グローバル化する近代医療と民族医学の再検討:イントロダクション
Reexamining Modern
Medicine and Traditional Medicine in an Era of Globalization: An
Introduction
☆In
an essay titled “The World Medical System” (Chapter 3 of my book
*Practical Medical Anthropology*, 2001), I coined the term “World
Medical System” to describe the globalizing modern medical system and
examined it. From the perspective of Wallerstein’s world-systems
theory, conceptualizing a “world medical system”—which implies
segmented and autonomous systems within itself—seems to be a
contradiction in terms. Although this terminology was proposed by
Singer and Bear, my intention was to deconstruct this concept through a
theoretical critique of the dualism between modern and traditional
medicine that their theory presupposes. My critique of their theory
centers on a single point. It was that when they presented the concept
of a “world medical system,” they used the term to critique modern
medicine (with a considerable degree of moral condemnation), and to
that end, they employed a rhetorical strategy in which the concept of
traditional medicine appealed to a “theoretical vacuum”—that is, “what
modern medicine lacks.” This understanding of traditional medicine can
be seen as a kind of route metaphor—a catalyst for criticism of modern
medicine that was frequently employed during the early emergence of
medical anthropology in the history of cultural anthropology. It
remains one of the arguments anthropologists use to appeal to the
general public when attempting to explain the diversity of medical
phenomena observed to this day solely in terms of cultural differences.[Index]
| 私
は、「世界医療システム」（拙著『実践の医療人類学』第３章、2001年）という文章のなかで、グ
ローバル化する近代医療を「世界医療システム」と名付け、考察をおこなった。ウォーラスティンの世界システムの理論からすると、そのシステムの中に分節化
され自律的なシステムを含意する「世界医療システム」を概念化するのは形容矛盾であるように思われる。この用語法はシンガーとベアの提唱した用語だが、私
が言わんとしたのは、彼らの理論が前提とする近代医療と伝統医療の二元論の理論的批判を通して、この概念を脱構築したいからであった。彼らの理論に対する
私の論難はただ１点である。彼らが世界医療システムという概念を提示する際に、その用語を通して（それもかなり道徳的非難を込めた）近代医療批判をおこな
いためであり、そのために伝統医療の概念が「近代医療に欠けているもの」という理論的空虚（theoretical
vacuum）に訴えるという修辞法をとっていることであった。このような伝統医療のイメージの理解は、文化人類学の学説史における医療人類学の最初の勃
興時に好んで使われた近代医療批判の起爆剤として伝統医療という一種のルートメタファーとも言えるもので、今日までつづく医療現象における多元性をすべて
文化の差異で片づけようとする際に人類学者が大衆に訴えかけるもののひとつである。 |
In an essay titled “The
World Medical System” (Chapter 3 of my book *Practical Medical
Anthropology*, 2001), I coined the term “World Medical System” to
describe the globalizing modern medical system and examined it. From
the perspective of Wallerstein’s world-systems theory, conceptualizing
a “world medical system”—which implies segmented and autonomous systems
within itself—seems to be a contradiction in terms. Although this
terminology was proposed by Singer and Bear, my intention was to
deconstruct this concept through a theoretical critique of the dualism
between modern and traditional medicine that their theory presupposes.
My critique of their theory centers on a single point. It was that when
they presented the concept of a “world medical system,” they used the
term to critique modern medicine (with a considerable degree of moral
condemnation), and to that end, they employed a rhetorical strategy in
which the concept of traditional medicine appealed to a “theoretical
vacuum”—that is, “what modern medicine lacks.” This understanding of
traditional medicine can be seen as a kind of route metaphor—a catalyst
for criticism of modern medicine that was frequently employed during
the early emergence of medical anthropology in the history of cultural
anthropology. It remains one of the arguments anthropologists use to
appeal to the general public when attempting to explain the diversity
of medical phenomena observed to this day solely in terms of cultural
differences. |
| フィールドワーク
の現場においてはほとんどありえない伝統医療のユートピアがそこにはある。しかし誰もそのような理論的理想が生起する場
（フィールド）に立ち会うことはほとんど稀であろう。現実は、なになに医療という峻別がむなしいほど概念が混雑しており、また個々の病気の発生は偶発的で
あると同時に、その処遇は事後的にみるかぎり唯一なものである。概念的に区分される近代医療と伝統医療はもっと補完的であり、全体論的な行為実践のなかに
包摂されている。また先の文書の中で、いい足りないと事後的に私が思ったのは、世界医療システムの中に包摂されたと思しき（シンガーとベアを含めた）我々
がおこなっている営為は、そのシステムの外に立って容易に批判の対象とできるようなものではなく、我々じしんそのものが世界医療システムという環境（＝世
界 Welt）に住まうエージェントそのものではないかという自己批判が、我々には欠けている［のではないか］という認識である。 |
There exists a utopia of
traditional medicine that is virtually unthinkable in the context of
fieldwork. However, it is extremely rare for anyone to witness the very
setting (field) where such a theoretical ideal comes to life. In
reality, concepts are so jumbled that the sharp distinction between
“such-and-such medicine” is futile; furthermore, while the onset of
individual illnesses is random, their treatment—as seen in hindsight—is
unique. Modern medicine and traditional medicine, which are
conceptually distinguished, are in fact more complementary and are
subsumed within holistic practices. Furthermore, what I realized in
hindsight—and felt was insufficiently expressed in the previous
document—is the recognition that we [Singer and Bear included], whose
activities appear to be subsumed within the global healthcare system,
cannot easily be criticized from a position outside that system; we
lack a sense of self-criticism regarding the possibility that we
ourselves are agents inhabiting the environment of the global
healthcare system—that is, the “world” (Welt). |
| このような自己反
省に立てば、次に何をやるべきかは明らかになる。全地球的拡張を目標にする（あるいはそのように見える）医療を、シンガーと
ベアの視点ではないもうひとつの〈世界医療システム〉論という観点から眺めることである。彼らの対抗概念である、もうひとつの〈世界医療システム〉を明確
に定義したいというのが私の理論的悪あがき（つまり未だ成功していない）なのであるが、そのためにコスモポリタンという一度マーガレット・ロックに使われ
た医学のカテゴリーを指した用語を掘り起こして考えた。奥野先生らと始めた帝国医療や植民地医療、あるいは開拓医学（飯島 2000）とい
う一連の歴史学
から提唱された医療概念の研究がある。国際協力ボランティア（池田 投稿準備中）はグローバルポリティクスという世界医療システムを実現するエージェント
の重要なひとつであると考えている。また、存在の普遍性という観点から考えると、亡霊や幻覚（ファントム）の存在に関する意味論の研究が重要になり、ファ
ントム・メディシン（『熊本文化人類学』第4号、Pp.93-98）という枠組み で、医療システムが我々に与える偏見を相対化してくれるかもしれない。 |
Once we engage in this
kind of self-reflection, it becomes clear what we should do next: view
a healthcare system that aims for (or appears to aim for) global
expansion from the perspective of another theory of the “global
healthcare system”—one distinct from that of Singer and Bear. My
theoretical struggle—which, to be honest, has not yet succeeded—is to
clearly define this alternative “world healthcare system,” which stands
in contrast to their concept. To that end, I dug up and examined the
term “cosmopolitan,” a medical category once used by Margaret Lock.
There is research on medical concepts proposed through a series of
historical studies—such as imperial medicine, colonial medicine, and
pioneer medicine (Iijima 2000)—that I began with Professor Okuno and
others. I consider international cooperation volunteers (Ikeda, in
preparation) to be one of the key agents realizing a “world medical
system” within the context of global politics. Furthermore, from the
perspective of the universality of existence, research into the
semantics of ghosts and phantoms becomes important, and the framework
of Phantom Medicine (“Kumamoto Cultural Anthropology,” No. 4, pp.
93–98) may help relativize the biases that the medical system imposes
on us. |
| このようなことを
私がこだわり続ける理由は、世界医療システムのエージェントかもしれない人類学者の社会的役割について、単に研究対象を観相
するだけでなく（でないとシンガーとベアの陥った穴に戻ることになる）まさに同時進行的に考えたいということである。それは「すでに研究しつくされたこと
／すでに判っていることをなぜ私は延々とおこなうのか」という諦めからくる倦怠に抗して、能動的無為（今村 2005）を実践するひとつの方法になりうる
ことを私は願っているからである。 |
The reason I continue to focus on these issues is that I want to think about the social role of anthropologists—who may be agents within the global healthcare system—not merely by observing our research subjects (otherwise we would fall back into the trap Singer and Bear fell into), but in a truly concurrent manner. I hope that this can serve as a way to practice “active inaction” (Imamura 2005) as a means of resisting the weariness that stems from resignation—the question of “Why do I keep endlessly doing something that has already been thoroughly researched or is already well understood |
|
目次［表 紙に戻る］
|
Index [back to preface] Reexamining Modern Medicine and Traditional Medicine in an Era of Globalization [this page] An Introduction The Role of Anthropology The Cosmopolitan Sphere of Thought Cosmopolitan Medicine Imperialism as a Means of Universalization Japan Problem in Modern Medicine The Characteristics of Unfinished Continuity: A Cosmopolitan Inquiry The Dead End of Modern Rationalization Continuation and Dis-continuation of Idealism in Modern Imperial Japanese Medicine Unfinished Cosmopolitan Healthcare |
Credit:
Reexamining
Globalized Modern Medicine and Ethnic Medicine. Mitzub'ixi Quq
Chi'j, 2002.
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