本論文以史學方法全面回顧及比較香港自西元1842 年至2023 年間，分三個歷史時期（西元1842–1948、西元1949–1997 及西元1998–2023）共十種主要流行病的爆發歷程、防疫應對與社會反應，並深入探討中、西醫在不同時期的角色轉變及制度演化。研究結合歷史比較分析與統計學中的卡方檢定(Chi-Square Tests)，從中歸納出香港防疫成效的關鍵風險與保護因素。本文首度將中醫從過往被忽視的情況，如何由輔助的角色逐步進入香港醫療制度內，從而補足以前文獻研究之不足。在流行病種類方面，三期呈現顯著差異：第一期以腺鼠疫、霍亂與天花為主，病原多為細菌類；第二期轉為麻疹、肺結核與流感等細菌和病毒類；第三期則多為首次出現的新興病毒，如嚴重急性呼吸道症候群(SARS)與新型冠狀病(COVID-19)，顯示人畜共通病與高量人際流動構成的新型風險源。防疫成效亦呈現前後兩波上升及下跌的波動。
第一期因公共衛生設施缺乏與政治邊緣化而致高死亡率；第二期因疫苗與抗生素廣泛應用、防疫制度日趨完善而成效最佳；第三期雖科技進步，但因政治干預與公信力下滑導致COVID-19 的致死率創下新高，反映制度應變與治理整合能力的瓶頸。在政府防疫主動性與組織效能方面，第一期屬於被動回應、組織鬆散；第二期建立常設防疫體系與跨部門合作，達到政策與科技的平衡；而第三期政府雖具備動員能力，但政策反覆、中央導向與民意落差造成整體執行成效不穩。此外，論文亦透過用卡方檢定，從本文研究中找出的14 個風險因素與8 個保護因素中探討其與防疫成效之間的統計關聯，雖整體大多未達顯著性；但個別風險或保護因素與防疫成效間的統計關聯則大多為顯性，這結果提供了防治未來流行病政策設計的量化參考。
本研究基於歷時共181 年的香港流行病史、建立起一個跨政治體制與中西醫體系的流行病史比較架構，並以制度轉型視角理解香港公共衛生治理的演進。這不僅補足了過去學界對中醫參與及邊緣治理的忽視，也提供防疫政策制定者參考不同制度下的歷史教訓與現代啟示。

This thesis presents a comprehensive historical and comparative analysis of ten major epidemic outbreaks in Hong Kong across three distinct periods. The study investigates the characteristics of epidemic transmission, government responses, socio-political reactions, and crucially the evolving roles of Chinese and Western medicine throughout these periods. The research is distinctive in its integration of Chinese medicine into the institutional framework, analyzing how it shifted from a marginalized and informal practice to a formally recognized, policy-supported system during Covid-19, particularly under support from mainland China.
Statistically, the thesis employs Chi-square tests to examine the correlation between identified risk factors and identified protective factors. While most associations were statistically non-significant; however, individual risk or protective factors of showed the highest relationship. By spanning 181 years of epidemic governance in Hong Kong, this thesis contributes an unusual institutional perspective to the historiography of public health in Asia. It offers a comparative view across different political regimes: colonial, transitional and post-colonial.

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