瘧疾治理與太平洋戰爭：美、日、中跨國視域下的疾病、資源與環境控制

Abstract

本論文探討瘧疾治理、環境與資源之間的關係，以太平洋戰爭的戰場瘧疾問題為中心，比較美國、日本、中國如何在太平洋戰爭爆發、地緣政治變動所致之不同的資源條件下，參照各自戰前的瘧疾治理經驗以對抗戰場上軍隊的瘧疾流行問題，及三國不同的戰場瘧疾治理成效又如何影響了各自的軍事能力和戰爭走向。本文將指出，各國不同的社會、政治情況及經濟發展思維，形塑出分別著眼於瘧蚊和帶原者之戰前瘧疾治理模式，不同的瘧疾治理模式又引導出不同的治理資源需求；各國的瘧疾治理模式及其資源需求，則影響了各國對戰場瘧疾流行問題的應變能力。筆者將嘗試論證，在奎寧和當時的合成抗瘧藥均無法預防和完整治療瘧疾的前提下，美國發展出藉環境改造來控制瘧蚊密度以降低瘧疾傳播率的治理模式，此為美國能夠在戰爭爆發、奎寧供應被日本切斷和其他抗瘧藥物供應無法保證的情況下，仍可以憑藉過去環境（瘧蚊）控制經驗來扼止軍隊內瘧疾感染情況的原因。更重要的是，美軍制度化的瘧疾防治有效支持前述治理模式，使之得以發揮效力，從而讓美軍能夠恢復和維持戰力。相較於美國，日本治理殖民地臺灣瘧疾問題的經驗，使之發展出偏重以帶原群體為中心的瘧疾治理模式，即高度依賴奎寧投藥來抑制瘧疾流行。儘管日本未完全偏廢環境（瘧蚊）控制，但因此未能發展出符合日本資源需求且制度化的環境治理實踐模式，而持續在戰場軍隊瘧疾問題上高度依賴奎寧，一旦戰場奎寧供應不足和奎寧本身的限制，加上軍隊的責任體系無法支持此一治理模式的有效運作，日軍內的瘧疾傳染便廣泛蔓延，從而極大程度地削弱日軍的體力和戰力。中國方面，儘管太平戰爭爆發前後已有來自國際、美國方面的瘧疾治理合作和援助，但中國政府和軍隊醫療體系長期失能，因此戰前中國未能累積出足夠的瘧疾治理實踐經驗，而軍隊疾病治理體制於戰爭期間持續失能，也使得國際援助和中國軍隊自身均無力矯正軍隊內部嚴重、深刻的瘧疾傳播問題。至緬甸與盟友共同作戰的中國遠征軍則因處於美軍瘧疾治理體制之下，而得以改善含瘧疾在內之各項疾病的問題，進而在軍事上取得重要成果。This dissertation aims to examine how the United States, Imperial Japan and China checked the spread of malaria among their own troops at battlefields during the Pacific War, and how their success or failure of overcoming malaria swayed their military capabilities as well as the war. I am going to point out that in the prewar period the public health campaigners and local governments of the United States made up their mind to eradicate malaria once for all by environmental engineering which aimed to eliminate breeding grounds of Anophelets to lower the population of the mosquitoes as well as the infection rate of malaria. The know-how of mosquito control helped the United States army check the spread of malaria among their solders when the supply of antimalarials were seriously curtailed because of the war. In comparison with the United States, Imperial Japan put great effort to find out malaria carriers for whom taking quinine regularly was compulsory. China, though barely developed any measures to fight malaria before the war, also relied on quinine or other traditional medicine to constrain the spread of malaria. Since quinine, as well as synthetic antimalarials available during that time, neither prevent people from getting infected by malaria nor cure Plasmodium falciparum malaria, the deadliest kind of malaria prevailing the Pacific region, troops of Imperial Japan and China, both of whom had no malaria control measures other than quinine, therefore experienced the full power of the deadly malaria, which obviously led to their military defeat in the war.