公医制度的地方困境--以四川省县级卫生院为例(1939-1949)

The Local Dilemma of the State Medicine:The Case of Health Centers of County in Sichuan Province(1939-1949)

1939—1949年间,四川省先后建立百余所县级卫生院,成为当时全国县级医疗卫生中心数量最多的省份。县卫生院的建设与发展,是国民政府落实公医制度在基层社会的实践表现,但在具体落实中,四川省各县卫生院在建立过程中受到地方社会人情、乡谊、血缘等因素的制约,甚至被不断卷入不同派系的政治斗争。公立医疗制度在基层县乡遭遇的困境,不仅反映了现代医疗体系本土化的艰难历程,同时折射出地方社会的复杂政治生态与多重弊病。

Between 1939 and 1949,more than a hundred county-level healthcenters were established in Sichuan province,which possessed the largest number of health centers in the country at that time.The construction and development of the health centers of county was the practice of the national government to implement the State Medicine at the grassroots level.In the process of localization,the health centers of county have faced the constraints in terms of groupbenefits,native friendship,and blood relations,even been involved in localpolitical conflicts.The dilemma of the health centers not only reflects the difficulty of localizing the modern health care system,but also reflects the complexpolitical ecology and multiple ills of the local society.