prosperous age

The next day, Wei Guangde entered the cabinet and asked Lu Bu to send someone to contact Xu Chunfu, the director of the Imperial Medical Bureau, and invite him to the cabinet to ask him questions.

Although Lu Bu was also very puzzled, he immediately went outside to find someone to go to the Imperial Hospital.

Half an hour later, Wei Guangde met the court official Xu Chunfu in the duty room.

Wei Guangde was as enthusiastic as ever towards people who came out of the Imperial Medical Bureau. After asking him to sit down, he asked about the current situation of Huimin Pharmacy.

Sure enough, when Xu Chunfu heard Wei Guangde say the words "Huimin Pharmacy", his expression changed slightly.

"Lord Wei, sigh."

With a sigh, Xu Chunfu spoke softly.

"Most of the pharmacies established by Taizu in various places to benefit the people are now in name only."

In the third year of Hongwu, Zhu Yuanzhang ordered the establishment of public pharmacies in prefectures, counties and cities, and ordered the selection of one internal medicine doctor and one external medicine doctor from medical households to specialize in making medicines to benefit the poor, sick, military and civilians, without demanding the payment.

The main responsibilities of the pharmacy are to diagnose and treat, and to provide medicines free of charge to sick poor soldiers and civilians.

Huimin Pharmacy originated from the Imperial Medical Bureau's Prepared Medicine Office set up in the capital Kaifeng in the ninth year of Xining in the Northern Song Dynasty. It was also known as the Xiuhe Medicine Office. It appointed officials to supervise the production and sale of finished medicines and was the founding of the government-run pharmacy.

In the fourth year of Zhenghe period, the prepared medicine bureau was renamed as the Medical and Health Bureau for the People. During the Jin Dynasty, the Health Bureau was also established based on the system of the Song Dynasty.

In the Yuan Dynasty, Huimin Pharmacy was supervised by the Imperial Medical Service, its system became more complete, and its scale expanded accordingly.

Since the Song, Jin and Yuan dynasties, the system of Huimin Pharmacy has been greatly developed and improved, and its establishment area and scale have also expanded, playing a certain role in solving and protecting the medical problems of the poor.

After Zhu Yuanzhang established the Ming Dynasty, he followed the system of the previous dynasty and set up Huimin Pharmacy.

Relief of poor patients and prevention of the spread of plague were highly valued by ancient rulers, so this practice has been continued since its inception.

During the Northern Song Dynasty, Wang Anshi carried out reforms. According to the "Market Exchange Law" in the new law at that time, the trade of medicines must be controlled by the government. The operation of medicines is a national patent, and no one is allowed to privately produce or operate any medicines.

In the Northern Song Dynasty, pharmacies not only sold medicines, but also had medical officers to diagnose and provide prescriptions for patients. Seeing a doctor and using medicines was very convenient and was quite popular among the people.

During the Southern Song Dynasty, the rulers were based in the southeast and their military strength was relatively weak, but the social economy was still very developed and they still attached great importance to the establishment of pharmacies that benefited the people.

Whenever an epidemic raged, the imperial court would order Huimin Pharmacy to send medical officers to carry medicines, go from street to street, provide home treatment, and dispense loose herbal medicines to prevent the spread of the epidemic.

During the outbreak of the plague, Huimin Pharmacy implemented an all-night service, with full-time staff on duty day and night. If "people urgently needed to redeem medicine at night, and the drugstore was not sold immediately," the defendant would be punished with "one hundred strokes of the cane."

The Huimin Pharmacy has gained great reputation due to its superb medical skills and strict management.

The original intention of setting up the Huimin Pharmacy was to make medical care accessible to the people and enable the poor and sick to afford medical treatment and medicine.

Therefore, the imperial court implemented a subsidy policy for Huimin Pharmacy, so that the medicines it sold were far below the market price, enabling more lower-class people to afford the cost of seeking medical treatment and using medicines.

If we encounter poor people or disaster victims who really cannot afford it, we can provide them with medicine for free.

Huimin Pharmacy was under the guidance and supervision of the Ministry of Rites and the Imperial Medical Service, and was responsible for the distribution of medicines and diagnosis and treatment of people inside and outside the capital.

Moreover, when there is an epidemic in the capital, medicines will be provided free of charge to patients in the surrounding areas of the capital.

Since the imperial court established medical institutions in prefectures, states, and counties in the 17th year of Hongwu, they gradually replaced the status of Huimin Pharmacy and became one of the permanent institutions in the local area.

The setting up and management of local public welfare pharmacies became increasingly chaotic, and in many places the buildings became dilapidated and gradually disappeared.

This was actually a change made by the Ming Dynasty in order to cut fiscal expenditure. The court reduced subsidies to Huimin Pharmacies, and in the end only maintained Huimin Pharmacies in the capital, while local governments chose to vigorously support medicine.

However, the medical household system was difficult to operate normally due to the collapse of the household registration system, and required local medical officials to raise funds on their own. This worked in the short term, but after more than a hundred years, local medicine gradually declined.

In this way, except for a few places in the Ming Dynasty where pharmacies supported by gentry and wealthy families still existed, most of them disappeared. It is no wonder that Li Shizhen often gave free medicine to patients during his travels.

In the present Ming Dynasty, Huimin Pharmacy only exists on paper, and there is no financial support at the local level.

After listening to Xu Chunfu's story, Wei Guangde slapped his forehead and suddenly asked, "Local medicine has collapsed, and Huimin Pharmacy has declined, but I remember that military medicine seems to still exist."

What Wei Guangde thought of was that there were still doctors in Bengshan Fort, that is, military doctors, and it seemed that the military doctor system in the garrisons across the Ming Dynasty was still in operation.

"Military doctors receive a salary, so doctors are willing to join the army and serve as military doctors."

Xu Chunfu explained, “Whether it was Huimin Pharmacy or local medicine, the court, since Emperor Xianzong, basically did all this on a voluntary basis, without any salary.

Not only that, they also have to take on the responsibility of providing free medical care and medicine. Naturally, no one would be willing to continue doing this in the long run.

Not to mention Huimin Pharmacies, even when it comes to the selection of local medical officers, most local doctors are unwilling to participate.

It is said that one can save the world by practicing medicine, but one must also have the necessary conditions to do so. "

Finally, Xu Chunfu spoke in a very low voice.

Wei Guangde understood that the Ministry of Rites and the Imperial Medical Bureau were now only maintaining the brand of the Beijing Huimin Pharmacy and could not take care of other places because the court would not give them money.

Local doctors are also unwilling to take this job because not only are they not paid, they even have to pay out of their own pocket.

When an epidemic breaks out, they are the ones who are on the front line.

Moreover, if the imperial court wanted to get something for free, they would give them an eighth or ninth rank official position but not provide any salary, which was obviously not attractive to them.

In the final analysis, if enthusiasm is gone, naturally no one will be willing to do it, and pharmacies and medicine will naturally decline.

"If the local government wants to rebuild Huimin Pharmacy, it will take real money to invest in rebuilding medicine. What do those doctors want, money or official positions?"

Wei Guangde suddenly asked.

Wei Guangde felt that it was necessary to rebuild the Huimin Pharmacy. It was an organization of a universal nature, and if the court squeezed some money out of it, it should be able to raise some money.

Moreover, Wei Guangde came from later times, so he naturally did not think that there was no way to make money. On the contrary, as long as it was in the right place, there were plenty of ways to get money from the rich to subsidize the poor people.

However, it is difficult to find local medical officers who are willing to provide free medical treatment and medicine, so we must first understand the needs of these people.

It is easy to get an official position. A county-level medical officer can be given an eighth rank, or even an eighth rank, and then move up one level at the provincial capital.

As Xu Chunfu said just now, at the beginning of the Republic of China, most of these people were actually elected by local medical households. They did not receive any salary and their labor was voluntary.

If the official position does not appeal to them, then the only option is to consider giving them money.

Well, the current Ming Dynasty court would naturally choose this if it could get things done without spending money.

Spending money to get things done is the last resort.

There is no way. No matter how much money there is, it is not enough to cover the expenses of the officials below. Even if we increase revenue, they can think of ways to spend the money and ask for money with a clear conscience.

Wei Guangde has no hope at all when it comes to cutting costs.

Apart from finding a more stubborn minister of the Ministry of Revenue to keep a close eye on the purse, he had no other options.

"This"

Wei Guangde asked so directly that Xu Chunfu didn't know how to answer for a moment.

He knew the following situation. When choosing between officialdom and money, he naturally knew that he should choose the latter. It was not that the doctor had no sympathy, but that he could not help.

There are so many people who have no money. Even if it is only one-tenth of them, the medical expenses will be an astronomical figure.

Even if it was Li Shizhen, a genius doctor who had plenty of money, he could not help every person he met when he traveled around, as he would never be able to solve all the problems.

Xu Chunfu didn't respond, and Wei Guangde knew that he was embarrassed to say those two words.

There was a characteristic of doctors in the Ming Dynasty, that is, they were all educated people. How could they read medical books if they could not read?

Therefore, these people who work as doctors actually have one thing in common, that is, they are all those who failed in the imperial examinations.

Yes, the medical household system collapsed, largely because the children of medical households gave priority to taking the imperial examinations, and only if they failed would they inherit the family business and become doctors.

Such people, influenced by Confucianism, are naturally ashamed to talk about money. They would rather not do anything than talk about money openly.

"The Huimin Pharmacies in prefectures, states and counties need to be rebuilt and cannot be left abandoned. Even if they cannot benefit all the people, as long as they can help some, it is worth it."

Wei Guangde said.

A photo taken in later generations still had a great impact on him. It showed a mother kneeling down in front of her child because she had no money to treat the child's illness.

Wei Guangde was helpless at the time because there were too many similar incidents and it was impossible for an ordinary person to handle them all.

But now, as the leader of the Ming Dynasty, he has the ability to solve this problem.

After hearing Wei Guangde's words, Xu Chunfu's face instantly turned red.

It’s not that the officials of the Ming Dynasty were without ideals, but after experiencing the ups and downs of officialdom, they mostly chose to go with the flow.

However, when you find that your dream has a chance to be realized, you will still be very motivated.

It cannot be said that Confucian education has failed. It is just that it has been influenced by the general environment and has changed unconsciously. There are very few officials like Hai Rui.

In fact, this has been the case throughout the dynasties.

However, after being excited for a moment, Xu Chunfu quickly calmed down.

The expenditure of Huimin Pharmacy is not a small number, and the current imperial court simply cannot support such a large business.

"Lord Wei, how should we pay for this expenditure?"

Xu Chunfu asked carefully.

“If the imperial court is willing to continue to provide subsidies to Huimin Pharmacy as it did in the previous dynasty, can the pharmacy be rebuilt and operated?”

Wei Guangde asked.

"Of course they can. Doctors from all over the country will do their best to treat patients."

This time, Xu Chunfu's answer was very decisive.

After hearing this, Wei Guangde was silent for a moment and asked, "Are you still collecting the silver for medicinal materials at the Herbal Medicine Storehouse?"

Hearing Wei Guangde asking about this, Xu Chunfu was stunned, and then immediately answered: "In the 13th year of Jiajing, it was stipulated that the medicinal materials received by the Huguang Provincial Administration Commissioner's Office and the Nanzhili Prefectures and Counties every year were stored in the Nanjing Imperial Hospital's Raw Medicine Warehouse, supervised by the Nanjing Ministry of Rites, and the rest were sent to the Beijing Raw Medicine Warehouse, with a total annual income of 7,246 taels.

However, these medicinal materials and silver are used to support the expenses of the Imperial Hospital, and also the expenses of the Beijing Huimin Pharmacy, which are already stretched to the limit. "

"Currently, medicinal materials are traded through pharmacists and dental clinics."

At this point, Wei Guangde thought of the fact that the dental clinics had already exchanged silver for the cards. If he continued to levy taxes on the drug dealers, it would seem like double taxation.

Thinking of this, Wei Guangde paused and started thinking again.

It is definitely unrealistic to ask the imperial court to directly take out money to support Huimin Pharmacy. The only option is to consider increasing taxes in appropriate areas.

In Wei Guangde's eyes, there is no such thing as ancestral system. The system that needs to be changed must be changed to keep pace with the times.

The situation two hundred years ago is very different now. How can we continue to use the old system?

So, the current situation is that the court has to find ways to increase taxes, especially on the rich.

Thinking of this, Wei Guangde suddenly felt that he was almost the same as the treacherous minister Wei Zhongxian.

Fortunately, Zhang Juzheng is now in front to support us.

If it weren't for Lao Zhang, I'm afraid the reforms I carried out would not have had any good results.

But fortunately, my own reform, at least in line with what the old people said, should not be too bad if I use one faction to fight another.

"Director Xu, I can't make up my mind about the money for the time being, but you, the Imperial Hospital, please write me a charter as soon as possible to restore the Huimin pharmacies in various places.

We can't just guard the one and a half acres of land in the capital, we have to rebuild the local pharmacies as well.

I have a preliminary idea, which is to collect taxes based on the medical fees charged by medical clinics in various places, and all the taxes collected will be sent to the Huimin Pharmacy for local use.

This tax does not need to be paid to the government, but can be used by local medical institutions to operate benefit pharmacies and provide free medical care and medicine in normal times.

As for epidemics, local medical experts will naturally be responsible for them, and the government will allocate medicinal materials.

This is just an idea of ​​mine. You can think about it first when you go back, and I will think about it too. "

Wei Guangde spoke out his inner thoughts, but he did not mention that the pharmacy would impose taxes on the circulation of medicinal materials, and he did not know whether Xu Chunfu had already known about the exchange of silver.

However, after Wei Guangde finished speaking, Xu Chunfu understood what Wei Guangde meant, and asked carefully: "What Wei Gelao meant is that those who have money should pay a tax in addition to the medical expenses.

And this tax is used to pay for local people-friendly pharmacies and subsidize poor patients, so that they can see doctors and receive treatment at very low cost? "

Wei Guangde nodded, "At the moment, the court needs money everywhere, and there is only so much money, which has long been stretched, otherwise the court would not have measured the land and collected the taxes that should be collected.

I thought that since the previous dynasty had a monopoly on medicinal materials, most likely the money they used to maintain the Huimin Pharmacy came from this.

All taxes collected locally will be used locally. Rich households can pay a little more to subsidize poor people. I don't think they will say anything.

The money for rebuilding the pharmacy can be provided by the local government, but the key is to have a set of rules and regulations to define who can donate medicinal materials."

Nowadays, due to restrictions on population mobility, the phenomenon of local cliques is actually very serious. Otherwise, the imperial court would not have forcibly introduced the system of floating officials, for fear of collusion among local people.

If we collect taxes on medicinal materials, it doesn't make sense because we already have the hurdle of dental clinics. So we can just come up with a business tax for medical clinics.

"The local government can nominate a highly respected doctor to manage the money and rotate them regularly. I think they will be able to accept this."

Wei Guangde continued.

"I will go back and summon the imperial physician to discuss the matter and submit a report as soon as possible."

Xu Chunfu also thought this was a good idea, so he agreed immediately.

After Xu Chunfu left, Wei Guangde sighed, "Money is really a good thing. It can solve any problem." (End of this chapter)