What was the state of the doctor patient relationship in ancient times?

The relationship between doctors and patients in ancient times can be explained by the social status of passive imperial doctors, equal sitting doctors and authoritative famous doctors. Let's talk about the doctor-patient relationship of the imperial doctor first, which can be described as dancing in shackles. Most of the diseases of the ancient emperors were due to the thick flavor of the ointment, the four bodies were not diligent and relaxed, and the palace struggle was deceitful, the scheming was exhausted, the qi was stagnant and did not disperse, and some were regarded as self-harm, so the so-called imperial doctor cured the emperor to death, and the emperor himself was the greatest.

For example, the emperor who overdosed on pills, the medical saint Zhang Zhongjing invited him to return to heaven and lack skills. In addition, it is worth noting that in many palace coups, the imperial physician would become an important assistant to the reactionaries, and in the Han Book alone, Huo Xian, the wife of the great general Huo Guang, conspired with the female doctor Chun Yuyan to poison Empress Xu of the Han Xuan Emperor with aconite, and Zhao Feiyan's sister Zhao Zhaoyi killed the prince born to Emperor Xu of the Han Dynasty together with the milk doctor because she did not have children; When Emperor Ping of Han was 14 years old, he was poisoned by Wang Mang in the pepper wine of Lari and became ill, and collapsed in three cases of Weiyang officials. From the doctor's point of view, this is a standard medical death for the emperor or his family.

Compared with folk doctors, almost all the tragedies of doctors in history have happened to imperial doctors, because of the underground of social status, the lives of imperial doctors are in the palm of the people they serve. The Ming and Qing Dynasty Tai Hospital was subordinate to the Ministry of Rites, and it had to be controlled by the Ministry of Officials, only the five products of the Yamen, that is to say, the Tai Hospital made the highest authority in the national medical academic circles, equivalent to the current director of the Health and Family Planning Commission (the former Minister of Health), at that time the status was not as good as a mayor (the prefect of the Qing Dynasty was from the four products), the Tai Hospital made so, and other imperial doctors can be imagined. Not to mention the vicious incident of killing the emperor, even if you are not careful, you may be punished.

For example, during the Warring States Period, Wen Zhi was cooked alive because of the rule of law of Qi Min with his affection, and during the Three Kingdoms, Hua Tuo died because he was suspected of Cao Cao, and the former Qin imperial physician Ling Cheng Yan bluntly said that the former Qin lord Fu was sick due to eating too many dates and died.

In ancient times, the relationship between the doctor and the patient was basically a reciprocal check and balance. From ancient times to the present, doctors have naturally existed with patients because of their own medical skills and skillsInformation asymmetry,Until the end of a medical relationship, the patient has no way of knowing the doctor's choice. Even after the doctor has prescribed it, the patient has no way of knowing the doctor's choice due to the asymmetry of information about the condition and the drug.

However, the patient body of the ancient medical relationship eliminated this asymmetry to a certain extent. From the perspective of the overall environment, the status of folk doctors is not high. In the order of the four people of the feudal society, doctors were completely regarded as "workers", and medical skills were classified as square skills.

Section 1: Ancient Medical Ethics.

Ancient medical ethics mainly refers to medical ethics during the period of slavery and feudalism; Medicine in this period basically belongs to the stage of empirical medicine.

1. Overview of medical ethics in ancient societies.

Overview of Ancient Chinese Medical Ethics (Pay attention to the use of rich historical facts to explain) 1. The embryonic period of ancient medical ethics.

Shennong tastes a hundred herbs".

2. The initial development period of ancient medical ethics.

Spring and Autumn Period and Warring States Period:

The Yellow Emperor's Neijing" famous doctor Bian Que's "six incurable" medical principles.

3. The period of perfection of ancient medical ethics.

Zhang Zhongjing, an outstanding physician in the Eastern Han Dynasty (150-219), wrote "Treatise on Typhoid Fever and Miscellaneous Diseases".

Hua Lun, a famous doctor in the late Eastern Han Dynasty.

Wei, Jin, Southern and Northern Dynasties.

Sui and Tang dynasties: Sun Simiao (581-682) "Preparation for Emergencies" (emphasis on explanation) Two Song dynasties: Jurist Song Ci (1186-1249) "Collection of Grievances".

Jin and Yuan periods: Liu Wansu, Zhang Congzheng, Li Gao and Zhu Zhenheng.

Ming Dynasty: Chen Shigong (1555-1636), "Five Precepts and Ten Essentials of Surgical Authentic Doctors"; Li Shizhen's "Compendium of Materia Medica".

Qing Dynasty: Yu Chang (1585-1664) "Medical Law".

2) Overview of Ancient Medical Ethics in Foreign Countries (Pay Attention to the Cultural Background of Foreign Countries) 1. Medical Ethics in Ancient Greece: Hippocrates (460-377 BC) "The Hippocratic Oath".

1) In terms of dealing with the doctor-patient relationship.

2) In dealing with mentoring (peer-to-peer relationships).

2. Ancient Roman medical ethics.

Physician Galen (c. 130-200) 3. Ancient Arabic medical ethics.

Maimonides (1135-1204) 4. Ancient Indian Medical Ethics.

The originator of Indian surgery, "Susruta", is the author of "Anecdotes".

In the "Collection of the Spike Lead Jarakya" by Jara Hidden Moga.

2. The basic content of ancient Chinese medical ethics (key explanations) 1) Loyalty to the medical profession and benevolence to save people.

2) Giving to all people and going to the rescue wholeheartedly.

3) Be diligent and in-depth in medical skills.

4) Be lenient and dignified, and not greedy for money.

5) Respect for like-minded people, humility and non-reservedness.

3. Evaluation of Ancient Chinese Medical Ethics (Attention should be paid to guiding students to think analytically and using the method of questioning) 1) The characteristics of ancient Chinese medical ethics.

1. Significantly influenced by Confucian culture.

1) The medical practice principle of "benevolence saves people".

2) Introspective and cautious medical ethics cultivation methods.

3) The medical moral sentiment of "pushing oneself and others" and "changing places to view".

2. Adhere to the overall medical concept of syndrome differentiation and treatment, and pay attention to the influence of psychological, social and natural factors on diseases.

2) The limitations of traditional Chinese medicine ethics.

1. Influenced by the dregs of feudal ethics.

2. Influenced by the Taoist idea of heavenly responsibility and karma.

3. Negatively influenced by Buddhist ethical thought.

In ancient times, there were also doctor-patient contradictions, and there were many doctors who were imprisoned and killed in ancient times because of doctor-patient conflicts, but there were not many of them recorded, and Hua Tuo was the most well-known one.

First, the relationship between doctors and patients in ancient times was indeed relatively stable. The ancients and the sick were considerate of each other. In addition to the fear of the emperor and his family in the official court, the market and village and town hospitals used medical ethics and medicine to spread medical ethics and reputation, and gave medical treatment to the wealthy, and the medical expenses given to the patients were high.

If the patient is in a poor state, then the doctor Langzhong will ask for less money, and those who are critically ill can still be treated, try their best to treat them when they come, and if they have no money, they will do everything possible to repay them, and tell their neighbors to Sanxiang Wuli, and make them famous, and their excellent Langzhong, those who save more people, the county government will report to the court, and the court will issue a plaque according to the facts, and hang it on the gate to encourage. Therefore, the relationship between medical ethics and medicine in ancient times was relatively stable.

Second, the doctor-patient relationship still existed in ancient times. Ancient human beings did not have a high means of fighting diseases, and death was a common thing. Doctors are called gentlemen, and most of them practice medicine alone or as a master and apprentice, and there is no such thing as a hospital today, so the doctor-patient relationship is better.

Doctors also lay down several principles to avoid disputes. For example, arrogance and irrationality cannot be cured, wealth is valued over body, and belief in witches and doctors is not cured, and so on can also prevent doctor-patient disputes very well. But doctor-patient disputes are unavoidable, and even a wise doctor can't do it in front of power!

Minister Cai Huan sent people to arrest Bian Que, Bian Que could only escape, Cao Cao suspected that Hua Tuo was executed, etc.

3. The real doctor-patient problem is two-fold. Regardless of the past or the present, the most important thing in health care is that patients cannot afford the financial pressure, which is the main point. The failure of medical ethics is the other side of this.

Hospitals are first and foremost places to save lives and help the wounded, not places for profiteering. In order to make huge profits, doctors will inevitably open more examinations and so on to make more profits for the hospital, and the hospital will distribute the value created by the doctors. This will inevitably lead to an increase in the burden on the patient's family, resulting in a great confrontation between the patient and the medical staff.

In addition, the money is spent and the patients are seriously ill and die, which aggravates the outbreak of contradictions.

Learning the medical ethics of the ancients and using them for today is not only a problem between doctors and patients, but also a question of how our medical institutions should assume their responsibilities and obligations to the society.

The characteristics of the ancient doctor-patient relationship include immediacy, comprehensiveness, and stability.

In ancient times, the doctor-patient relationship was formed in the process of diagnosis, care and nursing with medical staff as one side and patients and their families as one side, so the characteristics of the doctor-patient relationship in ancient China were active, direct and stable. During the socialist period, the relationship between doctors and patients was characterized by the principle of equality established by socialist humanism, the relationship of trust established by the socialist legal system, and the entrustment relationship related to saving lives and helping the wounded and guaranteed by medical technology.

The characteristics of the ancient doctor-patient relationship include immediacy, stability, and initiative. The doctor-patient relationship is an interpersonal relationship formed in the process of diagnosis, care and nursing with the medical staff as the one and the patient and his family as the other. The characteristics of the doctor-patient relationship in ancient China are that the stool has initiative, directness and stability.

The ancient harmonious doctor-patient relationship ......Hua Tuo expressed his dissatisfaction, the first medical trouble in Chinese history, Hua Tuo was the victim. However, compared to Hua Tuo's luck, after Tang Yizong's daughter Princess Tongchang died of illness, Ma Wei Baoheng framed the imperial doctor for not treating the princess well, and Li Kai "killed more than 20 people including Hanlin medical officer Han Zongshao, and arrested more than 300 people from his relatives in Jingzhao Prison."

Some people think that this is just the emperor's family will treat the doctor like this, but in fact, there are also doctor-patient disputes in ordinary people's homes, and there are many small jokes about doctor-patient conflicts in "Xiaolin Guangji", with a few examples: a doctor treats bad people and is bound by the other family. Escaped in the middle of the night and returned to the water.

Seeing his son Fang reading "Pulse Jue", he said: "My son is still slow to read, and it is important to learn to swim." A doctor heals a dead man, and the master wants to file a lawsuit.

I am willing to pay for it with my own son.

Heal the dead in one day, and stop the family with one servant. and to compensate for it. And there was a cloud of knockers in the night

The mother is sick in childbirth, and it is annoying to watch. The doctor said to his wife: "Naughty!

That family must have taken a fancy to you again. In these two jokes, a doctor jumped into the water to escape from the patient's family, and the other lost his son and a servant to settle the dispute, and it is obvious that the doctor-patient relationship is not harmonious.

In fact, as early as when Bian Que was in his time, he put forward six incurables, the first of which is that people who are "arrogant and unreasonable" will not be treated, and patients who are arrogant and unreasonable, and this kind of person is the most likely to become a doctor, so it cannot be cured. It is no wonder that when Bian Que saw Cai Huan Gong again later, he knew to run away quickly, and he thought that he had a lot of experience in dealing with medical disputes. Doctors are wary of patients, and patients are also very distrustful of doctors, Su Dongpo mentioned that there are often patients who deliberately do not talk about their illness, wanting to test doctors, "making the disease in the desert", which increases the difficulty of medical treatment.

Zhou Lianggong of the Qing Dynasty even more directly criticized this behavior as "the way to die". It gives people the feeling that there were relatively few doctor-patient disputes in ancient times, mainly because most of the doctor-patient disputes were not big, and unless they involved royal celebrities, they were rarely recorded in the annals of history and were not known to everyone. On the other hand, many doctor-patient disputes in ancient times were not reported to the authorities, such as the Qing Dynasty's "Criminal Case Review", which only recorded 10 cases of doctor-patient disputes.

In this case, there is a saying of "life and death" in ancient times, and many people think that the death of a patient is fate, and they will not care about the doctor, and the second is that some people who have to be concerned will often directly inflict violence on the doctor or ask the doctor to compensate for the private settlement as recorded in the previous "Xiaolin Guangji". In the face of this situation, most of the ancient doctors could only make compromises and do their best to compensate for the matter. Therefore, in ancient times, it was not that the doctor-patient relationship was harmonious, but that it was not harmonious, and everyone could rarely see it.

In the Ming Dynasty, there was a pediatrician named Wanquan, who adhered to a belief and treated patients equally. Dedicated and wise, careful diagnosis and treatment. He also asked patients to trust the doctor, cooperate, and not to make things difficult for the doctor.

He believes that doctors and patients need to trust each other and cooperate closely to get better medical results.

In ancient times, people lived very shortly, many infectious diseases were killers, and the mortality rate of children was higher. At that time, many, many diseases were incurable, and those who could cure some of them were famous doctors. The people's expectations for ** are very low, if they can be cured, Hua Tuo will be reincarnated!

Many people have problems that they heal on their own. It is normal for doctors to fail to treat diseases. So there will be very few medical disputes.

In ancient times, a harmonious doctor-patient relationship was maintained through the doctor's skill. After all, in ancient times, the circle of activity was very small, and once anything happened, the whole city would know.

In ancient times, the doctor-patient relationship was very harmonious, and the patients trusted the doctor very much, but the doctor would do his best to cure the patient without asking the patient for more money.

**Cheap to both sides happy, ancient Chinese medicine to save people for free.

In ancient times, it was the patient who sought medical treatment, and in modern times, it is the doctor who sought medical treatment.

The doctor-patient relationship in ancient times was still better than that in modern times, and the doctor-patient relationship in ancient times was not as shocking as it is now. Weeping ghosts and gods. Due to the improvement of the current level of knowledge and the difficulty of seeing a doctor, the big problem of expensive medical treatment has not been well solved, and the doctor-patient relationship is becoming more and more concernedThe doctor-patient relationship has become increasingly strained.

The conflict between doctors and patients is not a new thing that has only appeared at the moment, it has existed since ancient times. But I have to admit that the doctor-patient relationship in ancient times was far more harmonious than it is today. There are not many examples of doctor-patient disputes that are so shocking and crying today.

The reason for this is that in ancient China, a mechanism for coordinating the doctor-patient relationship has been implicitly formed. This mechanism has been effectively operated in medical practice, which has better prevented the occurrence of doctor-patient conflicts, and even if they occur, they can be properly resolved.

At present, the doctor-patient relationship is relatively tense, there is a lack of trust between doctors and patients, doctor-patient disputes and doctor-patient conflicts occur from time to time, and there are not a few doctors who fight and kill doctors. Patients are always worried about the high cost and difficulty of seeing a doctor, and doctors are also cautious and take more self-protective measures, sometimes preferring to take a conservative** or less risky** plan rather than take risks casually.

The harm of a bad doctor-patient relationship is very great, and it is a lose-lose thing for both doctors and patients. As a doctor, you should have more understanding, listen more to what patients have to say, and make promises that are true to your word. As a patient, you should not hide your condition, understand the pressure of the doctor, and look at the problem from the other person's point of view.

Let's work together to stop the tension between doctors and patients.