Chapter 329: Reform

Seeing that the hour had already reached weishi (1-3 PM), Zhu Youjian, after comforting Empress Zhou, took Wang Cheng'en with him to the Qianqing Palace.

Yang Sichang had already entered the palace that morning to report on his mission, stating that Sun Chuanting had successfully entered the capital and returned home, and had forwarded Sun Chuanting's handwritten memorial for presentation.

After Zhu Youjian offered a few words of praise, Yang Sichang, seeing that the Emperor had no new edicts, bowed and took his leave from the palace.

Looking at Sun Chuanting's handwritten memorial, Zhu Youjian could not help but recall the scene of their face-to-face conversation more than two years ago. Two years had passed in the blink of an eye, yet the situation had undergone earth-shaking changes.

A capable minister is a capable minister—as long as there is sufficiently strong support from all sides, such a capable minister can display the skill to turn the tide and save the situation.

In history, the reason Sun Chuanting failed was that obstruction from all sides was the most fundamental cause. No silver, no grain, no troops—only frantic rushing about after receiving edicts, ultimately dying on the battlefield with unwillingness and indignation, even leaving behind a reputation of seizing an opportunity to flee in secret.

Considering that Sun Chuanting had not seen his family for more than two years, and that no major military intelligence had recently arrived, Zhu Youjian planned to let him rest at home for a good while before summoning him to the palace—he would wait to grant him an audience together with that legendary female heroine when she entered the capital.

Zhu Youjian was waiting for news from Nanjing; counting the days, it should be about time to arrive.

This abolition of the Nanjing留守朝廷 (Nanjing留守朝廷) should not encounter too many twists and turns. Those people in Nanjing never imagined such an earth-shattering event would occur; lost in their comfort and pleasure, caught completely off guard, they would find it hard to devise countermeasures.

The Jiangnan region no longer had military force it could rely on to oppose the court. The vested interests in Nanjing now were like children carrying great gold through a bustling market—any slight force would knock them to the ground.

They had grown accustomed to the various tricks and rules of the Ming officialdom over more than two hundred years, and in their bones they believed that even the Emperor could not do anything to them—they had never even regarded the Emperor with any respect.

In the minds of these people, the Emperor was nothing but a monkey toyed with by court officials. Under the suppression of the powerful official-gentry bloc, if the Emperor's edicts did not suit their wishes, such edicts were nothing but waste paper.

Just as Zhu Youjian sat in contemplation, amid the loud announcement of the young eunuch outside the palace hall, Luo Yangxing strode into the hall.

"Done?"

Zhu Youjian looked up at Luo Yangxing.

"Reporting to Your Majesty, it should be done! This is the memorial report sent by Li Ruolian from Nanjing!"

Luo Yangxing bowed in salute and stepped forward a few paces, handing several memorial reports and routine memorials to Wang Cheng'en, who had descended the imperial steps.

"Good! Minister Luo, wait a moment. Companion, have someone summon the Grand Secretariat ministers, the six Ministry Ministers, and the Shuntian Prefect to the Zhaoren Hall for deliberation!"

After receiving the memorials and roughly reviewing the results, Zhu Youjian instructed in a relaxed and cheerful tone.

Wang Cheng'en acknowledged and descended the imperial steps; after exiting the hall door, he gave a few quiet instructions, and a young eunuch ran off swiftly.

"Give Minister Luo a seat!"

Following Zhu Youjian's instruction, a eunuch hidden in the corner of the hall hurriedly brought a brocade stool from the side hall and set it down. Luo Yangxing bowed and then sat.

Zhu Youjian chatted idly with Luo Yangxing for a while, and then Wen Tiren, Wang Yingxiong, and Zhang Zhifa—the three Grand Secretaries closest to the Qianqing Palace—arrived together. Before the three could even ask what matter they had been summoned for, Zhu Youjian instructed them to first go to the Zhaoren Hall to discuss other matters, and that the main event of the day would be deliberated once all the important ministers had assembled.

Seeing the Emperor seated on the imperial throne in the Zhaoren Hall, Wen Tiren and the others clasped their hands in salute and took their usual seats.

"Minister Wen, how is the progress on the matter of gathering Bureau Directors in the capital region for instruction? Are there any points that require revision?"

The Bureau Director instruction Zhu Youjian referred to was a new policy he had conceived just last month. After deliberation with the Grand Secretariat ministers, it was now being piloted in the prefectures and counties of the capital region, and after summarizing the experience gained, it would be promoted to other provinces.

This new policy was to comprehensively implement a court-subsidized medical system in all villages and towns of the Ming with convenient transportation over the next several decades, striving to equip every village with one Bureau Director who understood basic medical knowledge.

This policy could not yet benefit the people of remote mountain villages, because the constraints of transportation conditions were truly difficult to overcome.

When Zhu Youjian had proposed this new policy to the several Grand Secretariat ministers, Wen Tiren and the others had all fallen silent. Although they admired the Emperor's unprecedented idea, they were extremely pessimistic about its prospects.

What Zhu Youjian was doing was imitating the method of barefoot doctors implemented in the early days of the founding of later generations. Practice had proven this to be an effective strategy that would directly benefit the vast farming households throughout the Ming, lightening both their psychological and economic burdens.

However, this massive public welfare project—broad in scope and extremely long in cycle—would require no small amount of silver.

Of course, the greatest obstacle to promoting this new policy was not silver, but the severe shortage of Bureau Directors within the Ming.

The cultivation of traditional Chinese medicine practitioners could not be completed overnight; it required long-term accumulation. A qualified Bureau Director took at least ten to twenty years to grow into the role. At present, most Bureau Directors in the Ming were concentrated in cities at the prefecture and county level and above. Once farmers in villages fell ill, no matter how far the distance, they could only run to the county seat to find a Bureau Director for treatment—time-consuming and laborious, and if an acute condition struck, they might well lose their lives on the road.

Zhu Youjian also knew that given the current medical conditions and standards, coupled with the extremely backward transportation environment, even if someone with an acute illness was delivered to the city, it would basically still mean death. The purpose of his new policy was not to rescue patients who could not be cured, but to ensure that those suffering from common illnesses like wind-cold fevers, diarrhea, and abdominal pain—who would otherwise worsen for lack of timely treatment—could receive timely and effective treatment and help.

"Reporting to Your Majesty, since receiving your sacred instruction, your ministers have deliberated with the Shuntian Prefect on the specific implementation strategy, and it was resolved to include Daxing and Wanping counties under Shuntian Prefecture, as well as Tongzhou, Zhuozhou, Bazhou, Jizhou, Changping and other prefectures and counties in this public welfare new policy. This is because these prefectures and counties are close to the capital, with medical and pharmaceutical resources far superior to the rest of the Ming's prefectures and counties, so the new policy should proceed more smoothly by comparison. The Grand Secretariat has already sent documents to these prefectures and counties, ordering the local governments to select a spacious location within the city, equip it with appropriate facilities, and hire renowned local physicians to teach in rotation. The trainees are all those from towns and villages with shallow medical knowledge. As the implementation period has been short, no specific memorial reports have yet been returned."

Wen Tiren sat upright, clasped his hands, and reported.

After the Grand Secretariat ministers and the Shuntian Prefect Chen Qiyu had conferred, they produced the current plan being implemented, and from the Ministry of Revenue allocated two thousand taels of silver to each prefecture and county as funding for the new policy, to be spent on hiring renowned physicians and covering the room and board of trainees.

"All ministers have done well. This new policy cannot show results in a day or two; it must be maintained persistently and consistently. In my leisure time, I have also quietly pondered this matter. To prevent the new policy from being abandoned halfway due to various constraints, I have specially decided to establish a dedicated agency to take full responsibility for all related personnel and material allocations. The newly established agency shall be temporarily named the Health Bureau, with its director holding the rank of fourth grade, senior. The first director shall be Wu Youxing, the Imperial Academy of Medicine's deputy director. The ranks and numbers of other officials and clerks shall be decided by the Grand Secretariat and the Ministry of Personnel in consultation. The Health Bureau shall be directly under the jurisdiction of the Grand Secretariat, with its duties and authority to be reported up after deliberation by the Grand Secretariat. Its office shall be newly built at a site selected by the Grand Secretariat ministers. I hope the Grand Secretariat ministers will formulate its functions in detail, and I will weigh the pros and cons before implementing!"

Given that the current situation was running smoothly in a positive direction, Zhu Youjian placed the step-by-step promotion of basic health knowledge in places within the Ming where conditions permitted onto the agenda.

With the Health Bureau taking the lead and local governments cooperating, campaigns would be carried out in county seats, towns, and villages to eliminate rats, flies, mosquitoes, and cockroaches through mass clean-up drives; promote washing hands before meals and after using the latrine; ensure cold water must be boiled before drinking; require leftover summer food to be reheated before consumption; implement isolation for major infectious diseases; and reform village and town latrines—a series of measures to fundamentally rectify the sanitary environment of villages and towns and eliminate the various diseases caused by personal and environmental hygiene problems. This was Zhu Youjian's original intention in establishing the Health Bureau.

The costs for these upcoming rural environmental sanitation rectification efforts would be borne jointly by the privy purse and the Ministry of Revenue, with the privy purse contributing seventy percent.

As for whether public hospitals would be established in densely populated areas in the future, that could only be listed in the plans for now, with implementation to be decided according to specific circumstances.