出土古代醫療相關文本的書寫與編次

Writing and Editing of Excavated Medical Manuscripts in Ancient China

本文討論古代醫療技術、知識的傳授與流動。過去，學者透過文本的內容分析，往往強調其「敬慎」、「禁秘」、「非其人不傳」的特色。這類印象並非無據，但主要憑藉的是文本書寫者、持有者的說明或宣示。本文嘗試另覓取徑，透過出土實物，檢視、比較相關文本的出土脈絡、載體材質與形制，文本的字跡與書體，以及文本的編聯、組綴情況，以瞭解它們是如何書寫、如何編次的？並據此推估它們可能以哪些形式流通、可能反映哪些知識傳習和流通的樣態？檢視後發現：一、這類文本常由多人參與書寫，一人獨立書寫的案例反而相對罕見。多人書寫的情況又可分為兩種：(一)是在同一材質上接續書寫，但未必都在短時間內一氣呵成；(二)是在不同形制的載體上分別書寫，然後再加以組綴編聯。換言之，書寫能力固然是參與這類文本建構的基本門檻，但文本並不總在密而不宣的封閉環境下，而是在某種相對開放的人際網絡中，甚至是在書手彼此互動、相互知情的情況下形成的。二、相關文本的編次往往視實際需要處置，未必拘於一律。有的以個別牘版書載單方行世，有的以合方聯編或合卷成書形式流通，有的則與非關醫療的文本合寫一處以便閱覽或庋藏。這些現象除了一定程度反映醫療實務的需求多端、醫療相關知識的流通樣態多元，也說明文本體裁間的界限往往是浮動的、具有因事制宜色彩，不盡與兩漢之交由國家主導形成的圖書分類架構一致。三、根據文本的形制與流通情況及《史記‧扁鵲倉公列傳》中淳于意的證言推測，醫療相關文本的閱讀、理解、應用、驗證至少可能存在兩類作法：(一)在師資引導下，由弟子亦步亦趨學習、討教為之；(二)由能夠識讀圖像、文字者自主理解、體會，並據此運用、檢討。總之，古代醫療技術、知識的傳授或流動樣態不一，遠比文本內容本身揭露得更為複雜。

"This article discusses the way of transmission and circulation of medical technique and knowledge in ancient China. According to content analysis of existing texts, it is widely recognized that medical mentee not only should be qualified by his mentor, but also should pay respect to his mentor and swear to keep those texts, techniques and knowledge he received in secret. However, the content of existing texts were mainly self-assertions composed by writers or owners of those texts. In order to assess the way of circulation of relevant knowledge, this study takes a different approach to examine and to compare the excavated context, physical material, format, handwriting, way of writing, editing and compilation of those excavated bamboo or wooden slips, and silk manuscripts. Findings of this study are as follows: 1. Single medical texts were usually written during certain period of time by multiple scribes, who might or might not know each other, might or might not collaborate with each other. Therefore, those texts were made available under a more or less open circumstances, rather than a closed, or secret condition. 2. The formats of medical texts varied, depending upon the tasks they tried to serve. For example, it could be a single prescription put down on a single wooden plate, it also could be hundred pieces of prescriptions on a volume of bamboo slips. The fact that different kind of texts could be bundled together indicates that the boundaries between different knowledge were blurred or flexible. 3. Based upon those facts mentioned above, there would be at least two ways of learning medical techniques or knowledge, either instruction given by the mentor step by step, or spontaneous learning by the mentees. In sum, the format of excavated manuscripts displayed a far more complicated image of transmission of medical knowledge than what was presented in their content."