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

Doctor of Medicine and Surgery Ya.V. Willie played an important role in the organization of the medical service in the pre-war and war period. Scots by birth, he was at the head of the St. Petersburg Medical-Surgical Academy for thirty years. For a long time staying at the post of chief military medical inspector and being in the active army, J.V. Villie participated as a surgeon and organizer in more than 50 battles, incl. battles at Austerlitz, Vitebsk, Smolensk, Borodino (here he, together with Ya.I. Govorov and F.A. Giltebrant, assisted the wounded Russian commander P.I. Bagration) and in all other battles with the Napoleonic army. He did a lot to improve the military medical service. So, he drew up various regulations and instructions that regulated the activities of regimental hospitals, the duties of regimental and battalion doctors, the functions of mobile and militarytemporary hospitals. In terms of their content, these were works containing fresh, original thoughts, based on an analysis of the activities of military doctors and the experience of military doctors of the Russian army, including Ya.V. Willie. Professor of surgery at Moscow University F.A. Giltebrant also contributed to military medicine. In addition teaching at the university and the MedicalSurgical Academy, he had been consultant to the Mariinsky Hospital for the Poor for over 40 years. During Patriotic War of 1812 F.A. Giltebrant participated in the treatment of the wounded in Moscow and in Vladimir, where he left with a transport of the wounded on the day the French entered Moscow.

The tsarist government, seeking to hinder the development of democratic tendencies, pursued a reactionary policy. In the field of science, in particular medical, this reaction manifested itself in the persecution of materialistic tendencies, the imposition of official theology, the government auditing (revision) of universities in 1820. The government's repressions were especially vivid in the activities of the trustee of the Kazan educational district M.L. Magnitsky, on whose instructions the ban on autopsy at Kazan University was introduced, the anatomical theater and the anatomical museum were closed, and the preparations were buried according to the church rite. After the end of the war, the reactionary character of the autocracy became even more severe. Despite this, progressive Russian science,

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continuing and developing the positive traditions of the 18th century, overcoming difficulties and persecution, achieved major successes in the field of natural science and medicine.

The progressive trends were most expressed in the Decembrists' attempted rebellion in 1825. In the program of the Decembrists, along with general political and economic, requirements in the field of public health protection were presented (about helping women in labor, about the care of orphans and foundlings, about homes for the crippled and the elderly, about the creation of a hospital and the introduction of a doctor's position in each volost, etc.). A significant role in the organization of medical affairs belonged to the Free Economic Society, created back in the 18th century and resumed its active activity in the middle of the 19th century (organizing smallpox vaccination, discussing issues of combating high morbidity and mortality, publishing popular literature on medicine, etc.). A new type of doctors (“landlord doctors”) appear in the countryside. Medicine of the early 19th century had a number of features, which are characterized by the differentiation of medical knowledge and disciplines, the development of anatomical and physiological direction in clinical medicine, especially in surgery. Professors I.F. Bush, E.O Mukhin, I.E. Dyadkovsky, I.V. Buyalsky, N.I. Pirogov played an important role in this process. The works of the listed surgeons and clinicians, their scientific views were well known in Europe and the USA. At the beginning of the 19th century in Russia, the Faculty of Medicine of Moscow University and the St. Petersburg Medical-Surgical Academy were centers of scientific medical thought. Mainly anatomy, pathology, surgery, and later topographic anatomy were developed at the Medical-Surgical Academy. Scientists at Moscow University paid more attention to issues of physiology, pathology, therapy. Teaching at the St. Petersburg Academy was practical. Students performed anatomical dissections, participated in operations. Professor Petr Andreevich Zagorsky (1764-1846), who was the founder of the first Russian anatomical school at the St. Petersburg Medical-Surgical Academy, headed the Department of Anatomy. He wrote the first Russian manual on anatomy

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“Abbreviated Anatomy ...” in two books. Following M.I. Shein, A.P. Protasov, N.M. Maksimovich-Ambodik P.A. Zagorsky approved Russian anatomical terminology instead of Latin. Professor Ivan Fedorovich Bush (1771-1843), who was the greatest scientist-surgeon of his time, headed the department of surgery at the St. Petersburg Medical-Surgical Academy. All his works and, first of all, the three-volume “Guide to the Teaching of Surgery” (1807), for more than 30 years were the main textbooks by which students and doctors in Russia studied surgery. The founder of the Russian scientific surgical school I.F. Bush headed the Department of Surgery at the Academy of Medicine and Surgery for over 30 years. During this time, he brought up numerous students, including S.F. Gaevsky, V.V. Pelican, H.H. Salomon, I.V. Buyalsky, P.N. Savenko and others. Pupil P.A. Zagorsky and I.F. Bush, Professor Ilya Vasilievich Buyalsky (1789-1866) was a talented anatomist and surgeon, he left a noticeable mark on domestic and world medicine, published “Anatomical and surgical tables” (1828) – the first in the history of Russia atlas on operative surgery, combining the qualities of educational and practical guide, consisting of figures and 14 tables. “Tables” I.V. Buyalsky gained wide popularity not in Russia. All European universities acquired them, and they ended up the United States. For 33 years I.V. Buyalsky was a consultant to the Mariinsky Hospital. Here he performed many operations, including, such as ligation of the femoral arteries, removal of skin tumors, removal of the vaginal polyp, hernia repair, plastic surgery, removal of the uterine polyp, etc. One of the first surgeons in Russia I.V. Buyalsky began to perform operations on children and even newborns. He was the first in Russia to use a starch (flour paste) dressing proposed by the Belgian surgeon Seten in 1834. Possessing the art of preparation, I.V. Buyalsky prepared a number of unique anatomical preparations (for example, the so-called etched (corrosive) preparations of kidney vessels, prepared by the finest injections), created a number of new surgical instruments, developed new surgical operations (on the upper jaw, on blood vessels, etc.). For 35 years he taught anatomy at the Russian Academy of Arts, for 12 years he headed an instrumental plant. I.V. Buyalsky is the author of the famous bronze

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statue "Lying Body" together with the sculptor P. Klodt. Skilled surgeon and excellent diagnostician I.V. Buyalsky was very popular in St. Petersburg. Among his patients were both the wealthy and the poor, whom he treated for free. He was summoned to the most serious patients. In 1837 I.V. Buyalsky together with N.F. Arendt, H.H. Salomon and other doctors were at the bedside of the mortally wounded A.S. Pushkin.

Physiology, pathology, and therapy had been most developed in Moscow at the Faculty of Medicine of the University. Professor E.O. Mukhin (1766-1856) – an outstanding Russian anatomist, physiologist, surgeon, hygienist and forensic physician, who had a great influence on the formation of scientific views of N.I. Pirogov, was the largest representative of medical science at Moscow University. As a professor at the Medical and Surgical Academy and the Faculty of Medicine of Moscow University, E.O. Mukhin created a number of major scientific works (“Descriptions of surgical operations”, “Course of Anatomy”, “The introductions of bonesetter's science”), made a tangible contribution to the development of Russian anatomical nomenclatureOn his initiative, anatomical rooms were created, and the teaching of anatomy on cadavers was introduced. E.O. Mukhin took an active part in the against cholera, wrote a number of instructions and works on the fight against cholera, smallpox and other infectious diseases. Alexey Matveevich Filomafitsky (1807-1849), the founder of the Moscow physiological school, a university professor, strengthened natural science trend in physiology. He was one of the first in Russia to introduce the experimental method in physiology and medicine; by vivisection he studied the physiology of respiration and digestion, created devices for blood transfusion, a mask for inhalation ether anesthesia. A.M. Filomafitsky was the author of the first manual on physiology in Russia. I.T. Glebov became his talented follower and successor at the Department of Physiology at Moscow University. Professor of therapy and pathology at Moscow University, Justin Evdokimovich Dyadkovsky (1784-1841) was the most consistent representative of the natural sciences in medicine in the first half of the 19th century. I.E. Dyadkovsky developed the idea of the unity and integrity of the

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organism, its connection with the environment; he assigned the leading role to the central nervous system, being a representative of early nervism in Russian science. Professor of therapy, dean of the medical faculty of Moscow University Matvey Yakovlevich Mudrov (1776-1831) was a prominent Russian clinician. As a student and follower of S.G. Zybelin, he developed an individualized approach to patients (“… to treat not a disease, but a patient …”). M. Ya. Mudrov developed a patient survey system, which was improved by the largest clinician of the second half of the 19th century G.A. Zakharyin. One of the first in Russia M.Ya. Mudrov began to use such methods of patient examination as percussion, auscultation, palpation; he recognized the importance of keeping medical records and highly appreciated its (case of histories). He personally collected and kept 40 volumes of case histories of his patients for more than 20 years: M.Ya. Mudrov made a worthy contribution to the development of military hygiene, deontology and the doctrine of the unity and integrity of the body. The achievements of anatomy and surgery in Russia at the beginning of the 19th century were further developed in the works of Nikolai Ivanovich Pirogov (1810 1881) – an outstanding representative of domestic and world medicine, anatomist, surgeon, teacher, and public figure. Nikolai Ivanovich Pirogov was born on November 27, 1810 in Moscow in the family of a small employee. After graduating from Moscow University in 1828, N.I. Pirogov was sent to the Professorial Institute at the University of Dorpat (now Tartu), where among the students G.I. Sokolsky, F.I. Inozemtsev, A.M. Filomafitsky and others were also. After defending his doctoral dissertation in 1832 and a scientific trip to Germany, he returned to the University of Dorpat as a professor. In 1841 N.I. Pirogov was invited to the St. Petersburg Medical and Surgical Academy. He was a bright personality, combining the talent of an anatomist, surgeon, scientist, teacher, occupying a prominent position in world and national medicine. N.I. Pirogov is the creator of topographic anatomy and experimental direction in surgery, one of the founders of military field surgery, a participant in the Sevastopol defense, the Franco-Prussian and Russian-Turkish wars. His work in anatomy and surgery, the development of a number of important

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operations and surgical techniques (resection of the knee joint, transection of the Achilles tendon, etc.) gained worldwide fame. N.I. Pirogov first applied plaster and starch bandages in the field, performed the first osteoplastic surgery and surgery under rectal anesthesia (1854). The contribution of N.I. Pirogov to the solution of the most important problem of surgery - anesthesia is invaluable, he scientifically substantiated the use of ether anesthesia in an experiment on animals, studied its properties with various methods of administration (inhalation, intravenous, rectal). February 14, 1847 N.I. Pirogov performed his first operation under ether anesthesia to remove the mammary gland. In the same year, for the first time in the world, he applied ether anesthesia on a massive scale during the hostilities in Dagestan. During the Crimean War in Sevastopol, for the first time in the world, N.I. Pirogov carried out sorting of the wounded and sick, depending on the nature of the injury, and created transport detachments sisters of mercy.

Considering the war a “traumatic epidemic” and being convinced that “…not medicine, but the administration plays main role in helping the wounded and sick in the theater of war…” N.I. Pirogov tried to establish a clear organization of medical care for the wounded In October 1854, the Grand Duchess Elena Pavlovna, at her own expense, founded the “Holy Cross Sisters of Care Community for the Wounded and Sick Warriors”, and invited N.I. Pirogov to lead their activities in Crimea. More than 160 sisters of mercy were in the theater of war. N.I. Pirogov suggested the existence of pathogens that cause suppuration of wounds (“hospital miasms”), carried out valuable research on the pathological anatomy of cholera (1849). Attaching great importance to hygiene measures, he said: “I believe in hygiene. This is where the true progress of our science lies. The future belongs to preventive medicine”. After the Crimean War, at the age of 46, N.I. Pirogov was forced to leave the service at the Academy and for several years served as a trustee of the Odessa and then Kiev educational district, fought against class prejudices in the field of education, advocated the autonomy of universities, universal primary education. The last years of the life of the great surgeon and scientist were spent in the village of Vishnya near Vinnitsa (now the Museum-

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Estate of N.I. Pirogov). “The Diary of an Old Doctor” was his last work. Moscow and Odessa medical universities are named after Pirogov. One of the characteristic features of domestic medicine in the first half of the 19th century is the increase in the number of medical periodicals and the emergence of medical societies. “Medical Physics Journal”, “Universal Journal of Medical Science”, “Military Medical Journal”, “Herald of Natural Sciences and Medicine” and others were the most famous medical journals. Among the scientific societies the “Society of Nature Experts” and the “Physico-Medical Society” at Moscow University worked most fruitfully. The “Society of Russian Doctors”, created in 1833 in St. Petersburg (after the death of N.I. Pirogov – the “Pirogov Society”), was of great importance for Russian medical science. The successes of the main clinical and theoretical disciplines (therapy, anatomy, physiology, surgery) gave impetus to the development of other branches of medicine: obstetrics, psychiatry, pediatrics, drug science, hygiene, etc. In 1847, Professor the St. Petersburg Medical-Surgical Academy Stepan Fomich Khotovitsky (1796-1885) created the first Russian work on pediatrics “Pediatrica”. In the middle of the 19th century, the first works on professional hygiene appeared In general, in Russia in the first half of the 19th century, morbidity, especially epidemic, and infant mortality of the population remained very high. But, despite the difficulties and obstacles, the advanced domestic science has managed to make a big step forward and create conditions for the further development of Russian medicine.

Questions for self-control:

1.What was the socio-political situation in Russia in the first half of the 19th century?

2.What participation did doctors take in the Patriotic War of 1812, and how did this affect the development of medicine in Russia?

3.What did the Decembrists demand to change in the field of public health protection?

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4.What contribution was made to the development of domestic anatomy and surgery in the first half of the 19th century by I.F. Bush, P.A. Zagorsky and I.V. Buyalsky?

5.What was the development of clinical therapy in Russia thanks to the activities of M.Ya. Mudrov, P.A. Charukovsky and G.I. Sokolsky?

6.How was the struggle between materialistic and idealistic currents in medicine expressed in the first half of the 19th century?

7.What contribution did N.I. Pirogov in world and domestic medicine?

8.Which natural science views I.Ye. Dyadkovsky had and how did it affect his medical practice?

9.What contribution did A.M. Filomafitsky in the development of experimental physiology in Russia?

10.What role did the Crimean War of 1853 1856 play in the development of

domestic medicine?

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Theme 10. Development of medicine in Russia in connection with the successes of natural science (second half of the 19th century - the beginning of the 20th century)

Under the influence of the defeat in the Crimean War (1853-1856) and the liberation movement of the peasantry in 1861, serfdom was abolished in Russia by the reform “from above”. Raznochintsy, headed by N.G. Chernyshevsky and N.A. Dobrolyubov developed a democratic movement, which was accompanied by student unrest, the organization of revolutionary circles and the spread of illegal literature in Russia. The development of production in Russia at that time was characterized by a rapid transition from manufacture to factory; it was associated with the emergence of a free labor force as a result of the reforms of 1861. The pace of domestic industry development and the degree of production concentration were higher than in the West. Relying on the achievements of scientific natural science, using their own experience and the experience of their outstanding predecessors, Russian scientists created the foundations of Russian, consistently materialistic, theoretical and clinical medicine, which significantly differed from the medicine of Western Europe A characteristic feature of Russian medicine was a critical analysis and use the best achievements of world medicine, the desire to generalize and apply in practice the experience of both Western European and Russian medical science. Revolutionary Democrats N.G. Chernyshevsky, I.A. Dobrolyubov, A.I. Herzen, V.G. Belinsky, who insisted on a close connection between philosophy and natural science, on the study of the integrity of physiological and mental phenomena, were the ideological inspirers of Russian scientific thought. If the advanced philosophical views of the revolutionary democrats became the general methodological basis for the development of medical science in Russia in the second half of the 19th century, then the achievements of natural science were the environment that provided new natural science theories, research methods, and technical means. The development of three global theories covering all the diversity of natural phenomena was especially important among the many discoveries in this area. It were: the law of conservation

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and transformation of energy, developed by the works of M.V. Lomonosov, A. Lavoisier, J. Mayer, D. Joule, G. Helmholtz; the doctrine of the cell and the cellular structure of organisms thanks to the works of F. Raspail, P.F. Goryainov, L. Purkinye; M. Schleiden, T. Schwann; evolutionary doctrine, developed by J. Lamarck, K. Wolf, P.F. Goryainov, K.F. Rulier, N.A. Severtsev, A.N. Beketov, L.S. Tsenkovsky, who received the most complete development in the work of Charles Darwin “On the Origin of Species by Means of Natural Selection, or the Preservation of Favoured Races in the Struggle for Life” (1859). Charles Darwin's works had the most profound influence on the development of biology and medicine. Russian scientists of the second half of the 19th century (I.M. Sechenov, D.I. Mendeleev, N.N. Zinin, A.M. Butlerov, K.A. Timiryazev, A.O. and V.O. Kovalevskiy, I. I. Mechnikov, S.P. Botkin, A.G. Zakharyin, A.A. Ostroumov, I.P. Pavlov and others) have done a tremendous task of promoting evolutionary doctrine and of its development further raised it to a higher level. Charles Darwin highly appreciated the activities Russian scientists who made Russia the second homeland of Darwinism Russian scientists laid the foundations of comparative embryology (A . Kovalevsky, I.I. Mechnikov), comparative histology (A.I. Babukhin others), pathology (I.I. Mechnikov), developed the doctrine of the nature of heredity and variability (K.A. Timiryazev), discovered the phenomena of phagocytosis and variability of microorganisms (I.I. Mechnikov), discovered the energetic laws of photosynthesis (K.A. Timiryazev), the phenomenon of bacteriolysis (N.F. Gamaleya), made a bold attempt to find the physiological foundations of mental processes and objective methods for studying higher nervous activity (I.M. Sechenov), created the foundations of modern ideas about the physiology of digestion (I.P. Pavlov). These major discoveries made in Russia were the basis for the recognition of the principles of evolutionary theory and the leading importance of the nervous system in the life of the organism. The achievements of physiology, which were developed by I.M. Sechenov, I.P. Pavlov and their students, had a particularly great influence on the development of medicine. Ivan Mikhailovich Sechenov (1829-1905) made an outstanding

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