本文以美國宣教士孫理蓮(Lillian R. Dickson, 1901-1983)為例，探討二次大戰後基督教在臺灣醫療傳道的轉變及其中的性別與政治意涵。孫理蓮於1927 年隨夫孫雅各(James Dickson, 1900-1967)奉加拿大長老會差派來臺，1940 年因美日關係漸趨緊張而轉往南美圭亞那，1947 年重回臺灣宣教，至1983 年去世為止。最初十三年以師母身分協助丈夫的教會事工，戰後返臺則表示「不願只當宣教師的妻子，而要當宣教的妻子」，於是寫信募款，成立芥菜種會，創建宣教事業。本文利用孫理蓮的書信、報告、傳記和新聞資料等，嘗試呈現醫療傳道、性別政治和殖民議題在二十世紀下半臺灣的風貌。初步觀察所得有三。 首先，是關於醫療傳道性質的轉變。十九世紀中葉以降，西方宣教士藉著帝國主義擴張之便投入海外傳道，其中仰賴外科手術在東方醫病行神蹟者不乏其人。然而，經過日本殖民政府的強力推行，西方醫學在二十世紀中葉的臺灣已然成為主流。洋鬼醫生挖眼剖心的焦慮已息，手術治療雖非司空見慣，似乎也不再是神蹟奇事了。反而，自始至終都和這些著名外科故事並存的醫療照護工作，如施藥包紮、宣導衛生和緊急接生等，在戰後醫療資源不足的地區依然活躍。孫理蓮便是在西醫不成問題的時代展開她的傳道生涯。她的宣教事業包羅萬象，大多以醫療救助開始，而後擴及育幼和生技訓練，最終則以改信建堂為目標。她回應需求，寫信募款，網羅人才，集資建院。在戰後政局不穩、百廢待興的臺灣，外科手術已非神蹟，關懷照顧才算稀奇，而孫理蓮便是在這個轉變中施展長才，也為這個轉變推波助瀾。 其次，孫理蓮是以妻母的非正式形象從事她的宣教工作。她雖然受過醫護訓練，也穿著護士服從事第一線救助工作，卻不以醫護人員自居，反而以母親自況，認為發現貧病、傾聽痛苦、緊急救助、尋求支援，並解決問題，是任何母親都會身體力行的事。雖然她不願自限於師母的角色，而在返臺之後追尋女宣的生涯，並且成立正式的事業機構，但不論是她本人或她的傳記作者，都有意無意地持續塑造她非正式的形象。這種非正式的形象符合她隨機應變、彌縫補缺的行事風格，也彰顯芥菜種會和做為創辦人的她二而為一的實況，更重要的是，這種以退為進的自敘手法，也是孫理蓮遭遇各種困難和質疑時最有效的應對方式。 最後，孫理蓮得以在戰後臺灣以非正式形象從事醫療救助的宣教事業，實與她的美籍身分有關。她初次抵臺是在日據時代，身為美國人受加拿大差派，到一個統治者和被統治者互為異族的地方。這和十九世紀以降由殖民母國差派到殖民地的宣教士不同，也和清末來臺的英國或加拿大長老會傳教師有別。她和丈夫之前既未受日本殖民政府的支持保護，之後更因美日之間戰雲密佈而備受監控。然而，戰後中華民國政府遷臺，不論在政治、經濟或軍事方面，都仰賴美國的協助。孫氏夫婦因美國人的身分經常得以便宜行事。芥菜種會每個月收到的捐款信絕大多數來自美國，僅少數來自加拿大。孫理蓮定期返美巡迴演講、拜訪教會慈善機構尋求贊助，或接受媒體採訪、報導在臺宣教需要，然後將獲得的金錢和實物捐贈，透過美國軍方和在臺使館人員的協助運達分發。一方面，在戰後的臺灣，美援、慈善救助和基督教幾乎成為同義詞，而另一方面，孫理蓮也藉由各種管道介紹美國鄉親認識這個反共最前線的「自由中國」。如此一來，「基督教的美國」便先和日本殖民者對照，後與共產敵人抗衡，成為「自由中國」的盟友，而孫理蓮的醫療救助事業也在這個關係與形象的塑造過程中推展開來。

Lillian R. Dickson (1901-1983) accompanied her husband James Dickson (1900-1967), who was sent by the Presbyterian Church of Canada, to Taiwan, then a colony of Japan, in 1927. She lived and worked in Taiwan until she died at the age of eighty-two, except for the period between 1940 and 1947 when the couple were transferred to British Guiana because of growing tensions and war between Japan and the United States. During the first thirteen years of her life in Taiwan, Lillian helped out her husband as a dutiful pastor’s wife. Upon their return after the war, she claimed that she did not want to be just a missionary’s wife; instead, she wanted to be a “missionary wife.” Lillian then started to raise funds through her monthly chatty letters to American friends and churches and began her medical, charitable, and educational works throughout Taiwan. In 1954, she established Mustard Seed, Inc. so that the donors on her mailing list, that had then accumulated to 25,000 in numbers per month, could qualify for tax deductions in the US. This article uses Lillian’s private correspondence, her fund-raising letters, church reports, news clips, biographies, and other material to explore the transformation of medical missions in the twentieth century, the gender fashioning of missionary roles and related international politics. Three points stand out. First, we see the transformation of medical missions in Lillian’s works. Western missionaries came to the East with the imperial expansion of the mid-nineteenth century. Many among them were well aware of the effectiveness of Western medicine, most obvious in the case of surgery, not only in curing the body but also in conveying miraculous messages. Earlier missionaries to Taiwan, whether medical professionals or not, applied surgical techniques to make converts, much in accord with other nineteenth century practice. But after constant governmental promotion in the Japanese colonial period (1895-1945), Western medicine was accepted and perceived as normal and modern by the Taiwanese people. In post-war Taiwan, the fear that “the foreign devils would take out your organs” subsided, and at the same time surgery was no longer seen as miraculous. On the other hand, the preliminary medical help that had accompanied surgical success since the beginning of medical missions, such as dispensing drugs, bandaging wounds, and emergency deliveries of babies, became essential in poverty stricken locations, especially in the mountain areas. Lillian began her medical mission in a period when Western medicine was no longer challenged, and her works often followed the pattern of medical aid, nursing and caring, occupational training, and, finally, conversion. She reacted to needs, raised funds through all available means, recruited professionals, and built hospitals, sanitaria, maternity wards, orphanages and churches. Amidst the devastation of post-war Taiwan, surgery was no more a miracle than loving care. Lillian achieved her medical missions in this new context, and in turn encouraged ongoing trends. Second, although she accomplished numerous works, Lillian carried out her missions with the image of being “unofficial.” She has taken nursing training in New York before she came to Taiwan; she attended complicated childbirths in mountain villages, and she wore a nurse’s uniform when she bandaged the aborigines, but she often claimed that she was not a proper medical person. Instead, she positioned herself as an all-embracing mother who discovered illness in her children, listened to their moans, and solicited help to remove their pains. Indeed, she explicitly expressed that she did not want to be just a missionary’s wife and pursued her mission career to the extent of establishing an institute of her own. However, both she and the authors of her biographies continuously portrayed her medical, charitable and educational works as “unofficial” and only carried out by a woman who felt impelled to see people’s needs as a kind of housekeeping. This fashioning of an “unofficial” image probably demonstrated her style of reacting to incoming requests and making decisions on the spot instead of planning programs beforehand. But more importantly, this way of fashioning her role became a useful device to encounter challenges, whether from distrustful aboriginal leaders, questioning leper patients, suspicious medical professionals, uncomfortable board members of the Canadian Presbyterian Church, or from a free world that was about to forsake the “free China” she protected as a mother to its communist aggressors. Finally, the fact that Lillian was an American citizen should not be overlooked in evaluating her “unofficial” missions in post-war Taiwan. When she first arrived, she was an American sent by the Canadian Presbyterian church to a Japanese colony of mostly Chinese inhabitants. Her situation was different from a British missionary in nineteenth century India, nor was it similar to that of George Leslie Mackay (1844-1901), the first Canadian missionary to Taiwan when it was under China’s imperial rule. Lillian and her husband’s projects were not protected by the colonial government, and their lives were closely watched in the late 1930s as Japan’s relation with the US deteriorated. But the situation completely changed when they returned in 1947. After its retreat from mainland China to Taiwan, the Nationalist government completely relied on American aid, military, political, and economic. Being Americans, the Dicksons were often able to use discretion in their works. Mustard Seed, Inc. received donations mostly from the US rather than Canada. Lillian went back to the US for her annual speaking tours until 1978 when she was almost eighty; she recruited support by visiting charitable institutions, expressed the tremendous needs of Taiwan through interviews on television and other media, and asked American military and diplomatic agencies to help her transporting all the monetary and material resources she managed to obtain back to Taiwan. In the process, Taiwan was introduced in the US as “Free China,” the frontier in combating Communism and the best touch-stone location to spread Christianity, while America was perceived by the Taiwanese, in contrast first to the Japanese colonizers and then to the threatening Communists across the strait, as a synonym for Christian charity. Lillian became, perhaps involuntarily, the spokesperson for both sides and accomplished her mission work through the exchange of information and images.

孫理蓮；臺灣；醫療傳道；牧師娘；女宣教士；美國

Lillian Dickson; Taiwan; medical mission; women missionary; America