BN Mironov on infant mortality in Russia at the end of the 19th century. Child mortality in the 19th century

from the Almanac

Report in the joint meeting of the Society of Russian Doctors, the Society of Pediatric Doctors in St. Petersburg and the Statistical Department of the Highest Approved Russian Society for the Protection of Public Health, March 22, 1901, in the museum hall of N.I. Pirogov, D.A. Sokolov and V.I. .Grebenshchikova

Publishing our report in a separate book with the appropriate additions of some facts that took place after it, we hope that the intelligent part of Russian society will not refuse to inquire about the question of mortality in Russia, and having become acquainted with its sad state in our fatherland, will not refuse to help as much as possible. their forces in a possible fight against evil.

St. Petersburg. November 1901

Causes of "abnormal" mortality and measures to combat it

So, having familiarized ourselves with the conclusions of Dr. V.I. in this respect without a trace and to no avail.

From the above data of the venerable comrade, we have seen that the huge, in comparison with other states of Europe, mortality in Russia is due almost exclusively to the exorbitantly high mortality of children, discarding which, we would have almost the same figures for adults as for Western Europe. In view of this, I will allow myself to act as a defender of the interests of children and ask the meeting to jointly find out the reasons for such a pestilence of them and come up with possible measures to reduce it.

We have seen above that it is mainly the smallest of children who die, and especially terrible mortality occurs under the age of 1 year, and in some areas of Russia this mortality reaches such figures that out of 1,000 children born, far less than half live to a year, and the rest (for example, in the Karachai district of the Okhansky district of the Perm province - 60%) die during this first year life. If we add to this the mortality of older children, 1-5 years old, then from 5-10 years old and from 10-15 years old, then we will see that out of 1000 born children, a very small number of children will live to 15 years old, and this number in many places in Russia does not exceed one quarter of those born.

Thus, we have in Russia the undoubted fact of the extinction of children, and if at present the total number of the population in Russia is not decreasing, but increasing, then this is explained by a significant birth rate, which still exceeds mortality, which is why the population growth is, although, it must be confessed, there are many areas where a decline in population is noticed due to the predominance of mortality over births.

It can be seen from Dr. Grebenshchikov’s figures that such an exorbitantly large number of dying children does not in the least depend on the large number of births, and therefore it can by no means be said that the high death rate of children in Russia is only apparent, greater only in comparison with Western countries in the whole mass children, which, as if, depends on a very large number of children in Russia due to their large fertility. Of course, such a view is wrong, and with the above calculations by Dr. Grebenshchikov of the number of dying children under 1 year old and beyond for every 1,000 born, it will become quite obvious that in Russia we have a huge mortality rate of children that does not seem at all, but, unfortunately, exists on in fact, and without having any inclination to lower.

So, the fact of the extinction of children remains an undeniable fact.

We will try, if possible, to understand the reasons for this and, first of all, we will focus on the possible causes of the greatest mortality, namely, children under the age of 1.

It is clear that the smallest children are the least able to resist all harmful external influences, and the further existence of the child, of course, primarily depends on one degree or another of his viability. Obviously, the weaker children are born, the more will be less viable and even more so will die out ceteris paribus. Meanwhile, the congenital weakness of the child depends entirely on the state of health of his parents and, moreover, especially on the conditions in which the mother is during pregnancy. Thus, if we raise the question of the health and strength of parents, then, unfortunately, we must admit that the general level of health and physical development in Russia is very low and, one can unmistakably say, is getting lower and lower every year. There are, of course, many reasons for this, but undoubtedly the more and more difficult struggle for existence and the ever-increasing spread of alcoholism and syphilis are in the foreground.

The influence of the last two points on the part of parents on the generation to be born is, of course, clear to everyone, and since at present relatively few parents, both rural and urban, are free from one or the other of these vices, then birth is generally more weak children is understandable.

But an even more significant impact on children should have poor living conditions and nutrition of parents before, and mothers after conception. As you know, about 78% of the population of Russia belongs to the land, is saturated with its fruits and constitutes the main payment force of the state; meanwhile, this land gives, on the average, the peasant for subsistence, often much less than what is necessary. This issue is analyzed in great detail in P. Lokhtin's recently published work “The State of Agriculture in Russia in Comparison with Other Countries. Results for the 20th century. SPb., 1901.

According to the author's calculations, on average over 16 years, Russia consumes 18.8 poods of bread and potatoes per person (from 13 in crop failures to 25 in crops), while in other countries the amount of bread consumed by one person does not fall below 20-25 poods and the physiological norm for a person with moderate work cannot be lower than 17.2 pounds. Therefore, the figure of 18.8 pounds per person in Russia, excluding from them about 10% for bran and rubbish, turns out to be insufficient to feed even the peasant himself, not to mention his livestock, while, according to the calculations of prof. Lenzewitz, a German peasant consumes food, translated into bread, about 35 pounds, therefore, twice as much as our Russian. If we take into account, in addition, the expenditure of 18 poods for feeding the horses and livestock of the owners, townspeople and troops, for the production of alcohol, etc., for losses from fires, then only about 16 poods remain for personal consumption, but to buy somewhere impossible, since there is no more bread in the state. What can we say about lean years, but meanwhile, over the course of 16 years, the population went hungry 6 times, there were 4 times on the border of hunger and had some surplus in reserve for a period of only 1-2 weeks to 3 months only 6 times.

Thus, it turns out that crop failures are a completely normal phenomenon for modern Russia, while crops are pleasant exceptions. Speaking about the state of cattle breeding, the author concludes that it is as sad in Russia as arable farming, and both have nothing like it in other countries.

Having become acquainted with such hopeless conclusions regarding the nutrition of the majority of the population of Russia, of course, it will not come as a surprise to anyone that with chronic half-starvation, the population cannot produce a healthy generation, and even having given one, will not be able to feed it. Therefore, P. Lokhtin finds it very natural that where even the nutrition of the people is not sufficiently satisfied, mortality should produce an equation of balance and therefore it is second only to Honduras, Fiji and the Dutch Indies, although in some provinces in lean years it even surpasses these places.

Completely similar data on the lack of nutrition of the peasant can be found in the writings of Dr. Pochtarev and Dr. Gryaznov.

According to Dr. Gryaznov, the whole food of the peasants consists of rye and rarely barley bread, potatoes and black cabbage, and bread per day accounts for 2.8-3.5 pounds per adult. Meat is 14-16 pounds per person (including children) per year.

According to the calculations of Dr. Pochtarev, each worker in the Dukhovshchinsky district he studied, in addition to the grain born, only for one subsistence, must earn 17 rubles on the side. 26 kopecks, not to mention the fact that he still has to earn 15 rubles to pay taxes. 61 kopecks, which is why, due to the inability to earn so much, fall into arrears, for which you have to pay selling livestock. Is it surprising after this that, according to Dr. Svyatlovsky, 35% of households do not have a single cow, and 25% do not have any working cattle.

Of course, after all that has been said, it will become clear that a population that exists from hand to mouth, and often starving at all, cannot produce strong children, especially if we add to this those unfavorable conditions in which, in addition to lack of nutrition, a woman finds herself during pregnancy and after her.

As you know, many other peoples look at the appearance of a child as a blessing. For example, the Buryats value their children very much, and infertility often leads to a break between spouses; in Georgia, fertility is considered a special blessing of God, among Armenians, infertility is the greatest misfortune, Tatars and Jews, in case of infertility, take other wives for themselves, and therefore they look at a pregnant woman with special respect, relieve them of unnecessary work, such as, for example, among Jews, the community supports and helps pregnant women, which is why, first of all, the number of miscarriages and stillbirths is much less (among Christians 3.9%, among Jews 2.5%) .

Among the Russian people, the view of a pregnant woman does not differ from the usual view of a woman as a permanent and permanent worker day and night. The Russian peasant woman works during pregnancy in the same way as at any other time, and during the most difficult period of pregnancy, precisely during her last period, the hardest work usually falls. It is known that in Russia the highest birth rate is in summer, depending on autumn conceptions.(Prot. Gilyarovsky, V.I. Nikolsky, Svyatlovsky, Gryaznov, Ershov and V.I. Grebenshchikov), which in turn depend on the greatest welfare of the peasants in the autumn, their greatest freedom at this time from hard work, and therefore from the greatest number of marriages , along with frequent autumn fairs.

In addition, the retiree does not remain without influence, since, for example, according to Dr. Svyatlovsky for the Kharkov province, 912 annual leave certificates, 1159 semi-annual ones, 1844 3-monthly ones, 3946 1-monthly ones are issued; moreover, according to the season, the issuance of passports is distributed as follows: January - 439, February - 380, March - 386, April - 1400, May - 2587, June - 439, July - 334, August - 499, September - 506, October - 463, November - 467, December - 330, and women leave 24 per 100. Thus, we see that the largest number of departures in May and April, and at the same time the largest number of departures for 1 and 3 months, in the fall, most are at home, returning from those or other outdoor work.

So, therefore, with the largest number of births in the month of June and July, obviously, the hardest work falls to the lot of pregnant women in the most difficult time for them. , and in the largest number, for the care of many men on the side. And if we imagine the work of a pregnant woman from early morning until late at night in the field, where she sometimes has to walk 2-3 or more miles, work such as garden work, mowing, reaping, or, for example, a shelf, breakthrough and digging sugar beets, and to do all this, either bent over under the sultry rays of the sun, or in the rain, while having no other food than bread, onions and water, then it will become clear to everyone that not all women go through all this without some or other consequences for the child . “Never during the year,” says Archpriest Gilyarovsky in his wonderful work, “there are so many fetal outcomes, miscarriages, stillbirths, unhappy births, and never so many children are born who are unreliable for life, at the very birth of happy ones, as in July and August” .

As for the act of childbirth itself, since a woman works until her last moments, this act often takes place outside the home, in a field, in a garden, in a forest, in a barn, or a woman in labor is placed on purpose in a bathhouse and there she is subjected to various violence, allegedly with the aim of accelerating childbirth, such as: hanging, shaking, pulling, etc. and, finally, after childbirth, a woman often already on the 3rd - 4th day he gets up and gets back to work around the house or even goes to the field. Is it any wonder that under all such conditions, the health of a woman is rapidly shattered, reflecting even more on the next generation.

To all of the above, it is necessary to add the harmful effects of highly unhygienic dwellings., in which people are often placed in terrible cramped conditions, without any ventilation, and even in addition in the community of certain domestic animals .

So far, we have considered those moments that can adversely affect the health of a child indirectly, through his parents, but now we will consider what troubles and misfortunes a child undergoes from the moment of birth to maturity, and, having considered this, we will undoubtedly be surprised at the strength, strength and endurance of those who achieve last age.

newborn baby usually they immediately carry them to the bathhouse, smoke the weak, soar in a hot spirit, rule, shake their heads down, rub the body with salt, drink chamomile, kvass, carrot juices, etc. Often the first time a child lives with a woman in labor in a bath, being exposed to all temperature fluctuations here. “After all these troubles,” rightly remarks Dr. Pokrovsky in his above-mentioned outstanding work, “it is obviously not at all easy for a Russian newborn to start his young life in full health” .

Already on the 3rd - 4th day, the need makes the woman in labor get up and get to work. Going to the field, the mother either takes the newborn with her, or leaves him at home in the care of a nanny. Personally, for the mother, of course, it is more convenient to leave the child at home, since in such cases the mother does not need to carry the child with her to work, sometimes several miles away, and then, at work itself, the mother does not constantly tear herself away from her by crying the child who is right there. And meanwhile, in a time of trouble, work is hot, every hour, every minute is important, and therefore, understandably, the vast majoritymothers leave their newborns and babies at home. “Never does a baby lose his mother’s breast so much,” says such an expert on folk life as Archpriest Gilyarovsky, “and he never extracts such low-quality milk from the same breast as in July and August, because the mother in the best households on the third day in the morning should go to work in the field, where he cannot take the baby with him, and returns to him only late in the evening. And if the field work is further than 10 miles from home, then the mother should leave the child for 3-4 days every week. In some farms, the puerperal goes on another (!) day after the birth. “What will she bring,” the venerable author further exclaims, “to the baby in her breasts, when she herself is exhausted by labors and efforts beyond measure, thirst and callousness of food, which does not restore her strength, sweat and feverish movements of milk, which has become a product for her completely alien, bored with a baby who languishes from a lack of milk just as she from its excess. How ardently and truthfully the sad and difficult situation of mother and child in a difficult time is described!

What, however, feeds the child, and in what conditions is he staying at home? Perhaps the child is in better conditions than if he were taken by his mother into the field and there exposed under the open sky to all the hardships of changing weather.

Since the entire population of the village, capable of work, goes into a bad time, i.e. in July and August, in the field, then all the children remain in the care of children, teenagers of 8-10 years old, who act as nannies. Therefore, one can imagine what happens to small children with such supervision of children. “Supervision of children is never so insufficient as in July and August,” says Archpriest Gilyarovsky, based on his many years of observations, and gives examples of how one nanny, having tied the baby’s legs with a rope, hung him upside down outside the window and disappeared; another, for example, bored with the fact that a one-year-old baby ran after her everywhere with tears, tied him up by the legs and threw him in the stable, and when she looked into the stable in the evening, the baby’s entire back turned out to be a eaten pig.

We will speak about the results of the lack of supervision of adolescents below, but now we will consider living conditions of an infant in the village during the summer working time. The mother, leaving early in the morning for work, swaddles the child, even suppose wrapping it in a clean diaper. It is clear that soon after the departure of the mother and the 8-10 year old girl assigned to look after the child, who, due to her age and understandable complete misunderstanding of the importance of her task, wants to run and play in the fresh air, such a nanny leaves the child and the child for sometimes he lies in soaked and soiled diapers and swaddling clothes for a whole day. Even if the mother leaves enough changes of linen for the nurse, it is not in the interests of the latter to change this soiled linen as needed, since she herself will have to wash this linen. And therefore, one can imagine the terrible situation in which swaddled children are wrapped in diapers soaked in urine and feces, and this, moreover, in the hot summer season. The statement of the same observer Prot. Gilyarovsky, that from such a urinal compress and from the heat “the skin under the neck, under the armpits and in the groins sores, ulcers are obtained, often filled with worms”, etc. It is also easy to complete this whole picture with that mass of mosquitoes and flies, which are especially readily attracted by the smelly atmosphere around the child from the decay of urine and feces. “Flies and mosquitoes hovering around the child in swarms,” says Gilyarovsky, “keep him in an unceasing fever of wounding.” In addition, in the cradle of the child and, as we will see below, even in his horn, worms are bred, which, according to Gilyarovsky, are “one of the most dangerous creatures” for the child.

One should not think that only the smallest, newborn children are in such a helpless position. And older ones, until they have learned to sit, and the nanny cannot yet take him outside with her and put him there, they are left in the cradles, and, of course, for immobility, so that the child does not fall out of the cradle, and also, of course, by virtue of established customs, the child is swaddled, and the nanny tries to do this, for greater immobility, as tight and strong as possible.

There is, of course, no need to go into more detail about this: anyone with the most poorly developed imagination can easily imagine the whole horror-filled picture of the helplessness of a baby in the summer in the countryside.

It remains to dwell on the main thing - on the food of the child. It is clear that the food for the lungs of a child, through breathing, is the most terrible, since the child breathes all the time stuffy, stinking air, and sometimes the air entry ways are impassable and often the nostrils are clogged with flies and their larvae. But, perhaps, despite all these hardships, although the feeding of the child occurs more or less satisfactorily. “Regarding the feeding of children in the rural population,” says Dr. Pokrovsky, “which is vastly predominant here in Russia and precisely constituting 0.9 of the total population, I managed to collect about 800 pieces of information brought from different places in Russia, from which the following can be seen: immediately after birth, almost everywhere, in the entire native Russian population, is given to a newborn pacifier, i.e. a rag with chewed bread wrapped in it or similar substances (sometimes up to 3 days do not give the breast); in some places they do not give breasts until the mother prays, sometimes until baptism. The best remedy for this against "gnaw" and "internal hernia" this is a nipple (for expelling a hernia) from black bread with salt, sometimes from carrots, beets, apples, pretzels, gingerbread, walnuts and Volosh nuts, chewed oatmeal.Sometimes they wet the nipple in milk, vegetable oil, sugar and honey water.. In the Perm province. In places, the custom, along with the pacifier from the very first days, is to give children must, mash and kvass, which is especially developed in families that do not have cows. “At the same time, everywhere,” adds Dr. Pokrovsky, “the nanny moistens the nipple with her saliva before feeding.” Thus, feeding the child begins at the usual time from the very first days after birth, and from 5-6 weeks it is necessary, believing that breast milk is not enough, and chewing nipple , cow's milk, cereals, tyuri from bread and bagels, etc.

For about 4-5 months, all over Russia (Pokrovsky) they have been giving chews, potatoes, cabbage soup, cereals, scrambled eggs, peas, beans, baked pumpkin, beans, curdled milk, sour cream, wort, kvass, kulaga, mash, mushrooms, berries, cucumbers etc. Weaned milk is often not given on fast days, and there are 250 such days in a year.

So, from all this you can see in what unfavorable conditions the child is in relation to nutrition from the very first days of his life. But if we get acquainted with the nutrition of a child during the summer working months, then we will be directly horrified to see what a nursing, and even a newborn child eats and drinks. We have already said above that in the miserable summer time, mothers go to work, leaving food for the child for the whole day, and breastfeed the child only at night and in the evening, returning from work, in some cases only after 3-4 days. The so-called nipple and chewing are left to the child. The first one is usually represents a cow horn, to the free open end of which a cow's nipple is tied, bought either in Moscow in the meat rows, or from local butchers in the villages. Of course, everyone understands that such a nipple must necessarily rot and this piece of rot , no matter if he will wash or not, is almost all day in the mouth of the child . “Milk, passing through this smelly, dead piece, is naturally saturated with all the rot contained in it, and then this poison goes into the baby’s stomach,” says Dr. Peskov (Pokrovsky). Consequently, if a child is fed cow's milk, then this milk, left by the mother to the nanny, is poured from time to time into this impromptu horn, and, of course, the nanny will not try to wash this horn and nipple, but, by the way, as we have just seen, this is indifferent because rottenness will remain rotten with every wash. And besides, one can imagine how the milk left in the morning becomes by evening during a long hot summer day. But all this is still a comparatively better position than for many other children. Here, even through a rotten nipple, even if it is sour, they still get milk, thus satisfying hunger and thirst. In those households where there are no cows, therefore, there is no milk, the child is fed with the help of chewing, which consists of chewed bread, porridge or something similar, wrapped in a rag or tied in a bundle. Then they give this lump in a rag a conical shape with their fingers, and the cook, taking this conical rag into his mouth, moistens it abundantly with his saliva, after which this “nipple” enters the child’s mouth. And so, unfortunate children, with such and such "nipples" lie for days on end, sucking in the sour juice from chewed bread and porridge, swallowing almost only their saliva and thus, starving and experiencing intense thirst.

To illustrate, I will cite a sad scene recorded by Dr. Diatropov during one of his trips around the village:

“Once I changed horses in the village. The weather was hot. The people worked in the field. Diarrhea between children at this time was frequent and fatal.

I went up to the hut. There is not anyone.

- Where are the owners? I asked.

- Yes, let's go to bury the little boy.

- Was it chesty?

- Sosun was.

- What was sick?

- Yes, the diarrhea washed away.

A young woman entered the hut. The child lay in her arms. She went to the front corner, took out an uncovered pot with a chipped edge from under a shaped icon-case, took porridge out of it with dirty fingers, pulled out a rag from her belt, made a pacifier, stuck it into the mouth of a sleeping child and put it in the cradle. She herself went into the canopy ...

I looked at porridge. It turned out to be semi-cooked, oxidized, with an admixture of small cockroaches.

This is where the source of the national thinness is hidden, which has become, as it were, hereditary now, I thought, - the author adds, - and after all, on the horns and on the nipples, a large part of the state population grows in our country!

In order to show even more vividly how and with what the child is fed in the summer, I will give the floor to Archpriest Gilyarovsky, who lived among the people for many years and saw the scenes he describes every day in the summer.

“Never,” says the venerable author, “the food of an infant, in the absence of a mother, reaches such spoilage as in July and August. If we examined the food of children in the evening, then there is nothing resembling food in it: everything has turned into a mass, which is more capable of destroying than restoring and nourishing the strength of the baby.

I have seen,” says Fr. archpriest, - children under one year old remained for a whole day alone, but so that they would not die of hunger, then nipples were tied to their hands and feet. I sometimes brought milk to the children: either because all their daily food had been eaten in the morning by other animals, or because they sucked jelly, kvass and water from the horn, in which curd was dissolved, very stale. I saw,” the author adds, “horns in which worms swarm.”

What else can be added to these terrible pictures, not invented, not drawn in the office by the imagination of a scientist, but pictures drawn from nature by such respectable observers who have seen these pictures every day for many years of living together with the people.

It can be said that all these scenes took place long ago, precisely at the time of the observations of the mentioned authors, i.e. over 30 years ago. But that is the whole horror that more than 30 years have passed since then, and such scenes can now be found almost everywhere, not only in remote villages, but also in large villages and even cities, and the development of factory production across Russia industry has made such scenes even more frequent, seducing women with earnings for which they leave their children without food and care.

And is it necessary to prove that such starvation and such allegedly terrible nutrition of children will pass without a trace for them and as a result of this there will not be a large mortality of infants, especially in summer. Shall we be surprised at the statement of Fr. Gilyarovsky, that out of 10 people born during the suffering, only two survive.

Indeed, from the figures cited by Dr. Grebenshchikov, we see the highest mortality in Russia precisely in the summer months, which we do not find analogies in any Western state, and this highest mortality in the summer months is due to the huge mortality exclusively of children, and moreover, children up to 1 year. This enormous mortality of children under 1 year old, according to the observations of Dr. Svyatlovsky, is often aggravated by livestock deaths, which is why, obviously, the number of children on chewing gum turns out to be even greater. “The absence of cows and pieds of a completely macroscopic nature is not more important for children than the presence of invisible bacteria. Who does not eat, he dies of hunger, regardless of any bacteria.

As for contagious diseases, it can be seen from the statistics of Dr. Grebenshchikov that these diseases are more rampant in winter and spring and among older children, therefore, the high mortality of children under 1 year old, and especially in summer, does not depend on contagious diseases, and the whole thing is due to the development of gastrointestinal diseases, or rather, to agree with Dr. Svyatlovsky just quoted - mainly from hunger.

Let's compare the mortality data in Russia with those in Western Europe. There are many poor people there, there are unhygienic dwellings there (see Vodovozova's description), there are factories and plants there, and yet there the number of dying children in the summer is many times less. Yes, let's not go far in search of reasons beyond comparisons, since, of course, there are a lot of differences between Russia and Western Europe in all kinds of respects, and it is undoubtedly difficult to draw any analogy in the conditions of life of the population.

Even comparing the various provinces of Russia with each other is quite difficult, due to different climatic conditions.

From such a comparison of the northern and southern provinces, one thing can be said that the high summer temperature, to which so much is attributed in the etiology of high summer mortality, is not in fact such an important and exceptional moment, since in the southern provinces, where the average summer temperature is undoubtedly higher such in the northern provinces, the mortality of children in the summer is much lower than in the latter. The same fact of the comparatively smaller death of children in the summer in the southern provinces indicates that not only the increased birth rate in the summer months results in a greater number of deaths of these children.

Let us compare, however, the mortality among children of different nationalities living in the same locality, where, consequently, both are in the same climatic conditions and some others.

In this regard, we have a number of very interesting and detailed works in which this issue is developed with the utmost completeness and thoroughness, and in almost all of them, namely, on the scene, the personal experience of the authors, from their life among the described nationalities (Ershov51

from 6 months to 1 year10496

Total552302

a huge difference between the mortality of children under 1 year old between the Russian and Tatar populations. And, for example, the mortality rate, which among Russian children under 1 year old in 1871 reached 58%, among the Tatars only in 1883 reached 22%, going down even to 11% in 1881.

the author also analyzes other possible reasons for this phenomenon and, having proved that the reasons lie not in economic and hygienic conditions, since the Tatar part of the population is the least provided for and their dwellings are just as unhygienic, he comes to the conclusion (p. 144) that the difference in the strength of mortality children of two nationalities is due to the difference in time and methods of feeding, in the difference in the centuries-old habits and customs of caring for children. Infants of the Russian population of the Kazan province. (p. 116), left either completely unattended, or under the supervision of children, the blind, old men and old women and other cripples, wallow in a hotly heated hut in hardened, unchanging, unwashable diapers, often covered from head to toe with feces, urine and covered with thousands of flies, and usually feed, weaned before suffering, with a stinking horn stuffed with chewing; Tatar children are breastfed, and Tatar women take the child with them everywhere and do not take it away until 1-2 years old, starting feeding from the 2nd year with cow's milk, goat's, etc. Therefore, according to this eyewitness, Russian children suffer from diarrhea without exception, while the Tatars are healthy.

b about The higher infant mortality among the Orthodox is due solely to mortality from childhood diarrhea, and the mortality of Tatar children up to 1 year , sra

Epigraph:

“Stop, gentlemen, deceive yourself and cunning with reality! Do such purely zoological circumstances as the lack of food, clothing, fuel and elementary culture among the Russian common people mean nothing? … Doesn’t our shameful infant mortality, which is not found anywhere else in the world, mean nothing, in which the vast majority of the living mass of the people do not even live up to a third of a human century?

M. MenshikovFrom Letters to Neighbors. M., 1991. S. 158.

In one of my earlier posts on the topic: “RUSSIA WHICH THEY LOST” (it was about natural growth and mortality in the Russian Empire and European countries), I cited this quote from books by V.B. Bezgin Peasant everyday life. Traditions of the late 19th - early 20th century":

« According to demographers, a Russian peasant woman of this period (the turn of the 19th-20th centuries - approx.) gave birth on average 7-9 times. The average number of births among peasant women in the Tambov province was 6.8 times, and a maximum of 17. Here are some extracts from the report of the gynecological department of the Tambov provincial zemstvo hospital for 1897, 1901: “Evdokia Moshakova, peasant woman, 40 years old, married 27 years , gave birth 14 times”; "Akulina Manukhina, peasant woman, 45 years old, married 25 years, gave birth 16 times." In the absence of artificial birth control, the number of children in a family depended solely on the reproductive capabilities of a woman.

High infant mortality played the role of a spontaneous regulator of the reproduction of the rural population. According to survey data (1887-1896), the proportion of dead children up to five years the average for Russia was 43.2%, and in a number of provinces over 50% ».

Agree, the data on child mortality is impressive, isn't it? I decided to “dig” deeper into this issue, and what I “dug up” plunged me into a real shock - “ According to data for 1908-1910. the number of deaths under the age of 5 years was almost 3/5 of the total number of deaths. The infant mortality rate was especially high. "(Rashin" The population of Russia for 100 years. 1811-1913).

«… in 1905 out of every 1000 deaths of both sexes in 50 provinces of European Russia accounted for children under 5 years of age 606.5 dead, i.e. almost two-thirds (!!!) . Of every 1,000 deceased men, in the same year, 625.9 were children under 5 years old, and 585.4, of every 1,000 dead women, were girls under 5 years old. In other words, in Russia, a huge percentage of children who have not even reached the age of 5 die every year - a terrible fact that cannot but make us think about the difficult conditions in which the Russian population lives, if such a significant percentage of the dead are accounted for for children under 5 years of age.

Please note that in the quotations I have cited, we are not talking about the deaf and dark years of serfdom and the complete lack of rights of the peasantry of Tsarist Russia, but about the beginning of the 20th century! Speaking about this time, lovers and admirers of tsarism like to prove that the empire was “on the rise”: the economy was growing, the well-being of the people too, the level of education and medical care was rising.

"Gentlemen"!!! Not everything is as you think! Read the contemporaries of that "prosperous" time, for example, Nechvolodov (I note to you -Russian, gendarmerie general, the largest analyst of the tsarist special services) "From ruin to prosperity", edition of 1906 (I gave this material), Rubakin's "Russia in Numbers" edition of 1912, Novoselsky "Mortality and Life Expectancy in Russia" edition of 1916.

The main result is the gigantic external debt of the Russian Empire by 1914, the sale (“... we are not selling, but we are selling off,” as Nechvolodov wrote) of national wealth to foreigners, the purchase by the same foreigners of basic industries: metallurgy, shipbuilding, the oil industry, etc. ., its meager share of industrial production in global production, a significant lag behind the USA, England, France, Germany in terms of gross national product per capita - “European Russia, compared with other countries, - the country is impoverished "(Rubakin "Russia in Numbers", edition of 1912).

The main thing is that there would be a desire to read the authors I'm talking about, but no - at least read what I have already cited in my LiveJournal on the topic "RUSSIA WHICH THEY LOST" (tag "Tsarist Russia"). Everything that is posted there is based on these sources (and on other authors), plus statistical data from the Collection “Russia 1913. Statistical and documentary reference book.

However, I have somewhat moved away from the topic of infant mortality in the Russian Empire. I think that what you have already read about it from me, you are interested. Now I will give you the most detailed statistics that will convince you that the horror that both Rashin and Rubakin wrote about was such.

Let's start with infant mortality. under the age of 1 year in European Russia for the period 1867-1911.

The following table (source - P.I. Kurkin "Mortality and birth rate in the capitalist states of Europe", edition of 1938) shows infant mortality rates for the entire period under review.

Died out of 100 babies born under the age of 1 year :

1867 - 24.3;

1868 . - 29,9;

1869 - 27.5;

1870 - 24.8;

1871 - 27.4;

1872 . - 29,5;

1873 - 26.2;

1874 - 26.2;

1875 - 26.6;

1876 - 27.8;

1877 - 26.0;

1878 . - 30,0;

1879 - 25.2;

1880 - 28.6;

1881 - 25.2;

1882 . - 30,1;

1883 - 28.4;

1884 - 25.4;

1885 - 27.0;

1886 - 24.8;

1887 - 25.6;

1888 - 25.0;

1889 - 27.5;

1890 . - 29,2;

1891 - 27.2;

1892 . - 30,7;

1893 - 25.2;

1894 - 26.5;

1895 - 27.9;

1896 - 27.4;

1897 - 26.0;

1898 - 27.9;

1899 - 24.0;

1900 - 25.2;

1901 - 27.2;

1902 - 25.8;

1903 - 25.0;

1904 - 23.2;

1905 - 27.2;

1906 - 24.8;

1907 . - 22,5;

1908 - 24.4;

1909 - 24.8;

1910 - 27.1;

1911 - 23.7.

With an overall high infant mortality, infant mortality was extremely high in 1868, 1872, 1878, 1882, 1890 and 1892.

Minimum mortality for 1867-1911 was reached in 1907. But is it worth rejoicing at the fact that such a record low was achieved this year? In my opinion - no! In the future (1908-1910), it again grows to 27.1, after which it again declined to 23.7, which is quite natural if we analyze the trend in child mortality since 1867. The trend is the same after every drop in this indicator for infants under 1 year old, it rises again.

The only reason for some optimism of the supporters of the tsarist empire is that after 1892 until 1911 the infant mortality rate among infants under 1 year old did not reach the record for 1892 of 30.7 dead infants per 100 births and showed a slight decrease in the maximum. But at the same time, please do not forget that with the outbreak of the First World War, the economic situation in the Russian Empire only worsened, which could not but affect infant mortality, because, as Rubakin rightly noted: “... Any national disaster, be it a crop failure , epidemic, etc., first of all, is reflected in child mortality, which immediately increases.

And now, if one of the admirers of tsarism itches his tongue to accuse Kurkin of the fact that the figures he cited are biased (the edition, they say, of 1938, i.e. Stalinist), I propose, in fairness, to get acquainted with one more source.

In the work of S.A. Novoselsky "Overview of the main data on demography and sanitary statistics", editions of 1916 (!) ) published the following summary data on the mortality of infants under one year old in European Russia for 1867-1911.

So, out of 100 babies born died at the age of up to 1 year(for five years) :

1867-1871 - 26.7 (26.78 for Kurkin);

1872-1876 - 27.3 (26.26 for Kurkin);

1877-1881 - 27.0 (27.0 for Kurkin);

1882-1886 - 27.1 (27.14 for Kurkin);

1887-1891 - 26.9 (26.9 for Kurkin);

1892-1896 - 27.5 (27.54 for Kurkin);

1897-1901 - 26.0 (26.06 for Kurkin);

1902-1906 - 25.3 (25.2 for Kurkin);

1907-1911 - 24.4 (24.5 for Kurkin).

As you can see, the data of both authors are almost identical. And although the data for five years, show a downward trend in infant mortality among infants under 1 year from 1892-1896. to 1907-1911 by 11.27%, this decrease, in general, not very significant, was interrupted with the outbreak of the First World War due to the rapid deterioration of the economic and epidemiological situation in the empire.

For example, the incidence of typhus in the Russian Empire increased from 118.4 thousand diseases in 1913 to 133.6 thousand in 1916. And these are only registered cases, among which all in the same “prosperous” 1913, according to "Report on the state of public health and the organization of medical care for 1913" only 20% were hospitalized!

And now, a small "lyrical" digression for those who, after all, have not read my materials. The Russian Empire according to the data of the same Novoselsky (“Mortality and life expectancy in Russia” 1916 editions) among the countries of Europe he cited, even in the relatively prosperous 1905-1909. demonstrated superiority on mortality from smallpox, measles, scarlet fever, diphtheria, whooping cough . Hesotka (!)and malaria (!) in the prosperous year 1912 hurt more than the flu ( 4.735.490 people and 3.537.060 people. respectively, against 3.440.282 people.) ( Statistical compendium of Russia. 1914, data are given for 1912.). As always, cholera behaved unpredictably even in prosperous years. For instance, in 1909 10 thousand 677 people died from it, and in the next 1910 - 109 thousand 560 people, i.e. more than 10 times! And this too, only reported cases. (M.S. Onitkansky "On the spread of cholera in Russia", St. Petersburg, 1911). The annual incidence rate of tuberculosis steadily grew, from 278.5 thousand in 1896 to up to 876.5 thousand in the "prosperous" 1913. And he never (!) (since the mentioned year 1896) had a tendency to decrease! (Novoselsky "Mortality and life expectancy in Russia", 1916 edition).

This deplorable situation in the Russian Empire only worsened with the outbreak of the First World War. Therefore, as I said above, Rubakin absolutely rightly remarked: "... Any national disaster, be it a crop failure, an epidemic, etc., first of all, is reflected in infant mortality, which immediately increases."

I think that after the above statistics, no one wants to argue that the First World War, as a national disaster, was better than a crop failure or an epidemic, and its consequences did not affect infant mortality in general, and infants under 1 year old in particular.

Now we put an end to the "lyrical" digression and again return to the topic of conversation.

Do you want to know which of the 50 provinces of the European part of the Russian Empire were in the lead in infant mortality among infants under 1 year old?

(TO BE CONTINUED...)

In connection with the discussion about infant mortality in the Russian Empire, I will cite a fragment from the fundamental work of B.N. Mironov, whom no one can reproach for striving to denigrate life under the monarchy. Mironov will never fail to choose from two numbers the one that shows the Russian Empire from the best side, but the scientist still sincerely tries to maintain objectivity.

Source: Mironov B.N. Welfare of the population and revolution in imperial Russia: XVIII-early XX century. - M.: New Chronograph, 2010. S. 404-405

“The model explaining the geography of mortality has not changed in the post-reform period: the birth rate remained the dominant factor, almost monopolistically controlling mortality. This indicates that the traditional type of population reproduction, with its inherent high marriage rate, spontaneous and high birth rate and huge mortality, did not undergo significant changes by the end of the 19th century, although some changes were outlined in the pre-reform period, especially in the Baltic provinces23. Throughout the imperial period, a high birth rate was so important to the death rate that it provoked poor child care. Not a single society, not a single most developed economy would have been able to feed the huge number of children (8-10) that Russian women gave birth in the 19th century if children did not also die in huge numbers. In the first year of life at the end of the 19th century, almost 30% of boys died in European Russia, including 35% among Russians, and 56% and 50% of newborns, respectively, survived to 6 years of age24. In the middle of the XIX century. these figures were even worse. It was some kind of infernal machine: children were born to die, and the more children were born, the more died, and the more died, the more were born. High birth and death rates are two sides of the same coin, they stimulated each other. If fewer children were born, they would receive better care, and there would undoubtedly be fewer deaths. It is probably no coincidence that the higher the birth number was (starting with the third child), the less chance the child had of surviving: true evidence of increased mortality in families with many children26. In this case, we are not talking about a direct physiological relationship between fertility and mortality, but about such a dependence that existed indirectly, was determined by the influence of everyday, cultural and socio-economic factors27. The high average mortality rate that existed in Russia was not only a product of low culture and literacy, a lack of medical knowledge and poverty, it was a product of the Eastern European model of demographic behavior. In Western European countries, which adhered to a different, so-called Western, model of population reproduction, already in the 17th-18th centuries. the overall mortality rate was 25-28%o, less than in Russia in the middle of the 19th century, largely because the birth rate there was in the range of 28-32%o28. Thanks to this, mothers could nurse their children with the same level of general culture, literacy and medical knowledge that the Russian people of the 19th century possessed in the mass. Western model of population reproduction in the XVIII-XIX centuries. received some distribution among the Catholic and especially the Protestant population of the western Russian provinces, which contributed to a decrease in the level of marriage, fertility and, as a result, mortality, which in the Baltic provinces was minimal among all regions.

The model of military marriage turned out to be less satisfactory both for the middle, and especially for the end of the 19th century, since it explains less than half of the variation in the percentage of those rejected. In the middle of the XIX century. military marriage was determined to a greater extent by economic factors, and at the end of the 19th century. - ethno-cultural, although in both cases the ethno-cultural component is significant: the greater the proportion of Russians, Ukrainians, Belarusians, as well as representatives of peoples who professed Islam, Buddhism and paganism in the province, the more there was a military marriage. The presence of such a pattern is explained by the fact that in the period under study there were national peculiarities of childcare, on which the health of children - future recruits - depended to a large extent. According to the unanimous testimony of physicians in the 19th and early 20th centuries, childcare among Orthodox and non-Christian peoples was less satisfactory than among the Baltic peoples and Jews. In addition to unsanitary conditions, the degree of care and feeding habits were of great importance. “Crudely Spartan education dominates in Russia on the widest scale so far,” noted the zemstvo doctor E.A. Pokrovsky in 1884 - Such an attitude towards children develops such qualities as endurance, the ability to adapt to the most difficult conditions, patience, resignation to fate, hardiness, but at the same time it also has such negative consequences as huge mortality, many cripples and disabled people, and also the fact that many children with poor health pass from infancy to childhood”29. In an Orthodox village, there was a custom to give a child almost from the first days of his life, in addition to mother's milk, chewed bread, porridge, etc. additives, and not because of lack of milk or other insurmountable obstacles, but simply by tradition, because of ignorance of its healing properties30. As is now well known, breast milk contains, in addition to proteins, fats and carbohydrates, minerals, enzymes, hormones, vitamins, immunoglobulins and antibodies, thereby protecting the newborn from infection and allergic diseases31. The lack of mother's milk had a negative effect on the health of infants, increasing morbidity and mortality. Muslim women, following the Qur'an, be sure to feed their babies with mother's milk, so that they were less sick32.

23 - Mironov B.N. Social history of Russia in the period of the empire. T. 1. S. 209-211.
24 - Ptuha M. Mortality of 11 nationalities of European Russia at the end of the 19th century. Kyiv, 1928. S. 23, 52.
25 - Reproduction of the population of the USSR / A.G. Vishnevsky, A.G. Volkov (ed.). M., 1983. S. 61.
26 - Tomilin S.A. On the issue of the fertility of a peasant woman and her influence on child mortality // Soviet demography for 70 years / T.V. Ryabushkin (ed.). M., 1987. S. 107-109.
27 - Novoselsky S.A. On the tightness of the relationship between fertility and child mortality / / Novoselsky S.A. Demography and statistics: (Selected works). M., 1978. S. 146-153.
28 - Mironov B.N. Social history of Russia in the period of the empire. T. 2. S. 379-381.
29 - Pokrovsky E.A. Physical education of children among different peoples, mainly in Russia: Materials for medical and anthropological research. M., 1884. S. 365, 370-371.
30 - Novoselsky S.A. Review of the most important data on demography and sanitary statistics of Russia / / Calendar for doctors of all departments for 1916, Pg., 1916. P.66-67.
31 - Handbook of children's diet / I.M. Vorontsov; A.V. Mazurin (ed.). 2nd ed. L., 1980. S. 26-28, 39-40.
32 - Chebotaev N.P. Some data on the statistics of mortality and morbidity of peasant children in the Samara province. SPb., 1901. S. 6.

“The child was born on May 12 at 9 o'clock in the morning, and died on June 11 of the same year at 1 o'clock in the afternoon. How long did the child live? - an old arithmetic problem.

First, let's define the terminology:
1) Infant mortality - the mortality of children in the first year of life, that is, from 0 to 12 months;
2) Child mortality - mortality under the age of 15 years.

This is accepted in modern demographics, and it seems to me very fortunate due to the fact that the age of fifteen years roughly coincides with the age of integration into adulthood, marriage and offspring in the period before the twentieth century.

Child (hereinafter, instead of “child and infant”) mortality is an important characteristic of the general health and standard of living of the population of a country and is consistently used as one of the important factors in classifying countries by the standard of living of the population. Simply put, the better the life, the lower the infant mortality rate. At the beginning of the 21st century, African and Central Asian countries are leading in the ranking of countries with the highest infant (under one year) mortality with rates of 180-100 deaths per 1000 births, while in the most developed countries there are less than 5 deaths per 1000 newborns. These figures are steadily declining every year (not counting local outbreaks of mortality in a particular country associated with epidemics or social conflicts).

But what was the infant mortality rate in antiquity?

The topic of average life expectancy and its dependence on child mortality has already been touched upon above. As mentioned earlier, statistics appeared only at the end of the 19th century, that is, we can reliably trace the dynamics of child mortality only for a little over a century. However, indirect calculation methods come into play here: we know how many people lived at one time or another in a particular territory. Written sources: tax collections, parish books; demographic method: comparison of city size with building density; Together, they allow us to model very roughly the rate of population growth in a given area over a given period. Comparing these data with the average birth rate obtained from a set of written sources, we can calculate the approximate percentage of children who did not live to adulthood.

And this percentage varies depending on various factors from 30 to 90%. That is, throughout the history of mankind, until the middle of the twentieth century, when the progress of medicine and science led to a sharp reduction in child and infant mortality, an average of three to nine out of ten children died before reaching adulthood.

Such conclusions are also confirmed by the statistics we have for the 19th-20th centuries and the biographies of famous personalities of earlier eras - of course, mostly from the privileged sections of the population.

As an illustration, the calculation of average infant mortality using the example of the offspring of five European queens of the 15th-16th centuries, whose reproductive cycle was quite long (that is, they did not die and were not widowed too early): Isabella of Castile, Mary of Anjou, Charlotte of Savoy, Catherine de Medici and, for a change, Maria Yaroslavna, wife of Vasily the Dark.

And here's what happened:
Average life expectancy (women) - 58 years
Together they gave birth to 50 children
The age difference between the first and last child is from 12 to 23 years old, on average - 15
11 children died before the year
9 children died before the age of 5
Two died before the age of 15
16 out of 50 left offspring (by the way, the main reason for childlessness is, again, early death; although there were just bachelors / unmarried, the former can assume the presence of illegitimate offspring, if known, it is included here).
Infant mortality - 22%
Child mortality - 44%

And this brings us to the question of how legitimate it is to extend the data obtained from the study of the biographies of representatives of the highest aristocracy to the entire population on average. And, in my opinion, quite rightly so.

No. 1. The ratio of mortality in age categories.

The overall mortality-for-age ratio follows the same general pattern, regardless of all other factors: the earlier, the higher the risk.

For example, I give my calculation of the current ratio of child mortality to age, based on several more or less authoritative sources (for example, WHO).

If we take child mortality under 5 years as 100%, then of them:
22% died in the womb or within the first 24 hours of life;
33% died in the first week;
44% died in the first month;
and 69% in the first year of life.
This statistics confirms the pattern described above, but it cannot be unconditionally extended to epochs before the 20th century due to a significant decrease in child mortality in the category from one to five years due to vaccination and the development of medicine in general.

Rounding up modern statistics: about 2/3 of children die before the age of one year and only 1/3 - between the year and five years (of the total infant mortality, of course). This ratio was obtained from the absolute quantitative indicators of child mortality for 1990 and 2008, and both times it was almost the same - 69% (rounding tenths).

The ratio of infant mortality to total child mortality is gradually increasing with the development of medicine. Focusing on the previous calculation by queens, as well as my general idea of ​​​​medieval demography, formed on the basis of various sources, I will assume that the ratio of infant mortality (under one year old) to child mortality (from one to 15 years old) in the Middle Ages was 1: one. The statistics of child mortality in the Russian Empire in the late XIX - early XX century gives us 60-65% of infant mortality from the total child mortality. Despite the fact that at that time there was still no universal vaccination and antibiotics, and most of the population lived in rural areas, it must be assumed that through the efforts of zemstvo doctors, children over one year old and adolescents were still treated, which led to a reduction in mortality in this age group. category compared to the Middle Ages.

Further, in the first half - the middle of the twentieth century there was a breakthrough in the fight against infectious diseases - universal vaccination, the eradication of smallpox and the spread of antibiotics, which again reduced the mortality of children from one to five years and brought the ratio of child and infant mortality closer to modern indicators.

At the same time, babies continued and continue to die in the first days and weeks of life from natural factors, which depend less on the quality of the treatment provided and more on natural selection.

No. 2. Mortality on the first day of life.

What is the reason for such high rates of infant mortality on the first day of life, which is from 12 to 22% of total infant mortality? The answer is very simple - this category includes all cases of fetal death in the womb after the 28th week of pregnancy. And this happens, alas, not so rarely due to a variety of natural or traumatic causes.

In addition to stillbirths, the most common causes of neonatal death in the first hours of life are birth trauma and asphyxia. But all sorts of rare congenital pathologies and mutations that occur less frequently than 1 case in 10,000 can be safely ignored. Including the notorious "sudden infant death syndrome", which was noticed only when infant mortality dropped so much that people thought about the causes of individual deaths.

So, the main causes of death in the first day:
death of the fetus in the womb, stillbirth;
strangulation by the umbilical cord;
birth trauma with improper extraction of the fetus (fractures of the limbs, neck injuries);
weak respiratory activity or its complete absence (in maternity hospitals with a severe degree of asphyxia, resuscitation measures are taken, including mechanical ventilation);
Rhesus conflict;
prematurity;
intrauterine infections.

And considering that medieval medicine did not have in its arsenal practically no really effective means of obstetric aid or resuscitation of newborns, in this regard, women of all social strata were in an equally unenviable position.

Historical sources prior to the 18th century rarely give us enough information to distinguish with certainty between stillbirths, infant and child deaths. The ideal option is when the written source contains the exact date of birth of the child, as well as the time and cause of death, which makes it clear that the child lived for three years and four months and died, for example, from smallpox. However, most sources of the XIV-XVII centuries at best contain only the name and year of birth / death of the child, and if this is the same year, this tells us little.

In earlier medieval sources, everything is even more fun - children who did not reach adulthood may not be mentioned at all (for example, three sons who entered into inheritance rights and two daughters who married are listed, but this does not mean that there were five children in total, or even that only these survived, a few more could be “lost” due to insignificance); or the fact of the birth of a child is mentioned without further indications of his fate (naturally, this means his death at an early age, but without any details).

In addition, I suspect (this, however, my personal opinion) that in a number of cases, including - and especially - in families of the upper strata of society, stillborn children could be baptized as if they were alive. Of course, from a formal point of view, this is unacceptable, but it was in this respect that the church was ready to make indulgences. The death of a legitimate child - especially, of course, a boy - is always grief for his parents. However, the death of an unbaptized child is simply an unthinkable tragedy for the Christian consciousness of a medieval person.

One can delve for a long time into the dogmatic side of the question of where the souls of unbaptized children end up. Simplified, this whole dispute, which has been going on until now, looks like this: “Logically, of course, all unbaptized, including children, go to Hell, but this is very sad, so here’s a hundred excuses for why this is not quite so, but We won’t dogmatize this question just in case.” Nevertheless, medieval people were much less likely than modern people to rely on divine liberalism, so they probably believed that a child who died before baptism was doomed to stay in Limbo * at least until the Last Judgment. And, importantly, you can’t pray for him, you can’t bury him in a Christian way.

In general, you have to be a complete moral freak to tell a mother who just gave birth to this child in agony and herself, perhaps at death, that her child did not survive, and even go to Hell. Therefore, they tried to baptize the child at all costs.

The church even regulated the possibility of baptism if at least the head and part of the body of the child appeared; allowed that in exceptional cases, when a priest could not be found in any way, the rite was performed by a layman. Finally, in the second half of the 17th century, the so-called. "baptismal syringe" - I think it is unnecessary to explain the purpose and principle of operation.

And now a hypothetical situation: a noble lady or even a queen gives birth. Childbirth is difficult, perhaps there was a previous bad experience, everyone is psychologically tuned for the worst; a child appears - covered in blood and mucus, nothing is really clear, except that he does not scream. They clean his airways (yeah, “mouth-to-nose”), rub him on the back, slap on the buttocks. A minute or two passes, the child is still not breathing - a priest is pulled from the next room, who has been on duty there all this time just for such an occasion, he instantly baptizes the child with practiced movements, reads a prayer, and then - all the will of God. According to the documents it goes like this: "%Christian_name%, died in infancy."

In remote villages, where the priest is alone and knows everyone personally, women probably tried to persuade the dead to be baptized, bypassing the rules.

No. 3. Incest.

We will not touch on such extremes as dynasties supported by marriages between siblings, parents and children, as was the case, for example, in ancient Egypt and Westeros. Let's talk about Europe of the Late Middle Ages and Modern times.

It is probably well known that the situation with the gene pool among the representatives of the ruling European dynasties was not very good due to constant closely related marriages. Usually marriages were between cousins/second cousins ​​and sisters, as well as uncles and nieces. In order to conclude such a marriage, the permission of the Pope was required; and with his own permission, later such a marriage could be terminated due to close kinship - this is already a separate European diplomatic game.

This is especially true of the Habsburgs, whose power and vast possessions were based on marriage diplomacy. Even their family saying is known: “Let others wage wars; you, happy Austria, marry. What Mars bestows on others, the patronage of Venus will give you. The result was not only the dominance of different branches of the House of Habsburg in half of the countries of Europe, but also genetic diseases and mutations that often manifested themselves in their family.

So, from Juana the Mad (who, ironically, had excellent offspring survival rates - all six of her children survived and five left offspring), a branded “strangeness” bordering on schizophrenia was fixed, which now and then manifests itself in representatives of the Habsburg family.

Well, the most famous example of all this closely related obscurantism is the last ruler of the Spanish Habsburg dynasty, King Charles II, nicknamed the Enchanted. Due to several closely related marriages in the next generations (Charles' father, Philip IV, was married to his own niece), the heir's inbreeding coefficient was 25%, as was the case for children born as a result of incest between brother and sister. While an ordinary person in the fifth generation has 32 different ancestors, Charles II, due to closely related marriages, had only 10 of them in the family, and all 8 great-grandfathers and great-grandmothers were descended from Juana the Mad. Charles II was in poor health, suffered from many diseases: from tuberculosis to epilepsy, somehow lived to be 38 years old and died without issue. And so the dynasty was destroyed.

The negative impact of closely related ties on the gene pool of representatives of the upper strata of society is mentioned by all and sundry. It is much less often remembered that among the peasants, somewhere in the middle of the thoroughly fragmented Holy Roman Empire, the situation was not much better. It must be borne in mind that the average peasant is a person who is extremely attached to his area and has little inclination for any travel, just like hobbits in the Shire. And fragmentation, including on a confessional basis, completely discouraged the desire to go for personal happiness somewhere across the heels of borders, crossing each of which promises problems with local authorities and requisitions. Therefore, they married for generations and centuries within two or three neighboring villages, where each had three surnames. And with the right result. Tales of ugly foundlings did not just appear and are unlikely among the aristocracy.

No. 4. Seasonality of infant mortality and breastfeeding.

In modern conditions, in developed countries, the seasonality of infant mortality is absent or very insignificant; however, every statistical study of mortality in Russia in the 19th - mid-20th centuries demonstrates a terrifying - several times - increase in infant mortality, falling on the summer months and September. Moreover, this seasonality in Russia has always been more pronounced than in European countries, and also persisted much longer - until the second half of the twentieth century.

The explanation for this was found quickly - it is in the specifics of the agricultural season in Russia. Due to the long winter, the agricultural season in Russia is very short - 4 months, during which it is necessary to complete the entire amount of field work. Academician L.V. Milov at one time described the influence of the climatic factor on all spheres of the life of a Russian person, including the formation of the Russian mentality. The future harvest and, consequently, the survival of the entire community depended on the intensity of work in the summer months, everything else faded into the background. In the summer they didn’t get sick and weren’t treated, in the summer they worked for wear, for days, without thinking about anything else:

The time was, of course, hot - here and mow, here and carry, and collect bread. And here, my brothers, my woman is dying. Today, let's say, she fell down, and tomorrow she's worse. He rushes about, and raves, and falls from the stove.
- Well, - I say to her, - thank you, Katerina Vasilievna, - you cut me without a knife. Decided not to die at the right time. Be patient, I say, until autumn, and die in autumn. (Mikhail Zoshchenko, "The Bridegroom").

And in the summer, mothers could not breastfeed their children regularly. A newborn who needs feeding every 3-4 hours was thrown into the hut from early morning until late at night in the care of barely moving old people or older children of five or six years old, applying to the chest a couple of times a day. Early feeding (almost from the first days!), Notorious “chews” (that is, a chewed piece of bread wrapped in a rag or a cone, which could not be changed for several days), low hygiene, stuffy air and heat - all this contributed unusually high infant mortality in the villages during the summer months.

At the same time, by mid-autumn, the mortality rate sharply decreased and in October-November it was minimal; then there was again a seasonal surge, already in winter, associated with an increase in the frequency of colds, but it was incomparable in scale with summer. The elimination of the summer seasonality of infant mortality indicates an increase in the standard of living and industrial relations, an increase in the urban population - in Russia this was only achieved by the 1960s, when winter mortality exceeded summer mortality for the first time. This slight winter seasonality persists to this day.

But back to our medieval aristocrats. Practiced by the upper strata of society, the rejection of breastfeeding and, in general, personal participation in the life of a child in the first years of his life, transferring him to a wet nurse, and then to caregivers, is, of course, not the best parental decision. However, a specially found, healthy and young nurse, whose only job was to take care of the child entrusted to her, could provide him with the proper care that children from the lower strata of society were deprived of (yes, very often to the detriment of their own children).

An emotional bond arose between the child and the nurse, similar to the relationship between mother and child; very often nurses remained with their wards even after they reached adulthood. Whom, for example, did King Charles IX call before his death in Dumas' novel?..

No. 5. Alcoholism.

Alcoholism is not only a chronic mental illness, but also a way of life of our ancestors for several millennia. From antiquity to the 18th-19th centuries, low-alcohol drinks (wine in the southern countries and beer in the northern ones) were the main means of quenching thirst due to the lack of clean fresh water and the infections it contained.

So, for example, in the Nibelungenlied, one of the characters, tired of hunting, first of all demands wine or honey to quench his thirst, and only after that he agrees to the non-trivial proposal of another character to drink from the stream, and it was necessary to additionally justify that water it is clean and you can drink from it.

In addition, the very high calorie content of these drinks was a significant and necessary addition to the daily diet of ordinary people. According to tax collections in Holland in the 17th century, it can be seen that children and adolescents consumed only 2 times less beer than adults.
The technology for the production of low-alcohol drinks then differed from the modern one, plus they were often diluted with water, so that the strength was from 5 to 15 degrees.

But nevertheless: everyone drank and drank every day, including pregnant and lactating women. Here, for example, is an excerpt from the German treatise Versehung des Leibs, 1491: “I order the nurse to eat white bread and good meat every day, in addition, she must eat rice and lettuce. Almonds and hazelnuts should not be neglected. The drink of the nurse should be pure good wine.

This, of course, not counting the generally accepted practice of giving wine to newborns or giving a rag with wort so that they sleep more and do not distract from work. The peoples who did not practice this are easy to identify: they do not tolerate alcohol well.

No. 6. Childhood diseases.

Now the term "childhood diseases" is applied to infectious diseases that are ill mainly in childhood, these include: measles, rubella, chicken pox (chickenpox), scarlet fever, whooping cough and mumps (mumps) and I would also add black pox and diphtheria, although adults died remarkably from them.

Now all these diseases are practically defeated by universal vaccination and / or antibiotics. But until the middle of the twentieth century, they mowed down people around the world by the millions. And even a harmless chickenpox had a hand not only in the extermination of the Martians by Ray Bradbury, but also in the genocide of the Indians of America.

However, among the main causes of infant mortality were not only infections:

The main causes of death of children in the first year of life at the beginning of the 20th century were gastrointestinal and infectious diseases, respiratory diseases. So, out of 11,786 children who died in 1907 in Petrograd**, 35.8% died from gastrointestinal disorders, 21.1% from congenital weakness, 18.1% from catarrh of the lungs and respiratory tract, infectious diseases accounted for 11.0%.

Petrograd at the beginning of the 20th century is, after all, not medieval Europe. Revolutionary ideas were circulating there, but they already knew how to drive quarantine infections. Therefore, in relation to earlier eras, the proportion of infectious diseases can be safely increased several times. But forget about gastrointestinal diseases (a consequence of what has already been described above: in infancy, early complementary foods, in the older age - banal hunger) and all kinds of colds and pneumonia are not worth it.

There was no special branch of medicine dealing specifically with children's health until the 19th century; there was no diagnostic capability. Childhood illness was a completely literary metaphor for any unknown garbage, since it was impossible to understand from the crying of a child what happened to him - a slight malaise or a fatal illness. All parents had to do in this case was to pray.

An excellent diagnosis is "congenital weakness". Simply put, when a baby is born so weak and sickly - especially for premature babies - that he cannot suckle on his own breast. This, by the way, is hard just physically, even if all reflexes are normal. A vicious circle - the child cannot get enough food, this does not gain strength, but weakens even more, as a result, death in a few weeks.

Additions:
* Limbo is a place between Heaven and Hell, but not Purgatory. “They will not be glorified or punished by the righteous Judge; For not everyone who is unworthy of punishment is already worthy of honor. According to Dante - the first of the circles of Hell.

Protracted backlog

The end of the 19th - beginning of the 20th century in Russia was marked by an acute epidemiological crisis. This does not mean that the situation in Russia at that time was worse than, say, in the middle or at the beginning of the 19th century.

We are talking about a crisis lagging behind most of the developed countries of that time. As the prominent Russian demographer S. Novoselsky wrote in those years, “Russian mortality is generally typical of agricultural and sanitary, culturally and economically backward countries” (Novoselsky 1916a: 179).

Meanwhile, in the second half of the 19th century, Russia was developing vigorously, and Russian society found it increasingly difficult to put up with the preservation of antediluvian sanitary and epidemiological conditions, the structure of morbidity and mortality, mortality rates and life expectancy, which did not correspond either to its own rapidly changing criteria, or to those newer criteria, then approved in many Western countries. These countries were already beginning to get used to an increasingly noticeable and systematic decrease in mortality, while Russia was helplessly marking time and could not achieve at least some reduction until the last decade of the 19th century.

century, "mortality in Russia fluctuated either upwards or downwards" (Ibid., 181).

The construction of a Russian mortality table that meets modern scientific requirements became possible only after the first general census of the population of the Russian Empire took place in 1897. Such a table was built by S. Novoselsky for the population of European Russia (80% of the population of the empire in 1897) for 1896-1897. Novoselsky's table only confirmed what was known before and had long been disturbing the then relatively narrow circle of educated people in Russia who were beginning to think about such questions.

The rate of generational extinction in Russia was much higher than that of its more advanced European neighbors. At the turn of XIX

and XX centuries in European Russia, out of every 100 born boys, only 70 survived to one year, 49 - to 20 years, 36 - to 50; out of every 100 girls born, respectively, 74, 53, and 39. Life expectancy in European Russia in 1896-1897 was 31.32 years for men and 33.41 years for women. If we take only that part of European Russia, which now belongs to the territory of the Russian Federation, then life expectancy was even less - 29.43 and 3:.69 years, respectively (Mortality 1930: 108-111). Two or three hundred years ago, such indicators could be considered quite normal, but at the beginning of the 20th century they were already an indisputable sign of lagging behind. In France at that time, life expectancy was 43.44 years.

in men and 47.03 in women (1900), in the USA - 48.23 and 51.08 (1900-1902), in Japan - 43.97 and 44.85 (1899-1903).

According to pre-revolutionary statistics, at the end of the 19th century, the main difference between Russia and other countries was the extremely high mortality of children, especially in the first year of life.

In 1896-1900, the infant mortality rate in European Russia was 261 per 1000, while in France only 161 children died in the first year of life out of 1000 born, in England - 156, in Sweden - 100, in the USA (1901-1905) - 124 (La mortalite 1980: 147-149).

The difference between Russia and countries such as the United States and France in other age groups does not seem so significant, and at the age of over 70 years, the mortality rate in Russia was even lower than in other countries.

However, it is possible that the relatively low mortality of the adult, and especially the elderly population, is an artifact generated by poor accounting of deaths at older ages and / or overestimation of the age by older people in the 1897 census as a result of “senile coquetry” and errors, which is inevitable in conditions of low literacy of the population and the lack of documents confirming the age.

The immediate reason for the persistence of high mortality was a very archaic structure of morbidity and associated causes of death for a European country of that time. At the turn of the 19th and 20th centuries, the country did not get rid of epidemics of cholera, smallpox, and typhus; even in years free from epidemics, diseases and causes of death of an exogenous nature played a huge role, which in the West were more and more under control.

In particular, already at the end of the 19th century, European countries were very far ahead of Russia in terms of mortality from infectious diseases (Table 2.1).

Table 2.1. Mortality from certain infectious diseases in Russia and Western Europe, 1893-1895, deaths per 100,000

Smallpox Scarlet fever Diphtheria Measles Pertussis Abdominal All

typhoid infections listed European Russia 53.0 114.0 147.0 87.0 66.0 88.0 565.0 Austria 20.0 53.0 123.0 42.0 65.0 47.0 350.0 Belgium 28 .0 16.0 52.0 60.0 53.0 35.0 244.0 Germany 0.2 21.0 128.0 29.0 40.0 14.0 232.2 Italy 7.0 22.0 54 .0 37.0 25.0 49.0 194.0 Scotland 2.0 20.0 42.0 55.0 53.0 19.0 191.0 England 3.0 20.0 21.0 41.0 30 .0 20.0 145.0 Sweden 0.3 30.0 69.0 7.0 18.0 19.0 143.0 Holland 6.0 14.0 34.0 20.0 31.0 20.0 125 .0 Ireland 0.5 11.0 20.0 25.0 26.0 20.0 102.5