从出土简帛医学文献考中医“■疝”病名的演变

Study on the Evolution of the Disease Name of“Tui Shan”in Traditional Chinese Medicine Based on the Unearthed Medical Literatures

■疝是中医学中一个常见的病名,最早见于《黄帝内经》,其中有三种写法:頽疝、■疝、■疝。以出土简帛医学文献为依据,结合相关传世文献,从字形释义、症状表现、治疗方法三个方面对疝病名的演变过程进行考证,认为"■"与"疝"最初为两个病名,"■"指阴部疾病,"■疝"指腹部疾病,《黄帝内经》中的"疝"当为"■"病与"疝"病的合称,二者同为厥阴脉所产病,在症状和治疗方面都有密切联系;晋至宋的医学文献中,"■疝"逐渐发展成为一个独立病名,症状为阴部肿大兼有疼痛;金朝开始,因"疝"字衍生出了专指阴部疾病的含义,"■疝"也成了"疝病"诸多分类中的一种,其症状仅为阴部肿大不兼有疼痛。以中医"■疝"病名的演变考证为例,说明出土简帛医学文献所提供的大量新证据对于厘清传世医书中的古代病名源头和演变过程具有重要的文献价值和医学意义。

Tui Shan(■疝),a common disease in traditional Chinese medicine,was frst seen in Huang Di Nei Jing(《黄帝内经》,Huangdi’s Internal Classic).There are three expressions of it in Chinese,that is,“頽疝”,“■疝”and“■疝”.Based on the unearthed medical literatures written on bamboo slips and silks and other related literatures,this paper researches on the evolution of the disease name of“Tui Shan”from the aspects of character pattern and defnition,symptoms,and treatment.It suggests that“Tui”(■)and“Shan”(疝)were originally two disease names.“Tui”refers to the scrotum disease,while“Shan”is celiac disease.“Tui Shan”in Huangdi’s Internal Classic is a combination of“Tui”disease and“Shan”disease.And both of them are caused by the disorder of reverting yin meridian and are closely related in symptoms and treatment.In the medical literatures from the Jin to the Song dynasties(265 A.D.-1279 A.D.),“Tui Shan”gradually became an independent disease,with symptoms of scrotum swelling and pain.After the Jin dynasty(1115 A.D.-1234 A.D.),as the word“Shan”involves the meaning of vulvar diseases,“Tui Shan”became one of the“Shan”diseases.But it is characterized by swelling of scrotum,without pain.Taking the study on the evolution of the disease name“Tui Shan”in traditional Chinese medicine as an example,this paper illustrates that a large number of new evidences provided by the unearthed medical literatures written on bamboo slips and silks are of great literature value and medical signifcance to clarify the source and evolution of ancient disease names in handed-down medical books.