Medicine capitalism era
History Of Medicine / / August 12, 2017
Clinical activity EE Eichwald - a brilliant page of Russian medical science during its heyday.
He was born in 1837 in a family of EI Eichwald renowned scientist and physician.In 1859, he graduated with a gold medal of the St. Petersburg Medical-Surgical Academy and was left in the first clinic prof.Besser, and then - prof.Zdekauera.After defending his doctoral dissertation, he being abroad, he attended lectures of professors and Oppolzer Skoda in Vienna and Bamberger in Würzburg.
From 1875 to 1883 EE Eichwald - Professor of diagnosis and general treatment at the Military Medical Academy.Since 1886, his teaching and research activities continued at the Clinical Institute, where he read a course of internal medicine physicians.
EE Eichwald Died November 21, 1889
Like many other major therapists of his era, he was a young doctor began his scientific career to the study of some physiological and general pathological problems.The first major work "On colloidal degeneration of the ovaries" (1863) Eichw
In this paper EE Eichwald tried to understand the physiological significance of chemical processes.It should be noted that scientific direction, which adhered to the young scientist.He wrote: "The starting point of our physiological reasoning will be the simple anatomical units, over which could be observed so far the phenomena of life ... We know very well that this expansion of the body in the anatomical unit contains an error;but this error applies to the whole of modern science, and we are obliged to speak the language of modern "1.Thus, already in this first clinical and physiological work, the author as the representative of the Russian medical school opposed anatomical and lokalisticheskogo consideration of organic processes.
From even earlier physiological works EE Eichwald is necessary to point out the experiments with artificial digestion, which he made in the winter 1859-1860.laboratory EV Pelikan.Gastric juice for experiments was obtained from dogs with gastric fistulas.
Perfecting the clinic, EE Eichwald simultaneously studied the history of medicine.He soon realized that "every school has its bad side."We must not confuse the dogmas that have a real reason.Criticizing the unilateral commitment to any idea in science, Eichwald talked about the doctors: "We are always under the influence of the dominant school and that we somehow confident, based on what we know, judge what we do not know.This is a very big mistake to transfer what I know, the fact that I do not know. "
Arguing that such a disease, EE Eichwald turned to history.He knew that the modern tendency to look for anatomic causes of the disease begins with the well-known book Morgagni, who in presenting each case history and described the autopsy.Cruveilhier Virchow and deepened these local views on the disease."And now - I wrote EE Eichwald - all our modern direction, which directly leads to a desire to increase the way for the introduction of drugs, all this is a direct legacy of this local therapy."Against this scientific direction EE Eichwald objected in his first work.With even greater force, he argued inferiority and harm local therapy in the prime of their activities.Analyzing foreign guides private pathology and therapy, he pointed out that the major drawbacks of most of these works are the "paucity of information on the etiology, lack of consistency in the grouping of diseases, finally, a very exaggerated interest in the pathological anatomy of the disease", not to mention never encountered inlife paintings symptomatology.The doctor who learns these schemes and thinks of them treat the sick, defeated, and is unlikely to help the patient.According
EE Eichwald, "disease occur in the vast majority of cases are not influenced by any one of chemical, physical or mechanical agents, and a variety of conditions, often acting gradually and over time."The living body differently responds to external influence, and here is the problem of individuality, the uniqueness of each subject are very important for understanding the pathological process.That is why doctors need to know the physiology.Not only good to learn the cause of death.We must seek to understand the conditions under which the disease may occur.Here EE Eichwald develops what physiologist said Glebov, "is much more comforting to medical physiological point of view.Physiology refers to the supply voltage of power that exists in every living body. "
EE Eichwald applied thorough physiological analysis when solving any general pathological or clinical problems.Analyzing such as the origin and course of febrile process, he drew attention to the fact that the human body with great tenacity defends height temperature.EE Eichwald was inclined to think that, in many cases, a fever - it's self-defense process.According to him, to a clearer understanding of the benefits and harms of fevers, it is necessary to the concept of «febris» divided into simple elements.The analysis identified EE Eichwald:
- fever, toxic,
- dramatically undermine the power of the body;
- physiological fever - in runners, walkers, etc .;
- fever with mental illnesses;
- fever as a result of dry diet when taken out a lot of nitrogenous wastes without enough water.
experimentally fever can be caused by irritation of some sections corporis striati.Severity of different diseases can not be defined a thermometer, as did the German clinicians at the time.
very timely and valuable remarks were EE Eichwald on the state of anatomical knowledge.He drew attention to the fact that the anatomy textbooks and anatomy on cadavers do not comply with the anatomy of a living organism in many ways."It is necessary, he said - to know the conditions that affect the state of our viscera."For example, generally described by the position of the heart does not respond to that which it occupies a living person.Descriptions based on the autopsy, usually can not be important for the clinician."According to the just expression Girtlya, this kind of post-mortem examination may give only a caricature of the normal anatomic relationships."EE Eichwald believed that the method of freezing corpses and cutting them in three directions, applied NI Pirogov, is also not convincing, "as it is difficult to decide how to change the location of the parts in the transition of water in crystalline form, and it is impossible to sayas with the water evaporates.The frozen corpse is a much smaller volume than non-frozen corpse, and the decrease in the volume can not be performed in all directions equally. "The results of this process, according to him, can give an idea of the situation only at the time of the strongest parts of the exhalation, which makes the person before death.Thus, EE Eichwald argued that the need for the clinician to the anatomy of a living organism.
EE Eichwald paid much attention to the physical examination techniques.Of particular importance he attached to the ability percuss.Analyzing the works Skoda clinician and physics Tsamminera, trying to explain the physical basis of percussion, EE Eichwald, agreeing with them in some respects, I believed that these researchers have simplified the matter."At the extreme complexity of percussion sounds - it is argued - could be little doubt that such a complex phenomenon could have a value and price from the point of view of diagnosis."That unequal level of involvement of the body components in the event of percussion sounds and makes it possible to widely use this method for diagnostic purposes.When percussion EE Eichwald meant to get a certain sound effect and a sense of resistance.Percussion gave him an opportunity to identify the projection of the heart.
EE Eichwald took under their protection some conclusions Piorri Frenchman, who was accused of excessive enthusiasm for percussion.Due to study the anatomical location of the internal organs, EE Eichwald claimed that the disposal of physicians are no other equally precise method in the diagnosis as percussion.
With great observation EE Eichwald described some phenomena obtained by auscultation.He drew attention to the great clinical importance of tones force on the aorta.The stronger the first sound, the greater the tension of the aorta at the time of systole;the stronger the second sound, the sharper the voltage at the time of diastole.The first sound of the aorta is enhanced in people than ever excited.It weakens the decline of cardiac activity, for example, during fright, venous stenosis of the left hole.
When listening to the hearts of the most important is to establish the properties of the heart sounds and the determination of their relative strength at different points of the cardiac profile.It should be remembered that the position of the heart in a healthy and patient differently.
EE Eichwald understand the importance of the peripheral circulation in physiology and pathology.As a clinician and physiologist, he pointed out that the opposition vascular blood pressure is one of the reasons that put the limit of human life.Eichwald studied the phenomena occurring in the arteries and veins, and give more space to the old doctrine of the pulse and its properties.
EE Eichwald saw that only one anatomical diagnosis of the disease may not reflect the true condition of the patient, and pointed to the need to monitor the disease in its development with the treatment of attention on functional aspects.Among the works of EE Eichwald has a valuable and instructive work "Pathogenesis and semiotics circulatory disorders", in which he led the analysis of this or that aspect of the disease in the physiological understanding of the organism as a whole, which is characteristic of Russian therapeutic school.The subject of clinical analysis Eichwald did those disorders that are especially characteristic in this respect.However, he did not forget that the human body is the product of a long evolution, why he began the study of the subject with the embryology, with the fact that the vascular system with the blood contained in it and the surrounding connective tissue is one physiological whole which is formed from the middle germ layer.This intelligent data fusion embryology, physiology and clinics helped the author in many cases, a new way to illuminate problems of internal pathology.Eichwald perhaps the first of clinicians indicated that in its development the heart and blood vessels are closely dependent on the amount of blood: "We can say that the volume of heart cavities is directly dependent on the amount of blood that fills each of them during diastole."This interconnection is maintained in all phases of extrauterine existence and causes for disease, and the function of the whole system combined vasomotors.Based on this understanding of the circulatory organs, EE Eichwald examines various heart diseases, blood vessels and other organs, paying attention to the fact that as a result of stagnation may occur Cathars respiratory and digestive tract, inflammation of the kidneys and so on. Angina pectoris, accordinghis opinion, is often the result of vain attempts to overcome the obstacle of the heart.EE Eichwald offers physicians more frequently to monitor barometer readings, from which a fall is often the same as the appearance of angina attacks."Knowing that the barometer has fallen, I'm going straight to the patient and I get on the attack."
Turning to the presentation of treatments EE Eichwald, we can not dwell on his statements about the importance of medical historical knowledge.
Turning to the past, told EE Eichwald, you can identify two main thoughts that physicians interested in the field of treatment.One - is the Hippocratic idea that nature cures the disease, and the doctor only helps her.Another idea was born in the XVI century and is particularly pronounced Paracelsus.It was the fact that "the physician must cut off the disease as a lumberjack chops wood on the stump."Since that time in connection with the opening of an anti-syphilis began to talk about "specific treatment".For the first time this term was coined by the British pathologist Gunther.Sam EE Eichwald inclined to think that the future belongs to a specific therapy, ie. E. So that you can successfully influence the cause of the disease and thus to destroy it completely.One of the most significant works of EE Eichwald called "critical review of medicinal methods of healing."
In this work they are discussed in detail especially those drugs that act on the nervous system.Based on the achievements of the Russian physiological school, EE Eichwald considered feasible cause weakening of certain excitation of the nervous system, affecting exciting way on its other divisions."Thus, - he wrote - can be, for example, destroy the convulsions in hysterical patient, electrifying brush back skin;excitation sensitive skin nerves inhibits reflexes coming from other parts of the nervous system, and cramps disappear. "Thus in one area irritation caused inhibition in the other.The correctness of such statements in the future, as we know, has been proven by Pavlov in his teaching about the induction.
However, applying these nerve agents, can be expected, warns EE Eichwald, various surprises: "It depends on what personality plays a huge role in this matter."Knowing that the concept of individuality is still poorly understood, EE Eichwald doctors could offer only one piece of advice - to gain experience.
EE Eichwald as a physician and scientist thought for a broad and sustainable recovery of human need some radical measures.Seeing the sick and healthy people contemporary era, getting acquainted with the history of Greece during the Olympic Games and comparing these widely separated one from the other periods, he came to the conclusion that in this case, "the Greeks were indeed reasonable to us."
Thinking about the opportunities that are available to humanity, to restore strength and health, EE Eichwald is primarily addressed to the gym as a simple universal way to prevent further degeneration process.
EE Eichwald did not hide their mistakes and never became a human posture, all comprehended and all knowing.Being a great connoisseur of anatomy and physiology of the nervous system, he shied away from solving those issues, which had to move from the scope of the facts to the hypothetical.Realizing high value medical activities, EE
Eichwald appealed to his audience with these words: "Do not forget you need one, we have to be representatives of science and education, and should carry out this education into practice, that although any deviation from thisthorns way can actually deliver money, pleasure, luxury and honors, but never calm voice of conscience, which is our inner well-being. "
With the help of EE Eichwald was opened in St. Petersburg Clinical Institute for Advanced Training of doctors, for the organization of which he donated a lot of money.