臺灣漢人的醫療體系與醫療行為：一個臺灣北部農村的醫學人類學研究

MEDICAL BEHAVIOR AND MEDICAL SYSTEM OF TAIWANESE PEASANTS: AN ANTHROPOLOGICAL INQUIRY

臺灣漢人的醫療行為的研究一向少為人類學學者所作，已有的一些零星文獻，也多是以問題取向，在城市地區或某一醫療場所進行觀察。筆者在臺北縣仰之鄉作為期八個月的田野調查，試圖對臺灣漢人尤其是農村地區的漢人醫療行為作一深入了解。根據田野調查結果，筆者將臺灣漢人所使用的醫療體系分為三個次體系，即神聖的、世俗的、西方的三個次體系。文中探討形成三個次體系的歷史背景，以及民眾在選擇三個次體系時的影響因素。這些因素包括社會因素（有地理、歷史、交通、人口結構、大眾傳播等），現有的醫療組織因素，以及病人個人因素等三方面。同時提出三個醫療次體系間具有功能性分工、以及功能性的互補關係存在。西方的醫療次體系在效率上及經濟上見長，世俗的醫療次體系著重在長期的身心保養上，而神聖的醫療次體系則在病人疑慮的心理上提供了一個超自然的病因解釋。

The purpose of this paper is to analyze the medical system and medical behavior of Taiwanese peasants from a socio-cultural point of view. The medical system used by Taiwanese peasants has been influenced by changes in three governmental regimes, those of the Ching Dynasty, Japanese and National Government. There are in the author's opinion three aspects of this indigenous medical system: the sacred, the secular and the western. The ordinary Taiwanese people can switch over between these three sub-systems as they please. But what factors influence choice of usage between these three sub-systems and why can these three sub-systems be alternately and simultaneously used? Possible answers from author's fieldwork in yang-chi, Taipei, to the first question include social factors (including its geography, history, transportation, demography, mass media), the existing medical organization and patient's personal factor. As for the second question, the author finds these three sub-systems are functionally complemented, people use different sub-systems to cure different kind of disease and in different phases of disease course. Western medical treatments are important and the principles are efficacious and economical, secular treatments have the benefit of maintaining physical and mental health, and sacred treatments though super-empirical are to afford an etiological interpretation to relax patient's anxiety. These medical beliefs and practices are placed in the total context of Taiwanese society affording social scientist a reference to the problems of studying medical behavior in Taiwan.