子午流注中醫預測模型的建構

Building a TCM Predictive Model of ＂Midnight-Midday Ebb Flow＂

本文旨在探討建立子午流注法的醫家們究竟掌握哪些知識，以及他們如何獲得這些知識。使用這種針灸療法的醫家們，創建了哪些方式以預測經脈中的氣血狀態。子午流注模型在金元時期被創造、建構出來，而在明代更獲得了很好的發展。使用子午流注法的醫家們認為，當經脈中的氣血灌注在特定穴道的時候是最佳的治療時間。本文認為子午流注法是古人試圖理解天人相應下的氣血流注情形而產生的推導模型，其模型的創造是建立在三個相關連介面「理」、「物」、「數」之間的相互交錯下而產生的。「理」的部分是中國傳統的天人相應宇宙觀，醫家要選擇合適的時間和空間組合替患者治療，這樣的思維模式可能來自於中國的關聯性宇宙觀與擇吉信仰。「物」的使用，指的是漏刻、渾象和渾儀。改變了觀測器具的性能將提升對大自然的理解，這些器物表面上看來與醫學無涉，實際上是具有深刻意義的社會選擇。「數」則是指推測命理變化的術數技法，借用推命術的原理以術數的方式對天體運行做出層層推演，得出讓古代使用子午流注法的醫家集團們都認可的模型。但是當面對複雜且充滿許多「意外」的大自然／天，子午流注模型的運作法則竟能藉由術數運算而得出非常規律的推論，以致於許多後世的醫家認為未免有過於「理想化」之處。 This essay analyzes how TCM doctors constructed and mastered ＂Midnight-Midday Ebb Flow＂ knowledge within their acupuncture practice, as a means of predicting the condition of qi-blood in meridians. The Midnight-Midday Ebb Flow model was established in Jin and Yuan Dynasties and further developed in Ming Dynasty. Doctors who supported Midnight-Midday Ebb Flow believed that the optimal time to perform treatment is when meridian qi-blood flows through specific points (five transport points). We argue that ancient TCM practitioners modeled Midnight-Midday Ebb Flow of qi and blood on the correspondence between Heaven and human beings. The creation of the model was based on the convergence of three facets: ＂principle,＂ ＂equipment,＂ and ＂divination.＂ ＂Principle＂ refers to the traditional view of the correspondence between Heaven and human beings. The idea of doctors choosing suitable times and spaces to heal patients likely stems from this correlative view of the universe and auspicious beliefs. ＂Equipment＂ means observational knowledge based on water clock, celestial globe, and armillary sphere. The upgrade of measuring equipment could increase their understanding of Nature. Even though the equipment appears to be unrelated to medicine, it actually contains meaningful social choices. ＂Divination＂ means the fortune-telling numerology divination techniques used in Midnight-Midday Ebb Flow, from which the convergence of Eight Characters Numerology and traditional Chinese medicine is evident. By using the principles of numerology and methods of divination, rotation of Heaven was deduced and formulated using a model which was constructed by doctors of Midnight-Midday Ebb Flow in ancient days. Later, it was believed by some doctors that this idea was too idealistic. The complicated Nature/Heaven relationship is always full of ＂surprises＂ which cannot be predicted by simple numbers and operations.