南宋城市的公共衛生問題

梁庚堯

  南宋城市公共衛生問題的產生,與當時城市人口大量增加有密切關連。城市人口的增加,包括了定居於其中的居民,以及出入於其間的商旅和各類流動人口。一方面他們的居留及頻繁的活動,帶來了愈來愈多的污穢和垃圾,當時民間雖然已有一些處理的方法,但是仍有人任意倒置,污染城市的街道、河渠、湖泊;另一方面,不斷增加的人口,也使得市區愈來愈擁擠,房屋密集,空地消失,甚至使街道、河渠、湖泊都遭到侵佔,而污穢、垃圾也愈來愈不易清除。這些情況,再加上稠密的居住與活動環境,導致疾疫容易在城市流行,不僅影響到人們的健康,奪走了許多人的生命,也往往造成民眾心理上的不安。這樣的情形,不僅見於南宋最繁盛的城市行都臨安,也普遍見於各處的地方城市。無論中央或地方政府,面對問題,都不得不採取措施。南宋政府針對城市公共衛生問題所採取的措施是多方面的。有些是嘗試從心理上去安定民眾,緩和他們對疾病或死亡的恐懼;有些是企圖維持一個比較潔淨的環境,以減少疫病的發生;又有些則是提供醫藥的方便,以達成治療的目的,甚至進一步設立以養生送死為職責的公共衛生與社會福利設施。各類公共衛生與社會福利設施在城市中普遍設立,是宋代以後城市的一項特色,而城市衛生環境惡化之後,疫病容易流行,應是這項特色所以會出現並延續的部分原因。

關鍵詞:南宋 城市 公共衛生 河渠

 

The Problem of Public Health in Cities of the Southern Sung Dynasty

Ken-yao Liang

Department of History, National Taiwan University

    The problem of public health in cities of the Southern Sung dynasty is closely connected to a rising population during that time period. An increasing urban population included both permanent residents as well as incoming merchants and trade caravans and other groups of population flow. Incessant activity generated increasing amounts of garbage, and although residents had methods of handling these problems, many ignored these measures and polluted the roads, waterways, and lakes. Cities and other urban areas became more and more crowded, housing became more compact, and a shortage of space occurred which meant that lakes, waterways and roadways were often used to create more space. Consequently, getting rid of pollution and garbage became even more of a problem. A combination of high population density and an increasingly active social environment meant that disease became commonplace, affecting peoples' health and endangering their lives. This occurred in Southern Sung's most famous cities such as Lin'an and was also common in many other parts of the empire. Both central and local governments had to take steps to address these problems. The government of the Southern Sung initiated several measures in terms of public health in the cities. Some involved psychological measures to pacify peoples fears regarding diseases and death; some involved attempting to sustain a cleaner environment so as to decrease disease, while other strategies involved promoting medicinal methods and establishing public health facilities and welfare services. As public health in the cities deteriorated and disease became rampant, these measures became characteristic of the cities in the post-Sung period.

Keywords: Southern Sung, city, public health, waterway