Medical Statistics in Pre-Reform Russia: Intentions, Degree оf Reliability, Informative Value

Abstract

The authors explain the source peculiarity of medical statistics in Russia between the eighteenth and first half of the nineteenth centuries and identify the possibilities and limitations of its use for studying social history and the history of science. The features of the quantitative evidence at that time – them being fragmented, heterogeneous, and expressed in absolute numbers – prompted the authors to turn to the history of the organization of statistical studies in the Russian Empire. The estimation of information value and the discursive nature of health and morbidity statistics were performed based on the analysis of administrative documents (Polnoe Sobranie Zakonov – Complete Collection of Laws, ministerial prescriptions), accounts of medical administrations, uyezd doctors, and medical professors (military-historical and historical archives of Astrakhan, Moscow, Riga, and Vilnius). Based on the presumption that target setting, i. e. the purpose of quantitative indicators, determined the organization of the collection and processing of the data on morbidity, and they, in turn, determined the content of statistical knowledge, the authors reveal the possibilities of the health statistics of the time in question. This approach makes it possible to determine what can and what cannot be judged based on statistical data on health, general and infectious diseases. The authors conclude that medical statistics of that time describe the pathogenicity of landscapes and the state of public healthcare, but not the state of the residents’ health. Medical officials collected data on sick patients, distributed them by disease, and calculated how many lives each disease claimed. Although state doctors were not interested in healthy patients, the enlightened bureaucracy claimed that by doing so, the government was studying and preserving “public health.” The digital indicators collected do not make it possible to scrutinize the citizens’ health of the Russian Empire. But then the changes in the principles of collecting statistical data, their processing, and their use allow researchers to follow the process of the Russian state’s modernization. The participation of doctors in the collection of data on morbidity has two long-term consequences – the formation of aggregated thinking, which included the concept of “public health”, and the growing interest in the daily lives of Russians.