救命仙草、健康食品或生技靈藥？靈芝的科學、巿場與療效政治

Abstract

傳統醫療的科學化是科學家長期關注的議題，伴隨科技的社會研究的學術潮流，社會科學研究者也涉足藥物研究。在21世紀，臺灣政府關注如何透過生物技術的發展，將傳統醫療科學化與商品化，以便開創臺灣產業新局。科學家認為靈芝是帶領臺灣其他中藥材，進軍國際巿場的典範。因此，靈芝成為瞭解傳統醫療遭遇國家治理、資本主義巿場與新興科學研究的範例。 本論文以療效政治的理論，採取物的生命史取徑，分析靈芝在臺灣的商品化歷程。靈芝體現了傳統的再發明，說明靈芝作為中草藥，受跨國貿易、科技研究與法規制度的影響，轉變成為健康食品。產學界呼籲政府將臺灣打造成「靈芝王國」未果，傳銷業者接續投入靈芝科學研究。業者提出「靈芝的好壞在多醣體」之說，引發靈芝巿場大戰，業者相繼援引科學研究反擊，激發靈芝的新療效論述，產業界成為靈芝療效政治的推動者。 政府為了回應1990年代以來的健康食品爭議，於1999年公告施行「健康食品管理法」，強調健康食品需要科學依據，並以重罰遏阻非法健康食品。立法機關與行政機關立場矛盾，既形成世界上「健康食品」與藥品及食品的法規位階相同的獨特現象，也造成後續健康食品管理法立法嚴格，但健康食品管理法施行細則則寬鬆管制的弔詭現象。行政機關的立場，與其說是健康食品的管制者，不如說是為企業產品背書的認證者。由於健康食品管理法，科學家協助產業認證產品功效，協助政府制訂管理法規，促成新型科學研究形態的誕生，本文稱為「認證科學」。 靈芝業者投入申請健康食品認證，將靈芝從保健食品，轉變成為政府認證的健康食品。業者發現政府認證無法保證商機，因此挪用健康食品認證，游走法律邊緣，宣傳產品療效。傳銷業者援引多重證據，建構靈芝療效可信度，將靈芝從政府認證的健康食品，轉變為救命的生技靈藥，並自許為濟世救人的道德行動者。親近產業的科學家認為靈芝已從神話走向科學，本論文認為科學與神話並非對立兩極，療效始終充滿政治性。

Traditional medicine has long been a research focus of natural scientists. Social scientists now are also involved in the in the Current trends in Science, technology and society (STS) now also lead social scientists into the field of pharmaceuticals research. In the 21st century, Taiwan government lists the transformation of traditional medicine as an industrial priority of the nation with a renewed emphasis on the development of bio-technology industry and the commodification of traditional medicine. Natural scientists believe that Lingzhi (Ganoderma Lucidum,) as one example of commodified medicine, is a potent treatment and therefore a competitive product in the international pharmaceutical market and that it will become an exemplar of Taiwan’s success in the bio-technology industry. For social scientists, the case of Lingzhi illustrates how traditional medicine encountered with modern state, capitalism and technoscience. This thesis analyzes the commodification process of Lingzhi in Taiwan by adopting the biographical approach to things and the theory of efficacy politics. Lingzhi is a re-invention of the Chinese medicine tradition, and defined as “health food” (or “dietary supplements”) by the influence of international trade, the science and technology studies, and the state’s regulation of food and drug. Entrepreneurs and natural scientists once convinced the government to develop the LIngzhi industry as a national industry and Taiwan a “Lingzhi Kingdom.” The project failed and the government ceased the funding on Lingzhi research, but the entrepreneurs continued it and became the most important promoter of Lingzhi science studies in Taiwan. In 1999, the Taiwan government implemented the “Health Food Control Act”(HFCA) to respond to the health food controversy in 1990s. Under the HFCA, to qualify any product as “certificated health food,” health food companies must first present required scientific evidence. A conflict between the legislative authority and the administrative authority resulted in this act “especially for health food” and independent from the food and drug regulation, which is unprecedented in countries like China, the United State, and Japan, where health food (or dietary supplement) is regulated under the food category. Their disagreement further led to an unreasonable situation that the administration overstepped its legal authority when implementing the HFCA: the administrative authority loosened up on the rules of the HFCA with its subsidiary rules, the “Enforcement Rules of Health Food Control Act.” In this sense, the administrative authority seems more like an endorser of the companies’ health food product but less a regulator as it should be. This HFCA promoted a new type of science, the “Certificate Science,” which Scientists do to assist the industries to obtain the state’s endorsement for the efficacy of their health food products. The health food certificates obtained by Lingzhi companies made Lingzhi products be transformed from common health food into certified health food. However, the companies found that the government certificates couldn’t bring them anticipated profits, so they took the certificates as a shield against the government intervention and promoted the miraculous efficacy of Lingzhi products by face-to-face, record-free soliciting on the edge of the law. In this thesis, my case study reveals that a local Lingzhi multi-level marketing company (MLM company) cited multiple references to construct credibility for the efficacy claim of Lingzhi products so as to market the Lingzhi products as life-saving biotech drugs. The MLM sellers identified themselves as life-saving moral actors. The scientists who are friendly to the industry believe that Lingzhi has evolved from a myth into science. However, this thesis suggests that science and myth are not opposites, and the efficacy is always full of political controversy.