王叔和《脈經》中的手感論述

Abstract

王叔和彙整魏晉以前醫籍脈診論述、歷代醫家的診脈心得，編撰中醫史上第一部脈診專著。對脈診初學者而言，診脈技術提升的關鍵，取決於是否能真正分辨、掌握那難以精準描述、容易混淆的脈動手感。本研究由「身體感」的角度，尋繹王叔和《脈經》中的手感論述，探究於實際診脈時，如何由指下手感解讀身體的狀態，掌握脈診技術中難以言傳的「默會之知」（tacit knowledge）。 第二章闡明在傳統醫家「治未病」的追求中，脈診不僅是「治已病」的診病技術，更具有使病人成為無病之平人，並繼續踏上賢人、聖人、至人、真人此一不斷階級升進的理想與目標。 第三章將依脈診生手學習之次序，探究診脈部位、脈位與臟腑對應關係以及實際下指診脈的手法；第四章將進一步探討如何藉由控制力道之輕重探測不同深度的脈動，並瞭解透過觸摸感知的脈動深度其所表徵之生理與病理意義；第五章將探究中醫如何透過指下感知的脈動速度與力度，探知患者體內狀態之寒熱、虛實。

Wang Shu-he (王叔和) collected and organized the medical classics and doctor’s discourse of pulse diagnosis before the Wei and Jin Dynasties, therefore compiled the first monograph of pulse diagnosis in the traditional Chinese medical history. For a novice at pulse diagnosis, the key to advancing his pulse diagnostic technique is to identify the many touches of pulse accurately. This study attempt to research the descriptions of touches in Mai Jing (脈經) from the angle of “bodily sense”, investigating how to diagnose physical state through decoding pulse messages, grasping the “tacit knowledge” (Michael Polanyi, 1966) in the pulse diagnosis technique. The second chapter expounded that since traditional Chinese Physicians aimed to “ cure by prevention ”, pulse diagnosis was not only a technique used to cure the already ill into the healthy, but also have the capability of bettering common people’s physical and mental state therefore enabling them to continue the path of self improvement and enlightenment. The third chapter aimed to research the corresponding relationship between pulse positions and the viscera, and how to use fingers to feel the pulse. In the fourth chapter, we will investigate the method in controlling the force to enable touching the pulse deeply or lightly, and will explain the physiological and pathological meaning of the pulse depth. In the fifth chapter, we will find how traditional Chinese physicians diagnose patient’s chills and fever in addition to the deficiency and excess from the pulse rate.