作者 ｜
陳韻如(台灣大學歷史學系碩士)
摘要 ｜
本文以房事疾病統稱由失當的房事活動所引發的損傷或病痛。本文藉由探討此疾病在漢唐之間（約公元前三世紀至十世紀）的發展，呈現醫學論述中的性別意涵，並探討其所反映的醫學身體觀。
兩漢時期，醫書已載錄了房事失當損傷身體的主要原因。至六朝隋唐時期，醫書對此類疾病成因的看法雖不脫漢代既有的範疇，對疾病內容的記載卻出現明顯的性別差異。以男性患者而言，縱欲失精普遍見於醫書的房事疾病記載。而此情況不只源於醫學內部理論的發展，亦受社會服食壯陽之風的刺激。
在六朝隋唐的醫書中，女性的房事疾病所反映的性別特色更加鮮明。首先，在致病情境方面，不同於男患者常與縱欲過度相連，醫者關注婦女房事頻率過少，以及女性於特定的生理狀態行房所造成的損傷，例如妊娠、新產或月事行房導致的問題。醫者注意女性房事頻率過少之病，一方面是因其認為女性欲望多於男子，另一方面也是欲避免此病可能導致的生育問題。其次，關於病理機制，女性的陰道成為外在之氣由下侵入體內的主要管道。此時身體失常的場域多發生於胞內，進而伴隨著生育能力的虧損。甚者，血（包括月水、產後的分泌物等）的失常不僅為女性身體失序的象徵，亦成為致病原因之一，進而損害生育能力。由此觀之，至晚於唐代，血已成為醫學論說女性在產育方面的身體時的重要物質。
關鍵字 ｜
性、房中、醫學、身體
Title ｜
Gender and Coital Disorders in the Medical Texts of Early Imperial China
Author ｜
Yun-Ju Chen(Department of History National Taiwan University)
Abstract ｜
This essay analyzes how male authors of medical texts from the Han Dynasty through the Tang Dynasty ( 206 BCE-907 CE) interpreted coital disorders caused by improper sexual behavior in the light of gender differences in medical discourses.
The gender differences in medical discourses of coital disorders became apparent during the medieval period (around 220-907 CE). Reasons for improper sexual behaviors harming bodies were documented in medical books from the Han Dynasty. When it came to the medieval period, male coital disorders were gradually regarded to be divergent from female ones in considerable aspects, including pathogenic situations, pathological mechanisms, symptoms, and relevant body fluids—male essence and female blood.
First, regarding the differences between pathogenic situations, from the medieval period, losing essence from sexual indulgence became prevailing pathogenic reason for male coital disorders in medical texts. This prevalence resulted not only from internal development of medical theories but also from external social background, particularly the trend of taking mineral medicine. However, in contrast to above correlation between sexual indulgence and male coital disorders, women were often considered to be suffering from sexual deficiency or having intercourse at specific improper time, such as during pregnancy, menstruating, or in postnatal state. Male authors of medical texts paid attention to female sexual deficiency because of two possible reasons. First, the authors viewed that women had more sexual desires than men did. Second, the authors intended to prevent productive problems brought by long-term sexual deficiency.
Moreover, concerning the gender characteristics of pathogenic mechanisms for female coital disorders, vagina became a channel through which external bad aura intruded into the body. The intrusive aura would hurt abdominal viscera and then cause sterility. Furthermore, the disorder of female blood, including both menstrual blood and postnatal secretions, would not only reflect disorders of whole bodies, but also result in diseases.
Keywords ｜
sex, sexuality, the arts of the bedchamber, body