明代惠民药局的运作与地方医疗  

The Operation of the People-serving Pharmaceutical Bureau and the Local Level Medical Care in the Ming Dynasty

作　　者：刘桂海 Liu Guihai(School of History and Culture,Northeast Normal University,Changchun,130024,China)

机构地区：[1]东北师范大学历史文化学院,吉林长春130024

出　　处：《古代文明(中英文)》2025年第2期113-120,M0006,共9页The Journal of Ancient Civilizations

基　　金：国家社科基金中国历史研究院重大历史问题研究专项重大招标项目“面向中国自主知识体系构建的中医学史研究”(项目批号:24VLS013)阶段性成果。

摘　　要：惠民药局是明代府县设立的官办医药组织,其运作影响了明代地方医政的演进。药局设立的时间以洪武朝为主,随后各朝亦有添设;空间上远未覆盖全国半数的府县,未达到朝廷预期。药局的基本职能是为贫病者诊疗施药,也会因时因需承担一些其他的医学事务。药局的经营发展长期面临人员不足、经费短缺的困扰,亦受到医户、贡赋、捐纳制度变化以及药材商业化等因素的制约,明中叶后走向衰落。惠民药局的废弛代表官方力量在医疗救济中日渐懈怠,不过仍对地方医疗乃至后世产生影响。Huimin yaoju(惠民药局,pharmaceutical bureau to benefit people)were mainly established as local level medical care organizations by government during the Hongwu period.Barely covering half of the counties in the whole country,Huimin yaoju influenced the evolution of local level medical care system significantly.The basic function of the bureaus was to provide medical treatment and medicines for poor patients,in addition to some other related services.Due to shortages of human and financial resources and the commercialization of medicinal materials,Huimin yaoju failed to develop further and gradually declined since the mid-Ming period.The decline of Huimin yaoju indicates the retreat of the governmental involvement in local level medical care affairs,but the historical impacts of Huimin yaoju still lasted for generations to come.

关 键 词：明代 惠民药局 职责 经营困境 地方医疗 

分 类 号：R28[医药卫生—中药学]