Учебное пособие (Методичка) по Истории Медицины. И.Ю.Худоногов

Theme 8. Medicine in Russia in the XVIII century

Major changes took place at the turn of the XVII-XVIII centuries in the economic, political and cultural life of Russia. New commodity-money relations began to take shape, the formation of the Russian capitalist market went on. The beginning of the 18th century was marked by Peter's reforms, which were the impetus for the further growth of the country's economic potential. The reforms of Peter I aimed to create a strong, independent power, able to defend their vital interests and take their rightful place among other states. Transformation of Peter I significantly contributed to the development of medical affairs, the distinguishing feature of which was the preservation of the state character. Despite the difficulties associated with large-scale reforms, the state sought to take care of protecting the health of citizens, especially the military (almost the entire male population of draft age was put under arms), spending significant amounts from the treasury and managing all the medicine in the country Peter I was always interested in medicine, was present at autopsies, involved in anatomy and minor surgery. He was familiar with famous naturalists and doctors of Western Europe: G. Burhaave, F. Ruysch, A. van Levenguk, I. Newton, was interested in their scientific achievements. F. Ruysch, Peter I acquired for 30,000 Dutch guilders the famous anatomical cabinet of “monsters” (born with malformations), the exhibits of which have survived to the present in the museums of St. Petersburg and Kazan. Most of the effort, time and money of Peter I was spent on wars, because of it there was possible to carry out reforms and transformations in the country only if there was no threat of an attack from outside. In the north-west it was a long twenty-year (Northern) war with Sweden, as a result of which Russia gained access to the Baltic Sea, and on the shore of the Finland Gulf in 1703 the St. Petersburg city (the city of St. Peter) was laid down. In the south, a war was fought with Turkey for access to the Azov Sea, and then the Black Sea. And in the southeast, the war was with Persia (Iran) over access to the northern coast of the Caspian Sea. Under Peter I, for the first time in Russia, a standing army and a regular fleet (military and merchant) were created. During the period of hostilities,

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the flow of the wounded, which had to be treated, increased sharply, i.e. an acute need for military doctors, as well as the need for training in medicine arose. Peter I sent Russian people to study at the best Western European universities in Leiden, Padua, Krakow, etc. At the beginning of the XVIII century, Peter I invited 150 specialists from abroad, including doctors to establish production and medical services in Russia. However, all it was expensive and did not solve the problem. Therefore, the sovereign's goal became to train his specialists, including doctors, in Russia with the help of foreigners. For this, the first permanent military hospitals (sea and land) began to be created, in which medical (hospital) schools were opened. The first permanent land military hospital was founded in Moscow (now the Main Military Hospital named after I.N. Burdenko) in 1707, and with it a hospital school was opened. Later, hospitals and schools attached to them were established in St. Petersburg (1718), Kronstadt (1720), Revel (1720), Kazan (1722), Astrakhan (1725) and other cities. 10 hospitals and more than 500 hospitals were created during the life of Peter Nikolai Bidloo (student of G. Burhaave), invited to Russia by Peter I and initially held the position of a life doctor, headed the first hospital and hospital school in Moscow. He was a highly educated doctor, an excellent anatomist, surgeon and obstetrician, an expert in painting, architecture, music, an exceptionally honest, principled, friendly, energetic and persistent person. He created the project, completed the construction of the hospital and was the founder of professional medical education in Russia. Graduates of seminaries and the Moscow Slavic-Greek-Latin Academy, who knew Latin, were accepted to school regardless of origin. These were young people of democratic origin, immigrants from the lower layers of society, primarily from the petty clergy, artisans, Cossacks and soldiers; healers' children were among them as well. Forced to achieve everything with their own labor, they looked at teaching as work and for the most part engaged with desire with pleasure, i.e. motivated. The program of 5-7-year education included anatomy, surgery with desmurgy, internal diseases with pathological autopsy, “Materia Medica” (pharmacy science), Latin and drawing. Due to the lack of textbooks, teaching was based on rare books by

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well-known European scholars, but usually on manuscript books authored by N. Bidloo. Anatomy training was carried out on corpses; osteology was studied on skeletons and individual bones. Pharmacists of the hospital H. Eichler, then - I. Maak taught pharmacy science. There was a pharmacy garden at the hospital, and in the summer and autumn, the students together with the pharmacist went out of town to collect medicinal plants and replenish the hospital pharmacy. Internal medicine included private pathology and therapy. N. Bidloo taught surgery, and desmurgy was taught by his assistants: doctor Repken and doctor F. Bogdanov. After study course, the graduate not only passed theoretical exams, but had to perform 3-4 operations on a corpse on his own, i.e. show your knowledge as a surgeon and anatomist. Graduates of hospital schools who were competent in both surgery and therapy were sent to the army and navy. Thus, the training program for future doctors at the Moscow hospital school rich, not inferior, and in some ways even superior to the programs of medical faculties of Western European universities, in most of which scholasticism still prevailed. The main advantage was the practical training of future doctors at the patient's bedside, a high general educational level. The teaching system in hospital schools had been constantly improved. There were many talented teachers and scientists among teachers, such as K.I. Shchepin, P.I. Pogoretsky, K.O. Yagelsky, G.F. Sobolevsky, M.M. Terekhovsky, N.M. Maksimovich-Ambodik, M.I. Shein, P.M. Shumlyansky, L.F. Shafonsky, F.T. Tikhorsky. It should be noted that K.I. Shchepin was the first to give lectures on anatomy and surgery in Russian. Despite all the difficulties, the training of domestic doctors in hospital schools fully justified itself and existed for almost the entire 18th century. After the reform of medical education carried out by the first president of the Medical Chancellery P.Z. Condoidi, physiology, obstetrics, childhood diseases began to be taught in hospital schools, the examination system was improved. In 1786, hospital schools were separated from hospitals and transformed into medical-surgical schools, and in 1798, on the basis of schools in Moscow and St. Petersburg, Medical-Surgical Academies were created. Under Peter I, attempts were made to organize the birth and death rate

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records: keeping registers of births, where information about births and deaths of males was entered, was the responsibility of the clergy. Such a one-sided registration existed until the end of the 19th century, when in 1897 the first general census of the population of Russia was carried out. The Medical Chancellery, headed by the archiatrist (supreme physician), created instead of the Aptekarskiy prikaz, start to organize medical affairs in Russia since 1716. Dr. R. Erskine (Scotsman, descendant of a noble family), a close associate and friend of Peter I, became the first archiatrist. Thus, the state character of medicine was preserved and strengthened. The Medical Chancellery became the main governing body of medical affairs. All medical institutions, no matter which department or individual they belonged to, were subordinate to the medical Chancellery. During the period of R. Erskine had been of the archiatrist in St. Petersburg, the Admiralty and land hospitals were established, hospitals in Moscow, Revel, Kronstadt and other cities were founded. “Free” (private) pharmaci under the control of the Medical Chancellery were opened, the Pharmaceutical gardens where medicinal plants were grown, were organized and expanded In Moscow, such a garden for plants (now a botanical garden) was founded in 1706. In 1716, the Military Regulations (Ustavy), according to which a certain staff of medical personnel in the army and navy was envisaged, was adopted. At the beginning of the 18th century, women's care was first organized in military hospitals. Peter I issued a decree (1722) on the appointment of nuns to hospitals. And soon, in some hospitals, nuns-matrons with assistants to supervise linen and hospital workers were assigned. However, after the death of Peter I, Catherine I, who ascended the throne, canceled this decree and the nuns were returned to the monasteries.

At Peter I the study of domestic medicinal mineral springs and their use began (in Staraya Russa, Olonets Territory, Lipetsk). For the correct use of mineral springs, the "Dokhturskie Rules" were drawn up with the participation of Peter I. A number of decrees were adopted on the supervision of food in the markets, on the protection of meat from pollution, on the improvement of Moscow, on the care of foundlings. In St. Petersburg, an instrumental workshop for the repair and

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manufacture of surgical instruments (now a medical equipment plant in St. Petersburg) was opened. By decree of Peter I, expeditions to Siberia to study the local flora and fauna were organized; turpentine and rosin factories were opened. In 1725, the Imperial Academy of Sciences opened in St. Petersburg. L. Blumentrost became its first president. The Academy was not only a scientific, but also an educational institution. A gymnasium, an academic university, a library, the Kunstkamera, an astronomical observatory, an anatomical theater and a botanical garden were created at the Academy.

Mikhailo Vasilievich Lomonosov, a brilliant encyclopedic scientist, naturalist and educator, became the first Russian member of the Academy of Sciences. An extraordinary curiosity, a thirst for knowledge, faith in the power and possibilities of enlightenment, the search for truth and uncompromising in its defense allowed M.V. Lomonosov to reach the heights of world science, i.e. in many areas of knowledge far ahead of Western European scientists. A new stage in the development of Russian science and medicine is associated with the founding of Moscow University, consisting of faculties (philosophy, law and medicine), organized on the initiative of I. Shuvalov, designed by M.V. Lomonosov, in accordance with the decision of the Senate (1754). The decree on its establishment was signed by Empress Elizaveta Petrovna on January 12 (25), 1755. The University opened in May 1755. Due to the lack of professors and economic difficulties, the Faculty of Medicine began work in 1764, when professors I.Kh. Kershtens, who taught chemistry and mineralogy, and I.F. Erasmus, who taught a course in anatomy, surgery and “babich'ego iskusstva” (gynecology and obstetric), were invited. 16 students were enrolled in the 1st year of the Faculty of Medicine. Education at the faculty lasted three years; it was theoretical and was limited only to lecturing. There was no basis for practical training, and students were recruited every three years due to a shortage of professors.

Semyon Gerasimovich Zybelin (1735-1802) became the first Russian professor of the medical faculty. After graduating from the Slavic-Greek-Latin Academy and Moscow University, he was sent to Leiden University, where he defended his

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dissertation and received his doctorate in medicine. Returning to Moscow University in 1765, S.G. Zybelin was the first to teach medical disciplines in Russian, and not in Latin (before him, MV Lomonosov began teaching physics in Russian in 1746.) S.G. Zybelin taught various disciplines, but paid most attention to the issues of therapy, hygiene, pediatrics, dietetics, and public medicine. Possessing excellent oratorical skills, he often delivered keynote speeches (“Words”) on various issues of medicine. In 1784 S.G. Zybelin was elected a member of the Imperial Academy of Sciences for lecturing in Russian and developing anatomical terminology. Until the end of the 18th century Moscow University did not have its own permanent clinical base. To obtain practical skills, students were sent for several months to the Moscow military hospital. In 1797, the hospital assigned one permanent clinical ward (10 beds) for the Faculty of Medicine, which became the first clinical base, Efrem Osipovich Mukhin was in charge of it. In the first decades of the university's existence, professors F.F. Keresturi, P.D. Veniaminov, I.A. Sibirskiy, I.I. Vech, F.G. Politkovsky, M.I. Skiadan and F.I. Barsuk-Moiseev, who became the first doctor of medicine to defend his dissertation at Moscow University (1794). Professor F.G. Politkovsky created a natural history museum at Moscow University, which, according to contemporaries, was one of the best and richest museums in the world. Professor Nestor Maksimovich Maksimovich-Ambodik (1744 -1812) was one of the talented Russian scientists of the 18th century, the founder of scientific obstetrics, pediatrics and pharmacognosy in Russia. He was the author of the first Russian scientific manual on obstetrics and pediatrics “The art of obstetrics, or the science of babich'em dele (woman's medical problems)”. This work contains extensive information on physiological, pathological and operational obstetrics, on the hygiene of newborns, their feeding, care of young children. N.M. MaksimovichAmbodik was the first in Russia to conduct classes on the obstetric phantom (model of the female pelvis and fetus); using it to study the mechanism of childbirth and teach obstetric techniques and operations, he was one of the first to use obstetric forceps. The scientist devoted much effort to the creation of domestic

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scientific medical terminology. He compiled “Anatomical-physiological dictionary”, “Medical-surgical dictionary”, “New botanical dictionary”, fourvolume “Medical substance studies”. N.M. Maksimovich-Ambodik taught obstetrics at the St. Petersburg Medical-Surgical School and at the school of “midwives”. Doctor Danila Samoilovich Samoilovich (1742-1805) played an important role in the fight against epidemics, became the founder of Russian epidemiology and consistently developed the ideas of M.V. Lomonosov. D.S. Samoilovich devoted a lot of effort to studying the plague, was a supporter of the contagious theory of the spread of the disease, and participated in the elimination of plague epidemics in various cities of Russia. For the first time in Russia, he gave a detailed description of the clinical picture of the plague, studied the conditions of spread and the ways of the disease transmission, for the first time expressed the idea of the specificity of plague, to which he devoted his main scientific works. His life is an example of dramatic medicine.

The activities of the writer A.N. Radishchev (1749-1802) (the first Russian republican) dates back to the end the 18th century. Along with the issues of socio-political restructuring of Russia, A.N. Radishchev raised a number of issues of public health in his famous book “Travel from St. Petersburg to Moscow” (the difficult labor, bad sanitary conditions of the Russian countryside, the importance of a healthy lifestyle, proper nutrition and care for children, the role of hygiene, etc.). More than 200 books on medicine were published in Russian by the end of the 18th century in Russia. The first medical journal in Russia, St. Petersburg Medical Bulletin, published from 1792 to 1794, also contributed to the development of medical science in the country. Pox vaccination was introduced in the second half of the 18th century (first variolation, and since 1801 – vaccination). Vaccination centers – “smallpox houses” were opened everywhere. Significant changes took place under Catherine II in the management of medical affairs in Russia. In 1763 the Medical Chancellery was transformed into the Medical Collegium, which was headed by the President (not a doctor). Public charity Prikazy (orders, institutions) were created in 1775 in all provinces of the Russian

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Empire. Representatives of all classes took part in their work. Their main function was to organize orphanages, almshouses, hospitals and pharmacies. The regular posts of the county doctor were introduced. Provincial medical councils under the supervision of the Medical Collegium were established in 1797. Democracy (not aristocratic origin, domestic direction of activity for equality), patriotism (struggle against foreign domination, for the original national science and culture, for the rights of Russian scientists), a materialistic worldview were the main features of the advanced Russian doctors of the 18th century. The leading physicians of Russia considered observation and experience to be the basis of the study of medicine. The successes of Russian medical science in various fields in the 18th century were the basis for its subsequent development in the 19th century. However, the general state of public health protection remained very unfavorable (high mortality, morbidity, epidemics, insufficient medical assistance to the population).

Questions for self-control:

1. What socio-economic conditions have developed in Russia at the turn of the

XVII-XVIII centuries?

2.What prompted Peter I reforms in the field of training medical personnel and organization of medical business?

3.How has the appearance of the first permanent hospitals and hospital schools influenced the development of domestic medical science and practice in Russia?

4.What sanitary and recreational activities were carried out by the will of Peter I in the capitals, army and navy in the first quarter of the 18th century?

5.Why did Peter I want to open the Academy of Sciences and Arts in St. Petersburg, what functions was it supposed to perform and what significance did it have for the future of Russian science and culture?

6.What is the reason for the foundation of Moscow University and the Faculty of Medicine attached to it; how did this event affect the training of Russian scientific personnel?

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7.What are the merits of M.V. Lomonosov in front of domestic science and medicine ensured its rapid development?

8.What role did the leading doctors and scientists of Russia (K.I. Shchepin, S.G. Zybelin, D.S. Samoilovich, N.M. Maksimovich-Ambodik and others) play in the creation of an original domestic medicine?

9.What measures were used to combat epidemics in Russia in the 18th century?

10.What features characterized the activities and views of Russian scientists and doctors in the 18th century?

11.Who was the founder of domestic obstetrics, and what was his contribution to medical science?

12.Who was the founder of Russian epidemiology, and what was his contribution to medical science?

13.Who was the first Russian professor of medicine at Moscow University in the 18th century, and what was his contribution medical science?

14.Who was the first Russian professor anatomy and surgery, and what was his contribution to medical science?

15.Who was the first Russian member of the Academy of Sciences and Arts, and what was his contribution medical science?

16.Which Russian scientists worked most fruitfully in the 18th century, and what discoveries did they make?

17.When and where was the first hospital school opened, who headed the hospital and the first school under it in the city of Moscow, and what principles of teaching did he introduce in hospital schools in the 18th century?

18.When and where was the first Academy of Sciences and Arts opened in Russia, who and why was appointed the first president of the Petrovsk Academy of Sciences and Arts?

19.What is the contribution of Peter I to the development of medicine as a natural science and as a system of public health protection?

20.What decrees of Peter I in the field of organization of medical affairs are the

main ones, and why?

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Theme 9. Medicine in Russia in the first half of the 19th century

Shifts in the socio-economic development and social life of the country were outlined in Russia from the second half of the 18th century and were especially intensified by the beginning of the 19th century. They favorably influenced the further growth of the national culture and science. The development of the Russian economy in the first half of the 19th century led to a significant increase in the number of higher educational institutions. Universities were opened in Dorpat (now Tartu, 1802), Vilna (1803), Kazan (1804), Kharkov (1805), Kiev (1841). Military medicine and medical work in Russia were further developed during the Patriotic War of 1812. The war of liberation of the Russian people against the invading Napoleonic troops was one of the most important milestones in the history of our Motherland, a difficult test in which the great moral strength of the nation was manifested. The doctors selflessly performed their professional duty, providing assistance to the wounded and population. Ordinary doctors and scientists, such as professors of Moscow University I.P. Voinov and I.E. Gruzinov, future professor I.E. Dyadkovsky among them. Russian military medicine in the first half of the 19th century has accumulated rich practical experience, and valuable scientific works created by its best representatives. There are among them a work in five parts “Military field medicine” by A.A. Charukovsky, “The experience of the military medical police, or the rules for preserving the health of Russian soldiers in the ground service” by R.S. Chetyrkin, works “A word about the benefits and items of military hygiene” by M. Ya. Mudrov and “Pocket Book of Military Hygiene” by I.I. Enegolm, an essay “Experience of a brief medical survey of the campaign of 1812-1815” by Ya.I. Govorov which should be noted.

M. Ya. Mudrov was dean of the medical faculty of Moscow University before 1812 and after the expulsion of the French. During the war, together with professors of the medical faculty of Moscow University M.Ya. Mudrov left for Nizhny Novgorod, where he provided assistance to the wounded and sick soldiers. He devoted a lot of effort and energy to the restoration of the Faculty of Medicine, the building and property of which were almost completely destroyed by fire.

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