An Historical Sketch of Medicine in the Russian Empire, from the Earliest Period to the present Time. Communicated by Dr. von Embden of Hamburgh.

[From the Edinburgh Medical and Surgical Journal, for October, 1817.] THE first medical man mentioned in Russian history was called Smer; he was physician to the Grand Duke Wladimir, had seen foreign countries, and lived in the tenth century. Before that time they very likely had no physicians. Distinguishing themselves by firm health, strength, hardiness, and simple regimen, they were subject to but few disorders; which, being simple in their nature, they cured with domestic remedies. The bathing-houses also were in use among them, and organized in the same manner as at the present time. As in the eleventh century Christianity was introduced into Russia, and in consequence of it convents were instituted, the monks began to practise physic for charity's sake. Sick wards were constructed in the convents, and Jeffrem, Bishop of Peregaslaw, erected in 1091 the first hospitals in which patients were gratuitously received. From the twelfth to the fourteenth century, we find indeed mention made of physicians, but no one of them is named except Peter the Syrian. Under the authority of the Tartars in the thirteenth and fourteenth centuries, the cultivation of sciences was at a stand; besides which, famine and the plague depopulated the country. In 1351, the black death, as it is called, coming into Russia, killed a vast number of people, and police regulations were entirely wanting at that time.

zontale. De-là la possibilité desinfiltrations par les obstacles que les urines trouveront à s'écouler."

I have also no doubt, that some of the worst instances of extravasations of urine after lithotomy, have been owing to another cause, pointed out by the same excellent surgeon. "Imprudemment porté dans la vessie, le gorgeret peut aller, par le stylet beaucoup trop long qui le termine, heurter, déchirer, perforer même la membrane de la vessie, et donner lieu à des infiltrations d'autant plus dangereuses, que le lieu d'ou elles partent est plus inaccessible." (See Œuvres Chirurgicales de Desault, par Bichat, Tom. II. p. 460-461.)

In the fifteenth century, after the expulsion of the Tartars, the cultivation of science was revived, but the treatment of the sick still rested with the clergy, there being as yet hardly any physicians. Iwan Wasilie witsch, indeed, had one; and in 1483, sent emissaries to Rome to invite physicians to come to Russia. In this century, and particularly in 1499, syphilis made its way through Poland into Russia; besides which the plague, at intervals, still raged, and the leprosy still occurred. In the beginning of the sixteenth century, two very worthy foreign physicians, Nicolai Lugeo and Theophill, lived at the court of the Grand Duke Wasilei Iwanowitsch. After this, Czar Iwan Wasiliewitsch II. brought more physicians into Russia. It was in his reign that the Russian clergy stipulated in the consistory, held 1545, that it became the Czar, the metropolite, and the upper clergy, to tax the convents for the benefit of the aged and sick; and in 1360, hospitals were erected in many cities; and it is very probable that it was about the same time that the first apothecary's shop was set up in Moscow. in 1552 we find the first mention made of scurvy in that country.

In the reign of Fedor Iwanowitsch, in 1588, the first medical book was published. The original being written in Latin, a translation of it in Polish was published for Waiwaden of Frotyk at Krakow in 1423, and from that language into the Russian in 1588. It consists of 1561 pages, containing also drawings of plants, animals, and stones. In 1592, under the same reign, the erection of preventive buildings against contagious disorders was begun, by placing small quarantine guards on several frontiers. A forensic examination of the body of a neighbouring prince, under Russian protection, who had been poisoned, also happened about this time.

In the reign of Czar Boris Feodrowitsch in 1600, some more German physicians were called into Russia. Michael Feodrowitsch Romanow still more contributed to the promotion of physic in Russia. He enlarged the preventive measures against the plague, and ordained, in 1615, the first military physicians, and in 1620, the first medical, or rather apothecaries' board, (aptikarskoi priskas,) which was to ordain physicians and apothecary shops, and provide them with medicines. The board consisted of the archiater and the other physicians

of the court, was under the direction of the empire, and had a chancery and many officers. Ten thousand rubles were annually spent for the maintenance of the board and the apothecaries' shops. Native medicines were now also ordered to be gathered in different provinces of the empire, and to be delivered as a pecu iar tax. Some native Russians went into foreign countries to study physic, and foreign physicians came to Russia. A selection thus becoming possible, those that did not give satisfaction were sent back, the others for the most part receiving situations at court, with adequate salaries. From 1645 to 1676, under the reign of Alexei Michailowitsch, military apothecary shops were instituted, military surgeons and under surgeons ordained, who were obliged to get into the routine. A distinction was made between physicians and surgeons, the first being called doctor, or dochtur, of which there were upper and under dochturs, the same as upper and under surgeons. Strong measures were taken against the plague, and strict quarantine enforced. Physicians were sent abroad on purpose to buy exotic remedies in Holland and England, and greater care was employed in collecting the native drugs, and botanical gardens were established. The woiwodes were charged with the reception of the herbs, and their delivery to the board of apothecaries. Notwithstanding all these establishments, there was, nevertheless, no settled foundation for physic in Russia, and physicians and surgeons were still obliged to acquire their technical routine by serving as assistants to foreign practitioners, and no foundation was laid for the elevation of physic till in the reign of Peter the Great. He erected a medical board, which, in 1707, received the name of Apothecaries' Chancery, was removed to St Petersburgh, and received, in 1714, a sum of fifty thousand rubles, in order to buy foreign medicines, and to remunerate its medical officers.

In 1721, all hospitals and apothecary shops, as well those belonging to the crown as the private ones, were placed under its superintendence, and all unprivileged medical practitioners were interdicted the practice. In 1725 this board received the name of Medical Chancery, and was only called Medical Board for the time when the court and archiates were at Moscow passing ukases.

The establishment of the chief military hospitals in 1706

gave the first opportunity for institutions for medical instruction. These hospitals were to be provided with the ablest physicians. Each of them received a few under-physicians, assistants, and pupils; besides which, they were obliged to take many young Russians as apprentices, and instruct them in anatomy, pharmacology, and surgical operations; besides which, they were instructed in Latin and drawing. These pupils were afterwards, according to their abilities, made under-physicians, or physicians (Leckar). There were three medical schools of that description at the various hospitals of St Petersburg, Moscow, and Kronstadt. In 1715, the Great Admiralty Hospital was built on the borders of the Neva, at St. Petersburgh, with a church in the centre, and an anatomical theatre in each wing.

According to the military code, made by the Czar himself, each division received, in 1716, a doctor and a surgeon to the staff, each regiment a physician (Leckar), and each company an under-surgeon (Ziralaick); the whole army two field-apothecaries, one for the cavalry, and one for the infantry; each of them provided with two assistants and four apprentices.

Peter further ordained the establishment of foundling-hospitals in Moscow and other cities. A similar institution had already previously been established at Great Nowogarod, through the exertions of Bishop Zow.

A cabinet of anatomy and natural history, and a medical library, were now brought from Moscow to St. Petersburgh. The natural curiosities had been partly collected in Russia, and partly by Peter, on his travels in Holland, in 1698. The museum was afterwards increased by the addition of that fine collection of the apothecary Seba, at Amsterdam, which was purchased for fifteen thousand florins; and, in 1717, by the famous Ruysch's museum, which was bought for thirty thousand florins. Ruysch confided his secret of injecting and embalming to the Emperor, who communicated it to the archiater Blumentrast, who, in his turn, entrusted it to the inspector of the anatomical preparations, Schumacher. He again imparted the secret to the Archiater Rieger; who afterwards, on his leaving the Russian dominions, made it publicly known. In order to increase the museum, it was enacted, that from the whole em

pire, all the monstrosities should be sent to St. Petersburgh, for which rewards were offered by government. Travels were undertaken for the improvement of Russian na ural history. In 1719, Dr. Messerschmidt was sent to Siberia for that purpose, where he staid eight years. He learned the Tangutanian and Mongolian languages, from the Tangutanian Lamas, and gave convincing proofs of his activity in his ornithology and ichthyology. Dr. Buxbaum, who, in 1719, had entered the service, went, in 1724, with the Russian embassy to Constantinople, and returned from thence through Natolia and Persia, over Astrachan, and published his botanical observations. The Russian mineral waters now also began to be investigated; and now the native Russians began also to treat physic as a science.

As in 1726, under Catherine I., the Imperial Academy of Sciences was established, many physicians of note were called into Russia, among whom were Duvernoy, Burges, Weilbrecht, Kaau Boerhaave, Wolf and Protassoff; the latter was a native of Russia, and pupil of Boerhaave. Under the reign of Anne, from 1730 to 1740, many acts relating to physic were passed. In 1733, the sale of poison in the grocers shops was prohibited. In 1735, the duties of the physicians of hospitals were stipulated. In 1736, the construction of the field apothecary shops was improved, and four of them in Dubnow, Smolensk, Riga, and Wyburg, appointed to follow the army in time of war. In 1737, physicians were appointed in different cities with a fixed pay; and, in 1738, one for the poor at St. Petersburgh, whose duty it was to attend daily at the principal apothecary shop, in order to prescribe for the sick that came thither. Besides, this science received at that period considerable improvements through Heinzelman, Siegesbeck, J. G. Gmelin, Steller, and others; and Hahnhardt and Von Wellen published, in 1744, the first anatomy for the use of the pupils of the military hospital at St. Petersburgh. In 1754, in the reign of the Empress Elizabeth, the University at Moscow was established, and increased attention was paid to midwifery. In 1755, one physician and two surgeons were appointed for curing small-pox, measles, and other contagious and cutaneous disorders in St. Petersburgh; and, in the same year, VOL. VIII.

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No. 29.