A Study On Epidemic Rules Of Shanxi Province During The Ming And Qing Dynasties

The Ming-Qing dynasties period in China was marked by unusual historical and astrological events, including two periods of major natural disasters. The frequency and severity of natural disasters and epidemics was significantly worse than in previous periods. Shanxi province was area most seriously affected by the epidemic during that time. During the reigns of emperors Wanli, Chongzhen, Kangxi, Daoguang and Tongzhi, widespread epidemics occurred continuously in Shanxi province. The most notorious disaster was called "Ding-wu Qi Huang"(the Unusual Famine of the Ding-wu Era) and occurred during the early Guangxu era. The famine almost completely destroyed the entire Shanxi province and the epidemics that followed in its wake affected another57counties.The huge number of deaths and the disruption of agricultural production had a severe, negative impact on the entire country and interfered with the development of the entire society. Shanxi has very unique geographical features and is famous for its natural beauty; colloquially it is known as the "tableau of mountains and rivers." The natural environment and climate, as well as economic, military and political conditions made both the origins and the progress of epidemics in Shanxi different from other regions. My dissertation will discuss the characteristics of the epidemics, the natural and social causes of epidemics, the emergency strategies employed by government and society to deal with the epidemics and their effectiveness. Most importantly, I discuss the lessons that can be learned from the past for preventing and managing epidemics today.The epidemiological data that I have collected and analyzed in this dissertation will also be included in the large-scale, national, academic project on "The History of the Qing Dynasty" in the chapter on "Hygiene and Epidemic Prevention."This dissertation is based on a materialist, empirical perspective,and uses quantitative as well as qualitative analysis of the historical data. This is an interdisciplinary project that draws from the methodologies epidemiology, medical history and sociology. The collected data is first analyzed as a whole, and individual cases are then considered within this framework in order to give a comprehensive analysis of the epidemics, their causes, and their patterns in Shanxi province during the Ming and Qing Dynasties.There are six sections in this dissertation. The introduction includes a brief overview of the epidemics, the rationale behind the selection of this topic, and the aim of the study and its methodology.Chapter one is the "Introduction to the Epidemics" and is followed by four sections. Section one includes an overview of research materials and methodology. Research materials is a collection of official historical records, local chronicles, inscriptions, notes taken from lectures or speeches, ballads etc. in Ming and Qing dynasties to form a "Historical Explanations for Chronological Epidemics in Shanxi Province in the Ming and Qing dynasties." Statistical data were used to analyze the number of epidemics and the affected counties, and an "epidemic trend chart" was made based on the data and an analysis of epidemic patterns based on geographical area and time period.Section two,"Features of the Epidemics" illustrates the affected areas and the consequences of the epidemics. Statistics show that there were a total of149large epidemic outbreaks in Ming and Qing dynasties affecting507counties, and the frequency was about one outbreak per5.6years. In the Qing dynasty,101outbreaks affected219counties, with the average frequency of the epidemic outbreaks during the entire268years being2.65years. In general, the frequency of epidemic outbreaks in the Qing dynasty was higher than in Ming dynasty.The chart of epidemic trends shows the historical fluctuation patterns in Ming-Qing dynasties. The whole Ming dynasty can be divided into four periods. During the first period, from Hongwu to early Chenghua times, there were no records of epidemics during this period from which we can conclude there was no prevalence of large epidemic disease. The second period is from mid-Chenghua times, especially from the16th year of Chenghua to the23thyear, during this time there were continuous epidemics but they only affected individual states and counties. The third period is from Hongzhi to early Wanli times, and there were no significant references to epidemics. The fourth period is from mid-Wanli to Chongzhen times, when the scale and frequency peaked and the entire country was affected. The Qing dynasty can be divided into three periods: the first period includes the reigns of Shunzhi, Kangxi and Yongzheng, ad was marked by epidemics that were large in scale and high in frequency. The second period was Qianlong and Jiaqing times with small-scale epidemics occurring with low frequency. The third period is from Daoguang to Xuantong times. The scale and frequency had been rising significantly, and during the beginning of the Guangxu era, the epidemics rose to peak.Epidemic diseases occur primarily in the spring, summer and autumn and rarely in winter. There are no significant statistical differences in frequency between these three seasons.Basins were major population distribution areas and are also major sites for epidemics. The frequency of epidemics in the states and counties situated in the five basins (Da-Tong, Tai-Yuan, Lin-fen, Yun-cheng, and Chang-Zhi) was higher than in the states and counties situated in the mountains or hills, with the exceptions of the Xing-Ding basin. Zhe-Zhou state and Lu-An state in the Southeast had the highest epidemic frequency. Jiang-Zhou, Tai-Yuan, Da-Tong, Xie-Zhou, Ping-Yang, Shuo-Ping and Ping-Ding also had high frequency. The areas of less frequent outbreaks were Pu-Zhou, Fen-Zhou, Bao-De, and Qing-Zhou. The area with the very lowest frequency was Huo-Zhou and Ning-Wu, and there are almost no records indicating that there were epidemics in these areas in the Ming-Qing dynasties.Section three is analysis and identification of the type of epidemic diseases, classified according to cause, epidemic characteristics, and season and clinical manifestations. The historical data, including local chronicles, record that the diseases included Datou-Feng,(head and neck swelling), plague, diphtheria, cholera, malaria, macula, Shu-Gu or Mi-Gu (measles), malaria, yellow swelling and zoonose. The first four listed occurred on the largest scale and had the highest death rates.Section four is "the analysis of epidemic factors". The data shows that frequent natural disasters and the chaos caused by war had a tremendous bearing on the epidemics. In Shanxi, drought and famine were by far the most significant factors of all, Untimely frost and the plague of locusts, sometimes accompanied with drought, also made the famines more serious and led to epidemics. Snow, cold fronts and heat waves are contributed to epidemics, but their lack of frequency meant they were not a primary factor. Earthquakes rarely led to epidemics. Chaos by war, especially in the late stage of Chongzhen times, induced the outbreak of epidemics.Chapter two is "The Epidemic Process", and is mainly a study of11large epidemic processes during the Chenghua, Wanli, Chongzhen, Kangxi, Daoguang, Tongzhi, and Guangxu times. I analyze the reasons, seasons, clinical symptoms, and disease process, and provide a visual depiction of the epidemic area.Chapter three is "The Epidemic Background and Causes of Formation", in which there are five sections. Part one introduces the Ming-Qing dynasties as a special astral-historical period which included two major periods of natural disasters and epidemics. To a certain degree, astrometeorology research verifies that the outbreak of epidemics is associated with cosmic factors. Part two illustrates the changes in the natural environment since Ming dynasty. The deteriorating ecological environment brought about abnormal weather patterns and frequent disasters. Part three illustrates that ignoring Agricultural production and storing up grain against famine led to the occurrence of serious disasters, focusing on three aspects. I emphasize the inherent defects of the economy of Shan-Xi, the agricultural policies of Kang-Xi, Yong-Zheng and Qian-Long, policies of storing up grain against famine, warehousing andwater conservancy construction and the serious results of the cultivation of opium and making wines by grains. Part four illustrates that the sociopolitical state had a significant effects on epidemics, as illustrated by two examples. First, Wangli neglected politics and indulged in personal luxury during his reign; second, the chaos caused by war incited the disasters and epidemics in the late stage of Chongzhen.Chapter four is "Local Medical Health Care System and the Relief and Treatment Measures for Disasters and Epidemics," and there are six parts.Section one is a survey of local medicine in which I introduce the medical achievements of the local medical practices, and the development of the traditional medicine industry. Section two introduces "Local Public Health and Preventive Medicine". Section three introduces the "Peoples’ Attitudes Toward Epidemics" and the ideology of "interaction between heaven and mankind". Section four summarizes the Relief situation during all stages in the Ming-Qing dynasties. Section five narrates some individual doctors’ chronicles of saving patients and shows the level of medical skills and technology. Section six introduces and studies the treatment of epidemics based on syndrome differentiation and special recipes and herbal drugs.Chapter five is "Summary and Reflection" and is in three sections. Section one summarizes the general patterns of epidemics in Shanxi province and puts forward four conclusions.1) The areas of infectious disease epidemics were mainly in five basins mostly:Datong, Taiyuan, Linfen, Yuncheng, Changzhi;2) Epidemics were closely related to the economic, military and political conditions in the states and counties;3) Drought was most significant factor of all in determining the major type of diseases and the season in which the epidemic occurred; and4) The fluctuation trends of epidemics were associated with the social state. When infectious disease occurred insistently or repeatedly, they must be due to reasons which are worthy of our attention. Section two illustrates the problem of relief in the Ming-Qing dynasty. Section three discusses the lessons that we can draw from history, and proposes that Shanxi province faces great challenges in preventing and treating disease. We should reserve and improve the ecological environment, attach importance to agriculture production, and warehousing and water conservancy projects to reduce the occurrence of epidemics. We can control the spread of epidemics and treat infectious diseases by improving the national public health system and fully developing the advantages of traditional pattern differentiation and treatment of Chinese medicine.