Until the middle of the 19th century, medicine was practically not developed in Russia, and only people belonging to the upper classes could receive at least some help. But everything began to change when Zemstvo institutions appeared after 1864.
History of Creation
In 1581, the first pharmacy chambers appeared in Moscow, which was the first step in organizing the he althcare system. However, proper development did not happen, and only at the beginning of the 18th century, Peter I carried out a series of events, thanks to which medical institutions, pharmacies, schools and higher educational institutions began to open to train future doctors.
Later, under Alexander I, they started talking about the need to create hospitals in county towns, but first you need to open paramedic schools. However, such activities did not help to radically change the situation, and only 0.5% of people could receive medical care. There was one doctor per 6,000 people, and 1,500 residents per bed. Everything would have continued like this if zemstvo institutions had not appeared, which, at their own expense, becameorganize zemstvo hospitals, dispensaries, maternity clinics, etc.
Zemsky institutions were helped by citizens of all classes to improve the situation, and in each province the situation was different.
Zemsky doctors
When zemstvo hospitals appeared in the 19th century (especially in rural areas), specialists were needed who could provide assistance in various areas, from colds to serious illnesses.
Medicine in rural areas developed first at the expense of county and city doctors, and then young specialists initially left for the villages. There was such a portrait of a zemstvo doctor who had high moral and ethical qualities, disinterestedness and a desire to help all those in need, which had a good influence on the formation of future medicine.
Zemsky hospitals of the Moscow province
In 1869 Zemstvo medicine began to be created in the province. When the congress of doctors was held in 1877, a project was developed to divide the province into six medical districts, where there should have been hospitals with staff, beds, a doctor, a paramedic, a midwife.
Many believe that the zemstvo hospitals of the Moscow province were a model for other hospitals in other areas. The development of medicine was divided into two periods. In the first, from 1865 to 1876, there was a rapid increase in the volume of funding for medical institutions, and the number of personnel increased. In the second, from 1877 to 1907, the development of the medical infrastructure took place: medical congresses were held, institutes of sanitary doctors were created and paramedics opened.schools.
Moscow Zemstvo was one of the first to provide free and public medical services. This helped to improve the efficiency of epidemic prevention and control, and also increased the increase in the number of peasants seeking help. But at the initial stages it was necessary to direct all the energy to create a primitive form of medical work. The best medical care was organized in industrial counties, such as Bogorodsky and Moskovsky, and the situation was worst in agricultural counties (Mozhaysky, Volokamsky).
Zemsky hospitals of the Tver province
In 1867, the first zemstvo hospital appeared in Tver, which became not only a place where people had to be treated, but also a center of social and cultural life.
In Tver, at the congress of doctors in 1871, it was considered that before becoming a good doctor, it is necessary to study the environment in which patients live. It is important to know what is the hygienic environment, what are the living conditions, because this will help in the work, the picture will be clear, what people get sick most often.
The doctor Mikhail Ilyich Petrunkevich, who arrived in the city in 1874, played a special role in the development of medicine in the province. He was skillfully able to combine his work and social activities in order to raise medicine to the highest level. New equipment for those times was bought for the hospital, books were bought from abroad, a library was created, which helped to learn from foreign experience.specialists.
Hospitals in the Samara region
The opening of the first zemstvo hospitals in the Samara region took place in the second half of the 19th century, somewhere in the early 60s. Prior to that, only one hospital worked in the province, where there were only 12 beds per 20 thousand of the population, and not only ordinary citizens, but also military men and prisoners were treated here for all diseases.
In 1865, a Zemstvo hospital was opened on the outskirts of the city, which accepted everyone, regardless of class and nationality. At that time, 7 doctors, 26 paramedics worked, there were 360 beds. Due to the fact that several paramedical schools were opened, medicine began to develop faster, and already in 1899 zemstvo hospitals were opened in rural areas, there were about 70 of them.
By 1875, the main Provincial Hospital was opened, which in 1890 had 5 full-time residents and 9 supernumeraries. The most important thing that happened at the end of the century was that the poor were treated for free and medicines were given out for free.
Achievements and results of zemstvo medicine
Through zemstvo medicine, assistance was provided in 34 provinces, and such medicine played a progressive role in the development of the future. In addition, assistance was provided not only to urban residents, but also to rural residents, and this was considered a big step in the he althcare system.
Thanks to zemstvo medicine, such concepts as general accessibility, prevention, free assistance appeared, and also such institutions appeared that had not been thought about before -mud baths, medical and food stations, shelters.
In medicine, “progressive” doctors appeared who knew a lot, could provide assistance in various areas, and also conducted research and studied diseases, therefore they opened bacteriological institutes and laboratories, a sanitary bureau, obstetric and paramedical schools.
Despite the fact that zemstvo hospitals often did not receive funds, equipment, medicines, the very emergence of medicine, where everyone, regardless of their status, could receive at least some help, marked the beginning of the development of medicine.
