作者 ｜
傅大為(高醫性別所、清大歷史所)
摘要 ｜
本文從婦產科的基本技藝──子宮搔爬術 開始討論，然後再進入到戰後徐千田流派的婦產科絕學：子宮頸癌根除術，最後以七零年代而興盛的子宮頸抹片篩檢技術來結束，並同時旁及戰後剖腹產技術的興起過程。也許有人會問，為什麼要那麼重視婦產科的手術技藝？因為，在研讀文獻與沈浸在婦產科醫師們的回憶中，我常看到他們，雖然是婦產科醫師，但往往更是一群有著外科醫師般的手術執著、熱中於手術技藝、並以各種手術學習為婦產科醫師「行醫濟世之所必備」的群體。從這樣子一種「手術型婦產科醫師」的歷史類型來看，從戰後早年徐千田流派的興起與主導，到後來台大流派的改變與急起直追，在一個缺乏良好而廣泛的子宮頸抹片篩檢的社會中，婦產科醫師熱中於子宮頸癌根除術、子宮切除術、剖腹產術等等，並將這些手術技藝、還有手術動刀的比例與頻率推到一個有國際高知名度（或說壞名聲）的地步，這一切，畢竟有其戰後台灣婦產科傳統的歷史淵源。從上，可以追溯到日治時期日本與台灣婦產科門派的流變與消長，從旁或從下，以子宮頸癌根除術為顛峰與主軸，我們可以順游而下，看到從此發展孕育出來的台灣高剖腹產率、還有「手術技藝」所代表的高醫學價值，這一切，包括了這個技藝與器具組合傳統的歷史慣性，一直要到近年來如抹片篩檢等「他種＼醫療技藝」的逐漸發展與廣受重視，才稍有遏止的趨勢
關鍵字 ｜
婦產科、性別政治、手術技藝、台灣醫學史、子宮頸癌、抹片篩檢。
Title ｜
The Surgical Technique and Sexual Politics of Gynecology in Post-war Taiwan
Author ｜
The Surgical Technique and Sexual Politics of Gynecology in Post-war Taiwan
Abstract ｜
From the basic technique of D&C (dilatation and curettage) to the supreme gynecological operation called Radical Hysterectomy (RH) for cervical cancer, in this paper I trace the technical construction and development of a typical obstetrics-gynecology doctor during Taiwan’s post-war years of 50s and 60s. Because of the poor conditions of women’s health (high morbidity and mortality rate of cervical cancer) in the 50s, plus the difficulties and hence the medical prestige of RH operation, Taiwan’s postwar tradition of gynecology has constructed and developed a certain type of doctors who are eager to perform surgical operations and value them more than any other medical treatments. On the other hand, contrary to some feminists’ generalization, gynecology in Taiwan was not inherently fond of opening woman’s body by a surgical knife, and the complications and contradictions of different gynecological trends are explored and analyzed. However, ironically and almost sadly, around Taiwan’s 1970s various trends of gynecological tradition were finally unified under the paradigm of surgical operation, with RH for cervical cancer as the top of gynecological achievements. Only from the vantage point of this highest gynecological “achievement”, I argue in this paper, can we begin understanding why in later days Taiwan the notorious C/S operation is so prevalent among obstetricians, and why the long established Pap smear techniques was so much delayed in being received and practiced in Taiwan.