本文探討藥籤醫療知識的建構與被建構,旨在以臺灣寺廟藥籤的選用與創發 為中心,檢視「占卜問疾」背後所涉及之知識權威、實作慣習與社會歷史過程等 的相關議題;在此過程中,涉及諸多行動主體。研究資料,來自民族誌田野工作 及田野調查所得之寺廟藥籤,並取其中最具代表性的《呂帝仙方》為分析範本。 探討議題包含:在運作藥籤的脈絡中,醫療知識如何被傳載、轉化而為約定俗成 的實作慣習?藥籤所賦有的療癒之力所從何來?而各類不同藥籤品目之間有否本 質性差異,又差異為何? 筆者首先指出:藥籤療癒之力的有無,繫乎一套標準的求籤作業程序,其中, 「擲筊」最為關鍵。它是一套可及性高,並且足供自我立下判準的「多重確認」 機制;而「潔誠盡敬」,正是信眾自我檢證所求之方能否「盡應其效」的道德詮 釋基礎。這些面相,體現了藥籤的實踐邏輯,同時也正是藥籤之「提示性」療效 可能發揮之處。 再者,本文運用「世系群」(lineage)的概念,提出一個有關藥籤系統所屬「類 緣關係」的分類架構。筆者發現:臺灣寺廟藥籤的品目與神明來源之間,存在著 相當程度的「異化」(alienation) 現象;藥籤資料的版本與類型,與個別該寺廟所 祀的主神之間,並無絕對的關聯或必然的對應關係。或言,本質上,並無民間社 會所謂的「大道公籤」、「五穀王籤」、「呂祖籤」或「媽祖籤」。這些藥籤, 事實上大多在主祀醫藥神及媽祖的寺廟間,相互權宜流通、使用。 本文最後以藥籤版本學的追蹤、比較,探討《呂帝仙方》這一特定權威版本 在社會、歷史發展的進程中,如何被撿選,進而成為實作慣習的過程,從而更多 檢視「求取藥籤」背後所潛藏之藥籤知識權威與實作慣習的關係,並藉此說明臺 灣藥籤知識的流動性和歧異性。 透過「世系群」框架的分析,本文突顯臺灣各地寺廟選用藥籤版本的過程, 其實是相當具有策略性的。本文肯定分香廟宇與其母廟,在藥籤採用版本上的歷史關聯。然而,某些社會因素的影響,亦不可忽視:寺廟管理者、解籤者及相關 中醫業者在藥籤知識生成與傳載的過程中,舉足輕重;藥籤印刷刊本的有無、流 通的範圍,以及民間鸞堂的居中推促等等,亦是關鍵,從而建立或確認了某一特 定藥籤做為典範版本的權威性。此中,具備文本能力、掌理鸞堂事務的男性執事、 鸞生或地方仕紳,在成籤初期無疑扮演了重要的角色。這也顯示,臺灣寺廟藥籤 所承載的醫學知識,其實是在某種特定脈絡及權力協議的遞變情境中,不斷被創 發出來的。

In this paper, I aim to discuss the production of medical knowledge in rural Taiwan in light of the adoption and re-creation of prescription divinations (yaoqian), which entails an interrogation of the relation between authority, practice and history. My data are derived from ethnographic fieldwork and the laboriously collected materials of yaoqian from temples. Involved in this production of medical knowledge are local authorities, individual specialists, and the supplicants soliciting yaoqian. The key issues I raise include the following. How has such medical knowledge been historically established as a local practice? How has its healing efficacy been perceived by the faithful? What is thought to endow yaoqian with the power to heal in general? And further, what is the difference in essence between the diverse collections of yaoqian? 　　First of all, I suggested that the healing efficacy in soliciting yaoqian was perceived through a series of standard procedures with self-examination and easy access. Moreover, the solicitation of yaoqian is an act of divination established on the basis of morality and godliness of the worshippers. Among the procedures, the casting of wooden blocks (buabuei in South Fukien) serves as a cultural mechanism crucial for knowing what is unknown and obtaining multiple divine confirmations, which reflects the major logic of the practice. 　　Secondly, by using the ‘lineage’ approach instead of the divine origin ‘system’, I suggested that there exists ‘alienation’ between divine origins and healing power of yaoqian. There is no Dadaogong qian, Wuguwang qian, Lüzuqian or Mazu qian in essence, since most Mazu qian, Dadaogong qian and Lüzu qian were used interchangeably by those temples dedicated to the three Gods of Medicine (yiyao shen) and the Goddess of Heaven (Mazu). 　　Finally, with my lineage analysis I noted that the decision on which collection of yaoqian was to be adopted by an individual temple was influenced by historical ties with its premier temple, as well as the changes in timeline. Moreover, the impact of social factors on the adoption and re-creation of yaoqian collections is of great importance. By tracing the circulation of Efficacious Prescription Divinations from Lüdi (Lüdi xianfang) with many editions published, I highlighted that the influence of printing and the performative mediator of phoenix halls (luantang) have contributed to the production of yaoqian. In particular, the initiated members of phoenix halls and local gentry with textual knowledge administrating luantang are crucial to the transmission and local adaptation of yaoqian knowledge.

占卜問疾;藥籤;實作慣習;鸞堂;醫學知識

Soliciting Divination for Health Problems (zhanbu wenji); Prescription Divination (yaoqian); Local Practice; Phoenix Halls (luantang); Production of Medical Knowledge