Reacting to Epidemics: The Innovative Imperial Public Health System during the Late Northern Song Dynasty

Abstract

Song China was a period in which China experienced a great increase in its population. Concurrently, the Song dynasty also experienced a rise in the frequency of epidemics and two major wars with the Western Xia and Liao dynasties during the 1000s and 1040s. The consequences of these changes were exacerbated by the increased geographical mobility of certain social groups such as traders and examinees attending civil service examinations. Thus, casualties of wars, epidemics, or disease, especially of people whose families were far away and could not care for them were left without care and “their corpses often lay bare along the roads.” This new social environment created a need for general relief. The Northern Song government (960–1127 CE), especially during the reign of Emperor Huizong, established an innovative public health system to address this issue. The public health system included poorhouses, public hospitals, and pauper’s cemeteries. The first were more of charity organizations, whereas the latter two promoted public health by providing medical services for the poor and burial for those that nobody cared for. In terms of rationale behind these institutions, on the one hand, they constituted an attempt to get the poor and homeless off the streets while providing them relief or burial. On the other hand, it seems that Huizong’s deep concern with medicine propelled him to design and implement a comprehensive public health system oriented to prevent contagion and outbreak of epidemics. This article depicts the background, the organization, and the functions of the system. The article also discusses the conditions and reasons that gave rise to such a unique undertaking by the Northern Song government.