論《天回醫簡》的「疕」與「淪」

A Study on the Diseases Bi (疕) and Lun (淪) in the Tianhui Medicine Bamboo Manuscripts

本文的研究材料是《天回醫簡》，研究對象是兩種病症「疕」與「淪」。根據簡文及用藥，再與出土文獻、傳世醫書對讀，梳理「疕」與「淪」之義，及「淪」的命名理據。
綜觀出土與傳世、醫學與非醫學文獻，發現「疕」的詞義發展脈絡是戰國秦漢「疕」、「瘍」同義，是統稱，東漢「疕」縮小為頭瘍義。整理組注以「痂」解「疕」，「痂」為多義詞，宜明言瘡瘍義。另，《五十二病方》「露疕」懸而未決，本文主張是生於脛骨上端的瘡瘍，取象高起突露貌，為以形命名。
「淪」、「侖」、「𤷔」是同詞異字，參酌醫書「淫」、「瀝」、「沃」、「帶（下）」病症的描述與顏色詞的搭配，「淪」與諸詞相符，證明「淪」指異常的陰道分泌物（病），是以形命名（分泌物具絲狀線條貌）。

This research utilizes the Tianhui Medicine Bamboo Manuscripts as its primary material to investigate two specific diseases: Bi (疕) and Lun (淪). By coordinating textual analysis and pharmacotherapy with a comparative study of unearthed documents and transmitted medical classics, this paper clarifies the semantic definitions of these terms and the etymological rationale underlying the naming of Lun.
A comprehensive survey of medical and non-medical literature reveals that during the Warring States, Qin, and Han periods, Bi (疕) and Yang (瘍) (sores/ulcers) were synonymous, functioning as a generic term for skin diseases. By the Eastern Han dynasty, the meaning of Bi narrowed to specifically denote ''head sores'' (touyang). While the official editorial group glosses Bi as Jia (痂) (scab/crust), this study contends that due to the polysemous nature of Jia, it should be explicitly defined in the sense of ''sores and ulcers'' (瘡瘍). Furthermore, this paper addresses the long-standing ambiguity of Lubi (露疕) in the Wushier Bingfang (Prescriptions for Fifty-two Diseases), asserting that it refers to sores occurring on the proximal end of the tibia. This nomenclature is ''morphologically motivated'' (以形命名), reflecting the protruding and exposed (Lu露) anatomical appearance of the site.
The study further demonstrates that淪(Lun),侖, and𤷔are graphic variants of the same lexeme. By cross-referencing descriptions of diseases such as Yin (淫), Li (瀝), Wo (沃), and Daixia (帶下) (vaginal discharge) and their associated color descriptors in medical literature, the evidence confirms that Lun denotes abnormal vaginal discharge. The naming of Lun is also morphologically based, characterizing the thread-like or linear appearance of the discharge.