Medicine capitalism era
History Of Medicine / / August 12, 2017
outstanding Russian clinician GA Zakhar'in was born in 1829 in Penza.Secondary education future doctor was in the Saratov gymnasium.From 1847 to 1852 he studied at the medical faculty of Moscow University.Among the professors who listened Zakhar'in should call the therapist AI Auvers, talented student MJ Mudrova.At the suggestion of prof.AI overa young doctor was left intern Faculty therapeutic clinic and in 1854 defended his doctoral thesis on the topic «De puerperii morbis».1856-1859 gg.GA Zakhar'in spent abroad, where he attended lectures K. Bernard, Trousseau, Skoda, Oppolzer and others. Future outstanding clinician interested in different specialties and in an effort to gain knowledge on the disease of the whole body, studied ear, skin, neurological, gynecological diseases.On his return to Moscow, GA Zakhar'in in 1859 he began lecturing to students on the diagnosis rate.In 1864, following the resignation of AI Auvers, he was appointed Director of the Faculty Therapeutic Clinic and remained so unt
December 23, 1897 GA Zakhar'in died.
main scientific and clinical outlook GA Zakharyin evolved under the influence of the major figures of Russian science.Not having a clue about the healthy state, he said, it is impossible to study the disease.True health, according Zakharyin, is the ability to "resist the harmful effects of atmospheric and climate in general, irregularities in the room, the table, physical and mental activity."If the body fails to overcome these various influences, it will start to break down, to fall ill.Thus, the main source of any disease or is in the outside world, or in the wrong person's behavior, and often in one and the other at the same time.In this case, GA Zakhar'in went the scientific way, which at the beginning of the XIX century was scheduled EO Mukhin.In order to more clearly understand the causes of pathological processes, GA Zakhar'in had a lot to learn, "Over the years we became acquainted in practice with an important impact on health and can determine their relative strength," - he told his audience, reading the internal ratediseases.
Understanding medicine as a matter of highly practical, GA Zakhar'in could not for the improvement of medical science to close in the walls of the office and surrender to the study of books, the development of theoretical questions.Realizing the need for theory, he pointed out that haste in this area often gives unreliable, misleading results.
Thanks to the wonderful mind connected to deep observation and tireless energy, GA Zakhar'in moved into the ranks of the leading figures of medical science.
It is hardly necessary to dwell on the scientific methods GA Zakharyin, which has now become the property of any doctor, no matter what conditions and in what country he works - on anamnestic method.Of course, and in this area he had predecessors and especially M. Ya.Mudrov with students.However, the difference in the scientific level of these figures is obvious.As a result of GA Zakharyin doctors received a scientific and practical method of work, which has enabled the determination of diseases with exhaustive precision to take into account not only the environmental impact but also the features of the organism.All this taken together was of exceptional importance for practical medical work, and for the further development of medical science.GA Zakhar'in forced physicians interested in such "little things" in the life of the patient, which previously passed unnoticed.Of particular importance attached GA Zakhar'in hygiene.A lot of attention GA Zakhar'in paid value of climatic conditions.Here, his remarks are particularly valuable, and many of them are still not yet sufficiently understood by physicians and, in any case, not be implemented."With regard to our climatic conditions, the climate of central Russia, then we say here, contrary to the view, shared by very many, nevrachami and doctors that we do not think our climate is bad, we find him, perhaps harsh, but it is combined with the development of good health".
study of climate GA Zakharyin was associated with the study of its effects on the human body.The combination of a favorable climate to the natural resources, drinking medicinal waters, curative mud, etc. Made it possible to use such areas for therapeutic purposes.GA Zakhar'in considered unfortunate name "resort" as the word "alien to Russian ears."This German term he translated in Russian and spoke of the "medical field".And here, at the doctor's use of therapeutic beds Zakhar'in faced with confusion: Patients for Climate and any other treatment were sent without a thorough determination of needs in this treatment and even without knowledge of the treatment sites.GA Zakhar'in objected to such an abnormal situation harmful to patients.He pointed out that "every place has its own therapeutic personality to be reckoned with."Directing patients to think first of all about the climate, then the habits of the patient, the way of life, his home features: "One suitable place is quiet, calm, rich in natural beauty, the other is a large, bustling, lively center".If the doctor does not weigh all these features, it is unlikely to help the patient, but is likely to hurt him.Upon arrival to the treatment place the patient can again meet with the routine.For example, a man long accustomed to sleep in the morning, and they wake him up much earlier, offered in an unusual time for him to lunch, for a walk.All these indications GA Zakharyin very suitable, bearing in mind the improvement of health of the person.It is necessary, he said, "to prevent falling into a routine, indicate the need for this measure and, as always, personalize, change orders and routine drinking of property in accordance with the peculiarities of the case."
As a physician-hygienist GA Zakhar'in comparing the specific conditions of life in the countryside and in the city, considered that rural life for the many useful city.On this occasion, he wrote: "The main city has a hazardous atmosphere and damage the soil animal products metabolism - a natural and unavoidable consequence of never quite crowded of people and animals."Recognizing that urban life is a very important source of various diseases and systematic degeneration of the people, GA Zakhar'in put in place the problem of urban health.Above all, he insisted on their landscaping.
view of the fact that the causes of the disease in each case are numerous, and the body's response to the impact of diverse examination of patients is always to be difficult, time consuming and a lot of mental stress from the doctor.It is known that he for primary acquaintance with the patient spend at least two, sometimes three hours."Do not spare time on the sick" - was his rule.
With regard to the diagnosis of GA Zakhar'in said that to prove the situation and look for the unknown - are two different processes.For him the diagnosis - is to find the unknown.The first process - proving the situation - GA Zakhar'in called jugglery.It is impossible to speculate on human health.The doctor should be like a archaeologist.Very often in life GA Zakharyin, and after his death he was accused of neglecting to new survey methods that help in the diagnosis.Especially a lot of talk was about the use of a gastric probe.In this case, the charges presledodovali unworthy purpose - to humiliate GA Zakharyin as a doctor in the face of the public, to present human retrograde, reform medical science.GA Zakhar'in all these attacks replied that no matter how intelligent a new diagnostic method, there is no need to apply it everywhere and anywhere.In particular, it is about sensing rightly wrote: "Is the introduction of a gastric tube is not burdensome for patients, did not harm them?Solved it, patients with extreme disgust, only by resolute insistence of the doctor ... We can not say that lightly - without sufficient reason - the introduction of a gastric probe, unfortunately, not uncommon in practice, nutty novelty and fashion, deserves severe condemnation. "The physician must examine the patient so that no he did not lose precious time, neither the patient did not suffer from burdensome for him to diagnostic methods."How many times had I seen - said GA Zakhar'in - unsatisfactory work of doctors ... is gaining a lot of doctor petty and unnecessary data, and does not know what to do with them;will spend their time and attention to the collection of this data and, without going through proper clinical school, does not notice the simple, obvious and important facts together ... This doctor believes the entire "scientific" his course of action in the application of "thin", and, of course, the last, advanced research methods, not realizing that science - higher sanity - can not contradict simple common sense. "
Treatment is not a mechanical process, pointed GA Zakhar'in.In order to restore a person's health, it is necessary to put it in such terms, so that it can overcome the detrimental effects of the external world and to deal with their own shortcomings.And here, along with hygiene regulations GA Zakhar'in talked about the doctor so the ability to act on the will and mind of the patient, so that he, at first, was not afraid of his disease and, secondly, carefully follow the doctor's advice.Thus, among the medical means drug therapy did not play a major role.On this occasion, GA Zakhar'in said: "Equal to avoid therapeutic nihilism and Drug hobbies, should be fully aware that the true reality, and not only the apparent medical advice is only one that is based on full knowledge about the lifestyle, as well as the present andthe last state of the patient and which contains not only the treatment plan, and review the patient with the reasons supporting his illness and rooted in his way of life ... in a word, the explanation to the patient of his personal hygiene.Here it is necessary to add that, as patients mostly people with a weak will, the doctor's duty to help them, and his hardness, assigning treatment and lifestyle only the necessary steps, to demand their steady performance. "
GA Zakhar'in not subscribed to complex recipes.Symptomatic medication he used only with regard to their positive effect on the entire body.For him there was no diet disease and the patient's diet was.He applied the treatment of milk and mare's milk, and developed the first scientifically based indications for treatment with mineral waters.
Like all the outstanding Russian clinician, GA Zakhar'in in the treatment of each patient pay attention to the condition of the nervous system."Not improving sleep, you can not lead to the normal condition of the nervous system and, consequently, the whole body," - he said.But at the same Zakhar'in seen, which is not always the disease occurs by neurogenic.Analyzing one patient, he emphasized that his nervous system does not present any particular weakness, but, on the contrary, is the strong part of the body.In this case, he found that the nervous symptoms appeared again, as a result of the disease to other organs.Thus, GA Zakhar'in without following any pre-generated scheme, in each case depending on the facts in the condition of the body, which watched, knowing that a difficult human nature can not be the same cases.
Of the individual studies GA Zakharyin point to his description of the clinical picture of syphilitic lesions of syphilis lung and heart.He explained the neurogenic theory of hemorrhoids;a disease he regarded as angioneurosis.Works Zakharyin of bloodletting, the use of calomel, a series of articles devoted to the issues of drug therapy, as they have been published in the scientific developments of the country.
main work remaining after G. A.Zaharina his "Clinical Lectures", translated into all European languages, is still required reading every educated physician.
Effect of GA Zakharyin on the development of Russian medicine (and not only Russian) is extremely high.People suitable to him with a yardstick armchair, Wagner from science, believe that he has not created the school.This opinion is expressed generally by those who had never interested in the past of domestic science, and perhaps even new to medicine.In reality, there is no doctor who, applying scientific methods of clinical examination of patients developed GA Zakhar'in, would not have been in a sense, a disciple or follower of his.When people talk about someone else's school, usually implies the presence of the direct disciples who continue to creatively develop teacher achievement.With the name of GA Zakharyin related clinical activities such luminaries in various fields of medicine, as the NF Filatov, AA OSTROUMOV, VF Snegirev, AY Kozhevnikov.His pupils were MP Cherin.KM Peacocks, P. Popov.On the recommendation of GA Zakharyin to professorships have been appointed by such scientists as AI Pospelov, IF Ognev MN Nikiforov, I. Klein, NF Golubov.Hundreds of doctors, listen for a long teaching job shining on the whole life of the great clinician memorable lectures, as much by imitating the teacher, fought for the people's health.Chekhov, too, who had studied at AG Zakharyin, called him Leo Tolstoy medicine.
GA Zakhar'in among all our physicians of the XIX century was the brightest and most consistent advocate of preventive medicine.None of the author, we do not find such deep thoughts about this, like GA Zakharyin.He argued that where hygiene is absent, where do not take preventive measures, there is medical assistance is only illusory."Victorious argue hygiene can only with ailments of the masses."However, Zakhar'in seen that in terms of the time when he lived, could not achieve much.Yet he believed the spread of hygiene and sanitation skills among "one of the most important if not the most important subject of all practical activity of the doctor" of the population.