從《異法方宜論》談經絡之緣起

A Discourse on the Genesis of Meridians and Collaterals based on “Yì fǎ fāng yí lùn [Discourse on Different Therapeutic Treatments]＂

經絡是如何被發現的？其沿革過程為何？這兩個問題一直都是中醫學史上的不解之謎。本文中我們從《素問．異法方宜論》出發，來探索這兩個問題的答案。藉由文獻、考古文物與近代實驗三方面的考證，我們確立了以下論點：東方可能透過砭術發現了經筋、皮部，這與馬王堆醫書部分內容相符合；而北方灸法的發現反映在馬王堆醫書、雙包山木人上的經脈、老官山木人的紅脈系統三個方面；南方針法的發現則體現在老官山木人的穴道、白脈系統與《十二脈》中的內容；中央的導引（動功）、按蹻則可能與經筋較有關。然而，相較於現代經脈理論，考古文物所描述的經脈在體內循行、臟腑連繫部分著墨較少，而近代研究顯示，此部分經脈路線是較難透過砭、針、灸來誘發的，因此較可能是由「內景」修練者所發現。整體而言，經脈的發現與沿革的可以說是：不同地方的人，透過不同治療工具與手段，在長時間的積累下，有了各自對經絡現象的發現。這些發現，在內景修練者的幫助下，逐漸建構成了現代所見的體系。 How were the meridians and collaterals discovered? What was the evolution process? These are two questions that have been a mystery in the history of Chinese Medicine. In this study, we explored the answers to these two questions through exploring the literature “Y? f? f?ng y? l?n [Discourse on Different Therapeutic Treatments]?. From the evidence collated in the researches of literature, archaeological artifacts and modern experiments, we established the following point of discussions: The East may have discovered the Sinew Meridians, Cutaneous Regions through Stone Needle Acupuncture, this was consistent with the contents in the Mawangdui medical books; the discoveries made via the moxibustion method in the North are reflected in the Mawangdui medical books, the meridians system drawn on the wooden acupuncture statue found in the Shuangbaoshan tomb from Han Dynasty as well as the red meridians system drawn on the wooden acupuncture statue found in the Laoguanshan tomb from Han Dynasty. The discoveries made via the Acupuncture methods in the South was reflected in the acupoints and white meridians system drawn on the wooden acupuncture statue found in the Laoguanshan tomb from Han Dynasty as well as the content in the medical literature “The Twelve Meridians?; The Dao Yin [Conduction Exercise] methods (“methods of leading and guiding Qi?) and An Qiao [Massage] methods in the Central were likely to be associated with Sinew Meridians. However, compared with the modern meridian theory, the meridian pathways within the inner body and the connections with the visceral and bowels described by archaeological artifacts were less frequently documented. Modern studies had shown that this part of the meridian pathways was more difficult to induce through Stone needle acupuncture, Acupuncture and moxibustion. It is, therefore, more likely to be discovered by practitioners of the Insight Meditation (Vipassana). In general, the discovery and evolution of the meridians can be summarized as: people in different places had discovered the meridian phenomenon through different therapeutic methods and tools. In the long-term accumulation of the medical experiences, these discoveries had gradually established the current system with the assistance from the practitioners of the Insight Meditation.