漢代邊陲醫簡所見「支滿」試析

Study on ＂Zhi Man＂ (支滿) in Medical Manuscripts of Frontier Regions of the Han Dynasty

沈明得(Ming-Te Shen)

《興大歷史學報》 28期 (2014/06) Pp. 27-50

摘要

漢代邊陲遺址出土不少病書，或者因病死亡的報告爰書，都記載了邊境戍卒疾病的文字紀錄，常見有傷寒、頭痛、心腹疾病，還有發病時的症候，以及用藥結果。其中有一則病症的紀錄，因為簡牘釋文的關係，有時被釋作「支滿」，有時則釋為「丈滿」。儘管只是一字之差，解釋的意思也相近不遠，但如不先釐清原文，對於引起這個病症的原因，也就無法繼續追索。本文先針對各家說法進行整理，特別留意書寫者在書寫時，是否特意保留文字原有的特徵，進而論述原簡文字應該是「支滿」，而不是「丈滿」。第二，透過出土簡牘與傳世醫學文獻的記載，認為「支滿」為古代醫學文獻常用字彙，解釋上應該是有異物橫隔其中，表現有經絡實症的現象。同時推論心腹支滿與胸脅支滿的病症，恐怕都是因為邊陲士兵長期處於氣候溫差變化極大的環境中，若是飲食或飲水無度，或者是邪氣入侵造成經絡實症，經常會伴隨心悶、腹部撐脹的現象，如果不及時治療，將有生命之憂。

關鍵字

醫簡 ； 支滿 ； 丈滿 ； 漢代 ； 居延 ； 疾病

並列摘要

As tens of thousands wooden slips were excavated in the Juyan region in 1930s and 1970s. These slips recorded military actions of Juyan frontier fortress during Han dynasty. There had many soldiers illness records. On the medical manuscripts slips, there are many disease names and symptoms mentioned, which describe ＂Shang han＂ (傷寒), headache or disease on their chest and abdomen regions. Due to the translation of wooden slips, one of the records sometime were translated into Zhi man (支滿), and sometimes called into Zhang man (丈滿). Although the words are looked and translated close, if we are unable to determine the text of the medical manuscripts, it would be impossible to know what causes of the illness. First, when consolidate various conclusions to present their views, we pay attention to retain the character of the writer deliberately fonts. I think it's Zhi man (支滿), not Zhang man (丈滿). Then by comparing these records on wooden slips and traditional medicine literatures, we can find Zhi man (支滿) was a common used vocabulary of Traditional Chinese Medicine, that means something obstruct on body, that induces syndrome (實症) in meridians (經絡). Meanwhile we infer Xin Fu Zhi Man (心腹支滿) and Xiong Xie Zhi Man (胸脅支滿), were both induced that soldiers were in the extreme temperatures, food and drinking without control for a long-time or once physical weakness caused by syndrome in meridians. They usually induce heart stuffy, chest and abdomen swelling. If not treated quickly might result in death.

並列關鍵字

Medical manuscripts of wooden slips ； Zhi Man ； Zhang Man ； Han Dynasty ； Juyan ； Diseases

參考文獻

謝桂華校、李均明校、朱國炤校(1987)。居延漢簡釋文合校。北京:文物出版社。

漢班固(1997)。漢書。北京:中華書局。