https://www.nlm.nih.gov/exhibition/islamic_medical/islamic_12.html
Islamic Culture and the Medical Arts
Hospitals
The hospital was one of the great achievements of medieval Islamic society. The relation of the design and development of Islamic hospitals to the earlier and contemporaneous poor and sick relief facilities offered by some Christian monasteries has not been fully delineated. Clearly, however, the medieval Islamic hospital was a more elaborate institution with a wider range of functions.
In Islam there was generally a moral imperative to treat all the ill regardless of their financial status. The hospitals were largely secular institutions, many of them open to all, male and female, civilian and military, adult and child, rich and poor, Muslims and non-Muslims. They tended to be large, urban structures.
The Islamic hospital served several purposes: a center of medical treatment, a convalescent home for those recovering from illness or accidents, an insane asylum, and a retirement home giving basic maintenance needs for the aged and infirm who lacked a family to care for them. It is unlikely that any truly wealthy person would have gone to a hospital for any purpose, unless they were taken ill while traveling far from home. Except under unusual circumstances, all the medical needs of the wealthy and powerful would have been administered in the home or through outpatient clinics dispensing drugs. Though Jewish and Christian doctors working in hospitals were not uncommon, we do not know what proportion of the patients would have been non-Muslim.
An Islamic hospital was called a bimaristan, often contracted to maristan, from the Persian word bimar, `ill person', and stan, `place.' Some accounts associate the name of the early Umayyad caliph al-Walid I, who ruled from 705 to 715 (86-96 H), with the founding of a hospice, possibly a leprosarium, in Damascus. Other versions, however, suggest that he only arranged for guides to be supplied to the blind, servants to the crippled, and monetary assistance to lepers.
The earliest documented hospital established by an Islamic ruler was built in the 9th century in Baghdad probably by the vizier to the caliph Harun al-Rashid. Few details are known of this foundation. There is no evidence to associate the construction of the earliest hospital with any of the Christian physicians from Gondeshapur in southwest Iran, but the prominence of the Bakhtishu` family as court physicians would suggest that they also played an important role in the function of the first hospital in Baghdad.
In little more than a hundred years, 5 additional bimaristans had been built in Baghdad. According to some accounts, directions were given by a vizier in the early 10th century to provide medical care to prisons on a daily basis and visits by doctors with a traveling dispensary to villages in lower Iraq. The most important of the Baghdad hospitals was that established in 982 (372 H) by the ruler `Adud al-Dawlah. When it was founded it had 25 doctors, including oculists, surgeons, and bonesetters. In 1184 (580 H) a traveller described it as being like an enormous palace in size.
In Egypt, the first hospital was built in the southwestern quarter of present-day Cairo in 872 (259 H) by Ahmad ibn Tulun, the `Abbasid governor of Egypt. It is the earliest for which there is clear evidence that care for the insane was provided. By the end of the century, two hospitals were also said to have been built in Old Cairo (Fustat), though the evidence on this point is questionable. In the 12th century, Saladin founded the Nasiri hospital in Cairo, but it was surpassed in size and importance by the Mansuri, completed in 1284 (638 H) after eleven months of construction. The Mansuri hospital remained the primary medical center in Cairo through the 15th century. The Nuri hospital in Damascus was a major one from the time of its foundation in the middle of the 12th century well into the 15th century, by which time the city contained 5 additional hospitals.
Besides those in Baghdad, Damascus, and Cairo, hospitals were built throughout Islamic lands. In al-Qayrawan, the Arab capital of Tunisia, a hospital was built in the 9th century, and early ones were established at Mecca and Medina. Iran had several, and the one at Rayy was headed by al-Razi prior to his moving to Baghdad. Ottoman hospitals flourished in Turkey in the 13th century, and there were hospitals in the Indian provinces. Hospitals were comparatively late in being established in Islamic Spain, the earliest possibly being built in 1397 (800 H) in Granada.
Of the great Syro-Egyptian hospitals of the 12th and 13th centuries, we possess a considerable amount of information. They were built on a cruciform plan with four central iwans or vaulted halls, with many adjacent rooms including kitchens, storage areas, a pharmacy, some living quarters for the staff, and sometimes a library. Each iwan was usually provided with fountains to provide a supply of clean water and baths. There was a separate hall for women patients and areas reserved for the treatment of conditions prevalent in the area -- eye ailments, gastrointestinal complaints (especially dysentery and diarrhoea), and fevers. There was also an area for surgical cases and a special ward for the mentally ill. Some had an area for rheumatics and cold sufferers (mabrudun). There frequently were out-patient clinics with a free dispensary of medicaments. The staff included pharmacists and a roster of physicians who were required at appointed times to be in attendance and make the rounds of patients, prescribing medications. These were assisted by stewards and orderlies, as well as a considerable number of male and female attendants who tended the basic needs of the patients. There were also instructors (mu`allimun), possibly aspiring medical students, who trained the non-professional staff. The budget of such institutions must have been considerable, and in fact the budget of the Mansuri hospital in Cairo was the largest of any public institution there. Over the entire staff and responsible for the management of the hospital was an administrator who was not usually trained in medicine. In most instances he was a political appointment, subject to the unpredictable fluctuations of political favor, for the position of controller of a hospital was a very lucrative one. The chief of staff, on the other hand, was a medical man.
All the hospitals in Islamic lands were financed from the revenues of pious bequests called waqfs. Wealthy men, and especially rulers, donated property as endowments, whose revenue went toward building and maintaining the institution. The property could consist of shops, mills, caravanserais, or even entire villages. The income from an endowment would pay for the maintenance and running costs of the hospital, and sometimes would supply a small stipend to the patient upon dismissal. Part of the state budget also went toward the maintenance of a hospital. The services of the hospital were to be free, though individual physicians might charge fees.
Little detailed information is available regarding the hospitals as teaching institutions. We have accounts of teaching at certain hospitals, such as the `Adudi hospital in Baghdad, but how many hospitals had such formal classes is not known. Clinical training at bedside in a hospital, whether as an apprentice or through formal instruction, was, however, a part of medical learning for a substantial number of formally trained physicians. In the medical writings, such as the encyclopedia by al-Majusi, there was frequent encouragement of students to acquire clinical training.
Medieval Islamic hospitals[edit]
Main articles: Medicine in the medieval Islamic world and Bimaristan
The first Muslim hospital was an asylum to contain leprosy, built in the early eighth century, where patients were confined but, like the blind, were given a stipend to support their families.[63] The earliest general hospital was built in 805 CE in Baghdad by Harun Al-Rashid.[64][65] By the tenth century, Baghdad had five more hospitals, while Damascus had six hospitals by the 15th century and Córdoba alone had 50 major hospitals, many exclusively for the military.[63] Many of the prominent early Islamic hospitals were founded with assistance by Christians such as Jibrael ibn Bukhtishu from Gundeshapur.[66][67] "Bimaristan" is a compound of “bimar” (sick or ill) and “stan” (place). In the medieval Islamic world, the word "bimaristan" referred to a hospital establishment where the ill were welcomed, cared for and treated by qualified staff. The United States National Library of Medicine credits the hospital as being a product of medieval Islamic civilization. Compared to contemporaneous Christian institutions, which were poor and sick relief facilities offered by some monasteries, the Islamic hospital was a more elaborate institution with a wider range of functions. In Islam, there was a moral imperative to treat the ill regardless of financial status. Islamic hospitals tended to be large, urban structures, and were largely secular institutions, many open to all, whether male or female, civilian or military, child or adult, rich or poor, Muslim or non-Muslim. The Islamic hospital served several purposes, as a center of medical treatment, a home for patients recovering from illness or accidents, an insane asylum, and a retirement home with basic maintenance needs for the aged and infirm.[68]
The typical hospital was divided into departments such as systemic diseases, surgery and orthopedics with larger hospitals having more diverse specialties. "Systemic diseases" was the rough equivalent of today's internal medicine and was further divided into sections such as fever, infections and digestive issues. Every department had an officer-in-charge, a presiding officer and a supervising specialist. The hospitals also had lecture theaters and libraries. Hospitals staff included sanitary inspectors, who regulated cleanliness, and accountants and other administrative staff.[63] The hospital in Baghdad employed twenty-five staff physicians.[69] The hospitals were typically run by a three-man board comprising a non-medical administrator, the chief pharmacist, called the shaykh saydalani, who was equal in rank to the chief physician, who served as mutwalli (dean).[70] Medical facilities traditionally closed each night, but by the 10th century laws were passed to keep hospitals open 24 hours a day.[71]
For less serious cases, physicians staffed outpatient clinics. Cities also had first aid centers staffed by physicians for emergencies that were often located in busy public places, such as big gatherings for Friday prayers to take care of casualties. The region also had mobile units staffed by doctors and pharmacists who were supposed to meet the need of remote communities. Baghdad was also known to have a separate hospital for convicts since the early 10th century after the vizier ‘Ali ibn Isa ibn Jarah ibn Thabit wrote to Baghdad’s chief medical officer that “prisons must have their own doctors who should examine them every day”. The first hospital built in Egypt, in Cairo's Southwestern quarter, was the first documented facility to care for mental illnesses while the first Islamic psychiatric hospital opened in Baghdad in 705.[72][63]
Medical students would accompany physicians and participate in patient care. Hospitals in this era were the first to require medical diplomas to license doctors.[73] The licensing test was administered by the region's government appointed chief medical officer. The test had two steps; the first was to write a treatise, on the subject the candidate wished to obtain a certificate, of original research or commentary of existing texts, which they were encouraged to scrutinize for errors. The second step was to answer questions in an interview with the chief medical officer. Physicians worked fixed hours and medical staff salaries were fixed by law. For regulating the quality of care and arbitrating cases, it is related that if a patient dies, their family presents the doctor's prescriptions to the chief physician who would judge if the death was natural or if it was by negligence, in which case the family would be entitled to compensation from the doctor. The hospitals had male and female quarters while some hospitals only saw men and other hospitals, staffed by women physicians, only saw women.[63] While women physicians practiced medicine, many largely focused on obstetrics.[74]
Hospitals were forbidden by law to turn away patients who were unable to pay.[71] Eventually, charitable foundations called waqfs were formed to support hospitals, as well as schools.[71] Part of the state budget also went towards maintaining hospitals.[63] While the services of the hospital were free for all citizens[71] and patients were sometimes given a small stipend to support recovery upon discharge, individual physicians occasionally charged fees.[63] In a notable endowment, a 13th-century governor of Egypt Al Mansur Qalawun ordained a foundation for the Qalawun hospital that would contain a mosque and a chapel, separate wards for different diseases, a library for doctors and a pharmacy[75] and the hospital is used today for ophthalmology.[63] The Qalawun hospital was based in a former Fatimid palace which had accommodation for 8,000 people -[76] "it served 4,000 patients daily."[77] The waqf stated,
...The hospital shall keep all patients, men and women, until they are completely recovered. All costs are to be borne by the hospital whether the people come from afar or near, whether they are residents or foreigners, strong or weak, low or high, rich or poor, employed or unemployed, blind or sighted, physically or mentally ill, learned or illiterate. There are no conditions of consideration and payment, none is objected to or even indirectly hinted at for non-payment.[75]
The first, most well known physicians in the Medieval Islamic world were polymaths Ibn Sina, (Greek: Avicenna) and Al Rhazi (Greek: Rhazes) during the 10th and 11th centuries.[78]
要するにイスラム教徒や親イスラム派は例外無く反Godなわけです。
ペルシア医学・イスラム医学[編集]
詳細は「en:Medicine in medieval Islam」および「ユナニ医学」を参照
- ペルシア医学
ペルシアの医学研究および実践は長く豊かな歴史を持っている。ペルシアは東洋・西洋の交易路に位置するため、しばしばギリシアとインド両方の医学の発展を享受した。
東ローマ帝国と敵対していたサーサーン朝は、キリスト教徒による異端・異教徒の迫害を逃れたアレクサンドリアやアテナイの学者たちを積極的に受け入れ、ジュンディーシャープールに学者や生徒たちが集い、各国の医学書が翻訳され盛んに研究が行われた。教育を行う病院が考案されたのは、ジュンディーシャープール大学であるとも言われている。
- イスラム医学
ムスリムやキリスト教ネストリウス派など、様々な宗教・人種の医師、錬金術師、薬剤師たちによる、解剖学・眼科学・薬理学・薬学・生理学・外科学・製剤科学などの医学領域への多大な貢献により、イスラム文化はは古代ギリシア・ローマの医学技術をさらに発展させた。ガレノスとヒポクラテスが過去の典拠となっていた[29]。830年ごろから870年ごろまでのガレノスの著作129点は、フナイン・イブン・イスハークとその助手たちによってアラビア語に翻訳された。その中でも特にガレノスの主張する理性的・体系的な医学のアプローチが、イスラム医学のひな型として、イスラム帝国内に素早く広まった。医師によって初めて専門病院が設立された。専門病院はその後十字軍遠征の間にヨーロッパに広まったが、これも中東の病院から着想を得たものである[30]。
キンディー (801 - 873?)は『De Gradibus』を著し、数学を医学(特に薬学)へ適用して論じた。キンディーは『De Gradibus』の中で、薬の強さの度合いを測る数学的な軽量法や、医者が患者の病気の最も危険な時期を特定する仕組みを開発した[31]。
アル・ラーズィー(865-925)は自身の経験した臨床事例を記録し、様々な病気について有用な記録を残した。『包含の書』(al-Hawi, アル=ハーウィー)は、アル・ラーズィー(ラテン名でラゼス(Rhazes)とも呼ばれる)の最大の著作集である。この中で、ラーズィーは自らの経験による臨床事例を記録し、様々な病気の有用な記録を残している[32]。ラーズィーの『天然痘と麻疹の書』(al-Judari wa al-Hasbah)では麻疹と天然痘について記述し[33]、ヨーロッパに大きな影響を与えた。『ガレノスに対する疑念』(Al-Shukuk ʿala Jalinus、英:Doubts About Galen)では経験的な方法から四体液説の誤りを証明するなど、ガレノス医学に批判を加えた[34]。また錬金術に対する知識も深く、医師活動の中で意図的にアルコールを用いた初めての医師となった。
アブー・アル=カースィム・アッ=ザフラウィー(アブルカシム)は近代外科学の父と考えられ[35]、30巻の医学事典「Kitab al-Tasrif」を著した。これは17世紀までイスラム圏とヨーロッパの医学部で教材に使われた。アブルカシムは女性にのみ用いるものも含め、数多くの手術用具を用いた。これには腸線・鉗子・結紮糸・手術針・メス・キューレット・開創器・手術用スプーン・ゾンデ・手術用フック・手術用ロッド・膣鏡[36]・骨用鋸[37]・漆喰[38]などがある。
ムータジラ派の哲学者でもあった[要出典]イブン・スィーナー(980 - 1037、ラテン名アヴィケンナ)は、医学の父といわれ[39]、歴史上最高の思想家・医学者のひとりである[30]。著書『医学典範』(1020)および『癒しの書』(11世紀)は、17世紀までイスラム圏とヨーロッパの標準テキストであり続けた[40]。イブン・スィーナーの業績には、体系的な生理学研究の中に実験と量化を導入したこと[41]、感染症の感染性質の発見、感染症の拡散を抑制するための検疫の導入、実験医学・治験の導入[42]の他にも、細菌・ウイルスについて[43]、縦隔炎と胸膜炎の区別、結核の感染性質、水や土からの病気の蔓延、肌荒れについての詳細な記述、性感染症、倒錯、神経系の失調などの記述を初めて行い[30]、また発熱に対して氷を用いたり、薬理学・医学を区別したり(製薬科学の発展において重要)もした。
1021年、イブン・アル=ハイサム(アルハセン)(965 - 1040)によって眼科手術の重要な進歩があった。アル=ハイサムは視界と視覚のプロセスを研究し、著書『Kitab al-Manazir』(光学の書)の中で初めて正しく説明した。
イブン・アル=ナフィスは、初めて肺循環と冠動脈について記して[44]循環系の基礎を作ったため、循環理論の父と呼ばれる[45]。アル=ナフィスはまた、代謝の概念を最初に述べた[46]。また生理学および心理学の新しい体系を作り上げて、イブン・スィーナーやガレノスの体系に取って代わった。この中でアル=ナフィスは彼らの四体液説、脈動[47]、骨、筋肉、腸、感覚器、胆汁、管、食道、胃などについての誤った考えを批判した[48]。 イブン・アル=ルブディは四体液説を否定し、人体およびその保全は血液のみによることを発見した。また女性が精液を生産できるというガレノスの節を否定し、動脈の動きは心臓によるものではないこと、胎児の体で最初に作られる臓器は心臓だということ(ヒポクラテスは脳だと考えていた)、頭蓋骨を作る骨は腫瘍になりうるということを発見した[49]。モーシェ・ベン=マイモーン(マイモニデス)はユダヤ人だったが、13世紀のイスラム医学に様々な貢献を果たした。
マンスール・イブン・イリヤスの『人体解剖書』(Tashrih al-badan 1390年ごろ)には、人体構造上の神経系・循環器系の全図が掲載された[50]。14世紀のアンダルスにおけるペスト・腺ペスト流行期に、イブン・カティマとイブン・アル=カティブは、伝染病は人間の体に入り込む微生物が原因であることを発見した[51]。その他にもムスリムの医師によってなしとげられた医学上の発展には、免疫系の発見、微生物学の導入、動物実験の活用、他の科学分野とのコンビネーション(農学・植物学・化学・薬理学など)、注射器の発明(9世紀イラク アマー・イブン・アリ・アル=マウシリによる)、最初の薬局の誕生(バグダード 754年)、医学と薬学の区別(12世紀以前)、2000種類以上の医学・化学物質の発見などがある[52]。
現代の『西洋医学』 の原点はイスラム教と言っても過言じゃないんだゾ☆
実質的に米国の暴力病院医療利権にD-Flagだゾp
https://jyado.blogspot.com › 2023/11 › d-flag
5 日前 — 2023年11月10日金曜日. 実質的に米国の暴力病院医療利権にD-Flagだゾ☆. Netflix. 27.2M subscribers. Take Care of Maya | Official Trailer | Netflix.
イスラエル軍がガザのギリシャ正教教会に空爆 ターゲットは暴力病院 ...
https://jyado.blogspot.com › 2023/10 › blog-post_80
暴力病院と暴力教会. 2023年10月19日木曜日. NYTのIsraeli Strike改めStrike改めBlastが非常に不都合なキリスト教系のアル・アハリ・アラブ病院爆破のSIN実のConfirmation.p
暴力医療法人「颯心(そうしん)会」関係者がヤクザにダンプで突入 ...
https://jyado.blogspot.com › 2023/11 › blog-post_8
だから暴力病院だとあれほど… 2023年11月7日火曜日. 永遠に勝てない戦いを続けた挙句の果てに『バテレンの掌の上のワンダーランドの病院』で… https://jyado.blogspot ...
埼玉の病院で発砲事件、その後犯人は郵便局に立てこもりだゾp
https://jyado.blogspot.com › 2023/11 › blog-post
まあ暴力病院はガザで外出なので… 天皇陛下のマイ郵便局に迫る危機Part2 http ... 病院襲撃前に火災、犯行前の証拠隠滅か、西梅田で病院燃やした奴と同じ事やってます ...
頭が空っぽそうな「みおしん」医師が藁の『十字架』に『釘』を ...
https://jyado.blogspot.com › 2023/10 › blog-post_24
2023/10/20 — 2023年10月20日金曜日. イスラエル軍がガザのギリシャ正教教会に空爆 ターゲットは暴力病院と暴力教会. ハマス➡アングリカン/バプティスト病院.
パレスチナ国家を承認した国々=地球の癌の進行推進派
https://jyado.blogspot.com › 2023/10 › blog-post_90
イスラエル軍がガザのギリシャ正教教会に空爆 ターゲットは暴力病院と暴力教会. https://jyado.blogspot.com/2023/10/blog-post_80.html. 、、、(爆 ...
千束、それ慈善団体「アラン機関」やない
https://jyado.blogspot.com › 2023/10 › blog-post_925
2023/10/29 — 李さんが✭になった曙光病院から芋づる式に. https://jyado.blogspot.com/2023/10/blog-post_913.html. 暴力病院と言えば… リコリス・リコイル
ブルネイ兄さん他イスラム園の方々!吉田さんが支援が足りん ...
https://jyado.blogspot.com › 2023/10 › blog-post_29
2023/10/22 — 暴力教会暴力病院暴力学校が木端になって各勢力が居なくなれば同族嫌悪的な抗争が待ってマースw. 返信削除. 返信. 返信. 匿名 2023年10月22日 16:11. ミニ ...
ワクチン接種推進担当大臣、いつのまにか廃止
返信削除https://twitter.com/mysweetmoon1983/status/1724295046147854369
アララ羅~コララ羅~
返信削除出た、シルクロードで来なくて良かったヤツ
女医は出産の為がためってのが
(産婆って位置なんでしょうけど)これまた
7,8世紀の建造物ってのも今も尚大事がってるとこなんかも
極東に
6世紀には既に来た織物 錦 も謹んでお返ししたらええねん
ぇ?間に合わなさスギ て?
>負傷・けがの治療を目的とした西洋医療は科学 病気治療を目的とした西洋医学はオカルト・呪い術・魔術
https://tokumei10.blogspot.com/2021/08/blog-post_98.html
無敵じゃないんでこれがキープされてるんなら
せめて科学じゃない方
存分にパージされてねんのねんのねーん だ
寝言下痢ヲくんおはようさんw
削除またおまいさんのアフォなお仲間が発作起こしてるようですがw
https://jyado.blogspot.com/2023/11/too-late.html
匿名2023年11月13日 13:50
増税メガネ君のインスタのコメント欄ヤバスwwww
もうみんなにバレてるみたいねワクチン打ったらどうなるか
返信
返信
匿名2023年11月13日 14:43
そんなもんにかじりついてる意味があると思い込んでるのはニート糖質君だけ
無能な日本の政治家よりワクチン製造企業のオエライさんに凸った方がいいよ
Googleウンコ翻訳英語貼り付けてスパム扱いされるのがオチだと思うけどw
匿名2023年11月13日 14:48
やっぱりネットゲリラ一味が釣れましたwww
匿名2023年11月13日 15:18
2023年11月13日 13:50 だけど
>2023年11月13日 14:43
なんだコイツ?w
なんで凸しなきゃならないの?
頭大丈夫かお前?w
>そんなもんにかじりついて
勝手に流れてきたんだけどwしかも昨日の話だよw
かじりついてるのはお前だろw
匿名2023年11月13日 15:28
>2023年11月13日 14:48
あー、こいつらですか、最近ウザいひーちゃんとこの残党ってのはw
アクセス乞食から団長情報乞食という下等動物になってるんですねwwww
匿名2023年11月13日 23:20
>団長情報乞食
的確な表現でワロタwwww
返信
>ミネ2023年11月15日 5:45
削除秀才さんとこ嗅ぎまわってた話出してて草
ミネは医療ヒーラーw
削除オツムガバガバリエルお婆ちゃんはエアプヒーラーっすかw
削除まさに反GODパシリの同士討ちっすねwww
>2023年11月15日 20:45
削除見守りうんこクンスクランブルいらっしゃいw
秀才さんの話がマズかったかな?www
秀才って何?w
削除自分で秀才とか言ってる異常に自己評価高いやつがいんの?w
何に勝利宣言してんの?w
>匿名2023年11月16日 9:30
削除図星突かれてて草
>匿名2023年11月16日 9:43
削除そりゃ取り込めたと思ってたのに梯子外されたからねw
>匿名2023年11月16日 9:30
削除で、ここで喚きちらしてたお前のお仲間の馬鹿はどうしたの?w
https://tokumei10.blogspot.com/2022/08/blog-post_77.html
イスラム世界が
返信削除欧州地域に進出した頃は
数学始め科学が最新だった状況
欧州がそれを取り入れてましたもんね
Ralph Ellis のJesus関係の本に、Jesusは、エジプトとパルティア(ペルシア)の血筋だと書いています。
返信削除本当かどうか知りませんが。
https://twitter.com/shinchouha/status/1724511885553242473
返信削除mRNAワクチンは免疫を抑制する、陰謀論者の中では常識的になった知識を
MSMで放送
Hospitality
返信削除お・も・て・な・し 爆
米ファイザー、英で500人削減へ コストカットの一環
返信削除11/15(水) 10:34配信
ロイター
[14日 ロイター] - 米製薬大手ファイザーは14日、英ケント州サンドウィッチの拠点で500人を削減すると発表した。35億ドルのコスト縮小プログラムの一環。
同社は10月に通年の売上高見通しを引き下げ、コスト削減を発表していた。その後発表した第3・四半期決算は2019年以来初めて赤字に転落した。
ファイザーは世界で約8万3000人の従業員を抱えているが、コスト削減プログラムの影響を受ける人数は明らかにしていない。
広報担当は声明で「当社では営業の効率と効果を上げるため、さまざまな部門で変更が行われている」などと説明した。