醫療渴望地方、地方渴望照護：回顧並展望臺灣醫療史的地方性

Locating Medical Histories, Caring the Local: A Review of and a Proposal for the Concept of“Locale”in the History of Medicine in Taiwan

本文以「地方性」為分析視角，一方面回顧自1990年代以來臺灣醫療史研究的特質，另一方面提出未來研究可能的發展方向。十九世紀西方的醫療史研究是以介紹西方醫學發展的偉大成就與典範紳士醫師為主，作為一種補充醫學教育的人文素養而開展。二戰後臺灣醫療史發展最初是在醫界內部由零星醫師倡議，主要以引介西方醫學史為主，臺灣醫療史的位置相對邊緣。1990年代起在三股研究潮流的影響下，臺灣醫療史研究的主體性逐漸浮現。首先，以中國醫療史學者為主，中央研究院歷史語言研究所為核心基地，專業歷史學者開始投入醫療史研究並引入英美等地的醫療社會史、醫療文化史等思潮，順勢亦推動臺灣醫療史研究。與此同時，臺灣史研究的興盛也讓部分研究者將目光轉移至醫療相關議題，藉疾病、醫療專業等議題來深入探討臺灣政治、社會與文化變遷。2000年前後臺灣科技與社會研究（STS）領域的萌芽，則吸引更多跨領域研究者進一步探索臺灣獨有的醫療知識與實作，如何與政治、社會及文化相互交織的歷程。在三股學術思潮的推進下，臺灣醫療史研究的主體性雖已確立，但仍以臺北等地醫學中心的知識生產、人材養成與國際援助為主要研究架構，地方醫療史的位置仍屬邊緣。藉助後殖民研究中針對中心與邊陲之相對權力位置的反思，本文認為未來研究者可以藉由「醫療市場」、「地域社會」及「照護」等概念，一同思考如何書寫以地方為中心的臺灣醫療史。

Taking“locale”as the analytical perspective, this article, on the one hand, reviews the characteristics of medical history research in Taiwan since the 1990s, and on the other hand, proposes possible directions for future research. In the 19th century, research on medical history in the West emphasized mainly significant advances in the development of Western medicine and exemplary physicians, and it was carried out to complement the humanistic quality of medical education. In Taiwan after World War II, studies on the history of medicine were initiated only by a few doctors within the medical community, and focused more on introducing the history of Western medicine and less on Taiwan’s medical history. However, the history of medicine in Taiwan had taken center stage since the1990s under the influence of three research trends. First, with the Institute of History and Philology, Academia Sinica as the main base, professional historians, the majority being scholars on Chinese medical history, launched research on Taiwan’s history of medicine and introduced Social History of Medicine, Cultural History of Medicine, and other academic developments in Britain and the United States into Taiwan. Second, with research on Taiwan history gaining momentum, some researchers turned their attention to medical-related issues, and began in-depth exploration of Taiwan’s political, social and cultural development in the light of discourses on diseases and medical professions. Third, around 2000, the emerging discipline of Taiwan Science, Technology and Society Studies attracted more interdisciplinary researchers to further explore how Taiwan’s unique medical knowledge and practices intertwined with its politics, society, and culture. Although research on History of Medicine in Taiwan became more established under these three academic trends, the studies centered around knowledge production, human resources development, and international assistance of medical centers primarily in Taipei and other big cities. Research on local medical history remained peripheral. Inspired by reflections on the relative power relationship between the center and the periphery in post-colonial studies, this paper argues that future researchers can delve into the locale-centered History of Medicine in Taiwan using concepts such as“medical market,”“territorial society”and“care”.