【摘要】：公共衛(wèi)生是人類社會永恒的需求，隨著人類文明的遞嬗，公共衛(wèi)生漸由社會自發(fā)調(diào)節(jié)、隨機應對和慈善救濟活動，演變?yōu)橐孕l(wèi)生行政為主導、以科學方法為手段、以保障和增進公眾健康為旨趣，官方與社會合作推進的公共設施和公共事業(yè)。清末民國時期，由于近代以來西方醫(yī)學成就和租界衛(wèi)生管理制度的刺激示范，中國社會內(nèi)部對于衛(wèi)生強國和衛(wèi)生現(xiàn)代性的強烈追求，以及應對連年疫情的現(xiàn)實需要，國家開始自上而下的衛(wèi)生行政擘畫、建構(gòu)和實施，現(xiàn)代意義上的以城市為代表的中國公共衛(wèi)生事業(yè)由此肇端。在此時代訴求和社會趨向的引領下，歷史悠久、文化發(fā)達、商賈輻輳的蘇省重地、江南名城——蘇州，因應時勢，且合于地方防疫、市政建設之需要，遂在官方與社會的協(xié)作下，開啟公共衛(wèi)生之端緒，并逐漸粗成體例。 近代蘇州公共衛(wèi)生的演進，由清末民初的萌發(fā)到南京政府十年時期的初步發(fā)展再到戰(zhàn)后的粗具體例，主要沿著三個脈絡進行：一、公共衛(wèi)生行政管理，由衛(wèi)生行政寓于警政，走向衛(wèi)生行政與警政相對分離；二、辦理模式，由官商合辦走向以官辦為主社會協(xié)作；三、業(yè)務內(nèi)容，由清道防疫擴及其余，粗略形成疫病防治、環(huán)境衛(wèi)生、食品衛(wèi)生、婦嬰衛(wèi)生、學校衛(wèi)生、衛(wèi)生教育等多元并進的業(yè)務體系。蘇州公共衛(wèi)生的演進理路，既有時代共同趨向的投射，又有過程和形式上地方樣態(tài)的呈現(xiàn)。 疫病防治是蘇城公共衛(wèi)生的中心事務，這不僅因為它是時代性的嚴峻課題，也是水網(wǎng)密布、氣候溫潤的江南城市面臨的地方疫情壓力所致。近代蘇城疫病防治問題上，出現(xiàn)了二元對立的面相：一方面是驅(qū)瘟逐疫迎神賽會和挑痧等坊間防疫百態(tài)的恣肆，另一方面是官方對落后防疫行為的取締，并在與社會的互動合作下，初步形成了一套臨時救治與常規(guī)預防相結(jié)合的急性傳染病防控機制。蘇城疫病防治上二元對立的面相，從一個側(cè)面反映了蘇城公共衛(wèi)生，實際是在與民俗傳統(tǒng)特別是迷信觀念和舉措的b^格不入中得以曲折演進，并漸入民心的。 保障日常清潔的環(huán)境衛(wèi)生和食品衛(wèi)生被視為治疫之本，成為蘇城公共衛(wèi)生事務中的基礎工作�？偲浯蟾�，主要涵括街道清潔與垃圾清運、糞穢管理與廁所改良、飲水改良、各類飲食品及其制造經(jīng)營場所衛(wèi)生檢查與管理等內(nèi)容。街道清潔上日常與定期的結(jié)合，垃圾清運上行政與市場的相配，糞穢運除上加強時間、地點和面相的規(guī)范、廁所整改上的化多為少、棄舊迎新，飲水衛(wèi)生上改良與“革命”的統(tǒng)籌、食品衛(wèi)生上應時性強、制度化高、消極取締與積極建設規(guī)劃的并舉，構(gòu)成了各項業(yè)務的典型特質(zhì)。由于經(jīng)費的短缺、主事者和執(zhí)行者的顢頇敷塞、民的痼習、商的玩忽延宕等因素，蘇城環(huán)境衛(wèi)生和食品衛(wèi)生舉措實際成效并不甚佳，許多規(guī)劃也無果而終。然而，毫無疑義，在與社會的互動協(xié)作乃至沖突抵牾中，官方制定了一系列的規(guī)章條例，并盡力付諸實踐，一定程度上改良了蘇州城市生態(tài)環(huán)境和日常飲食健康，并多少促進了市民飲食住行衛(wèi)生生活方式及其觀念的形塑，更從理論和實際雙重意義上推動了蘇州城市社會管理和公共管理的制度化進程，加快了城市現(xiàn)代化變遷。 作為近代公共衛(wèi)生的長效追求，婦嬰衛(wèi)生、學校衛(wèi)生等保健事業(yè)和衛(wèi)生教育的漸趨并進，豐富了蘇城公共衛(wèi)生的業(yè)務內(nèi)涵。以“生”的方式嬗變、嬰兒健康比賽為主要內(nèi)容的婦嬰衛(wèi)生，以學校傳染病預防、學生健康檢查、學校衛(wèi)生教育為主要內(nèi)容的學校衛(wèi)生，以多主體、多形式、多場域、教育性與地方化和趣味性相結(jié)合為典型特質(zhì)的民眾（或曰社會）衛(wèi)生教育，其工作開展雖存在設施簡陋、業(yè)務單一、方式粗糙甚至走過場、普及性不強等諸多局限和不足，但它們確實開啟了蘇城婦幼保健以及衛(wèi)生教育事業(yè)的端緒，積淀了一定的寶貴經(jīng)驗。這些業(yè)務體現(xiàn)了蘇地政府維護婦嬰健康、增強青少年體格以及培育公眾衛(wèi)生觀念習慣的努力和自覺，更從一個側(cè)面反映了蘇州社會力量熱心公益，積極參與推進各項公衛(wèi)事業(yè)，與官方互動合作的地方風貌。 公共衛(wèi)生是蘇城近代化變遷的產(chǎn)物，又推動了城市社會變遷，并在變遷中曲折演進，公共衛(wèi)生與蘇州城市社會變遷之間呈現(xiàn)出一種互動張力。這種互動關(guān)系可以從兩點得以管窺：第一，公共衛(wèi)生的舉辦推動了市民生命狀態(tài)、生活方式和衛(wèi)生觀念的嬗變，生命、生活和觀念的嬗變又使市民增強了對公共衛(wèi)生的訴求，進而推動它的演進；第二，公共衛(wèi)生事務引發(fā)了蘇城衛(wèi)生輿論的勃興，公共輿論又以兼具批判與啟蒙功能的蘇城特色的“公共領域”形式，鞭策政府、啟迪民眾、引領社會在公共衛(wèi)生上通力合作，增強當局的行政自覺及市民的公民性和責任感，進而推動蘇州公共衛(wèi)生乃至整個城市近代化變遷的現(xiàn)實或可能演進。 總之，在時代性的公共衛(wèi)生訴求和發(fā)展趨向的影響下，在蘇城地方當局的行政努力，及民間社會的積極互動下，時至戰(zhàn)后蘇城公共衛(wèi)生體例初具。由于眾多瓶頸因素的掣肘，蘇城公共衛(wèi)生又呈現(xiàn)出粗陋面相。且其遭遇的窒礙和困境，在全國多具一定的普遍性，因此，某種程度上可以說，，蘇城公共衛(wèi)生發(fā)展情狀是近代中國（城市）公共衛(wèi)生總體鏡像的投射，是其時代共通命運的寫照。無論如何，近代蘇州乃至中國公共衛(wèi)生的篳路藍縷之功可圈可點。
[Abstract]:Public health is the eternal demand of human society. With the development of human civilization, public health has gradually evolved from social spontaneous regulation, random response and charitable relief activities to public facilities and public undertakings which are guided by health administration and promoted by scientific methods in order to protect and improve public health. In the late Qing Dynasty and the Republic of China, due to the modern western medical achievements and the stimulation and demonstration of health management system in concessions, the strong pursuit of health power and health modernity within Chinese society, and the actual needs of responding to successive epidemic situations, the state began to paint, construct and implement the top-down health administration, and in a modern sense, take the city as the city. Under the guidance of the demands of the times and the social trends, Suzhou, a famous city in the south of the Yangtze River, has a long history and a well-developed culture. Roughing up gradually.
The evolution of modern Suzhou public health, from the germination of the late Qing Dynasty and the early Republic of China to the preliminary development of the Nanjing government in the ten-year period and then to the rough and concrete cases after the war, mainly follows three lines: first, public health administration, from health administration in police administration, to health administration and police administration relatively separated; second, the mode of management, from the co-operation of government and business to move towards. Third, the development of Suzhou public health is characterized by both the projection of the common trend of the times and the local forms and processes. The presentation.
Disease prevention and control is the central task of public health in Suzhou, not only because it is a serious issue of the times, but also because of the local epidemic pressure faced by the cities in the south of the Yangtze River with dense water network and warm climate. On the other hand, the government banned backward epidemic prevention activities and, under the interaction and cooperation with the society, initially formed a set of acute infectious disease prevention and control mechanism combining temporary treatment with routine prevention. Popular traditions, especially superstitions and practices, have evolved in a tortuous way and gradually become popular.
Safeguarding the daily clean environment and food hygiene is regarded as the basis of epidemic prevention and treatment, and has become the basic work of public health affairs in Suzhou. Daily and regular combination of garbage clearance and transportation administration and market matching, waste removal to strengthen the time, place and appearance of the norms, toilet rectification and transformation of more than a few, abandon the old and welcome the new, drinking water hygiene improvement and "revolution" of the unified, food hygiene should be timely, highly institutionalized, passive ban and active construction planning of the simultaneous, constitute. Owing to the shortage of funds, the carelessness of the principals and executives, the habits of the people, the negligence of the merchants and other factors, the actual results of the environmental hygiene and food hygiene initiatives in Suzhou have not been very good, and many of the plans have been fruitless. A series of rules and regulations have been formulated and put into practice to a certain extent, which has improved the ecological environment and daily dietary health of Suzhou, and promoted the formation of the public's dietary, living and hygienic life style and their concept to some extent, and promoted the institutionalization of Suzhou's urban social management and public management in both theoretical and practical aspects. The process accelerated the change of urban modernization.
As a long-term pursuit of modern public health, health care undertakings such as maternal and child health, school health and health education are gradually advancing, enriching the business connotation of public health in Suzhou. The contents of school hygiene, with multi-subject, multi-form, multi-field, education and localization and interesting combination as the typical characteristics of public (or social) health education, although there are many limitations and shortcomings in its work, such as poor facilities, single business, rough way or even walk through the stage, not strong popularity, but they really opened up the city of Suzhou. Maternal and child health care and health education have accumulated valuable experience, which reflects the efforts and consciousness of the Soviet government in safeguarding maternal and child health, strengthening the physique of young people and cultivating public health concepts and habits, and reflects from one side the enthusiasm of Suzhou social forces for public welfare, and actively participate in promoting various public health undertakings. The interaction with the government.
Public health is the product of the modernization of Suzhou, it also promotes the social change of the city, and in the twists and turns of the evolution, there is an interactive tension between public health and the social change of Suzhou. This interactive relationship can be seen from two aspects: first, the holding of public health promotes the state of life, life style and social change of the citizens. The evolution of health concept, life, life and concept makes the public demand for public health enhanced, and then promotes its evolution. Secondly, public health affairs caused the vigorous development of health public opinion in Suzhou, and public opinion spurred the government and enlightened the people in the form of "public sphere" with both critical and enlightening functions. The public should lead the society to cooperate with each other in public health, enhance the administrative consciousness of the authorities and the citizenship and sense of responsibility of the citizens, so as to promote the reality or possible evolution of Suzhou public health and even the modernization of the whole city.
In a word, under the influence of the public health demand and development trend of the times, with the administrative efforts of the local authorities and the active interaction of civil society in Suzhou, the public health style of Suzhou began to take shape after the war. Therefore, to some extent, it can be said that the development of public health in Suzhou is a reflection of the general image of public health in modern China and a portrayal of the common destiny of the times.
【學位授予單位】：蘇州大學
【學位級別】：博士
【學位授予年份】：2014
【分類號】：R-09

【參考文獻】

相關(guān)期刊論文 前10條

1 鄭澤青;昨天的抗爭——近代上海防疫掠影[J];上海檔案;2003年04期

2 宋忠民;上海公共租界的狂犬病防治[J];檔案與史學;2001年05期

3 殳俏;回眸近代上�；魜y大流行[J];檔案與史學;2004年03期

4 崔文龍;;德國在膠澳租界地建設規(guī)劃中的衛(wèi)生措施及對中國人的歧視[J];德國研究;2008年01期

5 馬長林;劉岸冰;;民國時期上海傳染病防治的社會環(huán)境[J];民國檔案;2006年01期

6 羅芙蕓;作舟;;衛(wèi)生與城市現(xiàn)代性:1900-1928年的天津[J];城市史研究;1998年Z1期

7 杜麗紅;;南京國民政府時期城市公共事務管理初探——對北平環(huán)境衛(wèi)生管理的實證研究[J];城市史研究;2005年00期

8 袁德娟;;中國近代公共輿論空間的缺陷分析——以戊戌維新時期為例[J];青年記者;2009年24期

9 余新忠;;清代江南的衛(wèi)生觀念與行為及其近代變遷初探——以環(huán)境和用水衛(wèi)生為中心[J];清史研究;2006年02期

10 余新忠;;晚清的衛(wèi)生行政與近代身體的形成——以衛(wèi)生防疫為中心[J];清史研究;2011年03期

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