杜聰明的漢醫藥研究之謎兼論創造價值的整合醫學研究

The Enigma Concerning Dr. Tsungming Tu's Research in Traditional East Asian Medicine: On the Creation of Value in Integrative Medicine

"本文企圖解答一組台灣醫學史上明顯的謎題：身為台灣醫學現代性領航人的杜聰明，為什麼竟會長期支持研究前現代的傳統東亞醫療？反過來說，為什麼杜聰明堅持終生的志業，竟然持續地被視為落伍的、違反科學的行徑？本文指出，杜聰明被視為「不科學」的漢藥研究計畫，其實涉及多重、多脈絡的突破，至少包含下列四個向度。他倡議建立「實驗治療學」， 以突破日本帝國內沒有獨立「治療學講座」的醫學傳統；他主張以「實驗治療學」來研究漢藥，也構成了對於傳統藥理學取徑的突破；他計畫建立研究型的漢醫醫院，不僅在東亞前所未聞，也更是民國時期中醫支持者求之不得的突破；最後，他也支持「反向的」的漢藥研究程序，「藉由（在人體上進行）實際治療學的實驗而認定有效的生藥，之後再移至研究室內以抽出的有效成分進行實驗」，這正是民國時期飽受譏評（而在今日普遍接受）的「倒行逆施」的研究法。杜聰明為何會為漢醫藥研究構想出這樣一系列環環相扣、極具突破性、也從而易於遭到誤解的研究方案呢？在闡明杜聰明涉及多重突破的研究計畫後，本文反向地利用這個個案而進行系統性的反思，從而提出「創造價值」的理解架構。不同於東亞絕大多數的現代論者，杜聰明覺得他有理由相信，漢醫藥中還存有許多既有的研究方法所難以充分實現的價值，因而需要發展新的科學研究方法來嘗試將它們付諸實現。如此構想的研究方案，勢將深遠地挑戰東亞近杜聰明為何會為漢醫藥研究構想出這樣一系列環環相扣、極具突破性、也從而易於遭到誤解的研究方案呢？在闡明杜聰明涉及多重突破的研究計畫後，本文反向地利用這個個案而進行系統性的反思，從而提出「創造價值」的理解架構。不同於東亞絕大多數的現代論者，杜聰明覺得他有理由相信，漢醫藥中還存有許多既有的研究方法所難以充分實現的價值，因而需要發展新的科學研究方法來嘗試將它們付諸實現。如此構想的研究方案，勢將深遠地挑戰東亞近。

This article intends to solve a pair of salient enigmas in the history of medicine in modern Taiwan: Why did Dr. Tsungming Tu, a widely acclaimed representative of medical modernity in Taiwan, provide consistent support to research in traditional East Asian medicine? Reversely, why has Dr. Tu’s research vision long been criticized as backward-looking and even anti-science? This article argues that Dr. Tu’s research vision aimed at creating breakthroughs in at least the following four dimensions: first, Tu promoted the funding of ’experimental therapeutics,’ a disciple that did not exist in Japan proper, let along in colonial Taiwan; second, he promoted the study of traditional East Asian medicine with experimental therapeutics, which constituted a radical break from the pharmaceutical tradition; third, he intended to build a research-oriented hospital, which was unheard of in contemporary East Asia; and fourth, in studying traditional medicinals, he suggested adopting the ’reversed-order methodology,’ which started with clinical trials on the human body and therefore was widely criticized as violating the scientific and ethical code. Instead of being conservative or anti-science, Dr. Tu’s research program challenged the established boundaries of scientific research as he aimed to develop its frontier. Moreover, his vision challenged the entrenched great divide between modernity and traditional East Asian medicine. Drawing on Tu’s innovative research design, this paper develops a general model for understanding the dynamics of integrative medicine. It demonstrates that the two conventional positions -’respect and preserve the authenticity of traditional medicine’ and ’dissolve traditional medicine through scientific integration’ - are just the two polarized extremes. Between these two mutually exclusive positions, a whole spectrum of possibilities exists for integrating East Asian medicine with biomedicine, possibilities that I would characterize as the ’creation of value.’