東亞視野下醫學典範的建構與在地化：以五輸穴針灸技術發展史為例

Construction and Localization of a Medical Paradigm from an East Asian Perspective: Using the History of the Technological Developmental of Five Transport Points in Acupuncture as an Example

在針灸醫學中，五輸穴是被建成醫學典範，而且具有指標意義的特定穴道。隨著中國傳統醫學的傳播，五輸穴用法亦在東亞各地產生變化。事實上，醫學思想的變革與文化交流、戰爭事件以及社會思潮的起伏皆息息相關。對此議題，有學者分別從外感熱病的知識轉型以及中西醫衝突下的空間政治等面向進行討論。本文則是以五輸穴針灸技術發展史作為橫貫東亞社會的探查線，討論五輸穴的醫學典範建構與在地化。五輸穴針灸技術在東亞文明脈絡下建構而成，受到西學知識環流的影響而產生在地化現象。中醫存亡之爭劇烈的中國、臺灣兩地，對於五輸穴的關注轉向子午流注法的研究。在日本雖然曾有古典針灸派大力鼓倡，但最終仍走向以科學化的方式研究傳統針灸醫學。值得注意的是，韓國醫學在西學東漸的壓力下，不僅仍保持著對於古典醫學典範的運用，甚至別開新局。

The technology of ''five transport points'' represented a paradigm shift in traditional Chinese medicine. The five transport points technology evolved and changed significantly in different societies as traditional Chinese medicine spread across East Asia. Reforms in traditional Chinese medical thinking have been closely related to cultural exchanges, wars, and societal trends, an important example being challenges from Western sciences. Previous studies have focused on the transformation of exogenous febrile disease in Chinese medicine and discussed spatial politics in conflicts between Eastern and Western Medicines. In contrast, this study used the technology of five transport points as an example to discuss the paradigm construction and localism of acupuncture in different societies in the East Asia. This study argues that the five transport points technology was constructed within an East Asian cultural network. Serious debate over the abolishment of traditional medicine occurred in mainland China and Taiwan, leading to a shift in emphasis from the five transport points technology to ''midnight midday ebb flow.'' Although use of five transport points was preserved in Japan due to the high esteem given to classical acupuncture there, the research trend in East Asia generally moved toward the application of scientific methodology in examining traditional acupunctural medicine. It is noteworthy that in Korea, not only does the classical medical paradigm of the five transport points technology remain in use, but new artifacts have been developed despite significant pressure for reform from modern Western medicine.