction of Western medicine terms. Results: From the Classics of Traditional Chinese Medicine, we found that the terms for the disease included the term ＂rat＂, and the past disease name of the plague may be ＂rat fistula＂, etc. If we classify from the symptoms, the terms such as ＂pimple plague＂, diseases referred to as ＂big head plague＂, ＂neck plague＂ and ＂peach stone plague＂ all include symptoms of neck swelling or obvious lumps on the body. These symptoms can correspond to the redness and swelling of lymph nodes caused by bubonic plague, so we think these diseases are related and was named despite there being no direct mention of rats or Yersinia Pestis which might be the ancient name for the plague. It may be the ancient name for the plague. At the end of the 18th century and the beginning of the 19th century, the South China Plague also led to the exchange of Chinese and Western medicine between China in the late Qing Dynasty and Taiwan under Japanese rule. With the emergence of the modern term ＂Plague＂, combined with the observations of current microbiology, the formation and description of the definitions for plague in Chinese and Western medicine, these terms have been unified and became the term that we are now familiar. Conclusion: ＂The plague＂ is a terrifying infectious disease in both the Eastern and the Western medicine. In an era where the source of its infection was unknown, traditional physicians used its external symptoms as the source of its disease name. With the development of the medicine, people gradually discovered the term ＂plague＂ only appeared when the source of the disease came from rats. With the discovery of Yersinia pestis, it unifying of the term in both traditional and modern medicine.