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[高丽王朝早期的省级医疗体系]

[The provincial medical system during the early days of Koryo Dynasty].

作者信息

Lee Kyung-Lock

机构信息

Handok Museum of Medicine and Pharmacy.

出版信息

Uisahak. 2007 Dec;16(2):111-31.

Abstract

This article explores the setup and development of the provincial medical system during the early days of Koryo (918-1392) Dynasty. Under the reign of King HyunJong (1009-1031) the dualistic medical system of the UiSa (a medical officer) and the YakJumSa (a provincial medical officer) was established. The former, the officer of central government, were sent to the local government, and the latter, the successor of provincial powerful clan, operated the YakJum. The Uisa supervised the YakJumSa in 13 local governments, and it indicates the will and the limitation of the power of Koryo government. On the other hand, a great number of the YakJumSa were spreaded throughout the country except the capital and the vice capital, and it means the development of medical system during the early days of Koryo. The missions of the Uisa and the YakJumSa were instructing the medical students, collecting the tribute herbs, treatment, and relieve the poor people. And they just took the right of collecting tax of the land as their salaries, and it was different from the another officers. This dualistic medical system of the UiSa and the YakJumSa got under way in the reign of King MoonJong (1046-1083). But after the reign of King YeJong (1105-1122) the YakJumSa became the only provincial medical officer as the UiSa had been perished for reducing the ruling system. So the monistic medical system of the YakJumSa was the final provincial medical system of Koryo. Despite accomplishing the nationwide medical network with the YakJumSa, Koryo government failed to maintain and develop the provincial medical system with the UiSa. And it caused the difference of medical standard between the ruling class of the capital and the people of the province. Therefore, it can be said that the important principal of the medical system of Koryo was hierarchy accordance with the regional difference.

摘要

本文探讨了高丽王朝(918 - 1392)早期省级医疗体系的建立与发展。在显宗(1009 - 1031年在位)统治时期,建立了医官(UiSa)和地方医官(YakJumSa)的二元医疗体系。前者是中央政府官员,被派往地方政府,后者是地方豪门的继任者,负责运营医局(YakJum)。医官在13个地方政府监督地方医官,这体现了高丽政府的意愿和权力限制。另一方面,除了首都和陪都之外,大量的地方医官遍布全国,这意味着高丽早期医疗体系的发展。医官和地方医官的职责是教导医学生、收集贡药、治病以及救济穷人。而且他们仅以土地征税权作为薪酬,这与其他官员不同。医官和地方医官的这种二元医疗体系始于文宗(1046 - 1083年在位)统治时期。但在毅宗(1105 - 1122年在位)统治之后,随着医官因统治体系精简而消亡,地方医官成为唯一的省级医官。所以地方医官的一元医疗体系是高丽最终的省级医疗体系。尽管通过地方医官实现了全国性的医疗网络,但高丽政府未能与医官一起维持和发展省级医疗体系。这导致了首都统治阶层和地方百姓之间医疗水平的差异。因此,可以说高丽医疗体系的重要原则是与地区差异相符的等级制度。

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