本文主要探討日治時期臺灣總督府的結核病防治政策，由調查數據切入，再進一步說明當時醫界及衛生官員如何應對此一疾病。日治時期，因為在臺日人的結核死亡率遠低於臺人與日本國內，對在臺日人的健康無立即性的威脅，再加上日治前期臺灣總督府的疫病防治係以風土病及傳染病為要務，故至一九一五年才成立專門的收容機構。其次，從日治時期結核病防治機構的建立與法令的頒布做比較，發現日本國內已經進入以療養院對抗結核病的階段時，臺灣仍停留在病床數不足的問題上。另外從「痰盂法」和「結核預防法」的實施較日本國內延遲一、二十年亦可看出端倪。臺灣總督府至一九二○、三○年代才較積極介入結核病的防治，此與因應戰爭需求，重視人力資源的培養與強化人口素質有密切關係。再者，日治時期有關結核病致病因素的討論與防治意見，雖然一八八二年德國科學家科霍（Robert Koch）已建立「結核桿菌致病說」，但當時日本醫界對此一疾病的致病因素和防治意見仍眾說紛紜，部分人士仍強調「體質」、「遺傳」或「風土」等因素在感染結核病的過程中所扮演的重要性。在藥物治療方面並無重大突破，仍以延續生命或減緩痛苦的支持療法為主，藥物的給予也僅是症狀治療，安靜療養是當時的基本原則。最後，本文指出，即使結核病死亡率在日治時期的下降速度緩慢，但臺灣總督府的作為仍對戰後國民政府的結核防治措施有部分的影響。

This article is aimed at analyzing the control policies and researches on tubercu losis adopted by Japanese colonial government. It also covers treatment of and pre- vention recommendations on tuberculosis made by doctors and health personnel. First, the article will analyze the death rate of tuberculosis for Taiwanese and Japa- nese residing in Taiwan during the Japanese colonial period. The analysis shows such death rate is lower for the Japanese who resided in Taiwan than the Taiwanese and the Japanese who lived in Japan. Tuberculosis did not pose a significant threat on Japanese residing in Taiwan at that time. In addition, Japanese colonial govern. ment focused on treating contagious diseases to prevent epidemics. Therefore, it was not until 1915 that designated sanitariums were established. Second, the article analyzes the establishment of tuberculosis treatment and pre- vention institutes and the announcement of related regulations during the Japanese colonial period. This aspect focuses on the comparison of tuberculosis treatment and prevention institutes and the announcement of related regulations between colo- nial Taiwan and Japan. The comparison reveals that when treatment was the main focus of the fight against tuberculosis, the shortage of beds available for people infect- ed with tuberculosis became a serious problem. The announcement of the "Anti- Spitting Law" and the "Tuberculosis Prevention Law" in Taiwan came ten to twenty years later than that in Japan. Japanese colonial government took on an active role in the prevention of tuberculosis in the 1920's and 1930's. This was closely related to the need for manpower and strengthening the aptitude of the population as a result of the war. Third, the article analyzes researches and prevention recommendations on tuberculosis during the Japanese colonial period. Although German scientist Robert Koch had already established the theory that "the disease was caused by Mycobacter- ium tuberculosis" in 1882, some doctors still emphasized on the important roles played by "constitution," "heredity," or "endemic" in the process of being infected with tuber- culosis. What is worth noting is the way tuberculosis was treated during the Japa-nese colonial period. Treatments of tuberculosis were mostly for supportive ther- apies which focused on prolonging the life of and relieving the pain suffered by patients. The administration of medicine was only for the treatment of symptoms. Convalescence in a quiet environment was the general rule at that time. Finally, the article points out that, although the death rate of tuberculosis decreased slowly during the Japanese colonial period, actions taken by Japanese colonial government had some impacts on tuberculosis control measures taken by the subseguent KMT govern- ment.

結核病、癆、臺灣醫學史、疾病史

tuberculosis, phthisis, Taiwan medical history, disease history