百年台灣公共衛生歷史展 One Hundred Year History of Public Health in Taiwan

日治時代

臺灣，這個被十六世紀葡萄牙人稱的「ILha FORMOSA」（美麗島），其實在中國古

籍中，屢被稱為「瘴癘之鄉」。

日本領臺之初，誠如小田俊郎在《臺灣醫學五十年》中所說：「臺灣除了有鼠疫、傷

寒、赤痢、霍亂、天花、流行性腦脊髓膜炎、瘧疾、秋恙蟲病等急性傳染病之外，還

有各種寄生蟲病、蛇毒、結核病、癩病、梅毒、精神病等等蔓延著，各地也發現各種

皮膚病、地方性甲狀腺腫等。」此外，還有吸食鴉片、環境的髒亂，以及飲水的衛生

等，都是台灣總督府亟待解決的問題。

日治之前，清朝首位臺灣巡撫劉銘傳任內曾設「官醫局」、「官藥局」，後因經費短

促停辦，另由續任之巡撫紹友濂接辦；並先後聘請日人、洋人於臺北鑿井，供官衙人

員及一般民眾取用，但臺灣公衛醫療真正而持續走向近代化，卻是從一八九五年日本

治理臺灣開始。

本次展覽日治時期（１８９５－１９４５）公共衛生史部分，以衛生醫療政策與關鍵

人物兩大項目為主題，其中，衛生醫療政策分為市區改正、飲水思源、醫學教育、醫

療行政（醫院、防疫、公醫、甲乙種醫師）、及鴉片政策五類。展示之文物包括有總

督府檔案中相關檔案（複製品）、十二間府立醫院照片、及醫學校手抄教科書原件

等。

光復後

台灣自光復之後，40年

來，政府與國民一直努力

投入於國家的建設與經濟

發展，如今國民生活水

平提高，公共衛生也有顯

著的進步，死亡率大幅下

降，平均餘命不斷提升，

全民健保納保率高達96％

以上，不論在婦幼衛生、

疾病防治、基層醫療的普

及與醫療服務的水準上，

都有良好的成果。台灣在

亞洲國家中平均餘命屬於比較高的國家，在1951年，平均餘命為53.38歲；在2008年時

男性平均餘命為75.1歲，女性平均餘命81.9歲。

百年台灣公共衛生歷史展將展示自台灣光復後的重要公共衛生里程碑，讓民眾了解台

灣公共衛生成功的歷程。在醫療政策部分，將會介紹台灣醫療政策上的施政方向與改

革。如1975年開始培育一般公費醫師；1978年，行政院通過「加強農村醫療保健計

畫」；1983年推動「群體醫療執業中心計畫」；1986年，行政院亦核定「醫療保健計

畫：籌建醫療網計畫」；1995年施行「全民健康保險」。如今我國的醫療水準已達國

際水平。

而在健康促進方面，台灣的家庭計畫以及婦幼衛生可謂為公共衛生史上一向卓越的成

就。台灣的菸害防治亦是台灣最大的健康促進策略，政府所施行這些措施的目的皆為

了促進台灣人民的健康。

After the Restoration of Taiwan

Taiwan has one of the highest levels of life expectancy in Asia. In 1951, the average life expectancy stood at 53.38 years; in 2007, it was 75.1 years for men and 81.9 years for women. In the last 40 years, government and citizens alike have been working hard towards a

Japanese Colonial Period

Taiwan was called “Formosa” (beautiful island” in the sixteenth century by the Portuguese. However, in ancient Chinese documents, Taiwan was called the “the country of infectious diseases”.

When the Japanese occupied Taiwan, Odashunlo described in the book “Fifty years of Taiwanese medicine” that “in addition to plague, typhoid fever, dysentery, cholera, smallpox, meningitis, malaria, etc, there were all kinds of parasites, poisonous snakes, tuberculosis, leprosy, syphilis, psychiatric diseases, etc. Skin diseases and local thyroiditis were also found.” The colonial government-general also had to solve problems of opium addiction, environmental pollution, and drinking water sanitation.

Before the Japanese rule, the first governor of Taiwan assigned by the Qing Dynasty, Ming-Chuan Liu set up “official medical office” and “official drug store”. However, they were closed due to lack of funding. The following governor hired Japanese and Westerners to drill wells in Taipei for both officials and laypeople to use. Nevertheless, the real modernization of Taiwan’s public health system was founded by the Japanese regime.

This exhibition on public health in the Japanese period (1895-1945) has two themes: health policy and key people. Health policy includes district, water, medical education, medical policy, and opium policy. The objects displayed include replica of documents from colonial office, hospitals, medical school and hand-written textbooks, etc.

healthier nation. The living standard and public health have improved, death rate has radically declined, and life expectancy has been prolonged. The national health insurance covers more than 96% of the population. There are successful outcomes in maternal and child health, disease prevention, primary care, and quality of medical care systems.

The public health history exhibition demonstrates the important public health milestone since the establishment of the department of health in 1971. The exhibition is aimed to let the public understand the successful process of the development of public health in Taiwan.

In the medical policy part, we introduce the administration direction and the reforms of the medical policy in Taiwan, including the trainings of the doctors at government expense in 1975, the countryside medical care program in 1978, the community medical service disciple center plan in 1983, the medical service network plan in 1986, and the national health insurance in 1995. Today, our level of health has achieved the international level.

In the health promotion part, the family plan and the women and children's hygiene are two great remarkable achievements in public health history in Taiwan. The promotion of tobacco hazard prevention is also one of the biggest health promotion targets in Taiwan. The goal of these acts is to promote the health of the public in Taiwan.

主辦單位：台灣大學醫學院︱協辦單位：國史館台灣文獻館感謝民俗文物收藏家李景暘先生提供相關展覽文物。

光復後疾病控制

光復之後，由於政府致力於疾病防治工作，而有絕佳的成效，一些嚴重的傳染病如天

花、霍亂、鼠疫、狂犬病等，在光復後十五年內逐一被撲滅，而疫苗可預防的傳染病

如痲疹、小兒麻痺、破傷風、白喉、百日咳等亦被妥善控制。

1950年左右，瘧疾仍為臺灣十大死因之一，患者每年高達120萬名。1948年，政府特別

成立瘧疾研究所，展開全面性有系統的防治工作。在衛生當局與外援機構合作下，歷

經準備，攻擊和肅清三個階段之長期努力，終於在1965年被世界衛生組織宣布為「瘧

疾根除區」。

Disease control after Taiwan Restoration

After Taiwan Restoration, the government was devoted to the disease control works and achieved good effects. Some serious infectious diseases like smallpox, cholera, plague and rabies were exterminated one by one in the following 15 years. Meanwhile, some diseases which could be prevented by vaccine like measles, poliomyelitis, tetanus, diphtheria and whooping cough were also controlled.

In the1950s, malaria was still one of the top ten causes of death in Taiwan; the population of patients every year reached as high as 1,200,000. In order to control malaria, in 1948, the government established the institution of malaria research to launch a systematic program for the prevention of malaria. Thanks to the cooperation between the government institution of health and the foreign aid organization, after the three stages of malaria eradication acts, preparation, attack and elimination, in 1965, the World Health Organization announced that Taiwan was categorized as one of the ‘malaria eradication areas.”

烏腳病

烏腳病(Blackfoot disease)俗稱「烏乾蛇」的血管疾病，大部份是屬於血管疾病中因末

梢動脈血管硬化所造成的，並非傳染所致。烏腳病曾在台灣嘉南沿海一帶的北門、學

甲、義竹及布袋四個鄉鎮流行，早在日據時代(1920年左右)即已發生，惟當時罹患者不

多，1954年由高聰明與高上榮兩位學者以「特發性脫疽(Spontaneous gangrene)」之名，

發表於台灣醫學會雜誌上，1956年後大量發生，嚴重引起衛生當局和醫學界的注意。

北門免費診所成立後，烏腳病患者不斷地被送來醫治，國內外的衛生單位及醫生紛紛

前來探視，並提供醫療方面的幫助，同時也詢問及調查病因。而由台大公共衛生研究

所組成研究團隊，在陳拱北教授的率領下，實地調查研究後，發現烏腳病之病因與飲

用地河井的深水有關，係水中含砷量過高所致。於是政府開始著手改善該地區的的給

水計畫，70年代起居民改善飲水，烏腳病才逐漸消失而告絕跡。

Blackfoot disease

Blackfoot disease (BFD), also colloquially named as “black and dry snakes”, is scientifically known as “Spontaneous gangrene” (name given by two scholars, Cong-ming Gao and Shang-rong Gao, whose articles were published in Formosan Medical Association’s periodical in 1954.) Most of the cases are caused by vascular sclerosis in periphery artery; it is not a contagious disease. Blackfoot disease was first seen around 1920 during the period of Japanese Colonial government; yet it was not widespread until after 1956, when the water supply along the southwestern coast of Taiwan, including Beimen, Xiejia, Yizhu and Budai, was contaminated by arsenic. The disease affected mostly adults, but children were not excluded.

Ever since the free clinic policy was established, patients were continuously sent to clinics. Many medical organizations, either of Taiwan or foreign countries, offered supports for

Poliomyelitis

The poliomyelitis is the oldest disease of human beings. 3,500 years ago, ancient Egypt’s mural had recorded a lame pharaoh who suffered from paralysis. In the ancient times, poliomyelitis would be one kind of spreading diseases. Later, due to the urbanization, the disease became an epidemic disease.

The poliomyelitis is caused by the Poliovirus infection; it initiates the encephalitis symptoms, causing babies to have continuous high fever, and leading to sequels like body paralysis, handicap, and so on. In 50s and 70s, following the eruption of the disease, Poliomyelitis became the main health murderer for babies in Taiwan at that time. In response to the global disease control policy, the Department of Health, Executive Yuan, started the “Poliomyelitis, Neonatal Tetanus, Congenital Rubella Syndrome and Measles Eradication Project” In July 26, 1991. This project was aimed to eliminate Poliomyelitis, measles and other diseases. In 2000 on October 29, World Health Organization Western made an announcement in Kyoto, Japan, declaring that in Pacific area, where Taiwan was located, poliomyelitis was eradicated.

SARS

民國九十二年四月十六日世界衛生組織（WHO）正式宣布，SARS的致病原為一種變種的冠狀病

毒，並正式命名為「SARS病毒」。嚴重急性呼吸道症候群（Severe Acute Respiratory Syndrome，

SARS）為民國九十二年首次在人類爆發的傳染病。民國92年3月初，SARS在越南、香港、中國地

區開始發生流行，臺灣地區自3月14日首度發現一名可能病例以來，到和平、仁濟、高雄長庚及高

醫等醫院的院內感染事件，使全國籠罩在SARS風暴之中，對整個社會而言，在醫療保健體系及經

濟層面和心理層面上皆帶來嚴重的衝擊。 幸經全球醫界合作，臺灣地區終在7月5日解除疫情，為

利後續防疫措施之執行，乃於8月19日公布SARS為第一類傳染病。

SARS

On April 16, 2003 the World Health Organization (WHO) announced that the cause of SARS was one kind of variety corona virus which was officially named as “SARS virus”. The SARS (Severe Acute Respiratory Syndrome, SARS) was the first epidemic infectious disease in humanity in 2003, Taiwan. In the beginning of March, 2003, SARS started to become epidemic in South Vietnam, Hong Kong, and China. In Taiwan, following the first possible case discovered in March 14, the eruption of the infection inside hospitals, including Ho-Pin, Renji, Kaohsiung Chang-Gung, Kaohsiung Medical Hospital and so on, had shocked the whole society. This event has brought serious impacts on the healthcare system, society, economy and the psychological status of Taiwanese people. Fortunately, after the global medicine cooperation, Taiwan area got relieved from the epidemic in July 5. In order to improve the future disease control plans, the Department of Health, Executive Yuan announced SARS as the first kind of infectious disease on August 19.

researches, in hope of finding out the cause of the disease. A research team, led by Professor Gong-ming Chen and formed by the graduate school of public health in National Taiwan University, started to investigate the local environment and finally discovered that the disease was caused by drinking water which contained large amount of arsenic. The government then began to improve the water supply system of the area, and the quality of drinking water was much improved by the 70s. Consequently, Blackfoot Disease gradually ceased to exist.

小兒麻痺

小兒麻痺症（脊髓灰白質炎）是人類最古老的疾病，3500年前古埃及的壁畫中，就記

載了罹患麻痺性跛足的法老。在古代小兒麻痺是一種散發性的疾病，都市化以後因為

人口集中，演變為流行性的疾病。小兒麻痺症是因小兒麻痺病毒感染，引發腦炎症

狀，造成幼兒高燒不退，並出現肢體麻痺、殘障等後遺症，曾在五０及七０年代爆發

大流行，並成為當時臺灣幼兒主要的健康殺手。

為響應全球性防疫趨勢，行政院衛生署計劃自1991年7月26日起，開始實施「根除三麻

一風計畫」，在計畫中並將麻疹、腮腺炎、德國麻疹（MMR）混合疫苗納入幼兒預防

接種項目中。2000年（民國89年）10月29日，涵蓋我國區域之世界衛生組織西太平洋

區署，於日本京都宣布根除。台北市仁愛路一段一號

No.1, Jen Ai Road Section 1, Taipei 100 Taiwan R.O.C.Tel：886-2-23123456