第21卷 第一期
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2014 / 3
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pp. 151 - 218
樂生療養院與臺灣近代癩病醫學研究:醫學研究與政策之間
Lo-Shen Leprosarium and Leprosy Medical Research in Modern Taiwan: Relationship between Medical Research and Leprosy Control Policy
作者
范燕秋 Yen-chiou Fan
*
(國立臺灣師範大學臺灣史研究所)
范燕秋 Yen-chiou Fan
*
國立臺灣師範大學臺灣史研究所
中文摘要
本文主要探討臺灣近代癩病醫學研究如何形成與發展,並關注醫學研究與政策之間的關係,包括自戰前、以至戰後癩病政策推演的過程,及癩病醫學研究重點與定位。首先,本文以十九世紀末國際間癩病控制的範型「挪威」為討論的切入點,說明這種政策與醫學研究合作的管控模式之發展過程。其次,討論日本帝國如何受到這種管控模式的影響,並基於帝國自身的特有考量而發展出其癩病隔離政策與相關醫學研究。然後,以日本帝國在臺灣創設癩病控制機構:樂生療養院的過程為討論重心,說明日本的癩病控制政策與研究如何影響殖民地臺灣,而臺灣又如何發展有別於殖民母國日本的癩病研究。最後,分析1945年之後臺灣的癩病醫學,又如何歷經延續或斷裂的問題。本文重要結論是:樂生院的癩病研究立足於日本癩病醫學移植的基礎,因此議題設定、研究方法及研究重點,均有類似日本的部分,但因應殖民政策需求,也發展出有別於日本者,尤其闡明臺灣或臺灣人癩病的特性。1945年10月臺灣因政權轉移,癩病政策與醫學研究也迎向時代變動。1953年起,因美援衛生計畫介入癩病議題,引進癩病化學治療,開啟癩病政策從隔離封閉、轉向門診開放措施。癩病研究亦重新展開,美式醫學取代戰前德、日式醫學,醫學知識及其實作也從戰前細菌學研究轉向戰後現代免疫學發展。
英文摘要
This paper traces the development of leprosy research in modern Taiwan, with emphasis on the relationship between leprosy-related medical research and the corresponding control policy. The topics explored include the evolution of leprosy control from the Japanese colonial era to post-WWII as well as the focus and stance of Taiwan's leprosy medical research. In colonial Taiwan, the Lo-Shen Leprosarium served not only as a policy enforcement agency, but also a stronghold of leprosy research. Such collaboration between policy and medical research was originated from the model of Norwegian leprosy control in the nineteenth century, following the discovery of the leprosy bacillus by Dr. A. Hansen and the subsequent medical research. Therefore, this paper begins with the discussion on the then globally adopted "Norwegian model" on leprosy control. It then traces the establishment of the Lo-Shen Leprosarium in 1930, during which the leprosy control policy implemented in Imperial Japan was transplanted into colonial Taiwan. Henceforth, this paper also examines how leprosy medical research in Japan influenced that in Taiwan and how Taiwan eventually developed its own leprosy medical research distinctive from that of Japan. Transformations in Taiwan's leprosy medical research in the post-war era were also analyzed. Important findings of the above analyses are as follows. Leprosy research conducted at Lo-Shen Leprosarium had its root in leprosy medical research of Japan. Therefore, the research direction, methods and focuses bore great resemblance to those of Japan. Nevertheless, differences still existed, due to the unique necessity of colonial policy, and in turn illustrated the distinct characteristics of leprosy in Taiwan and among Taiwanese. The change of sovereignty in the aftermath of WWII ushered leprosy-related policy and medical research into an era of rapid transformation. With the introduction of the USAID health programs in 1953, the approach to leprosy care switched from close isolation management to open outpatient treatment. Leprosy medical research was also re-launched, with the former German-Japanese style taken over by the US approach, and the pre-war bacteriological research replaced by the development of modern immunology
中文關鍵字
樂生療養院;癩病醫學研究;癩病防治政策;近代臺灣;日治時期;細菌學;免疫學;體液免疫;細胞免疫
英文關鍵字
Lo-Shen Leprosarium; Leprosy Medical Research; Leprosy Control Policy; Modern Taiwan; Japanese Colonial Taiwan; Bacteriology; Immunology; Humoral Immunity; Cellular Immunity