Pirogov Nikolai Ivanovich: a short biography. Nikolai Pirogov: a philanthropic bore In what century did Nikolai Pirogov live
Nikolai Pirogov is a famous Russian surgeon who made an invaluable contribution to the development of Russian and world medicine. He was born in Moscow in 1810. His father was an officer in the Russian army, served as treasurer at the depot, earned good money, and was able to give his son a good education. Nikolai began his studies in a private boarding school. As a child, the boy showed not a hefty craving for the natural sciences. At the age of 14, Pirogov entered the Moscow State University, the Faculty of Medicine. It was possible to enter a prestigious educational institution with the help of deception. In the application form for admission, Nikolai attributed two years to himself. Being the 18th young man, he can already work as a doctor, but such work did not attract him. Pirogv decides to continue his studies - he wants to be a surgeon.
Nikolai Ivanovich moved to Tartu, where he entered the Yuriev University. After graduation, he defended his doctoral dissertation. The topic of the dissertation is ligation of the abdominal aorta. It was thanks to his research that in medicine for the first time information appeared about the exact location of the abdominal aorta, about the features of blood circulation in it.
By the age of 26, Nikolai Pirogov becomes a professor at Derpt University, is engaged in scientific activities and practice (heads a clinic at the university). Soon he finishes his work - "Surgical anatomy of arterial trunks and fascia." Pirogov became the first doctor in the world who tried to study the shells of the surrounding muscle groups. The world and Russian scientific community highly appreciated the work of Pirogov. The Academy of Sciences awarded him the Demidov Prize.
Nikolay Pirogov was the first doctor who insisted on the widespread use of antiseptics. He believed that these drugs are indispensable, especially in surgery. He did a lot for the development of medicine in the Russian Empire. The physician devoted himself completely to science and society. The wars in which Russia participated during his lifetime did not pass him by either. So Pirogov visited the Crimean War, Caucasian and Russian-Turkish. Over the years of military field medical practice, he came up with various effective ways to evacuate the wounded from the battlefield, as well as their subsequent treatment.
Nikolai Ivanovich was the largest researcher of the properties of ether anesthesia. Thanks to him, anesthesia has found wide application in hospitals and in military field conditions.
He developed methods for caring for the wounded, opened a number of measures to prevent the development of body decay. Nikolai Ivanovich improved plaster casts. Many of Pirogov's discoveries and innovations are still relevant today.
Nikolai Ivanovich Pirogov died in 1881.
The ingenious mind and incomprehensible scientific intuition of Pirogov were so ahead of their time that his bold ideas, for example, an artificial joint, seemed fantastic even to the world's luminaries of surgery. They simply shrugged their shoulders, made fun of his thoughts, which led so far into the 21st century.
Nikolai Pirogov was born on November 13, 1810 in Moscow, in the family of a treasury official. The Pirogov family was patriarchal, well-established, strong. Nikolai was the thirteenth child in her. As a child, little Kolya was impressed by Dr. Efrem Osipovich Mukhin (1766-1850), well-known in Moscow to the same extent as Mudrov. Mukhin began as a military doctor under Potemkin. He was the dean of the department of medical sciences, by 1832 he had written 17 treatises on medicine. Dr. Mukhin treated brother Nikolai for a cold. He often visited their house, and always, on the occasion of his arrival, a special atmosphere arose in the house. Nikolai liked the bewitching manners of the Aesculapius so much that he began to play Dr. Mukhin with his family. Many times he listened to everyone at home with his pipe, coughed and, imitating Mukhina's voice, prescribed medicines. Nikolai played so much that he really became a doctor. Yes, how! The famous Russian surgeon, teacher and public figure, the founder of the Russian school of surgery.
Nikolai received his initial education at home, later he studied at a private boarding school. He loved poetry and wrote poems himself. Nikolai stayed at the boarding house for only two years instead of the prescribed four years. His father went bankrupt, there was nothing to pay for education. On the advice of Professor of Anatomy E.O. Mukhin's father, with great difficulty, "corrected" Nikolai's age in the document (someone had to "grease") from fourteen to sixteen. Moscow University was accepted from the age of sixteen. Ivan Ivanovich Pirogov made it on time. A year later he died, the family began to beg.
On September 22, 1824, Nikolai Pirogov entered the medical faculty of Moscow University, graduating in 1828. Pirogov's student years passed during a period of reaction, when the preparation of anatomical preparations was prohibited as a "godless" thing, and anatomical museums were destroyed. After graduating from the university, he went to the city of Dorpat (Yuriev) to prepare for a professorship, where he studied anatomy and surgery under the guidance of Professor Ivan Filippovich Moyer.
On August 31, 1832, Nikolai Ivanovich defended his dissertation: “Is the ligation of the abdominal aorta for an aneurysm of the inguinal region an easy and safe intervention?” In this work, he raised and resolved a number of fundamentally important questions concerning not so much the technique of aortic ligation, but rather the elucidation of the reactions to this intervention of both the vascular system and the organism as a whole. With his data, he refuted the ideas of the then-famous English surgeon A. Cooper about the causes of death during this operation.
In 1833-1835, Pirogov was in Germany, where he continued to study anatomy and surgery. In 1836, he was elected professor at the Department of Surgery at Derpt (now Tartu) University. In 1849, his monograph "On the transection of the Achilles tendon as an operative-orthopedic remedy" was published. Pirogov conducted more than eighty experiments, studied in detail the anatomical structure of the tendon and the process of its fusion after transection. He used this operation to treat clubfoot. At the end of the winter of 1841, at the invitation of the Medical and Surgical Academy (in St. Petersburg), he took the chair of surgery and was appointed head of the hospital surgery clinic, organized on his initiative from the 2nd Military Land Hospital. At that time, Nikolai Ivanovich lived on the left side of Liteiny Prospekt, in a small house, on the second floor. In the same house, in the same entrance, on the second floor, opposite his apartment, there is the Sovremennik magazine, edited by N.G. Chernyshevsky and N.A. Nekrasov.
Dr. Pirogov in 1847 went to the Caucasus to the active army, where, during the siege of the village of Salty, for the first time in the history of surgery, he used ether for anesthesia in the field. In 1854 he took part in the defense of Sevastopol, where he proved himself not only as a clinical surgeon, but above all as an organizer of medical care for the wounded; at this time, for the first time in the field, he used the help of the sisters of mercy.
Upon his return from Sevastopol (1856) he left the Medico-Surgical Academy and was appointed trustee of the Odessa, and later (1858) Kyiv educational districts. However, in 1861, for progressive ideas in the field of education at that time, he was dismissed from this post. In 1862-1866 he was sent abroad as a leader of young scientists sent to prepare for a professorship. Upon his return from abroad, he settled in his estate, the village of Vishnya (now the village of Pirogovo, near the city of Vinnitsa), where he lived almost without a break.
Nikolai Ivanovich Pirogov also found ideas that reduced all the variety of surgical techniques to three basic rules: "... cut the soft parts, drink the hard ones, where it flows - bandage it there." He revolutionized surgery. His research laid the foundation for the scientific anatomical and experimental direction in surgery; Pirogov laid the foundation for military field surgery and surgical anatomy.
The merits of Nikolai Ivanovich to world and domestic surgery are enormous. In 1847 he was elected a corresponding member of the St. Petersburg Academy of Sciences. His works put forward Russian surgery to one of the first places in the world. Already in the first years of scientific, pedagogical and practical activities, he harmoniously combined theory and practice, widely using the experimental method in order to clarify a number of clinically important issues. He built his practical work on the basis of careful anatomical and physiological research. In 1837-1838 he published the work "Surgical anatomy of arterial trunks and fascia"; this study laid the foundations of surgical anatomy and determined the ways of its further development.
Paying great attention to the clinic, he reorganized the teaching of surgery in order to provide every student with an opportunity for practical study of the subject. Pirogov paid special attention to the analysis of the mistakes made in the treatment of patients, considering practice to be the main method for improving scientific and pedagogical work (in 1837-1839), he published two volumes of Clinical Annals, in which he criticized his own mistakes in the treatment of patients).
In 1846, according to the project of Pirogov, the first anatomical institute in Russia was created at the Medico-Surgical Academy, which allowed students and doctors to engage in applied anatomy, practice operations, and conduct experimental observations. The creation of a hospital surgical clinic, an anatomical institute allowed Pirogov to carry out a number of important studies that determined the further paths for the development of surgery. Attaching particular importance to the knowledge of anatomy by doctors, Pirogov in 1846 published "Anatomical images of the human body, assigned mainly to forensic doctors", and in 1850 - "Anatomical images of the appearance and position of the organs contained in the three main cavities of the human body".
After the death of his wife, Ekaterina Dmitrievna Berezina, Pirogov wanted to marry twice. By calculation. I didn't believe that I could still love. His wife, leaving Pirogov two sons, Nikolai and Vladimir, died in January 1846, twenty-four years old, from a postpartum illness. In 1850, Nikolai Ivanovich finally fell in love and got married. Four months before marriage, he bombarded the bride with letters. He sent them several times a day - three, ten, twenty, forty pages of small, compact handwriting! He revealed to the bride his soul, his thoughts, views, feelings. Not forgetting their "bad sides", "irregularities of character", "weaknesses". He did not want her to love him only for "great things". He wanted her to love him for who he is. While he was preparing for the wedding with the nineteen-year-old Baroness Alexandra Antonovna Bistrom, the niece of General Kozen, his mother died.
Pirogov's method of "ice sculpture" is known. May this smile be forgiven the author: maniacs are forbidden to read further, so as not to become a guide to action. Having set himself the task of finding out the forms of various organs, their relative positions, as well as their displacement and deformation under the influence of physiological and pathological processes, Pirogov developed special methods of anatomical research on a frozen human corpse. Consistently removing tissue with a chisel and hammer, he left the organ or system of interest to him. In other cases, with a specially designed saw, Pirogov made serial cuts in the transverse, longitudinal, and front-rear directions. As a result of his research, he created an atlas "Topographic anatomy, illustrated by cuts made through the frozen human body in three directions", provided with an explanatory text.
This work brought Pirogov worldwide fame. The atlas not only gave a description of the topographic relationship of individual organs and tissues in different planes, but also showed for the first time the significance of experimental studies on a corpse.
Pirogov's works on surgical anatomy and operative surgery laid the scientific foundations for the development of surgery. An outstanding surgeon, who possessed a brilliant technique of operations, Pirogov did not limit himself to the use of surgical approaches and techniques known at that time; he created a number of new methods of operations that bear his name. The osteoplastic amputation of the foot, proposed by him for the first time in world practice, marked the beginning of the development of osteoplastic surgery. Pirogov's pathological anatomy did not go unnoticed. His well-known work "The Pathological Anatomy of Asiatic Cholera" (atlas 1849, text 1850), awarded the Demidov Prize, is still an unsurpassed study.
The rich personal experience of a surgeon, obtained by Pirogov during the wars in the Caucasus and in the Crimea, allowed him to develop for the first time a clear system for organizing surgical care for the wounded in the war.
The operation of resection of the elbow joint developed by Pirogov contributed to a certain extent to limiting amputations. In "The Beginnings of General Military Field Surgery ..." (published in 1864 in German; in 1865-1866, in two parts - in Russian, in two parts in 1941-1944), which are a generalization military surgical practice of Pirogov, he outlined and fundamentally resolved the main issues of military field surgery (issues of organization, the doctrine of shock, wounds, pyemia, etc.). As a clinician, Pirogov was exceptionally observant; his statements concerning wound infection, the meaning of miasma, the use of various antiseptic substances in the treatment of wounds (iodine tincture, bleach solution, silver nitrate), are essentially an anticipation of the work of the English surgeon J. Lister.
Great is the merit of Pirogov in the development of anesthesia issues. In 1847, less than a year after the discovery of ether anesthesia by the American physician W. Morton, Pirogov published an experimental study of exceptional importance on the effect of ether on the animal organism (“Anatomical and Physiological Studies on Etherization”). He proposed a number of new methods of ether anesthesia (intravenous, intratracheal, rectal), and devices for "ether" were created. Along with the Russian physiologist Alexei Matveyevich Filomafitsky (1807-1849), professor at Moscow University, he made the first attempts to explain the essence of anesthesia; he pointed out that the narcotic substance has an effect on the central nervous system and this action is carried out through the blood, regardless of the ways it is introduced into the body.
At seventy, Pirogov became quite an old man. The cataract closed the joy of seeing the colors of the world clearly. His face still lived swiftness and will. There were almost no teeth. It made it difficult to speak. In addition, he suffered from a painful ulcer on the hard palate. The ulcer appeared in the winter of 1881. Pirogov mistook it for a burn. He had a habit of rinsing his mouth with hot water to keep the smell of tobacco out. A few weeks later, he dropped in front of his wife: "It's like cancer." In Moscow, Pirogov was examined by Sklifosovsky, then Val, Grube, Bogdanovsky. They suggested surgery. His wife took Pirogov to Vienna, to the famous Billroth. Billroth persuaded not to be operated on, swore that the ulcer was benign. Pirogov was hard to deceive. Against cancer, even the almighty Pirogov was powerless.
In Moscow in 1881, the 50th anniversary of Pirogov's scientific, pedagogical and social activities was celebrated; he was awarded the title of honorary citizen of Moscow. On November 23 of the same year, Pirogov died in his estate Vishnya, near the Ukrainian city of Vinnitsa, his body was embalmed and placed in a crypt. In 1897, a monument to Pirogov was erected in Moscow with funds raised by subscription. In the estate where Pirogov lived, a memorial museum named after him was organized in 1947; Pirogov's body was restored and placed for viewing in a specially rebuilt crypt.
A brief biography of Nikolai Pirogov, a doctor, the founder of military field surgery, a naturalist, a surgeon, a teacher, a public figure, is presented in this article.
Biography of Pirogov Nikolai Ivanovich briefly
Pirogov Nikolai Ivanovich a short biography begins on November 27, 1810, when the future surgeon was born in Moscow. He was 14 and the youngest child in the family of the state treasurer.
Until the age of 12, he was homeschooled. At the age of 14, he successfully passed the exams for admission to the Moscow University at the Faculty of Medicine. He had no difficulties in his studies, but he was forced to earn extra money in order to help his family. Nikolai managed to get a job in the anatomical theater as a dissector. This work served as the impetus due to which he chose surgery.
Pirogov successfully graduated from the university and for further education he was sent to the best university of that time - Yuriev University. Here he worked for 5 years in a surgical clinic and at the age of 26 received the title of professor of surgery, defending his doctoral dissertation.
Returning home, he fell ill and stopped in Riga, where he operated on a person as a teacher for the first time. Then he gets a clinic in Dorpat and creates the science of surgical anatomy.
As a professor, Nikolai Ivanovich studies in Germany with Professor Langenbeck.
In 1841 he was invited to the St. Petersburg Medical and Surgical Academy to head the Department of Surgery. In St. Petersburg, Pirogov organized the first hospital surgery clinic and headed it. He created a new medical direction of hospital surgery. He worked at the Academy for 10 years, gaining fame as a talented surgeon, public figure and teacher.
At the same time, he consults in hospitals and manages the Tool Factory for the production of medical instruments.
In 1843 he marries Ekaterina Dmitrievna Berezina. After four years of marriage, she dies after a second birth from bleeding, leaving her husband 2 sons - Nikolai and Vladimir.
In 1847, Pirogov went to the Caucasus, where he practiced field surgery, applied new developments - dressing with starched bandages and anesthesia with ether. During the war in Crimea, he operated on the wounded in Sevastopol, using plaster casts for the first time.
In 1850 he remarries Duchess Alexandra Bystrom.
In addition to medicine, he was also interested in education and public education. Since 1856, he worked as a trustee in the Odessa educational district and began to introduce new, his own transformations. The fact is that the education system in many ways did not suit him. This led to the fact that, as a result of denunciations and complaints against him, Pirogov was dismissed from the educational district in 1861 by order of the emperor.
In 1862 he went abroad as a leader in the training of future professors. But in 1866 he was dismissed from public service, and the group of young professors was disbanded.
From that time on, he carried out medical activities on his estate in the Vinnitsa region, organizing a free hospital there. The world-famous Diary of an Old Doctor was written here. Pirogov was elected an honorary member in many foreign medical academies. Sometimes he traveled abroad or to St. Petersburg to give lectures.
In Moscow and St. Petersburg in 1881, his 50th anniversary of activity was celebrated with great triumph. Pirogov on this day was awarded the title of honorary citizen of the city of Moscow.
On November 23, 1881, the great scientist died on his estate from an incurable disease. His embalmed body is still kept at his estate in Cherries.
" The people who had their own Pirogov have the right to be proud,
since this name is associated with a whole period of development of medical science.
The principles introduced into science (anatomy, surgery) by Pirogov,
will remain a permanent assetand cannot be erased from her tablets,
as long as European science exists,
until the last sound of rich Russian speech freezes in this place".
N.V. Sklifosovsky
"Like all the great people of Pirogov, already at the earliest time of his life, he felt inhimself a broad program of his existence and fulfilled it all to the end, in spite of its complexityfeatures and dimensions. Throughout his life, he showed extraordinary, persistent, tireless deeds.validity. Gifted with colossal self-control, he was steadfast, patient, courageous, cheerfully
forces blows of fate. An invincible will was the main nerve of his nature and enabled him to lay and build a building where the soil was not yet ready at all. With a rare strength of will, he combined the depth and insight of a tender heart, which gave him the opportunity to feel the pulse of life and events where the gaze of an ordinary person did not notice anything.
I.A. Sikorsky
Nikolai Ivanovich Pirogov was born in Moscow on November 13 (25), 1810 in a strong, pious (the family strictly and confidently observed all religious rites) and a patriarchal large family (there were fourteen children in the family, most of whom died in infancy) family. The grandson of a serf, he recognized the need early. His father, Ivan Ivanovich, served as treasurer, major of the provisions depot, was a commission agent of the 9th class. Nikolai Ivanovich's parents were firmly instilled with the system-forming qualities of his personality: true religiosity, sincere patriotism and deep love for Russia. This was due to the fact that religious education left a deep imprint on the boy's soul and, undoubtedly, to a large extent determined the shape of his further views. And patriotism was based on the stories of his father, a participant in the Patriotic War of 1812. Pirogov carried the image of his father's saber in an old scabbard through his whole life. In 1815, a collection of cartoons was published - “A gift to children in memory of 1812”. Each caricature was explained by verses. According to these cartoons, Nikolai learned to read and write. Read willingly and a lot. One of his first books - "Spectacles of the Universe": pictures with explanations in Russian, German, Latin. This little encyclopedia included tales of earth and sky, metals and stones, animals and plants, human activities, and inanimate bodies. Nikolay liked the adventures and travels of Vasco da Gama, Don Quixote, Robinson Crusoe, read Zhukovsky, Derzhavin, Krylov with pleasure.
N.I. Pirogov with his nanny Ekaterina Mikhailovna. Hood. A. Magpie.
He was helped to get an education by a family friend - a well-known Moscow doctor, professor of Moscow University E.O. Mukhin, who noticed the boy's abilities and began to work with him individually. At the age of eleven, Nikolai entered the private boarding school of Kryazhev. The course of study there was paid and designed for six years. The students of the boarding school were prepared for bureaucratic service. Ivan Ivanovich hoped that his son would receive a good education and be able to achieve a “noble” noble title. He did not think about his son's medical career, since at that time medicine was the occupation of commoners. Nikolai studied at a boarding school for two years, then the family ran out of money for education.
When Nikolai was fourteen years old, he entered the medical faculty of Moscow University. To do this, he had to add two years to himself, but he passed the exams no worse than his older comrades. Pirogov studied easily. In addition, he had to constantly earn extra money to help his family. The father died, the house and almost all the property went to pay off debts - the family was immediately left without a breadwinner and without shelter. Nikolai sometimes had nothing to go to lectures: the boots were thin, and the jacket was such that it was embarrassing to take off his overcoat. Finally, Nikolai managed to get a job as a dissector in the anatomical theater. This job gave him invaluable experience and convinced him that he should become a surgeon.
At Moscow University, the teenager Pirogov found himself involved in the activities of a free-thinking student socio-literary "circle of 10 numbers" (according to a room in a hostel). And although the views of Pirogov himself invariably remained quite conservative, his student years led to the folding of two important features of his personality: they instilled a deep and unchanging interest in public life, and also predetermined the broad democratism that distinguished him so much in subsequent years. But at the same time, all this student atmosphere for a long period caused him to cool towards religion. He becomes a materialist.
At 17 and a half years after graduating from Moscow University and being approved as a "doctor of the 1st class", Pirogov decided to enter the Professorial Institute, opened at the Imperial Derpt University (at that time it was considered the best in Russia). Examinations for applicants had to be taken at the Imperial St. Petersburg Academy of Sciences. In 1828, he successfully passed the tests and was accepted for training.
To understand the features of educational institutions in Russia, one should touch on some of the innovations of the Russian emperors. In the first decades of the 18th century Peter I considers various options for the development of science and higher education in Russia, in the last years of his life he makes an extraordinary decision. On January 28 (February 8), 1724, by order of Emperor Peter I, the Senate established the Academy of Sciences and Arts with a gymnasium and a university attached to it, where it was announced that Peter I had decided to establish an Academy in which languages would be taught, as well as other sciences. Peter I contributed to the creation of the Russian Academy of Sciences, proceeding from the interests of the state, so that not only glory would spread, but the development of sciences and teaching them would take place. It is important to note that the Academy of Sciences and Arts was created, and the university attached to it, and not vice versa. The regulations of the Academy were prepared by the life physician of the emperor L.L. Blumentrost, who also becomes the first president of the Academy.
Almost a century has passed, and in 1811 Emperor Alexander I decides to create a special educational institution to train the elite of society in the state administration system. On October 19, 1811, the Tsarskoye Selo Lyceum was opened. This is a new type of educational institution, which represented a compromise between the gymnasium, the cadet corps and the university. Its peculiarity was that the pupils had to receive an encyclopedic versatile education, to serve in the higher institutions of the Russian State.
A decade later, the idea of preparing a professorial corps in medicine is being developed. It should be noted that initially the preparation of Russian scientists for the professorship was carried out individually at various universities in Russia and abroad. But then, in connection with the progress of the higher education system and the organization of new universities, it was decided to improve the training of new professors and teachers and create a special Professorial Institute for this.
The idea of organizing a Professorial Institute dates back to the end of the 20s of the 19th century. It originated in St. Petersburg at the Russian Academy of Sciences. It was then that the well-known physicist and teacher academician Georg Friedrich (Egor Ivanovich) Parrot (formerly the rector of the University of Dorpat) developed a project to create an institute that would train highly qualified teachers and scientists, teachers and professors for all Russian universities. It was meant to select from all universities about two dozen of the best students or young graduates - "natural Russians" - and send them to Dorpat for five years so that they could complete a full course of study there in their chosen specialty, and then go for another two years abroad for further improvement. This is necessary for the preparation of "a class of natural Russian professors, true scientists worthy of this name."
This project was supported by progressive scientists and public figures, in particular, the outstanding navigator I.F. Krusenstern. After detailed consideration in various instances, the opening was finally accepted. It was decided to organize the institute at the University of Dorpat - the most capable and gifted graduates of both the oldest Moscow and Vilna universities and the relatively young St. Petersburg, Kharkov and Kazan universities were to study here.
During the ten years of its existence, the Professors' Institute (1828-1838) prepared and educated specialists who played a significant role in the development of science. Suffice it to recall the names of professors Alexander Petrovich Zagorsky (1805-1888), Ignaty Iakinfovich Ivanovsky (1807-1886), Fedor Ivanovich Inozemtsev (1802-1869), Karl Fedorovich Kessler (1815-1881), Stepan Semyonovich Kutorg (1805-1861) , Petr Grigorievich Redkin (1808-1891), Alexei Matveevich Filomafitsky (1807-1849), Alexander Ivanovich Chivilev (1808-1867), full members of the Imperial St. Petersburg Academy of Sciences (ISPbAN) Mikhail Semenovich Kutorga (1809-1886) and Alexei Nikolaevich Savich (1810-1883). The development of the scientific center around Dorpat University was facilitated (as always in Russia, by the way) by the goodwill of the "first persons" - Emperors Alexander I and Nicholas I.
On October 4, 1827, Nicholas I approved the creation of the Professorial Institute - "There are worthy professors, but there are few of them and there are no heirs for them, they must be trained, and for this, twenty best students should be sent ... to Dorpat, and then to Berlin or Paris, and not alone, but with a reliable boss for two years, all this to be done immediately.” Applicants were to be examined at the Imperial St. Petersburg Academy of Sciences.
Three physicians were selected at Moscow University, two candidates (among them the rector of St. Petersburg University, senator and member of the State Council Petr Redkin) and two students - Alexander Shumansky and Nikolai Pirogov. In August, a group arrived in the capital on a bed to carry out tests in order to determine the level of their training. Doctors were examined by two venerable professors of the Imperial Medical and Surgical Academy (IMHA). The first was the physiologist and anatomist Danilo Mikhailovich Vellansky (1774-1847), a philosopher (he was often called the "Russian Schelling"), the author of the first Russian textbook on physiology.
The second examiner was the surgeon Ivan Fedorovich Bush (1771-1843), who created the scientific school, the author of the first Russian manual on surgery, which went through five editions and for many years was a reference book for students and doctors. In 1832, one of his students, St. Petersburg obstetrician Andrey Martynovich Wolf (?-?), using the apparatus and technique of obstetrician James Blundell (J. Blundell, 1790-1877), performed the first successful blood transfusion in Russia, which saved the life of a woman in labor with bleeding.
The first group of applicants took their exams in June 1828, and in July they left for Dorpat. Teachers N.I. Pirogov at the Professor's Institute were - surgeon I.F. Moyer (1786-1858) - a major surgeon from the school of the Italian anatomist A. Scarpa, physiologist and pathologist I.F. Erdmann (1778-1846), anatomist, embryologist, pathologist, physiologist M.G. Rathke (1793-1860). In Dorpat (now Tartu), Pirogov rolled up his sleeves and got into practice. He listened to lectures by professor of surgery Moyer, attended operations, assisted, sat up until dark in the anatomical room, dissected, and performed experiments. In his room, the candle did not go out even after midnight - he read, made notes, extracts, tried his literary powers. Already after 3 months of stay in the clinic I.F. Moyer, he sent to Moscow for publication his first work "Anatomical and pathological description of the femoral-inguinal part with respect to hernias ..." (Vestn. natural. Nauk. 1829. Part 2, No. 5. S. 68-69).
Such a quick and fruitful start of research activity immediately singled out N.I. Pirogov from among the cadets and revealed his tendency to the anatomical and physiological justification of surgical activity, which was preserved for his entire life. At the university, Nikolai met Vladimir Ivanovich Dal, who in those years studied at the medical faculty of Dorpat University. He was older than Pirogov and had already managed to retire (they said that the caustic satire on the admiral helped the imminent resignation). At the clinic, they worked together a lot and became great friends. In the surgical clinic N.I. Pirogov worked for five years.
At the Professor's Institute N.I. Pirogov prepared a doctoral dissertation on the topic "Is ligation of the abdominal aorta for inguinal aneurysms an easy and safe intervention?". Its originality lay in the experimental substantiation of the expediency of such interventions and was subsequently used by Pirogov himself in clinical conditions.
On June 9, 1832, the work was submitted for publication; Pirogov was approved for the degree of Doctor of Medicine. The dissertation analyzed the structure and functions of the abdominal aorta, its position in relation to neighboring organs, the methods of exposure of the abdominal aorta, painful changes that cause the need for its ligation, the consequences of ligating the abdominal aorta. In the dissertation, as well as in other works of N.I. Pirogov, clearly formulates the original idea, ways to solve the fundamental problem, methods that can be used to achieve results in solving applied problems of clinical medicine.
Pirogov defended his doctoral dissertation. Hood. V. Pirogov.
After defending his doctoral dissertation, he was sent to Germany. The young professor came abroad, able to take what he needs, discard the excess, confident in his abilities. While in Berlin, he was shocked that "practical medicine is almost completely isolated from its main real foundations: anatomy and physiology." K. Grefe, for example, during the operation, asked the anatomist F. Slam, who was standing nearby: "Does the trunk or branch of the artery pass here?" D. Dieffenbach did not believe in the severe complications that the surgeon, who did not know anatomy, “gave” to the patient. Its principle was simple: "Saw bones, cut soft tissues, tie up bleeding vessels." But in Göttingen, Pirogov was delighted with the technical perfection of the operations of Konrad Langenbeck (Uncle Bernhard Langenbeck). Here he learned "... not to hold the knife with a full hand, with a fist, not to put pressure on it, but to pull, like a bow, along the fabric being cut."
N.I. Pirogov and K.D. Ushinsky in Heidelberg. Hood. A. Sidorov.
At the time of study and practical activities N.I. Pirogov at the University of Dorpat and in Germany account for an important internal stage in the formation of his worldview. There are undoubtedly two important factors here. First of all, the young man was deeply influenced by the great German philosophy of the early 19th century, literally permeated with universal ideas, striving for the Absolute, high idealism, as well as the works of German idealist teachers. It was in the enlightenment and romantic thought of Germany at that time that the ideal was formed as a special concept of value, in particular, moral consciousness and ethical reasoning. All this later laid the foundation for Pirogov's philosophy of education. At the same time, the humanistic ideal of N.I. Pirogov was closely linked with the development of a whole direction in pedagogy - with "humanistic pedagogy", the essence of which is attention to the pupil as an integral unique personality, striving for the maximum realization of his capabilities (self-actualization), the use of his abilities aimed at the expedient resolution of life situations.
It is impossible not to emphasize another important circumstance. It is impossible to understand the nature of all the moral qualities inherent in Pirogov and so striking to his contemporaries - inner freedom, human dignity, respect for the individual in all spheres of life, firmness in his moral convictions and unselfishness of the soul without understanding that these features were formed during his life in the West (part of Derpt was also, undoubtedly, a phenomenon of Western civilization), and not in Nikolaev Russia, where a person with such moral qualities could not take place and would sooner or later be broken by the bureaucratic machine.
Returning home, Pirogov fell seriously ill and was left for treatment in Riga. Riga was lucky: if Pirogov had not fallen ill, she would not have become a platform for his rapid recognition. As soon as Pirogov got up from the hospital bed, he undertook to operate. The city had heard rumors before about the promising young surgeon. Now it was necessary to confirm the good reputation that ran far ahead. He began with rhinoplasty: he carved out a new nose for a noseless barber. Then he recalled that it was the best nose he had ever made in his life. Plastic surgery was followed by the inevitable lithotomies, amputations, removal of tumors.
From Riga he went to Derpt, where he learned that the Moscow chair promised to him had been given to another candidate. But he was lucky - Ivan Filippovich Moyer handed over his clinic in Dorpat to the student. In 1836, at the age of 26, N.I. Pirogov was elected head of the Clinic for Theoretical, Operative and Clinical Surgery at Derpt University. It was not easy: "It was mainly theologians who rebelled against me. They said that ... only Protestants could be university professors." The new "Herr Professor" is strict, he has already seen enough of the unknowing Germans. A student who passed anatomy with a "troika" did not have the right to take a scalpel in his hand. For each student, a hundred questions are in store, and always one, the last one: "Why?". He shows great industriousness in surgical activities.In the 2 years prior to his work in the clinic, only 92 operations were performed, and under his supervision over the next 2 years - 326, and for all 4 years of his work, 1391 people received surgical treatment on an outpatient basis, and in a hospital - 656 patients.
Great doctor. Hood. K. Kuznetsov and V. Sidoruk.
He subjected his surgical activity to serious critical analysis in two editions of the Annals of the Surgical Department published during this period (1837 and 1839), which, in his words, "put his finger into the wounds of many clinical teachers." This caused bewilderment and indignation among some of the professors, sympathized - a few. In them, he "by the correct open recognition of his mistakes and by revealing the intricate mechanism of them, he wanted to save his students and novice doctors from repeating them." He then wrote that "... I made it a rule when I first entered the department not to hide anything from my students, and if not immediately, then immediately reveal to them the mistake I made, whether it will be in the diagnosis or in treatment". In 1907 I.P. Pavlov noted on this occasion: "Such merciless frank criticism of oneself and one's activities is hardly found anywhere in the medical literature, and this is a great merit."
In addition, heading the surgical clinic in Dorpat, N.I. Pirogov continues to study anatomy, physiology and surgical approaches to operations on large vessels. A year later, in 1837, he published the work "Surgical Anatomy of the Arterial Trunks and Fibrous Fascia" - an atlas in Latin, the text in German. These works soon became known not only in Russia but also abroad. They didn’t deal with fascia before Pirogov: they knew that there were such fibrous fibrous plates, shells surrounding muscle groups, stumbled upon them during operations, cut them with a knife, not attaching any importance to them. Pirogov studied the direction of the fascial membranes, their position, discovered certain anatomical patterns. Pirogov's monograph "On transection of the Achilles tendon as an operative-orthopedic treatment" (1837) is admired by specialists.
In 1838, N.I. Pirogov went to study in France, where five years earlier, after a professorial institute, the authorities did not want to let him go. In Parisian clinics, he got acquainted with teaching and hospital practice in the clinics of famous French surgeons D. Lisfranc, F.-J. Roux, D. Amussa. He meets with the famous surgeon and anatomist A. Velpo (Paris), a student of the outstanding French anatomist and physiologist M.F. Bisha. When N.I. Pirogov in the office of A. Velpo, the latter was busy studying the book "Surgical Anatomy of Arterial Trunks and Fibrous Fascia" and gave it a very high rating. He said: "It's not for you to learn from me, but for me to learn from you."
N.I. Pirogov wrote that "... from the very first entry into the educational and practical field, he put anatomy and physiology at the foundation at a time when this direction - now a general one - was still new, ... not recognized by everyone, and even by many significant authorities denied. ... My work could not but attract attention. " They "... showed for the first time with accuracy and clarity the relationship of the fascia to the arterial trunks and pointed out the methods that are most convenient and accurate for performing operations."
A direct confirmation of the clinical orientation of the anatomical studies of N.I. Pirogov in studying the possibilities of ligation of large vessels and the anatomy of their fibrous fascia is his exceptional experience in ligation of large arteries in 69 patients with aneurysms, malignant neoplasms, telangiectasias and bleeding, and success was achieved in 32 people ("The beginning of general military field surgery" , 1866). It seems that the study of the surgical anatomy of arterial trunks and fibrous fascia N.I. Pirogov formed the basis for the development of many operations in world surgery, and especially in the development of vascular and military field surgery, as well as other areas. Even at present, the principles of N.I. Pirogov are also used in the development of modern methods for isolating vascular formations in the hilum of the liver during hemihepatectomy.
On April 17, 1841, an extraordinary meeting of the Academy of Sciences was held to analyze the essays submitted to the Demidov competition. "Half the prize was awarded to N.I. Pirogov for his work "On the surgical treatment of arteries" (St. Petersburg, 1839). His work "Surgical anatomy of arterial trunks and fascia" was published in 1837 in Latin, in 1840 it was translated NI Pirogov received four Demidov Prizes - in 1841 and 1844, and then back in 1850 and 1860 he was awarded these high awards.
On January 18, 1841, Nicholas I approved the transfer of Pirogov from Dorpat to St. Petersburg to the post of head of the clinic for hospital surgery and pathological anatomy of the St. Petersburg Medical and Surgical (now Military Medical) Academy, which he led until 1856. , 300 people were packed. Not only doctors crowded on the benches, students from other educational institutions, writers, officials, military men, artists, engineers, even ladies came to listen to Pirogov. Newspapers and magazines write about him, compare his lectures with the concerts of the famous Italian Angelica Catalani: his speech about incisions, stitches, purulent inflammations and autopsy results is divine singing! Despite the hostility of the leadership, Nikolai Ivanovich achieves the realization of his ideas - he expands the clinical base of the department to 2000 beds, introduces new methods of teaching anatomy and surgery - clinical rounds with a detailed analysis of patients' diseases, students on duty. The organization at the suggestion of N.I. became extremely important in the teaching of medicine. Pirogov, the world's first hospital surgical clinic, where first here, and then in other educational institutions, students began to be trained directly in the treatment of patients.
Demonstration operation in Pirogov's clinic. The artist is not known.
Nikolai Ivanovich is appointed director of the Tool Plant. Now he comes up with tools that any surgeon will use to perform the operation well and quickly. He is asked to accept a consultant position at one hospital, another, a third, and he accepts.
In the literature there are references to the election of N.I. Pirogov to the Russian Academy of Sciences, but it was of undoubted interest to find authentic documents relating to his election, a more complete understanding of the conditions of this event. Many documents written by N.I. Pirogov, materials related to the award of the Demidov Prize to him, the original protocols of his election as a corresponding member. On Wednesday, November 27, 1846, a secret ballot was held for the election of members of the Department of Physical and Mathematical Sciences to the Imperial St. Petersburg Academy of Sciences. There were 18 academicians in the Department of the Academy, the following took part in the voting: K.M. Baer, P.A. Zagorsky, A.Ya. Kupfer, M.V. Ostrogradsky, V.Ya. Struve, E.Kh. Lenz, B.S. Jacobi, Yu.O. Fritzsche, H.P. Peters, G.P. Gelmersen and others. There were 7 candidates on the secret ballot list, among them N.I. Pirogov. 14 members of the Academy voted for Pirogov and he was elected.
December 5, 1846 N.I. Pirogov at the age of 36 was approved as a corresponding member of the Imperial St. Petersburg Academy of Sciences. Below are archival data not only about the election of Nikolai Ivanovich, but also how life was organized at the Academy according to the Charter of the 19th century, how an ordinary academician and corresponding member differed from the modern idea of \u200b\u200bthese academic titles, as in the 19th century. and at the beginning of the 20th century. evaluated the role of Nikolai Ivanovich in the development of fundamental science. The life of the Academy was subordinated in the first years of its organization in the 18th century. Regulations, and then the Charter of the Academy was prepared. Election of N.I. Pirogov took place in accordance with the Charter of the Imperial St. Petersburg Academy of Sciences, which was approved in 1836 and was valid until 1927, when it was formed on the basis of the Russian Academy of Sciences in the new country of the Academy of Sciences of the USSR and a new Charter was adopted - the Charter of the Academy of Sciences of the USSR. According to the Charter of 1836, the Academy of Sciences was recognized as "the leading scientific class in the Russian Empire." The number of ordinary academicians was determined to be 21 people - all of them were required to work in the Imperial Academy of Sciences. However, "in addition to full members, it elects honorary members and correspondents," who sit together with academicians in public and general meetings if they are in St. Petersburg. This provision was included in the Charter of 1836 and it must be remembered in order to understand the differences in the semantic content of the title of Corresponding Member of the Academy of Sciences in the 19th century. and XX century. It consisted in the fact that the number of vacancies for full members was limited in the 19th century. not only by the number of seats (this has been preserved to this day), but also by the indispensable provision of a permanent job at the Imperial St. Petersburg Academy of Sciences, elections for this position took place only when a vacancy for work at the Academy of Sciences opened.
In accordance with § 4 of the Charter of 1836, the sciences, the improvement of which the Academy should be engaged in, included: Pure and applied mathematics; Astronomy; Geography and navigation; Physics; Chemistry; Technology; Mineralogy; Botany; Zoology; Comparative anatomy and physiology; Story; Greek, Roman literature; Eastern literature; Statistics, political economy. Nikolai Ivanovich, following the results of voting, was elected a corresponding member in the category of biological sciences. Departments of Physical and Mathematical Sciences of the Imperial St. Petersburg Academy of Sciences, area of scientific interests - medical surgeon, anatomist. Among those who participated in the vote was Karl Maksimovich Baer (1792-1862), academician, zoologist. He highly appreciated the contribution of Nikolai Ivanovich to science and wrote that the applied anatomy of N.I. Pirogov is an important in its plan, completely original and independent creation, such a feat cannot be marked by anything other than a full wreath. The field of knowledge in accordance with the Charter, according to which N.I. Pirogov, - comparative anatomy and physiology. Many years later, on December 1, 1901, I.P. was elected a corresponding member of the Academy of Sciences in the same specialty. Pavlov. In 1904, he received the Nobel Prize, enjoyed exceptional respect in the scientific community, but only on December 1, 1907, I.P. Pavlov became an ordinary academician (comparative anatomy and physiology) at the Imperial St. Petersburg Academy of Sciences in the same Department as N.I. Pirogov. This became possible when a vacancy for a full member of the Academy opened after the death in 1906 of Acad. F.V. Ovsyannikov.
Following the results of the elections of 1846, together with N.I. Pirogov on the same day, December 5, 1846, in the Department of Physical and Mathematical Sciences, Bischoff and Edwards were approved as foreign members - corresponding members in the biological category at the Imperial St. Petersburg Academy of Sciences. Theodor Ludwig Wilhelm Bischoff, anatomist, embryologist, physiologist. Described the process of crushing an egg (1838). Henri-Milne Edwards - zoologist, physiologist.
From the moment the Academy of Sciences was founded in 1824 to the present day, its key role in the Society has been to develop the problems of fundamental science, which plays a special role in the arguments in the election of its members. By the middle of the 40s. 19th century, i.e. by the time of his election to the Academy, N.I. Pirogov made the most significant contribution to human anatomy, he proposed a method and obtained unique results in the development of problems that can be formulated as three-dimensional anatomy. N.I. Pirogov made an invaluable contribution to a number of branches of medicine - the introduction of ether anesthesia, a plaster cast, the principles of sorting the wounded, and some other areas in surgery into the clinic. These works were highly appreciated not only by contemporaries, but also by outstanding minds of the 20th century.
N.I. Pirogov repeatedly made presentations at meetings at the Academy of Sciences. On April 2, at a meeting of the Physics and Mathematics Department in 1847, K.M. Baer presented the article to N.I. Pirogov "A new method of conducting ethereal vapors for surgical operations". June 11, 1847 at a meeting of the Physics and Mathematics Department of K.M. Baer presented a brochure to N.I. Pirogov "Practical and physiological research on etherization". On April 17, 1851, the Demidov Prize for 1850 was awarded to N.I. Pirogov for the work "Pathological anatomy of cholera, with an atlas". On April 17, 1860, the Demidov Prizes for 1860 were awarded to N.I. Pirogov was awarded the prize for his work "Topographic Anatomy".
The deepest impact on the entire personality of N.I. Pirogov was rendered by his ardent appeal to God that happened in 1848 during the plague epidemic. In the "Diary of an old doctor" he recalled this: "I needed an abstract, unattainable high ideal of faith. And taking up the Gospel, I found this ideal for myself."
So in the personality of Pirogov there was an individualization of the universal ideal - he took personified forms, transforming into a personal ideal. At the same time, this ideal was concretized in the image of God while maintaining its absolute characteristics.
In a state of deep spiritual renewal, Pirogov again thinks about higher substances and categories as values that open up broader prospects for a person. Gradually, he begins to crystallize the idea of educating "true people" with developed mental abilities, moral freedom of thought and convictions, who sincerely love the truth and are ready to stand up for it with a mountain, capable of self-knowledge and self-sacrifice.
This is especially evident in his letters to his future wife, Baroness A.A. Bistorm (1849-50). It is no coincidence that the full title of his famous article is "Questions of life, an excerpt from forgotten papers brought to light by the unofficial articles of the Marine Collection on Education."
Since the duties of N.I. Pirogov included the training of military surgeons, he began to study the surgical methods common in those days. So, in 1854, Pirogov published in Russian and German the article "Osteoplastic elongation of the bones of the lower leg during exfoliation of the foot" - the advantage of this work is that "a piece of one bone, being in combination with soft parts, grows to another and serves ... to elongation of the limb", providing the possibility of using its support function. Thus, he laid the foundation for osteoplastic operations in world surgery, which served as one of the grounds for performing organ-preserving operations for injured limbs with bone damage. N.I. Pirogov emphasized that previously such injuries served as an indication for amputations, and he, in addition to the principle of osteoplastic interventions, proposed, according to appropriate indications, to strive to treat open fractures by immobilizing the limbs in a "starch" bandage, i.e. by imposing even a deaf plaster bandage in 1847, and thereby improved the possibility of healing a bone and soft tissue wound and began to preserve the function of the limbs.
All this became possible due to the fact that less than six months after the announcement of the first anesthesia with ether, N.I. Pirogov in February 1847 in St. Petersburg began to use "etherization" for surgical interventions, while about 400 out of 600 he did himself. (Note - The world's first operation under ether anesthesia was performed on October 16, 1846 in a Boston clinic (USA) by William Morton. A submandibular tumor was removed).
After operation. Hood. L. Koshtelyanchuk.
But not only well-wishers surrounded the scientist. He had a lot of envious people and enemies who were disgusted by the zeal and fanaticism of the doctor. In the second year of his life in St. Petersburg, Pirogov fell seriously ill, poisoned by hospital miasma and the bad air of the dead. I couldn't get up for a month and a half. At the same time, he met Ekaterina Dmitrievna Berezina, a girl from a well-born, but collapsed and greatly impoverished family. A hurried modest wedding took place. Having recovered, Pirogov again plunged into work, great things were waiting for him. He “locked” his wife within the four walls of a rented and, on the advice of acquaintances, furnished apartment. He didn’t take her to the theater, because he disappeared until late in the anatomical theater, he didn’t go to balls with her, because balls were idleness, he took away her novels and slipped her scientific journals in return. Pirogov jealously pushed his wife away from her friends, because she had to belong entirely to him, just as he belongs entirely to science. And for a woman, probably, there was too much and too little of one great Pirogov. Ekaterina Dmitrievna died in her fourth year of marriage, leaving Pirogov two sons: the second cost her her life. Nikolai Ivanovich's health is deteriorating. He runs from his native walls, where everything reminds of the loss. In March 1847 N.I. Pirogov leaves for Western Europe. He spends all his time in clinics, noting the achievements of K. Langenbeck and D. Dieffenbach in Germany, G. Dupuytren and A. Nelaton in France, E. Cooper in England, for whom he was already a recognized authority.
However, in the difficult days of grief and despair for Pirogov, a great event happened - his project of the world's first Anatomical Institute was approved by the highest. Working on its base, he carried out absolutely exceptional topographic and anatomical (the term was proposed by the author himself) developments that led to the creation of "sculptural anatomy" by cutting the frozen human body in three directions. As a result of the use of a special method, these preparations were sketched in full size (3 artists helped N.I. Pirogov). Further, images from these drawings were transferred to special printing stones (some of them are still stored at the Military Medical Academy), and then printed in the form of certain tables in special notebooks, issued from 1848 to 1856. In total, 995 such drawings were made, to which 4 notebooks of explanatory text by N.I. Pirogov "Illustrated topographic anatomy of cuts ..." (782 p.). The author wrote that on the basis of this atlas (later in the literature it was called "Ice Anatomy"), he spent 8 years. At the same time, he began to use the method of freezing corpses back in 1842 when publishing a course of applied anatomy (mainly on the image of the joints and the head) "Otechestvennye zapiski" in 1860.
At the same time, the publication of "Applied Anatomy" brought N.I. Pirogov has many bitter moments. The publisher of the journal "Northern Bee" F. Bulgarin accused him of plagiarism, claiming that the materials were borrowed from the English surgeon C. Bell. Nikolai Ivanovich insisted on a judicial investigation, but the case ended with Bulgarin's written apology. The scientist asks for his resignation, even the lines of this official paper characterize Pirogov’s personality: “... is it possible to be a true doctor and a good mentor without having convictions about the high dignity of one’s art? eyes of the world? Here is a frank statement of the reasons that prompt me to leave the service at the academy ... I have never sought personal benefits and therefore I will leave it as soon as my view of my own dignity, which I used to cherish, requires it. Nevertheless, Nikolai Ivanovich was persuaded not to leave the academy.
In 1847, Pirogov went to the Caucasus to join the army, as he wanted to test the operating methods he had developed in the field. In the Caucasus, he first used dressing with bandages soaked in starch. Starch dressing turned out to be more convenient and stronger than previously used splints. Here, in the village of Salty in July 1847, N.I. Pirogov for the first time in the history of medicine began to operate on the wounded under ether anesthesia in the field. He used ether anesthesia in 100 wounded (in 98 by inhalation through a device specially created by him and in 2 people by rectal "esterization"). In the same place, instead of amputation, he performed resections of the shoulder (4) and elbow (6) joints. All this was soon published in St. Petersburg and in Paris at the French Academy.
Nikolai Ivanovich Pirogov with his sons. 1850
After the death of Ekaterina Dmitrievna Pirogov was left alone. "I don't have any friends," he admitted with his usual frankness. And at home, the boys, sons, Nikolai and Vladimir were waiting for him. Pirogov twice unsuccessfully tried to marry for convenience, which he did not consider it necessary to hide from himself, from acquaintances, it seems that from the girls planned to be the bride. In a small circle of acquaintances, where Pirogov sometimes spent evenings, he was told about the twenty-two-year-old Baroness Alexandra Antonovna Bistrom, who enthusiastically read and reread his article on the ideal of a woman. The girl feels like a lonely soul, thinks a lot and seriously about life, loves children. In conversation, she was called "a girl with convictions." Pirogov proposed to Baroness Bistrom. She agreed. Gathering at the estate of the bride's parents, where it was supposed to play an inconspicuous wedding. Pirogov, confident in advance that the honeymoon, disrupting his usual activities, would make him quick-tempered and intolerant, asked Alexandra Antonovna to pick up crippled poor people in need of an operation for his arrival: work will delight the first time of love!
Not without effort Corresponding Member. Petersburg Academy of Sciences, Pirogov obtained permission to participate in the Crimean War, and in November 1854 he arrived in the besieged Sevastopol. Operating on the wounded, for the first time in the history of world medicine, Pirogov used a plaster cast, giving rise to a savings tactic in the treatment of limb injuries and saving many soldiers and officers from amputation. During the siege of Sevastopol, to care for the wounded, Pirogov supervised the training and work of the sisters of the Exaltation of the Cross community of sisters of mercy.
N.I. Pirogov and sailor Pyotr Koshka. Hood. L. Koshtelyanchuk.
The most important merit of Pirogov is the introduction in Sevastopol of a completely new method of caring for the wounded. The wounded were subject to careful selection already at the first dressing station: depending on the severity of the wounds, some of them were subject to immediate operation in the field, others, with lighter wounds, were evacuated inland for treatment in stationary military hospitals. Therefore, Pirogov is rightly considered the founder of a special area in surgery, known as military field surgery.
About 10,000 "significant" operations were performed in a year, most of them with anesthesia. For merits in rendering assistance to the wounded and sick N.I. Pirogov was awarded the Order of St. Stanislav 1st degree.
Pirogov in Simferopol. The artist is not known.
In October 1855, a meeting of two great scientists took place in Simferopol - N.I. Pirogov and D.I. Mendeleev. A well-known chemist, the author of the periodic law of chemical elements, and then a modest teacher at the Simferopol gymnasium, turned to Nikolai Ivanovich for advice on the recommendation of the St. Petersburg life physician N.F. Zdekauer, who found tuberculosis in Mendeleev and that, in his opinion, the patient had only a few months to live. It was obvious: the huge overloads that the 19-year-old boy put on his shoulders, and the damp climate of St. Petersburg, where he studied, had a negative impact on his health. N.I. Pirogov did not confirm the diagnosis of his colleague, prescribed the necessary treatment and thus brought the patient back to life. Subsequently, D.I. Mendeleev spoke enthusiastically about Nikolai Ivanovich: "That was a doctor! He saw through a person and immediately understood my nature."
N.I. Pirogov examines the patient D.I. Mendeleev. Hood. I. Quiet.
From the theater of operations, he brought contempt and hatred for the bureaucracy, for the constant substitution of the form of the real case. And also a deep conviction that the cardinal shortcoming of people is the lack of a spiritual and moral core, high human ideals, which in turn is a consequence of the lack of a true preparation of a person for life.
It is characteristic that, having returned to St. Petersburg, at a reception at Alexander II, Pirogov sharply critically told the emperor about the problems in the troops, and also spoke about the general backwardness of the Russian army and its weapons, which forever ruined relations with the emperor. This once again confirms the presence of a pronounced ideal in the worldview of N.I. Pirogov, which was associated with the presence of unshakable convictions, absolute faith in the correctness of the chosen ideas. The king did not want to listen to Pirogov. Moreover, straightforwardness, adherence to principles, exactingness not only to oneself, but also to others create many enemies. The struggle for the truth brings Pirogov hard times. "What am I to blame and before whom, that in my heart all the impulses to the high and holy have not yet died out, that I have not yet lost the willpower to sacrifice happiness ..." - he wrote. After reflection, and the journey from Sevastopol was long, 45-year-old Nikolai Ivanovich, in the prime of life and talent, submits a report on leaving the academy. "... Moral exhaustion in the struggle with people for whom the goals of scientific and moral truth are little understood ..." outweighed all arguments.
S.P. Botkin, a contemporary of Pirogov, said: “The feeling of envy for this big man turned into bitterness. Adored by his students and everyone who knew Nikolai Ivanovich closely, he was hated by a certain part of our medical corporation, which did not forgive him for his moral superiority and the truthfulness that distinguished him ... ".
At this time, the goal-oriented basis of his pedagogical system was finally formed. About the reasons for the doctor's appeal to pedagogical activity, N.P. Sakulin "Under the oppressive impression of the Sevastopol war, N.I. Pirogov plunged into a mournful civil thought. A citizen defeats a doctor and a scientist in Pirogov. He comes to a deep conviction that we "can achieve true progress in one, only way of education" that education after religion, the highest aspect of our social life."
External impulse of N.I. Pirogov to pedagogical problems is private and to a certain extent random. The editors of the journal "Sea Collection" suggested that the scientist write an article about possible changes in the content of education and the educational process in the naval cadet corps. The result of this was Pirogov’s program article “Questions of Life”, published uncensored in the July 1856 issue of the magazine, in which he pointed out a great discord between class education, school and reality, convinced that before a young person receives special knowledge, he must acquire " general human education. "Let the inner man work out and develop! Give him time and means to subjugate the outer man, and you will have merchants, soldiers, sailors, and lawyers; and most importantly, you will have people and citizens!" The article immediately attracted a lot of public attention and caused a huge resonance.
Why did this happen? After all, both before Pirogov's article and after it, various pedagogical articles were published on the pages of the Marine Collection, including those on broad universal topics. Their authors were well-known scientists - teachers, prominent figures of that time, for example, V.I. Dal, - but no one paid much attention to them.
Yes, and to the central issue of Pirogov's article - universal education - before Nikolai Ivanovich, many not only outstanding Western, but also domestic teachers have already addressed. Their articles appeared in various magazines and went almost unnoticed. Here there was a real sensation. According to N.S. Kartsov, "a first-class surgeon immediately becomes a deep teacher-thinker".
The loud public outcry that took place was caused by a combination of a number of circumstances. First of all, of course, the name of the author. The Crimean War, the heroism and tragedy of Sevastopol, in the defense of which the surgeon Pirogov took the most effective part, made him, in fact, a national hero and drew attention to the personality of Nikolai Ivanovich of great public interest.
Undoubtedly, the publication in which this article was published also had an effect. At first glance, a special journal of the maritime department is not the best place for publishing program pedagogical manifestos. But such a conclusion can only be drawn by a superficial person. "Sea Collection" at that time was personally patronized by the Grand Duke Konstantin - a very progressive statesman, a convinced reformer. And thanks to this, the publication of Pirogov's article in such a significant journal immediately gave it a state, almost imperial status. Moreover, the article was immediately reprinted in an appendix for 1856 in the pedagogical officialdom - "Journal of the Ministry of National Education" (No. 9) with a significant footnote "printed at the direction of the Minister of Public Education". All this gave "Questions of Life" almost the status of an official pedagogical concept, a new state philosophy of education, which teachers had to not only study, but also implement.
Well, the article by N.A. finally introduced "Questions of Life" into the circle of the most discussed publications. Dobrolyubov "On the Significance of Authority in Education", published in the May 1857 issue of the then most famous and popular social literary magazine Sovremennik, where the most favorable assessment of Pirogov's article was given. The publication noted that none of the previous articles on education, "has not had such a complete and brilliant success as" Questions of Life ". They struck everyone with their lightness of gaze, and the noble direction of the author's thought, and fiery, lively dialectics, and the artistic presentation of the issue raised. Actually, thanks to Dobrolyubov and through Dobrolyubov, the widest circles of readers, far from such special publications as the Marine Collection and the Journal of the Ministry of National Education, became acquainted with the contents of Questions of Life. In general, "Questions of Life" was highly appreciated by another then ruler of thoughts - N.G. Chernyshevsky.
However, it was not these, albeit very significant, circumstances that played the leading role in the enormous effect produced in society by the article "Questions of Life". The difficult social and political situation that developed in Russia after the defeat in the Crimean War and the humiliating Peace of Paris had a direct effect. Both in society and in government circles, the conviction grew stronger that "it is impossible to live like this", that cardinal reforms are necessary. And these Great Reforms of the 1860s, which began with the emancipation of the peasants in February 1861, would follow some time later.
But with the growing conviction of the need for reforms in the summer of 1856, their ideology and program were still absent. And the great merit of N.I. Pirogov is that he was able to offer such a program in the field of education to the humiliated and confused Russian society. According to N.P. Sakulina, "Pirogov appeared before the face of Russian society as a publicist-thinker when the spiritual awakening of the country began; with severe frankness and invincible sincerity, he raised the questions: do we live as we should? confession before your conscience, to a fundamental revision of the foundations of life.
It was the sincerity of the article, along with its fundamental nature, depth, integrity and comprehensiveness, that finally determined that public outcry, unprecedented in Russian pedagogy, neither before nor after. It immediately became a major social phenomenon. And as a result, it changed the fate of Nikolai Ivanovich Pirogov himself in a very significant way.
N.I. Pirogov, at the suggestion of the Minister of Public Education A.S. Norov, who followed on September 3, at the beginning of October 1856, he took the post of trustee of the Odessa educational district. This appointment came at the urging of Grand Duchess Elena Pavlovna and Grand Duke Konstantin, who supported Nikolai Ivanovich.
For N.I. Pirogov, this was, of course, a very serious decision. After all, not only did the sphere of his professional activity change radically - pedagogy to medicine, but its content also changed. Instead of the usual scientific, teaching work, medical practice, N.I. Pirogov was to be engaged in serious administrative activities as a general. As N.P. wrote Sakulin, "the famous surgeon was imbued with a purely evangelical faith in education and decides on a real feat of life: he abruptly breaks with his glorious past and becomes a teacher."
Pirogov's letters have been preserved, where he describes his state of mind in connection with the appointment. He wrote to Grand Duke Konstantin: "As a father and as a Russian, I understand the importance of education for our land and sincerely wish to see it based not only on the temporary needs of the country, but on deeper and more faithful principles."
And in a letter to a faithful friend, Baroness F.E. Raden, he stated his credo in this way: “I do not renounce my independence and my convictions. And I am not looking for anything. If they really want me to be useful, then let them not stop me halfway; now I no longer want to act against my conscience and my convictions; for this I may be too good, I may be too stupid.
As A.N. Ostrogorsky, "Pirogov went to his post of teacher-administrator, feeling like a missionary, a teacher of life, a preacher of a lofty and holy idea, drawn from the lessons and from the earthly life of the God-man."
I will also cite the judgment of N.S. Derzhavin: "Pirogov appeared in the pedagogical field as a public figure with a clear, precise and definite worldview, with ready-made solutions to all the smallest issues of pedagogical practice, and, moreover, with solutions that were not stereotyped, but deeply thought out and original."
However, the decision of N.I. Pirogov to agree with the proposal to take the post of trustee of the educational district, to a certain extent, logically followed from all previous events. As early as January 4, 1856, shortly after returning from the Crimean War, Nikolai Ivanovich filed a report on his resignation from the Medical-Surgical Academy, citing his "disordered health and domestic circumstances." In July 1856, an order was signed to dismiss Pirogov, which surprisingly coincided with the publication of Questions of Life. So the proposal of the Minister of Public Education to a certain extent resolved the resulting official and personal conflict. Moreover, this appointment gave a very high rank of Privy Councilor, which corresponded to the rank of Colonel General.
The results of N.I. Pirogov as a trustee, first of Odessa, and after the resignation from this position from September 1858 to March 1861, the trustees of the Kyiv educational district are always evaluated in two ways. On the one hand, there is an unconditional powerful personal contribution of Pirogov, as he called himself a “trustee - missionary”, to the development of enlightenment and education on the territory of these educational districts, which manifested itself literally in everything. As A.A. Musin-Pushkin, "this was a rare Trustee - a thoughtful philosopher who always carried out a serious pedagogical reform, comprehensively thought out in advance, which is the result not of an accidental thought, but of a whole pedagogical system, strictly carried out by him."
At the same time, if you look at it from the side of a personal career, then his activities, indeed, can hardly be considered successful. Reasons for the resignations of N.I. Pirogov from the post of trustee of educational districts, of course, are explained by the tough opposition that he met from the entire bureaucratic apparatus, which instantly sensed in him a dangerous stranger. The charges brought against N.I. Pirogov, were quite traditional for reformers in the field of education in the second half of the 19th - early 20th centuries. Sharp dissatisfaction on the part of influential Russian nationalists caused his desire to create equal conditions for the education of Poles and Jews. Naturally, this was seen not only as dangerous political consequences, but also "oppression of the interests of the Russian people."
The activities of the trustee in educating the broad sections of the working people, expressed, in particular, in supporting the opening of the first Sunday school in Kyiv, were considered extremely dangerous. These schools immediately fell under suspicion, frankly, not unfounded, in the dissemination of revolutionary ideas.
But the genuine democratism of N.I. Pirogov, his desire to strongly support various forms of amateur organizations and associations of students, high school students. In this, the bureaucracy saw only the danger of the spread of "free-thinking and nihilism."
Of course, all these radical movements had nothing to do with Pirogov himself. According to his socio-political views, Nikolai Ivanovich was never a radical. He always revered the supreme power, was a statesman in the highest sense of the word. He certainly had a negative attitude towards the revolutionary movements of the 1960s and 1970s, he was ardently indignant at the terrorist actions of the "seditious", and considered socialism "the purest utopia that threatens the freedom of the individual."
The immediate reasons for the resignations themselves are simply striking in their ludicrousness. So from the post of trustee of the Odessa educational district, N.I. Pirogov had to leave because of the party approved by him of the students of the Richelieu Lyceum, who noisily noted the message in the Belgian newspaper "Independence Belge" that preparations for the abolition of serfdom had begun in Russia. That is, in fact, those who ardently and loyally supported the actions of the supreme power.
As for the reasons for the resignation from the post of trustee of the Kyiv educational district, here, undoubtedly, a complex of circumstances that were not fully clarified played a role. Among them was direct dissatisfaction with the authorities, and a slanderous denunciation. But, of course, the problem was more complex. Pirogov wrote about it this way: “No matter how extensive and beneficial the activity of the person who is entrusted with the education of the region, but in reality, when the government focuses all attention on, in essence, the inevitable anxieties of the corporate life of the student generation, this activity takes on the character purely police.
The immediate reason was the decisive refusal expressed by N.I. Pirogov at a personal meeting with Emperor Alexander II, to perform supervisory and police functions in relation to students, who from the beginning of 1861 were assigned to the trustees of educational districts.
All these circumstances led, according to the decree of March 13, 1861, to the dismissal of Pirogov from the post of trustee of the Kyiv educational district. He also refused the position offered to him as a member of the council of the Ministry of Public Education. Pirogov was "stopped halfway" again. As Nikolai Ivanovich wrote bitterly in a private letter to Baroness Reden, "I lack something that must be possessed in order to be pleasant and seem useful." Regarding the dismissal of N.I. Pirogova A.I. Herzen wrote: "To see ... the fall of a man whom Russia is proud of - and not blush from ear to ear with shame - is impossible."
One way or another, immediately after the abolition of serfdom and the beginning of the stage of progressive development of all aspects of public life, especially education, N.I. Pirogov, paradoxically and unfairly, was out of work, although his historical time was just coming. As noted by N.S. Derzhavin, "Pirogov brought up in himself the best ideals of a great era, an era of broad humanism and enlightening ideas, and introduced them into his pedagogical activity. He wanted to raise the school of his time to the level of his high ideals, and if he did not always succeed in achieving this, then, of course, not because he did not have enough energy, will, perseverance and character, not because his ideals were too far from the real needs of modern school life... Pirogov could not realize the ideals of life in the sphere of his school work, because that in the life around him these ideals were only just outlined.
Fed up with public service, Nikolai Ivanovich leaves for his estate - in the village of Vishnya, Kamenetz-Podolsk province (now Vinnitsa region). Here he was mainly engaged in administrative and pedagogical work - he opened, for example, Sunday schools. But he did not leave medicine either. By this time, Pirogov had become a convinced Christian, and his professional skills had reached their peak. On his estate, he opened a free hospital and planted various medicinal plants for its needs. In this paradise, planted with lindens and permeated with the smell of a thousand herbs, treatment gave one hundred percent results, because there were no various hospital infections and stealing quartermasters.
Tchaikovsky at Pirogov. Hood. A. Sidorov.
The government twice turned to Nikolai Ivanovich with offers to serve in the pedagogical field. First, the new Minister of Public Education A.V. Golovnin suggested that Pirogov conduct a kind of revision of the educational process at the medical faculties of Russian universities in order to improve this activity. But this project never received its practical implementation.
But another proposal was accepted. In the spring of 1862, N.I. Pirogov was sent abroad "to perform various works on the educational and pedagogical part." The main task of the Minister of Public Education was "to guide and guide young people who are preparing for professorship." And here N.I. Pirogov showed his abilities and his inherent responsibility. He visited 25 European universities, got acquainted with the construction of the educational process in them, skillfully directed the scientific work of young scientists and supported their aspirations and undertakings. Pirogov compiled the characteristics of the professors for whom they worked. He studied the state of higher education in different countries, outlined his observations and conclusions. In his last official post, Nikolai Ivanovich earned great respect from scientists, many of whom left their mark on Russian and world science - A.N. Veselovsky, V.I. Guerrier, V.I. Lamansky, I.I. Mechnikov, A.A. Potebnya and others.
In October 1862, Pirogov advised the wounded Italian national hero D. Garibaldi. None of the most famous doctors in Europe could find the bullet lodged in his body. Nikolai Ivanovich determines the location of the bullet and asks not to rush to remove it - a little later it can be easily removed. And so it happened.
N.I. Pirogov at Giuseppe Garibaldi. Hood. K. Kuznetsov.
On behalf of the Society for the Care of the Sick and Wounded Soldiers (later the Red Cross Society), Pirogov travels to the Franco-Prussian front in Alsace and Lorraine, Bulgaria and Romania to monitor the activities of military medical institutions and develop measures to streamline care for the wounded.
However, in 1866, after the assassination attempt by D.V. Karakozov to Alexander II and the beginning of a change in the political course associated with the gradual curtailment of reforms, N.I. Pirogov was recalled to Russia and dismissed on June 17, 1866. Again, on a ridiculous external occasion, set out by the Minister of Public Education D.A. Tolstoy in a report to Alexander II as follows: "Taking into account that our universities mainly need professors in philological sciences, I find that N. Pirogov's stay abroad, as a specialist in medical sciences, does not seem essential for our professorial candidates" .
After that, N.I. Pirogov never returned. He was generally dismissed from public service even without the right to a pension. In the prime of his creative powers, Pirogov retired to his small estate in the village of Vishnya, where he organized a free hospital. He briefly traveled from there only abroad, and also at the invitation of St. Petersburg University to give lectures.
By this time, Pirogov was already a member of several foreign academies. For a relatively long time, Pirogov left the estate only twice: the first time in 1870 during the Prussian-French war, being invited to the front on behalf of the International Red Cross, and the second time, in 1877-1878. - already at a very advanced age - he worked at the front for several months during the Russian-Turkish war.
When Emperor Alexander II visited Bulgaria in August 1877, during the Russian-Turkish war of 1877-1878, he remembered Pirogov as an incomparable surgeon and the best organizer of the medical service at the front.
Despite his old age (then Pirogov was already 67 years old), Nikolai Ivanovich agreed to go to Bulgaria, provided that he was given complete freedom of action. His desire was granted, and on October 10, 1877, Pirogov arrived in Bulgaria, in the village of Gorna-Studena, not far from Plevna, where the main apartment of the Russian command was located.
Pirogov organized the treatment of soldiers, care for the wounded and sick in military hospitals in Svishtov, Zgalev, Bolgaren, Gorna-Studena, Veliko Tarnovo, Bokhot, Byala, Plevna.
From October 10 to December 17, 1877, Pirogov traveled over 700 km in a cart and sleigh, over an area of 12,000 square meters. km., occupied by the Russians between the rivers Vit and Yantra. Nikolai Ivanovich visited 11 Russian military temporary hospitals, 10 divisional infirmaries and 3 pharmacy warehouses located in 22 different settlements. During this time, he was engaged in treatment and operated on both Russian soldiers and many Bulgarians.
In early January 1881, the surgeon complained to his wife that he had some kind of painful ulcer in his mouth. So that he would not smell of tobacco (Nikolai Ivanovich was a heavy smoker), he rinsed his mouth with hot water - and considered it a burn. Alexandra Antonovna said: “I examined the alleged place of the burn and noticed behind the right upper canine on the hard palate, not far from the tooth cavity, a small grayish-white abscess the size of a lentil; when pressed, it caused pain, and a brick-colored circle the size of a dime formed around it. ". Pirogov said: "In the end, it's like cancer."
Doctor of the Kyiv military hospital S.S. Shklyarevsky, who observed the patient for a long time, connected the onset of the disease with the loss of N.I. Pirogov of the 3rd molar of the upper jaw in the spring of 1880. By that time, Nikolai Ivanovich had almost no teeth and categorically refused the offer to insert artificial ones. Most of his food was porridge, almost all his life he suffered from "catarrh" of the intestine, "earned" back in the Derpt period, and tried to follow a diet, from time to time left smoking cigars, drank alkaline water "Essentuki No. 17" and "Vichy".
During this period, Nikolai Ivanovich completed his work on visiting the theater of military operations in the Balkans and on November 5 (old style), 1879, he began the Diary of an Old Doctor.
Between the photographs of N.I. Pirogov in the late 60s and early 80s. In the 19th century, there was a huge difference: old age was advancing too hastily. The scientist did not hear so well, he did not remember the names well. Gray hair - even, white as snow, softened the sharp line of eyebrows that supported a high forehead, a beard covered a determined chin - now his stubborn features were only guessed. But he did not look like a decrepit old man. Even static photographic portraits did not hide the indomitability of his spirit. There is always some kind of aspiration in the face. This is how he looks in the picture of I. Repin.
Portrait of a surgeon N.I. Pirogov. Hood. I.E. Repin. (1881 . State Tretyakov Gallery. Moscow. Russia).
The 70-year-old doctor continued to operate at his place in Vishnu, consulted a lot, conducted extensive correspondence with friends, managed to take care of the vineyard, peaches, which he planted in greenhouses, a rose garden - more than 300 varieties of the queen of flowers. Ukrainian nature, the beauty of the garden had a calming effect on the surgeon, tired of everyday hardships.
In old age, people usually think about the meaning of life. Pirogov did not hide the fact that he often saw in her a manifestation of a higher mind: "In the recesses of the human soul, sooner or later, but inevitably, the realized ideal of the God-man had to develop and finally come." Religious and mystical views determined the attitude of Nikolai Ivanovich to his illness, he believed: what to be - that cannot be avoided. Everything must be patiently accepted.
The ulcer on the upper jaw could also be associated with the fact that, according to S.S. Shklyarevsky, the right maxillary alveolar process turned out to be slightly larger than the left one - due to uneven atrophy associated with tooth loss at different times. Constant injury could lead to a focus of inflammation.
The sensation and appearance of the painful place, according to Pirogov, at first resembled just an abrasion or a slight burn of the mucosa in the sky, but “then the abrasion quickly took the form of a hole and seemed to be an entrance to a dental fistula, quite possible in this place, but no channels, no discharge There was positively no pus."
An experienced doctor, N.I. Pirogov realized that a malignant process was developing, but he did not tell or write to anyone about it. Even in conversations with his wife, he avoided this topic, did not complain about the painful sensation, but continued to work calmly. It seemed to those around him that Pirogov was completely healthy. Many sick people came and besieged his house. He did not know how to refuse advice and help. However, the idea that the pathological process is progressing was disturbing. The doctor excluded irritating substances, alkaline waters, wine from food, and avoided solid foods. I drank up to 8 glasses of milk a day through a straw.
On the way to Odessa, the doctor I.V. Bertenson (friend and biographer of N.I. Pirogov). After examining the oral cavity, he said in an indifferent tone: "All this is nothing, and soon it will heal again ..." But in Odessa he did not hide from his friends that the nature of the disease was cancerous.
Instead of one sore on the palate mucosa, two have already formed. Pirogov takes various methods to protect the ulceration from injury: he uses pieces of oilcloth and Lister's protector (thin silk soaked in a 5% solution of carbolic acid in resinous substances). He still doesn't feel weak.
He found a method that he used until the end of his life: he took filter paper, moistened it in a thick broth of flaxseed and applied it to ulcers. Sometimes he added 2 drops of carbolic acid to the decoction, and later - tincture of opium and even a solution of morphine acetate. A gradual increase in the dose of morphine indicated growing pain. To drown them out, he made these stickers at night as well. However, the ulcer increased. Attempts to cover it with pieces of filter paper, oiled and soaked in a thick decoction of flaxseed, did not give any healing or analgesic effect.
Nevertheless, the fiftieth anniversary of the scientific, medical and social activities of N.I. Pirogov. It is not so easy to organize celebrations for a person in disgrace, who has not been dismissed, but removed from his duties. N.V. Sklifosovsky turned directly to the king with a request to organize a celebration, for which he received "the highest permission."
Arrival N.V. Sklifosovsky to the Cherry estate. Hood. A. Sidorov.
The message about the upcoming anniversary of the great scientist appeared in the newspapers as early as 1880, so some individuals and organizations sent congratulations to Pirogov in Cherry. At the Kaevsky railway station, carry out N.I. Pirogov gathered doctors, representatives of the medical faculty of the university.
He arrived in Moscow on May 22, 1881. The carriage in which the surgeon and his wife rode was decorated with garlands of flowers.
Arrival of Nikolai Ivanovich Pirogov to Moscow for the 50th anniversary of his scientific activity. Hood. I. Repin.
At the train station in the capital, he was met by a huge crowd. People shouted: "Long live the patriarch of Russian surgery!", "Glory to the Russian luminary Pirogov!". In agitation, Nikolai Ivanovich said: "Is it really so important to them. And they need me? .." Ilya Repin, who was present at the anniversary, wrote: “It was an extraordinary celebration. And how could it be otherwise, because Pirogov is a genius! Yes, undoubtedly a genius! Repin showed a deep interest in the personality of Pirogov and sought to recreate the image of the great scientist on the canvas. During the celebrations, the artist painted a portrait of the hero of the day. In addition, Repin made sketches to work on the bust of the scientist, which he then sculpted.
The celebrations took place on May 24 and 25, 1881 in the assembly hall of Moscow University. Delegations from all over Russia arrived to congratulate the hero of the day. Greetings came from Russian societies, departments and cities, universities of Western Europe (Paris, Strasbourg, Edinburgh, Prague, Munich, Vienna, Padua, Brussels).
Speech at Moscow University, brilliant in form and deep in content, is dedicated to the mission of the doctor. Russia saluted the great son. The City Duma appropriated N.I. Pirogov the title of "Honorary Citizen of the City of Moscow". He was the fifth person to receive this honorary title. THEM. Sechenov called Nikolai Ivanovich "a glorious citizen of his land." Russia saluted the great son. This was the last meeting of the great scientist with his colleagues, students. Exciting experiences for a short time distracted from the disease.
The first consultants for the illness of Nikolai Ivanovich were N.V. Sklifosovsky and I.V. Bertenson.
Nikolai Vasilievich Sklifosovsky (1836-1904) - Honored Professor, Director of the Imperial Clinical Institute of Grand Duchess Elena Pavlovna in St. Petersburg.
Having examined Pirogov, N.V. Sklifosovsky told S. Shklyarevsky: "There can be no doubt that the ulcers are malignant, that there is a neoplasm of an epithelial nature. It is necessary to operate as soon as possible, otherwise a week or two will be too late ..." This message struck Shklyarevsky like a thunder, he did not dare to tell the truth even to Pirogov's wife, Alexandra Antonovna. Of course, one can hardly assume that N.I. Pirogov, a brilliant surgeon, a highly qualified diagnostician, through whose hands dozens of oncological patients passed, could not make a diagnosis himself.
On May 25, 1881, a council was held in Moscow, consisting of the professor of surgery at the University of Dorpat E.K. Val, professor of surgery at Kharkov University V.F. Grube and two St. Petersburg professors E.E. Eichwald and E.I. Bogdanovsky, who came to the conclusion that Nikolai Ivanovich had cancer, the situation was serious, it was necessary to operate faster. Presiding at the council N.V. Sklifosovsky said: "Now I will remove everything clean in 20 minutes, and in two weeks it will hardly be possible." Everyone agreed with him.
But who will find the courage to tell Nikolai Ivanovich about this? asked Eichwald, given that Pirogov was in close friendship with his father and transferred his attitude to his son. He categorically protested: "I? .. No way!". I had to do it myself.
Here is how Nikolai Sklifosovsky describes the scene: "... I was afraid that my voice would tremble and my tears would betray everything that was in my soul ... - Nikolai Ivanovich! - I began, looking intently into his face. - We decided to offer you to cut ulcer. Calmly, with complete self-control, he listened to me. Not a single muscle on his face trembled. It seemed to me that the image of the sage of antiquity arose before me. Yes, only Socrates could listen with the same equanimity to the harsh sentence of approaching death! silence. Oh, that terrible moment!.. I still feel it with pain. "I beg you, Nikolai Vasilyevich, and you, Val," Nikolai Ivanovich told us, "do me an operation, but not here. We have just finished celebration, and suddenly then a feast! Can you come to my village? .. Of course, we agreed. The operation, however, was not destined to come true ... "
Like all women, Alexandra Antonovna still hoped that salvation was possible: what if the diagnosis was wrong? Together with his son N.N. Pirogov, she convinced her husband to go to the famous Theodor Billroth in Vienna for a consultation and accompanies him on a trip with his personal doctor S. Shklyarevsky.
Theodor Billroth (1829-1894) - the largest German surgeon.
On June 14, 1881, a new consultation took place. After a thorough examination, T. Billroth recognized the diagnosis as correct, but, given the clinical manifestations of the disease and the age of the patient, he reassured that the granulations are small and sluggish, and neither the bottom nor the edges of the ulcers have the appearance of a malignant formation.
Parting with an eminent patient, T. Billroth said: “Truth and clarity in thinking and feeling, both in words and in deeds, are the steps of the ladder that lead humanity to the bosom of the gods. Follow you, both a bold and confident leader, on this not always safe path has always been my deepest aspiration." Consequently, T. Billroth, who examined the patient, was convinced of a difficult diagnosis, but realized that the operation was impossible due to the difficult moral and physical condition of the patient, so he "rejected the diagnosis" made by Russian doctors. Of course, many people had a question, how could the experienced Theodor Billroth overlook the tumor and not perform the operation? Realizing that he must discover the cause of his own holy lie, Billroth sent a letter to D. Vyvodtsev, in which he explained: “My thirty years of surgical experience taught me that sarcomatous and cancerous tumors starting behind the upper jaw can never be radically removed ... I I would not have received a favorable result. I wanted, having dissuaded, to cheer up the patient who had fallen in spirit a little and persuade him to patience ... ".
Christian Albert Theodor Billroth was in love with Pirogov, called him a teacher, a brave and confident leader. At parting, the German scientist presented N.I. Pirogov his portrait, on the reverse side of which memorable words were written: “Dear Maestro Nikolai Pirogov! Truthfulness and clarity in thoughts and feelings, in words and deeds, are the steps of the ladder that leads people to the abode of the gods. To be like you, brave and as a convinced mentor on this not always safe path, steadily following you is my most zealous desire. Your sincere admirer and friend Theodor Billroth ". Date 14 June 1881 Vienna. N.I. Pirogov expressed compliments, also recorded on Billroth's gift. “He,” wrote N.I., “is our great scientist and outstanding mind. His work is recognized and appreciated. May it be allowed for me to turn out to be just as worthy and highly useful as his like-minded and reformer. The wife of Nikolai Ivanovich, Alexandra Anatolyevna, added to these words: "What is written on this portrait of Mr. Billroth belongs to my husband. The portrait hung in his office". Biographers of Pirogov do not always pay attention to the fact that Billroth also had his portrait.
Cheered up, Pirogov went to his place in Cherry, staying all summer in a cheerful state of mind. Despite the progression of the disease, the conviction that it was not cancer helped him to live, even to consult patients, to participate in the anniversary celebrations dedicated to the 70th anniversary of his birth. He worked on a diary, worked in the garden, walked, received patients, but did not risk operating. Methodically rinsed his mouth with a solution of alum and changed the protector. It didn't last long. In July 1881, while relaxing at the dacha of I. Bertenson on the estuary in Odessa, Pirogov again met with S. Shklyarevsky.
It was already difficult to recognize Nikolai Ivanovich. "Gloomy and focused on himself, he willingly let me look at his mouth and, keeping calm, with a gesture said several times significant:" It does not heal! .. It does not heal! .. Yes, of course, I fully understand the nature of the ulcer, but, agree yourself, it’s not worth it: a quick relapse, spread to neighboring glands, and, moreover, all this in my years cannot promise not only success, but can hardly promise relief ... ". He knew what awaited him. And being convinced of the imminent sad outcome, he refused the recommendation of S. Shklyarevsky to try electrolysis treatment.
He looked quite old. The cataract stole from him the bright joy of the world. Through the muddy veil, it seemed gray and dull. In order to see better, he threw back his head, screwed up his eyes piercingly, thrusting forward his overgrown gray chin - swiftness and will still lived in his face.
The more severe his sufferings, the more insistently he went on with The Old Doctor's Diary, filling the pages in an impatient, sweeping handwriting that grew larger and more illegible. For a whole year I was thinking on paper about human existence and consciousness, about materialism, about religion and science. But when he looked into the eyes of death, he almost abandoned philosophizing and began to hastily describe his life.
Creativity distracted him. Without wasting a single day, he was in a hurry. On September 15, he suddenly caught a cold and went to bed. The catarrhal condition and enlarged lymphatic glands of the neck aggravated the condition. But he continued to write lying down. "From the 1st sheet to the 79th, that is, university life in Moscow and Dorpat, was written by me from September 12 to October 1 (1881) in the days of suffering." Judging by the diary, from October 1 to October 9, Nikolai Ivanovich did not leave a single line on paper. On October 10, he picked up a pencil and began like this: "Will I still make it until my birthday ... (until November 13th). I must hurry with my diary ...". As a doctor, he clearly imagined the hopelessness of the situation and foresaw a quick denouement.
Prostration. He spoke little, ate reluctantly. He was no longer the same, a non-puppet person who did not know boredom, constantly smoking a pipe, smelling through and through of alcohol and disinfection. Sharp, noisy Russian doctor.
He relieved pain in the facial and cervical nerves with palliative means. As S. Shklyarevsky wrote, “an ointment with chloroform and subcutaneous injections of morphine with atropine are Nikolai Ivanovich’s favorite remedy for the sick and seriously wounded in the first time after being injured and while driving on dirt roads. Finally, in recent days Nikolai Ivanovich almost exclusively drank kvass, mulled wine and champagne, sometimes in considerable quantities."
Reading the last pages of the diary, one involuntarily marvels at the enormous will of Pirogov. When the pains became unbearable, he began the next chapter with the words: “Oh, hurry, hurry!.. Bad, bad... So, perhaps, I won’t have time to describe even half of St. Petersburg life ...” - and continued on. Phrases are already completely illegible, words are abbreviated strangely. "For the first time I wished immortality - the afterlife. Love did it. I wanted love to be eternal; - it was so sweet. To die at a time when you love, and die forever, irrevocably, it seemed to me then, for the first time in life, something unusually terrible ... Over time, I learned from experience that not only love is the reason for the desire to live forever ... ". The manuscript of the diary breaks off in the middle of a sentence. On October 22, the pencil fell out of the surgeon's hand. Many mysteries from the life of N.I. Pirogov keeps this manuscript.
Completely exhausted, Nikolai Ivanovich asked to be carried out onto the veranda, looked at his favorite linden alley to the veranda, and for some reason began to read Pushkin aloud: "A gift in vain, a random gift. Life, why were you given to me?". He suddenly drew himself up, smiled stubbornly, and then clearly and firmly said: "No! Life, you are given to me for a purpose!". These were the last words of the great son of Russia, the genius - Nikolai Ivanovich Pirogov.
A note was found on the desk among the papers. Skipping letters, Pirogov wrote (spelling preserved): “Neither Sklefasovsky, Val and Grube; neither Billroth recognized my ulcus oris men. mus. cancrosum serpeginosum (lat. - creeping membranous mucous cancerous mouth ulcer), otherwise the first three would not advise surgery, and the second would not recognize the disease as benign. Note marked October 27, 1881.
Less than a month before his death, Nikolai Ivanovich made his own diagnosis. A person who has medical knowledge treats his illness in a completely different way than a patient who is far from medicine. Doctors often underestimate the appearance of the initial signs of the disease, do not pay attention to them, are treated reluctantly and irregularly, hoping that "it will pass by itself." The ingenious doctor Pirogov was absolutely sure: all attempts are futile and unsuccessful. Distinguished by great self-control, he worked courageously to the end.
The last days and minutes of N.I. Pirogov was described in detail in a letter to Alexandra Antonovna by Olga Antonova, a sister of mercy from Tulchin, who was constantly at the bedside of a dying man: "1881, December 9, m. I am writing to you. On the 22nd Sunday, at half past two in the morning, the professor woke up, they transferred him to another bed, he spoke with difficulty, phlegm stopped in his throat, and he could not cough up. He drank sherry with water. Then he fell asleep until 8 in the morning. Woke up with increased wheezing from stopping sputum, the lymph nodes were very swollen, they were smeared with a mixture of iodoform and collodion, camphor oil was poured onto cotton wool, though with difficulty, but rinsed his mouth and drank tea. At 12 days he drank champagne with water, after which he was transferred to another bed and changed all clean linen, pulse was 135, respiration 28. At 4 days the patient became very delirious, they gave camphor with champagne one gram as prescribed by Dr. Shavinsky, and then every three quarters of an hour they gave camphor with champagne. At 12 o'clock at night, the pulse was 120. On the 23rd, Monday, at one in the morning, Nikolai Ivanovich completely weakened, the delirium became more incomprehensible. They continued to give camphor and champagne, after three quarters of an hour, and so on until 6 in the morning. The delirium intensified and became more indistinct with each passing hour. When I served the last time at 6 o'clock in the morning wine with camphor, the professor waved his hand and did not accept it. After that, he did not take anything, he was unconscious, strong convulsive twitching of his arms and legs appeared. The agony began at 4 o'clock in the morning and this state lasted until 7 o'clock in the evening. Then he became calmer and slept in an even deep sleep until 8 in the evening, then the contractions of the heart began and therefore breathing was interrupted several times, which lasted for a minute. These sobs were repeated 6 times, the 6th was the professor's last breath. Everything that I wrote down in my notebook I pass on to you. Then I testify my deep respect and deep respect for you and your family, ready to serve you. Sister of Mercy Olga Antonova.
On November 23, 1881, at 8:25 pm, the father of Russian surgery passed away. His son, Vladimir Nikolaevich, recalled that immediately before the agony of Nikolai Ivanovich "a lunar eclipse began, which ended immediately after the denouement".
He was dying, and nature mourned him: an eclipse of the sun suddenly came - the whole village of Cherry was plunged into darkness.
Shortly before his death, Pirogov received a book by his student, a famous surgeon from the St. Petersburg Medical and Surgical Academy, embalmer and anatomist, a native of Vinnitsa D. Vyvodtsev, "Embalming and methods of preserving anatomical preparations ...", in which the author described the method of embalming he found. Pirogov praised the book.
Long before his death, Nikolai Ivanovich wished to be buried in his estate, and just before the end he reminded him of this again. Immediately after the death of the scientist, the family filed a corresponding request to St. Petersburg. Soon an answer was received, in which it was reported that the desire of N.I. Pirogov can be satisfied only if the heirs give a signature on the transfer of the body of Nikolai Ivanovich from the estate to another place in the event of the transfer of the estate to new owners. Family members N.I. Pirogov did not agree with this.
A month before the death of Nikolai Ivanovich, his wife Alexandra Antonovna, most likely at his request, turned to D.I. Vyvodtsev with a request to embalm the body of the deceased. He agreed, but at the same time drew attention to the fact that the permission of the authorities was required for the long-term preservation of the body. Then, through the local priest, a petition is written "His Eminence to the Bishop of Podolsky and Brailovsky ...". He, in turn, applies for the highest permission to the Holy Synod in St. Petersburg. The case in the history of Christianity is unique - the church, taking into account the merits of N. Pirogov as an exemplary Christian and a world-famous scientist, allowed not to betray the body to the earth, but to leave it incorruptible, "so that the disciples and continuers of the noble and charitable deeds of the servant of God N.I. Pirogov could see his light appearance."
What made Pirogov refuse to be buried and leave his body on the ground? This riddle N.I. Pirogov will remain unsolved for a long time.
DI. Vyvodtsev embalmed the body of N.I. Pirogov and excised tissue affected by a malignant process for histological examination. Part of the drug was sent to Vienna, the other was handed over to the laboratories of Toms in Kyiv and Ivanovsky in St. Petersburg, where they confirmed that it was squamous epithelial cancer.
In an effort to implement the idea of preserving her husband's body, Alexandra Antonovna ordered a special coffin during his lifetime in Vienna. The question arose, where to keep the body permanently? The widow found a way out. At this time, a new cemetery was being laid near the house. For 200 silver rubles, she buys a piece of land for a family crypt from a rural community, encloses it with a brick fence, and the builders begin the construction of the crypt. The construction of the crypt and the delivery of a special coffin from Vienna took almost two months.
Only on January 24, 1882 at 12 noon did the official funeral take place. The weather was cloudy, the frost was accompanied by a piercing wind, but despite this, the medical and pedagogical community of Vinnytsia gathered at the rural cemetery to see off the great doctor and teacher. An open black coffin is placed on a pedestal. Pirogov in the dark uniform of the Privy Councilor of the Ministry of Public Education of the Russian Empire. This rank was equivalent to the rank of general. Four years later, according to the plan of the academician of architecture V. Sychugov, the construction of the funeral-red brick ritual church of St. Nicholas the Wonderworker with a beautiful iconostasis was completed above the tomb.
Glass sarcophagus with the body of N.I. Pirogov in the church-necropolis on the territory of his family estate in the village of Vishnya.
And today the body of the great surgeon, constantly reembalmed, can be seen in the crypt. In Vyshna there is a museum of N.I. Pirogov. During the Second World War, during the retreat of the Soviet troops, the sarcophagus with the body of Pirogov was hidden in the ground, while being damaged, which led to damage to the body, which was subsequently restored and re-embalmed. Officially, the tomb of Pirogov is called the "church-necropolis", consecrated in honor of St. Nicholas of Myra. The body is located below ground level in the mourning hall - the basement of the Orthodox church, in a glazed sarcophagus, which can be accessed by those who wish to pay tribute to the memory of the great scientist.
It is now obvious that N.I. Pirogov gave a powerful impetus to the development of scientific medical thought. "With the clear eyes of a man of genius, at the very first time, at the first touch of his specialty - surgery, he discovered the natural scientific foundations of this science - normal and pathological anatomy and physiological experience - and in a short time he established himself on this basis so much that he became a creator in his field ", - wrote the great Russian physiologist I.P. Pavlov.
Take, for example, "Illustrated Topographical Anatomy of Cuts Made in Three Dimensions Through a Frozen Human Body." To create the atlas, Nikolai Ivanovich used an original method - sculptural (ice) anatomy. He designed a special saw and sawed frozen corpses in three mutually perpendicular planes. Thus, he studied the shape and position of normal and pathologically altered organs. It turned out that their location was not at all what it seemed at autopsy due to a violation of the tightness of the closed cavities. With the exception of the pharynx, nose, tympanic cavity, respiratory and digestive canals, no empty space was found in any part of the body in the normal state. The walls of the cavities adhered tightly to the organs enclosed in them. Today, this remarkable work by N.I. Pirogov is experiencing a rebirth: the drawings of his cuts are surprisingly similar to the images obtained with CT and MRI.
Pirogov's name bears many of the morphological formations he described. Most are valuable reference points for interventions. A man of exceptional conscientiousness, Pirogov was always critical of conclusions, avoided a priori judgments, supported every thought with anatomical research, and if that was not enough, he experimented.
In his research, Nikolai Ivanovich was consistent - at first he analyzed clinical observations, then conducted experiments, and only then suggested an operation. His work "On the Achilles tendon transection as an operative-orthopedic treatment" is very indicative. Before him, no one dared to do this. “When I was in Berlin,” Pirogov wrote, “I had not yet heard a word about operative orthopedics ... I carried out a somewhat risky enterprise when, in 1836, I first decided to cut the Achilles tendon in my private practice.” At first, the method tested on 80 animals.The first operation was performed on a 14-year-old girl suffering from clubfoot.He relieved 40 babies aged 1-6 years from this shortcoming, eliminated contractures of the ankle, knee and hip joints.Used an extension apparatus of his own design, gradually stretching (dorsal flexion) feet with steel springs.
Nikolai Ivanovich operated on a cleft lip, cleft palate, tubercular "boneworm", "saccular" tumors of the extremities, "white tumors" (tuberculosis) of the joints, removed the thyroid gland, corrected convergent strabismus, etc. The scientist took into account the anatomical features of childhood, under his scalpel were newborns and teenagers. He can also be considered the founder of pediatric surgery and orthopedics in Russia. In 1854, the work "Osteoplastic elongation of the bones of the lower leg during exfoliation of the foot" was published, which marked the beginning of osteoplastic surgery. Anticipating the great possibilities of organ and tissue transplantation, Pirogov with his students K.K. Strauch and Yu.K. Shimanovsky was one of the first to perform a skin and cornea transplant.
The introduction of ether and chloroform anesthesia into practice allowed Nikolai Ivanovich to significantly expand the range of surgical interventions even before the beginning of the era of antiseptics. He did not limit himself to the use of well-known surgical techniques, he offered his own. These are operations for rupture of the perineum during childbirth, for prolapse of the rectum, nose plastic surgery, osteoplastic elongation of the bones of the lower leg, the cone-shaped method of amputation of the limbs, isolation of the IV and V metacarpal bones, access to the iliac and hyoid arteries, the method of ligation of the innominate artery and much more .
To evaluate the contribution of N.I. Pirogov to military field surgery, you need to know her condition before him. Helping the wounded was chaotic. Mortality reached 80% or more. The officer of the Napoleonic army F. de Forer wrote: “After the end of the battle, the field of the Battle of Borodino presented a terrible impression with almost no sanitary service ... All the villages and living quarters were packed with the wounded of both sides in the most helpless position. The villages died from incessant chronic fires. .. Those of the wounded who managed to escape from the fire crawled by the thousands along the main road, looking for means to continue their miserable existence. "An almost similar picture was in Sevastopol in the Crimean War. Amputations for gunshot fractures of limbs were considered as an imperative requirement and were carried out in the first day after the wound.The rule was: "by missing the time for the primary amputation, we lose more wounded than we save arms and legs."
His observations of the military surgeon N.I. Pirogov outlined in the "Report on a trip to the Caucasus" (1849), reporting on the use of ether for pain relief and the effectiveness of an immobilizing starch bandage. He proposed to expand the inlet and outlet of the bullet wound, excision of its edges, which was experimentally proven later. The rich experience in the defense of Sevastopol is described by Pirogov in "The Beginnings of General Military Field Surgery" (1865).
Nikolai Ivanovich emphasized the fundamental difference between general and military field surgery. “A beginner,” he wrote, “can still heal the wounded, not knowing well either head, or chest, or abdominal wounds; but in practice, his activity will be more than hopeless if he does not comprehend the significance of traumatic concussions, tension, pressure, general stiffness , local asphyxia and violation of organic integrity".
According to Pirogov, the war is a traumatic epidemic, and the activity of administrative doctors is important here. "I am convinced from experience that in order to achieve good results in a military field hospital, not so much scientific surgery and medical art are needed as efficient and well-established administration." It is not in vain that he is considered the creator of the medical evacuation system that was perfect for that time. Sorting of the wounded in European armies began to be carried out only after a few decades.
Acquaintance in the fortification of Salta with the methods of treatment by gakims (local doctors) of the highlanders convinced Nikolai Ivanovich that some gunshot wounds heal without medical intervention. He studied the properties of bullets used in the wars of 1847-1878. and came to the conclusion that "the wound should be left as far as possible at rest and not expose the damaged parts. I consider it a duty of conscience to warn young doctors against examining bullet wounds with their fingers, from extracting fragments, and in general from any new traumatic violence."
To avoid the danger of severe infectious complications after traumatic operations, Pirogov recommended dissecting the fascia to relieve the “tension” of the tissues, believing that it was harmful to tightly suture the wound after amputation, as advised by European surgeons. Long before, he spoke of the importance of wide drainage in suppurations in order to release "miasmatic wanderers." Nikolai Ivanovich developed the doctrine of immobilizing dressings - starch, "stuck on alabaster" (gypsum). In the latter, he saw an effective means of facilitating the transportation of the wounded, the bandage saved many soldiers and officers from the mutilation operation.
Already at that time, Pirogov was talking about "capillaroscopicity", and not about the hygroscopicity of the dressing material, believing that the better it cleans and protects the wound, the more perfect it is. He recommended English lint, cotton wool, cotton, peeled tow, rubber plates, but required a mandatory microscopic examination - a check for purity.
Not a single detail escapes Pirogov the clinician. His thoughts about the "infection" of wounds essentially anticipated the method of D. Lister, who came up with an antiseptic bandage. But Lister strove to close the wound hermetically, and Pirogov proposed "through drainage, carried out to the bottom and through the base of the wound and connected to constant irrigation." In his definition of miasms, Nikolai Ivanovich came very close to the concept of pathogenic microbes. He recognized the organic origin of the miasma, the ability to multiply and accumulate in overcrowded medical institutions. "Purulent infection spreads ... through the surrounding wounded, objects, linen, mattresses, dressings, walls, floors and even sanitary personnel." He proposed a number of practical measures: patients with erysipelas, gangrene, and pyemia should be transferred to special buildings. This was the beginning of the departments of purulent surgery.
Having studied the results of primary amputations in Sevastopol, Nikolai Ivanovich concluded: "Amputations of the hip do not give the best hope for success. Therefore, all attempts at saving treatment of gunshot wounds, hip fractures and knee joint injuries should be considered true progress in field surgery." The reaction of the body to injury is of no less interest to the surgeon than treatment. He writes: “In general, trauma affects the whole organism much deeper than is usually imagined. Both the body and the spirit of the wounded become much more susceptible to suffering ... All military doctors know how strongly the state of mind affects the course of wounds, how different the death rate is between the wounded of the vanquished and the victors ... "Pirogov gives a classic description of shock, which is still quoted in textbooks.
The great merit of the scientist is the development of three principles for the treatment of the wounded:
1) protection from traumatic effects;
2) immobilization;
3) anesthesia during surgical interventions in the field. Today it is impossible to imagine what and how can be done without anesthesia.
In the scientific heritage of N.I. Pirogov's work on surgery stands out very clearly. Historians of medicine say so: "before Pirogov" and "after Pirogov." This talented person solved many problems in traumatology, orthopedics, angiology, transplantology, neurosurgery, dentistry, otorhinolaryngology, urology, ophthalmology, gynecology, pediatric surgery, and prosthetics. All his life he convinced that it is not necessary to lock oneself within the framework of a narrow specialty, but to endlessly comprehend it in an inextricable connection with anatomy, physiology and general pathology.
He managed to selflessly work 16 hours a day. It took almost 10 years to make preparations for the 4-volume atlas of topographic anatomy alone. At night he worked in the anatomical theater, in the morning he lectured to students, during the day he operated in the clinic. His patients were both members of the royal family and the poor. Healing the most seriously ill patients with a knife, he achieved success where others gave up. He popularized his ideas and methods, found like-minded people and followers. True, Pirogov was reproached for not leaving a scientific school. The well-known surgeon Professor V.A. interceded for him. Oppel: "His school is all Russian surgery" (1923). It was considered honorary to be the pupils of the greatest surgeon, especially when this did not lead to disastrous consequences. At the same time, the sense of self-preservation, quite natural for homo sapiens, obligated many to give up this honorary privilege in case of personal danger. Then came the time of apostasy, eternal as the human world. This is what many Soviet surgeons did when, in 1950, an abridged version of N.I. Pirogov, devoid of the former core, which consisted in the spiritual heritage of the "first surgeon of Russia". None of the apostates spoke in defense of the mentor, caring more about themselves and retreating from the legacy of the founder of the Russian surgical school.
There was only one Soviet surgeon who saw it as his duty to protect Pirogovo's spiritual heritage. A worthy student and follower of N.I. Pirogov, Archbishop Luka (Voyno-Yasenetsky) proved himself in the Crimean period of hierarchical 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 to the spiritual heritage of N.I. Pirogov. For many years this work remained little known, like many achievements of Professor V.F. Voyno-Yasenetsky in his medical and scientific activities. Only in recent decades, "Science and Religion" by Archbishop Luke becomes public property.
Valentin Feliksovich Voyno-Yasenetsky, Archbishop Luka (1877-1961) - a great Russian surgeon and clergyman.
What new can you learn about N.I. Pirogov, reading "Science and Religion" today, a work half a century ago, when many Soviet surgeons, for many reasons, including out of a sense of self-preservation, refused to recognize the spiritual heritage of the "first surgeon of Russia"?
“The works of the ingenious humanist doctor Professor N.I. Pirogov,” Archbishop Luke wrote here, “both in the field of medicine and in the field of pedagogy are still considered classics. Until now, references to his writings are made as a strong argument. Pirogov to religion is diligently hidden by modern writers and scientists. Further, the author cites "silenced quotations from Pirogov's writings." These include the following.
"I needed an abstract, unattainable high ideal of faith. And taking up the Gospel, which I myself had never read before, and I was already 38 years old, I found this ideal for myself."
"I consider faith to be the psychic ability of man, which, more than all others, distinguishes him from animals."
“Believing that the basic ideal of Christ’s teaching, due to its inaccessibility, will remain eternal and will forever influence souls seeking peace through an inner connection with the Divine, we cannot doubt for a minute that this judgment is destined to be an inextinguishable beacon on a winding the path of our progress."
"The unattainable height and purity of the ideal of the Christian faith makes it truly blessed. This is revealed by an extraordinary calmness, peace and hope that penetrates the whole being of the believer, and short prayers, and conversations with oneself, with God," as well as some others.
It was possible to establish that all "hushed up quotes" belong to the same fundamental work of N.I. Pirogov, namely "Questions of life. Diary of an old doctor", written by him in 1879-1881.
It is known that the most complete and accurate (in relation to the original Pirogov manuscript) was the Kiev edition of "Questions of Life. The Diary of an Old Doctor", which was published on the occasion of the 100th anniversary of the birth of N.I. Pirogov (1910), and therefore, in pre-Soviet times.
The first Soviet edition of the same Pirogov work entitled "From" The Diary of an Old Doctor "was published in the collection of works by N.I. Pirogov" Sevastopol Letters and Memoirs "(1950). The content of the first Soviet edition indicates that, compared with the publications the pre-Soviet era (1885, 1887, 1900, 1910, 1916) was the only one from which, for censorship reasons, several large sections were first excluded.These included not only the philosophical section, which was part of the first part of Pirogov's memoirs, which he called "Questions of Life" , but the theological and political sections given in the "Diary of an Old Doctor", which represented the second part of this work. In particular, those very "hushed up quotations" that were mentioned by Archbishop Luke in his scientific and theological work entitled "Science" belonged to the theological section. and religion". All these censorship exceptions were partially restored only in the second Soviet edition of "Questions of Life. Diary of an Old Doctor" by N.I. Pirogov (1962), which saw the light after the earthly days of Archbishop Luke ended.
Thus, Nikolai Ivanovich Pirogov is not only the priceless past of our medicine, but its present and future. At the same time, it is important to emphasize that the activities of N.I. Pirogov does not fit only within the framework of surgery, his thoughts and beliefs go far beyond its limits. If in the 19th century there was a Nobel Prize, then N.I. Pirogov would certainly become its repeated laureate. On the horizon of the world history of medicine, N.I. Pirogov is a rare personification of the ideal image of a doctor - an equally great thinker, practitioner and citizen. So he remained in history, so he lives in our understanding of him today, being a great example for all new and new generations of doctors.
Monument to N.I. Pirogov in St. Petersburg. I. Krestovsky (1947).
In 2015, at the XII Congress of Surgeons of Russia, held in Rostov-on-Don, it was decided to approve the Surgeon's Day on the birthday of Nikolai Ivanovich Pirogov - November 25.
Childhood and youth
Pirogov Nikolai Ivanovich was born in Moscow, he was from the family of a treasury official. Education took place at home. As a child, he noticed a penchant for medical science. A friend of the family, who was known as a good doctor and professor at Moscow University, E. Mukhin, helped to get an education. He drew attention to the boy's penchant for medical science and began to study with him personally.
Education
At the age of 14, the boy enters the medical department of Moscow University. In parallel, Pirogov settles down and works at the anatomical theater. After defending his thesis, he worked abroad for several more years.
Nikolai Pirogov was the best in academic performance, graduating from the university. In order to prepare for the activities of a professor, he goes to the Yuryev University of Tartu. At that time it was the best university in Russia. At the age of 26, the young doctor-scientist defended his dissertation and became a professor of surgery.
Life abroad
Nikolai Ivanovich went to study in Berlin for some time. There he was known for his dissertation, which was translated into German.
Prigov falls seriously ill on his way home and decides to stay in Riga for medical treatment. Riga was lucky because it made the city a platform for recognizing his talent. As soon as Nikolai Pirogov recovered, he decided to perform operations again. Before that, and before, there were rumors in the city about a successful young doctor. The next step was confirmation of his status.
Moving to Pirogov in St. Petersburg
After some time, he arrives in St. Petersburg, and there he becomes the head of the Department of Surgery at the Medico-Surgical Academy. At the same time, Nikolai Ivanovich Prigov was engaged in the Clinic of Hospital Surgery. Since he trained the military, it was also in his interest to learn new surgical techniques. Thanks to this, the possibility of operations with minimal injury to the patient appeared.
Later, Pirogov went to the Caucasus to join the army, because he needed to check the operational methods that had been developed. In the Caucasus, for the first time, bandage dressing impregnated with starch is used.
Crimean War
The leading merit of Pirogov is the possibility of introducing a completely new method of caring for the wounded in Sevastopol. The method included the fact that the wounded were carefully selected already at the first point of care: the more severe the wounds, the sooner they would perform operations, and if the wounds were light, they could be sent for treatment to stationary hospitals in the country. The scientist is deservedly considered the founder of military surgery.
last years of life
He became the founder of a free hospital on his small estate Cherry. He left there only for a while, including in order to give lectures. In 1881, N. I. Pirogov became the 5th honorary citizen of Moscow, thanks to his work for the benefit of education and science.
At the beginning of 1881, Pirogov drew attention to irritation and health problems. N. I. Pirogov died on November 23, 1881 in the village of Cherry (Vinnitsa) due to cancer.
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