台灣現代法制對傷科推拿傳統的規範態度

The Attitude Toward Traditional Osteo-Traumatology in the Taiwanese Modern Law

林傳勝(Chung-Sheng Lin)

指導教授 ： 王泰升

國立臺灣大學/法律學院/法律學研究所/碩士(2013年)

https://doi.org/10.6342/NTU.2013.02409

摘要

摘要
本文由醫療史及法律史的角度，依時間的脈絡性編排，呈現傷科推拿醫學如何建立發展，並形成漢人的醫療傳統，進而傳入台灣土地，以及在日本統治後，首次遭遇現代法制的規範下，傷科推拿傳統面臨的轉型問題，繼而介紹中華民國法制施行於台灣後，傷科推拿傳統如何走入現今之困境。

本文共計六章，第一章「緒論」先說明本文之研究動機與問題意識、依次介紹研究方法、文獻回顧及論文架構。

自第二章「台灣漢人的傷科推拿」起，說明傷科推拿作為中醫醫學的一環，其發展與中原文化和漢人文化密不可分，在傳統中國，醫學有其發展之社會背景、脈絡性及國家管制體系，傷科推拿於其中亦深受影響，同時在此一環境下，傷科推拿又形塑出自身的醫療特殊性，並隨時間的流動，深植於漢民族的醫療習慣中。十七世紀時，漢人隨荷蘭人、西班牙人、鄭氏王朝、清朝的腳步進入台灣，在移民的同時，也將原鄉的社會文化、風俗民情、生活習慣、醫療體系一併移植於台灣土地，中醫醫學與傷科推拿亦隨之落地生根，而其所面對的國家管制，仍然維持在傳統中國的樣貌，官府並不介入民間的醫療事務。

第三章「日治時期的台灣傷科推拿發展」，則自1895年起，說明台灣成為日本帝國的領土後，總督府即開始有計畫的引進來自近代西方的法制，以進行殖民統治，總督府一方面建立現代衛生制度、西醫醫療體系，一方面進行對中醫與傳統醫療的管制、改造與消滅。在傳統醫療與現代型法律的碰撞之下，本文由總督府檔案、法院判決及其他民間史料，切入觀察漢人傷科推拿傳統面臨到衝擊之餘，與其他傳統醫學相較下，所存在的管制異同性，以及傷科推拿在總督府政策下轉型的可能。

第四章「中華民國時期的台灣傷科推拿發展」，先由民國時代中國談起，說明中華民國政府來台前傳統醫學與西方醫學在中國之衝突，以及法制規範的發展，次第說明在1945年第二次世界大戰結束後，中華民國法制開始施用於台灣，原先奄奄一息的中醫如何重新復甦，以及同樣引進近代西方法制的中華民國，於中央政府遷台後如何面臨現代化、西醫化的醫療體制與傳統醫療的衝突問題，而傷科推拿在傳統醫療與中醫的光譜間，所遭遇到因「人」而異的行為區分困境。

第五章「當今推拿技術員的法律管制」，講述中醫診所內推拿技術員的起源以及法律管制、醫療糾紛的相關問題，並進一步說明民國99年時，衛生署公告中醫診所內之傷科推拿助理必須限期退出診所後，此一政策的改變引發諸多議題的探討，其包含傷科推拿助理的工作權、民俗醫療的管制以及醫事專業執照建立等等的問題。

第六章結論，將結合先前數章的鋪陳，深入探討傷科推拿作為傳統醫療的一環，長久存在於民間社會，國家作為管制者，究竟存在何種規範態度，並思索這樣的規範態度，是否有助於解決傷科推拿的管制問題。

關鍵字

中醫 ； 傷科推拿 ； 法律史 ； 拳頭師 ； 漢醫 ； 推拿技術員 ； 醫療管制

並列摘要

Abstract
This essay provides historical approach of legal system and medicine to discuss the development of Osteo-traumatology. Relying on chronological order, the discussion begins with the nascent stage of Osteo-traumatology, followed by its transmission to Taiwan. Resting upon its struggle against the modern legal system . The essay further indicates the challenges posed by Japanese colonial government. Finally, the essay reveals how Osteo-traumatology finds itself in such situation in response to the regulation of law by the ROC government.

The essay contains six chapters in total. The first chapter specifies the research interest along with the bibliography, research methods and the overall structure of the six substantive chapters.

The second chapter will cover the practice of Osteo-traumatology performed by the Hans in Taiwan, elaborating the intimate and inseparable relation between Han culture and the Osteo-traumatology as it became an essential part of the Han-medicine. In China, medicine evolves with social context and national regulation, so does Osteo-traumatology. Under such circumstance, the uniqueness of Osteo-traumatology thus had been shaped. As time went on, the association of Ossteo-traumatology within medical treatment was deeply ingrained in Hans’ mind. Through many shifts in power, from Dutch and Spanish period、Zheng Dynasty to Ch’ing Empire?, in Seventeenth century, there came Hans. The Hans introduced their own social, political cultural trend to Taiwan. The medical system had been transmitted as well. Han medicine and Osteo-traumatology also found its place in Taiwan. The regulation of medicine had been maintained as that of in China, without being regulated by the officials.

The third chapter, “Osteo-traumatology development in Taiwan during Japanese colonial period” lays out the Taiwan Sotokufu’s plans of launching Western legal systems to reign over the island. While establishing modern sanitary and hygiene systems and forming Western medical system, Taiwan Sotokufu also initiated regulatory actions to extinguish Han medicine and traditional medical treatment. The context will explore the discrepancy between Osteo-traumatology and other traditional medicine under the regulation of Taiwan Sotokufu through Taiwan Sotokufu files、court judgments and other non-official documentations. Furthermore, discussion of possible transformation in response to the Taiwan Sotokufu policy is also being included.

The fourth chapter, “The development of Osteo-traumatology under the rule of ROC government”, first begins with evolvement in China after 1911, illustrating the clash between Western medicine and traditional medicine and the development of law. Then the essay addresses the resurgence of Han Medicine during the period the enactment of ROC law in Taiwan(roughly at the end of World War II). Lastly, it depicts how the KMT government handled the conflicts between the modernized/westernized medical systems and traditional medical treatments with the ROC law, which was on the basis of Western legal system.

The fifth chapter includes the discourse of current Osteo-traumatology practitioners, detailing its origin, regulation and its related malpractice. Taking a step forward, this chapter exemplifies that the practice of Osteo-traumatology formally be excluded from the Han medical clinic after the announcement made by Department of Health in 2000. Many issues arose of such change, such as the Right to work of Osteo-traumatological assistants… the issuance of medical license and so on.

The last chapter summarizes the aforementioned problems in previous chapters, delving into more to discuss the attitude toward Osteo-traumatological and clarifying the attitude of the regulator, here, the Officials. The policy should stem out of an attempt to solve the problems, rather than creating new problems. The essay will analyze whether the regulation/norm would help the such cause.

並列關鍵字

Chinese medical doctor ； Osteo-traumatology ； Legal history ； martial art master ； Tai-na technician ； Medical regulation

參考文獻

王泰升，《台灣日治時期的法律改革》﹝臺北市：聯經出版社，1999年﹞

吳基福，《中國醫政史上的大革命》，﹝台北市：中華民國醫師公會全國聯合會，1980年﹞

蘇士博，〈台灣地區國術館現況分析〉，《中華民國體育學會體育學報》，第十六輯， 1993年12月。

張秀蓉編註，《日治臺灣醫療公衛五十年》﹝臺北市：國立臺灣大學出版中心，2012年﹞

參考文獻