在地醫療的技術文本及其轉變-嘉南地區之藥籤

Author Info
陳柏勳
楊仕哲
衛生福利部臺南醫院中醫科、國立陽明大學科技與社會研究所
中國醫藥大學中醫學系、中國醫藥大學附設醫院放射線部
  藥籤是臺灣在地重要的民俗醫療,今日仍可在民間發現其蹤影。本文使用嘉南地區資料,從技術物和在地實作的概念,分析藥籤所連結的行動者和知識空間,進一步探討以西醫為主的政策與藥籤的互動。
  多元行動者為因應當地疾病與醫療資源,藉由實踐生活中的歷史經驗和文化資本,使得藥籤相應而生,經由實踐一系列的求籤過程,同時再生產藥籤技術文本之社會結構,也反回影響藥籤內容。藥籤的知識空間含括宗教、道德與中醫藥,其機制不能單以生物醫學的框架來分析。臺灣現代化的過程,藥籤被政府與生物醫學邊緣化,且受生物醫學所規範,然而,民眾的生病經驗看透生物醫學的限制與不足,進而選擇藥籤作為療病方式。  本研究認為藥籤的實作乃應事邏輯之結果。在西醫資源不足之地,藥籤的實作不但呈現藥籤與以西醫為主的政策之緊張關係,更指出民眾對醫療概念的多樣性,進而反思在生物醫學框架下對醫療本體的醫療化。
 
The Local Medical Text Yaoqian and It’s Contemporary Transformation in Chaiyi and Tainan
 
  Yaoqian, an important folklore medicine, is still in use in Taiwan. This article used Chaiyi-Tainan fieldwork data. From the standpoints of artifact and local practice, the actors and knowledge space connected to Yaoqian were analyzed. The interaction between Western medicine-dominant policies and Yaoqian was investigated.
  In response to endemic diseases and medical resources, multi-actors produced Yaoqian through historical experiences and cultural capitalism from daily practices. Through the process of Yaoqian system, they reproduced the social structure of artifact text and affect the context reciprocally. The knowledge space of Yaoqian included religion, morality and Chinese medicine. Its mechanism shouldn’t be analyzed through the framework of biomedicine single-handedly. During the modernization process, Yaoqian was marginalized by the government and biomedicine community and regulated by biomedicine. However, the population looked through the limitation and deficiency of biomedicine in their illness experiences and chose Yaoqian as therapy.
  This study considered Yaoqian as a result of the logic of practice. In areas deficient of Western medicine resources, the practice of Yaoqian not only presented the tense relationship between Yaoqian and Western medicine-dominant policies, but indicated the diversified medical concept of the population. Furthermore, it reflected the medicalization of the medical entity in biomedical framework.
Citation: 
《科技、醫療與社會》,第23期,頁77-136,2016年10月出版