Story

The struggle of the Russian people against the Mongol-Tatar yoke (1240-1480) united the Russian lands around Moscow, whose historical role especially increased during the reign of Ivan Kalita (1325-1340) and Dmitry Donskoy (1363-4389). Prince of Moscow Dmitry received his nickname (Donskoy) after the victory of the Russian regiments led by him over the army of Khan Mamai on the Kulikovo Field (1380) near the Don River.

The Kulikovo battle, which was the first major defeat of the Golden Horde, created real prerequisites for the unification of the Russian lands into a centralized Moscow state. Its creation was completed under Ivan III (1462-1505) after the victory of Moscow troops on the River Ugra (1480), which determined the final overthrow of the Mongol-Tatar yoke in Russia.

The Grand Duchy of Moscow became a large multinational state of Europe. By the end of the XVI century. the territory of the principality has almost doubled. There were 220 cities in the country. The population has reached 7 million people.

The development of medicine and medical affairs

Up to the end of the 17th century, traditional medicine occupied a leading position in Russia. The experience of Russian on-kindred medicine is reflected in numerous historical and household stories of that time. Among them - recorded in XV.v. "The Tale of Peter the Fevronia of Murom," which tells about the miraculous healing of Prince Peter of Murom. Having hacked the serpent-beast with his sword, he was sprayed with his blood and fell ill with a severe skin disease. Severely ill Peter went to the land of Ryazan, which was famous for its healers. A simple peasant girl - the daughter of a woodcrop (collector of honey from wild bees) - Fevronia cured the prince (most likely with the help of honey). The recovered prince returned to his Murom land, but without Fevronia, the disease resumed, and Peter married the wise Fevronia. For many years they lived happily and reigned in Murom. The prototypes of the heroes were actually existing Prince David and his wife Euphrosyne, who reigned in the Xuroad in the 13th century.

In medical books of this period, a significant place was given to surgery (cutting). Among rezalnikov there were chiropractors, shchuvotguski, s ^ ​​bovolota. In Russia, operations were carried out through borehole drilling, winging, amputation. The patient was put to sleep with mandrake, poppy and wine. Tools (files, scissors, chisels, axes, probes) were carried through fire. Wounds were treated with birch water, wine and ash, and sewn with flax, hemp or small intestines of animals. Magnetic iron was used to extract metal fragments of arrows. Famous in Russia and the original design of prostheses for the lower extremities.

The development of trade with neighboring countries has greatly expanded the knowledge of Russian people about foreign medicines. In Russia translated repeatedly; in the thirteenth century from the Greek “Christian Topography” (see p. 138) of the Kos-us Indikoplov, a Byzantine merchant, who in the 6th c. visited India, oh. Ceylon C Ethiopia. And described their nature, customs, as well as drug exchange with "countries to the West of them." Indian medicines have long been known in Russia. They are reported in the ancient Russian herbalists, the story "Alexandria" (on the march of Alexander the Great to India), in the travel notes (1466-1472) of the Tver merchant Afanasy Nikitin "Living over Three Seas", which, due to their great historical significance, were included in Russian chronicle, as well as in "Vertograd" ("Garden of Health"), translated from German in 1534 by Nikolai Bulev.

However, overseas trade had its downside. In the Middle Ages the trading gates of the country opened the tryt "povaltes etg-y.de -"% chi. ¥ h by the end of the XIV century. Their connection with the arrival of merchant ships was obvious. In Russia, such gates were the large trading cities of Pskov and Novgorod: edsozhay. There are 12 epidemics that broke out in a short period of the 14th — 15th centuries (Fig. 100).

The idea of ​​the "stickiness" of infection has led to the introduction of protective measures. At first, this was reflected in the isolation of the sick and the cordoning off of disadvantaged places: the dead were buried "in the same yards in which someone dies, in the whole dress and what dies on what." Communication with the plagued houses ceased, their residents were fed from the street through the gate. During the plague epidemic of 1521 in the city of Pskov, Prince Mikhail Kislitsa "ordered ... Petrovskaya Street to be locked from both ends".

At the end of the XVI - beginning of the XVII century. quarantine measures began to acquire a state character. From 1654 to 1665, more than 10 royal decrees "on precaution against plague" were issued in Russia. During the plague of 1654-55 gates and abutments were established on the roads through which no one was allowed to pass on pain of death penalty, regardless of rank or rank. All infected items were burned at the stake. The letters on the way of their passage were repeatedly rewritten, and the originals were burned. Money washed in vinegar. The dead were buried outside the city limits. Priests under penalty of death were forbidden to read the funeral of the dead. Lechtsov was not allowed to become contagious. If any of them accidentally visited the “sticky” patient, he was obliged to notify the sovereign himself and stay at home “until the tsar’s permission”.

Stopped the import and export of all goods, as well as work in the fields. All this led to crop failures and famine, which always followed the epidemic. Scurvy and other diseases appeared, which together with hunger gave a new wave of mortality.

The medicine of that time was powerless before epidemics, and the system of state quarantine measures developed at that time in the Moscow State was all the more important. The creation of the Pharmaceutical Order was of great importance in the fight against epidemics.

The Pharmaceutical Order, the first public medical institution in Russia, was founded around 1620. In the early years of its existence, it was located on the territory of the Moscow Kremlin in a stone building opposite the Chudovo Monastery (Fig. 101). At first it was a court medical institution, attempts to create which go back to the times of Ivan the Terrible (1547–1584), when in 1581 the first pharmacy in Russia was established at the royal court, since it served only the king and members of the royal family. The pharmacy was located in the Kremlin and for a long time (almost for a century) was the only pharmacy in the Moscow State. - In the same 1581, at the invitation of Ivan the Terrible, the court physician of Queen Elizabeth Robert Jacobus (Jacobus, Robertus) arrived in Moscow in the royal service; In his retinue were doctors and pharmacists (one of them named Yakov), who served in the Sovereign pharmacy. Thus, initially foreigners (British, Dutch, Germans) worked exclusively in the court pharmacy; pharmacists-professionals from born Russians appeared later.

The initial task of the Pharmaceutical Order was to provide medical assistance to the king, his family and those close to him. Prescribing medication and its preparation were mated with great severity. The medicine intended for the palace was answered by the doctors who prescribed it, the pharmacists who prepared it, and, finally, by the person to whom it was handed over for transmission “upstairs”. The “selected medical devices” intended for the tsar were kept in a pharmacy in a special room - “kazenka” under the seal of the clerk of the Pharmaceutical Order.

As a court institution, the “Tsarev Pharmacy” served the serving people only exceptionally. Quite a few petitions remained in the name of the king with a request to release this or that medicine. In P. Petrov Kalinowski’s petition dated March 11, 1662, it is written: “Zanemog ... I became sad, I lay at the village of light of life I don’t see the fourth month ... I die of starvation, I have nothing to eat ... grief (illness) to give drugs and led out of the treasury to give money. " Resolution: "... to issue medication from the Pharmaceutical Order."

In another petition of June 27, 1658, Mitka Ivanov’s soldier reports: “... I’ve killed your serf — punched through a carbine through the abdomen and below ... OTJ of that wound lay in a mountain and the wound hasn’t been shut up yet “Sovereign me ... to heal in a pharmacy." Resolution: “to treat it and give medicines without money”.

If there was only one pharmacy in the country, the population bought medicines in potions and mosquito shops, where free trade was carried out by potions. This led to the abuse of poisonous and potent substances. Thus, there is a need for state regulation of the sale of medicines. Moreover, the growing Russian army constantly demanded a regular supply of medical supplies to the troops. In this regard, in 1672, the second in the country was opened "... a pharmacy for the sale of all kinds of drugs of all kinds to the people."

A new pharmacy was located on the New Gostiny Dvor on Ilyinka, near the Ambassadorial Order. By a royal decree of February 28, 1673, both pharmacies were granted the right of monopoly trade in medicines.

Pharmaceutical order not only managed pharmacies. By the middle of the XVII century. from a court institution, he grew into a large national institution, whose functions have expanded considerably. He was in charge of: inviting doctors (domestic and, together with the Ambassadorial Order, foreign ones), monitoring their work and payment, training and distribution of doctors according to their positions, checking “doctor's tales” (case histories), supplying troops with medicines and organization of quarantine measures, forensic medical examination, collection and storage of books, management of pharmacies, pharmacy gardens. and the collection of medicinal raw materials.

Gradually, the state of the Pharmaceutical order increased. So, if in 1631 there were two doctors, five healers, one apothecary, one optometrist, two interpreters (translator) and one clerk (and foreign doctors used special privileges), then in 1681 there were 80 people in the Aptekarsky order among them there are 6 doctors, 4 apothecaries, 3 alchemists, 10 foreigners, 21 Russian doctors, 38 students of the medicinal and bone-stopping case. In addition, there were 12 clerks, gardeners, interpreters and economic workers.

In the second half of the XVII century. a peculiar system of collecting and harvesting medicinal herbs has developed in the Moscow state. In the Pharmaceutical Order it was known in which locality this or that medicinal plant grows predominantly. For example, St. John's Wort - in Siberia, malt (licorice) root — in Voronezh, Cheremitsa — in Kolomna, grass-nesting (antihemorrhoid) grass — in Kazan, juniper berries — in Kostroma. Specially appointed collectors (herbalists) were trained in methods of collecting herbs and their delivery to Moscow. Thus, there was a state "berry duty", for the failure of which was imprisoned.

At the walls of the Moscow Kremlin began to create sovereign pharmacy gardens (now. Alexander Garden). The number of them is constantly growing. So, in 1657, by decree of Tsar Alexei Mikhailovich (1645–1676), the “Sovereign Aptekarsky courtyard and garden were ordered to move ... from the Kremlin-city behind the Butcher-gate and set up in the garden in empty places”. Soon pharmaceutical gardens appeared at Kamenny Bridge, in German Sloboda and on other Moscow suburbs, for example, on the territory of the present Botanical Garden. Landings in them were made in accordance with the orders of the Pharmaceutical order.

In some cases, specialists in the procurement of medicines were shipped to other cities. A significant part of medicinal raw materials for pharmacies was discharged "from beyond the sea" (Arabia, Western Europe - Germany, Holland, England). The Pharmaceutical Order sent its diplomas to foreign specialists who sent the required medicines to Moscow. This is evidenced by the surviving correspondence. For example, in 1662 Ivashko Gebdon wrote to the Russian tsar from London: “... your letter from the Apothecary order was sent to me, and I was ordered to buy a foreigner ... pharmaceutical stocks against the painting, - and buying ... send them on ships to Arkhangelsk city ... And those pharmacist stocks are put in six chests and two barrels and in one bale and glued and released on ships to the Archangel city. ... To Moscow on summer carts with great care. "

At the beginning of the XVII century. foreign doctors enjoyed significant privileges in the Moscow State. The training of Russian doctors at that time was of a craft nature: for several years a pupil studied under one or several doctors, then served in the regiment as a medical assistant for several years. Sometimes the Pharmaceutical Order ordered a verification test (exam), after which a set of surgical instruments was issued to the rank of Russian doctor.

The first state Lekarsky school in Russia was opened in 1654 under the Apothecary order with funds from the state treasury. They took into it the children of archers, the clergy and service people. Training included collecting herbs, working in a pharmacy and practicing in the regiment. In addition, students studied anatomy, pharmacy, Latin, diagnosis of diseases and methods for their treatment. The international herbalists and therapists, as well as “doctor's tales” (case histories) served as textbooks. During hostilities, there were chiropractic schools. Teaching was conducted at the bedside - in Russia there was no scholasticism that prevailed at that time in Western Europe.

Anatomy at the school of medicine was taught clearly: for bone preparations and anatomical drawings, there were no textbooks yet.

In the XVII century. The ideas of the European Renaissance penetrated into Russia, and with them "some medical books (see Diagram 5). In 1657, the monk of the Chudov monastery, Epiphanius Slavinetsky, was entrusted with the translation of the reduced work of Andreas Vezalia Epitome (published in Amsterdam in 1642). E. Slavinetsky (1609–1675) was a very educated man, he graduated from the University of Krakow and taught first at the Kiev-Mohyla Academy, and then at the Lekarsky School under the Aptekarsky Prikaz in Moscow. His translation of the work of Vesalius was the first book on scientific anatomy in Russia. For a long time, it was kept in the Synodal Library, but during the Patriotic War of 1812, she died in the fire of Moscow.

The Pharmaceutical Order placed high demands on the students of the Lekar School. Admitted for study promised: "... do not harm anyone and do not drink or bastard, and do not steal with any theft ..." The training lasted 5-7 years. Drug assistants attached to foreign specialists studied from 3 to 12 years. Over the years, the number of pupils ranged from 10 to 40. The first graduation of the Lekar school due to the great shortage of regimental healers took place early in 1658. The school functioned irregularly. For 50 years, she has prepared about 100 Russian healers. Most of them served in the shelves. Systematic training of medical personnel in Russia began in the XVIII century.

Healers who provided medical assistance to the civilian population were most often treated at home or in a Russian bath. Inpatient medical care at the time practically did not exist.

When monasteries continued to build monastic hospitals. In 1635, at the Trinity-Sergius Lavra, two-storey hospital chambers were built, which have survived to the present day, as well as the hospital chambers of the New Maiden, Cyril-Belozersky and other monasteries. In the Moscow State monasteries had an important defense value. Therefore, in times of enemy invasions, temporary hospitals were established on the basis of their hospital wards to treat the wounded. And despite the fact that the Apothecary Order was not engaged in monastic medicine, in wartime the maintenance of patients and medical care in temporary military hospitals on the territory of the monasteries was carried out at the expense of the state. It was an important distinguishing feature of Russian medicine of the XVII century. The first medical doctors from the Russian people appeared in the XV century. Among them is George from Drohobych, who received his Ph.D. and medicine from the University of Bologna (modern Italy) and later taught in Bologna and Krakow. His work “The prognostic judgment of the current 1483 of George Drohobych from Russia, doctor of medicine at the University of Bologna”, published in Rome, is the first printed book of a Russian author abroad. In 1512 the degree of Doctor of Medicine in Padua (modern Italy) was received by Fran Skis Skorin from Polotsk. In 1696, also in the Padua University, the degree of Doctor of Medicine was awarded to P.V. Posnikov; being a highly educated man, he subsequently served as the Russian ambassador to Holland (see p. 259).