The history of medicine is brief. History of medicine: origin and development
MEDICINE is one of the most ancient branches of science, which has as its task the recognition, treatment, prevention of disease and strengthening of human health. Over the centuries, the nature and level of development of medicine has changed depending on the material conditions of society. The development of medicine is closely linked with the development of natural sciences, philosophy and technology.
Modern medicine is a complex set of scientific knowledge, including data on the structure of the human body (anatomy, histology), on its vital activity in a healthy and sick state (physiology, pathological anatomy and pathological physiology), the doctrine of disease recognition ( ), the doctrine of treatment various diseases (therapy, surgery and others), about medicines and their use (pharmacy and pharmacology), hygiene, which studies the effect of living conditions on human health and measures aimed at preventing disease. The development of medicine has led to the separation of private medical disciplines - obstetrics and gynecology, dermatology and venereology, neurology, ophthalmology, otolaryngology, pediatrics, psychiatry, epidemiology, and more. The specialization allowed to deepen and expand knowledge about the structure and function of the human body and significantly improved the ability to fight disease.
Medicine in socialist countries and in capitalist countries has fundamental differences. Medical science in capitalist countries is strongly influenced by various reactionary idealistic theories. Materially dependent on entrepreneurs, on firms producing pharmaceuticals, on private practitioners, it is forced, first of all, to fulfill their orders and requirements. The state, as a rule, helps medical science and practice to a very small extent. The great achievements of outstanding scientists in capitalist countries often become the subject of exploitation and profit. Leading medical practitioners are fighting to put medicine at the service of the people.
Medicine in the socialist countries is developing in the interests of the entire people, and makes it its task to protect the health of the working people. Caring for the health of workers has become one of the most important functions of the socialist states, and the state nature of medical care has become one of its leading principles. In the USSR, one of the first decrees of the Soviet government abolished the payment for medical care. Material guarantees are provided by law that make it possible to use this right (the right to rest, material security in case of illness and disability, as well as in old age, state protection of the interests of mother and child, and others, (see. ). The philosophical basis of medical science in the USSR is dialectical - materialistic understanding nature, society and man. The teachings of I. P. Pavlov are the natural scientific basis of medicine in the USSR; it helps to understand the phenomena occurring in the patient's body and healthy person, and find out the relationship between the body and the external environment. Medical science in the USSR is a subject of constant state concern.
Medicine originated in ancient times - among primitive peoples. The need to provide assistance with injuries, during childbirth made it possible to accumulate knowledge about the signs of the disease, about remedies forces of nature, as well as medicines from the plant and animal world. Over the centuries, this initial experience was collected, enriched, and the most valuable part of it was subsequently used by scientific medicine. The helplessness of primitive man in front of the forces of nature led to the fact that, along with rational data and methods, amulets, conspiracies, spells and other methods of a mystical nature became widespread. Many centuries before our era, in the slave-owning class societies, the division of labor and the emergence of crafts, and with them injury and illness, led to the emergence of professionals - healers. At the same time, representatives of various religions largely took over medical care - the so-called temple, priestly medicine arose, which considered illness as a punishment of God and considered prayers and sacrifices to be the means of combating diseases. However, along with temple medicine, empirical medicine was preserved and continued to develop. Accumulating medical knowledge, medical professionals in Egypt, Assyria and Babylonia, India and China have discovered new treatments for diseases. The advent of writing made it possible to consolidate their experience in the first medical writings.
Ancient Chinese medicine is already on early stages of her development she had a lot of knowledge on the protection of human health and their treatment. In ancient China, variolation was widespread - inoculation of the contents of smallpox bubbles to healthy people in order to protect them from disease. The advice on the hygiene regime that should be followed in order to be healthy was reasonable. In China, operations with pain relief using hashish and opium were used. Medicines from flora and fauna were various (for example, ginseng and antlers of young sika deer are still used as medicines). Unique Chinese methods of treatment were developed: moxibustion - moxa - and acupuncture - acupuncture, as well as su jok acupuncture, which are widely used and are still used today; the first major doctors appeared, for example Bian Qio, who lived in the 6th century BC and left the "Treatise on Diseases", which describes the diagnosis by the state of the pulse. Later, the surgeon Hua Tu (2nd century) and the author of the 52-volume pharmacopoeia Li Shi-cheng (16th century) became widely known. The influence of Chinese Medicine (Medicine) spread to many countries of the East.
Indian medicine also originated in ancient times and developed independently. Medical information was reflected in the codes of Manu (2nd century BC) and in Ayurveda (books of life), in which, like in Chinese medicine, hygiene prescriptions were of great importance: exercise was recommended, drug abuse was condemned and alcohol, cleanliness and body care were recommended; the rules of nutrition were justified - the use of meat was limited, vegetable food and milk were recommended. Many diseases were clearly described - leprosy, hemorrhoids, mental illness, jaundice and others. Specialists appeared - doctors who treated certain diseases, for example. surgical or bites poisonous snakes... Surgery was considered the first and best of all medical sciences in India. In ancient Indian, as well as in ancient Chinese, medicine, much attention was paid to the study of pulse and urine. The outstanding physician Sush-Ruta (one of the authors of Ayurveda) tried to develop a general theory of medicine, where the experience gained by medical techniques was theoretically substantiated, it was indicated that the human body combines three principles - air, mucus and bile. However, if the practice of Indian medicine gave satisfactory results, then its theory was built on fantastic assumptions.
Ancient Greek doctors played a huge role in the development of medicine. The famous physician, philosopher and naturalist Hippocrates (460-377 BC) taught physicians to be observant and attentive to the study of the patient. The requirement to treat not the disease, but the patient was his main principle; He considered the doctor's task to be to help the body's natural forces overcome the disease. In his numerous writings, which have come down to us in the form of the "Hippocratic Collection", a system of views is set forth that has helped doctors for many centuries to recognize diseases and treat them. The materialistic concept of illness, which Hippocrates pointed out in his struggle with those who gave them a religious explanation, reflected the experience accumulated over the centuries; special attention was paid to the environment in which a person lives, to the influence of climate, water, soil, lifestyle on the origin of the disease. Hippocrates and his successor, the Roman physician Galen (131-210 AD), whose anatomical and physiological concepts served as the basis of medicine until the 16th century, had a huge impact on the development of medicine in Europe: for many centuries [until the appearance of Avicenna (Ibn Sina , circa 980-1037)] these two medical authorities were the highest.
In the Middle Ages, medicine in Western Europe was subordinate to the Church and was under the influence of scholasticism. Doctors based diagnosis and treatment not on observation of the patient and rational remedial measures, but on abstract reasoning; the church forbade autopsies, which hindered the development of medicine. Since doctors were prohibited from performing operations that were always associated with bleeding, surgery, as opposed to therapy, was in the hands of uneducated barbers, chiropractors, and the like. The few medical faculties of universities trained an insignificant number of doctors; only in a few of them - in Salerno and in Padua (Italy) - scientific work was carried out.
In this era, in all European countries, doctors were guided by the ideas of the famous book "The Canon of Medicine", created by the outstanding Central Asian doctor Avicenna (Ibn Sina). Avicenna, a prominent philosopher, naturalist and physician, systematically set out the medical knowledge of his era, enriching every branch of medicine. Avicenna's observation allowed him to discover new ways in the diagnosis and treatment of diseases. Ibn Sina attached great importance to the influence of the environment in which a person lives; therefore, the hygienic section of the "Canon" was developed in particular detail. Medieval oriental medicine also put forward other remarkable doctors: al-Razi (864-U25) in his work on smallpox and measles gave a description of these diseases, Ali ibn Abbas (died in 994), Ibn al-Haytham (965-1038 years) and others have made many valuable discoveries in medicine.
The Renaissance era brought a new flowering of medicine in the 16th century, the Flemish anatomist A. Vesalius, who worked at the University of Padua, corrected Galen's mistakes in the theory of the structure of the human body and laid the foundations for a truly scientific anatomy. The development of natural science, in particular physics and chemistry, helped the emergence of new principles in medicine - the first successful attempts were made to use the laws of physics and chemistry in the treatment of diseases (iatrophysics and iatrochemistry, from the Greek iatros - doctor). Surgery was developed by practicing doctors, among whom the French surgeon Ambroise Paré introduced a number of valuable methods, in particular, in the treatment of wounds (he replaced the burning of wounds with a red-hot iron with a dressing of clean tissue).
The development of industry in the 17-18 century and the increase in the number of workers put forward the task of studying occupational pathology: the Italian doctor B. Ramazzini in his work "On the Diseases of Craftsmen" described about 50 occupational diseases. The English physician W. Harvey published his work on blood circulation in 1628. This discovery was met with hostility by official science, and it took many years for Harvey's teachings to become generally accepted. The clinical principle of patient observation, accompanied by experimental verification of treatment, became more and more widespread. Professor of Leiden University G. Burghav educated a galaxy of eminent doctors holding new positions: materialist physician J. O. La Mettrie in France, J. Pringle in England, H. van Swieten in Austria, A. Haller in Germany and many others.
In this era, the struggle in medicine between materialistic and idealistic currents continued: vitalism, according to which life phenomena are allegedly controlled by special non-material, supernatural forces ("vital force", "entelechy", "soul"), were opposed to the materialistic views that developed in Holland by G. Leroy (1598 - 1679), in France J. Lametrie (1709-51, his book "Man-Machine") and P. Cabanis (1757 - 1808), leader of the French Revolution.
In the 19th century, capitalism, which triumphed in Europe as a socio-economic formation, brought a significant expansion of research in the field of medicine. However, as in previous formations, medicine was placed at the service of the ruling classes. The successes of natural science, primarily physics, chemistry and biology, made it possible to enrich medicine with new methods. The doctrine of the structure and activity of the human body was supplemented by a new discipline - pathological anatomy, the founder of which was the Padua physician J. Morgagni (1682 - 1771). Pathological anatomy made it possible to compare the external manifestations of diseases with structural changes in organs and tissues in a particular disease. The autopsies of the deceased made it possible not only to accumulate a huge amount of material explaining the course of the disease, but also to control the actions of the doctor (dissection rooms, in which the corpses of dead patients were opened, became an obligatory component of the hospital); it became possible to compare data from intravital observation with autopsy data. The new approach to understanding the disease was progressive and gave a strong impetus to the development of medicine. However, in the process of development, it has led to the creation of theories that exaggerate the importance of local change.
The doctrine of body tissues, created by the French anatomist and surgeon of medicine Bichat (1771 - 1802), was a major stage in the study of the human body. Bisha listed 21 fabrics, each of which has different functions and properties. A decisive influence on the development of medicine was exerted by the creation of the doctrine of the cellular structure of plants and animals by the German scientist T. Schwann. The discovery of the laws of transformation of energy is the second great discovery that contributed to the development of biology and medicine. On the basis of this law, the development of natural science quickly moved forward, and medicine got its hands on a scientific principle that explained many of the phenomena of physiology. Biological chemistry and other disciplines brought to life by this law have made it possible to enrich medicine with new diagnostic and therapeutic possibilities.
The evolutionary doctrine of Charles Darwin is the third great discovery that was of great importance for medicine. Thanks to the discovery of Darwin, natural science not only became a system of materialistic knowledge of nature, but also made it possible to approach the solution of such problems of biology and medicine as heredity and its role in the development of human diseases, the correct understanding of the laws of origin and development of diseases. Russian scientists have played an important role in the development and promotion of Darwinism. The fierce ideological struggle that unfolded around Darwin's teachings divided natural scientists into two groups - those who made the correct materialistic conclusions from the teachings, and those who tried, resisting Darwinism, to defend idealistic positions, as well as criticize Darwinism from the standpoint of religion.
The developed capitalism led to the growth of cities and the overcrowding of the population, which increased the danger of epidemics. In the new conditions, medicine tried to solve the problems put forward by life. English physician E. Jenner in 1798 successfully vaccinated human cowpox, thus developing a method of combating infectious diseases by vaccination. Opox vaccination, with the support of leading doctors, quickly spread throughout all countries. Public health issues, its tasks and forms were developed by the German physician IP Frank; in his major work "Complete system of medical police" (1779 - 1819), he proceeded from the idea that health care is a matter of the state. Another solution was proposed by a contemporary of Frank, the German scientist H. Hufeland, who put personal hygiene at the forefront.
The successes of medicine were closely intertwined with the successes of the natural sciences. In the first half of the 19th century, physiology embarked on a broad experimental path. The English surgeon and physiologist C. Bell experimentally studied the distribution of sensory and motor fibers in the anterior and posterior roots of the spinal nerves. The establishment of this fact and the development of its French. physiologist F. Magendy contributed to the identification of the significance of the activity of the nervous system in the body, the emergence of experimental physiology as the basis of medicine. Even more important were the numerous discoveries of the German scientist I. Müller, who studied the structure and functions of the sense organs, the structure of the glands, the composition of blood and lymph. Müller was one of the first to develop physiological chemistry. The experimental method was successfully used by many of I. Müller's students - I. Liberkün, K. Ludwig, E. Haeckel, R. Virchow, G. Helmholtz. Widely using physiological experiment, the French scientist C. Bernard in the middle of the 19th century set himself the goal of combining physiology, pathology and therapy. The famous experience of K. Bernard - damage to the fundus of the cerebral ventricle in an experimental animal, causing a significant increase in blood sugar, was one of the links in a series of his experiments on the study of liver functions and its role in the process of assimilation of food. Karl Bernard put physiology at the service of the clinic. His successes in studying the processes of digestion, blood circulation and diseases of these systems allowed him to put forward the thesis: "an experimental doctor is a doctor of the future." However, the successes of physiologists Magendie, Müller, Bernard in specific areas but saved them from understanding the processes of life from the standpoint of idealistic philosophy. Only with the appearance of the works of Russian researchers, first of all S.P.Botkin, I. Medicine Sechenov, I.P. Pavlov, were for the first time correct, materialistic, disclosed and clarified the laws of the activity of the central nervous system and the entire organism as a whole. A materialistic, scientific interpretation of mental phenomena - thinking and consciousness - was given in Sechenov's work "Reflexes of the Brain" (1863). Russian scientists restructured physiology and had a profound impact on the development of medicine.
The development of pathology in the middle of the 19th century led to a struggle between its two directions - humoral (from the Latin humor - liquid) and the so-called cellular. The representative of the first - the Viennese pathologist K. Rokitansky believed that the cause of the painful phenomena was changes in the composition of the juices of the human body. The German pathologist R. Virchow objected to him; in his book "Cellular Pathology" (1858), he argued that the source of the disease is the abnormal activity of cells ("all pathology is a pathology of the cell"). Virchow's merit was the application of the doctrine of the cell to the study of diseases. He clarified the changes in tissues and cells of organs caused by the disease, which enriched clinical medicine and facilitated diagnosis. However, Virchow's theory, his cellular pathology, overestimated the role of cells, reducing the essence of the disease only to the defeat of certain cells and thereby denying the unity of the organism and the importance of the central nervous system. Russian medical scientists Sechenov, I.P. Pavlov, N.I. Pirogov, S.P. Botkin and others sharply criticized Virkhov's cellular pathology, opposing it with the idea of \u200b\u200bthe unity of the organism and the environment and the leading role in it (both in healthy and sick condition) of the central nervous system.
Thanks to the successes of natural science, clinical medicine has been enriched with new methods of diagnosis and treatment. Treatment options have expanded, in particular due to significant improvements in methods clinical research... Doctors began to use percussion (percussion), auscultation (listening), and measurement of body temperature. In the 19th century, the diagnostic technique was supplemented with devices based on the study of physical and chemical phenomena: measurement of blood pressure, bronchoscopy, electrocardiography, microscopic study of blood cells. A major step forward was the discovery in 1894 by the German scientist V.K. X-rays and their application for diagnosis and therapy (see. ,). The development of chemistry, the chemical industry, and then the pharmaceutical industry provided clinicians with a large number of new effective drugs.
Surgery in the 19th century experienced a new stage of development, as surgeons realized the need for a deeper study of anatomy for success surgical interventions. Big role this was played by N.I. Pirogov, who developed a new discipline - topographic anatomy - and published an anatomical and surgical atlas. The surgical method has become widely used in many clinical specialties - in the treatment of female diseases, eye and others.
The most important stage in medicine in the 2nd half of the 19th century, associated with the development , was the establishment by the French scientist L. Pasteur of the role of microbes in the occurrence of infectious diseases. The causative agents of anthrax, relapsing fever, amoebic dysentery, typhoid fever, tuberculosis, plague, cholera and others were discovered. Methods of treatment and prevention of infectious diseases were developed: in 1881, vaccinations against anthrax, in 1885 - against rabies (Pasteur, France), in 1890 - against diphtheria [Ә. Bering (Germany), S. Kitazato (Japan), E. Roux (France)] and others. The doctrine of immunity and the emerging new branch of science - immunology (one of the founders of which was II Mechnikov) armed medicine with new means of fighting infectious diseases - vaccines and serums (the so-called immunotherapy). Further development microbiology in the 20th century led to the separation of the doctrine of viruses - virology into an independent discipline.
Based on the discoveries of microbiology, hygiene has also made great strides. The growth in the 19th century of large cities, large industrial centers, their unsanitary state endangered the life and health of the population; this stimulated the development of extensive scientific research in the field of hygiene and sanitation. The German medical scientist Pettenkofer applied experimental research methods that gave hygiene a scientific basis. The study of the influence of air, water and soil on the human body made it possible to put on a scientific basis the device of water supply, sewerage and dwellings. Pettenkofer's students - Russian scientists F.F. Erisman, A.P. Dobroslavin and others - developed the direction created by Pettenkofer, founding the Russian school of hygienists, which was characterized by the study of social factors - the systematic accounting of the main indicators of statistics and dynamics of population health (birth rate, mortality, morbidity, physical development, and the like).
In addition to X-rays, radioactive substances have also been widely used in medicine for the recognition and treatment of diseases (see,). In the 20th century, the doctrine of vitamins was created and their role in the prevention of diseases and their treatment was established [the works of the Polish scientist K. Funk (1912), which confirmed the conclusions and experiments of Russian scientists N.I. Lunin (1880) and V.V. . Pashutin (1902)]. The development of organic chemistry from the beginning of the 2nd half of the 19th century led to the emergence of the chemistry of synthetic drugs, and the synthesis in 1909 by the German scientist P. Ehrlich of a powerful anti-syphilitic agent - salvarsan - laid the foundation for modern chemotherapy. The biggest advance in chemotherapy has been the discovery and therapeutic use of sulfa drugs (German scientist G. Domagk, 1935), and then antibiotics.
In the USSR, medicine received tremendous opportunities for development, provided it by the conditions of the new socialist social and state system. In the USSR, medical science is developing in accordance with the needs of protecting and strengthening the health of the population, for the fulfillment of which an extensive network of research institutions has been created.
Since the philosophical basis of medicine in the USSR is dialectical materialism, Soviet physicians have a deeper and more correct approach to solving such key questions of medicine as the question of the relationship between the social and the biological, the relationship between the organism and the environment, and the leading role of the nervous system.
The preventive focus of medicine in the USSR is its most characteristic feature. Physiological teaching of I.P. Pavlov, synthesizing the best progressive achievements of world scientific physiology, is creatively applied in all areas of medicine. Close connection with practice allows not only to quickly respond to the demands of life, but also to use the data of a huge network of medical institutions for scientific research.
One of the most important principles underlying Soviet medical science is the principle of development, evolution. The evolutionary direction was reflected especially in the major studies of A. A. Zavarzin and N. G. Khlopin. In addition to the evolutionary direction, morphology is also characterized by the principle of communication, the unity of form (structure) and function. This trend was most vividly expressed in the works of V.N. Tonkov and V.P. Vorobiev, B.I. Lavrent'ev. In the field of topography, anatomy, V. N. Shevkunenko and his students have developed questions of age "typical" anatomy, which is of great importance for practical surgery. Pathological anatomy in the USSR represented by its representatives A.I. Abrikosov, I.V. Davydovsky and others. consistently develops the clinical and anatomical direction.
Pathophysiology in the USSR is directly related to the clinic. IP Pavlov's student A.D.Speranskii widely developed Pavlov's idea of \u200b\u200bnervous trophism and put forward the leading role of the nervous factor in the pathogenesis of various human diseases. The works of NN Anichkov and his colleagues on arterial diseases, in particular atherosclerosis, and on infectious pathology are significant. Numerous works by A. A. Bogomolets and his students are devoted to the problems of longevity. The works of I.P. Pavlov play an important role in the development of domestic pharmacology. In the studies of N.P. Kravkov, who developed Pavlov's ideas, it should be noted experiments on isolated organs, work on the study of internal secretion. Pharmacological research is associated with the success of chemotherapy in the USSR and the development of the chemical and pharmaceutical industry, the synthesis of new Soviet drugs.
The social and preventive direction of Soviet health care and medical science finds its full expression in hygienic disciplines (general hygiene, communal hygiene, occupational hygiene, food hygiene, school hygiene). Among hygienic disciplines, social hygiene took a special place, in the development of which the most prominent theorists and organizers of Soviet health care N. A. Semashko, Z. P. Soloviev participated. The following have been greatly developed: communal hygiene in connection with the emergence and rapid growth of new cities, reconstruction of the country and gigantic housing construction; occupational health, which faces new challenges caused by the mechanization of agricultural production, the introduction of new production processes and the creation of new industries; hygiene of food in connection with the wide development of public catering.
Epidemiology, microbiology and virology occupied a prominent place in Soviet medicine. New highly effective anti-malarial, anti-anthrax, anti-brucellosis, anti-influenza, and others have been developed and put into practice. Great scientific advances have been made by Soviet microbiologists and epidemiologists in solving the problem viral infections - spring - summer encephalitis, Japanese (mosquito) encephalitis in the Far East, rickettsioses, hemorrhagic fevers and others, in the fight against malaria (works by P.G.Sergiev, V.N.Beklemishev and others). E. N. Pavlovsky and his students created a new theory about the natural focal nature of vector-borne diseases, which showed that the source of infection for various diseases is not always a sick person, but in some cases also various animals found in natural conditions of nature.
Of the clinical disciplines, the teachings of I.P. Pavlov primarily influenced the development of the clinic of internal diseases: the works of V.P. Obraztsov, N.D.Strazhesko, A.I. Yarotsky, N.I. Leporsky, related to diseases of organs abdominal, studies by GF Lang and AL Myasnikov, VF Zelenin and others on hypertension, disease, heart and vascular diseases, EM Tareev - on kidney disease. Soviet surgery avoided a narrowly practical bias (reduction of surgery to operational techniques) and is developing as an advanced scientific, practical, clinical discipline with a preventive direction. The issues of surgery of the abdominal cavity are widely presented in the works of I. I. Grekov, S. S. Yudin and others; brilliant work in the field of heart surgery belongs to A. N. Bakulev, A. A. Vishnevsky, I. I. Dzhanelidze, P. A. Kupriyanov, E. N. Meshalkin, B. V. Petrovsky; N. N. Burdenko, A. L. Polenov and others have done a lot in the development of neurosurgery; in the field of surgery, tumor treatment, a large place is occupied by the work of N.N. Petrov, P.A.Herzen, A.G. Savinykh, A.I.Savitsky, N.N.Blokhin, and others. Other branches of clinical medicine.
Research in the field of medicine is carried out according to state plans. The highest scientific and medical body of the country, exercising leadership in this area, is the Academy of Medical Sciences of the USSR, founded in 1944.
The successes of medical science in the USSR contributed to outstanding and fundamental achievements - a sharp decrease in overall and child mortality, an increase in life expectancy, a decrease in infectious diseases, the elimination of diseases in the USSR such as plague, cholera, smallpox, and relapsing fever. Malaria, syphilis and many other diseases are close to elimination.
The decree of the Central Committee of the CPSU and the Council of Ministers of the USSR dated January 14, 1960 "On measures to further improve medical care and health protection of the population of the USSR" contributed to a significant increase in the material development opportunities diseases (cancer and others) and raise the struggle for human health and longevity to a new level.
History of medicine in brief
Project of the Department of History of Medicine, Moscow State University of Medicine and Dentistry. A.I. Evdokimova
home
Tutorial
Textbook
Medicine in Western Europe
The feudal system was established in different countries of the world at different historical times. This process of transition from slavery to feudalism took place in specific forms for each country. So, in China it happened around the III-II century BC. e., in India - in the first centuries of our era, in Transcaucasia and Central Asia in the IV-VI centuries, in the countries of Western Europe - in the V-VI centuries, in Russia - in the IX century.
Fall of the Western Roman Empire in AD 476 e. represents for Western Europe the historical boundary between the slave formation and the new formation that came to replace it - the feudal one, between the so-called antiquity and the Middle Ages. The Middle Ages, the era of feudal, or serfdom, relations spanned the 12-13 centuries.
Under feudalism, there were two main classes: feudal lords and dependent serfs. Subsequently, with the growth of cities, the layer of urban artisans and merchants grew stronger - the future third estate, the bourgeoisie. Throughout the Middle Ages, there was an ongoing struggle between the two main classes of feudal society.
The feudal system of France, Germany, England went through three stages. The first stage of feudalism (from V to X-XI centuries) - the early Middle Ages followed directly after the fall of the slave system in Rome as a result of the uprising of slaves and the invasion of "barbarians".
The progressive features of the feudal system did not show themselves soon. New forms of social life took shape slowly. The Celtic and Germanic tribes, who defeated the slave-owning states, brought with them the remnants of the clan system with its economic and cultural features, primarily with natural forms of economy. The transition from the ancient world to the Middle Ages in Western Europe was associated at first with a deep economic and cultural decline. In the early Middle Ages, subsistence farming prevailed. In the countries of Western Europe, the decline of science has been noted for several centuries.
In the second stage of feudalism in Western Europe (approximately from the 11th to the 15th centuries) - in the developed Middle Ages - with the growth of productive forces, cities grew - centers of handicrafts and trade. Artisans in cities united in workshops, the development of which is characteristic of this stage. Along with subsistence farming, an exchange economy developed. Commodity-money relations strengthened. Trade within the country and between countries developed and grew.
The entire spiritual culture of the Middle Ages was under the yoke of church ideology, which affirmed the divine immutability of existence.
The gatekeeper of the medieval city does not allow entry to "lepers".
class order and oppression. "The world outlook of the Middle Ages was predominantly geological ... the church was the highest generalization and sanction of the existing feudal system." Blessed Augustine in the IV century put forward a characteristic position in this respect: "The authority of sacred scripture is higher than all the abilities of the human mind." The official church fought against heresies - attempts to critically relate to the scriptures and church authorities. These heresies reflected the social protest of peasants and townspeople. To suppress heresies at the end of this period in the Catholic countries of Western Europe, a special body was created - the Inquisition. The clergy were also the only educated class. From this it naturally followed that church dogma was the starting point and basis of all thinking. Jurisprudence, natural science, philosophy - all the content of these sciences was brought in accordance with the teaching of the church. In the Middle Ages, science was considered a servant of the church, and it was not allowed to go beyond the limits established by faith.
In the X-XII centuries, scholasticism became the dominant form of philosophy in Western Europe. In the XIII century, scholasticism reached its peak. The meaning of scholasticism was to justify, systematize and defend the official church ideology through artificial formalistic logical tricks. The class meaning of scholasticism was to justify the feudal hierarchy and religious ideology with the aim of the cruel exploitation of the working people and the stifling of progressive thought.
Scholasticism proceeded from the position that all possible knowledge had already been given either in Holy Scripture or in the creations of the church fathers ..
The philosophical foundation of medieval science was primarily the teachings of Aristotle, largely distorted and placed at the service of theology. In the Middle Ages, Aristotle was canonized by “scholastic science, he was called“ the forerunner of Christ in the explanation of nature. ”Cosmogony and physics of Aristotle turned out to be extremely convenient for the teachings of theologians. VI Lenin said about Aristotle that.
Universities were the centers of medieval medicine. The prototypes of Western European universities were the schools that existed in the Arab Caliphate and the school in Salerio. A university-type higher school existed in Byzantium already in the middle of the 9th century. In Western Europe, universities initially represented private associations of teachers and students, to a certain extent analogous to craft guilds, in accordance with the general guild structure of the Middle Ages. In the XI century, a university arose in Salerno, transformed from the Salerno medical school near Naples, in the XII-XIII centuries universities appeared in Bologna, Moipelje, Paris, Padua, Oxford, in the XIV century - in Prague and Vienna. The number of students at universities did not exceed several dozen in all faculties. The statutes and curricula of medieval universities were controlled by the Catholic Church. The whole system of university life was copied from the system of church institutions. Many doctors belonged to monastic orders. Secular doctors, when entering medical positions, took an oath similar to that of priests. Some ancient writers were also allowed to study in universities. In the field of medicine, such an officially recognized ancient author was primarily Galen. Medieval medicine took Galen's conclusions tinted with idealism, but his method of research (experiments, autopsies) was completely discarded, which was his main merit. From works
Hippocrates were accepted by those where his materialistic views in medicine were reflected with the least force. The task of scientists was, first of all, to confirm the correctness of the teachings of recognized authorities in the relevant field and to comment on it. Commentaries on the works of one or another authoritative writer were the main type of medieval scientific literature. Natural science and medicine were fed not by experiments, but by the study of the texts of Galen and Hippocrates. Galileo spoke about a scholastic who, having seen at an anatomist that the nerves converge in the brain, and not in the heart, as Aristotle taught, said: “You showed me all this so clearly and tangibly that if the text of Aristotle did not say the opposite (and it directly says that nerves originate in the heart), then it would be necessary to recognize this as true. "
The teaching methods and the very nature of science were purely scholastic. The students memorized what the professors said. The works of Hippocrates, Galen, Ibyasina (Avicenna) were considered dogmatic in medicine. The glory and brilliance of the medieval professor consisted primarily in his erudition and in the ability to confirm each of his positions with a quote taken from some authority and brought to memory. The disputes presented the most convenient opportunity to express all their knowledge and art. Truth and science meant only what was written, and medieval research became simply an interpretation of the known. Galen's comments on Hippocrates were widely used, many commented on Galen.
In the XIII-XIV centuries scholastic medicine with its abstract constructions, speculative conclusions and disputes developed in the universities of Western Europe. Therefore, in Western European medicine, along with the funds obtained medical practice, found a place and those whose application was based on a distant comparison, on the instructions of alchemy, astrology, which acted on the imagination or satisfied the whims of the wealthy classes.
Medieval medicine is characterized by complex medicinal recipes. Pharmacy was directly related to alchemy. The number of parts in one recipe often reached several dozen. A special place among medicines was occupied by antidotes: the so-called teriak, which included 70 or more components (the main component is snake meat), as well as mitridate (opal). Teriak was also considered a remedy against all internal diseases, including "pestilence" fevers. These funds were highly valued. In some cities, especially famous for their teriacs and mitridates and selling them to other countries (Venice, Nuremberg), the manufacture of these funds was carried out publicly, with great solemnity, in the presence of the authorities and invited persons.
Autopsies during pestilences were carried out as early as the 6th century AD. e., but they did not contribute much to the development of medicine. The first autopsies, traces of which have come down to us, were carried out from the 13th century. In 1231, Emperor Frederick II allowed an autopsy to be performed on a human corpse once every 5 years, but in 1300 the Pope imposed severe punishment on anyone who dared to dismember a human corpse or boil it down to make a skeleton. From time to time, some universities were allowed to perform autopsies. The medical faculty at Montpellier in 1376 received permission to open the bodies of those executed; in Venice in 1368, it was allowed to perform one autopsy per year. "In Prague, regular autopsies began only in 1400, that is, 52 years after the opening of the university. The University of Vienna received such permission in 1403, but for 94 Only 9 autopsies were performed there (from 1404 to 1498). At the University of Greifswald, the first human corpse was opened 200 years after the university was established. The autopsy was usually limited to the abdominal and thoracic cavities.
In 1316 Mondino de Lucci compiled a textbook on anatomy, trying to replace the part of the first book of Ibn Sina's Canon of Medicine, which was devoted to anatomy. Mondino himself only had the ability to dissect two bodies, and his textbook was a compilation. Mondino drew his main anatomical knowledge from a poor, error-prone translation of an Arabic compilation of Galen's works. For more than two centuries, Mondino's book remained an anatomy textbook.
Only in Italy at the end of the 15th and 16th centuries did the dissection of human corpses for the purpose of teaching anatomy become more frequent.
Among medieval universities in Western Europe, Salerno and Padua played a progressive role and were less influenced by scholasticism.
Already in ancient times, the Roman colony of Salerno, which lay south of Naples, was known for its healing climate. The influx of patients, naturally, led to the concentration of doctors here. At the beginning of the 6th century, meetings were held in Salerno to read the works of Hippocrates, later, in the 9th century, a medical school was created in Salerno, the prototype of the university that arose in the 11th century. The teachers at the Salerno school were people of different nationalities. Teaching consisted of reading the works of Greek and Roman, and later Arabic writers and interpreting what was read. The "Salerno Sanitary Regulations", a popular collection of personal hygiene rules, which was compiled in the 11th century in poetic form in Latin and was published several times, was widely known in the Middle Ages in Western Europe.
Unlike most medieval universities, the University of Padua in the domain of Venice began to play a role later, by the end of the Middle Ages, during the Renaissance. It was founded in the XIII century by scholars who fled from the papal regions and from Spain from the persecution of the Catholic church reaction. In the 16th century, it became the center of advanced medicine.
The Middle Ages in the West and in the East are characterized by a new phenomenon not known to the ancient world in such proportions - large epidemics. Among the numerous epidemics of the Middle Ages, the "black death" in the middle of the XIV century - the plague with the addition of other diseases to it - left a particularly difficult memory of itself. Historians, based on data from chronicles, church records of burials, city chronicles and other documents, argue that many large cities were empty. These devastating epidemics were accompanied by devastation in all areas of economic and social life. The development of epidemics was facilitated by a number of conditions: the emergence and growth of cities, characterized by overcrowding, cramped and muddy, massive movements of a huge number of people. the so-called great migration of peoples from East to West, later a great military colonization movement in the opposite direction - the so-called crusades (eight campaigns for the period from 1096 to "291). Epidemics of the Middle Ages, like infectious diseases of antiquity, are usually described under a general name “Pestilence” loimos (literally “plague.”) But, judging by the surviving descriptions, various diseases were called plague (pestilence): plague, typhus (primarily typhus), smallpox, dysentery, etc., often mixed epidemics.
The widespread spread of leprosy (under this name also hid a number of other skin lesions, in particular syphilis) during the Crusades led to the formation of the Order of St. Lazarus for the charity of the lepers. Hence, the shelters for lepers were called infirmaries. Along with the infirmaries, shelters were created for other infectious patients.
In large port cities of Europe, where epidemics were brought in by merchant ships (Venice, Genoa, etc.), special anti-epidemic institutions and measures arose: in direct connection with the interests of trade, quarantines were created (literally "forty days" - the period of isolation and observation of the crew of arrivals ships); special port overseers appeared - “health caretakers”. Later, also in connection with the economic interests of medieval cities, there appeared "city doctors", or "urban physicists," as they were called in a number of European countries; these doctors performed mainly anti-epidemic functions. In a number of large cities, special rules were published - regulations aimed at preventing the introduction and spread of infectious diseases; London, Paris, and Nuremberg rules of this kind are known.
To combat the widespread "leprosy" in the Middle Ages, special measures were developed, such as: isolating the "lepers" in a number of countries in the so-called infirmaries, supplying the "lepers" with a horn, rattle or bell for signaling from afar in order to avoid contact with healthy people. At the city gates, the gatekeepers examined those who entered and detained those suspicious of "leprosy".
The fight against infectious diseases also contributed to the implementation of some general sanitary measures - primarily to provide cities with good-quality drinking water. Among the oldest sanitary facilities in medieval Europe are the water pipelines of ancient Russian cities.
Following the first hospitals in the East-Caesarea and others, hospitals appeared in Western Europe. Among the first hospitals, more precisely, almshouses, in the West belonged to the Lyons and Paris "Hotel Dieu" - the house of God (they were founded: the first - in the 6th century, the second - in the 7th century), then Bartholomew's Hospital in London (XII century) and etc. Most often, hospitals arranged poi monasteries.
Monastic medicine in Western Europe was entirely subordinated to religious ideology. Its main task was to promote the spread of Catholicism. Medical assistance to the population, along with the missionary and military activities of the monks, was an integral part of the set of measures carried out by the Catholic Church during the conquest of new territories and peoples by the feudal lords. Medicinal herbs were used as a tool of Catholic expansion, along with a cross and a sword. The monks were ordered to provide medical assistance to the population. Most of the monks, naturally, lacked deep medical knowledge and medical "specialization, although there were undoubtedly skilled healers among them. The monastic hospitals served as practical schools for monks' doctors, they accumulated experience in treating diseases, making medicines. But, linking medicine with the church, observance of rituals, prayers, repentance, and healing with "miracles of the saints", etc., they hindered the development of scientific medicine.
Surgery developed from the branches of practical medicine in the Middle Ages in connection with numerous wars. Surgery in the Middle Ages was not so much practiced by doctors who graduated from medical faculties, as practitioners - chiropractors and barbers. The most complete generalization of the experience of medieval surgery was given in the 16th century by the founder of surgery.
The third stage of feudalism (XVI-XVII centuries) in Western Europe was a period of its decline and decomposition, the relatively rapid development of the commodity-money economy and then the emergence of capitalist relations and bourgeois society in the bowels of feudalism, representing the transition to the next socio-economic formation - capitalism.
Medicine is a science that studies a person in a healthy and diseased state with the aim of strengthening his health, protecting him from disease and treating him. Thus, the tasks of medical science include not only the treatment of patients, but also the strengthening of the health of the healthy.
It is quite obvious that these tasks cannot be solved without knowing how the human body is structured (i.e., anatomy) and how it functions (i.e., physiology). Therefore, medical science is based primarily on these two sciences - anatomy and physiology.
Sometimes physiology and medicine are mistakenly equated with meowyv. These sciences have different tasks and different ways of solving them. The difference between physiology and medicine lies primarily in the fact that a physiologist studies the general laws of the function of an abstract healthy person, while a doctor studies these functions in a particular person he is examining. In addition, a doctor, unlike a physiologist, must know not only how it functions healthy body, but also what morphological changes and dysfunctions occur in various diseases and pathological conditions. In other words, he must know deviations from the norm, that is, pathology. Otherwise, he will not be able to resolve the issue of the athlete's health and diagnose "healthy". But it is precisely this question that is the main one in physical culture and sports, since admission to classes primarily depends on its solution. physical exercise and their dosage. In addition, the physician must be able to treat diseases, injuries and injuries that occur in athletes, which are not the function of a physiologist.
Medicine consists of two large sections: theoretical and clinical.
In addition to anatomy and physiology, the theoretical section includes microbiology, pharmacology and a number of other disciplines.
In the clinical section, i.e. in the so-called clinical medicine, both a healthy and a sick person are studied - diagnosis, prevention and treatment of diseases, as well as the reactions of a healthy person to various external influences, factors affecting health, ways to strengthen it and maintenance.
The study of various diseases showed that, despite the external differences, they have common causes, general symptoms and general patterns of development. It turned out that, although outwardly the diseases are significantly different from each other, they obey general laws. Without knowledge, these laws, it is impossible to study either a healthy, let alone a sick person, since, without mastering the general laws of the occurrence and development of pathological processes, one can neither prevent, nor diagnose, nor treat diseases.
The science that studies these general patterns is called general pathology. Therefore, before studying clinical medicine, and sports medicine belongs precisely to this branch of medicine, it is necessary to master the basics of general pathology.
It would seem that medicine, designed to heal and cure a person, should be international and the tasks of health care should be the same both in a socialist and in a capitalist state. However, it is not.
Health care in a socialist state and health care in a capitalist state differ significantly.
The tasks of Soviet medicine are determined by the CPSU Program, which contains a special section "Caring for health and increasing life expectancy." Thus, in our country, caring for the health of Soviet people is, as noted above, a state task. Lenin spoke about this. He viewed the health of a worker in our country not only as his personal good, personal happiness, but also as a public wealth, which the state is called upon to protect and the plundering of which is criminal.
V.I.Lenin considered public health in combination with the conditions of the material and cultural life of the country and considered it necessary to resolutely strive to strengthen health, prevent diseases, improve physical condition, increase working capacity and increase the life expectancy of Soviet people.
All these fundamental instructions of V.I. Lenin lie at the basis of Soviet medicine, one of the constituent parts of which is sports medicine.
Free medical provision of the population with polyclinic and hospital care, careful monitoring of the state of health in order to prevent the occurrence of various diseases, starting from the first day of the birth of a Soviet citizen, and even before his birth - in antenatal clinics for pregnant women, is a huge socialist achievement ...
Our country has a wide network of state medical and preventive institutions (hospitals, clinics, consultations, etc.), all preventive measures are provided by the state. In the Soviet Union (as of 1971) there are 618,000 doctors, which is more than 25% of the number of doctors in the world.
The situation is completely different in capitalist countries, where qualified medical care is paid for by the patient himself, and it is quite expensive, and therefore is not available to everyone. There, caring for a person's health is a purely personal matter, and the state does not provide medical services to the population to the extent that it is necessary.
All of the above applies to sports medicine, which does not exist in isolation from medical science in general.
Only in recent years has a satisfactory definition of the concept of medicine been given: “Medicine is a system of scientific knowledge and practical measures, united by the purpose of recognizing, treating and preventing diseases, preserving and strengthening the health and working capacity of people, and continuing life 1. In this phrase, for the sake of accuracy, it seems to us that the word “society” should be added after the word “measures”, since in essence medicine is one of the forms of activity of society in the fight against diseases.
It can be repeated that medical experience, medical science and practice (or art) are of social origin; they cover not only biological knowledge, but also social problems. In human existence, it is easy to see that biological laws give way to social ones.
Discussion of this question is not empty scholasticism. It can be argued that medicine as a whole is not only a science, but also practice (and the most ancient), which existed long before the development of sciences, medicine as a theory is not only a biological, but also a social science; the goals of medicine are practical. B.D. Petrov (1954), arguing that medical practice and medical science, which arose as a result of critical critical generalization, are inextricably linked.
G.V. Plekhanov stressed that the influence of society on man, his character and habits are infinitely stronger than the direct influence of nature. The fact that medicine and human morbidity are social in nature, it would seem, is beyond doubt. So, N.N. Sirotinin (1957) points out the close connection of human diseases with social conditions; A.I. Strukov (1971) writes that human disease is a very complex socio-biological phenomenon; and A.I. Germanov (1974) considers it a "socio-biological category".
In a word, the social aspect of human diseases is beyond doubt, although each pathological process taken separately is a biological phenomenon. Let us also quote S.S. Khalatova (1933): “Animals react to nature as purely biological beings. The influence of nature on a person is mediated by social laws. " Nevertheless, attempts to biologize human disease still find defenders: for example, T.E. Vekua (1968) sees the difference between medicine and veterinary medicine in "the qualitative difference between the human body and the animal body."
The cited references to the opinions of many scientists are pertinent, because the relationship between the patient and the doctor can sometimes create the illusion that healing is, as it were, a completely private matter; such an involuntary delusion could be encountered in our country before the Great October Socialist Revolution and now exists in bourgeois states, while the knowledge and skill of a doctor is entirely of social origin, and a person's illness is usually caused by the way of life and the influence of various factors of a particular social environment; the physical environment is also largely socially conditioned.
It is impossible not to recall the importance of the socialist worldview for medical practice and the understanding of illness and understanding of human illness. ON. Semashko (1928) wrote that the view of illness as a social phenomenon is important not only as a correct theoretical setting, but also as a fruitful working doctrine. The theory and practice of prevention have their scientific roots from this view. This teaching makes a doctor not an artisan from a hammer and a tube, but a social worker: since a disease is a social phenomenon, then it is necessary to fight it not only with therapeutic, but also social and preventive measures. The social nature of the disease obliges the doctor to be a social activist.
Socio-hygienic research proves the social conditionality of the state of human health. Suffice it to recall the famous work of F. Engels "The Condition of the Working Class in England" (1845) 2. With the help of biomedical analysis, the mechanism of action of environmental factors (climate, nutrition, etc.) on biological processes in the body is established. However, we must not forget about the connection and unity of social and biological conditions of human life. Housing, food, working environment are social factors in origin, but biological in terms of the mechanism of influence on the anatomical and physiological characteristics of a person, i.e. we are talking about the body's mediation of social conditions.The higher the socio-economic level of modern society, the more efficient is the organization of the environment for human living conditions (even in space). Therefore, both biologism and abstract sociologism in solving problems of medicine are metaphysical and unscientific. In the listed facts, one can notice the decisive importance in understanding the theory of medicine and health care, the general worldview, the consideration of socio-economic foundations, the class approach.
Description of diseases in ancient times and modern terminology.Practical experience of doctorsaccumulated over several millennia. It may be recalled that the activity of ancient doctors was carried out on the basis of the great experience of their predecessors. In the 60 books of Hippocrates, in which, apparently, the works of his students were reflected, a significant number names of internal diseases,which were supposed to be fairly familiar to the reader. Hippocrates did not describe their symptomatology, he only had case histories of specific patients and many practical and theoretical remarks. In particular, the following, relatively speaking, nosological units are noted: peripneumonia (pneumonia), pleurisy, purulent pleurisy (empyema), asthma, exhaustion (phthisis), tonsillitis, aphthae, runny nose, scrofula, abscesses of various types (apostems), erysipelas, cephalalgia, phrenitis, lethargy (fever with drowsiness), apoplexy, epilepsy, tetanus, convulsions, mania, melancholy, sciatica, cardialgia (heart or cardia?), jaundice, dysentery, cholera, intestinal obstruction, abdominal suppuration, hemorrhoids, arthritis , stones, stranguria, edema (ascites, edema), leukophlegmasia (anasarca), ulcers, cancers, "large spleen", pallor, fatty disease, fevers - continuous, daily, tertsian, quartana, burning fever, typhoid, ephemeral fever.
Before the activities of Hippocrates and his school, doctors distinguished at least 50 manifestations of internal pathology. A rather long enumeration of various painful conditions and, accordingly, different designations is given in order to more specifically represent the great successes of observations, albeit primitive, of doctors of ancient civilizations - more than 2500 years ago. It is useful to realize this and thereby be attentive to the hard work of our predecessors.
The position of medicine in society.People's concern for the treatment of wounds and diseases has always existed and achieved some success in varying degrees in connection with the development of society and culture. In the most ancient civilizations - for 2-3 thousand years BC. - there were already some legislation regulating medical practice, for example, the Hammurabi code, etc.
Quite detailed information about ancient medicine was found in the papyri of Ancient Egypt. The Eberts and Edwin Smith papyri provided a summary of medical knowledge. A narrow specialization was characteristic of the medicine of Ancient Egypt, there were separate healers for the treatment of lesions of the eyes, teeth, head, stomach, as well as the treatment of invisible diseases (!) (Perhaps they refer to internal pathology?). This extreme specialization is considered one of the reasons that delayed the progress of medicine in Egypt.
IN Ancient India along with many empirical advances in medicine, surgery has reached a particularly high level (removal of cataracts, removal of stones from the bladder, plastic face, etc.); the position of healers seems to have always been honorable. In Ancient Babylon (according to the Hammurabi code) there was a high specialization, and there were also public schools of healers. Ancient China had extensive experience in healing; the Chinese were the first pharmacologists in the world, they paid great attention to disease prevention, believing that a real doctor is not the one who treats the sick person, but the one who prevents the disease; their healers distinguished about 200 types of pulse, 26 of them to determine the prognosis.
Repeated devastating epidemics such as the plague have at times paralyzed the population with fear of "divine punishment." "In ancient times, medicine, apparently, was so high and its benefits are so obvious that the art of medicine was included in the religious cult, was the affiliation of the deity" (Botkin SP, ed. 1912). At the beginning of European civilization, since the ancient period of Ancient Greece, together with the exclusion of religious views on diseases, medicine received the highest praise. This was evidenced by the statement of the playwright Aeschylus (525–456) in the tragedy "Prometheus", in which Prometheus's main feat was in teaching people to provide medical assistance.
In parallel with temple medicine, there were medical schools of fairly high qualifications (Kos, Knids schools), whose help was especially evident in the treatment of injured or wounded people.
The position of medicine and curative care, in particular during the era of Roman rule, was very low. Rome was inundated with many self-appointed healers, often fraudsters, and prominent scholars of the time, such as Pliny the Elder, called doctors the poisoners of the Roman people. We must pay tribute to the state organization of Rome in attempts to improve hygienic conditions (the famous water pipes of Rome, Maximus cesspool, etc.).
The Middle Ages in Europe essentially gave nothing for the theory and practice of medicine. In addition, it should be noted that the preaching of asceticism, contempt for the body, caring mainly for the spirit could not contribute to the development of medical methods, with the exception of the opening of separate nursing homes for the sick and the publication of rare books about medicinal plants, for example, the 11th century book by M. Floridus " On the properties of herbs "3.
The acquisition of medical knowledge, like any education, corresponded to the generally accepted scholastic method. Medical students were required to study logic for the first 3 years, then books by canonized authors; medical practice was not in the curriculum. Such a situation, for example, was even officially established in the 13th century and later.
At the beginning of the Renaissance, there were few changes in studies compared with the Middle Ages, classes were almost exclusively bookish; scholasticism, endless abstract verbal intricacies overwhelmed the heads of students.
However, it should be noted that along with a very heightened interest in the manuscripts of antiquity, intensified scientific research in general and the study of the structure of the human body in particular began. The first researcher in the field of anatomy was Leonardo da Vinci (his research remained hidden for several centuries). One can note the name of Francois Rabelais - the great satirist and doctor. He publicly performed an autopsy and preached the need to study the anatomy of the dead 150 years before the birth of the "father of pathological anatomy" G. Morgagni.
Little is known about the state organization of education and health care in this era, the transition from the dark Middle Ages to the new medicine was slow.
The state of medical care in the 17th and 18th centuries was rather miserable, the poverty of knowledge was masked by abstruse reasoning, wigs and solemn robes. This position of healing is portrayed quite truthfully in Moliere's comedies. The existing hospitals provided meager assistance to the sick.
Only during the Great French Revolution of 1789 did the state regulation of medical educationand help; so, for example, from 1795 by decree a mandatory teaching students at the bedside.
With the emergence and development of capitalist society, medical education and the position of a practical doctor took on definite forms. Medical education is paid, and in some states it is even very expensive. The patient pays the doctor personally, i.e. buys his skills and knowledge to restore his health. It should be noted that most doctors are guided by humane convictions, but in the conditions of bourgeois ideology and everyday life, they must sell their labor to patients (the so-called fee). This practice sometimes acquires the disgusting features of "cash" from doctors due to the desire for more and more profit.
The position of a healer in primitive communities, among the tribe, was honorable.
In semi-wild conditions, not so long ago, unsuccessful treatment led to the death of the doctor. For example, during the reign of Tsar Ivan IV, two foreign doctors were executed in connection with the death of the princes they treated, they were slaughtered "like sheep."
Later, during the period of serfdom, the remnants of feudalism, the attitude to the doctor was often disdainful. At the end of the 19th century V. Snegirev wrote: "Who does not remember how the doctors stood at the lintel, not daring to sit down ..." Zakharyin is honored to fight against the humiliation of doctors.
The position of "buying and selling" in medical practice was in pre-revolutionary Russia. The deviation of the doctor's activities from the rules of humanity (sometimes from elementary honesty) was noted in the works of D.I. Pisareva, A.P. Chekhov and others. However, doctors and the general public know the life and ideal behavior of most doctors (for example, F.P. Haas and others), as well as the actions of physicians-scientists who subjected themselves to life-threatening experiments for the development of science, the names of numerous doctors in Russia are familiar who conscientiously worked in the countryside. However, the practice of bourgeois relations prevailed everywhere, especially in the cities.
The Great October Socialist Revolution created new, most humane rules for medical practice. All relations between doctor and patient, distorted by bourgeois ideology and practice, have changed dramatically. Creation of a public health system that free medical care,established a new relationship between doctor and patient.
Taking care of the health of the population in our country is one of the most important tasks of the state, and the doctor has become the executor of this serious task. In the USSR, doctors are not people of the so-called free profession, but public figures,working in a specific social area. The relationship between doctor and patient has changed accordingly.
In conclusion, referring to the high value of the medical profession, it should be reminded to novice doctors or students that this activity is difficult both in terms of the chances of success and the environment in which a doctor will have to live. Hippocrates (published in 1936) eloquently wrote about some of the difficulties of our labor: “There are some of the arts that are difficult for those who possess them, but for those who use them they are beneficial and for ordinary people - a blessing that brings help, and for those who practice them - sorrow. Among these arts is that which the Hellenes call medicine. After all, the doctor sees the terrible, touches that which is disgusting, and out of the misfortunes of others he reaps sorrow for himself; the sick, thanks to art, are freed from the greatest evils, diseases, suffering, from sorrow, from death, for against all this medicine is a healer. But the weaknesses of this art are difficult to recognize, and the strengths are easy, and these weaknesses are known to some doctors ... "
Almost everything that Hippocrates said is worthy of attention, careful thought, although this speech, apparently, is more addressed to fellow citizens than to doctors. Nevertheless, the future physician must weigh his possibilities - the natural movement of helping the suffering, the inevitable atmosphere of difficult spectacles and experiences.
The difficulties of the medical profession were vividly described by A.P. Chekhov, V.V. Veresaev, M.A. Bulgakov; their experiences are useful for every doctor to think over - they complement the dry exposition of textbooks. Familiarity with artistic descriptions of medical topics is essential for enhancing the culture of the doctor; E.I. Liechtenstein (1978) has provided a good summary of what writers say about this side of our lives.
Fortunately, in the Soviet Union, a doctor is not a “lone handicraftsman,” dependent on the police or Russian tyrants, but is a worker, a rather respected member of the state health care system.
1 TSB, 3rd ed. - T. 15.- 1974.- P. 562.
2 F. Engels The Situation of the Working Class in England // K. Marx, F. Engels Works - 2-ed. - T. 2.- P. 231–517.
3 Odo iz Mena / Ed. V.N. Ternovsky .- M .: Medicine, 1976.
Source of information: Aleksandrovsky Yu.A. Frontier psychiatry. M .: RLS-2006. & Nbsp - 1280 p.
The guide was published by the RLS ® Group of Companies
Medicine is one of the most important aspects of the social life of society. Medicine as a science has existed as long as humanity has existed. The level of development of medical knowledge has always directly depended on the level of socio-economic development.
We can glean information about the initial stages of the development of medicine from ancient drawings and ancient medical supplies that have been found by archaeologists. We also learn information about the medicine of past times from written sources: works of thinkers of Ancient Greece and Ancient Rome, in annals, epics and thoughts.
In the early stages of the development of medicine, observation methods were mainly used. The first diagnoses were made after examining the external manifestations of the disease, in contrast, for example, to modern dentists, who can make a diagnosis based on your feelings, if you know everything about your smile.
In different parts of the world, medicine has developed separately. In China already in 770 BC. there was a book on medicine. Despite the fact that all the methods and advice on treatment in this book were mainly based on legends and myths, there was still genuine information about human health. It is known for certain that in the 5th century BC. even surgeries were performed in China using the first forms of modern surgical techniques.
In 618 BC. the doctors of ancient China first declared the existence of infectious diseases, and in 1000 BC. The Chinese even carried out smallpox vaccinations.
In another Asian country, Japan, medicine has not developed so successfully. Basic knowledge The Japanese learned from experience chinese medicine.
The real breakthrough in medicine took place in Ancient Greece. The first schools of doctors appeared here, which made medical education available to secular people.
It was thanks to the activities of one of these schools that Hippocrates received all his knowledge about medicine. The role of this thinker in the development of medicine cannot be easily overestimated. In his works, all the scattered accumulated information about the treatment of people is combined. Hippocrates identified the causes of diseases. The main reason, in his opinion, was the change in the ratio of fluids in the human body.
Hippocrates' conclusions became the basis of modern practical medicine, and his description of surgery is surprising even modern doctors... Hippocrates described methods of treatment that are widely used even in our time.
Of course, many famous scientists contributed to the development of medicine after Hippocrates. Thanks to their work, modern medicine reached unprecedented heights. In addition, modern technologies are used to train doctors.