From Big Medical Encyclopedia

CHINA, Chinese National the Republics and — the state in Central and East Asia. The area is 9597 thousand km 2 . Population of 800 million people (1976). The capital — Beijing (apprx. 8 million people with suburbs, 1975). In the administrative relation is divided into 21 provinces, not including the lake of Taiwan, 5 autonomous districts and 3 cities of the central subordination (Beijing, Shanghai, Tianjin). Provinces and autonomous districts are divided into districts and counties. Official language — Chinese.


People's Republic of China was formed as a result of a victory of national revolution on October 1, 1949. In 1954 the constitution of the People's Republic of China replaced in 1975 was adopted; in the new constitution results of «cultural revolution» were legalized.

This constitution in 1978 was replaced again. At the same time those provisions of the constitution of 1954 in which it was told about friendship and cooperation with the Soviet Union were excluded from the text.

Under the constitution of 1978 the supreme body of the government — the National People's Congress (NPC). The constitution of 1978 proclaims the Communist Party of China the leading kernel of all Chinese people. On places public authorities are meetings of national representatives. The supreme executive body — the State Council (government); under the law it otvetstven before the National People's Congress, and during the period between sessions of VSNP is accountable to the VSNP standing committee.

For To. the hl is characteristic. obr. midland climate of midlatitudes and monsoonal subtropical; on a small part of the Southern China climate of tropical monsoons. The monsoonal climate — from moderated to tropical is characteristic of the country with seaside lowlands and nizkogorye. On 3. with high uplands and large ridges, extensive plateaus and intermountain hollows — midland climate. For vost. districts of the country rather low air temperature and its big seasonal fluctuations are characteristic. Average temperature of January in Harbin — 20,4 °, in Beijing — 4,6 °, and July, respectively, 23 and 26 °. Continentality of climate to 3. and S.-Z. increases. Average temperature of January in Northern China, in Hailar — 28 °, on 3., in Urumqi — 14,9 °. On the Plateau of Tibet climate severe. In highlands there are glaciers, however the area them is rather small.

Vost. the part of the country has extensive river network with the deep rivers Yangtze, Huang He, Xi River, etc. On Page and S.-Z. the rivers are not enough, usually they shallow, flow down in drainless hollows, forming lakes, or are lost in sands.

After the victory of national revolution in 1949 with the brotherly help of the USSR and other socialist countries To. started recovery of the national economy and preparation of conditions of socialist construction. The first five-year plan (1953 — 1957) was successfully implemented, a great job on socialist transformation of small-scale country farms and the private-capitalist sector in the industry and trade is done. By the end of the first five-years period in the People's Republic of China it was constructed apprx. 10 thousand industrial facilities, fundamentals of the modern industry are created. Such industrial giants as Anshansky and Wuhan iron and steel works constructed by means of the USSR, Changchun automobile and Loyansky tractor the plants, the plant of heavy machines in At the khan, the Taiyuan plant of textile mechanical engineering, machine-building enterprises in Harbin, aircraft factories etc. became pride of the Chinese people. However declaration in 1958 of policy of national communes and «big jump» slowed down the solution of such major social and economic tasks as socialist industrialization of the country, creation of modern material and technical resources of agriculture, employment of increasing population, increase in the material and cultural standard of living of workers. Increase in military expenses and switching of a considerable part of funds of accumulation at the accelerated creation of nuclear missile weapon has an adverse effect on the solution of these tasks.

In the years of so-called «cultural revolution» the significant damage was caused to development of economy, culture and education that could not but have an adverse effect also on activity of bodies and healthcare institutions, scientific and educational in-comrades.

Seriously the temporary termination of preparation of medical shots of the top and average skills, and also demagogical promotion of the so-called «barefoot doctors» designed to replace shots of specialists doctors affected a condition of medical aid to the population.

As the main perspective the first session of the National People's Congress of the fifth convocation in February — March, 1978 put forward a problem of transformation of the country by the end of 20 century to the mighty modern power on the basis of modernization of the industry, agriculture, science and technology, military science. However development of the industry is slowed down by the low level of a condition of its primary branches, obsolescence and wear of the equipment, dependence on import of cars and materials, shortage of highly skilled workers and technical officers, and also militarization of all national economy. In 1976 military expenses exceeded 40% of the state budget.

In 1974 — 1976, according to official figures, recession of the industry and agriculture was observed. At a session of VSNP in February, 1976 admitted that «all national economy appeared almost on the verge of accident».

In fuel and energy balance the main place belongs to coal. Oil less than 1% of world production are extracted. Rated capacity of power plants exceeds 15 million Siberian salmons and makes about 2 — 3% in world production.

In ferrous metallurgy it is developed by hl. obr. production of cast iron. Hire and special staly is made insufficiently. In mechanical engineering and metal working more attention is paid to power and heavy mechanical engineering. The automotive industry, page are less developed - x. mechanical engineering. - mechanical engineering, machine-tool construction, shipbuilding and instrument making. The textile industry — one of the oldest industries in is rather developed To. The food industry is connected by hl. obr. with processing of page - x. raw materials.

An overwhelming part of the population is made by villagers (apprx. 85%). Level of agriculture remains low, hardly satisfying the minimum needs of the population for food. Agriculture is poorly mechanized.

By the beginning of 1977 cars processed about 15% of the cultivated lands, shortage of fertilizers was felt. A primary branch of agriculture is agriculture. The major cultures — rice (1/5 all acreage and to 1/2 collecting grain), wheat, corn, a kaoliang, millet, barley, a buckwheat. To. — large producer of cotton, soy, peanut, tobacco, tea and other cultures.

In East China pig-breeding and poultry farming, in the Inner Mongolia — sheep breeding, cultivation of cattle and horse breeding is developed.

Natural movement of the population. To. — the largest state on population in the world. Apprx. 94% of the population — Chinese (Han), other population — St. 50 other nationalities among which there are Uyghurs, Mongols, huey, Tibetans, Miao, and, Zhuang, buoys Koreans and Manchurians contain more than 1 million everyone. Population density To. it is uneven, in some districts it exceeds 1000 people on 1 km 2 . Population density on average and the lower current of the Yangtze River makes the St. 450 people on 1 km 2 , near the Central Chinese plain — apprx. 300 people on 1 km 2 , in areas of the Inner Mongolia, Tibet density is 1 — 5 people on 1 km 2 .

Average population density 89 people on 1 km 2 (1976).

According to official figures, prior to the anti-Japanese war of 1937 — 1945 the indicator of birth rate made 35, the general mortality — 25, the natural increase — 10 for 1000 zhit., child mortality in rural districts reached 200, in the cities — 120 on 1000 live-born. In 1955, according to min.-va internal affairs, birth rate made 32,6, the general mortality — 12,3, a natural increase — 20,3 for 1000 zhit., in the certain cities birth rate reached 40, and mortality decreased to 9 for 1000 zhit. In rural districts birth rate fluctuated within 34 — 35 and the general mortality 11 — 13 for 1000 zhit. The indicator of child mortality over the country was rather high — 74,3 (in the cities to 44,2) on 1000 live-born. According to a foreign press, in 1974 birth rate in To. made 29,0, the general mortality — 13,0, a natural increase — 16,0 for 1000 zhit. Decrease in birth rate happened in connection with broad use of steroid oral contraceptives. After 1955 official data on birth rate, mortality, average life expectancy, incidence in To. were not published.


In the country prevails incidence inf. and parasitic diseases. Before formation of People's Republic of China plague, smallpox, cholera, filariases, veins were eurysynusic. diseases, trachoma, leprosy.

In the middle of 20 century in To. epidemics raged. E.g., from 1937 to 1945 over the country 950 thousand cases of cholera were registered (the St. 100 thousand people), in 1947 — 30 thousand cases of plague, in 1946 — 54 thousand cases of natural smallpox (15 thousand with a lethal outcome died).

After creation of People's Republic of China events for creation a dignity were held. - protivoepid. services that allowed to reduce incidence inf. diseases. According to messages from To., the centers of smallpox and cholera were gradually liquidated, incidence sypny decreased and a typhinia, tuberculosis, spread of venereal diseases decreased. The task of elimination of the parasitic diseases which are most menacing to health of the population was set: schistosomatosis, malaria, filariasis, kala azar (visceral leushmaniosis), ankilostomidoz, etc. A schistosomatosis in To. it is widespread among the population of 12 provinces in the basin of the Yangtze River and in areas where there are many lakes and swamps. In the past hundreds of thousands of people perished from a schistosomatosis. E.g., in 1959 the number of patients with a schistosomatosis made apprx. 10 million persons.

In 1957 in min.-ve health care special management on fight against a schistosomatosis was created, 197 protivoshistosomatozny points and 19 stations, apprx. 1300 groups are organized, the St. 17 thousand specialists in fight against this disease is trained. However these actions did not yield essential results, the zone of distribution of a schistosomatosis did not decrease. According to radio station of the Province of Guangdong, at the beginning of 1972 in this province from 42,8 million zhit. the schistosomatosis struck 8,3 million persons.

Malaria is still an eurysynusic disease. In 1959 in the country was registered apprx. 30 million patients. In 1972 only in the Province of Guangdong of 18 million zhit. had malaria. The program of processing of places of breeding of malarial mosquitoes and in the next years was not carried out by hexachlorane and other drugs in connection with a lack of means in 1965 in many districts. According to the Chinese researchers, the centers of malaria in To. it is possible to divide into 3 zones: to S. from 32 °C. highway malaria struck a small part of the population, 3-day malaria prevails; the district of an average prevalence is located between 25 and 32 °C. highway, the greatest incidence is observed in mountain districts, 3-day and tropical malaria is noted, 4-day is more rare; the district of a high porazhayemost is located to the south of 25 °C. highways, meet all types of malaria.

The filariasis is endemic in districts to Yu. from 37 ° 5' NL where the number of patients made apprx. 40 million persons. In districts of high endemicity the disease captured about 40% of the population. In a number of provinces the kala azar meets. The disease is especially widespread in the central desert districts. In these provinces at the beginning of the 50th it was revealed apprx. 500 thousand patients. It is widespread also ankilostomidoz, most often it meets in the basin of the Yangtze River and on the coast. Adults are more often struck, but in high-endemic districts it is struck also to 50% of children. Also other parasitic diseases, napr are eurysynusic, in 1959 280 million addresses concerning these diseases were registered.

A problem for health care are also diseases of a leprosy and trachoma.

The organization of health care

the Chinese medicine has centuries-old history. Only the bourgeoisie, a top of officials, landowners and foreigners used methods of the modern medicine getting into China together with the European colonialists. For the first time mines - in health care it was created in November, 1928, and in April, 1929 it was transformed to the Master sanitary control of min.-va internal affairs.

In gomindanovsky To. in 1947 it was created mines again - in health care, but in a year it was abolished. In 1947 in To. in the cities would be 72 (on 7543 beds, or 1 bed on 10 thousand city zhit.). The country people were almost absolutely deprived of medical aid: on 500 million country people there would be 11 226 hospital beds in state district (about 1 bed on 45 thousand rural zhit.). Besides, 218 BCs on 18 928 beds belonging to various private missionary organizations functioned. Medical aid generally was paid.

During release from imperialistic aggressors and gomindanovsky troops in To. measures for improvement of public health care began to be taken. In the freed districts would be created for the population and wounded soldiers, medical educational institutions and the enterprises medical and pharm, the industries were organized.

With formation of People's Republic of China the health care began to gain the state character. It was recovered independent mines - in health care. In the constitution it was said that the state provides a people at large medical - a dignity. service. There was a reorganization of the state BCs. According to the government resolution foreign missionary would be nationalized. If in 1947 48,4% of all hospital beds were in hands of the private sector, then in 1953 3,4%, and in 1958 only 0,2% were the share of the private sector.

Philosophy of development of health care To. were formulated at the I All-China congress of workers of health care on August 7, 1950. They provided the preventive direction of development of medicine, combination of efforts of doctors of the modern and having centuries-old experience Chinese traditional (national) medicine, close connection of the state health care with grass-roots people's movement for strengthening of health, rendering free medical aid by the worker, to peasants and soldiers. However later medical aid to peasants began to appear on the cooperative beginnings, due to attraction of financial resources of peasants (1976).

As a result of the carried-out state measures medical aid to the population improved.

In 1953 the bed fund made 181,1 thousand beds (114,6 thousand beds in the cities and 66,5 thousand in rural areas). In 1958 the number of BC increased to 4949, including 61-tsa infectious (6018 beds), 61 tubercular (16 455 beds) and 62 psychiatric (15 004 beds), and the quantity of beds in them reached 371,5 thousand (243,7 thousand beds in the cities, 127,8 thousand in the village). In 1959 in the country there were 570 thousand hospital beds and 760 thousand so-called easy beds (extra sick-lists). In 1956, besides, 252, 1200 policlinics and a large number of drugstores of the Chinese traditional (national) medicine would function. However security of the population with hospital beds remained extremely low. E.g., in 1955 in the large cities of the country only 2,5 beds for 1000 of the population were necessary.

After 1959 the BCs given about quantity, their capacities and specializations were not published.

Essential organizational, methodological and technical assistance To. in development of health care rendered the Soviet Union. Right after World War II of M3 of the USSR and the Soviet Red Cross sent in To. protivoepid, groups as a part of which worked St. 100 Soviet specialists. Since 1946 in-tsakh and first-aid posts of the Soviet Red Cross in. Distant, Port Arthur, Kuldzhe, Urumqi, Chzying-Zhou, Chuguchake, the Sphere Suma, Kashgar, and since 1952 and in Beijing worked St. 3050 Soviet medics; from 1946 to 1957 they rendered medical aid of 2650 thousand Chinese citizens.

In 1957 all medical institutions with the medical equipment and stocks of medicines were donated to bodies of health care of the People's Republic of China.

In June, 1978 in Beijing the All-China meeting of medics took place, a cut accepted «Original positions of the development plan for science and technology in the field of medicine and pharmacology of the People's Republic of China for 1978 — 1985». In the document need of studying of achievements of world medical science, and also a combination of methods of the Chinese and European medicine is emphasized.

Medical care by the worker of the industrial enterprises. In the People's Republic of China the network is created to lay down. - professional, institutions (health centers) for service of the working industrial enterprises. In 1956 in the country there were 2793 shop health centers, 827 factory medical institutions with a hospital on 30 840 beds; the number of the workers who are completely captured by social insurance reached 7410 thousand people (without members of families and public servants).

Medical care to country people. Management of medical service in the village is decentralized. The centers of health care including rural-tsy are a part of executive committees of page - x. communes. Each commune would have central and maternity hospital. All volume would be assigned to central to lay down. - professional, and a dignity. - a gigabyte. works, at its order are available mobile medical - a dignity. crews. A production team of page - x. services communes filialb-ets with out-patient clinic and maternity hospital, and production group — a first-aid post or the medic. In 1958 in the country there were 17 346 first-aid posts and 115 548 joint out-patient clinics, and by 1962 different number of medical institutions in rural areas reached 210 thousand.

A number of actions was directed to country people to improvement of medical aid, involvement of doctors of the Chinese traditional (national) medicine to work in the public medical institutions is expanded.

E.g., in 1957 more than 200 thousand doctors of the Chinese traditional medicine worked in the joint out-patient clinics at the village and St. 29 thousand in city medical institutions; doctors with modern medical education went to rural districts for rendering the advisory help and practical work. However since 1966 there was an essential cut in expenditure on health care; incidence of various diseases increased. For rendering medical aid the new category of medics who after the termination on the job of short-term medical courses rendered the first medical aid is created. According to radio station of the Province of Hunan (1969), peasants preferred to ask for the help local sorcerers, but not so-called «barefoot doctors» who studied the craft of 2 — 3 weeks up to 2 — 3 months.

Medical care to women and children. According to 1956, 60% of all childbirth were accepted by the qualified medics. In 1957 in the country there were 4599 Houses and stations of protection of motherhood and the childhood, 230 maternity hospitals (7557 places) and 83 784 points of obstetric aid where the midwifes and midwives who had special training worked. In 1958 the quantity of a constant children's day nursery made 3186,3 thousand; in them there was a St. 47 million children. However there were very few children's hospitals — only 27 3682 beds (1958).

Sanitary and anti-epidemic service. Dignity. - protivoepid, the service is headed by the head sanitary and anti-epidemic department organized in 1950 at min.-ve health care. In provinces and the large cities this work is controlled by local bodies of health care. In the People's Republic of China in 1952 by an example of the Soviet Union SES are created; the number them in 1958 reached 1420. Besides, in 1958 in To. 667 special stations worked (antiplague, antimalarial, brucellous, etc.) and 190 to lay down. - a dignity. groups. Later data about protivoepid, service were not published.

Sanatorium help. In China in 1947 there were 10 private sanatoria on 300 places which serviced a top of the national bourgeoisie. In 1957 there were 835 sanatoria on 68 860 places and 329 night sanatoria on 12 792 places.

From balneol. resorts are most popular to Tanggajie (near Shenyang), Sinchen (in the Province of Liaoning) and Tszimo (in the Province of Shandong) with hyper thermal slaboradonovy waters. Besides, in To. low-mineralized nitrogen-siliceous thermal waters (t ° to 80 °), cold carbonic waters with the content of carbonic acid to 2,5 g/l are spread. On the coast of the Yellow and East Chinese seas seaside resorts of Yantai, Qingdao, Beidaihe with well-planned beaches are located. Near Hangzhou near the Western lake among the picturesque nature sanatoria of the general type are located.

On Yu. China in the Province of Yunnan, on the bank of the lake Dyan-Chi at the height of 1800 m there is above sea-level a resort town of Kunming where many sanatoria function. In East and Central China the mountain resorts Lushan, Mugangshan, Tai Shan, Changshan, etc. function. In the People's Republic of China the following order of the direction of patients on a dignity is established. - hens. treatment: the trade-union organization or administration of the enterprise send cards of medical selection for acquaintance to the chief physician of sanatorium; in his opinion permits are given by the patient.

Health care workforce

according to the League of Nations, in 1930 in To. there were 1200 thousand doctors of the Chinese traditional medicine and apprx. 7 million persons which treated the population various herbs. In 1955 in the country 486,7 thousand specialists of the Chinese traditional medicine were registered.

In 1932 in To. there were 2919 doctors who received sovr. medical education, by their 1937 was 9098 people, and by 1949 (by estimates) their number fluctuated from 20 thousand to 41,4 thousand. After 1949 and reform of medical education the number of doctors and average medics began to increase quickly.

After formation of the People's Republic of China big help in preparation of national medical shots was given by the Soviet Union. In the USSR a large number of the Chinese students studied, the Soviet doctors and teachers were sent to the People's Republic of China, the Soviet medical literature which was translated into Chinese went and gained mass distribution.

In 1957, according to official figures, there were 73 573 doctors of modern medicine, 135 701 paramedics, 35 774 midwifes and 128 174 nurses.

By the end of 1966 in the country was apprx. 150 thousand doctors sovr, medicine (1 doctor on 5000 zhit.), apprx. 172 thousand paramedics (1 on 4300 zhit.), 186 thousand nurses (1 on 3900 zhit.), 42 thousand obstetricians, 100 thousand druggists, 30 thousand stomatologists and 20 thousand pharmacologists. The number of doctors of the Chinese traditional medicine in 1965 was estimated at 500 thousand (1 doctor for 1500 of the population). Training of doctors and druggists was carried out in 1957 in 38 enlarged medical and pharm, in-ta (32 medical, 2 pharm, in-ta and 4 in-ta of traditional medicine). According to informal data, in 1962 the quantity of in-t increased to 60. A course in medical in-ta 5 — 6 years and 4 years for druggists.

Much attention was paid to preparation of averages medical and pharm, workers. The number of schools for their preparation in 1957 made 170, and in 1965 reached 230; the course in them was 2 — 3 years. During «cultural revolution» (since 1965) work of medical institutions and medical schools was sharply broken, medical in-you and schools actually stopped release of specialists. Many diplomaed doctors were discharged of work, directed «to re-education» to rural districts, in so-called schools on May 7. The term of training of students in medical in-ta was reduced to 1 — 3 years, in the village the new type of the medic, terms of preparation and volume of work to-rogo widely appeared varied in various districts of K. Naseleniye did not consider them as medical staff; among peasants they were called by «barefoot doctors», among workers — «doctors-workers», among housewives — «doctors of Red guard». It did not pay their so-called medical work, however during its performance they received an average salary on the main work. Training of these workers, as a rule, included 3-month courses for «barefoot doctors», 1-monthly courses for «doctors-workers» and 10-day courses for «doctors of Red guard».

The medical science

In 1957 was organized Academy of medical sciences of the People's Republic of China, in structure a cut there were 24 scientific research institutes, considerable scientific work departments medical and pharm spent, in-comrade. The Chinese specialists achieved certain achievements in area a wedge, medicine, especially surgeries (heart operations, the main vessels etc.). It was promoted by the agreement signed by the USSR and the People's Republic of China, «About joint carrying out the major researches in science and technology and assistance by the Soviet Union to China in this area» (1958), the agreement «About scientific cooperation on the most important questions of medicine between the USSR Academy of Medical Sciences and AMN People's Republic of China» (1960) which were strictly carried out by the Soviet party up to 1967 when there was explicit a tendency of the Chinese side on complete cessation of cooperation with the USSR. In medical science much attention was paid to development of complex actions for prevention and treatment of diseases, searches of new antibiotics, creation of new medical drugs (e.g., by the end of the 60th in production it was implemented apprx. 100 names of new medicines), improvement of the environment, development of the Chinese traditional medicine. The Chinese traditional medicine — heritage of the Chinese people. This type of medical practice has the own theory and specialists who allegedly gain therapeutic effect at treatment of a number of diseases. Many methods of the Chinese traditional medicine, in particular acupuncture (see. Acupuncture ), and a number of pharmaceuticals are used in some countries of the world.

However reduction of the state budgetary appropriations on health care in the 60th considerably affected development of medical science.

The medical industry

In the People's Republic of China production of a number of pharmaceuticals which in the country were not produced earlier is organized. By 1958 apprx. 80% of need for pharmaceuticals it was provided domestic pharm, the industry. In 1958 the largest plant on production of antibiotics (penicillin, streptomycin, biomycin) constructed by means of the USSR became operational. In 1960 the big plant on production of synthetic pharmaceuticals which is also constructed by means of the USSR, a little pharm is put into operation. and chemical - pharm, FC. Rentgenapparata, microscopes, devices UVCh, universal operating tables, surgical instruments etc. began to be issued.

According to a foreign press, in To. in the next years a certain attention was paid to development chemical - pharm, the industries. E.g., at the beginning of the 70th in Beijing was apprx. 40 pharm, the enterprises, in Shanghai — 12. On the largest pharm, the enterprise in Beijing in 1970 it was made apprx. 300 names of pharmaceuticals, 1/4 which fell on the new means developed by the Chinese researchers. Distinctive feature Chinese pharm, the industries is wide use as a feed stock of medicinal plants. A large amount of medicinal raw materials is exported.

Bibliography: Burnashev E. Yu. Health care in National China, Zdravookhr. Grew. Federations, No. I, page 35, 1958; Countries of the world, Short political and economic reference book, page 166, M., 1977; Jin Xin-chzhun and Kochergin I. G. Health care and medicine in People's Republic of China, M., 1959; Medicine and public health in the People’s Republic of China, ed. by J. R. Quinn, Bethesda, 1972.

V. B. Tsybulsky.