History of medicine. Cheat sheet: briefly, the most important

Lecture notes, cheat sheets
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History of medicine. Cheat sheet: briefly, the most important

Lecture notes, cheat sheets

Table of contents

1. Medical symbols and their meaning

History of medicine - is the science of the development, improvement of medical knowledge, medical activities of different peoples of the world throughout the history of mankind, which is inextricably linked with philosophy, history, natural science, and the development of culture. In fact, the history of medicine studies the patterns of development of medicine and healing, their history from ancient times to the present.

Medical emblem - this is a conditional image that symbolizes the medical field, belonging to the medical profession, various branches in the field of medicine, some separate medical specialties.

There are a number of common medical emblems:

1) an image of a snake, including in combination with a bowl, with Apollo's tripod, a candle, a mirror, a staff;

2) an image of a heart in the palm of your hand;

3) an image of a burning candle, symbolizing a certain direction in the field of medicine:

a) symbols of therapy - lily of the valley, Florentine baby, pelican, urinary (vessel for collecting urine), a hand that feels the pulse;

b) symbols of surgery - a drop of blood, various surgical instruments, a pentagram;

c) various military medical emblems, emblems of various medical societies.

The first inscriptions and images that personified medicine appeared on coins in Ancient Greece. Along with the gods and rulers, a snake was minted.

In some cases she was alone, in some with the tripod of Apollo, in others with the staff of Asclepius.

Consider the snake as a medical emblem. In primitive society, she was one of the main totem animals. In the mythology of ancient civilizations (Babylon, Egypt, Mesopotamia, China, India), the connection between the snake and fertility was often reflected. The snake is a dual, wise and insidious creature that can both betray and help. The snake personified knowledge, wisdom, immortality, power.

If we turn to Babylon, then the snake was the emblem of the god of doctors. Rejuvenation, recovery, wisdom were associated with the snake.

In Egypt, the snake was the symbol of the god Thoth. This god was the patron saint of doctors. But the Goddess of health and life (Isis) was depicted with snakes that personified eternal life.

Another emblem is the rod of Hermes (among the Romans - the rod of Mercury). I must say that in the Renaissance, doctors considered themselves merchants, and Hermes, respectively, their patron.

Consider another emblem - the emblem of the World Health Organization: the emblem is a staff, which is located vertically and wrapped around a snake. Depicted against the background of a globe bordered by laurel branches (this is the emblem of the UN).

The humanism of medicine as a science fosters a sense of pride and respect for the medical profession.

2. Prerequisites for the development of medicine in the primitive community

When medicine arose, or rather, the beginnings of medical care, it is not known exactly. There are many opinions and theories about this.

The most common version: medicine arose simultaneously with the emergence of man, it turns out that medicine arose several hundred thousand years before our era. If we turn to the words of the famous, prominent scientist I.P. Pavlov, he wrote: "Medical activity is the same age as the first person."

Traces of first aid were discovered during the period of the primitive communal system. Briefly trace the main points of the development of the primitive tribal community:

1) people began to live in small communities, which were then subdivided into clans, as well as tribal unions;

2) the use of stone tools in order to get food, hunt;

3) the appearance of bronze (hence the name "bronze age"), and after - iron. In fact, it changed the way of life. The fact is that hunting began to develop, and since hunting is the lot of men, there was a transition to patriarchy.

With the advent of various tools, the number of injuries that people could receive has increased. If you pay attention to the rock paintings, you can clearly see that hunting, various military battles brought people a lot of trouble and, of course, injuries, wounds, etc. Here you can see primitive first aid techniques - removing an arrow, etc.

It should be noted that initially there was no division of labor as such. Long before the beginning of civilization and the formation of the state, and especially during the period of matriarchy, women were a kind of keepers of the hearth - this included caring for the community, the tribe, as well as providing medical care. The next period of development was the receipt of fire by people. In fact, the extraction of fire accelerated anthropogenesis, accelerated the development of man. At the same time, the cult and importance of women as guardians of the hearth and healers weakened. Despite this, women continued to collect plants, which they then consumed.

So, from generation to generation, knowledge about plants was transmitted and accumulated, about which of them can be eaten, which are not; which can be used for treatment, and which should not. Empirically, medicinal products of animal origin (for example, such as bile, liver, brain, bone meal, etc.) were added to herbal remedies. Primitive man also noticed mineral remedies for treatment and prevention. Among the mineral remedies for treatment and prevention, one can designate a very valuable product of nature - rock salt, as well as other minerals, up to precious ones. I must say that by the period of Antiquity, a whole doctrine appeared about the treatment and poisoning with minerals, especially precious ones.

3. Paleopathology

In connection with the transition to a settled way of life, the role of women, in particular the economic one, decreased, but the medical role was preserved and even strengthened. Over time, the man became the master of the tribe, clan, and the woman remained the keeper of the hearth.

The history of medicine has only a few millennia. Despite everything, the medicine of primitive communities still deserves serious attention and study. After all, it was then that traditional medicine appeared and began to develop. The knowledge of people, obtained by the empirical method, accumulated, the skills of healing improved, at the same time the question of the causes of diseases began to arise. Naturally, people of that time did not have such an arsenal of knowledge as today, and could not explain the occurrence of diseases from a scientific point of view, therefore, people considered the causes of diseases to be any magical forces that are unknown to man. From another point of view, people found a magical explanation for the causes of the disease later, and the initial explanations were purely materialistic in nature, which was associated with the experience of obtaining means of life. During the period of late matriarchy, when well-being and life became more and more dependent on the results of hunting, a cult of an animal arose - a totem. Totemism in translation from the Indian means "my kind." It should also be noted that until recently, and among the Indians in America and still the names of the tribes were associated with the name of any animal or bird, the hunt for which gave food to the tribe - the monkey tribe, the bull tribe, etc. More than that , some even associated their origin with any animal. Such representations are called animalistic. Hence the wearing of amulets. In addition to all this, people could not but notice the effect of weather conditions on life and health.

There is an opinion that primitive people were distinguished by good health. The fact is that, of course, there was no impact on people then of adverse factors of a man-made nature - air pollution, etc. However, they constantly fought for their existence against natural conditions, also suffered from infectious diseases, died in wars with each other, were poisoned poor quality food, etc. It is believed that the average life expectancy of people at that time was 20-30 years. Now let's turn to such a concept as paleopathology.

Paleopathology is a science that studies the nature of diseases and lesions of ancient people. Among these diseases are such as necrosis, alkalosis, poliomyelitis, periostitis, rickets, bone fractures, etc.

4. The beginnings of traditional medicine

As society developed, it came to such phenomena as fetishism, that is, the direct personification and exaltation of natural phenomena, and later - animism.

Animism - the spiritualization of all nature, the settlement of its diverse spirits and supernatural beings, as if acting in it.

Already in the days of patriarchy, the so-called ancestor cult appeared. An ancestor, that is, already some kind of separate personality, maybe even born of a person’s fantasy, could become the cause of a disease, could move into the body of a person and torment him, causing illness. Accordingly, in order for the ailments to stop, the ancestor must be appeased by sacrifice or expulsion from the body.

So, we can say that such ideas largely formed the basis of religion. Shamans appeared who were "specialists" in exorcising or appeasing spirits.

Thus, along with materialistic ideas and the rudiments of knowledge acquired by people, animistic, religious views develop. All this forms folk medicine. There are two principles in the activities of traditional healers - empirical and spiritual, religious.

Although, of course, there are still healers who are limited to the usual gathering of herbs, the preparation of potions and without "theoretical and religious" beliefs.

The concept of traditional medicine is very closely related to the concept of "folk medicine", the separation of which from medicine is very conditional, since traditions and rules, observations about the dangers of unclean air, water, poor nutrition, etc., entered the arsenal of traditional medicine and were used in the treatment and prevention of various diseases.

It is necessary to define the concept of “traditional medicine”, which is presented in the orders of the Ministry of Health and Social Development of the Russian Federation.

Traditional medicine is methods of healing, prevention, diagnosis and treatment based on the experience of many generations of people, established in folk traditions and not registered in the manner prescribed by the legislation of the Russian Federation.

Now it is necessary to decide whether traditional medicine can be called traditional. The fact is that traditional medicine developed, as if coming out of the bowels of traditional medicine. So, from this point of view, it would be correct to talk about traditional folk medicine.

Thus, the beginnings of medical science appeared with the advent of man, and from the very beginning medicine was folk medicine, as it was carried out by healers, healers with the help of various potions of plant, animal, mineral origin, as well as using elementary "medical tools" for bandaging treatment of fractures and wounds, bloodletting, craniotomy, etc.

5. Brief information from the life of Hippocrates

In the history of the development of medicine, one can hardly find another name with which almost the birth of medicine would be associated. We will talk here about Hippocrates II the Great, who went down in history as Hippocrates. This great healer lived about 2500 thousand years ago at a time when Hellenic culture reached the apogee of its development. Temporal periodization dates this period to the V-IV centuries. BC e. Then not only medicine flourished, almost every branch of human activity moved forward by leaps and bounds and had its representatives who went down in history: the outstanding politician of that time was Pericles (444-429 BC), universally recognized then and subsequently as philosophers Democritus, Anaxagoras, Gorgias, Socrates, Empedocles, in poetry Aeschylus, Sophocles, Aristophanes stood out, in the field of architecture Praxiteles, Phidias, Polykpetes became famous, in history it was the era of Herodotus and Thucydides. Euryphon and Praxagoras became the great colleagues of Hippocrates, and Herophilus and Erasistratus became his followers.

However, no matter how they praised the contribution of Hippocrates to medicine, very limited information has reached our days about Hippocrates himself, which does not even allow us to accurately determine the date of his birth and death: some data indicate that he died at the age of 104 years, others - about that he died at the age of 83.

It is assumed that he was born in the first year of the XX Olympiad. The place of his birth was the island of Kos (later on, the flourishing of the Kos medical school is associated precisely with the name of Hippocrates). Translated from Greek, the name of the great healer is translated as "horse tamer". For a long time after his death there was not a single source containing information about the biography of Hippocrates. Only more than 600 years after the death of Hippocrates, the doctor Sorans Fr. Kos (around the XNUMXnd century AD) first recorded the biography of the healer, and his work was continued by the lexicographer Svida (XNUMXth century) and the prose writer, philologist I. Tsetse (XNUMXth century). Since they could not conduct a complete analysis of his activities and works, their stories bear the imprint of legend and mystery that surrounded the personality of Hippocrates. From the most reliable sources it is known that he was a descendant of the great Asclepius in the seventeenth generation on his father, and on his mother belonged to the genus of Heraclides (i.e., descendants of Hercules). In addition, he is credited with family ties with the rulers of Thessaly and the Macedonian court.

Hippocrates' teachers in the medical art were his grandfather Hippocrates I and father Heraclid. When he left his home and finished home schooling, he continued his further knowledge of the medical art in Cnidus, and later with Herodicus and the philosopher-sophist Gorgias. Hippocrates received a wide field for applying and improving his knowledge by becoming a wandering doctor. The fame of him quickly spread along the coast of the Eastern Mediterranean. After long wanderings, already in his old age, he stopped in Larissa (Thessaly), where he spent the rest of his life.

6. Creation of the "Hippocratic collection"

The name of Hippocrates was repeatedly mentioned in the writings of his contemporaries: he was mentioned by Plato, Diocles from Carista, Aristotle. In their works, comparisons of Hippocrates with the great sculptures and politicians of Ancient Hellas were found.

Hippocrates chose the path of medicine for himself not by chance, for all his predecessors, starting with Asclepius himself, were doctors. All seven Hippocrates left behind works on the art of medicine, just like many other healers of that time, but history does not know of a single work that would definitely belong to the pen of Hippocrates II the Great. This uncertainty is explained by the fact that all doctors of that time wrote anonymously, because knowledge was initially transferred only within family medical schools, that is, from father to son and to a few who wished to study the medical art. Thus, these works were intended "for home use", their author was known by sight.

Only in the III century. BC e. in the Alexandrian manuscript repository, writers, philologists, historians and doctors of that time compiled the first collection of ancient Greek medical writings. The work was then carried out colossal, since manuscripts from all over the world were brought to Alexandria. The total number of papyrus scrolls subject to further processing and translation soon exceeded 700 thousand. Among this huge number of works, 72 compositions on a medical theme were found. All of them were written in Greek, or rather in the Ionian dialect, around the XNUMXth-XNUMXth centuries. BC e. None of these writings had the signature of the author. It was practically impossible to single out those that could have been written by Hippocrates: not a single work matched the rest in terms of writing style, depth and style of presentation, philosophical and medical position. Moreover, open disagreements were found in the discussion of many issues up to directly opposite opinions. This once again confirmed that they all belonged to different authors. Having lost hope of establishing the authorship of the works, historians have combined all these medical texts into one collection and called it "Hyppokratiki sillogi", or "Hippocratic collection" in honor of the great Greek physician. Later, the title and text of the collection were translated into Latin, and it became better known as "Corpus Hippocraticum".

So that this great work would not be lost in the abundance of other literary treasures of that time, it was repeatedly copied, not only in Greek, but also in Arabic, Latin and Italian and many other languages of the world. And only eighteen centuries later, in 1525, when printing was invented, it was first published in Rome in Latin. The publication immediately gained immense popularity a year after its release in Greek in Venice, after which it became almost the most famous and widely read work in all of Europe.

7. "Prognostics and teaching about temperaments"

One of the works of the Hippocratic Collection, which became the basis for diagnosing diseases, is "Prognostics" (from the Greek prognosis - "initial knowledge"). This is the first work on ancient Greek therapy. The book provides detailed descriptions of the prognosis of various diseases, diagnosis, methods of examination, questioning the patient, monitoring him, as well as methods of "treatment at the patient's bedside." It was from this work that some diagnostic signs that have survived to this day have entered the centuries. For example, the "face of Hippocrates" (named not for external resemblance, but in honor of Hippocrates). This is a classic description of the face of a dying person, and now it is applied to people with certain certain diseases (metastatic cancer of the gastrointestinal tract, etc.).

"About air, waters, places" - an essay that has, rather, an ecological and geographical name, in fact, the first work devoted to the harmful effects of environmental factors on the human body. The work details various "types of people" depending on the locality in which they live. As a person who traveled to a large number of countries, he could draw some generalizing conclusions about the occurrence of certain diseases in people inhabiting, for example, sea coasts, high mountain regions, and desert territories. He was also able to link the frequency of occurrence of certain diseases with the time of year and even with biological and circadian rhythms. Thus, Hippocrates determined that "different types" of people had different susceptibility to diseases, and therefore looked for both treatments that could be applied to all people, and different types of approach to treating the same disease that arose in people of different types. He also for the first time made an assumption about four bodily juices, according to the predominance of one of them in the body - the division of people into different types. This theory formed the basis of the much later formed doctrine of the four temperaments. This was already in the Middle Ages. The teaching said that if mucus predominates in the body (from the Greek phlegma - "mucus"), then a person has a phlegmatic temperament; if blood predominates (from the Greek sanguis - "blood"), then the person is "sanguine"; if bile predominates (from the Greek chole - "bile"), then the character of the person is choleric; if there is a lot of black bile in the body (from the Greek melaine chole - "bile"), then the type of temperament will be melancholic. The basis of this system is erroneously attributed to the merits of Hippocrates, since even if he tried to divide people into types, it was not by temperament, but by predisposition to diseases. In addition, the names of temperaments in the work "On Air, Waters, Localities" are not contained, because some words (such as sanguis) are of Latin origin, and therefore they could not be used by Hippocrates. In the future, only the names of various "types of people" were preserved from the theory of temperaments. I. P. Pavlov connected them with the predominance of the processes of excitation and inhibition, as well as with possible body types.

8. "Epidemiology in seven parts"

In work like "Epidemiology in seven parts", you can find a description of 42 different diseases that were most studied, since observations of patients with these diseases were carried out separately and all data was recorded as a kind of medical history. Unlike modern concepts, epidemics then were understood not as infectious diseases, but as diseases that were most widespread among the population. Such diseases included consumption, paralysis, swamp fever, eye, colds, skin, venereal and other diseases. The origins of the clinical approach to the treatment of diseases were described here.

The ancient Greeks thought not only about treatment, but also about the causes of diseases, that is, about their possible prevention. The reasons were divided into general, depending on the quality and conditions of the environment in which the inhabitants of a particular area lived (something most common that everyone uses, that is, something that enters the body with breathing), and individual, which depended on the way of life, working conditions, nutrition and living of each individual person. Particular attention in ancient Greece was paid to physical education, hygiene, hardening. This was especially applicable to men who, from the cradle, were instilled with love for the Motherland and a readiness to defend it at any moment. The most severe methods of education were in Sparta, where children from the age of 7 were in the care of the state and were educated in military units.

Among the medical texts of that time, writings on surgery were found (from the Greek cheir - "hand", ergon - "business"). The main attention was paid to the study of methods of treatment of fractures, wounds, dislocations, injuries of the skull. Then, for the first time, devices for aligning dislocated joints were described, for example, the “Bench of Hippocrates”. Much has been written about dressings (from the Greek desmurgia - "the doctrine of dressings"). The types of dressings described in "Hippocratic collection", are still used today, for example, the “Hippocratic cap”.

The ancient Greeks also studied diseases of the teeth, gums, and oral cavity. Even then, they tried to eliminate bad breath, and local remedies were also used to treat diseases of the oral cavity: narcotic analgesics, herbal infusions and decoctions, astringents, etc. The ideas of ancient Greek doctors about the internal structure of the human body were rather scarce, since they did not open corpses . In this field they lagged far behind the Indian physicians, who, already several centuries before Hippocrates, introduced the autopsy of corpses into practice in order to study internal diseases. However, the advantage of the Greeks was that they achieved great success in the diagnosis and treatment of internal diseases, based on the data of examination, questioning, and physical methods of research.

"Hippocratic Collection" contains information on pharmacology, it contains a description of more than 250 herbal medicines, as well as preparations of animal and mineral origin.

9. Fundamentals of medical ethics

The foundations of modern medical ethics and deontology are also rooted in the ancient period. Then there were five main treatises, which contained information about what moral, physical, spiritual qualities a real doctor should have.

These were such works as "The Oath", "On the Doctor", "Law", "Instructions", "On Causal Behavior". These works mainly spoke about the need for a doctor to educate himself in such qualities as determination, neatness, aversion to vice, contempt for money, an abundance of thoughts, a denial of fear of the gods, for a good doctor himself is equated with God.

A true healer had to comprehend knowledge not only from the field of medicine, but also all those that are useful and can be useful, and also be able to keep in mind all the information known to him and apply them as needed.

However, the excessive application of this knowledge in practice, when they could cause harm, was condemned, because the first law of healing was the law "first of all, do no harm."

In addition, the doctor should not have paid special attention to monetary rewards, especially if the patient is in serious condition or poor (helping the poor was a holy deed).

Along with knowledge of his business, a person involved in medicine had to look neat and dignified so that people would have no doubts about his professional qualities. All the rules set forth in the "Oath" and other works on medical

ethics were strictly observed, for people feared not only the wrath of their compatriots and reprisals from the government, but also the punishment of the gods.

In the modern world, each state has its own doctor's oath, which reflects the level of development of medicine, national and religious traditions, but they all retain common features with the ancient Greek oath.

Thus, the "Hippocratic Collection" contains quite a few works whose authorship can be attributed to Hippocrates, and the names mentioned there - "Hippocratic Oath", "Hippocratic Bench", "Hippocratic Medicine" - did not appear because were what Hippocrates invented directly, but because many discoveries of that time were associated with the name of Hippocrates as the name of the then most famous doctor.

These names simultaneously glorified the era in which certain innovations appeared. Therefore, Hippocrates is more of a legend of Ancient Hellas, but a beautiful and noble legend. In no case should we belittle his merits in the formation and development of world medicine.

10. Hippocratic Oath

A special place in the medical practice of Ancient Greece was occupied by "The Hippocratic Oath", or "Oath of the Future Doctor", which was given to everyone who completed their training in the medical profession. The “oath” was not invented by Hippocrates; he only summarized into a single text all its main features that existed long before his medical practice. It first received literary design in the same Alexandria Library in the 3rd century. BC e.

Any oath of that time assumed the support of the gods, who were to become the first punishers in the event of perjury. The medical oath contained references to the gods who were directly related to the medical art, and those who were engaged in it. These were Apollo, Asclepius, Hygieia, Panacea. There are suggestions that the Hippocratic Oath got its name also because it mentions Asclepius, the ancestor of Hippocrates II the Great in the seventeenth generation.

By giving the "Oath" at the end of his training, the doctor secured the trust of society and provided a guarantee of a high level of professionalism.

"Oath" translated from ancient Greek, it reads as follows: “I swear by Apollo the doctor, Asclepius, Hygiea and Panacea and all the gods and goddesses, taking them as witnesses, to fulfill honestly, according to my strength and my understanding, the following oath and written obligation: to consider the one who taught me the art of medicine on an equal footing with my parents, to share with him my wealth and, if necessary, to help in his needs; to consider his offspring as their brothers, and this is an art, if they want to study it, to teach them free of charge and without any contract; instructions, learned lessons and everything else in teaching to inform his sons, his teacher and students, bound by an obligation and an oath according to the law of medicine, but to no one else.

I direct the regimen of the sick for their benefit, according to my ability and my understanding, refraining from causing any harm and injustice. I will not give to anyone the deadly plan asked of me, and I will not show the way for such a plan; likewise, I will not hand any woman an abortive caessary.

Purely and undefiled shall I conduct my life and my art. In no case will I make sections in those suffering from stone disease, leaving it to people involved in this matter. Whatever house I enter, I will enter there for the benefit of the sick, being far from everything intentional, unjust and harmful, especially from love affairs with women and men, free and slaves.

Whatever, during treatment - and also without treatment - I see or hear about human life from what should never be divulged, I will keep silent about it, considering such things a secret. To me, who inviolably fulfills the oath, may happiness be given in life and in art and glory among all people for all eternity, but to the one who transgresses and gives a false oath, let it be the opposite of this.

11. The role of Christianity in ancient Russia

Historical characteristics of the period under review

The Eastern Slavs founded their state at the beginning of the XNUMXth century. Thanks to the chronicles, information about this event reached us, and the state became known as Kievan Rus.

In Russia, there were significant advances in socio-economic terms: agriculture and craft began to be separated, communities gradually became smaller, strata of the population were formed, differing in income, and therefore early feudal relations developed. The largest centers of merchants and artisans were Kyiv, Novgorod, Polotsk, Chernigov, Pskov, in which the population grew, and consequently, the demand for goods of general use.

The most important historical milestone was the great road "from the Varangians to the Greeks", which connected Russia with Byzantium and Scandinavia. The unification of these lands was carried out by the first Kyiv prince Oleg (882-912). This association completed the formation of Kievan Rus.

All the lands of the Eastern Slavs were united and finally accepted into Kievan Rus under Vladimir the Red Sun (978-1015). For the formation of a single nationality, he also decided on the transition of Kievan Rus to a single religion - Christianity in its Byzantine version.

Some reasons for adopting Christianity:

1) the social inequality of people required justification and explanation;

2) a single state demanded a single religion;

3) isolation of Russia from Christian European countries.

The adoption of a single religion was a good political move for establishing contacts with Byzantine culture, and with Byzantium itself. The choice of religion was not accidental, since since the reign of Prince Igor (912-945), many of his associates, as well as his wife, Princess Olga, who ruled Russia after Igor's death and was Vladimir's own grandmother, were Christians.

In Kyiv there was already a church of St. Elijah, however, the spread, adoption and establishment of a single religion for all Slavic peoples was a protracted and painful process and lasted more than a century.

In the middle of the 827th century. In Rus', the Slavic alphabet was created - the Cyrillic alphabet. Despite the fact that before baptism in Rus' there were prerequisites for a written explanation, the beginning of Slavic writing dates back to this period. This merit should be attributed to Constantine (in monasticism Cyril (869-38)) and his brother Methodius, who came up with the Cyrillic alphabet, which initially consisted of XNUMX letters, so that it was possible to preach the Christian religion to people who did not speak languages other than Slavic.

Since Moravia most of all needed the preaching of Christianity at that time (an ambassador to Cyril and Methodius was sent from there with a request to create an alphabet), she was the first to adopt the Cyrillic alphabet, and the Day of Slavic Writing was established in the Bulgarian state, which over time acquired nationwide scale and is celebrated in countries with Slavic culture and writing on May 24th.

12. Significant events in the ancient Russian state

Since then, three monarchs of the highest rank have been officially approved in Europe - the emperor of the Holy Roman Empire, the Caesar of Byzantium and the Grand Duke of Kyiv. This facilitated the exchange of political and cultural information between countries, and also gave rise to such a phenomenon as Russian medieval culture.

Ancient manuscripts passed through Russia, which were translated by monks. Their works, written on parchment, have survived to this day.

The most important event of that time was the organization in the St. Sophia Cathedral, built in honor of the victory over the Pechenegs, the first library (1037). It was organized by Yaroslav the Wise, who was generally very interested in the spread of writing and culture in the Russian land. Later, his granddaughter Yanka Vsevolodovna organized the first women's school at the Andreevsky Monastery (1086). Judging by the archaeological excavations, literacy in Russia was very widespread, since the birch bark letters found during the excavations were written not only by princes, but also by simple artisans.

Having received a high development, the Old Russian state existed until 1132, when, after the death of Mstislav Vladimirovich, it began to disintegrate into feudal possessions, which marked the beginning of a period of feudal fragmentation. This had no positive significance at that time, since Russia lost its political independence and was subjected to the Mongol invasion - the Tatar Khan Batu (1208-1255).

However, in Russia, over time, the following prerequisites for unification took shape.

1. Political:

1) the general desire for liberation from the Horde yoke;

2) the unity of Russia in culture, religion, language.

2. Economic:

1) urban development;

2) settlement and land development in the northeast;

3) the expansion of feudal estates and the growth of the feudally dependent population;

4) transition to three-field and increase in productivity;

5) rise in trade.

The most important dates of the period under review

882 BC - Prince Oleg's campaign against Kyiv. After he killed Askold, he began to reign in Kyiv until 912.

988 BC - adoption of Christianity in Russia.

1072 BC - the creation of a code of laws - "Russian Truth". It was created by the sons of Yaroslav the Wise.

Early XNUMXth century - Creation of "The Tale of Bygone Years".

1223 BC - Battle of Kalka. The Mongol-Tatars defeated the Russian army.

1237-1240 - Batu Khan's invasion of Russia. The beginning of the Mongol-Tatar yoke.

1240 BC - Neva battle.

April 5, 1242 - Battle on the Ice, where Alexander Nevsky defeated the German knights.

September 8, 1380 - Battle of Kulikovo. Dmitry Ivanovich Donskoy defeated the army of the Mongol-Tatar Khan Mamai.

1382 BC - attack of the Golden Horde Khan Tokhtamysh on Moscow, destruction of Moscow.

13. Forms of healing, secular medicine

In ancient Russia there were three main forms of healing:

1) traditional healing. The people who dealt with it were called magicians and healers;

2) monastic medicine (mainly gained distribution after the adoption of Christianity in Russia);

3) secular (or it is also called worldly) медицина, which appeared during the reign of Yaroslav the Wise. It was also called foreign.

Secular medicine appeared in Russia since the reign of Yaroslav the Wise. The representatives of this branch of medicine were doctors of free practice, who did not consider themselves either folk healers or monastic doctors. These were people, often of foreign origin (an Armenian doctor, whose name is unknown, who was very popular even at the princely court; the healer Peter, a Syrian who lived at the court of Nikolai Davydovich (prince of the XNUMXth century) in Chernigov) and they took money for helping the sick , without being embarrassed, which caused indignation among representatives of other branches of medicine. The monastic medicine, which was gaining momentum, especially struggled with secular and folk medicine.

She erected the actions of magicians and sorcerers, as well as foreigners, into the framework of demonic deeds. There was an active persecution of sages, sorcerers, etc., caught even burned at the stake. These actions were akin to the European Inquisition. However, despite the stubborn struggle, healing in Russia did not become a purely ecclesiastical privilege. This can be seen from sources dating back to the period of the classical Middle Ages, which continue to mention both folk healing and secular medicine. With the passage of time, these two branches of medicine have acquired more and more differences and become isolated from each other.

14. Traditional medicine

ethnoscience is the oldest branch of medicine in the history of Russia. In fact, its roots were paganism, which was practiced by the Slavic tribes before the unification and creation of the state and before the adoption of Christianity. Thus, the moment of the birth of traditional medicine can be attributed to the time from which the historical description of the life of the Russian people begins, that is, to prehistoric times. With the adoption of Christianity, it has not been eradicated, it has survived more than a millennium of the already historical life of the people, and even in our time it continues to develop, is widely used in practice by those people who master this art, and sometimes come into dispute with scientific medicine.

In our time, a fair number of cases are known when scientific medicine turned out to be powerless in the face of some case of a disease, even though it has reached the highest theoretical and practical development and technical equipment. And there were cases when a person was literally "pulled out of the coffin" and restored to his health by people who knew the skills of traditional medicine. With the development and growth of the Russian state, traditional medicine until the second half of the XNUMXth century. remained the only way to treat diseases and maintain the health of ordinary people, since there was no more accessible medical care. The situation changed in the second half of the XNUMXth century, when the first zemstvo institutions and proper zemstvo medicine appeared.

No one can explain why, but the concern for the health of the entire Russian people was of little interest to the rulers of the Russian land for a very long time. existed until the end of the XNUMXth century. only "sovereign doctors" who treated the sovereign, his family and those close to him. Peter I tried to change the situation, but did not achieve radical changes, making medicine accessible to the privileged segments of the population.

Only Alexander II, who abolished serfdom in 1861 and carried out a large number of transformations in all spheres of Russian life, became the author of the first steps towards the availability of medical care, carried out the zemstvo reform and introduced zemstvo medicine.

Since its inception, healing has differed from other types of medicine in that it combines both knowledge of the healing properties of natural remedies and faith in miraculous powers.

Folk healers knew how to do bloodletting, trepanation of the skull, as well as treat injuries (apply splints), wounds with the help of various ointments, cauterization.

Folk healers compiled treatises on the use of the healing powers of nature - herbalists and healers. This became especially widespread after the adoption of Christianity and the appearance of writing. Unfortunately, we inherited only a small fraction of those sources, since most of them died or were stolen during the wars. It is interesting that in the books that have come down to us there are means that were used not only after the adoption of Christianity, but also long before it.

15. Monastic medicine

The emergence of monastic hospitals can be attributed to the time of the adoption of Christianity in Russia. The monks, who believed that God knows everything on earth, perceived illness as a punishment for human sins, and sometimes as the infusion of demons into the human soul and body. Therefore, healing from illness was seen as God's forgiveness and remission of sins.

The most famous of them were the hospital in Pereslavl, founded in 1091 by Metropolitan Ephraim of Kyiv, and the Kiev Pechersk Lavra, founded in 1051 by the monks Anthony and Theodosius on the outskirts of Kyiv. It got its name from the word “pechery”, i.e. caves in which the monks lived and did their noble work. The Kiev Pechersk Lavra left its traces in the development of medicine and culture in Rus'. Many chronicles were written there: from Nestor, Nikon, Selvester.

Hagiographic literature also came from there. In the 1661th century. there the "Kievo-Pechersk Patericon" was created - a collection of stories and stories about this famous monastery. Many famous architects and painters took part in creating the interior of the monastery. They, the life and activities of the monks, the ways and morals of Kyiv were described in the patericon. In XNUMX, it was first printed and published in the printing house of the same Kiev Pechersk Lavra.

People who entered the history of Russia are buried in the caves of the monastery: the founder of the Lavra, Anthony, the chronicler Nestor, the healers Damian and Agapius, and even the founder of Moscow, Yuri Dolgoruky.

Oddly enough, in the Lavra they found ways to treat a wide variety of diseases - from infectious to mental. Within the walls of the monastery there was even something like isolation wards, where the seriously ill were placed, they were provided with individual care. People who no longer had hope of recovery were often healed by monks, after which they believed in God and prayers and were tonsured monks.

Among the most famous healers who practiced in the Lavra were such people as the Monk Alimpiy, who became famous for treating people with the most severe cases of leprosy. For the treatment of skin diseases, he used icon paints, which apparently contained various medicinal substances. Also the holy and blessed Agapios was a monk of the Lavra. He is known for curing the grandson of Yaroslav the Wise, who later became the prince of Russia, and went down in history as Vladimir Monomakh.

The healers of the monastery treated for free, the patients were treated with tolerance, with love up to self-sacrifice. This attitude is the basics of medical ethics, which in our time, when studying at universities, is given great importance.

The monastic hospitals were also centers of learning and enlightenment: the monks collected Byzantine and Greek manuscripts, translated from Latin and Greek, combined information into collections, supplemented their knowledge and knowledge of their ancestors, and taught medicine from these sources.

16. Sanitation. Baths

Epidemics

Unlike Western Europe sanitary business in Russia in the X-XIV centuries. was quite well developed. This is evidenced by the excavations of ancient Novgorod, on the territory of which about 50 estates were found, equipped with baths, water pipes and drains. Entire areas were covered with wooden pavements dating back to the XNUMXth-XNUMXth centuries, in contrast to Western Europe, in which the first pavements were built only in the XNUMXth century, and the water supply system - in the XNUMXth century. These "innovations" were found in Germany.

A special place in ancient Russia occupied bathhouse. Traditional healers already understood the benefit that removing harmful substances through sweat brings to the body. A bathhouse in a house or estate was the cleanest place: they not only washed themselves, but also gave birth, cared for newborns, and invited doctors and chiropractors. The first mention of a Russian bath dates back to 1113 (chronicle from Nestor). A special misfortune of the Old Russian state was epidemics infectious diseases, or "pestilences". Generalized diseases were written in chronicles, and only for the period from the 47th to the XNUMXth centuries. you can find information about XNUMX epidemics. They fell ill with plague, cholera, leprosy and other diseases. The centers of the emergence of epidemics were the border cities through which foreign caravans passed - Novgorod, Smolensk.

So, for example, in 1230 in Smolensk, an epidemic claimed tens of thousands of lives, which indicates the extreme contagiousness of the disease. People understood that the disease passes from person to person, so they delimited the infected places where the sick were. If the epidemic spread to the whole city, the inhabitants went into the forests, leaving their houses, belongings and sick relatives, and sat out until the pestilence passed. However, the moment when the last patient died and there seemed to be no one to get infected was taken as getting rid of the disease. Knowing nothing about pathogens, people returned to the cities, and the epidemic sometimes returned with them. Considering the place cursed, people went so far as to burn entire settlements. Their mistake was also the fact that before the XV century. people who died from epidemics were buried, according to religious laws, in church cemeteries.

This contributed to the resumption and spread of the pestilence. Only in the 24th century. Those who died from infectious diseases began to be buried outside the cemetery, outside cities and villages. People did not understand that the cause of epidemics was not supernatural forces, but poverty and poor hygiene, so in some cases they resorted to desperate acts: for example, in the XNUMXth century. In Novgorod, during the plague epidemics, residents erected the Church of St. Andrew Stratelates in XNUMX hours. It has survived to this day. During the period of the Mongol-Tatar invasion in Rus' there was the largest number of epidemics, the most people died.

17. General characteristics of the historical period of the XV-XVII centuries

General characteristics of the historical period

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 1389-1425. At this time, the feudal war begins.

1480 BC - the overthrow of the Mongol-Tatar yoke.

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

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

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

1589 BC - the introduction of the patriarchy.

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.

Troubles - this is a civil war that pitted different classes: nobles, townspeople, boyars, serfs, peasants.

1613 g - 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 g - Adoption of the Council Code.

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.

18. The development of medicine in the XV century

Monastery hospitals and their role

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.

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.

19. "Sudebnik" Sovereign Pharmacy The heyday of traditional medicine

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 "Code of Law". They decided that in Moscow, as well as in other cities, it was necessary to create schools that would teach children to read and write, and also to establish almshouses in the cities for the care of the sick, elderly and crippled, “so that they could live in purity and in repentance and in all thanksgiving.”

However, in the XVI-XVII centuries. For almost the entire population of Russia, traditional medicine remained the only means of maintaining their health. The experience of Russian folk medicine was transmitted orally, and was also preserved in numerous medical books and herbalists, reflected in legislative acts, historical and everyday stories (among which “The Tale of Peter and Fevronia of Murom” - a story recorded in the 15th century, it tells about miraculous healing of the Murom prince Peter), chronicles. It must be said that in medical clinics a fairly large place was devoted to “cutting” (i.e., surgery). Among the “cutters” were bloodletters, chiropractors, and dentists. In addition, operations such as abdominal cuttings, cranial drillings, and amputations were performed in Rus'. Mandrake, wine, poppy were used as means to euthanize the patient. The tools were: probes, axes, saws, scissors, chisels, etc. These tools were carried through fire. Wounds were treated with wine, ash, and birch water. Wounds were sutured using hemp and flax fibers, as well as thin threads from animal intestines. In order to remove the metal fragment, they began to use magnetic iron ore. An interesting fact is that in Rus' original designs of prostheses for the lower extremities were created.

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 Pharmacy Chamber (court sovereign pharmacy). It was necessary to serve the royal family, as well as the closest boyars. The premises of the sovereign's pharmacy were furnished very luxuriously. The walls and ceilings were painted, the shelves and doors were covered with “good English” cloth, the windows had multi-colored glass. They worked in the pharmacy every day - from early morning until late evening, 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 by the pharmacists who prepared the medicine. Then the boyar tried the medicine, who subsequently gave it to the king. Having accepted a glass with the remainder of the medicine from the king, the boyar was obliged to “pour whatever was left in it into his palm and drink.”

The resettlement of foreign doctors, surgeons, and pharmacists to Moscow began in the first half of the XNUMXth century. They appeared in the royal lists of "necessary people." It should be noted that foreign doctors did not need practically anything.

20. Epidemics and anti-epidemic services

Particular attention must be paid epidemics, which 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 exposed to epidemics.

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.

In the XIV century. The first notes on the fight against epidemics began to appear. In the 1551th century, in XNUMX, 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 1552, during an epidemic in Novgorod, "there was an outpost on the Pskov road so that guests with goods would not go to Pskov, not from Pskov to Novgorod." In Novgorod in 1572 it was forbidden to bury people who had died from a "contagious" disease near churches. They had to be buried far outside the city. Outposts were set up on the streets where the sick were found, courtyards where a person died from a "contagious" disease were locked up, not allowing other survivors to go out. Nearby was a watchman who served people food and water directly from the street, that is, he did not enter the yard. Priests were also not allowed to visit the sick. For non-compliance with the last rule, they were burned along with the person who was sick.

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 "an 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.

21. Structure and functions of the pharmacy order

Pharmaceutical 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.

Pharmaceutical order - the first public health 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 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.

22. Methods of preparing medicines

Apothecary order, according to the instructions of the king, was to organize preparation of medicines. These are mainly herbal medicines.

The population received medicinal potions in the markets, green rows. Subsequently, two pharmacies were organized in Moscow by royal decree. 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.).

Pharmacies were supplied with medicines in various ways. From the very beginning, medicinal raw materials were imported from England. At the same time, some materials were purchased in shopping malls. For example, lard for a plaster - in the meat section, various medicinal herbs and berries - in the green row, flammable sulfur and black resin - in the mosquito row. There was also a so-called berry duty: royal decrees were sent to governors in different parts of Rus', which ordered the collection of various herbs for which these lands are famous 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. Failure to fulfill the berry duty was punishable by imprisonment. 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 reserves 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."

23 Russian doctors of medicine of the XV-XVIII centuries. Opening of the Academy of Sciences

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

Also, such foreign doctors worked in Russia, such as Lavrenty Blumentrost, Robert Jacob. Domestic doctors also traveled abroad for training. Among those who successfully completed training and also defended their dissertation abroad, we can note P. V. Postnikova. He received the title of Doctor of Medical Sciences from the University of Paduana, Italy. It must be said that Pyotr Postnikov was even the rector of the University of Padua. In 1701, Postnikov returned to Russia and was enrolled in the Apothecary Order.

You can also note George of 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 Drohobych from Rus', Doctor of Medicine of the University of Bologna,” which was published in Rome. It must be said that Peter I invited many foreign doctors to Russia, including to work in hospitals and hospital schools. Foreigners were the majority among doctors and teachers, and they fought with Russian doctors.

But it should be noted that the requirements for doctors in the era of Peter were high. For example, to become a professor at a hospital school, you need to get a "degree" of a doctor of medicine, defend a dissertation. Throughout the 89th century 309 Russian and XNUMX foreign doctors received the doctorate degree. Despite this, the number of Russian doctors of medicine grew. The first doctor of medicine who defended his dissertation in Russia was a graduate of Moscow University - F. I. Barsuk-Maiseev (the topic of his dissertation was "On breathing"). In 1764, the College of Medicine received the right to award doctors the degree of doctor of medicine. By the end of the XVIII century. 878 doctors worked in Russia.

Now let's turn our attention to administrative innovations. In 1710, the Apothecary Order was replaced by the Medical Office. The medical office became the central health authority. At the head of the Medical Office was a doctor-archiater. Subsequently, in 1763, the Medical Office was replaced by the Medical College.

And in 1803, the Medical College was closed, and its functions were transferred to the corresponding department of the Ministry of the Interior. In 1775, orders of public charity were formed to manage medical institutions, and the positions of county doctors were also introduced. In 1797, civil medical councils were created in the provinces, except for St. Petersburg and Moscow, in which all medical affairs were managed by the chief doctors of the city.

24. Empire of Peter I

1700th century begins the war, which was called the Northern War. It lasted from 1721 to XNUMX.

At that time, Peter I ruled in Russia. It must be recalled that Peter ascended the throne at the age of ten, in 1682. In fact, the state was ruled by Peter's elder sister, Sophia. However, in an attempt to stage a coup in 1689 to seize the Russian throne, Sophia failed. She was removed from power and imprisoned in the Novodevichy Convent. Peter I began to fully manage the state. On May 16, 1703, by order of Peter the Great, at the mouth of the Neva, on one of the islands, construction began on a wooden fortress (later it was replaced with a stone one), which was called Peter and Paul. In fact, this was the beginning of the construction of a new city - St. Petersburg.

The Northern War ended with the conclusion of the Nystadt peace, after which Peter I was proclaimed emperor. Russia has become an empire. Peter carried out a large number of reforms - ranging from reforms of public administration and ending with relations between church and state. In 1722 the "Table of Ranks" was published. It was one of the most important documents, since it determined the system of ranks, as well as the procedure for promotion in the public service, both military and civilian.

The era of Peter I was full of various transformations and innovations. During this period, Russia has significantly strengthened, strengthened, Russia's place in international affairs has increased significantly. Thanks to the creation of a regular army and navy, as well as the implementation of an active foreign policy, one of the most important historical tasks of Russia was resolved - it established itself on the shores of the Baltic Sea. Practically not a single foreign policy problem in Europe was solved without the participation of Russia. After the death of Peter I in 1725 and until 1762, palace coups took place in the Russian Empire, and emperors changed very quickly.

25 The main features of the economy and culture of Russia in the XVIII century

It must be said that in the XVIII century. the development of feudal society in Russia entered a new stage. This stage implied the strengthening of the Russian centralized state, the growth of commodity production, and at the same time the dominance of serfdom.

The reforms of Peter I, which were carried out directly in the interests of merchants and landowners, had a significant impact on the development of national culture and production forces. As the Russian state developed, some quantitative changes constantly accumulated, which were supposed to turn into qualitative ones. This happened precisely during the reign of Peter.

The transformation of quantitative changes into qualitative changes takes place through jumps. In fact, under Peter I, the process of the formation of a new culture, which began in the previous era, had its continuation.

Economic development of Russia in the XVIII century. was accompanied by the rise of Russian science, art, culture. There was a formation of socio-political and philosophical thought, and this formation was closely connected with the development of trade and industry in the country, as well as with the growth of Russian national culture, the emergence and further development of art, literature, and natural science.

In the XVIII century. Russia experienced a spiritual upsurge, the essence of which was as follows: the transition from a predominantly traditional, relatively closed and ecclesiastical culture to a secular and European culture with an increasingly distinct personal beginning. Enlighteners of that time: N. I. Novikov, D. I. Fonvizin, S. E. Desnitsky, D. S. Anichkov, A. N. Radishchev, etc. A state system of general education secondary school was created, higher education was born anew , vocational training and class educational institutions developed.

However, a fairly large part of the population, especially serfs, did not receive access to education. In 1725, the Academy of Sciences and All Arts was organized. 1755 - the opening of the Moscow University, 1783 - the Russian Academy was founded, studying the Russian language and literature. Members of the Academy: G. R. Derzhavin, D. I. Fonvizin, M. M. Shcherbatov, E. R. Dashkova, M. V. Lomonosov, etc.

The goal of the leading thinkers of Russia in the XVIII century. It was:

1) drawing attention to the study of natural science in order to competently use the natural resources of Russia for its progressive economic development;

2) separation of science from the church.

So, progressive Russian thinkers of the XVIII century. made a big step from "religious ideology to secular knowledge."

Let us turn to the St. Petersburg Academy of Sciences, which was opened in 1725. Foreign scientists were invited here. Thus, the first academicians published works on various medical issues. For example:

1) G. Duvernoy и I. Veitbrecht published a number of works on anatomy;

2) Daniel Bernoulli - "Works on the movement of muscles", "Works on the optic nerve";

3) Leonhard Euler published several papers on hemodynamics.

26. The development of medicine at the beginning of the XVIII century

To begin with, it should be noted that by the XVIII century. Russia stepped over the so-called period of backwardness, which was caused by the Mongol-Tatar yoke. Serfdom, which fettered a significant part of the country's population, was an obstacle to the development of the country, the Russian economy, science, and industry. However, if we consider certain areas, Russia was on the same level with civilized countries and even began to overtake them. Only in the 1755th century, namely in 1748, the first university was opened in Russia. This was done largely thanks to the Russian scientist M.V. Lomonosov, as well as the person supporting him, I.I. Shuvalov. In XNUMX, M.V. The university must necessarily have three faculties: law, medicine and philosophy (theological is left to synodal schools). In the XVIII century. and in the first third of the XNUMXth century. researchers such as S. N. Zatravkin и A. M. Stochik, published two monographs concerning the medical faculty of Moscow University. It was generally accepted that the medical faculty was opened in 1764. But Stochik and Zatravkin presented documents stating that the faculty began to function on August 13, 1758. Then Professor I. H. Kerstens from the University of Leipzig was invited to the university. Kerstens began teaching classes, giving lectures, and was even appointed “doyen” (i.e., dean) of the medical faculty. Here is an excerpt from the documents of the Russian State Archive: “Imperial Moscow University has received news: the Faculty of Medicine is equipped with a doctor called from the glorious Leipzig University with great medicine and great philosophy Johann Christian Kerstens Professor of Chemistry, Pharmacology and Mineralogy, who, as a result of this, by virtue of university institutions in medical science, has been entrusted and will perform in that entrusted position of entry, after the end of the present vacation days of this August, the thirteenth day at ten o'clock after midnight, and will make a speech in Latin, in which it will be proved that chemistry is the first and best means for the improvement of medical science.

From the very beginning, the faculty provided general education not only for future doctors, but later among its students began to appear those who devoted their whole lives to medicine. Over time, in addition to Kerstens, professors began to work at the Faculty of Medicine Erasmus, prosector (vice-rector) Keresturi, as well as domestic professors who returned from abroad - P. D. Veniaminov, S. Ya Zybelin. Since 1768, lectures began to be given in Russian. Thus, a base for training medical specialists began to form in Russia. The medical university provided high-quality general education to future doctors, however, it did not provide them with practical training. Future doctors acquired practical skills in hospital schools. Here, training took place directly at the bedside of patients, in hospitals.

27. Hospitals and hospital schools

Hospitals and hospital schools appeared in Russia at the end of the XNUMXth - beginning of the XNUMXth centuries. in the era of Peter I. He was a great reformer of the Russian state, he also did not disregard medicine. So, in his foreign trips, in addition to shipbuilding, he was interested in medicine. For example, Peter bought a collection of "freaks" from the famous anatomist Ruish for a lot of money, which later became the basis of the famous Kunstkamera.

Peter understood that healthcare in Russia was at a very low stage of development (high infant mortality, epidemics, shortage of doctors). So he started construction of sea and land hospitals, and with them - hospital schools, where doctors were trained. The organization of construction was entrusted Nikolai Bidloo.

So, the first hospital was opened in Moscow on November 21, 1707. It was a land hospital, and a hospital school was also opened with it, which was designed for 50 students. Further, hospitals and hospital schools were opened under them in St. Petersburg, Revel, Kronstadt, Kyiv, Yekaterinburg, etc. It must be said that hospital schools were opened even in such little-known cities as Koluvanovo, Elizavetgrad. There they were calculated 150-160 people.

in hospital schools there was a fairly high level of teaching, high quality curricula. There was no such system in medical education in any country in Europe. In hospitals, rooms were specially equipped for clinical classes, teaching anatomy, and the basics of obstetrics. The teaching of anatomy necessarily included dissections.

The activities of hospital schools were subject to general rules and guidelines. In 1735, a special "General regulation on hospitals" was issued. It included terms of training programs in medical disciplines (5-7 years), as well as in Latin language and philosophy, teaching rules, etc. The advanced character of hospitals is clearly visible in this regulation. Autopsies were allowed.

At the end of their studies at the hospital school, students took an exam that included theoretical knowledge, clinical knowledge, as well as what is today called practical skills.

After N. Bidloo, who led the training in hospital schools, his work was continued M. I. Shein, P. Z. Kondoidi(1710-1760).

By order of Pavel Zakharovich Kondoidi, prototypes of the history of the disease began to be kept - "mournful sheets" that were wound up for each patient. Medical libraries were organized in hospitals.

It should be noted that the head of the hospital (in accordance with the instructions of the medical office - the country's health management body) was a doctor. In hospitals, a pathological and anatomical examination was mandatory - an autopsy of corpses.

In 1786 hospital schools were reorganized into medical and surgical schools. These schools opened the way to the formation of the corresponding medical and surgical academies.

28. M V Lomonosov and his teaching

M V Lomonosov - brilliant scientist, philosopher, poet, geographer, naturalist.

In 1723, by decree of Peter I, the Academy of Sciences and All Arts was established. The opening of this academy took place in 1725. The pillar of the academy was M.V. Lomonosov (despite the large number of foreign doctors) and his students, famous doctors of that period (A.P. Protasov, S. Zybelin, N.M. , D. S. Samoilovich, etc.).

Lomonosov had truly enormous talent. He was very close and interested in medical problems. He believed that medicine is one of the most useful sciences for humans; it “through knowledge of the properties of the body... reaches the cause.”

It must be said that Lomonosov attributed medicine to the field of physics: "The greatest science of physics and the most useful science for the human race is medicine." The fact is that physics in those days had a wide meaning - natural science in general. So, M. V. Lomonosov introduced medicine into the circle of natural sciences.

In 1751, in his famous speech "On the Benefits of Chemistry," he made many striking statements about medicine. Lomonosov carefully studied anatomy, physics, physiology, as well as other sciences that could be useful for medicine. Lomonosov was sure that it was simply impossible "to talk about the human body without knowing either the addition of bones and joints to strengthen it, or the union, or the position of the muscles for movement, or the distribution of nerves for feeling, or the location of the viscera for the preparation of nourishing juices, or the length of the veins for the circulation of blood, or other organs of his wonderful structure.

Lomonosov considered it necessary to study chemistry for the knowledge of medical science; he writes that "a physician cannot be perfect without a sufficient knowledge of chemistry. She recognizes the natural mixture of blood and nutritious juices, she discovers the addition of healthy and harmful food. She prepares useful medicines not only from various herbs, but also from the core of the earth taken materials" . In 1761, M. V. Lomonosov wrote a letter to Count I. I. Shuvalov "On the reproduction and preservation of the Russian people." This letter is of great importance, in which he convincingly and vividly described the difficult situation of medicine in the country, the incidence, high mortality, especially high infant mortality. Lomonosov called for combating bad habits, improving the quality of training for doctors, and improving the level of medical care. It must be said that the letter to I. I. Shuvalov can be assessed as a kind of program for the revival of the health of Russians, but it was not published. It should be noted, however, that the progressive doctors of that period followed the precepts of Lomonosov.

29. S. G. Zybelin - the first Russian professor

Semyon Gerasimovich Zybelin (1735-1802) - the first Russian professor at Moscow University. It occupies an important place in Russian medicine in the XNUMXth century. After he graduated from the Slavic-Greek-Latin Academy in Moscow, he was sent for an internship and continued education at the University of Leiden. At the University of Leiden, he received the title of Doctor of Medicine.

After which he returned to Moscow. From 1765 to 1802 Zybelin was a university professor. He lectured on chemistry and medicine. Incidentally, he was one of the first to start lecturing in Russian. Lectures by S. G. Zybelin included a wide range of theoretical and practical medicine, as well as many other aspects of a doctor's activity:

1) obstetrics ("woman's business");

2) raising children;

3) diagnosis and treatment of various internal diseases;

4) hygiene;

5) study of the laws of nature;

6) laws of physiology and pathology;

7) prevention of the development of diseases. The teaching of pharmacy was also part of the duties of Semyon Gerasimovich Zybelin.

The teaching of pharmacy by Zybelin included a fairly large course of recipes, courses in the art of pharmacy, a course in pharmaceutical chemistry, etc. The titles of some of Zybelin's lectures.

1. "On the causes of the internal union of parts among themselves."

2. "A word about the cause of the internal union of the parts of the body and among themselves, and about the strength that comes from that in the human body."

3. "On the action of air on man and the ways in which he enters him."

4. "On the correct education from infancy in the reasoning of the body, serving for reproduction in the society of peoples."

5. "On the benefits of inoculating smallpox."

6. "On the additions of the human body and how they

protect against disease."

7. "On the harm resulting from keeping oneself excessively warm."

8. "About ways how to warn can be an important reason, among other things, the slow multiplication of the people, the reason consisting in the indecent food of babies given in the first months of their life."

According to these lectures, one can judge that the approach to medicine was broad and deep, and the problems of protecting the health of the population were touched upon.

In his lectures and teaching method, Zybelin followed the path of Lomonosov, followed the clinical principles of Hippocrates, Harvey's physiology, etc. Since the university did not have specialized clinics where students could gain clinical knowledge and experience, Semyon Gerasimovich Zybelin organized the so-called courses medical consultations, where he demonstrated patients.

30. Reign of Alexander I

In 1801, on the night of March 11-12, Emperor Paul I was killed as a result of a conspiracy.

Alexander Pavlovich, or Alexander I, ascended the throne. With the ascension to the throne of Alexander I, numerous changes were expected. His mentor in childhood was F. S. La Harpe, a prominent political figure from Switzerland, who was a liberal in his convictions, an opponent of slavery. These thoughts he instilled in his pupil. In addition, in his youth, Alexander was fond of the ideas of such enlighteners as F. Voltaire, C. Montesquieu, J. Rousseau. Thus, Alexander's thoughts about equality and freedom coexisted with autocratic rule, and this was reflected in his reforms, all of which were, so to speak, half-hearted.

The secret committee discussed the issues of the spread of education, various kinds of state reforms, as well as the problems of serfdom. In 1802, the boards that had been created under Peter I were replaced by ministries. At the head of the ministry was a minister who reported directly to the king. In 1803, a new regulation was issued, which spoke about the organization of educational institutions. There was now the following division between the schools:

1) parochial schools;

2) district schools;

3) gymnasiums;

4) universities.

In addition, new universities were opened: St. Petersburg, Vilna, Derpt, Kharkov. And already in the charter of 1804, universities received the right to choose their own professors and rector, as well as to solve their university problems on their own.

In 1803, the "Decree on free cultivators" was also issued. Its essence was that the landowners could now release peasants with land for a certain ransom.

June 1812 - the beginning of the Patriotic War. Russia's enemy was France, led by Napoleon. It is impossible not to mention the famous battle of Borodino - Borodino battle.

The Russians won a political and moral victory here. That's what Napoleon is. The Russian army won this war, and Napoleon's army was defeated.

It is necessary to mention the foreign campaigns of the Russians in 1813-1815. Two societies were established in Russia: in February 1821 - a large secret "Southern Society". It is headed by P. I. Pestel, the creator of Russkaya Pravda. Autumn 1822 - "Northern Society", which was headed by N. M. Muravyov. The main document of the "Northern Society" was the "Constitution".

December 14, 1825 at 11:00 a.m. the Decembrist uprising ("Northern Society") began. December 25, 1825 (lasted until January 3, 1826) - uprising in the South - "Southern Society". However, both of these uprisings were suppressed by the tsarist troops.

On November 19, 1825, Alexander I died.

31. Tsardom of Nicholas I

In 1825, Nicholas I, who at that time was 19 years old, came to the throne. Under Nicholas I:

1) strengthening of political investigation;

2) tightening censorship. 1826 - censorship charter (included 230 articles);

3) education reforms. 1828 - school charter; 1835 - new university charter;

4) 1839 BC - monetary reform (silver ruble);

5) peasant politics.

It must be said that the entire internal policy of tsarism under Nicholas I served the interests of the nobles and serfs. The main directions of the foreign policy of Nicholas I:

1) the fight against revolutionary movements in Europe;

2) attempts to resolve the Eastern question. The Eastern question is international relations related to the division of the territory of the former Ottoman Empire (Turkey).

In the 1820-1840s. in Russia there were two main directions in the social movement:

1) revolutionary;

2) liberal.

The most prominent representative of the liberal movement is P. Ya. Chaadaev ("Philosophical Letter").

Raznochintsy - people from different classes who received an education. Raznochintsy counted on a coup by the forces of the army with the obligatory involvement of the people. The most prominent representative of the revolutionary socialist trend was A. I. Herzen, who was the creator of "Russian socialism" (or "populism"):

1) Russia can enter socialism without going through the capitalist stage;

2) the basis of the future socialist system in Russia is the peasant communities;

3) it is necessary to overthrow the autocracy, abolish serfdom, distribute land to the communities. October 16, 1853 - Turkey declared war on Russia. Causes of the Crimean War:

1) the desire of Turkey to seize the Crimea and the Caucasus;

2) clash of colonial interests of Russia, England, France, Austria in the Middle East and the Balkans.

The nature of the war was predatory, predatory, predatory.

In 1856, the Treaty of Paris was concluded - the result of the Crimean War. Terms of the Peace of Paris:

1) Russia lost the mouth of the Danube and Southern Bessarabia;

2) the return of Turkey to Kare and the receipt of Sevastopol, Evpatoria;

3) Russia was forbidden to have a military fleet on the Black Sea.

The results of the Crimean War:

1) the war served as an impetus for the collapse of the autocracy and the abolition of serfdom;

2) the war dealt a crushing blow to the entire foreign policy system of tsarism.

32. N. I. Pirogov as an outstanding scientist

Nikolai Ivanovich Pirogov (1810-1881) - one of the largest representatives of domestic medicine in the XNUMXth century.

He graduated from the medical faculty of Moscow University. Among Pirogov's teachers are Professor of Anatomy and Surgery Yu. Kh. Lodara and Professor of Dorpat University I. F. Mayer (1786-1858). After that, he continued his studies at the Tartu Professorial University. In the same place, in 1832, he defended his doctoral dissertation.

After graduating from a professorial university, in early 1833, Pirogov was sent to Germany for improvement.

Upon returning from abroad, at the suggestion of Mayer, who resigned, Pirogov was elected extraordinary professor at the University of Tartu. The fact is that Nikolai Ivanovich was only 26 years old at that time, so he could not be elected as an ordinary professor, but a year later he became one. During his work in Tartu, Pirogov wrote about 10 major scientific works.

For more than 8 years, he studied the anatomy of fasciae, arteries in relation to the possibilities of surgical operations (in fact, he laid the foundations of operative surgery and topographic anatomy). So, the work of 1837, which is called "The Surgical Anatomy of the Arterial Trunks and Fascia", put Pirogov among the best anatomists in the world.

In 1840, Pirogov was invited to the department at the Medical-Surgical Academy of St. Petersburg. Then Pirogov proposed creating a department of hospital surgery so that the connection between practical activities and scientific achievements would become stronger, so that students could “... observe nature not with the eyes and ears of their teacher, but with their own.”

So, in addition to faculty clinics, hospitals began to be created. In St. Petersburg, Pirogov left in 1841 - a qualitatively new and most productive stage in the activity of Nikolai Ivanovich began. It was during this period that he created the well-known "ice anatomy".

In 1843-1844. Pirogov used the method of freezing corpses and the thinnest cuts of their parts and organs, which preserve the topography of the organs of a living person. Nikolai Ivanovich Pirogov wrote about this method in his work "A complete course in applied anatomy of the human body.

Pirogov improved the methods of teaching and researching anatomy, introduced the principles of layered preparation in the study of arteries and fascia, various anatomical regions. With this, N. I. Pirogov radically changed the idea of surgical anatomy.

Nikolai Ivanovich Pirogov died in 1881. He played one of the main roles in the development of medical science in Russia. After his death, the All-Russian Scientific Society was established in his memory. The estate of N.I. Pirogov Cherry was renamed Pirogovo, and the house became a museum named after. N.I. Pirogova. Next to it is a crypt where the embalmed body of the great Russian medical scientist lies.

33. Military field surgery N. I. Pirogov

During the Crimean War N. I. Pirogov went to the front, where he collected a lot of unique material, which formed the basis of another classic work by Pirogov "The beginnings of general military field surgery, taken from observations of military hospital practice and memoirs" (1865-1866). Later, Pirogov continued his observations and "principles of organizing surgical care" during wars.

For example, he worked as an inspector in 1877 during the Turkish-Bulgarian War. It is impossible not to recall the expression of Pirogov: "War is a traumatic epidemic. The properties of wounds, mortality and the success of treatment depend mainly on the various properties of weapons."

This is a statement from a brief work on the experience of the war in Bulgaria - "Military medical practice and private assistance in the theater of war in Bulgaria."

The main innovative ideas of N. I. Pirogov as a military surgeon.

1. Pirogov was against "hasty operations carried out, thus advocating saving tactics in relation to the wounded and sick." He called for abandoning early amputation in case of gunshot wounds of the limb, accompanied by bone damage. He was a supporter and recommended to all the so-called savings surgery.

2. Nikolai Ivanovich Pirogov attached great importance to the correct immobilization of patients with fractures. I must say that he was one of the first to introduce plaster bandages into widespread practice. Starch dressings were also used.

3. Particular attention was paid to "...well-organized triage at dressing stations and military temporary hospitals."

4. Pirogov was also an innovator in the use of anesthesia. He was one of the first in Europe to use ether anesthesia (ether dressing) in the conditions of hostilities near the village of Salty while helping the wounded. Thus, chloroform, ether, and other types of anesthesia are firmly rooted in medical practice.

5. It is impossible not to say about Pirogov's views on hygiene, on the prevention of various diseases. Here is what he said: "I believe in hygiene. This is where the true progress of our science lies. The future belongs to preventive medicine. This science, going hand in hand with the state, will bring undoubted benefits to mankind."

Nikolai Ivanovich Pirogov, apart from being a first-class surgeon, was an excellent organizer and innovator in the field of medicine and healthcare.

The defeat in the Crimean War, intrigues at the Medical and Surgical Academy and other factors influenced Pirogov, and at the age of 46 he decided to leave the academy and accepted an offer to become a trustee of educational districts in Odessa.

34. M. Ya. Mudrov and his teaching

Matvey Yakovlevich Mudrov (1776-1831) - dean of the medical faculty of Moscow University, one of the most outstanding therapists of that time. Mudrov's pedagogical and scientific views were based on the democratic tradition characteristic of Russian medicine, the doctrine of the integrity and individuality of the patient's body, the ideas of nervism and highly humane principles of approach to the suffering. Matvey Yakovlevich Mudrov repeatedly expressed his social and scientific views at ceremonial meetings of Moscow University. Probably the most complete idea of his views is given by the speech “A Word on the Way to Teach and Learn Practical Medicine or Active Medical Art in the Bedsides of the Sick” (1820). In this speech (as well as in other works of Mudrov), a program of approach to the prevention of the healthy and to the treatment of the sick was outlined, and a number of provisions were put forward that became aphorisms.

1. "We should not treat the disease itself, for which we do not find parts and names, we should not treat the cause of the disease, which is often unknown to us, the patient, or those around him, but the patient himself, his composition, his organ, his strength."

2. "The same disease, but in two different patients requires a very different approach."

3. “Starting with love for my neighbor, I should instill in myself all the others that stem from one medical virtue, namely: helpfulness, readiness to help at all times, day and night; friendliness that attracts the timid and the brave; mercy towards strangers and the poor, unselfish indulgence towards the sins of the sick, gentle severity towards their disobedience, polite importance towards the superiors;

talk only about what is necessary and useful; modesty and modesty in any case; moderation in food; inviolable peace of mind and spirit in the face of the dangers of the patient; gaiety without laughter and jokes in occasional family disturbances; curbing the language in competitions for whatever reason; cordial acceptance of good advice, no matter who it comes from, convincing rejection of harmful suggestions and advice, removal from superstition; chastity. in a word, wisdom. Medicine should be combined with wisdom, because, according to Hippocrates, a doctor who loves wisdom is like a father.

4. The doctor must "... guide the sick well for the sake of health, take care of the healthy so that he does not get sick, take care of the healthy and for the sake of well-being of behavior."

5. "To take healthy people into your own hands, to protect them from hereditary or threatening diseases, to provide them with a proper way of life, to eat honestly and calmly for a doctor. And it is easier to protect from diseases than to treat them."

Mudrov repeatedly emphasized the importance of the influence of the psyche, which he associated with the activity of the brain, demanded "to investigate the actions of the soul, depending on the brain, states of mind, melancholy, sleep."

35. S. P. Botkin - Russian clinician

Sergey Petrovich Botkin (1832-1889) - one of the outstanding domestic clinicians. He graduated from the medical faculty of Moscow University in 1854. From 1862 to 1889. he was the head of the academic therapeutic clinic of the St. Petersburg Medical and Surgical Academy.

I. M. Sechenov and S. P. Botkin put forward the following assumptions:

1) about the leading importance of the environment in the origin of acquired and inherited properties of the organism;

2) about the primary role of the environment in the origin of diseases.

S. P. Botkin was distinguished by the ability to find an individual approach to the patient, great observation, the ability to correctly assess the significance of various manifestations of a particular disease. All this made Botkin a subtle diagnostician. Here are a number of scientific generalizations and observations by S. P. Botkin:

1) infectious origin of catarrhal jaundice;

2) the doctrine of the peripheral heart, of collapse;

3) the doctrine of the causes of death in lobar pneumonia;

4) the relationship of the formation of gallstones with microorganisms;

5) the doctrine of the fall of the pulse due to the weakness of the vessels;

6) the doctrine of the "wandering kidney" and the phenomena of enteroptosis;

7) the presence of nerve centers;

8) in-depth analysis of the lesions of the nervous system, as well as the hematopoietic system, the circulatory system.

Sergei Petrovich Botkin showed the reflex mechanism of a number of pathological processes.

Botkin considered the neurogenic origin of some forms of fever, sweating on one side of the body, and contractility of the spleen. Botkin also introduced such a thing as a pathological reflex. With the creation of the neurogenic theory, Botkin marked the beginning of a new stage in the development of clinical medicine.

The organization of medical affairs was also included in the circle of interests of Sergei Petrovich Botkin. At his suggestion, the conditions and equipment of city hospitals in St. Petersburg began to improve.

Laboratories were set up in hospitals, medical conferences were held, post-mortem autopsies were performed, and the nutrition of patients was also improved. Thus, Botkin contributed to the improvement of medical care for the population. Another merit of Botkin in the organization of health care was the introduction of the so-called Duma doctors. They were supposed to provide assistance at home to the poorest population of the city.

In 1886, a commission was set up to improve sanitary conditions and reduce mortality in Russia. This commission was headed by Sergei Petrovich Botkin. The materials collected by this commission were analyzed and conclusions were drawn about high infant mortality, insufficient medical care, etc.

S. P. Botkin was an outstanding teacher of higher medical school. He created an extensive school of his followers.

36. G. A. Zakharyin, his contribution to therapy

Grigory Antonovich Zakharyin (1829-1897) - one of the leading clinicians of the 1852th century. He graduated from the medical faculty of Moscow University in 1862. From 1895 to XNUMX. G. A. Zakharyin was the head of the faculty therapeutic clinic of Moscow University. He was an innovator in his clinical and teaching activities. Through his students, he had a significant impact on the development of medicine.

G. A. Zakharyin expressed the main task of the clinician as follows: "To determine what disease (research and recognition), how it will go and how it will end (prediction), prescribe a treatment plan and carry out in accordance with the course of the disease (observation)". G. A. Zakharyin attached great importance to clinical lectures: "A clinical lecture should be an example of the correct methodology and individualizing clinic. And the more it differs from the chapter of the textbook, the more it has the right to be called a clinical lecture." G. A. Zakharyin's research covered a number of issues of clinical medicine. He described the picture of syphilis of the lungs (syphilitic pneumonia, clinic of pulmonary tuberculosis), syphilis of the heart, in addition, he gave a classification of tuberculosis. G. A. Zakharyin put forward a theory about the role of endocrine disorders in the etiology of chlorosis. One of the main merits of Zakharyin is the development of the method of direct clinical observation and the development of a method for questioning the patient.

The initiative of the survey should remain in the hands of the attending physician. It must be said that Zakharyin's survey covered not only the past (anamnesis), but also the present state, as well as the environment in which the patient lives. In fact, in the survey, G. A. Zakharyin has two main principles: physiological (by systems and organs) and topographic. The method of such a survey covers all systems and organs: blood circulation, respiration, genitourinary system, gastrointestinal tract (which includes the stomach, liver, intestines, spleen), hematopoietic system, metabolism, nervous system, as well as neuro-emotional state (headaches , intelligence, sleep, mood, memory, paresthesia, dizziness, etc.).

G. A. Zakharyin attached great importance to treatment. In the medical advice of Zakharyin, instructions to the patient about the lifestyle and regimen occupied a large place. Here's what he said: "Change the environment, change the activity, change the way of life, if you want to be healthy."

It is worth noting that, along with peace, Zakharyin recommended movement. G. A. Zakharyin, along with the use of medicines, also used hygienic and preventive measures, as well as general medical techniques - bloodletting, climatotherapy for patients with pulmonary tuberculosis (by the way, climatotherapy was recommended not only in the south, but also in nature in any area), massage , mineral water.

Questions of hygiene occupied an important place in Zakharyin's clinical teaching.

It must also be said that only rich people could follow most of the advice of G. A. Zakharyin.

37. A. A. Ostroumov and his works

Alexey Alekseevich Ostroumov (1844-1908) in 1870 he graduated from the medical faculty of Moscow University. From 1879 to 1900 He was the head of the Department of Hospital Therapy at Moscow University. Aleksei Alekseevich Ostroumov was a follower of Zakharyin, especially in the application of clinical methods.

He also attached great importance to questioning the patient, believed that it was necessary to identify all the features of the case of the disease in this particular patient.

He continued to develop the traditions of S. P. Botkin in the development of experimental pathology and physiology. Like S. P. Botkin, A. A. Ostroumov was interested in the then new sciences - experimental pathology and pharmacology. A. A. Ostroumov attached great importance to the nervous system.

Ostroumov wrote: “The organism is a whole. The disorder of one part is reflected in the whole organism by a change in the vital activity of its other parts, therefore, the weakening of the function of one organ upsets the entire organism... The organism as a whole changes in its functions when each of its parts is diseased.” Ostroumov believed that through metabolism and the neuro-reflex system, the unity of the body, the interconnection of various organs with each other and the correlation of their activities are realized. A. A. Ostroumov analyzed various factors operating in the pathological process.

He became the developer of the doctrine of the significance of the course and etiology of the disease of the external environment in which this person lives, develops, etc. A. A. Ostroumov clearly defined the tasks of the doctor: “The subject of our study is a sick person, whose normal life is disrupted by the conditions of his existence in the environment... The purpose of clinical research is to study the conditions of existence of the human body in the environment, the conditions of adaptation to it and disorders.”

Ostroumov attached decisive importance in the treatment of the patient to general treatment, considered it necessary to place the patient in conditions with the most favorable diet, work, and housing for this patient.

A. A. Ostroumov believed that medical science is a part of natural science, and therefore, its development should take place in connection with other natural sciences. That is why he sought to combine clinical findings with biological data.

The shortcomings of the views of Aleksey Alekseevich Ostroumov include the fact that he exaggerated the role of a person's hereditary, innate predispositions to various diseases and belittled the adaptive properties of his environment. He underestimated the social side of human society.

38. Aseptic and antiseptic

Mid XNUMXth century was marked for surgery by significant innovations - the use of ether and chloroform anesthesia. This made it possible for surgeons to operate more calmly and without unnecessary haste.

The fight against wound infection is one of the main tasks of surgery in the second half of the XNUMXth century. The development of surgery was greatly facilitated by the creation and introduction into practice of antisepsis and asepsis. Scourge of surgeons were purulent complications after operations and after wounds.

It must be said that even before Pasteur made his discoveries, Russian surgeons (I. V. Buyalsky, N. I. Pirogov) fought wound infections. Buyalsky used an antiseptic solution of bleach to wash his hands, he believed that this was one of the best protective agents for surgeons, midwives, obstetricians, doctors and paramedics, both during operations, internal examinations, bandaging of gangrenous, cancerous, venereal and inflicted by rabid animal wounds, and during the autopsy of dead bodies. N. I. Pirogov, in the treatment of wounds, used iodine tincture, silver nitrate, and bleach solution. It is also worth mentioning that in his clinic in St. Petersburg in 1841, N. I. Pirogov allocated a special department, which was intended for patients with erysipelas, pyemia, gangrene, etc. He did this in order to prevent the development of nosocomial infection.

During the 1880s the beginnings of asepsis appeared. Asepsis included some techniques that were developed by antiseptics (disinfectant treatment of the surgical field and the surgeon's hands, strict cleanliness of the operating room). Sterilization of instruments, clothing of operating room personnel, and dressings was introduced. In 1884, a domestic doctor L. O. Heidenreich proved that the most perfect is steam sterilization at elevated pressure. He suggested an autoclave. Gradually, chemical methods of disinfection (for example, dressings) were replaced by physical ones. It must be said that asepsis was the result of the work of surgeons from various countries. At the end of the 1880s. in Russia, aseptic methods began to be used in a number of clinics. For example, N.V. Sklifosovsky - in Moscow, A. A. Troyanov - in St. Petersburg, and M. S. Subbotin - in Kazan, etc.

It must be said that the introduction of antiseptics, asepsis and anesthesia contributed to the flourishing of surgery. Thanks to the knowledge of anatomy, surgeons were able to develop a technique for operating approaches, in particular to deep-lying organs and tissues. The introduction and development of asepsis allowed surgeons to operate not only on the limbs and the surface of the body, but also to penetrate into its cavities.

In the early 1890s "dry" method of operation was introduced. The essence of this method was that the surgeons avoided washing the wound with antiseptic agents and sterile saline. Tools E. Kocher и J. Peana, as well as a proposal F. Esmarch, made it possible for surgeons to operate with little blood loss and in a “dry wound”.

39. Development of surgery in Russia

At the end of the 1882th century. Abdominal surgery began to develop widely, and a large number of operations were performed on the abdominal cavity. For example: gastroenterostomy (G. Matveev, T. Billroth), pylorotomy (J. Pean), excision of the cecum (T. Billroth), gastrostomy (N. V. Sklifosovsky, A. Nussbaum), excision of the pylorus (T. Billroth), partial excision of the large and small intestines. Surgeries on the liver and kidneys began. The first cholecystotomy operations were performed in 1884 and XNUMX. Nephrectomy operations were performed quite often.

Surgeries began to be performed on peripheral nerves (nerve suture, nerve traction) and on the brain (for example, removal of tumors). In addition, new dressings were introduced (cotton wool, gauze bandage, muslin, gauze, etc.).

Local anesthesia began its development with the use of cocaine. The first to study the effect of cocaine on sensory nerves was St. Petersburg pharmacologist A.K. Anrep in 1880. He was also the first to administer subcutaneous injections of cocaine to patients. Well, since 1884, pain relief with cocaine began to be used in surgery.

In 1886 L. I. Lushkevich was the first to use regional (regional) anesthesia, he described the violation of the conduction of nerves in humans after cocaine was injected subcutaneously. L. I. Lushkevich was also the first to use conductive anesthesia of the finger during surgery.

A. V. Orlov pointed out in 1887 the advantage of weak solutions of cocaine. So, local anesthesia was quite common in the practice of zemstvo doctors.

Zemstvo medicine at the end of the 19th - beginning of the 20th centuries. significantly improved medical care for the rural population. Also, zemstvo medicine played a big role in the development of surgery in Russia. Thus, surgery was one of the first medical specialties required in zemstvo hospitals.

The surgical specialty developed not only in university clinics and hospitals in large cities, it also developed in districts, in zemstvo district hospitals. Major surgeons were formed there, who could perform fairly complex operations.

The use of spinal anesthesia and intravenous anesthesia marked the beginning of the XNUMXth century.

In the second half of the XIX - early XX centuries. in the field of surgery shone such surgeons as A. A. Bobrov, I. I. Dyakonov, N. V. Sklifosovsky, V. I. Razumovsky, N. A. Velyaminov In fact, they became in theoretical and practical terms the successors of the work of Nikolai Ivanovich Pirogov. They performed complex operations, studied the problems of general surgery, and created new surgical techniques.

Surgery expanded the possibilities of influencing the disease process. It is no coincidence that at the end of the XIX century. in some clinical specialties, such as, for example, urology, ophthalmology, gynecology, surgical methods appeared in addition to therapeutic methods.

Reconstructive surgery had its own development - plastic surgery, prosthetics. In surgery of the late XIX - early XX centuries. the effectiveness of surgical intervention has increased due to the emergence of new, the complication of old surgical methods, as well as the use of new complex instruments and devices.

40. I. M. Sechenov. The doctrine of reflexes

Ivan Mikhailovich Sechenov (1829-1905) graduated from the military engineering school, and after it - Moscow University. After that, he taught at Moscow, Odessa, St. Petersburg universities. Sechenov was fired from St. Petersburg University for his radical materialistic views, and continued to work at Moscow University in the Department of Physiology. Let us designate the main directions of Sechenov's research activity:

1) chemistry of breath;

2) physiology of the nervous system;

3) the physiological foundations of mental activity. So, I. M. Sechenov became the founder of Russian physiology. He was the founder of the materialistic school of Russian physiologists. This school played an important role not only in the development of psychology, physiology and medicine in Russia, but throughout the world.

Sechenov for the first time began to consider the activity of the brain as a reflex. Before Sechenov, only those types of activity that were associated with the spinal cord were considered reflex. I. M. Sechenov established that in the brain of a person (and animals) there are special nervous mechanisms that have an inhibitory effect on involuntary movements. Sechenov called such mechanisms "delay centers".

In numerous experiments, a physiological center was discovered, which is located in the middle parts of the brain. This center was called the "Sechenov center", and the phenomenon itself, established in these experiments, was called "Sechenov braking".

I. M. Sechenov laid the foundation for the modern natural-scientific substantiation of the materialistic theory of reflection, creating the doctrine of the reflexes of the brain, extending the concept of "reflex" to the activity of the higher department of the nervous system. Here some works by I. M. Sechenov

1. "To whom and how to develop psychology" (1873).

2. "Objective Thought and Reality" (1882).

3. "Elements of Thought" (1902).

In the above works, Sechenov developed the materialistic doctrine, thereby proving the formation and influence of the external environment.

I. M. Sechenov also dealt with the problems of occupational health, emphasized the paramount importance of upbringing and the external environment in the formation of personality, and emphasized the role of training and work skills.

Of all the works of Ivan Mikhailovich Sechenov, the work "Brain Reflexes".

The physiology of Sechenov was strongly influenced by the materialistic philosophy of N. G. Chernyshevsky, A. N. Dobrolyubov, D. I. Pisarev, who shared dialectical, evolutionary views, they also supported the teachings of Charles Darwin, and opposed vulgar materialists and racists.

41. I. P. Pavlov - the great physiologist

Ivan Petrovich Pavlov (1849-1936) - the great Russian physiologist. He became the developer of new principles of physiological research, which ensured the knowledge of the body as a single whole, which is in unity and constant interaction with the environment. Pavlov also acted as the creator of the materialistic doctrine of the higher nervous activity of animals and humans.

From 1874 to 1884 - the first period of Pavlov's scientific activity. During this period, he focused mainly on the physiology of the cardiovascular system. One of his works is "Centrifugal nerves of the heart", which was published in 1883, an important contribution to physiology. Here he showed (for the first time!) that on the heart of warm-blooded animals there are nerve fibers that are capable of weakening and strengthening the activity of the heart.

IP Pavlov suggested that the reinforcing nerve, which he discovered, acts on the heart by changing the metabolism in the heart muscle. During the same period of his work, Pavlov investigated the neural mechanisms that regulate blood pressure. It should be noted that already in the early works of IP Pavlov, high skill and innovation in experiments can be traced.

With regard to the methods of studying the whole organism, Pavlov was a progressive scientist:

1) abandoned traditional acute experiments;

2) noted the shortcomings of acute vivisection physiological experience;

3) developed and put into practice the method of chronic experiment;

4) developed a method for studying particular physiological functions on a whole organism under natural conditions of interaction with the environment;

5) developed new techniques that made it possible to conduct an experiment on a healthy animal that had recovered quite well from surgery;

6) developed new methods of "physiological thinking";

7) developed special operations on the organs of the digestive tract.

Let's turn to the famous work "Lectures on the work of the main digestive glands". Here he sums up a kind of summary of work on the physiology of the digestive system. It must also be said that it was for this work that Ivan Petrovich Pavlov was awarded the Nobel Prize in 1904.

Let us turn to the report of I.P. Pavlov in 1909, which was called “Natural Science and the Brain.” Here we can find the following lines: “Here and now I only defend and affirm the absolute, indisputable right of natural scientific thought to penetrate everywhere and as long as it can show its power. And who knows where this opportunity ends... ". In this talk, Pavlov shows that there are no limits to human knowledge.

42. I. I. Mechnikov and his teaching

Ilya Ilyich Mechnikov (1845-1916) played one of the main roles in the development of both domestic and world microbiology, immunology and epidemiology.

I. I. Mechnikov was an outstanding scientist in various fields of knowledge: zoology, embryology, pathology, immunology, etc. He was one of the founders of modern microbiology, as well as the founder of comparative evolutionary pathology.

Ilya Ilyich Mechnikov graduated from the natural department of Kharkov University in 1864, after which he continued his studies and specialization in Germany and Italy in the field of embryology. In 1868 he defended his doctoral dissertation at St. Petersburg University.

After that, he received an associate professorship at Novorossiysk and then at St. Petersburg Universities. From 1870 to 1882 was a professor at the Department of Zoology and Comparative Anatomy at the Novorossiysk University.

In 1886, I. I. Mechnikov participated in the organization of the Pasteur anti-rabies station - this was the first station in Russia.

In Paris, he headed one of the laboratories of the institute, is Pasteur's deputy, and after his death - the director of the institute. Subsequently, I. I. Mechnikov was elected an honorary member of the St. Petersburg Academy of Sciences.

The activities of I. I. Mechnikov can be divided into two periods. The first period includes the time from 1862 to 1882. At this time, Mechnikov was a zoologist and primarily an embryologist. It was he who showed the presence of germ layers - the laws of development of the animal organism common to animals. Mechnikov established a genetic link between the development of invertebrates and cavitary animals. The basis for the evolutionary doctrine was the data of embryology, which were discovered by Mechnikov.

The second period is, as it were, a logical continuation of the first and is based on it. The fact is that the ideas about intracellular digestion were leading in the works of Mechnikov on the problems of pathology in the second period.

In 1883, Mechnikov's speech "On the Healing Powers of the Organism" put forward a number of provisions on the active role of the organism in the infectious process, as well as on the relationship between the macroorganism and the microorganism. Subsequently, I. I. Mechnikov widely developed the doctrine of phagocytosis, confirmed it by numerous studies on a variety of materials.

Mechnikov repeatedly met opponents on his scientific path. For example, his phagocytic theory has been criticized by some microbiologists and pathologists.

He persistently and passionately defended his innocence for about 25 years, repeatedly proving the inconsistency of the arguments of his opponents. After many years of opposition, the theory of I. I. Mechnikov became widespread and universally recognized, and I. I. Mechnikov was awarded the Nobel Prize in 1908.

In addition to all this, I. I. Mechnikov conducted a large number of studies on particular issues of medicine. For example, he studied cholera, relapsing and typhoid fever, syphilis, childhood intestinal diseases, and tuberculosis.

43. Development of hygiene in Russia

Hygiene received its development in Russia almost simultaneously with its development in Germany. Together with Germany, Russia was one of the first countries in which independent departments of hygiene were created. The creation of these departments was provided for by the university charter of 1863. In 1865, the St. Petersburg Medical and Surgical Academy, as well as the medical faculties of Kazan and Kyiv universities, decided to create departments of hygiene at these universities. In 1871, teaching began at these departments in Kyiv and St. Petersburg. The creation of hygiene departments at universities significantly influenced the further development of hygiene as a science in Russia. The following conditions also contributed to this: the rapid development of industry (especially in the 90s of the XIX - early XX centuries), the increase in population, mainly in cities, various achievements in the field of natural science. The latter made it possible to accurately determine any hygienic expressions, and also made it possible to study the natural sciences by various qualitative and quantitative methods.

The question of improving public life in terms of hygiene and preventing various kinds of contagious diseases was constantly raised. Special features of the development of hygiene in Russia in the second half of the XIX century. social movements, the defeat in the Crimean War, the growth of the revolutionary upsurge (especially after the defeat in the Crimean War), and the difficult sanitary conditions of the Russian peasantry. Hygiene issues at that time were given great importance, even by the leading representatives of the Russian intelligentsia, who had no contact with medical science (for example, D. I. Pisarev).

Russian hygienists were closely connected in their work with chemists, physiologists, and other representatives of the natural sciences. Some of the hygienists worked closely even with various attending clinicians, as well as with practical sanitary workers in the field, in cities, and zemstvos. In 1882 V. V. Svetlovsky wrote that “... hygiene as a science must stop preoccupying itself with depicting some ideal, normal life, which does not exist for anyone anywhere, but must devote itself to the study of those sanitary conditions of life that exist in reality. Sanitary issues, such as known to be closely related to economic issues or, generally speaking, to issues of social science.”

A new understanding of hygiene as a science, which was different from the Western European understanding, was created by the largest hygienists of the second half of the XNUMXth century: F. F. Erisman и A. P. Dobroslavin. At the same time, domestic hygiene was of a public nature.

44. F. F. Erisman - the largest hygienist

Fedor Fedorovich Erisman (1842-1915) - one of the largest hygienists of the second half of the 1869th century. He is of Swiss origin. He graduated from the medical faculty of the University of Zurich. After graduating from the university, F. F. Erisman specialized in the ophthalmologist F. Horner, after which he defended his thesis, which was called "On embolisms" mainly of tobacco and alcohol origin. F. F. Erisman was carried away by the revolutionary democratic ideas of Russian students who were studying in Switzerland (the fact is that in Russia women were not yet allowed to study at medical faculties) and in XNUMX he came to Russia. Here, for the first time, he worked in St. Petersburg as an ophthalmologist. He conducted numerous studies of vision in schoolchildren, revealed patterns of the influence of school conditions on the development of children's vision. The results of these studies were published in the work "The influence of schools on the origin of myopia". He proposed a special school desk, which to this day is widely known as the Erisman desk.

In these works, F. F. Erisman clearly defined the immediate goal of hygiene. It consisted in investigating the influence on a person of various natural phenomena that act on him continuously, and then to study the influence of the artificial environment in which a person lives, and also to find such means that would mitigate the effect of all adverse factors on the human body, that act on the part of society and nature. In 1879, F. F. Erisman moved to Moscow. At first he worked in the sanitary organization of the Moscow provincial zemstvo, then in the Moscow city sanitary organization. From 1882 to 1896 F. F. Erisman was a professor of hygiene at Moscow University at the Faculty of Medicine.

F. F. Erisman wrote about the goals, objectives and essence of hygiene: “Only measures that improve the sanitary conditions of entire groups of the population or the entire population can bring benefit. The health of an individual is only part of public health. There is no reason for this in human nature “to recognize human illness as an inevitable fatal necessity... Human mortality is in close connection with the imperfection of our life system.”

In 1896, due to student unrest, F. F. Erisman was fired from Moscow University, and he was forced to leave for his homeland in Switzerland. He nevertheless continued to publish his works in Russia. Subsequently, at various congresses and in the press, F. F. Erisman repeatedly emphasized the advantage of Russian public sanitation and the social traditions of Russian doctors in comparison with doctors of other countries. N.A. Semashko correctly noted that “... many of the provisions that he (F.F. Erisman) defended during his lifetime have not lost their significance at the present time.”

45 A. P. Dobroslavin and his activities

Alexey Petrovich Dobroslavin (1842-1889) - a prominent scientist in the field of hygiene. In 1865 he graduated from the St. Petersburg Medical and Surgical Academy. In 1869, Alexei Petrovich Dobroslavin defended his doctoral dissertation. After that, he studied how things were with hygiene abroad in Paris and Munich, with M. Pettenkofer, with fairly well-known hygienists. And from 1870 until the end of his life he was a professor of hygiene at the Medico-Surgical (later it became the Military Medical) Academy.

He was the first in Russia to compile original textbooks on hygiene. These textbooks were based on experimental research.

It should be noted such fundamental work as "Hygiene, public health course" (1889), as well as "Course of military hygiene with practical exercises in it" (1884), "Essay on sanitary activities" (1874), textbook "Military hygiene" (1885).

He was the founder and editor of the magazine "Health", as well as one of the initiators of the organization "Russian Society for the Protection of Public Health". A.P. Dobroslavin mastered new methods of hygienic research and widely applied them.

He correctly assessed the positive aspects of experimental hygiene. Based on natural scientific premises (by the way, modern hygienists in Western Europe proceeded from the same premises), from the successes of physiology, physics, and chemistry, A.P. Dobroslavin gave hygiene primarily a social character.

He said that "hygiene gives its advice and instructions to the community, to entire groups of the population. Thus, the assistance provided by hygiene is of a public nature. There is no way to eliminate the pathogenic influences of the external environment without immediately acting on the entire population."

It must be said that A.P. Dobroslavin conducted pedagogical activities. However, in addition to teaching, he himself organized research in the field of food hygiene, school hygiene, communal hygiene, and military. A.P. Dobroslavin devoted a lot of time to the issues of protecting the health of large groups of the population - low-income strata of the population, the peasantry.

He studied the foods that were the main food for these population groups (sauerkraut, kvass, mushrooms, porridge from cereals, etc.). Dobroslavin conducted research on the improvement of places inhabited by people. These studies consisted in examining water supply, sewerage, etc. A.P. Dobroslavin repeatedly participated in anti-epidemic measures, improved disinfection equipment.

It should be noted that A.P. Dobroslavin believed that medical medicine should be divided into hygiene. However, this opinion was wrong. There was even some opposition between the views of A.P. Dobroslavin and F.F. Erisman.

46. Pediatrics

Stepan Fomich Khotovitsky - doctor, one of those who laid the foundations of pediatrics in Russia. S. F. Khotovitsky graduated from the Medical-Surgical Academy in St. Petersburg in 1817. From 1822, he began teaching forensic medicine there, as well as obstetrics, etc. In 1830, S. F. Khotovitsky became a professor, and already in 1832 - Head of the Department of Obstetrics, Women's and Children's Diseases.

Khotovitsky was the first to give a full course of lectures on childhood illnesses (1836). In 1847, the fundamental work of S. F. Khotovitsky was published, which was the first guide to pediatrics in Russia and was called "Pediatrics". Here are a number of works by Khotovitsky: “On Anthrax” (1831).

In the second half of the XIX century. was a prominent pediatrician in Russia Nil Fedorovich Filatov (1847-1903). He was a follower of Zakharyin. Filatov graduated from the medical faculty of Moscow University, and in 1876 he defended his doctoral dissertation, the topic of which was "On the relationship of bronchitis to acute catarrhal pneumonia". It is necessary to note the subtle observation of this doctor.

He was a good clinician who described a number of previously unknown diseases. For 25 years, he described glandular fever, scarlet fever, a latent form of malaria, and he studied acute childhood infections such as chicken pox, measles, scarlet fever, diphtheria. In addition to all this, N. F. Filatov was a talented teacher.

He has written a number of major textbooks on diseases in childhood. The following works by Filatov were widely disseminated: "Clinical Lectures" (1881-1902), "Lectures on Acute Infectious Diseases" (1885), "Textbook of children's diseases" (1893-1902), "Semiotics and diagnosis of childhood diseases" (1890). More than one generation of doctors was brought up on these textbooks.

In the book dedicated to the bicentenary of the Faculty of Medicine of Moscow State University, it is noted that "N. F. Filatov is the largest representative of the doctrine of childhood diseases in Russia, the founder of the Russian pediatric school, who enriched pediatrics with original guidelines and numerous scientific works." Among the students of N. F. Filatov, special fame received G. N. Speransky, V. M. Molchanov.

It is also necessary to note Nikolai Petrovich Gundobin (1860-1908). He developed the ideas of S. F. Khotovitsky. N.P. Gundobin studied the age characteristics of the child quite deeply in relation to the goals of the pediatric clinic. Under the leadership of Gundobin, a book was published in 1906 "Peculiarities of childhood Basic facts for the study of childhood diseases"

47. Pathological anatomy in Russia

Development of pathological anatomy in Russia occurred directly in connection with the clinics. Autopsies were regularly performed on the bodies of those who died in hospitals. Autopsies in Russia began to be carried out officially and regularly back in the first half of the XNUMXth century, at the Moscow Medical and Surgical Academy, which is earlier than in other countries. At Moscow University, St. Petersburg Medical and Surgical Academy, pathological anatomy was taught by anatomists in the course of normal anatomy, as well as by clinicians in courses of pathology and therapy. It should be noted that Russian doctors understood the great importance of pathological anatomy for the clinic.

I. V. Buyalsky, I. E. Dyadkovsky, G. I. Sokolsky, N. I. Pirogov began reading a special course of lectures that were devoted to the problems of pathological anatomy. The reading of these lectures took place even before the creation of special departments of pathological anatomy.

The first professor of pathological anatomy at Moscow University was A. I. Polunin (1820-1888). In his works, AI Polunin noted the importance of the nervous system in various pathological processes that occur in the body. Polunin criticized the cellular theory of Virchow, the humoral doctrine of Rokitansky. He believed that both solid parts and juices are equally important for the human body, and he was also sure that changes that occur in one thing (solid part or juice) entail changes in another. After Polunin returned from a trip to Western Europe in 1845, he noted that in some countries (for example, in Germany), clinicians paid insufficient attention to pathological anatomy. A. I. Polunin wrote: “Students do not have the right to be present at the autopsies of all the dead in the Charite. The autopsies themselves are carried out for the most part carelessly, superficially.

In the St. Petersburg Medical-Surgical Academy in 1859, an independent department of pathological anatomy was organized. In St. Petersburg, M. M. Rudnev (1837-1878) was a prominent pathologist. The microscope has become almost an everyday research instrument for students of the academy - this is the merit of M. M. Rudnev. He repeatedly noted the great importance of pathological anatomy for clinical disciplines.

MM Rudnev attached great importance to the nervous system in pathological processes. Rudnev used experimental methods in his research, which he conducted in various areas of pathological anatomy. He, like Polunin, criticized Virchow's teaching: "It is not true that the whole essence of morbid disorders was attributed to a change in cellular elements, for diseases can consist in a change in both solid and liquid parts of the body."

48. Zemstvo medicine

in Russia in the middle of the XNUMXth century. deep social and economic processes caused the emergence and development in the second half of the XNUMXth century. zemstvo medicine

The main links of zemstvo medicine at the end of the XNUMXth century:

1) rural district hospital;

2) county and provincial sanitary doctor (bureau);

3) district and provincial congress of zemstvo doctors. Zemstvo medicine has developed an original form of health care for the rural population: a rural medical district with free (in the richest provinces) medical care and a network of medical and sanitary institutions close to the population (zemstvo hospitals, feldsher and obstetric stations, outpatient clinics, a sanitary organization, etc.). ).

This way of organizing the health care of the rural population was the only example in history of organized medical care under capitalism for rural residents.

In addition to providing medical treatment and sanitary care to the population, progressive doctors of zemstvo medicine conducted a number of studies, gave sanitary descriptions of localities, and also studied the incidence of the population.

Zemstvo doctors examined the life of the peasants, their way of life, work. In addition to peasants, zemstvo doctors studied and described the life, way of life, working conditions of handicraftsmen, workers in factories that were located in the countryside, agricultural laborers in the southern provinces.

Zemstvo medicine also influenced the development of some clinical disciplines, such as obstetrics and surgery.

Zemstvo sanitary statistics played a major role in the development of medical science.

Numerous works by zemstvo sanitary statisticians dealt with demography, morbidity and physical development of the population, issues of the sanitary condition of individual localities, working conditions for factory and agricultural workers, handicraftsmen, etc. Studies of morbidity and infant mortality were of great importance. By the way, it was Zemstvo sanitary statistics that first began to study the incidence.

Zemstvo medicine was characterized by the features of domestic medicine - preventive, sanitary and hygienic orientation The activities of prominent zemstvo doctors characterized public health activities. In the works of many representatives of zemstvo medicine, advanced ideas of prevention were widely disseminated.

But it must be said that prevention in the understanding of zemstvo medicine differed from the concept of prevention in the Soviet sense. Zemstvo medicine had a half-hearted character. Many zemstvo doctors remained petty-bourgeois "culturalists" under the influence of populist ideology.

49. The formation of Soviet medicine

The historical events of 1917 brought ruin not only to the political and economic spheres of life. They affected the life of the population, and, of course, the general state of people's health. At the beginning of the Soviet period, with the coming to power of the Bolsheviks and the establishment of a new regime, a wave of epidemics of cholera, typhoid, smallpox and other diseases swept the country. The situation was aggravated by the widespread shortage of qualified personnel, equipment and medical equipment, and medicines. There were very few hospitals, preventive medical institutions.

At that time, the death rate increased 3 times, the birth rate halved.

Only an organized healthcare system could save the country from extinction, help in the fight against diseases and epidemics. Such a system began to actively form in 1918.

The formation of a unified health care system attracted more and more people and was of a "collective nature", the "collection" of medicine took place in several stages.

The first stage fell on October 26, 1917when was The Medical and Sanitary Department was formed.

The main task of the department was to unite and involve in the work of all doctors who recognized the new government; it was also necessary to radically change the medical and sanitary business in the country and organize qualified assistance to workers at enterprises and soldiers in the active troops, as well as those in reserve.

The Council of People's Commissars signed a decree establishing Council of Medical Colleges. This council became the highest medical body of the workers' and peasants' government.

The Council of Medical Colleges saw its main task in fulfilling the following conditions: continuing the widespread organization of medical and sanitary departments, consolidating the initiated reforms regarding the transformation of military medicine, strengthening, developing sanitary affairs and strengthening epidemic control throughout the country.

In order to act on the scale of the whole country and objectively monitor the results of the work carried out, it was necessary to hold the All-Russian Congress of Representatives of the Medical and Sanitary Departments of the Soviets.

The result of the work of the congress was the adoption of a decision on the creation of the People's Commissariat of Health, which was to become the main body of health and be in charge of all medical and sanitary affairs. On June 26, 1918, a project for the creation of the People's Commissariat of Health was presented.

Was created first board of the People's Commissariat of Health of the RSFSR, in which there were V. M. Velichkina (Bonch-Bruevich), R. P. Golubkov, E. P. Pervukhin, Z. P. Solovyov, P. G. Dauge, and the first commissioner of health was appointed N. A. Semashko. His first deputy was Z. N. Soloviev. In July 1936, the People's Commissariat of Health was renamed the People's Commissariat of Health of the USSR. Its first head was G. N. Kaminsky.

50. N. A. Semashko and his role in medicine

Nikolai Alexandrovich Semashko (1874-1949) made a huge contribution to the development of not only Soviet, but also world medicine.

Semashko's career did not start with brilliant success: he graduated from Kazan University, after which he worked for 3 years as a zemstvo doctor in the Oryol province, and then in Nizhny Novgorod. The revolution in February 1905 ended for him with arrest, imprisonment for 10 months, and then 10 years of emigration to France, Switzerland and Serbia. In the summer of 1917, at the age of 43, he returned to Moscow with a group of other emigrants. He took part in the medical arrangement of the country from the moment the idea of creating a state health care system arose: first headed the medical and sanitary department of the Moscow Council, and later became the first People's Commissar of Health of the RSFSR. He controlled Narkomzdrav for 11 years, in the most difficult years for the country, when the bloody Civil War was going on, epidemics raged in the Union.

He also took part in the development of anti-epidemic programs, seriously stated the need to create a program for the protection of motherhood and childhood and the need to develop Soviet medicine by improving and expanding the network of research institutes. Under him, sanitary-resort business began to develop intensively, the system of higher medical education was transformed.

N. A. Semashko made a huge contribution to the development of hygiene in the USSR, opening in 1922 the Department of Social Hygiene at the Faculty of Medicine of Moscow State University. He himself was the head of this department for 27 years.

In 1927-1936. the first edition of the Great Medical Encyclopedia was created and published, the initiator of which was N. A. Semashko. From 1926 to 1936 he headed the children's commission of the All-Russian Central Executive Committee.

He put a lot of effort into studying the sanitary and hygienic situation after the war.

N. A. Semashko became one of the founders and one of the first academicians and members of the Presidium of the USSR Academy of Medical Sciences. He was director of the Academy of Pedagogical Sciences from 1945 to 1949. Since 1945, he held the title of Academician of the Academy of Pedagogical Sciences of the RSFSR. He also became the founder of the Institute for the Organization of Public Health and the History of Medicine of the USSR Academy of Medical Sciences, after its creation he led it from 1947 to 1949. This institute bore his name for a long time, later it was renamed the National Research Institute of Public Health of the Russian Academy of Medical Sciences.

Semashko, managed to leave his mark on the development of physical culture and sports, as he became the first chairman of the organization in charge of this area of medicine, and also headed the board of the All-Union Hygienic Society (1940-1949).

Throughout his life, he wrote scientific works and works, of which there are more than 250. All of them were devoted to theoretical, organizational and practical issues of hygiene and health care in general, which earned him immortal memory among the people.

51. Principles of medicine in the USSR. Higher medical education

Four basic principles dominated the healthcare system that was being organized at that time.

At first, medicine was supposed to be of a state nature.

Secondly, medicine should have a preventive direction.

Thirdly, medicine had to attract the population to actively participate in the protection of public health.

Fourthly, medicine had to promote the need for the unity of scientific medicine and health preventive measures.

After the relative stabilization of the situation, the government began to pay the most attention to the development of higher medical education and the training of qualified personnel. Only a few years later, when the ranks of qualified medical workers were replenished, medicine returned to the mainstream of professionalism, and the participation of the general population in public medical education ceased to be a necessity.

At that time, it was necessary to work on the unification of practical activities in the field of health and medical science.

Throughout the country, despite the difficult economic and political situation, a mass organization of scientific research institutes and laboratories of national importance was carried out. In 1918, the Scientific Medical Council was established, which was engaged in the development of higher medical education, forensic medical examination, the compilation of the state pharmacopoeia, and many other issues.

With the active participation of the council, the State Institute of Public Health was opened, which included 8 research institutes dealing with issues of sanitary and hygienic conditions, tropical diseases, microbiology, etc.

Throughout Russia from 1918 to 1927. more than 40 research institutes were opened, among which was the Saratov Institute of Microbiology and Epidemiology (1918).

Science and practice merged together, because new scientific discoveries were immediately introduced into practical use, and observation and the fight against mass diseases helped to create new scientific principles and tasks. In the field of higher medical education, an innovation was that since 1930 all the medical faculties of the country separated and became medical institutes, of which by 1935 there were 55 throughout the country.

They included pharmaceutical, pediatric, dental faculties, which contributed to the formation of the first medical universities, as well as residency in clinical departments and postgraduate studies.

52. Medicine during the Great Patriotic War. The development of medicine in the post-war period

From 1941 to 1945 The Great Patriotic War was going on, which became the bloodiest in the entire history of mankind. More than 27 million soldiers and civilians died. But many survived and survived thanks to the actions of Soviet military doctors.

The initial period of the war was especially difficult in terms of medical support: there were not enough personnel, medicines, and equipment. In this regard, early graduations of fourth-year students from military medical academies and medical institutes were organized. Thanks to this, by the second year of the war, the army was provided with medical personnel in all specialties by an average of 95%. With the help of these people, soldiers and home front workers, mothers, children and the elderly received medical care.

Chief Surgeon of the Red Army N. N. Burdenko, Surgeon General of the Navy - Yu. Yu. Janelidze. Also, many famous people worked at the fronts and received awards after the war for their activities, memory and glory.

Thanks to the coordinated actions of doctors, numerous evacuation hospitals were organized, specialized medical care was improved for soldiers wounded in the head, neck, stomach, chest, etc.

Scientific work did not stop, which in the pre-war period led to the production of blood substitutes and the invention of methods for preserving and transfusing blood. All this later helped save thousands of lives. In the war years, penicillin was tested, domestic sulfonamides and antibiotics were invented, which were used to combat sepsis and heal purulent, difficult-to-heal wounds. The main successes of medicine in the postwar years include a thorough study of the sanitary situation and the effective elimination of problems in this area.

In the field of medical education, reforms unfolded in 1967-1969: then a system of seven-year training of medical personnel was introduced. The system of improvement of doctors began to develop intensively. In the 1970s

In the mid 1970s. Diagnostic centers were actively opened and equipped, maternal and child health was improved, and much attention was paid to cardiovascular and oncological diseases.

In the 1980s continued to actively explore issues cardiology, oncology, leukemia, implantation and organ prosthetics. In 1986, the first successful heart transplant was performed.

The ambulance system was also actively developed, automated control systems "ambulance" and "hospital" were created. A grandiose task in the field of public health in 1983 was the universal, nationwide medical examination and specialized treatment of the population.

53. The development of healthcare in the late XX - early XXI centuries

Health care system during the years of the country's transition from a socialist to a democratic-capitalist system, it underwent strong transformations, which initially did not have the best effect on the health of the population.

Funding has been drastically reduced, making health care unavailable to all segments of the population, reducing the influence of government agencies and guarantees in this regard, and, as a result, the standard of living and the main vital indicators of health of large groups of the population have declined.

At the beginning of 1990, the resources allocated to medicine were extremely inefficient and incompletely used, since there was no clear structure for the provision of medical care. In addition, there was a clear bias towards the development of expensive types of medicine, and the system for the development of generally accessible, high-quality and financially easy medical and preventive care did not find a way out.

Health system reform began in 1991.

The Law on Compulsory and Voluntary Health Insurance was adopted, the main expected results of which were the partial elimination of the problems of financing the medical industry and relief for patients representing the largest groups of the population. The hopes placed on reform did not materialize. The health insurance system is still unfinished, but with sufficient development, many problems in the financial system of providing the medical industry can be solved.

After a long period of stagnation, 1996-1997, the situation began to improve somewhat. This improvement began with the adoption of the concept of development of health care and medical science. When adopting this concept, the Government of the Russian Federation approved and consolidated the course for a new strategy for reforms in the healthcare system. Since then, the most important task in the field of medicine has been to unite all existing health care systems by establishing close contacts between individual sectors, as well as establishing a balance in the processes of centralization and decentralization, public administration and self-government. Boundaries were also established between public institutions and private estates, and consequently, a system of private supplies to the medical services market developed. A line was established between the financing of government health care structures and the financing of medical needs and requirements.

As before, the fact that "health is not when you are treated and recover, but when you do not get sick" remained relevant. In this regard, the most important task, after providing the necessary medical care, was to provide a full range of preventive methods in order to maintain the health of the healthy.

54. Modern Hippocratic Oath

In the new economic and social structure of post-Soviet Russia, the priority of human values and the value of human life itself, the impossibility of its donation in the name of fulfilling any state tasks, was affirmed. These changes prompted the idea of revising the text "Oath of a Doctor of the Soviet Union" (1971) and "The Oaths of a Doctor of Russia" (early 1990).

The issue was considered both from ethical and state-legislative points of view, as a result of which, in 1991, the State Duma of the Russian Federation adopted a law on amendments to Article 60 of the Fundamentals of the Legislation of the Russian Federation on the Protection of Citizens' Health.

In accordance with this law, persons who received a diploma of higher medical education in connection with the graduation from a medical higher educational institution on the territory of the Russian Federation took the Doctor's Oath, for violation of which they were criminally and civilly liable under the legislation of the Russian Federation "Fundamentals of the legislation of the Russian Federation on health protection citizens."

The modern "Doctor's Oath", which is given by a graduate of any higher medical educational institution in Russia, is a combination of the fundamental principles of the "Hippocratic Oath" and the best traditions of Russian higher education, which are presented in the "Faculty Pledge".

That's what it's like the content of the modern "Doctor's Oath" (approved by the State Duma of the Russian Federation in 1999).

"Having received the high title of a doctor and embarking on a professional career, I solemnly swear:

1) honestly fulfill their medical duty, devote their knowledge and skills to the prevention and treatment of diseases, the preservation and strengthening of human health;

2) to be always ready to provide medical care, keep medical secrets, treat the patient attentively and carefully, act solely in his interests, regardless of gender, race, nationality, language, origin, property and official status, place of residence, attitude to religion, beliefs , belonging to public associations, as well as other circumstances;

3) show the highest respect for human life, never resort to euthanasia;

4) keep gratitude and respect for their teachers, be demanding and fair to their students, promote their professional growth;

5) treat colleagues kindly, turn to them for help and advice, if the interests of the patient require it, and never refuse colleagues help and advice;

6) constantly improve their professional skills, preserve and develop the noble traditions of medicine."

55. International Red Cross

The history of the emergence of this organization has its roots in the distant 1862, during the Franco-Italian-Austrian war. It was then that a young Swiss journalist, Henri Dunant, who wanted to be interviewed by Napoleon III, Emperor of France, came to him. Napoleon III was constantly in the center of hostilities.

Henri Dunant for the first time I saw the consequences of hostilities with my own eyes: as a result of a bloody battle, thousands of wounded and killed lay right on the ground, burned by the sun. The journalist was struck by the fact that no one helped them. What Henry Dunant saw shocked him.

Returning from the theater of operations to Geneva, Henri Dunant told the world about the terrible consequences of military battles. He presented this information in his book, in which he called for the creation of social movements to help the wounded and injured in the wars.

In 1863, the Permanent International Committee for the Relief of the Wounded was created. The committee included 5 citizens of Switzerland, including Henri Dunant.

At the same time, the emblem was adopted traffic - red cross on white background

The Committee received worldwide support, approved by the governments of various states, on August 22, 1864, when the Interstate Geneva Convention was signed, according to which the number of the wounded and sick in active armies was to be improved, regardless of whether they belonged to "their own" or "enemy" camp.

In turn, the people who were supposed to provide medical care were supposed to be inviolable and not be considered as supporters or opponents of the army. The emblem of the Red Cross has become a sign of protection for medical personnel.

Russia was one of the earliest and most active participants in the movement. She proposed not to use explosive bullets during the hostilities of 1868 (St. Petersburg, International Conference).

Later, also at the initiative of Russia, at conferences in Brussels (1874) and Raoga (1899), conventions on the rules of land warfare and the protection of the wounded in naval wars were pleasant. In 1874, it was proposed to withdraw from use weapons that cause especially dangerous injuries.

In 1876, the Committee of Five was renamed the International Committee of the Red Cross and continued to put forward its proposals, promoting and implementing them through a series of conferences.

The achievements associated with the actions of the International Committee of the Red Cross cannot be overestimated, however, he could not prove that waging wars (at least in relation to human life) is unlawful, he could only humanize wars, that is, reduce the suffering they bring people.

Now the International Committee of the Red Cross - This is a society consisting only of representatives of Switzerland, performing the role of a neutral mediator in various kinds of armed conflicts. This body has inviolability in the provision of assistance during the war, both to wounded soldiers and civilians.

56. World Health Organization

World Health Organization is one of the most important agencies of the United Nations (UN). April 7, 1948 is considered the official day of the creation of the World Health Organization. On this day, the charter of the World Health Organization was approved by the members of the United Nations.

The main idea of the Charter was "the achievement by all peoples of the highest possible level of health."

Constitution of the World Health Organization proclaimed the principles necessary "for happiness, harmonious relations among all peoples and for their security." The main value was recognized as human health, which was given the definition adopted in all world health organizations - a state of complete physical, mental and social well-being, and not just the absence of disease or physical defects. The founding day of the World Health Organization is celebrated around the world as Health Day.

First World Health Assembly, which is the highest body of the World Health Organization, was held on June 24, 1948. By its completion, the number of states included in the World Health Organization increased from 26 to 55. The congress was held in Geneva.

At present, many outstanding scientists of our country are consultants to the World Health Organization. The World Health Organization has a regional structure that includes six regions: American - in Washington, European - in Copenhagen, headquarters of the Eastern Mediterranean - in Alexandria, African - in Brazzaville, headquarters of Southeast Asia - in New Delhi, headquarters of the Western Pacific - in Manila.

To date, the World Health Organization has more than 190 states in its membership, with the combined efforts of which more than one and a half thousand projects are implemented every year, which are aimed at solving a wide variety of tasks: combating various diseases, training highly qualified personnel, improving the environmental situation, protecting mothers and child, international drug control, etc.

The World Health Organization constantly organizes various symposiums and international conferences in Russia. Thus, in 1978, an international conference on primary health care was held in Alma-Ata, in which representatives from more than 130 countries and 70 different international organizations were present. At the end of the conference, the "Magna Carta of Public Health of the XNUMXth Century" was written.

In 1991 and 1994 conferences and meetings were held to address health problems at the present stage.

On the basis of Russian reference centers and laboratories, the World Health Organization is developing various international programs to combat epidemic situations. In general, Russia is one of the leaders in international cooperation in the field of healthcare.

Author: Bachilo E.V.

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Each user of mobile devices has repeatedly asked himself the question - when will global manufacturers decide to influence the current situation with the autonomy of their products and abandon standard lithium-ion or lithium-polymer batteries, replacing them with something more innovative? Alas, time goes by, the news about the next heavy-duty and long-lasting battery with fantastic characteristics one by one gets into the Network, and "things are still there."

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