1. Introduction ………………………………………………………………………… ..2
2. The emergence of pediatrics …………………………………………………… .3
3. The founder of pediatrics - S.F. Hotovitsky ……………………………… 3
4. XIX - XX centuries. Achievement of a high level of development of pediatrics ... ... ... ......... 5
5. N.F. Filatov is one of the founders of Russian pediatrics ………… .5
6. The works of N.P. Gundobin on the age anatomical and physiological characteristics of children …………………………………………………………… ..6
7. The contribution of A.A. Kisel to the development of Soviet pediatrics after the Great Socialist Revolution ………………………………………………… ..7
8. The emergence of the Center for Pediatric Research (GN Speransky) ... ..9
9. Opening of the Institutes for the Protection of the Health of Children and Adolescents in Leningrad, the Research Institute for the Protection of Maternal and Child Health in Moscow ………………………………………………………………………… ……ten
10. History of pediatrics in the Western Urals ……………………………………… ..11
11.XX century. Differentiation and integration of the main branches of pediatric medicine (pediatric surgery, neuropathology, psychiatry, ophthalmology, neonatology, perinatology, allergology, etc.) …………………………… ..14
12. Preventive focus and stages of treatment in pediatric activity …………………………………………………………………… .18
13. Bibliographic list ………………………………………………… .21
Introduction.
Medicine is a practical activity and a system of scientific knowledge about the preservation and strengthening of human health, the treatment of patients and the prevention of diseases, about the achievement of longevity by the human society in conditions of health and working capacity.
Medicine has developed in close connection with the entire life of society, with the economy, culture, and people's worldview.
Like any other field of knowledge, medicine is not a combination of ready-made truths given once and for all, but the result of a long and complex process of growth and enrichment.
The history of medicine is not limited to the study of the past. The development of medicine continues at an ever faster pace before our eyes. Past, present, future are links in the chain of historical development. The study helps to better understand the present, gives a scale for its assessment. At the same time, the knowledge of the patterns of the previous development of any phenomenon and the understanding of its current state help to better understand and scientifically foresee (predict) the ways of its development in the future.
The history of medicine clearly shows the shifts and fundamental changes that have taken place in it in connection with changes in the life of society. Especially profound changes in medicine took place in our country after the Great October Socialist Revolution and the radical transformations associated with it in all areas of social life and culture.
The treatment of childhood diseases has long been associated with the practice of obstetrics and the development of ideas about infectious diseases. This is evidenced by the ores of outstanding doctors of the ancient world (Soran from Ephesus, Galen) and the Middle Ages (Abu Bakr al-Razi, who gave the classical description of smallpox and measles, Ibn Sina and others). Special essays on children's illnesses began to appear in the late 15th - early 16th centuries.
Pediatrics as a branch of medicine has emerged recently. The independent profession of pediatrician is also relatively young. However, short articles and suggestions on feeding children, caring for them, treatment are found in the ancient manuscripts of the Armenian state of Urartu, as well as Ancient Egypt, India, China, Babylon, Assyria. Even in the time of Hippocrates, there are references to the stable growth and development of children. In the 15th and 16th centuries, books were published that described childhood illnesses, but they lacked recommendations. Since the 17th century, pediatrics has increasingly attracted the attention of doctors, and already in the 18th century, educational literature appears. All this was a consequence of the high mortality rate of children. Pediatric hospitals begin to open. The first such hospital was opened in 1802 in Paris for children from 2 to 15 years old. Subsequently, it trained specialists in childhood diseases. In 1834 a pediatric hospital was opened in St. Petersburg. In 1865, the departments of children's diseases, the medical-surgical academy were opened. KA Rauchfus built several children's hospitals in different cities of Russia. Over time, a course on childhood diseases began to be taught at universities.
Pediatrics as an independent science began to take shape in the 1830s - 1860s.
Pediatrics is a field of medicine that deals with the treatment of children. It is based not only on diseases of the early life of children, but also on all aspects of their life and development. Its founder is considered a pediatrician Stepan Fomich Hotovitsky(1796-1885). Becoming an ordinary professor of the Department of Obstetrics, Women's and Children's Diseases, he was the first to give (since 1836) a separate course on childhood diseases of 36 lectures and in 1847 published it in an expanded form under the title "Pediatrica". This was the first in Russia in the process of development, the original manual on pediatrics, in which the child's body was studied taking into account its anatomical and physiological characteristics, which qualitatively change in the process of development.
The study of the child's body has shown that a child is not an adult in miniature, his body is characterized by both quantitative and qualitative differences from an adult.
The development of the clinic of internal diseases, associated with the introduction of methods of percussion, auscultation and pathological and anatomical studies, led to the creation of a child examination system, which made it possible to detail the symptoms of childhood diseases.
The first hospital for children was opened in Paris in 1802. It became the leading center of Europe in the first half of the 19th century. for the training of specialists in the field of childhood diseases.
The second in Europe (and the first in Russia) special children's hospital with 60 beds was founded in St. Petersburg in 1834 (now the NF Filatov Children's Infectious Diseases Hospital No. 18).
In 1842, the first Moscow children's hospital with 100 beds was opened - the world's first hospital for infants (now Children's Clinical Hospital No. 13 named after NF Filatov).
The third children's hospital in Russia - Elizavetinskaya clinical hospital for young children - was opened in St. Petersburg in 1844. Its main difference from all children's hospitals that existed at that time was that it specialized in treating children up to three years of age.
Children's hospitals were supported mainly by charitable funds and private donations - government subsidies were negligible.
At the end of the XIX - beginning of the XX century. domestic pediatrics reaches a particularly high level, which is greatly facilitated by the fruitful activity of such pediatric scientists as N.F. Filatov and N.P. Gundobin. They studied and described a large number of childhood diseases, published a number of textbooks, teaching aids and works.
At Moscow University, the first clinic for children's diseases was established in 1866. Teaching pediatrics began with a theoretical (1861) and then a practical (-1866) course at the Department of Obstetrics, Women's and Children's Diseases, which was taught by N.A. Tolsky (1832-1891 ), and ended with the organization in 1888 of an independent department of childhood diseases. From 1891 it was headed by N.F. Filatov.
Neil Fedorovich Filatov(1847-1902) - one of the founders of Russian pediatrics, the creator of a large scientific school- developed the clinical and physiological direction. He was the first to isolate and describe chickenpox (1872) and scarlet fever rubella (1885), discovered an early sign of measles - pityriasis epithelium on the oral mucosa (Filatov-Velsky-Koplik spots). His works "Semiotics and Diagnostics of Childhood Diseases", "Lectures on Acute Infectious Diseases in Children" and "A Brief Textbook of Childhood Diseases" were reprinted many times. Filatov's lectures, recorded and published by his students S. Vasiliev, V. Grigoriev and G. Speransky, enjoyed great popularity.
In 1892 N.F. Filatov organized the Moscow Society of Children's Physicians. The formation and development of pediatrics as an independent scientific discipline is associated with the activities of many outstanding doctors in the world. Among them are K. A. Rauchfus, D. A. Sokolov, A. N. Shkarin, N. S. Korsakov, V. B. Zhukovsky, G. N. Speransky, I. V. Troitsky (Russia), K. Pirke (Austria), M. Pfoundler (Germany), V. Yutinel and J. Cruchet (France), G. Koplik and J. Hutchinson (England) and many others.
In 1902, leading pediatricians from various European countries came up with the idea of combining their efforts and created the League to Combat Child Mortality, which, despite the active work of individual doctors, was still high. The first International Congress for the Protection of Infancy was held in Berlin in 1911. This was the beginning of international cooperation in the field of pediatrics.
In 1911 the journal "Pediatrics" was published. A society for combating child mortality and a society of pediatricians appeared, congresses of pediatricians were organized, at which questions were decided on how to help newborns. M.S. Maslov wrote books on chronic disorders and digestion, kidney and liver diseases, diathesis, etc., which made a great contribution to pediatrics.
The task of pediatrics is to ensure that the state of health of the child allows him to maximize his innate life potential.
Pediatrics is divided into: preventive, clinical, scientific, social and environmental.
Clinical pediatrics is a set of measures based on the diagnosis, treatment and recovery of a sick child.
NF Filatov's works "Semiotics and Diagnostics of Childhood Diseases", "Lectures on Infectious Diseases", "Lectures on Gastrointestinal Diseases in Children", "Clinical Lectures", and other works formed the basis of Russian pediatric literature and quickly put it in on a par with the foreign, which then already had many years of existence. These books went through a number of editions and had a great influence on the development of pediatrics and on the training of pediatricians.
The works of N.P. Gundobin and his numerous students significantly expanded the knowledge of pediatricians about the age-related anatomical and physiological characteristics of children.
Such work of N.P. Gundobin and his students, as "Features childhood”, Has not lost its scientific significance in our time.
After NP Gundobin, the Department of Pediatrics at the Military Medical Academy was headed by A.P. Shkarin. He organized a dairy kitchen at the clinic, a consultation for infants and a department for infants, which made it possible to expand the development of issues of physiology and pathology of children of this age.
However, the conditions of tsarist Russia did not ensure the rapid growth and flourishing of pediatrics and hygiene. Preventive childcare facilities, nurseries and kindergartens, created, as a rule, for charitable funds, were sporadic; the network of children's hospitals and polyclinics grew slowly, the living and educational conditions of children of the poor continued to be very difficult.
After the Great October Socialist Revolution, a galaxy of outstanding scientists made a great contribution to the development of Soviet pediatrics. Among them are the names of the professors of the Moscow School. This is Alexander Andreevich Kisel (1859-1931), a student of N. I. Bystrov and S. P. Botkin, who did a lot to study rheumatism, chronic non-rheumatic polyarthritis, tuberculosis, and malaria.
The most famous in the twentieth century were the schools of G.N. Speransky and A.A. Kisel. Academicians of the RAMS M.Ya. Studenikin, VA. Tabolin, Yu.F. Dombrovskaya and their schools successfully conducted research on diseases of children of all ages. The studies of the pediatric surgeon Yu.F. Isakov and his students, showing skill in all areas of surgical intervention for diseases of children.
Alexander Andreevich Kisel (1859-1938) for 48 years he worked at the Olginskaya children's hospital in Moscow, was the head of the department of children's diseases of higher female courses, then at the MMI, the scientific director of the Central Institute of Children's Health. He is the author of over 600 works. Known for his research on childhood tuberculosis (tubercles), the development of an active method of combating it, the organization of anti-tuberculosis work, and the promotion of a preventive direction, Kisel introduced the concept of "Chronic tuberculosis intoxication" and established its signs, proved the rheumatic nature of chorea. He paid great attention to strict adherence to the hygienic regime at home and at school - cleanliness of the room, air, food, etc. According to his recommendations, forest schools began to be created. Kisel paid special attention to the labile child's psyche, physical education, the upbringing of positive emotions, the development of a sense of beauty: "In our upbringing," he said, "little is paid to the development of a sense of beauty in a child."
Kisel urged doctors to rely on a wide preventive measure of a state nature, developing a social and preventive direction and not only in relation to sick, but also healthy children. "Preventive measures," he wrote, "are especially desirable in relation to those children who still have a perfectly healthy appearance or who have very little changes." "Our task is to prevent disease." He also emphasized the need for tireless preventive and curative work between attacks or exacerbations of diseases. “The disease harms a person mainly not during short attacks, exacerbations (for example, in malaria), but during very long intervals (interictal periods), which can last not only months, but even years,” A.A. Kissel.
Establishment of a major center for pediatric research.
Peru G. N. Speransky owns a textbook on this pathology - "Textbook of diseases of children of early age", which for many years served as the main guide for doctors of the departments of newborns and pathology younger age... For many years, G. N. Speransky was the editor of the journal "Pediatrics" and headed the All-Union Scientific Society of Pediatric Physicians.
Georgy Nesterovich Speransky (1873-1969) - one of the founders of pediatricians in the USSR, Corresponding Member of the USSR Academy of Sciences, Academician of the USSR Academy of Medical Sciences, Hero of Socialist Labor, Lenin Prize laureate. After graduating from the medical faculty of Moscow University, he worked in the clinic of children's diseases under N.F. Filatov, one of the organizers of the system of protection of mothers and infants, on his initiative the Institute of Pediatrics of the USSR Academy of Medical Sciences was created; since 1932 Speransky - Head of the Department of Pediatrics at the Central Institute for Advanced Training of Physicians. He is the author of more than 200 scientific papers, he substantiated the methods of feeding and caring for children, antenatal prophylaxis, treatment of diseases of the fetus and newborns. A number of works by Speransky are devoted to respiratory and gastrointestinal diseases of children, he developed a classification of these diseases. On his initiative, the journal "Pediatrics" and the journal for the study of early childhood were organized, of which he was the editor.
Speransky - Chairman of the All-Union Society of Pediatricians. The scientist was an honorary member of a number of scientific societies. Among the books by G.N. Speransky - "Nutrition of a healthy and sick child" (1959), "Hardening of an early and preschool age"(1964).
A.A. Kisel and G.P. Speransky brought up a large school of pediatricians, including V.G. Tabolin, V.A. Vlasov, Z.A. Lebedeva, A.A. Kolotunin and many others.
In 1922 N.A. Semashko headed the country's first department of social hygiene at the medical faculty of Moscow University (since 1930 - Moscow Medical Institute, since 1990 - Medical Academy named after I.M.Sechenov) and directed 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).
In 1925, opened in Leningrad Institute for the Protection of Mothers and Infants, which in connection with the huge need for pediatricians in 1935, it was reorganized into the Leningrad Pediatric Medical Institute.
In 1927, the Institute for the Protection of the Health of Children and Adolescents was founded in Moscow, later transformed into the Moscow Research Institute of Pediatrics and Pediatric Surgery of the Ministry of Health of the RSFSR. Later, research institutes were opened in Kiev, Kharkov, Rostov-on-Don, Kazan, Sverdlovsk, Gorky, Minsk, Tbilisi, Baku, Alma-ata and other cities.
In 1979, the All-Union Research Center for Maternal and Child Health Protection of the USSR Ministry of Health was opened in Moscow. He leads all basic scientific research on maternal and newborn health. The successes in the development of the system of child health protection in the USSR are due to the achievements of domestic pediatric science.
The focus of scientists has always been research on the scientific foundations of the organization of medical and preventive care for children, the study of the dynamics of physical and psychomotor development, as well as the morbidity of children, the scientific development of forms and methods of pediatric care, including premature babies and newborns, children with recurrent and chronic diseases of the respiratory system, allergic diseases, diseases of the kidneys, stomach and intestines, metabolic disorders. These studies served as the basis for the development and implementation of anti-epidemic measures for the system of pulmonological, allergological, medico-genetic services, and the creation of specialized centers.
History of Pediatrics in the Western Urals begins in 1920, when the Faculty of Medicine of Perm University elected Pavel Ivanovich Pichugin, a privat-docent from Kazan, as the head of the department of childhood diseases, and on February 23, 1920, the first lecture on childhood diseases was given to the fourth-year students of the Faculty of Medicine. In those years in Perm there was not only a children's hospital, but even an outpatient clinic, and along with the teaching activities of P.I. Pichugin started organizing the clinical base of the department.
On October 7, 1923, the children's outpatient clinic created by Pichugin began to work. 34 years old Department of Childhood Diseases, headed by P.M. Pichugin, worked on the problems of childhood tuberculosis, constitutional anomalies, chronic eating disorders, rheumatism, and helminthic diseases. P.I. Pichugin has trained several generations of pediatricians. The clinic of childhood diseases that he created, according to the conclusion of the People's Commissariat of Health, was one of the best medical institutions of that time. By 1929, 25 pediatricians had already been trained, who completed their residency with P.I. Pichugin.
Under the guidance of Professor P.I. Pichugin published more than 50 scientific works, 3 Ph.D. theses were defended (LB Krasik - 1938, GM Rutenberg - 1954, RA Zif - 1946), "Notes on Childhood Diseases" by P.I. ... Pichugin is one of the first Soviet textbooks on pediatrics.
From 1954 to 1972, the Department of Children's Diseases was headed by Associate Professor Lev Borisovich Krasik. L. B. Krasik was born on May 28, 1904; in 1926 he graduated from the Medical Faculty of Perm University and was accepted as an intern at the Department of Childhood Diseases. On September 1, 1931, he became a staff assistant at a children's clinic. On March 9, 1938, he defended his Ph.D. thesis on venous pressure in children, on December 23, 1938, he was awarded the academic title of associate professor. It was a difficult time: high morbidity and mortality among children, especially from epidemic and tuberculous meningitis. The department provided great assistance to the region, the work required a lot of laboratory knowledge. There were no laboratory assistants. Lev Borisovich studied blood, urine, cerebrospinal fluid himself, teaching laboratory assistants and doctors. Simultaneously with medical work, he performed a great pedagogical - classes, lectures.
Pediatrics was taught at three faculties: medical, sanitary-hygienic and dental. The best students entered the clinical residency in pediatrics, later they formed the team of the department. Under the guidance of Associate Professor L.B. Krasik completed 5 candidate dissertations (G.K. Knyazkova, N.M. Avdeeva, A.M. Nikitin, S.G. Sofronov, N.F. Churin). The scientific topics of the department were associated with liver diseases, early diagnosis of tuberculosis, rheumatism, pathology of premature babies and other problems.
With the active assistance of L.B. Krasika, the children's sanatorium "Svetlana" and "Eaglet" were opened.
Under his leadership, collections of scientific papers and teaching aids on various sections of pediatrics. Lev Borisovich Krasik was an unusually disciplined, punctual person, he devoted himself entirely to work, and he strictly demanded the same from the staff of the department. Per long years His department at the department trained hundreds of pediatricians, trained highly qualified personnel who completed their clinical residency, became teachers and organizers of children's health care in Perm and the region, leading specialists in various fields of pediatrics. Lev Borisovich, after retirement, continued consulting work, worked on improving the clinical examination of the child population. Lev Borisovich died on March 17, 1982.
In 1971, a pediatric faculty was opened at the Perm Medical Institute, in connection with which the question arose about the formation of a number of pediatric departments. The department of childhood diseases of the medical faculty from 1972 to 1983 was headed by Professor A.I. Egorova, on whose shoulders lay the worries of organizing the course of propaedeutics of childhood diseases and the department of faculty pediatrics. Employees of the Department of Propedeutics of Childhood Diseases, which is based on the first clinic for childhood diseases in the Western Urals, honor and preserve traditions. The department has created stands and albums dedicated to the history of the clinic and its founder, professor P.I. Pichugin.
The department constantly cooperates with practical health care and provides scientific advice and methodological assistance to hospitals, sanatoriums, schools and preschool institutions of the city and region. Much attention is paid to the postgraduate training of specialists. Scientific work is carried out in close cooperation with the Perm Technical University, the Clinical Institute of Pediatric Ecopathology, departments and divisions of the Perm State Medical Academy.
The results of scientific research are being actively implemented in the work of practical health care and in the educational process. Since 1983, the staff of the department has published more than 500 scientific papers.
At the dawn of the 20th century, began differentiation and integration of the main branches of medicine. Within pediatrics, independent disciplines have emerged throughout the 20th century: pediatric surgery, pediatric neuropathology, child psychiatry, pediatric ophthalmology, neonatology, perinatology and many others.
In pediatrics, the physiological characteristics of the organism, the role of age factors and the influence of the environment on the development and growth of the child are much more widely studied.
Soviet pediatricians paid much attention to a comprehensive study of issues of age physiology, the characteristics of the development of higher nervous activity, age morphology, regularities in the formation of the body's reactivity and physical development, issues of age hygiene.
The system of upbringing children of preschool age, developed by Soviet pediatricians and physiologists, has received worldwide recognition, it served as the basis for building the work of children's institutions in our country and in a number of foreign countries.
The study of the issues of feeding a healthy and sick child should be considered a very valuable achievement of Soviet pediatrics. On the basis of scientific research, new milk formulas have been developed and introduced, intended for feeding young children, enriched food concentrates, dietary products for children with various diseases have been proposed.
The development of the foundations of the physiology and pathology of early childhood made it possible to substantiate and implement a set of effective measures to reduce child mortality, many important features intrauterine development, the relationship between the body of the mother and the fetus, the influence on the developing fetus of various factors of the external and internal environment.
Allergic diseases in children are being studied; principles for the diagnosis of hay fever, food and drug allergies were developed. New methods of allergological diagnostics (skin tests and provoking tests), as well as the principles of specific hyposensitization, have been proposed and introduced.
The principles of nutrition, regimen, physical education and sanatorium-resort treatment of children with allergic diseases have been developed.
Undoubted success has been achieved in the development of scientifically grounded methods of complex treatment, intensive therapy and resuscitation of children with severe pneumonia and respiratory failure, including controlled breathing, bronchoscopy, and homeostasis correction.
Pediatric surgeons took an active part in the development of these methods, on whose initiative intensive care wards and intensive care units were created.
A system of staged treatment of rheumatism in children has been created, its prevention has been widely introduced into practice, which has made it possible to significantly reduce the incidence and frequency of heart defects. The widespread introduction of scientific recommendations to combat rheumatism in children was ensured through the creation of cardiology offices. Methods for early detection of the initial forms of arterial hypertension are being developed, its frequency and prevalence are established in connection with various environmental conditions.
The structure of the incidence of infectious diseases in children has changed significantly. The use of the latest achievements in immunology, virology, pathological physiology made it possible to establish the patterns of the infectious process, immune reactions and allergies in acute childhood infections. A great achievement of recent years has been the elucidation of the effectiveness of leukocyte interferon as a therapeutic agent for viral diseases. New vaccines are being introduced to prevent infectious diseases (measles, mumps). A new direction in pediatrics is the development of non-infectious immunology of childhood, which studies the formation, development and violation of the specific immunological reactivity of the child.
Pediatric surgery has achieved great success: methods for correcting congenital malformations have been developed, mortality from purulent surgical diseases has sharply decreased, methods of intensive therapy and resuscitation are being developed.
The development of pediatric nephrology and urology is closely related to the achievements of immunology, biochemistry, genetics, and general pathology. There is a change in the nature of renal pathology in children, a decrease in the frequency of acute streptococcal nephritis and a relative increase in the frequency of recurrent protracted and chronic kidney diseases, often leading to the development of chronic renal failure.
Much more often than before, hereditary and congenital kidney diseases, metabolic nephropathy, nephrotic syndrome in young children are detected. The attention of pediatricians-nephrologists is attracted by various forms of glomerulonephritis, the diagnosis of which is carried out on the basis of functional immunological and histomorphological methods. Specialized help for children with kidney diseases has been developed, nephrological hospitals and sanatoriums are being organized.
The problems of pediatric gastroenterology are being developed in a number of scientific centers - the Institute of Pediatrics of the USSR Academy of Medical Sciences, the Gorky Research Institute of Pediatrics, the 2nd Moscow Order of Lenin Medical Institute named after N.I. Pirogov, etc. new data on the pathogenesis of gastroduodenitis, the syndrome of impaired intestinal absorption.
The study of anemias in children has made it possible to achieve significant success not only in their treatment, but also in prevention. A major achievement of domestic pediatrics is the development of methods for immunotherapy of hematological malignancies in children, which made it possible to significantly increase the duration of remission.
The main achievements of pediatric endocrinology are the elucidation of the pathogenesis and development of therapeutic tactics for diabetic ketoacidosis, elucidation of the pathogenesis of obesity in children, obtaining data on the endocrine interactions of the mother and the fetus, the study of hereditary and acquired diseases of the thyroid gland.
Scientific research in the field of childhood neuropathology is aimed at developing methods for the diagnosis and treatment of organic diseases of the nervous system, and in last years focused on the problems of intracranial birth trauma, hereditary diseases of the nervous system.
Medical genetics had a significant impact on the development of pediatrics, due to which a large group of hereditary diseases of children became known.
The Communist Party and the Soviet state paid great attention to protecting the health of the younger generation, considering this as the most important state task. In the USSR, state systems have been created to protect the health of children and adolescents, and to protect motherhood and childhood. It is characteristic that in pre-revolutionary Russia there were only 600 children's doctors, and in 1976 there were more than 96 thousand of them. The USSR Constitution guarantees the implementation of special measures to protect the labor and health of women; creating conditions that allow women to combine work with motherhood; legal protection, material and moral support for motherhood and childhood.
In the pediatric service, the leading principle of the organization of Soviet health care is especially vividly implemented, as preventive focus. In the organization of child welfare, the prophylactic medical examination is especially obligatory, in which the synthesis of preventive and curative medicine is embodied.
The constant and continuous process of introducing scientific achievements into the practice of children's health care is carried out simultaneously with the improvement of the entire system of organization of children's health care. In the early stages of organizing medical care for children, children's clinics were created, which in 1948 were combined with children's outpatient clinics into single children's polyclinics. Specialized care is being developed, specialized departments are being organized, in which diagnostics, treatment, and nursing of sick children are firmly located at a high level, intensive care and resuscitation departments are being created, this is combined with strengthening the main link of all therapeutic and prophylactic work - the children's polyclinic.
The tendency of the staged treatment of sick children with chronic diseases is noticeably increasing: a polyclinic - a hospital - a sanatorium. Of particular importance in preventive work among the child population is the development of a network of medical genetic services.
Much attention is paid to the training of nurses for children's hospitals. Textbooks and monographs are published. Many works of Soviet pediatricians have been translated into foreign languages... In the 60s. 20th century a ten-volume manual on pediatrics was published, which reflects the main achievements of Soviet pediatric science and healthcare practice.
Conclusion.
Soviet clinical medicine is developing in the clinical, physiological and preventive directions. The previously discovered diagnostic methods and the technical equipment of the clinician are at a new, higher level of development.
The achievements of Soviet medicine are great in all manifestations - in its connections with natural science, its philosophical dialectical-materialistic concepts, scientific successes, the creation of numerous large scientific medical schools, broad practical, preventive activities, the development of public undertakings, the activities of societies, congresses, medical periodicals, involving workers in the protection of the health of the people.
Medical science and healthcare are inextricably intertwined with each other. The state character of Soviet health care largely determines the possibilities and ways of developing medical science.
Bibliographic list.
1. P.E. Zabludovsky et al. "History of Medicine". Textbook. Moscow: "Medicine", 1981.
2. Yu.P. Lisitsin "History of Medicine". Textbook. M .: "GEOTAR-MED" 2004.
3. TS Sorokina "History of Medicine". A textbook for students of higher medical educational institutions. M .: "Academy" 2005.
4. BV Petrovsky "Great Medical Encyclopedia", volume 18,
M .: Publishing house "Soviet Encyclopedia", 1982.
5. Shabalov N.P. "Pediatrics". Textbook. S.-P.; SpetsLit 2002.
Topic 1: History of Pediatrics
Lecture material
Plan
1. History of Pediatrics. Development stages, goals and objectives. Pediatrics as a science of childhood diseases.
2. Features of the organization of the nursing process in pediatrics.
3. Preventive work to maintain the health of children.
History of the development of pediatrics
Pediatrics as an independent medical specialty has emerged relatively recently.
Pediatrics as a science of childhood diseases was formed in the late 18th and early 19th centuries.
Goals- to study the age-related patterns of the development of the child's body.
Tasks:
- to study the age-related patterns of the development of the child's body,
- to study diseases of childhood,
- to develop methods and methods of detection, treatment, rehabilitation,
- develop a system preventive measures,
- to develop a system of sanitary and educational activities among the population.
Separate statements and advice on feeding children, caring for them, treatment are available in the ancient manuscripts of the Armenian state of Urartu, as well as Ancient Egypt, India, China, Babylon, Assyria.
The book "On the Nature of the Child" by Hippocrates (c. 460-377 BC) contains information about the patterns of correct and stable growth and normal development of children. In the XV-XVI centuries. there are separate books devoted to childhood diseases, they also contained instructions on the high mortality rate in children, but there were no practical recommendations for reducing it. In the XVII century. thanks to the world-famous classical works of the English scientists Glisson and Si-Denham about rickets, smallpox and measles, pediatrics attracts the attention of doctors. In the XVIII century. textbooks on pediatrics are published.
MV Lomonosov drew attention to the enormous infant mortality in Russia. In his letter "On the reproduction and preservation of the Russian people," he proposed a number of measures to combat mortality. In 1721, a Senate decree was issued "On the construction of hospitals for the placement of illegitimate babies and on giving them and their wet-nurses a monetary salary." However, educational homes were opened only in 1763 in Moscow and in 1771 in St. Petersburg thanks to the activities of I.I.Betsky. True, infectious diseases, insufficient nutrition led to the fact that most of the children in orphanages died.
The leading scientists of that time S.G. Zybelin (1735-1802), N.M. Maksimovich-Ambodik (1744-1812) understood that caring for and feeding a child is important for the health of a child. They were ardent supporters breastfeeding, disseminated the rules of maternal and child hygiene among doctors and the public.
The long and lengthy process of separation of pediatrics as an independent scientific discipline coincides with the opening of the first children's hospitals. The first hospital for children 2-15 years old was opened in Paris in 1802. It became the center for the training of specialists in childhood diseases in Europe. In 1834 a children's hospital was opened in St. Petersburg. In 1835, a special course of childhood diseases was introduced into the training program for doctors in Russia. S.F.Khotovitsky (1796-1885) taught the course of childhood diseases at the Medical-Surgical Academy from 1831 to 1847. In his lectures, he outlined the anatomical and physiological characteristics of children of all ages and their diseases, including acute infections; in 1842 he opened children's wards in the obstetrics clinic. Khotovitsky wrote the first Russian textbook on childhood diseases "Pediyatrika" (1847), which provides advanced data for that time on the prevention and treatment of diseases in children, causes of infant mortality, describes measures to combat it, etc. the world's first hospital for young children.
In the first half of the 19th century. The Free Economic Society was involved in the issues of children's health care in Russia. It studied childhood morbidity and mortality, and published popular brochures. K. Grush wrote "Guidelines for the upbringing, education and health care of children" (1843-1848).
Further development of pediatrics is associated with the creation in 1865 of the Department of Pediatric Diseases, headed by V.M. Florinsky (1834-1899), at the St. Petersburg Medical-Surgical Academy. (In Europe, the first department of pediatrics was created in 1879 in Paris.) NI Bystroe (1841-1906) organized the first Russian society of pediatricians in St. Petersburg (1885). He trained many students who founded other departments of pediatrics in the country, who have done a lot in the issue of treating children and reducing the high mortality rate of children.
K.A. Rauchfus (1835-1915) made a great contribution to the organization of pediatric care in Russia. According to his plans, two children's hospitals were built - one in St. Petersburg, which bears the name of Rauchfus, the other in Moscow - a hospital named after Rusakov, as well as the first sanatorium for children. Rauchfuss was not only an organizer of health care, but also a prominent scientist. He owns research on purulent joint lesions in infants, congenital heart defects, effusion pleurisy, etc. He described the clinical symptom in pleurisy - the "Rauchfus triangle", substantiated the need for a second (sanatorium) stage of treatment for children.
At Moscow University, a course of childhood diseases in 1861. N.A. Tolsky (1830-1891) began to read. In 1866 he opened a children's clinic with an outpatient clinic, in 1873 - the department of children's diseases. Tolsky understood the tasks of pediatrics and believed that it should be not only a science of treatment, but also of the prevention of childhood diseases.
The founder of Russian clinical pediatrics is N.F. Filatov (1847-1902). He described an acute infectious disease of childhood unknown until that time - "scarlet fever rubella", idiopathic inflammation of the cervical lymph glands (Filatov's glandular fever - infectious mononucleosis), an early sign of measles - pityriasis epithelium on the mucous membrane of the lips and cheeks (Filatov's symptom). His works "Semiotics and Diagnostics of Childhood Diseases", "Lectures on Infectious Diseases of Children", "Clinical Lectures", "Brief Textbook of Childhood Diseases" had a great influence on the development of pediatrics. In 1887, Filatov created a circle of children's doctors in Moscow, which was reorganized in 1892 into the Moscow Society of Children's Physicians.
From 1898 to 1908, the Department of Pediatrics at the Military Medical Academy was headed by N.P. Gundobin (1860-1908). He wrote the books "Peculiarities of Childhood", "General and Private Therapy of Childhood Illnesses", "Education and Treatment of a Child up to 7 Years of Age", "Infant Mortality in Russia and Measures to Combat It", etc. Gundobin was one of the founders and active members of the Union for the Fight against Child Mortality in Russia. The study of tuberculosis, rheumatism, malaria in children, the training of pediatric personnel was carried out by A.A. Kissel (1859-1938). In its scientific and practical activities he attached decisive importance to the prevention of diseases, was an active advocate of improving the living conditions of children, creating the right regimen and nutrition for them.
The Department of Children's Diseases at the St. Petersburg Women's Medical Institute was headed by D. A. Sokolov. In 1911 he founded the journal "Pediatrics". On the initiative of leading Russian scientists in Moscow, St. Petersburg, Saratov and other cities, societies to combat child mortality, pediatric societies arose. In 1911, the First All-Russian Congress of Pediatric Physicians was held, at which issues of assistance to newborns were considered. At this time, the active work of G.N.Speransky (1873-1968) began. He studied physiological characteristics, dietetics and pathology of young children. Speransky attached great importance to the organization of services for children of the neonatal period. He owns works on eating and digestive disorders, pneumonia, sepsis, dysentery in young children. Speransky was an active organizer of children's health care.
V.I. Molchanov (1868-1959) studied the role of the adrenal glands in the genesis of toxic diphtheria, the autonomic nervous system in scarlet fever and other acute childhood infections, the influence of social factors on the etiology and pathogenesis of childhood diseases, etc. These works are of great importance for practical health care. Together with Yu. F. Dombrovskaya and D. D. Lebedev, he wrote the textbook "Propedeutics of Childhood Diseases".
M.S. Maslov (1885-1961) made a great contribution to pediatrics. He is the author of works on chronic nutritional and digestive disorders, kidney and liver diseases, diathesis, etc. He continued NP Gundobin's research on the age-related physiological characteristics of a child, studied biochemical parameters in healthy and sick children. Maslov wrote a number of books: "Fundamentals of the doctrine of the child and the peculiarities of his disease", "Children's diseases", "Clinical lectures on faculty pediatrics", "Diagnosis and prognosis of children's diseases", etc.
Lecture plan
1. Pediatrics as a science. Stages of development. The contribution of domestic pediatricians to the development of science.
2. The structure of the pediatric service in the Russian Federation.
3. Demographic indicators in the Russian Federation.
- Roles of a nurse in the context of the implementation of the "National Health Project".
"Not everyone is given to make
great thing
but everyone can and should
bring
all possible help
and facilitate
suffering of children "
N.P. Gundobin 1901
Pediatrics - is a science that studies the human body from birth to adolescence. The word "pediatrics" comes from two Greek words: paid - child and iatria - healing.
The path of development and establishment of pediatrics as an independent discipline was difficult and long. The first work in history "On the nature of the child" was written by the founder of medicine Hippocrates in the IV century BC. Subsequently, Celsus, Soranus, Galen (I, II century) will write about children, caring for them and their upbringing. For a long time, a child was viewed as a smaller copy of an adult; there were no reasonable rules for caring for children. The treatment of children was carried out according to the same principles as for adults. Childcare was mainly carried out by women, who passed on their experience from generation to generation. Morbidity and mortality in children, especially at an early age, have been very high for many centuries.
In the XVI, XVII, XVIII centuries, interest in the child, in the functional features of the development of the child's body, aroused, diseases inherent only in childhood began to be described. In 1650, the scientific work of the English doctor Glisson about rickets appeared, after which the English doctor Edward Jenner devoted his work to childhood infectious diseases. In 1764, the Swedish physician Rosen von Rosenstein wrote a manual for pediatrics for the first time.
In Russia, Peter I issued a decree "On the construction of hospitals in Moscow for the placement of illegitimate babies and on giving them and their breadwinners a monetary salary" in 1727. At the same time, in the works of Russian statesmen, scientists and doctors of various specialties, issues related to certain problems of protecting the health of mothers and children were considered.
Later, in the work of MV Lomonosov "On the reproduction and preservation of the Russian people" it was pointed out the need for state care for the woman in labor and the postpartum woman, measures were identified to combat infant mortality, and questions were raised about the creation of care homes for children born out of wedlock and the preservation of the life of newborns.
A significant role in the development of state care for children was played by the statesman of the 18th century I.I.Betskaya. Thanks to his initiative, orphanages were opened in 1763 in Moscow and in 1771 in St. Petersburg. In addition, I.I.Betskoy developed guidelines for the care and upbringing of children.
Professor-obstetrician N.M. Maksimovich-Ambodik. In his work "The Art of Twisting, or the Science of Woman's Business", he described individual diseases of newborns and gave recommendations for caring for a child after birth.
The first Russian professor-therapist S.G. Zabelin in his writings described the rules for breastfeeding a child and showed the importance of breastfeeding for the development of a healthy child.
The next stage in the development of pediatrics in Russia is associated with the organization of children's hospitals and the publication of the first guidelines on pediatrics. The first hospitals were opened in St. Petersburg in 1834 and in Moscow in 1842. Subsequently, both of them were named after the outstanding Russian pediatrician N.F. Filatov.
The founder of the Russian pediatric school is S.F. Hotovitsky, who singled out pediatrics as a separate branch of medicine. He was the first to teach a course on childhood diseases to students of the Medical-Surgical Academy in St. Petersburg. In 1847, Hotovitsky for the first time in Russia wrote a guide to childhood illnesses "Pediatrica". He owns the famous words: "A child is not a reduced copy of an adult, a child is a creature that grows and develops only according to its inherent laws."
Further development of pediatrics is associated with the opening of the Department of Pediatric Diseases in 1865 at the St. Petersburg Medical-Surgical Academy and in 1873 at the Moscow University with a children's clinic. During this period, pediatrics emerged as an independent specialty. In the 80s of the XVIX century, departments of children's diseases and children's clinics began to gradually open in many cities of Russia: Kazan, Tomsk, Saratov, Yuryev, etc.
A great contribution to the development of pediatrics was made by the scientist, clinician, teacher N.F. Filatov, who created a school of pediatricians in Moscow. He wrote several works on pediatrics: "Semiotics and Diagnostics of Childhood Diseases", "Lectures on Acute Infectious Diseases", where he described the most characteristic signs childhood infectious diseases: features of scarlet fever (Filatov's pale nasolabial triangle), "scarlet heart", an early sign of measles, a symptom of glandular fever, etc. In 1892 he became the head of the Moscow Society of Children's Physicians.
N.P. Gundobin (1860-1908)
- Professor of the Military Medical Academy in St. Petersburg, one of the founders and leaders of the Union for Combating Child Mortality in Russia. He was the first pediatrician who began to study the anatomical and physiological characteristics of the child's body. His works "Peculiarities of Childhood", "General and Private Therapy of Childhood Illnesses", which have been published in several editions, received great recognition.
The first schools for training nurses in Russia were established in the first half of the 18th century. By 1913 there were 124 educational institutions. By 1917, there were about 10,000 sisters of mercy in Russia. On August 26, 1917, the 1st All-Russian Congress of Sisters of Mercy was held in Moscow, at which the All-Russian Society of Sisters of Mercy was established.
The next stage in the development of pediatrics is associated with the years of Soviet power, when a number of decrees were issued that changed the position of women and children. In 1922, the State Scientific Institute for the Protection of Mothers and Infants (now the Scientific Research Institute of Pediatrics of the Russian Academy of Medical Sciences) was established in Moscow, headed by Professor G.N. Speransky. His works were devoted to the physiology and pathology of childhood, eating disorders in children, diseases of the bronchopulmonary system, sepsis in children in the first weeks and months of life. For the first time in the world, on the basis of the II Moscow State Medical Institute (now the Russian State Medical University), a pediatric faculty was organized (1932), later in Leningrad - the Leningrad Pediatric Medical Institute (1935), the main task of which was the training of highly qualified specialists in the field of pediatrics ...
The first nursing schools after the revolution were opened in 1920. The initiator of their creation was N.A. Semashko. Training programs for nurses, midwives and nurses have been developed. In addition, according to special programs, they began to train nurses for children's treatment-and-prophylactic, preschool institutions and schools. On June 15, 1927, under the leadership of Semashko, the "Regulations on nurses" were issued, which for the first time defined the responsibilities of nurses. In the 30-40s, there were 967 medical and sanitary schools and departments in the country.
A significant contribution to the development of pediatrics was made by Professor A.A. Kisel (1859-1938) and his students. A. A. Kisel studied the problems associated with tuberculosis and rheumatism in children, developed recommendations for the prevention of diseases and the organization of spa treatment for children.
An important role in the study of constitutional anomalies in children belongs to M.S. Maslov
(1885-1961) - Professor of the Military Medical Academy and the Leningrad Pediatric Medical Institute.
M.S. Maslov studied the characteristics of metabolism in a healthy and sick child.
Yu. F. Dombrovskaya (1891-1976) was a follower of the case of N.F. Filatov. For a long time she headed the children's clinic of the 1st Moscow Medical Institute. THEM. Sechenov (now the Medical Academy), where work was carried out to study collagenoses, vitamin deficiency, diseases of the respiratory system, blood.
AF Tour (1894-1974) - a prominent scientist who worked at the Leningrad Pediatric Medical Institute, published many works on the physiology and dietetics of young children, pathology of newborns, hematology, and also wrote the textbook "Childhood Diseases".
During the years of Soviet power, an integral system of state protection of the health of women and children was created in the country, new types of medical and preventive institutions were organized ( antenatal clinics and children's clinics, dairy kitchens, nurseries and kindergartens, pioneer camps and forest schools, sanatoriums and much more). Compulsory clinical examination and immunoprophylaxis in the prescribed time frame, mass health-improving activities have significantly reduced the morbidity and mortality of children.
Over the past decades, professors of educational and research institutions of the city of Moscow have made a significant contribution to the development of various areas of pediatrics: N. I. Nisevich, A. V. Mazurin, M. Ya. Studenikin, V. A. Tabolin, N. S. Kislyak , Yu. E. Veltischev, A. A. Baranov, St. Petersburg Pediatric Medical Academy - I. M. Vorontsov, N. P. Shabalov and others.
The treatment of childhood diseases has long been associated with obstetrics, the treatment of female diseases and the development of ideas about infectious diseases. Outstanding physicians of the ancient world in their writings gave a classic description of smallpox, measles and some other diseases. Special essays on children's illnesses began to appear only at the end of the 15th and beginning of the 16th century.
The English physician Thomas Sydenham made a great contribution to the study of childhood diseases. He described scarlet fever, rheumatic chorea, gout, whooping cough, rubella, erysipelas, rickets. In addition, Sydenham made an attempt to systematize the described diseases and subdivided them into acute (from God) and chronic (from ourselves). Sydenham's great merit consisted in the fact that he regarded illness as “... an effort of nature to restore health by removing an embedded disease-causing principle” and strove to study the healing powers of the organism itself.
In Russia, the first essays on diseases and the upbringing of children belong to N.M. Maksimovich-Ambodik. He wrote the famous work “The art of twisting, or the science of women’s business”, the fifth book of which is entirely devoted to childhood diseases, care and feeding of newborns.
In the 19th century, after the Great French Revolution, pediatrics began to form as an independent scientific discipline, mainly thanks to the works of French doctors. The first hospital for children was opened in Paris in 1802. It became the leading center of Europe in the first half of the 19th century for the training of specialists in the field of childhood diseases. French doctors studied diphtheria and croup in children, developed a technique for tracheotomy surgery, and created the first atlas of the pathological anatomy of childhood diseases.
In the first half of the 19th century, French pediatricians made a great contribution to the study of childhood dietetics, diseases of the gastrointestinal tract, various forms of pneumonia, tuberculous meningitis, congenital syphilis, acquired heart defects and other diseases.
In 1844, the first nursery school for children was opened in France, and in 1892 a scientific society of children's doctors was organized.
The second in Europe (and the first in Russia) special children's hospital with 60 beds was founded in 1834 in St. Petersburg. And in 1842, the world's first hospital for infants with 100 beds was opened in Moscow. Both hospitals were supported by charitable funds.
Pediatrics developed especially rapidly in the middle of the 19th century. V different countries Children's hospitals began to open in Europe, origi were published
nal works and textbooks, new scientific centers were organized. The first pediatric journals began to appear.
The founder of scientific pediatrics in Russia was Stepan Fomich Hotovitsky. He was the first to give a separate course on childhood illnesses of 36 lectures and in 1847 published them under the title "Pediatrician". This was the first pediatric manual in Russia in which the child's body was studied taking into account its anatomical and physiological characteristics that change in the process of development.
In the second half of the 19th and the beginning of the 20th century, pediatrics became independent subject teaching at medical faculties. Initially, teaching was carried out at the departments of obstetrics and women's diseases, then independent departments began to form. In Europe, the first department of childhood diseases was established in Germany, which at that time was at the forefront of pediatrics. In Russia, an independent department of pediatrics was created in 1870 at the St. Petersburg Medical-Surgical Academy, and in
In 1885, the first Russian scientific society of pediatric doctors began its work.
At Moscow University, an independent department of childhood diseases was organized in 1888. It was headed by one of the founders of Russian pediatrics and the founder of a large scientific school, Nil Fedorovich Filatov. He was the first to isolate and describe such diseases as chickenpox and rubella scarlet fever, discovered an early sign of measles, called Filatov-Belsky spots, organized a society of children's doctors in Moscow and was its chairman for many years. In addition, N.F. Filatov published several works on pediatrics, which have gone through many editions.
The formation and development of pediatrics as an independent scientific discipline is associated with the activities of many outstanding doctors in the world. In 1902, the League for the Fight against Infant Mortality, which was very high at that time, was created, and in 1911 the First International Congress for the Protection of Infants was held in Tallinn. This was the beginning of international cooperation in the field of pediatrics.
