LECTURE No. 5. Medicine in Russia XV-XVII centuries

1. General characteristics of the historical period. Required Concepts

From the middle of the XII to the end of the XV centuries. there was a period of feudal fragmentation in the country.

Causes of feudal fragmentation:

1) the development of feudal agriculture, as well as the formation of a new boyars - estates;

2) weak economic ties between different regions of the country;

3) urban growth;

4) the boyars, interested in a closer and more effective power of the local prince;

5) the fall of the economic and political influence of Kyiv.

February 27, 1425 - the death of Vasily I Dmitrievich, who ruled from 1838-1425. At this time, the feudal war begins.

The results of the feudal war include the following:

1) political instability;

2) recognition of Moscow as the capital;

3) the ruin and weakening of the country, which allowed the Horde and Lithuania to make new seizures of Russian lands;

4) the formation of a cruel, strong princely power in Russia;

5) the victory of the backward center over the economically powerful Galich, which predetermined the development of despotism in Russia.

1480 - the overthrow of the Mongol-Tatar yoke.

1549 - the First Zemsky Sobor was convened - a new body of power dealing with the most important state affairs until the election of a new king.

1530-1584 - years of life of Ivan the Terrible.

1565 - a decree was issued on the oprichnina. The oprichnina was beneficial in that the tsar could replenish the treasury, the army, and also expand his possessions.

Oprichnina results:

1) the unlimited power of the king;

2) the introduction of a "reserved summer" - a temporary prohibition for peasants to leave the feudal lord, even on St. George's Day;

3) ruin of lands. The peasants are moving to the Urals, in the Volga region;

4) the establishment of a historical tradition of unity between the monarch and the boyars;

5) general mistrust that hinders the successful development of the economy;

6) the transformation of many nobles, whose estates and estates were ruined during the oprichnina, into beggars;

7) the oprichnina played a major role (if not decisive) in establishing serfdom in Russia.

1589 - introduction of the patriarchate.

1598-1605 - Board of Boris Godunov.

June 20, 1605 - False Dmitry I entered Moscow.

This time in the history of Russia was called the Troubles. The Time of Troubles is a civil war that clashed various classes: nobles, townspeople, boyars, serfs, peasants.

The causes of the Troubles are as follows.

1. Economic:

1) strengthening the feudal exploitation of the peasantry;

2) the economic crisis that was caused by the oprichnina.

2. Political:

1) the growing dissatisfaction of the nobility with their position outside power;

2) dynastic crisis (appearance of False Dmitry).

3. The looseness of the moral foundations of society.

1613 - the beginning of the reign of the first of the Romanov family - Mikhail Fedorovich Romanov.

At this time, new features appear in the Russian economy:

1) the emergence of manufactories, which led to the onset of the era of capitalism;

2) the increasing importance of fairs in domestic trade;

3) formation of the internal market, specialization of regions;

4) there is an elimination of the natural isolation of agriculture and its gradual involvement in market relations;

5) improvement of foreign trade;

6) manufactories serviced by the labor of serfs.

1649 - adoption of the Cathedral Code.

Cathedral laying

1. Church and state.

The rights of the church were sufficiently curtailed: the lands belonging to the church were transferred to the management of the state. Churches were forbidden to transfer the patrimony.

2. Registration of serfdom.

Class years were abolished, the peasants were assigned to the landowner for life. The urban population was assigned to the city and had to engage in crafts and trade.

3. Nobles - a privileged class.

Duty - military service, for which they receive land and peasants. Previously, the estate could be inherited, and the estate was given for service. Now the estate could be inherited.

Meaning:

1) registration of serfdom;

2) the formation in Russia of a class system, including the clergy, the urban population, the nobility, and peasants.

In the XNUMXth century There is a split in the Russian Orthodox Church. This split was long overdue, since there were quite a lot of disagreements in church rituals and books. That is why the idea to put everything in order arises. The schism ended with the fact that the churchmen were divided into supporters of Nikon and supporters of Habakkuk. Nikon will lose in this confrontation.

A schism is a religious social movement that resulted in a separation from the Russian Orthodox Church of a part of believers who did not accept Nikon's reforms.

Reasons for the split:

1) Nikon's reforms practically coincided with the formalization of serfdom;

2) according to the Old Believers, Nikon violated the main principle of the church - catholicity! All reforms were carried out on behalf of the patriarch alone, which violated the autonomy of the church and indirectly subordinated it to the state.

In the period of historical development we are considering, it should be noted that the development of the Moscow principality took place, which became a fairly powerful medieval state.

Required Concepts

An epidemic is a widespread outbreak of an infectious disease.

A pandemic is an epidemic that covers an area, a country, or a number of countries.

Endemic is the constant presence of a certain disease in a given area, due to its natural features and the peculiarity of the living conditions of the population.

2. The development of medicine at the beginning of the XNUMXth century. Medical directions

The fact is that the Mongol-Tatar yoke, under which Russia was for a long time, slowed down the development of Great Russia, the Kievan state, which, by the way, was considered one of the most civilized and largest. Therefore, after the victory over the Mongol-Tatar yoke, in 1480, medicine did not undergo significant changes. In Europe, during this period, universities opened, the number of doctors increased, even despite the fact that scholasticism dominated, there were persecutions of genuine science by the church. In Moscow, which united the principalities around itself in order to create a centralized powerful state, medicine still remained popular. Education took place according to the type of family apprenticeship. It should be noted that the national culture and, along with it, medicine were primarily of a civil nature, they were not subjected to oppression, the power of the church. For example, Copernicus, Jan Hus, J. Bruno, Servest and others were burned in Europe. Although in Russia they also persecuted sorcerers, witches, and so on and burned them, however, this is in no way comparable with the so-called witch hunt in Europe (I must say that thousands of people died at church fires).

During the period under review, two main areas of medicine developed:

1) folk;

2) monastery.

And also, besides this, the first healers appeared in the troops.

3. Sudebnik of 1550 and traditional medicine. Sovereign Pharmacy

In 1550, Ivan the Terrible assembled the Zemsky Sobor in the Kremlin Palace, which received the name "Stoglavy" (according to the number of articles of laws or chapters approved by him). So, the "Stoglavy" cathedral approved the Sudebnik. It was decided that in Moscow, as well as in other cities, it was necessary to create schools that would teach children to read and write, as well as equip almshouses in the cities for the care of the sick, the elderly and the crippled, “so that they live in purity and in repentance and in every thanksgiving.”

However, in the XVI-XVII centuries. For almost the entire population of Russia, traditional medicine remained the only way to maintain their health. The experience of Russian folk medicine was transmitted orally, and also preserved in numerous clinics and herbalists, reflected in legislative acts, historical and everyday stories (among which is "The Tale of Peter and Fevronia of Murom" - the story was written down in the XNUMXth century, it tells about miraculous healing of Prince Peter of Murom), chronicles. It must be said that in the clinics a fairly large place was given to "cutting" (ie, surgery). Among the "cutters" were bloodletters, chiropractors, and teethers. In addition, in Russia, operations such as abdominal surgery, skull drilling, and amputations were performed. Mandrake, wine, poppy were used as a means to put the patient to sleep. The tools were: probes, axes, saws, scissors, chisels, etc. These tools were carried through the fire. Wounds were treated with wine, ash, birch water. The wounds were sutured with hemp and flax fibers, as well as with thin threads from the intestines of animals. In order to extract a metal fragment, they began to use magnetic iron ore. An interesting fact is that original designs of prostheses for the lower extremities were created in Russia.

It was clear that medicine required the creation of a central organ, that is, it required, in fact, the organization of the process. Under Ivan IV, in 1581, the Apothecary's Chamber was formed (the sovereign's court pharmacy). It was necessary to serve the royal family, as well as the nearest boyars. The premises of the sovereign's pharmacy were furnished very luxuriously. The walls and ceilings were painted, the shelves and doors were upholstered with "good English" cloth, the windows were with colored glass. They worked in the pharmacy every day - from early morning until late at night, and when one of the members of the royal family fell ill, pharmacists worked around the clock. The presentation of medicines to the king was very strict. First, the medicine that was intended for the king was tried by the doctors who prescribed it, as well as the pharmacists who prepared this medicine. Then the boyar tried the medicine, who subsequently gave it to the tsar. Having accepted a glass with the rest of the medicine from the tsar, the boyar was obliged "to pour it into the palm of his hand and drink it." The resettlement of foreign doctors, surgeons, and pharmacists to Moscow began in the first half of the 200th century. They appeared in the royal lists of "necessary people." It should be noted that foreign doctors did not need practically anything. For example, under Boris Godunov, every foreign doctor who came to serve in Russia received an estate with serfs, a fairly large annual salary (about XNUMX rubles), various goods and food, horses, for the maintenance of which hay and straw were allocated in sufficient quantities. , and also, when the medicine prescribed by the doctor had a positive effect, the king rewarded the doctor with expensive gifts. In addition, it should be noted that the service at the Russian royal court was quite prestigious.

Epidemics and state anti-epidemic measures

Particular attention should be paid to epidemics that claimed hundreds of thousands of lives. The development of trade with other countries had not only positive, but also negative sides. Trade gates quite often opened the way for terrible epidemics that raged in Europe in the Middle Ages. Pskov and Novgorod, large trading cities, were very often subjected to epidemics.

In 1401 (and if we consider the chronicle of Nikon, then in 1402) a pestilence was described in the city of Smolensk, but no symptoms were indicated. If we turn our attention to Pskov, then in 1403 an epidemic occurred there, which was characterized as "a pestilence with iron." Scientists have concluded that this epidemic can be attributed to plague epidemics. An interesting fact is that during this epidemic, cases of recovery were recorded, but, unfortunately, this happened extremely rarely. Usually people who have been exposed to this disease died on the 2-3rd day of illness. Such epidemics in Pskov were repeated in 1406, and also in 1407. It should be noted that people considered the invasion of these epidemics to be the fault of their princes. That is why in 1407 the inhabitants of Pskov renounced their prince Danila Alexandrovich and called for another prince. It should be noted that starting around 1417, plague epidemics almost continuously "walked" across Russia. In some sources there are notes that "death mowed down people, like a sickle mows ears." These epidemics continued until 1427. From 1427 to 1442. there is no mention of any epidemic. However, in 1442, an epidemic again appeared in Pskov, which, according to the descriptions, can be attributed to the plague. In the future, various kinds of epidemics arose that claimed hundreds of thousands of lives. For example, in the epidemics of 1552-1554. in Novgorod, Staraya Russa, as well as in the entire Novgorod region, 279 people died, and in Pskov - more than 594 thousand people. I must say that especially many people of the clergy (priests, monks, etc.) died. During epidemics, the people used the usual means of treatment - fasting, building churches, prayers, etc. Along with the plague, other deadly diseases raged in Russia. For example, in 25 the prince's army, which was supposed to fight with Kazan, was struck by scurvy in the city of Svyazhsk. By the end of the XVI century. people began to realize that it is necessary to fight epidemics with real actions, and not with the construction of churches, prayers, etc.

Now we need to talk about methods of combating epidemics (in particular the plague) in medieval Rus'. As already mentioned in the previous lecture, in the 1551th century. The first notes on the fight against epidemics began to appear. In the 1552th century, in 1572, the chronicles contain the first example of how outposts were constructed. The street where the sick were was closed on both sides: in Pskov, during the plague epidemic, “Prince Mikhailo Kislitsa ordered... Petrovskaya Street to be locked at both ends, and the prince himself ran on a ruin into the pasture.” In 1571, during an epidemic in Novgorod, “there was a checkpoint on the Pskov road so that guests with goods would not travel to Pskov, or from Pskov to Novgorod.” Let us pay attention to the Novgorod Chronicle. It says that in Novgorod in 1592 they began to prohibit burying people who died from an “infectious” disease near churches. They had to be buried far outside the city. Outposts were set up on the streets where sick people were found; courtyards where a person died from an “infectious” disease were locked, not allowing other survivors to leave. There was a watchman nearby who served people food and water directly from the street, i.e. he did not enter the yard. Priests were also not allowed to visit the sick. For failure to comply with the last rule, they were burned along with the person who was sick. Now let us turn our attention to Milton's History of Muscovy. The fact is that here was the first case of the introduction of quarantine in Russia, and this was done in relation to a foreigner. Jenkinson, the British ambassador, came to Russia for the third time. This was in XNUMX. He sailed across the White Sea on a ship. He was kept in Kholmogory for a long time, since there was a plague in Russia during this period. In Russian cities, quarantine was first registered during the plague in Pskov - in Rzhev in XNUMX.

Hospitals and almshouses were set up in Moscow, Kyiv, Pskov and other cities. It must also be said that the first "civilian" clinics appeared. For example, Rtishchev organized a hospital in one of the Moscow courtyards, consisting of two chambers, which accommodated 15 beds. From among the employees of this hospital, a team of messengers was organized, which went around the streets and collected the "sick and crippled" and delivered them to this hospital. The people called it "The Hospital of Fyodor Rtishchev". According to contemporaries, this hospital provided "outpatient shelter for those in need of temporary assistance."

It should be noted that for the period from 1654-1665. more than 10 special royal decrees were signed "on precaution against pestilence", and during the plague epidemics of 1654-1655. it was ordered to establish outposts on the roads and not to let anyone through under pain of death, this applied to everyone, despite ranks and ranks. Infected objects were also burned at these outposts, and the money was washed in vinegar. As for the letters, they were repeatedly rewritten along the way, and the originals were burned.

During epidemics, the export and import of various goods were suspended, and work in the fields was stopped. As a result, crop failures and famine arose, which always dragged along after epidemics.

Apothecary order and pharmacies

The Apothecary Order was created in 1620. It included a permanent staff, which was provided entirely at the expense of the royal treasury. From the very beginning, the Pharmaceutical order included a small number of people:

1) 2 doctors;

2) 5 healers;

3) 1 pharmacist;

4) 1 optometrist;

5) 2 translators (interpreters);

6) 1 leader - clerk.

However, later (60 years later) 80 people served in the Aptekarsky Prikaz:

1) 6 doctors;

2) 4 pharmacist;

3) 3 alchemists;

4) 10 foreign doctors;

5) 21 Russian doctors;

6) 38 students of medicine and bone-setting;

7) 12 clerks, translators, gardeners, business executives.

The management of the pharmacy and the Sovereign Pharmacy Order was entrusted only to the boyars who were especially close to the tsar.

Medicinal gardens began to be planted around the Kremlin, similar gardens were grown at the Nikitsky Gate, as well as in other places. That is why gardeners were needed in the Pharmaceutical Order. They were in charge of these medicinal gardens. The first of the sovereign's apothecary gardens was created near the western wall of the Moscow Kremlin (by the way, now the Alexander Garden is located on this site). It can be concluded that the Pharmaceutical order is the first state healthcare institution. Now it is necessary to identify the main functions of the Pharmaceutical order:

1) organization of medical care for members of the royal family;

2) organization of medical care for archers, boyars and other people who applied for it;

3) organizing the provision of domestic and imported potions;

4) strict control of land;

5) taking certain preventive and protective measures during epidemics;

6) invitation of foreign doctors and doctors;

7) training of doctors in the medical school under the Pharmaceutical Order;

8) supervision of apprenticeship in the pharmacy order;

9) providing internships for future domestic doctors with well-known doctors;

10) organizing the procurement of medicines.

In 1634, not far from Moscow, near the village of Duholino, a special "glass" factory was created. It was a kind of small manufactory, where 15 people worked. This plant produced the so-called alchemical vessels.

In 1654, under the Pharmaceutical Order, a school was opened that trained Russian doctors. From the very beginning, about 30 people have been trained in it. The training lasted from 4 to 6 years. After the doctor graduated from such a school, he, as a rule, was sent to the troops, and not only in wartime. The fact is that a little later each regiment will have a personal military doctor. Thus, along with the civil and monastic directions in medicine, there was another one - military medicine, which was not under the jurisdiction of the Pharmaceutical Order. Let's pay attention to the textbooks of schools under the Pharmaceutical order. Various medical books, zelniks, herbalists, cool gardens, as well as works translated from Latin and Greek by such authors as Vesalius, Galen, Aristotle "On the structure of the human body", "The Secret of Secrets", "Aristotle's Gates" were used as textbooks. and various others, which were supplemented by comments by domestic translators).

The Apothecary Order, according to the instructions of the king, was to organize the procurement of medicines. Mostly herbal medicines.

The population received medicinal potions in the markets, green rows. Later, by royal decree, 2 pharmacies were organized in Moscow. In 1581 - only for the king and his inner circle, and the second pharmacy, organized on March 20, 1672 - "for people and all kinds of ranks." The third pharmacy was opened in 1682 - at the first civilian hospital at the Nikitsky Gate. Foreign pharmacists were invited to Moscow pharmacies (French Jacobi, etc.).

The supply of pharmacies with drugs was carried out in various ways. From the very beginning, medicinal raw materials were imported from England. At the same time, some materials were bought in the malls. For example, pork fat on a plaster - in meat, various medicinal herbs and berries - in the green row, combustible sulfur and black tar - in the mosquito row. There was also the so-called berry duty: royal decrees were sent to governors in different parts of Russia, which ordered the collection of various herbs that these lands are famous for, for the sovereign's pharmacy. So, for example, black hellebore root was brought from Kolomna, juniper berries from Kostroma, malt root from Astrakhan and Voronezh, etc. For failure to fulfill the berry duty, imprisonment was supposed. Another way to supply pharmacies with medicinal raw materials was their importation by foreigners. So, back in 1602, the pharmacist James French brought with him from England a very valuable supply of medicines at that time. These medicines were the best at that time. When the imported stocks were depleted, raw materials were purchased or ordered from other countries - from England, Holland, Germany, etc.

I must say that usually medicines were prescribed from abroad, but then folk remedies were used more and more. Along with herbal remedies, exotic ones were also used, such as, for example, unicorn horn in powder, deer heart, powder from young rabbits in wine, "bezuy stone" (it was found on the seashore), etc. There was also a healthy lifestyle : the use of fir, pine from scurvy, cleanliness, a bath, which was a panacea for many diseases.

Although there was a school in the Aptekarsky Prikaz, the inhabitants still preferred traditional healers. Firstly, the population trusted them more, and secondly, it was much cheaper than being treated by doctors.

There was even a kind of hierarchy: "dokhtur, beaker and doctor, because the doctor gives his advice and orders, but he himself is not skilled in it, but the doctor applies and heals with medicine, and the beaker is a cook for these both."

4. Monastic and civil hospitals

Monastery hospitals were built at the monasteries. So, in 1635, two-story hospital wards were built at the Trinity-Sergius Lavra (it must be said that these wards have survived to this day). The hospital wards that were built at Kirillo-Belozersky, Novodevichy and other monasteries have survived to this day. It should be noted that the monasteries in the Muscovite state had a very important defensive value.

The fact is that during enemy invasions, temporary military hospitals were set up on the basis of hospital wards at monasteries, in which they treated the wounded. It must be said that the treatment and maintenance of patients in temporary hospitals was carried out at the expense of the state, although it was not under the jurisdiction of the Pharmaceutical Order. This is one of the distinguishing features of Russian medicine in the XNUMXth century.

Let's turn our attention to civilian hospitals. As mentioned above, the boyar Fyodor Mikhailovich Rtishchev organized almshouses in his homes in Moscow, which can be considered the first properly arranged civilian hospitals in Russia. Note that medicines were issued for these hospitals from the Sovereign Pharmacy. In 1682, a decree was issued on the opening in Moscow of two "spitals" (i.e., hospitals) that served the civilian population. In addition to treating the sick, these institutions also taught medicine. In the same 1682, the Slavic-Greek-Latin Academy was established in Moscow. As for military hospitals, the first of them was opened in 1656 in the city of Smolensk.

5. The first Russian doctors of medicine

in Russia in the 1621th century. the first doctors from Europe began to appear and began to dominate. Among the foreign doctors who were invited to the Russian service, one can meet quite well-known physicians. For example, in XNUMX Artemy Diya arrived in Moscow. He wrote a large number of works on medicine. Many of these works were printed in Paris.

Also, such foreign doctors as Lavrenty Blumentrost, Robert Yakob worked in Russia. Domestic doctors also traveled abroad for training. Among those who have successfully completed training and also defended their thesis abroad, one can note P. V. Postnikov. He received his MD from the University of Padua, Italy. I must say that Peter Postnikov was even the rector of the University of Padua. In 1701, Postnikov returned to Russia and was enrolled in the Pharmaceutical Order.

Unfortunately, Pyotr Postnikov, having returned to Russia, could not study medicine and physiology (this is his favorite branch of medicine), since he served as a Russian diplomat in France, England and Holland. He bought books, surgical instruments, supervised the education of Russian students abroad.

You can also note George from Drohobych. He received the title of Doctor of Medicine and Philosophy at the University of Bologna, and also wrote the essay "Prognostic judgment of 1483 by George Drogobych from Russia, Doctor of Medicine of the University of Bologna", which was published in Rome. At one time (1481-1482) he was rector of the University of Bologna. He lectured at the University of Krakow (since 1485), worked in Hungary (1482-1485). In 1512, Francysk Skaryna from Polotsk received the title of doctor of medicine at the University of Padua. Then he worked in Koenigsberg, Prague, Vilna.

Author: Bachilo E.V.

<< Back: Medicine in the ancient Russian state. Kievan Rus IX-XIV centuries (Historical characteristics of the period under review. Directions in medicine of the 9th-14th centuries)

>> Forward: Medicine in the Russian Empire in the 18th century (General characteristics of the historical period. Main features of the economy and culture of Russia in the 18th century. Development of medicine at the beginning of the 18th century. Medical faculty of Moscow University. Hospital schools. Doctors of medicine in Russia. Management of medical institutions. Opening of the Academy of Sciences and all kinds of arts. Hydropathics. Production of medical equipment in the 18th century)

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