the name of the ancient medical institution of Tai Hospital. It is a medical and health care organization dedicated to serving the upper feudal ruling class. Tai Hospital was established in the Jin Dynasty, and was affiliated to Xuanhui Hospital. The highest official of the Imperial Hospital is the Imperial Hospital's Chief Executive Officer (the first five products), and there are ambassadors, deputy ambassadors, judges, etc., "in charge of all medicines, he always judges hospital affairs." In addition, there is also a tube hook in the Tai Hospital to take charge of medical education, and there are also doctors and medical officers with various names. Yuan dynasty imperial hospital. Rank is positive. At the beginning, the chief officer was a propaganda officer, and later he was changed to a medical supervisor and a hospital supervisor. Its administration is subordinate to Xuanhui Academy. Under the Chief Executive, there are court envoys, deputy envoys and judges. In Yuan Dynasty, Imperial Hospital was in charge of all medical affairs, and the rank of officials was generally higher than that of any dynasty. There was also a Imperial Hospital in the Ming Dynasty, whose chief executive was originally called Imperial Hospital Order, and later renamed Imperial Ambassador. In the Ming Dynasty, there were two imperial hospitals in Beijing and Nanjing respectively, but the imperial hospital in Beijing was the highest medical administrative organ, with the highest medical minister's court ambassador and court judgment. However, Nanjing Tai Hospital only has a court judge and no court ambassador, so as to obey the leadership of Beijing Tai Hospital. In the Qing Dynasty, there was only one Imperial Hospital, which was in charge of medicine administration and medical treatment. In the early Qing Dynasty, the imperial pharmacy was also placed under the management of Imperial Hospital, and the national medical officers were sent, assessed and promoted by Imperial Hospital, thus strengthening the unified leadership. However, this system failed to persist, and the Ministry of Rites managed the raw drug storehouse and the general manager supervised the imperial pharmacy, which weakened the function of the imperial hospital. In the middle and late Qing Dynasty, medical administration was in chaos. In a word, from Jin Dynasty to Qing Dynasty, Tai Hospital continued for more than 7 years as the central institution of national medical administration and medical treatment.
in the Ming and Qing dynasties, the area around Dongjiaomin Lane (formerly known as Dongjiang Mi Lane) in Zhengyangmen (commonly known as Qianmen) was once the seat of many government offices. In this daunting place, there is a rather special institution, that is, the imperial hospital for the treatment of the royal family.
(1) Changes in the location of Tai Hospital
When Zhu Di, the founder of the Ming Dynasty, made Beijing his capital, he used the old official residence as the place for all yamen to handle affairs, which was mostly scattered in the urban area, but it was disorderly. Ming Yingzong orthodox seven years in April (May 1442), began in Daming Gate (called Qing Gate in Qing Dynasty, in Zhengyang Gate). After liberation, it was demolished) and many government offices were built. The Hospital Department is also built here. In the Qing Dynasty, Tai Hospital continued to be located there because of the old Ming Department. Its exact location is in front of Tiananmen Square, south of Qin Tianjian, east of the Ministry of Rites, that is, near the north of the west exit of Dongjiaomin Lane. The hospital has three gates, all facing west. Opposite is the zhaobi, and there is a red forehead with the words "Tai Hospital" written in black paint. The house in front of the gate is a doorman. On the left is the "land shrine" (facing north) and on the right is the "page office" (facing south). There are five halls in the department, which are the main venues for activities. Among them, Huang Yunshi, who was sentenced by Kangxi Imperial Court, hangs: "How can we be sacred? We can adjust our recent situation. Be sincere and cautious about medicine, and be benevolent for life. " On the left side of the lobby, there are three south halls, which are the offices of the physician. On the right side of the lobby is the North Hall. Behind it is the Temple of the First Doctor, whose door is called the Star, the inner door is called Xianji, and the temple is named Jinghui, facing south. The statues of Fuxi, Shennong and Huangdi are enshrined in the temple, and there is a plaque in Kangxi's imperial book "Yongji Qunsheng". The medicine king temple is the one facing north outside the first medical temple. There are bronze figures in the temple. The hall connecting the lobby is hall two, followed by three halls and five rooms.
in the twenty-seventh year of Guangxu (191), imperialism forced the Qing government to sign the "Xin Chou Treaty", which designated Dongjiaominxiang as an embassy area, and all China offices within the embassy area had to be moved. Too hospital can't find a new place for a while, so we have to temporarily borrow Bai Wenshou's mansion on Dong 'anmen Street. Soon, Tai Hospital temporarily moved to Beichizi Great Pessimistic Music Institute. In the 28th year of Guangxu (192), a new department was established outside Di 'anmen in the east of Huangchenggen and Bingzhan Bureau, which was completed in three years (after the Revolution of 1911, it was changed to a private Liangji Girls' Middle School). There are three main doors, with rooms along the door, tea for the valet in the west and the landlord for the science room. There is a land shrine in the east; There is a bronze temple in the west. In Yimen, there are five halls in the east and five in the west, which are the places where medical officers below the imperial doctor work. Due north is the lobby. The backyard is the second hall, which is still called "Chengshentang" after its original name. In the hospital, three rooms in the east wing are the leaders' hall, three rooms in the west wing are the medical hall, two rooms in the east wing are the general affairs office, two rooms in the west wing are the teaching rooms, and there are study rooms for students in the north. The site of this new hospital still exists. That is, Beijing No.32 Middle School Factory and Family Dormitory of No.113 Cultural Relics Bureau, No.111 Di 'anmen East Street, No.17 Di 'anmen Dongda, Dongcheng District, Beijing. The lobby has been demolished, but the foundation stone of that year can still be seen. The second hall and the east and west halls all retain the original buildings, but they have become houses. However, from these buildings, we can imagine the strict, luxurious and mysterious scene of the former Tai Hospital.
In the san huang Temple of Mingtai Hospital, there was a stone carving of the full text of Acupuncture and Moxibustion Sutra of Tongrenqi, which was inscribed by Yuan Yuanzhen (1295-1296) and written by Wang Weide of Song Dynasty. The inscription on the stone tablet was Song Renzong's imperial book. Stone carvings were moved here from the capital of song dynasty (now Kaifeng) from Hui Zong to the first year of Yuan Dynasty (1335-134). Wang Weide, also known as Wang Weiyi, was a famous acupuncturist in the Song Dynasty. He was once a medical officer in Hanlin and served the imperial palace with medicine. In the early years of Tiansheng, he was ordered to compile acupuncture books. He made a detailed textual research on the records and acupuncture patterns in ancient medical books, and systematically summarized the acupuncture practice of doctors in previous dynasties. In the fourth year of Tiansheng (126), he compiled three volumes of Acupuncture and Moxibustion Illustrations at Tongrenqi Point. Tiansheng Qifeng (129) was promulgated by the government throughout the country as a standard for learning acupuncture and selecting points in clinical practice. He also designed and presided over the casting of two acupuncture bronze men in Mingtang. The bronze man's body and viscera can be divided and combined. The names of acupuncture points are marked in gold on the body surface, and the holes are coated with yellow wax, which is empty and can be filled with water. If the needle is inserted correctly according to the acupuncture discretion, the water inside can flow out of the hole, otherwise it cannot be penetrated. It was used as an acupuncture teaching and examination doctor at that time. One of the two bronze statues was lost in the war, and the other one was hidden in the Yaowang Temple of Mingtai Hospital, but this bronze statue was rebuilt from Yuan Shizu to the first year (1264-1294). These relics of the former dynasty, due to their long history, were illegible in stone carvings and indistinguishable in bronze statues during the Ming Yingzong Orthodox period (1436-1449). When Ming Yingzong ordered the new Imperial Hospital to be built, the stone was carved into bronze, the stone carvings in the Acupuncture and Moxibustion Classic were rebuilt, and the bronze figures were cast in imitation, which were placed in the hospital department for French use. In Jiajing of Ming Dynasty, acupuncturist Gao Wu had cast three bronze figures, one for men, one for women and one for boys. In the Wanli period of the Ming Dynasty, Yang Jizhou, a medical officer, also cast a bronze man in Tai Hospital. So since the Northern Song Dynasty, there have been seven acupuncture bronze figures. I don't know which bronze statue was placed in the "bronze temple" of the new department of Di 'anmen Waitai Hospital in the late Qing Dynasty.
(II) The evolution and system of the Imperial Hospital
Doctors or medical institutions dedicated to the imperial court have existed in China since ancient times, but there are similarities and differences between different dynasties in the establishment and system of their officials. Zhou Guan has medical staff sergeant and corporal, who are in charge of medical orders. Qin ordered too much medical treatment. In the Western Han Dynasty, Taichang and Shaofu all had orders to cure doctors. Those who are too common treat officials, and those who belong to less government treat the court. Eastern Han Dynasty, Cao Wei along the home. The Sui and Tang Dynasties set up the Department of Imperial Physicians, and its competent official was the order of the Department of Imperial Physicians. In the Song Dynasty, there was a medical officer's hospital, which was renamed Tai Hospital in the Jin Dynasty, and its chief executive was TiDian. Yuan Dynasty was also called Tai Hospital. The Ming and Qing dynasties lived side by side.
The system of Tai Hospital in Qing Dynasty is as follows:
(1) Organization and clothing: At the beginning of Qing Dynasty, the official grades were different between Manchu and Han. In the ninth year of Kangxi (167), because the political power had been consolidated, in order to eliminate the hatred of the Han people, they flaunted the so-called "integration of Manchu and Han" and changed the official system to unification. Therefore, the officials of the Imperial Hospital were all in the same position. However, in the thirty-fifth year of Qianlong (177), there was still a minister who was appointed as the chief executive of the Imperial Hospital, and it was not abolished until the fifty-eighth year of Qianlong (1793). Since then, all the officials in Taiyuan Hospital have been filled by Han people, and sometimes a few Manchu people have been appointed. The personnel situation of the hospital is as follows: one court envoy is the competent official of the hospital's administrative and medical affairs, one judge from the left and one judge from the right hospital is the deputy competent official of the hospital, with 1-15 imperial doctors, 1-3 clerks, 2-4 doctors, 2-3 food doctors (or grain doctors, mainly engaged in writing and so on) and 3 cutting doctors (responsible for the cannon and roasting of drugs). Although the above-mentioned posts were increased or decreased in the Qing Dynasty, on the whole, the system remained unchanged. The medical officers in this hospital are generally called imperial doctors or imperial doctors.
in the 9th year of Kangxi (167), it was stipulated that the hospital should make five items, the left and right hospitals should judge six items, the royal doctors should make eight items, and the officials should follow nine items. In the seventh year of Yongzheng (1729), it was stipulated that all the doctors were awarded seven items, and six Pin Guan belts were allowed. The clothing of medical officers has also changed in the dynasties.
(2) departments and services: in the early Qing dynasty, there were eleven kinds of hospitals according to the old system of the Ming dynasty, namely, Dafang pulse, Xiaofang pulse, typhoid fever, gynecology, ulcer, acupuncture, ophthalmology, stomatology, orthopedics, laryngology and acne. In the second year of Jiaqing (1797), throat and mouth teeth, acne rash and small veins were combined into one family, and then nine families were formed. In the sixth year of Jiaqing (181), Orthopaedics was placed in the upper hospital. In the second year of Daoguang (1822), acupuncture and moxibustion was abolished because it was considered that "acupuncture and fire moxibustion were not suitable for the monarch". Tongzhi five years (1866), the original two families of typhoid fever and women were included in Dafang pulse, and with the addition of Xiaofang pulse, surgery, ophthalmology and stomatology, * * * became five families. Guangxu dynasty is still the same, and it has not changed.
The court ambassadors, court judges, imperial doctors, officials and medical practitioners all entered the palace in different classes according to their specialties, and they took turns to wait on them. What is in the palace is called "Gongzhi"; In the outer court, it is called "six straights". Palace straight in the pharmacy and all the classes outside the palace; Six straight outside the straight room to serve straight. When the Qing emperor was stationed in Yuanmingyuan, Gong Zhi served in Yuanmingyuan pharmacy. Liuzhi waits in a straight room outside Yuanmingyuan. In the 13th year of Guangxu (1887), it was agreed that there should be two officials of Tai Hospital staying in Xiyuan (now Zhongnanhai and Beihai) Shou Pharmacy every day, and the library palms, pen stickers, etc. of the pharmacy should be summoned in case of business; Dry and clean official royal pharmacy, a day by the Tai Hospital, a large, small pulse two families each stay straight, for the royal.
In order to facilitate the straightening, there is no office or "Tatan" in the Imperial Hospital in the palace and the garden (Qing Wen Hui Shu is interpreted as "living outside", that is, resting place). There is an office in an acre garden in the southeast of Yuanmingyuan, with more than 8 original rooms, and there is also one under the east wall of the forbidden city, north of the upper court and east of the south. The remains are long gone.
(3) education and assessment: the training of medical officials in Qing dynasty was divided into two types: internal teaching and external teaching. Internal teaching practice is to teach medical students in internal prison, while external teaching practice is to teach medical students among ordinary civilians and children of medical officials. The internal teaching practice is that the medical officer with a good knowledge is appointed by the Tai Hospital to take up the teaching work, and the teaching is located in the East Pharmacy. Professor of internal medicine, kitchen service and meals are provided by Guanglu Temple. The selection and training of foreign teachers are extremely strict. According to the regulations: "First-time doctors, take the official seal from their fellow villagers, report to the hospital (too hospital), and after being examined by the head office of our hospital, take the doctors and medical officers of our hospital to guarantee the knot, and the hall officials (hospital ambassadors, hospital judges, etc.) will take the exam face to face. Those who can be trained in medicine are allowed to wait for the test in the hospital and make up for it one by one [1] ". Only those who have undergone numerous examinations and are truly "well-versed in medical science and have committed no crime" can enter the foreign teaching hall to study. He teaches medical officers, and he also selects royal doctors, and those who are excellent in character and learning in the official's eyes are appointed. The lessons studied are mainly medical classics and related specialized books. In the seventh year of Qianlong (1742), Wu Qian and others compiled the Golden Mirror of Medical Cases, which was published in the fourteenth year of Qianlong (1749), that is, it was used as a medical textbook until the late Qing Dynasty. In addition to taking the exam quarterly every year, the dropouts who teach abroad will take the exam once every three years, and those who are admitted are called healers. Those who are not admitted to the school are still allowed to drop out of school as usual, waiting for the next exam. The Imperial Hospital also stipulates that anyone who has been out of school for more than one year and has been ranked first in three quarterly examinations can fill the vacancy of food doctors after reporting to the Ministry of Ritual. In the eighth year of Yongzheng (173), ten food doctors were added and renamed as Enliangsheng. From then on, they can be replenished without examination, just by reporting to the Department of Ritual from the Imperial Hospital.
After the Opium War, the capital of Taichi Hospital was insufficient, and the teaching and examination systems became increasingly lax, so did the teaching and learning hall. During the Tongzhi period, Hu Qingyuan, the imperial censor, called for the rectification of medical officers to take proper medicine. In the sixth year of Tongzhi (1867), he changed the teaching hall into a medical hall, and the Imperial Hospital sent three teachers to take charge of the medical hall, and tested the doctors, the grain and the students in the spring and autumn, and then ranked them and supplemented them according to their names. Every six years, Tai Hospital, together with the officials in charge of the Ritual Department, conducts a comprehensive examination for the medical officers who serve in Tai Hospital. This kind of examination, except for the court ambassador, the court judge and the imperial doctor who waits straight in the imperial court, was told that the emperor could not take part, and all the other officials, doctors and students should take the exam.
in the thirty-fourth year of Guangxu (198), a new medical museum was established, which was basically in accordance with the rules of schools in various provinces, with two medical officers as teaching staff, one inspector, one supervisor, one general clerk and one secretary to take charge of related affairs. Except for management, the rest of the staff must work in the hospital. Twenty students are selected from the old school, and the study period is set at four years. Although the personnel training and selection system of Taiyuan Hospital in the late Qing Dynasty has been increasingly relaxed, it is still very serious in the education and examination of medical officers because of the important tasks undertaken by this hospital.
(4) Personnel system: Under normal circumstances, the personnel system of Taiyuan Hospital is promoted and transferred step by step in strict accordance with the grade. If there is a vacancy in the hospital, the left hospital will be awarded a promotion; If there is a shortage of judges in the left hospital, the right hospital will make up for it; If there is a vacancy in the right court, it will be promoted by the physician; If there is a shortage of doctors, they will be promoted by officials; If there is a shortage of officials, it will be supplemented by doctors; If there is a shortage of medical staff, doctors will make up for it. Generally speaking, the title of the medical officer is: except for the court ambassadors and court judgments, when there is a vacancy below the imperial doctor, the Tang officer of the hospital first selects and nominates in the Neizhi medical palace, and submits it to the Li Department for appointment. If the Neizhi medical officer is completed, he can be selected from the foreign direct medical palace and submitted according to his salary. Before reporting, some have to pass the exam. This is a general promotion situation. There are also two special situations: first, there is a shortage of officials in the hospital, and if there is a special purpose, it will be supplemented according to Chongqing; First, when there were too many people in the hospital to be used, those who were proficient in medical science and willing to work were selected from the people's doctors in Zhili Province and those who had the title of supervisor of tribute students, and they were re-recorded according to certain procedures. But this kind of special situation is always rare.
(5) Other duties: The main duty of Tai Hospital is to serve the court (as mentioned above). In addition, it also undertakes some temporary tasks appointed by orders and relatively fixed tasks undertaken by the direct members of the hospital. There are three kinds of temporary tasks assigned by orders: first, all kings, government officials and civil and military ministers ask for medical treatment; Second, foreign vassals, princesses, ministers of forehead and taiji have to seek medical treatment. Third, the military camp needs medical treatment, and the official is sent to treat it. The members of this hospital (or in conjunction with relevant departments) are engaged in relatively fixed tasks, mainly including two tasks: first, the civil and military examinations (by the Ministry of Rites and the Ministry of Military Affairs), and the rural examinations in Shuntian (by Shuntianfu) each take two doctors and enter the venue to provide services. By the end of the period, "the hospital will select one person from the Department of Dafang Vein and the Department of Ulcer, who are familiar with medical science, and submit them to the Committee for use" [2]. Second, in the prison of punishments, "two doctors are selected by the hospital for service, and the drug price is given silver rice every month. After six years of service, he returned to the hospital and was promoted to the rank of official "[3]. In addition, there is a task of "sending outside the customs". In the thirty-fourth year of Kangxi (1695), it was decided to send two good doctors to mergen, Heilongjiang, to see a doctor. It is rotated once a year. It stopped in the forty-fifth year of Kangxi (176). This kind of dispatch is not long.
(6) Imperial Pharmacy: Imperial Pharmacy is an important institution for imperial court to purchase, store, prepare drugs and serve imperial doctors in different classes. The imperial pharmacy is divided into two parts: east and west. Western pharmacy ambassador of Guitai Hospital