熱、神經衰弱與在台日人－殖民晚期台灣的精神醫學論述

Tropics, Neurasthenia, and Japanese Colonizers: The Psychiatric Discourses in Late Colonial Taiwan

巫毓苓(Yu-Chuan Wu) ； 鄧惠文(Hui-Wen Teng)

《台灣社會研究季刊》 54期 (2004/06) Pp. 61-103

https://doi.org/10.29816/TARQSS.200406.0003

摘要

本篇文章處理日據時代熱帶神經衰弱的問題，重點則是放在殖民末期精神科醫師對此問題的論述。神經衰弱各種不特定症狀，與熱帶生活經驗連結在一起，形成殖民地移住者對於自己身體與環境的特殊感受與詮釋，同時建構出『熱帶神經衰弱』以及『台灣木瓜』或『海南木瓜』等身體經驗與概念。無可避免地，低下的工作效率造成殖民地勞動力的困擾，普遍存在的身心病痛也會影響整個殖民地的民心士氣。更進一步地，當日本國內的學者與政治人物以氣候決定論、精神疾病素質理論與退化理論解釋這些病態現象時，熱帶神經衰弱成為民族素質受氣候影響而退化的表現。在這些論述中，殖民地移住者－無論是上層階級或是勞動階級－被描述為介於本國人民與原住民之間的二等國民與危險個體，在他們身上所出現種種身心變化則是帝國崩毀滅亡的前兆。對於中脩三等精神科醫師而言，他們正親身經歷熱帶殖民地生活，為熱帶神經衰弱所苦的患者都是與他們一同在殖民地奉獻心力的同事或同胞，此外他們還具有殖民政府官員的雙重身份。因此，這些充滿歧視與偏見的論述所激起的反彈，殖民地經濟文化資源的困窘，被祖國拋棄的恐懼，以及必須提出具體對策的使命感，必然都在他們架構熱帶神經衰弱論述的過程造成一定的影響。藉著從器質性與退化性轉向心因性的解釋模式，他們使熱帶神經衰弱變成一個可以理解，應被同情甚或尊敬，更重要的是，可以治療克服的疾病。

關鍵字

熱帶神經衰弱 ； 殖民精神醫學 ； 台灣史 ； 中脩三 ； 退化 ； 森田療法 ； 心因性疾病

並列摘要

Almost three-fourths of Japanese in Taiwan suffered from one or several vague somatic or mental symptoms attributable to tropical neurasthenia. Along with other epidemic and endemic diseases, neurasthenia in its tropical form was associated with administrative consideration of productivity, the discipline of colony labor, the quality of colonizer's life and health, and the cost-benefit of colony policies. No less importantly, it aroused the fear for national degeneration. This negative sentiment manifested in common sayings like 'Formosan Papaya', which represented the contemporary disdain for the Japanese in Formosa as inferior nationals and dangerous to the national destiny. By shifting from somatic explanatory model and climate determinism to psychological model (Morita's theory and practice in particular), Japanese psychiatrists in Formosa repudiated both the degeneration theory and any plea for 'abandoning the southern colonies'. They instead emphasized the everyday reality and psychological difficulties experienced by the colonizers, especially those who possessed the highest of Japanese spirits. They suggested that the colony life helped preserve Japanese morals, such as perseverance and per. fectionism. In so doing they criticized the, contemporary extravagance and indulgence introduced by modernization to Japan proper. On the one hand, they demanded more investment of effort and resources from the government to mitigate the hard life in the colony. The psychiatrists, on the other, adopted the Morita therapy to discipline the 'sick' Japanese in Formosa in the name of spiritual and physical regeneration.

並列關鍵字

tropical neurasthenia ； colonial psychiatry ； Taiwan history ； Syuzo Naka ； degeneration ； Morita therapy ； psychogenic disease

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