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Category: History

Development of health care in Central Kuban at the end of XIX beginning of the 20th century



v. V. Azarova

DEVELOPMENT of HEALTH CARE IN CENTRAL KUBAN at the end of XIX - the BEGINNING of the 20th CENTURY

Work is presented by department of history of Russia of the Armavir state pedagogical university.

The research supervisor - the doctor of historical sciences, professor K.K. Hutyz

In article results of reform of the 60th of the 19th century in certain regions of Kuban in the field of health care and preparation of medical shots are considered.

The article investigates the development of the Medical system in the Middle Kuban at the end of the 19th - beginning of the 20th centuries that included military and private hospitals, midwives, private doctors and drugstores. The analysis of treatment of the Cossacks and foreign citizens in the military clinics is cited.

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Reforms of the 60th of the 19th century found the reflection in Russia which owing to cardinal changes it is accepted to call "revolution from above" and in Kuban. Stage-by-stage development of this fertile south country left the mark and on features of certain regions of Kuban. Later entry into structure of Russia, the new resettlement policy of the state, the being available previous experience left the mark on features of development of infrastructure in eastern regions of edge which according to V.B. Vinogradov's proposal it is accepted to call "Central Kuban", i.e. the territory of present areas Uspensky, New Kuban, Tbilisi, Ust-Labinsky and Armavir. Had the specifics and creation of a health care system in this region which formation and development during the pre-revolutionary period is reflected in historical literature obviously insufficiently.

Creation of a health care system in Kuban (including on Average) belongs to the beginning of the 19th century. In one of documents by the doctor of the Kuban Cossack army it was asked about construction of hospital and training in medical assistant's and pharmaceutical business of the Cossack children aged from 15 up to 20 years on what the office promised to construct hospital when there is an opportunity to that, and ordered to kurenny managements to make departure of children for training in a dress [1, page 730].

The solution of a question of opening district medical in the Caucasian area began in the mid-thirties of the 19th century. In 1835 the Ministry of Internal Affairs asked the Caucasian civil governor to send the reasons concerning establishment of district clinics in the Caucasian area [2, l. 1].

With carrying out administrative transformations at the beginning of the 19th century in the territory of the region governing bodies of medical and sanitary business - medical justices were created. They exercised supervision of medical institutions, petitioned

about appointment of physicians and release of medicines, ospenny committees and a veterinary part submitted to them.

Members of justices confirmed qualification of pharmaceutical pupils and held examinations after which they issued the document on the right of work [3, page 16].

By the beginning of the 60th of the 19th century in Kuban there was no educational institution for training of physicians. The shortage of medical shots affected health of the population and especially indicators of child mortality. The ataman of the Kuban Cossack army wrote by Nakazna in the official report: "The midwife who will train in povivalny art of girls and women is necessary for the regimental district. Now children are accepted by grandmas, old women, many children because of it are born the dead". However midwifes to the Kuban region were not sent. [3, page 125].

In the territory of Central Kuban till 1917 two army hospitals were engaged in treatment of patients. They opened in the largest villages playing a special role militarily: in the village of Prochnookopskaya which was the center of the second crew of the Kuban Cossack army and in the village Labinsk where the army hospital was open in connection with formation of the New Line and remoteness of these villages from Prochnookopskaya.

The Prochnookopsky army hospital (brigade infirmary) was open at the beginning of the 19th century in the village of Prochnookopskaya. By the end of the 19th century the lazaretny complex included nine buildings. Despite the taken measures, the Prochnookopsky army hospital was in the close, inconvenient room [3, page 118]. Meanwhile the number of settlements which serviced army hospitals steadily increased. For example, in 1864 9 villages [4, l belonged to Prochnookopsky brigade infirmary. 9-10], and in 1871 16 villages [5, l belonged to Prochnookopsky infirmary already. 3].

In army hospitals treated not only Cossacks, but also nonresident peasants.

Most often helped them in case of accidents [6, l.33].

All responsibility for treatment pain - ny, especially Cossacks, in Prochnookopsky and Labinsk army hospitals was born first of all by the ataman of the Labinsk military department. The ataman of the Labinsk military department controlled activity of commissioners of hospitals, doctors, all medical personnel and reported to the nakazny ataman of the Kuban Cossack army. Survey of hospitals personally and through the assistants belonged to its duties.

As doctors visitors from the Central Russia generally worked at Central Kuban. Though the quantity them over the years increased, but growth of the population happened quicker and therefore the region lagged behind the all-Russian indicators in calculation of doctors on 1000 inhabitants [3, page 19].

The physicians working in medical institutions and struggling with infectious diseases in the Caucasus got medical education mainly in the Central Russia.

For example, doctor P.G. Kudryavtsev the native of the village of the Caucasian Kuban region, graduated from the St. Petersburg army medical college, worked in Armavir as the private practitioner.

Armavir became the center of health care of Central Kuban by the beginning of the 20th century. In 1908 the doctors P.G. Kudryavtsev and A.N. Danzig acted as initiators of creation of the Armavir medical society. Unfortunately, the charter of this organization was not approved by higher bodies [3, page 34].

The big role in increase in professionalism of Prochnookopsky physicians was played by N.I. Pirogov's arrival. In November, 1847 in the village of Prochnookopskaya the outstanding surgeon trained in application of an anesthesia of medical officers, examined military hospital which represented a congestion of several one-storey lodges.

N. I. Pirogov in Prochnookopsky hospital in detail examined service and treatment of patients. In honor of N.I. Piro-

a gova the regional kostnotuberkulez-ny sanatorium which is in the village of Prochnookopskaya which costs on that place where the army hospital once was located was called [7, page 8-9].

Among junior medical staff the large role was played by nurses. From 40th of the 19th century in Russia, communities of nurses began to open.

From the second half of the 19th century use of female labor and training of nurses became widespread in hospitals also in the North Caucasus. In Kuban in the 70th of the 19th century the attempt to increase the number of average medics for assistance to patients and wounded in hospitals was made. In 1871 order No. 344 on the Defense Ministry where rules of appointment of nurses in army hospitals were explained was signed. In Central Kuban the nurses appeared in the late seventies of the 19th century

For all the 19th century in the Caucasus epidemics of intestinal diseases, plagues, cholera, malaria, diphtheria, smallpox and other diseases leading to death did not stop. Quite often the diagnosis for - a bolevaniye was made incorrectly or not put in general, and instead of the diagnosis entered one of disease symptoms. Due to these events the Army government of the Kuban Cossack army was faced by a paramount task - preservation of staff of army. From preventive actions the inoculation, first of all from smallpox prevailed.

For prevention and the termination of epidemics of other diseases serums were bought. For the first time insurance of families of the physicians who died at elimination of epidemics began to be entered.

Vaccination against natural smallpox in the first half of the 19th century considerably reduced incidence and mortality of the population. Ospoprivivatel were engaged in inoculation of Cossacks and their children.

in 1802 the emperor Alexander I issued the decree on universal vaccination from

smallpox. In its board in large settlements there were ospenny committees designed to teach the people inoculation technique, such institutions were created across all Russia.

Specially prepared peasants took examination where they to them granted the certificates confirming qualification, and a set of necessary medical tools, lancets and fragments of glass. Similar events took place also in Kuban. Chose from the circle of Cossacks capable to training in an ospoprivivaniye.

By Ospoprivivatelyami appointed the Cossacks who served the obligatory sentence of active service. In peace time the ospoprivivatel did not take part in training sessions. In wartime, during mobilization they were not exempted from an appeal on service, and therefore at a state in preferential parts were obliged to have equipment, regimentals and front horses.

By Ospoprivivateli from the Cossacks incapable of service, but capable to work and carrying out these duties, were not exempted from the established money due in income of the army capital of 12 rubles.

In the mid-sixties in the 19th century carried out large-scale work on inoculation of the Cossack children from smallpox. For example, in 1865 vaccination was done against smallpox to 1511 children of Cossacks in the 2nd crews from 9 villages [8, l. 6].

Since 1904 the Cossacks who served as an ospoprivivatel not less 1820 could be made in not front the senior category [9, page 139-140]. As ospoprivivatel belonged to the Defense Ministry, and they had to have a dress code military [10, l. 15]. In Central Kuban (the village of Prochnookopskaya, etc.) ospoprivivatel appeared approximately from the 2nd half of the 19th century

The deficiency of physicians in Kuban was felt constantly. In this regard the government not only established new established posts for the purpose of increase in number of physicians, but also allowed to replace average medicine -

sky workers less qualified personnel, for example company paramedics or midwives.

Pupils of ospoprivivatel were trained in this business by ospoprivivatel as there were no special medical institutions for their training.

Besides an ospoprivivaniye, also other preventive measures were taken. For example, the passing order through cordons was carefully regulated, processing of things of visitors was carried out [3, page 17].

During epidemics because of a lack of medical institutions were created times - ny quarantines and hospital. For example, in 1822 on the Caucasian line six quarantines were founded: Kizlyar, Mozdok, Prochnookopsky, etc. Strong okopsky the quarantine carried number - 1676 [2, 2. l. 5] In 1860 in fortress the Strong Trench the quarantine outpost [11, l was based. 2]. However infectious diseases still seriously influenced mortality indicators.

Special educational institutions on training of medical personnel in Kuban were not, however at army infirmaries "medical assistant's pupils" who studied medical assistant's business served. Only in Prochnookopsky infirmary in 1871-1872 studied medical assistant's business pupils [12, l. 7].

Doctors of army hospitals worked only in stationary conditions and to other settlements did not leave. At the same time in certain large villages at the end of XIX - the beginning of the 20th century private practitioners conducted paid reception [13, page 124].

The tsarist government interested in reduction of child mortality and especially among newborns contributed to the development of obstetrics (in the 19th century - "midwives"). Particular importance was attached to growth of their professionalism. For example, the famous Russian doctor A.I. Pospelov organized courses of midwives ("Pospelovsky courses").

In 1907 in the Kuban region 12 positions of local feld-sherov-midwifes were founded. According to the order of the Defense Ministry the salary in 360 rubles was established by it. Also paid them 180 rubles a year table and room on an ober-officer salary. But because of a shortcoming of paramedics-midwifes the petition for appointment to these positions of midwives was excited [13, page 83].

In Central Kuban also private hospitals were engaged in treatment of patients. By the end

XIX century some enterprises had the medical institutions. For example, at the Vladikavkaz railroad two accident wards worked.

In the Kuban manor "Farm" in 1893 the baron V.R. Shteyngel constructed hospital on 18 beds. At it there was a pharmacy, necessary surgical and medical instruments, devices for analyses and a microscope, other hospital stock. Annual medical care was received to eight thousand people here, was in hospital to four hundred people. Workers and serving with annual content less than five hundred rubles received medical care and medicines free of charge, those

who income had more than five hundred rubles a year, used relative privileges [14, page 23].

By the end of the 19th century in Central Kuban there was the whole system of the pharmacies which were in the largest villages: Besskorbny, Urupsky, Prochnookopsky, etc. At the beginning

XX century of pharmacy appeared in farms and other small settlements. For example, in the farm of Ube-women's, the settlement Kuban, etc.

And in these institutions there were preferential terms for the Cossacks. Cossacks received drugs from stanitsa pharmacy free of charge, non-residents - for a payment.

Pharmacies were very poor in drugs, in some there were no disinfectants even. Besides pharmacies in some large villages (Besskorbna, Urupsky, etc.) pharmaceutical shops worked.

Thus, it is possible to draw a conclusion that by 1917 in Central Kuban a certain health care system which included was created: army, private and departmental hospitals, pharmacies. However growth of the population advanced the formed system of health care. Cardinal measures for improvement of the situation of affairs were necessary.

LIST OF REFERENCES

1. F.A. Shcherbina. History of the Kuban Cossack army, Ekaterinodar, 1913. T. 2.
2. GASK. T. 444. Op. 1. 149.
3. V.G. Vasilenko. History of health care and medical education to Dona and Northern

Caucasus (XIX century -1940): Avtoref. yew.... edging. east. sciences. Krasnodar, 2006.

4. GAKK. T. 354. Op. 1. D. 41.
5. GAKK. T. 354. Op. 1. D. 98.
6. GAKK. T. 454. Op. 1. D. 5169.
7. A.M. Yakovenko. New Kuban district. Novokubansk, 1999, 2000.
8. GAKK. T. 354. Op. 1. 66. L. 6.
9. P.P. Orlov. The help book as regards military for managements, departments, for stanitsa boards and for the officers consisting at the disposal of troops of the administration of Kuban and Tersky Cossack troops. Ekaterinodar, 1904-1905.
10. GAKK. T. 396. Op. 1. 904.
11. AOAA. T. 1271. Op. 1. 177.
12. GAKK. T. 354. Op. 1. 122.
13. The Kuban calendar for 1899 Ekaterinodar, 1899.
14. A.V. Solovyov, A.M. Palastrov, Yakovenko A.M. Novokubansk: A local history album with a short essay. 1867-1997 Kurganinsk, 1999.

Abbreviations

GAKK - the State archive of Krasnodar Krai.

GASK - the State archive of Stavropol Krai.

AOAA - Archival department of administration of Armavir.

Jean Underwood
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