- 期刊
杜聰明與早期民間戒烟運動和鴉片癮治療
Eradication of Opium Smoking in Taiwan during the Japanese Colonial Period (1895-1945)
摘要
日治時代的鴉片癮成功治療是，讓台灣人感到相當驕傲的醫學成就。主導此項治療的人物是台灣人的典範，台北醫專藥理教授－杜聰明博士。他在台灣總督府的大力支持下，於1930年主持更生院醫局，以其獨創的鴉片癮治療方法，進行消除吸食鴉片的惡習。 杜氏的除癮治療，首先以嗎啡爲主藥替代鴉片烟膏，以不引起弦烈的禁斷症狀劑量，迅速漸減，一般是2，3日。杜氏認爲，禁斷症狀呈現副交感神經興奮及交感神經被抑制，亦開發補助散劑（6種）和溶劑（5種），消減自主神經系統的不平衡。應用以上的方法，戒斷治療一般在2-3週內可以完成。 然而，文獻考證顯示，台灣在日治初期已有民間的戒烟運動和一些西醫嘗試鴉片癮戒斷治療。民間的戒烟運動，以1898年開始的飛鸞降筆會爲主，信徒向神明祈禱符咒後戒烟，到1901年時信徒大增，共有34,370人參予，戒烟成功率爲58%。由於殖民政府擔心戒烟運動是一種排日表現，並影響專賣局鴉片烟膏的收入，而加以嚴禁。雖然飛鸞降筆會的戒烟運動如曇花一現，它的戒烟成效顯示，神明的力量加上堅弦的意志，亦能達成比更生院(46%)更好的戒斷成績。 1908年台中郡出現由地方仕紳出資設立的牛罵頭改烟局，聘請在地公醫治療鴉片癮。戒癮方法是，以嗎啡代替鴉片烟膏，在治療中，一方面將嗎啡減量，另一方面逐漸加弦補弦藥，一直到嗎啡完全消除。治療日數爲13-26日，治療人數共55人，治癒人數53人，治癒率高達96%。值得注意的是，牛罵頭改烟局鴉片癮戒斷治療的原理與方法，與更生院的治療幾乎相同，尤其是以嗎啡取代鴉片。 杜氏的醫專先輩林清月醫師在台北赤十字病院和自宅進行鴉片癮的研究和治療，其成果於1908年發表在台灣醫誌。林醫師也採用取代治療，以海洛英替代鴉片，並加那可汀(narcotine)提高禁斷症狀鎮壓的效果，也加乳糖補充體力。他的治癒率高達80%。林清月發表的論文長達43頁，詳細記錄鴉片中毒症狀，戒斷症狀，吸食鴉片的原因，等等。他的取代治療原理，也與杜氏的方法相同。所以，林清月應是以西醫科學的態度和方法，研究鴉片癮和治療的台灣先鋒。 由以上觀之，在台灣的鴉片癮治療史上，雖然杜聰明的貢獻無庸置疑，但在他之前的降筆會戒烟運動，牛罵頭改烟局，和林清月的成果，亦不應被忽視。
並列摘要
Eradication of opium smoking during the Japanese colonial period is one of the most proud medical accomplishments in Taiwan. The mission was accomplished mainly due to a governmental policy of gradual prohibition in 1897 and the establishment of the Government Center Hospital for Opium Addicts in 1930. Professor Tsungming Tu, medical director of the Government Center Hospital, was responsible for the unique medical treatment of opium addiction there. The latter consisted of an immediate withdrawal of opium smoking which was partly substituted by small amounts of morphine in gradual reduction, and at the same time special pills were given to enhance the sympathetic activity also to lessen the withdrawal symptoms. By such treatment, the habit of opium smoking could often be eliminated in a few weeks. The success rate was 46%. Shortly after the World War II, the number of opium smokers in Taiwan became negligible. In early colonial period, however, there were grass roots movements as well as private efforts by physicians of Western medicine to treat opium addiction. In 1898, the Flying Phoenix Society which was a laymen organization worshipping deities began to use supernatural power to force the addicts to stop opium smoking. More than thirty thousand were enlisted and the success rate was 58%. In 1908, the enthabitual treatment in a private correction infirmary called 'Newmatou' consisted of a substitute treatment using morphine to replace opium and a gradual reduction in morphine dosage afterwards. All addicts were hospitalized until treatment goal was achieved. Among 55 addicts thus treated, 53 (96%) were ridded of opium smoking habit. The treatment method was almost identical to that employed by Professor Tu. Another physician, Dr. Ching-yue Lin, who worked at the Red Cross Hospital in Taipei, also used substitute treatment, replacing opium by heroine, and obtained a success rate of 80%. Dr. Lin published his comprehensive study on opium addiction and treatment in the Journal of the Formosan Medical Association in 1908. Therefore, Dr. Tu's enthabitual treatment seemed to be not so unique. Previous treatments employed by physicians at 'Newmatou' infirmary and by Dr. Lin at the Red Cross Hospital were strikingly similar or nearly the same. This review may help us reassess the prevailing opinion regarding the history of eliminating opium smoking in Taiwan.