孔恩典範轉移研究：以H. Pylori的發現對醫學典範轉移之研究爲例

A Study of Thomas Kuhn's Paradigm Shift in Terms of the Finding of Helicobacter Pylori

董倫銓(Lun-Chuan Tung)

《國家發展研究》 8卷1期 (2008/12) Pp. 131-179

https://doi.org/10.6164/JNDS.8-1.4

摘要

本文以二○○五年諾貝爾醫學獎得主馬歇爾(Barry J. Marshall)和華倫(Robin Warren)的醫學革命爲例，說明醫學典範轉移的理論問題。兩人在一九八二年發現幽門螺旋桿菌(Helicobacter Pylori)確定造成人類消化性潰瘍的病因，徹底改變了舊消化醫學界的認知（壓力或生活不正常等因素造成人類消化性潰瘍主因）。如此顛覆醫學傳統認知的研究，確實印證孔恩對科學研究典範轉移(paradigm shift)特徵的重要例證。本文先論孔恩典範論基本概念，再導入雷文霍克發現細菌的歷史過程，敘述巴斯德提出微生物是肉汁腐敗之因，推翻亞里士多德的「自然發生說」，強調微生物觀點的醫學革命，說明過去細菌學建立醫學史典範的例證，爲細菌醫學奠下重要基石。人類消化性潰瘍疾病的困擾下，求證這個細菌與疾病的密切關係，兩位醫學家爲了驗證科學真理，遵循柯霍準則完成科學事實和理論的吻合，並詳述馬歇爾「以身試菌」過程，進而確立細菌感染的事實，創立醫學新典範等觀點，印證科學典範移轉的特徵與過程。孔恩的典範轉移論述了行動和理論的一致，完成了自然科學和社會科學解釋科學史之哲學。本文另分析典範認知之爭議，針對孔恩典範定義引起語言學的批判，分析不同的看法。但回歸社會科學對科學史認知主題，醫學科學革命的史實，詳盡描述細菌史研究及幽門螺旋桿菌發現的過程，說明科學家嚐盡科學社群的阻力，排除萬難焠煉典範，歷經了二十三年得以被肯定，印證是醫學科學革命成功的新典範。

關鍵字

典範轉移 ； 幽門螺旋桿菌 ； 消化性潰瘍 ； 醫學革命 ； 格式塔轉換

並列摘要

This paper deals with the example of the Nobel Prize winners for medicine in 2005, Barry J. Marshal and Robin Warren and its implications of paradigm shift in science asserted by Thomas Kuhn. The two scientists found the Helicobacter pylori in 1982 that caused the peptic ulcer. Having changed the cognition and assertion of conventional gastroenterological circles who assumed the factor of the disease being pressure on emotion and abnormal life style, they discussed and discovered the real cause of the disease. Such research subverts the traditional and conventional medical knowledge to the extent that it confirms the importance of Kuhn's theory of paradigm and its shift. This essay treats Anton van Leeuwenhoek's finding of bacterium, through the discovery of the microorganism causing the corruption of gravy by Louis Pasteur, to the conventional scientific community which accepted the concept of bacterium and its effect on the peptic ulcer. In the history of human peptic ulcer, bacterium in fact was close to the occurrence of the disease. However, the two Australian physicians, in order to solve the problem, began to take another research approach and finally found helicobacter pylori as the real cause of peptic ulcer. Thus confirmed the existence and application of Kuhn's postulate, namely the paradigm shift in science.
This paper discusses the historical fact of medical scientific revolution, including the doubts raised by the members of medical scientific community and the final success of the ”dissidents”, their efforts to get rid of the obstructions established by the scientific circles. Thus, it is worthy to study the theory and practice of the paradigm and its shift propounded by Thomas Kuhn.

並列關鍵字

Paradigm shift ； helicobacter pylori ； peptic ulcer ； medical scientific revolution ； gestalt switch

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