Brief history of medicine of the 18th and 19th centuries. Activities to organize medical care for the population of Russia in the 18th century

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Medicine in Russia in the 18th century

In the 18th century, especially in its second half, in Russia there was a stubborn struggle between the advanced, materialistic ideas of the most outstanding representatives of Russian natural scientific and socio-philosophical thought of the 18th century with reactionary, idealistic ideas, which were often planted and supported in Russia mainly by foreigners, representatives of predominantly German science . This struggle is chalk class in nature. The overwhelming majority of Russian scientists from the 8th century came from the working classes of the people and looked at science as a means of enlightening the masses, developing the productive forces and raising the well-being of the people. Supporters of reactionary theories, figures from the bureaucratic elite, and representatives of the noble-landowner class reflected the interests of this class.

In 1725, the St. Petersburg Academy of Sciences was opened, where foreign scientists were invited. Among the first academicians were those who published works on medical issues. Thus, Daniil published works “On the movement of muscles, on the visual system”, Leonard Euler - a work on hemodynamics, Duvernoy and Veit-eicht - a number of anatomical works.

Economic needs necessitated the expansion and formation of the army, financial and other reforms.

In the reforms of Peter I, significant attention was paid to the medical profession. Russians who traveled to the countries of Western Europe, including Peter I himself, along with shipbuilding, manufactories and schools, introduced hospitals, anatomical museums and outstanding doctors of Holland there. Peter I met advanced doctors, listened to Burgaw's lectures, purchased from Ruysch for a large sum his famous atomic collection, visited Leveiguk and became acquainted with his microscopic research.

In the 18th century in Russia, the need for a larger number of doctors became particularly apparent, primarily to meet the needs of the military and the emerging merchant class, as well as for medical care of factories and factories located in places remote from the cultural centers of the country. At the beginning of the 18th century, permanent military hospitals were created in Russia - land ones to serve the army and admiralty ones to serve the navy; the hospital was opened on November 21, 1707 in the eastern part of Moscow, across the Yauza River in a place for treating the sick.” Later, hospitals for crippled soldiers were created in St. Petersburg, Kronstadt, Revel, Kyiv and Yekaterinburg. In 1718, land and admiralty military hospitals were opened in St. Petersburg and in 1720 - an admiralty hospital in Kronstadt.

In 1721, the Admiralty Regulations, compiled with the participation of Peter I, were published, where a special section defined the tasks and forms of work in naval hospitals. In 1735, a special “General Regulation on Hospitals” was published. The advanced nature of the hospitals is clearly visible in the regulations. Each hospital was headed by a doctor; the economic part of the hospital was subordinate to the medical one. Mandatory pathological autopsies of corpses of those who died in the hospital were established, and it was recommended to make sketches of all the most medically interesting patients and drugs. In 1745, instructions for hospital schools in Russia emphasized the scientific and practical importance of autopsies. In 1754, the medical office drew up another instruction, which specified the forms of work of the pathologist. In the XVIII century, Russian science in the field of medicine and medical education united not with the overwhelming backward majority that dominated the medical faculties of many universities in Western Europe, but with the advanced, progressive for that time Leiden University. In contrast to the scholastic, purely bookish training of future doctors of medicine at the medical faculties of Western European universities that remained throughout the 17th century, hospital schools in Russia from the first years of their existence built the training of future doctors practically. In organizing medical education, Russia borrowed this advanced and not yet generally recognized method of teaching students at the patient’s bedside. It is no coincidence that schools for training doctors in Russia were created at hospitals. The task of training doctors in the 18th century was solved in Russia in an original, original way: a new type of higher educational institution for training doctors was created - schools based on large hospitals.

Russian hospital schools of the 18th century. The first hospital school for 50 students was organized in 1707 at the Moscow Land Hospital. In 1733, similar schools were opened at the land and admiralty (sea) hospitals in St. Petersburg, and the admiralty hospitals in Kronstadt, with 10 doctors and 20 students in each. In 1756, the student population at the St. Petersburg Land Hospital was increased to 50, and at the Admiralty Hospital - to 30 students. In 1758, a school for 15 students was opened at the Kolyvano-Voskresensky factory hospital, which graduated about 160 doctors. From 1788 to 1796 there was a hospital school at the Elisavetgrad hospital, which graduated 152 doctors.

Peter I entrusted the construction and organization of the Moscow hospital to the Dutch doctor Nikolai Bidloo, a student of Burgaw, the nephew of the anatomist, whose atlas Peter I himself used. Peter I also instructed him to organize a school for training doctors at the hospital. Foreign doctors unfamiliar with the Russian language were invited as teachers at the hospital and had the opportunity to teach only in Latin and foreign languages (mainly Dutch and German). Foreign doctors in Russian service, fearing competition, often tried to oppose the training of domestic Russian doctors. Some therefore recommended admitting only children of foreigners living in Moscow to the hospital school.

Among the foreign doctors there were even those who argued that Russians were not capable of acquiring the extensive knowledge necessary for a doctor. Later, in 1715, in a letter to Peter I, he spoke about this: “Many surgeons advised that I should not teach this (Russian) young man to the people, saying that you cannot do this thing.” To Bidloo’s credit, it should be noted that he correctly understood the tasks that were set before him and honestly served the interests of Russia, decisively overcoming the opposition of foreign doctors. Bidloo was not afraid of difficulties and found a way out of the situation: he received permission to recruit students to the hospital school from among the students of the Slavic-Greek-Latin Academy and schools of the ecclesiastical department, where students studied Greek and Latin.

The teaching program in hospital schools included all theoretical and practical medical disciplines to a greater extent than in the medical faculties of foreign universities. Theoretical disciplines were taught: human anatomy with physiology, elements of histology and forensic medicine, pathological anatomy, “materia medica”, including pharmacognosy, mineralogy, botany, pharmacy and pharmacology. With the transformation of hospital schools into medical-surgical schools in 1786, chemistry, mathematics and physics were introduced. Anatomical museums and botanical gardens (“pharmaceutical gardens”) were organized at hospitals.

Clinical disciplines were taught in hospital departments, and surgical training was considered paramount. The course of [internal diseases] included familiarizing students with infectious, skin-venereal and childhood diseases. Since 1763, the study of obstetrics was introduced. The senior and junior doctors of the hospital conducted lecture courses on therapy, pharmacology and anatomy, the chief physician taught a course in surgery, and the hospital operator supervised anatomical and surgical practice. Doctors conducted practical classes with students in surgery and internal medicine. In hospital schools they studied not only from books, students regularly worked in the hospital, “where every day there are from one hundred to two hundred patients.” Students cared for the sick, helped with dressings, worked<в аптеке, в аптекарском огороде по выращиванию лекарственных растений, присутствовали на операциях, судебно-медицинских и патологоанатомических вскрытиях. Благодаря этому учащиеся получали пир окне знания и практические навыки.

Russian scientists in the 18th century, for the first time in the world, they developed and put into practice a new system of medical education, ensuring the training of highly qualified Doctors. Graduates of hospital schools made up the bulk of the leaders in medicine in Russia in the 18th century and played a major role in the development of domestic healthcare.

The characteristic features of hospital schools of the 18th century were: a high general educational level of students who came from educational institutions of the ecclesiastical department, familiar with the Latin language, philosophy, many classical works of Greek and Latin writers and philosophers, their democratic origin, since hospital schools were attended by people from minorities wealthy segments of the population (children of minor clergy, doctors, Cossacks, court singers, merchants, soldiers' children, etc.). Training in hospital schools lasted from 5 to 7 years and ended with a strict public exam: the examinee, in addition to answering questions on anatomy, physiology, surgery and internal medicine, personally performed 3-4 operations on a corpse in the presence of examiners.

Doctors trained in hospital schools occupied a significant place in Russian medicine, especially in the middle and second half of the 18th century. They were part of active armies, were participants in many scientific expeditions (Kamchatka Bering, Brazilian) and round-the-world voyages of Russian ships in the 18th century. Some of them became teachers in hospital schools in the second half of the 18th century.

Education system future doctors in Russia was built and improved throughout the 18th century. It began in 1707 by N. Bidloo. In 1735, the General Regulations on Hospitals included a detailed chapter on the hospital school, which defined the tasks and periods of training in it. In 1753--1760 P. 3. Kondoidi and M.I. Sheya improved the teaching of anatomy and clinics, set up clinical wards, mandatory autopsies were introduced, the teaching of obstetrics and women's diseases was changed, and the order of examinations was changed. Many leading doctors (P. I. Pogoretsky, A. M. Shumlyansky, M. M. Terekhovsky, etc.) took an active part in developing issues of teaching medicine in the second half of the 18th century. In 1782, D. S. Samoilovich, while in France, wrote “A Speech to Students of Hospital Schools of the Russian Empire,” where he discussed in detail the tasks of medical education. In 1785

M. M. Tsrekhovsky and A. M. Shumlyansky were sent with the goal of “collecting and delivering accurate information about the structure and organization of higher medical schools in different European countries.” After this trip, they developed proposals for improving medical education, taking into account the expansion of medical knowledge by the end of the 18th century and the beginning of the division of medical sciences.

Hospital schools, as the main form of training doctors in Russia, existed for about 80 years, i.e., during almost the entire 18th century. In 1786, hospital schools were transformed into medical-surgical schools. In 1798, medical-surgical academies were organized in St. Petersburg and Moscow with more extensive programs and a new curriculum.

Founding of Moscow University and its medical faculty. Considering the need to “multiply Russian doctors and surgeons in Russia, of whom there are very few,” M. V. Lomonosov in 1748, in the draft regulations of the university at the St. Petersburg Academy of Sciences, wrote: “I think that the university should definitely have three faculties: law, medicine and philosophical (theological is left to the synodal schools).” In 1754, M.V. Lomonosov recommended the same for the organized Moscow University. At the same time, M.V. Lomonosov raised the issue of granting Moscow University the right to “produce worthy students into academic degrees.”

In 1755, Moscow University was opened. Since 1758, Mr. Kerstens began to give lectures here on physics “for the preparation of those who wish to study medicine,” then in the following years - chemistry, mineralogy and chemistry in connection with the natural history of simple pharmaceutical drugs, medical substance studies. In 1764, a professor was invited to the department of anatomy, and the medical faculty began to function. In 1765, the tasks of the medical faculty were more precisely defined. “The medical class or faculty has its exercise in discussing human health and life. In it they study practical and theoretical medicine, chemistry, botany, anatomy and surgery and produce from natural subjects such people who, as healers and physicians, help their fellow citizens, take care of their health and thus can contribute to the common good in countless cases.”

At Moscow University in the first decades of its existence, enrollment of students was carried out not annually, but approximately once every 3 years. Each professor continued his course for 2-3 years and only after completing it began a new one for a new set of students. Without having its own clinics, the medical faculty of Moscow University in the first decades of its existence was limited to theoretical training of future doctors. S. G. Zybelii, teaching internal medicine, occasionally showed patients and only at the end of the 18th century was he able to provide clinical teaching on a small scale.

In the second century of the 18th century, Moscow University was the center around which prominent representatives of domestic medical science, both Russian science and social thought in general, were concentrated.

Activities to organize medical care for the population of Russia in the 18th century

Among the administrative reforms of Peter I were measures in the medical field: a medical office was organized, headed by a doctor in 1716, and pharmacies were opened in a number of cities. In 1718, a “tool hut” was organized in St. Petersburg for the manufacture of surgical instruments. They began to use and study the medicinal use of mineral springs in the Olonets region, Lipetsk and Staraya Russa. Sanitary measures were taken: birth and death rates began to be taken into account, food supervision arose in markets, decrees were issued on the improvement of Moscow. The high morbidity and mortality rate of the Russian population, especially infant mortality, worried the best representatives of medicine. In the middle of the 18th century, reforms were carried out in the field of health care: in 1763, the Medical College was organized, the number of doctors in cities was increased, and much attention was paid to medical education and training of medical specialists and teachers. In 1763--1771. Orphanages were opened in Moscow and St. Petersburg with obstetric institutions attached to them, which served as schools for training midwives. In connection with the division into provinces, reforms were carried out in the medical profession: provincial medical boards were created, and the positions of county doctors were introduced. In 1775, orders for public charity were created in the provinces, under whose jurisdiction civil hospitals were transferred.

In the history of Russian medical science and medical education in the mid-18th century, a prominent role was played by Pavel Zakharovich Kondoidi (1710-1760), a Greek by birth, brought to Russia at an early age and raised in Russia. In 1732, P. 3. Kondoidi graduated from the medical faculty of Leiden University and, returning to Russia, served as a military doctor. In 1741 --1747 P. 3. Kondoidi was the assistant to the general director of the medical office and actually led the medical affairs of Russia. A few years later, he was again involved in the leadership of the medical administration and from 1753 to 1760 was the chief director of the Medical Office.

Kondoidi was the first outstanding medical administrator in Russia: under him, numerous instructions were drawn up for military sanitary affairs, instructions to general staff doctors, divisional doctors, army general medic, military doctors, on the treatment of patients with smallpox, measles and other diseases accompanied by a rash , on the examination of disabled people or those incapable of military service, etc. With the direct participation of P. 3. Kondoidi, the Russian military pharmacopoeia was compiled. He took the initiative in organizing obstetrics and training midwives. The merits of P. 3. Kondoidi are significant in the development and improvement of the medical education system in Russia, improving teaching in hospital schools. At the suggestion of Kondoidi, M.I. Shein translated textbooks on Geister’s anatomy and Platner’s surgery into Russian and published at public expense. P. 3. Kondoidi organized (after a break) the sending of doctors who graduated from hospital schools to foreign universities to receive the degree of Doctor of Medicine, without which it was impossible to become a teacher at a hospital school. P. 3. Kondoidi introduced scientific and medical meetings (the prototype of conferences and scientific medical societies), organized a medical library, was the initiator in the creation of medical and topographical descriptions and planned a permanent publication for the publication of the works of doctors.

In the second half of the 18th century, Russia played advanced role in carrying out smallpox vaccination in the form of variolation. This event did not meet with opposition in Russia, as was the case in some Western European countries. Doctors and the Russian public showed an understanding of the significance of variolation. Despite the difficulties due to the lack of trained workers locally, variolation became widespread in Russia: vaccination points (“smallpox houses”) were organized, and popular scientific literature was published. The same was later true for smallpox vaccination. In 1795, Jenner carried out the first vaccination in England, and in 1801, in the Moscow orphanage, the first vaccination against smallpox was carried out with the vaccine received from Jenner.

In the 18th century, Russia suffered several plague epidemics. The epidemic of 1770-1772 was the most widespread, affecting and claiming many victims in Moscow and in Russia in general. Leading domestic doctors D. S. Samoilovich, A. F. Shafonsky, S. G. Zybelil

Table of the first Russian anatomical atlas, published in 1744. They often fought the disease with danger to their lives, studied the clinic and etiology of the plague.

Medical issues and the organization of medical care for the population occupied the progressive public of Russia in the 18th century: they received significant attention in the works of the Free Economic Society, founded in 1765, in the publishing activities of N. I. Novikov, in the works of M. V. Lomonosov, A. N. Radishcheva.

The study of printed works and archival manuscripts suggests that in the second half of the 18th century, advanced doctors of Russia (N. M. Maksimovich-Ambodik, M. Gamaleya, N. Karpinsky, I. Protasov, D. Samoilovich. Ya. Sapolovnch and etc.) developed issues of organizing hospital care, carrying out sanitary, hygienic and epidemiological measures, and compiled numerous medical and topographical descriptions of various parts and cities of Russia.

The advanced ideas and numerous practical proposals of Russian doctors of the 18th century, aimed at improving health care for the population, remained in most cases unrealized under the conditions of the autocratic-serf system.

M. V. Lomonosov. The significance of his natural scientific discoveries and materialistic philosophy for the development of medicine. The beginning of a new period in the development of science and social thought in Russia, the emergence of an integral system of materialist philosophy is associated with the name of the great M. V. Lomonosov.

Having deeply studied and assimilated everything valuable and positive that natural scientists and philosophers in European countries gave, M. V. Lomonosov rejected idealism and metaphysical explanations of natural phenomena, which were given by many scientists in the 17th-18th centuries. Medieval scholasticism was alien to M.V. Lomonosov. He considered blind admiration for authorities and outdated theories to be a serious obstacle to the development of genuine science. M. V. Lomonosov was an encyclopedically educated natural scientist and thinker who paved new paths in various fields of scientific knowledge. His discoveries and generalizations were far ahead of contemporary science.

M. V. Lomonosov was an outstanding representative of natural scientific materialism of the 18th century. Lomonosov considered it impossible for science to exist without experience and observation: “I value one experience higher than a thousand thoughts born only from imagination.” However, no less important, in his opinion, is the comprehension of experience and observations, bringing them into a system, building theories and hypotheses. He criticized naked empiricism, which is unable to produce a generalization from many disparate facts. M.V. Lomonosov developed a materialist theory of knowledge.

The most characteristic feature of his work was his brilliant ability for theoretical thinking and broad generalizations of experimental data about natural phenomena. Acting as an innovator, boldly breaking the misconceptions and outdated traditions existing in science. M.V. Lomonosov laid the foundations for a new, scientific view of nature, matter and movement. He put forward a hypothesis of the atomic-molecular structure of matter, not as an abstract natural-philosophical concept, which had been done before him, but as a natural-scientific hypothesis based on experimental data. M.V. Lomonosov consistently developed this hypothesis about the structure of matter into a harmonious scientific system and extended it to all physical and chemical phenomena known at that time.

M.V. Lomonosov discovered the law of conservation of matter. The original formulation was given in a letter to Euler in 1748, then in 1756 in “Reflections on the Nature of Heat.” The law was finally formulated in the speech “Discourse on the hardness and liquid of bodies” in 1760. Having developed the doctrine of atoms and their motion, having discovered and scientifically substantiated the law of constancy of matter and motion, M. V. Lomonosov put it as the basis of a universal law of nature and made it he has many natural scientific and philosophical conclusions. He gave a natural scientific and philosophical explanation for the position of materialism about the unity of matter and motion.

The significance of M. V. Lomonosov's discovery was truly enormous not only for chemistry, but also for the entire natural science and materialist philosophy. Having discovered the law of conservation of matter and motion, the great scientist rejected the metaphysical position that motion is something external to matter and that therefore it can be destroyed and arise from nothing. His formulation of the law of conservation of matter and motion includes:

1) the idea of conservation of motion, under the sign of which the natural science of the 19th century further developed, when the law of conservation and transformation of energy was discovered;

2) the idea of the inseparability of matter and movement, under the sign of which modern natural science is developing.

The materialistic philosophical views of M. V. Lomonosov were closely related to his research and discoveries in the field of physics and chemistry. These studies and discoveries were the natural scientific basis of the materialistic worldview of M. V. Lomonosov. In turn, the materialism of M. V. Lomonosov invariably served as a theoretical source in his scientific research, in the justification and development of a new direction in natural science, whose supporters adhered to a spontaneous-dialectical view of nature.

The beginnings of spontaneous dialectics, along with a conscious materialistic understanding of nature, were clearly manifested in the worldview of M. V. Lomonosov. While remaining within the framework of mechanistic materialism, he at the same time dealt a significant blow to the metaphysical worldview, considering phenomena in nature in the process of their development. Thus, in his work “On the Layers of the Earth” in 1763, M. V. Lomonosov wrote about the evolutionary development of the animal and plant world and made an important conclusion that not only individual bodies change, but also nature as a whole.

The outstanding discoveries and bold theoretical generalizations of M. V. Lomonosov in natural science were a powerful ideological source for the development of the materialist worldview in the second half of the 18th century and in subsequent periods.

Lomonosov's materialistic philosophical, natural scientific views and socio-political democratic views had a great influence on the development of natural science and medicine in Russia. For many years in the second half of the 18th century and in the 19th century, they were among the students and followers of M.V. Lomonosov as the scientific basis for the development of domestic medicine.

Lomonosov explained the process of oxidation and combustion and thereby established the nature of respiration. He was a staunch opponent of the theory of “weightless” phlogiston; 17 years before Lavoisier, he first clearly formulated the position about the chemical nature of oxidation. Quantitative studies of the chemical composition of various substances in the time of M.V. Lomonosov were just beginning. The systematic use of balances in chemical experiments, which began in the middle of the 18th century, found one of the pioneers and ardent adherents in the person of M.V. Lomonosov. The law of conservation of matter, quantitative analysis, and explanation of combustion processes were the basis for future research by physiologists and biochemists.

M.V. Lomonosov emphasized the importance of chemistry for medicine. “A physician cannot be perfect without a thorough knowledge of chemistry. It recognizes the natural mixture of blood and nutritious juices, and it reveals the composition of healthy and harmful foods. V. Lomonosov also emphasized the need to study anatomy.

Lomonosov edited the translation of anatomical terms for the atlas made by his student, one of the first Russian anatomists A.P. Protasov.

Lomonosov not only pointed out the shortcomings, but also set the tasks of improving medical care to the population, increasing the number of doctors, medical institutions, pharmacies, compiling and publishing books on assistance during childbirth and the treatment of children accessible to the general public. He called for improving child care, combating unhygienic practices in everyday life, in particular those associated with church rituals, and considered measures to combat child mortality.

The calls of M.V. Lomonosov largely remained unfulfilled, but in a number of points, for example, with regard to improving obstetric care and training midwives, advanced doctors of the second half of the 18th century (N.M. Maksimovich-Ambodik, D.S. Samoilovich, A.M. Shumlyansky) in their practical medical and sanitary educational activities followed the precepts of Lomonosov. M.V. Lomonosov fought against foreign scientists who hampered the development of Russian science. Exposing anti-Russian tendencies in the historical and ethnographic works of G. Miller, he wrote that this author “most of all looks out for stains on the clothing of the Russian body, going through many of its true decorations.”

The leading role of Russian scientists of the 18th century in the development of evolutionary doctrine. Wolf Caspar Friedrich (1734--1794) studied medicine in Berlin and Halle. In 1759 he published a dissertation “The Theory of Generation”, in 1764 a more detailed work (Theorie von der Generation)2 under the same title. In Germany, Wolf's work was not recognized and met with strong opposition from Albrecht Haller. Wolf was not elected to the department of physiology. In 1764, Wolf accepted the invitation of the St. Petersburg Academy of Sciences, moved to Russia and worked in Russia for 30 years until the end of his life.

At that time, the theory of preformationism was popular, according to which it was believed that in an egg or in a sperm there was a formed organism (preformed, reshaped) in a miniature and folded form, and that the development of the embryo was only the unfolding of what existed. Wolf criticized this metaphysical theory of preformationism and developed a theory of epigenesis that was progressive for that time. Wolf came to this theory on the basis of his own experimental data from studying the initial stage of development of plants and animals. In his work “The Theory of Generation,” Wolf traced how and when leaves, flowers and their parts appear in plants, how and when fruits and seeds are formed. Wolf studied the origin of individual organs of an animal organism using a chicken embryo. In contrast to the metaphysical ideas of the preformationists, Wolf established that there are no “preformed”, i.e., prepared organs in either plants or animals. Studies of the chicken embryo have shown that, for example, the heart of the embryo appears only after its other, simpler parts have formed. Wolf established that the birth and development of every living being is a purely quantitative increase, not simple growth, but a consistent process of the appearance of more and more new organs, which become more complex in the future. Thus, Wolf was the first to put the study of the individual development of an organism (ontogenesis) on a scientific basis.

The role of Wolf in the development of biological science in the historical preparation of the evolutionary idea was highly appreciated by Engels. “It is characteristic,” he wrote in “Dialectics of Nature,” “that almost simultaneously with Kant’s attack on the doctrine of the eternity of the solar system, K. CD. Wolf made the first attack on the theory of the constancy of species in 1759, proclaiming the doctrine of evolution. But what he had only as a brilliant anticipation took a definite form in Oken, Lamarck, Baer and was victoriously carried out in science exactly one hundred years later, in 1859, by Darwin.”

The idea of the gradual development of living nature in the second half of the 18th century was also put forward by the Russian natural scientist Afanasy Kaverznev. In his essay “On the Rebirth of Animals,” published in 1775 in German and then in Russian, Kaverznev expressed a number of guesses that anticipated some provisions of the theory of development in biology, in particular the position that the variability of animals is determined by environmental conditions. Under the influence of environmental conditions and food, animal species undergo such profound changes over time that they are impossible to recognize immediately.

The struggle of advanced domestic doctors of the 18th century for the independent development of Russian medical science and the training of Russian doctors. In the 18th century in Russia there was a struggle between leading domestic doctors for the independent development of Russian medical science and the training of Russian doctors. This struggle took place in various forms at various stages of the development of medicine in the 18th and 19th centuries. Both at the beginning of the 18th century, when creating hospital schools and recruiting students for them at Bidloo, and at the end of the 18th century, when creating a higher medical educational institution in St. Petersburg, the so-called Kalinkin Institute, Russian youth had to fight for the right to study medicine.

By the middle of the 18th century, among the doctors who graduated from hospital schools and medical faculties of foreign universities, the most talented (M. Shein, S. Zybelin, etc.) fought for the right to be teachers in medical schools in Russia. For a whole century (from the middle of the 18th century to almost the middle of the 19th century), the struggle for the right to use the Russian language in medicine lasted. There are numerous examples of the struggle for the opportunity for domestic doctors to occupy leadership positions in hospitals and educational institutions, in scientific and administrative institutions.

In 1764, the Medical College recognized the equality of the Russian and German languages in teaching in hospital schools: “From now on, for the future, teaching in hospital schools will be public, in Russian and German.” And only in 1795, in the “Preliminary Resolution on the Positions of Teachers and Students” it was stated: “... A professor must know completely the Russian language in order to accurately and intelligibly express his thoughts in it when teaching; in case of need, when it will be impossible to find one, a person who knows Latin thoroughly is allowed, in which he will be obliged to teach after 3 years (for a period of 3 years), during which he must study the Russian language.” As a result of this concession, many professors did not study Russian.

In the first half of the 19th century. For example, in the first quarter of the 19th century, Moscow University published translations of medical textbooks from German into Latin for the needs of students.

In 1764, the Medical College received the right to award doctors the degree of Doctor of Medicine, but in the 18th century it was awarded to only 16 doctors who were educated at hospital schools. In addition, the Medical College awarded the title of professor to 8 scientists who had completed postgraduate training, as well as I. Bush and Ya Sapolovich, the title of professor without defending a dissertation and completing an adjunct course. The Medical Faculty of Moscow University received the right to award the degree of Doctor of Medicine only in the 90s of the 18th century. Finally, in 1859-1860. was allowed to defend dissertations in Russian.

A striking example of the struggle were the events associated with the opening in St. Petersburg in the 80s of the 18th century of the Kalinkin Institute for the training of doctors, which did not exist for long and in the last years of the 18th century joined the then created St. Petersburg Medical-Surgical Academy. In 1783, foreign doctors who were at the head of medical affairs in Russia had the idea of establishing in St. Petersburg (on the basis of the hospital near the Kalinkin Bridge) a higher medical educational institution, a special school for training medical administrators and teachers. The draft charter of this institution frankly wrote: “When distributing service places, the best places should be provided to students of this school.” Having set such tasks for the new higher medical educational institution, its organizers, with the consent of the ruling circles of Russia, decided to make the Kalinkin Institute accessible exclusively to Germans. The draft charter proposed to prohibit Russians from enrolling as students at this new school. Having learned about this project, M. M. Terekhovsky sharply spoke out against the attempt to create a higher medical school in St. Petersburg exclusively for Germans and proposed making the Kalinkin Institute a purely Russian institution.

Under the influence of the protests that followed the speech of M. M. Terekhovsky, when approving the charter of the Kalinkin Institute, the government was forced to remove the clause prohibiting Russians from enrolling as its students, but left another restriction, introducing the teaching of all subjects at the institute in German.

It is a mistake to think that this struggle with Vasily in domestic medicine among foreign doctors was in the nature of personal competition. Without denying such elements in individual cases, we at the same time must emphasize that basically this struggle had deeper roots, which played a role not only in medicine, but also in the entire culture and science of Russia in the 18th-19th centuries. In various phases and episodes of this stubborn struggle, which was of a class nature, the struggle of advanced materialist ideas of the most outstanding representatives of Russian natural science and social philosophical thought of the 18th century with reactionary, idealistic ideas, implanted and supported in Russia mainly by representatives of foreign, mainly German science, was reflected.

The overwhelming majority of Russian scientists and doctors of the 18th century came from the working classes of the people, familiar with their situation and needs. They looked at science as a means of enlightening the masses, developing productive forces and raising the well-being of the people. Foreigners, scientists and doctors who worked in Russia, mostly former supporters of reactionary theories, associated with figures from the bureaucratic elite and were themselves often from among this elite, supported representatives of the noble-landowner class and reflected the interests of this class. Starting from the last decade of the 17th century, under Peter I and in the subsequent 18th century, especially in its second half, the tsarist government invited a large number of foreign doctors from other countries and provided them with official and material advantages and privileges in comparison with domestic doctors. In the Medical College and other government institutions, the army, hospitals and clinics, hospital schools, and Moscow University, there were many foreign doctors who did not know or understand the needs of the Russian people.

Many foreign doctors, alien to advanced science in general and Russian science in particular, pursuing almost exclusively selfish goals, hindered the development of advanced Russian scientific thought and, not disdaining any means, created obstacles for advanced Russian scientists as much as they could. Foreign doctors, fearing competition, in various ways opposed the development of Russian medical science and the creation of a cadre of Russian doctors, teachers and scientists. Numerous examples of such attitude towards talented Russian doctors are found in the biographies of K.I. Shchepin, S.G. Zybelin, D.S. Samoilovich, A.M. Shumlyansky and many other doctors of the 18th century.

Of course, among the foreigners who worked in Russia, there were people who honestly served the Russian people, who understood their tasks, who made Russia a permanent place of their activities and remained here until the end of their days (father and sons Blumentrosty, N. Bidloo, K. Wolf, P. Pallas and others).

Scientific activity of Russian doctors in the 18th century. The 18th century was an important stage in the development of medicine in Russia. This was the period of formation and growth of Russian medical science, when scientific medicine appeared and rapidly developed in Russia. Among the doctors who contributed to the development of medical science, students of Russian hospital schools played a major role in the 18th century. biological medical friedrich russia

Domestic doctors were not only good practical doctors serving the civilian population and the army, but many of them became teachers. In the second half of the 18th century, many *domestic doctors contributed to the development of medical science with their works.

Most dissertations was defended at foreign universities. During the 18th century, 309 Russian natives and foreigners naturalized in Russia received the degree of Doctor of Medicine at foreign universities. Of the doctoral dissertations defended in the 18th century by Russian doctors at foreign universities, the most interesting are the 89 dissertations of students of Russian hospital schools, which was explained by the extensive theoretical and practical training received by their authors in hospital schools, thanks to which they deeply and comprehensively resolved issues and opposed idealistic views, used experiment in their research, and interpreted the issue from a materialistic point of view. These were the dissertations of M. M. Terekhovsky, M. Shumlyansky, D. S. Samoilovi A. A.F. Shafonsky, K.O. Yagelsky and others. These dissertations were repeatedly reviewed in the literature of that time and were even completely republished abroad.

The scientific research of Russian doctors of the 18th century was not limited to doctoral dissertations. The doctors carried out research work quite intensively, their numerous manuscripts were submitted to the Medical Office. In 1764, the Medical College under P. Z. Kondoidi issued a special decree inviting all doctors to send scientific works for publication in the “Russian Medical Commentaries”. After this, the flow of works increased, but the Medical College and its leaders, foreign doctors, were dishonest in their duties and did not review the submitted scientific works. By 1793, the archives of the Medical College contained 463 handwritten works by Russian doctors.

After the Medical College was replenished with advanced Russian doctors, the attitude changed. In 1793--1795. All the works were considered at the conference of the board, divided by quality into 4 categories, and 103 works were considered worthy of publication, but only in 1805 was a collection containing 50 works published. The archives of the Medical College have preserved to this day more than a thousand manuscripts devoted to the problems of infectious diseases and epidemiology, surgery, internal medicine, hygiene, botany, pharmacology and chemistry. The authors of these manuscripts, for example, studied anthrax, leprosy, studied the toxicology of ergot, and established nutritional factors influencing the occurrence of scurvy. Among these manuscripts there are a number of valuable works that reflect the following features: the desire to solve the most important issues of practical medicine (infectious diseases, hygiene, domestic medicinal raw materials) and the use of experimental research in nature. These works reflected the materialistic views of M.V. Lomonosov, his teaching on the need not only to treat, but also to prevent diseases, and recognition of the importance of experience.

The medical literature of Russia in the 18th century is characterized by a large number of translated works. In 1757, M.I. Shein published the first translation of Geister’s widely distributed anatomy textbook, and in 1761, a translation of Platner’s textbook on surgery. M. I. Shein’s work on translating medical textbooks and books into Russian was continued by N. M. Maksimovich-Ambodik, M. M. Terekhovsky, F. I. Barsuk-Moiseev and others. For translations, widely used ones, the best at that time, were selected textbooks. By the end of the 18th century, textbooks on all medical specialties were available in Russian. Acquaintance with translated medical literature printed in Russia in the 18th century shows that this “translated” period of Russian scientific medical literature was far from being a simple, much less slavish imitation. Russian doctors, acting as the first translators, clearly set themselves the task of being active in the critical perception of contemporary medical science in Western Europe. The independence and originality of the first Russian translators of the 18th century are visible in almost every significant translation work. The authors were critical of the original text, omitted what did not correspond to their views, made significant amendments, clarifications and comments to the translated text, and often supplemented the text with their own material (data from their own observations, materials from other works). Thus, M.I. Shein included case histories from his own observations in his translation of a foreign book on surgery. N. M. Maksimovich-Ambodik, when translating a book about venereal (“lusty”) diseases, added 60 pages of his notes to the 140 pages of the author’s text.

In the last decades of the 18th century, large original works and teaching aids were published in Russian in Russia. In 1792--1794. the first medical journal in Russian was published, “St. Petersburg Medical Gazette”

When giving lectures and printing textbooks and scientific works in Russian, great difficulties arose in medical terminology. The vernacular language could not convey many details of medical terminology, and in the 18th century, translators and authors had to create medical terminology in Russian. A. P. Protasov, M. I. Shein, S. G. Zybelin worked a lot in this regard. N. M. Maksimovich-Ambodik paid a lot of attention to the creation of medical terminology, not only in his writings and translations of medical books, but also in the compilation of special dictionaries. He published medical-surgical, anatomical-physiological and botanical dictionaries.

The main features of the scientific activity of domestic doctors of the 18th century were materialism with the resulting connection of medical research with experimental, natural sciences and interest in the nervous system, patriotism and democracy. In the development of Russian medicine in the 18th century, in the activities of a number of its leading representatives who ideologically followed M.V. Lomonosov, materialist principles were formed in the fight against the influence of the idealistic reaction of the 18th century (Leibniz, Kant).

Russian naturalists and doctors XVIII centuries acted as consistent supporters of contemporary materialist views. We find such statements among prominent doctors of the 18th century - S. G. Zybelin, N. M. Maksimovich-Ambodik, A. F. Shafonsky and others. For example, the Dictionary of the Russian Academy played a large role in the promotion of materialism in Russia in the 18th century ", where doctors A.P. Protasov and P.I. Ozeretskovsky wrote articles on anatomical, physiological and pathological terms in accordance with the advanced materialistic views of that time.

The materialistic orientation of advanced doctors greatly contributed to the progressive nature of their medical activities.

Leading Russian doctors of the 18th century were characterized by the desire to introduce medicine into the circle of natural sciences and connect it with the achievements of natural science. S. G. Zybelin, K. I. Shchepin, A. M. Shumlyansky, D. S. Samoilovich’s acquaintance with physics, chemistry, and botany allowed them to take away everything advanced from contemporary natural science. F.G. Politkovsky wrote: “...I advise you to look at all systems with impartial eyes, which should be guided by reason and experience.” N. M. Maksimovich-Ambodik pointed out: “Speculation with experience - action is associated with a continuous union, so that one without the other is very weak and useless, and sometimes it can be detrimental... I don’t think much about other people’s or my own. I believe, and for the most part I follow observations and experiences in nature.”

Physician-researchers heeded this advice and widely used the experimental method.

In 1775, M. M. Terekhovsky, working on his dissertation “On bulk annmalicles,” used microscopic examination. D. I. Ivanov in 1780, in his dissertation on the topic “On the origin of intercostal nerves,” abandoned the generally accepted views of that time on the structure of the border sympathetic trunk, discarded speculative theories, began dissecting nerves, was the first to use tissue maceration and proved the ascending direction of the cervical and head divisions of the sympathetic nervous system. D.I. Pianov took a strictly materialistic position and did not recognize the mystical “nerve fluids” that flow through the nerves). Russian doctors of the second half of the 18th century showed great attention to the nervous system as a leading link in the functional functions of the body.

Attention to issues of hygiene and public health distinguished the leading figures of Russian medicine of the 18th century. The works, public lectures and speeches of S. G. Zybelin, N. M. Maksimovich-Ambodik, D. S. Samoilovich and others were devoted to hygienic topics. These statements, intended not only for doctors, but also for a wide audience, raised issues of raising and protecting the health of children, hygiene of the rural population, etc.

Outstanding figures of Russian medicine of the 18th century. K. I. Shchepin. Konstantin Ivanovich Shchepin (1728-1770) was born in Kotelnich, studied at the Vyatka Theological Seminary, Kiev-Mohyla Academy, then lived in Constantinople, Greece and Italy, and mastered Greek, Latin and several Western European languages perfectly.

Upon returning to Russia, Shchepin was a translator at the Academy of Sciences and worked on botany with Academician. S. P. Krasheninnikova. In 1753 Shchepin was sent to Leiden to further study botany. He intended to become a botanist, the successor of S.P. Krasheninnikov, but when he died, the position of botanist was offered to the son-in-law of a prominent German. Apparently, as a result of these intrigues, K. I. Shchepin in 1756 went to serve in the Medical Chancellery, which paid the Academy of Sciences for the expenses incurred on K. I. Shchepin’s business trip. M.V. Lomonosov wrote about this: “They sold Shchepin to the Medical Office.” K.I. Shchepin began to study medicine. In 1758 he defended his doctoral dissertation on plant acid in Leiden. In this work, K.I. Shchepin analyzed the influence of plant acids in human food, indicated the preventive value of plant acids in the fight against scurvy, and anticipated some of the data of modern vitaminology. In the thesis for the dissertation there are guesses about hormones, about the neurohumoral regulation of functions of the human body.

After this, K.I. Shchepin visited Paris and London. Copenhagen, visited Linnaeus in Sweden and everywhere improved in medicine. Returning to his homeland in 1759, he worked for a short time at the St. Petersburg General Hospital, from where, during the Seven Years' War, he voluntarily went into the army to become familiar with the peculiarities of the work of a military doctor.

Since 1762, K.I. Shchepin taught anatomy, physiology, surgery, botany and pharmacology, being the first Russian teacher at the Moscow Hospital School. K.I. Shchepin was an opponent of dictation, adopted at that time by many teachers, which was caused by the lack of textbooks. He made sure that students had textbooks. As a teacher, he sought to acquaint his audience with new advances in medicine. An experienced linguist and translator, K. I. Shchepin taught in Russian.

He insisted on the need for visual and practical teaching; he taught anatomy with the demonstration of corpses. His notes on the methods of teaching medical sciences have been preserved. With his innovations, KI. Shchepin made enemies among the heads of hospital schools, was removed from teaching and even deprived of the right to practice medicine. He participated in botanical expeditions; took part in the fight against the plague epidemic, from which he died...

Semyon Gerasimovich Zybelin (1735-1802) is deservedly considered the most outstanding Russian doctor of the 18th century.

S. G. Zbelinn studied at the Slavic-Greek-Latin Academy and from there in 1755 he was sent as a student to the newly opened Moscow University. After graduating from the general faculty in 1759, Zybelin was sent to the University of Leiden, where in 1764 he graduated from the Faculty of Medicine and received the degree of Doctor of Medicine. From 1765 to 1802, S. G. Zybelin taught it for 35 years at the medical faculty of Moscow University, reading theoretical medicine, anatomy, surgery, ethical medicine and chemistry at different times. Since 1768, S. G. Zybe-i was one of the first to give lectures in Russian.

...

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Particularly important for the history of medicine is the letter “On the reproduction and preservation of the Russian people” written by M. V. Lomonosov in 1761 to the major statesman of that time I. I. Shuvalov, in which he drew attention to a number of issues related to the state of medicine in Russia in his time." In this letter, M.V. Lomonosov showed patriotism and a deep understanding of the issues of protecting public health and population. He noted the low birth rate of RUSSIA, poor care during childbirth, high mortality of children during childbirth and in early childhood, high morbidity and mortality of children and adults, lack of medical care, both for the civilian population of Russia and in the army. Lomonosov not only pointed out the shortcomings, but also set the task of improving medical care for the population, increasing the number of doctors, medical institutions, pharmacies, compiling and publishing, books on assistance during childbirth, on the treatment of children, available to a wide circle.He called for improving child care, combating unhygienic customs in everyday life, in particular those related to church rituals, and considered measures to combat child mortality.

The calls of M.V. Lomonosov largely remained unfulfilled, but in a number of points, for example, with regard to improving obstetric care and training midwives, advanced doctors of the second half of the 18th century (N.M. Maksimovich-Ambodik, D.S. Samoilovich, A. M. Shumlyansky) in their practical medical and sanitary educational activities followed the precepts of Lomonosov. M.V. Lomonosov fought against foreign scientists who hampered the development of Russian science. Exposing anti-Russian tendencies in the historical and ethnographic works of G. Miller, he wrote that this author “most of all looks out for stains on the clothing of the Russian body, going through many of its true decorations.”

The leading role of Russian scientists of the 18th century in the development of evolutionary doctrine. Wolf Caspar Friedrich (1734-1794) studied medicine in Berlin and Halle. In 1759 he published a dissertation “The Theory of Generation”, in 1764 a more detailed work (Theorie von der Generation)2 under the same title. In Germany, Wolf's work was not recognized and met with strong opposition from Albrecht Haller. Wolf was not elected to the department of physiology. In 1764, Wolf accepted the invitation of the St. Petersburg Academy of Sciences, moved to Russia and worked in Russia for 30 years until the end of his life.

At that time, the theory of preformationism was popular, according to which it was believed that in an egg or in a sperm there was a formed organism (preformed, reshaped) in a miniature and folded form, and that the development of the embryo was only the unfolding of what existed. Wolf criticized this metaphysical theory of preformationism and developed a theory of epigenesis that was progressive for that time. Wolf came to this theory on the basis of his own experimental data from studying the initial stage of development of plants and animals. In his work “The Theory of Generation,” Wolf traced how and when leaves, flowers and their parts appear in plants, how and when fruits and seeds are formed. Wolf studied the origin of individual organs of an animal organism using a chicken embryo. In contrast to the metaphysical ideas of the preformationists, Wolf established that there are no “preformed”, i.e., pre-prepared organs in either plants or animals. Studies of the chicken embryo have shown that, for example, the heart of the embryo appears only after its other, simpler parts have formed. Wolf established that the birth and development of every living creature is not a purely quantitative increase, not simple growth, but a consistent process of the appearance of more and more new organs, which become more complex in the future. Thus, Wolf was the first to put the study of the individual development of an organism (ontogenesis) on a scientific basis.

In the 18th century in Russia there was a struggle between leading domestic doctors for the independent development of Russian medical science and the training of Russian doctors. This struggle took place in various forms at various stages of the development of medicine in the 18th and 19th centuries. Both at the beginning of the 18th century, when creating hospital schools and recruiting students for them at Bidloo, and at the end of the 18th century, when creating a higher medical educational institution in St. Petersburg, the so-called Kalinkin Institute, Russian youth had to fight for the right to study medicine.

In 1764, the Medical College recognized the equality of the Russian and German languages in teaching in hospital schools: “From now on, for the future, teaching in hospital schools will be public, in Russian and German.” And only in 1795, in the “Preliminary Resolution on the Positions of Teachers and Students” it was stated: “... A professor must know completely the Russian language in order to accurately and intelligibly express his thoughts in it when teaching; in case of need, when it will be impossible to find one, a person who knows Latin thoroughly is allowed, in which he will be obliged to teach after 3 years (for 3 years), during which he must study the Russian language.” As a result of this concession, many professors did not study Russian.

In 1764, the Medical College received the right to award doctors the degree of Doctor of Medicine, but in the 18th century it was awarded to only 16 doctors who were educated at hospital schools. In addition, the Medical College awarded the title of professor to 8 scientists who had undergone postgraduate training, as well as to I. Bush and J. Sapolovich the title of professor without defending a dissertation and completing an adjunct course. The Medical Faculty of Moscow University received the right to award the degree of Doctor of Medicine only in the 90s of the 18th century. Finally, in 1859-1860. was allowed to defend dissertations in Russian.

Foreign doctors, fearing competition, in various ways opposed the development of Russian medical science and the creation of a cadre of Russian doctors, teachers and scientists. Numerous examples of such attitude towards talented Russian doctors are found in the biographies of K.I. Shchepin, S.G. Zybelin, D.S. Samoilovich, A.M. Shumlyansky and many other doctors of the 18th century.

Domestic doctors were not only good practical doctors serving the civilian population and the army, but many of them became teachers. In the second half of the 18th century, many domestic doctors contributed to the development of medical science with their works.

After the Medical College was replenished with advanced Russian doctors, the attitude changed. In 1793-1795 all the works were considered at the conference of the board, distributed according to quality into 4 categories, and 103 works were considered worthy of publication, but only in 1805 was a collection containing 50 works published. In the archives of the Medical Board, more than a thousand manuscripts dedicated to problems of infectious diseases and epidemiology, surgery, internal medicine, hygiene, botany, pharmacology and chemistry. The authors of these manuscripts, for example, studied anthrax, leprosy, studied the toxicology of ergot, established nutritional factors influencing the occurrence of scurvy. Among these manuscripts there are a number of valuable works reflecting the following features: the desire to solve the most important issues of practical medicine (infectious diseases, hygiene, domestic medicinal raw materials) and the use of experimental research of nature. These works reflected the materialistic views of M. V. Lomonosov, his teaching about the need not only to treat, but and prevent disease by recognizing the value of experience.

In the development of Russian medicine in the 18th century, in the activities of a number of its leading representatives who ideologically followed M.V. Lomonosov, materialist principles were formed in the fight against the influence of the idealistic reaction of the 18th century (Leibniz, Kant).

The materialistic orientation of advanced doctors greatly contributed to the progressive nature of their medical activities.

Leading Russian doctors of the 18th century were characterized by the desire to introduce medicine into the circle of natural sciences and connect it with the achievements of natural science. S. G. Zybelin, K. I. Shchepin, A. M. Shumlyansky, D. S. Samoilovich’s acquaintance with physics, chemistry, and botany allowed them to take away everything advanced from contemporary natural science. F. G. Politkovsky wrote: “...I advise you to look at all systems with impartial eyes, which should be guided by reason and experience.” N. M. Maksimovich-Ambodik pointed out: “Speculation with experience - action is associated with a continuous union, so that one without the other is very weak and useless, and sometimes it can be detrimental... I don’t have much faith in both other people’s and my own speculations.” , and for the most part I follow observations and experiments in nature.”

Physician-researchers heeded this advice and widely used the experimental method.

At the same time, we must not forget about the importance of connections with world science. The trips of Russian youth to study abroad, which began at the beginning of the century, became more and more frequent. To study medicine and defend their dissertations, young doctors traveled to Halle, Heidelberg, Strasbourg, and Leiden. Meetings with foreign scientists and familiarity with their research methods enriched our doctors. Recognizing everything essential and practically important, domestic doctors very often critically assessed the philosophical views of foreign authorities. This was explained by the fact that most Russian doctors of the second half of the 18th century were materialists, followers of Lomonosov. The philosophical principles of this brilliant man were a reliable basis for theoretical medicine.

Description of work

Progressive thinkers in Russia in the 17th and especially the 18th centuries sought to substantiate the need for the spread of education and the free development of scientific knowledge, to free science from the tutelage of the church, and to draw attention to the study of natural science in order to use revenue resources for the progressive economic development of Russia. In this regard, the best representatives of philosophy and natural science turned to experience, to observations of natural phenomena, and strived for the practical application of scientific knowledge.

From the end of the 16th to the beginning of the 17th century, natural science, and with it medicine, began to develop rapidly. Science began to take on an international character. Scientists exchanged letters and informed each other about their observations, discoveries, inventions and theories.

In Europe, scientific centers began to be created one after another:

in 1660, the Royal Society of London was founded in England, and somewhat later - the Royal College of Physicians and the Royal College of Surgeons

in 1665 the first scientific journal was founded in 1666 - the Paris Academy of Sciences.
Gradually, Academies of Sciences are opening in other European countries: Berlin and Munich (in Germany), Stockholm (in Sweden), St. Petersburg (in Russia).

A great contribution to the development of medicine was made by the English philosopher and naturalist FRANCIS BACON, who, after L. da Vinci, continued to introduce the experimental method into natural science. Not being a doctor by profession, Bacon showed great interest in medicine and largely determined the path of its further development. In his main work, “The Great Restoration of the Sciences,” the second part, “New Organon,” was published in 1620. In this work, F. Bacon formulated three main tasks of medicine: “the first is to preserve health, the second is to cure diseases, the third is to in the continuation of life."

F. Bacon considered feelings, experience, and experiment to be the main tools of knowledge.
(2 slide)
While engaged in experimental research, Bacon posed several specific questions to medicine:

on the study of the anatomy of not only a healthy, but also a sick organism, on the use of effective painkillers in surgery
about the need to write down everything that happens to the patient (medical history)

on the use of specific drugs in the treatment

on the use of primarily natural factors in the treatment of diseases; on treatment with artificial mineral waters (the development of balneology); on the development of rational methods of nutrition with food concentrates.

Thus, F. Bacon predicted the development of medicine and, thus, looked ahead for many centuries.

Another representative of the experimental method in science was a contemporary of F. Bacon, the outstanding French scientist RENEE DESCARTES. He left a bright mark in various fields of knowledge (physics, mathematics, philosophy, medicine).

At that time, scientists tried to explain all the phenomena of the material world using the laws of physics and mechanics established in experiments, which were automatically transferred to living beings. From these positions, scientists examined the mechanism of pulmonary ventilation, kidney function, and the functioning of the musculoskeletal system. A new direction in natural science and medicine appeared - iatrophysics, which examined the vital activity of all living things from the standpoint of physical processes.

Descartes was no exception. He also believed that life’s actions obey mechanical laws and have the nature of reflection (later called “reflex”). He divided all nerves into centripetal (through which signals enter the brain) and centrifugal (through which signals from the brain move to the organs).

Thus, in physiology, Descartes approached the concept of reflex in the most general form and developed the simplest diagram of a reflex arc.

Another direction in natural science was iatromechanics. Its representatives believed that a living organism is like a machine in which all processes can be explained using mathematics and mechanics. A supporter of iatromechanics was the famous Italian anatomist and physiologist GIOVANNI ALFONSO BORELLI. He was the first to determine the center of gravity of the human body and showed that when muscles and bones act together, the bones act as levers and the muscles act as driving forces.

Following Borelli, his compatriot, the Italian scientist BELLINI, introduced the concept of elasticity of body tissues and proved that tissues that have been stretched and compressed by any force return to their original state.

Thus, the rapid development of natural science and the experimental method in science in
17-18 centuries gave a powerful impetus to the development of the most important medical disciplines. Physiology, one of the oldest natural sciences that studies the vital functions of the human body, began to develop.

The first ideas about the work of individual organs of the human body began to take shape in ancient times. They are set out in the extant works of philosophers of the Ancient East, Ancient Greece and Ancient Rome.

Physiology as an independent science, based on the experimental method of research, originates from the works of V. Harvey, who mathematically calculated and experimentally substantiated the theory of blood circulation.

The Swiss doctor played a major role in the further development of physiology
ALBRECHT GALLER. Him: (3 slide)

* tried to understand the essence of the breathing process in the lungs

* established three properties of muscle fibers (elasticity, contractility and irritability)

* proved that nerves are conductors of irritation and carriers of sensitivity in the body

* was the first to suggest that the heart contracts involuntarily under the influence of a force that is located in the heart itself.

In addition, Haller achieved great success in the study of anatomy and published an 8-volume anatomical atlas, which was considered the best in the 18th century.

Thus, physiology of the 17-18 centuries. was of a mechanistic nature. However, with all its shortcomings, in comparison with medieval scholasticism, for that stage of the development of science it was a progressive phenomenon.

Physics developed especially rapidly during that period, and advanced doctors sought to use its achievements in the interests of medicine.

One of the most outstanding achievements of the 18th century was the discovery of the Italian anatomist and physiologist LUIGI GALVANI, who in 1791, based on 20 years of research, proved the existence of the so-called bioelectric phenomenon. “animal electricity” and showed that under the influence of electric current muscle contraction occurs.

Galvani's research marked the beginning of electrophysiology - a new direction in science, thanks to which many life processes were studied, new diagnostic and treatment methods arose and were developed (electrocardiography, electroencephalography, physiotherapy).

At the end of the 18th century, discoveries in the field of chemistry also began to be used in medicine. Experimental studies by LAVOISIER and LOMONOSOV showed the role of oxygen in combustion and respiration, and this created the prerequisites for the study of gas exchange, the physiology of respiration and metabolism.

In the mid-18th century, another new branch of medicine arose - (4 slide) pathological anatomy - a science that studies the structural basis of pathological processes. BARTOLOMEO EUSTACHIUS contributed to the formation of pathological anatomy as a science. In the second half of the 16th century in Rome, he was the first to introduce systematic autopsies of the dead in a hospital.

The first pathological anatomical works were the studies of the Swiss scientist THEOPHILE BONET, who in 1679 published the book “Morgue, or practical anatomy based on autopsies of patients.”

Bonet's followers were the Italian doctor, anatomist and naturalist MARCELLO MALPIGHI. He was responsible for the discovery of capillaries, which completed the work of V. Harvey. He also described blood cells and renal corpuscles, which were later named after him.

The founder of pathological anatomy as a science was his compatriot Eustachius, an Italian anatomist and physician, professor at the University of Padua GIOVANNI BATTISTA MORGAGNI. He wrote a major work, “On the location and causes of diseases discovered by dissection,” in which he summarized the observations of his predecessors and his own experience, and which was published in 6 volumes in 1761.

What was especially valuable was that Morgagni himself was a practicing physician. Carrying out autopsies of the dead, he compared the changes he discovered in the affected organs with the symptoms of diseases that he observed during the patient’s lifetime.

Having summarized the enormous material for those times (700 autopsies), Morgagni showed that each disease causes certain changes in a specific organ and identified the organ as the site of localization of the disease process. Thus, the concept of disease was connected to a specific material substrate. This localistic principle played a great positive role in medicine in the 18th century and dealt a strong blow to metaphysical and vitalistic theories. Bringing anatomy closer to clinical medicine, Morgagni laid the foundation for the clinical-anatomical direction in medicine and created the first scientifically based classification of diseases.

With the development of pathological anatomy, a new medical specialty emerged - the dissection service, which gave doctors the opportunity to make a reasonable diagnosis and thereby contributed to the improvement of medical practice.

Morgagni's research in the field of pathological anatomy was continued by the French anatomist, physiologist and physician MARIE FRANCOIS XAVIER BICHAT. He showed that the vital activity of an individual organ is composed of the functions of the various tissues that make up its composition, and that the pathological process does not affect the entire organ, as Morgagni believed, but only its individual tissues.

Great development in the 17th and 18th centuries. received clinical medicine, which very slowly mastered the achievements of biomedical sciences. Therefore, there was a large gap between the advanced thinking of natural scientists, based on the experimental method of research, and the thinking of doctors, who, until the beginning of the 19th century, practically did not use any instrumental methods of examining the patient in their work. All this led to a serious lag between clinical medicine of that time and the developing natural sciences.

That is why the greatest achievement of medicine of the 17th century - the discovery of blood circulation by W. Harvey, which gave rise to modern physiology and the modern doctrine of the pathology of the cardiovascular system - did not have a real impact on practical medicine either in the 17th or 18th centuries.

It is no coincidence that V. Harvey himself, who was recognized by his contemporaries as an anatomist, was not considered a good therapist. This happened because he was engaged in healing at that period in the history of medicine, when it was based on chaotically piled up empirical data, when almost every doctor had his own recipes and “secrets”, when, for example, for heart disease, they used plants whose fruits were shaped like a heart, and with jaundice - celandine, only because its juice was yellow.

Nevertheless, the teaching of internal diseases at the end of the 17th – beginning of the 18th century underwent a major restructuring. (5 slide) Observation at the patient’s bedside, collection and systematization of symptoms, searches for the “nature of the disease” replaced the previous interpretations of memorized texts and verbal disputes. The doctor looked up from his parchment scrolls and tomes and stood facing the patient.

This was, in essence, the beginning of the rapid development of clinical medicine. One of the representatives of this trend was the Italian scientist, professor at the University of Padua GIOVANNI BATISTA MONTANO, who argued that “... you can teach only by visiting the sick” and conducted all his teaching in the hospital.

The clinical method received significant development in Holland, at the University of Leiden, thanks to the outstanding physician, chemist and teacher HERMAN BURGAW. G. Burhav is considered the founder of clinical medicine. He was the first to define it as “medicine that observes patients at their bedside.” He combined a thorough examination of the patient with a physiological basis for the diagnosis and anatomical studies (for which he was the first to use a magnifying glass).

G. Burgaw led the clinic organized (6 slide) at the University of Leiden and created his own clinical school there, which played an exceptional role in the development of European and world medicine. Students and doctors from many countries came to see him and called him “the teacher of all Europe.” Burgaw's lectures were attended by prominent figures of the time, including Peter the Great.

In the second half of the 17th century, a major contribution to the development of internal medicine (which was then called internal medicine) and pediatrics was made by the London physician THOMAS SYDENGAM. He described scarlet fever, chorea, gout; he also proposed treating malaria with cinchona bark; tried to systematize diseases and thereby contributed to the development of nosological trends in medicine.

T. Sydenham was rightly called by his contemporaries “the English Hippocrates”. He viewed the disease as a process, as “nature’s effort to restore health by removing the introduced pathogenic principle” and sought to understand the healing capabilities of the patient’s body.

The system of practical medicine developed by T. Sydenham, based on medical observation at the patient’s bedside, had a great influence on practicing doctors of that time.

During this period, for the first time in the history of medicine, physical examination methods and instruments began to appear.

Until the beginning of the 18th century, not a single diagnostic device or instrumental method for examining a patient was used in European clinics. When making a diagnosis, the doctor proceeded from the results of questioning the patient, feeling the pulse, examining his body and secretions.

The first instrumental examination method was thermometry. Before this, body temperature was determined empirically (by applying the hand), although the first thermometric device was invented at the end of the 16th century by Galileo Galilei. Many of Galileo's precious manuscripts were burned by the Inquisition. But in those that remained, drawings of the first aerial thermoscope were discovered. Unlike a modern thermometer, it was not the mercury that expanded in it, but the air.

The first in the history of medicine to measure a person’s body temperature was an Italian doctor, anatomist and physiologist, professor at the University of Padua SANTORIO SANTORIUS. At the beginning of the 17th century, he proposed a water thermoscope for measuring temperature in the mouth, which was the prototype of a thermometer for measuring body temperature. The device was very bulky, and Santorius installed it in the courtyard of his house for public viewing. The warmth of various parts of the body was determined by changes in the level of liquid in the tube, on which an arbitrary scale was applied.

After the Santorius water thermoscope, many original thermometric instruments were created in Europe. The first thermometer, the readings of which did not depend on changes in atmospheric pressure, was created in 1641 at the court of the Holy Roman Emperor Ferdinand II, who was not only known as a patron of the arts, but was also the author of several physical instruments. With his participation, funny-shaped thermometers that looked like little frogs were created. They were intended to measure the heat of the human body and were easily attached to the skin with a patch. The cavity of the “frogs” was filled with liquid in which colored balls of varying densities floated. When the liquid warmed up, its volume increased and its density decreased, and some balls sank to the bottom of the device. Body heat was determined according to the number of multi-colored balls remaining on the surface: the fewer there are, the higher the body heat.

The development of a unified degree scale took a whole century. The first reliable alcohol and then mercury thermometer with a scale from 0° to 600° was invented by the Dutch scientist Daniel Fahrenheit at the beginning of the 18th century. About 30 years after him, the Swedish physicist and astronomer Anders Celsius proposed the centigrade scale. At first, he took the boiling point of water to be 0, and the melting point of ice corresponded to 100. Subsequently, this scale was turned upside down, making 0 the melting point of the ice and the beginning of the countdown, and it was in this form that the thermometer became world famous and has survived to this day. Practicing doctors began to use thermometry much later - only in the second half of the 19th century. The first doctor to use a thermometer in clinical practice was Herman Burgaw.

Related information.

The development of feudal society in Russia in the 17th century entered a new stage, which was characterized by the dominance of serfdom, the growth of commodity production, and the further strengthening of the Russian centralized feudal state. Since the 17th century, a new period of Russian history began, when the process of merging all Russian regions, lands and principalities into one whole took place, caused by the concentration of local markets into one all-Russian market. Since the 17th century, capitalist relations arose in Russia, and the Russian bourgeoisie took shape. However, the feudal-serf system continued to dominate the country, which hampered the development of bourgeois relations. Within the framework of the Russian multinational state, the formation of the Russian nation took place. In the depths of the feudal-serf system, a new, bourgeois layer of society grew and rose - the merchant class.

Unlike many countries of Western Europe, the development of bourgeois ties in Russia in the 17th and first half of the 18th centuries took place in the peculiar conditions of strengthening serf relations. The feudal state, taking measures to establish trade and industry, defended with all its might and means the interests of the ruling class of landowners and protected serfdom, turning into serfs even those peasants who were previously free. The strengthening of the Russian state was accompanied by increased feudal oppression. The consequence of this was the widespread development of the anti-serfdom peasant movement in Russia and Ukraine (the uprisings of Razin, Pugachev, etc.).

The reforms carried out by Peter I in the interests of landowners and merchants played a progressive role in the development of productive forces and national culture in Russia, in the strengthening of the centralized feudal state. State-owned factories were built in the country, roads and canals were laid, cities arose, a regular army was created, a navy was built, etc. By encouraging trade, creating manufactories, reforms and other means, the state tried to adapt feudal production relations and the political system to the needs of developing the productive forces of society, to create conditions for the development of industry and trade, to eliminate the technical and military backwardness of serf Russia.

It cannot be considered that only the personal will of Peter I carried out this revolution in Russia, the consequence of which was the transformation of Russia into a powerful state. The reign of Peter I “was one of those eras, completely inevitable in the process of social development, when gradually accumulating quantitative changes turn into qualitative ones. Such a transformation always takes place through leaps." Under Peter I, the process of formation of a new culture, which began in the previous era, continued.

The process of economic development of Russia in the 18th century was accompanied by the rise of Russian culture, science and art. Anti-feudal protests and, above all, peasant uprisings of the 17th and 18th centuries gave a strong impetus to the development of progressive social thought in Russia, the emergence of anti-serfdom ideas among the advanced nobility and commoners, first educational, and then revolutionary.. Formation of advanced socio-political and philosophical thought in Russia The 17th-18th centuries were closely connected with the development of industry and trade in the country, the growth of Russian national culture, the emergence and development of art, literature, and experimental natural science.

Progressive thinkers in Russia in the 17th and especially the 18th centuries sought to substantiate the need for the spread of education and the free development of scientific knowledge, to free science from the tutelage of the church, and to attract attention to the study of natural science in order to use revenue resources for the progressive economic development of Russia. In connection with this, the best representatives of philosophy and natural science turned to experience, to observations of natural phenomena, and sought the practical application of scientific knowledge. Progressive Russian thinkers of the 18th century made a significant step from religious ideas to secular knowledge. But they had not yet risen to the pre-revolutionary, anti-serfdom worldview.

In the 18th century, especially in its second half, in Russia there was a stubborn struggle between the advanced, materialistic ideas of the most outstanding representatives of Russian natural scientific and socio-philosophical thought of the 18th century with reactionary, idealistic ideas, which were often planted and supported in Russia mainly by foreigners, representatives mainly German science. This struggle is chalk class in nature. The overwhelming majority of Russian scientists from the 8th century came from the working classes of the people and looked at science as a means of educating the masses, developing the productive forces and raising the well-being of the people. Supporters of reactionary theories, figures from the bureaucratic elite, and representatives of the noble-landowner class reflected the interests of this class.

Economic needs necessitated the expansion and formation of the army, financial and other reforms.

In the reforms of Peter I, significant attention was paid to the medical profession. Russians who traveled to the countries of Western Europe, including Peter I himself, along with shipbuilding, manufactories and schools, introduced hospitals, anatomical museums and outstanding doctors of Holland there. Peter I met advanced doctors, listened to Boerhaw’s lectures, acquired Ruysch paid a large sum for his famous atomic collection, visited Leweiguck and got acquainted with his micro-optical research.

In the 18th century in Russia, the need for a larger number of doctors became particularly apparent, primarily to meet the needs of the military, the serving nobility and the emerging merchant class, as well as for medical care of factories and factories located in places remote from the administrative and cultural centers of the country. At the beginning of the 18th century, permanent military hospitals were created in Russia - land hospitals to serve the army and admiralty hospitals to serve the navy; the hospital was opened on November 21, 1707 in the eastern part of Moscow, across the Yauza River in a place for treating the sick.” Later, hospitals for crippled soldiers were created in St. Petersburg, Kronstadt, Revel, Kyiv and Yekaterinburg. In 1718, land and admiralty military hospitals were opened in St. Petersburg and in 1720 - an admiralty hospital in Kronstadt.

In the XVIII century, Russian science in the field of medicine and medical education united not with the overwhelming backward majority that dominated the medical faculties of many universities in Western Europe, but with the advanced, progressive for that time Leiden University. In contrast to the scholastic, purely bookish training of future doctors of medicine at the medical faculties of Western European universities that remained throughout the 17th century, hospital schools in Russia from the first years of their existence built the training of future doctors practically. In organizing medical education, Russia borrowed this advanced and not yet generally recognized method of teaching students at the patient’s bedside. It is no coincidence that schools for training doctors in Russia were created at hospitals. The task of training doctors in the 18th century was solved in Russia in an original, original way: a new type of higher education institution for training doctors was created - schools on the basis of large state hospitals.

Peter I entrusted the construction and organization of the Moscow hospital to the Dutch doctor Nikolai Bidloo, a student of Burgaw, the nephew of the anatomist, whose atlas Peter I himself used. Peter I also entrusted him with organizing a school for training doctors at the hospital. Foreign doctors unfamiliar with the Russian language were invited as teachers at the hospital and had the opportunity to teach only in Latin and foreign languages (mainly Dutch and German). Foreign doctors in Russian service, fearing competition, often tried to oppose the training of domestic Russian doctors. Some therefore recommended admitting only children of foreigners living in Moscow to the hospital school.

Among the foreign doctors there were even those who argued that Russians were not capable of acquiring the extensive knowledge necessary for a doctor. Later, in 1715, in a letter to Peter I, he spoke about this: “Many surgeons advised that I should not teach this (Russian) young man to the people, saying that you would not be able to accomplish this work.” To Bidloo’s credit, it should be noted that he correctly understood the tasks that were set before him, and honestly served the interests of Russia, decisively overcoming the opposition of foreign doctors. Bidloo was not afraid of difficulties and found a way out of the situation: he received permission to recruit students to the hospital school from among the students of the Slavic-Greek-Latin Academy and schools of the ecclesiastical department, where students studied Greek and Latin.

Clinical disciplines were taught in hospital departments, and surgical training was considered paramount. The course of [internal diseases] included familiarizing students with infectious, skin-venereal and childhood diseases. Since 1763, the study of obstetrics was introduced. The senior and junior doctors of the hospital conducted lecture courses on therapy, pharmacology and anatomy, the chief physician taught a course in surgery, and the hospital operator supervised anatomical and surgical practice. Doctors conducted practical classes with students on surgery and internal diseases. In hospital schools they studied not only from books, students regularly worked in the hospital, “where every day there are from one hundred to two hundred patients.” Students cared for the sick, helped with bandages, worked<в аптеке, в аптекарском огороде по выращиванию лекарственных растений, присутствовали на операциях, судебно медицинских и патологоанатомических вскрытиях. Благодаря этому учащиеся получали пир окне знания и практические навыки.

Russian scientists in the 18th century, for the first time in the world, they developed and put into practice a new system of medical education, ensuring the training of highly qualified Doctors. Graduates of hospital schools made up the bulk of the figures in medicine in Russia in the 18th century and played a major role in the development of domestic healthcare.

The characteristic features of hospital schools of the 18th century were: a high general educational level of students who came from educational institutions of the ecclesiastical department, familiar with the Latin language, philosophy, many classical works of Greek and Latin writers and philosophers, their democratic origin, since hospital schools were attended by people from small wealthy segments of the population (children of minor clergy, doctors, Cossacks, court singers, merchants, soldiers' children, etc.). Training in hospital schools lasted from 5 to 7 years and ended with a strict public exam: the examinee, in addition to answering questions on anatomy, physiology, surgery and internal medicine, performed 3-4 operations on a corpse with his own hands in the presence of examiners.

Education system of future doctors in Russia was built and improved throughout the 18th century. It began in 1707 by N. Bidloo. In 1735, the “General Regulations on Hospitals” included a detailed chapter on the hospital school, which defined the tasks and periods of training in it. In 1753-1760. P. 3. Kondoidi and M.I. Sheya improved the teaching of anatomy and clinics, set up clinical wards, mandatory autopsies were introduced, the teaching of obstetrics and women's diseases was changed, and the order of examinations was changed. Many leading doctors (P. I. Pogoretsky, A. M. Shumlyansky, M. M. Terekhovsky, etc.) took an active part in developing issues of teaching medicine in the second half of the 18th century. In 1782, D. S. Samoilovich, while in France, wrote “A Speech to Students of Hospital Schools of the Russian Empire,” where he discussed in detail the tasks of medical education. In 1785

Founding of Moscow University and its medical faculty. Considering the need to “multiply Russian doctors and surgeons in Russia, of whom there are very few,” M. V. Lomonosov in 1748, in the draft regulations of the university at the St. Petersburg Academy of Sciences, wrote: “I think that the university should definitely have three faculties: law , medical and philosophical (theological is left to the synodal schools).” In 1754, M.V. Lomonosov recommended the same for the organized Moscow University. At the same time, M.V. Lomonosov raised the issue of granting Moscow University the right to “produce worthy students into academic degrees.”

In 1755, Moscow University was opened. Since 1758, Mr. Kerstens began to give lectures here on physics “for the preparation of those who wish to study medicine,” then in the following years - chemistry, mineralogy and chemistry in connection with the natural history of simple pharmaceutical drugs, medical substance science . In 1764, a professor was invited to the department of anatomy, and the medical faculty began to function. In 1765, the tasks of the medical faculty were more precisely defined. “The medical class or faculty has its exercise in discussing human health and life. In it they study practical and theoretical medicine, chemistry, botany, anatomy and surgery and produce from natural subjects such people who, as healers and doctors, help their fellow citizens, take care of their health and thus contribute to the common good in countless cases they can."

At Moscow University in the first decades of its existence, enrollment of students was carried out not annually, but approximately once every 3 years. Each professor continued his course for 2-3 years and only after completing it began a new one for a new set of students. Without having its own clinics, the medical faculty of Moscow University in the first decades of its existence was limited to theoretical training of future doctors. S. G. Zybelii, teaching internal diseases, occasionally showed patients and only at the end of the 18th century was he able to provide clinical teaching on a small scale.

Measures to organize medical care for the population of Russia in the 18th century.

training of medical specialists and teachers. In 1763-1771. Orphanages were opened in Moscow and St. Petersburg with obstetric institutions attached to them, which served as schools for the training of midwives. In connection with the division into provinces, transformations were carried out in the medical profession: provincial medical boards were created, and the positions of county doctors were introduced. In 1775, orders for public charity were created in the provinces, under whose jurisdiction civil hospitals were transferred.

In the history of Russian medical science and medical education in the mid-18th century, a prominent role was played by Pavel Zakharovich Kondoidi (1710-1760), a Greek by birth, brought to Russia at an early age and raised in Russia. In 1732, P. 3. Kondoidi graduated from the medical faculty of Leiden University and, returning to Russia, served as a military doctor. In 1741-1747. P. 3. Kondoidi was the assistant to the general director of the medical office and actually led the medical affairs of Russia. A few years later, he was again involved in the leadership of the medical administration and from 1753 to 1760 was the chief director of the Medical Office.

Kondoidi was the first outstanding medical administrator in Russia: under him, numerous instructions were drawn up for military sanitary affairs, instructions to general staff doctors, divisional doctors, army general medic, military doctors, on the treatment of patients with smallpox, measles and others diseases accompanied by a rash, on the examination of disabled people or those incapable of military service, etc. With the direct participation of P. 3. Kondoidi, the Russian military pharmacopoeia was compiled. He took the initiative in organizing obstetrics and training midwives. The merits of P. 3. Kondoidi are significant in the development and improvement of the medical education system in Russia, improving teaching in hospital schools. At the suggestion of Kondoidi, M.I. Shein translated textbooks on Geister’s anatomy and Platner’s surgery into Russian and published at public expense. P. 3. Kondoidi organized (after a break) the sending of doctors who graduated from hospital schools to foreign universities to receive the degree of Doctor of Medicine, without which it was impossible to become a teacher at a hospital school. P. 3. Kondoidi introduced scientific and medical meetings (the prototype of conferences and scientific medical societies), organized a medical library, was the initiator in the creation of medical and topographical descriptions and planned a permanent publication for the publication of the works of doctors.

Table of the first Russian anatomical atlas, published in 1744. They often fought the disease with danger to their lives, studied the clinic and etiology of the plague.

Medical issues and the organization of medical care for the population occupied the progressive public of Russia in the 18th century: they received considerable attention in the works of the Free Economic Society, established in 1765, in the publishing activities of N. I. Novikov, in the works of M. V. Lomonosov, A. N. Radishcheva.

The study of printed works and archival manuscripts suggests that in the second half of the 18th century, leading doctors of Russia (N. M. Maksimovich-Ambodik, M. Gamaleya, N. Karpinsky, I. Protasov, D. Samoilovich. Ya. Sapolovnch and others) developed issues of organizing hospital care, carrying out sanitary, hygienic and epidemiological measures, and compiled numerous medical and topographical descriptions of various parts and cities of Russia.

Having deeply studied and assimilated everything valuable and positive that natural scientists and philosophers in European countries gave, M. V. Lomonosov rejected idealism and metaphysical explanations of natural phenomena, which were given by many scientists in the 17th-18th centuries. Medieval scholasticism was alien to M.V. Lomonosov. He considered blind admiration for authorities and outdated theories to be a serious obstacle to the development of genuine science. M.V. Lomonosov was an encyclopedically educated natural scientist-thinker who paved new paths in the most diverse areas of scientific knowledge. His discoveries and generalizations were far ahead of contemporary science.

M.V. Lomonosov was an outstanding representative of natural-scientific materialism of the 18th century. Lomonosov considered it impossible for spiders to exist without experience and observation: “I value one experience higher than a thousand thoughts born only from imagination.” However, no less important, in his opinion, is the comprehension of experience and observations, bringing them into a system, constructing theories and hypotheses. He criticized naked empiricism, which is unable to produce a generalization from many disparate facts. M.V. Lomonosov developed a materialist theory of knowledge.

The most characteristic feature of his work was his brilliant ability for theoretical thinking, for broad generalizations of experimental data about natural phenomena. Acting as an innovator, boldly breaking the misconceptions and outdated traditions existing in science. M.V. Lomonosov laid the foundations for a new, scientific view of nature, matter and movement. He put forward a hypothesis of the atomic-molecular structure of matter, not as an abstract natural-philosophical concept, which had been done before him, but as a natural-scientific hypothesis based on experimental data. M.V. Lomonosov consistently developed this hypothesis about the structure of matter into a harmonious scientific system and extended it to all physical and chemical phenomena known at that time.

M.V. Lomonosov discovered the law of conservation of matter. The original formulation was given in a letter to Euler in 1748, then in 1756.

in "Reflections on the Nature of Heat". The law was finally formulated in the speech “Discourse on the Solidity and Liquidity of Bodies” in 1760. Having developed the doctrine of atoms and their motion, having discovered and scientifically substantiated the law of constancy of matter and motion, M. V. Lomonosov placed it as the basis of a universal law of nature and made it he has many natural scientific and philosophical conclusions. He gave a natural scientific and philosophical explanation for the position of materialism about the unity of matter and motion.

1) the idea of conservation of motion, under the sign of which the natural science of the 19th century further developed, when the law of conservation and transformation of energy was discovered;

2) the idea of the inseparability of matter and movement, under the sign of which modern natural science is developing.

The materialistic philosophical views of M. V. Lomonosov were closely related to his research and discoveries in the field of physics and chemistry. These studies and discoveries were the natural science basis of the materialistic worldview of M. V. Lomonosov. In turn, the materialism of M. V. Lomonosov invariably served as a theoretical source in his scientific research, in the justification and development of a new direction in natural science, the supporters of which adhered to a spontaneous-dialectical view of nature.

Lomonosov explained the process of oxidation and combustion and thereby established the nature of respiration. He was a staunch opponent of the theory of “weightless” phlogiston; 17 years before Lavoisier, he first clearly formulated the position on the chemical nature of oxidation. Quantitative studies of the chemical composition of various substances in the time of M.V. Lomonosov were just beginning. The systematic use of balances in chemical experiments, which began in the middle of the 18th century, found one of the pioneers and ardent adherents in the person of M.V. Lomonosov. The law of conservation of matter, quantitative analysis, and explanation of combustion processes were the basis for future research by physiologists and biochemists.

M.V. Lomonosov emphasized the importance of chemistry for medicine. “A physician cannot be perfect without a thorough knowledge of chemistry. It recognizes the natural mixture of blood and nutritious juices, it reveals the composition of healthy and harmful foods. V. Lomonosov also emphasized the need to study anatomy.

Lomonosov edited the translation of anatomical terms for the atlas made by his student, one of the first Russian anatomists A.P. Protasov.

Particularly important for the history of medicine is the letter “On the reproduction and preservation of the Russian people” written by M. V. Lomonosov in 1761 to a major statesman of that time, I. I. Shuvalov, in which he drew attention to a number of issues related to with the state of medicine in Russia in his time." In this letter, M.V. Lomonosov showed patriotism and a deep understanding of the issues of protecting public health and population. He noted the low birth rate RUSSIA, poor care during childbirth, high mortality of children during childbirth and in early childhood, high morbidity and mortality in children and adults, lack of medical care both for the civilian population of Russia and in the army.

The leading role of Russian scientists of the 18th century in the development of the doctrine of evolution. Wolf Caspar Friedrich (1734–1794) studied medicine in Berlin and Halle. In 1759, he published a dissertation “The Theory of Generation,” and in 1764, under the same title, a more detailed work (Theorie von der Generation)2. In Germany, Wolf's work was not recognized and met with strong opposition from Albrecht Haller. Wolf was not elected to the department of physiology. In 1764, Wolf accepted the invitation of the St. Petersburg Academy of Sciences, moved to Russia and worked in Russia for 30 years until the end of his life.

At that time, the theory of preformationism was popular, according to which it was believed that in an egg or in a sperm there is a formed organism (preformed, reshaped) in a miniature and folded form and that the development of the embryo is only the unfolding of what exists. Wolf criticized this metaphysical theory of preformationism and developed a theory of epigenesis that was progressive for that time. Wolf came to this theory on the basis of his own experimental data from studying the initial stage of development of plants and animals. In his work “The Theory of Generation,” Wolf traced how and when leaves, flowers and their parts appear in plants, how and when fruits and seeds are formed. Wolf studied the origin of individual organs of an animal organism using a chicken embryo. In contrast to the metaphysical ideas of the pre-formists, Wolf established that there are no “preformed”, i.e., pre-prepared organs in either plants or animals. Studies of the chicken embryo have shown that, for example, the heart of the embryo appears only after its other, simpler parts have formed. Wolf established that the birth and development of every living being does not represent a purely quantitative increase, not simple growth,

but a consistent process of the appearance of more and more new organs, which become more complex in the future. Thus, Wolf was the first to put on a scientific basis the study of the individual development of an organism (ontogenesis).

The role of Wolf in the development of biological science in the historical preparation of the evolutionary idea was highly appreciated by Engels. “It is characteristic,” he wrote in “Dialectics of Nature,” “that almost simultaneously with Kant’s attack on the doctrine of the eternity of the solar system, K. CD. Wolf made the first attack on the theory of the constancy of species in 1759, proclaiming the doctrine of evolution. But then, What he had only a brilliant pre-admiration, took a definite form in Oken, Lamarck, Baer and was victoriously carried out in science exactly a hundred years later, in 1859 by Darwin.”

The idea of the gradual development of living nature in the second half of the 18th century was also put forward by the Russian natural scientist Afanasy Kaverznev. In his essay “On the Rebirth of Animals,” published in 1775 in German and then in Russian, Kaverznev expressed a number of guesses that anticipated some provisions of the theory of development in biology, in particular the position that the variability of animals is determined environmental conditions. Under the influence of environmental conditions and food, animal species undergo such profound changes over time that they are impossible to recognize immediately.

The struggle of advanced domestic doctors of the 18th century for the independent development of Russian medical science and the training of Russian doctors. In the 18th century in Russia there was a struggle among leading domestic doctors for the independent development of Russian medical science and the training of Russian doctors. This struggle took place in various forms at various stages of the development of medicine in the 18th and 19th centuries. Both at the beginning of the 18th century, when creating hospital schools and recruiting students for them at Bidloo, and at the end of the 18th century, when creating a higher medical educational institution in St. Petersburg, the so-called Kalinkin Institute, Russian youth had to fight for the right to study medicine.

In 1764, the Medical College recognized the equality of the Russian and German languages in teaching in hospital schools: “From now on, for the future, teaching in hospital schools will be public, in Russian and German.” And only in 1795, in the “Preliminary Decree on the Positions of Teachers and Students” it was stated: “... A professor must know completely the Russian language in order to accurately and intelligibly express his thoughts in it when teaching; in case of need, when it will be impossible to find one, a person who knows thoroughly the Latin language is allowed, in which he will be obliged to teach after 3 years (for a period of 3 years), during which he must study the Russian language.” As a result of this concession, many professors did not study Russian.

In the first half of the 19th century. For example, Moscow University c. In the first quarter of the 19th century, for the needs of students, he published translations of medical textbooks from German into Latin.

In 1764, the Medical College received the right to award doctors the degree of Doctor of Medicine, but in the 18th century it was awarded only to 16 doctors who were educated in hospital schools. In addition, the Medical College awarded the title of professor to 8 scientists who completed postgraduate training, as well as I. Bush and Ya Sapolovich, the title of professor without defending a dissertation and completing an adjunct course. The Faculty of Medicine of Moscow University received the right to award the degree of Doctor of Medicine only in the 90s of the 18th century. Finally, in 1859-1860. was allowed to defend dissertations in Russian.

A striking example of the struggle were the events associated with the opening in St. Petersburg in the 80s of the 18th century of the Kalinkin Institute for the training of doctors, which did not exist for long and in the last years of the 18th century joined the then created St. Petersburg Medical-Surgical Academy. In 1783, foreign doctors who were at the head of the medical field in Russia had the idea of establishing in St. Petersburg (on the basis of the hospital near the Kalinkin Bridge) a higher medical educational institution, a special school for training medical administrators and doctors. - servers. The draft charter of this institution frankly wrote: “When distributing service places, the best places should be provided to students of this school.” Having set such tasks for the new higher medical educational institution, its organizers, with the consent of the ruling circles of Russia, decided to make the Kalinkin Institute accessible exclusively to Germans. The draft charter proposed to prohibit Russians from enrolling as students at this new school. Having learned about this project, M. M. Terekhovsky sharply spoke out against the attempt to create a higher medical school in St. Petersburg exclusively for Germans and proposed making the Kalinkin Institute a purely Russian institution.

Under the influence of the protests that followed the speech of M. M. Terekhovsky, when approving the charter of the Kalinkin Institute, the government was forced to remove the clause prohibiting Russians from enrolling among its students, but left another restriction, introducing the teaching of all subjects at the institute in German.

It is a mistake to think that this struggle with Vasily in domestic medicine among foreign doctors was in the nature of personal competition. Without denying such elements in individual cases, we at the same time must emphasize that basically this struggle had deeper roots, playing a role not only in medicine, but also in the entire culture and science of Russia in the 18th-19th centuries. In various phases and episodes of this persistent struggle, which was of a class nature, the struggle of advanced materialistic ideas of the most outstanding representatives of Russian natural science and social philosophical thought of the 18th century with reactionary, idealistic ideas, implanted and supported in Russia mainly by representatives foreign, mainly German science.

The overwhelming majority of Russian scientists and doctors of the 18th century came from the working classes of the people, familiar with their situation and needs. They looked at science as a means of enlightening the masses, developing the productive forces and raising the well-being of the people. Foreigners, scientists and doctors who worked in Russia, mostly former supporters of reactionary theories, associated with figures from the bureaucratic elite and were themselves often from among this elite, supported representatives of the noble-landowner class and reflected the interests of this class. Starting from the last decade of the 17th century, under Peter I and in the subsequent 18th century, especially in its second half, the tsarist government invited a large number of foreign doctors from other countries and provided them with official and material advantages and privileges in comparison with domestic doctors. In the Medical College and other government institutions, the army, hospitals and clinics, hospital schools, and Moscow University, there were many foreign doctors who did not know or understand the needs of the Russian people.

Many foreign doctors, alien to advanced science in general and Russian science in particular, pursuing almost exclusively selfish goals, hindered the development of advanced Russian scientific thought and, not disdaining any means, created obstacles for advanced Russian scientists as much as they could. Foreign doctors, fearing competition, counteracted in various ways the development of Russian medical science and the creation of a cadre of Russian doctors, teachers and scientists. Numerous examples of such an attitude towards talented Russian doctors are found in the biographies of K. I. Shchepin, S. G. Zybelin, D. S. Samoilovich, A. M. Shumlyansky and many other doctors of the 18th century.

Of course, among the foreigners who worked in Russia, there were people who honestly served the Russian people, understood their tasks, made Russia a permanent place of their activities and remained here until the end of their days (father and sons Blumentrosty, N. Bidloo, K. Wolf, P. Pallas and others).

Most dissertations was defended at foreign universities. During the 18th century, 309 Russian natives and foreigners naturalized in Russia received the degree of Doctor of Medicine at foreign universities. Of the doctoral dissertations defended in the 18th century by Russian doctors at foreign universities, the most interesting are 89 dissertations from students of Russian hospital schools, which was explained by the extensive theoretical and practical training received by their authors in hospital schools, thanks to which they they resolved issues deeply and comprehensively, opposed idealistic views, used experiment in their research, and interpreted the issue from a materialistic point of view. These were the dissertations of M. M. Terekhovsky, M. Shumlyansky, D. S. Samoilovi A. A.F. Shafonsky, K.O. Yagelsky and others. These dissertations were repeatedly reviewed in the literature of that time and were even completely republished abroad.

The scientific research of Russian doctors of the 18th century was not limited to doctoral dissertations. The doctors carried out research work quite intensively, and their numerous manuscripts were submitted to the Medical Office. In 1764, the Medical College under P. Z. Kondoidi issued a special decree inviting all doctors to send scientific works for publication in the “Russian Medical Commentaries”. After this, the flow of works increased, but the Medical College and its leaders, foreign doctors, were dishonest in their duties and did not review the submitted scientific works. By 1793, the archives of the Medical College contained 463 handwritten works by Russian doctors.

After the Medical College was replenished with advanced Russian doctors, the attitude changed. In 1793-1795. all the works were considered at the conference of the board, distributed according to quality into 4 categories, and 103 works were considered worthy of publication, but only in 1805 was a collection containing 50 works published. In the archives of the Medical Board, more than thousands of manuscripts devoted to the problems of infectious diseases and epidemiology, surgery, internal medicine, hygiene, botany, pharmacology and chemistry.The authors of these manuscripts, for example, studied anthrax, leprosy, studied the toxicology of ergot, and established nutritional factors influencing the occurrence of scurvy. Among these manuscripts there are a number of valuable works that reflect the following features: the desire to solve the most important issues of practical medicine (infectious diseases, hygiene, domestic medicinal raw materials) and the use of experimental research in nature. These works reflected the materialistic views of M V. Lomonosov, his teaching about the need not only to treat, but also to prevent diseases, recognition of the importance of experience.

The medical literature of Russia in the 18th century is characterized by a large number of translated works. In 1757, M. I. Shein published the first translation of Geister’s widely distributed textbook on anatomy, and in 1761, a translation of Platner’s textbook on surgery. M. I. Shein’s work on translating medical textbooks and books into Russian was continued by N. M. Maksimovich-Ambodik, M. M. Terekhovsky, F. I. Barsuk-Moiseev and others. For translations, widely used ones, the best at that time, were selected textbooks. By the end of the 18th century, textbooks on all medical specialties were available in Russian. Acquaintance with translated medical literature printed in Russia in the 18th century shows that this “translated” period of Russian scientific medical literature was far from being a simple, much less slavish imitation. Russian doctors, acting as the first translators, clearly set themselves the task of being active in the critical perception of contemporary medical science in Western Europe. The independence and originality of the first Russian translators of the 18th century are visible in almost every significant translation work. The authors were critical of the original text, omitted what did not correspond to their views, introduced significant amendments, clarifications and comments into the translated text, and often supplemented the text with their own material (data from their own observations, materials from other works). Thus, M.I. Shein included case histories from his own observations in his translation of a foreign book on surgery. N. M. Maksimovich-Ambodik, when translating a book about venereal (“passionate”) diseases, added 60 pages of his notes to the 140 pages of the author’s text.

In the last decades of the 18th century, large original works and teaching aids were published in Russian in Russia. In 1792-1794. the first medical journal in Russian was published, “St. Petersburg Medical Gazette”

When giving lectures and printing textbooks and scientific works in Russian, great difficulties arose in medical terminology. The vernacular language could not convey many details of medical terminology, and in the 18th century translators and authors had to create medical terminology in Russian. A. P. Protasov, M. I. Shein, S. G. Zybelin worked a lot in this regard. N. M. Maksimovich-Ambodik paid a lot of attention to the creation of medical terminology, not only in his writings and translations of medical books, but also in the compilation of special dictionaries. He published medical-surgical, anatomical-physiological and botanical dictionaries.

The main features of the scientific activity of domestic doctors of the 18th century were materialism with the resulting connection of medical research with experimental, natural sciences and interest in the nervous system, patriotism and democracy. In the development of Russian medicine in the 18th century, in the activities of a number of its leading representatives who ideologically followed M.V. Lomonosov, materialistic principles were formed in the fight against the influence of the idealistic reaction of the 18th century (Leibniz, Kant).

Russian naturalists and doctors XVIII centuries acted as consistent supporters of contemporary materialist views. We find such statements among prominent doctors of the 18th century - S. G. Zybelin, N. M. Maksimovich-Ambodik, A. F. Shafonsky and others. For example, the “Dictionary of the Academy” played a large role in the promotion of materialism in Russia in the 18th century Russian", where doctors A.P. Protasov and P.I. Ozeretskovsky wrote articles on anatomical, physiological and pathological terms in accordance with the advanced materialistic views of that time.

The materialistic orientation of advanced doctors contributed greatly to the progressive nature of their medical activities.

Leading Russian doctors of the 18th century were characterized by the desire to introduce medicine into the circle of natural sciences and connect it with the achievements of natural science. S. G. Zybelin, K. I. Shchepin, A. M. Shumlyansky, D. S. Samoilovich’s acquaintance with physics, chemistry, and botany allowed them to take away everything advanced from contemporary natural science. F. G. Politkovsky wrote: “...I advise you to look at all systems with impartial eyes, which should be guided by reason and experience.” N. M. Maksimovich-Ambodik pointed out: “Speculation with experience - action is associated with a continuous union, so that one without the other is very weak and useless, and sometimes it can be detrimental... I am both someone else’s and my mentality. I don’t believe much in the teachings, but for the most part I follow observations and experiments in nature.”

Physician-researchers heeded this advice and widely used the experimental method.

In 1775, M. M. Terekhovsky, working on his dissertation “On bulk annmalicles,” used microscopic examination. In 1780, D. I. Ivanov, in his dissertation on the topic “On the origin of intercostal nerves,” abandoned the generally accepted views on the structure of the border sympathetic trunk at that time, discarded speculative theories, began dissecting nerves, and was the first to use tissue maceration and proved the ascending direction of the cervical and head sections of the sympathetic nervous system. D.I. Pianov took a strictly materialistic position and did not recognize the mystical “nerve fluids” that flow through the nerves). Russian doctors of the second half of the 18th century showed great attention to the nervous system as a leading link in the functional functions of the body.

Upon returning to Russia, Shchepin was a translator at the Academy of Sciences and worked on botany with academician. S. P. Krasheninnikova. In 1753 Shchepin was sent to Leiden to further study botany. He intended to become a botanist, the successor of S.P. Krasheninnikov, but when he died, the position of botanist was offered to the son-in-law of a prominent German. Apparently, as a result of these intrigues, K. I. Shchepin in 1756 went to serve in the Medical Chancellery, which paid the Academy of Sciences for the expenses incurred on K. I. Shchepin’s business trip. M.V. Lomonosov wrote about this: “They sold Shchepin to the Medical Office.” K.I. Shchepin began to study medicine. In 1758 he defended his doctoral dissertation on plant acid in Leiden. In this work, K.I. Shchepin analyzed the influence of plant acids in human food, indicated the preventive value of plant acids in the fight against scurvy, and anticipated some data from modern vitaminology. In the theses for the dissertation there are guesses about hormones, about the neuro-humoral regulation of functions of the human body.

After this, K.I. Shchepin visited Paris and London. Copenhagen, visited Linnaeus in Sweden and everywhere improved in medicine. Returning to his homeland in 1759, he worked for a short time at the St. Petersburg General Hospital, from where, during the Seven Years' War, he voluntarily went into the active army to become familiar with the peculiarities of the work of a military doctor.

Since 1762, K.I. Shchepin taught anatomy, physiology, surgery, botany and pharmacology, being the first Russian teacher at the Moscow Hospital School. K.I. Shchepin was an opponent of dictation, adopted at that time by many teachers, which was caused by the lack of textbooks. He made sure that students had textbooks. As a teacher, he sought to acquaint the audience with new achievements in medicine. An experienced linguist and translator, K.I. Shchepin taught in Russian.

He insisted on the need for visual and practical teaching; he taught anatomy with the demonstration of corpses (“on cadavers”). His notes on the methods of teaching medical sciences have been preserved. With his innovations, KI. Shchepin made enemies among the heads of hospital schools, was removed from teaching and even deprived of the right to practice medicine. He participated in botanical expeditions; took part in the fight against the plague epidemic from which he died...

Semyon Gerasimovich Zybelin (1735-1802) is deservedly considered the most outstanding Russian doctor of the 18th century.

S. G. Zybelin studied at the Slavic-Greek-Latin Academy and from there in 1755 he was sent as a student to the newly opened Moscow University. After graduating from the general faculty in 1759, Zybelin was sent to the University of Leiden, where in 1764 he graduated from the Faculty of Medicine and received the degree of Doctor of Medicine. From 1765 to 1802, S. G. Zybelin taught it for 35 years at the medical faculty of Moscow University, reading theoretical medicine, anatomy, surgery, ethical medicine and chemistry at different times. Since 1768, S. G. Zybe-i was one of the first to give lectures in Russian.

In addition to teaching students, S. G. Zybelin repeatedly gave ceremonial speeches at the annual acts of the university and devoted them to personal issues of medicine. These speeches by Zybelin (“Words” in the terminology of the 18th century) were aimed at promoting medical information among various circles; after delivery, they were published and made available. In “Words” Zybelin expressed views that were advanced for his time only on issues of practical medicine and hygiene, but also on broad philosophical issues.

The topics of S. G. Zybelin’s speeches are varied: on the aphorisms of Hyipo-1ta, “On the effect of air on a person and on the ways in which it enters him,” the reasons for the internal union of parts with each other,” “On the benefits of smallpox vaccination,” “On the harm , resulting from keeping oneself in too much warmth”, “On the constitution of the human body and on ways to protect against diseases”, “On proper education from infancy in the development of the body, which serves for reproduction in the society of the people”, “On ways to prevent an important reason, among other things, for the slow intelligence of the people, consisting of indecent food for babies, borrowed money in the first months of their life,” etc.

From the early period of his activity, S. G. Zybelin showed himself to be an advanced scientist, setting the task of resolving the most difficult issues related to the study of the world and man. According to S. G. Zybelin, science must cognize not only the “external beauty” of the phenomena surrounding centuries, but their internal content, connections, objective over the years of existence.

S. G. Zybelin considered the study and knowledge of the laws of nature to be extremely important for the development of medicine, the prevention of diseases and the preservation of public health. He recognized the objective nature of the laws of nature and encouraged his listeners to follow and study them.

In his works, he covered the main problems of medicine: the ethnology of diseases, heredity, constitution and its importance for the health of children. Zybelin's views reflected the originality of his judgments, the anger of his thoughts, his broad outlook and commitment to progressive children.

In his natural historical materialism, in his persistent proclamation of the experience of fundamental science, S. G. Zybelin was a follower of M. V. Lomonosov. He well mastered the philosophical and scientific insights of the great scientist and in his works relied on his basic ideas about the essence of natural and human phenomena.

In 1768, S. G. Zybelin proposed choosing nature, rather than its biased interpreters, as the leader of reason. Like M.V. Lomonosov, he believed that our knowledge should be based on observations and experience and their meaningful perception, and not on prescribing our own laws to nature, based on ideas abstracted from life.

At the same time, the works of S. G. Zybelin testify to his creative assimilation of the views of M. V. Lomonosov and their further development in medicine. In his “Tale on the action of air in man and the ways in which it enters,” S. G. Zybelin pointed out the material nature and unity of man with the surrounding world, his subordination to the laws of nature. S. G. Zybelin ended his “Tale on the Reason for the Internal Union of Parts” with the following words: “We should not talk about things as this or that writer described them, but as nature produced them and presents them to our eyes. It is desirable that everyone would agree more with nature and follow it everywhere, and not warn with their worldly reasoning and, as if with an armed hand, prescribe their laws to it, but they themselves would obey and captivate the mind into its obedience, for inventions that are contrary to its mind will soon are decaying" "" "Science especially suffers a lot from those," he said, "who either adore the antiquity of an opinion, or the old age of the author, or his nobility." Citing the example of Harvey, who boldly fought for the correctness of his views, S. G. Zybelin called on young people to be courageous in scientific research and to overcome ingrained misconceptions.

Teaching theoretical medicine, S. G. Zybelin began with the physiology of a healthy person, physiological semiology and dietetics, then outlined pathology, pathological semiology and, finally, therapy. Zybelin taught medical substance science and formulation with a demonstration of the preparation of the most important medicines: under his leadership, pharmacists showed students the preparation of medicines.

Realizing the shortcomings of teaching medicine at Moscow University, S. G. Zybelin introduced demonstrations of patients during clinical lectures and demonstrations of experiments during reading

Lecture plan Development of medicine in Russia in the century. Development of higher medical education. Founding of the St. Petersburg Academy of Sciences. M.V. Lomonosov and the influence of his ideas on the development of Russian medicine. Fighting epidemics. Measures to combat the plague. Measures to combat anthrax. The fight against smallpox. Measures to prevent scurvy. Main features of medicine in Russia by the beginning of the 19th century

At the turn of the century, Russia embarked on the path of national revival and major government reforms in the socio-political, economic and cultural life of the country.

At the beginning of the 18th century, Peter I carried out a number of major reforms that accelerated the economic development of the country: the Senate was declared the highest governing body, collegiums were established instead of Orders, registration of all births and deaths was introduced, and a regular army and navy were created. It was then that an acute shortage of medical personnel emerged, especially for the Russian army. Therefore, among the urgent matters, Peter I carried out the reorganization of medical affairs in the country.

In 1707, the first permanent military hospital and a hospital school attached to it were opened in Moscow. Later, hospitals for crippled soldiers were created in St. Petersburg, Kronstadt, Revel, Kyiv and Yekaterinburg. In 1718, the land and admiralty military hospitals were opened in St. Petersburg and in 1720 the admiralty hospital in Kronstadt.

In 1706, a Decree was issued on the opening of free pharmacies. In 1719, instead of the Pharmacy Order, a Medical Office was established, headed by archivist P.Z. Kondoidi, and in 1763 this institution was transformed into the Medical College. The most important government reform was the opening in 1725 of the Academy of Sciences in St. Petersburg.

Under Peter I, they began to take care of the life and health of soldiers and sailors. The military and naval regulations (), as well as in the “regulations” (), determined the medical staff: “... there should be one doctor and one staffer in every division, and in every regiment a field doctor, and also in every company there should be a barber.”

In 1721, the Admiralty Regulations, compiled with the participation of Peter I, were published, where a special section defined the tasks and forms of work in naval hospitals. In 1735, a special “General Regulation on Hospitals” was published. Each hospital was headed by a doctor; the economic part of the hospital was subordinate to the medical one. Mandatory pathological autopsies of corpses of those who died in the hospital were established, and it was recommended to make sketches of all the most medically interesting patients and drugs.

Development of public medicine Sanitary statistics Audits of the population began to be carried out (“audit tales”), i.e. population census, birth and death rates. In the first 2 revisions, the male population was taken into account, and with the third, the female population was also taken into account.

The first workshop for repairing surgical instruments and making new ones was opened. In 1721, a decree was published “.. on the construction of hospitals in Moscow for the placement of illegitimate babies and on giving them and their nurses a cash salary.”

The beginning of anatomical dissections in Russia is associated with the name of Peter I. While in Amsterdam, he listened to lectures and attended operations and anatomical dissections. In 1717, Peter I acquired the anatomical collection of Ruysch in Holland, which laid the foundation for the holdings of the first Russian museum - the Kunstkamera.

Illness of Peter the Great The life of Emperor Peter ended on January 28, 1725 in terrible agony. There are many legends associated with his death. But the reliability of the two sources is beyond doubt. Kazimir Waliszewski in his book “Peter the Great” wrote: “On September 8, 1724, the diagnosis of the disease was finally clear: it was sand in the urine, complicated by the return of a poorly treated venereal disease.” In 1970, all known contemporary testimonies about the illness and death of Peter the Great were sent to the Central Institute of Dermatovenerology in Moscow for conclusion. A commission composed of professors came to the conclusion that “Peter the Great apparently suffered from a malignant disease of the prostate gland or bladder, or urolithiasis.”

Organization of healthcare management bodies Pharmacy order Founded in 1620 and was the first state medical institution. Its functions included: inviting doctors (domestic and foreign), monitoring their work and their payment, training and appointing doctors, supplying troops with medicines and organizing quarantine measures, forensic medical examinations, managing pharmacies, and collecting medicinal raw materials.

Organization of health care management bodies Instead of the Pharmacy Chancellery, in 1721 the Medical Chancellery was established - the highest body of medical management in Russia. It was headed by an archivist, later a director, who single-handedly managed these institutions. In 1763, instead of the Medical Chancellery, the Medical College was established. The board included: the president, 3 doctors of medicine, a staff doctor, an operator and a pharmacist. The Medical College was charged with organizing medical and drug assistance to the population, training medical personnel, and monitoring the activities of pharmacies. In 1803, the Medical College was closed and its functions were transferred to the Medical Department (Ministry of Internal Affairs)

Higher medical education in Russia. At the beginning of the 18th century, there were no more than 250 doctors in Russia, most of them were foreigners. The first Russian doctor with a university education was P.V. Posnikov, who received his doctorate in medicine from the University of Padua in 1696.

According to the decree of Peter I (May 25, 1706), it was decided to build a permanent military hospital and a hospital school in Moscow. In 1707, the grand opening of a hospital with 300 beds took place and at the same time a hospital school for training doctors began to function. The Moscow Hospital School was headed by the Dutch doctor Nikolai Bidloo.

Foreign doctors unfamiliar with the Russian language were invited as teachers at the hospital and had the opportunity to teach only in Latin and foreign languages (mainly Dutch and German). Foreign doctors in Russian service, fearing competition, often tried to oppose the training of domestic Russian doctors. Among the foreign doctors there were even those who argued that Russians were not capable of acquiring the extensive knowledge necessary for a doctor

Nikolai Lambertovich Bidloo (1670 – 1735) Was invited to Russia in 1702 as a physician of Peter I Founded the first medical school in Moscow and compiled a handwritten manual “Manual for students of surgery in the anatomical theater”, according to which the first Russians studied healers (first published 1979)

The chief doctor was not only a teacher, but also an attending physician. In the morning and evening, he made rounds in the presence of doctors and sub-healers, talking about the causes of the disease, its “signs” (symptoms) and methods of treatment. The chief physician is the second person in charge in the hospital. With his students, he made rounds of surgical patients twice a day and operated on them. Practical classes were conducted by “hospital doctors.” Undermedics were on duty around the hospital.

The main subjects in hospital schools were: anatomy, “materia medica” (including mineralogy, botany, pharmacy and pharmacology), surgery with desmurgy and internal diseases. According to the regulations, autopsy of corpses becomes mandatory. Teaching was carried out at the patient's bedside.

Since 1754, a new curriculum has been introduced in hospital schools, designed for a 5-7 year period of study. In the first and second years, anatomy, pharmacy and drawing were taught. In the third year - physiology. In the fourth - physiology and pathology. In the fifth and sixth - physiology, pathology, operative surgery and medical-surgical practice. In the seventh - medical practice (in internal medicine).

In 1786, hospital schools were reorganized into medical-surgical schools, and in 1798 - into the Medical-Surgical Academy (in St. Petersburg). In Moscow, the Medical-Surgical School became a branch of the Medical-Surgical Academy. Thanks to the efforts of the brilliant Russian scientist Mikhailo Vasilyevich Lomonosov (), on May 7, 1755, the first university was opened in Moscow, consisting of 3 faculties: philosophical, legal and medical. Initially there were only 30 students.

In 1791, Moscow University was allowed to award an academic degree - the “degree” of doctor - after the public defense of a dissertation. After defending his dissertation “On Breathing” in 1794, medical student F.I. Barsuk-Moiseev was awarded the academic degree of Doctor of Medicine for the first time. In 1805, the first three clinics were opened at the Faculty of Medicine: surgical, therapeutic and obstetric.

Semyon Gerasimovich Zybelin () Was the first Russian professor of the medical faculty of Moscow University. In 1758, he graduated from the Faculty of Philosophy of Moscow University, studied for several months at the academic university at the Academy of Sciences, which was headed by M.V. Lomonosov, and in 1759 he was sent to Leiden to receive the degree of Doctor of Medicine. Returning to Russia in 1765, he began teaching theoretical medicine (physiology and pathology with general therapy and dietetics). He was the first; professor at Moscow University, who began to give lectures in Russian, and not in Latin, as was then customary.

Foundation of the St. Petersburg Academy of Sciences The Academy of Sciences in St. Petersburg was established by decree of Peter I in 1724 and opened in 1725. Its first president () was Peter I's physician Lavrentiy Blumentrost.

At the Academy, a gymnasium, an academic university (developing three directions: mathematical, physical, and humanities), a library, a Kunstkamera (1728), an astronomical observatory, an anatomical theater and a botanical garden were created. At first, the Academy was dominated by invited foreign scientists, among whom were outstanding figures of their time: D. Bernoulli, L. Euler and others. Each academician was obliged to write a textbook on the relevant science and prepare one or two people to replace him from among the Russian students.

The first Russian national member of the St. Petersburg Academy of Sciences was Mikhailo Vasilyevich Lomonosov () - a brilliant domestic scientist, encyclopedist and educator

M.V. Lomonosov completed 8 classes during his four years of study at the Slavic-Greek-Latin Academy. Among the best three students, Lomonosov was sent to continue his studies in Germany, where he studied mathematics, physics, chemistry, mechanics, mining and received the title of candidate of medicine. Returning to his homeland, from 1742 until the end of his life he worked at the Academy of Sciences in St. Petersburg. In a number of Lomonosov’s works there are statements about the causes of human diseases, which, in his opinion, nest in the external environment, in food errors, and climate changes.

One of the most important problems of medicine is the problem of preserving the health of the people, which at that time was just beginning to emerge. M.V. Lomonosov showed great interest in the problems of preserving the health of his people. In a letter to Count Shuvalov “On the reproduction and preservation of the Russian people” M.V. Lomonosov expressed deep concern and concern about the high morbidity and mortality rate of the population of the Russian Empire. He drew the attention of the state rulers to the insufficient number of doctors and pharmacies, to the lack of medical books available to the people. His students and followers continued to strive for the implementation of M.V.’s ideas. Lomonosov.

N.M. Maksimovich-Ambodik (gg.) Received his medical education at a hospital school in St. Petersburg, then at the University of Strasbourg, where in 1775 he received the degree of Doctor of Medicine. For the first time in Russian, he wrote a large work, “The Art of Midwifery or the Science of Womanhood,” which became a reference book for obstetricians in Russia. This extensive manual was considered the best manual for both doctors and midwives until the mid-19th century. N.M. Maksimovich-Ambodik widely used obstetric forceps, and when teaching practical obstetrics he introduced a phantom.

N.M. Maksimovich-Ambodik (gg.) In the 18th century, diseases of young children were within the competence of obstetricians. In accordance with this, N. M. Maksimovich-Ambodik devoted the fifth part of his book “The Art of Weaving” to the care of children and their upbringing. He believed that children should be hardened, taken out into the fresh air more often, and gave preference to breastfeeding. When translating a book about venereal (“lusty”) diseases, I added 60 pages of my notes to the 140 pages of the author’s text.

The fight against epidemics is one of the most important problems of medicine in Russia in the 18th century. The organization of the fight against frequently occurring epidemics of plague, anthrax, and smallpox in the 18th century was carried out both through the personal initiative of advanced Russian medical scientists and through the state. In order to prevent and eliminate epidemics, national measures were carried out: Quarantines and quarantine outposts were organized in places where epidemics appeared; The Senate approved a special “quarantine charter”; “Smallpox houses” were opened in Moscow and St. Petersburg and the positions of “smallpox doctor” were established; “Small hospitals” have been opened on ships; Things were disinfected.

Measures to combat the plague were developed by the famous Russian epidemiologist D.S. Samoilovich. For this purpose, quarantines, isolation of patients, fumigation of premises, disinfection of things, and burial of corpses outside the city limits were carried out. In addition, during periods of plague epidemics, it was recommended to “wash the body with cold water or vinegar, drink a spoonful of liquid tar a day for both healthy and unhealthy people.” During the plague epidemic in Ukraine, “guards were posted around cities and villages and gallows were set up for those who fled from the infected area.”

Icon in frame "Our Lady of Bogolyubskaya", made in memory of the deliverance of Moscow from the plague epidemic. Russia (Moscow), 1772. The most terrible plague epidemics in Russia are epidemics in Pskov and Novgorod in the 17th century, the Moscow plague (pestilence), which led to the “plague riot” (1771)

The winner of the Moscow plague, Count Grigory Grigorievich Orlov (gg.), provided Moscow with food, doctors, and organized strict adherence to anti-epidemic measures. He used the tactics of material incentives - those placed in quarantine were paid 5 rubles for single people and 10 rubles for married people; those who reported hiding a plague patient - 10 rubles; those who reported the theft or sale of belongings of a plague patient - 20 rubles. Doctors received an additional salary of 36 rubles per month.

D.S. Samoilovich (gg) Was a participant in the elimination of 9 plague epidemics. He wrote that the plague “is a sticky disease, but easily curbed and suppressed. You cannot become infected from contact if you immediately wash your hands with vinegar or kvass or water with salt or clean water.” He rejected the idea that existed at that time that the plague was brought to earth from other planets. He emphasized that the plague does not occur on its own, but appears after being brought in by sick people or importing infected things from other countries, so he paid great attention to improving the border quarantine service. Tried to develop preventive vaccinations against the plague.

D.S. Samoilovich (gg) For scientific works and dissertations, D.S. Samoilovich proposed topics closely related to the needs of the people. He taught that medicine serves “for the benefit and benefit of the people.” The merits of D. S. Samoilovich were noted by his election as an honorary member of a number of academies and scientific societies in France, Italy and Germany.

Measures to combat anthrax Anthrax in the Middle Ages was known as “Persian fire”. No means of combating this disease were found until the beginning of the 19th century. In 1763, N. Nozhevshchikov and A. Eshke, doctors of the Kolyvan-Voznesensky factories (Siberia), gave a brief description of the clinical picture of human anthrax disease.

S.S. Andreevsky Described the clinical picture of anthrax in humans and animals. He proposed various means of treating this disease. So, he recommended applying sour rye dough mixed with chalk three times a day to the tumor until it softens, then wiping the area with cold water, ice and vinegar. In addition, he recommended laxatives. As a precautionary measure, S.S. Andrievsky proposed to refrain from selling livestock and eating meat and dairy products during an epidemic, to separate healthy animals from sick ones, and to bury dead animals deep in the ground. In 1788, he experimented with self-infection, observed and recorded all manifestations of the disease until he lost consciousness. He completed his research by writing the work “Anthrax.”

The fight against smallpox Advanced Russian scientists began to introduce the method of variolation only in the middle of the 18th century. The initiator of the fight against smallpox was S.G. Zybelin. Russia, after England, became the first country where Jenner’s vaccination method became widespread

The fight against smallpox Smallpox began to be vaccinated in Russia in the fall of 1768. Dr. Dimsdal was discharged from England and his first patient was Catherine II, the second G.G. Orlov; a week after them, heir Pavel Petrovich was vaccinated. The vaccination material was taken from patient A.D. Markova. As a reward for this, the patient received a noble title.

The fight against smallpox The first vaccination against smallpox in Russia using the Jenner method was made in 1802 by Professor E.O. Mukhin to the boy Anton Petrov, who in honor of this event received the surname Vaktsinov. The first organizers of smallpox vaccination in Siberia were doctors Semyon Shangin and Timofey Andreev

Measures to prevent scurvy Diseases of scurvy in Russia have been known since the formation of the Moscow State (16-17th century). During the period of development of the natural resources of Siberia, Academician P.S. Palace visited the mines in the Nizhny Tagil region. He noticed that hired workers from the peasants of the Cherdyn district suffer in winter from a “sorrowful disease,” which, according to him, is born from a lack of “fresh food.”

Measures to prevent scurvy A. Bacherakht in his work “Practical Discourse on Scurvy Disease” (1786) described methods of treating and preventing scurvy. He writes that from young shoots of pine trees you can prepare a drink called “Russian infusion.” His experience in treating patients with “Russian infusion”, cranberry juice, cabbage, and garlic allowed him to cure 2/3 of the patients in the hospital in a short time. He was convinced that the main preventative against scurvy was a correct lifestyle.

Medicine in Russia at the final stage of the era of feudalism By the beginning of the 19th century, Russia was the largest state in Europe in terms of territory and population. As for socio-political development, in this respect it lagged behind the advanced countries of the West, despite the fact that the process of disintegration of the feudal-serf system began in it.

The main features of medicine in Russia by the beginning of the 19th century 1. Anatomical and physiological direction becomes leading; 2. Clinical medicine is born and the first scientific medical schools appear; 3. The fight against anti-scientific, metaphysical and speculative theories in medicine continues; 4. The doctrine of illness receives a materialistic explanation in the works of advanced Russian scientists; 5. Further differentiation of medical knowledge; 6. The base for training medical personnel is expanding; 7. The medical faculty of Moscow University and the Medical-Surgical Academy in St. Petersburg become the main scientific medical centers.