在帝國醫學與殖民醫學的夾縫之中：日治時期臺灣人腳氣病問題

Caught between Imperial Medicine and Colonial Medicine: Beriberi in Colonial Taiwan

本文以臺灣人日記為切入點，探究日治時期腳氣病問題對於臺灣人的影響及意義。日治初期，腳氣病最初盛行於「在臺日本人」之間，但新式機構成為其向臺灣人傳播的據點，其中矛盾在於新式機構作為殖民地文明設施，卻挾帶散播疾病的危害因素。即使在1910年代，微量營養維生素被發現，日本帝國醫學仍陷於腳氣病因爭議，以致阻礙其醫療的合理進展。甚至，1920年代國際遠東熱帶醫學會商議腳氣病防治措施，日本寧可選擇消極的營養教育，而不願如西方殖民國家以立法積極管控米食營養。就此觀之，日治臺灣的腳氣病史與西方殖民地有極大的差異。不過，回歸臺灣人的主體經驗，臺人患者和醫師所經歷的腳氣病問題，自有其獨特的歷史經驗。本文解析3位患者在不同年代的醫療狀況，其中固然反映帝國醫學的權威，以及殖民醫學連動下日本腳氣病政策的推演，但也呈顯個人教育與世代的差異。本文也指出3位臺籍醫師在帝國與殖民醫學的夾縫之中，展開研究對話，以及相對突顯其研究的主體位置。 Taking Taiwanese diaries as a starting point for discussion, this article explores the impact and significance of beriberi problem in Japanese-ruled Taiwan. In the early days of that period, beriberi was first prevalent among the Japanese, but modern institutions later became strongholds to spread beriberi to the Taiwanese. The contradiction lies in the fact that the modern institutions, which acted as civilized facilities in the colony, carried harmful factors of spreading the disease. Although micronutrient vitamins were already discovered in the 1910s, Japanese imperial medicine was not settled on the cause of beriberi, which hindered its sound medical progress. When the international Association of Far Eastern Tropical Medicine discussed prevention and control measures for beriberi in the 1920s, Japan preferred nutrition education, rather than actively resorting to legislation to control the rice and nutrition as the Western colonial countries did. In this regard, the history of beriberi in colonial Taiwan is highly different from that in the Western colonies. Furthermore, considering the subjective experience of the Taiwanese, the beriberi problem experienced by Taiwanese patients and physicians was their own unique historical experience. This article analyzes the medical status of three patients at different times, in which it reflects not only the authority of imperial medicine and the progress of Japanese beriberi policy interlinked by the colonial medicine, but also the educational and generational differences of the patients. This paper also points out that there were three Taiwanese physicians engaged in research dialogues in the interstices between imperial medicine and colonial medicine, and relatively highlighted the subjective position of their researches.