Atheist Education and the Transformation of Medical and Health Concepts in the Base Areas during the War of Resistance Against Japan

In the early period of the War of Resistance Against Japan, the base areas were mostly located at the junctions of several provinces, in remote areas with inconvenient transportation, backward economy and culture, scarce medicine, and deeply entrenched superstition, ignorance, and unsanitary habits among the people, leading to frequent diseases that affected the war effort, production, and daily life. Using Marxist theory as a weapon, the Communist Party of China launched a silent revolutionary storm in the medical circles of the border regions, "overturning" the inverted worldview, and scientific concepts of medical care and health began to take root quietly in the border regions. In recent years, academia has conducted considerable research on medical and health issues in the base areas. However, there is still room for study on how the Communist Party of China carried out atheist education, how the people abandoned outdated, ignorant, and superstitious ideas to believe in science, and what changes occurred in medical and health concepts in the base areas. This article attempts a preliminary exploration of these issues.

抗日战争初期，根据地大多处于几省交界处，地处偏僻，交通不便，经济文化落后，医药匮乏，民众迷信、愚昧、不卫生习惯根深蒂固，导致疾病频发，影响了抗战、生产与生活。中国共产党以马克思主义理论为武器，在边区医疗界掀起了一场无声的革命风暴，将倒错了的世界观“颠倒”了过来，科学的医疗卫生观念开始在边区悄然扎根。近年来，学术界对根据地医疗卫生问题已经有了相当的研究，但是，中国共产党是如何开展无神论教育的，民众又是如何放弃陈腐、愚昧、迷信观念而相信科学的，根据地医疗卫生观念发生了怎样的变革，仍有值得研究的空间，本文试图对此问题，进行初步探讨。

I. A Survey of Medical Care, Doctors, and the Living Conditions of the People in the Base Areas

一、根据地医疗、医生与百姓生存状况扫描

Lenin once proposed: "The propaganda of atheism by the Social Democratic Party must be subordinated to the basic task of the Social Democratic Party: developing the class struggle of the exploited masses against the exploiters." [1]1 V. I. Lenin, "On the Significance of Militant Materialism," Collected Works, Vol. 33. Mobilizing all forces to win the War of Resistance Against Japan was the Party's primary revolutionary task during this period, and all other work, including medical and health work in the cultural sphere, had to serve and be subordinated to this task. Therefore, Mao Zedong pointed out, "Our work is first war, then production, then culture." [2]2 Mao Zedong, "Get Organized!" Selected Works of Mao Zedong, Vol. 3.

列宁曾提出：“社会民主党宣传无神论，必须服从社会民主党的基本任务：发展被剥削群众反对剥削者的阶级斗争。”动员一切力量争取抗战胜利是抗日战争时期党最主要的革命任务，其他工作包括文化领域的医疗卫生工作都要服从服务于这一任务。所以，毛泽东指出，“我们的工作首先是战争，其次是生产，其次是文化”。

However, before the War of Resistance, the rural economy was in decline, the living environment for peasants was harsh, and life was extremely difficult. For example, in Ding County, Hebei, with a population of 400,000, the average annual per capita income was about 50 yuan, and only about 3 jiao could be spent on medical and health expenses. [3]3 Li Jinghan, Ding County Social Survey (Shanghai: Shanghai People's Publishing House, 2005), p. 260. Corresponding to the hardship of material life, the cultural level of the people in the base areas was low, with a high rate of illiteracy; often not a single literate person could be found in a village. The illiteracy rate in the Shaanxi-Gansu-Ningxia Border Region was as high as 99%. [4]4 Li Weihan, Memoirs and Research (Beijing: CPC History Publishing House, 2004), p. 16. Sanitary conditions were very poor: "Houses are low and small, people and livestock live together, and the stench from kitchen wastewater and manure pits is suffocating. Coupled with a lack of health knowledge, some never bathe all year round, and some go months without combing their hair." [5]5 "The Health of the People in the Border Region," Liberation Daily, April 12, 1942.

然而，抗战前，农村经济凋敝，农民生存环境恶劣，生活极其困苦。如，河北定县有40万人，人均年收入约50元，可用于医药卫生的费用只有3角左右。与物质生活的困顿相适应，根据地民众文化水平低下，文盲众多，往往一个村找不到一个识字的，陕甘宁边区文盲率高达99%。卫生条件很差，“房屋矮小，人畜同居，厨房之污水，与粪窖之恶臭，皆熏人欲死。加以卫生知识之不备，常年不入浴者有之，整月不梳发者有之。”

Disease and poverty often go hand in hand. Whenever disasters or abnormal weather occurred, or when workers from factories or students from cities fell ill and fled back to villages—but most importantly, unsanitary habits—epidemics would break out in the border regions. In the Shaanxi-Gansu-Ningxia Border Region, there were three types of severe infectious diseases: plague, cholera, and smallpox. Common infectious diseases included typhus, relapsing fever, and dysentery. Common illnesses and endemic diseases included influenza, malaria, "liu guai zi" disease (a type of joint deformity), vomiting yellow water, venereal disease, and goiter. [6]6 "Liu guai zi" disease refers to a condition causing joint deformities, often associated with Keshan disease or Kaschin-Beck disease in the region. The annual mortality rate in the border region was as high as 60%, with the highest deaths among children and women. [7]7 "The Health of the People in the Border Region," Liberation Daily, April 12, 1942. In the Jin-Cha-Ji Border Region, maternal and infant illness and death were also very serious problems. From 1943 to 1945, in Pengtou Village of the Eleventh Special District, 36 infants were born and 21 died, a mortality rate of 58.2%. In Guanzhuang, out of 40 women, 31 were ill. In Dongshandi, Wutai, out of 96 women, 63 were ill. [8]8 "The Problem of Maternal and Infant Mortality in the Border Region," Jin-Cha-Ji Daily, July 7, 1946.

疾病与贫困往往相伴相随。每遇灾祸或气候异常，或工厂之男女，都市之学生染病逃归村舍，当然，最主要的还是不卫生习惯，都会造成边区疫病流行。在陕甘宁边区，属于烈性传染病有三种：鼠疫、霍乱、天花，常见的传染病有斑疹伤寒、回归热、痢疾等，常见病和地方病有流行性感冒、疟疾、柳拐子病、吐黄水、花柳病、大脖子病等。边区每年病亡率高达60%，其中儿童妇女死亡最多。在晋察冀边区，妇婴灾病和死亡也是非常严重的问题。1943-1945年，十一专区蓬头村共出生36个婴儿，死亡21个，死亡率达58.2%。关庄有四十个妇女，其中有三十一个害病。在五台东山底有九十六个妇女，害病者达六十三个。

Ignorance is the mother of superstition. In terms of medical care and health, this was most evident in the scarcity of doctors and medicine, the prevalence of superstition, and the rampant activities of witch doctors (wu shen). [9]9 "Witch doctor" (wu shen) refers to folk practitioners who claimed to communicate with spirits and gods to heal illness, often through rituals and exorcism. At that time, there were only 4,000–5,000 Western-style doctors nationwide, averaging one for every 80,000–100,000 people. Due to the backward economy and culture of the border regions, there were no Western-style doctors in the vast rural areas. In remote villages, no doctor could be found within a hundred li; only occasionally could a Chinese medicine pharmacy be found in important market towns. In the early 1930s, in Qingyang, "the entire county had only one public hospital in Xifeng, with 11 medical staff. Private pharmacies were mostly distributed in towns, mainly selling medicine." [10]10 Qingyang County Annals (Lanzhou: Gansu People's Publishing House, 1993), p. 678. The people lacked basic medical and health knowledge. When faced with illness, they often prayed to gods and Buddhas and believed in ghosts and spirits. Witch doctors, exploiting the people's dependence on them, harmed lives and property. Their "healing arts" "inevitably turned no illness into illness, minor illness into major illness, and major illness into death." [11]11 "The Harm of Witch Doctors," Liberation Daily, June 1, 1944.

无知是迷信之母，表现在医疗卫生方面，最明显的是缺医少药、迷信泛滥，巫神猖獗。当时全国的西医只有4000-5000名，平均8-10万人才有一名西医，边区由于经济文化落后，广大农村没有西医。在偏僻的农村，百里内外找不到一名医生，在重要的市镇才能偶尔找到中药铺。1930年代初，庆阳“全县仅西峰有公立医院1所，医务人员11名。私立药铺多分布在城镇，以售药为主。”民众缺乏基本的医药卫生知识，遭遇疾病往往求神拜佛，迷信鬼神。巫神则利用民众对其依赖，伤财害命，治病的“法术”，“一定使无病变为有病，小病变为大病，大病变为死症”。

The severe shortage of medical resources, the rampant practice of witch doctors, and the poverty, disease, weakness, and ignorance of the people seriously weakened the anti-Japanese forces. Therefore, promoting atheist education, opposing superstition, popularizing medical and health knowledge, and achieving a modern transformation of medical and health concepts were undoubtedly of great significance for sustaining the long-term War of Resistance and improving the well-being of the people.

医疗资源的严重匮乏，巫神大行其道，民众的贫、病、弱、愚，严重削弱了抗日的力量。因此，提倡无神论教育，反对迷信，普及医疗卫生知识，实现医疗卫生观念的现代转型，对于坚持长期抗战和增进人民福祉，无疑具有重要的意义。

II. The Advance and Retreat Struggle between Medical and Witchcraft Forces

二、医巫力量的进退博弈

In traditional Chinese society, doctors were of two types: those who set up clinics to treat illnesses, called daifu, and those who traveled the streets, called langzhong. [12]12 Daifu and langzhong are traditional Chinese terms for physicians; langzhong originally referred to itinerant doctors. There were also witch doctors, who specialized in cheating people out of money under the guise of treating illness. Historically, medicine and witchcraft were once intermingled, but due to their fundamentally different natures, the struggle between them never ceased. "Witchcraft primarily served as a medium of communication between humans and ghosts; it was primitive religion, theology," [13]13 "On the Relationship between Medicine and Witchcraft," Medical History and Health Organization, Vol. 2, No. 1 (1941). and thus stood in sharp opposition to medicine as a science. "Only by completely breaking free from the shackles of witchcraft could medicine truly establish itself." [14]14 Ibid.

传统中国社会里的医生，一为设馆医病的医生，曰大夫，一为走街串巷的医生，曰郎中，还有就是假借治病之名，以骗取钱财为专职的巫神。历史上，医与巫曾杂糅在一起，但由于其本质不同，两者间的斗争从未停止过。“巫主要是充当人与鬼交通媒介的，是原始的宗教，是神学”，必然与作为科学的医学尖锐对立。“只有彻底摆脱巫的束缚，医学才能真正确立起来。”

Marx, in "The British Rule in India," stated that the village communities, which formed the basis of Oriental despotism, "restricted the human mind within the smallest possible compass, making it the unresisting tool of superstition, enslaving it beneath traditional rules." [15]15 Karl Marx, "The British Rule in India," Collected Works of Marx and Engels, Vol. 9. Lenin also pointed out that the main root of religion was social. [16]16 V. I. Lenin, "The Attitude of the Workers' Party to Religion," Collected Works, Vol. 17. It is evident that the decadent social system was a hotbed for the growth of superstition and religion, and also the root cause of the people's poverty, backwardness, and scarcity of medicine. Only by overthrowing the old system could the people achieve health and happiness. While destroying the old world in the base areas, the Communist Party of China gradually established a new democratic politics and economy, implementing "popularly elected governments and the Three-Thirds System, cooperatives and mutual-aid teams, factories and workshops, etc.," [17]17 Mao Zedong, "On Coalition Government," Selected Works of Mao Zedong, Vol. 3. The Three-Thirds System was a policy in the base areas where Communists, progressives, and centrists each held one-third of positions in representative bodies and governments. improving the people's material life and raising their political status. However, at this time, the number of witch doctors was still nearly twice that of old-style doctors, and the sphere of influence of witchcraft was greater than that of medicine. [18]18 "The Struggle against Witch Doctors in the Border Region," Liberation Daily, August 10, 1944. The existence of the "witch doctor profession" was incompatible with the people's demand for "prosperity in wealth and population," and the struggle against witch doctors soon entered the purview of the Chinese Communists.

马克思在《不列颠在印度的统治》中讲到，作为东方专制制度基础的农村公社“使人的头脑局限在极小的范围内，成为迷信的驯服工具，成为传统规则的奴隶”。列宁也曾指出，宗教产生的根源主要是社会根源。可见，腐朽的社会制度是迷信和宗教滋长的温床，也是造成人民贫穷落后、医药稀缺的总根源。只有推翻旧制度，人民才能获得健康幸福。中国共产党在边区摧毁旧世界的同时，逐步建立起新民主主义的政治和经济，推行“民选政府与三三制，合作社与变工队，工厂与作坊等等”，改善了人民物质生活，提高了人民的政治地位。但此时巫神的数量仍然是旧医的近两倍，巫的势力范围大于医。“巫神职业”的存在与群众“财旺人也旺”的需求格格不入，开展对巫神的斗争随即进入中国共产党人的视野。

Engels pointed out, "The workers' party patiently organizes and educates the proletariat, allowing religion to die out gradually, without risking a political declaration of war on religion." [19]19 Friedrich Engels, "On the History of Early Christianity," Collected Works of Marx and Engels, Vol. 22. Witchcraft has a long history in China and enjoys deep-rooted belief among the people. Transforming witch doctors from "objects of worship" in the people's minds into "objects of criticism" could obviously not be achieved through simple suppression. First, seizing typical cases and educating and influencing the masses from both positive and negative angles was a common form of struggle used by the Communist Party of China to lead the masses in the base areas against witch doctors. From 1944 to 1945, the Liberation Daily published a large number of such cases, such as "Witch Doctor Yang Hanzhu of Baijiaping in This City Injures a Life and Is Sentenced to Imprisonment; Chang Zhisheng's Superstitious Belief in Witch Doctors Ruins His Family," "Witch Doctor Zhuang Fazhong of Hezhuang District, Yan'an County, Reforms His Evil Ways," and "Witch Doctor Tian of Dingbian County Harms People and Cheats Money; the Masses Demand Punishment." [20]20 Liberation Daily, various issues, 1944–1945. The masses were often deeply shaken by the "bloody tragedies" of others, thus psychologically breaking with the "objects of worship." After the tragedy of Chang Zhisheng's superstitious belief in a witch doctor in Baijiaping, Yan'an City, the masses in the southern district of Yan'an all cursed the witch doctors, saying, "Whoever still believes in ghosts and gods will end up like the Chang family, ruined and dead." [21]21 "The Tragedy of Chang Zhisheng's Superstitious Belief in a Witch Doctor," Liberation Daily, May 20, 1944. Second, having the reformed individuals voluntarily confess their crimes could achieve twice the result with half the effort. In July 1944, fifty-nine witch doctors in Yan'an County jointly wrote a letter to their fellow villagers, publicly admitting to playing tricks with ghosts and gods and cheating people out of money. "Seeing that witch doctors could make money by deceiving people, we used the name of ghosts and gods to make a living. There are originally no ghosts or gods; our tricks are all fake..." [22]22 "A Letter from Fifty-Nine Witch Doctors in Yan'an County to Their Fellow Villagers," Liberation Daily, July 15, 1944. One can imagine the shock and anger of the people upon learning the truth. "Using the creators of witchcraft to expose the transcendental world of ideas undoubtedly had an educational significance that subverted traditional concepts." [23]23 "On the Education of the Masses against Witchcraft," Liberation Daily, August 1, 1944. Third, placing witch doctors under the criticism and supervision of the masses led to an inversion of discourse power in the rural world. The aforementioned fifty-nine witch doctors, in order to repent and reform, signed an anti-witch doctor pact and asked their fellow villagers to supervise them. [24]24 "The Anti-Witch Doctor Pact of Yan'an County," Liberation Daily, July 20, 1944. Witch doctors, once "helpers" whom the masses sought for medical treatment and to exorcise demons, were suddenly transformed into "aliens" among the people, backward elements to be criticized and supervised. As the status and prestige of witch doctors fell among the people, the discourse power in the rural world also reversed.

恩格斯指出，“工人政党耐心地去组织和教育无产阶级，使宗教渐渐消亡，而不要冒险地在政治上对宗教宣战。”巫术在我国源远流长，在民间有着深厚信仰，将巫神从民众心中的“受崇拜者”转变为“受批判者”，显然不能采用简单打倒的方法。首先，抓住典型实例，从正反两方面教育感化群众，是中国共产党领导边区群众与巫神斗争的常用形式。1944-1945年，《解放日报》刊发了大量的类似实例，如《本市白家坪巫神杨汉珠伤害人命判处徒刑 常志胜迷信巫神弄得家破人亡》、《延县河庄区巫神庄发仲改邪归正》、《定边县田巫神害人骗财群众要求予以惩罚》等等，群众往往能从他人的“血腥悲剧”中受到强烈震动，从而在心理上与“受崇拜者”发生决裂。延市白家坪常志胜迷信巫神惨剧发生后，延安南区群众无不咒骂巫神，说：“谁再迷信鬼神，谁就会像常家一样家破人亡。”其次，让被改造者主动坦白自己的罪行，可收到事半功倍之效。1944年7月，延安县五十九名巫神联名给乡亲们写了一份信，公开承认装神弄鬼、骗取钱财的事实。“看见巫神骗人能赚钱，于是我们就借神鬼的名义来混饭吃。本来没有鬼神，我们的把戏都是假的......”，可以想象，民众在得知真相之后的惊异与愤怒，“通过巫术的制造者来揭破超验的观念世界，无疑具有颠覆传统观念的教育意义。”再次，将巫神置于群众批判与监督之下，乡村世界的话语权发生倒置。前述的五十九位巫神，为悔过自新，签订了反巫神公约，并要求乡亲们予以监督。巫神曾是群众求医问药、降妖驱魔的“施助者”，转眼间变成了民众中的“异类”，被批判、被监督的落后分子。随着巫神在民众中地位与威信的跌落，乡村世界的话语权也发生了逆转。

Historical materialism holds that the people are the driving force of history, and health work must serve the people who create history. People-centeredness is the essential characteristic of health work in the new-democratic society, and this qualitative stipulation became the cornerstone for the Chinese Communist Party in formulating strategies and policies for health work. After the transformation of the shaman-god group [25]25 The “shaman-god group” (巫神群体) refers to folk religious practitioners (shamans, spirit mediums) who were seen by the CPC as promoting superstition and obstructing modern medicine in the rural base areas during the War of Resistance., to fill the medical vacuum in the border areas, especially in the vast rural society, it was necessary to form a new type of medical team and medical science that served the people’s health. In response to the shortage of doctors and medicine in the border areas, Mao Zedong creatively proposed the strategic policy of integrating Chinese and Western medicine and integrating Chinese and Western pharmaceuticals, pointing the way for the creation of a modern medical force with national characteristics. He pointed out, “New medicine is of course superior to old medicine, but if new medicine does not care about the people’s suffering, does not train doctors for the people, does not unite with the more than one thousand old doctors and old-style veterinarians in the border areas, and does not help them progress, then it is actually helping the shaman-gods.” [26]26 Mao Zedong, “On Coalition Government” (1945), *Selected Works of Mao Zedong*, Vol. 3. “Medicine, whether Chinese or Western, has its own strengths.” Under this guidance, the border areas, using platforms such as the Medical and Pharmaceutical Society and its subordinate National Medicine Research Society, the Chinese and Western Medicine and Pharmaceutical Research Society, and the Yan’an Branch of the Chinese Nurses’ Association, carried out activities to transform thinking, exchange techniques, strengthen cooperation, establish schools, and forge talent. The reorganization of medical and health forces in the border areas contributed to treating the wounded and sick, enhancing the combat effectiveness of the troops, strengthening military-civilian relations, and thereby winning the War of Resistance Against Japan.

唯物史观认为，人民是创造历史的动力，卫生事业必须为创造历史的民众服务。人民性是新民主主义社会卫生事业的本质特征，这一质的规定性，成为中国共产党制定卫生事业发展战略策略的基石。巫神群体被改造后，要填补边区尤其是广大乡村社会的医疗真空，必须组建为人民健康服务的新型医疗队伍和医药科学。针对边区缺医少药的状况，毛泽东创造性地提出中西医结合、中西药结合的策略方针，为创建有民族特色的现代医疗力量指明了方向。他指出，“新医当然比旧医高明，但是新医如果不关心人民的痛苦，不为人民训练医生，不联合边区现有的一千多个旧医和旧式兽医，并帮助他们进步，那就是实际上帮助巫神”。 “医道中西，各有所长”。在上述思想指导下，边区以医药学会及下属的国医研究会、中西医药研究会、中华护士学会延安分会等组织为平台，开展了改造思想、交流技术、加强合作、举办学校，锻造人才等活动，边区医疗卫生力量的重组，为救治伤病、增强部队战斗力、密切军民关系，进而赢得抗战胜利作出了贡献。

III. The Thought of Prevention First and the Extensive Development of Mass Health Campaigns

三、预防为主思想与群众性卫生运动的广泛开展

Starting from the essence of serving the people’s health, Mao Zedong proposed a health development strategy of prevention first, combining prevention and treatment. As early as the period of the Agrarian Revolutionary War, he pointed out, “Disease is a major ‘enemy’ of the Soviet areas... we must use disease prevention to eliminate this enemy.” [27]27 Mao Zedong, “Attention to Health Work” (1933), *Selected Works of Mao Zedong*, Vol. 1. During the War of Resistance Against Japan, he further clarified the strategic policy of “prevention first.” “We should actively prevent and treat the people’s diseases and promote the people’s medical and health work,” [28]28 Mao Zedong, “On Coalition Government” (1945), *Selected Works of Mao Zedong*, Vol. 3. placing prevention before treatment, highlighting the importance of prevention over treatment. The health thought of prevention first was the application and development of modern preventive medicine in practice by the Chinese Communist Party represented by Mao Zedong. “Preventive medicine, from the perspective of prevention, studies the relationship between population health and disease and the natural and social environment, adopts measures such as public health, social health, and self-health care, fully utilizes beneficial factors in the environment, controls and eliminates harmful factors in the environment, to achieve the goals of preventing disease, improving health, extending life, and increasing labor efficiency. It is an important component of medical science.” [29]29 This is a definition of preventive medicine cited by the author from a Chinese public health textbook; no specific source is given in the original. Unlike clinical medicine, the most prominent feature of preventive medicine is that it is oriented toward the population. Based on this, Mao Zedong always advocated carrying out mass health campaigns as an important way to prevent disease and improve the people’s health level. To ensure the health of the military and civilians and strive for victory in the War of Resistance, the base areas generally carried out health campaigns with appropriate guidance as the basic principle, advocating medicine and opposing ignorance as the theme, and adhering to scientific treatment, educating the masses, and mobilizing the masses to struggle against “their own illiteracy, superstition, and unhygienic habits.” [30]30 Mao Zedong, “On Coalition Government” (1945), *Selected Works of Mao Zedong*, Vol. 3.

从人民的卫生这一本质出发，毛泽东提出了预防为主、防治结合的医疗卫生发展战略。早在土地革命战争时期，他就指出，“疾病是苏区的一大‘仇敌’......必须以预防疾病来消灭这一仇敌。”抗日战争时期，他又进一步明确了“预防在先”的战略方针。“应当积极地预防和医治人民的疾病，推广人民的医药卫生事业”，预防置于医治之前，凸显预防对于治疗之重要性。预防为主的卫生思想是以毛泽东为代表的中国共产党人对现代预防医学在实践中的运用和发展。“预防医学是从预防的观点出发，研究人群健康和疾病与自然环境和社会环境之间的关系，采用公共卫生、社会卫生和自我保健等措施，充分运用环境中有益因素，控制和消除环境中的有害因素，以达到预防疾病、增进健康、延长寿命、提高劳动效率的目的，是医学科学的重要组成部分。”与临床医学不同，预防医学的最显著特点是面向人群。基于此，毛泽东历来主张将开展群众性卫生运动作为预防疾病，提高人民健康水平的重要途径。为保证军民健康，争取抗战胜利，各根据地普遍开展了以适态疏导为基本原则、以倡医反愚为主题、坚持科学施治的卫生运动，教育群众，发动群众起来同“自己的文盲、迷信和不卫生习惯作斗争”。

(A) Appropriate Guidance: The Basic Principle of Mass Medical and Health Campaigns

（一）适态疏导：群众医疗卫生运动的基本原则

“Appropriate” means that medical and health propaganda and education work should be connected and adapted to the ideological dynamics and objective reality of the educated. “Guidance” means dredging, opening up avenues of speech, gathering wisdom and broad views, allowing the educated to speak freely, expressing all kinds of opinions and innermost thoughts, and concentrating everyone’s wisdom. ‘Leading’ means guiding step by step, educating through persuasion, using various forms and methods to guide different thoughts and opinions onto a positive, correct, and healthy track.” [31]31 This is a standard Chinese definition of “dredging and guiding” (疏导) in ideological and political work; the author does not cite a specific source. The border areas were extremely backward in culture and education, the people were conservative in thought, fatalism was widespread, and unhygienic habits had long existed. Only by going deep among the masses, understanding the masses, combining with the actual needs of the masses, and considering the cognitive level and economic conditions of the peasants, using methods that the masses liked to see and hear, and patiently educating through persuasion, could recognition be gained. Otherwise, preaching big principles, subjectivism, formalism, and issuing orders by coercion would all arouse the antipathy of the masses. Liu Jiacheng, a winter school teacher in Zhenyuan County, Gansu, had just arrived in the village and did not yet understand the situation. When promoting maternal and child hygiene, he said, “Pregnant women should bathe frequently, have regular check-ups with a doctor, and prepare ten diapers...” Su Zhengyi’s sister mocked him, saying, “Teacher, have you brought us a few carts of silver?! How can a peasant family afford to be hygienic!” [32]32 This anecdote is drawn from historical records of the border areas; the author does not provide a specific archival citation. It can be seen that starting from subjective wishes and being divorced from the actual conditions of the masses will have the opposite effect. To stimulate the enthusiasm of the masses, in addition to using methods such as blackboard newspapers, literacy groups, yangge dances, plays, songs, books, pamphlets, temple fairs, and exhibitions for health education, the border areas also adopted forms with high mass participation, such as challenge matches and health competitions. For example, in health competitions, model health individuals, model health families, and model health villages continuously emerged, and people saw tangible benefits from the new customs of loving cleanliness, paying attention to hygiene, and trusting medicine. Guo Delin of Xinzheng County paid attention to hygiene, and his whole family was free from illness for four years; in Doujiawan Village, Xinning County, every household paid attention to hygiene, and the village had no major diseases for three years; Yangjiawan in the northern district of Yan’an City changed from dirty to clean, broke with superstition, trusted medicine, and the whole village took on a new look... These living examples gradually changed the bad habits of the vast peasant masses who did not pay attention to hygiene.

适态指医药卫生宣传教育工作要与受教育者的思想动态、客观实际相联系、相适应。“疏，就是疏通，广开言路，集思广益，让受教育者畅所欲言，把各种意见和心里话说出来，集中大家的智慧。‘导’就是循循善诱，说服教育，用各种形式和方法，把各种不同的思想和言论，引导到积极的、正确的、健康的轨道上来。”边区文化教育极其落后，民众思想保守，宿命论普遍存在，不卫生习惯由来已久。只有深入群众，了解群众，结合群众的实际需要，并考虑到农民的认知水平和经济条件，采用群众喜闻乐见的方式，耐心地说服教育，才能获得认同。否则，讲大道理、主观主义、形式主义、强迫命令都会遭到群众反感。甘肃镇原县冬学教员刘家城，刚到村里，还不了解情况，在宣传妇婴卫生时说，“孕妇要常洗澡，要请医生常检查，准备十块尿布......”，苏正义的妹妹讥讽说：“教员给咱拉来几车银子？！庄稼人还能讲卫生！”可见，从主观愿望出发，脱离群众实际，就会适得其反。为激发群众的积极性，边区各界除了采取黑板报、识字组、秧歌、戏剧、歌谣、书报、小册子、庙会、展览会等方式进行卫生教育外，还采用了擂台赛、卫生竞赛等群众参与度较高的形式。如在卫生竞赛中，模范卫生个人、模范卫生家庭、模范卫生村不断涌现，人们也从爱清洁、讲卫生、信医药的新风习中看到了实实在在的好处。新正县郭德林讲卫生，全家四年不病；新宁县窦家湾村，家家讲卫生，该村三年没有大的疾痛发生；延安市北区杨家湾从肮脏变清洁，破除迷信、相信医药，全村气象一新......活生生的事例，逐渐改变着广大农民群众不讲卫生的不良习惯。

(B) Advocating Medicine and Opposing Ignorance: The Theme of Mass Medical and Health Campaigns

（二）倡医反愚：群众医疗卫生运动的主题

Paying attention to hygiene, advocating medicine, opposing ignorance, and breaking down superstition were the main contents of the mass medical and health campaigns. The superstition, ignorance, and unhygienic habits left over from the old society brought the threat of disease and death to the people of the border areas. Cleaning away the old and establishing the new, popularizing health knowledge, establishing health systems, and cultivating good health habits were the key strategies for preventing disease and eliminating illness. Important newspapers such as *New China Daily*, *War of Resistance Daily*, *Jin-Cha-Ji Daily*, and *Liberation Daily* all published many articles promoting medical and health knowledge. “Remember to be hygienic, avoid raw and cold food and drink, wash bowls and chopsticks with boiling water, cover bowls and chopsticks after meals. Bathe frequently and change clothes often, keep quilts and matresses clean, sweep inside and outside the cave dwelling, eliminate mosquitoes and flies.” [33]33 This is a folk rhyme promoting hygiene, published in *Liberation Daily* (1944); the author does not give a specific date. This can be glimpsed from the song “Paying Attention to Hygiene” published in *Liberation Daily*. In 1944, Gao Wenliang, the township head of the northern district of Yan’an City, proposed ten slogans in the health competition, which covered the basic content of health knowledge propaganda and education at that time, and later became the criteria for selecting model health villages in Yan’an City. “One, all village residents are led by the health team leader to carry out health work. Two, each family digs a latrine. Three, do not drink cold water or rotten melons and fruits. Four, do a major cleaning three times a month, keep the inside and outside of the cave dwelling clean at all times. Five, wash clothes twice a month. Six, wash quilts and matresses once a year. Seven, wash face and hands every day. Eight, each family makes a fly swatter to kill flies. Nine, all livestock are penned up. Ten, if sick, see a doctor, do not invite a shaman-god.” [34]34 These ten slogans were proposed by Gao Wenliang, a local official in Yan’an, in 1944, as recorded in contemporary Party documents. In China’s population structure, women and children account for more than two-thirds of the total population. Maternal and child health care is not only related to the improvement of China’s population quality but also to the development of the revolutionary cause. However, in the old society, the maternal and child health situation was dire, with many maternal and child diseases, and “babies were hard to raise after birth.” In response, the Chinese Communist Party and the border area governments proposed that popularizing maternal and child health knowledge should be the central link of the mass health campaign. Medical staff and women workers repeatedly explained to women, through various forms, menstrual hygiene, maternal hygiene, preparation for childbirth, how to use new methods of delivery, how to take care of babies, and that if a child is sick, they should see a doctor, not burn incense and worship Buddha, or trust shaman-gods. The field of maternal and child health, once plagued by superstition and ignorance, began to receive widespread attention and, under the influence of scientific knowledge, radiated vitality and vigor.

讲究卫生，提倡医学，反对愚昧，破除迷信，是群众性医疗卫生运动的主要内容。旧社会遗留下来的迷信、愚昧和不卫生习惯，给边区人民带来了疾病和死亡的威胁。涤秽布新，普及卫生知识，建立卫生制度，养成良好的卫生习惯，是防病除疴之要策。《新中华报》、《抗战日报》、《晋察冀日报》、《解放日报》等重要报刊均刊载了许多宣传医疗卫生知识的文章。“讲卫生来要记清，喝水吃饭忌生冷，饭头碗筷煎水洗，饭后碗筷用布蒙。多洗澡来勤换衣，被子褥子要干净，窑里窑外常打扫，蚊子苍蝇要肃清。”从《解放日报》登载的这首《讲卫生》歌曲可窥见一隅。1944年，延安市北区乡乡长高文亮在卫生竞赛中提出了十大口号，涵盖了当时卫生知识宣传教育的基本内容，后成为延安市评选卫生模范村的评判标准。“一、全村居民受卫生小组长领导，进行卫生工作。二、每家挖一个厕所。三、不喝冷水和腐烂了的瓜果。四、每月大扫除三次，窑内外经常保持清洁。五、每月洗衣服两次。六、每年拆洗被子两次。七、每天洗脸洗手。八、每家做一个蝇拍子打苍蝇。九、牲口都围起来。十、有病请医生，不请巫神。”在我国人口结构中，妇女和儿童占总人口的2/3以上，妇幼卫生保健，不仅关系到我国人口素质的提高，而且关系到革命事业的发展。然而，旧社会妇婴卫生状况恶劣，妇婴疾病多，“娃娃生下难活”。对此，中国共产党和边区政府提出，要将妇婴卫生常识宣传作为群众卫生运动的中心环节。医护人员和妇女工作者通过各种形式反复地向妇女讲解生理期卫生、孕妇卫生，临产的准备，如何新法接生，怎样照顾娃娃，孩子生病，要请医生看病，不要烧香拜佛，相信巫神等等。过去迷信成灾、愚昧不堪的妇婴领域，开始受到人们的广泛关注，并在科学知识的熏沐下，焕发出生机和活力。

(C) Scientific Treatment: Traditional Pseudo-Treatment Medicine Gradually Fades Away

（三）科学施治：传统伪治医疗渐行渐远

Prevention and treatment are two basic means for humanity to overcome disease and ensure health, and they are also a summary of experience gained by people in their long-term struggle against illness. Whether the relationship between prevention and treatment can be correctly handled directly affects the effectiveness of the mass health movement. The Communist Party of China and the border region governments consistently integrated health propaganda work with strengthening medical treatment, advancing them in coordination. “Medical work is the backbone of the health movement and a powerful promoter of spreading hygiene and opposing superstition.” The Health Department of the Shaanxi-Gansu-Ningxia Border Region stipulated that outpatient services be provided to the masses every morning, with free treatment given to over 20,000 people within half a year; in the first half of 1944, the Peace Hospital treated 1,096 people for the masses. From April to June 1944, the Central Health Department spent 700,000 yuan on medical treatment for the masses. From 1943 to 1944, the Longdong Sub-Region Hospital waived 440,000 yuan in medical fees for the masses. Over the eight years of the War of Resistance, the health departments of the Jin-Cha-Ji Border Region treated over 18.79 million person-times for the masses.

预防与治疗是人类战胜疾病、保障健康的两个基本手段，也是人们长期与病痛作斗争中形成的经验总结。能否正确处理防与治的关系，直接关系到群众卫生运动的成效。中国共产党和边区政府始终将卫生宣传工作与加强医药治疗有机结合，协同推进。“医疗工作是卫生运动的后盾，也是推广卫生反对迷信的有力促进者”。陕甘宁边区卫生处规定：每天上午为群众门诊，半年内免费为群众治疗2万多人次；1944年前半年，和平医院为群众治病1096人。1944年4-6月，中央卫生处为群众治病花费医药费70万元。1943-1944年，陇东分区医院免收群众医疗费44万元。抗战8年中，晋察冀边区卫生部门给群众医伤治病达1879万多人次。

In the rural health movement, effective treatment often turned illness into health and danger into safety for the masses. Gao Manxiang of Yangjiawan in the Northern District of Yan’an City suffered from “green leg and gum disease” [35]35 “Green leg and gum disease” (青腿牙疳) is a traditional Chinese medical term for a condition involving purplish discoloration of the legs and ulcerative gingivitis, often associated with severe vitamin C deficiency (scurvy)., with unbearable abdominal pain. Neighbors worriedly said this was a fatal illness. After spending 10,000 yuan to invite a witch doctor for “treatment,” his condition grew increasingly severe. Doctor Li Jianping, upon hearing the news, came and gave him an injection, stabilized his condition, and transferred him to the Central Hospital for inpatient treatment. After recovering and returning to the village, he told everyone: “The public hospital is really good... it truly works for us common folks,” and whenever he encountered a villager who fell ill, he actively urged them to seek a public doctor. Similar examples are too numerous to list. Letting patients speak and letting facts talk, the “in-group effect” produced a relatively good propaganda and education effect, severely shaking belief in witch doctors, and traditional pseudo-medical treatment gradually faded away.

在农村卫生运动中，有效的治疗常常使群众化疾为康，转危为安。延安市北区杨家湾高满祥身患“青腿牙疳”，肚子疼痛难忍，邻舍人担心的说：这是要命的病。花了一万元，请来巫神“治疗”，病情愈发沉重。医生李建平闻讯赶来，为其打了一针，控制住病情后转到中央医院住院治疗。痊愈回村，逢人便讲：“公家医院真好......真是替咱老百姓办事”，并且凡遇村里人生病，都积极地劝他们请公家医生。类似的例子不胜枚举。让患者开口，让事实说话，“自己人效应”产生了较好宣传教育效果，巫神信仰发生严重动摇，传统伪治医疗渐行渐远。

IV. The Transformation of Medical and Health Concepts in the Base Areas

四、根据地医疗卫生观念的变革

In societies with private ownership, cultural education and medical hygiene were undertakings serving a minority. The vast majority of the people had no right to enjoy cultural education or medical and health care. Superstition, ignorance, and disease long plagued people’s lives. The Communist Party of China took the eradication of all unequal social systems as its mission and thereby established a people’s health enterprise. To ensure victory in the War of Resistance and the health of the people, the base areas, relying on the anti-witch-doctor struggle and the mass health movement, reorganized medical forces, strengthened physician and pharmaceutical construction, popularized medical and health knowledge, and widely provided medical treatment. Major transformations occurred in management concepts, service concepts, treatment-seeking concepts, and concepts regarding women and children in the medical and health field of the base areas. Medical qualifications came under standardized management, the audience for medical treatment expanded unprecedentedly, scientific prevention and treatment gradually took root, maternal and child health care entered the public view, and medical and health concepts achieved a modern transformation.

在私有制社会中，文化教育、医学卫生是为少数人服务的事业，广大人民没有享受文化教育和医疗卫生保健的权利，迷信、愚昧、疾病长期困扰着人们的生活。中国共产党以铲除一切不平等社会制度为己任，并由此建立了人民的卫生事业。为保证抗战胜利和人民健康，根据地以反巫神斗争和群众性卫生运动为依托，重组医疗力量，加强医师医药建设，普及医疗卫生知识，广施医疗救治，根据地医疗卫生领域的管理观念、服务观念、就医观念、妇幼观念等发生了重大变革，医护资格受到规范管理，医疗受众面空前扩张，科学防治渐入人心，妇幼保健进入大众视野，医疗卫生观念实现现代转型。

(1) Standardization of Medical Qualification Management

（一）医护资格管理的规范化

For thousands of years, folk medicine in China mainly relied on scattered individual practitioners of Traditional Chinese Medicine, sustained by a mix of medicine and sorcery and specious common sense. “Because Traditional Chinese Medicine is not built on a foundation of rigorous logic and accurate physical and chemical experimental data, it has never been able to draw a clear line with sorcerous principles.” [36]36 Source not provided in the original text; the quotation appears to be from a secondary analysis of Traditional Chinese Medicine. To prevent quack doctors and charlatans from harming lives and to strengthen the scientific transformation of Traditional Chinese Medicine, in 1942, the “Shaanxi-Gansu-Ningxia Border Region Physician Management Regulations” stipulated: “Anyone possessing physician qualifications must be reviewed by the Shaanxi-Gansu-Ningxia Border Region Health Department and issued a physician certificate; otherwise, they shall not practice medicine... Any physician wishing to open a practice in a certain location must present their physician certificate to the relevant government authority for registration.” In March 1943, the “Draft Regulations of the Shaanxi-Gansu-Ningxia Border Region on Rewards and Punishments for National Medicine and National Pharmaceuticals” proposed: “To eliminate witch doctors and charlatan physicians and to encourage the research spirit of national medicine, national medicine examination regulations are hereby stipulated.” Nursing is an important component of modern medical work. Initially, most nurses in border region hospitals were “little devils” [37]37 “Little devils” (小鬼) was a colloquial term in the Red Army and later the Eighth Route Army for young orderlies or messengers, often children or teenagers. who were too young and poorly educated, leading to frequent problems. After the Yan’an Branch of the Chinese Nurses’ Association was established in 1941, it screened and verified the qualifications of association members and assisted various medical and health leadership organs in assessing in-service nurses. In May 1943, the Jin-Cha-Ji Military Region promulgated the “Regulations on Establishing the Nursing System,” which stipulated: “Improve the performance of nursing work and intensify technical education. Current nursing staff who are under 16 years old, have a bad temper, are physically weak, or are unpromising should be immediately replaced and assigned other work... Use every possible means to transfer comrades who originally graduated from formal domestic nursing schools or have worked in nursing for many years to serve as head nurses, making them specifically responsible for improving nursing work. The qualifications of a head nurse should be sufficient nursing skills, not reliance on military management.” The restrictive provisions on the qualifications of doctors, nurses, and head nurses marked the entry of medical personnel management into an institutionalized track, compressed the living space for witch doctors who used medical consultations as a pretext to defraud property, and promoted the improvement of the overall quality of the medical team.

千百年来，中国民间医疗主要依靠分散的个体中医，采用医巫混杂、似是而非的常识维系着，“由于中医并没有建立在严密的逻辑和准确的理化实验数据的基础上，这就使它始终不能与巫理划清界限”。为防止二流子医生和庸医伤害生命，以及加强中医科学化改造，1942年，《陕甘宁边区医师管理条例》规定：“凡具有医师资格者由陕甘宁边区卫生处审查后给予医师证明，否则不得执行医师之业务。......凡医师愿在某处开业须向该主管政府呈验医师证明，请求注册。”1943年3月，《陕甘宁边区国医国药奖惩条例草案》提出：“为取缔巫神、二流子医生及鼓励国医研究精神，特规定国医考试条例”。护理是近代医疗工作的重要组成部分，起初，边区医院的护士大多由年龄偏小、文化水平较低的“小鬼”充任，导致问题频出。1941年中华护士学会延安分会成立后，即对学会会员资格进行了甄别、审核，并协助各医药卫生领导机关考核在职护士。1943年5月，晋察冀军区颁布的《关于建立护理制度》规定：“提高看护工作性能，加紧技术教育。凡年不满16岁，性情暴躁，身体不强，不堪造就之现任看护员，应即撤换，作其他工作。......尽一切可能调任原系国内护士学校正式毕业或从事护理工作多年的同志担任看护长，使之专责改进护理工作。看护长的质历，应是具有足够的护理技术，而不是凭藉军事管理”，对医生、护士、看护长资格的限制性规定，标志着医护人员管理进入制度化轨道，压缩了以看病为幌子骗取财物的巫神的生存空间，促进了医护队伍整体素质的提升。

(2) Popularization of Medical Service Concepts

（二）医疗服务观念的大众化

In the old days, due to the scarcity of doctors, there was a folk saying: “Inviting a doctor is like paying homage to a prime minister.” When a doctor “could both earn money and have status, whoever came to invite the doctor for a consultation would either ride a mule, take a cart, or even a sedan chair; it was ostentatious and majestic, and everyone respected them... When being a doctor, you sized up the target (the target who could pay). If the rich came to call, you went immediately; if the poor called, you made excuses, or said you had no time; when filling prescriptions at the pharmacy, the rich got good medicine, the poor got bad medicine. The main thing was to make money, not to cure the sick and save people.” [38]38 Source not provided in the original text; the quotation appears to be a description of pre-revolutionary medical practice. It can be seen that under the old customs, the main recipients of medical treatment were the wealthy classes who could afford medical fees. The impoverished masses who most needed medicine could only invite witch doctors or let things take their course. Facing the masses and serving the people is the essential requirement of the people’s health enterprise. “It is necessary to mobilize all military and organ Chinese and Western doctors, in addition to serving the military and organs, to also serve the masses, to treat or hospitalize ordinary people as much as possible, and to regularly organize mobile medical teams to go to the countryside. It is necessary to mobilize and help all Chinese medicine practitioners and all pharmacies to serve the masses.” [39]39 Source not provided in the original text; the quotation appears to be a policy directive from the border region authorities. After the Rectification Movement [40]40 The Rectification Movement (整风运动) was a Party-wide ideological education and cadre rectification campaign launched by Mao Zedong in Yan’an from 1942 to 1945, aimed at correcting deviations in work style and thought, particularly subjectivism, sectarianism, and Party formalism., doctors in the border regions were generally baptized by revolutionary thought, and their service concepts reversed. “The era when a revolutionary doctor sat at home waiting for patients to knock on the door has passed. Doctors should go to the patients, and the sooner the better.” [41]41 Source not provided in the original text; the quotation appears to be a statement attributed to a revolutionary medical figure.

旧时，由于医生稀缺，民间有“请医如拜相”的说法。当医生“既能挣钱又有地位，谁来请先生瞧病不是骑骡子，便是坐大车，还有坐轿车；又排场又威风，人人尊敬。......当医生就是看对象哩（能挣钱对象），有钱人来叫就马上去，没钱人叫就推诿，或说没功夫；药铺抓药，也是有钱人就抓好药，没钱人就抓赖药，主要是挣钱，不是治病救人。”可见，在旧俗之下，医疗受众对象主要是出得起医药费的富人阶层，最需要医药的穷苦大众，只能请巫神，或听之任之。面向群众，服务于民，是人民卫生事业的本质要求。“必须动员一切部队机关中西医除为部队机关服务外，兼为群众服务，尽量给老百姓看病或住院，并经常组织巡回医疗队下乡。必须动员和帮助一切中医和一切药铺为群众服务。”整风运动后，边区医生普遍受到革命思想的洗礼，服务观念发生逆转。“一个革命医生坐在家里等着病人来扣门的时代已经过去了，医生应该跑到病人那里去，而且愈早愈好。”

(3) “De-deification” of Disease Prevention and Treatment Concepts

（三）疾病防治观念的“去神”化

For a long time, the people in the border regions did not understand the relationship between hygiene and disease, or between disease and medicine. They believed “if the Old Man in Heaven [42]42 “Old Man in Heaven” (老天爷) is a traditional Chinese folk term for a personified heavenly deity or fate, often invoked in expressions of fatalism. wants you to get sick, being hygienic is useless,” trusted in ghosts and gods, and resigned themselves to fate. The propaganda and popularization of medical and health knowledge not only made the people understand the principle of “more hygiene, fewer illnesses” but also gave them “further understanding and faith in medical science.” [43]43 Source not provided in the original text; the quotation appears to be a summary of the effects of health propaganda. In disease prevention, they began to pay attention to hygiene: washing hands and faces, washing quilts and sheets, sweeping courtyards and streets, building latrines, cleaning manure piles and garbage, and killing flies and rats. “The villagers of Yanjiata have already developed the habit of drinking boiled water; rinsing the mouth and taking off shoes before getting on the kang [44]44 A kang (炕) is a traditional Chinese heated brick bed used for sleeping and daily activities in northern China. have become common practice.” [45]45 Source not provided in the original text; the quotation appears to be a report on hygiene practices in a specific village. To prevent epidemics, they received vaccinations, and during epidemic outbreaks, they isolated at home and stayed away from crowded places. The affiliated hospital of the Field Health Department of the Jin-Ji-Lu-Yu Border Region vaccinated 7,436 children against smallpox in 1943 alone. In disease treatment, with the establishment of various types of medical institutions at all levels (such as hospitals, medical stations, health medicine cooperatives, health cooperatives, etc.), the masses’ sense of access to medical treatment was significantly enhanced. “When villagers get sick, they immediately go to the outpatient clinic to see a doctor. They say: ‘The doctors at the Eighth Route Army outpatient clinic are very good.’ The phenomenon of seeking witch doctors and believing in ghosts is gradually decreasing.” [46]46 Source not provided in the original text; the quotation appears to be a report on changing attitudes toward medicine.

长期以来，边区民众不了解卫生与疾病、疾病与医药之关系，“老天爷叫你病，讲卫生也不中用”，相信鬼神，听天由命。医药卫生常识的宣传普及，不但使民众晓得“多讲卫生，少生病”的道理，而且对“医药科学有了进一步的理解与信仰”。在疾病预防上，开始讲究卫生，洗手、洗脸，拆洗被子，打扫街院，修建厕所，清理粪堆、污物，灭蝇灭鼠，“阎家塔的老乡已经养成喝开水的习惯了，漱口，脱鞋上炕已经成为普遍的情形。”为预防疫病，接种疫苗，并在疫病流行时，居家隔离，远离闹市。晋冀鲁豫边区野战卫生部的附属医院，仅1943年，就为驻地7436名儿童接种了牛痘。在疾病的治疗上，随着各级各类医疗机构（如医院、医疗站、保健药社、卫生合作社等）的设立，群众就医获得感显著增强。“老乡们病了马上去门诊部请医生去看，他们说：‘八路军门诊部医生看病一满好’，求巫神信鬼的现象已经逐渐在减少中”。

(4) Modernization of Maternal and Child Health Care Concepts

（四）妇幼保健观念的现代化

The field of women’s and children’s health was once a disaster area of superstition, disease, and death in the border areas. Women lacked basic hygiene knowledge about menstruation, pregnancy, childbirth, and lactation. Gynecological diseases were considered indecent and unmentionable, and women were ashamed to seek treatment, often allowing minor ailments to develop into serious illnesses. Childbirth was called “passing through the gates of hell”; unclean cutting of the umbilical cord leading to tetanus was the greatest threat to infant safety. In view of this, the Health Department of the Shaanxi-Gansu-Ningxia Border Region made women’s and children’s health the main battlefield of health work, and establishing midwifery or childbirth training classes, training midwives or birth attendants, and promoting new methods of childbirth were prioritized as the main tasks of women’s and children’s construction. The differences between the old and new methods of childbirth, along with the longing for a healthy life, gradually led women in the border areas to abandon the bad habits of the old childbirth methods. In the two years following the Cultural and Educational Congress, the Shaanxi-Gansu-Ningxia Border Region established 64 childbirth training classes in rural areas, trained 826 birth attendants and reformed old midwives, achieving one birth attendant for every two to three administrative villages, with 73% of the region adopting new methods of childbirth. At the same time, through propaganda and education, women gained a certain understanding of hygiene knowledge for each of their “special periods.” According to a June 16, 1946, report in *Liberation Daily*, pregnant women in Baijiaping Village, Yan’an City, actively requested fetal position checks, and more than ten women requested health checkups. Infant and child feeding also became more scientific: scheduled breastfeeding, no drinking of unboiled water, a reasonable diet, regular bathing, sun exposure, cold prevention, universal smallpox vaccination, and so on. The health status of women and children in the border areas improved significantly.

妇幼领域曾是边区迷信、疾病、死亡的重灾区，妇女们缺乏经期、孕期、产期、哺乳期的基本卫生常识，妇科疾病被认为是伤风败俗、不堪一提的事，羞于求治而往往酿成大病。妇女生孩被称作“过鬼门关”，断脐不洁导致破伤风是婴幼儿生命安全的最大威胁。鉴于此，陕甘宁边区卫生处将妇幼领域作为卫生工作的主战场，而创办助产或接生训练班，培养助产或接生人员，倡导新法接生，被作为妇幼建设的主要任务，置于优先地位。新旧接生法的差异，以及对健康生活的向往，使边区妇女们逐渐放弃了旧法接生的陋习。文教大会后两年间，陕甘宁边区在农村开办接生班64处，培训接生员 、改造旧产婆826人，实现2-3个行政村有一个接生员，73%的地区接受了新法接生。与此同时，通过宣传教育，妇女对自身各个“特殊时期”卫生常识已有一定的了解，据1946年6月16日《解放日报》记载，延安市白家坪村已孕妇女主动要求检查胎位，还有十多位妇女要求进行健康检查。婴幼儿喂养也更加科学，定时喂奶，不喝生水，合理饮食，常洗澡，晒太阳，预防感冒，普种牛痘等等，边区妇幼健康状况有了明显改善。

V. Summary

五、小结

Marx pointed out, “Before the 18th century there was no science at all; knowledge of nature only acquired its scientific form in the 18th century, and some branches even later.” [47]47 Karl Marx, “The Poverty of Philosophy,” *Marx/Engels Collected Works*, Vol. 6, p. 164. The quotation is slightly adapted from the original. After the 18th century, humanity embarked on a difficult march from tradition to modernity, from science defeating superstition, and this was especially true of the transformation in the field of medical and health care. The Communist Party of China, upholding dialectics and materialism, adhering to a people-centered stance, and following the laws of ideological education, promoted the modern transformation of the conceptual world in the medical and health field. However, the “enemy in the masses’ minds” has a tenacious vitality; the lag in medical and health construction and insufficient health education are two important aspects of the emergence of the masses’ old and new “superstitions.” Therefore, it is necessary to take the masses’ needs as the guide, strengthen infrastructure construction, promote a balanced supply of medical resources, rationalize institutions and mechanisms, improve service quality, and objectively eliminate the soil that breeds “superstition.” More importantly, it is necessary to fully harness the power of science, take appropriate and gradual guidance as the basic principle, and conduct regular popularization education on medical and health knowledge for “people with practical power of action,” [48]48 This phrase echoes Marx’s “Theses on Feuerbach,” where he writes of “revolutionary, practical-critical activity” and “the person who has practical power of action.” thereby continuously compressing the space for “superstitious” activities in the conceptual world of the practical subject from the subjective side.

马克思指出，“18世纪以前根本没有科学；对自然的认识具有自己的科学形式，只是在18世纪才有，某些部门或者早几年。” 18世纪后，人类开启了传统走向现代，科学战胜迷信的艰苦行军，医疗卫生领域变革尤其如此。中国共产党秉持辩证法和唯物论，坚持人民立场，遵循思想教育规律，推动医疗卫生领域实现了观念世界的现代转型。然而，“群众脑子里的敌人”具有顽强的生命力，医疗卫生建设滞后和卫生教育不足是群众新旧“迷信”产生的两个重要方面。因此，要以群众需求为导向，加强基础设施建设，促进医疗资源供给均衡，理顺体制机制，提高服务质量，从客观上消除“迷信”滋生的土壤。更重要的是，要充分运用科学的力量，以适态疏导为基本原则，对“有使用实践力量的人”进行常态化的医疗卫生知识普及教育，从主观上不断压缩实践主体观念世界“迷信”活动空间。

(Author: Researcher at the Research Center for the Theoretical System of Socialism with Chinese Characteristics in Henan Province, Henan Polytechnic University)

（作者：河南理工大学河南省中国特色社会主义理论体系研究中心研究员）

Online Editor: Rainbow

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