Botkin Sergey Petrovich is a great Russian clinician-therapist. Born in Moscow in 1832. After graduating from the course at the best Moscow boarding school, in 1850 he entered the medical faculty of Moscow University. After graduating from the medical faculty, in 1855, S.P.Botkin went to the Crimea to the theater of military operations and for more than 3 months worked as an intern at the Simferopol military hospital. Here his direct supervisor was the famous Russian surgeon Nikolai Ivanovich Pirogov.
At the end of the Crimean campaign, S.P. Botkin returned to Moscow. He became convinced that he needed to continue his medical education, and at the beginning of 1856 he went abroad. In Germany, he worked at the Pathological Institute of R. Virchow, the founder of cellular pathology, and at the same time was engaged in physiological and pathological chemistry.
In autumn 1800 Botkin returned to St. Petersburg; where he successfully defended his dissertation on the topic "On the absorption of fat in the intestines" and in the same year was appointed an adjunct of the academic (faculty) therapeutic clinic of the Medical-Surgical Academy. Botkin became an ordinary professor at this clinic. From the very first year of joining the department, Sergei Petrovich created a laboratory at the clinic, which at first was in charge of himself, and from 1878 for ten years the management of the laboratory was carried out by I.P. Pavlov. Here, in addition to clinical analyzes, the pharmacological action of new drugs was studied, and experiments were carried out on animals with the aim of artificially reproducing pathological processes and elucidating their pathogenesis.
Botkin introduced physiological and laboratory-experimental research methods into the clinic, considered the experiment in the clinic as a means of revealing the mechanism of diseases. Botkin's clinical and theoretical views are most fully described in the editions of the course of the clinic of internal diseases and clinical lectures.
Botkin's attention was constantly attracted by the "sore" issues of the capital's hospitals. Despite the overload of work in the clinic, supervising the dissertation work of numerous students, in the Society of Russian Doctors in St. Petersburg as its chairman, in the position of a physician, he was the permanent chairman of the Duma commission for the protection of public health, improvement of the sanitary state of St. Petersburg and hospital and outpatient care. in him.
He created a new direction in medicine called I.P. Pavlov's nervousness. Modern medicine owes Botkin the fact that he was one of the first to notice what an important role the central nervous system plays in the human body. He realized that the disease does not affect a single part of the body or organ, but affects the entire body through the nervous system. Only by comprehending this, the doctor can properly treat the patient. Botkin developed this idea in his works. His scientific views were taken up by the majority of Russian advanced doctors, so we are talking about Botkin as the founder of the Russian scientific medical school. Science owes Botkin and other major discoveries. In the early days of microbiology, he argued that a disease known as jaundice was caused by microorganisms. This prediction came true: scientists have found the causative agent of infectious jaundice, which is now called Botkin's disease. Botkin made many wonderful predictions. In his lectures, he expressed, for example, the confidence that special centers will be found in the human brain that control hematopoiesis, the separation of sweat, the regulation of heat, etc. Now the existence of such centers has been proven. Botkin was the first to express the idea of the specificity of the protein structure in various organs; established the infectious nature of the disease - viral hepatitis, previously known as "catarrhal jaundice"; developed the diagnosis and clinic of the vagus kidney.
Botkin published the Archives of the Clinic of Internal Diseases of Professor SP Botkin (1869-1889) and the Weekly Clinical Newspaper (1881-1889). He acted as an active fighter for the equality of women. In 1872 he took part in the organization of the Women's Medical Courses. In 1861 he opened at his clinic the first free outpatient clinic in the history of clinical treatment of patients. In 1878 he was elected chairman of the Society of Russian Physicians in memory of N.I. Pirogov and remained in this post until the end of his life. For the first time in Russia he achieved the construction of a free hospital, opened in 1880 (Aleksandrovskaya barrack hospital, now the Botkin Infectious Disease Hospital) in St. Petersburg. In 1881, Botkin was elected a member of the City Duma, deputy chairman of the Public Health Commission, the creator of the system of Duma doctors and school sanitary supervision. Since 1886 he has been the trustee of all city hospitals and almshouses in St. Petersburg. He introduced the institute of sanitary doctors, developed measures to improve the sanitary state and reduce mortality in Russia (1886). He is the founder of the scientific school of therapists: out of 106 of his students, 85 became doctors of science, 45 headed clinical departments in St. Petersburg and other cities.
Published works of Botkin: "Stagnation, formed in the blood vessels of the frog's mesentery, from the action of medium salts" ("Military Medical Journal." 1853); "Quantification of protein and sugar in urine by means of a polarizing apparatus" ("Moscow Medical Gas", 1858, No. 13); also "Determination of milk sugar" ("Moscow medical gas.", 1882, No. 19); "On the absorption of fat in the intestines" ("Military medical journal", 1860); "On the physiological effect of atropine sulfate" ("Med. Vestn.", 1861, No. 29); "Ueber die Wirkung der Salze auf die circulirenden rothen Blutkorperchen" (Virchow's Archive, XV, 173, 1858); "Zur Frage von dem Stofwechsel der Fette in thierischen Organismen" ("Virchow Archive", XV, 380); "" Untersuchungen uber die Diffusion organischer Stoffe: 1) Diffusionsverhaltnisse der rothen Blutkorperchen ausserhalb des Organismx " 26); 2) "Ueber die Eigenthumlichkeiten des Gallenpigment hinsichtlich der Diffusion" ("Virchow Archive", XX, 37) and 3) "Zur Frage des endosmotischen Verhalten des Eiweis" (ibid., XX, 39); "Case of portal thrombosis veins "(" Med. Vestn. ", 1863, 37 and 38);" Preliminary report on the epidemic of recurrent fever in St. Petersburg "(" Med. West. ", 1864, No. 46);" On the etiology of recurrent fever in St. Petersburg " ("Med. V.", 1865, No. 1); "The course of the clinic of internal diseases" (issue 1 - 1867; issue 2 - 1868 and issue 3 - 1875); "Preliminary report on the cholera epidemic" (appendix to No. 3 of the "Epidemiological leaflet" for 1871); "Archives of the clinic of internal diseases" (7 volumes. From 1869 to 1881); "Clinical lectures", 3 issues; since 1881 published under his edition of the "Weekly Clinical Newspaper".
Addresses in St. Petersburg
(5 (17) September 1832, Moscow - 12 (24) December 1889, Menton) - Russian physician-therapist and public figure, created the doctrine of the body as a single whole, subject to the will. NS Professor of the Medical-Surgical Academy (since 1861). Member of the Crimean (1855) and Russian-Turkish (1877) wars.
Biography
Sergei Petrovich Botkin comes from a merchant family engaged in the tea trade. As a child, he wanted to become a mathematician, but by the time he entered the university, a decree of Emperor Nicholas was issued, which allowed free access only to the medical faculty. He studied at the Faculty of Medicine of Moscow University, studied with famous professors - physiologist I. T. Glebov, pathologist A. I. Polunin, surgeon F. I. Inozemtsev, therapist I. V. Varvinsky. During his studies he was friends with I.M.Sechenov. In the summer of 1854 he took part in the elimination of the cholera epidemic in Moscow. In 1855 he graduated from the university, received the title of "doctor with honors." In the same year he took part in the Crimean campaign under the command of N.I. Pirogov as a resident of the Simferopol hospital. Already during this period, S.P. Botkin formed the concept of military medicine and proper nutrition for soldiers:
Received extensive training in various fields of medicine abroad. At the clinic of Professor Hirsch in Königsberg, at the pathological institute at R. Vikhov in Würzburg and Berlin, at the Hoppe-Seiler laboratory, at the clinic of the famous therapist L. Traube, neuropathologist Romberg, syphilidologist Berensprung in Berlin, at the physiologist K. Ludwig Opwig and clinician Vienna, in England, as well as in the laboratory of the experimental physiologist C. Bernard, in the clinics of Barthez, Buchu, Tryusseau and others in Paris. Botkin's first works are published in the Virchow Archive.
At the end of 1859, Yakubovich, Botkin, Sechenov, Bokkers and Jung were invited to the therapy clinic of the Medical-Surgical Academy (St. Petersburg). On August 10, 1860, Botkin moved to St. Petersburg, defended his thesis for the degree of Doctor of Medicine on the topic: "On the absorption of fat in the intestines" and was appointed acting adjunct at a therapeutic clinic headed by Professor PD Shipulinsky. Soon, however, the relationship between Botkin and Shipulinsky soured, and the latter was forced to resign. However, the academy conference did not want to transfer the management of the clinic to the talented Botkin, only a letter from students and doctors allowed him to take the vacant position in 1861, and at the age of 29 he received the title of professor.
SP Botkin was elected to the department of faculty therapy at the age of 28 and led it for 30 years. Botkin's daily routine looked like this: he arrived at the clinic at 10 a.m., from 11 a.m. chemical and microscopic studies began, carried out by students and young doctors, as well as research work with senior students, from 1 p.m. he lectured to students, after the lecture followed bypassing and examining outpatients, from 17 to 19 hours - an evening visit to the clinic, from 19 to 21 hours - lectures for associate professors, to which everyone was allowed. After that, Botkin returned home, where he had dinner and was preparing for the next day, but after 12 o'clock in the morning he paid attention to his favorite business - playing the cello. In his letter to N.A. Belogolovy, Botkin notes:
The first stone of S.P.Botkin's fame as a subtle diagnostician was laid in 1862 after his lifetime diagnosis of portal vein thrombosis. After the diagnosis was established, the patient lived for several weeks. The ill-wishers hoped for a mistake. SP Botkin paid much attention to cholelithiasis, which he himself suffered for a long time. He pointed out the role of infection in stone formation. He emphasized the clinical diversity of this disease. The scientist believed that until the doctor discovers the erupted stone, his diagnosis remains a hypothesis. In the work "On reflex phenomena in the vessels of the skin and on reflex sweat" S.P. Botkin gives a number of interesting clinical observations, one of which demonstrates that when a stone passes through the bile ducts, the upper and the armpit rises to 40 ° C.
Thanks to the outstanding pedagogical abilities, the professors who headed the departments at the medical faculties of Russian universities, V. T. Pokrovsky, N. I. Sokolov, V. N. Sirotinin, V. A. Manassein, Yu. T. Chudnovsky, A. G . Potebnov, N. P. Simanovsky, A. F. Prussak, P. I. Uspensky, D. I. Koshlakov, L. V. Popov, A. A. Nechaev, M. V. Yanovsky, M. M. Volkov , N. Ya. Chistovich and others. A total of 87 graduates of his clinic became doctors of medicine, of which more than 40 were awarded the title of professor in 12 medical specialties. S.P.Botkin 66 times acted as an official opponent on dissertations.
In 1865, S.P.Botkin initiated the creation of an epidemiological society, the purpose of which was to combat the spread of epidemic diseases. The society was small in number, but active, its printed organ was the Epidemic Leaflet. As part of the work of the society, Botkin studied the epidemic of plague, cholera, typhus, smallpox, diphtheria and scarlet fever. Observing liver diseases occurring with a high temperature, S.P.Botkin was the first to describe the disease, which before him was considered gastrointestinal catarrh with mechanical retention of bile. This disease was manifested not only by jaundice, but also by an enlargement of the spleen, sometimes by kidney disease. The disease, as pointed out by S.P. Botkin, lasts for several weeks, in the future it can lead to a serious complication - cirrhosis of the liver. Searching for the causes of the disease, S.P.Botkin came to the conclusion that contaminated food products are the source of infection. He attributed this type of catarrhal jaundice to infectious diseases, which was later confirmed (Botkin's disease, viral hepatitis A).
Botkin was at the forefront of women's medical education in Russia. In 1874 he organized a school for paramedics, and in 1876 - "Women's medical courses". In 1866, Botkin was appointed a member of the Medical Council of the Ministry of the Interior. An active life position, interest in social activities allowed the medical community to elect S.P. Botkin in 1878 as chairman of the Society of Russian Doctors, which he led until his death. At the same time, he was a member of the main directorate of the Society for the Care of the Wounded, a member of the St. Petersburg Duma and Deputy Chairman of the Commission for Public Health of St. Petersburg. Fame and medical talent played their part, and S.P.Botkin became the first Russian life-physician of the imperial family in history. SP Botkin laid the foundation for sanitary organizations in St. Petersburg. From the first years of the existence of the Aleksandrovskaya Barracks Hospital (now the S.P.Botkin Clinical Infectious Diseases Hospital), he became its curator for the medical part. Largely thanks to the activities of S.P. Botkin, the first ambulance carriage appeared, as a prototype of the future ambulance.
Died on December 24, 1889 at 12:30 in Menton. They buried Botkin at the Novodevichy cemetery. At this time, there was a congress of Russian doctors, whose work was interrupted. The coffin with Botkin's body was carried in his arms for 4 miles.
A family
Father - Pyotr Kononovich Botkin, a merchant of the first guild and owner of a large tea company, mother - Anna Ivanovna Postnikova. The family of S.P. Botkin's parents had 25 children, Sergei was 11 children from his father's second marriage.
Brothers: collector D. P. Botkin, writer V. P. Botkin, artist M. P. Botkin. Sisters: M.P.Botkina - the wife of the poet A.A.Fet
Children: Alexander Botkin (naval officer), Pyotr Botkin (c. 1865-1937, diplomat), Sergei Botkin, Evgeny Botkin (1865-1918, life doctor), Victor Botkin.
Addresses in St. Petersburg
- 1860-1864 - Spasskaya street, building 1;
- 1878-12.12.1889 - Galernaya street, house 77 (memorial plaque).
Memory
Botkin hospitals operate in Moscow and St. Petersburg. Also in the city of Oryol, the hospital is named after him.
In 1898, in memory of the outstanding physician's services, Samarskaya Street in St. Petersburg was renamed Botkinskaya Street. A memorial plaque is installed on the house number 20.
On May 25, 1908, a monument was erected in the park in front of the clinic at the corner of Botkinskaya Street and Bolshoy Sampsonievsky Prospect (sculptor V. A. Beklemishev).
In the 1920s, a bust by I. Ya. Gintsburg (1896) was installed on the territory of the Botkin Hospital.
By the middle of the 19th century, Russian medicine was in a terrible state. Medical historians write that most of the teachers in medical faculties have used the same information from year to year, ignoring discoveries in their field and shying away from innovation. Sometimes the information passed on to the students was from the category of medieval ones, for example, about the liver it was argued that it was “a coiled intestinal canal many times,” there were other incongruities that were taught from the departments of respected educational institutions.
At that time (and, apparently, not without reason), it was believed that foreign doctors treat better than domestic ones, so wealthy patients preferred to see Aesculapius of Prussian origin in their homes. The dominance of German doctors sometimes led to the fact that the doctor could not intelligibly explain himself to his patient, due to his ignorance of the Russian language.
Indeed, students from the medical faculty were often sent abroad, where medical thought was more progressive. So it happened with the future great therapist, clinician and physiologist, a prominent Russian scientist Sergei Petrovich Botkin. His friend, the historian T.N. Granovsky, who lived on the ground floor of his house, noted the extraordinary curiosity of the young Botkin and his extraordinary abilities. Returning from a long journey to European educational institutions and clinics, the young doctor began his career with reforms in medical business. In the years 1860-1861, he founded a laboratory that was destined to become a research and experimental center. In this laboratory Botkin researched the effect of drugs on the human body, conducted chemical and physical research. Thus, experimental directions in therapy, pharmacology, and pathology were born in Russian medicine.
Sergei, born in 1832, was one of the 14 children of a wealthy merchant and factory owner. The eldest son, the future famous writer Vasily Botkin, was engaged in raising children in the family. Until the age of 15, the future beacon of Russian medicine was taught by his elder brother and friends, including T.N. Granovsky, V.G.Belinsky, A.I. Herzen. A philosophical circle gathered in Botkin's house, which largely shaped the views of the young man.
Botkin wanted to enter the Faculty of Mathematics, but life decided otherwise, and in the year of admission, a decree was issued abolishing admission to any faculty, except for medicine. With internal resistance, Botkin chose the Faculty of Medicine. If everything were different, there would be one more eminent mathematician in Russia, because, as you know, talented people are talented in everything.
Immediately after graduating from Moscow University in 1855 Sergey Petrovich Botkin went with a detachment participate in the Crimean company. By that time, hundreds of enemy ships had already landed off the coast of Evpatoria, representing four European states opposing Russia - Turkey, France, England and Sardinia. The losses of the Russian side were in the tens of thousands, and there was a continuous stream of wounded. Then Pirogov created field teams of nurses and opened first aid training courses, where everyone could enroll. By the time of the Crimean War, Pirogov had already mastered ether anesthesia, which greatly eased the pain of the wounded during the operations. In addition, he used a plaster cast, which made it possible to preserve the limbs of a huge number of wounded. Botkin, being around all the time, studied with the most progressive compatriot physician and absorbed innovations like a sponge.
Thanks to his experimental laboratory at the clinic for internal medicine, Botkin was able to use research to diagnose and treat patients. He introduced the mandatory measurement of body temperature with a thermometer, the method of listening to the patient (auscultation) and tapping (percussion), physical examination, collection of information about the patient's lifestyle and anamnesis. So he received a complete vision of the disease and made an accurate diagnosis. He tirelessly taught students how to diagnose using these methods, which then became an integral part of Russian clinical science.
Interestingly, it was not so easy for Botkin to get the position of professor at the clinic of internal diseases. They had to overcome a fierce debate, in which, on the one hand, there were fans of Western doctors who invited a German professor to this position, and on the other, Botkin's students, who were indignant at injustice and stood up for their teacher as a progressive young force in Russian medicine. Botkin's theoretical work and his name were already known at that time in professional circles, and he was offered the position of professor and head of the clinic.
Like any bright personality with an innovative approach, Botkin was immediately disliked by envious colleagues who never missed an opportunity to inflate the rumor of an error or to slander the doctor. It should be noted that Botkin was a real ace in diagnostics. His ear was so trained to listen to internal organs through a pessimeter (a device for medical listening to a patient) that no disturbances could escape his attention. Once envious people had the opportunity to accuse the eminent doctor of charlatanism. Botkin diagnosed one patient with portal vein thrombosis. Such a diagnosis did not leave hope, and the patient had to leave the mortal world soon. However, he lived for a full six weeks, which gave enemies reason to doubt the diagnosis. An autopsy after the death of the patient showed the absolute correctness of the diagnosis, and the spiteful critics were put to shame. It was the finest hour of the great scientist, he was showered with lucrative offers, and there was no end to the rich patients.
In 1872, Botkin had the honor to treat the ailing Catherine II. Having saved her from weakness, he prolonged her health for many years, became a royal physician and just a welcome guest at court.
One of the main achievements of S.P.Botkin as a scientist was the advancement of a new theory of medicine. This happened almost simultaneously with the emergence of a new theory in Germany, where its author was a professor, under whose supervision the best of Russian doctors studied. Botkin's new theory was that reflexes lie at the heart of all life. Whereas Virkhov, putting forward his theory, spoke of the beginning of everything thanks to the cell. Both of these theories, independently of each other, were opposed to humoral, or vital, medicine, based on the theory of the vital spirit, which underlies all phenomena. This theory has dominated medicine unwaveringly for centuries. Thanks to the emergence of two new theories of medicine, two directions arose - anatomical, according to Virchow, and physiological, according to Botkin.
Botkin's fundamental view of the body was in its inextricable relationship with the outside world. Adapting to the environment, the body changes its metabolism and forms new properties. These new characteristics of the organism are inherited and determine survival in a changing environment. Botkin saw the origin of the disease in the inability of the body to respond to the external environment or qualities transmitted by previous generations.
Botkin saw the failure of Virkhov's cell theory in limited functionality: the disease, according to Virkhov, is caused by the transfer of pathogens from one cell to another or, in the second version, together with blood or lymph. Botkin thought that the theory of the organism as a "country" consisting of cells was limited; he opposed to it the doctrine of the organism as a single whole, controlled by the nervous system. In this regard, Botkin paid great attention to the study of various parts of the brain. Empirically, he opened the centers of perspiration, hematopoiesis, and lymph formation. Thus, he came to the conclusion that the treatment of the disease consists in a selective effect on each of the nerve centers responsible for a particular process or organ. Unfortunately, he failed to complete the proofs and studies in favor of his theory. However, he managed to prove the main position of his theory: the unity of the organism as a whole, neurological and physiological connections between the organs and systems of the body, treatment not of the disease, but of the patient.
Among the exceptional discoveries of S.P. Botkin, most of them belong to the diagnosis and etiology of diseases. So, he discovered and proved the infectious nature of catarrhal (now Botkin's disease, viral hepatitis A) and hemorrhagic jaundice (Botkin-Weil jaundice), developed the diagnosis and clinical manifestations of the "wandering" kidney. Botkin successfully fought the spread of epidemics, he was instructed to reduce mortality and improve sanitary conditions in Russia, in connection with which he undertook to reorganize Russian health care, but no resources were allocated to him.
An outstanding Russian scientist and doctor, Sergei Petrovich Botkin, died in 1889 in France. Two of his 12 children followed in their father's footsteps. Eugene, who served as a physician for the royal family of the Romanovs, followed them into exile, where he was shot, refusing to leave the disgraced family. Later he was canonized.
BOTKIN Sergey Petrovich
BOTKIN Sergey Petrovich(1832 - 1889) - a classic of Russian medicine, an outstanding therapist, the founder of the functional direction in domestic clinical medicine, a talented teacher, organizer and public figure, the founder of a large school of therapists.
Born in Moscow into a merchant family. At first he studied at home, and since 1847 - in a private boarding school.
In 1850, S.P.Botkin entered the honey. Faculty of Moscow University, which he graduated in 1855, receiving the title of doctor with honors. At the university, S.P. Botkin was distinguished by his modesty, diligence and inquisitive mind. Among the university professors, he subsequently singled out the physiologist I. T. Glebov, the pharmacologist N. E. Lyaskovsky, and especially F. I. Inozemtsev, who admired him for his adherence to therapy, honesty in life and science and, most importantly, sincere love for Russian medicine.
In 1855, S.P. Botkin voluntarily went to the Crimea, in the army. For three months he worked as an intern at the Simferopol military hospital under the direction of N.I. Pirogov.
In 1856, S. P. Botkin went abroad - first to Würzburg, then to Berlin, where he listened to R. Virchow's lectures, visited the Traube clinic (L. Traube); in Vienna he worked (1858) at the physiologist Ludwig (C. F. W. Ludwig) and the clinician J. Oppolzer. After a short stay in Switzerland and England, S.P. Botkin moved to Paris, where he visited fiziol, S. Bernard's laboratory and A. Trousseau's therapeutic clinic.
During his years abroad, SP Botkin wrote several scientific works published in the journal "Virchovs Archiv ...". In the same years, G. A. Zakharyin and I. M. Sechenov lived abroad, with whom he often met. A strong friendship between S.P.Botkin and I.M.Sechenov began in 1853 in Moscow and continued throughout his life.
In 1860, S. P. Botkin returned to St. Petersburg, defended his thesis "On the absorption of fat in the intestines", received a doctorate in medicine and was approved as an adjunct professor of the academic therapeutic clinic of the Medical Surgical Academy. In this title, as an assistant to prof. P. D. Shipulinsky S. P. Botkin stayed for a year. In 1861 he was approved as an ordinary professor of this clinic and did not leave the academy until the end of his life.
SP Botkin was the first in Russia to create a laboratory at the clinic: general clinical, chemical, bacteriological and physiological. Fiziol, the laboratory was headed by I.P. Pavlov for ten years since 1878. Pharmacol was studied here. the effect of new drugs, experiments were carried out on animals with the aim of reproducing pathological processes and elucidating their pathogenesis.
The worldview of S.P. Botkin developed under the influence of the leading figures of Russian culture - V.G.Belinsky, T.N. Granovsky and A.I. Herzen. An important role in the formation of S.P.Botkin's views was played by his friendship and scientific contact with I.M.Sechenov. The multifaceted scientific activity of S.P. Botkin as an experimental pathologist and clinician was largely determined by the direction of work and the achievements of his compatriots. This is especially true of the general understanding of the pathological process. Even at the beginning of his medical career, he pointed out that illness is not something independent: "It represents the usual phenomena of life under conditions that are not beneficial to the body." SP Botkin taught that it is impossible to talk about the clinical picture of the disease in general, without connection with a given organism. The disease always proceeds in a peculiar way, depending on the characteristics of the individual. “That is why,” pointed out S. P. Botkin, “along with medical knowledge, one must value medical experience.” Striving for the most accurate understanding of the patient,
SP Botkin resorted to working hypotheses, many of which were later scientifically confirmed. Trying to identify the cause of the disease, its pathogenesis, features of the course of the disease, SP Botkin, when examining the patient, paid special attention to the state of the nervous system and psyche. From his student years he was a virtuoso master of physical. research methods - palpation, percussion, auscultation, but he attached no less importance to a detailed questioning of the patient; emphasized the importance of the functional connections of organs and systems in the whole organism.
Understanding the pathogenesis of the disease opens, according to Botkin, the possibility of predicting the further course of the course, correctly determining the necessary treatment and preventing complications, as well as making theoretical conclusions that contribute to the development of the doctrine of internal pathology.
Deep knowledge and exceptional observation allowed S.P. Botkin to develop a number of complex issues of pathology of internal organs and to enrich Russian clinical medicine with important discoveries.
S.P.Botkin established the difference between hypertrophy and dilatation of the heart, described postsystolic murmur with stenosis of the left venous orifice, indicated that with insufficiency of the aortic valves, diastolic murmur can be heard in the third or fourth intercostal space to the left of the sternum (Botkin's point, or 5th auscultatory point of the heart). He was the first in the world literature to give a clinical description of arteriosclerosis. SP Botkin introduced a lot of new things into the theory of peripheral circulation. In 1867, he expressed the idea of the activity of the arterial and venous circulation, which was later developed into the theory of the peripheral heart in the works of his students and followers (M.V. Yanovsky and others). In 1875, S.P.Botkin and his students established the participation of the spleen in blood deposition, which was much later confirmed by J. Barcroft's experiments.
In the laboratory of S.P. Botkin, Ya. Ya. Stolnikov (1879) first carried out the experiment of applying clamps to the renal artery, which opened up the possibility of obtaining renal hypertension in experiment. Similar experiments, which contributed to the progress in the study of the problem of hypertension, were made by N. Goldblatt and his co-workers only in 1934, albeit on a wider scale.
A lot of new things were introduced by S.P.Botkin in the clinic of Graves' disease. He drew attention to the uneven contraction of the atrium and the contrast between the sharp pulsation of the common carotid artery and the small pulse of the radial arteries, as well as irritability and tearfulness that usually occur with this disease. SP Botkin is the creator of the neurogenic theory of the pathogenesis of Graves' disease. He was the first in Russia to describe the clinic of myxedema. In the doctrine of nephritis, S.P. Botkin considered it possible to talk about diffuse nephritis with a predominance of interstitial or parenchymal process. He drew attention to the variety of clinical manifestations of gallstone disease and the difficulties of its diagnosis. The mobile kidney was known earlier, but only S.P.Botkin gave an exhaustive description of the clinic of this suffering and scientifically substantiated the method of its recognition. SP Botkin singled out infectious hepatitis as an independent disease (see. Viral hepatitis), described his clinic and was the first to point out that sometimes this disease can lead to cirrhosis of the liver. This disease is now often called Botkin's disease. He introduced a lot of new things into the clinic of such infectious diseases as typhus, typhoid fever and relapsing fever.
In a number of works by S.P.Botkin there are statements that the body has such fiziol, mechanisms that enable it to fight diseases. Even many prominent clinicians of that time, carried away by microbes, forgot about the macroorganism, which was strongly opposed by S.P.Botkin.
For SP Botkin, medicine was "the science of preventing disease and treating the patient." First of all, he drew attention to the need to adhere to an appropriate regimen and diet, while prescribing medications, he took into account the characteristics of the patient. He appreciated balneotherapy, but criticized Brandt's method (treatment of typhoid patients with cold baths).
SP Botkin demanded from the doctor a careful approach to the treatment of the patient, reasonably arising from an understanding of the essence of the disease and the pathogenesis of its symptoms. He objected to the experiment on the sick, because "our medicine is still far from being based on exact science, and one must always bear in mind that saving fear so as not to harm the patient."
SP Botkin and his students studied a lot of medicines in the experiment and clinic. In particular, they found that atropine sulfate acts specifically on the peripheral branches of the sensory nerves; in experiments with foxglove, they proved that the substances contained in the leaves of this plant increase, and not decrease, as previously thought, the force of heart contractions. Were studied to lay down. the properties of the adonis, the diuretic effect of Blattae orientalis, the beneficial effect of Grindelia robusta in angina pectoris was found out, it was investigated to lay down. the action of potassium salts, lily of the valley tincture, etc. SP Botkin went down in the history of Russian medicine not only as the pioneer of experimental therapy, but also as one of the founders of clinical pharmacology.
As a teacher, S.P. Botkin developed scientific and philosophical thinking among students, called for a critical assessment of the dominant doctrines. He had a rare talent to pass on his knowledge and experience to the audience. Most of the lectures given by S.P.Botkin in the last years of his life were recorded and published by his students (V.N.Sirotinin, M.V. Yanovsky, etc.).
Proceeding from the main provisions of the work of IM Sechenov "Reflexes of the brain" and developing the functional direction in medicine, SP Botkin approached the creation of a new, progressive theory of clinical medicine - "nervousism". However, the state of science at that time did not allow him to develop this theory. This was done by the great Russian physiologist I.P. Pavlov. “By nervousism,” wrote IP Pavlov, “I understand a physiological trend that seeks to extend the influence of the nervous system to as many of the body's activities as possible.” The views of S.P.Botkin had nothing to do with the localistic medicine of the West. He, who highly appreciated Virkhov as a major pathologist, following I.M.Sechenov, Ε. F. Aristov and other representatives of Russian science criticized his theoretical views.
SP Botkin was one of the founders of military field therapy. During the Russian-Turkish war (1877-1878), S.P. Botkin, being a doctor at the headquarters, paid much attention to the organization of therapeutic assistance in the war. He pointed out that a military doctor should be not only a surgeon, but also a therapist who knows how to treat and prevent the development of diseases among soldiers. S.P.Botkin attached particular importance to the study of morbidity during the war, to the issues of antiepids. service, relocation of hospitals, evacuation of sick and wounded soldiers and training of military doctors.
Peru S.P. Botkin belongs to apprx. 75 scientific papers devoted to topical problems of therapy, infectious diseases, experimental pathophysiology and pharmacology.
In 1867, the "Course of the Clinic of Internal Medicine" was published. In this and subsequent (1868 and 1875) issues of the book, S.P. Botkin showed that domestic medicine was put on a scientific basis, introduced Russian doctors to the method of his clinical work, and gave a description of clinical cases with such power and depth of analysis that these books are still the internists' desk guides. S.P.Botkin at his own expense published in 1869-1889. 13 volumes of the "Archives of the Clinic of Internal Medicine", in which numerous scientific works of his students were published.
In 1886, at a ceremony at the Medico-Surgical Academy, S.P. Botkin made a speech in which he outlined his views on the main problems of medicine and outlined its next tasks: the words. Knowledge of physics, chemistry, natural sciences, with the widest possible general education, constitutes the best preparatory school for the study of scientific practical medicine. "
During the management of the academic therapeutic clinic, S.P. Botkin and his students wrote more than 100 works devoted only to the problems of treating patients, of which 40 became doctoral dissertations.
The greatness of S.P. Botkin lies in the fact that he was the first Russian clinician, at the cost of hard work and great talent, to create the largest and most advanced school. Of the 106 students of S.P. Botkin, 45 headed clinical departments not only in St. Petersburg, but also in various cities of Russia. Among them are professors-clinicians N.A. Vinogradov, V.G. Lashkevich, N. Ya.Chistovich, V.N. Sirotinin, M.V. Yanovsky, V.A. Popov, M. M. Volkov, V. T. Pokrovsky, J. Ya. Stolnikov, S. V. Levashev, S. M. Vasiliev and many others. Under the influence of S.P.Botkin's clinical views, other branches of honey also developed fruitfully. knowledge: neuropathology, psychiatry, dermatology, otorhinolaryngology.
In 1866, with the assistance of SP Botkin, the Epidemiological Leaflet was founded - a journal that had been published for 2 years. At the same time, he organized an epidemiol, a society in St. Petersburg. Since 1881, with the assistance of SP Botkin, the "Weekly Clinical Newspaper" was published - the first newspaper of domestic clinical medicine.
In 1872, S.P. Botkin was approved as an academician by the conference of the Medical-Surgical Academy.
The social activities of S.P. Botkin are significant and multifaceted. In 1878, he was elected chairman of the Society of Russian Physicians in St. Petersburg and performed these duties until the end of his days. With his assistance in 1872, women's medical courses were founded. In 1881, S.P. Botkin was elected a member of the City Duma and deputy. Chairman of the Public Health Commission. On his initiative, free medical care was organized for the "poor classes". At the suggestion of S.P. Botkin, school sanitary supervision was introduced in St. Petersburg.
In 1886, S.P.Botkin was elected trustee of all city hospitals in St. Petersburg and chairman of the Commission under the Medical Council on improving the dignity. conditions and mortality reduction in Russia. In these public posts, he took part in the organization of health care in Russia.
SP Botkin was an honorary member of Moscow and Kazan universities, 35 Russian and 9 foreign medical societies.
Compositions: On the absorption of fat in the intestines, Voen.-med. zhurn., v. 78, no. 2, p. 443, 1860; On the physiological effect of sulfuric acid atropine, Med. vestn., no. 29, p. 261, 186i; The course of the clinic of internal diseases, v. 1 - 3, St. Petersburg, 1867-1875; On pernicious anemia, Yezhened. wedge, gas., No. 6, p. 81, 1884; On the mobility of the kidneys, ibid., No. 23, p. 353; Basedow's disease and a tired heart, ibid., No. 21, p. 367, no. 22, p. 383, no. 23, p. 399, 1885; General Foundations of Clinical Medicine, ibid., No. 37-38, p. 731, 1886; Clinical lectures by S. P. Botkin, comp. V.N.Sirotinin and others, V.N. 1 - 3, St. Petersburg, 1887-1888; Acute infectious bile duct catarrh, Ezhened. wedge, gas., No. 37-38, p. 795, 1888; S.P.Botkin's letters from Bulgaria, 1877, St. Petersburg, 1893.
Bibliography: Arinkin MI and Farber VB, SP Botkin, 1832 - 1887, M., 1948, bibliogr .; White-headed A. N., S. P. Botkin, his life and medical activity, St. Petersburg, 1892; Ghukasyan A.G., S.P. Botkin - the founder of the Russian clinic of internal diseases (to the 50th anniversary of his death), Sov. med., No. 5-6, p. 8, 1940; Molchanov N.S. Development of S.P.Botkin's ideas in modern clinical medicine, in the book: Botkin readings 1970, p. 7, M., 1972.
A. G. Lushnikov, D. Ya. Shurygi.
Medic. The name of Botkin is forever inscribed in the history of world medicine, because he played a huge role in its development.
Sergei Botkin was born in mid-September 1832, in Moscow. He came from a good family, his father was a merchant, was engaged in the tea trade. Sergei had two brothers: Vasily studied literature, and Mikhail was a good artist.
The upbringing of Sergei, for the most part, was occupied by his older brother Vasily, who had a certain fame in literary circles, was friends with Belinsky. Interesting guests could often be seen in their house - Belinsky, Stankevich and many others famous of their time.
After graduating from the boarding school, the doors of the institute were opened in front of Sergei Petrovich. He wanted to study at the Faculty of Mathematics, but mathematicians were not particularly in demand. Due to circumstances, he began his studies at the Faculty of Medicine.
Studying at the Faculty of Medicine once and for all instilled in Sergei Petrovich a love for this science. While studying at the university, he received a solid foundation of basic medical knowledge. Having learned the theory, upon graduation from the university, Botkin immediately proceeds to practice. He goes to Crimea, where events are actively unfolding.
Sergei Botkin worked for more than three months at the Simferopol military hospital. The Crimean War is over, and he goes back to Moscow. Once at home, he realizes that there is still a lot of theoretical knowledge that he needs. So he decides to continue his medical studies abroad. Botkin spent several years in Germany, then in France.
In 1860, Sergei Petrovich returned to. Here he was immediately offered to work as an adjunct at the Moscow Medical and Surgical Academy. A year later, he headed the department of the therapeutic clinic. In this position, he worked until the end of his life.
We have already said that Botkin forever inscribed his name in the history of medicine. What is this? Medicine as a science developed only in the 19th century. Sergei Petrovich was one of those, thanks to whom, today's medicine is what we are used to seeing. After studying abroad, he noticed the peculiarities of the healing of that time.
Treatment of people was based on empiricism (by touch), there was no rationalism in the treatment of people. And only in the middle of the 19th century, including thanks to his research and activities, medicine takes the form of a rational science. He was a scientific innovator. Many of Botkin's thoughts went against the understanding of medicine in his era. But today, many of the works of the Russian scientist are the main ones in medicine.
It is impossible to list all the achievements of Sergei Petrovich in one small article. Here are just a few. He talked about the importance of the nervous system in the treatment of heart disease, the role of the body during infectious diseases, and the origin of jaundice. He discovered the role of the spleen in the circulatory system. Botkin assumed that there are several centers in the human brain - sweat, sugar, heat and others. Today this assumption is an axiom in medicine.
Sergei Petrovich Botkin died in 1889, leaving his descendant with a huge legacy of his medical knowledge and experience.