In the Soviet historical literature, the beginning of modern times is considered to be October 1917. In most foreign publications, the beginning of modern times is associated with 1918, the end of the First World War. In a number of publications, modern times are defined as modern history (eng. - contemporary history) or as history of the 20th century.

Due to the unevenness of the historical development of mankind, modern times, like other periods of history, are characterized by a diversity of socio-economic relations in various countries of the globe.

The newest time is the shortest period in the history of mankind; its duration is calculated only for decades. However, the achievements of this period in all spheres of social activity (including in the field of medicine) in many respects surpass those created by the human mind during many previous centuries. A short course in the history of medicine, which is read by second-year students, allows you to study only the main directions and trends in the development of medicine in the period of modern history. Moreover, second-year students still do not have sufficient specialized knowledge for professional perception of material on the history of clinical disciplines. That is why the history of the development of individual medical specialties in the newest period is studied in the relevant medical, biological and clinical departments (in the process of professional development of the future doctor); It is no coincidence that a special chapter is devoted in textbooks and teaching aids for each discipline of its history.

In this textbook, the history of modern medicine is represented by three chapters: 1) the development of health and medicine in the USSR (the first years of Soviet power), 2) the Nobel Prizes in physiology and medicine and related sciences, 3) the development of international cooperation in the field of health. The content of these chapters, on the one hand, reflects the main achievements of medicine in this period, and on the other, it allows us to realize the development of medicine in the modern world as a single world-wide historical process.

In the early years of Soviet rule, epidemics of typhus, cholera, typhoid fever and other infectious diseases raged in Russia. The medical case was distributed to departments, was not sufficiently funded and was provided mainly by the budgets of the zemstvo councils and the dedicated work of the advanced zemstvo doctors. Everywhere there was an extremely lack of qualified medical personnel, medical institutions, and medicines. Civil war and military operations throughout the country intensified, devastation in industry and agriculture. The population of the country was starving. Not enough fuel. Transport, water supply and cleaning systems of cities and villages were in a very poor condition, which created a dangerous epidemiological situation.

“The main impression of the situation in Russia is a picture of a colossal irreparable collapse,” wrote Herbert Wells, who visited our country in September and October 1920. “The huge monarchy I saw in 1914 with its administrative, social, financial and economic systems , collapsed and shattered under the heavy burden of six years of continuous wars. History did not know yet such a grand disaster. In our opinion, this collapse overshadows even the Revolution itself ... The Bolshevik statistics with which I met are completely frank and honest ... The mortality rate in Petrograd is over 81 people and a thousand; it used to be 22 per thousand, but it was also higher than in any. European city. The birth rate among the undernourished and deeply depressed population is 15 people per thousand; before it was almost double

In this emergency situation, the efforts of the government of Soviet Russia were aimed primarily at establishing peace, so necessary for solving all internal problems. The Decree on Peace of October 26 (November 8), 1917 was one of the first decrees of Soviet power. He created the conditions for the implementation of tasks to preserve the life and health of workers, proclaimed by the government among the priority. “In a country that was ravaged,” said V.I. Lenin in 1919, “the first task is to save the worker. The first productive force of all mankind is the worker, the worker. If he survives, we will save and restore everything. ”

The fight against dirt, epidemics and diseases across the country demanded organizational unity of health care, the elimination of departmental fragmentation, the creation of a state network of hospitals and pharmacies, and overcoming the shortage of medical personnel. The implementation of these tasks on the scale of a huge country in the conditions of war, famine and devastation was possible only with the state health care system, which was organized in 1918.

Creation of the People’s Commissariat of Health

On October 26 (November 8), 1917, at the Military Revolutionary Committee of the Petrograd Council of Workers 'and Soldiers' Deputies, the Medical-Sanitary Department was formed (headed by M. I. Barsukov); the department was instructed to reorganize the health care business in the country.

Realizing the tasks set back in 1903 in the first program of the RSDLP, the Council of People's Commissars issued decrees: on the 8-hour working day - October 29 (November 11), 1917, on aid to victims of accidents at enterprises - from 9 (22) November 1917, on the free transfer of all medical institutions of the enterprises to the hospital bills - from 14 (27) November 1917, on insurance in case of illness - from December 22, 1917 (January 4, 1918) and others.

To implement these decrees and to provide medical care to the population on the ground, from November 1917, medical departments (at local councils) and medical boards (at some people's commissariats) began to be established in various regions of the country.

On December 2 (14), 1917, the medical boards of the People's Commissariats of the Interior, the Railways and the State Charity appealed to the population of Soviet Russia with a joint appeal "On the fight against morbidity, mortality and unsanitary living conditions of the broad masses of the population." This appeal was the first policy document of the Soviet state in the field of medical affairs. The appeal said:

The war, the economic collapse and the malnutrition caused by them and the depletion of the population pose to the workers and peasant government the question of combating morbidity, mortality and unhygienic living conditions of the broad masses of the population on a national scale.

Comprehensive sanitary legislation on water supply, rationo-1 tracing sewers and sanitary supervision, for commercial and industrial establishments, living quarters, for organizing elected from the public sanitary inspection, for combating morbidity and mortality and, in particular, for infant mortality, tuberculosis, syphilis, to fight against infectious diseases, to provide the population with folk sanatoriums, healing places, etc.

The commonality of the tasks faced by the medical boards led to their unification. On January 24 (February 6), 1918, the Council of the Medical Collectives was established by the decree of the Council of People's Commissars, which was entrusted with the functions of the “highest medical body of the Worker and Peasant Government”. A. N. Vinokurov was appointed its chairman, V. M. Bonch-Bru-Evnych (Velichkina) and M. I. Barsukov were appointed vice-chairmen.

On May 15, 1918, the first issue of the official press organ of the Council of the Medical Collectives under the Council of People’s Commissars of the RSFSR, “The News of Soviet Medicine”, the first Soviet medical newspaper-magazine, was published.

The Council of Medical Colleges (as M.I. Barsukov later wrote) had three main tasks:

"one. To continue the organization of the local medical departments under the Soviets of Workers 'and Soldiers' Deputies.

2. To fix the begun reorganization of military medicine ...

3. In every way to strengthen the sanitary business, to establish the fight against epidemic diseases and by all means help the Soviet authorities in eliminating sanitary chaos. ”

At the same time, the main task of the Council of Medical Colleges was to unite efforts in the field of health care throughout the country. In this regard, work was carried out on the preparation of the All-Russian Congress of Representatives of the Medical and Sanitary Departments, which was to decide on the formation of the RSFSR National Public Health Commissariat.

The All-Russian Congress of the Medical and Sanitary Departments of the Soviets was held in Moscow on June 16-19, 1918. Along with the main question “Tasks and organization of the People’s Commissariat of Health” (report 3. P. Solovyov and V. M. Bonch-Bruevich), the congress discussed the most important health problems of that period: “On the organization and tasks of Soviet medicine in the field” (report by N. A. Semashko), “On the organization of the fight against epidemics in the conditions of the Soviet Republic” (report by A. N. Sysin), “On insurance medicine” ( reports of I.V. Rusakov and G.V. Lindov).

The resolution of the congress noted: “On the basis of the unity of state power laid at the basis of the structure of the Soviet Republic, it is necessary to recognize the creation of a single central body - the Health Commissariat, responsible for all medical and sanitary affairs.”

On June 26, 1918, the Council of Medical Colleges sent to the Council of People’s Commissars a memorandum and a draft decree on the establishment of the People’s Commissariat of Health (Narkomzdrav) of the RSFSR. On July 9, 1918, they were published in the Izvestia of the All-Russian Central Executive Committee for general information.

On July 11, 1918, after repeated and thorough discussion, the Council of People's Commissars adopted a decree "On the establishment of the People's Commissariat of Health" - the first highest state body, united under its leadership all branches of the country's health care.

The first Board of the National Commissariat of Health of the RSFSR included: V. M. Bonch-Bruevich (Velichkina), A. P. Golubkov, P. G. Da-uge, E. P. Pervukhin, N. A. Semashko, 3. P Solovyov. The first people's commissar of health of the RSFSR was appointed "N. A. Semashko (Fig. 153), his deputy - 3. P. Solovyov.

Nikolai Alexandrovich Semashko (1874–1949) —he was the Commissar of Health until 1930 — during the civil war, foreign military intervention, and the post-war period, when the state health care system was created, the fight against epidemics was developed, the maternity and childhood protection program was developed, - resort business, the network of research institutes expanded, the system of higher medical education was reorganized.

In 1922, N. A. Semashko headed the country's first department of social hygiene at the medical faculty of Moscow University (from 1930 — Moscow Medical Institute, since 1990 — the IM Sechenov Medical Academy) and led it in for 27 years.

N. A. Semashko was the initiator and editor-in-chief of the first edition of the Great Medical Encyclopedia (1927–1936).

For ten years (1926–1936), he headed the children's commission of the All-Russian Central Executive Committee (VTSIK).

After the Great Patriotic War (1941-1945), on the initiative of N. A. Semashko, the study of the sanitary consequences of the war began. He participated in the creation of the Academy of Medical Sciences of the USSR (1944), became one of its first academicians and became part of the first Presidium of the Academy of Medical Sciences of the USSR. In 1945-1949 He was the director of the Institute of School Hygiene of the Academy of Pedagogical Sciences, and since 1945 - Academician of the Academy of Pedagogical Sciences of the RSFSR.

Under his leadership, the Institute of Organization of Health Care and the History of Medicine of the Academy of Medical Sciences of the USSR (now the All-Union Scientific Research Institute of Social Hygiene, Economics and Health Management named after NA Semashko of the Russian Academy of Medical Sciences) was created, whose director he was in 1947-1949. He was also the first chairman of the High Council for Physical Culture and Sports and headed the Board of the All-Union Hygienic Society (1940–1949). The scientific heritage of N. A. Semashko is more than 250 works on organizational and theoretical health issues. Among them are "Essays on the theory of the organization of Soviet health" (1947).

Zinovy ​​Petrovich Soloviev (1876-1928) was appointed first deputy people's commissar of health of the RSFSR. Along with this, from 1918 he was the head of the medical unit and a member of the board of the People’s Commissariat of Internal Affairs, as well as a member of the Medical Council Board.

In 1919 3. P. Solovyov was elected Chairman of the Executive Committee of the Russian Red Cross Society, and in January 1920 he headed the Main Military Health Administration of the Workers 'and Peasants' Red Army (which since August 1918 has been a member of the RSFSR People’s Commissariat of Health).

In 1923 3. P. Soloviev organized and headed the country's second department of social hygiene at the medical faculty of the 2nd Moscow State University (now the Russian State Medical University). On his initiative in 1925, the All-Union Young Pioneer Camp Artek was established on the Black Sea coast.

In his writings “Ways and crossroads of modern medicine”, “Preventive tasks of medical care”, “Which doctors should be trained by the higher medical school”, “Scientific bases of the military sanitary service” developed the organization of medical affairs and medical education in the country.

In July 1936, the People's Commissariat of Public Health of the USSR was established by a resolution of the CEC and the Council of People's Commissars of the USSR.

The first people's commissar of public health of the USSR was Grigory Naumovich Kaminsky (1895–1938, fig. 154). Prior to this appointment, in 1934-1936. He served as the People's Commissar of Health of the RSFSR, was the Chief State Sanitary Inspector of the USSR (the All-Union State Sanitary Inspectorate was established in 1935 on the initiative of G. N. Kaminsky). At the XIV-XVII party congresses, he was elected a candidate member of the Central Committee for Political Affairs (BCE).

On June 25, 1937, after a speech at the Plenum of the Central Committee of the CPSU (b) to condemn the policy of repression, G. N. Kaminsky was arrested and executed in February 1938. Together with G. N. Kaminsky, his deputies for the Commissariat of Health of the RSFSR and the USSR and other associates were arrested.

Currently, they are all rehabilitated (posthumously).

Despite the short term of work as Commissar of Health of the RSFSR and the USSR, G. N. Kaminsky managed to leave a deep imprint on the history of national health care.

The XVI All-Russian Congress of Soviets (1935) adopted, according to its report, a detailed program of measures to improve the medical support of the urban and rural population. On his initiative, the All-Union Association of the chemical and pharmaceutical industry was transferred from the heavy authority of the People's Commissariat. industry c. Commissar of the RSFSR. G. N. Kaminsky showed particular concern for scientists, the development of research institutes, and higher and secondary medical education. With his direct participation, the formation and construction of the All-Union Institute of Experimental Medicine (VIEM) in Moscow and Leningrad (now St. Petersburg) took place.

G. N. Kaminsky contributed to the establishment of international scientific cooperation: with his active participation, the first international congresses were organized and successfully held in our country - the IV International Congress on Combating Rheumatism (1934) and the XV International Congress of Physiologists (1935) . The activities of G. N. Kaminsky caused deep respect from fellow doctors and medical scientists.

The development of the ideas embodied in them began long before 1917. It suffices to recall Johan Peter Franck (see p. 313), who for the first time clearly formulated the idea of ​​public health, developed it in his 6-volume "General Medical Police System", or turn to the heritage of great thinkers of various epochs that foreshadowed — the future of medicine — preventive (Hippocrates, Ibn Sina, N. I. Pirogov, and many others). Nevertheless, the construction of these principles to the rank of state policy was carried out only in Russia in the early years of Soviet power.

1. The state character is the basic principle of public health in the USSR in the period of its formation. Its main contents are: centralization of management, state financing and state planning of health programs. Public health provides free and accessible medical care to the entire population of the country.

Thus, the Resolution fixed the rigid centralization of the country's health management. Under the conditions of the first years of Soviet power, this system, on the one hand, provided the necessary for that time needs in providing medical care to the population. In those years, free of charge and benefits of health care made the network of hospitals and dispensaries (now - polyclinics) accessible to the masses. It was in those years for tens of millions of people to go to a doctor, medical assistant or to a state medical institution became a common form of behavior in the event of illness. On the other hand, the centralization of health management, erected in an absolute principle, together with the residual financing of health care already in force at that time, laid down elements of an unbalanced development of the health care system. However, during the years of collectivization and industrialization, they were not so obvious. Nowadays, while maintaining the principle of public health, in addition to it, new forms of medical and social assistance to the population are being developed.

2. Preventive direction - the principle of health care, which has been consistently implemented in the USSR since the first years of Soviet power. This is evidenced by the first decrees: on measures to combat typhus (January 28, 1919), on measures to combat epidemics (April 10, 1919), on mandatory opprivate (April 10, 1919), on the supply of bacteriological institutes and laboratories materials and equipment necessary for their work (April 10, 1919), about the sanitary protection of dwellings (June 18, 1919), about the fight against typhus on the Eastern and Turkestan fronts (November 5, 1919), about providing the Red Army and civil population of soap (December 30

1919), about sanitary checkpoints at railway stations in Moscow (May 13, 1920), on providing the population of the Republic with baths (September 30, 1920) and many others.

The tasks of the state in this area were defined in a special section of the second program of the RCP (B.), Adopted in March 1919 at the VIII Party Congress:

The basis of its activities in the field of public health, the RCP believes, first of all, to carry out extensive health and sanitary measures aimed at preventing the development of diseases ...

Nowadays, when clouds of environmental catastrophe are gathering over mankind, attention is drawn to the fact that in the first years of Soviet power (in conditions of civil war, intervention and the devastation, blockade, famine and poverty that accompanied them), among the first state tasks in health protection of the people was and "improvement of populated areas (protection of soil, water I and air). "

For a long time, the prevention and control of epidemics in our country remained among the top state tasks. In 1919, speaking at the VII All-Russian Congress of Soviets, V.I. Lenin identified three key problems of that time - war, famine, epidemics. His words: “Comrades, all attention to this issue. Either lice win socialism, or socialism win lice! ”*, Were not an exaggeration. For five years (from 1918 to 1922), 20 million people have had typhus. Poor nutrition, lack of necessary medicines, insufficient network of medical institutions led to a high mortality rate. Other diseases claimed many lives: relapsing fever, typhoid fever, paratyphoid fever, malaria, etc.

More than 100 decrees of the Council of People's Commissars were aimed at combating epidemics and preventing diseases. A special place among them is occupied by the decree "On the sanitary bodies of the Republic" (September 15, 1922). He defined the range of tasks and rights of the sanitary-epidemiological service as a state sashttar-control body.

In those years, the concept of “sanitation” included not only sanitary and anti-epidemic measures, but also maternity and infancy protection, the fight against tuberculosis, the protection of children and adolescents, physical education and health education. Therefore, the Decree “On the Sanitary Authorities of the Republic” provided not only further development and strengthening of the sanitary organization (sanitary protection of water, air, soil, food, catering, housing, public places), but also defined measures to prevent infectious diseases and combat for them, for the protection of the health of children and adolescents, for health education to physical culture, health labor protection and health statistics.

This decree finalizes the rights of sanitary authorities in the field of preventive sanitary supervision. The same decree established the categories of sanitary doctors, their rights and obligations, stressed the need to develop the specialization of sanitary doctors, increase the number of epidemiologists, housing and sanitary doctors and other specialists.

Sanitary doctors were given the right to enter for the purpose of sanitary examinations in all public and private premises without exception, the right to ask Soviet executive bodies questions about the imposition of administrative penalties for violation of sanitary requirements. They also had the right to initiate proceedings in local people's courts, to bring guilty persons to responsibility for violation of sanitary requirements and to act as official prosecutors or experts.

In 1921, when the first results of the fight against epidemics were already being felt, on the initiative of the head of the Moscow health department, V. A. Obukh (1870–1934), the slogan “From combating epidemics to improving labor” was put forward. The "improvement of labor" was understood then not only to improve the conditions of production itself, but also to change the life of workers: improving and improving living conditions, increasing wages, rational distribution of work and rest time, improving nutrition, etc. It was in those years that basic theoretical principles of clinical examination; new types of treatment-and-prophylactic institutions have been created - specialized dispensaries (tuberculosis, psycho-neurological, narcological, venereal), night and. Day care centers, dispensaries, dietary canteens; Dispaner services for workers at large industrial enterprises have been introduced; The dispensary observation of mother and child has been started. On the basis of dispensaries began to be conducted research on the health of workers.

Changing the prevention goals has led to the strengthening of sanitary and epidemiological. . country services. In 1935 (as already mentioned) the All-Union State Sanitary Inspectorate was established. In an extremely short period of time, particularly dangerous infections were eliminated in the country: cholera (G923), smallpox and plague (1936). The network of sanitary and epidemiological stations was expanding everywhere — a cordon of epidemiological well-being. This system has historically justified itself: there were no mass epidemics in the country not only during

Peaceful development, but during the Great Patriotic War (1941-1945), an all-time fact in the history of wars.

In the postwar period were there | typhus (abdominal, return sypha) were seen; the incidence of gastrointestinal infection was significantly reduced: infections and trachoma. By 1960, malaria was practically eliminated. The structure of the incidence has changed significantly: infectious | illnesses retreated and at first glance | left cardiovascular and evil | fair diseases. In these conditions, the question was again raised of the need for a wide clinical examination of the population.

Such is the brief history of the development of the preventive health care system in the USSR — a principle; organization of the medical case, which is adopted today in one way or another! degrees in all countries of the world. In each particular country, the success of its implementation is determined by: the socio-economic development of society, the level of development of science and the perfection of the system of organizational measures.

3) Public participation in health care is a principle of health care that originated in the most difficult conditions of the first years of Soviet power, when the fight against epidemics, diseases and hunger was conducted with an acute shortage of medical personnel. In those years, a significant portion of doctors did not share the re-1 of voluntary ideas. Many of the scholars emigrated abroad, others took a wait-and-see attitude. Many medical workers died on the fronts during hostilities or in the rear of hunger and disease. Many died in the fight against epidemics. "Perhaps, after the military front] no other work gave | there are so many victims like yours, ”said V.I. Lenin, addressing delegates to the II All-Russian Congress of Health Workers (1920).

As already noted, in those years the task of preserving the life and health of workers was proclaimed as one of the most important in the state policy of the country, but under the conditions of total shortage of medical personnel it could be done only by attracting the masses of workers (workers, peasants, intellectuals).

After the civil war, new forms of medical and sanitary work appeared: the commission for the improvement of labor and living; sanitary courts; mass dramatization and sports activities that promote a healthy lifestyle and cleanliness; the issue of special posters and windows of the Russian Telegraph Agency (the GROWTH window), in the design of which the poet V. V. Mayakovsky also took part, writing specially for them brief, easily remembered poems about a healthy lifestyle.

At the same time, work was under way to train qualified medical personnel in medical schools, the number of which was constantly increasing. By 1922, in addition to the 13 existing medical faculties, 16 new ones were opened.

The development of higher and secondary medical education in our country, the training of a sufficient number of professional medical workers returned medicine to the mainstream of professionalism, and over time the relevance of this principle, so important for the first years of Soviet power, gradually decreased. Today, health education and health culture are becoming an integral part of the overall education system and the national culture as a whole.

4. The unity of medical science and health practice is the principle of health care, directly related to its national character.

During the period of civil war and intervention, Russian science developed in extremely difficult conditions.

“Our blockade,” wrote Herbert Wells in 1920, “cut off Russian scholars from foreign scientific literature. They do not have new equipment, there is not enough writing paper, the laboratories are not heated. It's amazing that they do something at all. And yet they successfully work: Pavlov conducts a study of the higher nervous activity of animals, striking in its scope and virtuosity; Ma-nuhin, they say, has developed an effective method of treating tuberculosis, even in the last stage. ... All of them are eager to get scientific literature; knowledge is dearer to them than bread. ”

Many prominent scientists of Russia PL N. Burdenko, N. F. Gamaleya, V. M. Bekhterev, D. K. Zabolotny, A. A. Kisel, M. P. Konchalovsky, T. P. Krasnobaev, V. M. Levitsky , E. N; Pavlovsky, S. I. Spasokukotsky, A. N. Sysin, L. A. Tarasevich and others from the first years of Soviet power took part in the restoration and development of national science.

In August 1918, the Scientific Medical Council (chairman - L. A, Tarasevich) was created at the People's Commissariat of Health of the RSFSR, which included representatives of various branches of medicine. His tasks included the development of areas of scientific, practical and educational activities in the field of medicine and sanitation. The Scientific Medical Council rallied around itself hundreds of scientists who participated in the implementation of government programs on the most pressing problems of practical public health at that time.

In 1920, at the initiative of the People's Commissariat of Health of the RSFSR, the State Institute of Public Health (GINZ) was established. It consists of eight research institutes: the Institute for the Control of Vaccines and Serums (Director —L. A. Tarasevich), the Sanitary and Hygienic Institute (Director — P.N. Diatroptov), ​​the Tropical Institute, or the Institute of Protozoan Diseases and Chemotherapy (Director —E. I. Martsinovsky), Microbiological Institute (Director — V. A. Barykin); and later - the institutes: nutrition (director - N. M. Shaternikov), biochemistry - (director - A. N. Bach), tuberculosis (director V. A. Vorobiev) and experimental biology. In the 1930s, institutes belonging to the State Reference Institute became independent scientific institutions.

During the first 10 years of Soviet rule, 40 scientific and 1 research institutes were organized in the country. Among them: the Institute of Microbiology and Epidemiology in Saratov (1918), the Bacteriological Institute in Tiflis (1918), the Institute of Infectious Diseases. I. Mechnikova (1919), State Venereological Institute (1921), Institute of Maternal and Infancy Protection (1922), Institute of Occupational Diseases (1923), Institute of Blood Transfusion (1926), Institute of Brain (1927) in Moscow, etc.

It is clear that in the conditions of those years the principle of the unity of medical science and health care practice was most clearly manifested in the fight against epidemics and mass diseases. Scientific research institutes have been used in healthcare practice. Conversely, a successful fight against epidemics made it possible to test in practice and consolidate scientific findings, to put forward new scientific tasks.

In those years, the mechanism of typhus transmission was finally established and ways of its prevention were developed. (L. V. Gromashevsky), major successes were achieved in the fight against plague (DK Zabolotny, Fig. 155), and vaccines against plague were obtained and put into practice (N.N. Zhukov-Verezhnikov, MP Pokrovskaya) and brucellosis (P. F. Zdrodovsky), a live vaccine against poliomyelitis was created, which made it possible to completely eliminate this disease (A. A. Smorodin-tsev, M. P. Chumakov), a set of measures to eradicate malaria was developed and implemented, study of the natural foci of vector-borne diseases such as plague, tularemia, brucellosis, tick-borne typhus, rickettsiosis, en efality (EN Pavlovskii). Scientific parasitological expeditions under the leadership of E. N. Pavlovsky traveled all over the country and, at the invitation of the governments of other countries, continued research in Iran, Afghanistan, and India.

Thus, despite the economic difficulties of the first years of Soviet power, the state found the strength and means for the development of priority research areas vital for the whole country.

The path traversed by Soviet science at the stage of its formation, its problems and successes, as if in a drop of water, were reflected in the fate of IP Pavlov - one of the greatest scientists in the world and the greatest physiologist of the 20th century.

Ivan Petrovich Pavlov (1849–1936), the only Nobel Prize winner at the time in the country, an honorary member of 90 foreign and domestic academies, universities and various scientific societies, warmly welcomed the fall of autocracy in February 1917; but October 1917 did not accept, as he believed, “that the social and political experience carried out over Russia is doomed to an unsuccessful failure”.

June 11, 1920 I.P. Pavlov turned into. The Council of People's Commissars with a petition, in which the request was expressed: “about finding me a place outside my homeland, on which I could soak enough with my wife to continue my scientific work without hindrance, which I dare to consider very important and for which my brain is still quite capable ... "*. And, P. Pavlov believed that his business, "as a scientific one, is universal, international, and not specifically Russian," and dreamed of bringing it to its logical conclusion.

On June 25, 1920, V.I. Lenin sent a well-known letter to the Chairman of the Petrograd Executive Committee, which states:

"The famous physiologist Pavlov asks to go abroad because of his difficult material situation ...

Meanwhile, this scientist is such a great cultural value that it is impossible to allow its forcible retention in Russia under the condition of material insecurity.

In view of this, it would be advisable, as an exception, to provide him with an over-ration and, in general, to attend to a more or less comfortable environment for him, unlike any other.

I heard that life in Petrograd rest homes is very favorable for those living there. Something similar could be done for Professor Pavlov at his apartment. ”

At the beginning of October 1920, HG Wells, who met with I. P. Pavlov in Petrograd, wrote: "Pavlov is still continuing his' remarkable research - in an old coat, in an office littered with potatoes and carrots, which he grows in his spare time" . In those days, the foreign press had already discussed Pavlov’s petition, but there was no talk about this in conversation with Mr. Wells.

Information that IP Pavlov would like to continue his research abroad reached the Karolinska Medical-Surgical Institute, which awarded the Nobel Prize in Physiology and Medicine. On November 9, 1920, the Swedish Red Cross, sending a wagon of medicines to Petrograd, included in a covering letter addressed to V. I. Lenin a request to allow I. P. Pavlov “to go to Sweden, where he would be given the opportunity in a favorable and calm atmosphere to carry out their greats it was emphasized that “this idea originated in the scientific circles of the Institute awarding the Nobel Prizes and was picked up by the Swedish Red Cross; Professor Pavlov knows nothing about her. ”

February 2, 1921 V.I. Lenin signed a response to the letter of the Central Committee of the Board of the Swedish Red Cross:

“The humane aid in the form of sending various medicaments, proposed by the Swedish Red Cross to the sick of the Petrograd commune, was received by the government of the Russian Soviet Federative Socialist Republic with sincere gratitude.

However, to its regret, the Russian Soviet government was forced to reject the request of the Central Committee of the Swedish Red Cross to relocate Professor Pavlov for scientific work to Sweden, since at present the Soviet Republic has entered a period of intensive economic construction, which requires exertion of all the country's spiritual and creative forces and makes it necessary to effectively promote and cooperate such eminent scientists as Professor Pavlov ...

: Now that the military attacks of all the enemies of Russia have been repulsed and mutual ties with the countries of Western Europe are again gradually but steadily established, there is hope that the necessary conditions will be created for the development and application of Russian science. ”

And they really were created.

On January 24, 1921, a resolution was adopted by the Council of People's Commissars “On the Conditions Ensuring the Scientific Work of Academician I. P. Pavlov and His Staff” - one of the most famous acts of the Soviet government. Here is the text:

Taking into account the absolutely exceptional scientific achievements of academician I. P. Pavlov, which are of great importance for the working people of the whole world, the Council of People's Commissars decided:

To form, on the basis of the submission of the Petrograd Soviet, a special Commission with broad powers in the following composition: Comrade. M. Gorky, head of the Higher Educational Institutions of Petrograd, Comrade. Christie and member of the Board of Petrograd Soviet Comrade. Kaplun, who is to instruct in the shortest possible time to create the most favorable conditions for ensuring the scientific work of Academician Pavlov and his staff.

I.P.Pavlov gladly accepted any help for the physiological laboratory, which he headed at the Institute of Experimental Medicine (IEM), but flatly refused from the reinforced food ration, considering it unacceptable for himself "to be in a privileged position, compared with close friends" (good It is known that in difficult times for the country, the most valuable for the experiment dogs were fed by the academic ration of laboratory staff).

In 1923, “Twenty years of experience in objective study of the higher nervous activity (behavior) of animals” was published - the result of the tireless long-term work of the world's largest physiologist, who created the theory of nervous activity.

In December 1925, the physiological laboratory of IP Pavlov in IEM was transformed into the Physiological Institute of the Academy of Sciences of the USSR. In 1927, Lectures on the work of the cerebral hemispheres were published. In April 1931, at the request of I. P. Pavlov, a decision was made to build a biological station in Koltushi near Leningrad.

IP Pavlov counted himself among the second generation of Russian physiologists. He considered I. M. Sechenov to be the founder of Russian physiology, “who formed the first physiological school in our country” (for the sake of truth, here it is necessary to recall the predecessor of I. M. Sechenov — A. M. Filomafitsky, see p. 251). “... I am glad,” wrote I.P. Pavlov in 1934, “that together with Ivan Mikhailovich and the regiment of my dear employees we acquired for the mighty power of physiological research, instead of half, the whole inseparable animal organism. And this is entirely our unquestionable Russian merit in world science, in the general human thought "(how not to recall here the well-known words of L. Pasteur:" Science has no homeland, but scientists have it ").

In August 1935, the XV International Congress of Physiologists was held in our country. The largest physiologists from the USA, Canada and many European countries who arrived at him recognized I. P. Pavlov as "the elder of physiologists of the world." Opening this first International-congress of physiologists in our country, I. P. Pavlov said:

"Our government now provides extremely large funds for scientific work and attracts a lot of young people to science, and this youth should have a huge stimulating influence on the world scientific work in their faces."

... We, so different, however, are now united and excited by a keen interest in our common life task. We are all good comrades, even in many cases connected by clear friendship feelings. We are working, obviously, on the rational final unification of humanity ... Now we can see an almost universal desire and desire to avoid wars ... And, of course, we should especially sympathize with and contribute to this. ”

IP Pavlov belonged to those great minds who boldly surrounded themselves with young talented people and considered it their duty to grow alongside themselves — young scientific growth. AT . As a result, J.P. Pavlov created one of the greatest physiological scientific schools in the world. Academician of the Academy of Medical Sciences of the USSR P. K. Anokhin (1898-1974) became the successor of his ideas in Russian science.

In 1935, being ill, I.P. Pavlov wrote “A Letter to the Youth”, which became his testament to future generations of young people who devoted themselves to science.

Letter to youth

What would you like to wish the youth of my homeland, who devoted themselves to science?

First of all - the sequence. I can never speak about this most important condition of fruitful scientific work without excitement. Sequence, sequence and consistency. From the very beginning of your work, accustom yourself to a strict sequence in the accumulation of knowledge.

Learn the basics of science before trying to climb its tops. Never take up the subsequent, not having learned the previous one. Never try to cover up the shortcomings of your knowledge even with the most courageous conjectures and hypotheses. No matter how much your soap bubble aggravates your gaze, it will inevitably burst, and you will have nothing but embarrassment.

Accustom yourself to restraint and patience. Learn how to do hard work in science. Study, compare, accumulate facts.

No matter how perfect the wing of a bird is, it could never lift it up without leaning on the air. Facts are the air of the scientist. Without them, you can never fly. Without them, your "theory" - empty attempts.

But, studying, - experimenting, observing, try not to stay at the surface of the facts. Do not turn into archivists of facts. Try to penetrate the mystery of their occurrence. Persistently seek laws governing them.

The second is modesty. Never think that you already know everything. And no matter how highly they rate you, always have the courage to tell yourself: I am an ignoramus.

Do not let pride take you. Because of her, you will persist where "you have to agree, because of her, you will refuse useful advice and friendly help, because of her, you will lose the measure of objectivity.

In the team that I have to lead, the atmosphere does everything. We are all engaged in one common cause, and each moves him according to his strength and capabilities. We often cannot figure out what is “mine” and what is “yours”, but our common cause only benefits from this.

The third is passion. Remember that science requires a person from his whole life. And if you would have two lives, then you would not have enough. Great tension and great passion requires science from man. Be passionate about your work and your quest.

Our homeland opens up vast spaces for scientists, and we must pay tribute - science is generously introduced into life in our country. To the last degree generously.

What to say about the situation of a young scientist with us? Here, after all, it is clear and so. He is given a lot, but much will be asked of him. And for young people, as for us, the issue of honor is to justify the great hopes that our homeland places on science.

These are the main results of the development of health and medical science in the USSR in the early years of Soviet power.

Nowadays, healthcare in the CIS countries is developing in difficult socio-economic conditions. With the transition to a market economy and the decentralization of management in general, the strategy for developing health care also changes. In accordance with the trends of socio-economic and political development, new relations are established between the regions of the country and government structures, a new strategy is being developed to improve public health management, and a number of reforms are outlined and implemented to help overcome the pressing problems and strengthen the health of the nation.

Today, protecting the health of the population and each person individually is real only if all sectors of the national economy are involved in this most important state-wide business, while implementing a wide range of socio-economic and medico-social measures across the country (these issues are studied in detail at the Department of Social Medicine and health organizations)