藥品宅急便 : 「寄藥包」之研究

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题名:	藥品宅急便 : 「寄藥包」之研究
其它题名:	Home delivery service for drug : a study on "medicine kit"
作者:	吳秋儒;Wu, Chiu-Ju
贡献者:	淡江大學歷史學系碩士在職專班張素玢;Chang, Su-Bing
关键词:	家庭配置;寄藥包;外務員;成藥;藥廠;Household Medicine Kit;Medicine Kit;Salespeople;Over-The-Counter;Pharmaceutical Company
日期:	2011
上传时间:	2011-12-28 18:38:56 (UTC+8)
摘要:	日治時期總督府透過國家力量扶植西醫，自此臺灣成為以西醫藥為主體的醫療張本，總督府透過種種手段刻意限縮傳統漢醫的發展，造成西醫醫權高度擴張，漢醫人數日漸萎縮。傳統漢醫藥受限於漢醫人數的驟減，似乎失去臺灣的醫療市場，但臺灣漢藥店數於日治時期明顯仍高居不下，原因乃日本傳統生藥材在1891年《日本藥局方》改版中，以摻雜科學製程及經驗效果的混和標準成為合法藥品，即「科學漢方」，從此漢藥穿上科學製劑的外衣生存下來且更受歡迎。根據日本1907年「藥品營業並藥品取締則」修正案，臺灣傳統漢藥舖、藥房與藥局取得與成藥製造商一樣合法成立藥廠的依據，日後以規模不大的家庭製藥工廠模式經營，但實際上藥品製造僅侷限於成藥或分裝從日本運來的藥品原料。昭和年間，日本藥商杉澤榮貫堂將富山縣的『先用後利』賣藥制度引進臺灣，1940年代彰化地區有一批人受雇於杉澤榮貫堂，在全臺各地配置藥品，此為臺灣人將日本「家庭配置」改稱為「寄藥包」的肇始。戰後彰化伸港柯氏家族承繼日人留下來的家庭配置事業，陸續成立長安堂、永生堂、正長生等製藥廠，並藉由聘請外務員（又稱寄藥包仔）以寄售藥包的方式推銷藥品。藥廠與外務員兩者間的雇庸關係造就「寄藥包」的興起，寄藥包仔經由藥廠的訓練後取得「外務員證」，並憑此證至全臺寄售藥包，戰後儼然成為藥廠販售藥品的重要通路。日治時期「寄藥包」在臺灣似乎是遊走於法律邊緣的藥品銷售管道，總督府曾透過衛生警察試圖管控民間的成藥銷售，但效果顯然有限，官方雖然訂有相關規定，寄藥包仍因為價格較低廉、具便利性、效用不比西醫用藥差，反而更受大眾歡迎。戰後「寄藥包」主要提供合格藥廠製造的家庭藥，影響所及使臺灣民眾養成生病時先以自療為主，求診為輔的醫療習性。目前留存下來的藥包袋封面大部分是臺灣省衛生處許可，證明寄藥包約在臺灣省衛生處總管全臺衛生事業的時期最為興盛。1970年代以降，由於藥政管理漸入正軌、製藥產業政策緊縮及藥局與私人診所大量增加，民眾對於醫療的需求日漸脫離「寄藥包」的服務，1995年全民健保開辦後，更使「寄藥包」失去競爭優勢成為夕陽產業。「寄藥包」適時填補戰後政府推展公共衛生的空窗期，並深深影響臺灣民眾的藥品消費文化與用藥習慣。當「寄藥包」已成為大多數臺灣民眾的回憶時，本論文除了釐清「寄藥包」在臺灣的興起與沒落的歷程，也為「寄藥包」在特定時空下的歷史意義留下註記。 The General Governors in Taiwan supported western medicine with nationwide resource during Japanese occupation, establishing a medical system prioritizing western medicine. The General Governors purposefully oppressed the development of Chinese medicine by all means, resulting in the overexpansion of western medicine and the decline in the number of Chinese medicine practitioners. Traditional Chinese medicine seemed to lose its market in Taiwan due to the sudden decline in the number of Chinese medicine practitioners while the amount of Chinese medicine stores remained high during Japanese occupation because Chinese medicine became more popular for it was crowned as scientific preparation after Japanese raw medicinal material was listed as eligible medicine in the revision of “The Pharmacopoeia of Japan” in 1891 under the criteria mixing the application of scientific manufacturing and empirical efficacy. In accordance with the revision of “Regulation of Business and Ban on Medicine” in Japan in 1907, traditional Chinese medicine stores, drug stores, and pharmacies in Taiwan were eligible to set up pharmaceutical companies as the manufactures for over-the-counter. Afterwards, these pharmaceutical companies operated on a small scale in the pattern of family-based pharmaceutical factory. However, medicine manufacturing was actually limited to over-the-counter or the sub-packaging of medicinal raw material shipped from Japan. During the Showa Era, Japanese drug manufacturers, RongGuanSugisawa Tang, introduced the medicine distribution system of "pay after use" into Taiwan. In the 1940s, a group of people were employed in Changhua by RongGuanSugisawa Tang to distribute its medicine all over Taiwan, which initiated the system of “medicine kit” transformed from the “household medicine kit” in Japan. After World War Two, the Ke family at Shengang, Changhua inherited the “household medicine kit” system left by Japanese and gradually established pharmaceutical companies such as ChangAn Tang, YungShenTang andChengChangSheng . They also hired salespeople (also known as “medicine kit guys”) to promote their medicine by the medicine kit system. The employment of salespeople by pharmaceutical companies resulted in the popularity of “medicine kit”. A medicine kit guy got the “salesperson license” after receiving training from a pharmaceutical company, selling medicine kits to clients around Taiwan with this license. This became the major channel for pharmaceutical companies after World War Two. The “medicine kit” seemed to be a medicine distribution channel on the edge of law during Japanese occupation. Although the General Governors tried to control the distribution of over-the-counter among the general public by health policeman, the effect was obviously limited. Against official regulations, medicine kit was quite popular among the general public for its cheap price, convenience and comparable efficacy with western medicine. Most “medicine kits” provided medicine for families from eligible pharmaceutical companies after World War Two, which cultivated the habit of Taiwanese to treat illnesses by oneself before going to a doctor. The covers of medicine packages preserved until now were printed with the permission from Taiwan Provincial Health Department, indicating that “medicine kit” was most popular during the time when Taiwan Provincial Health Department was in charge of all health affairs in Taiwan. From 1970s, people needed other medical services rather than “medicine kit” because of the more sophisticated regulations of pharmaceutical affairs, the tightening of policies on the pharmaceutical industry and the rapid increase in the number of private clinics. “Medicine kit” further lost its competiveness and became a sunset industry after National Health Insurance started in 1995. “Medicine kit” functioned during the window period of public health promotion by the government after World War Two, influencing substantially the consuming culture and taking habits of medicine for Taiwanese. As “medicine kit” has become a memory for most Taiwanese, this study clarifies its history from rise to disappearance and notes the existence of “medicine kit” in the specific time of history.
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