• Domestic science and medicine in the 19th - early 20th centuries Chemistry of the 19th century in medicine
• What are peptides? Types and types of peptides. All about peptides and anti-aging cosmetics with peptides Additional peptides are not formed
• Toxic effect on humans of hazardous chemicals
• Radioautography Method of autoradiography in cytology
• Identification of bacteria by antigenic structure
• Organic matter in wastewater What are organic compounds in water
• Hydrogen index (pH factor)
• What is the pH of water and why is it important to know it?
• Redox potential Redox systems
• Reversible redox system Reversible redox systems

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Biology

1868 - discovery of the pattern of hereditary traits

Gregor Johann Mendel (1822-1884). Austrian naturalist. Engaged in experiments on hybridization of peas, he traced the inheritance of parental traits in the offspring of the first and second generations and came to the conclusion that heredity is determined by constancy, independence and free combination of traits.

1892 - the theory of heredity

August Weisman (1834-1914). German biologist. Observations of the developmental cycle of protozoa led Weisman to the hypothesis of the continuity of the "germ plasm", and he saw in this cytological arguments about the impossibility of inheriting acquired traits - a conclusion that is important for the development of the theory of evolution and Darwinism. Weisman emphasized the sharp difference between inherited traits and acquired traits, which, as Weisman argued, are not inherited. He was the first to understand the fundamental role of the chromosome apparatus in cell division, although at that time he could not prove his assumptions due to the lack of experimental scientific data.

1865-1880s - biochemical theory of fermentation. Pasteurization. Research in the field of immunology

Louis Pasteur (1822-1895). French scientist, whose works laid the foundation for the development of microbiology as an independent scientific discipline. Pasteur developed the biochemical theory of fermentation; he showed that microorganisms play an active role in this process. As a result of these studies, a method was developed to protect wine, beer, milk, fruit juices and other food products from spoilage, a process later called pasteurization. From the study of fermentation processes, Pasteur moved on to the study of pathogens of infectious diseases in animals and humans and the search for methods to combat these diseases. Pasteur's outstanding achievement was the discovery of the principle of protective vaccinations against chicken cholera, anthrax in cattle, and rabies. The method of preventive vaccination developed by him, in which active immunity is developed in relation to the causative agent of the disease, has become widespread throughout the world. His studies of pathogenic microbes served as the basis for the development of medical microbiology and the study of immunity.

1846 - discovery of ether anesthesia. W. Morton, American physician.

1847 - the first use of ether anesthesia and plaster casts in the field

19th century medicine

Nikolai Ivanovich Pirogov (1810-1881). Russian surgeon and anatomist, whose research laid the foundation for the anatomical and experimental direction in surgery; founder of military field surgery. The rich personal experience of a military surgeon allowed Pirogov to develop for the first time a clear system for organizing surgical care for the wounded in the war. He proposed and put into practice a fixed plaster cast for gunshot wounds (during the Crimean War of 1853-1856). The operation of resection of the elbow joint developed by Pirogov contributed to the limitation of amputations. Pirogov's practical experience in the use of various antiseptic substances in the treatment of wounds (iodine tincture, bleach solution, silver nitrate) anticipated the work of the English surgeon J. Lister on the creation of antiseptics. In 1847, Pirogov published a study on the effect of ether on the animal organism. He proposed a number of new methods of ether anesthesia (intravenous, intratracheal, rectal), created devices for the introduction of anesthesia. Pirogov investigated the essence of anesthesia; he pointed out that the narcotic substance has an effect on the central nervous system through the blood, regardless of the route of its introduction into the body. At the same time, Pirogov paid special attention to the presence of sulfur impurities in the ether, which can be dangerous for humans, and developed methods for cleaning the ether from these impurities. In 1847, Pirogov was the first to use ether anesthesia in the field.

1863 - research by I. M. Sechenov "Reflexes of the brain"

Ivan Mikhailovich Sechenov (1829-1905). Russian naturalist, materialist thinker, founder of the Russian physiological school, founder of the natural science trend in psychology. Sechenov dealt with many problems of physiology and psychology. However, his "Reflexes of the Brain" are of the greatest importance, where for the first time the problems of psychology were solved from the standpoint of physiology, from the standpoint of natural science.

1867-1880s - discovery of antiseptics

Joseph Lister (1827-1912). English surgeon, famous for introducing antiseptics into medical practice. Based on the works and clinical data of N. I. Pirogov, L. Pasteur and others, Lister, as a result of many years of research, developed methods for disinfecting wounds with a solution of carbolic acid. He was also offered an antiseptic dressing impregnated with carbolic acid. Lister also developed new methods of surgical technique, in particular, he introduced antiseptic absorbable catgut as a material for surgical sutures.

1895 - discovery of conditioned reflexes. Research in the field of higher nervous activity.

Ivan Petrovich Pavlov (1849-1936). Russian physiologist, creator of the doctrine of the higher nervous activity of animals and humans. He carried out exceptional research on the work of the human cardiovascular system, on the physiology of digestion, on the functions of the cerebral hemispheres, the principle of reflex self-regulation of all body systems was proved, and conditioned reflexes were discovered.

In the second half of the 19th century, medicine in its development largely approached natural science. The data of physics, chemistry and biology began to be used more widely than before in various branches of medicine: in the recognition and treatment of a disease, in understanding the phenomena occurring in a healthy and diseased organism, in theoretical generalizations. The struggle between materialism and idealism found its reflection in medicine and, first of all, in its theoretical sections.

The formation of new essentially dialectical views on nature throughout the 19th century took place in the process of a sharp struggle between materialism and idealism, dialectical ideas and metaphysics.

The influence of the materialistic philosophy of the revolutionary democrats on the development of natural science and medicine in Russia. In the middle of the 19th century a great role in the struggle for materialism in natural science, in exposing idealism and agnosticism and in the development of materialism, was played by Russian philosophers, materialist revolutionary democrats. The advanced materialist philosophy of the Russian revolutionary democrats, who came close to dialectical materialism, although due to objective historical circumstances they did not completely overcome the metaphysical limitations of materialism, played an enormous positive role in the development of natural science and medicine in the 19th century.

Tsarist Russia entered the path of capitalist development later than other countries. Until the 1960s there were very few factories and factories in Russia. The serf economy of the noble landowners prevailed. In the 1850s and early 1860s, Russia underwent a transition from the first, noble, stage of the liberation movement to the second, the bourgeois-democratic stage. The final bourgeois-democratic stage in the history of the liberation movement in Russia came after the fall of serfdom in 1861. A relatively short period of time (the 50s and early 60s), full of major historical events, was a turning point in the life of Russia. The feudal landlords could not prevent the growth of Russia's commodity exchange with Europe, they could not keep the old, crumbling forms of economy. “The Crimean War showed the rottenness and impotence of serf Russia. Peasant revolts, growing every decade before liberation, forced the first landowner Alexander II to admit that it was better to free him from above than to wait until he was overthrown from below.

The feudal-serfdom system of Russia was in deep crisis: feudal relations hindered the development of both agriculture and industry. The autocracy was forced to go for the "liberation" of the peasants under the pressure of growing opposition sentiments in the country, thereby assuming the execution of a program that was contrary to the principles of the autocracy. But the revolutionary situation that developed at that time, which testified that a bourgeois-democratic revolution was ripe in the country, did not lead to a revolution. The peasantry, spontaneously rising to fight, remained scattered and unorganized and could not solve revolutionary problems. The proletariat that was taking shape in Russia had not yet emerged as an independent political force. The bourgeoisie, in fear of the revolutionary movement of the popular masses in Russia and abroad, was ready to be content with concessions on the part of tsarism and the landowners and was not capable of a decisive struggle. The transition to capitalism in Russia in the early 1960s therefore took place not through a bourgeois-democratic revolution, but through a bourgeois reform carried out by the hands of the feudal lords. The abolition of serfdom was followed by reforms of local self-government (the introduction of a zemstvo in 1864), courts, legislation, school affairs, etc. As a result of the fall of the serfdom, Russia embarked on the path of capitalism, although after the 60s hampered by numerous and strong remnants of the serfdom.

The changes that took place in the social life of Russia in the 50s and early 60s of the 19th century as a result of the crisis of the serf system, and then its fall, the growth of the class struggle of the peasants against the landowners, the transition to a new, bourgeois-democratic stage in the Russian liberation movement caused the development revolutionary democratic ideology and materialistic philosophy. In the context of the ideological struggle against reaction and liberalism, the revolutionary democrats of the 1850s and 1860s defended materialist philosophy and revolutionary democratic theories of social development. The initial task of Russian materialist philosophy in the 1950s and early 1960s was the struggle against the hidden idealistic philosophical currents of positivism and agnosticism. It was necessary to raise the role of natural science, to fight against idealism and agnosticism in natural science, to link the latest achievements of science with materialist philosophy, and, relying on natural science, to defend and further develop the foundations of materialism.

Through their activities, the revolutionary democrats had a great influence on the development of natural science and medicine in Russia. The revolutionary democrats of the 1960s solved these questions from materialistic positions. Their views were a major stage in the development of the materialist philosophy of the pre-Marxian period. They understood that the development of the natural sciences would contribute to the progressive development of the Russian economy, the country's productive forces, and thereby raise the well-being of the people. The revolutionary democrats were well acquainted with the current state of the natural sciences, their main problems and achievements, in particular with Darwin's newly formed evolutionary doctrine. N. G. Chernyshevsky and his like-minded people understood that natural spiders with their material reinforce the provisions of materialistic philosophy.

In their writings, N. G. Chernyshevsky and D. I. Pisarev promoted the natural sciences, emphasized the need to study them, and encouraged young people to do so.

The growth of interest in natural science was one of the characteristic features of public sentiment in Russia in the 50s and 60s of the 19th century. The outlook of the advanced circles of young people was formed under the influence of the propaganda of the revolutionary democrats and the successes in the development of the natural sciences. It was a time when the worldviews of D. I. Mendeleev, K. A. Timiryazev, I. I. Mechnikov, I. M. Sechenov, S. P. Botkin, I. P. Pavlov and many other outstanding domestic naturalists and doctors were formed . The works of A. I. Herzen, N. G. Chernyshevsky, and D. I. Pisarev had an enormous beneficial effect on the development of the materialistic views of scientists. Philosophical and general scientific views of A. I. Herzen, V. G. Belinsky, later N. G. Chernyshevsky, N. A. Dobrolyubov, D. I. Pisarev determined the main scientific positions of Russian scientists and doctors of the second half of the 19th century - physiologists, pathologists and clinicians.

N. G. Chernyshevsky. Nikolai Gavrilovich Chernyshevsky (1828-1889), revolutionary, philosopher, militant materialist, played a major role in the development of the natural sciences and medicine in Russia, since with his writings he had a great influence on the views and activities of many prominent Russian doctors in the middle and second half of the 19th century. century. In the works of N. G. Chernyshevsky, the proposition was consistently carried out about the primacy of matter, the nature and secondary nature of consciousness, that the content of human consciousness and its forms are causally determined by the development of external material phenomena that exist outside and independently of people's consciousness. The materialistic philosophical convictions of N. G. Chernyshevsky were based on the achievements of contemporary natural science. They were imbued with a spirit of militancy, intransigence towards idealism, and contributed to a sharp delimitation of philosophical camps in Russia. Lenin, in the appendices to the book Materialism and Empirio-Criticism, wrote about N. G. Chernyshevsky: “Chernyshevsky is the only really great Russian writer who managed from the 50s until the 88th year to remain at the level of integral philosophical materialism and discard the neo-Kantian nonsense , positivists, Machists and other muddleheads. But Chernyshevsky was unable, or rather, due to the backwardness of Russian life, could not rise to the dialectical materialism of Marx and Engels.

In a number of his works, N. G. Chernyshevsky touched upon issues of physiology and psychology close to medicine, and in interpreting these issues he indicated the direction in which the research of natural scientists and doctors should go. In the writings of I. M. Sechenov, S. P. Botkin and a number of other doctors, one can find the influence of the views of N. G. Chernyshevsky, responses to his calls and specific factual materials on the problems he raised. Of particular importance for physiology in this regard was the main philosophical work of N. G. Chernyshevsky - "The Anthropological Principle of Philosophy", published in 1860. N. G. Chernyshevsky devoted this work to the refutation of dualistic, essentially idealistic theories, claiming that there is called "spiritual substance", manifested in the consciousness and will of people and allegedly independent of matter, nature. Based on the data of natural science, especially physiology, N. G. Chernyshevsky proved the unity of the human body, the causal dependence of sensation, concepts, will and consciousness of a person on the external material environment.

“... It is necessary to look at a person as one being, having only one nature, so as not to cut human life into different halves belonging to different natures, in order to consider each side of a person’s activity as an activity or his entire organism from head to toe inclusive or, if it turns out to be a special function of some particular organ in the human organism, then consider this organ in its natural connection with the whole organism. ... The principle of the philosophical view of human life with all its phenomena is the idea developed by the natural sciences about the unity of the human organism; the observations of physiologists, zoologists and physicians have removed any idea of ​​the dualism of man. Proceeding from the principles of materialistic monism, Chernyshevsky gave in general a correct solution to the psychophysical problem, but in this case he limited himself to revealing the physiological basis of human consciousness.

Chernyshevsky emphasized: “...physiology considers supposedly special subjects - the processes of respiration, nutrition, blood circulation, movement, sensation, etc., conception or fertilization, growth, decrepitude and death. But here again it must be remembered that these different periods of the process and its different aspects are separated only by theory in order to facilitate theoretical analysis, but in reality they constitute one inseparable whole.

In his writings, N. G. Chernyshevsky held the idea that the material substrate of mental processes, the basis of consciousness, memory, and excitation are the sense organs and the nervous system of humans and higher animals. He criticized the vulgar materialists for identifying matter and consciousness. In contrast to vulgar materialism, N. G. Chernyshevsky emphasized the qualitative difference between physiological and mental phenomena, matter and thinking.

In the controversy of 1860-1862. idealists disputed the materialistic understanding of life processes, the importance of physiology for the analysis of complex processes occurring in the body, and in particular the processes of higher nervous activity. The materialistic positions of N. G. Chernyshevsky, expressed with the utmost clarity in the "Anthropological Principle of Philosophy", were met with sharp criticism from representatives of theological, religious and idealistic circles, who tried to prove that the spirit dominates the body, consciousness over matter, that the inner world man is independent of external objects, that external experience is studied by physiology, the natural sciences, and internal by psychology, and that psychology must place itself in complete independence from the natural sciences.

N. G. Chernyshevsky was unshakably confident in the ability of people to cognize the world, he argued, in contrast to the Kantians and other agnostics, that all objects (things in themselves) are fully cognizable both in their existence, and in their qualities, and in their actual relations. N. G. Chernyshevsky rejected the assertions of the agnostics about the inability of man to know the world, condemned skepticism in science. He emphasized that "our time is a time of great discoveries, firm convictions in science, and whoever indulges in skepticism now testifies only to the weakness of his character or backwardness from science, or insufficient acquaintance with science." N. G. Chernyshevsky understood the perniciousness for natural scientists of enthusiasm for Kantian and positivist philosophy, he called agnostic views "illusionism."

N. G. Chernyshevsky gave a deep assessment of the progressive aspects of Darwin's teachings, acted as a resolute supporter of the idea of ​​the development of wildlife, but rightly noted that Darwin underestimated the influence of the external environment on the development of organisms. He criticized Darwin for transferring the reactionary idea of ​​"the struggle of all against all" into natural science. N. G. Chernyshevsky regarded the Malthusian false theory of “overpopulation” as a malicious falsification of the truth and criticized it.

N. G. Chernyshevsky defended the leading importance of the environment and education in the formation of the human personality. Regarding racial differences, he wrote: “All races are descended from the same ancestors. All the features that distinguish them from one another are of historical origin. “The slave owners were white people, the slaves were Negroes, so the defense of slavery in scholarly treatises took the form of a theory about the fundamental difference between different races of people.”

N. G. Chernyshevsky’s comrade-in-arms and like-minded person, N. A. Dobrolyubov (1836-1861), highly appreciated the importance of natural science in the struggle for materialist philosophy. While studying at the Theological Seminary and later at the Pedagogical Institute in St. Petersburg, N. A. Dobrolyubov got acquainted in detail with the state of the natural sciences, developed (consistently materialistic views on nature. N. A. Dobrolyubov criticized idealism for trying to present nature as a creation of the spirit, to look for non-material principles in nature, exposed dualistic theories that tried to split the world into the world of visible and material phenomena and the world of unknowable spiritual values.N.A. Dobrolyubov repeated and developed Chernyshevsky's position that there is no dualism in human nature.

In a number of his speeches (translations, mostly reviews of books published in those years), N. A. Dobrolyubov expressed a number of propositions on issues close to medicine with great depth. For physicians, of particular interest are two works by N. A. Dobrolyubov, devoted to the analysis of the speech of the idealist Bervi, who read physiology at Kazan University in the late 50s. Bervey published the book Physiological-Psychological Comparative View of the Beginning and End of Life, in which he sharply criticized the materialistic trend in physiology and medicine and outlined extremely reactionary thoughts. Analyzing Bervy's book, N. A. Dobrolyubov showed that “the direction of the natural sciences for Bervy is more than a sharp knife. Because of the natural sciences, he is indignant at all of our time ... It seems that we would be a little mistaken if we even attributed the time of the formation of the city of Bervey to the Middle Ages ... The research of the latest naturalists is completely unknown to Mr. Bervey. “... Is it any wonder that, in this state of his knowledge, Mr. Bervy is extremely dissatisfied with our time, in which the natural sciences have made such a huge step forward, reconciling philosophical reasoning about the forces of nature with the results of experimental research on matter. The positive method has now been adopted in the natural sciences. All conclusions are based on experimental factual data, and not on dreamy theories, once compiled at random by someone, and not on old fortune-telling, which in the old days was content with ignorance and half-knowledge.

Thinking, the spiritual life of man was considered by N. A. Dobrolyubov as the highest result of the development of matter. Recognizing the complex structure of the human brain, N. A. Dobrolyubov called for its study. In the works of domestic researchers N. M. Yakubovich, F. V. Ovsyannikov, V. A. Betz and their successors, one can clearly see the responses to this appeal of N. A. Dobrolyubov.

D. I. Pisarev (1840-1868) was a passionate revolutionary publicist and an outstanding thinker, a fighter for the abolition of serfdom and the emancipation of the working people, a militant materialist and atheist. Solving the main question of philosophy materialistically, D. I. Pisarev proved that matter exists independently of sensation, that sensations only reflect what is happening in the surrounding reality. He criticized those natural scientists who limited themselves to the accumulation and description of factual material and did not rise to theoretical generalizations, did not reveal causal relationships, the laws of phenomena.

Particularly great was the importance of D. I. Pisarev’s struggle for materialism against idealism in natural science, for the development of advanced science in Russia. He was "a propagandist of science, a talented popularizer of scientific discoveries. One of the first in Russia, D. I. Pisarev made a brilliant propaganda of Darwinism. He noted that "in almost all branches of natural science, Darwin's ideas make a complete revolution" and will be the guiding thread, "which will connect many of the observations made and direct the minds of researchers to new, fruitful discoveries". Popularizing Darwin's theory, D. I. Pisarev emphasized the role of the external environment in the formation of species, substantiating the position on the inheritance of acquired characteristics as the law of the development of nature. "All the various forms of organisms that exist on the globe are generated by the influence of living conditions and natural choice.

D. I. Pisarev fought against vitalism, stood on the side of N. II. Chernyshevsky in disputes after the publication by the latter of the book "The Anthropological Principle in Philosophy". D. I. Pisarev wrote: “We must assume and hope that the concept of “mental life”, “psychological phenomenon” will eventually be decomposed into its constituent parts.” In a number of his articles, D. I. Pisarev dwelled on questions of physiology and medicine, and emphasized the importance of physics and chemistry for medicine. He also touched on hygiene issues. D. I. Pisarev recommended that physiological knowledge be widely disseminated as the basis of personal and public hygiene. He sharply criticized the anti-hygienic nature of the school education of his time, demanded the introduction of physical labor in educational institutions, insisted on increasing the influence of the school doctor on the pedagogical process. He emphasized the need to organize medical statistics in Russia. D. I. Pisarev saw the reasons for the suffering of the working masses not in “overpopulation” and not in the supposedly excessive increase in the birth rate, as the Malthusians and other reactionaries insisted, but in the economic and social structure of contemporary society. “To treat this society,” wrote Pisarev, “it is necessary to carry out radical economic transformations... The real evil lies precisely in the plight of the masses...”.

With his fiery propaganda of the natural sciences, D. I. Pisarev raised the importance of the natural sciences for the practical life of the people and for the development of a correct world outlook in the minds of the progressive Russian intelligentsia. In the memoirs of his youth, I. P. Pavlov spoke about the influence of D. I. Pisarev's articles on the formation of the views of young people. I. P. Pavlov in 1874, in his student work “On the nerves that manage the work in the pancreas,” wrote a motto, clearly inspired by the works of D. I. Pisarev: “The best school for human thinking is independent scientific research.”

Materialistic views and scientific discoveries of domestic natural scientists of the second half of the 19th century

A characteristic feature of natural science in Russia in the second half of the 19th century was independence, originality, and the spirit of innovation. It did not "rewrite" and did not repeat the "backsides" of Western European science, but it said its new, weighty word. This new word was not about minor details, more or less essential details, particular tasks. Outstanding domestic figures of natural science are characterized by a special breadth of views and tasks, and the enormous scale of the results they have achieved. Domestic natural scientists are the founders of a number of new sciences, creators of new directions, creators of new methods of scientific research and innovators in the field of technical applications. Among the outstanding representatives of Russian natural sciences were remarkable thinkers, whose historical significance lies not only in the fact that they made major natural scientific discoveries that significantly expanded our knowledge of nature, but also in the fact that with all their scientific creativity they had a fertilizing influence directly on the formation of scientific knowledge. materialistic worldview. These domestic scientists played such an important role in the history of scientific thought due to the fact that each of them stood at the level of the most progressive scientific ideas for his time, widely and skillfully used them in his scientific work, was guided by them in his approach to the study of natural phenomena and, thus, he was distinguished by a more correct way of scientific thinking than many natural scientists of his time.

Domestic natural scientists and doctors, who from the beginning of the development of their science were adherents of scientific experiment, did not stop at systematizing individual facts, at bare empiricism. Rebelling against abstract idealistic systems, over time, as the data of experimental natural science accumulated, they quickly perceived the need for a serious theoretical generalization, which was the hallmark of the new period in the development of Russian science in the second half of the 19th century. The solution of this problem for domestic natural scientists and doctors was facilitated by the fact that they could rely on such a solid methodological basis, which was the development of the main theoretical issues in natural science and general philosophical problems by its outstanding representatives of Russian materialistic philosophy - A. I. Herzen, V. G Belinsky, N. G. Chernyshevsky, N. A. Dobrolyubov and D. I. Pisarev. As a rule, with only a few exceptions, natural-science materialism in Russia among prominent representatives of science was not half-hearted, it was alien to duality, not associated with constant fluctuations, self-justification in front of an official reaction, which was often noted among scientists from other countries. These features of the leading Russian scientists - naturalists and representatives of medicine were directly perceived by them from the great Russian democrats - from A.N. Radishchev, the Decembrists and N.G.

Domestic scientists in the field of natural sciences in the second half of the 19th century solved major problems of modern natural science and made major generalizations in science. Such were the studies, discoveries and generalizations of D. I. Mendeleev in the field of chemistry, A. G. Stoletov in physics, A. M. Butlerov in organic chemistry, K. A. Timiryazev in plant biology and physiology, A. O Kovalevsky - in embryology, I. I. Mechnikov - in zoology and pathology, I. M. Sechenov - in physiology.

D. I. Mendeleev (1834-1907) in 1869 made one of the greatest discoveries in the history of science - he discovered the periodic law of chemical elements and created a system of elements. The meaning of the periodic law D. I. Mendeleev formulated briefly: “If all the elements are arranged in order according to the magnitude of their atomic weight, then we get a periodic repetition of properties. This is expressed by the law of periodicity: the properties of simple bodies, as well as the forms and properties of compounds of elements, are in a periodic dependence ... on the magnitude of the atomic weights of the elements.

F. Engels highly appreciated the discovery of D. I. Mendeleev:

“Mendeleev, by unconsciously applying the Hegelian law of the transition of quantity into quality, accomplished a scientific feat that can be safely put next to Lsverie's discovery. who calculated the orbit of the still unknown planet - Neptune "

D. I. Mendeleev spoke out against idealism in natural science and against agnosticism. Referring to human practice, D. I. Mendeleev found weighty and irrefutable arguments against the agnosticism of Hume and Kant. He asserted with deep optimism: "... There is no reason to see anywhere the limits of knowledge and possession of matter."

D. I. Mendeleev was a great patriot, he was deeply concerned about the needs of Russia and the needs of the people. In 1880, in a speech at the VI Congress of Russian Naturalists and Doctors, D. I. Mendeleev said: “It is time for us to think in order to serve the needs of the country where we live and work. Working for the benefit of world science, we, of course, make our tribute to the motherland, but after all, it has personal, local needs ... Let's create something so that they don’t say someday: they gathered, discussed comprehensively the interests of science, but those close, they did not see a friend in which they could be of great benefit to the country. Let them know in Russia that natural scientists are not scholastics, but pay their debt to the Motherland.” Domestic scientists K. A. Timiryazev, A. O. Kovalevsky, V. O. Darwinism. The evolutionary doctrine was created in Russia. Russian scientists—evolutionists of the pre-Darwinian period—K. F. Wolf, A. N. Radishchev, P. A. Zagorskii, Kh. prepared the ground in Russia for the recognition, dissemination and further development of Darwinism. Therefore, Darwin's evolutionary teaching was not something unexpected for Russian science. Darwin's theory gave only a more detailed and scientifically substantiated explanation of what had already been previously expressed by leading Russian scientists. The final form of evolutionary doctrine—Darwin's theory—has found fertile ground in Russia. K. A. Timiryazev, A. O. Kovalevsky, V. O. Kovalevsky, I. I. Mechnikov were in the forefront of the defenders of Darwinism against reactionary attacks and perversions. The Russian doctors followed them in the main on the right path and thus prevented Russian medicine from the corrupting influence of the crisis of bourgeois science.

K. A. Timiryazev (1843-1920) promoted and defended Darwinism and continued Darwin’s cause in his special works. K. A. Timiryazev was a talented popularizer and interpreter of Darwinism. By this he significantly contributed to a deep philosophical understanding of the evolutionary doctrine. In addition, K. A. Timiryazev was a brilliant theoretician of the evolutionary doctrine. With his research, he made a significant contribution to the development of the doctrine of the causes and patterns of development of the organic world, which creatively developed the evolutionary doctrine.

In his research work on plant physiology, K.A. Timiryazev studied one of the most important natural phenomena: the formation of complex organic compounds in the green leaf of a plant from the simplest substances - water and carbon dioxide - under the influence of sunlight. He gave a solution to one of the cardinal problems of natural science - photosynthesis.

The works of K. A. Timiryazev on photosynthesis were a brilliant achievement of materialism; they give one of the most important proofs of the unity of the world, animate and inanimate nature.

Being a plant physiologist by profession, K. A. Timiryazev had a broad understanding of the tasks of a natural scientist. In the book “The Life of Plants”, intended for a wide circle of readers, K. A. Timiryazev wrote: “The task of the physiologist is not to describe, but to explain nature and control it ... His method should not be in the passive role of an observer, but in the active role of a tester .. He must enter into a struggle with nature and the power of his mind, extort his logic, elicit from her answers to his questions in order to take possession of her and, having subjugated her to himself, be able at his own will to call or stop, modify or direct life's phenomena."

K. A. Timiryazev made extensive use of the historical method, which contains elements of materialist dialectics. He criticized vitalism, Machism and Weismann's reactionary theory of heredity -

Mendel. He wrote that Mendelism, along with other signs of the regression of bourgeois science, was "only a particular manifestation of a long-conceived clerical-capitalist and political reaction."

A. O. Kovalevsky showed that the embryonic development of all multicellular animals proceeds in principle in the same way, rejected the previous idea that each type of animal was “something isolated, closed in itself.” He laid the foundations for the comparative physiology of invertebrates, developed evolutionary ideas in the field of embryology, and through his research provided new experimental evidence for evolutionary theory. Darwin called the work of A. O. Kovalevsky "a discovery of the greatest importance." Darwin thanked Russian scientists for the fact that in their works they brought new ma-Karl Rokitansky (1804-1878). materials and evidence supporting and developing the evolutionary doctrine.

The development of pathological anatomy in the XIX century. The development of pathology in the middle of the 19th century was determined by the struggle of two directions - humoral and cellular, the main representatives of which were Rokitansky and Virchow.

Karl Rokitansky (1804-1878), a Viennese pathologist, of Czech origin, performed more than 30,000 autopsies in his life and described in detail pathological changes in organs in various diseases. In published in 1841-1846. "Guide to Pathological Anatomy" Rokitansky developed the old humoral direction in pathology. Even the terminology of Rokntansky was reminiscent of the teachings of Hippocrates: Rokitansky called the various states of body fluids "krases" and associated with them a predisposition to certain pathological processes. Rokitansky considered disturbances in the composition of fluids, juices of the human body (dyscrasia) as the main cause of painful phenomena. He saw the essence of the disease process in the abnormal mixing of body juices, and Rokitansky considered the pathoanatomical changes in organs and tissues that he saw during the autopsy to be secondary phenomena that arose as a result of sedimentation and deposition of substances from body fluids. The humoral pathology of Rokntansky came into sharp conflict with the actual data known in his time. Virchow, speaking out against the speculative theories prevailing at that time in medicine, sought to ensure that all conclusions were substantiated by actual observations and that ideas about diseases were associated with their material substrate. For these purposes, Virchow applied the theory of cellular structure to the study of a diseased organism. In a dispute with Virchow, Rokitansky easily gave up his positions and abandoned the main provisions of his theory in favor of Virchow's theory of cellular pathology.

It should be noted that regarding the origin of many pathological processes, Rokitansky put forward a number of more substantiated provisions than Virchow in his theory of cellular pathology. Rokitansky wrote that "where anatomy has hitherto not been able to discover any organic changes ... explanations should be expected from future researchers in the field of diseases of the blood and nervous system ...". He believed that “the mere multiplication of lesions does not create a general disease. It is impossible to destroy the disease, eliminating only the focus of the lesion and not destroying the metabolic disorders that underlie local changes.

Rudolf Virchow (1821 - 1902) received his medical education in Berlin and began his scientific career under the direction of Johann Müller. Since 1843, Virchow worked as a prosector at the Berlin Charité Hospital. Virchow expressed his main views of that period in 1845 in his report "On the necessity and correctness of medicine based on a mechanistic point of view." Virchow united a group of young doctors, who began in 1847 to publish the journal Archive of Pathological Anatomy, Physiology and Clinical Medicine, which later became known as the Virchow Archive. During the social upsurge and revolution in Germany in 1848, young Virchow took part in public life. Even the very moderate scientific and socio-political views of the young Virchow in 1848 made him unreliable in the eyes of the ruling bourgeoisie and the Prussian government. This prompted Virchow to move from Berlin to the Department of Pathological Anatomy in the provincial Würzburg. In 1856 Virchow returned to Berlin as professor of pathological anatomy and therapy and director of the Institute of Pathology. Later, especially after 1870, frightened by the Paris Commune, Virchow acted in his social activities as an ardent supporter of the reactionary bourgeoisie.

In the Virchow method, new for the middle of the 19th century was the rejection of speculative reasoning in scientific research and the substantiation of conclusions and conclusions by objective data from the morphological study of cells, tissues and organs using microscopy. In the very first years of his scientific activity, Virchow spoke out against the humoral direction of Rokntansky, which was dominant at that time in pathology, and showed its inconsistency.

The application of microscopic examination and cellular studies to the study of pathological processes enabled Virchow to make numerous discoveries and generalizations: he discovered leukocytosis, studied the phenomena of embolism, thrombosis, phlebitis, described leukemia, established the tuberculous nature of lupus, discovered neuroglia cells, described trichinosis and a number of other pathological diseases. processes.

Along with numerous actual achievements, Virchow made an extensive generalization - he created a direction in medicine that entered the history of science under the name of cellular (cellular) pathology.

Virchow outlined the main provisions of his teaching, formulating them as follows: "For every living being, the cell is the last morphological element from which all life activity, both normal and pathological, comes." “Botanists and zoologists have become teachers of physiologists and pathologists. The eggs of animals and the germ cells corresponding to them in plants have bridged the gap between separately living cells and higher organs. "Every cell from a cell ... Abnormal activity of cells is the source of various diseases ... All pathology is the pathology of the cell ... The cell is the tangible substrate of pathological physiology, the cornerstone in the stronghold of scientific medicine." Each component of the animal organism, according to Virchow, has its own life. “The life of an organism is nothing but the sum of the lives of the individual cells that are connected in it. The place where pathological processes are played out is the cells themselves and the territories adjacent to them. It is clear from the above quotations that Virchow, having proclaimed the cell an elementary and autonomous life unit, overestimated its role. The organism did not appear to Virchow to be qualitatively different from its constituent cells, but was reduced to the sum of cells.

Virchow considered disease to be a purely local process, a local change in the cells of the body, underestimating the role of general processes. He did not understand the organism in its integrity and individuality, in its inseparable unity with the environment. For representatives of localistic, organoid, cellular pathology, there are no diseases that do not have local localization, and even the very formulation of the question of diseases common to the whole organism is absurd for them. Virchow wrote: “I affirm that no doctor can think correctly about a disease process if he is not able to point out to him places in the body ... Pathological phenomena ... everywhere lead us to the same cellular beginning, they everywhere contradict thought about the unity of the organism... It is necessary to discard the fabulous unity and keep in mind separate parts, cells as the cause of existence.”

Virchow approached problems mechanically and did not understand the qualitative distinctiveness of the organic in relation to the inorganic. In his opinion, organic processes, like inorganic ones, are controlled only by the laws of mechanics, physics and chemistry. Virchow wrote: “In vain they try to find the opposite between life and mechanism ... Electrical processes in the nerve take place in no other way than in a telegraph wire ... A living body produces its heat as a result of combustion, just as it happens in an oven: starch turns into plant and glycogen into sugar, just like in a factory.” Virchow had a negative attitude towards the evolutionary teachings of Darwin. The main defect of Virchow's pathology is that it ignores the principles of the development of the organism. Virchow believed that the ideas of Darwinism led to "dangerous" socialism, and fundamentally rejected the teachings of Darwin.

The fundamentally vicious doctrine of Virchow was exposed by the classics of Marxism. Engels wrote in the preface to Anti-Dühring in 1885: “If, as a result of the discovery of the cell, Virchow was compelled many years ago to decompose the unity of the animal individual into a federation of cellular states, this was more progressive than natural-unscientific and dialectical.

The application of cellular learning to pathology played a positive role in its time. Thanks to this, morphological changes in the body during various pathological processes were studied, which dealt a significant blow to many prescientific and speculative theories that prevailed until the middle of the 19th century (for example, studies about the sympathies and antipathies of organs, about crazes and dyscrasias). This contributed to the development of macro- and microscopic pathological anatomy and, at the same time, the development of clinical medicine (mainly diagnostics).

Virchow performed essential work for his time; in the field of describing the classification and terminology of the main pathological conditions. He was the first to identify a number of new nosological conditions (cloudy swelling of various organs, amyloidosis, leukemia, etc.). This analytical work, by its nature, filled in the gap that existed at that time in medicine and was progressive for its time. The theory of cell pathology put forward by Virchow was anti-scientific, anti-dialectical, anti-historical already at the time of its inception. Virchow’s theory had a great inhibitory effect on the development of theoretical and clinical medicine in second half of the 19th century For a number of decades, Virchow's authority was widely recognized. His many disciples and adherents continued to work in his spirit; at the same time, many in their one-sided passion went further than their teacher and looked for the essence of the disease exclusively in the cells. In foreign medical science, cellular pathology in the spirit of Virchow is still the main direction, since the methodological foundations of this direction are fully consistent with bourgeois ideology and are inextricably linked with it. Bourgeois science, called upon to defend the "inviolability" of the foundations of capitalism, also denies the doctrine of development. Therefore, bourgeois scientists defend the anti-evolutionary principles and provisions of Virchow's cellular pathology. The localistic direction created by Virchow led Western European medicine into a dead end, from which many Western European scientists still cannot get out: without considering the body in its entirety, in its inseparable connection through the nervous system with the external environment, medicine cannot develop.

The basically erroneous provisions of Virchow's cellular pathology met with sharp criticism from leading Russian scientists. Kazan anatomist E.F. Aristov already in 1859 clearly saw the fallacy of Virchow’s views, sharply criticized the main provisions of Virchow’s teaching, exposed his idealism and showed that Virchow’s idealistic concept of the “attractive power” of tissues disarms practitioners, deprives them of guidance for action for the treatment of diseases. E. F. Aristov did not agree with Virchow's views on the universal applicability of the localist principle and, using the example of scurvy, caustically ridiculed Virchow's theory of the "starting point" of each disease. E. F. Aristov noted the close dependence of the human body on the external environment and the mediation of the external in the internal. The young IM Sechenov sharply criticized Virchow's mistakes. In the theses of his doctoral thesis in 1860, he wrote: “Cell pathology, which is based on the physiological independence of the cell, or at least its hegemony over the environment, is false as a principle. The doctrine is nothing more than an extreme stage in the development of the anatomical direction in physiology. IP Pavlov pointed out that. “Pathological anatomy alone cannot give a complete analysis, a complete knowledge of the mechanism of the disease process. She's too rough for that." The studies of I. M. Sechenov and I. P. Pavlov approved the idea of ​​the body as a single, integral system and fundamentally rejected the foundations of Virchow's cellular pathology.

Among those who objected to Virchow, N. I. Pirogov should be mentioned. He criticized Virchow's "mechanical theory of pyemia" in "Principles of General Military Field Surgery". The incorrect position of Virchow's cellular pathology that the basis of any pathological process is local changes in cellular elements, caused sharp objections from the Russian pathologists M. M. Rudnev and N. P. Ivanovsky. KA Timiryazev spoke out against Virchow's assertions. The founders of Russian therapy, S. P. Botkin and A. A. Ostroumov: rejected Virchow's position on the leading role of local phenomena in the picture of the disease. Pathological anatomy in Russia developed in direct connection with the clinic. Regular autopsies of the corpses of those who died in hospitals, established in Russia as early as the first half of the 18th century, began earlier than in other countries. At Moscow University, St. Petersburg and Moscow Medical and Surgical Academies, pathological anatomy in the first half of the 19th century was taught by anatomists in the course of "normal anatomy" and by clinicians in courses of pathology and therapy. Advanced Russian doctors understood the importance of pathological anatomy for the clinic. Reading a special course in pathological anatomy was started by clinical professors (I. V. Buyalsky, I. E. Dyadkovsky, A. I. Over, N. I. Pirogov, etc.) even before the foundation of special departments By the middle of the 19th century, conditions were created in Russia for the allocation of a special department pathological anatomy In 1849, the first independent department of pathological anatomy in Russia was organized at Moscow University.

The first professor of pathological anatomy at Moscow University, A. I. Polunin (1820-1888), in his works emphasized the importance of the nervous system in the pathological processes occurring in the body. Criticizing the one-sidedness of both Rokitansky's humoral teachings and Virkhov's cellular pathology, A. I. Polunin wrote that both juices and solid parts are equally important for the body, and that changes occurring in some entail changes in others. Returning in 1845 after a trip to Western Europe, A. I. Polunin noted that at that time German clinicians did not pay enough attention to pathological anatomy. “Students do not have,” wrote A. I. Polunin, “the right to be present at the autopsy of all the dead in Charite. Most of the autopsies are done carelessly, superficially. In general, it is impossible not to reproach the Berlin clinical teachers for an inexcusable neglect of pathological anatomy.

In 1859, an independent department of pathological anatomy was organized at the St. Petersburg Medical and Surgical Academy. M. M. Rudnev (1837-1878) was a prominent representative of pathological anatomy in St. Petersburg. He made the microscope for the students of the academy the same everyday research tool that the sectional knife and the naked eye had previously served. M. M. Rudnev emphasized the importance of pathological anatomy for the clinic and the need to instill practical skills in students. He opposed the extremes of Virchow's teaching: "It is not true that the whole essence of morbid disorders was attributed to a change in cellular elements ... for diseases can consist in a change in both solid and liquid parts of the body." MM Rudnev attached a certain importance to the role of the nervous system in pathological processes. In his numerous scientific studies in various sections of pathological anatomy, M. M. Rudnev used the experimental method.

Soviet scientists have shown that the ideological and methodological foundations of Virchow's teachings are metaphysical, that they are in sharp contradiction with advanced biological science and medicine, with materialistic ideas about the development of the organic world, about the relationship between the organism and its environment. A huge amount of facts and data accumulated in medicine, especially in domestic medicine, clearly showed the scientific inconsistency of the doctrine of Virchow's cellular pathology, the impossibility of using it to explain the essence of pathological phenomena. The methodological viciousness of Virchow's pathology was noted even in the critical speeches of the founders of Marxism-Leninism, in particular F. Engels, as well as the classics of Russian medical science I. M. Sechenov and S. P. Botkin. Of great importance for the critical elucidation of the failure of the doctrine of cellular pathology were the studies of Soviet scientists.

The generalization of the accumulated critical data allows us to formulate the following main provisions. Supporters of Virchow's cellular pathology, leading the essence of pathological processes to morphological disorders of cells, directed the study of the disease of the body towards a narrow morphological description of local changes in cells, organs and tissues; separated morphology from physiology. Followers of cellular pathology fixed their attention mainly on the study of the results of pathological phenomena, and not on the very process of their development; therefore, one of the main methodological flaws in this direction was the fact that the river was also ignored. the principle of development and the historical method of studying diseases. The metaphysical nature of cellular pathology is also manifested in the fact that its followers considered changes in organs and cellular structure as a purely local process, as a result of which the study of pathological processes in the body system as a whole was ignored. This was due to the fact that the supporters of the Virchowian direction denied the unity and integrity of the organism.

In the doctrine of the etiology and pathogenesis of diseases, the followers of Virchow's cellular pathology stood on the positions of a simplified mechanical explanation of their essence, considering them as the result of a direct effect of external stimuli on the cells of the body. Such a simplified approach ruled out the possibility of revealing the patterns and mechanisms of the development of diseases as reactive disorders of the functional functions of the most important systems of the body as a whole. Virchow's cell pathology for a number of decades hampered many progressive aspects of the theoretical and clinical sections of medicine and, with its authority, supported reactionary trends and ideas in biology, pathology, and the clinic.

Theoretical provisions of organopathology led doctors to a passion for narrow specialization. There appeared many specialists in this organ or even in a particular disease who did not understand the life of the organism as a whole and the connections of the organism with the external environment. Another consequence of the extremes of organ pathology was the fascination with specific drugs. The interests of capitalist firms, which profit heavily from this hobby for specific drugs, contributed to the expansion of this branch of pharmacy to the detriment of the development of medicine, since entire generations of doctors were brought up in the spirit of blind worship of patented drugs, in the spirit of disregard for methods of general therapeutic influence and hygiene requirements that promote healing. and disease prevention. Virchow's teaching contributed to the oblivion of those hygienic foundations of therapy that were characteristic of outstanding doctors of the previous era.

In contrast to Virchow's cellular pathology, which directs the study of diseases towards a narrow "morphologism", leading figures in Russian medicine S. P. Botkin and I. P. Pavlov put forward to doctors and researchers the requirements of a deep physiological approach to the study of diseases and methods of their treatment. One of the most fruitful ideas of these great scientists was the idea of ​​nervism. Its essence boiled down to the fact that the laws and mechanisms of the development of diseases of the body are most intimately connected with functional and trophic disorders of the central nervous system.

The development of the physiological sciences in the second half of the 19th century. Application of experiment in medicine. The 19th century is characterized by a large number of major discoveries in biology, physiology and pathology based on experiments on animals. The rejection of the metaphysical view of nature, the departure from the recognition of the impenetrable line between man and animals, the development of a dialectical view of nature, the recognition of the relationship of man with animals, and especially the evolutionary doctrine, contributed to the fact that natural scientists and doctors began to use animal experiments more widely to understand the patterns of human life. organism. In the first half of the 19th century, many experiments on animals were carried out by F. Magendie, I. Muller, A. M. Filomafitsky, N. I. Pirogov. Especially widely the experiment in medicine began to be used in the second half of the 19th century. Experimentally, they tried to solve the problems of physiology, then they switched to studying the effects of drugs on animals, primarily of plant origin, then drugs obtained by chemical synthetic means. Then the experiment began to be applied to the study of pathological painful phenomena. At the end of the 19th century, animal experiments acquired exceptional significance in the development of microbiology. In the development of the experiment in medicine in the second half of the 19th century, a major role was played in France by C. Bernard, in Germany by K. Ludwig and G. Helmholtz, in Russia - I. M. Sechenov, I. P. Pavlov, N. E. Vvedensky and V. V. Pashutin.

Claude Bernard. In the middle of the 19th century, Claude Bernard set the task of creating an experimental medicine that would combine physiology, pathology, and therapy. Claude Bernard (1813-1873) began working in 1841 in Paris with the physiologist Magendie and later, in 1855, replaced him at the chair of experimental medicine in Paris. Claude Bernard conducted experimental studies in various areas of physiology: he studied the functions of the spinal cord, the influence of the nervous system on physiological and pathological phenomena, clarified the role of the secrets of the alimentary canal in the process of digestion (saliva, gastric, intestinal and pancreatic juice), established the glycogenic function of the liver, discovered vasomotor function of the sympathetic nervous system and showed its influence on the processes of blood and heat transfer. In his studies, Claude Bernard covered many departments of the physiology of that time, both general and normal, and pathological.

Extensive experimental experience gave Claude Bernard the opportunity to leave a major mark in a number of branches of physiology. The most famous works of Claude Beriar on the study of sugar metabolism and the body and liver function. Claude Bernard was the first to establish that the liver accumulates sugar brought with blood in its cells and converts it into glycogen. Previously, this function of the liver was unknown. In this way, Claude Bernard first discovered animal starch. He further pointed out that glycogen in the liver can also be formed from protein. Before Claude Bercart, it was believed that blood glucose comes directly from food substances. He was the first to prove that blood glucose is continuously formed in the liver. He began studying the mechanism of glycogen formation in the liver and its relationship to carbohydrate metabolism, in particular the role of the nervous system in this. The experience of Claude Bernard with damage to the bottom of the IV cerebral ventricle is widely known, causing a significant increase in the amount of sugar in the blood and its passage into the urine (“Bernard's sugar injection”) in an experimental animal. In the experiments of Bernard, for the first time, a connection was established between the formation of sugar and the intake and use of carbohydrates and other nutrients. Of great importance were the works of Bernard on the establishment of the function of the liver and its role in the process of assimilation of food. Bernard proved the difference in the content of sugar in the blood vessels coming to the liver and departing from it. Claude Bernard also conducted a lot of research on the effects of drugs and poisons, which contributed to the development of experimental pharmacology. He emphasized the importance of physiology for the clinic and argued that therapy should be based on knowledge of the mechanism of painful phenomena and the properties of drugs. He wrote: “Physiology is the basis of all scientific disciplines that wish to control the phenomena of life, in particular the basis of practical medicine”, “The clinic sets tasks, and physiology explains the phenomena that arise in a sick organism. Experimental medicine is not detached from the patient. She constantly comes back to him, each time in the best weapons. "The doctor-experimenter is the doctor of the future."

In the second half of the 19th century, many prominent representatives of medicine in Western Europe were characterized by the duality of their scientific creativity: while continuing to enrich the concrete content of science with new facts and methods of great importance in their research, they often stood in their philosophical and socio-political views on idealistic, reaction positions. In the worldview of Claude Bernard, these features, common to most bourgeois scientists in Western Europe, stand out vividly - limitedness and inconsistency. Claude Bernard began by recognizing the materiality of physiological and pathological processes. He wrote: "We are not those who accept functional impairments or changes in vital properties without material changes." But Bernard's materialism remained mechanistic. The motion of matter was considered by him as a simple movement of particles without qualitative changes. Starting his scientific path with the denial of the vital force, Claude Bernard later moved to the position of vitalism and agnosticism. He recognized that the entire complex of conditions underlying a harmoniously functioning organism is created and controlled by a higher metaphysical or teleological principle. He believed that the metaphysical principle is a kind of life force that does nothing by itself, since everything in the body is provided with physico-chemical conditions, that this life force regulated and brought these conditions into harmony, because all this could not have happened by chance. depend. “The only life force that we could admit would be something like a legislative force, but by no means an executive ... In order to summarize our thought, we could say metaphysically: the life force controls phenomena that it does not produce, but physical agents produce phenomena that they do not control.

Claude Bernard recognized the fundamental limits for human knowledge and wrote: “In no branch of science we can go beyond this limit, and it is a pure illusion to imagine that it is possible to cross this limit and capture the very essence of any phenomenon.” Claude Bernard represented the organism, like Virchow, as a simple sum of cells, and considered the principle of autonomy of anatomical elements to be the leading principle in physiology, but along with cells, he assigned a certain role in the life of the organism to the nervous system and physicochemical changes. Claude Bernard had a negative attitude towards the evolutionary teachings of Darwin and therefore could not apply the provisions of this teaching to the analysis of pathological phenomena. This merit belongs to our compatriot I. I. Mechnikov.

In many speeches, Claude Bernard fought against speculative systems, the remnants of which existed in medicine in the middle of the 19th century. Claude Bernard fought against the philosophical systems prevailing at that time and ended up rejecting philosophy in general. He argued that "experimental physiology has no need for any philosophical system." "The only philosophical system ... is not to have one." "As a physiologist we must refute the hypotheses of the vitalistic and the materialistic." "We will only be physiologists, and as such we can neither join the camp of the vitalists nor the camp of the materialists." According to Claude Bernard, he sought to rise above idealism and mechanistic materialism. “We disassociate ourselves from materialists, although all life processes are conditioned by physical and chemical processes. By themselves, these processes;:g and able to be arranged in groups and in the strict sequence in which it is observed in living beings. “We also dissociate ourselves from the vitalists, since the vital force cannot manifest itself as something independent, outside the general properties of nature. It is a mistake to admit real existence and to attribute material activity to something immaterial, which is nothing more than an invention of the mind. He also wrote: “Between the two extreme schools (materialism and vitalism) there is room for a third doctrine, for physical vitalism. The latter takes into account both that which is especially in life phenomena, and that which is common to everything under study. Phenomena are based on physics, while the regulation of Phenomena is vital.”

Engels in his "Dialectics of Nature" aptly characterized such statements: "Whatever pose the natural scientists take, philosophy rules over them. The only question is whether they want to be dominated by some bad fashionable philosophy, or whether they want to be guided by a form of theoretical thinking that is based on familiarity with the history of thinking and its achievements. Natural scientists imagine that they are freed from philosophy when they ignore or scold it. But since they cannot move a single step without thinking, logical categories are necessary for thinking, and they uncritically borrow these categories either from the ordinary general consciousness of so-called educated people, over whom the remnants of long-dead philosophical systems dominate, or from crumbs obligatory attendance at university courses in philosophy (which are not only fragmentary views, but also a hodgepodge of the views of people belonging to the most diverse and for the most part to the worst schools), or in an uncritical and unsystematic reading of all kinds of philosophical works, then in the end they still find themselves subordinate to philosophy, but, unfortunately, for the most part the worst, and those who most abuse philosophy are slaves of just the worst vulgarized remnants of the worst philosophical doctrines.

Similar phenomena of ideological hesitation, a departure from materialism towards idealism, agnosticism and vitalism, as in the case of C. Bernard, were noted by a number of other major physiologists of the second half of the 19th century - Dubois-Reymond and Helmholtz. The ideological departure of natural scientists from materialism towards idealism and agnosticism intensified sharply in the second half of the 19th century, especially after the defeat of the Paris Commune.

Helmholtz. The leading German naturalist, physician, physiologist and physicist Hermann Helmholtz (1821-1894) became famous for the fact that in 1847 he gave the first mathematical interpretation of the law of conservation and transformation of energy. Of great importance was the proof by Ielmholtz of the fact that the processes occurring in living organisms obey the law of conservation of energy. This was the strongest argument against the recognition of a special "life force" supposedly controlling living organisms. Many of Helmholtz's works were devoted to physiology. He studied the nervous and muscular systems, discovered and measured heat generation in the muscle, measured the speed of propagation of excitation in the nerves, determined the latent period of reflexes, the rhythm of impulses sent by the brain to the muscle. A number of Helmholtz's works were devoted to the physiology of vision and hearing. Helmholtz's conclusions turned out to be contradictory: experimental data led to materialism, and preconceived theoretical and philosophical provisions led to idealism. Then, when Elmholtz acted as an experimental natural scientist, he accurately described the facts, thereby confirming the conclusions of materialistic psychology and the materialistic theory of knowledge. Helmholtz was an elemental materialist. He strongly opposed vitalism and metaphysical speculation in physiology and medicine. However, his views were inconsistent. But in explaining psychological processes, he sank into subjectivism, refusing the objective method of natural science.

Helmholtz's philosophical position was analyzed in detail by V. I. Lenin in his book "Materialism and Empirio-Criticism" 1. Recognizing the objective reality of the external world, Helmholtz argued that concepts and ideas are formed as a result of the impact of objects of the external world on the human senses. At the same time, Helmholtz put forward a theory according to which a person's ideas about the outside world are a collection of conventional signs (symbols, hieroglyphs) that have nothing to do with objects of nature, the outside world.

These views were formed by Helmholtz under the influence of his teacher Müller, the founder of physiological idealism. Helmholtz slipped into a denial of objective truth and, ultimately, into subjective idealism, into agnosticism. “Helmholtz’s agnosticism,” wrote V.I. Lenin, “is also similar to “shameful materialism” with Kantian attacks, in contrast to Huxley’s Berkeleian attacks.” Following Kant, Helmholtz tried to draw a semblance of a fundamental line between "appearance" and "thing in itself." An extreme mechanist in natural science views, Helmholtz was alien to dialectics. Until the end of his life, he did not abandon attempts to limit the entire qualitative diversity of natural phenomena to the narrow framework of mechanistic ideas.

In the middle of the 19th century there was a group of so-called vulgar materialists (Vocht, Büchner, Moleschott), who considered physiological phenomena in a simplified way, only on the basis of physics and chemistry. “Blood moves in the arteries and veins in the same way that any other fluid could move in them, obeying the pressure of a pump,” Buechner wrote, “the heart is nothing but an unconsciously operating pump.” Engels showed that in this the vulgar materialists, "cheap peddlers of materialism," as he called them, did not stray far not only from the French materialists of the eighteenth century, but also from their predecessors who lived in the sixteenth century. A mechanical understanding of life phenomena and anti-dialectics are characteristic of vulgar materialists.

Vulgar materialism was especially sharply criticized by Engels in his work Ludwig Feuerbach and the End of Classical German Philosophy, and he reproached Buchner, Moleschott and Vocht not for their materialism, but for the fact that "they did not advance materialism, did not even think about developing further on the theory of materialism.”2 In Dialectics of Nature, Engels wrote: “Physiology is, of course, the physics and especially the chemistry of the living body, but at the same time it ceases to be specifically chemistry: on the one hand, its scope is limited, but, with On the other hand, at the same time it rises to some higher level.

Later, in 1917, the Russian physiologist N. E. Vvedensky wrote: “The initial physico-chemical scheme of life turned out to be too narrow: if strictly applied, it could turn out to be a Procrustean bed for physiology. With the further development of physiology, more and more facts were accumulated that spoke against a simple physico-chemical or mechanical interpretation of vital phenomena. Of course, the matter of living matter obeys the same laws that are established for dead matter, but it also presents such complications that physics and chemistry do not know about, but at least in their present state.

The idealistic views of Johann Müller and Claude Bernard and their numerous students and followers led to the limitations of the physiology of Western Europe in a number of its main provisions and for many years delayed the development of biology, physiology, experimental pathology, and clinical medicine. Physiologists of Western Europe believed that, regardless of the qualitative and quantitative characteristics of the acting external stimulus, the response of the tissue is constant both in its qualitative content and in magnitude. The all-or-nothing law is not just an empirical rule, but above all a methodological principle of bourgeois physiology. Logically, the “all or nothing” rule as a methodological principle follows from Müller’s “law of specific energy” and together with it determines the methodological positions of modern bourgeois physiologists, which prevented physiology from approaching evolutionary doctrine. Until recently, physiology, in contrast to morphology, proceeded in its development almost in complete isolation from the basic ideas of evolutionary doctrine. The separation of physiology from evolutionary doctrine was expressed in the fact that physiology was not used as one of the bases in the construction of evolutionary doctrine. The evolutionary doctrine substantiated the fact of evolution mainly “but the data of paleontology, comparative anatomy and embryology; the main provisions of evolutionary doctrine did not influence the development of physiology Against the general background of the development of the physiology of Western European scientists, the fundamental differences in Russian physiology, created by the works of I. M. Sechenov, I. P. Pavlov, and N. E. Vvedensky, come out especially sharply.

The development of physiology in Russia in the second half of the 19th century

In its development, materialistic domestic physiology was closely connected with the philosophical views of the revolutionary democrats, who, in their philosophical views, dialectics and materialism, as V. I. Lenin noted, came close to dialectical materialism and stopped short of historical materialism. Russian materialistic philosophy of the 19th century had a huge impact on the formation of a materialistic worldview and the direction of the work of the creators of Russian physiology. The formation of the worldview of I. M. Sechenov, I. P. Pavlov and N. E. Vvedensky was influenced by the philosophical works of A. I. Herzen, N. G. Chernyshevsky, N. A. Dobrolyubov and D. I. Pisarev. Such philosophical works of revolutionary democrats as "Letters on the Study of Nature" by A. I. Herzen and "The Anthropological Principle in Philosophy" by N. G. Chernyshevsky affected the direction of research by I. M. Sechenov, and later in the ideological design of the main physiological schools I. P. Pavlov, N. E. Vvedensky and A. A. Ukhtomsky.

Russian physiologists, and among them mainly I.M. Sechenov, did not act as epigones of Western European science, but, adopting the best traditions of the classical representatives of experimental physiology of the 40-60s in Europe, were able to critically assess the content of the science of their time, master and innovatively enrich the methods and the content of contemporary physiology and to lead domestic physiology along an independent path.

In 1860, the Kyiv professor of anatomy and physiology A.P. Walter in his journal "Modern Medicine" published an article entitled "What is Physiological Medicine?" S. P. Botkin, among progressive domestic scientists, an understanding of the need for a close connection between clinical medicine and experimental physiology took shape. “Knowledge of modern physiology should illuminate the path of the therapist, just as anatomy is the work of the surgeon,” wrote Walter. He recommended: “... For this, one must have a broad and solid physiological education, gleaned not only from reading manuals, but from one’s own observations and experiments, which one must be, if not always a producer, then at least a frequent witness.” In such an atmosphere, in the fall of 1860, I. M. Sechenov and S. P. Botkin began their teaching activities at the St. Petersburg Medical and Surgical Academy (I. M. Sechenov at the Department of Physiology, S. P. Botkin at the therapeutic clinic).

I. M. Sechenov (1829-1905). After graduating from the medical faculty of Moscow University, Ivan Mikhailovich Sechenov devoted himself to teaching and research in the field of physiology in St. Petersburg, Odessa, and Moscow. The persecution by the tsarist government of I. M. Sechenov for his progressive philosophical and social views repeatedly interrupted his activities and forced him to change jobs. I. M. Sechenov was closely associated with the advanced social trends of his time. His worldview was formed under the direct influence of the revolutionary liberation movement and the acute ideological and philosophical struggle that took place in Russia in the 40s-60s of the 19th century. Sechenov was a fighter of the revolutionary-democratic camp, a comrade-in-arms and a staunch follower of N. G. Chernyshevsky. IM Sechenov critically overcame German idealist philosophy and physiology.

The studies and writings of I. M. Sechenov were mainly devoted to three problems: the physiology of the nervous system, the chemistry of breathing, and the physiological foundations of mental activity. With his work, I. M. Sechenov laid the foundation for Russian physiology and created the materialistic school of Russian physiologists, which played an important role in the development of physiology, psychology and medicine not only in Russia, but throughout the world. K. A. Timiryazev and I. P. Pavlov called I. M. Sechenov “the pride of Russian thought” and “the father of Russian physiology.”

Unlike a number of spontaneous materialists, natural scientists, I. M. Sechenov was a conscious champion of materialistic philosophy. He actively preached materialism as the only scientific worldview compatible with natural science and defended it from attacks by representatives of philosophical idealism of all shades. With his materialistic views, I. M. Sechenov differed significantly from his foreign contemporaries - I. Muller, Claude Bernard, G. Helmholtz, E. Dubois-Reymond, who took the position of agnosticism and idealism.

Already in his early work, his dissertation in 1860, along with conclusions of a special nature arising from the experimental part of the work, I. M. Sechenov put forward a number of philosophical provisions: on the material unity of the world, on the unity of forces acting in organic and inorganic nature, on the unity of the organism and the conditions of existence, the possibility of using objective methods of the natural sciences, in particular physiology, to reveal the secret of consciousness. These dissertation theses showed I. M. Sechenov as a consistent materialist, a worthy student of N. G. Chernyshevsky. In them, I. M. Sechenov outlined a program for further work in the field of physiology of the nervous system. In subsequent works, Sechenov repeatedly dwelled on these provisions and developed them. I. M. Sechenov wrote: “The basis of all our reasoning is the immutable conviction inherent in every person in the existence of the external world, immutable to the same or even much greater extent than everyone’s confidence that tomorrow, after tonight, there will be a day” .

Of great importance for the natural science substantiation of the materialist theory of knowledge was the discovery by I. M. Sechenov of the reflective, reflex nature of the higher nervous (mental) activity of animals and humans. I. M. Sechenov carried out physiological experiments related to the analysis of the activity of the brain, and thus overcame the doubts that existed before him about the possibility of experimentally studying the activity of the brain and its products - the phenomena of consciousness, feelings and will. These experiments interested him because they were directly related to the phenomena of consciousness and will, which even the most prominent physiologists of the world did not dare to touch before I. M. Sechenov. Before I.M. Sechenov’s research, science did not have knowledge of the processes that take place in the brain and are the basis of mental activity. I. M. Sechenov for the first time in the history of physiological science began to consider the activity of the human brain as a reflex, while before him only those types of vital activity of the body that were associated with the spinal cord were considered reflex.

N. G. Chernyshevsky got acquainted with the physiological scientific work of I. M. Sechenov on inhibition, on the inhibitory centers and suggested that, on the basis of these studies, he write a popular science article intended for the general readership for placement in the journal edited by N. G. Chernyshevsky " Contemporary". I. M. Sechenov wrote this article and gave it the title "An attempt to reduce the methods of origin of mental phenomena to physiological foundations." By the time the article ended, Chernyshevsky had already been arrested, and the second editor of Sovremenik, N. A. Nekrasov, expressed his fear that the censors would not let the article with such an obviously materialistic title pass. The article went to censorship with a changed title "An Attempt to Introduce Physiological Foundations into Mental Processes." The censor understood well the main content and direction of the work of I. M. Sechenov, forbade the publication of this article in such a widespread and very popular journal as Sovremennik, and allowed it to be printed in a medical journal, provided that “the title of the article was changed, pointing too clearly to the final conclusions that follow from it. The article by I. M. Sechenov, under the dry academic title "Reflexes of the Brain"2, which did little to reveal the main goals of the author, was published in the small journal "Medical Bulletin", which had a limited, purely medical readership. Despite this, she gained wide popularity.

I. M. Sechenov empirically found out the natural causes, physiological mechanisms, due to which the human will is able to both cause and suppress, restrain (depress) involuntary urges to Movements (for example, the urge to cough, to movements caused by pain, etc. .). I. M. Sechenov established that in the brain of animals and humans there are special nervous mechanisms that have an inhibitory effect on involuntary movements. I. M. Sechenov called these mechanisms “delay centers”. The physiological center discovered by him, located in the middle parts of the brain.

With his research, I. M. Sechenov solved the most difficult problem of natural science. The brain, which in its highest formation, the human brain, created and creates natural science (IP Pavlov), itself became the object of this natural science. This was a remarkable blow to the idealistic doctrine of the psyche. I. M. Sechenov turned out to be immeasurably superior to the vulgar materialists of his day, who tried to reduce mental processes entirely to physical and chemical laws. The discoveries of I. M. Sechenov irrefutably proved that mental activity, like bodily activity, is subject to quite definite objective laws, is due to natural material causes, and is not a manifestation of some special “soul” independent of the body and environmental conditions. Thus, an end was put to the religious-idealistic separation of the mental from the physical and the foundations were laid for a scientific materialistic understanding of the spiritual life of man. I. M. Sechenov proved that the first reason for any human action, deed, is rooted not in the inner world of a person, but outside it, in the specific conditions of his life and activity, and that no thought is possible without external sensory stimulation. With this, I. M. Sechenov opposed the idealistic theory of “free will”, characteristic of the reactionary worldview.

I. M. Sechenov studied the organism in unity with the conditions of its existence. He argued: “Always and everywhere life is made up of the cooperation of two factors - a certain, but changing organization, and external influences” because without the latter the existence of an organism is impossible.

I. M. Sechenov showed experimentally for the first time that mental activity can and should be studied in the same scientific, strictly objective ways as the bodily activity of animals and humans is studied, without any reference to non-material, supernatural causes. This, according to I. P. Pavlov, "is entirely our Russian undeniable merit in world science, in the general human thought."

Proceeding from the materialistic position that “the brain is an organ of the soul, i.e. such a mechanism that, being set in motion by whatever reasons, gives in the final result that series of external phenomena that characterize mental activity ... all that infinite the variety of movements and sounds that a person in general is capable of” 3, I.M. Sechenov was the first in the history of science to set himself the task of developing and explaining the laws of external manifestations of mental activity. He showed that all acts and phenomena of the conscious and unconscious mental life of a person are controlled by certain physiological mechanisms and, according to the method of origin, are reflexes that begin with the excitation of the sense organs by objects of the external world, continue with a certain mental act and end with a muscular movement. “The objective world has existed and will exist, in relation to each person, before his thought.

In the last years of his life, I. M. Sechenov studied the regularity of physiological processes associated with the labor activity of people. In the difficult historical conditions of the tsarist regime, I. M. Sechenov substantiated the demands of workers in their struggle for an hourly working day.

I. M. Sechenov especially emphasized that the content of mental activity, the mental outlook and the level of cultural development of a person are determined not by his individual or racial characteristics, but primarily by the influence of the conditions of life and activity of the person by his upbringing. I. M. Sechenov exposed the scientific inconsistency: misanthropic racist theories about the supposedly natural division of people into “higher” and “lower” races. I. M. Sechenov devoted many pages in "Resess of the Brain" to the upbringing and development of children's children and solved these issues in accordance with his main task. that the environment is a determining factor in human development. He ended this section with a sharp rebuke to the racists that resounds today: “In the immeasurable majority of cases, the character of the mental content is 999/1000 given by education in the broad sense of the / and only 1/1000 depends on the individual. By this I do not want to say, after all, that one can make a fool out of a smart one: it would be all the same to give a person born without an auditory nerve.

Describing the "Reflexes of the brain", I. P. Pavlov wrote that the creation by I. M. Sechenov of the doctrine of the reflexes of the brain is opposed by the ingenious wave of Russian scientific thought. The extension of the concept of a reflex to the activity of the higher part of the nervous system is the proclamation and implementation of the great principle of causality in it, the limit of the manifestations of living nature. I. P. Pavlov considered I. M. Chenov his teacher and ideological inspirer. Outlining the history of the formation of his physiological teaching and emphasizing the close connection between his teaching on conditioned reflexes and I. M. Sechenov’s teachings on the reflex nature of the activity of the brain, I. P. Pavlov wrote: realized then, there was a long-standing influence, even in his youth, of the talented pamphlet of Ivan Mikhailovich Sechenov, the father of Russian physiology, entitled “Reflexes of the Brain” (1863) ... This pamphlet made - and outwardly brilliant - a truly extraordinary attempt for that time (of course, theoretical in the form of a physiological scheme) imagine our subjective world purely physiologically.

The ideas of I. M. Sechenov determined the materialistic direction of domestic medicine in the second half of the 19th century. They attracted the attention of leading Russian doctors to the study of the role of the external environment for the body and the role of the nervous system in the appearance and development of pathological processes in the body. The doctrine of the reflex as the main anatomical and physiological mechanism of all activities of the animal organism was the scientific substantiation of the neurogenic pathogenesis of diseases.

The life of I. M. Sechenov and his students was spent in struggle. In 1866, Sechenov re-published "Reflexes of the Brain" as a separate book, but it was arrested. The government did not dare to go to an open trial, fearing that this would attract even more attention to the work of I. M. Sechenov, and he was repeatedly persecuted for his materialistic views.

The work of I. M. Sechenov "Reflexes of the brain" made a huge impression both in Russia and abroad. It aroused the ardent approval of progressive scientists and the furious anger of the reactionaries. Participating in extensive controversy, progressive scientists and doctors followed I. M. Sechenov and supported his positions.

I. M. Sechenov was opposed by idealist philosophers and psychologists. In his pamphlet directed against I.M. Sechenov, Archimandrite Boris wrote that all evil is not in physiology itself, which allegedly cannot harm religion with its facts, but in materialism, which uses these facts. Moscow Metropolitan Filaret, speaking about the attitude to natural science, understood perfectly well that to deny the need for the development of natural sciences in the second half of the 19th century would be too obvious obscurantism, moreover, at odds with the interests of Russian industrialists. Filaret demanded “only” that natural scientists should not deviate from narrow practicality, “seek anthracite”, “work for industry”, but not engage in “cosmogony”, “questions of the universe” and philosophy. In other words, the priesthood put forward its own program of "union" of fideism and natural science. About such a program, V. I. Lenin wrote: “We will give you science, gentlemen. naturalists, give us epistemology, philosophy—such is the condition for the cohabitation of theologians and professors in the advanced "capitalist countries."

The struggle of I. M. Sechenov for materialism captured physiologists as well. After the forced departure from the department of the St. Petersburg Medical and Surgical Academy, Sechenov's place was taken by the physiologist Zion. Zion was known for his work in the field of regulation of the functions of the cardiovascular system, he discovered the depressor nerve (Zion's nerve), was a virtuoso in the field of experimental surgical technique, and the author of an atlas on the technique of physiological experiment. Being an ardent reactionary, I.F. Zion, having entered the department after I.M. Sechenov (1872), decided to take up the eradication of nihilism and in his lectures discredited I.M. Sechenov, especially in relation to materialistic ideas, and spoke out against Darwinism. Zion wrote: “Only semi-consciously one can (enjoy in the theory of Ch. Darwin the very little flattering relationship of man with a monkey, which is proved by it.” The protests of the students forced Zion to stop teaching and go abroad. All experimental physiological work of I. M. Sechenov was permeated with struggle with idealism and vitalism in science, the struggle for a new materialistic worldview.Vsduschie direction of Russian physiological thought more and more z, strengthened on the positions of materialism.

Despite the unfavorable living and working conditions, constant persecution by government officials and frequent travels, I. M. Sechenov had many students and followers in various areas of scientific activity: in the field of studying the nervous system, its structure and function, the physiology of the peripheral nervous about the system (N. E. Vvedensky), questions of metabolism (V. V. Pashutin, M. N. Shternikov), the study of brain physiology (I. P. Pavlov). The influence of I. M. Sechenov was not limited only to the field of physiology: his ideas affected the activities of morphologists in the study of the structure of the nervous system and clinicians in the application of reflex theory to the analysis of pathological phenomena.

N. E. Vvedensky. Sechenov's student Nikolai Evgenievich Vvedesky (1856-1922) studied the basic life processes: excitation, inhibition and contraction. His research chronologically decays< на три этапа: изучения физиологии периферического нерва (1884—1901 изучения патологии периферического нерва (1901—1905) и опыты на ц лом животном (1905—1920). Н. Е. Введенский в 1883—1884 гг. прим нил телефоническое выслушивание возбужденного нерва. Развивая уч ние И. М. Сеченова о значении торможения в процессах, протекающ! в нервной системе, Н. Е. Введенский своими исследованиями показал, ч: возбуждение и торможение в периферическом нерве не два различнь процесса, как утверждал тогда видный английский физиолог Фервор а две фазы одного и того же процесса. Торможение в своем возникнов нии связано с возбуждением, является особой формой возбуждения и з висит от функционального состояния возбудимой ткани и частоты де ствующих в данный момент раздражителей. Далее Н. Е. Введенский и у чал изменение проводимости нерва при воздействии на него наркоз высокой температуры, сильного постоянного и перерываемого тока, мех нического сдавливания, анемии и ряда других раздражений. Н. Е. Введе ский создал учение о парабиозе, особом состоянии протоплазмы нервш ткани, находящейся на обратимой грани необратимых в дальнейнн изменений, что привело его к принципиально новому пониманию пр цесса торможения. В своих исследованиях на целом животном Н. Е. Вв Денский пришел к выводам, подтверждающим закономерности в рабо головного мозга, другими методами открытые И. П. Павловым.

V. V. Pashutin. Another student of I. M. Sechenov, Viktor Vasilyevich Pashutin (1845-1901), widely applied the physiological experiment to the study of pathological phenomena and for the first time singled out general pathology as an independent subject of study and teaching in higher medical school. In his scientific activity, V. V. Pashutin was a staunch successor to the direction of I. M. Sechenov’s work, which concerned the problems of metabolism, thereby substantially completing the understanding of these aspects of physiology and pathology. V. V. Pashutin experimentally investigated metabolism during starvation, gave a classical development of the doctrine of starvation, studied scurvy, suggested the existence of vitamins, developed methods for studying gas exchange and calorimetry, studied carbohydrate metabolism, pathological glycogen deposits in tissues, and carbohydrate degeneration. While teaching at Kazan University, then at the St. Petersburg Military Medical Academy, V. V. Pashutin brought into a coherent system numerous, scattered data of physiology, pathological anatomy and clinic, created a new independent discipline - general pathology, managed to achieve its separation into an independent department from course of diagnostics and general therapy, published a textbook and created a school of students. The general pathology created by V. V. Pashutin was a huge progressive step in Russian medicine in the sense of overcoming the morphological direction in pathology. IP Pavlov noted this leading role of domestic pathologists, who separated general pathology (pathological physiology) from pathological anatomy. "It must be remembered that we have the honor of being one of the first to separate and with great success an independent department of pathological physiology from the department of pathological anatomy."

Chronic experiment in physiology. The dominant direction of foreign physiology in the 19th century did not know the methods of studying the whole organism in its inseparable interaction with the environment. IP Pavlov developed a method for studying particular physiological functions on a whole organism under natural conditions of interaction with the environment.

In 1893, I. P. Pavlov wrote: “Acute experiment, with certain precautions, can most often be conveniently used for the purposes of physiological analysis, that is, to understand in general the functions of a given part of the organism and its conditions. But when, how and to what extent the activities of individual parts are linked during the normal course of a living machine, which constitutes the content of physiological synthesis, it is often difficult or completely impossible to deduce from the data of acute experience, since its setting (anesthesia, curarization and all kinds of operations) is inevitably connected with a known disruption of the normal course of affairs in the organism... Thus, in order to obtain impeccable analytical data in many cases, and synthetic data, it is almost always necessary to proceed from an organism that is possibly normal at the given moment. And this is achievable if, by preliminary operations, the animal is made fit for certain observations and experiments.

In the works of I. P. Pavlov and the school of physiologists he created, the methodology of physiological experiment moved to a new, higher level. In connection with the new guidelines on the need to take into account the whole organism, IP Pavlov developed new methods that make it possible to conduct an experiment on a healthy animal that has completely recovered from surgical intervention.

In contrast to the agnosticism of Claude Bernard, Dubois-Reymond, Helmholtz and other representatives of Western European physiology, advanced domestic physiologists I. M. Sechenov, I. P. Pavlov, N. E. Vvedensky and others believed that there were no boundaries for human knowledge . In response to Dubois-Reymond's assertion that no significant gain will ever be made by natural science, both in the understanding of force and matter, and in the understanding of spiritual activity from material conditions, I. P. Pavlov in his famous report "Natural Science and the Brain" in 1909 G. with faith in the power of science objected: “Here and now I only defend and affirm the absolute, indisputable right of natural scientific thought to penetrate everywhere and for as long as it can manifest its power. And who knows where that opportunity ends.”

Influence of I. M. Sechenov on morphologists

The influence of the ideas of the revolutionary democrats and the teachings of I. M. Sechenov is clearly noticeable in the activities of domestic morphologists in the second half of the 19th century. Anatomists, histologists, physiologists and clinicians paid great attention to the study of the structure of the nervous system. N. M. Yakubovich published "Microscopic study of the beginnings of nerves in the large brain", which received wide recognition and was awarded the prize of the Paris Academy of Sciences. VF Ovsyannikov in his work "On the tectonic and reflex centers of the vascular nerves" in 1871 proved the presence in the medulla oblongata of the rabbit of vasomotor centers that regulate blood pressure. In 1875, V. Ya. Danilevsky established the presence in the frontal lobe of the cerebral cortex of a center related to the activity of the heart, and thus for the first time showed the existence in the cerebral cortex of special centers related to the regulation of internal organs and autonomic processes.

A. S. Dogel did a lot of research on the histology of the nervous system and sensory organs and proposed a technique for intravital staining of nerve elements. In 1897, A. S. Dogel reported on his discovery of sensory nerve endings in the heart and blood vessels of mammals. I.-P. Pavlov noted the importance of this discovery. According to him, what physiologists only imagined became visible after Dogel's work: the results of histological studies perfectly coincided with the data of physiology, the discovery of sensory nerves in the heart explained the existence of cardiac reflexes. In these studies, morphological confirmation of the idea of ​​I. M. Sechenov about the reflex mechanism of cardiovascular activity was received. These studies were continued in Russia by N. A. Mislavsky, M. D. Lavdovsky, K. A. Arnshtein, and in other countries by V. Gis, S. Tavara, and L. Ashoff. N. A. Mislavsky in 1886-1890 together with V. M. Bekhterev showed that in the diencephalon there are centers that control the activity of the heart, blood vessels, gastrointestinal tract and bladder, discovered the nervous regulation of the endocrine glands. P. V. Rudanovsky was the first to use frozen tissue sections in the histological study of the nervous system. His works, in particular "On the structure of the roots of the spinal nerves, the spinal and medulla oblongata of man and some higher animals" (1871-1876), received world fame. For them, PV Rudanovsky was elected a corresponding member of the Paris Academy of Sciences. The development of microbiology and its impact on the development of medicine. Microbes have been known since Leeuwenhoek's observations at the end of the 17th century. They were considered lower plants. By the middle of the 19th century, many microorganisms found in humans, animals, and plants had been described, but the role of microbes remained unclear. Pasteur, with his research in the middle of the 19th century, showed that microbes play an essential role in the life of nature: they are beneficial, important in industry and agriculture, but along with this, microbes cause harm, causing diseases in humans and animals. After Pasteur and at the same time with him, many researchers of various specialties took up the study of the role of microbes. Pasteur in his laboratory. Painting by Edelfeld.

The great French scientist Louis Pasteur (1822-1895) was a chemist by training. His first scientific work was devoted to the study of tartaric acids, and he discovered their molecular dissymmetry and the associated difference in optical properties. The developing industry and agriculture of France posed practical questions for scientists. Influenced by the demands of life (winemaking and brewing), Pasteur began to study the phenomena of fermentation. According to the views of scientists of that time, fermentation was considered a purely chemical process. Thinking about the "diseases" of wine and beer, irregularities in fermentation processes, Pasteur in 1857 established the dependence of fermentation processes on specific microbes. He refuted Liebig's opinion that the decomposition of a fermenting liquid occurs under the influence of the decomposition of easily decaying organoleptic bodies. The study of butyric and acetic fermentation led Pasteur to the discovery of the presence of aerobic and anaerobic bacteria. Subsequently, Pasteur carried out a number of studies at the request of various sectors of the economy: in 1865, Pasteur was asked to study diseases of silkworms, in 1877, anthrax in sheep and cholera in chickens. With these studies, Pasteur established the "microbial nature of infectious diseases. In experiments with anthrax and chicken cholera, he found that the influence of the external environment (temperature, t" drying) changes the virulence of microbes. Pasteur's further research on anthrax led in 1881 to preventive vaccination against anthrax. Our domestic scientists I. I. Mechnikov and N. F. Gamaleya took part in these works of Pasteur. In 1885, Pasteur developed a method of inoculation against rabies, which especially glorified his name. In the same year, for the first time, according to the Pasteur method, a boy bitten by a rabid dog was vaccinated, and the child did not get rabies. These experiments of Pasteur aroused special interest in Russia. The first post-Paris vaccination station for rabies was founded in Odessa in 1885 on the initiative of II Mechnikov. In the same year, anti-rabies laboratories were opened in Russia in St. Petersburg (A. N. Kruglevsky and X. I. Gelman), Moscow, Warsaw (O. Buivid) and Samara.

The development of microbiology was greatly facilitated by the German physician Robert Koch (1843-1910), who devoted most of his life to the study of infectious diseases. Koch made extensive use of animal experiments, solid nutrient media for microbiological purposes, the microscope immersion system, and began to stain microbes with aniline dyes. These methods significantly expanded microbiological techniques and allowed Koch, his students and followers to make a number of major discoveries in a short time. In 1876, Koch began studying the etiology of anthrax, then moved on to the establishment of pathogenic microbes that cause wound infections, in 1882 he discovered the causative agent of tuberculosis, and in 1883, Vibrio cholerae. In addition to these important private discoveries, Koch established the general principles known as the Koch triad: 1) finding the microbe in all cases of disease, 2) obtaining a pure culture of the microbe, 3) reproducing the disease by inoculating the culture on an animal. A major merit of Koch is the development of the fundamentals of microbiological technology, which allowed this science to take a huge step forward.

Koch and many of his students overestimated the role of microorganisms in the infectious process. Recognizing that the presence of a pathogenic microbe necessarily causes a disease in an animal or a person, Koch believed that only the microbe, the place of its penetration into the human body, its quantity and virulence determine the occurrence and further development, course and outcome of the infectious process. The etiological doctrine associated with the names of Koch, Flügge and their numerous students, essentially put an equal sign between the pathogen - "Microbe and disease. At the same time, the significance of the reaction of the macroorganism and its main role in the infectious process was ignored. In 1890, Koch allegedly found by him a remedy for treating tuberculosis with the help of tuberculin, a toxin extracted from tuberculosis bacteria, but this remedy did not justify itself and was quickly abandoned, significantly reducing Koch's prestige in the scientific world.

Koch metaphysically considered the "basic laws of microbiology" (Koch's triad) formulated by him as immutable. For a long time he did not recognize the opportunity discovered by L. Pasteur to weaken virulent cultures of microbes, which makes it possible to prepare vaccines from them.

He also opposed the theory of phagocytosis by I. I. Mechnikov. The German government sent Koch to study the diseases of hot countries in Africa. Koch looked at the world idealistically and metaphysically. He was a follower of the philosophy of the idealist Mach. Having discovered tuberculosis bacteria, he reduced the understanding of the causes of the disease to simple contact and did not take into account the social causes of the disease. Koch also denied the possibility of contracting tuberculosis from animals.

After the work of Pasteur and Koch, microbiology has been widely developed in many countries. From the late 1970s to the early 1990s, scientists discovered the causative agents of many infectious diseases.

At the end of the 19th century, the beginning of virology was laid: in 1892, D.I. Ivanovsky discovered filterable viruses.

The establishment of the pathogenic role of microbes and the numerous private discoveries of pathogens have significantly changed many aspects of the clinical branches of medicine, raising questions of recognition, prevention, and treatment of many diseases in a new way.

Numerous discoveries and successes in microbiology at the end of the 19th century (this time was called the “bacteriological era” in the history of medicine) gave rise to an exaggerated assessment of the role of microbiology, when it seemed to many that along the path of establishing microbial pathogens and measures to combat them, all would be successfully resolved. medical problems. Advances in microbiology and knowledge enriched by them in the field of epidemiology formed the basis for organizing practical measures to combat infectious and epidemic diseases.

The role of domestic scientists in the development of microbiology and epidemiology. In the development of microbiology in the second half of the 19th century and the beginning of the 20th century, domestic scientists played a major role: the botanist L. S. Tsenkovsky, the zoologist and pathologist I. I. Mechnikov, S. N. Vinogradsky, the doctors G. N. Minkh, O. O Mochutkovsky, G. N. Gabrichevsky, N. F. Gamaleya, D. K. Zabolotny, V. L. Omelyansky and others. and posed common broad problems that go beyond microbiology and epidemiology and are deeply related to general medical, biological and philosophical problems (problems of general microbiology, the essence of infection and immunity, the variability of microbes, their nature, problems of bacteriophage, chemotherapy, etc.).

L. S. Tsenkovsky, being a professor of botany, specialized in bacteriology in the 80s, since he foresaw, understood and appreciated the practical significance of this new, just emerging branch of knowledge earlier than others. Tsenkovsky was in a hurry to apply theoretical information on bacteriology and practical needs in sugar beet production, in the fight against agricultural pests and in the fight against anthrax in farm animals. In 1882, L. S. Tsenkovsky was sent to Paris to Pasteur to study methods for making anthrax vaccine. Since Pasteur sold the right to manufacture a vaccine to a private company, he refused L. S. Tsenkovekom. In the same year, L. S. Tsenkovsky produced his own live attenuated vaccine, which turned out to be no less effective than the Pasteur vaccine. With his work on anthrax, L. S. Tsenkovsky resolved the essential issue of veterinary medicine and at the same time contributed to the resolution of the general issue of the pathology of infections, which is important for medicine.

G. N. Minkh and O. O. Mochutkovsky in 1874-1876 established the role of blood-sucking insects in the transmission of typhus and relapsing fever, 30 years ahead of the French scientist Nicolas, who in 1908 confirmed the role of lice in the spread of typhus, in 1913, relapsing fever. On April 25, 1874, G. N. Minkh injected himself with the blood of a typhoid patient, fell ill with relapsing fever, refused to undergo treatment, believing that the disease should be investigated in its normal course, and almost died during the third attack. At the same time, he discovered “Spirilla” in his blood and proved the contagiousness of blood. O. O. Mochutkovsky proved that "there is no relapsing fever without spirochetes, no spirochetes without relapsing fever." For the purposes of the experiment, on March 10, 1876, Mochutkovsky inoculated himself with the blood of a patient with typhus and after 18 days became seriously ill. After recovery, O. O. Mochutkovsky had chronic myocarditis and memory impairment. O. O. Mochutkovsky also repeated on himself the experience of Minch - inoculation of relapsing fever.

I. I. Mechnikov. The most striking figure in Russian microbiology at the end of the 19th century, a man who stood on a par with Pasteur and Koch, was Ilya Ilyich Mechnikov (1845-1916). The enormous importance of I. I. Mechnikov in the development of microbiology and epidemiology, in the creation of immunology is largely due to the fact that his research in these areas was a continuation and development of his capital work in the field of pathology, which had a broad general biological basis.

II Mechnikov was an outstanding scientist in a number of fields of knowledge - zoology, embryology, pathology and immunology, one of the founders of modern microbiology, the founder of comparative evolutionary pathology.

The activity of I. I. Mechnikov falls into two periods. In the first period (1862-1882), I. I. Mechnikov, a zoologist and primarily an embryologist, solved a number of complex problems of embryology. He showed the existence of germ layers - the laws of development of the animal organism common to all animals. He established a genetic link between the development of invertebrates and cavitary animals. The scientific atmosphere in which I. I. Mechnikov was brought up was Darwinism, the doctrine of the gradual complication of life, of the origin of its higher forms from the lower, of the genetic connection between them. The embryological data established by I. I. Mechnikov served as one of the essential pillars of evolutionary doctrine. I. I. Mechnikov creatively developed the teachings of Darwin and, together with A. O. Kovalevsky, was one of the founders of comparative evolutionary embryology. Being an active follower of Darwin, I. I. Mechnikov criticized him for his uncritical transfer to biology of the teachings of Malthus on the role of "overpopulation" as a factor in evolution. The significance of Mechnikov's work on motional embryology is enormous. It can be said without exaggeration that II Mechnikov was one of the builders of evolutionary theory and one of the founders of invertebrate embryology.

Research on the origin of multicellular animals led II Mechnikov to the discovery of intracellular digestion. He showed that in the body of an animal equipped with digestive organs, there are cells capable of digesting food, but not taking a direct part in digestion. Works on intracellular digestion ended the first period of scientific activity of I. I. Mechnikov.

From the teachings of I. I. Mechnikov on intracellular digestion, the phagocytic doctrine, the doctrine of immunity, a new look at inflammation, the doctrine of atrophy and senile degeneration, which formed the main content of the second period of his research activity (from 1883 to 1916), were developed. During this period, I. I. Mechnikov should be characterized as a pathologist.

The idea of ​​intracellular digestion, put in. connection with the teachings of Darwin on evolution, was leading in the works of I. I. Mechnikov on the problems of pathology in the second period of his activity. I. I. Mechnikov laid the foundation for these works in 1883 at the congress of natural scientists and doctors in the speech “On the healing powers of the body”, where he put forward the position on the active role of the body in the infectious process, on the relationship of the macro- and microorganism, as opposed to the one-sided etiological principle of Koch . This speech was the first stage in the development of the theory of phagocytosis. In a particular phenomenon, like the death of daphnia fungi devoured by cells, in the larva of a starfish, the evolutionary biologist I. I. Mechnikov saw something that no one had seen before him, and in this he was helped by the well-mastered method of comparative pathology and embryology. In the future, I. I. Mechnikov developed his ideas in many ways and confirmed them by numerous studies on a variety of factual material. In 1892, I. I. Mechnikov published Lectures on the Comparative Pathology of Inflammation, where he wrote: “A real comparative pathology should embrace the entire animal world as a whole and study it from the most general biological point of view.” Developing the doctrine of phagocytosis and speaking on its basis with criticism of the theories of inflammation prevailing at that time, Conheim and Virchow, I. I. Mechnikov created a new theory of inflammation. According to I. I. Mechnikov, inflammation is an active defensive reaction of the body against the painful principle that penetrates into it, developed by representatives of the animal world in the process of their historical development. I. I. Mechnikov wrote: “Inflammation as a whole should be considered as a phagocytic reaction of the body against irritating agents; this reaction is carried out either by mobile phagocytes alone, or with the action of vascular phagocytes or the nervous system.

In 1900, in the book "Immunity in Infectious Diseases", I. I. Mechnikov summed up his research. Based on the phagocytic theory and the theory of inflammation, he developed the doctrine of immunity to infectious diseases, the doctrine of immunity. "By immunity against contagious diseases one should understand the body's resistance against the microbes that cause them." II Mechnikov saw the essence of immunity in the phagocytic reaction of the organism. He was the founder of a new science - immunology.

The significance of the reaction of a human or animal macroorganism in the infectious process was first shown by I.I. Mechnikov, who, in contrast to the metaphysical etiological interpretation, developed a view of infectious diseases as a process of interaction between macro- and microorganism. I. I. Mechnikov showed that the mechanism of the onset and development of an infectious disease depends not only on the microorganism, but along with the microorganism at all stages of the infectious process - during its occurrence, development, course and outcome - an important role is played by the macroorganism, which does not remain indifferent. Infection is a struggle between two organisms. An infectious disease is a complex process of interaction between a pathogenic microbe and a macroorganism, the emergence and development of the process is greatly influenced by the external environment. II Mechnikov pointed to the participation of the nervous system in the protective functions of higher organisms.

The ideas of I. I. Mechnikov were hostilely met by supporters of the etiological principle, and for a number of years he had to defend his teaching against the attacks of Koch, Flügge, etc. The phagocytic theory of I. I. Mechnikov met with sharp criticism from a number of pathologists and microbiologists. He defended his theory with exceptional consistency, passion and perseverance for 25 years and proved the inconsistency of the arguments of his opponents, led by Koch, who took into account only the role of the microorganism in the infectious process. Subsequently, the theory of I. I. Mechnikov received universal recognition, and in 1908 I. I. Mechnikov was awarded the Nobel Prize. The discovery by I. I. Mechnikov of a single phagocytic system of the body, which later became known as the reticuloendothelial system, the facts obtained by I. I. Mechnikov were further developed in the works of L. Ashof (1913), N. N. Anichkov (1914-1922 ), A. Carrel (1922-1924), Fischer (1930), and others. The doctrine of immunity, created by I. I. Mechnikov, has not yet lost its significance.

II Mechnikov conducted a lot of research on particular issues of medicine. He studied experimental syphilis, cholera, relapsing and typhoid fever, tuberculosis, childhood intestinal infections. He owns the ideas about the presence of antagonism and struggle between different types of microbes and about the variability of microbes. II Mechnikov foresaw the possibility of using microbial antagonism in order to fight against pathogenic microbes, which was implemented and further developed in the theory of antibiotics.

I. I. Mechnikov's research on the fight against old age was of great importance. Putting the process of aging of the organism in connection with chronic intoxication by the microbial flora of the large intestine, II Mechnikov put the use of microbial antagonism as the basis for the fight against premature aging. As an antagonist of putrefactive intestinal microbes, I. I. Mechnikov proposed the use of lactic acid bacteria.

His outlook was spontaneously dialectical. It was characterized by a comparatively biological method, the desire to consider the phenomena of organic nature in their connection and interdependence and in contradictory development. II Mechnikov was not consistent in his views: being a materialist in understanding the phenomena of nature, he remained an idealist in explaining the phenomena of social life. He sought to change the reactionary political system in Russia, but had a negative attitude towards the revolutionary struggle. The weak side of I. I. Mechnikov's public views was biologism. This was the influence of positivism experienced by I. I. Mechnikov in his youth. His main mistake was that he did not take into account the significance of socio-economic factors, did not take into account the social conditions of human life in modern society. These aspects of I. I. Mechnikov's worldview were especially vividly reflected in his teaching on premature aging and the fight against it. The problem of life extension is not only biological, as II Mechnikov thought, but mainly social.

II Mechnikov created an extensive school of microbiologists and epidemiologists both in Russia and abroad. His students were G. N. Gabrichevsky, N. F. Gamaleya, L. A. Tarasevich, D. K. Zabolotny, A. M. Bezredka, the first woman, Professor of Microbiology P. V. Tsnklinskaya, and many others.

G. N. Gabrichevsky. Georgy Norbertovich Gabrichevsky (1860-1907) played a major role in the development of microbiology and epidemiology. In 1889-1891. in Berlin under Koch and in Paris, under the guidance of I. I. Mechnikov, he got acquainted with microbiology and, returning to Moscow, from 1892 began to teach a special course at Moscow University. In 1893, G. N. Gabrichevsky published the first textbook "Medical Bacteriology", which went through three editions and greatly contributed to the development of a science that was new for that time. In 1895, G. N. Gabrichevsky, in difficult financial conditions - without financial assistance from the government - was the first in Russia to begin the production of diphtheria serum and created a bacteriological institute in Moscow. He was the initiator of the serum-vaccine business in Russia.

Along with organizational activities, G. N. Gabrichevsky carried out a lot of research work. His scientific interests were many-sided: E. coli and its role in pathology, diphtheria, its recognition, preparation of serum, inoculation, vaccination, malaria, propaganda of the "mosquito" theory of malaria, biology of the causative agent of plague, anti-plague serum, relapsing fever, serotherapy for spirochetal infections, scarlet fever , vaccination against scarlet fever with dead streptococci freshly isolated from a person, the antitoxic properties of aniline dyes - this is an incomplete list of questions that G. N. Gabrichevsky developed.

N. F. Gamaleya. The research and organizational activities of Nikolai Fedorovich Gamaleya (1859-1949) in the pre-revolutionary period were devoted to the study of many theoretical and practical problems of combating infectious and epidemic diseases. Together with Pasteur, N. F. Gamaleya studied rabies, developed and improved methods of anti-rabies vaccinations, supported Pasteur in his disputes with opponents of vaccination, studied anthrax, cholera, plague, tuberculosis, typhus and other infections. Of great importance were the works of N. F. Gamaleya in the field of studying bacterial poisons, his discovery in 1898 of bacteriolysis, and the improvement of methods of disinfection and deratization. N. F. Gamaleya attached great importance to the study of the variability of microbes and viruses and adaptability to environmental conditions.

Heroism, selflessness, readiness to sacrifice oneself in the name of science is a characteristic feature of advanced Russian doctors, which is especially pronounced in the field of microbiology and epidemiology. This feature was expressed in the examples of heroic experiments "in itself, which are rich in domestic science. G. N. Minkh and O. O. Mochutkovsky inoculated themselves with the blood of patients with relapsing fever in order to prove that the infection was in the blood. D. K. Zabolotny and I. G. Savchenko immunized themselves by taking killed vibrio cholerae and to test the action; immunizations drank a live culture and thus proved the possibility of enteral vaccination against cholera. G. N. Gabrichevsky made himself a test inoculation of the scarlet fever vaccine prepared by him. I. I. Mechnikov adopted cholera culture in order to prove the specificity of vibrio in the etiology of Asiatic cholera. V. M. Khavkin injected himself with a cholera vaccine to determine the timing of the onset of immunity.

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GBOU VPO Orgmu MINISTRY OF HEALTH OF RUSSIA

DEPARTMENT OF HISTORY OF THE HOMELAND

The development of national medicine in the 19th century

Performed:

student 114 gr.

Rakhmankina D.P.,

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department assistant:

Pakhomov A.V.

Orenburg, 2014

Introduction

1. The meaning of studying the topic:

The study of the advanced, progressive nature of the formation of the most important areas of medical science in Russia in the 19th century allows us to understand the historical problems of the development of medical science, to form a respectful attitude towards the founders of domestic medical science. To get acquainted with the advanced, progressive nature of the development of the fundamental disciplines of medical science in Russia in the 19th century.

2. The purpose of studying the topic.

Learn about the features, important dates and scientists involved in the development of domestic medicine in the 19th century. To achieve this goal, it is necessary: ​​to get an idea of ​​the main stages in the development of medicine in the 19th century To know: the names of great scientists, the dates of important discoveries in medicine in the 19th century. Be able to: make a message, report on the topic of the lesson. Have an idea about the development of medicine in this period. Have the skills of independent work with primary sources: books, archival materials. surgery anatomy antiseptic smallpox vaccination

3. Basic concepts and provisions of the topic.

Development of general pathology (pathological anatomy and pathological physiology). Pathological anatomy (from the Greek. pathos - disease) - a science that studies the structural foundations of pathological processes - stood out from anatomy in the middle of the 18th century. Its development in modern history is conditionally divided into two periods: macroscopic (until the middle of the 19th century) and microscopic, associated with the use of a microscope.

1. Development of surgery and topographic anatomy

In the Medico-Surgical Academy, surgery, anatomy, and topographic anatomy found a predominant development. Within the walls of the Medico-Surgical Academy, the first Russian anatomical school arose, the founder of which was Pyotr Andreevich Zagorsky. He headed the department of anatomy and physiology in 1799 and directed it until 1833. This was preceded by a large practical medical, and then teaching activities. Among his students were many prominent teachers and scientists. The work of P.A. Zagorsky "Abridged Anatomy, or a guide to understanding the structure of the human body", which appeared in 1802 and went through five editions. Studying anatomical anomalies and questions of teratology - the doctrine of deformities, he used the methods of comparative anatomy, studied phenomena in development. He created an anatomical museum, restored preparations of the Kunstkamera, founded by Peter I. He sent out an extensive questionnaire concerning the lifestyle, work patterns and nutrition of pregnant women. P.A. Zagorsky rejected mystical ideas about the appearance of deformities. These studies led him to the idea that human nature is not once and for all given by the creator, but changes under the influence of the laws of nature, the external environment, and the conditions of existence. Rejecting idealistic notions of vitality, he examined the fluids of the body and argued that "in the moisture of the human body there is no vitality." So, exploring the "crimson of blood" - red blood cells and wanting to prove that they contain iron and promote the transfer of oxygen, Zagorsky took "a few pounds of liver blood" (a clot), washed the "crimson", removed the fibrinous mass, evaporated the washed liquid, calcined and applied a magnet to the residue. The rest was attracted, which proves the presence of iron. The development of surgery in Russia due to established historical traditions until the middle of the 19th century. was closely associated with German surgery. Many German surgical manuals and textbooks were translated into Russian. In the first half of the XIX century. The leading center for the development of surgery in Russia was the St. Petersburg Medical and Surgical Academy. Teaching at the Academy was practical: students performed anatomical dissections, observed a large number of operations and participated in some of them themselves under the guidance of experienced surgeons.

Within the walls of the Medico-Surgical Academy, the first Russian surgical school of Ivan Fedorovich Bush, who since 1800 was a professor of surgery, arose. He owns the first Russian "Guide to teaching surgery" in three volumes. I.F. Bush seriously placed the teaching of clinical and operative surgery. Students had to practice surgical techniques on corpses, and in the fourth year they had to publicly perform 4 major operations on patients. I.F. Bush has trained several surgical professors. P.A. Zagorsky and I.F. Bush with their activities answered the main questions of the time: they created original domestic educational manuals, trained qualified personnel for teaching and scientific work.

The most prominent student of P.A. Zagorsky and I.F. Bush was Ilya Vasilievich Buyalsky (1789-1866), who had great anatomical knowledge, operational technique and deep clinical ideas. In 1842 he became an academician. Since 1829, he managed a surgical tool factory, and from 1831, in addition to teaching at the Medico-Surgical Academy, until the end of his life he lectured on anatomy at the Academy of Arts. I.V. Buyalsky stood for the gradual development of the organic world, relying on comparative anatomical data and embryological data. I.V. Buyalsky can be considered the founder of plastic anatomy. Anatomical studies of I.V. Buyalsky were the basis for the development of surgical anatomy. The most outstanding work in this area was his Anatomical and Surgical Tables, the first issue of which was devoted to the ligation of large arteries. I.V. Buyalsky became an excellent operator, a clinician who closely followed the development of science. He was one of the first to use ether anesthesia in the clinic. He attached great importance to blood transfusion, he designed a special double-walled syringe for this operation. I.V. Buyalsky put a lot of effort into the creation of Russian surgical instruments, excellent sets. Instruments such as Buyalsky's stick and spatula are still used in surgical practice.

In Moscow, the development of surgery is closely connected with the activities of Efrem Osipovich Mukhin (1766-1859), a prominent Russian anatomist and physiologist, surgeon, hygienist and forensic physician. As a professor at the Moscow Medical and Surgical Academy (1795-1816) and the Medical Faculty of Moscow University (1813-1835), E.O. Mukhin published "for the benefit of his compatriots, students of medical and surgical science, and young doctors involved in the production of surgical operations", his works "Description of Surgical Operations" (1807), "The First Beginnings of Bone-Setting Science" (1806) and "Course of Anatomy" in eight parts (1818). He made a significant contribution to the development of Russian anatomical nomenclature. On his initiative, anatomical rooms were created at Moscow University and the Medico-Surgical Academy, the teaching of anatomy on corpses and the manufacture of anatomical preparations from frozen corpses were introduced (a method subsequently developed by his students I. V. Buyalsky and N. I. Pirogov). Developing the ideas of nervism, E. O. Mukhin recognized the leading role of the nervous system in the life of the body and the occurrence of many diseases.

Nikolai Ivanovich Pirogov (1810-1881) - an outstanding figure in Russian and world medicine, surgeon, teacher and public figure, creator of topographic anatomy and experimental direction in surgery, one of the founders of military field surgery. The years of his studies at Moscow University coincided with the period of the revolutionary movement of the Decembrists and the political reaction that followed it in Russia. It was then that at the Kazan University, by order of the trustee M. L. Magnitsky, all the preparations of the anatomical theater were buried according to the church rite. Book teaching also prevailed at the Moscow University at that time. “There was no mention of exercises in operations on corpses,” Nikolai Ivanovich later wrote, “... I was a good doctor with my diploma, which gave me the right to life and death, having never seen a typhoid patient, not having never a lancet in hand! In 1828, after graduating from Moscow University, the 17-year-old "doctor of the first department" N.I. Pirogov, on the recommendation of Professor E.O. Mukhin was sent to the Professorial Institute, just established in Derpt (Yuriev, now Tartu) to train professors from "born Russians". The first set of students of this institute also included G. I. Sokolsky, F. I. Inozemtsev, A. M. Filomafitsky and other young scientists who made the glory of Russian science. As his future specialty, Nikolai Ivanovich chose surgery, which he studied under the guidance of Professor I.F. Moyer (1786-1858). In 1832, at the age of 22, N.I. inguinal region is an easy and safe intervention. Her conclusions are based on experimental physiological studies on dogs, sheep, and calves. N. I. Pirogov always closely combined clinical activity with anatomical and physiological research. That is why, during his scientific trip to Germany (1833-1835), he was surprised that “while still in Berlin, he found practical medicine, almost completely isolated from its main real foundations: anatomy and physiology. It was like anatomy and physiology on their own, and medicine on its own. And surgery itself had nothing to do with anatomy. Neither Rust, nor Grefe, nor Dieffenbach knew anatomy. Moreover, Dieffenbach simply ignored anatomy and made fun of the position of the various arteries.” Upon his return to Dorpat (already as a professor at Dorpat University), N. I. Pirogov wrote several major works on surgery. Chief among them is "The Surgical Anatomy of the Arterial Trunks and Fascia" (1837), which was awarded the Demidov Prize of the St. Petersburg Academy of Sciences in 1840, the highest award for scientific achievements in Russia at that time. This work marked the beginning of a new surgical approach to the study of anatomy. Thus, N. I. Pirogov was the founder of a new branch of anatomy - surgical (topographic) anatomy, which studies the relative position of tissues, organs and body parts.

In 1841, N. I. Pirogov was sent to the St. Petersburg Medical and Surgical Academy. The years of work at the Academy (1841-1846) became the most fruitful period of his scientific and practical activity. At the insistence of N. I. Pirogov, the department of hospital surgery was first organized at the Academy (1841). Together with professors K. M. Baer and K. K. Seidlitz, he developed a project for the Institute of Practical Anatomy, which was created at the Academy in 1846. Simultaneously heading both the department and the anatomical institute, N. I. Pirogov led a large surgical clinic and advised in several Petersburg hospitals. After a working day, he performed autopsies and prepared material for atlases in the morgue of the Obukhov hospital, where he worked by candlelight in a stuffy, poorly ventilated basement. For 15 years of work in St. Petersburg, he performed almost 12 thousand autopsies. In the creation of topographic anatomy, the method of "ice anatomy" occupies an important place. For the first time, freezing of corpses for the purpose of anatomical research was carried out by E. O. Mukhin and his student I. V. Buyalsky, who in 1836 prepared a muscular preparation of the “lying body”, subsequently cast in bronze. In 1851, developing the method of "ice anatomy", N. I. Pirogov for the first time carried out the total sawing of frozen corpses into thin plates (5-10 mm thick) in three planes. The result of his titanic many years of work in St. Petersburg were two classic works: "A complete course of applied anatomy of the human body with drawings (descriptive-physiological and surgical anatomy)" (1843--1848) and "Illustrated topographic anatomy of cuts made in three directions through a frozen human body" in four volumes (1852-1859). N.I. Pirogov created the doctrine of fascia and interfascial spaces. Both of them were awarded the Demidov Prizes of the St. Petersburg Academy of Sciences in 1844 and 1860. Another (fourth) Demidov Prize was awarded to N. I. Pirogov in 1851 for the book “Pathological Anatomy of Asiatic Cholera”, in the fight against epidemics of which he repeatedly took part in Dorpat and St. Petersburg.

The role of N. I. Pirogov is also great in solving one of the most important problems of surgery - anesthesia. Even in the dissertation "Is ligation of the abdominal aorta for inguinal aneurysm an easy and safe intervention." For the first time in the history of surgery, using an experiment on animals, he showed the ways of an extra-abdominal approach to this deep-lying segment of the aorta, which was due to the impossibility of disturbing the peritoneum due to inevitable suppuration. N.I. Pirogov, like many surgeons of that time, was fluent in surgical technique and performed operations quickly. N. I. Pirogov - the founder of military field surgery Russia is not the birthplace of military field surgery - it is enough to recall ambulance volante Dominique Larrey, the founder of French military field surgery, and his work "Scientific Notes on Military Field Surgery and Military Campaigns" (1812--1817). However, no one has done so much for the development of this science as N. I. Pirogov, the founder of military field surgery in Russia. In the scientific and practical activities of N. I. Pirogov, much was done for the first time: from the creation of entire sciences (topographic anatomy and military field surgery), the first operation under rectal anesthesia (1847) to the first plaster cast in the field (1854) and the first idea about bone grafting (1854). In Sevastopol, during the Crimean campaign of 1854-1856, when the wounded arrived at the dressing station in hundreds, he first substantiated and put into practice the sorting of the wounded into four groups. The first group consisted of the terminally ill and mortally wounded. They were entrusted to the care of the sisters of mercy and priests. The second group included the seriously wounded, requiring an urgent operation, which was performed right at the dressing station in the House of the Noble Assembly. Sometimes they operated simultaneously on three tables, 80-100 patients per day. The third group included the wounded of moderate severity, which could be operated on the next day. The fourth group consisted of the lightly wounded. After providing the necessary assistance, they went to the regiment. Postoperative patients were first divided by N. I. Pirogov into two groups: clean and purulent. Patients of the second group were placed in special gangrenous departments - "mementomori" (Latin "remember death"), as Pirogov called them. Assessing the war as a "traumatic epidemic", N. I. Pirogov was convinced that "not medicine, but the administration plays a major role in helping the wounded and sick in the theater of war." And with all his passion he fought against the “stupidity of official medical personnel”, “the insatiable predatory hospital administration” and tried with all his might to establish a clear organization of medical care for the wounded in the theater of operations, which in those conditions could only be done due to the enthusiasm of the obsessed. Such were the sisters of mercy of the Exaltation of the Cross community.

A year after the Crimean War, N. I. Pirogov was forced to leave the service at the Academy and retired from teaching surgery and anatomy (he was 46 years old). Pinning great hopes on improving public education, he accepted the post of trustee of the Odessa, and since 1858 - the Kyiv educational district, but numerous clashes between the restless academician and local authorities and bureaucracy forced him to resign again in 1861. In March 1862, N. I. Pirogov was appointed head of the Russian professorial fellows abroad (with residence in Heidelberg). This was the last official post of Pirogov, in which he won the deep respect of his wards; many of them (I. I. Mechnikov, A. N. Veselovsky, and others) later became the glory of Russian and world science. In Heidelberg, N. I. Pirogov prepared for publication his classic work “The Beginnings of General Military Field Surgery, Taken from Observations of Military Hospital Practice and Memories of the Crimean War and the Caucasian Expedition”, which was published first in German (1864), and then in Russian (1865-1866). In 1866, after the dismissal of N. I. Pirogov, he finally settled in the village of Vishnya near the city of Vinnitsa (now the Museum-estate of N. I. Pirogov). Nikolai Ivanovich constantly provided medical assistance to the local population and numerous patients who came to him in the village of Vishnya from different cities and villages of Russia. To receive visitors, he set up a small hospital, where he operated and dressed almost daily. For the preparation of medicines on the estate was built a small one-story house - a pharmacy.

He himself was engaged in the cultivation of plants necessary for the preparation of medicines. Many medicines were dispensed free of charge: propauper (lat. - for the poor) - was listed in the prescription. N. I. Pirogov lived in his estate in the village of Vishnya for almost 16 years. He worked hard and rarely traveled (in 1870 - to the theater of the Franco-Prussian war and in 1877-1878 - to the Balkan front). The result of these trips was his work “Report on a visit to military sanitary institutions in Germany, Lorraine and Alsace in 1870” (1871) and work on military field surgery “Military medical practice and private assistance in the theater of military operations in Bolgarin and in the rear of the active armies in 1877 - 1878.

In these works, as well as in his work "The Beginnings of General Military Field Surgery ..." N. I. Pirogov laid the foundations for the organizational, tactical and methodological principles of military medicine. The last work of N. I. Pirogov was the unfinished Diary of an Old Doctor.

2. Antisepsis and asepsis

The empirical beginnings of antiseptics (from the Greek anti - against and septicos - putrid, causing suppuration) are associated with the name of the Hungarian doctor Ignaz Semmelweis (Semmelweis, IgnazPhilipp, 1818--1865). While working in the obstetric clinic of Professor Klein in Vienna, he drew attention to the fact that in one department where students were trained, the mortality rate from puerperal fever reached 30%, and in another, where students were not allowed, the mortality rate was low. After a long search, not yet knowing about the role of microorganisms in the development of sepsis, Semmelweis showed that the cause of puerperal fever is the dirty hands of students who come to the maternity ward after dissecting corpses. After explaining the reason, he proposed a method of protection - washing hands with a solution of bleach, and the mortality rate decreased to 1--3% (1847). However, during the lifetime of Semmelweis, the largest Western European authorities in the field of obstetrics and gynecology did not recognize his discoveries. In Russia, hand washing with disinfecting solutions was used by I. V. Buyalsky and N. I. Pirogov, who contributed to the development of antiseptics and asepsis. There was no scientific justification for antiseptics and asepsis until the works of L. Paser, who showed that the processes of fermentation and decay are associated with the vital activity of microorganisms (1863). The idea of ​​Pasteur in surgery was first introduced by the English surgeon Joseph Lister (Lister, Joseph, 1827-1912), who associated suppuration of wounds with the ingestion and development of bacteria in them. Having given a scientific explanation - a surgical infection, Lister for the first time developed theoretically substantiated measures to combat it. His system was based on the use of 2-5% solutions of carbolic acid (water, oil and alcohol) and included elements of antiseptics (destruction of microbes in the wound itself) and asepsis (treatment of objects in contact with the wound: the surgeon's hands, instruments, dressing material).

Attaching great importance to air infection, Lister also sprayed carbolic acid into the air of the operating room (carbolic spray). In 1867, J. Lister published a number of articles in the Lancet magazine (“On the antiseptic principle iri the practice of surgery”, etc.) , in which he outlined the essence of his method, which was disclosed in detail in his subsequent works. The teachings of J. Lister opened a new antiseptic era in surgery. J. Lister was elected an honorary member of many European scientific societies and was president of the Royal Society of London (1895-1900).

3. Macroscopic period

The need to study the anatomy of not only a healthy, but also a sick body was written by Francis Bacon (156I-1626) - an outstanding English philosopher and statesman, who, not being a doctor, largely determined the paths for the further development of medicine. In the second half of the XVI century. in Rome, B. Eustache was the first to introduce a systematic autopsy of the dead in the Roman hospital and, thus, contributed to the development of pathological anatomy. The beginning of pathological anatomy as a science was laid by the compatriot Eustachia, the Italian anatomist and physician Giovanni Battista Morgagni (1682-1771). At the age of 19, he became a doctor of medicine, at 24 he headed the department of anatomy at the University of Bologna, and five years later, the department of practical medicine at the University of Padua. Performing autopsies of the dead, J. B. Morganyi compared the changes he discovered in the affected organs with the symptoms of diseases that he observed as a practicing physician during the life of the patient. Summarizing the material collected in this way, huge for those times - 700 autopsies and the works of predecessors, J. B. Morgagni published in 1761 the Classical six-volume study "On the location and causes of diseases discovered by dissection." J. B. Morganyi showed that each disease causes certain material changes in a particular organ and defined the organ as the place of localization of the disease process (organopathology). Thus, the concept of illness was connected with a specific material substrate, which dealt a powerful blow to metaphysical, vitalistic theories. Bringing anatomy closer to clinical medicine, Morgagni laid the foundation for the clinical-anatomical principle and created the first scientifically based classification of diseases.

J. B. Morgagni's merits were recognized by awarding him honorary diplomas from the academies of sciences in Berlin, Paris, London and St. Petersburg. An important stage in the development of pathological anatomy is associated with the activities of the French anatomist, physiologist and physician Marie Francois Xavier Bichat (1771-1802). Developing the positions of Morgagni, he showed for the first time that the vital activity of an individual organ is composed of the functions of 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 (tissue pathology).

4. Microscopic period

In the middle of the 19th century, the use of the microscope brought natural science to the level of cellular structure and dramatically expanded the possibilities of morphological analysis in normal and pathological conditions. The principles of the morphological method in pathology were laid by Rudolf Virchow (1821-1902), a German physician, pathologist and public figure. Having adopted the theory of cellular structure (1839), R. Virchow was the first to apply it to the study of a diseased organism and created the theory of cellular (cellular) pathology, which is set out in his article “Cellular pathology as a doctrine based on physiological and pathological histology” (1858) . According to Virchow, the life of a whole organism is the sum of the lives of autonomous cellular territories; the material substrate of the disease is the cell (i.e., the dense part of the body, hence the term "solidary" pathology); all pathology is the pathology of the cell: "... all our pathological information must be reduced to changes in the elementary parts of tissues, in cells." Some provisions of the cellular theory of pathology, based on mechanistic materialism, contradicted the doctrine of the integrity of the organism. They were criticized (by I. M. Sechenov, N. I. Pirogov and others) during the author's lifetime. But in general, the theory of cellular pathology was a step forward compared to the theories of Bish's tissue pathology and Rokitansky's humoral pathology. She quickly gained universal recognition and had a positive impact on the subsequent development of medicine. R. Virchow was elected an honorary member of scientific societies and academies in almost all countries of the world.

Rudolf Virchow made a great contribution to the development of pathological anatomy as a science. Using the method of microscopy, he was the first to describe and study the pathological anatomy of inflammation, leukocytosis, embolism, thrombosis, phlebitis, leukemia, amyloidosis of the kidney, fatty degeneration, the tuberculous nature of lupus, neuroglial cells. Virchow created the terminology and classification of the main pathological conditions. In 1847, he founded the scientific journal "Archive of Pathological Anatomy, Physiology and Clinical Medicine", today published under the name "Virchow's Archive" ("Virchow "sArchiv"). P. Virchow is also the author of numerous works on general biology, anthropology , ethnography and archeology. The cellular theory of pathology, which at one time played a progressive role in the development of science, was replaced by a functional direction based on the theory of neurohumoral and hormonal regulation. However, the role of the cell in the pathological process was not crossed out: the cell and its ultrastructures are considered as integral components of the whole organism.

In Russia, the beginning of pathological anatomy and forensic autopsy was laid in 1722, when Peter I's "Regulations" on hospitals came out. It prescribed the obligatory autopsy of those who died a violent death. In 1835, the "Charter on Hospitals" introduced a mandatory autopsy of all those dying in hospitals. The first department of pathological anatomy in Russia was established in 1849 at Moscow University. It was headed by Alexei Ivanovich Polunin (1820-1888), the founder of the first pathoanatomical school in Russia. A great contribution to the development of pathological anatomy in Russia was made by M. N. Nikiforov (1858--1915) - the author of one of the first textbooks on pathological anatomy in the country, which was repeatedly reprinted; N. I. Pirogov, who from 1840 led a course of autopsy at the Medico-Surgical Academy; M. M. Rudnev (1823-1878) - the founder of the St. Petersburg school of pathologists and others. In the middle of the 19th century, an experimental direction was formed in Russian pathology (later called "pathological physiology"). For the first time, a course in general and experimental pathology in Russia was taught at Moscow University by the well-known pathologist A. I. Polunin. Polunin Alexey Ivanovich (1820-1888), Russian pathologist. In 1842 he graduated from the medical faculty of Moscow University; since 1849 professor at this university, where in the same year he founded the department of pathological anatomy. In 1869 he created the department of general pathology and was the first in Russia to begin teaching an independent course in general pathology. He gave a pathoanatomical description of cholera, the first to establish, on the basis of numerous autopsies, the curability of pulmonary tuberculosis. As dean of the Faculty of Medicine (1863-78), he carried out a number of progressive measures for the differentiated teaching of medical disciplines (the organization of special clinics). President of the Moscow Physico-Medical Society (1866-70). One of the first medical publicists in Russia, editor and publisher (1851--59) of the Moscow Medical Journal, where R. Virkhov's Cellular Pathology was published for the first time in Russian.

The birth of pathological physiology as a science is associated with the activities of Viktor Vasilievich Pashutin (1845-1901), the founder of the first national school of pathophysiologists (Fig. 121). In 1874, he organized the Department of General and Experimental Pathology at Kazan University, and in 1879 he headed the Department of General and Experimental Pathology at the Military Medical Academy in St. Petersburg. Being a student of I. M. Sechenov and S. P. Botkin, V. V. Pashutin introduced the ideas of nervism into general pathology. He owns fundamental research on metabolism (the study of beriberi) and gas exchange (the study of hypoxia), digestion and the activity of the endocrine glands. V. V. Pashutin was the first to define pathological physiology as the “philosophy of medicine”. His two-volume Lectures on General Pathology (Pathological Physiology) (1878, 1891) long remained the main textbook on pathological physiology. At the end of XIX - beginning of XX century. I. I. Mechnikov, G. P. Sakharov, A. A. Bogomolets made a great contribution to the development of pathological physiology. development of histology. Histology (from the Greek. histos - tissue, logos - teaching) - the science of the structure, development and vital activity of the tissues of living organisms. The development of histology is closely connected with the development of microscopic techniques and microscopic studies, the creation of the cellular theory of the structure of organisms and the theory of the cell. In the history of the study of tissues and the microscopic structure of organs, two periods are distinguished: 1) pre-microscopic and 2) microscopic (within it - the ultramicroscopic stage).

5. Premicroscopic period

During this very long period (up to the 18th century), the first ideas about tissues were formed on the basis of anatomical studies of corpses, and the first scientific generalizations were made without the use of a microscope. At the same time, it was during this period that microscopic techniques were born and created (the use of magnifying glasses and the creation of the first microscopes) and the first fragmentary information about the microscopic structure of individual cells was accumulated. The first magnifying glass device was designed around 1590 by Hans and Zachary Jansen in the Netherlands (Holland). In 1609, Galileo Galilei, using the information that had come down to him about the invention of the magnifying tube, designed his optical device, which had a 9-fold increase. His first demonstration in Venice made a huge impression. Galileo first used his optical system to study the structure of various objects (1610-1614), and then for the first time turned it into the night sky to examine the heavenly bodies. The term microscope appeared only in 1625. Its first use in natural science is associated with the name of Robert Hooke (1635-1703), who in 1665. first discovered and described plant cells on a section of cork using a microscope of his own design with a magnification of 30 times.

Of great importance for the development of histology, embryology and botany were the works of Marcello Malpighi (1628-1694), an Italian physician, anatomist and naturalist. He owns the discovery of capillaries (1661), which completed the work of W. Harvey, and the description of blood cells (1665). The renal corpuscles and the layer of the epidermis are named after him. A significant contribution to the development of microscopy was made by the Dutch self-taught naturalist Anton van Leeuwenhoek (van, 1632-- 1723). Being engaged in polishing optical glasses, he achieved a high perfection in the manufacture of short-focus lenses, which gave an increase of up to 270 times. Inserting them into metal holders of his own design (Fig. 110), he first saw and sketched erythrocytes (1673), spermatozoa (1677), bacteria (1683), as well as protozoa and individual plant and animal cells. These scattered observations of cells were not accompanied by generalizations and have not yet led to the creation of science. The first attempt to systematize body tissues (without the use of a microscope) was made by the French physician Marie Francois Xavier Bichat (Bichat, MarieFrangoisXavier, 1771-1802), who is considered the founder of histology as a science. Among the variety of body structures, he singled out the tissue "system" and described them in detail in his works "Treatise on membranes and membranes" ("Traitedesmembranesengeneral et de diverses membranes enparticulie", 1800) and "General anatomy in application to physiology and medicine" ("Anatomiegenerale, appliquee a la physiologieet a la medecine", 1801).

Along with cartilaginous, bone and other tissue "systems", he distinguished hair, venous, circulatory, which (as it is known today) are structures of an organ nature, and not tissue. Bisha died in the prime of life at the age of 32. After his death, J-N. Corvisart wrote to Napoleon: "No one has done so much and so well in such a short time." The Microscopic Period The period of systematic microscopic studies of tissues opens with one of the largest generalizations of natural science in the 19th century—the cellular theory of the structure of organisms. In its main features, the cellular theory was formulated in the works of German scientists - the botanist Matthias Schleiden (1804-1881) and the zoologist Theodor Schwann (1810-1882). Their predecessors were R. Took, M. Malpighi, A. van Leeuwenhoek, J. Lamarck. In 1838, M. Schleiden in his article "Materials for Phytogenesis" showed that every plant cell has a nucleus and determined its role in the development and division of cells. In 1839, the fundamental work of T. Schwann "Microscopic study of the conformity in the structure and growth of animals and plants" was published, in which he defined the cell as a universal structural unit of the plant and animal world, showed that plant and animal cells are homologous in their structure , are similar in function, and gave the main characteristics of their formation, growth, development and differentiation.

One of the founders of the theory of cellular structure was Jan Evangelist Purkyne (1787-1869) - a Czech naturalist and public figure, founder of the Prague histological school, an honorary member of many foreign academies of sciences and scientific societies (including in St. Petersburg and Kharkov). Purkine was the first to see nerve cells in the gray matter of the brain (1837), described the elements of neuroglia, isolated large cells in the gray matter of the cerebellar cortex, later named after him, discovered the fibers of the conduction system of the heart (Purkine fibers), etc. He was the first to use the term protoplasm (1839). One of the first microtomes was created in his laboratory. J. E. Purkyne was the organizer of the Czech Scientific Society of Physicians, which now bears his name. The cell theory gave the key to the study of the laws of structure and development of various organs and tissues. On this basis, in the XIX century. Microscopic anatomy was created as a new branch of anatomy. By the end of the XIX century. In connection with advances in the study of the fine structure of the cell, the foundations of cytology were laid. In Russia, histology developed in close connection with the achievements of world science. In the 40s of the XIX century. histology was included in the curriculum of teaching related disciplines - anatomy and physiology. The first course in histology in Russia was given by the embryologist KM Baer, ​​who was in charge of the Department of Comparative Anatomy and Physiology at the Medical-Surgical Academy in St. Petersburg. Since 1852, this subject has been separated into an independent course, which was taught by N. M. Yakubovich. The first departments of histology and embryology in Russia were organized in 1864 at Moscow (A.I. Babukhin) and St. Petersburg (F.V. Ovsyannikov) universities. Later they were created in Kazan (K. A. Arshtein), Kyiv (P. I. Peremezhko), Kharkov (N. A. Khrzhonshevsky) and other cities of the country. Russian scientists have made a great contribution to the development of histology. The Kazan school of neurohistologists glorified Russian science with studies of the retina of the eye in various vertebrates and an analysis of the neural composition of the spinal and autonomic ganglia (A.S. Dogel). In 1915 A.S. Dogel founded the journal "Archive of Anatomy, Histology and Embryology". The fundamental works of the Kyiv histologist V.A. Betz, who studied the cytoarchitectonics of the cerebral cortex and discovered giant pyramidal cells (Betz cells).

6. Smallpox vaccination

“Exploring,” wrote the Canadian pathophysiologist and endocrinologist Hans Selye, “is to see what everyone sees, and to think in a way that no one thought.” These words fully apply to the English physician Edward Jenner (1749-1823), who noticed that peasant women who milked cows with cowpox developed blisters on their hands that resemble smallpox pustules. After a few days they fester, dry up and scar, after which these peasant women never get smallpox. For 25 years, Jenner tested his observations and on May 14, 1796, he conducted a public experiment on the method of vaccination (from Latin vacca --- cow): he inoculated an eight-year-old boy, James Phipps, with the contents of a pustule from the hand of a peasant woman, Sarah Nelma, who had contracted cowpox. A month and a half later, E. Jenner introduced the contents of the pustule of a smallpox patient to James - the boy did not get sick. A second attempt to infect the boy with smallpox five months later also did not give any results - James Phipps was immune to this disease. After repeating this experiment 23 times, E. Jenner in 1798 published an article "Investigation of the causes and effects of cowpox." In the same year, vaccination was introduced in the British army and navy, and in 1803 the Royal Jennerian Society was organized, headed by Jenner himself. The society set as its goal the widespread introduction of vaccination in England. Only in the first year and a half of its activity, 12 thousand people were vaccinated, and the death rate from smallpox decreased by more than three times. In 1808, smallpox vaccination became a state event in England. E. Jenner was elected an honorary member of almost all scientific societies in Europe. "Jenner's lancet," wrote J. Simpson, "saved many more human lives than Napoleon's sword did." However, even in England there was a long-standing skepticism about Jenner's method: the ignorant believed that after vaccination with cowpox, patients would grow horns, hooves, and other signs of the anatomical structure of a cow. The fight against smallpox is an outstanding chapter in human history. Many centuries before Jenner's discovery, the ancient East used the method of inoculation (variolation): the contents of the pustules of a patient with moderate smallpox were rubbed into the skin of the forearm of a healthy person, who, as a rule, fell ill with a mild form of smallpox, although deaths were also observed. In the XVIII century. Mary Wortley Montagu, the wife of the British ambassador to Turkey, transferred the method of inoculation from the East to England. Doctors had a wide debate about the positive and negative aspects of inoculation, which nevertheless spread widely in Europe and America. In Russia, Catherine II and her son Pavel in 1768 subjected themselves to inoculation, for which the doctor T. Dimsdal was discharged from England.

In France, in 1774, the year Louis XV died of smallpox, his son Louis XVI was inoculated. In the US, George Washington ordered all the soldiers of his army to be inoculated. Jenner's discovery was a turning point in the history of smallpox control. The first vaccination against smallpox in Russia according to his method was made in 1802 by Professor E. O. Mukhin to the boy Anton Petrov, who, in honor of this significant event, received the surname Vaccinov. At the same time, in the Baltic States, vaccination according to the Jenner method was successfully introduced by I. Gong. Vaccination of that time was very different from today's smallpox vaccination. Antiseptics did not exist (they did not know about it until the end of the 19th century). The contents of the pustules of vaccinated children served as the grafting material, which means that there was a danger of side infection with erysipelas, syphilis, etc. Based on this, A. Negri in 1852 proposed to receive anti-smallpox vaccine from vaccinated calves. It took almost 200 years for mankind to go from the discovery of Jenner to the discovery of the smallpox virus (E. Paschen, 1906) and achieve the complete elimination of this dangerous infectious disease throughout the globe.

Conclusion

In the first half of the 19th century, advanced surgeons recognized the need for an accurate knowledge of anatomy in order to perform surgical interventions. In this regard, the role of domestic surgeons was significant. The reasons for this were the peculiarities of the development of medicine in Russia in the past. In the XVI-XVII centuries, Russia did not know that guild division of medical workers, which during the period of feudalism divided them in the countries of Western Europe. There were no workshops for doctors, barbers, etc. in Muscovite Rus'. A guild division of medical workers existed in the western Russian and Ukrainian regions, in Poland and partly in the Baltic states, which became part of Russia in the 18th century. The author of the first original Russian textbook on surgery, I. F. Bush at the beginning of the 19th century, correctly and clearly characterized the situation. A major role in the development of anatomy in Russia was played by Pyotr Andreevich Zagorsky (1764-1846). In 1786 he graduated from school at the St. Petersburg General Land Hospital, after which he worked as a prosector in the same school in the department of anatomy, physiology and surgery. P. A. Zagorsky considered anatomy as part of natural science; he developed and taught it in relation to surgery, obstetrics, and forensic medicine. Being the only doctor on large warships for that time, I.F. Bush provided medical care to the wounded during naval battles: during one of the battles, more than 200 wounded were in the hands of a young physician. In 1790, I. F. Bush became a dissector and teacher of the hospital school at the Kronstadt Marine Hospital. Since 1797, I. F. Bush became a teacher of anatomy and physiology at the Kalinka Medical and Surgical Institute. His main merit was in teaching. In the Medico-Surgical Academy, reading the course of surgery, I. F. Bush achieved a significant improvement in teaching and the expansion of the surgical clinic. As an example of I. F. Bush's deep understanding of his tasks, it should be noted that he, a German by birth, from 1800 lectured in Russian (much earlier than other, even Russian higher school teachers of that time, who continued to lecture in Russian). Latin language). I. F. Bush skillfully selected his assistants and created a school of surgeons. His students Savenko and Salomon occupied the departments, I. F. Bush singled out the teaching of practical, theoretical and operative surgery. In 1807, he published the original textbook "A Guide to Teaching Surgery" in 3 volumes, compiled by him, the first in Russian. For 1807-1833. This textbook went through five editions. The brilliant surgeon I. V. Buyalsky was distinguished by sensitivity and humanity. He wrote: “It is easy to take away an arm and a leg, to flaunt the elegance of operations, but it has never been possible to attach an erroneously taken away arm or leg, and a vain mutilation, no matter how brilliantly produced, will not be rewarded either with the glory of the surgeon or his late repentance; It is the duty of an honest man to think seven times before cutting once. The operation is done in order to save life, but we should also think about how this saved life should be as less painful as possible. For the development of surgery and the introduction of the anatomical direction into it, surgical atlases compiled by I. V. Buyalsky and his students were of great importance. Efrem Osipovich Mukhin (1766-1850) was versatile in his scientific interests, teaching and practical medical activities. Long-term teaching of medical disciplines, extensive clinical experience in military and civilian medical institutions in internal medicine and surgery, long-term work of E. O. Mukhin in a higher medical school in administrative work showed an extreme need for textbooks for students. E. O. Mukhin did a lot to satisfy this need of life. Fedor Ivanovich Inozemtsev (1802-1869) was a major figure in Russian medicine, an active participant in the restructuring of medical education in Russia in the middle of the 19th century. Inozemtsev took an active part in expanding and improving the system of medical education; in order to improve the clinical training of future doctors, he set the task of "educating as many scientific and practical doctors as possible." Nikolai Ivanovich Pirogov (1810-1881) in 1828. The significance of his scientific activity lies in the creation of a natural scientific basis for surgery and in overcoming empiricism to a large extent. Pirogov laid the foundation for a new science of surgical anatomy. All this led to the creation of a new anatomical and physiological direction in surgery. Pirogov's anatomical, pathoanatomical, experimental and clinical studies had primarily practical goals: insight into the essence of pathological processes and improvement of methods of treatment. In practical medical and teaching activities, Pirogov is best known as a surgeon. The outstanding role of N. I. Pirogov in the creation of military field surgery and the development of questions of the organization of military medical affairs is well known. N. I. Pirogov formulated in detail the main provisions of the organization of military medical affairs. They had a great influence on the development of surgery in all countries. For modern medicine: the creation of topographic and surgical anatomy, the introduction of ether anesthesia into surgical practice, the interpretation of inflammation as a reaction of the body as a whole, the development of a doctrine of the infectious nature of the wound process, the action of antiseptics.

Literature

1. Sorokina T.S. History of medicine: a textbook for students. higher medical studies establishments. - M.: Publishing center "Academy", 2004. - 560 p.

2. Lisitsin Yu.P. History of medicine: a textbook for medical universities. - M.: Medicine, 2004. - 270 p.

3. Sorokina T.S. The origins of university education // Proceeding soft he International Higher Education Academy of Sciences. - M., 2005. - 178 p.

4. Mirsky M. B. Surgery from antiquity to the present. History essays. - M., 2000. - S. 533.

5. Meyer-Steineg T., Zudgof K. History of medicine: Per. with him. - M., 1925. - S. 436.

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Today, many residents of our country believe that getting to a good doctor is a great success, akin to winning the lottery. I must say that medicine in Russia is currently in decline, so many patients can only dream of attentive and highly qualified doctors. The division into rich and poor is becoming more and more apparent, not to mention other aspects of the life of an ordinary person. In this regard, paid clinics that offer the patient quality care in the form of long-term appointments and the appointment of a number of diagnostic measures are becoming increasingly popular.

The history of medicine in Russia recorded a case when one of the most famous therapists of the 19th century met a patient on the doorstep with the words: "Hello, patient with mitral heart disease." Of course, such doctors are rare.

The level of education of future doctors is also important. The introduction of a one-year training course for general practitioners will not only significantly reduce the quality of medicine in general, but may also increase the mortality rate among the population. For example, to become a doctor in the 18th century, one had to study from 7 to 11 years.

XVIII century. Origin

For the first time the term "medicine" in our country was used under Peter I. The emperor himself attached great importance to medical practice, opening a hospital school in 1707, and in 1764 - a medical faculty at Moscow University. Medicine in Russia of those times was transformed from folk to scientific. If earlier conditional education was limited only to surgery, then the following sciences began to be taught at the educational institution:

• pharmacology;
• neurology;
• dentistry;
• maxillofacial surgery;
• physiology and anatomy;
• forensic medicine.

Many specialists traveled abroad and adopted the experience of foreign doctors. The emperor himself was quite closely engaged in the study of medical affairs and successfully carried out dental manipulations and operations for both ordinary people and representatives of the nobility.

XVIII century. Development

The development of medicine in Russia was in full swing. At the end of the 18th century, several hospitals, hospitals and the first psychiatric clinic were opened. It was with the advent of the latter that the birth of psychiatry as a science began. At the same time, it became mandatory to perform an autopsy of the patient after his death.

Despite the rapid activity, the demographic situation was disappointing in connection with the epidemics of smallpox and plague. Medical figures of that time, for example, S. G. Zybelin, associated the wide spread of diseases, as well as high infant mortality, with the lack of proper hygiene among the population.

In the 90s of the 18th century, Moscow University, which at that time became the largest center of education and science, was allowed to award the degree of doctor of medical sciences. F. I. Barsuk-Moiseev was the first to receive this honorary title. Medicine in Russia began to replenish with qualified personnel.

18th century medical reform

In the 18th century, a fundamentally new approach to the organization of medical care, training in medical and pharmaceutical business was formed. Pharmaceutical orders, the Office of the main pharmacy, the Medical Office were created, and reforms were carried out in the organization of the educational process and the formation of medical institutions. So, in 1753, P. Z. Kondoidi established a new education system, according to which students spent 7 years at the university and passed mandatory exams at the end.

XIX century. Start

Medicine in Russia at the beginning of the 19th century began to develop at a faster pace. In order to study, special literature was required. Periodicals and the first manuals on anatomy began to be published, the authors of which were the medical luminaries of that time I. V. Buyalsky and E. O. Mukhin.

Obstetrics and gynecology were carefully studied. The results of research and experiments have become a breakthrough in the prevention and treatment of diseases of the female genital organs. Experiments were carried out with regard to the activity of the central nervous system, which gave an explanation for all the processes occurring in the body.

Researchers in this field (I. E. Dyadkovskii, E. O. Mukhin, K. V. Lebedev and others) formulated and developed the position of the reflex theory.

M. Ya. Mudrov founded the method of dialogue with the patient, which made it possible to identify the main signs of the disease and its etiology at the stage of questioning. Later, this method was improved by G. A. Zakharyin.

XIX century. Development

The development of medicine in Russia was marked by the replenishment of the list of diagnostic measures. In particular, G. I. Sokolsky singled out the percussion method in the study of chest diseases. In this regard, the scientist published the work "On medical research using hearing, especially with the help of a stethoscope", which was published in 1835.

At the beginning of the 19th century, an institution was formed to protect against plague, smallpox and other dangerous diseases through vaccination. Many professors, creating a remedy, considered it their duty to test it on themselves. In this regard, one of the Russian doctors, M. Ya. Mudrov, died heroically, whose death was the greatest loss for Russia.

In 1835, by decree of the censorship committee, the essence of teaching at medical universities was determined, which was reduced to the divine nature of man. In fact, this meant that the history of medicine in Russia had to end at this stage. However, doctors continued their research and achieved amazing results.

Results of the 19th century

In the 19th century, the foundations of all modern scientific positions in medicine were laid, including dermatology, histology, and even balneology. Thanks to the developments of the most famous scientists of that time, anesthesia, methods of resuscitation and physiotherapy began to be used. Also, such sciences as microbiology and virology were formed, which began to develop later.

The state of medicine in Russia in the 20th century

Opinions

However, modern medicine in Russia cannot provide a high quality of service, so many experts believe that changes should begin with education. Doctors also see the reform as a rollback to the old service system, which involved the division into hospitals for the poor and the rich.

The problems of medicine in Russia lie not only in insufficient funding of healthcare institutions, but also in the complete indifference of some doctors to patients. Judging by the history of the development of medical practice, many doctors have devoted their lives to studying and developing the latest methods for studying the body and getting rid of various diseases. Unfortunately, in modern medicine there is a tendency to monetize life.

Medicine in Russia in the 19th century began to reach a higher level. This was facilitated by the opening of a large number of medical schools headed by such prominent figures in the field of medicine as M.Ya. Mudrov, E.O. Mukhin and E.I. Dyadkovsky, I.F. Bush, P.A. Zagorsky and N.I. Pirogov and others. They adhered to a certain scientific direction, became the authors of many scientific works and had many students and followers. At the beginning of the century, two main centers of medical science developed in Russia - the St. Petersburg Medical and Surgical Academy and the Faculty of Medicine of Moscow University. Such areas as surgery, anatomy, and topographic anatomy have been developed at the Medico-Surgical Academy. Within its walls, the first Russian anatomical school was formed, the founder of which was P.A. Zagorsky (1764-1846), and the first Russian surgical school I.F. Bush (1771-1843). Professors of Moscow University dealt mainly with issues of general pathology, therapy, and physiology.

A characteristic feature of the development of medicine in Russia in the first half of the XIX century. - the construction of large hospitals, often with charitable funds, as well as the emergence of specialized medical institutions and clinics. So, in Moscow in 1802, the Golitsyn hospital began to operate. By 1806, the Mariinsky Hospital (St. Petersburg) was opened for the treatment of the poor, where in 1819 an eye department was organized.

An exemplary medical institution in Moscow was the Hospice of Count N.P. Sheremetev (1810). His hospital became the clinical base of the Moscow branch of the Medical and Surgical Academy. At the beginning of the century, the construction of the 1st Gradskaya and Novo-Ekaterininskaya hospitals began with city funds. In 1834, Russia's first children's hospital was opened in St. Petersburg. The emergence of specialized children's medical institutions contributed to the separation of pediatrics into an independent medical discipline.

Elements of scholasticism began to appear in medical education in the 19th century.

In the first half of the 19th century, in difficult conditions, the leading doctors of Russia successfully continued to develop a materialistic understanding of the main problems of medicine: the relationship between the body and the environment, the integrity of the body, the unity of the physical and mental, the etiology and pathogenesis of diseases.

In the middle and second half of the 19th century, new diagnostic techniques appeared: lighting and optical devices that allowed doctors to observe areas of the body closed from the naked eye: cystoscope, gastroscope, bronchoscope. The development of medicine was facilitated by new discoveries in other sciences, such as biology, chemistry, physics, which provided the basis for subsequent discoveries already in the field of medicine.

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