關於殖民時期的防瘧成就，幾乎所有有關臺灣醫療、衛生的著述都會記上一筆。然而日治時期的防瘧政策並非如同多數的醫學通史或回憶錄式的記述所宣稱，是一個科學的、全然奠基於防瘧知識與流行病學調查的合理政策。而以「對人法」為主、「對蚊法」為輔的原則亦不是一個靜態而一貫的防瘧方針。 　　本文應用近年在歷史研究中被受重視的地理資訊系統（GIS），以及戰前的檔案、醫學論文及小說等文本分析，試圖澄清某些假設的謬誤，並深化過去研究的不足之處。GIS有助於追溯防瘧措施在空間結構上的變化。「對人法」實施試點的區位分布特徵，一方面暴露出政策決定的非科學因素，一方面也佐證了瘧疾與開發的密切關係。一九一九年防瘧主要方針由「對人法」轉向「對蚊法」，此一政策急轉並非歷史偶然或意外，一九一〇年代國際上撲滅瘧蚊的成功案例及臺灣島內瘧疾的再流行為此項政策變革提供了時空脈絡。而「對蚊法」的實證分析顯示，相對於多數國家以中央權力指派「滅蚊部隊」或專家調查瘧文滋生來源並實施環境控制，臺灣的「對蚊法」僅由受過短期訓練的地方官員指定作業對象，因而常出現錯誤判斷，或假防瘧之名實施環境美化等非科學、不合理的政策，這也常常導致「對蚊法」無法收到成效。此外，區民被強迫成為「對蚊法」無償的執行者，其反感與無奈表現在對防瘧作業的被動與漠視上，並直接影響了防瘧成果。一九二〇年代後期，國際間「對蚊法」的樂觀主義逐漸退潮，而我們也並未看到總督府轉換方針的努力，事實上，這個政策與實際中呈現出的落差，才真正反映出瘧疾防制作為殖民醫學之一環的本質：以最容易的方法確保立即的效益。 　　透過以上動態的觀察，本文重新思考防瘧措施的樣貌與本質，並企圖指出日治時期臺灣防瘧政策之特色。

The anti-malaria program in colonial Taiwan has always been regarded as a scientific and modern disease control policy, or been described as a success in imple- menting the "anti-parasite measure". This paper argues that the anti-malaria policy under Japanese rule was not wholly based on professional knowledge, and the policy- making process, instead of being consistent or static, involved dynamic revisions and frequent compromises with reality. The Geography Information System (GIS) is employed in this study as a tool for handling spatial data, analysis and map-making. Since the "anti-parasite measure" had been implemented at selected points initially, GIS proves to be very efficient in mapping the locations of these points. The distribution analysis shows that these points were chosen not according to scientific epidemiological investigation. Rather they were selected to protect the Japanese and their interests. This also provides evidence that the spread of malaria is closely related to regional environmental devel- opment. Since 1919, the focus of the anti-malaria program had shifted from "anti-parasite" to "anti-mosquito". This drastic change in policy was neither an accident nor a coinci- dence. The remarkable worldwide success of the anti-mosquito strategy in the 1910s had aroused great hope in this prevention approach. At the same time, Taiwan suffered from another outbreak of malaria after the anti-parasite measure had been practiced for some years. These two reasons contributed to the change in the disease control strategy. However, the anti-mosquito approach in Taiwan proved to be fruitless for several reasons. First, unlike other countries, this measure was carried out in colonial Taiwan by district officials who only received short-term expertise training. As a result, wrong decisions were inevitable. Moreover, residents were often forced to comply with the government measures without any compensation. Their reluctance worsened the situation and the anti-mosquito program was doomed to failure. In the late 1920s, with the optimism of the anti-mosquito measure gradually fading, and the lukewarm effort of the government in its implementation, the anti-parasite measure once again became the main strategy of the anti-malaria program under Japanese rule. Prior researches on the anti-malaria program in colonial Taiwan have much simplified the scene. In fact, there was an inconsistency between principle and practice. It is this inconsistency that reflects the real essence of the anti-malaria program in colonial medicine: Using the simplest method to achieve the maximum effects. Through the above-mentioned observations, this paper aims to clarify fallacies in previous studies, and tries to point out the unique features of the anti-malaria pro- gram in colonial Taiwan.

瘧疾;GIS;殖民醫學;科學殖民;防瘧政策

Malaria; GIS; Colonial Medicine; Scientific Colonialism; Anti-Malaria Program