The great Russian surgeon Nikolai Pirogov. Doctor from God
The achievements of the great doctor, founder of military surgery, naturalist, surgeon, teacher, and public figure are outlined in this article.
Pirogov Nikolay Ivanovich contribution to medicine
1. Among the great events for Pirogov was the highest approval of the project of his first Anatomical Institute. He invented the “Pirogov operations”, opened the discipline “ topographic anatomy", developed an Atlas for surgeons, which allows one to see the detailed anatomical structure of the human body.
2. On October 16, 1846, carried out the first test ether anesthesia, to which quickly conquered the whole world. In February 1847, Russia began to practice operations using of this substance. Pirogov even invented a mask for inhaling ether anesthesia, and those who did not want to use an inhaler injected the drug internally.
3. Pirogov created modern surgical anatomy- he was the first surgeon who called for operations not “by eye”, but based on an accurate knowledge of the location of tissues in individual areas of the body.
4. Nikolai Pirogov introduced his own casualty triage system. Some people had operations performed under open air, in combat conditions, other wounded were evacuated after first treatment medical care inland. At his insistence, a new form of medical care was introduced in the army - now nurses appeared. Therefore, Pirogov is considered the founder of military field medicine.
5. He proposed a new method of embalming the bodies of the dead. He himself was embalmed using this method and Pirogov’s body was kept in his museum for over 100 years.
6. Created the first surgical clinic in Russia. Here he founded a new direction - hospital surgery.
7. He was the first in the world to applied plaster casts.
8. Pirogov was the first surgeon who treated festering wounds by opening them.
9. Nikolai Ivanovich is the founder of osteoplastic operations.
10. Investigated the role of a blood clot in the process of restoring violations of the integrity of body tissues.
11. Pirogov was the first to insist on the use of antiseptics in treatment.
We hope that from this article you learned what contribution Nikolai Ivanovich Pirogov made to medicine.
Nikolai Ivanovich Pirogov is one of the most outstanding personalities of the 19th century. The contribution that he made to the development of science in our country is so great that it is quite comparable with the achievements of such great geniuses of science and political figures of our history, such as D.I. Mendeleev, M.V. Lomonosov.
Many streets in many cities of our homeland are named after him. The Leningrad Surgical Society, the 2nd Moscow and Odessa Medical Institutes are named after Pirogov. After the death of Pirogov, the “Society of Russian Doctors in Memory of N.I. Pirogov” was founded, as well as the regularly convened “Pirogov Congresses”.
Nikolai Ivanovich Pirogov is a domestic doctor and scientist, an outstanding teacher and public figure; one of the founders of surgical anatomy and anatomical-experimental trends in surgery, military field surgery, organization and tactics medical support troops; member corr. Petersburg Academy of Sciences (1847), honorary member and honorary doctor of many domestic and foreign universities and medical societies.
N. I. Pirogov’s contribution to military field surgery huge and recognized all over the world. He identified the main features of military field surgery compared to peacetime surgery. By defining war as a “traumatic epidemic,” Pirogov gave a clear idea of the scale of medical and evacuation measures in war and brought to the forefront in military field surgery the importance of organizing medical support for troops. The main tool for organizing the provision of surgical care to the wounded. Pirogov believed medical triage with determination of the severity of injuries and the order of care. Pirogov first used anesthesia in war. He widely introduced a plaster cast for the treatment of gunshot bone fractures in the wounded and on this basis formulated the idea of “saving treatment” to replace the prevailing opinion at that time about the need for early amputations of limbs. Pirogov gave detailed recommendations on the use of temporary and definitive bleeding control in the wounded. He attracted women to help those wounded in the war, thereby laying the foundation for the institute of nurses. Pirogov’s merits in the study of the pathology of combat injuries are great. His description of traumatic shock has become a classic and is mentioned in all modern manuals. Brilliantly predicted infectious nature purulent complications for the wounded associated with pathogenic organic agents (“miasms”), Pirogov proposed specific measures of prevention and treatment - a system of “dispersing the wounded in the war.” In general, the role of N. I. Pirogov in the history of Russian medicine can be characterized by the words of V. A. Oppel: “Pirogov created a school. His school is all Russian surgery.”
N.I. Pirogov was the first among domestic scientists to come up with the idea of plastic surgery (a test lecture at the St. Petersburg Academy of Sciences in 1835 “On plastic surgery in general and rhinoplasty in particular”), and for the first time in the world he put forward the idea bone grafting, having published in 1854 the work “Osteoplastic lengthening of the bones of the lower leg during enucleation of the foot.” His method of connecting the supporting stump for amputation of the lower leg at the expense of the calcaneus is known as the Pirogov operation, and it served as an impetus for the development of other osteoplastic operations. The extra-abdominal access to the external iliac artery (1833) and the lower third of the ureter proposed by N. I. Pirogov received wide practical application and was named after him.
The exceptional role of N.I. Pirogov in developing the problem of pain relief. Anesthesia was proposed in 1846, and already in next year N.I. Pirogov conducted a wide experimental and wedge test of the analgesic properties of ether vapor. He studied their effect in experiments on animals (with various methods of administration - inhalation, rectal, intraocular, intratracheal, suo-arachnoid), as well as on volunteers, including himself. He was one of the first in Russia (February 14, 1847) to perform an operation under ether anesthesia (removal of the mammary gland for cancer), which lasted only 2.5 minutes; in the same month (for the first time in the world) he performed a rectal ether anesthesia operation, for which a special apparatus was designed. He summarized the results of 50 surgical interventions performed in hospitals in St. Petersburg, Moscow and Kyiv in reports, oral and written communications (including in the Association of Doctors of St. Petersburg and the Medical Council of the Ministry of Internal Affairs, in the St. Petersburg and the Paris Academies of Sciences) and the monographic work “Observations on the effect of ethereal vapors as an analgesic in surgical operations” (1847), which had vital importance in promoting a new method in Russia and introducing anesthesia into wedge and practice. In July-August 1847, N.I. Pirogov, sent to the Caucasian theater of military operations, where he first used ether anesthesia in the conditions of active troops (during the siege of the fortified village of Salta). The result was unprecedented in the history of wars: operations took place without the groans and cries of the wounded. In “Report on a trip to the Caucasus” (1849), N. I. Pirogov wrote: “The possibility of broadcasting on the battlefield has been indisputably proven... The most comforting result of broadcasting was that the operations we performed in the presence of other wounded were not at all frightening, but, on the contrary, they reassured them about their own fate.”
The activities of N. I. Pirogov played a noticeable role in the history of asepsis and antiseptics, which, along with anesthesia, determined the success of surgery in the last quarter of the 19th century. Even before the publication of the works of L. Pasteur and J. Lister, in his wedge lectures on surgery, N. I. Pirogov expressed a brilliant guess that the suppuration of wounds depends on living pathogens (“hospital miasma”): “The miasma, while infecting, itself and is reproduced by an infected organism. Miasma is not, like poison, a passive aggregate of chemically active particles; it is organic, capable of developing and renewing itself.” From this theoretical position, he drew practical conclusions: he allocated special departments in his clinic for those infected with “hospital miasma”; demanded “to separate completely the entire staff of the gangrenosis department - doctors, nurses, paramedics and attendants, to give them dressings that are special from other departments (lint, bandages, rags) and special surgical instruments”; recommended that the doctor "of the miasmic and gangrenous department pay special attention to his dress and hands." Regarding dressing wounds with lint, he wrote: “You can imagine what this lint must look like under a microscope! How many eggs, fungi and various spores are there in it? How easily it becomes a means of transmitting infections!” N.I. Pirogov consistently carried out anti-putrefactive treatment of wounds, using iodine tincture, solutions of silver nitrate, etc., emphasizing the importance of gigabyte. measures in the treatment of the wounded and sick.
N.I. Pirogov was a champion of preventive medicine. He owns the famous words that have become the motto of Russian medicine: “I believe in hygiene. This is where the true progress of our science lies. The future belongs to preventive medicine.”
In 1870, in a review of the “Proceedings of the Permanent Medical Commission of the Poltava Provincial Zemstvo,” N.I. Pirogov advised the zemstvo to pay special attention to medical care. organizations for hygienic and sanitary education. sections of its work, and also not to lose sight of the food issue in practical activities.
N.I. Pirogov's reputation as a practical surgeon was as high as his reputation as a scientist. Removal of a mammary gland or a stone from the bladder, for example, was carried out by N.I. Pirogov in 1.5–3 minutes. During Crimean War at the main dressing station of Sevastopol on March 4, 1855, he performed 10 amputations in less than 2 hours. The international medical authority of N. I. Pirogov is evidenced, in particular, by his invitation for a consultative examination to the German Chancellor O. Bismarck (1859) and the national hero of Italy G. Garibaldi (1862).
Military medicine owes N.I. Pirogov the creation of the scientific foundations of domestic military field surgery and a new section of military medicine - medical organization and tactics. services. In 1854–1855 During the Crimean War, N.I. Pirogov twice traveled to the theater of military operations and directly participated in the organization of medical services. ensuring combat operations of troops and in treating the wounded, he was the initiator of involving women ("sisters of mercy") in caring for the wounded at the front. To familiarize himself with the work of dressing stations, infirmaries and hospitals in combat conditions, he also traveled to Germany (1870) and Bulgaria (1877). N. I. Pirogov summarized the results of his observations in the works “The beginnings of general military field surgery, taken from observations of military hospital practice and memories of the Crimean War and the Caucasian expedition” (1865–1866), “Report on a visit to military health institutions in Germany, Lorraine and Alsace in 1870." (1871) and “Military medicine and private assistance at the theater of war in Bulgaria and behind the lines of the active army in 1877–1878.” (1879). The practical conclusions set out by N. I. Pirogov, in the form of “provisions,” formed the basis of the organizational, tactical and methodological principles of military medicine.
The first position of N.I. Pirogov says: “War is a traumatic epidemic.” This is the definition of war with medical point vision has become firmly established in military medical literature. It stems from the fact that combat operations by troops are characterized by massive numbers and extreme unevenness of sanitary losses, and hence the uneven flow of casualties to field hospitals. institutions. Already during the Crimean War, the shortage of doctors at dressing stations and in field hospitals was so great that there was sometimes only one resident for 100 or more seriously wounded people. Unevenness of dignity. losses in subsequent wars manifested themselves even more clearly, exerting an increasing influence on the organizational principles of building the military medical service, on the tactical methods of its work and the combat training of personnel.
N.I. Pirogov did not consider combat damage as a simple mechanical violation of the integrity of tissues; He attached great importance in the occurrence and course of combat injuries to general fatigue and nervous tension, lack of sleep and malnutrition, cold, hunger and other inevitable unfavorable factors of the combat situation, contributing to the development of wound complications and the occurrence of a number of diseases in soldiers of the active army.
The second position of N.I. Pirogov states: “The properties of wounds, mortality and the success of treatment depend primarily on the various properties of weapons and especially firearms.” N. I. Pirogov’s views on surgical interventions, on preventive operations at dressing stations and in field hospitals changed throughout his entire career. At first he was a strong supporter of preventive operations. After a thorough analysis of the wedge, the outcomes of wounds, which gave a particularly high mortality rate from complications of wounds by putrefactive processes, as well as mortality among patients operated on in hospitals and in private practice, P. I. Pirogoi concluded that preventive operations at dressing stations were inappropriate and that surgeon in these conditions in the fight to reduce mortality and disability among the wounded. Having become acquainted with honey during the Russian-Turkish war. ensuring military operations of troops and with the organization of surgical work at the main dressing stations in hospitals (and in particular, with the results of applying the Lister method of fighting infection during operations), N. I. Pirogov changed his attitude to the role surgical interventions in the prevention of complications of gunshot wounds. In his last work, “Military Medicine...”, he already spoke about two ways of developing surgery (especially military field): expectant-saving and active-preventive. With the discovery and introduction of antisepsis and asepsis into surgical practice, surgery began to develop along the second path, about which N.I. Pirogov wrote: “For field surgery, a vast field of the most energetic activity opens up at the dressing station - primary operations on an unprecedented scale.”
The third position of I. Pirogov, closely related to the first, states: “It is not medicine, but the administration that plays main role in helping the wounded and sick at the theater of war." According to this provision, the success of medical support for combat operations of troops depends on the organizational structure of medical institutions, their number, subordination, purpose, mobility and relationships between them, which, in turn, should be determined features of the theater of military operations, the nature of war and methods of conducting combat operations, on the one hand, and the achievements of medical science and healthcare practice, on the other.
N.I. Pirogov recognized the need to regulate the purpose and tasks of honey. institutions, rights and responsibilities officials, but emphasized that for success honey. affairs in a war with numerous surprises, rapid changes in the combat situation, forcing, in the interests of the case, to violate these regulations, but at the same time emphasized that the skillful leadership of the military medical service, which must be authoritative, medical from top to bottom, capable of being responsible for the assigned it is a matter of substance, not of form.
N.I. Pirogov considered the main task to ensure the interconnectedness of treatment and evacuation, while he proceeded from the decisive importance of the combat situation in solving the main tasks of medical care. ensuring combat operations of troops, in particular when establishing the deployment and grouping of medical personnel. institutions, as well as the volume of medical care provided to the injured and sick.
P.I. Pirogov is the founder of the doctrine of honey. sorting. He argued that sorting the wounded according to the urgency and extent of surgical care and according to indications for evacuation is the main means of preventing “confusion” and “confusion” in medical institutions. In this regard, he considered it necessary to have in medical institutions intended for receiving the wounded and sick and providing them with qualified assistance, triage and surgical dressing units, as well as a unit for the lightly wounded (“weak teams”), and on evacuation routes (in area where hospitals are concentrated) – “triage” – triage hospitals.
The works of P. I. Pirogov on the problems of immobilization and shock were of great importance not only for military field surgery, but also for wedges and medicine in general. In 1847, at the Caucasian theater of military operations, he was the first in military field practice to use a fixed starch bandage for complex fractures of the limbs. During the Crimean War, he also for the first time (1854) imposed field conditions plaster cast. belongs to N.I. Pirogov detailed characteristics pathogenesis, presentation of methods of prevention and treatment of shock; The wedge he described, the picture of shock, is classic and continues to appear in manuals and textbooks on surgery. He also described concussion, gaseous tissue swelling, and identified “wound consumption” as a special form of pathology, now known as “wound exhaustion.”
Characteristic feature N.I. Pirogov, a doctor and teacher, was extremely self-critical. Even at the beginning of his professorial career, he published a two-volume work “Annals of the Dorpat Surgical Clinic” (1837–1839), in which a critical approach to own work and analysis of one’s mistakes are considered as the most important condition for the successful development of medicine. science and practice. In the preface to the 1st volume of the Annals, he wrote: “I consider it the sacred duty of a conscientious teacher to immediately make public his mistakes and their consequences in order to warn and edify others, even less experienced, against similar errors.” I. II. Pavlov called the publication of “Annals” his first professorial feat: “...in a certain respect, an unprecedented publication. Such merciless, frank criticism of oneself and one’s activities is hardly found anywhere in medical literature. And this is a huge merit! " In 1854, the Military Medical Journal published an article by N. I. Pirogov, “On the difficulties of recognizing surgical diseases and on happiness in surgery,” based on an analysis of the main image of one’s own medical errors. This approach to self-criticism as an effective weapon in the struggle for genuine science is characteristic of N. I. Pirogov in all periods of his varied activities.
N. I. Pirogov - the teacher was distinguished constant desire to greater clarity of the presented material (for example, extensive demonstrations at lectures), the search for new methods of teaching anatomy and surgery, conducting wedges, rounds. His important merit in the field of medicine. education is the initiative to open hospital clinics for 5th year students. He was the first to justify the need to create such clinics and formulate the tasks facing them.
N. I. Pirogov’s speeches on issues of upbringing and education had a great public resonance; his article “Questions of Life”, published in 1856 in the “Sea Collection”, received a positive assessment from N. G. Chernyshevsky and N. A. Dobrolyubov. From the same year, N.I. Pirogov’s activities in the field of education began, which was marked by a constant struggle against ignorance and stagnation in science and education, against patronage and bribery. N.I. Pirogov sought to spread knowledge among the people, demanded the so-called. autonomy of the high fur boots, was a supporter of competitions that provide places for more capable and knowledgeable applicants. He defended equal rights to education for all nationalities, large and small, and all classes, strived for the implementation of universal primary education and was the organizer of Sunday public schools in Kyiv. On the question of the relationship between “scientific” and “educational” in higher education, he was a resolute opponent of the opinion that universities should teach, and the Academy of Sciences should “move science forward,” and argued: “It is impossible to separate educational from scientific at a university. But The scientific, even without the educational, still shines and warms. But the educational without the scientific, no matter how attractive its appearance, only shines.” In assessing the merits of the head of the department, he gave preference to scientific rather than pedagogical abilities. Pirogov was deeply convinced that science is driven by method. “Even if the professor is dumb,” wrote P.I. Pirogov, “but teach by example, in practice, the real method of studying the subject - for science and for those who want to do science, it is more valuable than the most eloquent speaker...” A, I. Herzen called P. I. Pirogov one of the most prominent figures in Russia, who, in his opinion, brought great benefit to the Motherland not only as the “first operator”, but also as a trustee of educational districts.
“The principles introduced into science (anatomy, surgery) by Pirogov will remain an eternal contribution and cannot be erased from its tablets as long as European science exists, until the last sound of rich Russian speech freezes in this place.” N.V. Sklifosovsky
On November 25, 1810, Nikolai Ivanovich Pirogov was born in Moscow - a Russian surgeon and anatomist, naturalist and teacher, creator of the first atlas of topographic anatomy, corresponding member of the St. Petersburg Academy of Sciences. Nikolai Pirogov was the first to use new healing methods during the Crimean War and gave the world military field surgery and plaster casting for fractures and anesthesia (anesthesia) in combat conditions, women's service for caring for the wounded (sisters of mercy), topographic anatomy and osteoplasty. He invariably combined his knowledge and medical practice with a state view, uncompromising civic position, burning heart and love for the Motherland. And this is close to two other Russian titans - Mikhail Lomonosov and Dmitry Mendeleev.
Pirogov-with-nanny-Ekaterina-Mikhailovna.-Khud.-A.-Soroka.
Father of Nikolai Pirogov - Ivan Ivanovich
served as treasurer. In the Pirogov family there was fourteen children, of whom eight died in infancy.
Of the six surviving children in the Pirogov family, Nikolai was the youngest child.
Nikolai Pirogov was helped to obtain a medical education by a family friend, a famous Moscow doctor, professor at Moscow University E. Mukhin, who noticed the boy’s abilities and began to work with him individually. At the age of fourteen, Nikolai Pirogov entered the first year of the medical faculty of Moscow University, adding two years to himself. Pirogov studied easily, despite the fact that he had to constantly work part-time to help his family. A medical student was able to apply for a position prosector in the anatomical theater and this work gave him invaluable experience in studying human anatomy and he gained confidence that surgery was his calling.
Pirogov entered at the age of 14, and at the age of 18 he graduated from Moscow University with excellent success, he went to the Yuryev University in Tartu, where one of the best surgical clinics in Russia was located, where Nikolai Ivanovich worked for five years on doctoral dissertation and at the age of 22 became Doctor of Sciences IN 26 years old Nikolai Pirogov became a professor of surgery . In his dissertation, Pirogov first studied and described the location abdominal aorta in humans, circulatory disorders during aortic ligation, circulatory pathways during aortic obstruction, explained the causes of postoperative complications.
After five years of work in Dorpat, Nikolai Pirogov went to study in Berlin. Pirogov's dissertation was translated into German and the famous surgeons, to whom he went to study, respectfully bowed their heads before the innovative ideas of the Russian surgeon.
While still a young man, practicing in Dorpat, he created the fundamental work “ Surgical anatomy arterial trunks and fascia", discoverer new era in operations on arteries and was soon translated into all European languages. Later, in one of his letters to his wife, he admitted: “I love my science, how can a son love a tender mother.”
Sitting in the autopsy room on frosty nights, Pirogov scrupulously studied the inner "map" of human flesh , little known to surgeons of that time. It's interesting that this monumental medical work found embodiment in fine art called "Lying Body" From a corpse actually frozen and dissected by Pirogov young manProfessor of Anatomy at the Academy of Arts Ilya Buyalsky took a plaster cast, and the outstanding Russian sculptor Pyotr Klodt then created a unique bronze sculpture, copies of which were made for many academies in Western Europe.
In the Dutch city of Gottingen, Pirogov met the outstanding surgeon Professor Langenbeck, who taught him the purity of surgical techniques.
Humanistic ideals of Nikolai Pirogov closely related to the educational and romantic thoughts of Germany at that time, which shaped ideal of moral consciousness and philosophical the importance of human values in the life of society. Nature moral qualities, characteristic of Pirogov and so amazed his contemporaries, such as inner freedom, human dignity, respect for the individual in all spheres of life, firmness in one’s moral convictions and unselfishness of the soul, It is impossible to understand without understanding that these traits were formed during Nikolai Pirogov’s life in the West.
Returning home to Russia, Pirogov became seriously ill on the road and was forced to stop in Riga. As soon as Nikolai Pirogov rose from his hospital bed, he began to operate, and started with rhinoplasty : A new nose was cut out for the noseless barber. Plastic surgery was followed by various other operations, lithotomy, amputation, and tumor removal. During Pirogov's absence in Moscow, the management medical department given to another candidate.
From Riga Nikolay Pirogov went again to Dorpat, where he received a surgical clinic and
wrote one of his most significant works -
Nikolai Pirogov provided descriptions of surgical operations with drawings that were not similar to the anatomical atlases and tables that were used by surgeons before, which were common at that time.
Finally, Nikolai Pirogov went to France, where his superiors did not allow him to go, five years earlier. In Parisian clinics, Nikolai Ivanovich did not find anything new or unknown for himself. As soon as he found himself in Paris, Nikolai Pirogov hurried to the famous Professor of Surgery and Anatomy Velpeau and found him reading his latest printed work - "Surgical anatomy of arterial trunks and fascia." Monograph by Pirogov “On transection of the Achilles tendon as an operative orthopedic treatment”(1837) aroused the admiration of specialists.
Osteoplasty
Pirogov had to defend the priorities of Russian surgery related to osteoplastic surgery , which gave rise to osteoplasty, and osteotome, an instrument for bone surgery, a German professor suddenly declared himself the inventor of it.
Pirogov understood technology no worse than science. In 1841, Nikolai Pirogov was invited to the Department of Surgery at the Medical-Surgical Academy of St. Petersburg,
where he worked for more than 10 years and created the first surgical clinic in Russia. At the Medical-Surgical Academy of St. Petersburg, Pirogov founded another branch of medicine - hospital surgery.
Having become the director of the Tool Plant, Nikolai Pirogov came up with and developed new surgical instruments,
with which each surgeon could more successfully perform the most complex surgical operations. Pirogov not only mastered “import substitution”, but also launched the production of new surgical instruments, which were sold in great demand abroad.
Pirogov was asked to accept the position of consultant in one, another, third hospital, and he again agreed. In the second year of his life in St. Petersburg, Pirogov fell seriously ill, poisoned by hospital miasmas and the bad air of the dead, and could not get up for a month and a half. The illness made him think about his bachelor and lonely life. Sad thoughts about the years lived without love led him to Ekaterina Dmitrievna Berezina, a girl from an impoverished high-born family, with whom he married.
Over four years of living together as a family The Pirogovs had two sons, Nikolai and Vladimir, but after the second birth, Ekaterina Dmitrievna died.
After the death of his wife, Pirogov felt very lonely. "I have no friends"
“, he admitted with his usual frankness.
In the difficult days of grief and despair for Pirogov, a great event happened - his project was approved by the highest command creation of the world's first Anatomical Institute.
Pirogov twice unsuccessfully tried to marry for convenience, which he did not hide from himself, from his acquaintances, or from the girls planned as brides. In a small circle of acquaintances, where Pirogov sometimes spent evenings, he was told about the 22-year-old Baroness Alexandra Antonovna Bistrom. Pirogov proposed to Baroness Bistrom, and she agreed.
Pirogov continued to work successfully and 1
On October 6, 1846, the first trial of ether anesthesia took place.
In Russia, the first operation under anesthesia was performed on February 7, 1847 by Pirogov’s friend at the professorial institute, Fyodor Ivanovich Inozemtsev.
During During the Crimean War, Nikolai Ivanovich Pirogov took part in military operations in the Caucasus, where the great Russian surgeon performed about 10,000 surgical operations under ether anesthesia.
In 1855, Nikolai Ivanovich considered it his civic duty to go to Sevastopol, besieged by Anglo-French-Turkish troops. Pirogov achieved his appointment to the active army. Operating on the wounded on the front line, Pirogov for the first time in the history of medicine applied a plaster cast, which made it possible to speed up the healing process of fractures and saved many soldiers and officers from ugly curvature of their limbs.
Rescue plaster
Of course, before Pirogov, attempts were made to fix damaged parts of the human body. Among the predecessors who used plaster: medieval Arab doctors, Dutch, French, Russians surgeons Karl Giebenthal and Vasily Basov. In Western sources, a Dutch doctor is considered the creator of medical plastering. Antonius Mathisen, who started using plaster in 1851 , however, the plaster was not on the fabric and, due to its obvious shortcomings, such plaster did not find widespread use.
To replace linden bast blocks, Pirogov, back in the Caucasus at the end of 1840, tried different materials: starch, colloidin and even gutta-percha. It was necessary to resolve this issue, because most wounds with bone fragmentation ended in amputation, and simple fractures often resulted in injury. The creation of a modern version of medical plaster was helped, as often happens, by chance and observation. He saw the effect of a gypsum solution on a canvas in the workshop of the St. Petersburg sculptor Nikolai Stepanov. The next day at the clinic, the doctor applied bandages and strips of canvas to the patient’s lower leg. The result was brilliant: the fracture healed quickly. And already in Sevastopol, where Nikolai Ivanovich operated sometimes for several nights without sleep, plastering saved the limbs and the lives of hundreds of compatriots. “I introduced a plaster cast into military hospital practice for the first time in 1852, and in the military field in 1854, finally... took its toll and has become a necessary accessory to field surgical practice,” - he wrote to his second wife Alexandra von Bistrom, a German baroness who converted to Orthodoxy. In most Western encyclopedias the name of the Russian doctor is completely silent.
Legends about the almighty doctor were born during his lifetime. During Crimean War (1854 - 1856) to the dressing station in Sevastopol, where he operated, they brought - separately - the body of a soldier and the head torn off by a cannonball. “Where are you taking a headless man, Herods!” - the paramedic yelled and received a discouraging answer: “It’s okay, Mr. Pirogov will sew it on somehow, maybe our brother soldier will come in handy!”
Ether and chloroform.
The hypnotic effect of ether was known back in the 16th century. In the early 1840s, Americans Crawford Long and William Thomas Morton used diethyl ether for pain relief, and October 16, 1846, dentist John Warren, considered in the West to be the “father of anesthesia,” performed the famous “first operation under anesthesia.”
Just a few months later, operations under anesthesia were successfully carried out in St. Petersburg. A in the summer of 1847, during the siege of a fortified Dagestan village, Pirogov was the first in the world to operate under anesthesia many wounded, using chloroform, stronger than ether . Pirogov was the first in Russia to scientifically develop technologies for pain relief with chloroform, study its effect on the body, possible dangers. He developed methods of etherization through the rectum and trachea, designed a special apparatus, proposed deep anesthesia technique.
Applying all this during the Crimean War, Nikolai Ivanovich noted: “From now on, the etheric device will be, just like a surgical knife, a necessary accessory for every doctor.” Today, Americans are proud of the priority of performing surgery under anesthesia. However, in Crimea, 43 American surgeons were trained in “conveyor” anesthesia from Pirogova, with good reason, who asserted: “The benefits of anesthesia and this bandage (plaster) in military field practice were learned by us in practice before other nations.”
The Russian Sisters of Mercy were the first.
Namely, Pirogov laid the foundations of military field medicine, and his achievements formed the basis of activities military field surgeons of the 19th-20th centuries. On the initiative of the surgeon Pirogov, a new form of front-line medical sanitary service was introduced in the Russian army in October 1854 - sisters of mercy appeared - "Krestovozdvizhenskaya community of sisters caring for the wounded and sick." Objecting to Western journalists who proclaimed the Englishwoman Florence Nightingale as the “progenitor” of the Sisters of Charity movement, Nikolai Pirogov emphasized: “About Miss Neutingel” and “about her high-spirited ladies” - We heard it for the first time only at the beginning of 1855... We Russians should not allow anyone to alter historical truth to such an extent. We have a duty to claim the palm in such a blessed matter.”
Pirogov-and-sailor-Peter-Koshka.-Khud.-L.-Koshtelyanchuk.
The grandson of a peasant soldier, the son of a major in the quartermaster service, Nikolai Pirogov himself spent a good half of his life on four warriors: Caucasian, Crimean, Franco-Prussian and Russian-Turkish . Pirogov’s most important merit is the introduction in Sevastopol of completely a new method of caring for the wounded. At the first dressing station, all wounded were subject to thorough selection depending on the severity of injuries - some wounded were subject to immediate surgery in the field , and the lightly wounded were evacuated inland for treatment in stationary military hospitals.
Before Pirogov, chaos reigned at the dressing stations, which Nikolai Ivanovich succinctly described in a letter: "Bitter need, carelessness, medical ignorance and evil spirits joined together in fabulous proportions.” Having begun to harshly correct the situation, the doctor concluded: “In war, the main thing is not medicine, but administration.” And later he supplemented this maxim with one more: "War is a traumatic epidemic." Z It means that organizational and medical measures are needed “anti-epidemic”.
Long before Pasteur discovered the pathogenicity of microbes, the Russian surgeon Pirogov guessed that infection could be transmitted through water and air. Even before the creation of dietetics, Pirogov introduced a special diet of therapeutic nutrition, including carrots and fish oil. Another truth was revealed to him, which has become generally accepted today: “The future belongs to preventative medicine!”
For services to the wounded and sick N.I. Pirogov was awarded the order St. Stanislaus 1st degree.
Pirogov briefly formulated his achievements in twenty paragraphs of the brochure “The Basic Principles of My Field Surgery” and developed it in the book “Military Medicine” in 1879. The Russian army successfully used its technologies in all wars of the 20th century. ABOUT scientific discoveries The greats responded with gratitude to Pirogov surgeons Nikolai Burdenko and Archbishop of Crimea Luka (surgeon Voino-Yasenetsky) during the Great Patriotic War and in peacetime.
In October 1855, a meeting between two great scientists took place in Simferopol - Nikolai Pirogov and Dmitry Mendeleev. Famous chemist, author of the periodic law chemical elements and then modest teacher of the Simferopol gymnasium Dmitny Mendeleev, turned to Nikolai Ivanovich Pirogov for advice on the recommendation of St. Petersburg physician N.F. Zdekauer, who found Mendeleev to have tuberculosis and, in his opinion, the patient had several months left to live. Dmitry Mendeleev, a 19-year-old young man, shouldered a lot of work, and the damp climate of St. Petersburg, where he studied, had a negative impact on his health. Nikolai Pirogov did not confirm the diagnosis of his colleague, appointed necessary treatment and this brought the patient back to life. Subsequently, Dmitry Mendeleev spoke enthusiastically about Nikolai Ivanovich : “That was the doctor! He saw right through the person and immediately understood my nature.”
To Man, Fatherland and God
A great scientist, surgeon, statesman - he was a man of great Russian soul, combining uncompromisingness and kindness of heart, honesty of doubt and courage of faith.
«… We live on earth not only for ourselves; remember that a great drama is being played out before us, the consequences of which will echo, perhaps, centuries later; It’s a sin, with folded hands, to be just an idle spectator...”- wrote to his wife from besieged Sevastopol.
Having gone through a passion for atheism in his youth, he returned to God in his mature years, finding, by his own admission, at 38 years old, “the high ideal of faith” in the Gospel. He often “could not remain silent,” as Leo Tolstoy later defined this moral state. Afterwards, Pirogov exposed, wherever he could, the theft of quartermasters and other moral rot that he witnessed.
After the fall of Sevastopol, Nikolai Pirogov returned to St. Petersburg, where, at a reception with Alexander II, he reported on the incompetent leadership of the army by Prince Menshikov. The Tsar did not want to listen to Pirogov’s advice, and from that time on Nikolai Ivanovich fell out of favor and was forced to leave the Medical-Surgical Academy.
Pirogov actively opposed class boundaries in education and advocated the abolition of corporal punishment in schools. " Being human is what education should lead to.” "Contempt for native language disgraces national feeling." In a number of his pedagogical articles he warned about the onset corrupting "commercial aspiration" , which destroys the conciliarity of society and leads to painful mutual misunderstanding.
Appointed Trustee of the Odessa Educational District, Pirogov tries to change the school education system that existed in them, which led to a conflict with the authorities, and the scientist again had to leave his post. Many people disliked him. Among some of the bureaucrats he was known as a “red”, but even among extreme liberals he was a stranger. Trustee of the Odessa educational district Pirogov worked for almost two years, significantly improving the education system, and then he was transferred to the same position in Kyiv. However, his teaching career ended overnight in 1861, when Nikolai Ivanovich refused to establish police surveillance over some students , announcing that “The role of a spy is unusual for his calling.”
Sklifosovsky-in-the estate of Pirogov Cherry. Artist-A.-Sidorov
Having retired in 1861, he lived until the end of his life with his wife and two sons from his first marriage. in the Vyshnya estate near Vinnitsa. There was no question of idleness; on his estate he opened a hospital with 30 beds, built a pharmacy and pharmacy nearby and donated the land to the peasants. Almost daily operations, seeing dozens of patients, mostly free of charge - such was the happy old age of this irrepressible Russian genius. Suffering people from all over Russia flocked to Vishnya to see the “wonderful doctor” (as defined by Alexander Kuprin). Pirogov nursed, fed poor patients, and organized a Christmas tree for peasant children.
Vishnya Pirogov left his estate only at the invitation of St. Petersburg University to give lectures or abroad. In 1862-1866. supervised young Russian scientists sent to study in Germany. Nikolai Pirogov was a consultant on military medicine and surgery, went to the front during the Franco-Prussian War - 1870-1871, and the Russian-Turkish War of 1877-1878. By this time, Pirogov was already a member of several foreign academies and successfully operated by Giusepe Garibaldi.
Nikolai Pirogov, Vladimir Stasov, Maxim Gorky, Ilya Repin
In May 1881, the 50th anniversary was solemnly celebrated in Moscow and St. Petersburg scientific activity Pirogov. However, at this time great surgeon and the scientist was already terminally ill, and on November 23 1881, the great surgeon died on his estate in age 71 from cancer.
Tchaikovsky visiting Pirogov in Vishny. Hood. A. Sidorov
In 1879-1881. Pirogov worked on “The Diary of an Old Doctor,” completing the manuscript shortly before his death.
Shortly before his death, Nikolai Pirogov made another discovery - he proposed completely a new method of embalming the bodies of the dead
And own death he managed to immortalize himself.
In the village of Vishnya (now within the boundaries of Vinnitsa), Podolsk province, there is an unusual mausoleum: in the family crypt, in the church-burial vault of St. Nicholas the Wonderworker, rests the embalmed body of the world famous scientist, legendary military surgeon Nikolai Pirogov.
Scientists still cannot unravel the recipe by which Pirogov’s student embalmed Pirogov’s body.
A unique case in the history of Christianity - Orthodox Church, taking into account the merits of Nikolai Pirogov as an exemplary Christian and a world-famous scientist, she allowed not to bury his body, but to leave it incorrupt; permission to embalm the body was given by the Holy Synod, “so that the disciples and continuers of the noble and godly deeds of N.I. Pirogov could see his bright appearance.” During the post-mortem procedure The funeral service was performed by a priest. Then the body of the great surgeon in a ceremonial uniform with the Order of Stanislaus of the first degree and a sword donated by Franz Joseph was laid in the family crypt-mausoleum.
The monument to Pirogov in Moscow was erected in 1897. Sculptor V.O. Sherwood
Since then, people have come to the church in the unique Vinnitsa necropolis to worship the remains of the surgeon Pirogov, like holy relics , and ask for help and healing.
At the end of the 20s of the 20th century, Pirogov’s crypt was robbed by “Mist’s lads”. They damaged the lid of the sarcophagus, stole a sword and pectoral cross. During the Great Patriotic War, during the retreat of the Soviet army, the sarcophagus with the remains was hidden in the ground, after which the body had to be embalmed again. Nowadays it can be seen in the basement of an Orthodox church, under glass.
He became a worthy student and follower of Nikolai Ivanovich Pirogov Archbishop Luke (surgeon Voino-Yasenetsky) during the Crimean period of episcopal and professorial activity. At the turn of the 50s of the last century in Simferopol, he wrote a scientific and theological work entitled "Science and Religion", where he paid considerable attention spiritual heritage N.I. Pirogov.
Portrait of Nikolai Pirogov. Khud.-I.E. Repin. 1881
Portrait of Nikolai Pirogov, written by Ilya Repin, is in the Tretyakov Gallery. After Pirogov’s death, the Society of Russian Doctors was founded in his memory, and Pirogov congresses of Russian surgeons are regularly convened.
The memory of the great surgeon continues to this day. Every year on his birthday, a prize and medal are awarded in his name for achievements in the field of anatomy and surgery. The 2nd Moscow, Odessa and Vinnitsa medical institutes are named after Pirogov.
In 2015, at the XII Congress of Russian Surgeons, held in Rostov-on-Don, a decision was made to in memory of Pirogov, establish Surgeon Day on the birthday of Nikolai Ivanovich Pirogov - November 25.
Asteroid No. 2506 was named in honor of Nikolai Pirogov. A large star named Nikolai Pirogov shines in the heart of every compatriot who recognizes himself as Russian.
Nikolai Ivanovich Pirogov- Russian surgeon and anatomist, naturalist and teacher, creator of the first atlas of topographic anatomy, founder of military field surgery, founder of anesthesia. Corresponding Member of the St. Petersburg Academy of Sciences.
Nikolai Ivanovich was born in Moscow in 1810. As a fourteen-year-old boy, he entered the medical faculty of Moscow University. After receiving his diploma, he studied abroad for several more years. At the Professorial Institute at the University of Dorpat (now the University of Tartu), he brilliantly defended his doctoral dissertation and, at the age of only twenty-six, was elected professor at the University of Dorpat. A few years later, Pirogov was invited to St. Petersburg, where he headed the department of surgery at the Medical-Surgical Academy.
In 1847, he performed his first operation under ether anesthesia in the 2nd Military Land Hospital, on February 16 he operated under ether anesthesia in the Obukhov hospital, on February 27 in Petropavlovskaya (St. Petersburg). Having further tested etherization (ether anesthesia) on healthy people again, on himself and having the material of already 50 operations under ether anesthesia (using the latter in hospital and private practice), Pirogov decided to use ether anesthesia in military field surgery - directly in the provision of surgical care on the battlefield. At this time, the Caucasus was a constant theater of military operations (there was a war with the highlanders), and Pirogov left for the Caucasus on July 8, 1847, with the main goal of testing on large material the effect of ether anesthesia as an anesthetic.. In Ogly, where the wounded were placed in camp tents and there was no separate room for operations, Pirogov began to specifically operate in the presence of other wounded people in order to convince the latter of the analgesic effect of ethereal vapors. Such visual propaganda had a very beneficial effect on the wounded, and the latter fearlessly underwent anesthesia. Here, near Saltami, in a primitive “infirmary”, consisting of several huts made of tree branches, covered with straw on top, with two long benches made of stones, also covered with straw, the great surgeon had to operate on his knees in a bent position. Here, under anesthesia, Pirogov performed up to 100 operations. Thus, Pirogov was the first in the world to use ether anesthesia on the battlefield. During the year, Pirogov performed about 300 operations under ether anesthesia (in total, 690 of them were performed in Russia from February 1847 to February 1848). Pirogov outlined his research and observations in several articles: “Report on a trip to the Caucasus” in French; in Russian - “Report in 1849.” Personal experience Pirogov by this time was about 400 anesthesia with ether and about 300 with chloroform. Thus, main goal Pirogov's scientific journey to the theater of military operations in the Caucasus - the use of anesthesia on the battlefield - was achieved with brilliant success.
Plaster casts and the “principle of sparing treatment of the wounded.” N.I. Pirogov was the first in the history of military medicine to use a plaster cast on the wounded. He used it as a means of transport and therapeutic immobilization, and also used blind and removable bandages. The harmonious system of using gypsum as a means of immobilization, developed by N.I. Pirogov, retains its importance in modern military field surgery. The use of a plaster cast formed the basis of the principle of cost-saving treatment of the wounded developed by N.I. Pirogov. Before N.I. Pirogov, when providing assistance to victims, they proceeded from the need for urgent removal of foreign bodies (bullets, fragments) stuck in tissues, and early (primary) amputations for most gunshot fractures or joint injuries. The pursuit of foreign bodies, which were removed without an incision, through the wound entrance, entailed massive probing of fresh wounds and their examination with a finger, which in the conditions of the pre-antiseptic period gave especially disastrous results. It was believed that early amputation is the main means of preventing severe septic complications and providing the possibility of rapid evacuation of victims. In contrast, the saving method of treatment developed and introduced into the practice of military field surgery by N.I. Pirogov was based on a sharp reduction in indications for primary amputations and removal of foreign bodies from the wound, as well as on widespread use plaster cast in all indicated cases.
Sisters of Mercy. The name of N.I. Pirogov is associated with the world’s first involvement of women in caring for the wounded at the theater of military operations. Especially for these purposes, the “Exaltation of the Cross Community of Sisters for the Care of Wounded and Sick Soldiers” was founded in St. Petersburg in 1854. N.I. Pirogov and a detachment of doctors left for Crimea in October 1854. Following him, the first detachment of 28 nurses was sent. In Sevastopol, N.I. Pirogov immediately divided them into three groups: dressing nurses, who helped doctors during operations and with dressings; sister-pharmacists who prepared, stored, distributed and distributed medicines, and sister-housewives who monitored the cleanliness and change of linen, the care of the sick and housekeeping services. Later, a fourth, special transport detachment of sisters appeared, who accompanied the wounded during long-distance transport.
Attaching paramount importance to the problem of organizing assistance to the wounded in war. N.I. Pirogov in his works developed scientifically based principles of medical and evacuation support for military operations of troops. Pirogov’s ideas of planned provision of assistance to victims, the creation of a reserve maneuverable bed fund, training of personnel in self- and mutual assistance techniques, involving women in providing medical care in war, and many others have been further developed in modern conditions.
The experience of the Russian-Turkish war allowed N.I. Pirogov “to take the path of recognizing the importance of primary interventions under the guise of antiseptics” (V.A. Oppel). Pirogov introduced a number of antiseptic agents into practice, such as ethyl alcohol, tincture of iodine, silver nitrate, bleach, etc. Thus, we see that Pirogov is already close to the microbiological theory of infection.
The contribution of N.I. Pirogov to the maxillofacial and plastic surgery. He gained extensive experience in performing facial plastic surgery and was a pioneer in this field of surgery. In 1835, in a lecture on rhinoplasty, based on his rich practical experience, the scientist substantiated the value of plastic surgery on the face, providing not only the elimination physical disabilities, but also the normalization of mental aspects of human life. For 20 years, from 1836 to 1856, N.I. Pirogov performed about 40 rhinoplasties, while only 71 operations were performed all over the world before 1836. Acting as the manager of the St. Petersburg plant for military medical supplies (the former “tool hut”), N. I. Pirogov created various types of surgical kits, which contain instruments for maxillofacial operations, dental instruments.. By order of N. I. Pirogov was made a backpack with surgical instruments, which included: a dental key, an apparatus for ligating fractures of the lower jaw, a T-shaped head bandage, a facial bandage, a nasal bandage and other items.
N.I. Pirogov’s contribution to forensic medicine. N.I. Pirogov made a significant contribution to the development of forensic medicine with his works. In 1841, he compiled a special atlas “Anatomical images of the human body, intended primarily for forensic doctors.” N.I. Pirogov did a lot in the study of gunshot injuries in relation to the needs of forensic medical practice. The input and output signs he described for the first time gunshot wound are important for modern medicine(in 1849, he first described a tissue defect as a sign that allows one to distinguish between entry and exit bullet wounds, and to this day this sign is called N.I. Pirogov’s sign).
At the beginning of 1881, Pirogov drew attention to pain and irritation on the mucous membrane of the hard palate; on May 24, 1881, N.V. Sklifosovsky established the presence of cancer upper jaw. N.I. Pirogov died on November 23, 1881 in the village. Cherry, now part of Vinnytsia.
Pirogov enjoyed great love among the common people and the broadest masses of students. He was loved for his simplicity, good kinship and selflessness. He treated the poor and students for free, and often helped them financially. This wonderful doctor and scientist, teacher and social activist devoted his entire life to selfless service to domestic science and his people.
Nikolai Pirogov - a surgeon from God
The name of the Russian surgeon and anatomist Nikolai Ivanovich Pirogov is known not only to doctors, but also to all cultured people. Pirogov occupied the same place in the history of surgery as Mendeleev did in the history of chemistry, Pavlov in the history of physiology, and Lobachevsky in the history of mathematics.
Nikolai Pirogov was born in 1810 in Moscow into a poor family of a treasury official. He studied at Kryazhev's private boarding school. The boy loved it when a doctor came to visit them, Uncle Efrem - a famous Moscow doctor, professor at Moscow University, surgeon, anatomist and forensic physician Efrem Mukhin. Mukhin treated the Pirogov family and paid special attention, of course, to little Kolya. After his beloved doctor left, the boy threw a white towel over his shoulders, picked up a straw and, posing as a doctor, began treating the family. So, even as a child, Pirogov chose his profession. Imperceptibly, childhood fun grew into a real passion for medicine.
In 1824, Nikolai, under the influence of Dr. Mukhin, decided to enter the medical faculty of Moscow University. But the young man was only 14 years old, and they were accepted there from the age of sixteen! He had to take credit for two years. Nikolai Pirogov successfully entered the medical faculty of Moscow University. Student years young man took place in conditions quite unfavorable for the development of surgery. There were public demands to stop the “vile and ungodly use of man, created in the image and likeness of the creator, for anatomical preparations.” In Kazan, things came to the burial of the entire anatomical cabinet: coffins were specially ordered, all the preparations were placed in them, and after the funeral service the coffin was carried in a procession to the cemetery. This happened in Russia in the 19th century, although even at the beginning of the 18th century, Tsar Peter himself studied anatomy and bought anatomical preparations abroad, which have been partially preserved to this day. The teaching of anatomy at universities was not carried out on corpses, but, in particular, on handkerchiefs, by tugging the edges of which muscle functions were depicted.
In 1828, Pirogov graduated with honors from the university and defended his Ph.D. thesis. Among his teachers were the anatomist H. I. Loder, clinicians M. Ya. Mudrov, E. O. Mukhin. As the best graduate, Pirogov was sent to the University of Dorpat (now Tartu) to prepare for professorship.
Nikolai wanted to specialize in physiology, but due to the lack of this profile special training chose surgery. In 1829 he received a gold medal from the University of Dorpat for performing a competitive research in the surgical clinic of Professor Moyer. At the age of 22, Pirogov defended his doctoral dissertation. In 1833–1835, to complete his preparation for professorship, he improved his skills in anatomy and surgery in Germany, at the Langenbeck Clinic. Upon returning to Russia, he worked in Dorpat, and in 1836 he became a professor of theoretical and practical surgery at the University of Dorpat.
In 1841, Pirogov created a hospital surgical clinic of the St. Petersburg Medical-Surgical Academy and headed it until 1856, at the same time being the chief physician of the surgical department of the 2nd military land hospital, and from 1846 - director of the Institute of Practical Anatomy created at the Medical-Surgical Academy . When he turned 36 years old, Nikolai Ivanovich became an academician of the Medical-Surgical Academy.
In 1856, due to illness and home circumstances, Pirogov left his service at the academy and accepted an offer to take the position of trustee of the Odessa educational district; from this time begins a ten-year period of his activity in the field of education. Since 1862, Nikolai Ivanovich has been leading young Russian scientists who were preparing in Germany for teaching careers.
Since 1866, Pirogov lived on his estate in the village of Vishnya near Vinnitsa. But as a consultant on military medicine, he traveled to theaters of military operations during the Franco-Prussian (1870–1871) and Russian-Turkish (1877–1878) wars.
The scientific, practical and social activities of N. I. Pirogov brought him world medical fame, undeniable leadership in domestic surgery and nominated him among the largest representatives of European medicine of the mid-19th century. Nikolai Ivanovich worked in various areas medicine. He made a significant contribution to each of them, which has not yet lost its significance. Despite being almost two centuries old, Pirogov’s works continue to amaze the reader with their originality and depth of thought.
Pirogov’s classic works - “Surgical anatomy of arterial trunks and fascia” (1837), “ Full course applied anatomy of the human body" with drawings - descriptive-physiological and surgical anatomy (1843–1848) and "Illustrated topographic anatomy of cuts made in three directions through a frozen human body" (1852–1859). Each of these works was awarded the Demidov Prize of the St. Petersburg Academy of Sciences and was the foundation of topographic anatomy and operative surgery.
Nikolai Pirogov was the first among Russian scientists to come up with the idea of plastic surgery and the first in the world to put forward the idea of bone grafting. His method of connecting the supporting stump during amputation of the tibia at the expense of the calcaneus is known as the “Pirogov operation”; it served as an impetus for the development of other osteoplastic operations. The extra-abdominal access to the external iliac artery (1833) and the lower third of the ureter proposed by Pirogov also received wide practical application and was named after him.
Nikolai Ivanovich played an exceptional role in developing the problem of pain relief. Anesthesia was proposed in 1846, and the following year Pirogov conducted extensive experimental and clinical testing of the analgesic properties of ether vapor. He studied their effect in experiments on animals using various methods of administration and on volunteers, including himself.
On February 14, 1847, one of the first in Russia, the surgeon performed an operation under ether anesthesia, which lasted only 2.5 minutes; in the same month, for the first time in the world, he operated under rectal ether anesthesia, for which a special apparatus was designed. Pirogov believed that the possibility of using ether anesthesia on the battlefield had been indisputably proven.
Nikolai Ivanovich Pirogov made a significant contribution to the history of asepsis and antisepsis, which, along with anesthesia, determined the success of surgery in the last quarter of the 19th century. The surgeon carried out anti-putrefactive treatment of wounds using iodine tincture and silver nitrate solution, and constantly emphasized the importance of hygienic measures for the treatment of the sick and wounded. Pirogov also tirelessly promoted preventive direction in medicine.
Nikolai Ivanovich Pirogov's reputation as a practical surgeon was brilliant. Even in Dorpat, the young doctor’s operations amazed him with the boldness of his plan and the skill of his execution. At that time, there was no anesthesia, so they tried to do the operations as quickly as possible. For example, Pirogov removed a stone from the bladder or mammary gland in 1.5–3 minutes. During the Crimean War on March 4, 1855, at the main dressing station of Sevastopol, he performed 10 amputations in less than 2 hours. The authority Nikolai Ivanovich Pirogov had among the international medical community is evidenced, in particular, by his invitation for a consultative examination to the German Chancellor Otto Bismarck (1859) and the national hero of Italy Giuseppe Garibaldi (1862). The best European surgeons could not determine the location of the bullet in the body of Garibaldi, wounded at Aspromonte. Pirogov not only removed the bullet, but also cured the famous Italian.
Military medicine owes a lot to Pirogov: he created the scientific foundations of domestic military field surgery and a completely new section of military medicine - the organization and tactics of the medical service. In 1854–1855, during the Crimean War, Nikolai Ivanovich traveled to the sites of military operations and took part in organizing medical support for troops and in treating the wounded. He initiated the involvement of women in caring for the wounded at the front: this is how the sisters of mercy appeared. To familiarize himself with the work of dressing stations, infirmaries and hospitals in combat conditions, he later traveled to Germany (1870) during the Franco-Prussian War and Bulgaria (1877) during the Russian-Turkish War. Later, Pirogov summarized the results of his observations in his works.
Nikolai Ivanovich did not consider combat damage as a simple mechanical violation of the integrity of tissues; he attached great importance in the occurrence and course of combat injuries to general fatigue and nervous tension, lack of sleep and malnutrition, cold, hunger and other inevitable unfavorable factors of the combat situation, contributing to the development of wound complications and the occurrence of a number of diseases among active army soldiers. He spoke about two ways of developing surgery (especially military): expectant-saving and active-preventive. With the discovery and introduction of antisepsis and asepsis into surgical practice, surgery began to develop.
Pirogov is the founder of the doctrine of medical triage. He argued that triaging the wounded by urgency, extent of surgical care, and indications for evacuation was the main means of preventing “confusion and confusion” in medical institutions. To do this, he considered it necessary to have in medical institutions intended to receive the wounded and sick and provide them with qualified assistance, triage and surgical dressing units, as well as a unit for the lightly wounded, and triage hospitals on evacuation routes.
Of great importance not only for military field surgery, but also for clinical medicine in general, there were works by Pirogov devoted to the problems of immobilization and shock. In 1847, at the Caucasian theater of military operations, he was the first in military field practice to use a fixed starch bandage for complex fractures of the limbs. During the Crimean War, he also applied a plaster cast in the field for the first time (1845). Nikolai Pirogov described the pathogenesis in detail, outlined methods for the prevention and treatment of shock; the clinical picture of shock he described is classic and continues to be mentioned in surgical textbooks. He also described concussion, gaseous tissue swelling, and identified “wound consumption” as a special form of pathology, currently known as wound exhaustion.
Pirogov’s important achievement in the field of medical education is the opening of hospital clinics for 5th year students. He was the first to justify the need to create such clinics and formulate the tasks facing them. In 1841, a medical-surgical clinic began operating at the St. Petersburg Medical-Surgical Academy, and in 1842, the first hospital therapeutic clinic. In 1846, hospital clinics opened at Moscow, Kazan, Kiev and Dorpat universities with the simultaneous introduction of the 5th year of study for medical students. Thus, a reform of higher medical education was carried out, helping to improve the training of doctors.
Nikolai Ivanovich Pirogov sought to spread knowledge among the people and was a supporter of competitions that provided places for more capable and knowledgeable applicants. He defended equal rights to education for all nationalities, large and small, and all classes, and strove for the implementation of universal primary education and was the organizer of Sunday schools in Kyiv. In assessing the merits of the head of the department, he gave preference to scientific rather than pedagogical abilities and was deeply convinced that science is driven by method.
The outstanding surgeon died in 1881. After his death, the Society of Russian Doctors was founded in memory of Pirogov, which regularly convened Pirogov congresses. In 1897, in Moscow, a monument to Nikolai Pirogov was erected in front of the building of a surgical clinic on Tsaritsynskaya Street. In the village of Pirogovo (formerly Vishnya), where the crypt with the embalmed body of the surgeon has been preserved, a memorial estate museum has been opened. Over three thousand books and articles are dedicated to Nikolai Ivanovich Pirogov. His works on issues of general and military medicine, upbringing and education continue to attract the attention of scientists, doctors and teachers.
Meaning:
Anatomy became a practical school for Pirogov, which laid the foundation for his further successful surgical activities. His works formed the foundation of topographic anatomy and operative surgery.
Pirogov is rightly called the “father of Russian surgery” - his activities led to the emergence Russian surgery to the forefront of world medical science. His works on the problems of pain relief, immobilization, bone grafting, shock, wounds and wound complications, on the organization of military field surgery and the military medical service in general are fundamental. His scientific school is not limited to his immediate students: essentially all advanced surgeons of the 2nd half of the 19th century developed an anatomical and physiological direction based on the principles and methods developed by Pirogov.
His initiative in involving women in caring for the wounded, that is, in organizing the Institute of Sisters of Mercy, played important role in attracting women to medicine and contributed to the creation of the international Red Cross.
Pirogov first
– came up with the idea of plastic surgery,
– used anesthesia in military field surgery,
– applied a plaster cast in the field,
– suggested the existence of pathogenic microorganisms that cause suppuration of wounds.
What they said about him:
“Pirogov created a school. His school is the whole of Russian surgery... it was built by a mass of surgeons - academic, university, zemstvo, city, built by male surgeons, now it is built by female surgeons - and all these surgeons are grouped around the figure of the brilliant Pirogov"(V.A. Oppel).
“If only his pedagogical works remained from Pirogov, he would have remained forever in the history of science.”(N.A. Dobrolyubov).
“...In the darkness of the deep darkness of ignorance, in the darkness of the Russian night, the genius of Pirogov shone like a bright star in the Russian sky, and the radiance of this star, the radiant shine was visible beyond the borders of Russia... Even during the life of Nikolai Ivanovich, the learned European world recognized him, and recognized him not only as great a scientist, but in certain areas his teacher, his leader"(V.I. Razumovsky).
What he said:
“I believe in hygiene. This is where the true progress of our science lies. The future belongs to preventative medicine. This science, going hand in hand with medicine, will bring undoubted benefit to humanity.”
“Where the spirit of science reigns, great things are done with small means.”
“Every school is famous not for its numbers, but for the glory of its students.”
"War is a traumatic epidemic."
“It is not medicine, but the administration that plays a role in helping the wounded and sick in the theater of war.”
“The rod corrects only the faint-hearted, who would be corrected by other, less dangerous means.”
From the book 100 great mysteries of Russian history author Nepomnyashchiy Nikolai NikolaevichPirogov was dying of starvation. After walking several dozen steps down a steep staircase, you find yourself in a cool and dimly lit room. The lamps snatch from the twilight a sealed glass sarcophagus made at one of the military factories in Moscow, and in it -
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From the book Russian Istanbul author Komandorova Natalya IvanovnaMilitary surgeon I.P. Aleksinsky A hereditary nobleman, professor at Moscow University, Ivan Pavlovich Aleksinsky was evacuated to Constantinople with the troops of General Wrangel at the end of 1920. Famous personality, caressed by attention Grand Duchess Elizabeth
From the book The First Defense of Sevastopol 1854–1855. "Russian Troy" author Dubrovin Nikolay FedorovichNikolai Ivanovich Pirogov Professor, surgeon. After the Battle of Inkerman, the deplorable state of treatment and care for the wounded and sick was clearly revealed. In view of the urgent need to urgently improve this matter, the famous
From the book Imam Shamil [with illustrations] author Kaziev Shapi Magomedovich From the book Imam Shamil author Kaziev Shapi MagomedovichProfessor Pirogov The capture of Salta was Vorontsov’s first victory over Shamil. But the governor’s triumph was overshadowed by the fact that neither one nor the other took direct part in the battle. And also huge material losses (more than 12 thousand artillery shells were fired
From the book One Hundred Stalin's Falcons. In battles for the Motherland author Falaleev Fedor YakovlevichHero of the Soviet Union Guard Captain Pirogov V.V. “Free Hunt” of a bomber - a low torpedo bomber In December 1943, the German command, taking advantage of the length of darkness in the north, carried out transports in the Honningsvåg - Kirkenes section.
From the book We all had the same fate author Skokov Alexander GeorgievichSURGEON If tomorrow there is war, a child lives in anticipation of happiness, noted one Russian writer, wise from a long life, and the main thing in this happiness is, of course, the upcoming choice life path. In childhood, adolescence, everything is possible, you just need to be able to predict, feel with your soul
From the book One Hundred Stories about Crimea author Krishtof Elena GeorgievnaPirogov and sisters She walked next to a tall truck loaded with wounded. Quite recently, the dead were transported to the Count's pier in the same trucks, and then a non-commissioned officer, nicknamed Charon, transported them to the North side to be buried... Now between the South and North sides
