漢字文化圈疾病觀在日本的發展

The Historical Evolution of Illness Perceptions in Japan under Sinographic Cultural Influence

在拙稿中，筆者探討了東亞漢字文化圈中的疾病與疫病觀。中國古代認為疾病是由鬼，即惡靈，附著於病人的身體或進入體內而引起的。在漢字的結構中，也有與疾病原因及其治療相關的元素。疫病的「疫」字的甲骨文似乎描繪了用棍狀物體擊打附著於病人的疫鬼以將其驅逐的情景。筆者將此稱為「鬼系病因論」。這種觀點透過漢字及文獻也對日本產生了影響。具體來說，分為以下幾點進行考察：（一）基於陰陽五行論的氣系病因論；（二）鬼系病因論；（三）文字中所見鬼系病因論；（四）儺與方相氏的關聯。此次考量到在台灣的發表，筆者特意介紹了日本人皆知的內容。作為整體發展，中國醫學從「鬼系病因論」轉向強調氣流動的「氣系病因論」。然而，在宗教及傳統文化中，基於「鬼系病因論」的信念並不少。我們可以在日本的追儺和祇園祭中看到這些影響及其延展。

This study examines concepts of illness and epidemics within the East Asian Sinographic cultural sphere, focusing on the influence of ancient Chinese beliefs on Japan. In ancient China, diseases were attributed to Gui (malevolent spirits) attaching to or invading the body, a view reflected in the structure of Chinese characters. For example, the oracle bone script for“疫”(epidemic) seemingly depicts a scene in which a stick-like implement is used to expel Gui afflicting a patient. The author terms this concept“Spirit-Centered Etiology.”This perspective, conveyed through Chinese characters and literature, also influenced Japan. The paper explores: (1) Qi-Centered Etiology from Yin-Yang and Five Elements theory; (2) Spirit-Centered Etiology; (3) textual evidence of Spirit-Centered Etiology; and (4) the link between Nuo rituals and Fangxiangshi (exorcists). Given the context of presenting this paper in Taiwan, the author has intentionally included content that is widely recognized in Japan. While Chinese medicine transitioned from the“Spirit-Centered Etiology”to the“Qi-Centered Etiology,”spirit-based beliefs persist in religious and cultural practices, influencing Japanese rituals like Tsuina and the Gion Matsuri.