| 摘要: | 不孕症的盛行是台灣地區在人口結構轉型後所面臨的重要公共衛生問題之一，而不孕症的防治，自民國七十九年起即為國家新家庭計畫的工作要項。面對無法生育的狀態，不孕婦女在企求子嗣的動機中，生活開始與醫療產生連結，不但尋求西醫的療治，也嘗試傳統中醫及具文化意涵的民俗醫療之協助，而呈現具本土文化特色的中、西、民俗醫療三元複向醫療運用現象。本研究主要探討不孕症婦女求助民俗醫療體系之醫療經驗與求醫行為，關注之主題包括其選擇民俗醫療的動機、求助的對象、所獲知病因解釋以及處理方式和在其中影響求醫抉擇之因素，不但呈現現今台灣地區民俗醫療在協助生育上的各項面貌，亦由不孕婦女之民俗醫療經驗中了解其於各醫療體系中轉換的原因。 研究發現，不孕婦女受傳統孝道思想與生育觀影響，一但不孕常陷於因悖離社會期待所造成的困窘生活處境中，因此為求達成懷孕生子的目標以脫離此困境，而轉換於中、西及民俗醫療三種體系。選擇民俗醫療的主要原因：一來為解決不孕所帶來之生活困境，二來為尋求更高層次力量之協助。求助的對象包括中醫葯之密醫、蔘藥店、祕方、神明單、保建功法，以及祈求生育女神(註生娘娘、臨水夫人、觀音)、祖先等協助；或透過靈媒以栽花、換花、換斗等巫術協助，或以制煞方式解其沖煞問題；或以算命、卜卦，抽籤來獲知天命進而改變命運或安於命運。其病因解釋是文化面的解析，包括：魂魄觀、祖先崇拜、鬼魂信仰。因緣果報及命定思想，內容則為有形身體之氣虛、冷底、氣血不調；無形身體之靈樹生長欠佳、沖煞鬼魂、嬰靈作崇、待轉生靈魂太少、倒房討嗣、姑娘仔討嫁、祖靈不安、祖墳有敗、品德有瑕、陽宅風水、祖先牌位安置有誤、著驚等。 促使不孕婦女選擇民俗醫療的原因，研究結果顯示包括：在中、西醫處的挫折、個人與家人的宗教信仰及個人的人生體驗，其求醫的行動線索以別人的忠告建議、家人經驗傳承、以及報章雜誌或大眾媒體報導為主。而在民俗醫療求治中，個案原本對民俗醫療之認知、病因解釋、療法的接受度、醫病互動、治療的副作用與效果、地點遠近與金錢花費等皆會影響其是否繼續求治或促使其更換求醫體系。 本研究之結果，使我們了解不孕婦女尋求民俗醫療協助及醫療體系轉換的原因，並對傳統文化與一般民眾對不孕病因的解釋及此體系處理不孕之方法與理論有所認識。此發現一方面可作為醫療人員全方位照護不孕婦女之參考，另一方面則可提供整合本土三元醫療體系之參考方向。民俗醫療具心理治療與社會學、人類學意涵，對民眾而言是貼近於生活的醫療方式，因此不應僅以迷信或巫術視之。
The prevalence of infertility is one of the important public health issues Taiwan confronted after the transformation of population structure. The cure of infertility has been an important new item of national family planning since 1990. Confronted with the status of being unable to conceive, infertile women in the motives of hoping to have offspring started to get involved with medical treatment. They not only seek western therapy, but also try to seek help from traditional Chinese medical treatment and cultural folk therapy, thus shows local color of the combination of Chinese, Western, and folk therapies. This research is mainly to investigate the experience and the help-seeking behavior infertile women resort to folk therapy, including the motives they chose it, the target they resorted to, the root cause explanation they obtained and the way they handled it, and the factors which determined their choice of therapy. This not only shows all aspects of the present folk therapy in helping childbearing, but also understands the reason the infertile women switched treatment system from the folk therapy experience they underwent. The study shows that infertile women are affected by traditional filial piety and childbearing concepts. Once found infertile, they often tried to escape from the plight of social expectation. In order to get pregnant and give birth, they often switch help from one to the other among Chinese, Western, and folk therapies. The main reasons they chose folk therapy are: first, to solve the plight infertility brought; second, to seek help from higher-level power. The target they seek help from includes Chinese quack doctors, ginseng stores, secret recipes, efficacious charms, health-care practices, Goddess of birth, and ancestors, etc. They will either seek help from psychics by way of witchcraft such as plant flowers, change flowers, change dippers/dou, etc, or solve the devil-offending problem by curbing the devils, or get to know the fate through fortune-telling, divination, and lot-drawing in order to change fate or accept the fate. The root cause explanation of the disease is analytical in culture, which includes concept of soul, worship of ancestors, worship of ghost, karma, and fatalism. The content of the explanation in the physical body includes lack of “chi”, more “Yin” than “Yang” in the body, and imbalance of “chi” and “blood”; in the virtual body includes the retarded growth of spiritual tree, the offense to the devils, the haunting of fetus-ghost, the lack of souls waiting to be born, the unmarried man died hoping to be worshiped, the unmarried girl died hoping to get married in the underworld, the uneasiness of the ancestral souls, bad ancestral tombs, flawed moral, bad feng-shui in this world, dislocation of ancestral tablet, being frightened, etc. The reasons that made the infertile women choose folk therapy include: the setbacks they encountered at the Chinese doctors’ and Western doctors’, personal or family’s religious believes, and personal experiences. Their motives depend mainly on other’s advices, family’s experiences, and reports from newspapers, magazines, and mass media. In the cases of seeking folk therapy, whether they will continue to stick to it or switch to other medical treatment system depends on how well they understand it, how clear the explanation of the root cause of the disease is, what their acceptability of the therapy is, what the interaction between the doctor and the patient is, what the effect and side effect of the therapy are, how far the distance is, and how much money it takes. The result of the study makes us understand the reason why infertile women resort to folk therapy and why they change to other medical system, and understand the explanation of infertility from traditional culture and common people point of view and the way and theory they handle infertility. The discovery can be used as a reference for medical personnel when they take omnidirectional care of the infertile, and as a reference for the integration of the three medical treatment systems as well. Folk therapy has the effect of psychological therapy, and reflects sociological and anthropological meanings. Therefore, folk therapy, a kind of medical treatment close to daily life, cannot be regarded as superstition or witchcraft. |
