Kim Dae-Gi
Uisahak. 2017 Dec;26(3):455-502. doi: 10.13081/kjmh.2017.26.455.
Although the healthcare system of the Yuan Dynasty followed that of the Song Dynasty, there are certain differences between these two dynasties in terms of practices. Including appointing 'Yihus' in 'Zhusehuji' and setting up 'Guanyitijusi' to oversee Yihus, the Yuan Dynasty developed an effective management system for their physicians and, soon after the coronation of Khubilai, built 'Yixue (Medical school)' all over its territories in order to establish an organized and substantial medical training system. Moreover, the Yuan Dynasty not only revived the civil service examination system system between 1314 and 1320 as well as the medical examination system, but also increased the quota for qualification to twice that of Confucian examination in Song. These changes resulted in producing many brilliant people at the time. In the second half of the reign of Emperor Chengzong it was decided that the incompetence of the government healthcare organizations and the abundance of charlatans could not be neglected any longer. Existing policies and systems was limited in educating and training proper physicians, and this problem was not restricted to the field of medicine. The need for new systems that could reform the social order led to the restoration of the civil service examination system. The civil service examination system for Confucianism and for medicine began in 1314 and 1316, respectively. The purpose of the medical examination system was to select medical officials. The medical examination system which started in 1316 had a significant impact on the medicine of the Yuan dynasty for many reasons. Firstly, the qualification to apply to the medical examination did not remain constricted to 'Yixue' but opened to all 'Zhusehuji'; and secondly, the examination system did not have a restriction on the number of applicants was not restricted. The most important aspect of the examination system was that the number of test takers that passed the first test was one hundred and the number of passers of the second test were thirty, which were not low compared to the number of passers of the Confucianism examination. As such, the impact of the medical examination on the Yuan society was substantial. The Confucian examination selected 300 persons to pass the first test. The second test had 100 test takers which was equally divided among the four social classes at 25 percent each. The medical system selected 100 persons in the first test and 30 in the second. What is important is that unlike the Confucian examination system, the medical system was not divided into four classes. Hypothetically, the 30 qualified persons could all be South Chinese. In terms of the number of passers, it was much more promising for the South Chinese to flourish through the medical test than through Confucian examination test. Such facts support the claim that the Yuan Dynasty emphasized the field of medicine compared to the Song Dynasty. Although the Song Dynasty implemented the civil service examination system early on, the medical system was not implemented until 1115, which started with the founding of 'Yixue' across the country and assigning student capacity. During the Song Dynasty, the number of students in the medical system was 15 percent of that in the Confucianism system, and compared to that in Yuan, it raised to 30 percent, which is twofold. The indications of the Yuan Dynasty valuing medicine and making an effort to educate and train medical experts can be seen in the 'Yihu system', 'Guanyitijusi', Yixuetijusi', and medical school as well as the ratio of the medical system capacity.
尽管元朝的医疗体系沿袭宋朝,但两朝在实际做法上存在一定差异。元朝在“诸色户计”中设置“医户”,并设立“广医提举司”来监管医户,从而形成了一套有效的医官管理体系。忽必烈即位后不久,便在全国范围内设立“医学”(医学院),以建立一个有组织、成规模的医学培训体系。此外,元朝不仅在1314年至1320年间恢复了科举制度和医学考试制度,还将医学考试的合格名额增加到宋朝科举考试的两倍。这些举措在当时造就了许多杰出人才。元成宗在位后期,政府医疗组织的无能和江湖郎中的泛滥问题再也无法忽视。现有的政策和制度在培养合格医官方面存在局限性,而且这个问题并非仅存在于医学领域。对能够改革社会秩序的新制度的需求促使科举制度得以恢复。儒家科举和医学科举分别始于1314年和1316年。医学考试制度的目的是选拔医官。始于1316年的医学考试制度对元朝医学产生了重大影响,原因如下:其一,参加医学考试的资格不再局限于“医学”,而是向所有“诸色户计”开放;其二,考试制度对报考人数没有限制。考试制度最重要的一点是,第一次考试通过的考生有100人,第二次考试通过的有30人,与儒家科举考试的通过人数相比不算少。因此,医学考试对元朝社会的影响很大。儒家科举第一次考试选拔出300人通过,第二次考试有100名考生,四个社会阶层各占25%。医学考试第一次选拔100人,第二次选拔30人。重要的是,与儒家科举制度不同,医学考试没有分为四个阶层。假设,这30名合格者可能全是南方汉人。就通过人数而言,南方汉人通过医学考试比通过儒家科举考试更有前途。这些事实支持了元朝比宋朝更重视医学领域的观点。宋朝虽早有科举制度,但医学制度直到1115年才开始实施,当时在全国设立“医学”并规定学生名额。宋朝医学体系中的学生人数是儒家体系的15%,而元朝则提高到30%,增加了一倍。元朝重视医学并努力培养医学人才的迹象可见于“医户制度”“广医提举司”“医学提举司”、医学院以及医学体系的规模比例之中。