인도 안과의학의 동아시아 전래와 『용수보살안론(龍樹菩薩眼論)』

Abstract

Medical knowledge in India began to be introduced to China in earliest from the Later Han Dynasty period to the times of Wei-Qin and South &North Dynasties(魏晉南北朝). This is proved by many Buddhist medical books(佛醫經) appeared in those days. Of the contents of Indian medicine,the theory of four major elements(四大論) affected Chinese medicine more than did the theory of body fluids. Based on the theory of four major elements that was began to be introduced in Fú shuō fú yī jīng(佛說佛醫經), an attempt to establish a new medical system was made in Zh u hòu b i yīfāng(肘後百一方) written by Táo Hóng-j ng (陶弘景) and Sūn Sī-mi o(孫思邈) who tried to develop etiology further but could not achieve any great outcomes. Unlike the foregoing situation,Indian medicine aroused a large echo in China in the field of ophthalmology with ophthalmological knowledge mentioned in Suśrutasa hitā and ‘Jīnzhēn-shù’(金針術, cataract couching) introduced as a surgical treatment of cataract. The Suśrutasa hitā which is one of the three major texts of Indian medicine contains additional information on surgical operations not introduced in the Carakasa hitā. The technique of cataract surgery was particularly popular in the Tang and Song dynasty periods in China under the name Lóng shù pú sà y n lùn(龍樹菩薩眼論, The Ophthalmological Treatise of Bodhisattva Nāgārjuna) or Lóng shù lùn(龍樹論) and was even designated as a subject to educate medical officers. While the original text of Lóng shù pú sà y n lùn was not handed down,the first testimony that show the trace of the introduction of this text into China was the Tiān zhú jīng lùn y n(天竺經論眼) mentioned in Wài tái mìyào(外臺秘要, Arcane Essential from the Imperial Library) written by Wang Tao(王燾). L ng shàng dào ren(隴上道人) who was mentioned as the compiler of the book is assumed to be Lóng shù. Although Tiān zhú jīng lùn y n introduced anatomical knowledge about the eyeball that could have not been in the traditional Chinese medicine, this book has only limited quantity of information in this regard. Thereafter, Tài píng shèng huì fāng (太平聖惠方, Holy Prescriptions for Universal Relief ) compiled by a national agency at the beginning of the Song Dynasty period introduced Lóng shùpú sà y n lùn without clear indication of the reference. Contemporary with this book, many ophthalmological books such as Mì chuán y n kēlóng mù lùn(秘傳眼科龍木論, Longmu’s Ophthalmology Secretly Handed Down) were published. As Chinese culture was spreading out into surrounding countries,medical knowledge was also introduced to Korean peninsula and Japan. The ophthalmological knowledge contained in Lóng shù pú sà y n lùn was also reflected and some parts of it were introduced in I shin bō(醫心方)in Japan. Based on the policy decision of King Sejong, the fourth king of Joseon Dynasty, large scaled promoting projects of medical knowledge was established. It is notable that the Ui bang ryu chwi (醫方類聚) compiled as a result of the synthesis of the medical treatises available at that time initiated by King Sejong contained a considerable part of Lóng shù pú sà y n lùn in reedited form that had already passed into oblivion in China. The intellectuals in Joseon Dynasty who participated in the compilation of Ui bang ryu chwi not only indicated that Lóng shù pú sà y n lùn was a medical text published in the times of Wei-Qin and South & North Dynasties in China but also clearly indicated the textual reference and left the original text for later generation without modifying the contents. According to the Ui bang ryu chwi, the Lóng shù pú sà y n lùn indicated that the core causes of eye diseases were heat(熱), winds(風), and three body fluids(trido a) and contained the analyses of symptoms, related treatments, and several analyses of wrong treatments. In addition, Lóng shù pú sà y n lùn explained diverse eye diseases through more than 30medical treatments. In particular, this book accurately described golden needle acupuncture for treatment of a Nèi-zhàng(內障) understood to be cataract. Therefore, this book is a significant textual record in the history of ophthalmological medicine in East Asia. Along with the golden needle acupuncture which is a method of removing the crystalline lens in which white turbidity occurred by stabbing the eyeball with a needle, traces of Indian medicine that had been already lost in China were clearly indicated in Lóng shù pú sà y n lùn kept in the Ui bang ryu chwi. In particular, the book indicates that the eyes were directly correlated with the brain and that to treat the internal disorder, treating the brain that lost stability due to heat and bodily wind was indispensable; these are the traces of Indian influence. This textual source demonstrates a case of knowledge exchange in field of medicine with concrete cases of the encounter and clash between the standpoints of understanding human body.