唐宋食療概念與行為之傳衍──以《千金‧食治》為核心的觀察

Food and Healing in the T'ang and Sung: the Shih-chih Chapter in Sun Szu-miao's Ch'ien-chin Yao-fang

認為特定「食物」有助「健康追求」與「治癒疾病」的看法，在今日的東亞文化圈內，可說是一種既普遍又風行的醫療概念與飲食行為。然而，這種今日名之為「食療」的知行，卻並非當代的原創，它自有其古典的淵源可尋；換句話說，「食療」一事是可以擺在歷史的脈絡中來加以察考的，而本文即為之作。在以唐代名醫孫思邈所撰《千金‧食治》觀察伊始的行文裡，本文指出，《千金‧食治》一方面誠然是唐代以降「食療奉行者」們的行為準繩，但另方面，相涉的體認，其實也早存見於漢魏時人的言論，以及唐以前的若干醫學古典中。因此，考量現存史料的狀況，對於這些早期的食療認知，我們祇能說其是零散，卻不能將其在唐以前的存在視之為矇昧。通過文本的比對，本文發現，孫思邈的「食療觀」確實是基礎於這些前人的知見；整篇《千金‧食治》的內容，其實就是孫思邈「乃博群經，刪裁繁重」後的成果。「食療」概念與行為在兩宋的傳衍內容，基本上是足以體現傳統醫學知識傳承方式的轉變，以及近世士人文化的部份特徵，而有關這課題在唐代以降的「社會史」與「文化史」研究旨趣，亦正由此展露。就社會的層面而言，「食療」這種在唐代似為「傳播範疇有限」的認知體系，在宋代卻開始被「士人」──這個當日新興的社會階層所掌握，而北宋官方對於醫籍刊印事業的熱衷致力，則在其間扮演了媒介性的角色。這些士人是「尚醫」的一群，他們是醫學在宋代普及的主要對象，也是醫籍中「食療概念」的傳衍者。作為「醫療概念」的「食療知識」，其為宋代尚醫士人所掌握，或許可以歸屬於社會性的因素；然而，由此一掌握所使然的「行為」，卻又別有文化上的特色。從《養老奉親書》的「為長者壽」，到《士大夫食時五觀》所隱含的對同質群體的期許，再下至《山家清供》裡那群視「食療」為「清高」的士人們。我們不難發現，「食療行為」在宋代的這層文化意義，其實是與時俱深的。時間愈後，「食療行為」的施用背景愈切近於士人日常的飲食習慣。是則，「食療」確已成為足以反映當日士人文化特質的行為。

The notion of food being able to improve health and cure illness is a common treatment concept widely practiced throughout Asia. The modem notion of shih-liao (food treatments) has its origins in the past and thus can be investigated from a historical perspective and understood historically. This essay focuses on such a task. By looking at the T'ang dynasty doctor Sun Szu-miao and his Shih-chih chapter of Ch'ien-chin Yao-fang to understand the style of treatments common at that time, I argue that the Shih-chih chapter, while definitely being used as a foundational text in medical treatment during the T'ang period, its concepts did in fact exist earlier and can be seen during the Han and Wei periods and in pre-T'ang texts such as: Huang-ti Nei-ching, She-nung Pen-tsao Ching, and Ming-yi Pie-lu. Today the historical materials we have for these earlier knowledge systems pertaining to food treatments are scattered. Sun Szu-miao's ''food treatment concepts'' can first be seen in earlier works and his Shih-chih chapter is the result of his editing previous works and choosing what he felt were the more important arguments. While many researched shih-liao before and after the T'ang, none surpassed Sun Szu-miao on the conceptual level. It is the social and cultural ramifications of shih-liao, however, which have yet to be determined and explored. Shih-liao concepts and practices constituted a change in traditional medical knowledge since the T'ang period. This was particularly the case in terms of the Sung literati and the culture surrounding them. At this level of Sung society, shih-liao evolved from a special knowledge system during the Tang into a system that became part of the common knowledge of Sung literati. In the Northern Sung, medical texts and records were something that came under the control of the government but which later became easier to access by other social groups such as the Sung literati. The literati became the advocators of food treatments during the Sung and came to regard concepts of shih-liao as part of other medical treatments and thus as an element of the wider social arena. Control over these social practices therefore also had strong cultural characteristics. If we look at Ch'en Chih's book Yang-lao Feng-ch'in Shu and the treatments it proposes to increase ones lifespan, or Huang Ting-chieng's Shih-tai-fu Shih-shih Wu-kuan embodying the literati group, and shih-liao practices in the Shan-chia Ch'ing-kung, we can already see the high cultured world of Lin Hung and his literati companions. At this level, shih-liao represented a strong cultural phenomenon within a social spectrum which, over time, became more popular and widespread as a practice. Shih-liao became an everyday part of literati practices and thus constituted an important component of literati culture.