熱帶環境、移居者與敏感身體：1980年之前臺灣過敏研究與診療

Tropical Environment, Immigrant Population, and Sensitive Bodies: Research on Allergy and Treatment in Taiwan before 1980

本文係探究「過敏」此一常見疾病在臺灣的歷史，透過分析概念的引介與轉化、知識的生產與流通、醫師的投入與培育、診療的實作與轉變等面向，勾勒促成過敏研究在臺快速發展的多元行動者及特殊時空脈絡。相較於西方過敏史所關注的階級、都市化與現代文明之影響，臺灣的殖民經驗及頻繁人群移動讓過敏呈現出獨特的風貌。在研究概念方面，本文認為殖民時期過敏在臺的引介，是在細菌學與熱帶醫學的架構中開展，並與免疫和神經兩概念息息相關。在免疫部分，日治時期強調過敏是一種整體、長程的免疫病理反應，與戰後將過敏視為一種免疫反應異常的想法大不相同；至於神經部分，殖民醫者則認為過敏是熱帶環境導致組織或神經病變所引起，但戰後過敏的神經論述慢慢衰退，以細胞免疫學為基礎的過敏免疫則逐漸成為主流。在診療實作部分，殖民時期起由零星的研究者或團隊透過手術、藥物及減敏療法等多元療法進行，並特別關注外來移居者的環境適應與過敏病徵。直到1970年代醫界才將過敏視為好發於一般民眾的疾病類型，並出現以免疫學及減敏療法為主的過敏醫師培訓。此間，由過敏患者所發動，透過非正式美援網絡促成的過敏基金與臺灣過敏病中心，是推廣過敏研究及診療的意外推手。

The article analyzes the development of research on allergy and treatment in Taiwan, focusing on the introduction and evolution of concepts, the production and circulation of knowledge on allergy, the recruitment and cultivation of specialists, and the practices and transformation of its treatments. It aims to decipher the multiple actors and unique historical contexts that facilitated the rapid development of allergy research in Taiwan. Unlike studies on allergy in Western societies that highlight the importance of class, urbanization and modernization, research on allergy in Taiwan was closely related to its colonial past and the immigrants from Japan and China. Exploration reveals that research on allergy in Taiwan began with the bacteriology and tropical medicine during Japanese colonization. On the one hand, during the colonial era, allergy was identified as a long-term and systematic immune response to infectious diseases, rather than an abnormality. On the other hand, allergy was also considered a nervous system disorder, one of the many symptoms of tropical neurasthenia. The discourse of allergy as a neurological disorder gradually lost its popularity after WWII while that of allergy as a malfunction of immune system became increasingly dominant. In terms of its treatment, multiple strategies had been applied since the colonial era, including surgeries, medications and desensitization therapies. At the same time, there had been growing attention paid to the relationship between immigrants, environment and allergic diseases. It was not until the 1970s that allergy was seen as a common disease among the general population on the island, and specialists with training of immunology and immunotherapy gradually became available. US aid solicited by civilian allergy sufferers that contributed to fund research and training as well as the establishment of the Taiwan Allergy Center in the 1970s were crucial for the promotion of allergy research in that period.