What are the tasks responsible for the establishment and development of Ming Dynasty Tai Hospital?
The term "Tai Hospital" often reminds us of a place to treat diseases, especially in TV dramas, and our perception of it is mainly based on this. However, the knowledge of the Tai Hospital is not limited to seeing patients, and during the Ming Dynasty, it played a more important role.
On the basis of inheriting the experience of medical administration and the establishment of medical institutions in the previous generation, the Ming Dynasty carried out many reforms to the Taiyi institutions to solve the existing problems, and established a centralized medical and political structure with the Taiyi Hospital as the core. However, the establishment of this system went through a complex and tortuous process in the early Ming Dynasty.
Specifically, in the summer of the twenty-fourth year of the Yuan Dynasty (1364 AD), Zhu Yuanzhang imitated the Yuan system and set up a medical lifting department in Nanjing, setting up positions such as lifting, co-lifting, deputy lifting, medical professor, Xuezheng, official doctor, and promotion. Then, in June of the twenty-sixth year of Yuan Zhizheng (1366 AD), the medical promotion department was renamed as the Taiyi Supervisor, with the positions of young eunuch and eunuch. Among them, Sun Shouzhen served as a young eunuch, and Ge Jingshan served as a supervisor.
In September of the first year of Wu (1367 AD), the Taiyi Supervisor was restructured into the Tai Hospital again, and the positions of envoy, Tongzhi, court judge, and pawn book were set up. The basic structure of Tai Hospital was initially established, and the headquarters of Tai Hospital was set up in the south of Zhan Shifu in Nanjing. At the same time, Tai Hospital has a Yasheng Medicine Depot and a Huimin Pharmacy, which have ambassadors and deputy envoys respectively. The locations of these yamen are all connected to the Tai Hospital.
In September of the 14th year of Hongwu (1381 AD), the Tai Hospital was changed to the Zhengwupin Yamen, with the positions of Tai Hospital Order, Cheng, and Officials. At the same time, it is stipulated that the Tai Hospital** shall be appointed from the rank and awarded to civilian officials. In the first month of the spring of the twenty-second year of Hongwu (1389 AD), the Tai Hospital Order was renamed the Yuan Envoy again, and the Cheng was changed to the Yuan Judgment.
From the twenty-fourth year of Yuan Zhizheng (1364 AD) to the twenty-second year of Hongwu (1389 AD), the Ming Dynasty spent nearly twenty-five years to complete the construction of the Ming Dynasty Tai Hospital. Tai Hospital was built in Nanjing, the capital city, and has hospital envoys, hospital judges, officials, imperial doctors, etc. This establishment played a key role in the soundness of the Ming court's medical system and the effective management of medical institutions. Tai Hospital played an active medical role throughout the Ming Dynasty.
On the first day of the first month of the 19th year of Yongle (1421 AD), Zhu Di, the ancestor of the Ming Dynasty, moved the capital to Beijing, officially designated Beijing as the capital of the Ming Empire, and Nanjing was reduced to the capital. This marked the beginning of the Ming Dynasty's implementation of the system of two capitals. The main feature of the Ming Dynasty's two-capital system was that there was a complete set of ** institutions in Beijing and Nanjing. Nanjing's ** institutional setting corresponds to Beijing, but the word "Nanjing" is added in front of the name of the institution. Therefore, after moving the capital to Beijing, Beijing also set up the Tai Hospital, forming a pattern of coexistence of two Tai hospitals in the north and south, which lasted until the fall of the Ming Dynasty.
Regarding the exact location of the Beijing Tai Hospital in the Ming Dynasty, Lu Yingfan pointed out in the "Qing Dynasty Tai Hospital" that the Tai Hospital was located in the south of Qintianjian and east of the Ministry of Rites, which is now near the north of Xikou Road, Dongjiaomin Lane. Liang Jun basically supported Lu Yingfan's research conclusions in his article "Examination of Beijing Tai Hospital in the Ming and Qing Dynasties" based on Chen Zongfan's "Yandu Cong Examination" and Zhou Jialin's "Guangxu Shuntianfu Chronicles". However, in terms of the time of establishment, Liang Jun determined the time of its establishment between the 18th year of Yongle (1420 AD) and the 22nd year of Yongle (1424 AD) according to the "Chronicles of the Tai Hospital" written by Zhu Ru of the Ming Dynasty and the "Chronicles of the Tai Hospital" written by Ren Xigeng of the Qing Dynasty.
In contrast, Lü Yingfan, in the Qing Dynasty Tai Hospital, believes that the Ming Dynasty Beijing Tai Hospital was renovated in April of the seventh year of the orthodoxy of Ming Yingzong (1442 AD). According to the time span and the authenticity of historical materials, Liang Jun's research conclusions are relatively more accurate. Judging from the above research, around the twentieth year of Yongle in the Ming Dynasty (1422 AD), Beijing Tai Hospital was indeed established in the south of Qintianjian, just east of the Ministry of Rites, that is, near the north of Xikou Road, Dongjiaomin Lane. In the seventh year of Orthodoxy (1442 AD), the Tai Hospital was renovated. Although the history books of the Ming Dynasty do not have an exact record of the general appearance of Beijing Tai Hospital, we can learn some relevant information according to the records of Ren Xigeng's "Tai Hospital Chronicles" of the Qing Dynasty.
The establishment of the Tai Hospital Department can be traced back to the Yongle period of the Ming Dynasty, it is located in the south and west of the Que Dong Soft Heavenly Prison, and there is a vermilion wall standing at the entrance, with three black lacquer characters of "Tai Hospital" written on it. Around the entrance, there are the residences of the gatekeepers, the land shrine, and the messenger office on the left and right. There is an ancient well in the northeast corner of the entrance, which has survived the vicissitudes of time. The pine and cypress trees vary in height throughout the campus, some of which are hundreds of years old, and are known as bronze gods by the locals. In the southeast and northeast directions, there are soap servant dwellings, and further east is the crude medicine storehouse, which contains buildings such as the Kushen Hall and the Land Hall.
Ren Xigeng was the imperial physician of the Daoguang and Xuantong dynasties of the Qing Dynasty, and served as the imperial physician of the Tai Hospital, and has an in-depth understanding of the Tai Hospital. His historical record is considered to be extremely credible. According to his records, the construction of the Tai Hospital in the Ming Dynasty basically continued into the Qing Dynasty, although after the 26th year of Daoguang, the area where the Tai Hospital was located was assigned to the Russian Embassy, resulting in the destruction of the Tai Hospital in 1847. This shows that the hospital has experienced a history of more than 400 years, but it has faced the fate of abandonment in a short period of time.
The ** of the Tai Hospital is divided into three categories: the chief officer, the subordinate official and the chief officer, of which the chief official is mainly responsible for **, the subordinate official is responsible for the transfer of documents and internal affairs, and the chief official is an institution with specific leadership. The same is true for Tai Hospital. According to the "Ming Huidian", the chief officials of the Tai Hospital include the court envoy and the court judge, the chief official has a head, and the subordinate officials include the imperial doctor. Nanjing Tai Hospital has a hospital judge and a judge.
The setting of Taiyi** originated from the Tianguan of the Western Zhou Dynasty, and its title has changed greatly in the course of development. The setting of the Ming Dynasty Tai Hospital is more concise and clear, and the responsibilities are clearer, which improves the administrative efficiency of the Tai Hospital and the ability to deal with medical affairs.
The chief officials of the Tai Hospital include the court envoy and the court judge, as well as the chief officer with the purpose of the officer. The subordinate officials of the Tai Hospital are mainly imperial doctors, who are responsible for examining the imperial pulse and repairing the imperial medicine. There are certain differences in the responsibilities of these **, which ensure the orderly operation of the hospital. As the chief officer, the rank was the third grade when it was first established, and then it was adjusted to the fifth rank official. The physicians of the hospital are the chief of all doctors, who are in charge of medical decrees and manage medical affairs. These settings and adjustments of responsibilities evolved from generation to generation, and eventually formed a relatively complete system in the Ming Dynasty.
In the Qin and Han dynasties, the Imperial Physician Order was established and retained during the Three Kingdoms, Two Jin Dynasties, and Northern and Southern Dynasties. Subsequently, institutions such as the Imperial Physician's Decree and the Imperial Physician's Bureau Decree appeared, which were mainly responsible for managing the court's medical affairs. The Ming Dynasty continued the system of the Jin and Yuan dynasties, and set up an envoy to take charge of the daily affairs of the hospital. The duties of the envoy included presiding over the palace medical service, providing medical care to the emperor and the royal family. The adjutant of the Tai Hospital is the court judge, and his official rank is Zhengliupin. The origin of the position of court judge can be traced back to the sergeant of the disease doctor in the Zhou official system, known as the Taiyi Cheng. The main responsibility is to assist the hospital envoy in handling the affairs of the hospital. In addition, in addition to being responsible for the medical services of the emperor and the imperial family, the Shangguan of the Tai Hospital Hall also undertook the duties of carrying out medical edicts and sacrificing to the ancestors.
The leadership of the hospital has 10 officers. It is recorded in the "Ming Huidian": "In the old days, there was only one member, but later the doctors were experienced and gradually no longer limited by fixed posts. They are in charge of various duties within the Temple of the Sacred Confession and outside the headquarters of the Tai Hospital. In the fifth year of Longqing, it was stipulated that it was ten members. "The position of official was called Guan Gou in the Jin Dynasty, and it was called the experience or capital in the Yuan Dynasty. In the Ming Dynasty, the Tai Hospital, the Thousand Households, the Salt Division and other places all had the post of official. The main responsibility of the officials is to deal with the clerical affairs within the organ, and their official rank is relatively low, ranging from the ninth rank to the ninth rank.
However, "although the position of the official of the Tai Hospital is small, the road to promotion can be through the imperial doctor, the court judge, and the hospital envoy." They are responsible for the health care of the royal family, from housekeeping to the best craftsmen in the army, with great responsibilities. In the 43rd year of Wanli (1615 AD), in a ritual recital in September of Jichou, it was mentioned that "the officials must pass the years of training and be strictly supervised in the temple to stimulate their enthusiasm." This shows that although the duties of the officials are lowly in official positions, they need to go through professional study and practice for a long time.
The ** of Tai Hospital includes ten imperial doctors. In the sixth year of Hongwu, the Imperial Pharmacy of the Inner Prefecture set up four imperial doctors, who were served by the doctors of the Tai Hospital. Later, it was increased to eighteen, and then adjusted to ten in the fifth year of Longqing. Their official rank is the eighth grade, although the rank is lower than that of the court envoy and the court judge, but it is higher than the official. The position of imperial physician originally originated from the corporal of the Zhou official physician, and there were already medical attendants in the Qin and Han dynasties. During the Southern Qi Dynasty, the imperial master was established, and later there were titles such as serving the imperial master, serving the imperial doctor, and serving the imperial doctor.
During the Ming and Qing dynasties, imperial physicians became a common title, and they were responsible for the medical treatment of emperors, princes, concubines, and other members of the royal family. Sometimes, according to the edict, he would also treat the illness of the princes, ministers, and foreign guests. The imperial physician had to be a well-versed and experienced physician whose duties were directly related to the emperor's physical health, and were therefore highly valued.
In the Ming Dynasty, the official system of the Tai Hospital was complete and reasonable. In May of the second year of Chongzhen, Nanju Yi Shilang pointed out in a memoir: "The old system of the Tai Hospital included one court envoy, two court judges, ten officials, ten imperial doctors, and two ambassadors and deputy envoys of Huimin Pharmacy and Crude Medicine Depot, a total of 110, and slightly by the first year of Chongzhen, the total number of official doctors reached 533. ”
According to the second volume of the mountain book, since the Wanli period, the demand and attention of medical officials in the Ming Dynasty have been increasing, and compared with the promotion lists of various official offices in the capital, the number of them is often very different. Sun Chengze pointed out this point, indicating the need and importance of the Ming rulers for medical officials.
In order to ensure the normal management and operation of the complicated medical affairs of the royal family, the officials of the Tai Hospital were reasonably set up.
It should be noted that Nanjing Tai Hospital also has corresponding official positions, but its management of Nanjing Tai Hospital's affairs is greatly reduced compared with Beijing Tai Hospital. Since Nanjing is not the emperor's residence, there are obvious differences with Beijing Tai Hospital in terms of setting and functions.
First of all, in Nanjing Tai Hospital, since the establishment of the Yongle period, the institutions in the south have always existed, and some ** positions have been omitted. The chief official of Nanjing Tai Hospital does not have a left position, but only one member of the hospital. The number of subordinate officials was also small, with only one member of the bureaucracy, and no imperial physician was established.
Secondly, the authority of Nanjing Tai Hospital is relatively small, and the affairs that need to be handled are significantly simplified.
Furthermore, although Nanjing Tai Hospital is nominally on the same level as Beijing Tai Hospital, it is inevitably restricted by Beijing Tai Hospital in the handling of specific affairs. Beijing Tai Hospital has a principal title as a hospital envoy and a subordinate deputy title as a court judge; Nanjing Tai Hospital, on the other hand, has only a deputy position, also known as a hospital judge, which is subject to the jurisdiction of Beijing Tai Hospital, which itself is subject to the restrictions of the Ministry of Rites.
The Huimin Pharmacy and Crude Medicine Depot under Tai Hospital are designed to assist in handling the affairs of Tai Hospital, so as to achieve the goal of clear division of labor and ensuring administrative efficiency.