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8至9世纪是日本律令制的全盛期,国家通过律令统筹管辖疫病预防和救济。律令实施之初,以医疗为主的救济曾被严格实行,然而在735至737年天花大流行的催化下,疫病救济措施向赈给等经济手段转变。自奈良时代中后期开始,律令医疗体制暴露了诸多问题,国家虽加以改革,然收效甚微,且使律令医疗体制更加孱弱。同样,使用经济手段的救济,也暴露出了地方官员失职等诸多问题。面对这些难题,朝廷在疫病流行之际不得不更多地依靠社会自身的力量,鼓励民众摒弃陋习,积极参与到本应由国家统筹的疫病救济之中。这是日本律令体制开始走向弛缓的重要标志之一。
From the eighth to the ninth century, the heyday of the Japanese legal system, the state co-ordinated the prevention and relief of epidemics through the law. Medicare-based remedies had been strictly enforced at the beginning of the law, however, and the catastrophic remedies shifted to such economic measures as relief to the aid of the smallpox in 735-737. Since the middle and late Nara period, the legal system has exposed many problems. Although the state reforms, it has little effect and makes the law system more weaker. Similarly, relief using economic instruments has exposed many problems such as the dereliction of office of local officials. Faced with these difficulties, the imperial court has to rely more on the strength of society itself to encourage people to abandon their bad habits and actively participate in the relief that should have been co-ordinated by the state. This is one of the important signs that the Japanese legal system started to relax.