Traditional medicine

Scientific pediatrics. Fundamentals of clinical medicine in pediatrics

Pediatrics - according to the definition of the founder of Russian pediatrics S.F. Khotovitsky, given in 1847 - “is the science of the distinctive features in the structure, functions and diseases of the child’s body and, based on those features, the preservation of health and the treatment of diseases in children.”

In other words, the main task of pediatrics is to preserve or return (in case of illness) the child’s state of health, allowing him to fully realize his innate life potential.

“Health is a state of complete physical, mental and social well-being, and not just the absence of disease and physical defects,” is written in the Constitution of the World Health Organization (WHO).

More than 100 years ago, the outstanding Russian pediatrician M.S. Maslov (1961) defined the tasks of pediatrics as follows: “Being the science of the growing and developing human body, pediatrics, based on an in-depth study of the characteristics of the child’s body at different age periods, has as its main goal the creation of the best conditions for its comprehensive development and the greatest resistance to harmful factors. . Therefore, the main direction of pediatrics is preventive.”

The tasks of preventive medicine are the restoration of health in healthy people according to the formula: healthy parents - healthy lifestyle and work - healthy child (A.M. Razumov).

Researchers have proven that a child is a constantly developing organism from birth to adulthood.

Children experience 6 “critical” periods in their development, during which the likelihood of damage to the body and the development of diseases is highest:

1. The most dramatic period is the stage of intrauterine development of the embryo (1st trimester of pregnancy) and fetus (3rd trimester of pregnancy). At this time, there is a high probability of death of the nascent organism, the occurrence of congenital anomalies and intrauterine infections.

2. Neonatal period (0-28 days of life). By the time of birth, the child’s developed vital organs and systems ensure his independent existence.

3. Infancy period – from 28 days to 1 year. A very important and responsible time. By the age of one year, the baby is already a conscious being, actively responding to everything around him. The child’s weight is already 3 times greater than at birth, and his height has increased by 25 cm.

4. Toddler age – from 1 to 3 years. During this period, basic skills and functions are mastered - speech develops, the child begins to understand a lot, dresses himself, and becomes more and more interested in the world around him. A lot during this period depends on the proper upbringing of the child.

The early preschool period - from 3 to 7 years - is characterized by the formation of the higher nervous system, most biochemical parameters, accelerated growth, the formation of chronic diseases, and neuroticism. It is very important to help the child develop correctly and harmoniously.

5. School age is a crucial time for the formation of the human personality. We need to help the child develop character, choose a job he likes and determine a profession for his future life. And here the teacher and parents can have a good assistant - a pediatrician.

6.Adolescence – from 15 to 18 years – is an extremely important period of growing up. In the body of a teenager, a significant restructuring of many functional systems occurs, and puberty begins. It is accompanied by significant changes in the endocrine system, with normal or even delayed development of other systems - the central nervous system, cardiovascular system, etc. Such “scissors” can cause various functional disorders - instability of blood pressure, headaches, pain in rapidly growing bones , cardiac weakness during physical overload, etc.

A pediatrician is the most important doctor for the baby and his mother, as he takes responsibility for the health of your child. A pediatrician is a doctor, a consultant, and even a teacher for parents. The pediatrician’s task is to teach the mother to understand her baby and know the characteristics of his age. A mother who knows how to correctly assess her child’s condition is the best assistant for a pediatrician. In the process of communication between the pediatrician and the baby’s parents, mutual understanding and trust play a decisive role.

A regular doctor who knows the individual characteristics of your child will be able to give clear and specific recommendations. The child and mother should not be afraid to consult a doctor again, because this particular visit may be especially important.

Pediatrics occupies a special place in medicine.

It is the pediatrician who assesses the neuropsychic and physical development of the little patient and evaluates his school maturity.

During the appointment, the doctor determines which health group the children belong to, selects the most favorable recommendations regarding feeding the child and raising him; implements measures to prevent chronic diseases.

A pediatrician's examination for a child can be planned or unscheduled.

Scheduled inspection:

Before the birth of the child: when registering at the antenatal clinic for pregnancy, the expectant mother is sent to the pediatrician for prenatal care;
- after discharge from the maternity hospital, the child is observed by a pediatrician and a visiting nurse. sister 4 times during the first month;
- up to 1 year of age, a child visits a children's clinic every month on Healthy Child's Day, where he is examined by a pediatrician, anthropometric data and neuropsychic development are assessed, recommendations are given on rational feeding of the child, and routine preventive vaccinations are carried out. According to a certain schedule, the child consults with specialized specialists, undergoes laboratory and ultrasound diagnostics;
- from 1 year to 2 years – regularity of examinations once every 3 months (1 year 3 months; 1 year 6 months; 1 year 9 months; 2 years).
- from 2 to 3 years – frequency of examinations – 2 times a year;
- after 3 years, the child undergoes a routine medical examination once a year. In order to detect tuberculosis infection, all children under 18 years of age undergo an annual Mantoux test, and from the age of 15 years, fluorography of the chest organs.

An unscheduled examination by a pediatrician for any symptoms:

Increased body temperature; - catarrhal phenomena (cough, shortness of breath, hoarseness); - headache, abdominal pain, pain in joints, lower back, spine; - rash on the skin; change in stool (diarrhea, constipation); - disturbance of consciousness; - lethargy, increased fatigue or excitability, restless behavior; - belching, vomiting, flatulence, intestinal colic; - speech development disorder; - violation of physical development; - fading or cessation of skills that the child has already acquired, etc.

Diseases in children occur differently than in adults; in the treatment of children, different dosages of drugs are used than in adults. Some drugs are not acceptable for treatment in pediatrics. Children are more likely to experience complications from illnesses than adults.

Pediatrician Elena Viktorovna Yaroslavtseva will be happy to answer all your questions. Make an appointment by calling 722-722.

The profession of “pediatrician” is one of the most difficult and responsible in medicine, because it involves interaction with the youngest patients who are not yet able to explain what and where they hurt, are very vulnerable, fragile and vulnerable. In order to cope with their work adequately, doctors have to look for an individual approach to each child, which is not at all easy. This profession requires good communication skills with people, because a good pediatrician always knows what to tell parents to reassure them, and how to support patients so that they are not afraid of the upcoming treatment and believe in their speedy recovery.

Pediatrics is a branch of medicine that studies childhood diseases, physiology and anatomy of the child’s body. It also implies the development of new methods of treatment and prevention, and has several varieties.

The term “pediatrics” itself came to us from the Greek language, and it was formed from two words - paidos, which means “child” or “child”, and iatreia - “treatment”. Its main goal is to preserve or return the child to normal health.

Today, pediatric medicine includes many areas: oncology, hematology, surgery, therapy, and many others. In turn, the pediatrician is responsible for therapy. His responsibilities also include examining sick children, making a diagnosis, treatment, as well as carrying out preventive measures to protect the child from the occurrence of various diseases.

Pediatrics is conventionally divided into several categories: clinical, scientific, social, environmental and preventive.

Types of pediatrics:

Clinical pediatrics. Involves diagnosis, treatment and further rehabilitation of the patient. This is what children and their parents most often have to deal with.
Scientific pediatrics. She sets the formulation of paradigms that other pediatricians can use in their work; in essence, she deals with the theoretical component.
Social pediatrics. Aimed at optimizing the organization of health care management, the practice of medical care, carrying out preventive measures among the population, establishing relationships between public organizations and foundations, and so on.
Environmental pediatrics. Necessary for studying the influence of natural factors on children's health, including climatic and geographical ones, in different regions.
Preventive pediatrics. Aimed at preventing diseases and disability.

Pediatrics, as a separate branch of medicine, appeared not so long ago, but nevertheless, the first advice regarding child care is found in ancient works by other prominent scientists and physicians. Pediatrics began to be identified as a separate science only in the second half of the 19th century.

The first printed manuals describing childhood diseases began to appear in the 15th-17th centuries in Europe. Two centuries later, the first hospitals for children were created, staffed by doctors who dealt exclusively with childhood diseases. Towards the end of the 19th century, a school was founded in Paris that trained qualified pediatricians. In the 20th century, other countries also picked up this idea and began to create their own pediatric schools.

The first Russian pediatrician's name was S.F. Khotovitsky. He not only practiced, but also made a significant contribution to the promotion of pediatrics in Russia. In 1836, he taught a course on childhood diseases at the St. Petersburg Medical-Surgical Academy. He also published the first manual on childhood diseases called “Pediatrics” in 1847.

In 1834, the first hospital for children appeared in St. Petersburg, which was named Nikolaevskaya, and in 1842 the Olginskaya children's hospital was opened in Moscow. In 1869, the first department of childhood diseases in Russia was opened at the Medical-Surgical Academy.

The work of a pediatrician is very important and responsible, since it is this doctor who monitors the health of little people from the first days of their lives. He monitors development, tells parents how to properly care for their child in order to avoid the occurrence of various unpleasant diseases, and also provides the necessary medical care, both at home and in his office.

Pediatricians specialize in children of different ages and are divided into those who deal exclusively with newborns, that is, babies up to 28 days old, and those who care for older children, including teenagers.

In order to become a really good pediatrician, it is not enough just to have a medical education and understand their specialization, because these doctors have to work with the youngest patients, who most often cannot explain what and where they hurt. You must be attentive and responsible, sincerely love children, have a stress-resistant character and patience. A good pediatrician is not only a reliable doctor, but also a good person who knows how to approach his patients.

In his work, it is important to know all the features of the child’s body and the clinic of their diseases, understand the properties and characteristics of various medications, know Latin at the proper level, and also have good communication skills. Only with these qualities will a pediatrician be able to do his job well and help his patients.

MINISTRY OF HEALTH OF UKRAINE

KHARKIV STATE MEDICAL UNIVERSITY

Department of Propaedeutics and Pediatrics No. 2

Pediatrics as a science, its place, stages of development

Completed:

3rd year student,

1 medical faculty,

Kachan B.B.

Teacher: Associate Professor Shmulich V.K.

Kharkov – 2007

Plan:

Pediatrics as a science
The place of pediatrics in world science and the stages of its development

3. Conclusions

4. References

1. Pediatrics as a science
Pediatrics (from Greek pais, genus paidos - child, iatreia - healing) studies the patterns of development of children, the causes and mechanisms of diseases, methods of their recognition, treatment and prevention. Therefore, it can be defined as medicine during the period of growth, formation and development of the human body, which is the most responsible in human life. This is the so-called progressive stage in the human life cycle. That is why the humanism of this specialty and the responsibility of a person who has chosen pediatrics as his profession are unusually great.

The pediatrician is in constant communication with the child and his parents, as well as with grandparents. A pediatrician must be a good psychologist and teacher. This will allow him to gain authority among parents and relatives so that their joint efforts can be directed towards proper development, and in case of illness, towards the rapid recovery of the child. The origins of many adult diseases begin in childhood. Therefore, what will be the childhood and the conditions for the growth and upbringing of the child, such will be the health status of an adult.

Teaching pediatrics at pediatric faculties of medical institutes begins with the third year, in which the propaedeutics of childhood diseases is studied. This is actually the first department that provides students with professional training. Since pediatrics studies the period of growth and development of a child, it becomes clear that at each age stage of his life, a child is characterized by special morphological, physiological and psychological qualities. Therefore, knowledge of the clinical anatomy and physiology of children of different ages is the basis for understanding the uniqueness of research methods and evaluating the results obtained. In addition, taking into account the basic anatomical and physiological characteristics allows us to determine the specific organization of the environment and lifestyle, as well as nutrition of children of different age periods

The Department of Propaedeutics of Childhood Diseases also studies the semiotics of the main lesions of various systems and the body as a whole. Since a systematic presentation of nosologenic forms of childhood diseases is already the subject of the main course in pediatrics, when studying propaedeutics, diagnostic issues are considered in two more general aspects. Firstly, this is symptomatic diagnosis, based on knowledge of the age norm and research method and pursuing the goal of establishing the presence of a pathological symptom; secondly, it is a syndrome diagnosis, that is, a statement of the pathophysiological connection between several symptoms of the disease and a reflection in this connection of the functional insufficiency (decompensation) of a given physiological system.

The objective of the course also includes the student’s mastery of child care techniques and medical manipulations and procedures within the scope of the skills of a nurse.

In more senior courses, teaching of pediatrics will be carried out not only in the departments of pediatrics, but also in special departments (childhood infections, pediatric surgery, pediatric neurology, pediatric otolaryngology, pediatric ophthalmology, etc.)

The effectiveness of self-education and the subsequent growth of qualifications are largely determined by how firmly one was able to master the basic medical and biological disciplines at the university stage of study. They form the foundation for subsequent clinical training and improvement. The opportunities for self-education of a pediatrician are great and varied. This is, first of all, constant work on scientific literature and, first of all, reading scientific pediatric journals, manuals and monographs. A very important role in improving the knowledge of pediatricians is played by their participation in the work of local branches of the All-Union Scientific Society of Children's Doctors, created in all republics, regions and large cities of the country. To be a member of this society is a matter of professional honor for every Soviet pediatrician.

Pediatrics is not only a field of medical science, but also the name of the main medical specialty in the state system of child health care. Pediatricians implement the main achievements of medical science and carry out practical measures to ensure and control the harmonious development of children, to recognize, treat and prevent their diseases. The workplaces of pediatricians are children's institutions (nurseries, nurseries, kindergartens, schools, children's homes, pioneer camps), children's clinics, children's hospitals (general and specialized), pediatric ambulance teams, children's wards of maternity hospitals, various consulting rooms and dispensaries, children's sanatoriums.

2. The place of pediatrics in world science and the stages of its development
The beginning of the doctrine of the child is usually attributed to the 4th century BC, to the time of writing the book “On the Nature of the Child” by the father of medicine, Hippocrates. Following Hippocrates, Celsus, Galen and Soranus (1st and 2nd centuries) write about children, their care and education. Over the next 15 centuries, what was outlined by Galen and Soranus was repeated. Treatment of children during these years was carried out according to the same principles as adults, or was not carried out at all. Only in the 15th-18th centuries did interest in the treatment of children and its characteristics awaken again. This is due to the very high infant mortality rate, the emergence of charitable organizations and the creation in some European countries of orphanages or shelters for foundlings and street children. A large number of works devoted to the upbringing and care of children appear. In 1650, the scientific work of the English physician Glisson on rickets was published, this work was followed by a series of publications by Sydenham, Habergen, and Jenner devoted to the study of infectious diseases in children. Approximately 100 years after Glisson's work, the first manual on pediatrics is published in 28 chapters. It was written in 1764 by the Swedish physician Neil Rosen von Rosenstein. 30 years later, his manual was published in Russia in Russian.

After the opening of the first children's hospitals, there was an intensive growth in the number of scientific research in the field of pediatrics and the formation of schools of pediatricians. The first children's hospital in the world was the Paris Children's Hospital, which opened in 1802. Somewhat later, the German school of pediatrics appeared. Its centers are Vienna and Berlin. German pediatricians chose the biochemical and microbiological aspects of childhood diseases, as well as nutrition issues, as the main direction of their research. In the second half of the 19th century, scientific and clinical pediatric centers also began to function in England, Switzerland, Italy, the Scandinavian countries and the USA.

In Russia, the sequence of events was very similar to what happened in Europe. In 1727, Peter I issued a decree “On the construction of hospitals in Moscow for the placement of illegitimate infants and on giving them and their nurses a cash salary.” M.V. Lomonosov in his letter “On the reproduction and preservation of the Russian people” points out the need to create public almshouses for illegitimate children and publish instructions on curing childhood diseases. However, educational houses were opened only in 1763 in Moscow and in 1771 in St. Petersburg thanks to the persistence and energy of I. I. Betsky, who himself drew up designs for these houses and wrote instructions on the care and education of children.

The beginning of the formation of pediatrics as an independent scientific discipline occurs within the framework of other, closely related medical specialties. This is therapy and, above all, obstetrics. Of the therapists, the first to read the issues of childhood diseases were Moscow University professors S. G. Zybelin and G. I Sokolsky. Of the obstetricians, the greatest contribution to the development of pediatrics and its formation as an independent discipline was made by N. M. Maksimovich-Ambodik, S. F. Khotovitsky and N. A. Tolsky. The lectures and the book by Maksimovich-Ambodik, “The Art of Midwifery, or the Science of Babishing,” presented valuable thoughts about the characteristics of children and methods of caring for them.

Professor-obstetrician of the Medical-Surgical Academy in St. Petersburg (now the Military Medical Academy) Stepan Fomich Khotovitsky was at the same time the first Russian pediatrician scientist. During 1831 -1847 1st year. he taught an independent course on childhood diseases, in 1842 he opened children's wards in the clinic of obstetrics, women's and children's diseases, and in 1847 he published the first Russian textbook on pediatrics - “Pediatrics”.

The first children's hospital in Russia was opened in St. Petersburg in 1834. Currently it bears the name of N. F. Filatov. At the time of its opening, this hospital was the second children's hospital in Europe. After 8 years, a children's hospital in Moscow begins to operate (now also the hospital named after N. . F Filatova), and 2 years later, in 1844, the world's first hospital specifically for young children opened in St. Petersburg (now the L. Pasteur Hospital).

The date of birth of the first Russian department of pediatrics can be considered 1865, when a separate course of childhood diseases was assigned to Professor V. M. Florinsky at the Medical-Surgical Academy. Since 1870, Nikolai Ivanovich Bystroe (1841 - 1906) worked at this department. N.I. Bystroe in 1885 organized and was the first chairman of the Society of Children's Doctors of St. Petersburg. He trained many students who later became professors and founded other departments of pediatrics in the country.

In Moscow, giving a course of lectures on pediatrics began in 1861, associate professor of the department of obstetrics, and later professor Nikolai Alekseevich Tolsky (1830-1891). After 5 years, he opened a small children's clinic (11 beds) as part of the faculty therapeutic clinic of the university. Thus, in Moscow, simultaneously with St. Petersburg, the Department of Pediatrics appeared.

In those same years, the activities of the most prominent doctor and public figure Karl Andreevich Rauchfus (1835-1915) developed in St. Petersburg. Hospitals were built according to his designs in St. Petersburg (now the hospital bears his name) and in Moscow (now the I.V. Rusakov Hospital) . These were the first hospitals in the country designed according to the requirements of hospitalization of children with multidisciplinary pathologies. The first of these hospitals was led by K. A. Rauchfus until the end of his life. He trained a large number of pediatricians dedicated to their work. His works on heart defects in children and the organization of pediatric care were included in the fundamental three-volume manual on pediatrics, created by a team of European authors edited by Gerhardt (1877).

A significant contribution to the development of domestic pediatric science was made by N. I. Bystrov’s successor in the Department of Pediatrics of the Medical-Surgical Academy, a student of N. A. Tolsky, Professor Nikolai Petrovich Gundobin (1860-1908). He and his students in a short time accumulated a large amount of scientific material on the anatomical and physiological characteristics of children, and on this basis N.P. Gundobin published a fundamental work that has not lost its value to this day - “Peculiarities of Childhood.” In addition to this book, he wrote the popular guide “General and Special Therapy of Childhood Illnesses,” which went through several editions.

The most striking mark in the history of our pediatric science was left by the activities of the most talented doctor and teacher, N.A. Tolsky’s successor in the Department of Pediatrics at Moscow University, Nil Fedorovich Filatov

^ S F Khotovitsky I I Bystroe

(1847-1902) His erudition, medical logic and observation gained deep respect and gathered dozens of talented students around him. He was the first to describe the clinical picture of scarlet fever and glandular fever (infectious mononucleosis), as well as an early sign of measles - pityriasis-like peeling of the mucous membrane of the lips and stripes of the mouth. He was one of the first to understand the significance of atelectasis in the occurrence of pneumonia and described heart damage in scarlet fever in children. The most vivid memory of the activities of this outstanding clinician remained his books, which are still read and popular. These are “Semiotics and diagnosis of childhood diseases”, “Lectures on acute childhood infections”. “Clinical lectures”, “A short textbook of childhood diseases”. All of them were translated into many European languages and brought

^ N. A. Totsky and K. L. Rauchfus

Before the Great October Socialist Revolution, there was no state care for children in Russia. The first more or less accurate data on child survival in 1845 indicate that out of 1,000 children born, only 367 survived until the age of 15, and in certain regions of the country even more less. The causes of child mortality, according to the conclusion of the Botkin Commission in 1886, were “intestinal infections, poor quality, inappropriate, untimely feeding and complete lack of child care”

Infant mortality (the number of deaths per 1000 children born during the first year) in 1913 reached terrifying proportions - 273 The well-known figure in zemstvo medicine, P. I. Kurkin, wrote "It can hardly be disputed that in a country where the value of life in general is low, there is no The life of a child can also be highly valued.” There were 23 children’s clinics throughout Russia, and they were mainly located in large cities (Moscow, St. Petersburg, Kiev, etc.), and the total bed capacity for children over the 80 years of the existence of children’s hospitals in Russia reached that level. At the time, there were only 750 beds. The mortality rate of women in childbirth and mothers was extremely high. This clearly illustrates the complete lack of involvement of the state in protecting the health of children and the people as a whole under tsarism.

The draft Program of the Russian Social Democratic Labor Party, developed by V.I. Lenin in 1894 and adopted in 1903 at the Second Congress of the RSDLP, outlined the main provisions for the protection of motherhood and childhood. The practical implementation of these measures began after the Great October Socialist Revolution. In November 1917, the People's Commissariat of State Charity was created, within which a special board was formed, whose responsibilities include the development of urgent measures for the protection of motherhood and childhood. January 31 (February 13), 1918 the corresponding resolution, in the development of which N. K. Krupskaya and A. M. Kollontai took part, and was advised and edited by V. I. Lenin. It read: “All large and small child-serving institutions of the Commissariat of State Charity, from educational homes in the capitals to modest village nurseries, all of them, from the date of publication of this decree, merge into one state organization and are transferred to the jurisdiction of the department for the protection of motherhood and infancy, so that , forming an inextricable link with institutions serving pregnancy and maternity, to accept from them the glory of Russian clinical thought. In the USSR, a prize was established for the best works in pediatrics named after N. F. Filatov. In Moscow, a monument to N. F. Filatov was erected with the inscription “Friend of Children.”

Children's clinics and pediatric departments were created gradually in many cities and regions of Russia. In Kazan, the Department of Pediatrics was headed by Professor N.A. Tolmachev, in Kiev - Professor V.E. Chernov, in Kharkov - Professor I.V. Troitsky, in Odessa - Professor V.F. Yakubovich, in Yuryev (now Tartu) - Professor V. . P. Zhukovsky, in Saratov - professor I. N. Bystrenin.

An important feature of pediatrics in the last pre-revolutionary decade was the growing interest in the youngest age. In 1908 in Moscow, on the initiative of G.N. Speransky, the first consultation for infants was opened, and in 1910 - the first hospital for infants, in 1913 - a department for infants in the Morozov Children's Hospital (now Children's Clinical Hospital No. 1). Since that time, the proportion of young children in all children's clinics and hospitals in Russia has increased significantly.

Thus, the pre-revolutionary period of development of pediatrics is significant primarily for the names of outstanding domestic scientists and doctors who, with their talent, ensured the accumulation of knowledge about age-related physiology and diseases of childhood and won Russian science world recognition and priority in many areas of pediatrics. During this period, the main scientific schools arose and at the same time the unity of Russian pediatrics was determined, its social and humanistic moral platform was formed, aimed at solving a wide range of problems in protecting the health of mothers and children. A unique result of the development of pediatrics in the country was the First All-Russian Congress of Children's Doctors held in 1911, which discussed issues of care for newborns. Through the efforts of leading pediatricians and public figures, various societies and charitable movements were created, the purpose of which was to provide assistance to the country's child population in distress. Thus, in 1904, the St. Petersburg Union for the Fight against Infant Mortality was created, in 1909 - the Society for the Fight against Infant Mortality in Moscow, in 1913 - the All-Russian Trusteeship for the Protection of Motherhood and Infancy.

From the first days of the Soviet state, purposeful, huge-scale activities were launched to create the world's first state system of assistance to mothers and children. This happened in a climate of civil war and severe devastation, when the government had to solve thousands of seemingly more important problems on which the very fate of the socialist republic depended. On the 6th day of the establishment of Soviet power, a law on social insurance is signed, according to which women are guaranteed paid maternity leave, and mothers are given the right to leave work every three hours to breastfeed their children. The Party Program adopted by the VIII Congress of the RCP(b) identified tasks for the development of maternal and child health. The main principle of the development of Soviet healthcare was proclaimed - its preventive orientation. In February 1919, the Council for the Protection of Children was created under the leadership of A.V. Lunacharsky, special children's funds were formed, free meals for children were organized in schools and child care institutions. The network of children's institutions was rapidly developing, the network of children's institutions was expanding. hospitals.

The VIII Extraordinary Congress of Soviets on December 5, 1936 adopted the Constitution of the USSR, which contained a number of articles related directly to healthcare, in particular to protecting the interests of mothers and children. During the Great Patriotic War, the Decree of the Presidium of the Supreme Soviet of the USSR was issued “On increasing state assistance to pregnant women, large and single mothers, strengthening the protection of motherhood and childhood, establishing the honorary title “Mother Heroine” and establishing the Order of “Maternal Glory” and the medal “Medal” motherhood" In 1960, the Central Committee of the CPSU and the Council of Ministers of the USSR adopted a resolution "On measures to further improve medical care and health protection of the population of the USSR." In the Party Program adopted at the XXII Congress of the CPSU, concern for the health of the entire population was further developed

A big event was the adoption by the session of the Supreme Soviet of the USSR on December 19, 1969 of the law of the Union of Soviet Socialist Republics “On approval of the Fundamentals of Legislation of the USSR and Union Republics on Health Care.” During 1970-1971, the legislation of the Union republics was brought into line with this law. This was another stage of improving legislation. In Law V, its section is devoted to the protection of motherhood and childhood.

In the new Constitution adopted in 1977, the protection of public health was further developed, including legal, material and moral support for motherhood and childhood, including the provision of paid leave and other benefits to pregnant women and mothers

A manifestation of the concern of the Party and the Government was the resolution of the Central Committee of the CPSU and the Council of Ministers of the USSR “On measures to further improve public health care” dated October 15, 1977. The honorary title “People's Doctor of the USSR” was established. A new manifestation of concern for the health of children and adolescents is the resolution of the Central Committee of the CPSU and the Council of Ministers of the USSR “On measures to strengthen state assistance to families with children” (1981). Partially paid additional leave was introduced for mothers with preservation of their place of work until the child reaches age

1 Resolution of the People's Commissariat of State Charity of the RSFSR on the protection of infancy in the country - In the collection Formation and development of healthcare in the first years of Soviet power - M Medicine, 1966.
3. Conclusions
Currently, our country has many research institutes and many pediatric departments in medical institutes, which employ a large number of doctors and candidates of medical sciences and researchers.

The opening of the All-Union Center for Maternal and Child Health in Moscow is of great importance for the intensification of pediatric research in our country.

Pediatrics of recent decades has been an extremely dynamic field of knowledge; the growth of information, the revision of previously existing points of view, the introduction of new research and treatment methods are occurring at an increasing speed. This is primarily due to both the rapid development of fundamental theoretical sciences in medicine (physiology, biochemistry, genetics, immunology), and the development of purely clinical concepts, accumulation and generalization of collective medical experience.

References:

Mazurin A.V., Vorontsov I.M. “Propaedeutics of childhood diseases” - Medicine, 1985 – 432 pp.
N.P. Shabalov “Childhood diseases” textbook 5th edition in two volumes. “Peter” - 2002 – 832 s

The main task is to study the patterns of development of children, the causes and mechanisms of diseases, methods of their diagnosis, prevention and treatment.

Subject of study

age characteristics of children of early and preschool age;
physical and NP development of children;
diseases, their diagnosis, treatment and prevention.
assistance in case of accidents and injuries.

Areas of pediatrics:

Preventive pediatrics

A system of measures aimed at the prevention of childhood diseases (professional vaccinations, asepsis, professional rickets, screening programs to identify inherited diseases, etc.)

Clinical pediatrics- This section is aimed at diagnosis and treatment.

Scientific Pediatrics has the task of formulating the paradigms that guide the pediatrician in his work.

Social pediatrics as a branch (component) of pediatrics, it studies the health of children, the complex of factors that determine it, and also develops an effective system of social prevention and provision of medical care to the child population.

Environmental Pediatrics studies the influence on the health of children of natural factors: climatic, geographical, as well as harmful environmental factors in a particular region (insecticides, pesticides, phenol, dioxide, sulfur dioxide, lead, penetrating radiation, etc.)

The history of the development of pediatrics consists of 3 stages.

Stage 1 is associated with Hippocrates, Celsus, Galen. The first writings on the nature of the child. During the Middle Ages, orphanages were opened (the first one opened in 787)

Stage 2, state educational homes and orphanages were created - 1638-1707. 1650 - scientific work on rickets. 1764 - the first manual on pediatrics.

Stage 3, pediatrics was considered as a science. 1802 - the first children's hospital in Paris. 1834 - the first children's hospital in Russia. 1842 - the first children's hospital in Moscow.

1847 - the first Russian manual on pediatrics “pediatrika”, written by S.F. Khotovitsky.

Khotovitsky Stepan Fomich - the first Russian pediatrician, formed the right of pediatrics to independent existence. Organized the first systematic course in pediatrics in Russia.

1865 - the first department of pediatrics in Russia, Vasily Markovich Flovinsky in St. Petersburg.

Nim Fedorovich Filatov is the father of clinical pediatrics, its founder. Wrote “Semiotics and diagnosis of childhood diseases”, “Semiotics and diagnosis of infectious diseases”, “A short textbook of childhood diseases”, “Clinical lectures”.

Socialist period 1964 - 1985:

social protection of motherhood and childhood
reduction in infant mortality
vaccination

Perestroika period 1985 - 1991:

increase in infant mortality
increase in perinatal pathology, VAR
increase in the incidence of schoolchildren
increasing social deprivation among adolescents

Modern pediatrics is characterized by the formation of the Union of Pediatricians of Russia in 1994. Solving the problems of protecting the health of mothers and children.

Submitting your good work to the knowledge base is easy. Use the form below

Students, graduate students, young scientists who use the knowledge base in their studies and work will be very grateful to you.

Posted on http://www.allbest.ru/

GBOU VPO OrGMA MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF RUSSIA

DEPARTMENT OF NATIONAL HISTORY

Pediatrics as an independent science

Completed:

student 116 gr.

Zhanetova M.K.

Checked by: assistant

A.E. Esbusinova

ORENBURG, 2013

Introduction

1. The emergence of pediatrics

2. Founder of pediatrics S. F. Khotovitsky

6. Contribution of A.A. Kisel to the development of Soviet pediatrics after the Great Socialist Revolution

7. The emergence of the Center for Pediatric Research (G.N. Speransky)

8. Opening of the Institutes for the Protection of Child and Adolescent Health in Leningrad, the Research Institute for the Protection of Maternal and Child Health in Moscow

9. History of pediatrics in the Western Urals

10. Differentiation and integration of the main branches of pediatric medicine (pediatric surgery, neuropathology, psychiatry, ophthalmology, neonatology, perinatology, allergology, etc.)

Conclusion

Introduction

Relevance. Pediatrics is a modern branch of medicine that deals with the study of children's diseases and their treatment. It plays an integral role in modern medicine and is a significant part in the destiny of a growing person.

Objectives: pediatrics science physiological anatomical

1. To trace the development of pediatrics as an independent science from its foundation to the present day.

2. Determine the importance of pediatrics and its leading representatives.

3. Show the importance of domestic scientists for the development and establishment of pediatrics.

Medicine represents practical activities and a system of scientific knowledge about preserving and strengthening people’s health, treating patients and preventing diseases, and achieving longevity in human society in conditions of health and performance.

Medicine developed in close connection with the entire life of society, with the economy, culture, and worldview of people.

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 - links in the chain of historical development. Studying helps to better understand the present and provides a scale for assessing it.

At the same time, knowledge of the patterns of the previous development of any phenomenon and an understanding of its current state help to better understand and scientifically anticipate (predict) the paths of its development in the future. The history of medicine clearly shows the shifts and fundamental changes that took place in it in connection with changes in the life of society. Particularly profound changes in medicine occurred in our country after the Great October Socialist Revolution and the associated radical changes in all areas of public life and culture.

The treatment of childhood diseases has long been associated with the practice of obstetrics and the development of ideas about contagious diseases. This is evidenced by the ores of outstanding doctors of the ancient world (Sorana of Ephesus, Galen) and the Middle Ages (Abu Bakr ar-Razi, who gave a classic description of smallpox and measles, Ibn Sina and others). Special works on children's diseases began to appear at the end of the 15th - beginning of the 16th centuries.

1. The emergence of pediatrics

Pediatrics as a branch of medicine has emerged recently. The independent profession of pediatrician is also relatively young. However, short articles and proposals on feeding children, caring for them, and treating them are found in ancient manuscripts of the Armenian state of Urartu, as well as Ancient Egypt, India, China, Babylon, and 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 diseases, 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 are starting to open. The first such hospital was opened in 1802 in Paris for children from 2 to 15 years old. Subsequently, specialists in childhood diseases were trained there. In 1834, a pediatric hospital opened in St. Petersburg. In 1865, the departments of childhood diseases and the medical-surgical academy were opened. And K. A. Rauchfus built several children's hospitals in different cities of Russia. Over time, courses on childhood diseases began to be taught at universities.

2. Founder of pediatrics - Kh. F. Khotovitsky

Pediatrics as an independent science began to take shape in the 1830s - 1860s. gg.

Pediatrics is the field of medicine that deals with the treatment of children. It is based not only on diseases of children's early life, but also on all aspects of their life and development. Its founder is considered to be pediatrician Stepan Fomich Khotovitsky (1796-1885). Having become an ordinary professor of the department of obstetrics, women's and children's diseases, he was the first to read (since 1836) a separate course of childhood diseases consisting of 36 lectures and in 1847 published it in an expanded form under the name “Pediatrics”. This was the first original manual on pediatrics in Russia in the process of development, in which the child’s body was studied taking into account its anatomical and physiological characteristics, which qualitatively change during the development process. 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-anatomical studies, led to the creation of a child examination system, which made it possible to detail the symptoms of childhood diseases.

3. XIX - XX centuries. Achieving a high level of pediatric development

The first hospital for children was opened in Paris in 1802. It became the leading center in Europe in the first half of the 19th century. for training 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 N. F. Filatov Children's Infectious Diseases Hospital No. 18). In 1842, the first Moscow children's hospital with 100 beds opened - the world's first hospital for young children (now the N.F. Filatov Children's Clinical Hospital No. 13). The third children's hospital in Russia - the Elizabeth 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 under three years of age.

Children's hospitals were supported mainly by charitable funds and private donations - government subsidies were insignificant.

At the end of the 19th - beginning of the 20th centuries. domestic pediatrics is reaching a particularly high level, which is greatly facilitated by the fruitful work 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 created in 1866. The teaching of pediatrics began with a theoretical (1861) and then a practical (-1866) course at the department of obstetrics, women's and children's diseases.

4. N.F. Filatov - one of the founders of Russian pediatrics

Nil 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 chicken pox (1872) and scarlet fever rubella (1885), and discovered an early sign of measles - pityriasis-like peeling of the epithelium on the oral mucosa (Filatov-Velsky-Koplik spots). His works “Semiotics and diagnosis of childhood diseases”, “Lectures on acute infectious diseases in children” and “A short textbook of childhood diseases” were reprinted many times. Filatov's lectures, recorded and published by his students S. Vasiliev, V. Grigoriev and G. Speransky, were very popular.

In 1892, N. F. Filatov organized the Moscow Society of Children's Doctors. 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. Pfaundler (Germany), V. Utinel 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 Infant Mortality, which, despite the active work of individual doctors, was still high. The first International Congress for the Protection of Infants 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 to combat infant mortality and a society of pediatricians appeared, congresses of children's doctors were organized, at which questions about how to help newborns were resolved. M. S. Maslov wrote books about chronic digestive disorders, kidney diseases, liver diseases, diathesis, etc., thereby making a great contribution to pediatrics.

The goal of pediatrics is to ensure that the child’s health allows him to fully realize his innate life potential.

Pediatrics is divided into: preventive, clinical, scientific, social and environmental.

Clinical pediatrics is a set of activities based on diagnosis, treatment and the recovery process of a sick child.

The works of N. F. Filatov “Semiotics and diagnosis 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 placed it in on a par with the foreign one, which had already been in existence for many years. These books went through a number of editions and had a great influence on the development of pediatrics and on the training of pediatricians.

5. Works of N.P. Gundobin about age-related anatomical and physiological characteristics in children

The works of N.P. Gundobin and his numerous students significantly expanded the knowledge of pediatricians about age-related anatomical and physiological characteristics in children.

Such work by N.P. Gundobin and his students as “Peculiarities of Childhood” has not lost its scientific significance in our time.

After N.P. Gundobin, the Department of Pediatrics at the Military Medical Academy was headed by A.P. Shkarin. He organized a dairy kitchen, a consultation for infants and a department for infants at the clinic, 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 provide for the rapid growth and flourishing of pediatrics and hygiene. Preventive children's institutions, nurseries and kindergartens, created, as a rule, with charitable funds, were sporadic; The network of children's hospitals and clinics grew slowly, and the living and educational conditions of low-income children continued to remain 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 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 schools of G.N. became most famous in the 20th century. Speransky and A.A. Kiselya. Academicians of the Russian Academy of Medical Sciences M.Ya. Studenikin, VA. Tabolin, Yu.F. Dombrovskaya and their schools successfully conducted research into diseases of children of all ages. The studies of pediatric surgeon Yu.F. have become generally accepted. Isakov and his students, showing mastery in all areas of surgical intervention for children's diseases.

6. Contribution of A.A. Kisel in the development of Soviet pediatrics after the Great Socialist Revolution

Alexander Andreevich Kisel (1859-1938) worked for 48 years at the Olga children's hospital in Moscow, was the head of the department of childhood diseases of higher women's courses, and then at MMI the scientific director of the Central Institute of Children's Health. He is the author of more than 600 works. Known for his research into childhood tuberculosis (tuberculosis), the development of an active method of combating it, the organization of anti-tuberculosis work, and the promotion of preventive measures, Kisel introduced the concept of “Chronic tuberculosis intoxication” and established its symptoms, and proved the rheumatic nature of chorea. He attached great attention to strict adherence to the hygienic regime at home and at school - cleanliness of the premises, air, food, etc. According to his recommendations, forest schools began to be created. Kisel paid special attention to the labile children's psyche, physical education, the education of positive emotions, and the development of a sense of beauty: “In our education,” he said, “little place is given to the development of a sense of beauty in a child.”

Kisel urged doctors to rely on broad preventive measures of a state nature, developing a social and preventive direction not only in relation to sick, but also healthy children. “Preventive measures,” he wrote, “are especially desirable in relation to those children who still look completely healthy or who have very minor changes.” “Our goal is to prevent the disease.” “The disease harms a person mainly not during short attacks or exacerbations (for example, malaria), but during very long intervals (inter-attack periods), which can last not only months, but even years,” believed A.A. Kissel.

7. The emergence of the main center for pediatric research (G. N. Speransky)

G. N. Speransky is the author of a textbook on this pathology - “Textbook of Diseases of Young Children”, which for many years served as the main guide for doctors in the departments of newborns and pathology of young children. For many years, G. N. Speransky was the editor of the journal Pediatrics and headed the All-Union Scientific Society of Children's Doctors.

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 Russian Academy of Medical Sciences, Hero of Socialist Labor, Lenin Prize laureate. After graduating from the Faculty of Medicine of Moscow University, he worked in the clinic of childhood diseases under N.F. Filatov, one of the organizers of the maternal and infant health care system, on his initiative the Institute of Pediatrics of the USSR Academy of Medical Sciences was created; Since 1932, Speransky has been the head of the Department of Pediatrics at the Central Institute for Advanced Medical Studies. He is the author of more than 200 scientific papers; he has substantiated methods of feeding and caring for children, antenatal prevention, and treatment of diseases of the fetus and newborns. A number of Speransky’s works 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 is the 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 a child of early and preschool age” (1964).

A.A. Kisel and G.P. The Speranskys trained 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 - I. M. Sechenov Medical Academy) and directed it 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).

8. Opening of institutes for the protection of the health of children and adolescents in Leningrad, a research center for the protection of maternal and child health in Moscow

In 1925, the Institute of Maternity and Infancy Protection was opened in Leningrad, which, due to the huge need for pediatricians, was reorganized in 1935 into the Leningrad Pediatric Medical Institute.

In 1927, the Institute of Child and Adolescent Health was founded in Moscow, which was 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 Kyiv, Kharkov, Rostov-on-Don, Kazan, Sverdlovsk, Gorky, Minsk, Tbilisi, Baku, Almaty and other cities.

In 1979, the All-Union Research Center for Maternal and Child Health of the USSR Ministry of Health was opened in Moscow.

The focus of scientists has always been on research on the scientific foundations of organizing medical and preventive care for children, studying the dynamics of physical and psychomotor development, as well as morbidity in children, and the scientific development of forms and methods of pediatric care. These studies served as the basis for the development and implementation of anti-epidemic measures in the system of pulmonological, allergy, medical and genetic services, and the creation of specialized centers.

9. History of pediatrics in the Western Urals

The history of pediatrics in the Western Urals begins in 1920, when the medical faculty of Perm University elected private associate professor from Kazan Pavel Ivanovich Pichugin as head of the department of childhood diseases, and on February 23, 1920, the first lecture on childhood diseases was given to fourth-year students of the medical faculty. 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 began organizing the clinical base of the department. On February 5, 1922, the first children's clinic in the Urals was opened, designed for 30 beds. On October 7, 1923, the children's outpatient clinic created by Pichugin began operating. For 34 years, the Department of Childhood Diseases, headed by P.M. Pichugin, worked on the problems of childhood tuberculosis, constitutional anomalies, chronic nutritional disorders, rheumatism, and helminthic diseases. P.I. Pichugin trained several generations of pediatricians. According to the People's Commissariat of Health, the clinic he created for children's diseases was one of the best medical institutions of that time. By 1929, 25 pediatricians had already been trained, having completed their residency with P.I. Pichugina.

Under the guidance of Professor P.I. Pichugin published more than 50 scientific papers, defended 3 candidate dissertations (L.B. Krasik - 1938, G.M. Rutenberg - 1954, R.A. Zif - 1946), “Notes on childhood diseases” by P.I. . Pichugina is one of the first Soviet textbooks on pediatrics.

From 1954 to 1972, the department of childhood diseases was headed by associate professor Lev Borisovich Krasik. L.B. Krasik was born May 28, 1904; in 1926 he graduated from the Faculty of Medicine of Perm University and was accepted as a resident at the Department of Children's Diseases. On September 1, 1931, he became a full-time assistant at the children's clinic. On March 9, 1938, he defended his candidate's thesis on venous pressure in children, and 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 enormous assistance to the region; the work required extensive laboratory knowledge. There were no laboratory assistants. Lev Borisovich examined blood, urine, and cerebrospinal fluid himself, training laboratory assistants and doctors. Simultaneously with the medical work, he performed a lot of pedagogical work - classes, lectures.

Teaching of pediatrics was carried out at three faculties: medical, sanitary-hygienic and dental. The best students entered clinical residency in pediatrics, and later they formed the staff of the department. Under the guidance of Associate Professor L.B. Krasik completed 5 candidate dissertations (G.K. Knyazkova, N.M. Avdeeva, A.M. Nikitina, S.G. Sofronova, N.F. Churina). The scientific topics of the department were related to liver diseases, early diagnosis of tuberculosis, rheumatism, pathology of premature babies and other problems. With the active assistance of L.B. Krasik opened the children's sanatorium "Svetlana" and "Orlyonok".

Under his leadership, collections of scientific papers and teaching aids on various areas of pediatrics were published. Lev Borisovich Krasik was an unusually disciplined, punctual person, he devoted himself entirely to his work, and strictly demanded the same from the department staff. Over the many years of his leadership at the department, hundreds of pediatricians were trained, highly qualified personnel were trained who completed clinical residency, became teachers and organizers of children's healthcare in Perm and the region, and leading experts in various fields of pediatrics. After his retirement, Lev Borisovich continued his advisory work and worked to improve the medical examination of the child population. Lev Borisovich died on March 17, 1982.

In 1971, a pediatric faculty was opened at the Perm Medical Institute, which raised the question of forming a number of pediatric departments. From 1972 to 1983, the Department of Childhood Diseases of the Faculty of Medicine was headed by Professor A.I. Egorova, who was responsible for organizing the course of propaedeutics of childhood diseases and the department of faculty pediatrics. The staff of the Department of Propaedeutics of Childhood Diseases, whose base was the first clinic of childhood diseases in the Western Urals, honors and preserves 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 healthcare and provides scientific advisory and methodological assistance to hospitals, sanatoriums, schools and preschool institutions in the city and region. Much attention is paid to postgraduate training of specialists. Scientific work is carried out in close cooperation with Perm Technical University, the Clinical Institute of Ecopathology of Children, departments and divisions of the Perm State Medical Academy.

The results of scientific research are actively introduced into the work of practical healthcare and into the educational process. Since 1983, employees of the department have published more than 500 scientific papers.

10. Differentiation and integration of the main branches of pediatric medicine

XX century Differentiation and integration of the main branches of pediatric medicine (pediatric surgery, neuropathology, psychiatry, ophthalmology, neonatology, perinatology, allergology, etc.)

At the dawn of the 20th century, differentiation and integration of the main branches of medicine began. Within pediatrics throughout the 20th century, independent disciplines were distinguished: pediatric surgery, pediatric neuropathology, child psychiatry, pediatric ophthalmology, neonatology, perinatology and many others.

In pediatrics, the physiological characteristics of the body, the role of age factors and the influence of the environment on the development and growth of the child are studied much more widely.

Soviet pediatricians paid much attention to a comprehensive study of issues of age-related physiology, features of the development of higher nervous activity, age-related morphology, patterns of development of the body's reactivity and physical development, and issues of age-related hygiene.

The system of education of preschool children, developed by Soviet pediatricians and physiologists, has received worldwide recognition; it has 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 feeding a healthy and sick child should be considered very valuable achievements of Soviet pediatrics. Based on scientific research, new milk formulas intended for feeding young children have been developed and introduced, fortified food concentrates and dietary products have been proposed for children with various diseases.

The development of the fundamentals of 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 of intrauterine development, the relationship between the mother and the fetus, and the influence of various external and internal environmental factors on the developing fetus were clarified.

Allergic diseases in children are being studied; principles for diagnosing hay fever, food and drug allergies were developed. New methods of allergy diagnostics (skin tests and provoking tests), as well as the principles of specific hyposensitization, have been proposed and implemented.

The principles of nutrition, regimen, physical education and sanatorium-resort treatment of children with allergic diseases have been developed.

Undoubted successes have been achieved in the development of scientifically based methods of complex treatment, intensive care 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 significantly reduced the incidence and incidence of heart defects. Widespread implementation of scientific recommendations to combat rheumatism in children was ensured through the creation of cardiology rooms. Methods for early detection of initial forms of arterial hypertension are being developed, its frequency and prevalence are being established in connection with various environmental conditions.

The structure of children's incidence of infectious diseases has changed significantly. The use of the latest achievements of immunology, virology, and pathological physiology has made it possible to establish patterns of the infectious process, immune reactions and allergies in acute childhood infections. A great achievement in 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 disruption 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, and methods of intensive care and resuscitation are being developed.

The development of nephrology and urology in childhood is closely related to the achievements of immunology, biochemistry, genetics, and general pathology. There has been 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 long-term and chronic kidney diseases, often leading to the development of chronic renal failure.

Much more often than before, hereditary and congenital kidney diseases, metabolic nephropathies, and nephrotic syndrome in young children are detected. The attention of pediatric nephrologists is drawn to various forms of glomerulonephritis, the diagnosis of which is carried out on the basis of functional immunological and histomorphological methods. Specialized care for children with kidney diseases has been developed; nephrology hospitals and sanatoriums are being organized.

Problems of childhood 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. The studies conducted made it possible to obtain important information about the prevalence of gastrointestinal diseases, as well as new data on the pathogenesis of gastroduodenitis, impaired intestinal absorption syndrome.

The study of anemia 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 hemoblastoses in children, which has made it possible to significantly increase the duration of remission.

The main achievements of childhood endocrinology are elucidation of the pathogenesis and development of therapeutic tactics for diabetic ketoacidosis, elucidation of the pathogenesis of obesity in children, obtaining data on endocrine interactions between mother and fetus, and 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 diagnosing and treating organic diseases of the nervous system, and in recent years has focused on the problems of intracranial birth trauma and hereditary diseases of the nervous system.

Medical genetics had a significant influence on the development of pediatrics, thanks 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 it as the most important state task. In the USSR, state systems for protecting the health of children and adolescents and protecting motherhood and childhood have been created. It is characteristic that in pre-revolutionary Russia there were only 600 pediatric doctors, but in 1976 there were more than 96 thousand. The Constitution of the USSR guarantees the implementation of special measures for the protection of labor and women's health; creating conditions that allow women to combine work with motherhood.

11. Preventive focus and stages of treatment in pediatric activities

In the pediatric service, the leading principle of the organization of Soviet health care, as a preventive focus, is especially clearly implemented. In the organization of child protection, medical examination is especially mandatory, which embodies the synthesis of preventive and curative medicine.

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 organizing child health care. At 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 clinics. Specialized care is being developed, specialized departments are being organized, in which diagnosis, treatment, and nursing of sick children are at a high level; intensive care and resuscitation departments are being created, this is combined with the strengthening of the main link of all treatment and preventive work - the children's clinic.

The trend of staged treatment of sick children with chronic diseases is noticeably increasing: clinic - hospital - 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 nursing staff 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 clinical, physiological and preventive directions. 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 its manifestations - in its connections with natural science, its philosophical dialectical-materialist concepts, the successes of science, the creation of numerous large scientific medical schools, broad practical, preventive activities, the development of public initiatives, the activities of societies, congresses, medical periodicals, involving workers in protecting public health.

Medical science and healthcare are inextricably harmoniously linked with each other. The state nature of Soviet healthcare largely determines the possibilities and paths for the development of medical science.

List of used literature

1. Avdeev V.I., “History of the Ancient East”. Publishing house: Gospolitizdat, USSR, 1948.

2. P.E. Zabludovsky and others. “History of Medicine.” Textbook. M.: “Medicine”, 1981.

3. Yu.P. Lisitsin “History of Medicine”. Textbook. M.: "GEOTAR-MED" 2004.

4. T.S. Sorokina “History of Medicine”. Textbook for students of higher medical educational institutions. M.: "Academy" 2005.

5. B.V. Petrovsky “Big Medical Encyclopedia”, volume 18, M.: Publishing House “Soviet Encyclopedia”, 1982.

Posted on Allbest.ru

...