歷史學X醫療史新時代

日治時期臺灣中醫研究

On the Evolution of Traditional Chinese Medicine in Taiwan under Japanese Rule

作者：周珮琪

名稱：中國醫藥大學中醫學系博士班學位論文（2010年）

指導教授：林昭庚

中文摘要：

臺灣四面環海位處於亞洲重要航海路徑上，因而蘊育出獨特而豐富的歷史人文文化背景。在如此多變的地理、歷史、社會變遷的作用下是否使臺灣傳統中醫學的發展過程受到相當程度的影響？臺灣人民在20世紀以前深深仰賴並藉以維護生命健康的傳統中醫學在西方醫學進入臺灣之後，在臨床上逐漸退居二線的角色，這又是如何漸漸的蔚為風潮？雖然這情境是研究中醫學，深知中醫學內涵廣博深奧對人體健康深有助益的中醫人所不樂意見到的，但是唯有真實地去面對這曾發生的過程，梳理出所有相關因子，並將這一切作為日後借鏡方能不再重蹈覆轍。因此本論文希望藉著探尋前人所走過的足跡，從記載於官方歷史文獻的內容、民間生活的片段以及關於中醫學臨床、教育等紀錄來挖掘出臺灣中醫曾經面對的發展過程進而釐清當時的歷史事件對目前中醫發展的影響，冀望對於台灣中醫未來的發展能有些微裨益。研究方法本研究除了搜尋整理現有的中醫學書籍文獻之外，亦將未歸類在醫書類籍之外的資料作全面搜尋與探索。透過收集明清時期臺灣地方志、日據時期及光復後有關教育、醫療、宗教、日常生活與中醫有關研究的相關官方公報、檔案、文獻、報紙、期刊、論文等資料，加以彙整，用以建構全文論述。針對近年新史料的整理與研究，大量使用原始史料（含已翻印的史料），及官方文書報告，以資料來源及性質分篇章整理，架構呈現此研究成果，也利用當時人的日記以做為本論文的輔佐資料，綜括研究探討臺灣中醫教育制度、醫事制度建立的過程，作為臺灣中醫（漢醫）學及建立管理與中醫教育制度永續發展之參考。研究結果 研究結果顯示，曾經在臺灣生活的人群有原住民、中國大陸的移民、西方傳教士、商人以及日本人等，這來自世界各地的人群各帶著其原有的文化背景加入臺灣這塊土地。因此隨著其加入臺灣社會的時間長短以及在這社會中所扮演的不同角色，分別對臺灣中醫學的發展起了不同程度的影響，其中包含了有形的法律限制以及無形中所形成的社會氛圍，這一切都左右了臺灣人民對待及使用中醫學的態度，當然也影響了臺灣中醫學的研究與發展。臺灣中醫也在1902年正式由民間一般行業轉變為專門職業，人民若欲執行中醫醫療業務者必須通過國家專業考試取得證照後方可為之，執行各項醫療業務時也必須依循各項醫療法規之規範。臺灣中醫的臨床自此開始走上專業道路，也因此臺灣中醫師有了法律的保障，在社會文化的地位上也有所提升。從臺灣民間生活記錄中可以發現中醫使用歷史久遠而應用廣泛，然而其教育與傳承方式多半依靠師徒相傳或是父業子傳的方式流傳，除了以中醫學傳世典籍作為教育基礎外，多半的中醫醫療者是以臨床使用技巧為出發點。因此，在這時期所創作的中醫醫書多是以紀錄臨症治療方法為主，對於醫理之論述與研究則幾無所見。長期以來經過這樣的教育方式，雖然不乏有少數鳳毛麟角之醫術高明的中醫師，但是的確也出現為數不少不知醫理但僅知醫術使用的行醫者，更深的傷害是許多珍貴的經驗並未保留下來。又因著缺乏中醫學理論作為基礎，故此時期學習中醫者能在前人的基礎作更進一步發揮的不多。這樣的結果呈現更令人深刻體會所謂教育乃百年大計，不可不慎！長期以來臺灣民間生活早已將中醫學的內涵深深融入日常生活中，回顧臺灣歷史中官方、民間，專業、非專業的各項紀錄後，發現這些都是對中醫發展有影響的面向，由此即可知今日中醫的樣貌是如何成形。同樣地，今日中醫的教育、研究及臨床方式都將會默默卻深長久遠地影響著臺灣中醫未來的去向！

英文摘要：

On the Evolution of Traditional Chinese Medicine in Taiwan under Japanese Rule Pei-Chi Chou Advisor: Jaung-Geng Lin School of Chinese Medicine, China Medical University Abstract Taiwan has been known for her unique yet abundant historical and cultural backgrounds as being located on the important navigating route of Asia. Was the development of traditional Chinese medicine (TCM) in Taiwan before 1945 somehow influenced by the great diversity of geographical, historical and social perspectives? TCM, which had been the mainstream of the provider of health care system in Taiwan before the 20th century, was gradually replaced by the new coming Western medicine system. How did this evolve? As researchers and clinical practitioners of TCM who hold definite belief in its values, it is still necessary and important for us to face the facts and processes during that period thus hindcasting could be obtained by organizing all the associated factors. As a result, the objectives of this dissertation are to understand the development of TCM and the influences from major historical events by searching all official documents, fragments of civil lives and any records regarding TCM education and clinical practicing. Hopefully, this dissertation will benefit the future development of TCM in Taiwan. According to the researches, there were many populations living in Taiwan including aborigine, immigrants from mainland china, western missionaries and merchants and Japanese. With various time length and social roles, their original cultures and life styles deeply affected the development of TCM in Taiwan with different grades. For example, the solid law restrictions and the intangible social atmosphere. Folk attitude to utilize and judge TCM was also directed under the above condition. Consequently, it had impacted the development and research of TCM in Taiwan. Clinical practitioners of TCM in Taiwan had changed their roles from folk technicians to professionals since 1902. TCM practicing had been under the supervision of national examination and license system and regulated by medical laws as well. This professionalized the clinical TCM practicing and the socioeconomic status of TCM clinicians was lifted. TCM practicing began to have lawful protection. From the civil documentations, we learned that the employment of TCM has been wide and can be traced far back in Taiwan. Yet the knowledge passed on merely through master to apprentice or father to son mode. In addition to TCM classics, most of the TCM practitioners focused on the clinical skills rather than basic theories and researches. Hence, the writings during this period were mainly description of clinical experience of various symptoms or diseases. Although few TCM clinicians with great skills as well as knowledge of profound medical theories emerged from that situation but there were more ones with only ordinary level of clinical skills without basic understanding of TCM theories. What was further harmful was that so much valuable clinical experience got lost. Furthermore, writings regarding the elaboration of basic TCM theories were even fewer due to the lack of basic TCM theory understanding. We profoundly realize the importance of the establishment of long-term education system of TCM from historical retrospects. The essence of TCM has been integrated into the daily lives in Taiwan. We found how various aspects described in this dissertation had influenced the development of TCM by reviewing considerable quantities of official/civil, professional/non-professional documentations during that period and we have a clear picture of how modern TCM has been shaped. Similarly, the way we practice TCM; the manner we conduct TCM researches and the mode we educate medical students nowadays would have a quiet yet long-term effect on the future development of TCM in Taiwan.

關鍵字：臺灣；中醫；漢醫；中醫發展；中醫歷史；中醫師證照考試；Taiwan；traditional Chinese medicine (TCM)；development of TCM；history；license system of TCM

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