The development of military medicine refers to the process of studying the development of medical and health institutions serving the military. Because of the special environment of the army, it is different from general medicine.
From ancient times to the Western Zhou Dynasty (before 770 BC), military medicine was in its infancy. In the history of social development in China, he entered the fishing and hunting society and invented the bow and arrow, which was used for fishing and hunting and fighting against the enemy. What is the word Shuowen? Like a man lying in bed wounded by an arrow; Oracle Bone Inscriptions's works are interpreted as a man with an arrow under his arm. So it can be said that when China used bows and arrows as weapons, he had the activity of saving lives.
In the Xia army, in order to prevent the enemy from poisoning the water, officials were specially set up to manage and dig military wells. The Hu family in Xiaguan is such an official. Great agricultural development in Shang and Zhou Dynasties. In Shangshu, cereals, wheat beans and other grains are cooked and ground into dry food, which can be preserved for a long time and maintain the nutrition of the grains. Most of the rations are famine food.
The period from the Spring and Autumn Period to the Qin and Han Dynasties (770-220 BC) was the period of the formation of military medicine. During the Spring and Autumn Period and the Warring States Period, vassal states merged with each other and wars were frequent. Sun Bin, a famous strategist in the Warring States Period, said in his March that "no disease in the army is victory", which shows the great significance of preventing and treating diseases in the army. In the military medical system, Zhou Li Tianguan recorded eight scholars with swollen palms and broken wounds. Including the military medical officer. Lv Wang's "Six Towers" mentioned that there were three alchemists in the army, who prescribed hundreds of medicines to cure gold sores and all diseases. Mozi's order pointed out: when fighting against the enemy, local rich households should vacate some houses for military use, or set up temporary hospitals, give medicines, wine and meat, and send personnel to inspect them. When they are well, they have to make a report before they can return to the team. There is a system in the General Code and other documents for officials to visit the wounded and sick for rehabilitation; Provisions on penalties for medical personnel's dereliction of duty; There is also strict military discipline for the wounded and sick to escape privately, pretend to be ill, and self-harm after recovery. It is mentioned in the Spring and Autumn Annals of Wu Yue that Gou Jian, the king of Yue, said to the soldiers before attacking the State of Wu, "I want to give medicine to those who are sick and can't accompany the army. Give them porridge, accompany them to eat, and other simple medical assistance systems and regulations.
In the Qin and Han Dynasties, in order to resist the invasion of northern nationalities and strengthen the troops stationed in the border areas, it was learned from the records of Han bamboo slips in Juyan that there were military doctors specializing in war medicine and medicine in the northwest border areas, and they were slightly embryonic as hospitals stationed in the border areas. In the Western Han Dynasty, there were officials in charge of military medicine. According to Hanshu, the official doctor Wei 8 1 person. The Rear Infectious Disease Isolation Hospital was founded in Yan Xi in the Eastern Han Dynasty for five years (162). When Huangfugui levied Longyou, an epidemic of infectious diseases occurred in the army. He isolated sick soldiers, put them in temporary designated houses and gave them medicine. Due to the improvement of weapons, golden sores and broken wounds have become common injuries in war, and the methods of hemostasis and dressing have developed accordingly. Rehmannia glutinosa was widely used in the traumatology department of Han Dynasty to treat internal bleeding and continuous injury. "Materia Medica" records that Liu Bang used "zygote" as a medicine for treating golden sores in the army. For the treatment of traumatic internal bleeding, there are prescriptions for preventing frostbite such as "Fa Han San" in Juyan Han bamboo slips. Prescriptions such as vinegar can be used to prevent eye damage caused by fireworks. In Fifty-two Diseases Prescription, there is a considerable understanding and treatment of knife injury, gold injury, arrow injury, purulent infection caused by trauma and tetanus. At that time, burnt hair (gray hair) was used to stop bleeding, and the wound was treated by decoction and washing, such as wet compress with juice extracted from Scutellaria baicalensis Georgi, Dipsacus asperata and Aconitum, to remove blood stasis and relieve pain; Apply ointment to protect the wound. At that time, according to the severity of the wounded, different arrangements were made for battlefield rescue. "Biography of Li Hanling" records that "Lien Chan is a foot soldier, and the wounded in Zhongya III carry chariots; The two creators will drive the car; "A creator holds the specific provisions of the war. "
The Jin Dynasty to the Five Dynasties (265 ~ 1 127) was the development period of military medicine. Military doctors in the Jin Dynasty included a captain, Sima He, and the former two may be officers, doctors or surgical military doctors. With the development of tactics, prescriptions for fire injury and soup injury appeared, which were recorded in Gehong's Elbow Queen in Jin Dynasty and Yao Sengyuan's Fangji. To treat arrow wound with poison, Xiao Pian Fang uses realgar to smear the wound, and Liu Gui Yi Fang uses powder for oral detoxification. It is also recorded in the Book of the Later Zhou Dynasty that the father and son of Yao Monk had served as the military doctor of Yu Wenyong, the emperor of the Northern Zhou Dynasty, and cured Liang Wudi's blindness (drooping eyelids) militarily.
During the Sui and Tang Dynasties, the highest military institution in the central government set up a general's office, and the two men were in charge of the medical work of the national army. Local * * * also has Gong Cao and Si Cao in charge of medical administration. In addition, because the three local governments have only one doctor on average, local medicine not only undertakes medical education and local medical care, but also serves as the medical work of local troops. At this time, there were still alchemists in the army engaged in medical work. Zhao Kun described in Kaiyuan (7 13 ~ 74 1 year) that "there were three alchemists in the army, mainly engaged in medicine, with injuries and diseases." The Tang Dynasty established a relatively perfect patrol system. Each battalion of the army has a sick child prosecutor, who is responsible for the daily examination of the wounded and arranges treatment and evacuation according to their illness. If there are new patients or critically ill patients, they must report to the general manager, and let the doctors patrol the camp and give appropriate treatment. Moreover, military academies are required to inspect soldiers' barracks every three days, check their daily life and the medical conditions of sick soldiers, give pensions to the dead and reward the injured according to the degree of injury. There are two applications in war wound rescue: nursing (similar nursing) and binding webbed (stretcher); It is stipulated that one can walk, one is too sick to walk, two can not ride, and two can be bundled and transported. The Law of the Tang Dynasty also promulgated the detailed rules for the punishment of the wounded and sick in medical rescue. Medical rescue work has been guaranteed by law, which has greatly developed and improved compared with the previous generation. In the Tang Dynasty, the system of government soldiers was implemented, and there was a similar experience in conscription. The standard of enlistment is those who wear armor but can still fight.
In the Five Dynasties, the army had special military doctors in charge of medicine. According to the records of the Five Dynasties Conference, in the third year of the Qing Dynasty in the late Tang Dynasty (936), the late emperor Li Congke used the title of "military doctor" for the first time. During this period, the military medical organization was gradually improved, and with a relatively perfect medical system and regulations, the war wound rescue was also improved and developed.
The mature period of military medicine is from Song Dynasty to Opium War (960 ~ 1840). The military doctors in the Song Dynasty were also in charge of medicine and treatment by Hanlin Medical College. Besides medical education, Taiyi Bureau is also in charge of military medical treatment. This system lasted from the Song Dynasty to the late Qing Dynasty. Local troops and border guards have military doctors in charge of medicines; The medical work in the troops stationed in the capital was mainly carried out by the students in the Imperial Medical Bureau, and the medical officers of the Imperial Medical Bureau only temporarily served as medical care for the soldiers and civilians in the capital during the epidemic. During the popular season, Imperial Medical Bureau often distributes medicines to all military units. When the epidemic is serious, medical personnel will be sent for treatment. In addition, the emperor often sent envoys to announce medicine to officials from all walks of life as a law. According to Xu Dong's Tiger Bell Classic: "The number of doctors must be more than 20, and the number of soldiers must be increased", it can be seen that there was a certain proportion at that time, but it was still insufficient. In the first year of Huizong Jingkang (1 126), under the massive attack of the Jin people, the northern counties fell one after another, and the wounded were scattered and exhausted. Zhao Jiangzhi first established a hospital in Cizhou (now Cixian County, Hebei Province) to take care of them, and established a local military hospital.
In the treatment of gold sores, Xu Dong summarized the experience of treating gold sores such as "eight taboos", "nine incurable diseases" and "four terminal diseases" in Tiger Bell Classic. This shows that at that time, the differentiation and treatment of its syndromes had reached a certain level when dealing with golden sores. Is it often used to treat internal leakage of golden sore in Huber Classic? Insect, peach kernel, rhubarb, leech, boy's stool and other products have changed the tradition of treating internal injuries and bleeding with yellow earth since the Han Dynasty. There are also records that repairing the abdomen with mulberry skin has weapons and the skin is broken. Frostbite is also a common disease in the army. At this time, we have a specific and correct understanding of the location and causes of frostbite. For example, it is mentioned in the Tiger Bell Classic that "the foot soldiers waded through the ice, suffered from frost and snow, suffered from all kinds of freezing, or lost their diet and were exhausted, so the leader was paralyzed." And ... "Pay great attention to water quality, water source and its environment, put forward specific identification methods and five' don't eat' (that is, stagnant water, those with enemies in the upper reaches, those with uncertain water flow, those with feces and grass, and those with human and animal corpses on the water), otherwise they will die or get sick; Another method is to use colloid to clarify turbid earthquake water. In the Song Dynasty, great progress was made in military surgical medicine and military health and epidemic prevention.
The rulers have specific requirements for the physical quality and skills of candidates, and they are admitted according to the prescribed standards of height, brawn and martial arts. In the Yuan Dynasty, soldiers were ill. In addition to giving medical workers symptomatic treatment, they were also sent to add tribute officers to take charge of the treatment of soldiers. Only after they recovered were they allowed to return to their original posts. In the assessment, according to the number of soldiers who died of illness, the punishment for sick officers was determined. At the beginning of the Yuan Dynasty, a "comfort station" similar to the military station hospital began to appear, which accommodated the wounded soldiers passing by and gave them a place to rest and recuperate. However, Anletang did not develop as a system and disappeared after the demise of the Yuan Dynasty. After the first year of Dade in Yuan Chengzong (1297), the provisions on the pension for the dead and wounded soldiers were put forward.
In the Ming Dynasty, military doctors were sent to the army by Imperial Hospital at any time. In addition, there are official military doctors and fixed places in the Beijing army, the mainland or border posts, and pharmacists and veterinarians are also needed in mainland health stations. The company commander and other officials will ask for dispatch where the border defense bureau is short of medicine. The medical work of the army has also established a system, such as the treatment of sick soldiers, the handling of the dead, the declaration procedures for new wounded and sick, the treatment of doctors sent to the army by Imperial Hospital, the punishment of dereliction of duty, and the protection of water sources. According to Lu, the medicine of the army is provided by the state free of charge, and there are officials in the army who are responsible for the medicine. There is a Hui Jun pharmacy in the army, and doctors who are proficient in business work in the pharmacy. This is a great reform in the history of China's military doctors. In the Ming dynasty, medical departments were set up in frontier defense stations, and medical officers and doctors were sent from imperial hospitals to teach non-commissioned officers to learn medical skills to solve the problem of insufficient military doctors. Zheng He made seven voyages to Southeast Asia from 1405 to 1433, and there were many military doctors besides official schools and warriors, which was the earliest record of naval military doctors in China. The sanatorium is a local government-run institution for the aged, which takes in the sick and disabled elderly without support and orders the old, weak, sick and disabled soldiers to adopt in the sanatorium, but by the time of Injong (1425), the sanatorium had existed in name only.
After the Song and Yuan Dynasties, gunpowder was widely used. Some people mix gunpowder and poison to make deadly weapons, which can not only burn the enemy, but also poison the enemy. In the early Ming dynasty, there was a record of gunpowder as a magical prescription to treat this kind of burn. This is the earliest record of treating gunpowder burns in the history of China military doctors. "Five Elements of Ming History" once recorded that people were injured by gunpowder, covered in red and rotten, soaked in stinky sauce, white wine and other liquids, and were saved.
Before the Opium War (1840), the Qing Dynasty followed the system of the Ming Dynasty, and military doctors were still dispatched by the Imperial Hospital. The army does not have a fixed number of doctors. When a sergeant is ill, most of them are sent temporarily. According to "Donghua Record", during the period from Qianlong to Guangxu, general senior generals were injured or injured, such as minor illness or nervous military situation, and were sent to camp for treatment or transferred to the rear for treatment; Those with serious illness will be given leave to go home or come to Beijing for treatment. As for soldiers, they are only paid by hospitals in summer or when there is an epidemic. If there are wounded soldiers, rest in the camp during the war and repatriate after the war. At that time, there was no fixed military doctor in the army, and once an epidemic broke out, it often caused a large number of deaths of non-commissioned officers. Since the introduction of western artillery in the late Ming Dynasty, the military doctors have never had a definite treatment for modern firearm injuries, and they still can't figure out the past oral and external application methods for treating gold sores.
7 The development of modern military medicine (post 1840) After the Sino-Japanese War (post 1894), the Qing court established a new army modeled on the German military system, and the military medicine and military medical system also underwent major reforms. In the thirty-third year of Guangxu (1907), the military medical department was set up in the army and navy, and there were two departments in the department: health department and medical department. The guard has a military medical department, marked with a deputy military medical officer, and the team has a military medical chief. Establish naval and army medical halls and military hospitals. For example, Beiyang Medical College was established in Tianjin (1893), 19 12 was renamed as China Naval Medical College managed by Beijing Admiralty, and 1930 was closed. Army Medical College (1902) was opened in Tianjin, and 19 15 was moved to Beijing. It is the earliest army medical college in China. Since then, army and naval medical schools have been established in Guangdong (1909), which has led to the emergence of western-style schools specializing in training military doctors in China, but the right to education is in the hands of foreign teachers, which fully reflects the semi-feudal and semi-colonial dependence. In the thirty-first year of Guangxu (1906), Suiying Hospital and Suiying Military Medical School were established in Guangdong successively, and a Japanese doctor of medicine was hired as the chief teacher and hospital inspector, and another assistant and pharmacist were hired as the deputy. Shortly after the founding of the new army, the Qing court collapsed, and the newly established military medical system did not play much role. After the Revolution of 1911, the Military Medical Department under the Temporary Operations Department was in charge of medicine. Later, the warlord regime formed. Warlords have crude military hospitals, doctors or health teams in their respective units, and there is no unified military medical system. After the Northern Expedition (1927), a certain management system was gradually formed. There are military hospitals at all levels, and all regiments have medical teams or clinics.
The Kuomintang Nanjing * * * has a military medical department (the highest administrative department in the army) under the Ministry of Military and Political Affairs, and all group armies, war zones and divisions (brigades) have military medical departments to take charge of military medical work. 1946 changed to the newly established joint logistics headquarters. In terms of medical institutions, there are Army General Hospital and Military Division (Brigade) Field Hospital, while rear hospitals and military station hospitals are configured accordingly according to the number and distribution of troops in various places. Hospitals at all levels are roughly divided into departments, clinical departments are divided into large departments, and auxiliary departments are also very rough. Most drug (pharmaceutical) personnel have not received professional training. Drugs and medical devices are supplied to the troops under their jurisdiction by various supply areas or supply bureaus (health department groups). The formal education of military doctors started earlier in Beijing Army Medical College. After the Northern Expedition, it moved to Nanjing as the Central Army Military Medical School (university nature), 1938 moved to Anshun, Guizhou, with branches in An and Kun. The major is medicine and pharmacy, with research department, undergraduate department and specialist department. The research department trains teachers for three years. The undergraduate course has three disciplines: medicine, pharmacy and dentistry. There are two groups in the specialty: medicine and pharmacy. Recruiting on-the-job personnel will return to their original units after graduation. After the victory of War of Resistance against Japanese Aggression, the Army Military Medical School 1946 moved to Jiangwan and merged with the Health Personnel Training Institute to form the National Defense Medical College, and 1948 moved to Taiwan Province Province. Because the Kuomintang * * * does not attach importance to soldiers' injuries and pains, military medicine cannot develop.
During the Red Army period of Chinese workers and peasants, the Red Army Hospital was built on Jinggangshan from the day of 1928, and a health team was organized to treat the wounded and sick with folk remedies and herbs. 193 1 workers and peasants red army nursing school opens. 1932 set up a medical cadre school. At the beginning of the Long March, about 300 medical staff had been trained. After 1932, health organizations and institutions at all levels of the workers' and peasants' red army were initially formed. The company has health personnel, the regiment has a health chief, and there are health departments at or above the division level. The central government established the General Military Medical Service (later changed to the General Ministry of Health) and promulgated the health regulations for the whole army. In terms of hospital system, there are general hospitals, hospitals and hospitals with health centers.
During the period of War of Resistance against Japanese Aggression, the medical rescue work was greatly improved. Every hospital has generally established a formal system. Many reforms have been made in medical technology, such as emphasizing the principle of disinfection and non-toxicity in wound treatment. Early debridement and plaster sealing were used. Actively promote modern war treatment principles such as liquid supplementation and active prevention of tetanus. In terms of rescue work, we began to advocate the "mutual rescue package" way in which soldiers helped each other to rescue and bind up on the line of fire. In terms of health and epidemic prevention, the General Ministry of Health once put forward the slogan of "prevention first", which made the soldiers form a good habit of paying attention to health. At that time, the sources of drugs and equipment were enemy-occupied areas and the rear, which were solved from three aspects: enemy-occupied areas and production self-help At that time, the anti-Japanese democratic base areas also established schools to train medical cadres at all levels, and some adopted short-term training and short-term rotation training.