中島醫案：德川幕府晚期針灸在日本的實踐

Nakashima Yūgen's Medical Cases: Acupuncture Practice in Late Tokugawa Japan

日本漢方針灸醫書的出版、針灸銅人和圖像的製作，是德川幕府（1603－1868）經絡理論在日本內化和傳播的必要元素。然而，此理論的臨床實踐罕為人知；而有關病人為何造訪針灸專家、他們造訪的頻率，以及接受了哪些治療等訊息亦相當匱乏。中島友玄（1808－1876）記錄日常實踐的醫案提供了重要的觀點，然而迄今卻未見於幕府晚期針灸實踐的歷史敘述中。本文首先檢視十七世紀晚期開始日本醫療環境的演變，聚焦於醫療知識的本土化與當時新興的關懷，將臨床實踐作為知識來源的一部分。在傳記資料交叉連結的基礎上，本文主要關注中島的五本針灸醫案，據此重建其日復一日的針灸臨床實踐，進而討論其如何將幕府時期藉由刊印和抄錄醫書傳播有關經絡的理論知識，轉化成他臨床實踐的知識基礎。

The publication of Sino-Japanese acupuncture textbooks and the production of acupuncture mannequins and charts became necessary components of the appropriation and dissemination of the channels theory in Tokugawa Japan (1603-1868). However, very little is known about its implementation in clinical practice. There is also scant information on why and how often patients visited acupuncture specialists, or what treatment they received. The casebooks of Nakashima Yūgen's 中島友玄 (1808-1876) daily practice add an important perspective, hitherto neglected, to the history of late Tokugawa period acupuncture practice. In this article, I begin by examining the changing medical environment of Tokugawa Japan from the late seventeenth century, focusing on the vernacularization of medical knowledge and the new concern for clinical practice as a source of knowledge. In conjunction with biographical information, I then reconstruct Nakashima Yūgen's day-to-day acupuncture practice focusing on the data within five of his acupuncture casebooks, and discuss how the theoretical knowledge related to the channels theory that circulated in print during the Tokugawa period translates into his clinical practice.