Our children 

History of the development of domestic pediatrics. Abstract development of domestic pediatrics. After studying the topic, the student must

  1. Konyus E. M. Origins of Russian pediatrics - People's Commissariat of Health of the USSR, Medgiz - 1946.
  2. Brzhesky V.Ch. Names of pediatricians, immortalized by history // Pediatrics - 1985. - No. 4. –p.72.
  3. Danilishina E.I. 200 years of the first domestic scientific manual on obstetrics, gynecology and pediatrics // Soviet Medicine. –1985. - No. 11. – p.119-121.
  4. Mikirtichan G.L. History of domestic pediatrics - St. Petersburg: St. Petersburg GLMA. 1998.
  5. Suvorova R.V., Mikirtichan G.L. Issues of health care and the history of medicine on the pages of the first domestic pediatric journals // Issues of maternal and childhood protection. –1989. – T.34, No. 3. – p.75-77.
  6. Reshetkina L.P., Biktimirov V.V. The origins of the formation of domestic pediatrics // Pediatrics. – 1993. -№1.- p. 103 – 105
  7. Speransky G.N. Moscow pediatric schools. – M., 1949.
  8. Studenikin M.Ya., Kislyak N.S. . Achievements of Soviet pediatrics // Pediatrics -1977 - No. 10.
  9. Studenikin M.Ya., Efimova A.A., Tatochenko B.K. Ways of development of pediatrics // Pediatrics - 1974 - No. 10.

V.F. Snegirev is the founder of Russian scientific gynecology.

  1. Serdyukov M. G. V. M. Snegirev: life and scientific activity - M.: publishing house of the USSR Academy of Medical Sciences, 1950.
  2. BME / Ed. Petrovsky B.V. – T. 23. – P. 462

The formation of psychiatry and the clinic of nervous diseases in Russia (A. Ya. Kozhevnikov, S. S. Korsakov, V. Ya. Kandinsky, V. P. Serbsky).

  1. Portnov A. A., Fedotov D. D. Textbook of psychiatry - M.: Medgiz, 1960.
  2. Samoilov V.O. History of Russian medicine. – M.: Epidar. –1997.
  3. Buyanov M.I. Premature man. – M., Sov.Russia, 1989.
  4. Alexandrovsky Yu.A. Through the eyes of a psychiatrist. – M: Sov. Russia, 1977.
  5. Vlasov V.P. Charity and mercy in Russia. – M.: ZAO Publishing House Tsentrpoligraf, 2001.
  6. Shoifet M.S. One hundred great doctors. – M.: Veche, 2004. – p. 218-223.
  7. BME / Ed. Petrovsky B.V. – T. 11. – P. 117

Test tasks

1. Head of the Moscow therapeutic school of the 19th century: 1) Zakharyin; 2) Botkin; 3)Samples; 4) Yanovsky.

2. The modern structure of the medical history was developed in detail by: 1) Strazhesko; 2) Mudrov; 3) Ostroumov; 4) Zakharyin

3. Insisted on filling out the medical history “at the very beds of the vale”: 1) P.A. Zagorsky; 2)I.E. Dyadkovsky; 3) N.I. Pirogov; 4) M.Ya. Mudrov; 5) A.M. Philomafitsky.



4. The works of Hippocrates were first translated into Russian and widely propagated: 1) Gundobin; 2) Badger-Moiseev; 3) Botkin; 4) Wise.

5. The first experimental laboratory in Russia at the clinic was opened on the initiative of: 1) Zakharyin; 2) Botkin; 3) Zybelina; 4) Mudrova.

6. The method of sliding palpation of the abdominal organs was developed by: 1) Ostroumov; 2)Samples; 3) Zakharyin; 4) Petrovsky.

7. The Clinical Institute at Moscow University was opened on the initiative of: 1) Lomonosov; 2) Shuvalov; 3) Mudrova; 4) Hiltebrandt.

8. The first Moscow educational home was created according to the project: 1) Peter I; 2) Betsky; 3)Novikov; 4) Radishcheva.

9. Founder of domestic obstetrics and pediatrics: 1) Tolsky; 2) Zybelin; 3) Maksimovich-Ambodik; 4)N. F. Filatov.

12. Head of the St. Petersburg therapeutic school of the 19th century: 1) Zakharyin; 2) Botkin; 3) Ostroumov; 4)Strazhesko.

13. The method of subjective questioning of the patient was developed in detail by: 1) Zakharyin; 2) Botkin; 3) Yanovsky; 4) Samples.

14. One of the initiators of the introduction of balneo- and climatotherapy: 1) Krasovsky; 2) Mudrov; 3) Botkin; 4) Zakharyin.

15. Botkin was a supporter of: 1) empirical direction in medicine; 2) experimental method of development of medicine; 3) humoral theory; 4) cellular theory.

17. All but one were related to the formation of Russian pediatrics: 1) Khotovitsky; 2) Tolsky; 3) N. Filatov; 4) Maksimovich-Ambodik; 5) Pirogov.

18. Founder of military field therapy in Russia: 1) Mudrov; 2) Pirogov; 3) Dobroslavin; 4)Larrey.

19. Outstanding Russian psychiatrist, head of the Moscow Scientific School of Psychiatry: 1) Bekhterev; 2) Pinel; 3) Korsakov; 4) Gannushkin.

Written questions and assignments

1. Fill the table.

Comparative characteristics of therapeutic scientific medical schools of Botkin and Zakharyin

2. Is it possible to say that there is continuity between the Moscow therapeutic schools of M.Ya. Mudrova and G.A. Zakharyin? Give your reasons.

Find an error in the listing of some dates for the course on the history of Russian medicine.

1707 – opening of the first hospital school in Moscow

1725 – opening of the St. Petersburg Academy of Sciences

1755 – opening of Moscow University

1761 – publication of M.V. Lomonosov’s open letter “On the reproduction and preservation of the Russian people”

1847 – first use of ether anesthesia in Russia (F.I. Inozemtsev)

1847 – publication of S.F. Khotovitsky’s work “Pediatrics”

1867 – publication of I.M. Sechenov’s work “Reflexes of the Brain”

Please provide a name.

7.1. The first civil hospital in Russia was opened in the city of ________________ in

Year boyar ___________________________________________________.

7.2. For the first time in Russia, he introduced the teaching of gynecology as an independent discipline, opened the first gynecological clinic in Moscow

7.3. Founded the Moscow Scientific School of Psychiatry, author of the classic “Course of Psychiatry”, developed and put into practice a system of care for the mentally ill at home

_________________________________________________________________________

7.4. Headed the Kyiv therapeutic school, author of the technique of deep sliding palpation of the abdominal organs_____________________________________________

7.5. Created the largest pediatric clinical and physiological school in Russia, organized the first society of pediatric doctors in Moscow

_____________________________________________________________________________

Interesting facts from the history of medicine

V.F. Snegirev

Famous gynecologist, professor V.F. Snegirev (1847-1916) in the conference room of his clinic, next to the portraits of outstanding scientists - N.I. Pirogov, Ch. Darwin and others - placed a portrait of nanny Makarova with the inscription “A thousand operated patients came out.”

Source: Petrov B.D. From Hippocrates to Semashko: continuity of ideas (Essays and portraits). – M.: Medicine, 1990. – P. 164-165

(...) In his speech “From what he experienced,” delivered on December 23, 1903 at the 1st congress of the Society of Russian Gynecologists and Obstetricians in Petrograd, Snegirev spoke about an incident that occurred in 1884, when a seriously ill patient died after a dangerous but inevitable operation. The relatives of this patient, from the princely family of Shakhovsky, ordered an inscription to be made on the monument to the deceased stating that the deceased died from the operation of Dr. Snegirev (Donskoy Monastery cemetery). However, the surgeon continued to work. At the same time, the mortality rate in Snegirev’s clinics, despite the huge number of advanced cases, was 4.7%, and at the same time, 22-38% of those operated on died in the clinics of Western European celebrities.

Source: Serdyukov M.G. V.F. Snegirev: life and scientific activity - M.: Publishing House of the USSR Academy of Medical Sciences, 1950.

N.F. Filatov

The great pediatrician Nil Fedorovich Filatov was invited to a consultation. The doctors' opinions were divided: some believed that the child had measles, others even believed that it was smallpox. The child, exhausted by illness, slept. Not wanting to disturb him, the professor asked not to light the candles. He carefully felt the child’s face in the dark and, based on the density of the papules, made the correct diagnosis. Neil Fedorovich had highly developed vision, hearing, and sense of smell, which greatly helped him when examining a patient and diagnosing an illness. However, all outstanding doctors possessed these qualities to one degree or another.

Source: N.B. Korostylev - Professor of the Moscow Medical Academy named after I.M. Sechenov. From notebooks.

S.P. Botkin

A number of Botkin’s diagnoses went down in the history of medicine. For example, Botkin was the first in the world to make a lifetime diagnosis of portal vein blockage. One of his contemporaries recalls that when Sergei Petrovich made this diagnosis, no one believed in him. The patient lived for several weeks, “indulging the gloating of Botkin’s ill-wishers.” They hoped for a clinical error on Botkin’s part and hoped that the autopsy would clearly prove the “charlatan arrogance of the young professor.”

The patient died. The anatomical theater was filled with friends and foes of Sergei Petrovich and simply curious people. It is easy to imagine the mood of this crowd when Professor Ilinsky (then pathologist) removed the portal vein, which actually contained a thrombus. Sergei Petrovich's ill-wishers at the academy conference have quieted down since then.

Botkin proposed a new method for diagnosing a wandering kidney and carefully described all the symptoms of this disease, which had previously escaped the attention of doctors. In the literature about Botkin, there are cases when Sergei Petrovich literally performed miracles during diagnosis. Here, for example, is one of such cases. A woman with a very high fever was admitted to the clinic. The ward resident diagnosed him with catarrhal pneumonia. Symptoms: dry cough, cyanosis on the face, cold extremities, drowsy state, refusal to eat. The patient was shown to doctors Chudnovsky and Koshlakov. They noted a decline in cardiac activity and determined pneumonia or typhus. Botkin, having examined the patient, said:

At autopsy tomorrow, look for an abscess in the posterior mediastinum near the esophagus. The patient can no longer be helped.

Chudnovsky expressed some bewilderment with a smile, Koshlakov remained silent.

The next morning the patient died. The autopsy fully confirmed Botkin's conclusion: purulent inflammation of the esophagus with the formation of an abscess in the posterior mediastinum and purulent blood poisoning.

And then everyone remembered that the patient repeated: “Day 8 ago, after a fish soup, I fell ill.” No one paid attention to this, but the abscess was caused by a fish bone that had fallen into the esophagus.

And yet, even this great diagnostician made mistakes. He experienced them hard, even very hard. There was such a case: a paramedic student who worked in a pharmacy fell ill with typhoid fever. After recovery, he complained of headaches, but there were no objective indications, and he was discharged. Three months later he came in complaining of persistent headaches. And again, no objective evidence. The next day he died. The autopsy was performed at a lecture by Professor Rudnev. When he asked what the diagnosis was, he was told that Sergei Petrovich did not find any reason that could explain his prolonged complaints, and in the “mournful sheet” it was written: “Simulation.” At autopsy, an extensive abscess was discovered. Professor Rudnev said in a sarcastic and mocking tone: “This is enough, I think, to make sure that the lazy paramedic did not die from simulation.” For many days afterwards, ill-wishers happily talked about an abscess called “simulation” and relished Botkin’s mistake. But this was not what depressed Sergei Petrovich - he could not forgive himself for not believing the patient’s complaints and not taking timely measures. When the diagnosis was made correctly (and this almost always happened), Sergei Petrovich was very inventive in finding treatment methods.

Botkin sometimes treated people in a very unique way. Here, for example, is how Ivan Petrovich Pavlov’s wife recalls her treatment during a severe nervous illness: “After examining me, Sergei Petrovich first of all asked if I could leave. When I said “no way,” he replied: “Well, let’s not talk about it.” “Tell me, do you like milk?” “I don’t like it at all and I don’t drink.” “But we will still drink milk. You're a Southerner, and you're probably used to drinking at dinner." "Never, not a bit." “We will drink, though. Do you play cards? “What are you, Sergei Petrovich, never in your life.” “Well, let's play. Have you read Dumas and such a wonderful thing as Rocambole? “What do you think about me, Sergei Petrovich? After all, I recently finished my courses, and we are not used to being interested in such trifles.” "That's fine. This means that you will drink first half a glass of milk a day, then a glass. This will get you up to 8 glasses a day and then back down to half a glass. You will pour a teaspoon of good, strong cognac into each glass... Then, after lunch, you will lie down for an hour and a half. Every day you will play screw, robert 3-4, and you will read Dumas. And walk every day in any weather for at least an hour. Yes, you will still be wiping yourself with room water at night and rubbing yourself with a thick peasant sheet... Now goodbye. I am sure that you will soon recover if you follow all my instructions.” Indeed, following exactly all his advice, after 3 months I was a healthy woman.”

Lecture outline

1. Pediatrics as a science. Stages of development. Contribution of domestic pediatricians to the development of science.

2. Structure of pediatric services in the Russian Federation.

3. Demographic indicators in the Russian Federation.

  1. The role of a nurse in the context of the implementation of the “National Healthcare Project”.

Pediatrics – is a science that studies the human body from birth to adolescence. The word "pediatrics" comes from two Greek words: paid - child and iatria - healing.

Professor-obstetrician N.M. made a significant contribution to the development of pediatrics in Russia. Maksimovic-Ambodik. In his work “The Art of Midwifery, or the Science of Babishing,” he described certain diseases of newborns and gave recommendations for caring for a child after birth.

The first Russian professor-therapist S.G. Zabelin in his works described the rules of breastfeeding a child and showed the importance of breastfeeding for the development of a healthy child.

The next stage in the development of pediatrics in Russia is associated with the organization of children's hospitals and the publication of the first manuals on pediatrics. The first hospitals were opened in St. Petersburg in 1834 and in Moscow in 1842. Subsequently, both of them were given the name of the outstanding Russian pediatrician N.F. Filatov.

S.F. is considered the founder of the national pediatric school. Khotovitsky, who identified pediatrics as a separate branch of medicine. He was the first to teach a course on childhood diseases to students at the Medical-Surgical Academy in St. Petersburg. In 1847, Khotovitsky, for the first time in Russia, wrote a manual on childhood diseases, Pediatrika. He owns the famous words: “A child is not a reduced copy of an adult, a child is a being that grows and develops only according to its inherent laws.”

The further development of pediatrics is associated with the opening of departments of childhood diseases in 1865 at the St. Petersburg Medical-Surgical Academy and in 1873 at Moscow University with a children's clinic. During this period, pediatrics became an independent specialty. In the 80s of the 18th century, departments of childhood diseases and children's clinics began to gradually open in many cities of Russia: Kazan, Tomsk, Saratov, Yuryev, etc.

A great contribution to the development of pediatrics was made by the scientist, clinician, and teacher N.F. Filatov, who created a school of pediatricians in Moscow. He wrote several works on pediatrics: “Semiotics and diagnosis of childhood diseases”, “Lectures on acute infectious diseases”, where he described the most characteristic signs of childhood infectious diseases: features of scarlet fever rash (Filatov’s pale nasolabial triangle), “scarlet fever heart”, an early sign measles, symptom of glandular fever, etc. In 1892, he headed the Society of Children's Doctors in Moscow.

BRIEF HISTORY OF DOMESTIC PEDIATRICS

The first rudiments of pediatric knowledge date back to ancient times. In the works of Hippocrates, in his “Aphorisms,” in the works of Soranus and Galen, you can find interesting instructions on caring for newborns and on children’s dietetics. In the writings of Arab doctors there are already descriptions of certain diseases characteristic only of childhood. However, neither Greek, nor Roman, nor Arabic medicine, despite a fairly high level of development for its time, left a systematic presentation of information about the child, since observations of children were carried out along the way, while studying the adult organism.

Medical care for mother and child among all peoples had this significant difference from other types of medical care, for example, from surgery and therapy, that for thousands of years it remained in the hands of a woman - the keeper and bearer of experience accumulated and passed on from generation to generation.

Morbidity and mortality rates among children, especially at an early age, were very high. Here, in addition to the general social factors causing high morbidity and mortality of the entire population, there were also unsanitary customs for caring for newborns, a complete lack of medical care, and the results of the actions of ignorant midwives and healers.

The development of pediatrics as a medical science can be divided into three periods.

The first period covers the 16th, 17th and 18th centuries. There was no systematization of knowledge at that time. Pediatrics as a special discipline has not yet been singled out, however, in the works of outstanding Russian public figures of that time and medical scientists of other specialties, there are statements on the issues of protecting children's health. Thus, the brilliant Russian scientist M.V. Lomonosov, in his treatise “On the Reproduction and Preservation of the Russian People,” outlining the main measures to protect the health of the population, pointed out, in particular, the need for state care for women in labor and childbirth, and the fight against infant mortality. This treatise spoke of measures aimed at preserving the lives of newborns and the need to create shelters for illegitimate children.

A major role in the development of pediatrics was played by professor-obstetrician N. M. Maksimovich-Ambodik, who left a number of original works on the protection of maternal and child health. His work “The Art of Midwifery, or the Science of Babishing” contains instructions on the proper care of a child, and there are descriptions of diseases characteristic of young children.

The first Russian professor-therapist at Moscow University, S. G. Zybelin, being a supporter of breastfeeding, in his works outlined the rules for breastfeeding a child.

An outstanding role in the development of Russian pediatrics belongs to the professor-obstetrician S. F. Khotovntsky, who first identified pediatrics as an independent branch of medicine and clearly defined its goals and objectives. He owns the wonderful words: “... a child is a creature that grows and develops only according to its inherent laws. A child is not a smaller copy of an adult.” He was the first to separate a children's department from the obstetrics clinic. S. F. Khotovitsky owns the first Russian original manual on childhood diseases - “Pediatrika” (1847), so he is rightly considered the first Russian pediatrician.

The second period is from the beginning of the 19th century to 1917. At this time, pediatrics was developing as an independent discipline. The colossal infant mortality rate of that time was not reduced by treating sick children with the same drugs that were used for adults. This forced us to abandon the view of the child “as an adult in miniature” and required a separate study of the child’s body.

The opening of children's hospitals in a number of large Russian cities played a major role in this. Thus, in 1834, the first in Russia and the third in the world special children's hospital with 50 beds was opened in St. Petersburg, now the N. F. Filatov Children's Hospital. The second children's hospital opened in 1842 in Moscow, and later it was also named after N. F. Filatov. Several children's hospitals are starting to operate in other large cities of Russia.

In 1865, the first department of childhood diseases in Russia was organized at the Medical-Surgical Academy. In 1886, a department was created at Moscow University with a children's clinic with 11 beds and a small outpatient clinic attached to it. The opening of these departments had a great influence on the further development of pediatrics and the training of doctors with relevant knowledge about childhood diseases.

At the end of the 19th and beginning of the 20th centuries, there was an upsurge in the development of domestic pediatrics, which was greatly facilitated by the extremely fruitful activities of two leading Russian doctors - N.F. Filatov in Moscow and N.P. Gundobin in St. Petersburg.

N. F. Filatov is rightfully considered the founder of domestic pediatrics. He created a school of pediatricians and made a valuable contribution to the development of science. Talent of N. F. Filatov

as an outstanding clinician, scientist and teacher, found expression in the description of various diseases of children and in his scientific works. He was the first to describe scarlet fever rubella, as well as idiopathic inflammation of the cervical lymph nodes, which is currently called infectious mononucleosis, or Filatov's disease.

The works of N. F. Filatov “Semiotics and diagnosis of childhood diseases”, “Lectures on infectious diseases”, “Lectures on gastrointestinal diseases in children”, “A short textbook of childhood diseases”, “Clinical lectures” and other works were the basis of Russian pediatric literature, putting it on a par with foreign literature, which had existed by that time for many years. These books went through a number of editions and had a great influence on the development of pediatrics and on the training of pediatricians.

The work of Professor N.P. Gundobin of the Medical-Surgical Academy and his numerous students significantly expanded the knowledge of pediatricians about the age-related anatomical and physiological characteristics of children. N.P. Gundobin was the first pediatrician to organize an exceptionally broad study of the anatomical, histological and physiological characteristics of the child’s body. N.P. Gundobin summarized the research data carried out by his many students in his outstanding work “Features of Childhood,” which has not yet lost its scientific significance.

N.P. Gundobin was one of the founders and leaders of the Union for the Fight against Child Mortality in Russia.

Despite the presence of talented enthusiastic doctors and inquisitive researchers, pediatrics in Tsarist Russia could not develop widely. Children's hospitals and institutions arose only on the private initiative of individuals, supported by private charity with negligible assistance from the state. By 1917, there were only about 30 children's hospitals in Russia with a total number of beds of 3,300, and there were very few beds for infants. The largest part of these hospitals was concentrated in Moscow and St. Petersburg. Throughout Russia in 1913 there were 550 places in permanent nurseries, 9 women's and children's clinics, 6824 maternity beds.

The third period in the development of pediatrics begins after the Great October Socialist Revolution, when exceptionally broad opportunities opened up for the development of all branches of knowledge, including medicine.

The decree adopted in December 1917 and signed by V.I. Lenin clearly and clearly defined the tasks of protecting motherhood and childhood. For the first time in the history of mankind, the protection of motherhood and childhood in our country has become a state matter. The protection of motherhood and childhood is a coherent system of government measures aimed at resolving issues related to the protection of maternal and child health, child morbidity and mortality, the organization of obstetric care and women’s labor protection.

After the Great October Socialist Revolution, a number of decrees were adopted that dramatically changed the situation of working women.

During the Great Patriotic War, the Presidium of the Supreme Soviet of the USSR issued a decree dated June 8, 1944. “On increasing state assistance to pregnant women, large and single mothers, strengthening the protection of motherhood and childhood, establishing the honorary title “Mother Heroine” and establishing the Order of “Maternal Glory” and the medal “Motherhood Medal.”

Professor A. A. Kisel and his school made a great contribution to the development of Soviet pediatrics. A. A. Kisel attached great importance to the prevention of diseases, carrying out extensive health measures, and organizing sanatorium and resort treatment for children. A. A. Kisel’s contribution to the study of tuberculosis and rheumatism was especially great.

The largest pediatrician in our country, Professor G. N. Speransky, did a lot to organize the protection of motherhood and infancy. He and his school comprehensively studied the problems of physiology and pathology of early childhood, with particular attention paid to nutritional disorders and digestive disorders. The fight for the health of the child was the starting point of the scientific activity of G. N. Speransky.

Professor V.I. Molchanov developed the basic ideas of the teachings of N.F. Filatov. He made a great contribution to the study of the clinic, pathogenesis and treatment of childhood infectious diseases, especially diphtheria. He established a pathogenetic connection between scarlet fever and rheumatism. The great merit of V.I. Molchanov is the study of endocrinological diseases in children and the characteristics of childhood pathology in wartime.

Professor M. S. Maslov is an outstanding Soviet pediatrician scientist. For many years, he studied the pathogenesis of many childhood diseases, the metabolic characteristics of a healthy child, the biochemistry of the child’s blood in normal conditions and pathologies. He developed a doctrine about constitutional anomalies in children.

Professor Yu. F. Dombrovskaya was a worthy successor to the work of N. F. Filatov and V. I. Molchanov. Scientific research by Yu. F. Dombrovskaya and her school was focused on a comprehensive study of the etiology, pathogenesis, clinical picture and treatment of pneumonia in childhood. The problem of vitamin deficiency in children has been thoroughly developed and from a new perspective, and wartime pathology has been studied. In the clinic, under the leadership of Yu. F. Dombrovskaya, scientific work was widely carried out to study respiratory pathology, collagen diseases, blood diseases, and allergies.

Professor A.F. Tur is a prominent pediatrician scientist in our country. In his scientific activities, he paid much attention to issues of hematology, dietetics of healthy and sick children, physiology and pathology of newborns, and issues of medical care for children.

Professors A. A. Koltypin, P. S. Medovikov, A. I. Dobrokhotova, M. G. Danilevich, O. D. Sokolova-Ponomareva, D. D. Lebedev, N. I. Krasnogorsky, developing various problems of pediatrics, contributed a lot of new and valuable things to the study of healthy and sick children.

The main task is to study the patterns of development of children, the causes and mechanisms of diseases, methods of their diagnosis, prevention and treatment.

Subject of study

  • age characteristics of children of early and preschool age;
  • physical and NP development of children;
  • diseases, their diagnosis, treatment and prevention.
  • assistance in case of accidents and injuries.

Areas of pediatrics:

Preventive pediatrics

A system of measures aimed at the prevention of childhood diseases (professional vaccinations, asepsis, professional rickets, screening programs to identify inherited diseases, etc.)

Clinical pediatrics- This section is aimed at diagnosis and treatment.

Scientific Pediatrics has the task of formulating the paradigms that guide the pediatrician in his work.

Social pediatrics as a branch (component) of pediatrics, it studies the health of children, the complex of factors that determine it, and also develops an effective system of social prevention and provision of medical care to the child population.

Environmental Pediatrics studies the influence on the health of children of natural factors: climatic, geographical, as well as harmful environmental factors in a particular region (insecticides, pesticides, phenol, dioxide, sulfur dioxide, lead, penetrating radiation, etc.)

The history of the development of pediatrics consists of 3 stages.

Stage 1 is associated with Hippocrates, Celsus, Galen. The first writings on the nature of the child. During the Middle Ages, orphanages were opened (the first one opened in 787)

Stage 2, state educational homes and orphanages were created - 1638-1707. 1650 - scientific work on rickets. 1764 - the first manual on pediatrics.

Stage 3, pediatrics was considered as a science. 1802 - the first children's hospital in Paris. 1834 - the first children's hospital in Russia. 1842 - the first children's hospital in Moscow.

1847 - the first Russian manual on pediatrics “pediatrika”, written by S.F. Khotovitsky.

Khotovitsky Stepan Fomich - the first Russian pediatrician, formed the right of pediatrics to independent existence. Organized the first systematic course in pediatrics in Russia.

1865 - the first department of pediatrics in Russia, Vasily Markovich Flovinsky in St. Petersburg.

Nim Fedorovich Filatov is the father of clinical pediatrics, its founder. Wrote “Semiotics and diagnosis of childhood diseases”, “Semiotics and diagnosis of infectious diseases”, “A short textbook of childhood diseases”, “Clinical lectures”.

Socialist period 1964 - 1985:

  • social protection of motherhood and childhood
  • reduction in infant mortality
  • vaccination

Perestroika period 1985 - 1991:

  • increase in infant mortality
  • increase in perinatal pathology, VAR
  • increase in the incidence of schoolchildren
  • increasing social deprivation among adolescents

Modern pediatrics is characterized by the formation of the Union of Pediatricians of Russia in 1994. Solving the problems of protecting the health of mothers and children.

MINISTRY OF HEALTH OF UKRAINE

KHARKIV STATE MEDICAL UNIVERSITY

Department of Propaedeutics and Pediatrics No. 2

Pediatrics as a science, its place, stages of development

Completed:

3rd year student,

1 medical faculty,

Kachan B.B.

Teacher: Associate Professor Shmulich V.K.

Kharkov – 2007

Plan:


  1. Pediatrics as a science

  2. The place of pediatrics in world science and the stages of its development
3. Conclusions

4. References

1. Pediatrics as a science
Pediatrics (from Greek pais, genus paidos - child, iatreia - healing) studies the patterns of development of children, the causes and mechanisms of diseases, methods of their recognition, treatment and prevention. Therefore, it can be defined as medicine during the period of growth, formation and development of the human body, which is the most responsible in human life. This is the so-called progressive stage in the human life cycle. That is why the humanism of this specialty and the responsibility of a person who has chosen pediatrics as his profession are unusually great.

The pediatrician is in constant communication with the child and his parents, as well as with grandparents. A pediatrician must be a good psychologist and teacher. This will allow him to gain authority among parents and relatives so that their joint efforts can be directed towards proper development, and in case of illness, towards the rapid recovery of the child. The origins of many adult diseases begin in childhood. Therefore, what will be the childhood and the conditions for the growth and upbringing of the child, such will be the health status of an adult.

Teaching pediatrics at pediatric faculties of medical institutes begins with the third year, in which the propaedeutics of childhood diseases is studied. This is actually the first department that provides students with professional training. Since pediatrics studies the period of growth and development of a child, it becomes clear that at each age stage of his life, a child is characterized by special morphological, physiological and psychological qualities. Therefore, knowledge of the clinical anatomy and physiology of children of different ages is the basis for understanding the uniqueness of research methods and evaluating the results obtained. In addition, taking into account the basic anatomical and physiological characteristics allows us to determine the specific organization of the environment and lifestyle, as well as nutrition of children of different age periods

The Department of Propaedeutics of Childhood Diseases also studies the semiotics of the main lesions of various systems and the body as a whole. Since a systematic presentation of nosological forms of childhood diseases is already the subject of the main course in pediatrics, when studying propaedeutics, diagnostic issues are considered in two more general aspects. Firstly, this is symptom diagnosis, based on knowledge of the age norm and research method and with the goal of establishing the presence of a pathological symptom; secondly, this is syndromic diagnosis, that is, a statement of the pathophysiological connection between several symptoms of the disease and a reflection in this connection of the functional insufficiency (decompensation) of a given physiological system.

The objective of the course also includes the student’s mastery of child care techniques and medical manipulations and procedures within the scope of the skills of a nurse.

In more senior courses, teaching of pediatrics will be carried out not only in the departments of pediatrics, but also in special departments (childhood infections, pediatric surgery, pediatric neurology, pediatric otolaryngology, pediatric ophthalmology, etc.)

The effectiveness of self-education and the subsequent growth of qualifications are largely determined by how firmly one was able to master the basic medical and biological disciplines at the university stage of study. They form the foundation for subsequent clinical training and improvement. The opportunities for self-education of a pediatrician are great and varied. This is, first of all, constant work on scientific literature and, first of all, reading scientific pediatric journals, manuals and monographs. A very important role in improving the knowledge of pediatricians is played by their participation in the work of local branches of the All-Union Scientific Society of Children's Doctors, created in all republics, regions and large cities of the country. To be a member of this society is a matter of professional honor for every Soviet pediatrician.

Pediatrics is not only a field of medical science, but also the name of the main medical specialty in the state system of child health care. Pediatricians implement the main achievements of medical science and carry out practical measures to ensure and control the harmonious development of children, to recognize, treat and prevent their diseases. The workplaces of pediatricians are children's institutions (nurseries, nurseries, kindergartens, schools, children's homes, pioneer camps), children's clinics, children's hospitals (general and specialized), pediatric ambulance teams, children's wards of maternity hospitals, various consulting rooms and dispensaries, children's sanatoriums.

2. The place of pediatrics in world science and the stages of its development
The beginning of the doctrine of the child is usually attributed to the 4th century BC, to the time of writing the book “On the Nature of the Child” by the father of medicine, Hippocrates. Following Hippocrates, Celsus, Galen and Soranus (1st and 2nd centuries) write about children, their care and education. Over the next 15 centuries, what was outlined by Galen and Soranus was repeated. Treatment of children during these years was carried out according to the same principles as adults, or was not carried out at all. Only in the 15th-18th centuries did interest in the treatment of children and its characteristics awaken again. This is due to the very high infant mortality rate, the emergence of charitable organizations and the creation in some European countries of orphanages or shelters for foundlings and street children. A large number of works devoted to the upbringing and care of children appear. In 1650, the scientific work of the English physician Glisson on rickets was published, this work was followed by a series of publications by Sydenham, Habergen, and Jenner devoted to the study of infectious diseases in children. Approximately 100 years after Glisson's work, the first manual on pediatrics is published in 28 chapters. It was written in 1764 by the Swedish physician Neil Rosen von Rosenstein. After 30 years, his manual was published in Russia in Russian.

After the opening of the first children's hospitals, there was an intensive growth in the number of scientific research in the field of pediatrics and the formation of schools of pediatricians. The first children's hospital in the world was the Paris Children's Hospital, which opened in 1802. Somewhat later, the German school of pediatrics appeared. Its centers are Vienna and Berlin. German pediatricians chose the biochemical and microbiological aspects of childhood diseases, as well as nutrition issues, as the main direction of their research. In the second half of the 19th century, scientific and clinical pediatric centers also began to function in England, Switzerland, Italy, the Scandinavian countries and the USA.

In Russia, the sequence of events was very similar to what happened in Europe. In 1727, Peter I issued a decree “On the construction of hospitals in Moscow for the placement of illegitimate infants and on giving them and their nurses a cash salary.” M.V. Lomonosov in his letter “On the reproduction and preservation of the Russian people” points to the need to create public almshouses for illegitimate children and publish instructions on curing childhood diseases. However, educational houses were opened only in 1763 in Moscow and in 1771 in St. Petersburg thanks to the persistence and energy of I. I. Betsky, who himself drew up designs for these houses and wrote instructions on the care and education of children.

The beginning of the formation of pediatrics as an independent scientific discipline occurs within the framework of other, closely related medical specialties. This is therapy and, above all, obstetrics. Of the therapists, the first to read the issues of childhood diseases were Moscow University professors S. G. Zybelin and G. I Sokolsky. Of the obstetricians, the greatest contribution to the development of pediatrics and its formation as an independent discipline was made by N. M. Maksimovich-Ambodik, S. F. Khotovitsky and N. A. Tolsky. The lectures and the book by Maksimovich-Ambodik, “The Art of Midwifery, or the Science of Babishing,” presented valuable thoughts about the characteristics of children and methods of caring for them.

Professor-obstetrician of the Medical-Surgical Academy in St. Petersburg (now the Military Medical Academy) Stepan Fomich Khotovitsky was at the same time the first Russian pediatrician scientist. During 1831 -1847 1st year. he taught an independent course on childhood diseases, in 1842 he opened children's wards in the clinic of obstetrics, women's and children's diseases, and in 1847 he published the first Russian textbook on pediatrics - “Pediatrics”.

The first children's hospital in Russia was opened in St. Petersburg in 1834. Currently, it bears the name of N. F. Filatov. At the time of its opening, this hospital was the second children's hospital in Europe. After 8 years, a children's hospital in Moscow begins to operate (now also the hospital named after N. . F Filatova), and 2 years later, in 1844, the world's first hospital specifically for young children opened in St. Petersburg (now the L. Pasteur Hospital).

The date of birth of the first Russian department of pediatrics can be considered 1865, when a separate course of childhood diseases was assigned to Professor V. M. Florinsky at the Medical-Surgical Academy. Since 1870, Nikolai Ivanovich Bystroe (1841 - 1906) worked at this department. N.I. Bystroe in 1885 organized and was the first chairman of the Society of Children's Doctors of St. Petersburg. He trained many students who later became professors and founded other departments of pediatrics in the country.

In Moscow, giving a course of lectures on pediatrics began in 1861, associate professor of the department of obstetrics, and later professor Nikolai Alekseevich Tolsky (1830-1891). After 5 years, he opened a small children's clinic (11 beds) as part of the faculty therapeutic clinic of the university. Thus, in Moscow, simultaneously with St. Petersburg, the Department of Pediatrics appeared.

In those same years, the activities of the most prominent doctor and public figure Karl Andreevich Rauchfus (1835-1915) developed in St. Petersburg. Hospitals were built according to his designs in St. Petersburg (now the hospital bears his name) and in Moscow (now the I.V. Rusakov Hospital) . These were the first hospitals in the country designed according to the requirements of hospitalization of children with various pathologies. The first of these hospitals was led by K. A. Rauchfus until the end of his life. He trained a large number of pediatricians dedicated to their work. His works on heart defects in children and the organization of pediatric care were included in the fundamental three-volume manual on pediatrics, created by a team of European authors edited by Gerhardt (1877).

A significant contribution to the development of domestic pediatric science was made by N. I. Bystrov’s successor in the Department of Pediatrics of the Medical-Surgical Academy, a student of N. A. Tolsky, Professor Nikolai Petrovich Gundobin (1860-1908). He and his students in a short time accumulated a large amount of scientific material on the anatomical and physiological characteristics of children, and on this basis N.P. Gundobin published a fundamental work that has not lost its value to this day - “Peculiarities of Childhood.” In addition to this book, he wrote the popular guide “General and Special Therapy of Childhood Illnesses,” which went through several editions.

The most striking mark in the history of our pediatric science was left by the activities of the most talented doctor and teacher, N.A. Tolsky’s successor in the Department of Pediatrics at Moscow University, Nil Fedorovich Filatov



^ S F Khotovitsky I I Bystroe


(1847-1902) His erudition, medical logic and observation gained deep respect and gathered dozens of talented students around him. He was the first to describe the clinical picture of scarlet fever and glandular fever (infectious mononucleosis), as well as an early sign of measles - pityriasis-like peeling of the mucous membrane of the lips and stripes of the mouth. He was one of the first to understand the significance of atelectasis in the occurrence of pneumonia and described heart damage in scarlet fever in children. The most vivid memory of the activities of this outstanding clinician remains his books, which are still read and popular. These are “Semiotics and diagnosis of childhood diseases”, “Lectures on acute childhood infections”. “Clinical lectures”, “A short textbook of childhood diseases”. All of them were translated into many European languages ​​and brought



^ N. A. Totsky and K. L. Rauchfus

Before the Great October Socialist Revolution, there was no state care for children in Russia. The first more or less accurate data on child survival in 1845 indicate that out of 1,000 children born, only 367 survived until the age of 15, and in certain regions of the country even more less. The causes of child mortality, according to the conclusion of the Botkin Commission in 1886, were “intestinal infections, poor quality, inappropriate, untimely feeding and complete lack of child care”

Infant mortality (the number of deaths per 1000 children born during the first year) in 1913 reached terrifying proportions - 273 The well-known figure in zemstvo medicine, P. I. Kurkin, wrote "It can hardly be disputed that in a country where the value of life in general is low, there is no The life of a child can also be highly valued.” There were 23 children’s clinics throughout Russia, and they were mainly located in large cities (Moscow, St. Petersburg, Kiev, etc.), and the total bed capacity for children over the 80 years of the existence of children’s hospitals in Russia reached that level. At the time, there were only 750 beds. The mortality rate of women in childbirth and mothers was extremely high. This clearly illustrates the complete lack of involvement of the state in protecting the health of children and the people as a whole under tsarism.

The draft Program of the Russian Social Democratic Labor Party, developed by V.I. Lenin in 1894 and adopted in 1903 at the Second Congress of the RSDLP, outlined the main provisions for the protection of motherhood and childhood. The practical implementation of these measures began after the Great October Socialist Revolution. In November 1917, the People's Commissariat of State Charity was created, within which a special board was formed, whose responsibilities include the development of urgent measures for the protection of motherhood and childhood. January 31 (February 13), 1918 the corresponding resolution, in the development of which N. K. Krupskaya and A. M. Kollontai took part, and was advised and edited by V. I. Lenin. It read: “All large and small child-serving institutions of the Commissariat of State Charity, from educational homes in the capitals to modest village nurseries, all of them, from the date of publication of this decree, merge into one state organization and are transferred to the jurisdiction of the department for the protection of motherhood and infancy, so that , forming an inextricable link with institutions serving pregnancy and maternity, to accept from them the glory of Russian clinical thought. In the USSR, a prize was established for the best works in pediatrics named after N. F. Filatov. In Moscow, a monument to N. F. Filatov was erected with the inscription “Friend of Children.”

Children's clinics and pediatric departments were created gradually in many cities and regions of Russia. In Kazan, the Department of Pediatrics was headed by Professor N.A. Tolmachev, in Kiev - Professor V.E. Chernov, in Kharkov - Professor I.V. Troitsky, in Odessa - Professor V.F. Yakubovich, in Yuryev (now Tartu) - Professor V. . P. Zhukovsky, in Saratov - professor I. N. Bystrenin.

An important feature of pediatrics in the last pre-revolutionary decade was the growing interest in the youngest age. In 1908 in Moscow, on the initiative of G.N. Speransky, the first consultation for infants was opened, and in 1910 - the first hospital for infants, in 1913 - a department for infants in the Morozov Children's Hospital (now Children's Clinical Hospital No. 1). Since that time, the proportion of young children in all children's clinics and hospitals in Russia has increased significantly.

Thus, the pre-revolutionary period of development of pediatrics is significant primarily for the names of outstanding domestic scientists and doctors who, with their talent, ensured the accumulation of knowledge about age-related physiology and diseases of childhood and won Russian science world recognition and priority in many areas of pediatrics. During this period, the main scientific schools arose and at the same time the unity of Russian pediatrics was determined, its social and humanistic moral platform was formed, aimed at solving a wide range of problems in protecting the health of mothers and children. A unique result of the development of pediatrics in the country was the First All-Russian Congress of Pediatric Doctors held in 1911, which discussed issues of care for newborns. Through the efforts of leading pediatricians and public figures, various societies and charitable movements were created, the purpose of which was to provide assistance to the country's child population in distress. Thus, in 1904, the St. Petersburg Union for the Fight against Infant Mortality was created, in 1909 - the Society for the Fight against Infant Mortality in Moscow, in 1913 - the All-Russian Trusteeship for the Protection of Motherhood and Infancy.

From the first days of the Soviet state, purposeful, huge-scale activities were launched to create the world's first state system of assistance to mothers and children. This happened in a climate of civil war and severe devastation, when the government had to solve thousands of seemingly more important problems on which the very fate of the socialist republic depended. On the 6th day of the establishment of Soviet power, a law on social insurance is signed, according to which women are guaranteed paid maternity leave, and mothers are given the right to leave work every three hours to breastfeed their children. The Party Program adopted by the VIII Congress of the RCP(b) identified tasks for the development of maternal and child health. The main principle of the development of Soviet healthcare was proclaimed - its preventive orientation. In February 1919, the Council for the Protection of Children was created under the leadership of A.V. Lunacharsky, special children's funds were formed, free meals for children were organized in schools and child care institutions. The network of children's institutions was rapidly developing, the network of children's institutions was expanding. hospitals.

The VIII Extraordinary Congress of Soviets on December 5, 1936 adopted the Constitution of the USSR, which contained a number of articles related directly to healthcare, in particular to protecting the interests of mothers and children. During the Great Patriotic War, the Decree of the Presidium of the Supreme Soviet of the USSR was issued “On increasing state assistance to pregnant women, large and single mothers, strengthening the protection of motherhood and childhood, establishing the honorary title “Mother Heroine” and establishing the Order of “Maternal Glory” and the medal “Medal” motherhood" In 1960, the Central Committee of the CPSU and the Council of Ministers of the USSR adopted a resolution "On measures to further improve medical care and health protection of the population of the USSR." In the Party Program adopted at the XXII Congress of the CPSU, concern for the health of the entire population was further developed

A big event was the adoption by the session of the Supreme Soviet of the USSR on December 19, 1969 of the law of the Union of Soviet Socialist Republics “On approval of the Fundamentals of Legislation of the USSR and Union Republics on Health Care.” During 1970-1971, the legislation of the Union republics was brought into line with this law. This was another stage of improving legislation. In Law V, its section is devoted to the protection of motherhood and childhood.

In the new Constitution adopted in 1977, the protection of public health was further developed, including legal, material and moral support for motherhood and childhood, including the provision of paid leave and other benefits to pregnant women and mothers

A manifestation of the concern of the Party and the Government was the resolution of the Central Committee of the CPSU and the Council of Ministers of the USSR “On measures to further improve public health care” dated October 15, 1977. The honorary title “People's Doctor of the USSR” was established. A new manifestation of concern for the health of children and adolescents is the resolution of the Central Committee of the CPSU and the Council of Ministers of the USSR “On measures to strengthen state assistance to families with children” (1981). Partially paid additional leave was introduced for mothers with preservation of their place of work until the child reaches age

1 Resolution of the People's Commissariat of State Charity of the RSFSR on the protection of infancy in the country - In the collection Formation and development of healthcare in the first years of Soviet power - M Medicine, 1966.
3. Conclusions
Currently, our country has many research institutes and many pediatric departments in medical institutes, which employ a large number of doctors and candidates of medical sciences and researchers.

The opening of the All-Union Center for Maternal and Child Health in Moscow is of great importance for the intensification of pediatric research in our country.

Pediatrics of recent decades has been an extremely dynamic field of knowledge; the growth of information, the revision of previously existing points of view, the introduction of new research and treatment methods are occurring at an increasing speed. This is primarily due to both the rapid development of fundamental theoretical sciences in medicine (physiology, biochemistry, genetics, immunology), and the development of purely clinical concepts, accumulation and generalization of collective medical experience.

Bibliography:


  1. Mazurin A.V., Vorontsov I.M. “Propaedeutics of childhood diseases” - Medicine, 1985 – 432 pp.

  2. N.P. Shabalov “Childhood diseases” textbook 5th edition in two volumes. “Peter” - 2002 – 832 s