交換經驗,吸取新知--現代醫學會議成果豐碩

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1981 / 9月

文‧沈玫姿 圖‧榮民總醫院提供


今年七月二十六日,中華醫學會第十二屆大會暨國際近代醫學研討會,在台北市揭幕。來自十個國家的醫學專家四十餘人,包括世界醫學會秘書長懷尼恩、澳洲醫學會理事長威爾遜、南非醫學會理事長克拉克、南非心臟移植聖手巴納德博士……等,與我國醫學界人士千餘人,就目前醫學上最新發展與有關問題,交換心得與經驗。這次的會議,一方面由於各科外籍專家的應邀前來,顯示我國醫藥水準已受到國際上的重視;另一方面,更由於這些專家的與會討論,對帶動我國醫藥的進一步發展,亦勢必大有裨益。


常作交流,彼此觀摩

我國醫學界為提高醫療水準,不但時常派遣醫師赴外國醫院研習或參加國際醫療會議,亦常在國內舉辦各種學術演講與討論會,以交換臨床經驗和研究心得。

中華醫學會是一個醫藥學術團體,早在抗戰時期就已成立,會員必須是取得正式醫師資格者。該會成立的目的,在促進會員們相互交換醫藥新知,討論及研究醫藥衛生問題;同時,將討論所得醫藥衛生學術上的意見,提供給衛生行政及醫學教學單位做參考。

因此,該會除發行「中華醫學雜誌」雙月刊外,每年並定期舉行醫學研討會,讓平時忙碌的醫生們,有機會坐下來吸收新知,並和同業交換臨床的經驗。

今年中華醫學會為慶祝建國七十周年,決定將每年一度的醫學會議擴大舉行,稱為「國際近代醫學研討會」,並邀請世界各國醫學專家、我國旅外傑出醫學人才及國內優秀醫師們參加。

籌備之初,主辦單位因過去沒有辦過這麼大的國際醫學會議,並沒有把握能請到多少國際醫學專家前來赴會。但寄出去的邀請函很快就收到回音,大部份的醫學專家都樂於前來參加這一個醫學盛會,人數大大超過原先所估計的。

巨星前來,研究層次很高

七月二十四日起,一個個國際醫學界的「巨星」陸續抵台,他們包括了美、英、法、比利時、西班牙、南非、澳洲、日本、菲律賓與韓國共計十個國家的醫學專家,計有:南非心臟移植聖手巴納德博士、法國兩位B型肝炎疫苗製造與臨床專家柯薩蓋與高迪樂、世界醫學會秘書長懷尼恩、前世界皮膚學會會長久木田淳、前世界心臟醫學會會長古德溫與澳洲醫學會理事長威爾遜等四十餘人。

第一位從事心臟移植手術的「南非國寶」巴納德醫師偕夫人芭芭拉,在到達桃園中正機場時說,這是他第一次來華,但他很早就聽說,自由中國台灣臨床醫學方面很進步,一直想來參觀訪問。這次能來此參與這個盛會,並提供他個人有關心臟外科方面的經驗,感到很高興。

中華醫學會總幹事、榮民總醫院復健部主任徐道昌,分析這次能邀到這麼多國際醫界要人的原因,他說:「除了他們久聞自由中國台灣的美麗、富庶外,更重要的,是他們認為這次會議所研討的題目層次很高,都是屬於尖端醫學方面的,代表我國醫藥發展已達世界一流水準。」

孫院長提示進一步提昇醫療保健水準

這是近年來在我國舉行最大規模的國際醫學研討會,不但備受醫界人士的矚目,亦受政府的重視。行政院院長孫運璿在致開幕詞時說,我國近三十年來,在醫藥衛生方面的努力,如死亡率的降低、平均壽命的延長、急性傳染病的絕跡,以及各種高度醫事技術的開創與發展……等,都足以使我們的醫療保健水準步入開發國家之林。但為了貫徹民生主義經濟建設,與增進全民健康福祉,他認為還有三個重點我們要繼續努力:

一、加強醫藥科技研究、提高醫療保健水準——培育醫藥科技人才,促進預防、保健、診斷、治療、復健、醫學工程等科技研究,發展自製原料藥、藥品及醫療器材,並提高其品質。

二、改進醫療保健體系,擴大醫療衛生服務——充實醫療設備、均衡醫療機構分佈,建立衛生保健醫療網,增加醫事人力,獎勵醫事人員至偏遠地區服務。並推廣心理衛生及營養教育,加強公共衛生服務,以及強化藥品管理及食品衛生檢驗。

三、配合經濟建設、緩和人口成長——台灣經濟建設十年計畫中,訂於民國七十八年人口自然成長率降至千分之十二點五以下。為達成該項目標,必須全力推行家庭計畫,加強婦幼衛生及老人福利措施。

開幕式由中華醫學會理事長鄒濟勳主持,他在致詞時也指出:各國權威醫學專家訪華,對我國醫學界具有很大的精神鼓舞作用。希望今後能繼續加強國內與國際醫學的交流與合作,以進一步提高我國醫療水準。

發表論文,交換經驗

會議分四個會場一連舉行三天。在這期間,中外專家學者提出的論文報告有二七○篇,如:嬰兒睡眠時呼吸暫停症、發育障礙兒童的早期治療、耳鼻喉科手術中顯微鏡之應用、老年性白內障囊內冷凍摘出術及其併發症與處理法、系統性紅斑狼瘡之關節症徵……等。還有專題討論與特別演講五十三次,如Goris博士所講的「周邊法鉈——二○一心肌造影之定量」、Goodwin博士所講的「心肌病變在心臟病學之重要」、Goebelsmam博士所講的「原發性閉經之鑑別診斷」、榮寶峰醫師的喉癌……等,幾乎囊括了所有的醫學項目。

在這些專題演講中,南非心臟外科權威巴納德博士發表的「心臟移植」專題演講,最受矚目。

巴納德醫師在演講中指出,現代醫學再進步,仍有許多醫學上的難題,人類至今無法克服,像死亡就是無法避免的事。因此醫學在幫助病人延長生命的同時,更應注重使病人減少身體與精神上的痛苦,使病人盡可能在經醫療後,感到舒適與充實。

醫療品質比治癒率更重要

基於上述原因,巴納德醫師強調,醫學界今後努力的方向,應是注意醫療品質的提高,使病人得到身體與精神上最佳的照顧,而不是一時追求治癒數量的多寡。

對於台灣的醫學水準,巴納德博士說,台灣能成功完成連體嬰的分割,顯示醫療水準已非常進步。台灣的開心技術亦已足以做心臟移植手術了。

不過,國內醫師們指出,由於我國法律上的限制,目前我們不能進行換心手術。因為我國法律上死亡的定義與外國不同,而心臟移植手術的最重要關鍵,就是承認「腦死」的觀念。當一名病人腦細胞停止活動時,即無生存的意義,醫師即可將他的心臟取出,移植到一個亟需接受心臟移植的病人體內。但國內醫界根據法律判定人的死亡是以「心死」為標準,必須在心臟停止跳動以後才能宣判死亡,因此我國在短期內還不可能做心臟移植手術。

這次會議的另一個熱門話題,是美國科學家羅納.艾里克森博士所發表的,以精蟲分離法來達到控制生育男孩。

「重男輕女」的觀念,中國自古就有,近年來雖已較淡薄,但為求一子而連續生了好幾個女兒的,仍大有人在,嚴重破壞了家庭計畫的推行成果。艾里克博士所提供的最新精蟲分離法,是把Y精蟲設法分離出來,然後用人工授精方法,打入婦女子宮內以控制生男,這個方法如果真能在國內施行,對於降低我國的人口出生率,大有幫助。

艾里克森博士表示,精蟲分離法除可使想生兒子的夫婦如願以償外,也可幫助因精蟲過少而不孕的夫妻生育子女。過去臨床經驗顯示,成功率已達百分之八十。

年輕醫師用心聽講

這次中華醫學會除邀請國際醫學權威人士與會外,為擴大影響力,更開放讓國內非會員的醫師參加研究的發表、討論與專題演講。因此,參加這次會議的會員中,有四、五百位非中華醫學會的會員。

在每一場的研究報告或專題演說中,在聽眾席裡經常可以看到成群身著白色醫生制服的年輕醫師,專心地聽講或做筆記。他們都是利用看病的空檔,前來吸收醫學新知的。一位外國醫師說:「從這些年輕醫生求知若渴的態度上,可以看出貴國醫學前途的遠大。」

經過三天熱烈的討論,國際近代醫學研討會於二十八日下午圓滿閉幕。

世界醫學會秘書長懷尼恩、南非醫學會理事長克拉克、澳洲醫學會理事長威爾遜及英國醫學會理事長柏伯翰,在閉幕記者招待會上,一致讚揚我國醫療事業已達世界水準,並表示回國後將更進一步推展與我國醫學的合作。

南非醫學會理事長克拉克是位泌尿科專家,他舉例說明台灣醫療水準之高,他說:「前幾天我應邀在榮民總醫院為兩個腎臟阻塞的病人開刀。手術時,無論是醫院的各項設備,或是麻醉師護士、助理的水準,都能充分和我配合。開刀是一個『集體作業』,要程度相當才能配合得好的。」他又說,榮總安排的這兩個病人,病情都很複雜,治療相當棘手,可能有「考」他的意味在內。但他又頗得意的說,幸好他沒被「考倒」。

基礎醫學研究宜再加強

世界醫學會秘書長懷尼恩說,此地醫師的年齡平均都很輕,看來頗具自信與熱誠,也有很好的學習精神;而一般人民臉上常掛著笑容,似乎生活得十分幸福、滿足。這兩件事讓他留下深刻的印象。

三位醫學理事長並提出語重心長的意見,他們說,中華民國的醫師很少從事基礎醫學的研究工作,以至醫學研究設備雖都是世界一流的,卻往往缺乏一等的研究人才。因此,在國際醫藥學術界,也少見中國醫師發表的學術研究報告,這是值得注意改進的事。因為基礎醫學研究,應與臨床醫療齊頭並進,這樣的發展才會紮實。

我國旅美心臟內科專家,因心臟病臨床與研究方面具有貢獻,今年榮獲全美醫學最高榮譽凱撒獎的余南庚醫生亦說:「國內各教學醫院的設備良好,無論心導管、核子醫學以及超音波等都是國際水準。心臟科醫師的質與量也都可觀,不但受過嚴格的訓練,也各有好的醫療成果。唯一尚待加強的就是研究工作。」

對於我國在國際醫學組織的會籍問題,世界醫學會秘書長懷尼恩說,世界衛生組織在幾年前曾去函要求該會排除中華民國的會籍,但世界醫學會未予理會。

至於將來,懷尼恩秘書長亦肯定地說:「不必擔心!」他說,目前該組織還沒有一個共產國家的會員。世界醫學會對申請入會者,資格審查非常嚴謹,入會國必須具備完整的醫事教育制度,方可獲准入會。例如,蘇俄亦曾申請入會,但由於蘇俄醫師十之八九未曾受過正規醫事教育,雖自稱擁有六百五十萬名醫學會會員,但該組織依然未承認蘇俄的資格。至於中國大陸,合格醫師的比率就更低了。

醫事人員與技術亦可輸出

威爾森及克拉克則表示,廣大的澳洲與南非很缺醫護人員,他們非常歡迎我國的醫師及護士前往兩地服務。他們回國後亦將大力促成此事。

醫學的進步與整個科學技術的發展攸關。科技發展的水準不夠,醫療技術即不可能超越向前。我們的科技及醫學,能有今日的成就,乃是政府和民間共同努力的成果。國際醫學會議閉幕後,國內醫界人士都有一個信念:往後,我們不但要繼續充實醫療設備、注重良好的管理、提高醫療效果及加強國民保健服務,在醫學上,要鼓勵更多的醫療人員,作精深的研究,務使基礎醫學研究與臨床醫療並駕齊驅,得以不斷向前推進,力求迎頭趕上歐美先進國家的水準。

〔圖片說明〕

P.56、P.57

圖1:中華醫學會第十二屆大會暨國際近代醫學研討會,於今年七月二十六曰,在台北市來來香格里拉大飯店揭幕,行政院長孫運璿應邀在開幕典禮中致詞。圖2:世界醫學會秘書長懷尼恩在開幕典禮中致詞。圖3:南非醫學會會長克拉克教授在分組討論中,以「用腸置換膀胱」為題發表演講。圖4:開幕典禮中,國軍退除役官兵輔導委員會主任委員鄭為元將軍(左)頒贈獎牌給澳洲醫學會會長威爾森醫師,以感謝其過去數度來台擔任客座醫師,對促進我國醫學進步頗有貢獻。圖5:中華醫學會理事長鄒濟勳伉儷歡迎英國醫學會會長葛瑞亨(右)蒞臨大會。圖6:心臟移植鼻祖「南非國寶」巴納德博士,在分組討論中作專題演講。圖7:出席大會的各國代表及與會人員之盛況。

P.58、P.59

圖1:英國古德溫教授(右)以「心臟病變在心臟病學之重要性」為題發表講演後,榮民總醫院丁副院長特贈予獎牌以示謝意。圖2:今年榮獲美國醫學最高榮譽凱撒獎的我國旅美醫師余南庚博士,專題演講後,接受榮總丁副院長致贈的紀念品。圖3:巴納德醫師偕夫人到外交部拜會外交部長朱撫松(左二)及外交部政務次長錢復(左一),並接受贈勳。圖4:許多年輕的醫生,利用醫護工作的空檔,趕來會場吸收醫學新知。

P.60、P.61

自由中國台灣近年來在各方面努力建設,在醫療保健工作上更是急起直追,有可觀的進展,無論技術與設備均已完全現代化。圖1:這是醫院中手術室的設備,圖為正在進行心臟外科手術。圖2:電腦斷層攝影機對頸部外傷或腦出血患者的檢查最俱功效,圖為醫院中放射部作業情形。圖3:直線加速治療機,可提供10Mev(百萬電子伏)的光子射線和4—11Mev的電子射線,是人體深部和淺部癌病的剋星,圖為醫院中癌病治療中心作業情形。圖4:病患在手術過後,需先在加護中心內接受悉心的觀護,一般醫院中都有現代化的監視系統,有五部閉路電視,視察病人呼吸,心跳、血壓等情形,隨時可作各種醫護處理。

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近期文章

EN

Advances in Chinese medicine


The 12th Chinese Medical Congress & Scientific Meeting was held on July 26, 1981 at the Lai Lai Shangri-la Hotel in Taipei. Participants included the Secretary General of the World Medical Association, Dr. A. Wynen, as well as other distinguished guests from the medical field. Altogether 1,000 people from 10 countries attended.

The purpose of the meeting was to exchange information and discuss recent developments in the medical world, as well as to upgrade the quality of medicine in Taiwan. The meeting lasted only two days, but its contribution to Taiwan's medical establishment was invaluable.

The Chinese Medical Congress is an academic group of highly qualified personnel, established during World War Ⅱ. It has provided new medical knowledge and a forum at which members could discuss scientific, research, and medical health problems. Proposals were also made to health and medical-education administrators for their evaluation. The Medical Congress was expanded this year to include all members of the international medical community, in celebration of the 70th anniversary of the founding of the ROC.

Participating countries included the US, Britain, France, Belgium, Spain, South Africa, Australia, Japan, the Philippines, Korea, and other countries.

The conference was proud to have as a participant South African surgeon Professor Christian Barnard, the first doctor in the world to perform a heart transplant in 1967. On disembarking from the plane at the Chiang Kai-shek International Airport with his wife Barbara, he remarked that he had heard the ROC's clinical medicine was very advanced, and was therefore happy to be able to attend the conference.

Chairman of Veterans' General Hospital's therapy department, Hsu Do-chang, explained why almost every person invited had attended: "They heard that Free China on Taiwan was very beautiful. More important, the level of the theses and reports presented was high, and raised many important in-depth medical questions, so medical experts were, of course, eager to attend such a conference."

At the meeting, foreign guests discovered that the quality of Taiwan's medicine had improved rapidly over the past 30 years. The death rate has declined and the average life expectancy has increased. This period has seen the eradication of most acute infectious diseases. Medical techniques and knowledge have advanced to such a degree that Taiwan may be considered equal to developed countries.

Medical authorities in Taiwan have set three goals to maintain this progress: (1) To strengthen medical and technical research, raise the standard of medicine, diagnoses, rehabilitation, etc., and to develop and manufacture drugs and medical equipment. (2) To improve the system of medical care and hygiene awareness, increase the number of medical personnel, and to encourage doctors to offer their services in underdeveloped rural areas; to promote mental health care and nutrition education; to improve public health services and food inspection procedures. (3) To promote family planning and to effect measures aimed at increasing women's and children's health care, and increase benefits for senior citizens.

During the conference, 270 papers were delivered, covering areas such as ophthalmology, immunology, surgery, otolaryngology, and cancer.

Special topics and speeches totaled 53, some delivered by specialists such as Drs. U. Goebelsman, J. F. Goodwin, and M. L. Goris.

In a special presentation, Professor Barnard pointed out there are many problems which medicine cannot solve such as the inevitability of death. Doctors, he said, should try to make the patient as comfortable as possible, both physically and mentally, especially during post-operative care. He continued that although the caliber of Taiwan's doctors is high, the law prevents heart transplant operations. In other countries, a person is declared legally dead when his brain ceases to function. But in China, a person's heart must have stopped beating before he can be declared dead. If this is the case, then how can a 'dead' heart be used for a transplant?

Another point discussed was that in Chinese society, parents still prefer boys to girls. In view of recent developments in sperm-splicing, many couples may soon be able to choose the sex of their children. This would be a great boon to Taiwan's family-planning program. It would greatly reduce the population rate, since couples continue to have children until a boy is born.

Others in the medical congress pointed out some ways in which Taiwan's medical practices could be improved. Doctors rarely engage in basic research work, it was pointed out. Furthermore, while there is a great deal of advanced technological equipment, there is a lack of people qualified to use it.

The Republic of China's standing in medical organizations was threatened a few years ago by political factors. But because of the country's progress in the medical field, no action was taken.

Assessing the ROC's future standing in the international medical community, Dr. Wynen said, "Don't worry. So far, Communist countries are not members of the World Medical Association. Applicant countries must go through a rigorous evaluation concerning the quality of their medical knowledge and standards. The Soviet Union had applied, but was not granted membership; 90% of their doctors did not have formal or sufficient education in medicine. Mainland China's qualifications are even worse."

[Picture Caption]

1. The 12th Chinese Medical Congress and Scientific Meeting was held on July 26, 1981 at the Lai Lai Shangri-La Hotel in Taipei. Pictured here is Premier Sun addressing the participants at the opening ceremony. 2. The keynote speech was delivered by Dr. A. Wynen, Secretary General of the World Medical Association. 3. President of the South African Medical Association, Dr. J. N. de Klerk, delivering a speech. 4. General Chen Wei-Yuan (left) presenting an award to Dr. L. L. Wilson, President of the Australian Medical Association for his contribution to the promotion of the study of medicine in the ROC 5. Dr. John F. Goodwin (right) being welcomed to the meeting. 6. Heart transplant specialist, Prof. Christian Barnard, delivering a speech. 7. Representatives from participating countries attending the meeting.

1. British Prof. J. E. Goodwin (right) who received an award for his speech on "The relevance of cardiomyopathy to general cardiology." 2. Medical specialist Prof. Jin Nan-geng receiving an award after the meeting. 3. Mrs. Christian Barnard seen during a visit to the Ministry of Foreign Affairs where she met with Minister Chu Fu-sung (second from Left) and Vice Minister Friedrick F. Chien (left) 4. Many young doctors attended the meeting to learn about new methods in medicine.

1. Open heart surgery being performed in the newest operating theater at the Veterans General Hospital . 2. Computer photographs are effectively used in analyses of head injuries. 3. The cancer treatment center at the Veterans Hospital. 4. The Veterans Hospital uses five closed-circuit TV monitors to observe patients' blood pressure and breathing and heart rate.

 

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