疾病與醫療:往昔與當下
主持人:洪廣冀(國立臺灣大學地理環境資源學系 副教授)
現代臺灣漢醫的開端:日治初期鼠疫防治與臺人醫院蔡令儀(駿琳大直中醫診所 醫師) 十九世紀末,鼠疫傳入香港,港英政府下令封港並進行隔離檢疫、清潔消毒等防疫措施,造成不小的華洋衝突。這波鼠疫大流行(pandemic)因香港疫 情爆發而有了國際關注。1896 年,正值臺灣政權轉換之際,鼠疫分別登陸臺南 與臺北,有香港作為先行者,日殖民政府在臺灣展開類似的防疫行動,並設置 隔離醫院。現代公共衛生政策同樣造成臺灣民眾不安,地方仕紳請願要求建立 使用漢醫藥專屬臺灣人的醫院。本文透過比較歷史分析,論證臺灣漢醫在日治 初期提升地位的關鍵因素在於與地方仕紳的聯盟以及透過學習新知與臨床實作 與西醫產生合作關係。在嚴峻的疫情當中,許可傳統醫學參與並非必然,甚至 可能是特例,對照東華醫院,香港中醫未能也不願意如同臺灣漢醫一般參與治 疫工作,在香港鼠疫歷史中便難以見到他們的身影。 關鍵字:臺灣漢醫、臺人醫院、隔離醫院、鼠疫、黃玉階、香港 |
Tuberculosis and the Quest for Modernity in Shanghai, 1911-1928《結核病與上海的現代化》Rachel Core(Stetson University, Sociology, Associate Professor) The pneumonic plague, which ripped through Manchuria in 1910-11, redefined China’s quest for medical “modernity.” While there is consensus among scholars that this plague accelerated acceptance of Western medicine and laid the foundation for modern public health protocols in China, scholars have not examined how the recommendations arising from plague control directly informed policies to control a more widespread respiratory disease: tuberculosis (TB). Perhaps more than any other disease, tuberculosis has been closely aligned with the quest for modernity in nations throughout the globe. The intertwined processes of urbanization and industrialization—with crowded living and working spaces, exploitative conditions, and rampant inequality–create ample conditions for the spread of TB. After Robert Koch’s 1882 discovery of the tuberculosis bacillus and before discovery of effective antibiotics in the mid-twentieth century, several successful public health interventions were made globally to control tuberculosis. Before turning to China, this paper will review the literature on the factors contributing to the global decline of TB in the early 20th century, including labor laws and sanatoria creation. As was the case elsewhere in the world, prevalence and mortality from TB underscored a need to social change in China; however, scholars largely have not examined how tuberculosis closely aligned with China’s quest for modernity, particularly in its most industrially advanced city, Shanghai. The paper draws upon archival documents, newspaper and journal articles, and reports of the colonial Shanghai Municipal Council to investigate efforts to control TB. Despite minimal attempts to regulate labor and living conditions, TB declined in China’s largest cities in the early twentieth century. What intervention were made? The paper will examine both infrastructural and behavioral interventions informed by wider global health protocols. Among these interventions, the state and private actors built hospitals to isolate persons with infectious disease. Although the rise of hospitals had some success, attempts to develop norms regarding civilized behavior were less so. This paper demonstrates that various actors had difficulty establishing social control over TB sufferers and the authority of biomedicine in an era when the germ theory of disease was not widely accepted. 關鍵字:tuberculosis, Shanghai, public health, modernity/modernization, China |
明清時期大風子的醫療文化史試探官柏勳(國立臺灣大學歷史學系 碩士班學生) 梁其姿反省回溯診斷(retrospective diagnosis),重建大風、癘(癩)、麻風的命名過程、疾病分類與醫療史,也指出南宋以降的傳染概念影響明清以降的麻風隔離院。她檢視大風子(大楓子)的相關文獻,指出元明以降醫者愛用大風子治療大風、癩。本文從貿易網絡、本草知識和醫療實作的角度,進一步分析大風子從南海輸入明清中國的過程。傳統中國對於外來醫藥並非一無所知,第三章綜覽歷代外來醫藥入華的主要媒介,說明中外本草與醫療知識的相遇。 關鍵字:大風子、文化交流、本草知識、醫療實作、中國麻風史、楊梅瘡 |
英屬馬來亞瘧疾研究的國際網絡:以金雞納生物鹼和合成藥物測試為例洪均燊(國立臺灣大學歷史學系 博士生) 本文以吉隆坡醫學研究所(Institute for Medical Research, IMR)以及國聯衛生組織瘧疾委員會的檔案等史料,以英屬馬來亞的金雞納生物鹼和其他化學合成藥物的人體測試,了解英屬馬來亞瘧疾研究的國際網絡。 英國與國聯瘧疾委員會於1920-30年代尋找比奎寧更便宜但同樣有效的抗瘧製劑,並研究生物鹼混合物與奎寧相比之下的效力,如Cinchona febrifuge,撲瘧母星(Plasmoquine),阿的平(Atebrin)等,以用於治療各國的瘧疾。IMR於1921年開始受到英國Medical Research Council的委託進行了金雞納生物鹼(Cinchona Alkaloids)如奎寧丁(Quinidine)、辛可寧(Cinchonine)以及Cinchona febrifuge對各種瘧原蟲作用的差異,評估在人體的有效劑量及副作用。德國藥廠拜耳(Bayer)先後於1926年及1930年製造出化學合成藥物撲瘧母星與阿的平,在國聯瘧疾委員會的支援下,相關藥物的測試在阿爾及利亞、撒丁島、羅馬尼亞、蘇聯與馬來亞等地進行。馬來亞部分的藥物測試由IMR執行,以確認預防性投藥的劑量、間隔時間與長效性。 關鍵字:馬來亞、瘧疾、奎寧、藥物測試 |
Bricolage for a Troubled World: Chinese medicine and the Response to COVID 19Eric I. Karchmer(中國醫藥大學 訪問學者、助理教授)、賴立里(北京大學醫學人文學院)、楊慧宇宙(南京信息工程大學)、趙笑芃(北京中醫藥大學) One of the surprising developments in the COVID 19 pandemic response in mainland China was that doctors of Chinese medicine were given a sizeable role in the clinical management of COVID 19 patients. Perhaps even more unexpected, given the historical ambivalence of the Chinese Communist Party (CCP) towards traditional healing, has been the numerous official announcements trumpeting the clinical successes of Chinese medicine therapies. What can we learn from doctors of Chinese medicine working to treat a newly emergent disease about indigenous forms of knowledge? If the claims of the CCP are correct, how is it possible that these traditional therapies were effective in treating a disease caused by a virus that had never existed before? In this paper, I will argue that the answers to these questions will push us to think more deeply about how to “indigenize” science and technology studies and reconceptualize the relationship between alternative knowledges and the more established field of science and technology studies. To outline a tentative response to this important theoretical work, I want to propose a return to Claude Levi-Strauss’s Savage Mind and his concept of bricolage. Levi-Strauss famously defined bricolage as the practice of making do with whatever is at hand, and he contrasted it to the work of the engineer, who supposedly is liberated from the constraints of the moment. Although Jacques Derrida later critiqued this opposition between bricoleur and engineer, we should not abandon many of the other rich insights to be found in Levi-Strauss’ work. By examining the clinical work of Chinese medicine doctors in the bewildering, early days of the pandemic, I will show how bricolage allows for efficacious action in moments of instability and dislocation, for pragmatic solutions that do not require a privileged claim to truth and total knowledge. 關鍵字:Chinese medicine, bricolage, COVID 19, indigenous knowledge |