北宋科技与政治的互动关系——以医政改革为例

北宋的医政改革主要涉及政令、人才与机构三个方面。首先,北宋长期坚持扬医抑巫的政策,表现出京师与地方同步、惩治与改造并举等特点。其次,北宋在明确医官阶衔、确定磨勘办法、分离医政与医学、研制教材与教具等方面完善了医药人才制度。最后,北宋革新了太医局、福田院、安济坊、官办药局等机构,推动了社会医疗水平的发展。不过,北宋医政仍存在贪腐成风、朝令夕改等问题,启示我们在改革医政时要兼顾现实性与前瞻性、延续性与针对性、原则性与灵活性。

Analysis of functions of government＇s role in health care reform

Since reform and opening, China＇ s medical system reform has achieved remarkable success, but also brought a lot of problems, such as： hospitals are ill-defined in for-profit and nonprofit, the Office of the Ministry of Health hospitals and managed hospital are also ill- defined, solving our health care reform issue is urgent, the crux is the government and market positioning and how to build a service-oriented government, provide medical supplies, establish fair and equitable health care system which is the basic duty of government, are also urgent needs for building a socialist harmonious society.

末代太医院院使张仲元

太医院是“掌医之政令，率其属以供医事”的中央医疗行政管理机构，也是培养人才的医学教育机构。在太医院供职的太医因与外界隔绝，故史料少有记载。经考查《爵秩全览》《大清搢绅全书》《太医院志》及清宫医药档案等资料，可勾勒出清代最后一任太医院院使张仲元的生平，包括他从最基层的医士到最高管理者院使的升迁过程，为慈禧、光绪等皇族的诊疗情况，以及他的医学主张和对太医院管理的改革等多方面的内容。通过张仲元的个案研究，可以管窥太医群体的工作生活情况。