Organization of Anti-Epidemiological Measures by Workers of Zemstvo Medicine in Russia at the end of the XIX – at the beginning of the XX century

P. N. Aleshin
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Abstract

Introduction. The bodies of zemstvo self-government, created in 1864 and gradually spreading throughout the territory of the Russian Empire, performed important social functions: the development of education, medicine, assistance in difficult circumstances (crop failure, fires), etc., and this activity was directed primarily on the peasant population. The prevention of epidemics and the provision of medical assistance in the event of their beginning were the most important areas of work of zemstvos. In the provinces, a district network of medical and paramedic points was created which constantly monitored the epidemiological situation in the villages, in a number of provinces special sanitary points were opened. The implementation of anti-epidemiological measures was carried out at the expense of the provincial zemstvo on the proposal of the governor. Special infectious barracks were opened to reduce the number of patients and for seriously ill patients during the epidemic. Employees of zemstvo hospitals carried out work in different directions: conducting explanatory conversations with the population about the observance of sanitary standards, the need for vaccinations for children, vaccinations (mainly for children), examination and prescribing treatment for patients, maintaining medical statistics. Such work yielded results: the number of epidemics and cases decreased, but it was impossible to prevent epidemiological diseases completely until 1917. Methods. The solution of the set research tasks was provided by a complex of interrelated theoretical (analysis of scientific literature, comparative analysis, comparison, generalization, systematization), empirical (study and generalization of sources) and hermeneutic methods. Results. Zemstvo medical activity from 1864 to the end of the 1870s only determined the directions of work, was inconsistent and in the field of combating epidemics was fragmented. In fact, the work was not limited to preventing epidemics but to eliminating those that had already broken out. The state did not provide special assistance to the zemstvos in this direction. Only in 1879, due to the strongest epidemic of diphtheria at the government level, “Mandatory rules on measures to prevent the development of infectious diseases” were introduced. In accordance with which, mandatory sanitary and police measures against the spread of these diseases began to be determined. Conclusion. The selfless work of zemstvo medical workers, the introduction of a system of measures to prevent diseases led to a reduction in both the number of epidemics and the number of cases, but it was impossible to eliminate the epidemics completely until 1917.
19世纪末- 20世纪初,俄罗斯Zemstvo医学工作者组织的反流行病学措施
介绍。1864年成立的自治地方自治机构逐渐扩展到整个俄罗斯帝国的领土,履行了重要的社会职能:发展教育、医疗、援助困难情况(作物歉收、火灾)等,这些活动主要针对农民人口。预防流行病和在流行病开始时提供医疗援助是地方自治组织最重要的工作领域。在各省,建立了一个地区医疗和辅助医疗点网络,不断监测村庄的流行病情况,在一些省开设了特别卫生点。根据州长的建议,由省地方自治政府出资实施了防治流行病的措施。在疫情期间开设了专门的传染病营房,以减少病人和重症病人的人数。zemstvo医院的雇员在不同的方向开展工作:就遵守卫生标准、为儿童接种疫苗的必要性、接种疫苗(主要是为儿童接种)、为病人进行检查和处方治疗、维护医疗统计等问题与居民进行解释性对话。这些工作取得了成果:流行病和病例的数量减少了,但直到1917年才可能完全预防流行病学疾病。既定研究任务的解决方案是由相互关联的理论(科学文献分析、比较分析、比较、概括、系统化)、实证(来源的研究和概括)和解释学方法的综合体提供的。从1864年到19世纪70年代末,地方自治组织的医疗活动只确定工作方向,前后不一致,在防治流行病方面支离破碎。事实上,这项工作不仅限于预防流行病,还包括消除已经爆发的流行病。在这方面,国家没有向地方自治政府提供特别援助。直到1879年,由于白喉在政府一级的流行最为严重,才出台了“关于预防传染病发展措施的强制性规定”。据此,开始确定强制性卫生和警务措施,以防止这些疾病的传播。地方自治组织医务工作者的无私工作,以及预防疾病措施系统的引入,减少了流行病的数量和病例数量,但直到1917年才完全消除了流行病。
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