Current location - Plastic Surgery and Aesthetics Network - Plastic surgery and medical aesthetics - Why were there no hospitals in ancient times?
Why were there no hospitals in ancient times?
How could there be no hospital in ancient China? Developed medicine is an important part of Chinese civilization. Without developed medicine, it can't be called brilliant civilization. There were hospitals in China in the Zhou Dynasty, but the names of ancient hospitals were not modern, and pharmacies all over the country also had the functions of hospitals.

"Hospital" has a long history in China. According to Guanzi, during the Spring and Autumn Period, Guan Zhong established a "sanatorium" in Linzi, the capital of Qi State. "In every country, there are deaf, blind, dumb, extreme, greedy people who can't bear their own diseases. Take care of their faces, eat their clothes, and then stop." It is equivalent to receiving disabled patients.

If the nursing home built by Guan Zhong is not a real hospital, the emergence of real hospitals in ancient times has a lot to do with the prevalence of diseases. A regional drought occurred in the Western Han Dynasty, which led to an epidemic, so the emperor ordered doctors to be sent to specially designated places to see people. Huang was a corps commander in the late Eastern Han Dynasty. He once established an army field hospital. Because of the epidemic disease in the army, Huangfugui rented houses and concentrated patients for treatment. This place is called Anlu.

In the Song Dynasty, "Anlefang" and "Anjifang" were set up in prefectures and counties, and an outpatient department was set up, which was called "Hehe Bureau". The pharmacy of the pharmacy was called the pharmacy at that time. In the Southern Song Dynasty, the pharmacy was called Taiping Huimin Bureau, and the prescription of Hutchison Bureau handed down in the Northern Song Dynasty was renamed Taiping Huimin Hutchison Bureau. A volume of thirteen volumes, divided into many categories, typhoid fever, various asthenia, phlegm and so on.

As for the medical care in Imperial Hospital, it is strictly set. There was no separate Tai Hospital before Yuan Dynasty. Generally, the Ministry of Imperial Doctors and the Bureau of Imperial Doctors all belong to Taichang Temple. The name of "Tai Hospital" began in the Jin and Yuan Dynasties and became an independent institution in the Yuan Dynasty. At this time, Thai hospital is not only responsible for medical treatment, but also for making physician. In the Ming Dynasty, imperial hospitals were divided into very fine divisions, including court ambassadors, court judges, imperial doctors and officials, as well as medicinal materials warehouses and Huimin pharmacies.

Who said there were no hospitals in ancient China? There are two main reasons why ancient hospitals in China failed to develop. First, doctors in ancient China were passive in the doctor-patient relationship. Second, the confidentiality between doctors is very serious.

Go to the museum and look at an inscription on the map of Pingjiang handed down from the Southern Song Dynasty. There is a building on it, marked with the word "hospital". This is a hospital in Suzhou in the Southern Song Dynasty, also known as a sanatorium, which was built by Lin Jie, a prisoner in western Zhejiang. Therefore, the hospital has a "foundation of 100, three hectares of land, food, alcohol and tobacco burning, responsible for supervising the people in the hospital, and the method of storage, which is awarded to the excited people." Simple and good materials, extract famous prescriptions, and refine them with the method of giving medical doctors. "

In fact, in the Song Dynasty, hospitals were being built everywhere. Hospitals are sometimes called "wards". During the period of Yuan You in the Northern Song Dynasty, "Su Wenzhong knew Hang Cheng well and set up a hospital in the city with a private sum of 52 Liang, which was called' Anle' and was run by monks. In three years, more than 1000 people were cured. " Later, the hospital was renamed "Anji Hospital". In the first year of Chongning (1 102), the court ordered the establishment of Anjifang all over the country. In the fourth year of Daguan (1 1 10), the Law of Anjifang was promulgated: every village in the city with more than 1,000 households must set up Anjifang, and anyone who is sick and helpless in the territory can be sent to Anjifang for treatment. Anji Fang "should be treated in different rooms according to the severity of the patient's condition to prevent gradual infection." It is also used as a kitchen, thinking that soup and medicine are eaten in other people's dormitory. "Is the patient isolation system, provide soup, medicine, rice.

Drugstores in the Song Dynasty generally had doctors sitting in the clinic, which was similar to the outpatient department. For example, the pesticide administration of Lin 'an Prefecture in the Southern Song Dynasty said, "People who come to see a doctor should be treated with drugs" and "If people throw drugs into the administration according to symptoms, they will be cured". Can you say this is not a hospital?

Most Chinese medicine practitioners in China are "sitting in the classroom for consultation", which is comparable to "Tongrentang", "Yixiaotang" and "Jiuzhitang", etc. Second, doctors come to the door to prescribe drugs, so that patients can go to the pharmacy to get medicine according to the prescription. Nowadays, the "barefoot doctor" of that year carried a medicine box for home service and treatment. In ancient times, medicine was separated, and most Chinese medicine practitioners sat in pharmacies to diagnose diseases and prescribe medicines. Traditional Chinese medicine doesn't need injections and surgery, so it doesn't need hospitalization. They only need doctors to prescribe a few medicines or make several home visits, so there is no hospital and no hospital name. In the sixties and seventies of last century, every household in rural areas still kept a crock for boiling traditional Chinese medicine. Chinese medicine residue fell in the middle of the road, let the vehicles crush it, and let thousands of people step on the ground to take away the disease and bad luck!

There were many doctors in ancient times, but there was no sign of "hospital". If there were no hospitals in ancient times, who would treat the diseases of ordinary people, and who would see the diseases of emperors and dignitaries in feudal dynasties? But one thing I believe is that the ancient medical equipment is relatively backward, and there is no B-ultrasound examination, but there are still drops of bone scraping and healing.

As far as the Big Dipper knows, in ancient times, the names of hospitals were different. The place where ordinary people see a doctor is called "Health Hall". Of course, folk doctors, together with monks and nuns in temples, also played a role in treating diseases for the people.

In ancient times, the places where nobles of imperial power went to see a doctor were often called "too hospitals", which were designed for emperors, concubines in three palaces and six hospitals and court officials. It is not open to ordinary people, and unlike you and me today, it can freely enter and leave major hospitals.

In ancient times, doctors, except foreign missionaries, were mostly Chinese medicine practitioners. They also sat in the classroom for consultation and relied on "listening, listening, asking and feeling". For example, Huang Feihong's ancestral "Baozhilin" is a typical folk medical light, famous for its ancestral medical skills and secret recipes, and Liuwei Dihuang Pill produced by Jiuzhitang has become a classic of Chinese medicine.

With the development and wide spread of traditional Chinese medicine, folk doctors have been integrated and standardized by the government and divided into specialized departments, and gradually formed the patron saint of treating diseases and protecting people's health. Please respect the achievements of medicine and doctors and work hard to build a harmonious society!

First of all, the view that there were no hospitals in ancient China is not rigorous enough.

Let's take a look at the example of the Ming Dynasty.

In the Ming Dynasty, Tai Hospital, medicinal materials storehouse and Huimin pharmacy were set up in the central government. There is a court ambassador, two court judges and more than a dozen doctors in the Imperial Hospital. The pharmacognosy database and Huimin pharmacy have ambassadors and assistant ambassadors respectively.

The main task of Thai hospital is to be responsible for the medical care of the emperor and his family, which needs no elaboration. In addition, when princes and nobles are ill, Imperial Hospital will send people to treat them according to the emperor's will. "The minister of civil and military affairs and the foreign monarch were ill and were ordered to watch. Is it possible for its treatment to have this playback? "

Obviously, these treatments are all doctor visits.

In addition, the Ming dynasty set up Huimin pharmacy in the local area and stationed doctors. There are doctors, healers or medical officers in border guards and mass gathering places, all of whom are sent by our hospital on a trial basis. "

The number of such doctors and medical personnel is very small. It is estimated that there are only one or two people in a county, and there will not be too many doctors in Huimin pharmacy at the prefecture level, and there will certainly not be more than a dozen doctors in hospitals. These are actually government-run medical institutions in the Ming Dynasty, which are actually government-run hospitals.

The source of these selected doctors is that they need to pass the exam and be hired by the Tai Hospital. The Tai Hospital will regularly assess: "They are all doctors' children and choose teachers to teach. Try, try, try three times in three to five years, that's what you want. "

In addition to these official pharmacies, there are a large number of private doctors.

When discussing the problems of ancient hospitals, we should also consider the following two aspects: the first is the treatment method of ancient Chinese medicine, and the second is economic feasibility.

Ancient Chinese medicine mainly diagnosed the disease and prescribed prescriptions for patients to take, and sometimes acupuncture, massage, massage, scraping and other treatment methods were used.

For most patients, after doctors diagnose and prescribe, they should take the medicine according to the prescription, and take it orally and externally, as long as it slowly exerts its efficacy. In the meantime, it is useless to stay with the doctor, and the patient would rather take medicine at home.

Some trauma or emergency patients may need to stay with the doctor for a short time, but this situation should be rare. Once the illness is relieved, you should go home and take medicine.

From the doctor's point of view, practicing medicine is a means of making a living, not charity. If we take in patients, it will inevitably expand the scale, and the increased cost will ultimately be borne by patients. This will also encourage patients to choose to take medicine home to save money. In addition, in ancient times, traffic was inconvenient, and patients could only choose to make a diagnosis and treatment on the spot.

Although the medical system in ancient China was primitive, it already had a basic framework. Just because of various factors, hospitals in the modern sense have been delayed.

I'm Qian Qiu Shi Wen. Let me answer this question.

The illusion that the hospital gave us was introduced to China from the west.

In fact, the ancient hospitals in China have a long history, but their names are not called hospitals.

The formation and development of ancient hospitals in China can be roughly divided into three periods.

Early germination

The ancient hospitals in China originated in the early Spring and Autumn Period.

Let's explain, the consciousness of this sentence is that Guan Zhong of Qi has set up many medical and welfare institutions in Kyoto to take in deaf-mute and paralyzed people and provide them with accommodation and treatment until they recover.

This happened in the seventh century BC, which was the prototype of the earliest hospital, nearly 300 years earlier than the Roman sanatorium established in the fourth century BC in Europe.

At the beginning of the Western Han Dynasty, Chao Cuo proposed to Wendi that "the people should be nurtured to strengthen the fortress", and at the same time stressed the need to set up a cure for diseases.

According to Hanshu, in the second year of Yuan Dynasty (A.D. 2), due to the drought of the Yellow River, Emperor Han Ping ordered to treat patients in the epidemic area. This temporary "epidemic hospital" is the predecessor of modern infectious disease hospital and the earliest public hospital.

This is very similar to the current specialist ward.

Development and promotion period

From the late Han Dynasty to the Southern and Northern Dynasties, Buddhism prevailed. Because many monks are proficient in medical skills, some monasteries have become institutions for treating patients. Of course, the treatment of the monastery belongs to charity.

In the 4th year of Southern Qi Yongming (49 1), a flood occurred in Xing Wu, followed by a plague. King Jingling vacated his residence to treat patients, which is the earliest private hospital in China.

During the Sui and Tang Dynasties, the country was unprecedentedly prosperous and hospitals developed rapidly. At first, they were called "Sad Tian Fang", but in the Kaiyuan period, they were changed to "Sick Fang" and spread all over the country.

At the same time, a "patient workshop" was set up to treat leprosy patients in a centralized isolation treatment.

The royal health care institutions established in the Southern and Northern Dynasties were more perfect in the Sui and Tang Dynasties, with specialties such as physiotherapy, juvenile, hearing, oral English and angle therapy. This is a government-run health care hospital, which also trains medical talents. It is the earliest medical school in the world.

In the Song Dynasty, various hospitals were widely set up.

In a.d. 1076, a pharmacy was established in Kaifeng, which was quickly popularized throughout the country. Later, it was renamed the Harmonious Agency Huimin Bureau, which brought great convenience for people to buy and treat diseases.

Suzhou Fu Zhi records that Su Shi and others set up "An Ji Fang" in Hangzhou in A.D. 1089 to treat the poor people. At that time, there was a perfect management system and medical records.

It is still a comprehensive institution of teaching and medical treatment to change the name of the Imperial Medical Department in the Tang Dynasty.

In addition, a child-friendly bureau has been established to treat abandoned babies, a soldier's hospital, a prisoner's sick prison and a Futian hospital for the elderly and the weak.

Introduction of Arab and Western Hospitals

By the Yuan Dynasty, in addition to hospitals that nourished the economy and pharmacies that benefited the people, some Arabic-style hospitals-Guanghui Temple and Hui Hui Pharmacy were established.

At the beginning of the Ming Dynasty, frontier health centers and towns with large population set up Huimin pharmacies, mainly for internal diagnosis, and also set up nursing homes for widowed and disabled people.

After Emperor Chengzu moved the capital to Beijing in the Ming Dynasty, Taichi Hospital set up thirteen departments, including big room pulse, small room pulse and obstetrics and gynecology.

After the middle of Ming dynasty, western medicine began to be introduced. 1569, Bishop Garnelo of Macao established a missionary hospital in Macao.

After the Qing Dynasty, western hospitals were established in China, which also played a certain role in the reform of traditional hospitals in China.

To sum up, there were hospitals in ancient China, from the medical welfare institutions in the Spring and Autumn Period, to the plague temporary relief institutions in the Han Dynasty, to the welfare hospitals in the Jin Dynasty, and then to the Sardianfang in the Sui and Tang Dynasties, forming the early form of hospitals. The establishment of specialized hospitals in Song Dynasty marked the development of specialized hospitals, and the establishment of Guanghui Hospital in Yuan Dynasty and West Hospital in Ming and Qing Dynasties promoted the exchange and development of Chinese and Western medicine.

On the contrary, China is the first country in the world to establish a hospital.

"The Book of the Scholars" records: "All countries have palm diseases, such as deafness, blindness, dullness, dryness, holding hands, intolerance to spontaneous growth, eating and raising clothes, and then stop." It can be seen that in the early Spring and Autumn Period (7th century BC), Guan Zhong, a politician of Qi State, founded a "sanatorium", which was the earliest record of an ancient official hospital.

In the second year of Emperor Han Yuan (AD 2), drought and plague occurred in the Yellow River, and Ada set up many doctors and medicines in the area to treat the people free of charge. This is probably the first public temporary hospital in the history of China.

In the 9th year of Yongming in the Southern Qi Dynasty (49 1), Xing Wu was flooded and epidemic diseases raged. Wang Xiao of Jingling vacated his house, set up doctors and adopted poor patients, which was the earliest form of private charity hospital in China.

In the 21st year of Northern Wei Dynasty (497), Emperor Xiaowen (Justin) set up a "other room" in Luoyang and sent four doctors to buy medicine. Anyone who can't afford medical treatment can see a doctor.

Hospitals in the Tang Dynasty were all called "wards". Twenty years after open source (733), the name of the sick workshop began to appear. At that time, most of the hospitals were located in temples, and the hosts were mostly monks and nuns. Not only in big cities like Chang 'an and Luoyang, but also in other states.

In the fourth year of Song Zhezong Yuan You (1089), Su Dongpo became an official in Hangzhou and donated five hundred taels of silver. We set up a disease studio named "Anlefang" with public funds, and cured thousands of patients in three years. This is the first public-private hospital in the history of China.

From then until the Ming Dynasty, most counties and counties had public hospitals called "Anjifang". Private hospitals are called "nursing homes" and "Shouan home"; Hospitals of charitable classes are called "kindness bureaus", and they hate different classes to recruit and treat patients.

Of course, these hospitals always give alms to the poor or publicize general affairs as their main tasks. They do not play an important role in medical research and the creation and dissemination of medical knowledge, or in the training of medical staff, and there are few professional doctor positions and subject classifications.

The word "hospital" first appeared on the floor plan of Suzhou in13rd century. Ancient Su Zhi during the Hongwu period in the early Ming Dynasty recorded that "the nursing home was behind the Zhouzhong Temple, which was formerly called the hospital". This "hospital" began in the Baoqing period of the Southern Song Dynasty and was called "nursing home" at that time. Its main function is actually to recuperate sick prisoners awaiting trial, and its task is more political than scientific, and it has not had an important social impact.

The real appearance of the name "hospital" will be after the 1930s of 19.

The appearance of the word "hospital" in modern times was related to the entry of western medicine into China. At the beginning of 1837, East-West Examination Monthly, a church periodical founded by European Protestant missionaries in Guangzhou, mentioned "Guangdong Provincial Hospital" for the first time: "Today, there are disciples of this religion (Jesus) who are charitable, open hospitals, practice ghosts and gods, and enjoy themselves. It can be said that you are really anxious. Pick up patients and symptoms every day ... if there are blind people, many people will see them again. Even if you are infected with chronic diseases, you will be cured. The yard is often crowded with people from all directions, so it is not hot. The doctor is gentle and kind, and can't bear to sit by and watch the danger. Men, women and children, everything gathers. " Although the main feature of this passage is "charity", it talks about the role of doctors, the focus of treatment (eye disease) and other details of the medical industry. However, the main activities of modern western hospitals such as teaching and scientific research are not mentioned at all, and the religious factors of hospitals are minimized at the same time.

Since then, the word "hospital" has gradually become a popular saying to refer to the medical places set up by western missionaries in commercial ports. 1876, John Flair (1839- 1928), a Shanghai missionary publication with the purpose of promoting western science and technology, described "hospitals" as follows: "All the poor and sick are sent to hospitals, but those who are seriously ill can stay, and the medical expenses of famous doctors are nothing ... and some of them specialize in western medicine." The author also mentioned that many people in China didn't believe in western medicine at that time, and few people were willing to donate money to build hospitals.

In the 20th century, western-style hospitals in China, especially those with Protestant background, developed more rapidly. For example, Xiangya Hospital founded by Yale Yali Club 1906 in Changsha, Peking Union Medical College Hospital and Medical College founded by Rockefeller Foundation 192 1, and Sun Yat-sen University Hospital 1835, formerly known as Guangzhou Eye Hospital, were all developed by modern western medicine in China. Another example is MacKay Hospital, which was built in 19 12. It is based on MacKay Yiguang and has always been an important hospital in Taiwan Province Province. Western-style hospitals with church background flourished in China society throughout the 20th century.

1936, the famous book "History of Chinese Medicine" co-authored by Lian Dewu and recorded the statistics of 426 western-style hospitals in various provinces of China in 1934, of which Jiangxi was the largest, followed by Hebei and Shandong, followed by Fujian and Guangdong, and remote Gansu and Heilongjiang also had one each. It can be said that the first half of the 20th century was the era when the foundation stone was laid for the specialized western-style hospitals in China.

It is definitely necessary for the hospital to become such a large-scale treatment today. Without development, you would not have such a castle in the air.

The inability of finance to support hospital expenditure is an important reason for the long-term inability to scale up in ancient China.

There were large-scale treatments in ancient China, but they were all temporary institutions. In addition, Chinese medicine at that time was not based on large-scale treatment, but on patients.

There was a hospital in ancient China. During Emperor Han Ping's reign, "there was a great drought in counties and counties, locust plague, ... people were sick and infected, and they abandoned empty houses to buy medicine." This is a relatively early recorded hospital, but this kind of hospital can only be set up temporarily in case of plague or disaster, because most hospitals can't make ends meet, which will cause a very large deficit to the national finance, so it can only be set up temporarily.

During the Northern Song Dynasty, the court also set up the Ji Fang to provide medical treatment, diagnosis and adoption for patients, and exempt them from soup and meals. This also has its limitations. The financial resources of the court can only be set in cities and other places, and it is absolutely not allowed to go to the countryside. This kind of welfare institution had a great influence on the state, state and county finances, so that some people said at that time: "No athletes, beggars, regardless of the living, only the dead."

Another reason is that Chinese medicine is patient-oriented rather than efficiency-oriented.

At present, the efficiency of large-scale treatment is very high, but patients have a lot of antipathy to hospitals, which is the result of modern medical care focusing on efficiency, which leads to the forced reduction of patients' medical experience.

Fan Ceng, a famous doctor, wrote a pair of couplets, which well represented the mainstream thought of the doctors at that time: "May people be always healthy, why bother to be poor alone?" Traditional Chinese medicine has clear values. They often choose patients between money and patients. This made Chinese medicine have a high reputation in ancient times, but at the same time, due to the low income of Chinese medicine, fewer people engaged in difficult medicine.

Modern hospital

In modern times, the main driving force for hospitals to realize large-scale treatment is commercial capital. Because they can profit from the hospital, the hospital can continuously receive patients and export healthy people like a factory. The advantage of this is that hospitals compete with each other, have a good medical experience and patients are generally satisfied. The disadvantage is that civilians look down on the disease.

There is also a public or state-owned hospital that subsidizes hospitals by collecting taxes from the state, so that hospitals can treat patients on a large scale without making a profit. The advantage of this scale is high efficiency, and civilians can look up to doctors. The disadvantage is that because there are many civilians who see a doctor, the experience of seeing a doctor is poor, and the people are full of anger at hospital doctors.

In ancient times, the earliest time was to practice medicine. What is medical practice? It means that people who walk around to see a doctor are called people. At that time, the population was small and the villages were not concentrated, so it was necessary to practice medicine and see a doctor. There are also some members of the Xiandao family, and the monks in the temple also know medical skills and can cure diseases. Sitting Jane to see a doctor came into being in the Southern Song Dynasty. Court doctors don't see people. From the period of China, I only saw doctors and took them in to treat diseases. Later, westerners came to China and established various hospitals, and hospitals came into being. The establishment of hospitals is beneficial to people's livelihood and has many benefits in prolonging people's life. In the future, the alliance between family hospitals and regular hospitals will be more conducive to people's livelihood.

Not only is there no hospital, but there are no planes and cannons!