「名不徒設，皆有深意」：由穴道名稱重審中國古代神氣觀

Abstract

穴道不僅是中國傳統醫學臨床治療上的要角，更是幫助中國傳統醫學打入以西方醫學為主流的國際舞台的先鋒。在2006年所頒定的針灸腧穴定位國際統一標準中，對全身穴道以經絡英文縮寫、阿拉伯數字並加上穴位的羅馬拼音進行命名，這樣的國際命名標準，簡單好記又具系統性，但卻使得穴道成為經絡上一個個毫無特出之處的數字記號。然《黃帝內經．素問．陰陽應象大論》說：「氣穴所發，各有處名。」指出氣穴所發之部位，各有其特定之名稱。唐代醫家孫思邈《千金翼方》云：「凡諸孔穴，名不徒設，皆有深意。」明言遍佈於身上的各個穴道名稱，絕對不單單只是代號，其中更蘊藏著深意。 本文以《針灸科學》爲標準，整理出十二正經絡、任督二脈以及經外奇穴共412個穴位名稱，試圖歸納古人的命名原則之後，發現穴位名稱可簡單分為兩大類：一是身體認識，二是形象譬喻。筆者以這兩大類命名方法為基本框架，嘗試對各穴名進一步歸類，透過這數百個穴道名稱來析論中國傳統醫家思想中對穴道、對身體乃至於對大自然的認識，並由此考掘中國古代之神氣觀。 第一類命名方法「身體認識」乃是「近取諸身」（《說文解字．敘》）地透過已知的自身之身體部位來替穴位命名，而其中又可再細分為兩類。一是有形可觸的身體，透過已知的身體部位、骨骼肌理、器官臟腑等既有的名稱，或是聚焦於穴道主要能夠對治身體何處不畏的疾病症狀，來替穴位命名。二是穴名中帶有無形、不可見的「氣」與「神」相關元素的穴道，並由此窺探中國傳統醫家有別於西方科學認知中有形可見的身體。透過構成身體的基礎無形之「氣」，與人之所以為人、驅動生命的根源的無形之「神」，來重新定義「身體」，進一步探討普遍存在於古代中國傳統思想中的神氣觀。 第二類命名方法「形象譬喻」則是而「遠取諸物」地「仰則觀象於天，俯則觀法於地，視鳥獸之文，與地之宜」（《說文解字．敘》）在觀察天象地理、鳥獸草木的形象後，以相似或有相近特性的事物為穴位命名。本文將走訪身體多處穴名中帶有與自然風景、人文建設相關元素之穴位，讓取穴法不再只是一趟按圖索驥的枯燥旅程，在穴道名稱中不僅可以看見山光水色、草木鳥獸的自然風景，也看見了車水馬龍、都城市集的人間煙火。 透過爬梳人身上的諸多穴道名稱，明白孫思邈所說的「凡諸孔穴，名不徒設，皆有深意」之名，不僅是認知、交談時所需要一個供以區別的記號，名字應當蘊藏著知識的積累與建構，思想的記錄與傳承。並藉由這些穴道名稱進一步瞭解中國古代之神氣觀：「氣」被視為自然與生命共通之本源，所謂「通天下一氣耳」（《莊子．知北游》），整個世界萬物皆由氣所構成，因此構成形軀之「氣」，是人與萬物同質的基礎所在；而「失神者死，得神者生」（《黃帝內經．靈樞．天年》），居住在人體形軀中的「神」，則是驅動生命現象的根源。我們活在人間世有生之年的分分秒秒，都需要由「氣」構成的形體容器，與居住於其中的「神」來共同成就。形神皆具，才是醫者眼中完整的「身體」，我們才有投身遊歷於世、嚐盡人間冷暖、經歷春夏秋冬、看遍萬千風光的可能。因此在這人間世的有身之年，必當愛養身體、珍惜心神。

Acupuncture points, or acupoints for short, not only play a key role in traditional Chinese medicine (TCM) clinical treatments, but they also help TCM advance onto the world stage where Western medicine has become mainstream. In 2006, an international conference standardized and codified the English nomenclature of acupuncture points along the meridians of the entire body using transliterations along with Roman letters and Arabic numerals. Such an international naming standard is simple, easy to remember, and systematic, but it has also rendered acupuncture points mere alphanumeric notations without distinct meanings. However, the Huangdi Neijing Su Wen states: “Wherever the acupoint originates, each has a position and name.” This indicates that the location of each acupoint comes with its very own specific naming. The Tang Dynasty physician Sun Simiao says in Qianjin Yifang (Supplementary Prescriptions Worth a Thousand Gold): “In every case, acupoints are not named in vain—they all possess deep meanings,” clearly suggesting that the various names of the acupoints are definitely not just codes but names that embody deep meanings. Using the standard text The Science of Acupuncture and Moxibustion as basis, this thesis organizes the acupoints on the twelve main meridians, those of the two additional meridians of Ren and Du, as well as the extraordinary points outside the meridians, into 412 acupoint names in total. After attempting to induce the naming principles of the ancients, I argue that the names of acupoints can simply be divided into two categories: first, bodily cognition; second, imagistic metaphors. Taking these two categories of naming methods as a basic framework, I try to classify each acupoint name further. Through examining and analyzing these hundreds of acupoint names in the context of traditional Chinese medical thought on the body and even with respect to an understanding of nature, I uncover the ancient Chinese view of shen and qi. The first type of nomenclature, bodily cognition, is accomplished through “being nearby, taking clues from the body” (“Narration,” Shuowen Jiezi). The naming of these acupuncture points is based on known body parts, which can be further subdivided into two subcategories. The first subcategory consists of the tangible body, or the known names of body parts, skeleton, muscles, organs, etc., or with a focus on which part of the body whose illness the acupoints are mainly used to treat, and these acupoints are thusly named. In the second subcategory, there are no visible forms, and the acupuncture points are related to the invisible “qi” and “shen.” We thus come to see that traditional Chinese medicine (TCM) view of the body differs from Western scientific reliance on the visible body. In TCM we redefine the “body” as composed of the invisible “qi” that constitutes the foundation of the body along with the invisible “shen” or spirit that drives the root of life. We further explore this view of shen and qi that is found all over ancient traditional Chinese thought. The second type of nomenclature, “imagistic metaphor,” is carried out by “being afar, taking clues from objects” and “looking up to view the images in the sky; looking down to observe the laws of the earth; examining the patterns of birds and animals; and adapting to the earth.” (“Narration,” Shuowen Jiezi). After observing astronomical and geographical phenomena, the forms of birds, beasts, plants, and trees, the ancients named the acupoints after relevant or similar objects. This thesis will visit many such acupoints related to many parts of the body with elements of natural scenery and humanistic construction in the name of the acupoints, so that this view of acupoints becomes not just a boring trip to the map. In the name of these acupoints, one can see not only the natural scenery of mountains, rivers, vegetation, birds and beasts, but also much traffic and human liveliness in urban markets. Combing through the names of many acupuncture points on the human body, one comes to understand what Sun Simiao states: 'In every case, acupoints are not named in vain—they all possess deep meanings.” A name is not only a mark used to distinguish things when cognition and conversation are needed—a name contains the accumulation and construction of knowledge, the recording and inheritance of ideas. By learning more about acupuncture points we come to understand the ancient Chinese view of shen and qi. 'Qi' is regarded as the root source of nature and life in common. As Zhuangzi states in “Knowledge Wandered North”: “You have only to comprehend the one breath (qi) that is the world.” The entire world with its ten thousand things is composed of qi; therefore, the qi that constitutes the human body is the foundation of the sameness of human beings with all things. Moreover, according to the Huangdi Neijing Ling Shu, “Those who lose their shen (spirit) die, and those who gain shen (spirit) live.” The shen inhabiting the human body is the root of the phenomenon that drives life. Every minute, every second of the lifetime of a human being requires a physical form composed of qi, within which the shen dwells, to accomplish things in unison. Only when both bodily form and shen (spirit) are present is the “body” complete in the eyes of the ancient School of Physicians, and only then do we have the possibility of devoting ourselves to experience the world, taste the warmth and coldness of the world, experience spring, summer, autumn and winter, and see thousands of scenery. Thus, in this world, when you are alive and have a body, you must love your body and cherish your mind and spirit (shen).