| During the Republican period, epidemic diseases was particularly rampant in Hunan, Hubei, Jiangxi and Anhui province, and became one of the major threats of people’life and health. Futher analyzing the geographical features of epidemic diseases, the interaction between public health system and epidemic diseases, and the change of people’public health consciousness can provide historical background and experience to the research of contemporary infectious diseases. Based on newspapers of the Republican period and the local chronicles in 1980s and 1990s, this paper dissected the spatial-temporal distribution of epidemic diseases, the construction of public health system, and the transiton of people’public health awareness in Hunan, Hubei, Jiangxi and Anhui during the Repubilican period by the method of spatial analysis, mathematical statistics and literature review. The conclusions are as follows:Firstly, epidemic diseases occurred every year during the Republican period. The regions affected kept rising with fluctuations, ranging from 5 counties to 132 counties, and reached the top in 1946, with 1918 and 1932 as the second peaks. At least 2 epidemic diseases burst every year, and 82% years had more than 5 epidemic diseases prevailing simultainously.1941 and 1945 were years which had the most species of epidemic diseases. Followed by dysentery, malaria, epidemic cerebrospinal meningitis and plague, smallpox and cholera were the two epidemic diseases breaking out most frequently and spreading most widely, which burst every year and involving 15 counties and 11 counties each year on average respectively. Diphtheria, typhoid fever, kala-azar, relapsing fever, typhus fever and scarlet fever happened rarely. Most epidemic diseases burst in summer, less in autumn and spring, least in winter. The ten years epidemic disaster indices of the whole area and each province were high, which proved that the epidemic disaster was almost prevalent every year. The epidemic disaster span was rising with fluctuation, and appeared four peaks at the year of 1918,1932,1942, and 1946, with epidemic disaster span of 21.7%,32.3%,33.7, and 46.3% respectively. Moreover, the time span between the four peaks was shrinking, declaring that the epidemic disaster became more aggravated.Secondly, more than 95% counties had occurred epidemic diseases in Hunan, Hubei, Jiangxi and Anhui during the Republican period. With epidemic frequency of 55.3%, Pingjiang County in Hunan province was the most frequent epidemic prevalence aera, where epidemic disasters burst once every less than two years. Next were Xiakou, Changsha, Wuhu County, with epidemic frequency of 52.6%, 50.0% and 50.0% respectively. Districts of Pingjiang-Xiangyin-Changsha-Liuyang-Xiangtan in northeast Hunan province, Hengyang-Qiyang-Baoqing in central south Hunan province, Badong-Changyang-Yichang-Yidu in west Hubei province, Hanchuan-Xiakou-Wuchang-Huanggang in east Hubei province, Nanchang-Fengcheng in central Jiangxi province, and single counties like Zhijiang, Yuanling, Changde, Linwu, Chaling, Gongan, Suixian, Nanfeng, Shangrao, Jiujiang, Fuiang, Wuhu, Huaining were places relatively prone to epidemic diseases, with pestilence outbreaking at least 11 years. Each epidemic disease also had its unique spatial distribution features, but the prone areas always coincided with the general severely afflicted areas.Thirdly, at the beginning of the Repubican period, health section was established in interior department and police agency to supervise medicine and health in Hunan, Hubei, Jiangxi and Anhui, meanwhile, the Civil Affairs Department and police department of each county dispatched one or two member to currently control public health. After the year of 1929, four provinces all set up health office successively to govern the health excutive affairs of the whole province, and administrative career hospitals also founded one after another in each county, responsible for the health administrative management. Futhemore, governments at various levels had formulated and promulgated a series of regulations on physicion, medicine, public environmental health and dietetic hygiene, which provided foundation to the launching of health management, the rectification and regulation of citizens’ behaviors.Fourthly, during the late Qing dynasty and early Republican period, western missionaries came to China and organized numbers of missionary hospitals, thus pulling open the prelude of the medical facilities construction. Regional public and private hospitals were founded gradually since then. After the year of 1929, each county also established its regional hospitals, and private clinics were too numerous to list. In addition, many medical and health organizations were set up, such as branches of the Red Cross, Traditional Chinese physician union, Chinese Medical Association, Nurses Association and so on, which becoming one significant part of the public health service system in Hunan, Hubei, Jiangxi and Anhui during the Republican period.Fifthly, there only existed temporary epidemic prevention organization in Hunan, Hubei, Jiangxi and Anhui during the Republican period, such as the temporary epidemic prevention office, the summer health campaign committee, the vaccination bureau and the quarantine station. Home Affairs Branch, police office and Public Security Bureau were in charge of regional epidemic prevention affairs in the early Republican period, and handed over to regional hospitals later. Temporary epidemic prevention hospitals were built whenever infectious diseases occurred, such as provisional pestilence hospitals and pesthouses, and some general hospitals even set up infectious disease department.Sixthly, however, the public health system in Hunan, Hubei, Jiangxi and Anhui during the Republican period was quite fragile. The health administrative institution was imperfect, and there was no health management regulation at a regular basis. Corruption, limited health fund, low medical technique, laggard medical facilities, insufficient medical and health staff and shortage of drugs deprived the lives of incalculable infectious disease patients. Therefore, positive actions were taken whenever epidemic diseases outbroke. Governments at various levels had organized temporary epidemic prevention institutions, formulated epidemic prevention plans and regulations, sent physicians to take emergency treatments, convene physicians to seek effective prescriptions, injecting vaccine compulsively, controlled traffic, regulated the medicine market, and held hygiene campaigns. Social groups had gave away free medical treatment, free medicines, and free vaccination, gathered and buried corpses and coffins, and carried out health propaganda. Ordinary people also inoculated vaccine initiatively and paid more attention to health, but superstition and migrating to orther places were more common.Seventhly, thankfully, the frequent impact of epidemic diseases had enlightened people’wisdom. Multitudinous epidemic prevention regulations emerged, superstitious epidemic prevention customs were been denounced, hygiene campaigns were taken regularly, vaccination was becoming initiative action, and child care activities emerged, all of this explained the progress in epidemic regulation, custom and thought. |
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