女人要藥考──當歸的醫療文化史試探

“Essential Medicine for Women”: A Cultural History of Danggui in Traditional China

李時珍《本草綱目》為當歸釋名，破題稱其調血，利於嗣續，故為女人要藥。然而當歸最早在歷史舞臺上嶄露頭角時，卻以相招芳草和止痛良方聞名，曹操以之招引名士並舒緩頭疼，則當歸的女人要藥之譽，究竟從何而來？本文從東漢當歸首見入藥，至宋代婦人獨立成方，蒐羅傳統典籍中當歸為人所認知並運用的各種情況，尤其著重比較本草、醫方與通說等不同種類文獻對當歸的論述和實作，試探其成為女人要藥的歷程。考察發現，以當歸對治婦人，自漢代以來最頻繁而顯著的功能，在於安胎助產，而其止痛神效，偶亦用於產後陰脫腫瘍。至於《神農本草經》等藥典所稱療崩中漏下、補諸虛不足，在醫方實作中難得一見。然而，五至十三世紀間，女性的健康照顧逐漸獨立成方，醫者對產育的介入，從妊娠、產後，提前至求孕受胎，在「婦人以血為本」的身體觀影響下，具調血功能的當歸逐漸跨出胎產範疇，得以單方形式治療月經不通。兩宋之間，以當歸命名之婦人諸方，不僅用於孕產婦人和調經室女，甚至七七數盡之後五十行經的婦女也應服用。當歸成為全方位補養女性健康的本草，在元明以降盛行的四物湯中扮演君藥角色，至十九世紀更遠傳歐洲提煉為調經浸膏，並於二十世紀初回銷中國。至今不論臺灣女性調養身體，或日本醫家開方下藥，當歸仍被視為婦科聖藥，其在中國之外的傳播與運用，及其與各地婦科醫學之間的關係，是未來可繼續探究的課題。

The renowned Chinese pharmacologist Li Shizhen (1518-1593) stated in his Compendium of Materia Medica that danggui (often rendered as Chinese angelica) was the essential medicine for women. Literarily, the Chinese character “dang” means “should” and “gui,” “to return.” Women were expected to be married by their late teens and their natal families were considered temporary dwelling place before they could “return” to their permanent homes, i.e., their husbands’ households. Li Shizhen, citing the classical notion, claimed that danggui, with its function of replenishing the blood, was essential to women’s reproductive power, and therefore acquired the name of “should return.” Danggui has been perceived as important to women’s health till this day, but a survey from Chinese antiquity onward shows diverse images and varied functions. Since the name carries the connotation of summoning someone, the plant was often used as a gift in the socio-political networking of early imperial China. It was first noted in medical texts as being effective in clearing clogged blood, and appeared in historical documents in the third century for its efficacy in soothing headaches. When it was applied on women, it was more often enlisted to help smooth deliveries than to enhance conception, and was hardly used as a drug for menstrual regulation in early medical recipes. Between the fifth and the thirteenth centuries, however, Chinese gynecology was gradually established on a gendered body view that saw the yin-blood as women’s constituent (versus the yang-essence as men’s). It was during this period that danggui began to assume the role of women’s medicine. From the tenth century onward, danggui was increasingly included in medical recipes for women of all ages, from menarche, postpartum to menopausal healthcare. This article traces the shifting and growing knowledge of danggui throughout Chinese history in the context of an evolving body view. It is reported that danggui was introduced to Europe, extracted to produce menstrual stimuli, eumenol, and sold back to China in the early twentieth century. Hopefully the current research will also serve as a point of departure for further case studies on international exchanges of materia medica.