The development of ancient Chinese Tai Medical Institutions has undergone a more tortuous and complex process. In the Zhou Dynasty, the physician system of the court was the germ of the Taiyi system. The earliest appearance of tai medical institutions in the Western Jin Dynasty, the central government set up a medical department. Since then, there have been medical institutions in the past generations.
I. The development of the Tai medical system from the Western Zhou Dynasty to the Eastern Han Dynasty
China's ancient Tai medical system first appeared in the Western Zhou Dynasty. According to the Zhou Li Tianguan Tsukasa Zai, the Court of the Zhou Dynasty had physicians in charge of medical decrees, and was subordinate to tianguan Tsukasa Zai, who was in charge of food medicine, disease doctors, swing doctors, and veterinarians. It also stipulates that "wherever there is a disease in the state, and where there is a disease in the common, the doctor shall divide and cure it." At the end of the year, he will supervise his medical affairs in order to make his food. ”
The meticulous and clear medical and evaluation system of the Zhou Dynasty court, coupled with the initial scale of medical sub-disciplines, the reasonable setting of officials, and the complete medical system, created a precedent for the ancient Tai medical system in China. It also laid an important foundation for the improvement of the Tai medical system and the establishment of Tai Medical institutions in later generations.
During the Qin and Han Dynasties, the central government set up a tai doctor Ling Cheng to be in charge of court medical affairs. The position of Taiyi Ling was first established in the Qin State during the Warring States period. After Qin unified the Six Kingdoms, there was a subordinate official Tai Yi Ling Cheng under shaofu. Shaofu was the emperor's private treasury, and the Taiyi Lingcheng was undoubtedly an official who provided health care services exclusively for the emperor.
Qin died in Hanxing, and Han inherited the Qin system. The Western Han Dynasty set up Taiyi Ling subordinate officials under Shaofu and Taichang, forming two sets of Taiyi systems belonging to different systems. In the Eastern Han Dynasty, however, it was still like the Qin system, and only the officials of the Shaofu Prefecture were left, and the officials of the Shaofu Prefecture were lingcheng, who commanded the doctors.
After more than a thousand years of development from the Western Zhou Dynasty to the end of the Han Dynasty, the establishment and management of officials was gradually improved. During the Eastern Han Dynasty, Taiyi officials already had a clear system of Feng Lu, such as stipulating that "Taiyi orders one person, six hundred stones." At the same time, the ranks of court medical officers also gradually expanded, and in the Eastern Han Dynasty, there were "two hundred and ninety-three staff doctors and nineteen staff officials." In addition, various types of medical officials emerged, such as Shangfang, Taiyi Supervisor, female doctor, etc., and eunuchs also began to enter the medical team to assist in supervising the medical treatment of the court. Due to the development of pharmacology, there are also prescriptions, medicines, medicines, and prescriptions.
The development of the Taiyi system was very mature by this time, and the huge medical team and complex court medical treatment urgently needed a new institution to manage, and the Taiyi institution came into being in the subsequent dynasty.
2. The evolution of Tai medical institutions from the Western Jin Dynasty to the Yuan Dynasty
According to the above, from the Zhou Dynasty to the Eastern Han Dynasty, although the state had a Taiyi system, the central government did not set up an institution specializing in the management of Taiyi and responsible for medical treatment. It was not until the early Western Jin Dynasty that the earliest Tai Medical Institution in China was born, the Medical Bureau.
The Western Jin Dynasty Medical Department was subordinate to Zongzheng, and during the Eastern Jin Dynasty, it was changed to Menxia Province, and during the Southern and Northern Dynasties, it was renamed Taiyi Bureau. As the highest medical and health management organ in the country, the medical administration of the feudal state began to move towards institutionalization, fixation and orderliness. At the same time, under the management of the medical department, the medical activities of the court, which was mainly the supreme ruler of the feudal dynasty and the emperor, gradually became institutionalized and standardized.
During the Sui and Tang dynasties, the central government also set up a Taiyi Bureau. The Sui Set up the Taiyi Bureau to order the main medicine, physician, teaching assistant, and doctor of the Tang Dynasty to be subordinate to Taichang, and the Tang Taichang Temple also had the Taiyi Bureau, so that the four doctors of the Tang Dynasty could teach the doctors and examine the lessons. In addition, there is a Shang Pharmacy bureau and a monk food bureau, which specializes in providing medical and catering services for the emperor. During the Sui Dynasty, it was under the jurisdiction of Menxia Province, and in the Tang Dynasty, it was under the jurisdiction of Dianzhong Province. There is also a Pharmacopoeology Bureau dedicated to providing medical and health care services to the prince. There was a clear division of labor among the various medical institutions, which was designed to provide medical care for the emperor and the imperial court. Among them, the Taiyi Bureau was the largest and most official medical institution in the court medical institutions of the Sui and Tang dynasties, and the premier of the country was medical administration and medical education.
During the Song Dynasty, the Tai medical system followed the Tang system and suffered at the expense. Medical administration and medical education are each managed separately. The central government set up a Hanlin Medical Officer's Hospital, later renamed the Medical Officer Bureau, with envoys and deputy envoys in charge of providing medicine for the imperial court, and dispatching medical officers to the court, hundreds of officials, military camps, schools, and localities. It also set up the Taiyi Bureau, which is subordinate to the Taichang Temple, and has the posts of a beggar and a professor, specializing in managing medical education and cultivating medical talents. "There are nine doctors with a quota of three hundred, and at the end of the year, they will all lose their rewards and punishments." The two temples of Dianzhong and Taifu also set up medical officers such as Shangyi, who were responsible for imperial medicines and medicines and diagnosis and treatment. The Liao imitated the Song system, and set up a Taiyi Bureau in the northern official, with officials such as envoys, deputy envoys, and Durinya, and a soup pharmacy bureau in the southern official, which belonged to the inner service province.
In the Jin Dynasty, the central Tai Medical Institution was originally called Tai Hospital, which was subordinate to Xuanhui Hospital. The Hospital has a staff, envoy, deputy envoy, judge, medicine, consul general, and doctor in charge, and is a medical institution dedicated to royal service. At the same time, the Imperial Pharmacy was set up specifically for the emperor's medical care, and subordinate officials such as the mention point, the direct chief, the capital supervisor, and the same supervisor were set up to take charge of the imperial soup medicine.
In the Yuan Dynasty, it inherited the Jin Dynasty system and also set up a Tai Hospital, which was subordinate to Xuanhui Hospital. The Yuan Dynasty Tai Hospital led each subordinate medical position, was in charge of imperial medical affairs, and set up officials such as envoys, court judges, tongzhi, and experience. However, compared with Jin, Yuan Dynasty Tai Hospital is more complete in terms of both system and scale. The quality of the Tai Hospital has been improved, its scope of authority is also wider, it leads the national medical administration, integrates administration, medical treatment and management, and is the highest medical management institution in the Yuan Dynasty. In addition, there are medical institutions such as the Imperial Pharmacy, which collects tribute drugs from various fields, and the Medical Promotion Division, which is in charge of medical examination and medical education. In short, the Tai medical institutions of the Yuan Dynasty were unprecedentedly complete and strict in the system, and had an important position in the history of ancient Chinese medical administration.
Third, the development trend and deficiencies
From the Western Zhou Dynasty to the Yuan Dynasty, with the improvement of the cognitive ability of the ancient people and the continuous progress of social productivity, people's understanding of medicine and pharmacology has gradually deepened, and medical technology has also continued to advance. The increasing emphasis on health care by the supreme rulers has made the Tai Medical Institution and its system, which are an important part of the national canonical system, continue to develop and improve in the process of inheritance and reform.
The setup of the Tai Medical Institution has gone through a process from scratch, from simple to complex. Since the establishment of the Western Jin Dynasty Medical Bureau, various types of Tai medical institutions have been set up in the central government, and their functions have also been different.
The medical system has been continuously improved, the establishment of officials has become more reasonable and clear, the medical sub-disciplines have become more meticulous, and the number of medical officers has been increasing. The relevant medical officer management, medical education and medical personnel selection system is also constantly evolving and progressing. These laid a very important foundation for the establishment and improvement of the Ming Dynasty Tai Medical Institution. But it is undeniable that they still have many flaws and deficiencies.
In the dynasties before the Ming Dynasty, there were many tai medical institutions set up in the court, but these institutions were subordinate to different ones. For example, in the Tang Dynasty, the Taiyi Bureau was subordinate to the Taichang Temple, while the Shang Food Bureau and the Monk Pharmacy Bureau were subordinate to Dianzhong Province, and the Yaozang Bureau, which was responsible for the prince's medical treatment, was subordinate to Zuo Chunfang. Leadership and restraint among tai medical institutions lack a fixed set of rules and mechanisms. This undoubtedly reduced the efficiency of medical treatment, and at the same time, it was very difficult for the implementation of the palace medical system and the unified management of medicine.
In the Ming Dynasty, the feudal absolutism centralized power was unprecedentedly strengthened, and the establishment of the Tai Medical Institution was also influenced by the idea of centralization, and the establishment of the Tai Hospital coordinated the handling of the relationship between the medical institutions, and the situation of centralized and unified management of the palace medicine began to appear, which greatly strengthened the role of the Tai Hospital and improved the medical efficiency.