Medicine capitalism era
History Of Medicine / / April 29, 2016
The development of domestic medical science particularly significant impact among scientists of the XIX century had a SP Botkin.A study of his work is of interest for our time.
SP Botkin was born in Moscow on 5 September (Art. Art.) 1832 His father, Peter Kononovich Botkin, led a large trade with China.Home Botkins on Maroseyka in Petroverigsky Lane was in the 40s known cultural circles of Moscow society.
After teaching in a private school SP Botkin entered the medical faculty of Moscow University.Among the teachers Botkin, influenced him, it should be noted physiologist Ivan T. Glebova, pathologist AI Polunin, therapist IV Varvinsky.
In 1855, SP Botkin as a military doctor went to the Crimea to the theater of war, where he worked under the leadership of NI Pirogov.After the war, in 1856, he went abroad, where he attended the clinic and the laboratory in Berlin University, Vienna and Paris.Abroad Botkin stayed until 1860 During this period, he wrote several scientific papers and doctoral thesis "On
In the late 50-ies in the scientific life of the St. Petersburg Medical-Surgical Academy has come a marked revival.President of the Academy NA Dubovitsky and assistant vice president of Glebov, desiring to improve the pedagogical affairs, invited new professors among them - Botkin.Despite protests from the reactionary professors, young scientist, in November 1861 he was approved at the rank of full professor therapeutic clinic instead departed prof.PD Shipulinskogo.
The Academy Sergei Petrovich worked until the end of life.For many years he suffered from bouts of gallstone disease and angina.In 1889, feeling ill health, for medical purposes Botkin went to France and died in Menton, on 12 December the same year.
World Botkin was influenced by the best men of the time -. TN Granovsky, VG Belinsky and others of great importance for the development of the materialist views of the young scientist had the works Chernyshevsky, as well as personal friendshipwith Sechenov and meetings with AI Herzen.
As Botkin, any pathological process occurs under the influence of external conditions.The disease is not something separate from the body.It is impossible to speak about the clinical picture of the disease in general, out of touch with the sick.Diseases always develop differently depending on the individual characteristics.Hence the need for a versatile survey sick.It is not enough only one objective research, it is necessary to examine the patient and the environment, to get acquainted with his past.It is known that SP Botkin in the analysis of patients in class a lot of attention is paid to questions.
Possessing, as a virtuoso, by percussion and auscultation, using necessary laboratory tests, SP Botkin was different at the same time a remarkable observation.This gave him the opportunity to describe the many new, unknown to him signs of disease.SP Botkin pointed to a number of symptoms observed with organic heart disease.With great depth described them Clinic venous constriction of the left hole.Botkin drew attention to the extreme variety of symptoms, depending on the period of the disease.
Describing first discovered them signs and pointing to their importance, the great clinician, however, warned that the heart, as well as to other organs, it is impossible to watch "in the anatomical points", as eventually all the organs are influencednervous apparatus influences.Investigating where possible, the anatomical basis of the disease, SP Botkin always sought to emphasize the functional connections of organs and systems.By studying the disease, SP Botkin delved into the development process.Setting dynamic diagnostics feasible thanks to the deep penetration of the pathophysiology of the organism by means of analytical and synthetic method of thinking opens up the possibility, on the one hand, to predict the future course of the disease, making the right conclusion about prognosis and treatment, and on the other - to make excursions into the history of pathologythis patient.
great merit Botkin was the setting for understanding the history of the disease process in the body.In describing this or that disease, Botkin refused any ready-made schemes.It is understood that the body can not be studied in detail.Any unilateral experimentation harmful if forget the whole.SP Botkin argued that clinical medicine - an independent science that has as its object the most difficult thing in the world - a living human body.You can not experiment on patients and animal experiments can not always be used by doctors.
On this occasion, SP Botkin said, "You have to look for ... specific funds, and have the right to go and also by theoretical considerations, but only a place for the application of the latter should be a laboratory rather than clinical.You can not afford to experiment without extreme caution, on a living person.You have to remember that our medicine is far not on the basis of an exact science, and always keep in mind that salutary fear, not to hurt the patient does not worsen anything his condition. "
symptomatology Pushing the boundaries by identifying new signs of disease, witnesses in the aspect of the body as a whole, SP Botkin, introduced many new and in private therapy.
particularly significant achievement Botkin in the study of diseases of the cardiovascular system.The clinical arteriosclerosis, SP Botkin has proved that this disease usually leads to the defeat of the heart muscle with consecutive disorder compensation.In the peripheral circulation JV.Botkin has opened a new page of Medicine.He pointed out that the arteries and veins are not simple mechanical devices for blood distribution and are independent, occasionally twitch and dilate blood bodies.Trainee Botkin SV Levashov argued that, in addition to the normal physiological vascular contractions, they can sometimes occur (eg, epilepsy) and changed, pathological.
Analyzing the issues of internal pathology, SP Botkin always stopped especially on the state of the cardiovascular system.Describing the clinic Graves' disease, he drew attention to the shortness of cardiac origin, the uneven contraction of the atria, the contrast between great content and sharp throbbing arteries belonging to the system of the common carotid artery, and small, barely palpable pulse of the radial artery.By the way, one can not but recall that the most characteristic symptom of the disease in the film SP Botkin believed mental state of patients - their fearfulness, anxiety, indecision."The impact of mental things, not only on the course, but also on the development of this form can not be the slightest doubt further", - he claimed.The clinical work Botkin, we can see that in his quest as a deeper understanding of the origins of diseases can be, he always came to value the role of the nervous system."It may be - he wrote that under the influence of mental turmoil evolved suddenly not only functional, but also any and anatomical changes in the brain centers that affect paralyzing manner on the function of the vagus nerve or, on the contrary, initiated accelerating machines, moreprobably".Much has been done
Botkin and study of rheumatic diseases.Regarding rheumatic endocarditis, he pointed to doctors that a diagnosis of this disease should not be approached lightly because, as the French clinician Buyo, finding endocarditis in 60% of cases of articular rheumatism.Often the development of systolic murmur is associated with damage to the papillary muscles and their weakening, and not with the presence of endocarditis.
The doctrine of nephritis SP Botkin did not agree with the view that arose in connection with postmortem studies, in which interstitial and parenchymal shape up if various pathological units and have a special clinical course.SS Zimnitsky in 30-ies of XX century, wrote in this connection that the issue of clinicians nephritis is time to return to the views of Botkin expressed over 50 years ago, and talk in general about Bright's disease.
diagnosis wandering kidney has been known to work, and Botkin, but he has made clear to the clinic of the disease.Botkin showed the way to a correct diagnosis and combined into a whole series of phenomena, wrongly associated with the heart, liver and other organs.They are a special inspection method in which the stomach was examined not only in the supine, but in a standing position of the patient was proposed."Moving the kidney - wrote S. Botkin - worried sick for the most part due to nerve stimulation apparatus", and why there are different disorders.
SP Botkin left an imprint in the study of infectious diseases.Seeing the enthusiasm microbiology doctors, he said that we should not forget about the defense forces of the organism."We are in the clinic at every step we see in the actual existence of those unknown to us the physiological conditions in the body, which gives him the opportunity to fight with the disease."It is hardly necessary to dwell on the well-known fact that the gastro-intestinal catarrh with mechanical delay of bile has been correctly understood by the outstanding Russian clinician as one of the symptoms described to them parenchymal hepatitis, now bears the name of Botkin's disease.
Diagnostic talent Botkin was based on in-depth analysis of all found signs of the disease and the subsequent synthesis.In this respect, the case where it is at the beginning of the medical and teaching diagnosed portal vein thrombosis, confirmed by later opening.Throughout his scientific career a great clinician improved diagnostic and therapeutic techniques.In the laboratory at his clinic were studied different medications;some of them were taken from traditional medicine.Along with medication Botkin paid attention to improving the living conditions of patients, the need for physical and mental rest for climatic treatment.
Proceedings Botkin had an impact on the development of military-field therapy.In this respect, it was based on the experience of two wars - the Crimean War and the Russian-Turkish War of 1877 From a time when the rate of in-Chief in the Balkans, Botkin inspected hospitals, observed the work of doctors, general sanitary condition of the army.Heavy impression made on him as a doctor patriot incompetence of senior management and the work of various predatory trade "private partnerships", which was given at the mercy of the Russian army.He saw how the soldiers were starving, while in a country with rich reserves of bread.With regard to what is seen in all SP Botkin wrote: "Let's hope for a Russian man, his power, his star in the future.Maybe he and his invincible force will be able to get out of trouble, although strategists, commissaries, and the like. "
As chairman of the Society of Russian Physicians in St. Petersburg and as the editor of the medical journal, which published only original articles, SP Botkin contributed to the development of the domestic medical science.But it is especially important the Botkin as a teacher.He has trained hundreds of doctors and prepared for an academic career dozens of medical scientists.
His disciples were professors therapy VG Lashkevich (Kharkiv), MV Yanovsky (St. Petersburg), NA Vinogradov (Kazan), VP Obraztsov (Kiev), NY Chistovich (Petersburg), VN Sirotinin (St. Petersburg), AA Nechaev (St. Petersburg) and many others.Under the influence of the clinic nervism Botkin began to develop such medical disciplines such as dermatology, otolaryngology, nervous and mental diseases, as well as domestic physiology.Proceedings of Pavlov and his students were the direct creative development of those ideas nervism with whom they met in the clinic and the laboratory of the great Russian doctor.
Lectures Botkin, his patient reception remembered for a lifetime.Dr. P. Graziano wrote: "I was then in the fourth year Medical-Surgical Academy, where one of the most popular and favorite professors was Sergey Botkin.We were on a course of about 40 people, but not the one we were brilliant students of professor;I attended his lectures, and fifth-year students who have read the same thing prof.Eichwald.Patrons Botkin lectures were doctors, which this year (after the Turkish campaign), especially a lot of it was assigned to the academy.There were lectures and outsiders not involved in medicine person.These lectures had the same number of students, and during the gatherings, when other audience empty."There was at Botkin" - served as a sufficient justification for non-arrival to the meeting.Due to the interest, which consisted of Sergei Petrovich lectures his audience, calculated almost 500chelovek was always full from top to bottom. "
SP Botkin was not the speaker, it was not so hot beautiful phrases, which are usually clever people compensate the lack of thought and content.His lectures were filled with a deep analysis of the parsed clinical cases, the broad scientific and philosophical generalizations, bold reasonable hypotheses.
Despite the exceptionally gifted Botkin, his way of life was not easy.The democrat and humanist, he often met obstacles that put him professor of foreigners striving to hamper the development of advanced Russian science.Attempts were made to discredit the work of Botkin, deny the importance of his achievement, and thus achieve the entire Russian Clinical School and in later times.The basis of this "criticism" as when Botkin life and after his death was biased, arrogant attitude towards domestic science mixed with ignorance and worship of science abroad.
about such attacks that took place at different times, we can recall the words of the Czech Skoda scientist: "Following a stranger and doubt, applies to all of their own, often served to mask weak thinkers of the mind."SP Botkin put all their energy to serving the people, besides teaching, he and his listeners.
SP Botkin avoided talking about himself.Only, perhaps, once in his letters to his wife from Bulgaria in 1877, he wrote: "... Do not fear of accusations of boasting, I still have a gratifying consciousness that brought its contribution to good moral standards, which wereour doctors during this campaign.This thought I'd let you express just knowing that you're not seeing in this a trace of self-delusion that I had never been and will not be typical.Looking at the works of our youth, their sacrifice, their honest attitude to work, I have often said to myself, not without reason, I do not fruitlessly lost its moral strength in a variety of tests, which suited me my destiny. "
SP Botkin was one of the most outstanding representatives of Russian medical school, which originated in the second half of the XVIII century and found a strong philosophical and scientific foundations in the work of the classics of Russian science of the first half of the XIX century.In the context of his time, SP Botkin went on and developed the achievements of their predecessors.In his work we found a scientific basis and the further development of the idea of early materialistic nervism.In an age where anatomical direction reached its extreme development in the cellular pathology of Virchow, the domestic clinical thought opposed to this direction nervism fruitful ideas, grounded researches Russian physiologists.
basic idea Botkin as a clinician, he has bequeathed to future doctors, was the thought of the need for a deep, comprehensive study of nature."We can not allow - he said in the speech of December 7, 1886 g, -. To advance theoretical knowledge is only in the specific sectors of proper medicine, for example, normal and pathological anatomy, physiology, etc. For the future medical research direction is necessary to study nature.the full sense of the word.
knowledge of physics, chemistry, natural sciences, if possible wide general human education, constitute best prep school in the study of scientific practice of medicine. "