Until the middle of the 19th century , medicine was practically not developed in Russia , and only people belonging to the upper classes could receive at least some help. But everything began to change when, after 1864, zemstvo institutions appeared.
History of creation
In 1581, the first chemist's chambers appeared in Moscow, which was the first step in organizing the healthcare system. However, proper development did not happen, and only at the beginning of the 18th century Peter I held a number of events, thanks to which medical institutions, pharmacies, schools and higher educational institutions began to open to train future doctors.
Later, under Alexander I, they started talking about the need to create hospitals in district cities, but first you need to open feldsher schools. However, such events did not help radically change the situation, and only 0.5% of people could receive medical care. There was one doctor per 6000 people, 1,500 inhabitants per bed. All this would have continued if the Zemstvo institutions had not appeared, which at their own expense began to organize Zemstvo hospitals, outpatient clinics, maternity hospitals, etc.
Citizens of all classes helped the Zemsky institutions to improve the situation, and in each province the situation was different.
Zemsky doctors
When Zemstvo hospitals appeared in the 19th century (especially in rural areas), specialists were needed who could provide assistance in various areas, ranging from colds and ending with serious illnesses.
Medicine in rural areas developed first at the expense of county and city doctors, and then young specialists initially left for the villages. There was such a portrait of a Zemstvo doctor who had high moral and ethical qualities, selflessness and a desire to help all those in need, which had a good impact on the formation of future medicine.
Zemsky hospitals of the Moscow province
In 1869, zemstvo medicine began to be created in the province. When the medical congress was held in 1877, a project was developed to divide the province into six medical stations, where there should be hospitals with staff, beds, a doctor, a paramedic, and a midwife.
Many believe that Zemstvo hospitals in the Moscow province were a model for other hospitals in other areas. The development of medicine was divided into two periods. In the first, from 1865 to 1876, there was a rapid increase in the funding of medical institutions, the number of personnel increased. In the second, from 1877 to 1907, the medical infrastructure developed: medical congresses were held, institutes of sanitary doctors were established, and feldsher schools were opened.
The Moscow Zemstvo was one of the first to provide free and accessible medical services. This helped to increase the effectiveness of the prevention and control of epidemics, and also increased the growth of peasants' appeal for help. But in the initial stages it was necessary to direct all the energy to creating a primitive form of medical work. Medical aid was best organized in industrial districts such as Bogorodsky and Moscow, and worst of all was the situation in agricultural districts (Mozhaisk, Volokamsky).
Zemsky hospitals of the Tver province
In 1867, the first Zemstvo hospital appeared in Tver, which became not only a place where people had to be treated, but also a center of social and cultural life.
In Tver, at the congress of doctors in 1871, they considered that before becoming a good doctor, it was necessary to study the situation in which patients live. It is important to know what the hygienic environment is, what living conditions, because it will help in the work, the picture will be clear, what people get sick most often.
A special role in the development of medicine in the province was played by the doctor Mikhail Ilyich Petrunkevich, who arrived in the city in 1874. He skillfully could combine his work and social activities to raise medicine to the highest level. At that time, new equipment was bought at the hospital, books from abroad were bought, a library was created, which helped to learn from foreign experts.
Hospitals in the Samara region
The opening of the first zemstvo hospitals in the Samara region took place in the second half of the 19th century, somewhere in the early 60s. Before that, there was only one hospital in the province, where there were only 12 beds per 20 thousand people, and they treated here for all diseases not only ordinary citizens, but also military and prisoners.
In 1865, a zemstvo hospital was opened on the outskirts of the city, which accepted everyone, regardless of class and nationality. At that time 7 doctors worked, 26 paramedics, there were 360 beds. Due to the fact that several paramedic schools were opened, medicine began to develop faster, and already in 1899 zemstvo hospitals were opened in the countryside, there were about 70 of them.
By 1875, the main Provincial Hospital was opened, which in 1890 had 5 full-time residents and 9 supernumerary. The most important thing that happened at the end of the century - the poor began to be treated for free and were given medicines for free.
Achievements and results of zemstvo medicine
Through Zemstvo medicine, assistance was provided in 34 provinces, and such medicine played a progressive role in the development of the future. In addition, assistance was provided not only to urban residents, but also to rural residents, and this was considered a big step in the healthcare system.
Thanks to Zemstvo medicine, such concepts as accessibility, prevention, free help appeared, and also institutions that had not been thought of before appeared - mud baths, food and health centers, shelters.
“Progressive” doctors appeared in medicine, who knew a lot, could provide assistance in various fields, and also conducted research and studied diseases, therefore they opened bacteriological institutes and laboratories, a sanitary bureau, obstetric and feldsher schools.
Despite the fact that often Zemstvo hospitals received less funds, equipment, medicines, the very emergence of medicine, where everyone, regardless of their status, could receive at least some help, laid the foundation for the development of medicine.