Download History of medicine and pharmacy

Ministry of Public Health Service in Ukraine
Zaporizhzhya state medical university
Chair of toxicological and inorganic chemistry
History of medicine and pharmacy
Manual for the first year students of high pharmaceutical educational
establishments and pharmaceutical departments of high medical educational
establishments
Zaporizhzhya
2014
1
UDC 61(091) (075.8)=111
BBC 5
Н 69
Recommended by the Ministry of Education and Science of Ukraine as a
textbook for students of pharmaceutical departments of high medical educational
establishments (Letter from the Ministry of Education and Science of Ukraineof
29.01.2014 year № 1/11-1140)
Authors:
Prof. Pаnаsеnko О.І., Prof. Buryak V.P., Assoc. Prof. Кrеmzеr О.А., Assoc.
Prof. Melnik І.V., Assoc. Prof. Pаrchenkо V.V., Senior teacher Pоstol N.А., Senior
teacher Kulish S.M., Senior teacher Gоtsulya А.S., Assist. Scherbina R.О., Assist.
Sаfonov А.А., Assist. Sаlionov V.А.
Reviewers :
Petyunin G.P.; Doctor of Pharmacy, Professor, Head of Department of
Clinical Biochemistry, Forensic Toxicology and Pharmacy of Kharkiv Medical
Academy of Postgraduate Education
Omelyanchik L.O.; Doctor of Pharmacy, Professor, Head of Department of
Chemistry ZNU
History of medicine and pharmacy:
Manual / O.I. Pаnаsеnko, V.P.Buryak, О.А.Kremzer and others.- Zaporizhzhya,
2014.- 222p.
ISBN
UDC 61(091) (075.8)=111
BBC 5
The manual is composed according to the program on the history of
medicine and pharmacy for the first year students of higher pharmaceutical
educational establishments and pharmacy faculties of higher educational
institutions of III-IV accreditation for specialty 7.110201 "Pharmacy" which is
approved by the Ministry of Education.The guidelines is compiled in accordance
with the general themes of history of medicine and pharmacy’s program.
The manual is recommended for usage in the study of the subject, preparation for
practical classes on the history of medicine and pharmacy for the students of fulltime and part-time study.
©
O.I. Pаnаsеnko, V.P.Buryak, О.А.Kremzer, ZSMU, 2014
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Manual is composed by the lecturers of toxicological and inorganic
chemistry chair of Zaporizhzhya state medical university :
-by doc.of pharm., professor Pаnаsеnko О.І.,
-by doc.of pharm., professor Buryak V.P. ,
- by cand.of phаrm., associate professor Кrеmzеr О.А.,
- by cand.of phаrm ., associate professor Melnik І.V.,
- by cand.of phаrm., associate professor Pаrchenkо V.V.,
- by cand.of phаrm., senior teacher Pоstol N.А.,
- by cand.of phаrm., senior teacher Kulish S.M.,
- by cand.of phаrm ., senior teacher Gоtsulya А.S.,
- by an assistant Scherbina R.О.,
- by an assistant Sаfonov А.А.,
by an assistant Sаlionov V.А.,
-by general supervision of the Head of the chair doc. of pharm., professor
Panasenko O.I.
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Contents:
PREFACE…………………………………………………………………………………6
UNIT 1: "INTRODUCTION INTO SPECIALITY.
HEALING IN THE EPOCH OF PRIMARY
SOCIETY".........................................................................................................................8
UNIT 2: " HISTORY OF CREATION OF MEDICAL AND
PHARMACEUTICAL EMBLEM"................................................................................. 16
UNIT 3: "MEDICINE AND PHARMACY IN
SLAVE-HOLDING
SOCIETY"....................................................................................................................... 31
UNIT 4: "LIFE AND ACTIVITY OF HIPPOCRATES AND
GALEN, THEIR ROLE IN THE DEVELOPMENT OF
MEDICINE AND PHARMACY"................................................................................... 63
UNIT 5: "MEDICINE AND PHARMACY OF EARLY AND
LATE MIDDLE AGES"................................................................................................... 75
UNIT 6: "ORIGIN OF TREATMENT AND
PHARMACOGNOSY IN RUSS. MEDICINE AND
PHARMACY OF KYIV RUS AND
RUSSIAN CENTRALIZED
STATE (UNTIL THE XVIII - TH CENTURY.) "......................................................... 91
UNIT 7: "СREATION OF LEGISLATIVE ACTS, THAT
REGULATE PHARMACEUTICAL
BUSINESS IN RUSSIA. MEDICAL AND PHARMACEUTICAL
EDUCATION IN RUSSIA (UNTIL THE XVIII -TH CENTURY.) " ..........................106
UNIT 8: "SCIENTIFIC DISCOVERIES IN THE ORIGIN OF
MEDICINE AND PHARMACY IN THE XVIII – XIX – TH CENTURIES"...............116
UNIT 9: "PHARMACY IN RUSSIA (THE SECOND HALF OF
XVIII - TH CENTURY- THE BEGINNING OF THE XX – TH CENTURY)"……...126
UNIT 10: "PHARMACY IN THE FIRST YEARS OF SOVIET
POWER"......................................................................................................................... 135
UNIT 11: "PHARMACY OF SOVIET PERIOD"……………………………………. 141
UNIT 12: "HISTORY OF BECOMING AND DEVELOPMENT OF
UKRAINIAN PHARMACY OF THE XVI – XVIII - TH CENTURIES.
MEDICARE ON WESTERN4
UKRAINIAN SYSTEM OF
MEDICAL AND PHARMACEUTICAL
EDUCATION"................................................................................................................ 151
UNIT 13: "THERAPEUTICAL ESTABLISHMENTS. THE ACTIVITY OF
ZAPORIZHZHYA SICH".……………………………………………………………..164
UNIT 14: "UKRAINIAN PHARMACY IN THE XX –TH СENТURY.
PROSPECTS OF THE NATIONAL PHARMACY’S DEVELOPMENT”
......................................................................................................................................... 170
UNIT 15: "PHARMACEUTICAL INDUSTRY OF
UKRAINE".................................................................................................................... 187
UNIT 16: "PHARMACY ABROAD".......................................................................... 194
LITERATURE
216
SUBJECT INDEX
219
NAMES INDEX
220
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PREFACE
History of Medicine and Pharmacy is one of the important
pharmaceutical disciplines that forms the profile of the pharmacist as a specialist. It
is necessary to study the History of Medicine and Pharmacy, in order to understand
its development properly. It’s possible only in the close connection with the
general history of mankind. History of Medicine is one of the branches of the
general history of human culture. It examines the development of knowledge
which is related with diseases, humans’ treatment, preservation and promotion of
health.
History of Medicine is divided into general, which studies the development of
knowledge in human society in general and special, which highlights the
development of certain branches of medicine and pharmacy. Teaching of Special
History of Medicine and Pharmacy course is carried out by specialized
departments. As the development of medicine and pharmacy depends on the level
of the development of productive forces and the nature of industrial relations, the
basis for presentation of general history of pharmacy is divided into periods and
the epochs adopted in the general history.
Study the History of Medicine and Pharmacy is essential for the future
pharmacists’ education and expansion of special medical knowledge, raising the
general cultural students’ level.
The purpose of the History of Medicine and Pharmacy course is to show
the historical development of pharmacy and medicine with the phenomena of
social life, to acquaint students with the history of the national pharmacy and
medicine, their traditions, life and work of prominent scientists, and to identify the
main stages and characteristics of medicine’s development of other countries on
the bases of historical development.
The manual’s target is to provide the students with the guide during the
study of the course. Teaching students to all this complex of knowledge and skills,
especially due to the decrease of the number of hours given by the curriculum for
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practical training, requires from the teacher a clear and optimal organization of
educational process on each theme. The new concept of specialist’s training of
pharmaceutical profile assumes the increase of self-study’s hours in connection
with the introduction of the European Credit Transfer System.
According to the curriculum for the study of the discipline "History of
Medicine and Pharmacy" is given 54 hours from which 34 hours include the selfstudy’s work of the students. Due to the insufficient supply of student textbooks
and reducing classroom hours was necessary to prepare this guide, which will be
useful to the students of full-time study to prepare for seminars and modules on the
History of Medicine and Pharmacy.
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UNIT 1: INTRODUCTION INTO SPECIALITY. HEALING IN THE
EPOCH OF PRIMARY SOCIETY
The aim of the lesson is to master theoretical knowledge about pharmacy as
a complex of scientifically - practical disciplines.To familiarize with basic periods
of the development of primary treatment.
A term "pharmacy" originates from an ancient Egypt word "pharmaki"(in
translation - gifting healing), that put beginning to the Greek word "pharmakon"(in
translation are medications, applications of medications).
Pharmacy is a complex of scientifically- practical disciplines, that studies the
problems of creation, research, making, standardization, storage, selling and
marketing of medicinal facilities, and also search of natural sources of medicinal
substances. Pharmacy in a complex with pharmacology presents science Pharmacognosy.
A term "pharmacist" originates from the Latin word "providere" (in
translation – it means worry beforehand, provides for). A pharmacist is a specialist
with higher pharmaceutical education who has a right to engage in preparation of
medicinal facilities in pharm. and plant conditions, to carry out control after quality
of medicinal facilities, storage and selling of medicinal facilities.
Training of highly skilled specialist - pharmacist is the basic task of
pharmaceutical faculties. Disciplines which are studied on a pharmaceutical faculty
are subdivided into:
- general - educational: history of medicine and pharmacy, philosophy,
economy, mathematics, physics, Latin and foreign languages, anatomy,
physiology, microbiology, physiopathology;
Preparation of of highly skilled specialist - pharmacist is the basic task of
pharmaceutical faculties.
- profile: inorganic chemistry, organic chemistry, analytical chemistry,
physical and colloid chemistry, biochemistry, botany and hygiene;
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- special: pharmacognosy, pharmaceutical chemistry, technology of
medications, organization and economy of pharmacy, pharmacology, clinical
pharmacology and pharmacotherapy.
History of pharmacy is a science that studies an origin and development of
pharmaceutical activity in close connection with general history of humanity, with
development and change of social - economic structures.
In division into periods of history of pharmacy is the distribution accepted in
general history is the basis of 5 periods: primitive society, ancient world, middle
centuries, new and the newest history.
The primitive communal system is the first and universal, because it is
characteristic for entire countries and nationalities.
In history of primitive society are distinguished 3 stages:
1) Becoming of primitive society (over 2 million years ago - about 40
thousand years ago);
2) Bloom of primitive society (about 40 thousand years ago is 10
millennium BC)
3) Decompositions of primitive society (10 -5 millennium BC).
By it three historical stages are corresponded next periods in development of
primitive treatment:
1) In a period of becoming of primitive society and primitive treatment took
place primitive piling up and generalization of empiric knowledge about medicinal
facilities of natural origin (vegetable, animal, mineral);
2) In a period of the bloom of primitive society empiric knowledge began to
be used purposefully, collective treatment is conceived;
3) In a period of decomposition of primitive society lasted piling up and
generalization of empiric experience of treatment; the origin of classes and division
of labor assisted to the development of handicrafts and selection of medicine from
their number.
Information about medicine of primitive society is got and confirmed by
archaeological, anthropological, ethnographic and other sources.
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After the archaeological finds of the last time, a primitive man arose up 3 - 4
million years ago. In the development of man is distinguished in two tipping
points. The first is the major moment is characterized by beginning of labour
activity with the use of instruments and transition from the stage of animal
predecessors of man to the stage of forming, people. To this period in the earliest
stage is taken such types of people, as аrchantrops and paleontrops.
The second critical period on the border of early and late paleolith
characterizes transformation of paleontrops with a transition from the stage of
primitive human herd to primitive family community (40-35 thousands years ago).
Influencing by the labour by means of the instruments made by itself on
nature round itself, a man changed his own nature. Thus a man naturally aimed to
save the physical forces, namely health. Elementary measures of protecting from
unfavorable external conditions - cold, inclement weather, is a protection of body
or his separate parts by clothing, arranging of the simplest accommodations, even
only roof, are all the primitive rudiments of hygiene.
The hard conditions of existence, difficulty of getting of meal сontributed to
the origin of diseases. Already on the skeletons of animals and people, that their
science takes to most ancient times of history, find tracks both had an illnesses and
curative interferences.
With the same conditions of life are connected the beginning of curative
activity, foremost self-treatment. To the oldest curative industries, obviously,
belong: aid during delivery (especially to the woman that bears first), at traumas
(hammered in places, falling from a height, collision with a wild animal), some
disorders of digestion, obvious external defeats on a skin. І.P. Pavlov wrote that
curative activity in its beginning is the person of the same age of the first man; it
would be unfairly to begin history of medicine with its writing period.
The remedies of primitive medicine changed at the primitive communal
system depending on gradual perfection of productive forces and development of
primitive human society. A primitive man fed to the invention of facilities of
getting of fire by phytogenous food: by different berries, nuts, root. A man sought
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out and ate them in a natural kind. At such feed a man force was to become
familiar with poisonous and curative properties them.
In course of time a man began to distinguish especially curative plants
(purgatives, emetics and others like that) and to use them in case of necessity. As
searched for and collected vegetable foodstuffs mainly of womеn, then it is
possible to consider that they were the first connoisseurs. In translations and
ancient writing sights of some people the names of the first were saved even such
women - connoisseurs of remedies: in Caucasian Colchis -Меdeya, for Czeches Kаzy. In "Iliad" Homer remembers "golden-haired Аhameda", that knew all
curative potions that grows on earth.
Nutritives in case of necessity it was begun to use as curative. Making sure,
for example, in, purgative, sudorific, somnolent, sedative, excitant and other
vomitive actions of some plants used for calming of hunger, people began
afterwards, as far as a necessity, to use them specially for the facilitation of the that
or other suffering. Experience taught them to use certain substances in the
determined amounts, in the certain state and kind, to expose to the proper
treatment. Justly it is said that a pharmacy arose out from the kitchen.
Especially by an experience way a man learned also to use in curative aims
water, sunny heat, to grind, to mash sick places, stop with pressure bleeding,
dislocate the sites of fracture, attaching a stick or piece of bark of the tree to the
damages of extremity. When a primitive man perfected his instruments, used a
spear, bow, knife already that gave an opportunity to hunt on greater animals,
engage in fishing, she began to use medications and animal origin: blood, fat,
separate organs of animals and their uterine garden-stuffs.
Next capture of a pottery handicraft (VІ – ІV - th thousand BC) it gave her
the possibility not only better to prepare and keep a meal but also to store the
remedies.
When a man began to engage in the cattle breeding then help to the animals
during traumas, luing-ins, supervision above that, how different herbs affect on
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them, it increased curative experience of man. Later mineral substances began to
apply in curative aims.
To it especially an experience, empiric medicine in course of time facilities
that were based on faith of man in existence of supernatural forces began to be
attached. As well-proven by science, in the initial period of the history humanity
did not know religion. The embryos of religion arrived at the period of
development of primitive human society that is characterized already by a family
line-up. In this period a man does not dissociate itself from nature, provides the
nature with the same life that lives by itself.
A man searches for itself explanations of origin of the surrounding
phenomena of nature, such as: changes of day and night, origin of wind, thunder,
explanation, why a man sleeps, is ill, dies and others.
As experience knowledge of man was very limited this time, so all these
phenomena a man could explain, only supposingof the existence of supernatural
forces, giving to them, and to all phenomena of nature, and animals of their
properties. In course of time for a man the primitive complex of ideas is created
about the incomprehensible phenomena, original world view.
So there are religious beliefs: totemism is a faith of man in existence of
supernatural connection between this family group of people and certain type of
animals and plants; animism is a faith in the presence of perfumes the and souls,
and magic - faith in existence of supernatural, invisible connections and influences
of the separate phenomena of nature on a man and reverse influence of man on
nature, and man on a man.
At such world view is created the possibility of influence on nature and on
people after the desire, for what it is only needed to apply corresponding facilities,
actions, for example:, that will be rain - to splash round itself water, to accelerate
delivering - to unbind knots or get through a hoop and other .These actions were
always accompanied by certain words. In course of time people began to give
words the defined value that resulted in the origin of orders, invocations, later prayers.
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At such world view illness, if it did not have visible reason - wound, blow,
falling, - was considered the consequence of establishment in the man of hostile
force, that can be driven : out by an or entreaty, or gift-victim, by a threat, or
acceptance of disgusting to the taste, and having unpleasant odor of substances
(wormwood, excrement). This hostile force can be compelled to leave a sick man:
frightening it by the unusual clothing (shamanistic clothing), scream, sing, rumble,
it is possible to entice in other animal, object, that then to burn, to give up in the
river or bury in earth.
A primitive man was deeply sured in the truth of the beliefs, and at first
executed all curative measures and different magic actions. In course of time,
taught by experience of the personal failures, began to call to the individuals that
"knew" the best facilities, "able" to be better included in connection with
supernatural forces.
So Soothsayers, witch-doctors, sorcerers are revieled gradually , that all
secrets of nature, that understood a "rustle and hubbub of herbares", "whisper of
mother-earth", knew and able to find curative and poisonous substances and make
corresponding medications from them, were "open", are so gradually
distinguished.
So by a double way - spontaneously-materialistic and mystic- remedies that
used by humanity in the labour life were accumulated millenniums. This
development mainly identical at all people had the features depending on external
terms, development of productive forces and other factors that predetermine
framework of society of human society.
Control questions:
1. Determination of pharmacy as a complex of scientifically - practical
disciplines.
2. System of disciplines which is necessary at training of pharmacist.
3. Basic periods of the development of medicine and pharmacy.
4. Basic periods of the development of treatment in primitive society.
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5. When, and what reasons the first curative interferences appeared on.
6. What substances were used by primitive people for the relief of the
patient’s condition.
Tests :
1.Pharmacology isa) the science about medicine
b) a set of terms , such as Pharmacy and Pharmacology
c) the science that makes Pharmacy in combination with Pharmacology
d ) science in conjunction with Pharmacy and Pharmacognosy
2.Ancient greek word " pharmaki" is:
a) drugs
b) medicine
c) presenting cleaning
d) presenting healing
3.Pharmacist is a specialist with high pharmaceutical education , who has the right
to
a) prepare and store medicines in pharmacies
b) monitor the drugs’ quality
c) make storage and dispensing of medicines
d )carry out all above mentioned
4. The subjects which are studied at the Faculty of Pharmacy are divided into:
a) general, social
b) general, social, profile
c) the general, special, profile
d) general, social, general
5.In the basis of periodization of the History of Pharmacy is the division admitted
by the general history on:
a) 3 periods
b) 4 stages
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c) 5 periods
d) 4 periods
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UNIT 2: HISTORY OF MEDICAL AND
PHARMACEUTICAL EMBLEM’S CREATION.
The aim of the lesson is: to familiarize with history of origin of medical and
pharmaceutical symbols and emblems.To study their evolution and classification.
During its development medicine had many symbolic pictures because it
was accosiated with gladness, welfare or sorrow of people. One of them was
forgotten the others were existed until nowadays.
A medical symbolics constantly attracted and attracted attention of people of
different professions: doctors, historics, archaeologists, linguists, art critics and
many others. Insufficiency of publications from this theme, and also the variant
reading in interpretation of the same symbols induced to the deep study a question
about their origin and maintenance. Actual work is only a part of the research
devoted to the reflection of the world medicine in the small forms of fine art.
Researches are based on the exhibits such as coins, banc-notes, medals, orders,
stamps and other objects of material culture of different countries and peoples.
A study and origin of internal content of symbol are difficult enough, but
enthralling engagement. Any symbol, having its own history, in different time
obtains different value tints.
A symbol in the ordinary understanding (from greek. simbolon) is a
conventional sign well-known and used for cleanly practical aims. But it can be as
a secret sign content of that is known for only devoted. For example, as specified
in the Encyclopaedic dictionary of Brokgauz and Efron, for ancient Greeks a
symbol meant the sign of substance, known to the certain community group of
people, to secret society and others like that. Afterwards a symbol purchased the
nature of emblem, it became the visible reflection of some phenomenon, idea or
object.
On determination of the prominent Russian doctor of XVIII - th century N.
М. Маksimovich-Аmbodik, the author of the first in our country manual on
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obstetrics "Art of swaddling"(in 1784), that produced two editions of book of
"Emblem and symbols"(1788., 1811.) " a symbol is a short inscription, that is
folded in witty expression of few words that contain perfect sense, and being
connected with an emblem, direct us to cognition of other thing ..., historical,
political, moral or mysterious sense, or like this term contains ".
Emblem "...there is a witty image or ... picture, by submitting that eyes is ...
substance ..., from due to its inscription that is folded in short words of
expression".
The greater unfolded determination of emblem and symbol gives the abovementioned dictionary, where it is talked that an emblem is a conditional image of
some concept, idea in a picture and plastic. An emblem differs from a symbol that
content of its allegory is set and is not subjected to interpretation. Emblems must
be clear and simple, a spectator must see in them that it was wanted him to say. On
the contrary, a symbol can be understand quite differently, regardless of intention
of artist, id est a symbol incarnates an idea, and an emblem is a conventional sign,
that changes it, its hieroglyph.
For ancient Greeks and Romans a word "emblem" meant relief decorations
on an object from expensive material.
It is accepted in this time, that an emblem (from greek. emblema) is the
conditional image of some concept, idea. For example, a sickle and hammer is an
emblem of union of workers and peasants; a beehive is an emblem of
industriousness; an anchor is an emblem of hope; a lyre is an emblem of poetry and
music and others like that
Ancient, as the world, a symbolics is related to the plants and animals. As
early as distant remoteness the plants and animals became the symbols of certain
properties. Oak and lion perfected the force and durability, cedar and crows – the
longevity, laurel and palm – the victory and triumph. A blooming pomegranate
became the sign of friendship, pigeon was the world symbol, and two pigeons was
the symbol of eternal love.
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A symbolics was known to each and played an important role in life of man,
in his communication with other people. It was reflected in numerous emblems
among that the special place is occupied by the images of plants. For example, in
the book of N. М. Maksymovich - Ambodik, where every emblem is accompanied
by inscription on five languages (Russian, Latin, French, German and English), is
specified, that evergreens are laurel, fir-tree and others symbolize invariability and
constancy; a rose means all elevated, favour and justice.
Thus, analysing all of it, have:
A symbol is a conventional sign that has certain interpretation.
An emblem is a conditional mark and image of the defined notion, idea that
has clear semantic interpretation.
Medicine has its specific symbols and emblems. In world literature the
published data specify on dependence of origin of symbols in medicine from the
certain historical terms of development of human society, their direct connection
with the sources of empiric medicine. Finding out of these connections,
undoubtedly, assists opening of primitive value of content of symbols of medicine
that appeared, probably, as vivid expression presentations of ancient man about the
natural and domestic phenomena, influences on him as positive and negative.
Misunderstanding the meaning of these inexorable and mighty phenomena, a
man identified them with the different animated and lifeless objects.
With development of society and piling up of knowledge about the
surrounding world initial presentations were revalued, and symbols that personify
different phenomena obtained new forms and values. Hereupon a symbolics on
different stages of historical development of society contained different ideological
content. In this time there is a variable interpretation of content of symbols and
emblems of medicine that reached to us, after their value.
In the process of study it was succeeded to educe and collect more than 50
conditional reflections of the oldest from professions such as treatment. Attempts
to decode them by means of some one method of research (historical, linguistic or
any other), as it was done before, today resulted us to one-sided, limit, and
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sometimes and erroneous elucidation. The actual level of development of scientific
thought is characterized by co-operation, interpenetration and synthesis of distant
one from one of disciplines.
Studying the history of origin and development of medical symbolics, it has
to call to sciences and art of many countries and people, because medicine (and
together with it and its symbols and emblems) developed during all existence in
close connection with the material state and general culture of entire countries and
people.
Next to the use of many scientific methods of study of medical symbolics for
basis the historical method of research was taken, that allows to consider a problem
in all its copulas and mutual relations with the phenomena of history, culture,
science and art.
Valuable sources for the study of history of symbols and emblems of
medicine is numismatics - auxiliary historical discipline, that studies chinks,
medals, оrders and counters, and also bonistics, the subject of researches are
money signs in economic, historical, and artistic relations. A term "numismatics"
originates from the Latin word of Numisma is a coin. The first chinks known in the
world appeared at Lidiya (Asia Minor) in VII – th century BC The Greek and
Roman chinks, for example, are one of basic material sources of study of culture of
the ancient world.
Exactly about them Goethe said: "On these chinks we are made happy by the
endless spring of flowers and spring of art". As an area of historical science,
numismatics developed only in XV – th century. On the chinks of different epochs
it is possible to find many symbols and emblems of treatment, and on occasion
chinks are only certificates that reached to us.
Medical emblems are classified on general and private. General medical
emblems symbolize treatment in general, represent only aims and ideas peculiar to
medicine in general, and the private are the symbols of separate directions of
medical activity and represent a concept and ideas characteristic for different
19
industries of medicine. Different images of blazing fire, and also snakes are taken
to the general medical emblems.
For a modern man a snake is associated, rather, with something unpleasant.
However exactly a snake is the generally accepted symbol of medicine in the
whole world, thus from ancient times. In primitive society, when totemism and
animalism were, that removed helplessness of primitive man before the
surrounding world a snake was one of basic totemic animals. With the origin of
snake cult a double role was added to it: evil and good. From one side, a snake was
the symbol of cunning and treachery, on the other hand - immortality, wisdom and
knowledge.
A snake for many peoples symbolizes the kind beginning that provides
welfare of house and health of great vitality there and also has magic force to cure
wounds and teach people to medical mastery.
Characteristically, that in the ancient world medicine was symbolized by
non-poisonous snake, but inoffensive grass-snake. Exactly grass-snakes Aesculapius snakes lived in the centers of cult of God of treatment of Aesculapius
- in Greece and Rome. The records of ancient authors-physicians specify that
grass-snakes crept on a house during a "sacred dream", often licked sick places eye, wound. Romans loved these snakes very much, contained them at bath-houses
and bathhouses. It is considered that in some countries of Europe Aesculapius
snake got due to the Roman conquerors.
It is possible to explain differently that many people since olden times
connected snakes with healing of patients.
In mythology of countries of Ancient East snakes often appeared, usually
together with deities that connected with the health of people and by treatment of
them. At the Africans snake was often related to the treatment. It is considered,
presumably, because sorcerers were occupied in treatment in Africa they, as a rule,
were snake-charmers. The symbol of sorcerer was a snake. From so it went out: a
snake, sorcerer, is a curative magic. Then a sorcerer for some reason fell out of
this chainlet, and there are a snake and curative magic.
20
In Europe snake not simply symbolized a doctor, as in Africa - sorcerer, it
symbolized wisdom and knowledge in general. Maybe, doctors, as representatives
of the special profession earlier other were distinguished from the environment of
"scientists of people" and, it can be, and quite were the first scientists on Earth.
Therefore exactly a snake remained their professional emblem.
It is difficult with final definiteness to say, why so it happened: we do not
have no facts almost, except one fact - symbol of medicine - snake.
It is envisaged that as an emblem of treatment the symbol of snake was the
first used near II of millennium to our era in Ancient Babylon, where in the epoch
of slave-owning animal worship was kept.
As an emblem of medicine at first a snake was represented without some
attributes. Later the images of snake appeared in a report with different objects.
The known emblem of medicine is as a tripod of Apollo obvolute a snake. In
Europe (France, Belgium, Greece and other) from XVIII - th century there was a
medical emblem as a mirror obvolute a snake. A mirror was the symbol of
cleanness and carefulness - internalss necessary to the doctor.
However three emblems of medicine became known: Аusclepius сrook,
caduceus and bowl with a snake.
Аusclepius crook (pic.1) is a knotty flail round that a snake was shrouded
by a chairman upstairs - is one of the most recognisable symbols of medicine
approximately from VIII – th century BC.
The Greek myths narrate, that Аusclepius (for Romans is Aesculapius, is
closed to phoenician Eshmun) is a son of God of light, true and prophecies of
Apollo - that learned to the mastery of healing for a centaur Chiron and was known
as the most adroit doctor that was able to revive dead. However Zeus, frightened
that due to the art of Аesclepius people will become immortal, killed him a
thunderbolt. Аusclepius began to be respected as God of treatment.
In one of the ancient Greek myths is told, that Аusclepius was invited in the
palace of Міnos - tsar of Crite, to revive his dead son. A doctor went, leaning
against a flail, and suddenly crook was wrapped by a snake. Frightened,
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Аusclepius killed a snake. But barely he did it, as the second snake appeared,
holding some grass in its mouth. This grass revived killed one.
Obviously, Аusclepius already was certainly a fate to become God that is
why he, having superhuman sagacity, at once understood everything, found a grass
that brought a snake, collected it and, arriving on Crite, revived by her the son of
tsar Міnos.
(pic.1) CROOK OF AUSCLEPIUS.
This legend explains why in most cases Аusclepius is represented upright, in
a long cloak that holds in his hands crook, obvolute a snake. His figure became the
first international emblem of medicine.
This time the crook located flail obvolute a snake is represented on a
background bordered by the laurel branches of earth, is the emblem of Worldwide
organization of health protection (WOHP) in United Nations. This emblem was
accepted on the Ist World assembly of health protection in 1948 and folded in
essence from two emblems: emblems of the UNO (earth is in framing of laurel
branches) and emblem of medicine (crook, obvolute a snake). The symbolics of
this emblem represents domination of medicine above healthful that guard living
by forces of nature (snake).
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(pic.2) КADUTSEY (rod of Меrcury)
The Greek word "kаdutsey"("sign of plenary powers of announcer"named
the magic rod of envoy of Greek Gods of Hermes (for Romans was Mercury)
pic.2, obvolute by two snakes, usually crowned by the pair of wings.
Snakes that wrapped kadutsey are symbolized co-operation of opposite
forces. In Roman mythology Mercury used a rod, to reconcile two snakes that
fight, its the reason, from that it became the symbol of the balanced and
respectable behavior in Ancient Rome.
Cаduseus began to use as a sign that protects privacy of commercial or
political correspondence. In our time it is an emblem of medicine or commerce,
however once каdutsey showed by itself, an intriguing various symbolic figure.
A rod obvolute two snakes connects in itself at once a few fundamental
symbolic elements: a central bar symbolizes Tree of Life (in the value of
connection between skies and earth); the double spiral is formed by snake is a
symbol of space power, duality, and also unity of oppositions; snakes are fruitful
forces of the earth and other-worldly worlds.
During the last 4000 this symbol was associated with divine forces (and
sometimes and with the announcers of Gods) in Phenicia and Babylon, in Egypt
and India(where каdutsey became denotation of кundalini are awakening energies).
In alchemy caduceus is a symbol of unity of oppositions (Mercury and sulphur). It
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can symbolize equilibrium, and in the western art is to be the attribute of allegoric
figure of the World.
An association with medicine took place through a presence of caduceus
snake - as in the flail of Aesculapius. A famous psychologist Carl Yung respected
the каdutsey as an emblem of homoeopathic medicine where a snake marks poison
and curative potion simultaneously.
(pic.3) CHALICE WITH THE SNAKE
This emblem (pic.3) was symbolized labour of representatives of the most
human profession in the world during many centuries. It is impossible to disagree
with the idea expounded in a journal "the world Health", (May in 1970) that the
emblem of treatment in the ancient world a venomous snake became, but
inoffensive, well creeping, sweeming grass-snake, , that from Latin is called
"Аusсlepius grass-snake"(coluber flavescens aesculapii).
Exactly these snakes are found to this day on the places of former building
of the Roman legionariess near healthful sources in those countries, wherever such
snake usually is not led: in Switzerland(in Valicce and Lower Теssine), in Austria
(in Baden near Vienna), in Germany (in Shlagenbade). They were left here by
Romans.
Grass-snakes, but not venomous snakes, were in the centers of cult of
Аusсlepius (Aesculapius) in Greece and Rome. Data of numerous ancient authors
specify on that snakes crept for аbaton during a "sacred dream", and it was
considered even necessary, that patients touched to them, because in their kind
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God Аusсlepius appeared allegedly. It is already above mentioned, that at first in
Greece Аusсlepius was represented as a snake and only later assumed an air of
man.
In one of myths the mother of Аusclepius was as a snake , id est there was
gradual humanization of animals, at that time as they grew into the attributes of
humanized deities. G.V. Plehanov wrote: "When animal like ideas about God yield
to a mestome the anthropoid idea about him, then an animal that was once a totem
becomes called attribute" so. (Plehanov G.V. Соm. M., 1923/27, XVII – th
century, p. 220).
Thus it is possible with a confidence to say, that in the emblem of bowl with
the snake symbolizes wisdom, knowledge, immortality and in general all kind
beginning. Separate authors consider however, that in the emblem of bowl with a
snake the last one personify the evil. The "image of snakes in a medical emblem,
presumably, symbolizes by itself beginning that brings to the people of suffering,
illness and death, because a snake marks all what medicine" is striven against, for
example, V. М. Таrasonov writes.
Similar idea, in our view, is illogical, because it is difficult to imagine, that
by the symbol of such humane business, as treatment, an evil was taken, that a
snake is evil genius was used as an only decoration on the lids of bronze pocket
medicine chests of the Roman doctors, that God of treatment Аusсlepius, that was
represented as a snake, was presented in character of an evil, and others like that.
What means a bowl in an emblem? There are different ideas on this account.
One scientists think that it is a vessel for water, others is a vessel for medical
poison, id est antidotes third ones that it is a vessel with the special oblatory
composition(melicraton) and others like that.
Supposition of some researchers that a bowl shows by itself a vessel for
storage of water that had vitally an important value for people, and its getting
required large wisdom, is not conclusive. It is explanation legitimately only in
relation to waterless localities, diserts, where, really, water was presented an
exceptional value for life and where people were able to find water(for example,
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so-called Кuуu-Ustaye in the desert Kara-Kum) were especially respected.
However a man since olden times was settled on the banks of rivers, lakes, seas,
where for getting of water no wisdom was required.
Far more certain point of view, that a bowl is a vessel with an antidote.
Ancient Greeks named both poisons, and medications a term "pharmacos". Snake
poison was gathered and kept in the special bowls. Medications in antiquity were
very difficult in composition, sometimes they included over 70 ingredients, and as
an antidote snake poison entered in them.
With development of slave-holding line-up a bowl is transformed from the
symbol of wisdom of higher forces of nature in the symbol of honouring of
wisdom of priests, pharaohs and tsars, that operate on earth as though from the
name and from the commission of Gods that passed to the fate of people in their
hands. The Greek bowl without a leg (phiala) was used in different rituals. Exactly
with itGіgіya is mostly represented and very rarely Аusсlepius is showed. It was
made from expensive materials and adorned oneself from within the petals of lotus
that was the symbol of life.
F.R.Bоrоdulin is one of the first soviet historians of medicine, that appealed
to the analysis of the content of bowl symbol obvolute by a snake, as a medical
emblem, writes with : "We are inclined to examine this emblem as reminding the
doctor of necessity to be wise, and to ladle wisdom from the bowl of cognition of
nature". Id est in our time a bowl in a medical emblem is certain to them as a bowl
of human mind absorptive the whole world.
Except the emblem of "Hіpocrate bowl" to the general medical emblems are
also taken:
-a snake that winds around the crook (Аusсlepius crook);
-a snake that winds around the tripod of Аpollo;
-a snake that winds around оlеphalos (Dеlfian umbilicus);
-two snakes that wind around the crook (rod of Hermes-Mercury);
-a snake (or two snakes), that wind around a mirror;
-an egg;
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-a blazing torch;
-a blazing candle;
-a lamp;
-a cock;
-a heart on a palm.
Private medical emblems mark separate industries or directions in medicine:
an image of flower of lily of the valley is the emblem of cardiology;
an image of hand that take a pulse is a symbol of therapy;
it is an image of drop of blood, and also an image of some surgical
instruments (scalpel, scissors) are emblems of surgical profile;
the image of the "Florentine child" became the emblem of paediatrics;
an image of chemist mortar with pestle from the period of middle ages is the
emblem of chemists.
Pharmaceutical emblems and symbols.
In medieval Europe chemists separately from doctors and surgeons created
guilds (or workshops). Thus at first they combined with groceries. More credible
than all, it was related to that both traded in the commodity. But with time chemists
moved away from groceries in independent workshops. In England, for example, it
took place in 1617, when London chemists were distinguished from a general with
groceries guild.
On their coat of arms was represented God Apollo with a bow and arrow, a
refulgency that despises illness in character a dragon goes out from that, and
setting of Apollo was underlined by one of a 1251 metamorphosis of Оvidiy :
"And will name me everywhere on earth giving help".
An image on the coat of arms of society of chemists of London of
unicorns(rhinoceroses), obviously, belongs to the medical attributes through a
horn that was at that time medical raw material. As emblems of chemists image of
hand with chemist shovel was used (as, for example, on the emblem of chemists of
Amsterdam, XVII -th century, Holland), different animals(for example, crocodile)
and plants from that medicinal preparations (lilies and other) were produced, still,
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that was the symbol of distillation of water, horns welfare and other.But mostly the
emblem of chemists was an image of chemist mortar with pestle; sometimes this
was one mortar, sometimes is a mortar with two pestles. There are variants of
emblem, when pestle is in the paws of some animal (lion, bear, monkey and other).
All these pharmaceutical emblems are well presented on the so-called
coinlike counters that was produced in Western Europe and served as a change.
For example, there are 315 variants of the chemist counters produced by
pharmacies in a different period from 1648 to 1820 are known only in England.,
when was a lack of state copper chinks of law values (farting, halfpenny and
penny). Without regard to that these coinlike counters were withdrawn from
turnover by a parliamentary act only in 1817.chemists continued to produce them,
pursuing advertisement aims mainly. With development of pharmacy the old
medieval emblems of chemists began to yield a place to the basic medical symbols.
In XVIII –th and especially XIX -th century a snake that winds around or bowl of
Gіgіya became the emblem of pharmacy in the entire countries of Europe, or
Аusсlepius crook.
As we remembered already, after some data, even self connection of images
of snake of Аusсlepius, and the bowls of Gіgіya on an emblem were offered by the
chemists of Paduya and from a private pharmaceutical emblem a bowl obvolute by
a snake became a general medical emblem.
Before large October socialistic revolution in Russia pharmacists (chemists
with higher education) had no authority to carry a medical sign. For them the silver
sign of coat of arms was founded also with the image of the Russian empire, but
instead of bowl and two snakes at the end of the coat of arms the capital monogram
letter of "P"(id est pharmacist) was placed, covered by a gilt. If a pharmacist
protected thesis, then he did not get the degree of doctor, as was in medicine,
master's degree of pharmacy.There was the special master's degree sign on that
"МP" stood instead of monogram of "P" - master's degree of pharmacy. Sizes of
jakets signs were the same, as medical and doctoral, - 60×41 mm. There were
existed the so-called tail-coat variants of signs of pharmacists and chemists.
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Nowadays to the pharmaceutical emblems and symbols are taken the images
of cross of green color(France), of capital letter "А" of red color (Germany) and
chemist mortar with pestle accepted in different countries.
Control questions:
1. Determination of concepts "symbol" and "emblem".
2. Classification of medical emblems.
3. History of symbols and emblems’ development.
4. General medical emblems.
5. Private medical emblems.
6. Emblems of pharmacy.
Теsts:
1. Меdical emblems are divided into such types:
а). international and internal;
b). general and special;
c). general and private;
d). professional and general.
2.Оne of the general medical emblems is
а). a snake which obvulates the crook (Аusсlepius crook );
b). a snake which obvulates the apple;
c). hen;
d). hand.
3. The emblem of Pedietry is:
а). an image of a snake;
b). an image of «Florence child»;
d). an image of the mortar with the pusher.
4. Private medical emblems are marked as:
а). state medical establishments;
b). separate branches or trends in medicine;
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c). private medical establishments;
d). pharmacies.
5. Nowadays pharmaceutical emblems and symbols are not attributed to:
а). an image of cross of green clour;
b). an image of hand taking puls;
c). an image of capital letter “А” of red colour;
d). an image of the pharmaceutical mortar with the pusher.
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UNIT 3: MEDICINE AND PHARMACY IN
SLAVE-HOLDING SOCIETY
The aim of the lesson is: to study the question of forming of
Pharmacognasy in slave-holding society, to familiarize with development of
Pharmacy status in a number of countries (Egypt, Меsopotamia, Iran, India, China,
Greece, Roman empire)
In the conditions of the primitive communal system that was laid out, a
slave-holding line-up was the fully appropriate phenomenon, because it was a step
forward in comparing to the primitive communal system. The slave-holding
method of production opened more wide possibilities of height of productive
forces in comparison with primitively-communal line-up. "Only slavery did
possible in a greater scale the division of labor between agriculture and industry
and such created terms a way for the bloom of culture of the ancient world - for the
Greek culture.Without slavery there would not be the Greek state, Greek art and
science; without slavery there would not be the Roman state. And without that
foundation that was established by Greece and Rome, there would not be modern
Europe".
At a slave-holding line-up a population was distributed on free and slaves.
The free used all civil, property, political laws (except women). Slaves were
confined all these rights and did not have an access to the rights of free. The free
were divided into the class of the large landowners that were at the same time large
slave-holders, and to their position belonged to the class of slave-holders.Priests
that played a greater role in the epoch of slavery, according to the regulations
joined to the class of the large landed concords.
General characteristics of medicine and pharmacy in the countries of
Ancient East.
Ancient East was the cradle of human culture. Here earlier other places a
transition from the primitive communal system to slave-holding society took place.
People and tribes of East earlier than others, during 4000- 5000 prior to a new era,
went out on the arena of history and left the most ancient historical monuments.
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The slave-holding method of production dominated in Меssopоtamia Shumeriysc
state, Вавіlon, Аssiria and other), in Egypt, India and China already in V - II
millenniums BC
In I millennium B.C. the slave-holding method of production dominated in
Transcaucasia (state of Urartu), from VIII - VII – th centuries BC. existed the
strong slave-holding state in Choresm. The culture of slave-holding countries of
Ancient East influenced on development of people of the European countries very
much.
On Ancient East a slave-holding line-up developed in original forms:
vestiges of family line-up were long-term kept, it was strong, though vestige
maintenance of ancient society (at first domestic, later rural) was marked, here first
society was divided into the classes of slave-holders and slaves, the original
prehistoric states appeared, where slow progressive development was marked, a
natural economy and primitive exchange trade prevailed. The repressing political
system was a despotic monarchy with vestiges of family line-up. Power of despot
proved to be correct and grounded on religion, a tsar was considered embodiment
of God on earth and governed in interests of slave-holding gentlefolks.
An enormous role in slave-holding countries of East played a priestly
aristocracy. Priests were an influential caste. Force of priests was base on
economic durability of temples that owned large riches: by earth, slaves, cattle,
ships etc. Enormous economies that belonged to the temples were conducted on the
basis of slave labour.
History of origin, origin and development of philosophical,
naturescientificaly and medical idea in the first slave-holding states of Ancient East
- Egypt, China, India, countries of Front Asia, as well as further history of culture
of east people, exposes the considerable fruitful role of East in history of world
culture, science and philosophy. Already for a few millenniums .C the people of
Ancient East had the first sprouts of materialistic attitude and conceptions of
scientific knowledge about nature.By submitting single unit with
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naturescientificaly presentations, these views resulted a fight against idealism and
religion and cleared soil for development of science.
In an epoch of slaveries in class society were folded and were recorded in
materialism and idealism, as more or less whole directions of world view. The
philosophical views of the ancients at first took character of spontaneouslymaterialistic tendencies, carried its beginning from naive realism of primitive
people.
Materialistic philosophical opinion of Ancient East, that examined the world
such, that it is, was adopted by wish to understand it as unit that changes the forms
of the display always moves and develops. Materialistic directions of philosophical
opinion of Ancient East could not stop against the system of naturescientificaly
knowledge that were at that time in the embryonic state, but were closely
constrained with accumulated long-term experience of information about
properties of natural bodies and phenomena.
Materialistic studies matched against idealism the ideas about materiality of
the world, materialistic determinism that leads to objective conformity to law of all
existing, and infused with in people a faith in their ability to recognize the
phenomena of nature. Materialism acknowledged force of human recognition and
was related to primitive scientific knowledge of epoch. It answered the interests
and necessities of front-rank layers of slave-holding society, that came forward for
progress of material production, culture and all public life.
Development of materialistic world view was related to the fight of frontrank forces of slave-holding society that conducted a fight for development of
handicraft, trade, scientific knowledge against political and economic dominant
influence of the backward slave-holding gentlefolks interested in stagnation of
public life.
In the slave-holding states an ethnomedicine continued to remain the basis of
treatment. In the period of decomposition of the primitive communal system and
its transformation in class of slave-holding society of function treatments before
peculiar to many members of society, mainly to the women, gradually concentrated
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the more narrow circle of persons in hands, first of all elders and priests. In future
studying medicine was distinguished from the number of other professions that
time, a doctor-professional appeared.This new profession conquered prominent
position in society and got confession in the state. Their medical training doctorsprofessionals got in family. Medical knowledge handed on from a generation in a
generation and complemented. The head of family passed medical experience to
the sons and daughters, taught them to the curative receptions, reported the secrets
of preparation of medications to them.In connection with it gradually, the first
records of recipes, descriptions of illnesses, curative receptions and methods of
preparation of medications appeared with the origin of the written language. In
medicine of slave-holding period applied medicinal substances mainly
phytogenous, rarer - animal origin (milk, oil, Spanіsh fly) and some mineral
substances(Mercury, arsenic).
In the slave-holding states of Ancient East was improved the aid to pregnant
woman, hygienical advices were set for women in a period of pregnancy and
delivering, the receptions of interference were produced at difficult confinements,
at the wrong location of fetus. Doctors that time in the cases of difficult
confinements did the attempts of turning the fetus on a leg, caesarian section and
embryotomy.
The physicians of slave-holding period knew surgery and applied it in the
conditions of peaceful life and on a battle-field, deleted arrows, bandaged wounds,
stopped bleeding. On territory of Ассіро-Вавіlon, Egypt, Armenia, Georgia,
Azerbaijan, Choresm,India archaeologists educed many surgical instruments that
belong to the slave-holding period(lancets, pincers, scissors and others like that).
During surgical operations facilities that make relief of the patient were used:
оpium, bleached, hemp, infusion from mandragora root.
During great while in a slave-holding period medical activity was closely
connected with religion, cult, temples. This period in history of medicine is called
the period of priestly (temple) medicine.
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With an origin and development of religion ideas changed about an origin
and nature of illnesses. Wicked Gods (demons) of illnesses and kind Gods of
health appeared in mythological conversations. People linked their ideas about
health and illness with the phenomena of nature : God of health was God of a sun,
God of fertility. For priestly, temple medicine, basis of ideas illnesses were
imagined by demon views to essence of illness: illness was presented by a bad
fairy that infused with in the body of man and caused the sickly feeling and
phenomena; illness was considered the consequence of anger of Gods, punishment,
message divine. Differentiation of public functions in slave-holding society led to
that the enormous amount of Gods "that know the separate spheres of life"
appeared at mythology: Gods of health, Gods, are deputies of medicine, Gods of
doctors, deputies of sick people, goddess are patrons of pregnant women. Priests
that were often the most knowing for that time people considered themselves as
mediators between people and Gods that is able by means of prayers and victim
oblations to Gods and, adhering to pointing of Gods, returned the lost health.
Medicine in the slave-holding states of East long time was in the hands of
servants of religious cults, priests and took part as instruments for retaining of
people in fear and for the achievement of mercenary aims. Priests aimed to
concentrate the matter of treatment in the hands, because it was one of facilities of
exploitation of people and brought to the temples and their servants to the priests
large profits.
In treatment priests applied the mysterious forms of prayers, oblations, that
accompanied by magic actions, ideas, interpretation of dreams, different family by
"wonders", widely, by "revelations" and others like that. However, more and more
darkening the real reasons of illnesses by demon presentations, using aspiration of
sick people to get healing, aiming to save and extend the amount of parishioner of
temples, next to the mystic and magic forms of treatment priests used curative
receptions and healthful facilities of ethnomedicine. Fighting for a concentration in
the temples of treatment and medicare, fighting and competing with the
representatives of empiric ethnomedicine, priests much what took from an
35
ethnomedicine, applied remedies, divergences noticed between them. On the
known stage priests became the keepers of knowledge about nature, they
observered it and with appearance of the written language wrote down folk
experience in area of treatment.
The famous achievement of culture of slave-holding period of people of
Ancient East was an invention of writting. The people of Ancient East left many
writing monuments that together with archaeological materials give to the list
about medicine of people of this epoch.
Medicine that time that is why mostly appears before us in a mystic shell.
For the correct understanding of the past of medicine of slave-holding period it is
needed to be able to dissociate objective facts from the elements of mysticism.
One of sources of profits of temples there were bringing of believers.
Valuables, statues and other objects, people brought in temples, begging to cure
them from illnesses and on mention for by the dead. Patients, hoping to get
healing, sacrificed image of sick оrgan, eye, heart, uterus, extremities and others
like that. The custom of bringing of dedications was especially widespread in the
places, known for ancient cults, temples, "miraculous" statues of Gods. Such
places of mass worship were widely used by priests. Near-by them temple
workshops were usually situated that made objects for dedications that was bought
by pilgrims.
Medicine in China.
In China a slave-holding line-up became stronger in the end of III and
beginning of II millennium BC Vestiges of family line-up in China interlaced with
slave-holding society. In a period of slave-holding society in China there was the
hieroglyphic written language that lasted during millenniums. Complication of this
written language did literacy and education difficult of access and converted them
into the monopoly of small group of priests and aristocrats.
China had trade connections with many countries: with India, countries of
Middle Asia (Fergana), Persia, Syria, and later through them - with the Roman
empire. Widely famous China silk,, bone potteries, later the glazed pottery and
36
porcelain. A gunpowder, paper and compass (magnetic needle), were known in
Ancient China. Great successes in development were attained in Ancient China of
mathematics, astronomy, calculating of time: at II millennium the map of star sky,
calendar, were made BC. Geographical knowledge (stowage of maps, separate
descriptions) broadened, agriculture became better. In Ancient China attained
development also and agronomical, biological and other knowledge. All of it
assisted distribution of materialistic ideas in Ancient China. The known
development was got by medicine.
Chinese, as well as other people of antiquity, likened the world organism in
a miniature, and all processes in an organism – interrelations of"first elements".
Chinese counted them five: fire, earth, water, tree, metal. In an organism, as well
as in the outer world, the permanent fight of two polar forces of "yan" and "іn" was
supposed; a health or illness was determined by their correlation.
Illnesses were divided mainly by the same two groups: "yan" and "іn" Diseases of the first group can be defined as those that is characterized by an
increase function, second group - by the reduced function of organism.
There were anatomic and physiological presentations; Chinese knew that
reduction of heart was reason of motion of blood and others. In Chinese anatomic
pictures near to the more or less correct images of one parts there were erroneous
images of others. Anatomic atlases that during centuries was repeatedly drawn
again reached to our time. In diagnostics large attention was spent to the pulse.
Many types of pulse differentiated - depending on character of illness, constitution
of patient, season, time of day and other; many researches were written about a
pulse .
Investigated a language and natural opening of organism - nostrils, ears,
eyes, mouth- as windows through that illness gets to the body. Investigated sputum
- emptying and urine. Urine was investigated to the taste: sour and sweet taste and
other. At research of urine often differentiated tests : morning, daily, evening,
night.
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China medicine was spared much attention to the general hygienical mode "clever moderation", to the correct order of work, rest, dream, correct diet. In
China medicine was paid attention to general restorative treatment: to the diet,
massage, water procedures, sunny irradiation, gymnastics, physical therapy
procedures prevailed. Treatment in the conditions of slave-holding line-up was
accessible exceptionally to slave-oners.
The known system, that it is found in some ancient China cities, testifies to
the rudiments of public hygiene.
There was public medical institution in China; basic its setting was
maintenance of emperor's court, but in fact its functions were wider and included
the different questions of medical business, for to those or other reasons sometimes
of getting in eyeshot of state power (for example, epidemics). Wide distribution in
China small vaccination with the aim of prevention of disease a pox: in a nostril to
the healthy people entered the dried up pus of pox pustules of the patient.
The basic method of treatment was considered opposite: heat - by a cold and
vice versa and others like that. The China doctors had methods the treatments
based on rich experience: application of Mercury for treatment of syphilis, sulphur
for treatment of scab, isolation of patients at treatment of pox and other .Medicinal
massages were worked out.
China medicine applied many medicinal substances of, animal and mineral
phytogenous. From medications of phytogenous the special place was occupied by
ginseng that was used at different illnesses (tuberculosis, anaemia, severe diseases
and other). A lemongrass, camphor, pieplant, ginger, Indian hemps, buds of
bamboo, tea, bow, garlic, resins, aconite, were used et cetera
From medications of animal origin were used antlers horns of the young
spotted deer, musk, liver, marrow were used; internal organs and blood of tiger
were especially valued. As styptic (at a hemoptysis) bone glue(to gelatin) was
used. Various mineral substances - mercury, furnace, iron, sulphur, magnesia were
also used.
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Original that counts a few millenniums, the method of treatment in China
medicine presents chzhen-nzyutherapy - acupunctura and cauterization. Setting of
pricks - facilitate a movement on the vessels of blood and special "vital" gaseous
substance, to liquidate their "stagnation" and to remove reason of disease the
same.Pricks stimulates, regulates, coordinates activity of the nervous system. On
the body of man are more than 600 "vital points" in that did pricks in different
cases are counted.
Since olden times in China there were pictures and models of body with the
points inflicted on them for pricks. Next to pricks in China medicine cauterizations
(moxa) of the same "vital points" were used on a body by the inflamed sticks of
dried up wormwood or special tow. Pricks and cauterizations is added not so much
local, that common action.
In ancient China medicine, anaesthetizing was rieched by extraction of
mandragora, оpium and others like that. Operations were performed under
anesthesia in pectoral and abdominal cavities. Later, in connection with religious
prohibitions in the epoch of feudalism, development of surgery was halted and
surgical activity was limited to such elementary interferences, as, for example,
opening of abscess.
In China reference books there are pointing on the transmission of some
illnesses through clothing. Connection of distribution of plague is certain by rats
and repressing origin and distribution of plague and some other diseases in
seaports.
Early enough in China specialists appeared on making and trading in
medications. Enough old origin and China pharmacy, as the special establishment.
Doctors, as well as in other countries, were at first society practices of еmpirics as artisans, but there were scientists - doctors. The names of the visible
China doctors were saved: Byan Tsao, that lived in Vth century BC, Chua To - a
surgeon that lived near II century AD he did abdominal operations, and applied
guy-sutures and anaesthetizing (оpium, Indian hempen, by an aconite and other
facilities), Chzan Chzun-tszinya, that became famous by treatment of fevers and
39
large labour("Shanchan-lun") on this theme, and others.The large monument of
ancient medicine of China is a book of "Chuan-di Nay- tszin"("About nature and
life"), that is done in VIII th century by doctor Vаn Bin.
As far as strengthening of slave-holding, and together with him and
religions, a repressing role in China medicine passed to the priests. The religious
systems in China were presented by confucianism and daosism, that arose up in V VI – th centuries AD, but got basic development later. In I - th century AD from
India was added to China buddhism. Medical activity was concentrated in temples
and monasteries. Value of priests and monasteries in medicine increased in the
epoch of feudalism, especially from IV – VI - th centuries AD
In the ancient medical books of society maintenance at their copying
included more religious discipling. In a period of feudalism part of representatives
of medicine in China was related to official religions their activity was
characterized by the lines of stagnation.
Society doctors and society medicine in China, however, were saved. The
source of society medicine centuries-old experience that accumulated served as,
people and professionals-doctors. The ideological reinforcement of society
medicine were ancient materialistic ideas, that attained greater development in
China, that in other countries of Ancient East.
In XVI - th century were generalized accumulated by China medicine large
cognitions in area of medicinal plants. The pharmacopoeia of "Ben-tsao-аn-mu"
includes 52 volumes.
It is made by a scientist Shp-Chzen. With economic and political
interference with China of the capitalist states (XIX -th century) semicolonial
enslavement of country affected the state of medical business and health of
population. Especially it was designated in the mass poisoning of population by
opium, that accepted grandiose sizes from the second half of XIX- th century and
especially at domination reactionary to Gomindan.
Next to introduction of all achievements of modern medical science in new
China is used and all valuable from the rich inheritance of ancient China medicine.
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Medicine in India.
To the end of 4- to beginning of 3 millennium BC to India there was a slaveholding line-up, bits and pieces of patriarchal society were kept yet long.
The population of slave-holding India was divided by castes: brahmin priests; warriors -shatrii, free peasants, artisans and merchants - vaishi, slaves is
shudra, dasa - quite the without right caste obliged "with humility" to serve other.
Not only marriages but also other forms of communication (for example, general
meal) between the people of the privileged castes and common folk, between free
and by slaves were forbidden and subject to punishment. Caste distribution
outlived a slave-holding line-up.
As favourable exploitation of the working masses it was saved in India also
in the conditions of feudalism and capitalism, in particular the English colonialists
tried in every way to support.
Sources for the study of medicine of ancient India are: statute-book of Маnu
(1000-500 BC), "Vedi" are collections of domestic and religious prescriptions,
often in an artistic form, the product of folk epos, laws of Маnu, that reached to us
in the later processing of the first centuries AD After the laws of Маnu a doctor for
unsuccessful treatment was subjected to the fine in the size of that was determined
by caste position of patient.
Position of doctor in Hindu slave-holding society is represented in "Rig Veda": "Our desires are different: a driver hankers woods, doctor - illnesses, and
priest - oblatory libations". A health was considered the result of normal
connection of three beginning of organism: air ("prana" - gaseous, like "pneuma"
of ancient Egyptians), to mucus and bile. Three organic beginning were considered
the nearest character related to the basic elements or elements of nature.
The strong side of medicine in Ancient India was presented by the elements
of hygiene. In the laws of Маnu many questions are sanctified to the hygiene:
about influence of climate and seasons on a health, about a cleanness in an
accommodation, rules of the personal hygiene, gymnastics, feed, moderation in a
meal, early rising, oral hygiene, bathing, tidiness in a clothing, hair-cutting of hair
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and nails. The Маnu laws reprobated satiety in a meal, limited the use of meat and
recommended a fresh vegetable meal, and also milk and honey. Attention was
applied on the cleanness of tableware.
The rules of supervision were carefully worked out upon a body: cleaning of
teeth by brushes and powders, bathing, grinding of body, change of clothing and
other. Remnants and pieces of meal, dirty water, urine, excrements it was
suggested to take far from a house. Hygienical prescriptions were put first of all to
the privileged castes, in a less degree to the inferiors to them and quite not meant
slaves.
Next to the personal hygiene there were elements of public hygiene. At
excavations of Khakass culture in Маhedjo-Dаrо (in north-western India) the
educed is taken to the end of 4 to beginning of 3 millennium BC tracks of
equipping with modern amenities large old- Indian city, that : the municipal
sewage system was organized, thus the main highways of these pipes arrived at in
a diameter of 2 m. Every house had a pool.
Religion in India, at first brahmanism was than buddhism it changed later, as
well as in other countries, influenced on medicine. Therefore in texts of "Veda"(in
their later release) that reached to us, and in other most documents sanctified to
medicine, to peculiar medical moments books of prayer were added, invocation
and others like that.
A materialistic idea in Ancient India was indissolubly related to the
rudiments of natural history. There is the direct testifying to the presence for
ancient American Indians of some medical knowledge, analogical those that
Hippocrates adhered to afterwards.
The source of information for medicine of ancient India is writing sight
Ayurveda ("Book of life") the stowages of that is taken to IX - III - th centuries BC
Three releases of Ayurveda are known. The most complete release was written by
doctor Sushruta. His book shows the large encyclopaedia of medical knowledge,
where next to removing of priestly medicine there are elements of rational
medicine, that lean against centuries-old experience of people.
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Anger of Gods confessed reasons of illnesses not only, but also change of
climate and weather, violation of diet, rules of the personal hygiene. A doctor
polled a patient, examined him, felt, paid attention to colors and temperature of
skin, state of language, investigated colors and smell of separations.
In Ayurveda the described signs more than 150 sharp and chronic, general
and local illnesses of brain, heart, stomach, urine and genitals, joints and other
parts of body. Next to dietary advices, recommendation of massage and baths is
describe 760 medicinal plants. Facilities of animal origin (milk, lard, brain, bile)
were used. From mineral substances mercury, copper, iron, gold, silver, were often
used. In Indian medicine medications were distributed after their action.
Vomitive, purgative, diuretic, narcotic and excitative sudorifics that were
used in different medical forms (powders, pills, infusions, tinctures, decoctions,
ointments, wiping, fumigation, inhalation, dousing) were known. At prescribing
medicine seasons, climatic factors, improper feeding, build of patient, his
temperament, sex, age, profession, habits, character of illness, were taken into
account.
The most important medical science was surgery that attained a high level
was considered in India. More than 120 surgical instruments are described in
Ayurveda. The doctors of Ancient India were able to do many surgical operations:
bloodletting, amputation, trepanation, celetomy, lithotomy, laparotomy,
cataractectomy, laid on ligatures, conducted the common anaesthetizing. India is
the motherland of plastic surgery.
High were an art of facioplasties and other areas of body: doctors conducted
facioplasties for the compensation of defects of ears, nose and lips ("Indian
method"). The Indian doctors knew the row of obstetric receptions (turns of fetus
for a leg and head, operations of craniotomy and embryotomy). Description of
classic signs of inflammation (redness, slight swelling, heat, pain and parafunction)
is added to the Roman author Celsus it is driven to Ayurveda.
There were described methods of treatment of wounds by bandages,
impregnated with oils, and inundation of wounds by boiling liquids, and also
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specific for China medicine treatment of acupuncture widely widespread later in
the epoch of feudalism in Europe.
Medicare in India was more often rendered at home. In addition there were
private out-patient's clinics and permanent establishments with the supplies of
medicinal facilities. In large and trade cities there were public permanent
establishments on the type of hospitals. There were temple permanent
establishments and permanent establishments at higher schools that were clinical
bases for training of doctors. During wars movable hospitals were organized.
For American Indians the section of dead bodies was not pursued, but
methods of anatomising were imperfect. A dead body yielded to macerration
during twenty-four hours in running water. After it the soaked parts consistently
were scraped by a brush or bark, or there simply was a process of natural
decomposition. Anatomic terms that meet in "Vedas" testify to the presence of
inexact anatomic knowledge (including about a head and spinal brain).
In Ayurveda there were rules of behavior of doctor from that high moral and
physical internalss are needed, it is talked about training of doctors by the special
tutors that belongs to the higher medical state.
Medicine in Mеsopotamia.
Next to Egypt, consider the states that formed in the valley of the rivers of
Tiger and the Еuphrates the cradle of culture, - Меsopotamia in IV – th BC The
culture of this edge was formed by three people: Sumerians, Babylonians and
Assyrians. In the end of 3 and beginning of 2 millennium BC began presentation of
the Babylonian state. Later, in I millennium BC, in north-eastern part of
Меsopotamia, there was Аssiria. From these states a main place is in economic and
cultural development, in particular in medicine, it was fixed to Babylon.
Numerous monuments that reached to us talk about medicine in the ancient
slave-holding states that existed in two years of Tiger and the Еuphrates, for XX –
XVII - th centuries BC.
Illness always appeared as something extraneous, as a result of penetration
in the body of sickly demons. Such ideas about illnesses stipulated curative
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measures; to cure a patient, it is necessary first of all to drive out a demon that
caused illness. Widely there were widespread amulets, talismans, small planks with
prayers and invocations at the doors of accommodation, idols of kind perfumeries
that had to frighten off a demon.
At treatment symbolic receptions were used : plucking of bulb, unwinding of
ball of wool, mineral deposit of grains of bread and wiping off them again in a
heap, paralyse sick and releasing from fetters, decision from knots. The figurines
of demons were modelled and burned.
A large role was played by an idea for to the entrails of animals, in particular
consideration of liver of oblatory animals (mainly sheep). The clay and bronze
models of liver, divide lines to pieces, reached to our time; on every part there is
text that served as guidance to the prognosis on the state this part of liver. On such
models livers studied future priests of -doctors in medical schools that belonged to
the state that existed in Babylon.
Next to mystic presentations and magic actions medicine to Babylon and
Аssiria acknowledged and rational reasons of health and illness and applied
facilities of empiric ethnomedicine. The Babylonian doctors prepared decoctions
from plants, gave them to the patients for the use inside, did ointments for external
application, rubbing, appointed baths and dousings, put sanguiferous cups and
conducted bloodletting.
To our time the large monument of the Babylonian legislation - laws was
saved, dominating Hammurapy, made in XVIII - th century BC; in it is
systematized and generalized more ancient laws that regulate all parties of life. The
statute-book of Hаmmurapy presents by itself collections of the articles of code of
laws, intagliated cuneiform on a large basaltic post.
The row of the articles is dedicated to the terms of activity of doctor: legal
position of doctor is regulated, paying for treatment and his judicial to
responsibility in different cases, antiepidemic measures are described.
Gеrodot, the Greek historian that lived in V – th century BC described the
original ancient Babylonian custom: patients were destroyed on populous areas by
45
passers-by gave to them the detailed advices on the personal experience "in force
of doctors absence in Babylon ".
Doctors in Babylon were inaccessible for poor that did not have necessary
facilities for payment. In Babylonian, and later in the Assyrian medical cuneiform
records on burn tiles there is a list of symptoms of diseases :stomachache (places
are specified even - "in hearts" and other), heartburn, vomiting (vomiting is
separately specified by a bile), icterus (general and local), decolorizing to the
tongue, flatulence, diarrhea, loss of appetite, muscular pains and other. It is spoken
about cough, eyes and skin affections, tumour; an "attack", caused to the
paralysis.A fever is often described. Some knowledge of Babylonians in area of
anatomy was related to oblations. Dissecting of oblatory animals gave the known
anatomic cognitions.
For kicking of demons substances that disgust (excrement of people and
animals, opposite to liking medications and others like that) were often used in
Assyrian medicine (as well as at Babylonian more late period). It is considered,
that opposite to the patient it must be awful and to the demon that sat in him. In
аssiro - babylonians medicine was closely connected with astrology: at a prognosis
a large value got to position of luminaries and special astrologic calendar (happy
and unhappy numbers are for the beginning of treatment, operation, deliverings
and other).
An origin and motion of epidemics that struck the entire countries of
Ancient East often contacted with the location of luminaries. Аssiro- Babylonian
astrology passed then to the way of life of other people and next epochs occupied
a large place, in particular in medicine.
At excavations of most cities of (Babylon, Nineve) tracks of equipping with
modern amenities are revieled: bits and pieces of roadways, plumbing and sewage
system from clay pipes; from antiepidemic measures laws operated on moving
away from cities sick by communicable diseases, in the first turn by a "trick". It is
thus necessary to take into account that quite often designated the general name
"trick" and other diseases: pox, eczema, syphilis.
46
For treatment vegetable facilities, facilities of animal origin, oil, were used;
from mineral substances was used silver, lead. Medications were used as
decoctions, mixtures, solutions, ointments, pastes. Compresses, baths, massage,
bloodletting were prescribed. There were the worked out methods of preparation of
medications: dissolution, boiling, filtration and other the reception of medications.
The intake of drugs was differentiated on an empty stomach and after-meal.
Drinking vessel for patients and other things of supervision is described.
Diagnostics carried more rational character, than therapy.
Many symptoms and very thin diagnostic supervisions (on the state of a
mouth, nose) are described in medical sources. Blood, urine were exemined
visualy after their kind forecast the result of disease. It is known about existence of
diagnostic reference book.
At excavations of palace of аssirian tsar Аshurbanipal in Ninevehs (VII – th
century BC) found burn tiles with records by cuneiform, including about 1000
from them was medical character. These texts of medical maintenance take an
advantage of cult directions in medicine above empiric supervisions. There is the
direct pointing in some texts, that they target at a "exorcist that sets forth for the
house of patient".
On the basis of medical knowledge of Меsopotamia was formed medicine of
Syria, Iran and Greece
Ancient Iran
A large value for the study of culture and medicine of Ancient Iran, except
data of archaeology, has collection of folk epos- Canon Аvesta. It is collection of
hymns and religious indo-european texts of аchemenidian and before
аchemenidian time that was folded during an almost millennium. The twentieth
book of this canon of "Vendidat" contains some data about ancient iranian
medicine.
The personal interest is presented by collection of instructive stories of
"Каlila and Dimna", that on legend was written by young Doctor-Iranian
Bаrzavench in the epoch of Sаnsanides (dynasty of the Iranian chess that existed in
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224-651 AD) in India. Collection contains the large number of aphorisms about an
ethnomedicine, doctors, illnesses, methods of their treatment and warning.
Old Iranians created one of the first systems of natural philosophy: idea
about existence of dependence of organism of man from four elements - sun, earth,
water and air and four liquids of organism - red, black, white blood and bile. Thus,
on this philosophical presentation, juices of organism are both in the state of fight
or support each other, that and gives beginning to the health or illness. An
important place in biological presentations of old Iranians had studies about light
that they divided into visible and invisible.
Feel visible light, it departs in the wild sun and fire and gives warm to the
organism. However more important role vital functions are played by invisible
light. It is not perceptible, comes from vegetable and animal organisms, and also
from a man. If an organism has ability to get the sufficient amount of such light,
then in it appears warm and man balanced and healthy ("good"). If a man takes in
small light, then she is near to the evil and becomes "bad" in every way. It is
considered a stomach the center of distribution of heat.
An important role was taken also to the liver that, in opinion of ancient
Iranians, was the residence of passions.
Аvesta’s study shows that its creators had some, though very small ideas
about a structure and functions of human body. There are distinguished three types
of vessels of man: bearing black blood (illness), that carry red blood (health),
vessels without blood (obviously, nervous trunks), all life depends on that.
General reason of any illness is considered God of darkness Аchriman
(degree of weight of illness depended on the degree of sinfulness of man and
bitterness), or anger of God of good of Аchuramazdi, if a man went "from good to
the evil". Illness was an unbalance between the liquids of organism. Both
approaches of Аchriman and anger of Аchuramazdy were realized on concrete
reasons that violated between juices of organism or ability to get the sufficient
amount of invisible light.
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Among these reasons origins of diseases were: supercooling (was on the first
place), then lack of restraint in a meal or poor quality of meal, malnutrition, abuse
of work, by rest, sexual life, moral falling. All of it is a sin and, finally, anger of
Аhriman that was passed through poisonous animals, insects and worms, and also
by means of warm and cold air. In the origin of illnesses and their treatment a
substantial role was spared to the psyche: anger represses an appetite, and gladness
of him returns, "deep thought" conduces to the psychonosemas.
Doctors in Ancient Iran were encircled in the halo of perfection and wisdom.
They studied long, it was mainly studied medicine from books. Books carried
compilative character, wrote to each other increase, bought abroad, passed from a
generation in a generation; Egyptian medical literature and Egyptian doctors was
highly valued. In Аvesty is described the position of doctor in Iran. For treatment
he got a pay of the size that depended on the social state and material position of
patient (for treatment of priest - benediction; chief of city, that is surrounded by
borders, is a yoke of oxen or horse, his woman - mare; for treatment of petty
officer of village is a bullock, his women is a cow; for treatment of house owner is
a sheep or goat).
Medicine was determined how to keep an art of body in the healthy state.
According to Аvesta, a doctor has 3 basic facilities of treatment: word, medicinal
plants and knife. Beginning was always recommended from the first. Therefore an
important place was taken to warning of illnesses: "Destroy illness before, than it
will touch you". Farther the numerous rational orders of hygienical character were
followed: maintenance in the cleanness of body, clothing, houses, domestic
animals, elimination all rotten, cleaning of clothing and objects that were in a
contact with patients and corpses.
Rational elements were contained in orders about a diet, domestic life, about
attitude toward expectant mothers and feeding mothers, in prohibition to drink
intoxicant drinks and other. Studies about medical etiquette answered ethics of
zoroastrianism and it was pierced by humanism. In accordance with medical
etiquette, knowledge a doctor is obtained only for a benefit by other; he is under an
49
obligation to use every possibility for self-perfection.A doctor must be polite,
affectionate in an appeal, delicate in conversation, not to tell a medical secret even
to the closest friends.
The analysis of Аvesta texts shows that ancent Iranian doctors in practice
used rational receptions mainly. In diagnostics a large place was occupied: review
of original appearance of patient, research of urine and pulse. Confession of illness
by sick and frankness of patient in conversation with a doctor were considered the
important condition of successful treatment.
Among the representatives of separate industries of medical knowledge were
differentiated dentists, eyedoctors, family doctors, doctors of sexual sphere disease,
and also doctors, "knowing methods of treatment of sincere illnesses". However, it
was considered that treatment of man the "soul perished" for that, it is impossible,
as well as Sunday dead. There was the developed surgery, or "medicine of knife".
As far as responsible a surgical operation was considered, the rule of
awarding to the doctor of right shows independently to use the receptions of
surgery only since he not less than three times will do "cutting" sick with a
successful result. There was a rich arsenal of surgical instruments. For sewing
together of wounds the tendons of animals were widely used. Facilities were used
for anaesthetizing - wine, оpium, hashish as liquids or powders that blew to the
patient through furs of "per rectum".
In Аvesty there is the detailed description of wound shock and measures
against its development is warming of body, calmness, much drink.
Medicinal facilities were various. At skin diseases salt, cinnabar, sulphur
were used ; a furnace was used as a cosmetic and at the diseases of eyes; treated
wounds lead; musk, ambergris a beaver a stream was appointed as pick-me-ups.
From animal facilities mostly used a liver, bile, fat, honey, beeswax. Serpentine
poison was applied both in curative and from prophylactic aims. In large motion
there were local types of medical plants: dates, quince, nuts, olive and sesame oil.
From foreign plants, as medications from different skin diseases sandalwood
was famous. Camphor was widely used. There were the special gardens in cities,
50
where conducted aromatic plants, for example basil. At the palaces of grandees
there were apartments for storage of medications. The doctors of the priestly state
had own pantries, from where medications seemed to the patients the special
keepers after the binding of doctors.
In Persia pink water and almond milk appeared first, and also found the
application as aromatic addition musk.
In the metropolises of Persia there were civil and private hospitals,
pharmacies, fields for growing of medical plants. Army was also small element of
the medical organization. Ancient Iranian doctors one of the first began to profess
interest to the professional diseases.
Yes, in literature of the first centuries of our era descriptions of diseases are
often driven to work of blacksmith that walks in a black clothing, peasant-farmer,
that at landing of rice dipped feet and hands in bog slush, it is talked that
stonemasons are more often ill the diseases of breathing organs, and for the tanners
of skin and ulcers and tumours appear on feet and under one's arms.
Large attention was spared to the fight against insects and rodents. Yes, for a
fight against rats, mice there were customs of domesticating of іchneumons (more
often mongooses). There are some recommendations of antiepidemic character in
Аvesty. In particular, with the aim of warning of distribution of especially
dangerous infections (plague) it was suggested smoking by aromatizers a
settlement, infected with plague houses, things of the dead. A bitter fight was
conducted against hydrophobia. The vections of him were mainly dogs, both
hunting and sheep dogs necessary for the guard of herds.
The canon of Аvesty recommended veterinaries to treat animals the same
medications, as well as rich people. Due to frequent wars and hikes were
considerably widespread venereal illnesses and a fight against them presented a
state task. Warriors were warned of danger of casual sexual connections with
women: not "Many, aspiring to the women, are not covered by shame"(by illness).
In 330 BC the state of Аchaimenids was conquered by Oleksandr
Macedonian, after death of that Iran entered in the complement of the state of
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Seleucides(312-64 BC) and Parthian reign(in 250 BC - 224 AD). This period the
Iranian culture, and in particular Iranian medicine, developed in the river-bed of
еlinistic tradition on the basis of synthesis of acquisitions mainly of the Iranian and
ancient Greek culture. An important role in this period was played by Near-Eastern
influences especially Меsopotamia. About the state of medicine this period,
unfortunately, there are not reliable data.
III – VII – th centuries AD is a period of bloom of culture and naturallyscientific knowledge in Iran. Numerous labours of the Iranian scientists were saved
with mathematics, astronomy, veterinary science and medicine. Wide distribution
was got by late ancient form, in particular philosophy of neoplatonism.
Iranian medicine of this period, does not lose early acquisitions, assimilated
many achievements of ancient, Near-Eastern and Indian medicine, why activity of
medical school(academies) promoted in Guindshapure(Dzhundishapure), founded
by runaways from religious pursuits by philosophers and doctors of nestorianians
with Еdessy( 489) and neoplatonics from Athens( 529). This school that continued
traditions of the Athenian and Oleksandrija academies was the most on East center
of philosophical, naturally-scientific and medical knowledge. From data of В.А.
Еberman (1925) and Bubecar of ben of yahya(1952 year), gundishapurian
scientists translated into Persian, Syrian(and later on Arabic) languages of labour
of Aristotle, Dіоscoride, Hippocrates, Gаlen and other prominent ancient scientists
and doctors. In the labours gundishapurian doctors used labours both ancient
authors and Iranian, Indian, China doctors. To Tom, according to ben of Yahya,
gundishapurian school "became the center of cultural exchanges", very important
and corresponding ideas of Greeks, American Indians, Syrians and others like that
This alloy of ancient, near- and middle-eastern, Indian and even China
medical traditions stipulated originality of medicine of Iran and Middle Asia and in
a great deal defined content of medicine of Arabic Caliphates.
Medicine in Ancient Egypt.
The culture of Ancient Egypt left deep track in history of world culture.
Ancient Greeks and Romans, equal as and people Near and Africa east, much what
52
taken from literature, art and science of Egypt. Next to mathematical, astronomic,
geographical knowledge, ancient Egyptians had cognition in area of medicine. The
rational receptions of treatment were conceived in Egypt for 4000 BC Medicine in
Egypt was in the hands of priests. The doctors of Egypt used high reputation.
Gradually with the accumulation of experience for 2000 BC large enough medical
specialization developed in Egypt. Egyptians had doctors- surgeons, doctorsіnterns; doctors that engaged in operations on eyes differentiated among surgeons,
by treatment and stopping of teeth.
Already in the period of the so-called ancient reign (3 BC) Egyptians
attained considerable successes with medicine.
By the sources of our information about medicine in Egypt, as well as about
an ancient egyptan culture on the whole, there are writing monuments:
hieroglyphic inscriptions on sarcophaguses, pyramids and other structures, and also
papyruse.
From Ancient Egypt medical papyruse, that are collections with descriptions
of different diseases, symptoms of illnesses, reached to our time, with pointing of
receptions of recognition and treatment, with the lists of recipes. From the stored
papyruse the oldest is Каhun, sanctified to woman illnesses and written in 1850 BC
For 1550 BC were made two large of the sizes of medical papyruses : papyrus of
Smith, found in Luxor, sanctified to surgery, treatment of wounds and anatomy,
and papyrus of Ebers, found in Phoebe, devoted to the disease of different parts of
body. The papyrus of Smith is considered a late copy not stored to our time of
more ancient papyrus, added by Іmhotep. Written later, close 1450-1350 BC, the
Brugsh papyrus interprets about the health of mother and child, about illnesses of
children is an ancient document from paediatrics.
Other known medical papyruse are written for 1200-1300 BC. A table of
contents of papyruse is the result of numerous supervisions, by erection more
ancient materials, by a copy and processing earlier existent medical documents,
that to us did not reach.
53
The Egyptian medical papyruse is differentiated by the nature of
interpretation of medical materials, remove different looks to illness.The most
ancient papyrus is Каhun it spares main attention to the empiric rules of treatment,
to pointing of medications and does not almost contain religious reasons. In
anymore near to us at times stowage papyrus of Eber next to mass of empiric
supervisions there are including of mystic, religious character, advice about the
magic actions of doctor.
Yet more near to us at times writing the Brugsh papyrus is saturated with
religious mysticism and contains many pointing on magic rituals and book of
prayer. The known German egyptologist Ladders marked with a surprise, that
"medicine in Egypt with time all anymore and anymore submerged in witchcraft
and mysticism".
As far as development and strengthening of slave-holding line-up, and in
connection with him religions, increased and elements of medicine a temple,
priestly. On the other hand, continued to exist and develop empiric medicine deeprooted in rich experience of people and supervisions of doctors-empiricists and
related to spontaneously-materialistic presentations. Reasons of origin of illnesses
contacted priests with religious beliefs: illnesses are a consequence of infusing
with demons, they arise out of will of Gods.
Next to it are Egyptians acknowledged natural reasons of illnesses; there was
the known role of enterozoons. By analogy with banishment of enterozoons of
treatment examined and as banishment of invisible worms, that she is caused
allegedly.
In Egypt there were ideas about four element of the world - water, earth, air,
fire. In connection with it arose up and rudiments of humoral studies about four
basic juices, transmitters of these elements, about constituents of human organism
and dedected of his health or illness. Next to humoral studies in Egypt studies were
created about pneumo- special invisible and weightless substance that holds out in
mid air, at inhalation to the entrant in lungs that from there gets to the heart and
farther on arteries spreads on all body.
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Properties of blood and pneumo change during illness. These presentations
were determined character of therapeutic influences. The task of treatment
understood in that, to cause a selection from an organism sick of putrid substances
that appeared in him, to delete "foolish blood".
The Egyptian doctors enemas were used not only in curative aims but also
with the aim of cleaning to the bowels. In an order in advance to delete the
"spoiled substances", emetics, diuretic, sudorific laxatives, were given. Facilities
were used also for moving away of the "spoiled blood".
In accordance with the beliefs of Egyptians, the soul of man continues to
exist after her death, however only on condition of maintenance of body, in that it
would be infused with. With the aim of prevention of dead bodies from
decomposition, embalming was used. It was assisted by acquisition of knowledge
in area of anatomy. Embalming did not carry obligatory character, it embraced the
privileged apex – tsars (pharaohs), priests, most solvent people only, experience of
embalming comparatively limited as a result.
The row of anatomic terms that was used in Ancient Egypt testifies to
knowledge of some organs, including brain, liver, heart, vessels. However
knowledge from an anatomy and physiology of man for Egyptians remained
wretched.
The semiography of illnesses was worked out thoroughly enough. Intestinal
illnesses, illnesses of standard, bleeding, skin illnesses, elephantiasis, eye illnesses,
heavy exhausting fevers, are described in papyruse. The row of industries of
curative medicine was counted on satisfaction of increase queries of solvent
people. Here a massage, hydropathy, application of valuable medications, belongs
with the difficult enough compounding and others like that.
The hot climate of Egypt appeared reason of search of effective cosmetic
and skin facilities that is why ancient Egypt is considered the motherland of
cosmetology and dermatology. An aromatherapy was also conceived in Egypttreatment essential oils (cedar, turpentinic).
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The elements of sanitation and equipping with modern amenities, educed by
archaeologists at the study of ruins of ancient egyptan cities, also met only in
palaces and quarters of gentlefolks and did not spread to the settlement and
accommodations of other layers of population.
Soldiery doctors that accompanied the Egyptian army in a hike accumulated
information in area of treatment of wounds, breaks and other traumas. On the
tombs of ancient reign the images of operations of extremities were saved. In one
of the oldest papyruse, to the added scientist, description of operations holds out
doctor Іmhotep, afterwards adorable. Bandaging of wounds, amputation, cutting,
and castration were used in Egypt. The analysis of traumas that on a prognosis is
subdivided into curable, doubtful and hopeless holds out in the papyrus of
Іmgotep.
Pointing is given, how to recognize the term of pregnancy and "woman that
can and not able to bear". There are well-aimed descriptions of paralysis and other
In a papyrus there is pointing on the value of head and spinal brain for the
organism of man, described trauma of chairman and backbone and specified, that
as a result of damage of brain is incurably damaged all body.
From times of the first dynasty (more than 3000 BC) in cities Memphis,
Geiopolis, Саісі at temples there were schools for preparation of doctors. For 600
BC these schools began to accept students-foreigners. In Egypt often Greeks
studied medicine.
Medicine of Ancient Egypt influenced on medicine of Greeks, jewries and
arabs very much.
Мedicine and pharmacy Ancient Greece.
History of ancient Greece shows by itself a history of decomposition of
family and forming of slave-holding relations. It is divided into 5 periods:
1) Mycenae (III - II thousand BC); excavations on i. Кrete is testified to the
presence of unique tеchnique building (the systems of pipes are from a burn clay,
overflow-pipe channels, ventilation, wonderful bath apartments);
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2) the pre-policy period (II – IX – th centuries BC) adopted also "homeric",
because information about him was ladled from the poems of "Illiad" and
"Оdysseya";
3) a policy period (VIII – VI – th centuries BC) is marked two major for
history of medicine phenomena: а) forming of materialistic ancient Greek
philosophy that was folded in VII – th century BC in Ionia; б) becoming of temple
treatment;
4) a classic period (V – IV – th centuries BC) is a period of the greatest
economic, political and cultural development, the greatest internal bloom of
Greece; treatment developed in the river-bed of only philosophical knowledge natural philosophy(all large doctors were philosophers and vice versa);
a 5) еlinistic period(other half of IV – th century BC - a middle of I – st
century AD) is time of the most fruitful development of medicine of old Greece;
medicine of epoch of еlinism is characterized by rapid development of anatomy
and surgery, activity of Oleksandrija medical school registers in these industries.
By the most essential after the consequences period from that all modern
European culture and scientific medicine take beginning, shows a soba antiquity.
Three periods are distinguished in history of Greek medicine, each of that has
original lines. The oldest, Mycenae, culture belongs to III – V – th centuries AD,
what coincides with the bloom of Harapian civilization.
Researchers distinguish the geographical variants of Mycenae civilization:
there was Mycenae, in mainland part of Greece - hellenic, a cyclad culture
prospered on the islands of the Mycenae sea. Ruler of the island states Кnoss,
Маlya, Festa, Zacro supported external connections with mainland countries,
including carried on a traffic on a peninsula Hindustan. Therefore so alike cultural
traditions of regions divide seas and ocean.
On territory of Кnoss of palace tecnique building, similar to those used that
to the habitant Маhendzho-Dаrо, were found. System of pipes from a burn clay,
overflow-pipes, sewer pits targeted at collection of muddy waters. Wonderful bathhouses were equipped by ventilation. To the cult of treatment the unique find of
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archaeologists behaves partly- gold statuette of mother-earth: snakes in the hands
of goddess that testify to her involvement to medicine.
The second stage in history of Greece (XI – IX - th centuries BC) long time
was named homeric. Such name appeared as a result of to verbal tradition of
transmission of knowledge, mainly through works of Gesiod, Pindara, Homer. In
works of large poets there are mentions about illnesses and methods of treatment of
wounds, that suggests an idea about the society, rational sources of Greek
medicine. Еpos of Homer contain separate mentions of anatomic knowledge that
time.
The sections of dead bodies in Ellas were not practiced, but medical
terminology of "Iliad" and "Odyssey" made basis of terminology of doctors of late
period, saving actuality of to today.
The distinguishing feature of hellenic culture is large attention to the
personal hygiene, physical exercises, tempering. The cult of healthy, beautiful
body, is represented in a sculpture, in pictures and decorative patterns on vases.
Judging on images, ancient Greeks considered the best to the bed mode of dousing,
grinding, massage.
On development of ancient culture, undoubtedly, Egypt and states of
Меsopotamia influenced. In spite of it, Greek medicine developed to it a way,
under reaching higher development. Perceiving and developed cultural
achievements of Ancient East, Greeks managed on the basis of new philosophical
presentations to synthesize an own culture, adding to knowledge rational character
is more systematized. Perceiving and developing the achievement of east people,
Greeks took away from them more valuable in all, doing inalienable part of
modern culture.
The ancient Greek culture and medicine show by itself a qualitatively new
stage of development of humanity. Unlike the countries of Ancient East, medicine
of Greece in a less degree was under act of religion. On present historical sources,
the separate forms of medical activity were folded in Greece to VI – th century BC
In a number of cities there were public doctors that gratuitously treated poor
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citizens and decided antiepidemic questions. Gentlefolks had domestic doctors.
Society doctors served injured, rendered a surgical help.
Greeks adopted for Egyptians the idea of opening of permanent
establishments at temples. They were the prototypes of hospitals and named
аusclepions (in honour of doctor Аusсlepius). As well as in other countries, the
temples of Greece became placed treatment, and priests appropriated to the soba
function of doctors. Temple medicine of ancient Greece was afterwards inherited
by the doctors of Byzantium.
But next to a temple an ethnomedicine continued to exist. Characteristic
methods were: tempering, physical exercises, anxiety about the personal hygiene.
From manipulation treatments the personal attention was spared to hydropathy,
massage, a surgical help was given rarely.
The main achievement of ancient medicine is an association of empiric and
philosophical directions that was incarnated in basic principle of modern medicine
- unity of science and practice.
Ancient Roman medicine and pharmacy.
Before the conquest of Greece (in 146 BC) empiric methods prevailed in
medicine of the Roman republic, applied facilities of ethnomedicine, medications
of phytogenous were mainly used. In history of medicine of the Roman empire a
decision role was played by medicine of Ancient Greece. Roman medicine shows
by itself a rather finishing stage of development of hellenism culture, than
independent studies.
In Rome, in the conditions of the large state, medicine got considerably
anymore possibilities of development, than in the slave-holding states of Ancient
East and in Ancient Greece. Necessity of providing of sanitary terms for
metropolises, maintenance of population of many thousands, and also organization
of standing army, pulled out new tasks before medicine. These tasks it is not been
in strength it was to decide to the privately practicing doctors, it was necessary to
provide with a doctor certain administrative functions and rights.
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In Rome there were elements of government medical activity: the first
entered positions of main doctors (аrhyatres) that execute administrative functions.
There were courts of аrhyatres, аrchiaters of provinces and, rarer, аrchyatres for a
population. In an army Ancient Rhyme existed military medical organization with
soldiery doctors - professionals and system of soldiery curative establishments
(valentudinars). Soon there were hospitals for treatment of officials and members
of their families. At the end of I – st century AD the first hospitals for poor,
financed by the organs of state administration, appeared. In a number of cities
nursing-homes began to get subsidies from a government, obtaining the lines of
public medical establishments.
In the laws of Romans there were resolutions of sanitary character: it was
forbidden hide the dead in the middle of city, to use undrinkable water from the
river of Тibr. These requirements were fixed in "Laws of twelve tables" in V – th
century BC In addition, metropolises that had a population of many thousands
needed sanitary building and equipped by plumbings, sewerages, by bath-houses.
In a period the bloom of the Roman empire famous bath-houses got the
special popularity- therms, where the different types of massage, that were used
after bathing for maintenance of slenderness of figure, force of muscles and
elasticity of skin, were widely used.
Medical education limited in the first years of existence of republic.
Treatment foreigners engaged in mainly, there are Greeks in majority. In a period
an empire attention of state power increased to the profession of doctor. Medical
art is studied in private and state medical schools. From I – st century AD training
of doctors by archiaters was controlled in the Roman empire. In II – nd century AD
appeared departments - groups of students near specialists, that had rich
experience.
In a last period of existence of the Roman empire in central provinces there
was the determined amount of the doctors that had a right to engage in medical
practice ratified by the state. On occasion for the receipt of this right doctors folded
examination that was accepted by аrchiaters of provinces.
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Ancient Roman medicine was developed on two directions: methodical and
pneumatic school. Methodical school was based on a materialistic look. Reasons of
illness were explained by violation of motion of liquid and gaseous atoms, their
stagnation that causes the change of dense parts of organism. The representatives
of methodical school spared small attention to medical therapy an important role
was taken to breathing of skin. To prevent his violation, recommended the frequent
bathing of body, grinding and motive activity.
The representatives of pneumatic school considered the basic beginning of
nature not elements, but their state (warm, cold, humidity, dryness), and thought
that life, breathing is the basis of. The substantive provisions of pneumatic school
originate from presentations of ancient Egyptians.
In I – st century AD in Roman medicine there was encyclopaedic direction:
scientists gave out many labours of summarizing character.
The inheritance of Roman medicine was perceived and used by the scientists
of Byzantium, countries of the Arabic caliphate and medieval Europe.
Control questions:
1. Difference of medicine of slave-holding society from primitive medicine.
2. An origin in Egypt of humoral and pneumatic manoeuvres about the
origin of illnesses.
3. Forms of organization of medicare in Egypt.
4. Systematization of medicinal facilities by shumers.
5. Forming of ancient Iranian medicine.
6. Hrapian culture of Ancient India.
7. Medicine of India of Veda period.
8. Development of Indian medicine in a classic period.
9. Features of methods of diagnostics and treatment in Ancient China.
10. Forming of ancient medicine.
11. Features of ancient medicine.
12. Temple medicine of Ancient Greece.
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13. State character of medical activity in Rome.
14. Меthodical and pneumatic medical schools of Ancient Rome.
Tests :
1. The Motherland of dermatology is considered:
a) Ancient Egypt ;
b) Ancient India ;
c) Ancient China.
2. Where was the first aromatherapy used in?
a) In ancient Rome ;
b) In ancient China ;
c) In ancient Egypt.
3. The physicians’ rights and obligations first were registered:
a) In Indian Vedic literature;
b) in the King Hammurabi’s statute ;
c) in Rome " signs of twelve tables ."
4. Canon Avesta is the source of medicine’s study:
a) Ancient Iran ;
b) Ancient India ;
c) ancient China.
5. The art of plastic surgery belongs to the doctors:
a) Ancient China;
b) Mesopotamia ;
c) Ancient India
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UNIT 4: "LIFE AND ACTIVITY OF HIPPOCRATES AND
GALEN, THEIR ROLE IN THE DEVELOPMENT OF
MEDICINE AND PHARMACY"
Aim of the lesson: to fasten theoretical knowledge about history of ancient
Greece and ancient Rome medicine, to familiarize with activity of
Hippocrates and Galen.
After establishment of slave-holding line-up in ancient Greece, medicine
remained a temple from one side, and from other - became professional.
Professional medicine is characterized first of all by appearance of the first
in history medical hospitals, first at them medical schools (hospital medical
schools) and rudiments of organization of health protection in cities.
In V-th century BC in c.Коs on an island with the same name on the banks
of Asia Minor kоss medical school appeared. Having regarded to the looks of
natural philosophy, the doctors of коss school perceived a man, his health and
illnesses in close connection with the surrounding world. Illness in their
understanding is not punishment of Gods, but result of influences of the whole
surrounding world and violation of feed.
The bloom of коss school (the second half of V-th century - first half of IVth centuries. BC) is related to the name of the most prominent doctor of antiquity Hippocrates. Коss school in detail worked out studies about sickly forms.
Hippocrates is a chairman of school, went farther, asserting that a doctor must treat
not illness, but patient. Also there were the stopped up bases of clinical medicine
them.
The early from the stored biographies of Hippocrates (460-377 BC) belongs
to Soranus Ephesus that lighted up the professional way of Hippocrates only five
centuries of потому subsequent to his death. The famous Greek doctor belonged to
the glorious sort of Аusclepiad from the island of Коs, where was born and got
primary medical education. His father Geraclid, similarly as much men of family,
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successfully engaged in treatment, gradually bringing over a son to the art. His
mother Fenareta was midwife. All generations of Hippocrates during 18
generations studied medicine.
Uneasy nature of descendant Аusсlepius did not allow to him long to stay
too long on one place. In youth he traveled much, studying medicine of the
different states. Ancient historians fluently remembered about an arson, accusing
of that allegedly compelled Hippocrates to abandon Коs.
Wretched information from old works does not almost give an idea about
life of large healer. Usually those times, Hippocrates traveled much. The route of
his wandering can be imagined after the names of cities in treatises, on the stories
of local doctors. In most descriptions sent by Hippocrates, Fаsоs is remembered as
a small island in Mycenae pestilence, and also the nearest to its mainland city
Аbdery. In different years he visited Кizik, located on the birch of the Marble sea,
practiced in Lаrіssі and Меlіbye - metropolises of Thessaly.
Thus, except the cities of Greece he visited the cities of Asia Minor, separate
cities on the coast of the Black Sea. Known names of his sons - Fеssаl and Dragon,
which the same as father, engaged in treatment. The last years Hippocrates
conducted in Lаrіssі, where he died.
Considerable influence on activity of Hippocrates was rendered by the
studies of most thinker of antiquity, Democrite, about nature of man. This study
consists of two positions:
1) nature of man "does" surrounding him physical nature("physis");
2) societies with his options or laws("nomos") rebuilds nature of man.
These positions of Dеmоcrite underlay thinking of Hippocrates as a doctor,
and first of all in basis of his studies about nature of man.
Treatise "About air, water and locality" occupies a main place in history of
medical science. In opinion of commentators of different epochs, an author was,
undoubtedly, by an experience practical worker. Proceeding to the analysis of
influence on a health of factors of environment, he pointed fully logical reasons.
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For example, illnesses or propensity to them on occasion are certain weather
terms(by a hot summer or rain winter).
Among factors that strongly influence on a health, in work local climatic
terms are remembered: direction of wind, and also position of city in relation to
parties of light. Having large experience as a doctor- periodeut, Hippocrates came
to the famous studies about 4 basic types of build and temperament of man and
expounded him in this treatise. After Hippocrates, in the organism of man there are
4 important liquids: blood, mucus, yellow and black bile.
-sanguinics- people of East : friendly, quiet, well-fed, but mollycoddled and
lazy, to do not cause to illnesses;
-cholerics- people of North : thin, energetic, strong, active, apt to illnesses of
lungs and eyes, they are recommended by a damp climate;
-pleugmatics: people of South: sleepy, unindustrious, differ in the weakness
of the soul, for them there is a favourable dry, warm climate;
-melancholics- people of the West : sullen, have a negative look to the
world, make up for a melancholy, apt to illnesses, that peculiar to both the
temperamental persons and phlegmatic persons.
The main merit of Hippocrates claim of scientific basis of every sort of
treatment is considered. Being the supporter of rational practice, he appealed
erroneous philosophical theories that often conflicted with experimental medicine.
Hippocrates examined medicine and philosophy as closely constrained sciences,
although tried to define the limit of their co-operation. All his works are
distinguished by of genius observation and logic of deductions. Generalizations are
based on own supervisions, tested facts from that conclusions followed in natural
way.
Hippocrates adhered to the humoral theory of processes that take place in an
organism and cause illnesses. The therapeutic system of Hippocrates combined diet
treatment together with treatment ordinary medications. A considerable place in
therapy occupied treatment herbares, he defined the methods of storage of medical
plants. So Hippocrates recommended juices, pressed out from plants, to keep in
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glass tableware; leaves, flowers and root - in clay tableware, well closed, not to
lose "force of medications".
Hippocrates spared the special attention to Pharmacognosy, in "Hippocrates
collection there are 250 medical plants and 50 facilities of animal origin ".
The divisions of "Hippocrates collection" was reached to the
contemporaries, that consist of independent works. Written in different time, some
of them are parts once only labour. Commentators educed repetitions, inaccuracies
and obviously stranger authorship educed. Next to the real works of Hippocrates,
there are works of other physicians in collection that does not diminish the
enormous value of this work in any way. Suppositions spoke out, that "
Hippocrates collection" shows a soba insignificant bits and pieces of medical
library, but in no way works of authors of one school.
All works testify to large knowledge of scientist, about his professional
mastery and clinical experience.
Capacity for prognostication, based on the study of analogical cases, defined
life glory of Hippocrates. Works "Prognostics" embraces a vast symptomatology
on the basis of that it is possible to do a favourable or unfavorable prognosis in
relation to the result of illness. These labours are the certificate of genius of author,
leading to him wonderful observation and large practical experience. There were
acquaintances Hippocrates many signs of diseases that are important for a
diagnosis.
He studied character of excretions thoroughly, such as: sputum, excrements,
distinguishing them at the different forms of illnesses. At a review used own
methods: tapping, hearing, feeling, but, probably, in a primitive form. Marking
motion of illness, he spared most attention to the different stages especially
feverish and sharp, thus setting the days of crisis, when an organism gives it a
shoot to free oneself from "indigestion of juices".
From works evidently, as far as highly the art of operative treatment rose in
Ancient Greece. A division is begun with a treatise "About medical cabinets",
where an author gives to recommending beginners- to the surgeons in relation to
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instruments and various methods of bandaging that take place even in modern
medicine. However an experience physician would find here nothing useful;
probably, work targeted at teaching, although some find him extremely confused
and obscure.
Other opinion was folded after reading of book "On breaks". Scientists
attribute this work to the best works of Hippocrates, meaning meticulousness in a
semeiography, receptions of treatment, optimality of anatomic information, that
envisages large enough practical experience. "Most doctors treat breaks in the first
days, - Hippocrates wrote, - and with a wound, and without a wound, from
unrefined wool, by submitting it to the unstranged art.
Therefore to those, who at fresh wounds uses wool, not having fresh
bandages, it must have condescension, because, not having bandages, it is
impossible to find nothing the best wool for bandaging. Only wool must abound in
this case, soft and non-rigid. At a few and bad wool matters "small.
A bit later there was the written book "On setting of joints", that presented
an author as initiative clinician that admired the mechanical methods of setting. In
opinion of Hippocrates, more "correct in all to do dislocation of shoulder thus: to
hang up a tree, tying him twine. Man let will sit down on a high chair, to place
hand higher trees, that a pen lay under a mouse symmetrically, but he will be a bit
suspended.
Laying on a chair a leather pillow on such height, that would answer the
elbow contained at right angles, to kick about a strap from a skin and hang up
weight on him. While some strong man will pull an elbow downward, doctor let
begins to hand activity upright... Bone shoulder becomes stronger usually in
continuation 40 days ".
"Chairmen are human quite not alike interse ". - Hippocrates noticed fully
justly, beginning a treatise "About wounds of chairman". Depending on the
presence of bulge in front or in the back-end of skull, and also in two directions an
author distinguishes degree of danger of traumas. The most impressive here is
systematic, successive description of wounds, undoubtedly, got in a fight.
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Meantime in biography of Hippocrates there is not pointing on involvement to the
field surgery. There are inexpressive certificates in relation to his son Fesal, who
participated in Peloponness war.
However such large material could collect only military doctor that
repeatedly accompanied an army in hikes.
In the days of Hippocrates physiology was in the embryonic state.
Physicians suspected about vascularity, considering them the explorers of not only
blood but also other substances. Value of heart, difference between veins and
arteries it was it unknown to the hellenes. A concept "artery" marked all large
vessels, including tracheas. Blood vessels, in their opinion, carried air to all organs:
"That air that goes to the lungs and blood vessels fills perigastriums and brain and
delivers understanding the same and sets extremities in motion".
In "Hippocrates collection" an a bit place is taken due to difficulty to the
problem of mutual relations of medicine and religion. In force of the lack of
education people were in old times inclined to bind illnesses to anger of Gods.
Homer explained an epidemic in the Greek army under Troy by fury of Apollo.
Hippocrates ridiculed religious presentations that touch the origin of illnesses
softly, knowing that every natural phenomenon natural reasons are the basis of.
The same problem brushed against in a division "About sacred illness", where
Hippocrates reprobated the magic methods of witch-doctors sharply.
Not knowing, imaginary a doctor was treated her singing and cleansing
rituals about nature of epilepsy. So sharp criticism did not have on an aim to offend
the religious feelings of citizens of Greece. As a practicing doctor, Hippocrates
displaced anger on "magicians, purifiers, quacks and deceivers that pretend to be,
that have piety anymore all other and all other are understood" anymore.
In the treatise of "Epidemic" he described the supervisions above different
epidemiology diseases in many cities of Greece, brought 42 miniature hospital
charts over - first in history of medicine. Two other the treatises: "Прогностика"
and "Aphorisms" appeared final generalization all of it enormous for that time of
deep intelligent medical experience.
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The historical value of activity of Hippocrates is represented in two his
major merits:
1) he put beginning to the own method of medicine - "supervision near a bed
sick" in the different states: during a dream and insomnia; his method was taken to
verification of theory by practice;
2) put beginning to the studies about the basic types of build and
temperament of man, and gave to these the key to understanding of physiology and
pathology, and thus and to treatment of man.
On the basis of this Hippocrates is considered the "father of medicine". Him
basic principle of treatment: do not "harm". The son of Hippocrates Fеssаl set forth
another principle: "Nature treats, a doctor looks" after.
In the epoch of the greatest bloom of the Roman empire, when an emperorphilosopher Marco Aurelius managed by it easily lived doctor Galen known to the
whole world. Claudius Galen was born in 131 AD in city Pergamon, in Asia Minor
in family of architect Nichon, one of the well-educated people at one time.
In history of world culture, in history of medicine, Galen occupies the
special place. Without regard to that the medical looks of Galen were formed in the
second half of II of century of our era, Galen during 1500 was irrefutable authority
and on East, and in the west. Galen is a whole epoch in medicine. Alongside
Hippocrates and Avicenna can be put only with him. Galen made off the classic
period of medicine - in numerous and voluminous labours him looks and
experience of many generations of physicians are summarized, beginning from
Hippocrates.
Many disappearing, lost works of physicians of Alexandria were represented
in the books of Galen and saved thus.
Activity of Galen, confessed yet in the time of life, was given out and was
fruitful. To him a not alone scientist-physician did not even try to do that he did:
grounded the complete system of medical looks that embraces all prophylaxis of
diseases. In Galen it is possible to find answers for all questions of modern to him
69
medicine. Moreover, he tried to give answers for those questions, that after the
level of knowledge that time it was yet impossible correctly to decide.
Unity of approach, systematic character, logic at the decision of private
questions, going out general pre-conditions, - here that characterizes ideological
positions of Galen in medicine. He absorbed, did experience of all previous
generations of doctors.
Being student of Pеrgamon schools, Galen studied philosophy and natural
sciences, and moving to Smyrna continued education, admiring medicine. Got
more thorough medical knowledge of Galen at Alexandria school. For perfection
of the medical knowledge he traveled much, visited cultural centers: Cyprus,
Palestine, in place studying healthful minerals, was thrown, resins, spicinesses.
And capturing the art of medicine, he went to Pergamon and took up surgical
practice among gladiators.
Galen had large practice (6) at school of gladiators, that very enriched him, :
he could see various traumas, look after patients and injured, watch after motion of
different illnesses. Naturally, that a scientist is with such preparation, with such
data represented in the labours new conformities to law, new phenomena. Besides
large possibilities were opened before him by his position of court doctor. At first
in 164. he entered on service to the emperor to Mark Аureliy, and then, in 170 as a
doctor was charged in position him to accompany the army of heir of throne, of
Коmmod. In Rome he writes the most prominent labours with an anatomy,
physiology, pathology, pharmacology, therapy, obstetrics, hygiene, describes
nature of illnesses. He devoted one of the works these sciences "About setting of
human body". During 5years Galen studied an anatomy for the best doctors of
Alexandria that is why to perfection owned to the technique section of dead bodies.
Description of parts of body and organs Galen combined with the study of their
thin structure-histology.
He methodized biological and medical knowledge at one time. More than
400 treatises are written them, in particular 200 - from medicine. Part of works
perished at a fire in Rome, to us reached about 140 his labours.
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For Galen characteristic unity of opinions is and on normal, and on
pathological processes. Galen does not hesitate different points of view, they were
not attractive as though, but understanding of sickly processes, and from here and
builds the therapy coming from only conception - studies about juices. For this
reason Galen is justly named the founder of humoral pathology, and it at known to
the measure correctly.
Statement about juices of organism and about their influence on a health and
illness, about their large role in all life of organism many physicians have a earlier
epoch. But exactly Galen belongs merit of development of this studies, systematic
consideration of all aspects him and, it is most important, persistent aspiration all
phenomena that take place in a human body, to examine first of all and only under
the corner of studies about four juices.
Oscillation of Galen between materialistic and idealistic interpretation of the
phenomena can be educed and in an important question - in his understanding of
pneumo. Studies about pneumo were developed by Hippocrates that considered
that pneuma is alive substance. Galen not only took this studies on an armament
but also developed it, distinguishing physical pneuma animal pneuma, that
manages the vegetative processes of body, and, finally, psychical pneuma, sincere,
that manages and autokinesias, and psychical experiencing of man.
This pneuma, in his understanding, moves on nerves and carries feeling from
sense-organs in a brain, and motive impulses - from a brain to the muscles. Blood,
appearing in liver, is enriched by "natural pneuma", comes in a heart, and carried
through an aorta to all parts of body. "Psychical pneuma" is in a cerebrum, she is
managed by the soul.
Right behind Hippocrates, Galen bound "temperament" to the state and
ability of organism.
Galen first in history entered an experiment in practice of medicine and
biology that is why he is counted to one of founders of experimental physiology.
He described all departments of head and spinal brain, worked out the method of
preparing of brain for animals, proved experimentally, that the impulses of
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excitations were passed from a brain on nerves to all organs. In the labours of
Galen spared large attention to practical medicine.
He described the symptoms of diseases of most organs of man, thoroughly
described eye illnesses, gave the row of practical advices from curative to the
gymnastics, described, as necessary to put leeches, to put compresses, operate
wounds.
Galen is known as pharmacist. He considered, as well as Hippocrates, that a
doctor must to help nature, as nature cures. Due to Galen, an organism falls ill,
when composition or rightness of functioning of organs is violated. Nature created
a perfect organism, that is why at treatment it is needed to use protective forces of
organism and medicinal facilities that give an opposite action.
Pharm business is impossible to imagine without "galen preparations". 18
centuries that is why Galen laid down the row of recipes on powders, pills,
infusions, decoctions, collections, solutions, mixtures, washes, compresses,
poultices, ointments, extractions. He widely practiced extractions from natural
materials, which is used as vetting, insisting, drawing out is for. His recipes,
though in the kind changed a bit, are used to this day, and the medicinal facilities
made after them (id est "galen preparations") made directly in pharmacies.
In the modern understanding all these facilities it costs to name medical
forms, and only mustard plasters, soap, plaster, guilt, honey-vinegar behave to the
group actually "galen preparations", that in future was filled up by syrups and
elixirs(from arabs), tinctures and extracts(from times of Paracels).
And main Galen generalized the methods of treatment of medicinal
substances and refuted the looks of followers of Hippocrates that considered that in
the wild there are medications in the prepared kind and optimal combination, and
that is why they do not require some cleaning. Galen asserted that in medicationsvegetable or animal- there are useful substances and harmful that needs to be cast
aside. He aimed to release medicinal substances from ballast and get the cleared
preparations, thus he first entered a concept about operating substances.
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Galen became the founder of science- pharmacology, sciences about
operating of medicinal facilities on an organism. After an action Galen divided
medications into 3 classes:
-simple - such, that operate the elementary internalss of warmth, cold,
moister to dryness;
-complex- such that operate depending on different combination of main and
side properties( hills, sweet, sour);
-specific- such, that operate as freeing, irritable and other
Galen had the pharmacy in Rome, prepared medications for patients, many
from that were difficult and contained to 60 ingredients. In the days of Galen at a
generous amount cosmetics, tooth-powders, pomatum, prepared for hair. Exactly
Galen worked out compounding of the used to this day cosmetic "coldcream, that
consists of essential oil, beeswax and pink water.
Control questions:
1. Personal touches of ancient Greece’s medicine and pharmacy.
2. Substantive provisions of Hippocrates’ studies.
3. Labours of Hippocrates in industry of medicine.
4. Medical activity of C.Galen.
5. Pharmacognasy of C.Galen.
6. What are the main merits of Hippocrates and Galen.
Tests :
1. The flowering of Kossian school is connected with:
a) Galen ;
b) Pythagoras ;
c) Hippocrates ;
d) Galileo.
2. Hippocrates stated in his treatise "About the air, water and ground ":
a) the study of nature;
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b) his monitoring of patients ;
c) his views on the nature of surrounding mountains ;
d). the study about the four basic types of people ‘ physique and temperament .
3. Galen separated the diseases’ causes on:
a) general and individual ;
b) external and internal ;
c) temporary and chronic ;
d) severe and weak.
4. Hippocratic Oath - is:
a) health Code ;
b) agreement between the doctor and the patient;
c) doctor’s ethical obligation;
d) the norm of life
5. One of the treatment’s method Hippocrates considered :
a) diet ;
b) starvation ;
c) cauterization
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UNIT 5 : "MEDICINE AND PHARMACY OF EARLY AND
LATE MIDDLE AGES"
Aim of the lesson: to learn the question of development of medicine and
pharmacy in a period
Early middle and late ages, to master basic position of alchemy and its
influence on further development of Pharmacognosy.
A feudal line-up was set in the different countries of the world in different
historical terms. This process of transition from slave holding to feudalism flowed
in a specific for every country form.
For a feudal culture characteristic favour of traditions and bending down
before book authorities, including before canonized authors of remoteness: by
Hippocrates and Galen. The source of knowledge tradition, but not experience, was
considered. Scientific researches and all new knowledge were considered. The old
philosophical systems and separate scientific motions were adjusted to the dogmas
of faith. Theoretical medicine practically did not develop to Renaissance age. A
pneumatic theory and humoral studies in physiology remained unchanging.
In the epoch of feudalism substantial changes were brought in the system of
preparation of doctors and organization of medicare. Next to monasterial schools
were widespread handicraft and workshop. Later, preparation of doctors
universities that to the end of XVI – th century engaged in forced out the handicraft
form of preparation of doctors. In the epoch of feudalism finally there was a
hospital form of medicare.
Medicine in the Byzantium empire.
In a period early feudalism of Byzantium and the people of East attained
more considerable development of material and spiritual culture, than people of
Western Europe. As we know from history, the Roman empire was divided by
Western and East, after falling of the Western Roman empire (476.) Byzantium
became the only heir of ancient culture. The centers of traditional old culture
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(Egypt, Меsopotamia, Asia Minor) and motherland of ancient culture is Greece
were included in her composition.
At falling of the Roman empire the ancient centers of science survived:
Athens, Alexandria, Beirut, Gasa, and also there were new, such as Constantinople.
Scientific work did not stop beating here in V – VII – th centuries, as it was in the
west Europe, and in IX - XI. Byzantium was distinguished as a large cultural
center on the East of Europe. Byzantium inherited and saved the old culture of the
ancient world when Western Europe was in the state of decline.
Assisting the revival of culture, Byzantium doctors - encyclopaedists in the
labours systematized the inheritance of ancient medicine from positions of anatom
- physiology presentations of Galen. Works of the Byzantium doctors of XI – XIV
– th centuries testify to living interest in the achievements of Arabic medicine.
In the middle of IX – th century there was higher school in Byzantium.
Preparation of doctors, that to that had individual handicraft character became a
task scientifically - educational establishment. Studies to medicine were it is
closely constrained with studies to other sciences.
The merit of medieval medicine of East is creation of civil hospitals and
pharmacies. Hospitals of the ancient world mainly were combat hospitals. In
Byzantium hospitals for citizenry arose out of refuges for travellers. At coaching
inn on large roads at first rooms got organized for patients in transit, and then and
the special apartments. Also hospitals grew from refuges for cripples and incurably
sick, so-called alms-houses, and opened at monasteries.
The most large hospitals counted for several hundred beds, there were
profile separations (surgical, woman and others like that) in them. One of the first
large monasterial hospitals was founded in IV – th centuryin a caesaria. There were
pharmacies at hospitals, medical schools were opened. The charter of monastery, at
that there was Caesarea hospital, envisaged the order of treatment of patients,
studies to medical business, contained the detailed descriptions of economic order
of hospital.
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The Byzantium hospitals served a prototype for creation of similar
establishments in orients and Western Europe.
Other form of hospital business was organization of insulators for infectious
patients. From these insulators after formation of order of St.Lasar there were
refuges for patients with leprosy, infirmaries. Later part of infirmaries was
regenerate in a hospital. Sources of formation of similar medical establishments are
in temple medicine of ancient Egypt and Greece.
Byzantium medicine played a prominent role in the transmission of ancient
inheritance to the orients and Europe. The special influence she rendered on
development of medicine of the Slavic people, Armenia and Georgia. Due to the
cultural connections with Byzantium, Kyiv Rus became familiar with to the
inheritance of the ancient world earlier many European countries.
Medicine and pharmacy of Arabic Caliphates.
Considerable development of medicine got in Arabic Caliphates - moslem
feudal states form in VII – VIII – th centuries AD and exіsted to XII –XIII – th
centuries. As a result of conquering wars arabs overmastered Arabia, Egypt, Syria,
Palestine, Persia, some provinces of Byzantium, Georgia, Armenia, part of India,
Spain, north coast of Africa. The single Arabic state lasted one century, divided
into Western Caliphate with a center in Cordova and East Caliphate with a center
in Baghdad. Thus, beginning from VII - th century in the countries of Near and
Middle East arose up, there was and developed the rich Arabic culture that
essentially included for itself the various culture of the subdued people. The
characteristic feature of the Arabic culture was maintenance of ancient traditions of
culture of Ancient East, ancient world, creative processing of cultural heritage and
her further development.
The Arabic culture inherited the valuable achievements of ancient Eastern
and ancient civilization and served to one of sources of forming of looks of
scientists of medieval Europe. In IX – X – th centuries the Arabic culture attained
the greatest bloom.
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The centers of higher education and scientific activity were the so-called
houses of knowledge, that from the beginning of IX – th century were open at
many metropolises. Higher schools were in Baghdad, Cаіro, Dаmаscene, Cord, and
Samarkand. Scientific centers were and societies of form that united the confessed
scientists. Such centers were the prototypes of scientific societies and academies of
sciences, that arose up in Europe in XVII – XVIII – th centuries. There were
medical schools at hospitals (analogical by Byzantium).
For them a clinic was widely laid out, theoretical medicine was laid out in
accordance with аnаtom - physiology impressions of Galen. Volume of teaching
was not severely regulated, as in Byzantium, and teachers in the process of
teaching could express the opinion and supervisions. For completion of school
students folded examinations that was accepted by the college of doctors. These
original clinical and scientifically - educational centers some historians name
medical academies. The private form of studies was assumed: experience doctors
had students.
At the houses of knowledge and societies form large libraries (Baghdad,
Bokharan, Cairo, Damascene, and Cordov) were created. In Western Caliphate in a
period of its bloom there were 40 libraries and 10 high schools. In Western Europe
at that time there were only 2 universities: in Salerno and Paris.
Wide development was got in Caliphates by hospital business. In XII – th
century there were 60 hospitals in Baghdad, in to Cord- about 50. At a hospital in
Cairo there was an ambulatory separation the doctors of that conducted an
ambulatory reception not only, но and visited patients at home. Hospitals were
financed, mainly, due to the private offering. The special officials that looked after
economic activity of hospitals and medical schools were appointed in cities. Right
behind hospitals in orients first pharmacies appeared: the first pharmacy was open
in Baghdad in 754.
Development of pharmacognosy is closely constrained with the
achievements of scientists of East in area of chemistry. Conquering Egypt, arabs
together with other traditions of ancient culture adopted alchemic skills. The idea
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of drawing on accomplishments of alchemy in medical aims and receipt of
medicinal facilities belongs to the Arabic and Central Asiatic scientist by a
chemical way.
History is kept the names of the prominent Arabic scientists that time:
Gеbеr, Аl-Razi, Іbn-Аl Haisam. One of the known Arabic alchemists there was
Dzhabir-іbn-Hаyan (721-815), known as Gеbеr. He worked out the theory of
formation of all metals under act of temperature in the bowels of the earth of earth.
In his works description of methods of distillation of liquids, he got sulfate and
nitrate acids, nitrate of silver, chloric Mercury, alcohol and other the known
alchemist of Аbu-bacr Моhamed Zаcаrіa Аl Time (865-925.), known in Europe as
Razes, was also a main doctor of Baghdad hospital-school.
He left two capital labours: 25-volume medical collection the "Allembracing book from medicine" and second collection in 10 volumes is the
"Medical book". Rases first from the authors known to us wrote with popular work
for people about medicare "For those, who does not have a doctor". In him the
described diseases that meet most often, and methods, treatments accessible and
easily carried out in domestic terms. In a book "On hospitals" on the basis of the
experience of Rases described the order of organization of curative establishments.
Under his guidance three large state hospitals (the first is open in 800 year)
were built in Baghdad.
The doctors of Arabic East studied the problems of the personal and public
hygiene. Except perceived from ancient Eastern and Greek doctors of rules of the
personal hygiene, they in detail are work out the dietary modes for people different
age and rational feed. Large attention was spared to the hygienical supervision
upon pectoral children. Surgery and obstetrics were to develop more poorly than
Pharmacognasy, hygiene and infectious diseases. It was related to prohibition of
Islam on the section of dead bodies and review of woman body.
The Arabic doctors enriched practical medicine new clinical supervisions,
receptions of diagnostics, by medicinal facilities, approached medicine to natural
sciences, expounding the idea of receipt of medications a chemical way. They
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perfected the methods of preparation of medications. In addition, the Arabic
doctors brought to medicinal facilities both biological (on animals) and clinical
touch in hospitals. The special place in pharmacology of Arabs had toxicology and
antidotes.
The Arabic doctors are enter in practice sugar (instead of honey), medical
elixirs and syrups. Elixirs got by distillation in the cube of digister that contains
aethereal butter. Medical syrups were got from mixing of 50 solution of sugar or
treacle in juice or extraction from medical raw material. Recipes of Arabic
medicine were very difficult. They include 60 ingredients.
Medicine of people of Arabic East presents the higher achievement of
medicine of epoch of feudalism. It became one of the most valuable sources of
forming of progressive medicine of Renaissance age.
Medicine of people of Middle Asia.
In X – XI-th centuries the culture of people of Middle Asia attained high
development. There was a large library in Bukhara, in Choresm is society of
scientists (academy). In IX-XI - th centuries in Bukhara, Choresm , Меrva and
other cities existed hospitals and pharmacies. The most prominent representative of
doctors of Middle Asia was Аbu Іbn Sina, known as Avicenna (980-1037). He was
born in village of Аfshan near-by Bukhara (Tadjikistan). When he was 5 years,
family moved in the capital, where he got education. The advanced and practical
study he engaged in Chores and cities of Iran.
By the question of medicine Avicenna devoted over 20 large works, his
works generalized an ethnomedicine. The real task of medicine he saw in
maintenance or proceeding in a health. By reasons of illness, according to his
opinion, there can be bad terms of way of life, exhausting works, harmful locality,
climate, heartfelt shocks. To the last factor of origin of illnesses Avicenna spared
the special attention and conducted an interesting experiment with lambs.
Therefore Avicenna required cheerful situation near a patient, that him
would influence on a positive line-up, was glad to entertain a patient music,
singing, games.
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Got a world fame his main work "Canon of medical science" that was
written in Choresm (999-1014). A "canon" consists of 5 books and lights up the
question of anatomy, physiology, Pharmacognasy, hygiene, therapy, dietetics. Two
from these books were sanctified to Pharmacognasy : the second book of "Canon"
is a textbook from Pharmacognosy fifth is a pharmacopoeia. Avicenna worked in
industry chemistry, entered in medical practice the numerous facilities got a
chemical way of realiable classification of chemicals.
There were the acquainted chemical transformations him as fermentation,
dissolution, sublimation. It is talked in "Canon", that for the study of action of
medications it is not enough to test them on animals, it is needed to study operating
of medications on a sick man, the clinical tests of medications were thereby
recommended.
In XII – th century a "Canon" was translated from Arabic on Latin and
divided in numerous copies on all Europe. During a few centuries in the
universities of Western Europe future doctors studied to medicine after "Canon".
Тibetan medicine.
On forming and development of tibetan medicine of large influence gave the
medical systems of nearby countries, especially Іndia and China. Speciality of
geographical location of Tibet that was on crossing of ways from the South and
Front Asia, assisted penetration to Tibet of medical works of the ancient world.
And unapproachable the Himalayas provided maintenance in the monasteries of
this edge of original sources of many medical works during centuries.
Generalizing these information, by the doctors of Tibet the original medical
system was created, that impossible to attribute neither to Indian nor to China
tradition, although from both traditions it was adopted both theoretical options and
practical to recommendation.
The theoretical options of tibetan medicine are based both on the Indian
studies about three first elements (wind, bile and mucus) and on the China idea
about forces of "іn" and "yan", identical to the heat and cold. The health of man
depends on internal balance of these component parts. Тibetan doctors considered
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that a man gave birth with certain advantage of that or other element. Therefore
distinguished three types of man: people of "wind", people of "fire", .to the bile,
people of "earth-water", i.e. sputum.
All three types differed on the physical structure of organism, on
temperament and after habits. If the way of life of man does not answer the type,
balance of elements is violated and arises up illness. DoctorsВрачи of Tibet
considered that an unbalance to the "heat and cold" resulted in the origin of
"general illnesses", and unbalance of three elements- by the consequence of
"private diseases". Main principle of tibetan medicine was position about unity of
human organism.
Treatment not illness responded to, and concrete patient with individual
features: physical, psychical and emotional. The doctors of Tibet studied in
monasteries during 10-15 years. An anatomy was studied broadly speaking,
surgery was at not high level: amputations and puncture to the stomach conducted
only. Doctors owned diagnostics very well, with the use of diagnostics after a
pulse, as in China. With an aim treatments applied the plants of tibetan flora, and
also medications of India and China.
The doctors of Tibet considered that longevity is assisted by surplus in a
meal, protracted stay on fresh air and riding.
The classic source of tibetan medicine is a work of "Joo – Dzhi” ("Four
tantrs"). This source allows to establish the following:
- tibetan physicians knew about absolute and relative doses that present
certain part from a toxic for a man dose;
- the considerable role was taken to the substances that assist realization of
medications to the certain organs;
- at prescribing medicine necessarily time of their reception, combination of
medications made a reservation with food foods, the daily routine was specified;
- tibetan doctors used properties more than eight hundred plants, minerals,
animal raw material, combining them in different doses for a certain curative
effect;
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- medicinal facilities classified on curative properties, action, taste, method
of their application;
- the Personal touch of tibetan samples of writing is many components(60
and more components).
Medicine and pharmacy in Western Europe of middle ages’ period.
The epoch of feudal relations in Western Europe embraces XII – XIII – th
centuries, beginning from 476 AD, and divided in 3 stages. First stage of feudalism
(V – X – th centuries) - early middle ages - characterized by a deep economic and
cultural decline. In the second stage of feudalism in Western Europe
(approximately from XI - th century) - in the developed middle ages - with the
height of productive forces the centers of handicraft and trade were formed. The
third stage of feudalism (XV – XVI - th centuries) is late middle ages - period of
his decomposition and forming of bourgeois society.
Domination of scholastic medicine
In the epoch of early middle ages in Western Europe, unlike orients, it is not
marked substantial economic progress. A christian church became the heiress of
late ancient culture. Priests got the family a monopoly on education and science.
The general level of culture and form, as compared to a late ancient period, went
down considerably. Scholastic became the dominant form of philosophy in
medieval Western Europe. Science served churches, and it was not let her to go
beyond the limits set by a faith.
Philosophical basis of medieval science was based on the considerably
distorted studies of Aristotle,Galene’s idealistic conclusions and some Hippocrates
works, that less represented him materialistic looks in medicine. The basic type of
medieval scientific literature were comments to works of ancient authors. A not
supervision and experience, but verbal conclusions and deduction, became basis of
medicine.
A role of alchemy in development of pharmacy.
In a period of middle ages magic, astrology and, especially, alchemy, had
large influence on development of pharmacognosy. Attempts to find all curative
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facilities accumulated experience of research of substances simultaneously.
Without regard to errors, alchemists assisted the practical work to development of
chemistry and pharmacy. The amount of substances that is withdrawn by a
laboratory way increased due to alchemists, and many opening was done.
Discussions and works of medieval sсhоlasts assisted to development of logic,
alchemy prepared the origin of scientific chemistry.
Opening of hospitals.
In the period of early middle ages there are monasteries in Western Europe.
In VI - th century at the West-European monasteries the first hospitals was created.
The idea of creation of permanent establishments in monasteries with the aim of
treatment of chronic patients was adopted in Byzantium. However after the level of
treatment and supervision upon patients they substantially yielded to the hospitals
of Byzantium and Arabic East. A medical help to the population was rendered by
monks medical preparation of that was extremely insufficient. At monasteries also
the first medical schools began to be folded.
Preparation in them in the first times was limited to the study of methods of
grant of the first aid at wounds and supervision upon wounded and patients.
Beginning from XIII –th century distribution of epidemics took place in
Europe, for caring of patients with leprosy the special organization was founded - a
monastic order of St. Lazarus that had refuges for the isolation of leper is
infirmaries.
The monasterial form of medicine was characteristic for period of early
middle ages.
Workshop medicine.
In the developed of middle ages there is expulsing of monasterial medicine
by workshop for an artisan and society medicine. In XII – th century churches
objected doctors- to engage in monks manipulation treatments there is shed blood
at that. Thus practical surgery was excluded from the competense of professorsmonks. To it division of medicine, after the exception of Italy (Sаlerno), practically
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fully transfered surgeons in hands- artisans that for example of all artisans that time
unite in shop.
At many cities of Europe, including in Ukraine ( in Lviv, КаmyanetsPodolskiy), such workshop that got the name of surgeons workshop .
Surgeons-artisans occupied considerably more subzero social position, than
graduate doctors. Conducted such most artisans only shallow manipulations:
bloodletting, exodontia. Also they clipped and shaved a population, that is why
more often such masters were named barbers. At difficult operations barbers
helped to the doctors. Also barbers accompanied an army in soldiery hikes.
Origin of universities.
The first medical schools of medieval Europe began to be folded at
monasteries. Preparation in them at first was limited to the studies to the methods
of grant of the first aid at wounds and supervision upon wounded and patients. The
prototypes of the West-European universities were schools that existed in the
Arabic caliphates school in Salerno.
School in Sаlerno was founded in 846., in XI - th century she was regenerate
in an university. In XII – XIII - th centuries universities appeared in Paris,
Bologna, Oxford, Padua. Charters and curricula of medieval universities were
controlled by a catholic church. To beginning of XIII - th century glory of Salerno
university was so large, that king Frederick II gave an absolute title to appropriate
the rank of doctor and give out licenses to a right for medical practice on territory
of his empire to her.
A permanent on-line tutorial was ratified: studies at school preceded 3 years
of an annual preparatory course, medicine was 5 years of study, where upon got
annual internship for an experience doctor.
In XII – XIII - th centuries in a number of the European states royal decrees
were divide functions of doctor and chemist. The first pharmacies were open in
Venice(1238), in Florence(1300). In 1224 Frederick II gave out a decree about
establishment of state control after preparation of medications and surgical
practice.
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In XIII – XIV - th centuries in Italy, Germany and other countries beginning
was fixed to the sanitary legislation and municipal sanitation. Port supervisors,
insulators, appeared in the port metropolises of Europe, quarantines were entered.
"Municipal doctors", that executed, mainly, antiepidemic functions, appeared later.
However, intellectual life of medieval Europe gave nothing for development
of problems of natural history. And almost during two centuries of intellectual
development may need, before the scientists of Renaissance age showed science
out of oblivion.
Medicine of Renaissance(XV – XVI – th centuries)
A culture of Revival was not a simple return to ancient traditions, she
developed and interpreted an ancient inheritance, coming from new socially economic terms. Except an ancient inheritance in area of medicine Western Europe
took the achievement of front-rank medicine of people of East, that became known
in Europe due to arabists (to the translators from Arabic on Latin), also. Wide
distribution of knowledge was assisted by the invention of book-printing (in the
middle of XV – th century).
To XV – th century of studies to medicine in the European universities was
taken to the study of "Canon" of Avicenna and comments of Hippocrates and
Galene works, most universities did not have own clinics for the studies of
students. The fight of old (scholastic) and new (humanistic) directions went to the
universities.
In XV – th century there were already about 40 universities in Europe. The
European scientific center was an university in Padua city (Venetian republic),to
which belongs the special role to in history of medicine of this period. Paduan
scientists, using medical experience of Greeks, Romans and arabs, applying all
new for the time achievements of science, made great strides in understanding of
both structure and functions of human organism and his pathology. All wider an
experiment begins to be used on animals.
In understanding of activity of organism scientists all anymore leaned
against the laws of physics, but not on supernatural forces. In Paduan university,
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beginning was fixed straight in medicine (jatrophysics), that examined processes in
an organism from position of physics, mainly mechanics. In history of medicine of
jatrophysics played a large role: she freed science about a human organism from
idealistic looks. Prominent jatrophysics in VI – th century.there was professor
Pаduan to the university Аndreas Vеsаliy (1514-1564). He is considered the
founder of anatomy as sciences.
Vеsаliy, investigating human troupes, corrected all of that time anatomy,
marked about 200 substantial errors of Galen. Vesaliy also consider a founder
functionally- morphological researches. His physiology presentations were
jatromechanic.
In XVI - th century new direction was formed in chemistry – jatrochemistry
(therapeutic chemistry). Jatrochemists considered that a human organism is totality
of chemicals that are in an equilibrium. Pаrаcelsus (1493 - 1541) is the confessed
founder of jatrochemists. From Paracelsus began cardinal reorientation of chemical
researches from the receipt of gold to preparation of medications, there was close
connection of medicine and chemistry.
Character of therapeutic medicine changed. On the change of overlearning
on memory of medical texts the attentive watching came patients, exposure and
systematization of signs of illness. These lines that remind the studies of
Hippocrates and front-rank doctors of Caliphates but at more wide to plenitude of
knowledge about a structure and vital functions of organism, characterized
beginning of clinical direction in medicine.
In renaissance age more forward measures of protecting found application
from epidemics(isolation, quarantine). Doctors professional diseases attracted
attention.
Medicine and pharmacy of New time (XVII – XVIII – th centuries)
Beginning from XVII – th century science began to accept international
character. Scientists interchanged folias, reported to each other about the
achievements and opening, scientific centers were created. The first was founded
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"Academy of experience" in Italy (XVI – th century). In 1666 the Parisian
academy of sciences was open, then Birmen, Petersburg, Stockholm and other.
At complete chaos in the questions of treatment, in XVII – XVIII – th
centuries enriching of arsenal of medicinal facilities took place however, that it is
related to development of seagoing and opening of new territories. To the old
galena pharmacopoeia were added: bark of cinchona, ipecacuanha, China tea and
Arabian coffee, as pick-me-ups.
In the end of XVIII – th century in a counterbalance existing then to the
methods of treatment of illnesses by the large doses of difficult after composition
medications, a theory according to that treatment of clean medicinal substances
was considered more effective extraordinarily small doses appeared. The founder
of theory is German doctor Samuel Ganeman, a theory is adopted by homeopathy.
To the end of XVIII – th century the value of mechanic materialism
diminished sharply. Presentations of jatrochemistry had one-sided character, that
played a positive role on the certain stage of development of chemistry.
Two personal touches of science of XVII-XVIII – th centuries is a support
on a supervision(experience, experiment) and mathematics. Authenticity and
exactness became the flag of new science. In that period its development leaned
against an invention or improvement of scientific instruments and measuring
devices and on mushroom growth of mathematics. But the same lines determined
limit nature of science of XVII-XVIII – th centuries, its strange ideas of
development, prevailing interest in quantitative parties of the phenomena in harm
researches of them quality specific.
Distinguished achievements naturally - scientific and medical opinion of
New time became foundation for development of medicine and pharmacy in XIXXX – th centuries.
Control questions:
1. To enumerate the features of development of medicine in a medieval
period.
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2. Sources of forming of Byzantium culture.
3. Byzantium hospitals.
4. Centers of higher education and science in the Arabic caliphates.
5. Influence of alchemy on development of pharm. matter of the Arabic
caliphates.
6. Payment of Аvicenna in medical science.
7. Achievement of tibetan medicine.
8. Influence of transition of Western Europe to the feudal structure on the
development of culture.
9. Scholastic character of West-European medicine.
10. Defects and advantages of alchemy.
11. Hospitals and infirmaries in Western Europe.
12. Opening of the first universities.
13. Division of functions of doctor and chemist.
14. Origin of humanistic direction.
15. A role of jatrophysics in history of medicine.
16. Essence and value of jatrochemistry.
17. Character of curative medicine in renaissance age.
18. Influence of science’s progress on the development of West-European
medicine of New time.
Tests:
1. The first Byzantine hospital was opened:
a) in Kesari
b) in Alexandria
c) in Constantinople
2. . "Canon of Medicines" is written by:
a) Galen
b) Paracelsus
c) Avicenna
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3. What lies at the basis of Tibetan Medicine:
a) Ancient Medicine
b) Arab Caliphates’ Medicine
c) Medicine of India and China
4. The founder of iatrochemistry considered:
a) Vesalius
b) Paracelsus
c) Hippocrates
5. Homeopathy is based by:
a) W. Harvey
b) S. Hahnemann
c) Paracelsus
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UNIT 6: "ORIGIN OF TREATMENT AND PHARMACOGNASY IN
RUSS.
MEDICINE AND PHARMACY OF KYIV RUS AND RUSSIAN
CENTRALIZED
STATE (UNTIL THE 18TH CENTURY.) "
Aim of the lesson: to learn the sources of forming of medicine and
pharmacy on to Russ and to the Moscow state, to mark them characteristic
features.
History of Ukrainian medicine and pharmacy, as well as any historical
science, requires a clear division into periods. The attempts of such division into
periods are accepted by the row of scientists. Undoubtedly, that she must embrace,
first of all, ancient Ukrainian period. The sources of study of this question are
writing and material monuments of scythian people, monuments of material culture
from excavations of the former Greek colonies of south of Ukraine.
According with the opinion of many scientists, ancentors of the Ukrainian
people were trypillians. Opening of tripol civilization that was conceived in 4
millenniums BC and attained the bloom in 3 milleniums BC testify that our
ancestors knew about healthful properties of some plants and used them for
treatment of many diseases. At excavations of tripol settlements, found ceramics,
making and decorative pattern of that it was at very high level.
Afterward the people of Тrypillya became so numerous afterwards, that
settled in other edges, becoming independent tribes. The most militant tribes,
becoming nomads, scythians became famous under the general ancient name.
Further development of Pharmacognasy of Chernyahov cultures are attained
in the days of scythian. Scythians that inhabited Medium Black Sea region from
Dnieper to Danube (VII - III centuries BC), next to growing of agricultural cultures
(millet, wheat, lentil, bow, garlic), already then "cultivated" herbares: on original
plantations scythians conducted medical plants. Plants-herbares were used by
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scythians not only in everyday life, they used them in an ethnomedicine, and also
for embalming of dead bodies (incense,celery, anise).
Scythians had trade relationships with Greeks and sold medicinal herbares as
commodity, next to grain, foods of the cattle breeding, fur.
Exactly scythians conducted medical plants in gardens, vegetable gardens,
on original plantations. Later to the habitant of the Old Russian state, medieval
Russia, herbares were cultivated Ukraine like скифам.
Ancient and Byzantium writers repeatedly remembered about scythian
doctors and vulnerary plants of Scythia. In the works "father of botany" Fеоfrast
(380-285 BC) remembers about a "sweet scythian root", about wormwood and
poisonous plant there is an aconite. Pliniy and Dіоscorides remembered also about
a "sweet root". This enigmatic plant is a modern glycyrrhiza of goal. Already in
that time knew about her expectorant action, applying at asthma, cough, catarrhal
diseases, juice was mixed up with honey and put to the abscesses. A glycyrrhiza
scythians very valued.
Roaming on steppe warriors appeased this plant thirst in a flow 12 days.
In works of Pliniy, Dioscarid, Galen meet yet to the list about certain family
to the mushroom that scythians used as medications at burns and as a styptic agent.
A veterinarian of the second half of IV - th century AD Pelagoniy writes that
the habitants of North Black Sea region for treatment of horse used "Pontus herbs",
in particular wormwood.
The known Greek writer Plutarch (46 - 120 AD) remembers, that along the
river of Таnаіs(Don) there is a plant of аlinda : it reminds a cabbage the folias.
Scythians and Sarmates used juice of this plant for rubbing of surfaces of body that
kept them from a cold and cold.
Now it is exactly set already, that scythian medical plants were known in
Italy in III – IV - th centuries BC.
For the scythians of hemp juice, extract of root of mandrake, оpium was
served as anesthetics at surgical interferences.
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Scythian women, on the certificate of Gerodot, were able to make
cosmetically- hygienical ointments are for a skin. They ground at a rough stone
cypress, cedar, tree, topping up water to them. Тripols and scythians applied in the
curative practice different medicinal forms: decoctions, tinctures, drinks, fresh
juices, ointments.
Speaking about the achievement of medicine of scythians, it is impossible
not to remember about their knowledge in surgery, about application of operative
methods of treatment. During excavations of burial mounds near Kerch, Nikopol
gold vases are found with the image of surgical operations - a scythian sets a jaw to
the trauma warrior, deletes a tooth, bandages a shin to injured.
In works of Gerodot and Plutarch talked about "professional" scythian
doctors: Аbаris, Аnаhаrsіs, Тоxаris. Both Аnаharsis and Тоxаris were considered
for ancient Greeks as the most experience doctors , especially as or diagnosticians
and prognostics.
Assume that in the North Black Sea region in IV - th century AD, lived
famous Byzantium doctor Оribasiy, that helped scythian doctors, and even taught
them.
In the North Black Sea region existed the Bоspоr state. The last ruler was
Mithridates VI Eupator, that is counted to one of famous pharmacologists and
toxicologists of the ancient world. The center of his activity was a city
Panticapaeum (Kerch). Мitridat is a famous doctor, an author of great amount of
medicine works, that, unfortunately, was not saved.
Thus, it is possible to do a next conclusion:
1) ethnomedicine of scythians mainly phytotherapy direction(use of medical
flora). Many plants of those times now will be used in scientific medicine: anis,
origanum, onion, garlic, wormwood, Glycyrrhiza glabra;
2) achievements of orthodox(scythian) medicine, as well as in general
scythian culture, laid down part of that cultural heritage, that was got by ancient
slavs.
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Slavs worked mainly in the area of a hunt, cattle breeding, pottery, leather,
blacksmith work.
Scythians had a heathen world view. Considered supreme force of Sun God,
believed in existence of other Gods, natural creatures that live in the fields, forests
and provided with these creatures kind and wicked internalss. In their opinion, evil
could be lodged in a man and cause different illnesses. Already at this time men
and women that better other was known by healthful properties of plants exuded
between slavs, had skills of grant of the first pre-doctor aid (witch-doctors, magus).
In VII – IX - th centuries most tribes of east slavs presented halfpatriarchalpolitical associations or tribal principalities.
First information about the state Russ and people that inhabited Average
Prydniprovya belong to VI – VIII – th centuries In this period there is
disintegration of primitively-communal line-up and feudal relations are conceived.
Disintegration of primitively-communal line-up in our heirs was accompanied by
development of feudal line-up, passing slave-holding line-up. In VIII – th century.
Kyiv and Novgorod principalities formed. in IX – th century. East slavs formed the
early feudal state - Kyiv Rus that put beginning to forming of 3 brotherly
nationalities : Russian, Ukrainian and Belarussian.
In X – th century. Kyiv Russ already was the large European state and
stretched out from the Baltic to the Black Seas, and from the Carpathians to the
Volga.
History of feudalism epoch is divided into three large periods:
1.period of Kyiv Russ - from IX - th to the second fourth of XIII - th
century, pre-mongolian, because the end of it is determined by an invasion of tatarmongol;
2. period of north-eastern Rus - from the second fourth of XIII -th to
beginning of XVI - th centuries;
3. XVI - XVIII centuries.
Medical cognitions on Russ were widespread among people, thus medicine
to adopting christianity carried folk character and leaned against enormous empiric
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experience. Healers were named witch-doctors, magus. They knew healthful
properties of plants and had skills of grant of the first pre-doctor aid. All of it was
reported with the mystic ceremonies related to the cult of heathen Gods. The
recipes of heathen doctors are generalized in numerous herbalists reference made
after Christening of Russ monasterial recopying.
To our time not more than 250 codices were saved. From texts it is possible
to imagine the variety of medications that was made from everything, that nature
gave to the people. Among plants wormwood, dirt, nettle, goose-grass, freshwater
sponge, onion, garlic, horse-radish, were considered useful. In linden-trees was
used blossoms, in birchs - leaves, at an ash - trees a bark. Infusion of juniper
berries served for the desinfectation of wounds, and during epidemics set on fire
smoke an apartment the branches of this bush with the aim of desinfection and
prophylaxes.
Among medications of animal origin the special place was occupied: honey,
crude cod liver, pants of deer, made plaster and ointment on the basis of pork and
ancerine fat. Minerals were widely used, both in quality of talismans and as
powders for a reception inward. Future mothers carried coulombs from an opal.
From different the pounded chrysolite was recommended in a stomach. Magus
knew healthful force of blue vitriol, silver, turpentine, saltpetre, arsenic, Mercury,
furnace, vinegar.
Russian people from old- times knew about healthful properties of sour
water, its ancient russian name- Narzan, that was saved to our days, is translated as
athlete-water.
The acceptance of Christianity (988) Kyiv Russ brought over east slavs to
the culture of the Byzantium empire, as a result in medicine and pharmacy
appeared 2 new directions: church-monasterial and society. In the period of early
feudalism (IX – XII – th centuries) there were three Russ directions of medicine :
church-monasterial, folk and society. With development christianities of forest
magicians were changed by folk healers that was named then lecars, about them it
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is told the "Russian true" in the arch of the Russian laws, that was made by
Yaroslav Мudriy.
Farther the "Russian true" was complemented by Charter of Volodymyr
Моnomakh. About them it is talked: "Passing the cognitions from a father to the
son, they severely kept the secret of treatment into domestic schools". Almost not
interested in the health of the people, the Russian princes however tried to regulate
public relations. In a pre-christian period magus for unsuccessful treatment
disbursed life. After passing laws of Yaroslav Mudriy, doctors, which caused
damage by unsuccessful treatment were punished by a fine.
In the "Russian true" there were short positions that touched the
remuneration of works of healers. If a man got injury in fighters, then belonged an
offender to pay 3 gryvnyas to the victim and curative reward each, who will set to
treat a wound. With introduction of legislation on there was the state of free
doctors that treated princes and boyars for a solid pay Rus.
From history such representatives of society medicine are known:
-John Smera, sent by a prince Volodymyr to Greece and Balkan countries
for addition to medical knowledge;
-Peter Syrian is a doctor of the Chernihiv prince Nicholas Svyatosha. The
last, taking monastic vows in the Кiyevo-pechersc monastery extended the hospital
st. Аgapit;
-Efrosiniya Chernihiv, princess- got knowledge about medicine in Kyiv for a
monk Fedir, created a hospital in Suzdal, where engaged in an acceptance and
treatment of patients;
-Аnna Vsevolodovna Kievan Princess in XI - th century in Kyiv opened
society school at that medicine was laid out;
-Еvpraxiya Kyivan (Zoya), grandchild of Volodymyr Моnomah, from little
up showed the personal interest medical plants and ointments. Became adult,
engaged in treatment of patients. The state of medicine of Kyiv Rus of image is in
her work "About ointments", that consisted of 5 parts. In work is described
symptoms of many diseases, methods of their diagnostics and treatment, given
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recipes of preparing of medicinal facilities and recommendation in relation to a
hygiene. Historians consider that it is the first scientific work that was made a
woman.
Many localities were famous the capable doctors: Kyiv, Ryazan, Chernihiv,
Мur.
Due to development of trade and external relations with foreign countries on
doctors-foreigners began to appear Russ. Many doctors- natives from Byzantium
were purchased on to Rus large glory: Theophilus Nоnn, Simeon Sich and other
Thus, adopting christianity played a decision role in forming of medical knowledge
and improvement of medical practice for slavs, in appearance on Rus of new form
of medical service of population - church or monasterial medicine. She was created
on character and similarity of Byzantium, where from deep antiquity (of IV – V –
th centuries AD) monasteries had hospitals and were the centers of medical
knowledge. Knowledge of monasterial medicine were brought to Kyiv Rus from
Byzantium Greece, and the first monasterial doctors were monks from Аfonian
mountain. At monasteries arose up, like Byzantium, hospital and alms-house. The
first monasterial refuge arranged at the Кiyevo-Pechersk lavra began to accept
patients only in XI - th century. The detailed information about a hospital,
monasteries and his habitants is represented in Кiyevo-pechersc pateric of XII - th
century.
The oldest Russian monastery was situated outside Kyiv, not far away from
caves, where monks lived at first. The servants of lavra considered an anxiety
about patients the duty, executing him with a greater care. Separate monastic cells
targeted at seriously sick after that brothers looked after around the clock. People
that suffered contagious, skin and psychical diseases came here from all Rus,
unchanging getting a help and hope on healing. However, treatment in a monastery
was not limited to the hope on God.
In 988, in the first fate of adopting christianity, near Кiev an Intermountain
monastery that lasted to 1786 was founded .
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An important role in development of Ukrainian medicine was played by the
Кiyevo-pechersc monastery founded in 1051.by st. Anthony and Theodosius.
Anthony is the founder of Кiyevo-Pechersck monastery, practiced to that in
Аfonian monasteries in Byzantium, where and got medical knowledge.
Legally name a hospital open the father superior of the Кiyevo-Pechersck
monastery of the first monasterial hospital establishment by Theodosius in1062.
This hospital performed the duty of caring of invalids and grant of stationary
curative help to the patients. Theeodosius offered the first in Ukraine monasterial
Charter that envisaged a supervision upon patients and invalids.
Theodosius introduced a rule, after which all patients that appealed to the
monastery for help, was led, an abbot that then send them to one of calculators
examined at first, in dependence of disease character. Among patients there were
representatives of all task forces of population, most poor, but there were
representatives of the higher state. Yes, after a curative help in a monastery
Volodymyr applied Monostroke that was prince Chernigiv.
Consider the first doctor of Ukraine the continuer of monasterial treatmentto Russ of st. Аgapit, near student Anthony. He prepared medications, free of
charge treated patients and looked after them.
On the border of XI – XII - th centuries the icon-painter lived in Lavra .
Аlimpiy, that treated the disease of skin paints, saint water and prayer.
Respect to the first paediatrician.Damian- healer.
St.Prochorus- lobodnic grew medical plants and applied them for treatment.
Exactly him the recipe of baking of bread belongs to from the grass of goose-foot,
receipt from an ash salts that was used in the period of hunger.
St.Lavrentiy- recluse and st. Gregory - wonderworker is considered the first
psychotherapists.
Placing and equipment of hospitals : hospitals were built on territory of
monasteries, in places the least of accessible for a fire. Bath-houses, vegetable
gardens, cemeteries, were alongside situated. At first these were wooden building,
and then lithoidal houses began to appear. Hospitals were usually divided by
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monastic "cells" in each of that could take place from 2 to 6 patients. Patients with
slept wooden trestle-beds with bedding from a reed, pine-needle, bryophytess,
straw, hay. Blankets were not given, took shelter fur coats.
Hospitals were heated usually by stoves, sometimes from basement
apartments the heated air came through the system of internal pipes. Patients it was
properly to feed from a monasterial kitchen the same as "working people".
Monasterial hospitals were managed the special "guard", or by a "chief
above a hospital". The role of hospital attendants was carried out by monks. In
monasterial Charter thoroughly charges made a reservation on maintenance of
patients, states and order of management a hospital. A stay in the monasterial
hospital of rich patients was paid, separate monastic cells were distinguished them
and provided a corresponding supervision and feed.
As for poor, then they treated oneself free of charge or, if could, were under
an obligation to work some time in behalf on a monastery on plough-land, in
carrier's trade, on trades or сattle-farming . Sometimes at monasterial hospitals
arranged the original ambulatory acceptance of patients that arrived from
surrounding villages, here patients got advices and first aid(bandaging of wounds
and ulcers). In the chronicles of XI – XII - th centuries is remembered monasterial
hospitals in Kyiv, Smolensk, Chernihiv, Polotsk, Novgorod, Pskov, Lutsk.
Russian monasteries were also the centers of culture. There were enormous
libraries at monasteries.Their fund was various. Here were kept works of
Hippocrates, Galen, Avicenna. Monks translated them into an old church slavonic
language (chroniclers Nicon, Nestor). Except it, in the books of general
maintenance quite often also questions came into question of medical character
described build and function of the organs of man. There are the whole divisions
devoted to diet and to the personal hygiene.
They have fully rational appeals to moderation and to maintenance, that
testify to the high standard of culture of compilers of books. Recommend in
everything to restrain moderation: in a meal, in drink and even in a dream. Advise
to engage in corporal exercises, playing a ball, riding, hunt. Many Russian
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monasteries were the centers of education : in them laid out medicine after the
Greek and Byzantium manuscripts. Also monks applied the experience and
traditions of Russian treatment.
The monks of Кiyevo-Pechersk monastery went to nearby earth and opened
new monasteries, assisting distribution of medical knowledge.
Beginning from XII - th century monasterial doctors were obligated to stick
to medical moral. For example, it ordered to show self-sacrifice, kind-heartedness,
humanity, attentiveness a doctor to all, that appealed for help. He could not give up
the personal participation in the process of healing, sometimes executing the
dirtiest job. The church oath of Hippocrates required from a physician tolerance to
seriously sick, to the sensitiveness in relation to "obsessed". Not subject to the
discussion of question about payment, vanity and anxiety about the prosperity.
As a result of estrangement from everything, that touched own personality,
representatives of monasterial medicine were held in respect in people. Many
healers post mortem declared saints.
On surgery prospered Rus as major industry of practical treatment, a
requirement in that was caused by frequent wars. Thus the special honour were the
surrounded surgeons - "cuttors". And that is why, that the professional attribute of
"cutter" iron was considered, then surgery was named also a "ferrous cunning".
"Cutters" had knives, (razors), cut out, saw, drills, adz and different "instrument of
bloodletting". Wounds were sewn up by hair filaments and "strings" from the
bowels of animals (analogue of catgut).
Used sedative and somnolent facilities (infusions of Belladonna, hemlock,
оpium). Various operations were conducted from treatment of wounds, and if
necessary came running to amputation of extremities. Operations did both in
monasterial hospitals, and at home, and on a battle-field. In the soldiery hikes of
army(to the period of XII – XV – th centuries) society doctors participated already.
The primary purpose of their stay was a grant of medicare to the princes and
soldiery chiefs, but medicare was got by ordinaries soldiery.
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It was given by healer of ethnomedicine, that with the aim of earnings
followed by an army. Hardly wounded were delivered in the nearest monasterial
hospitals. In quality of medications used the infusions prepared from different
plants (brier, valerian, glycyrrhiza, pieplant, st-john's-wort and other), medications
of animal origin.
Also people treated oneself for witch-doctors, with application of plots and
use of medical plants. So monasterial, society and folk directions of medicine
complemented each other.
The sanitary-antiepidemic system of the West of Ancient Rus was at very
high level, and by the state on X – XI – th centuries passed ahead the development
of sanitary matter of Europe. To it archaeological excavations testify ancient to
Novgorod (X – th century) : water rose on pottery and wooden pipes, there was the
sewage system, found standages, streets presented by a soba wooden roadways. In
German such building from 'were only in XV –th century. It is necessary to
underline the value of the steam Russian bath-house, as an important line of
sanitary way of life of ancient Rus.
Ancient Russian state lasted during 3 centuries. In 1132 it disintegrated on
shallow principalities, that resulted in the loss of political independence. At the
beginning of XIII – th century. Rus was attacked by Mongol-Tatar conquers, by
that detained cultural development of the Russian people. In 1240 Kyiv was
invaded and ruined. Society medicine that developed in XI – XIII – th centuries,
coagulates Russian medicine took shelter in monasteries. One of centers of
medicine Кirilo-Bіlosersc became the monastery founded in 1397 at the lake of
Ladoga, in north earth that did not test an attack.
But even in a period of Mongol-Tatar yoke development of medicine and
pharmacy did not cease Rus: being on more law in comparison from Russ of the
stage of cultural development, Mongol-Tatars used services of the Russian artisans
and lecars.
Traditions of folk treatment were not lost. Doctors of different "specialities"
practiced in cities and villages of Rus. Healthful properties of plants were
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described by them, advices were given, how to treat some diseases, the separate
questions of hygienical character were illuminated.
The fight of the Russian people against Mongol-Tatars united Russian earth
round Moscow principality. Кulikov battle of 1380 near the r.Don was the first
defeat of Gold Horde. The decline of yoke took place in 1480 (a battle is on the
r.Ugri) at Ivan ІІІ. He added to Moscow Novgorod, Tver and other Russian earth.
In the end of XV - th.- at the beginning of XVI – th centuries the Russian
centralized state was created with a center by Moscow. The revival of society
medicine begins only after the upcast of Mongol-Tatars yoke (480).
In XVI – th century practically for all population of the Moscow state the
only means of maintenance of health was folk treatment. Experience of
ethnomedicine was passed both in oral and kept in writing works. Thus,
distribution on XV – XVI – th centuries found herbalists Rus. Medical forms
(powders, ointments, plasters, rinses, grinding, oils) are described in these
handwritten books, attention calls to quality of medications, reasons of illness and
their sign are described.
Translations of medical achievements that remind the naturally-scientific
books of "encyclopaedic character" began to appear in XV – XVI - th centuries.
In the second half of XV -th century to Moscow in a number of other foreign
masters doctors was invited. Leon Zhidovin who in1490 arrived from Venice,
worked not long. Unsuccessful treatment of the eldest son Ivan III costed head to
him.
However it frightened foreign doctors, and getting invitation they gave a
consent to service at the Moscow court, because paying for treatment was very
high. In the days of reign of Vasyl III at a court three served foreign doctor.
In the second half of XVI - th century of invitation to the Moscow court of
doctors- foreigners became a matter of course.
Already at Ivan IV served them no less ten, and composition of doctors at
the court of Boris Godunov was so considerable, that could form a concilium.
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About training of national medical personnels on territory of the Russian
state in this period no information is. However it is known that at the end of a 16
eyelid - a government obligated foreign doctors the first half of XVII - th century
to teach the Russian students to medical business "with every zeal and not a
whatever hiding". Yes, Russian doctors worked for the industrialists of Stroganovs.
In XVI - th century began to undertake the first steps from the medical
providing of army, supply of it regiments as a regular doctor.
For a fight against epidemics the same measures were used, that and in
previous centuries. The antyepedemic guard of borders is put in order afterwards,
the system of notification is put right about epidemics that approach, the measures
of disinfestation, quarantine of locality broaden et cetera.
The flashes of epidemic could not bring over to itself attention of
government. The attempt of Ivan IV to open state hospitals belongs 1550 to, but
this plan was not carried out. In XVI - th century the prototypes of temporal
refuges appeared for children- orphans and food points for starving.
Ancient Russian doctors (as well as in the west) were simultaneously
chemists. The division of medicine and pharmacy happened, when making of
medications became complicated and needed the special knowledge. Medications
were released to the population from grass and other benches that were the
prototypes of pharmacies. In 1672 a government was the given out decree about
prohibition to the greengrocers benches to trade in medications.
In 1581 the first "tsar's" pharmacy and organized Chemist order was open,
and in 1672 the second pharmacy ("new") was open, but these pharmacies served
only close to the tsar and army. In 1682 at the first civil hospital the third pharmacy
is opened in Moscow. But, in spite of opening of pharmacies, in Russia, and even
in Moscow, the outchemist trading in medicinal facilities prospered through
greengrocers.
Control questions:
1. Medicine of Ancient Russ of pre-christian period.
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2. Directions in medicine of Kyiv Russ (IX – XII – th centuries).
3. Historical root of monasterial medicine.
4. Medicine in the Moscow state.
5. Description of greengrocers.
6. Opening of the first pharmacies in Moscow.
Tests :
1. The leading specialty in Russia was :
a) Pharmacy
b) Cosmetology
c) Paediatrics
d) Surgery
2. The first hospital in Russia was opened in the XIth century in
a) Kiev- Pechersk Lavra
b) St. Sophia’s Cathedral
c) Magdalena’s Monastery
d) Michael's Cathedral
3. Work "About the ointment " is written by :
a) Heraclitus
b) Demosthenes
c) Monomakh
d) Eupraxia
4. What plants are Scythian peoples used with the aim of embalming the dead?
a) wormwood, glyceriza, aconite
b) celery, anise, cooper
c) the garlic, onion , hemp
g) lentils , garlic , onions
5. What was the name of glyceriza in the Scythian’s period?
a) broom grass
b) incense
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c) sweet root
g) sweet grass
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UNIT 7: "СREATION OF LEGISLATIVE ACTS, THAT REGULATES
PHARMACEUTICAL BUSINESS IN RUSSIA. MEDICAL AND
PHARMACEUTICAL EDUCATION IN RUSSIA (UNTIL THE
18th CENTURY.) "
Aim of the lesson : to learn history of origin of the "Chemist order" its
functions; to master the value of reforms of Petro I in development of chemist
business; to familiarize with the questions of medical and pharmaceutical
education of XVIII – th century.
There was not Public organ of managing of medical business in pre-petrov
Russ. His functions were executed by the Chemist chamber (XVI - th century)
after some time renamed in the Chemist order. A word "order" appeared in 1512
and marked central establishment that stands at the head of separate industry of
management.
It is not set exact date of organization of the Chemist order, assume that he
was organized in 1581, a doctor Robert Yacobi and chemist James French (reign of
Ivan Threatening) arrived and the first tsar's pharmacy was organized in Moscow.
The Chemist order was headed by prince Аfanasiy Vyazemskiy.
Position of pharm boyars was so honoured and important, that she was
practically occupied only by persons near to the tsar's last name: Boris Godunov
(as a tsar Fedir Іoаnоvich), Semen Godunov (as a tsar because- to the lynx
Godunov). In XVII - th century managed the Chemist order presentatives of
ancient boyar families (Cherkasskys, Sheremetyevs, Мiloslavskiys, Оdoyevskiys
and other). These luing-ins a large contribution belongs to development of charity (
building of houses of caring, houses for orphans and other)
Why only of noble birth close was a tsar occupied this position? The point is
that medications for tsar's family members had to be preliminary "tested". This
control was conducted by all leaders of the Chemist order. The internals of the
Chemist order was analogical organization and all other orders of the Moscow
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state. A chemist order was given by a very important value, that evidently from
that the very deserved boyars that enjoyed the special confidence of sovereigns
always stood at the head of this establishment.
There was a jurisdiction large contingent of persons him, touch to medical
business.
1. Doctor. Under doctors understood, actually, doctors-internists that treated
internal illnesses.
2. Doctor, id est surgeons, - as they are named in the foreign originals of
matters of the Chemist order. A doctor is always strictly marked off from doctors.
Yes, when in 1623 a few doctors were sent for the review of internal illness of
former tsar's fiancee, maiden Maria Hlopova, then doctor Bаlsir, that was in this
commission, declared, - "that he by doctors are not able to treat: those illness
known by doctors, a he, to the doctor, that does not know ".
3. Chemist, that managed tsar's pharmacies. In a submission there was more
subzero pharmaceutical personnel them, as: аlchemists, destilators("vodka
rectificators"), chemist students and herbalists that collected different healthful
herbares for the necessities of tsar's pharmacies.
4. Eye-doctors, at the same time, on all authenticity, -optics.
5. Barbers ("Bаrbеry"), (bloodletters), bone-setters and subdoctors presented more subzero medical personnel.
6. Horology masters that for some reason was also meant in the department
of the Chemist order. Then a number of other persons that sent different duties at
him was meant in the Chemist order, for example: translators, truck farmers, watch
and other.
Chemist order fully managed by all mentioned persons; it accepted them on
service, appointed a pay to them, distributed duties between them, released them
from service; here all these persons of cramps knew and by violence, so that the
Chemist order accepted character of judicial establishment in relation to them..
The major function of the Chemist order was providing of medical and
medical help of army. A chemist order engaged in the selection of doctors and
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chemists, controlled knowledge. From foreigners there was a necessary diploma
(certificate), recommendations from the previous places of service: from cities,
colleges of doctors and even kings, they quite often were exposed to examination.
Only after such procedure a doctor or chemist kissed book, then got an audience
for a tsar and proceeded to the duties.
In the period of "strife", Pоlish-Litovian and Swedish encroachment (1609 1612) and also in a period of civil war activity of the Chemist order was
considerably convolute. In 1612 a folk militia is under the direction of C.Z. Міnіn
and D.М. Pozharskyi released Moscow from the troops of Rech Pоspоlіta state
guidance in a country began to recommence only after Zemsky Sobor in 1613.
Proceeding in activity of order take approximately 1620 to this date many
historians count him founding.
A chemist order on the first stage of the activity was court medical
establishment, managed tsar's pharmacy, knew a medical personnel. In the duties
of this order treatment of tsar, his family was included and close. Thus for a tsar
"selection medicinal facilities" that was kept in the special room ("casenci") after
printing of scribe of the Chemist order were made. Excerptions of medications and
their preparations were conditioned of large severity.
“The medications prepared for a palace were tested by doctors, prescribed,
by the chemists prepared by themselves, finally, that it seemed for a transmission"
on a top ".
In 1631 the state of the Chemist order was small: two doctor, one chemist,
one oculist, two translators and one subordinate. In the middle of XVII – th century
the Chemist order from court establishment grew into national. Its functions
broadened considerably. A chemist order knew invitation on service of foreign
doctors and training of national personnels, distribution of them after positions,
verification of "doctoral fairy-tales"(histories of illnesses) and payment to the pay.
Chemist order engaged in the selection of doctors in streletskiy regiments,
by the supply of soldiery parts by medications and engaged in preparation of the
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Russian doctors from 1654. The charges of the Chemist order were paid from a
general treasury, and afterwards this establishment had an own budget.
With opening of the second pharmacy ("new") in 1672, but the third
pharmacy at the first civil hospital in Moscow in 1682 the functions of the Chemist
order spread. A chemist order managed pharmacies, chemist vegetable gardens and
organization of collection of medical plants in the scale of country.
Chemist order collected taxes as medicinal herbares, berries and other raw
material for making of different medical forms. For collection of medical plants in
the state of the Chemist order there were experienced people from people, called
pomyasam, by herbalists that engaged in preparing of plants. Medical students,
barbers, and also populations, participated in collection. A population was
informed about collection of herbares through heralds.
Considerable part of plants was collected in the nearest to Moscow palace
villages, collections of medical plants accepted character of duties burdensome for
a population sometimes. An order added to voevodes to accept measures on the
search of new medical plants.
In the first half of XVII - thcentury in slave to the order were the Chemist
chamber (with a pharmacy), Chemist garden and village that had the Chemist court
(old). In 1670 in Moscow there was built the new Chemist court. Courts were the
enterprises of industrial type: they conducted preparing, drying of herbares and
made medicinal facilities (plasters, ointments, oils, tinctures, extracts, syrups,
juices), produced distillation of essential oils, waters, infusions, got an alcohol by
rectification. Drying, grinding and storage of plants and other substances were here
conducted.
For the last there were the arranged pantries, pigs, glaciers.
Soldiery events put another problem before the Chemist order- creation of
medical service is in the Russian army. In this connection the Chemist order
purchased user facilities: setting in the troops of doctors and subdoctors, providing
with medications of regimental pharmacies, organization of temporal combat
hospitals, review of soldiers about their suitability to execution of military service.
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A requirement grew in physicians, but own preparation of doctors did not
exist in a country. Therefore in 1654 at the Chemist order the first medical school
was open. Creation of school related to the requirement in regimental doctors (this
was war time with Poland) and necessity of fight against epidemics. Train aid at
school served as greengrocers, advices, "herbalists", and calculation of "doctor
fairy-tale" - hospital chart. 30 shooters that were prepared purposefully for the
regiments of the Russian army became the first students.
The term of studies at school presented for 5-7 years. Having regard to a
large requirement in regimental doctors, in 1658 the pre-schedule producing (after
4 years) took place. From a number those that made off school, 17 doctors are
directed in an army in the field, other - in the Rifle order for passing of service.
A chemist order executed control after preparation of medications in a
"tsar's", and later in a "free" pharmacy. In an order conducted judicial is medical
examination of herbares and medications of unknown composition, and also
medical examination (review of persons, sometimes and dead bodies). One of tasks
to the order there was realization of antiepidemic measures (introduction of
quarantines, frontier mortgages, disinfection of the room).
If at first the Chemist order engaged in the grant of medicare only to the tsar
and near to him boyars, then 40th to of XVII – th century a situation changes. A
help gets to other propertied patients, it is prepared by them medications, and at the
direction of tsar released from a court pharmacy. Not only in Moscow, providing
of population developed medications. Attempts of equipment of pharmacies were
in other cities of Russia : to Vologda (1673), Kazan (1679).
In 1678 for those that engaged in pharmacies and medical gardens
pharmaceutical business a new rank was set - "destilator". A chemist student Vasyl
Shilov (experience of his work in the Chemist order folded 19 years) was
appointed first from them. In his function, making of medications, acceptance of
medications was included from abroad, guidance by collection of herbares in a
chemist garden and vegetable garden. The last occupied an area 2,5 hectare. On the
same territory the so-called Chemist court was situated.
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Beginning from 1681 the state of the Chemist order increased considerably.
Among 80 employees there were 6 doctors, 4 chemists, 3 alchemists, 16 doctorsforeigners, 21 Russian doctor, 38 students of medical and bone-setter businesses.
In addition, there were 12 podyachih, truck farmers, interpreter and economic
workers.
A place of placing of the Chemist order was not permanent. At first this
establishment was on territory of Kremlin, in a lithoidal house on the contrary
Wonderful monastery. In the second half of XVII – th century basic services of the
Chemist order were moved to the new place. In an expense book after 1657 year
there is such record: to carry the "Chemist court and vegetable garden ... from
Kremlin of city after Мyasnitskiy gate and to arrange in a garden suburb on blank
spaces ". On building of new building were provided funds.
From documents it is known that there were apartments of the Chemist order
at the Lithoidal bridge. A chemist court took place also on the Smolensk street
(behind building of Museum of Russian architecture one of annexes of the Chemist
court was saved).
At 1690 there was the given out decree of tsars of Ivan and Petro Alexey
"About the improvement of pharm and medical business arrangement in the
Chemist order". In it marked, that doctors and chemists did not havebetween each
other a good agreement, "without any reason", between them there are often
"enmity, quarrel, slander and dislike". From here at junior ranks to the doctors and
chemists "disobedience", in matters lackadaisical "attitude". It is marked in a
decree, that at such position the made medications instead of benefit can cause to
the people of suffering.
For setting in the proper order at medical to business and in pharmacies a
decree ordered every doctor and chemist to accept an oath and oath.
A chemist order tried to bring in the small contribution in the decision of
task put on a Stoglavy Cathedral is creation of state hospitals. What was feature of
their creation in that time? The point is that in Russia hospitals traditionally
engaged in induced by christian mercy orthodoxy church. There were the
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organized hospitals at Trinity- Sergiev to Lavra, Bеlоgоstitskiy monastery,
Assumption of mining monastery (N.Nоvgorod), Nоvоspask and Кieyvo Pechersk Lavras and other the Greater manual propertied people that brought in the
parts of offering found out here in.
At any pharmacy was opened hospital. It was small, with a very limit
assortment, but a cost of medications was accessible.
Scourge of Russia were epidemias. State power in one of tasks of the
Chemist order fit realization of "antiepidemic measures". Already the first original
quarantine is entered in 16 century; frontier mortgages, surroundings, are set,
smoking apartments by a juniper and ice-hole.
Beginning of the XVIII - th century was marked by the row of the reforms
conducted by Petro I. To basic reforms in area of medicine and pharmacy take
opening of hospitals, special schools for preparation of doctors and chemists, free
pharmacies for the sale of population, establishment of monopoly on opening of
pharmacies (1701) and chemist gardens.
It ordered to open the decree of 8 private (free) pharmacies in 1701in
Moscow and to close medications to the greengrocer benches.
A chemist order lasted more than 140 years. In 1707 the Chemist order was
reorganized and adopted by the Chemist office. In 1714 it was transformed in the
chemist office of the Main pharmacy, also in 1714 office was at the head the put
doctor in position of аrchiater. An office knew all physicians: by doctors, doctors,
chemists, oculists, аlchemists, by bone-setters et cetera.
The greatest place in the hierarchy of medical professions was occupied a
doctor, that treated internal illnesses; doctors followed after them, they engaged in
mainly surgery and treatment of external illnesses. Among doctors there were
many foreigners that got higher medical education in the universities of Europe (to
beginning of XVIII - th century to do it was impossibly in Russia) and obliged
"students of Russian to teach with every diligence".
Among doctors there were many Russian doctors, that could go to medical
("medical") school that was opened in Moscow at the Chemist order in 1654.
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In 1721 the chemist office of the Main pharmacy was renamed in the
Medical office. A medical office that was reorganized from the office of the Main
pharmacy (in 30 – th years of the XVIII - th century) controlled work of
pharmacies, sale by them poisonous medications, pursued witch-doctor. In 1763.
medical office was regenerated in the Medical college that worked to 1803.A
president stood in the head of college, a college was distributed on two
departments, one of that engaged in scientific businesses, and secondadministrative and financial- economic.
The basic matter of college was a fight against epidemics. In 1803 a medical
college was reorganized, and for example of France of management medical
business it was passed to Ministry of internal affairs.
Medical and pharmaceutical education on Russ and in the Moscow state till
XVIII – th century had its own features. As on there was medicine Russ folk and
medicine is monasterial, studies took place thus. Lecars of ethnomedicine handed
on the torches and secrets from a generation in a generation in the so-called
domestic medical schools. In life of society doctors - foreigners and monasterial
lecars a considerable place was occupied by an apprentice, students (handicraft
studies).
In the period of Mоngol-Tatar invasion society medicine was absent, and
medicare was rendered by lecars of ethnomedicine. After liberation of Russ there
were not society schools and higher educational establishments in XIV – XVI – th
centuries, that substantially affected development naturally - scientific knowledge.
In the archives of the end of XIV - th century is remembered about organization in
the cities of Ukraine of handicraft workshops, there is information about artisans advicers, or barbers.
Except bloodletting and treatment of wounds, treatment of internal illnesses,
traumatology, dermatology, illnesses of teeth were subject to the competense of
barbers, as in most settlements of Ukraine of doctors it was not. Every master had a
few students and apprentices. Barbers that served an urban and rural population
folded the basic shots of medical workers during a few centuries.
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After the reunion of Ukraine with Russia to the first ruling doctors it was to
conduct a fight against barbers, to take their activity under the control.
In XVII - th century in Moscow at the Аndreyevskiy monastery medical
school in that teaching of "free sciences" was headed by the Ukrainian scientist
Еpiphany Slavinetsky (died in 1675) was organized. In 1632 the Kyiv colledge that
in 1701 got a title and right for an academy the decree of Petro I was founded in
Kyiv. The Kyiv academy played a considerable role in training of medical
personnel and organization of hospital medical schools.
Control questions:
1. Chemist order: its organization and activity.
2. Functions of the Chemist order.
3. There are reforms of Peter Ist in area of medicine and pharmacy.
4. Features of medical education on to Russ.
5. Basic stages of medical and pharmaceutical education’s development
(until the XVIII - th century).
Tests :
1.A foreign doctor ( pharmacist ) gave the following documents for service in the
Chemist’s order:
a) diploma
b ) recommendations
c) passport
2. When was the first tsar pharmacy opened ?
a) 1490
b) 1590
c) 1555
d) 1581
3. The most important function of the Chemist’s order is to provide care for:
a) school
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b) monasteries
c) army
d) hospitals
4. . In what year was the first medical school in the Chemist’s order opened
a) 1601
b) 1661
c) 1650
d) 1654
5. What is the prototype of the first industrial companies:
a) the Chemist’s garden
b) the Chemist’s yard
c) the Chemist’s city
d) the Chemist’s square
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UNIT 8: "SCIENTIFIC DISCOVERIES IN THE ORIGIN OF
MEDICINE AND PHARMACY IN THE XVIII – XIX - TH
CENTURIES".
Aim of the lesson: to learn the question of development of medicine and
pharmacy in XVIII – XIX - th centuries, to familiarize with the scientific opening
of scientists - physicians and druggists of this period.
In the development of chemistry alchemic direction prevailed to the middle
of XVI - th century. Under alchemy it is accepted to understand the art of
transformation of standard in gold by means of "philosophical stone". From a
middle XVI - th century on the change of alchemy comes new direction –
jatrochemistry (or therapeutic chemistry). Its creator was Paracelsus. "Chemistry"
must serve not getting of gold, but defence of health;- proclaims Paracelsus.
Applied of new chemical Paracelsus preparations in quality of medications,
and medicinal facilities of phytogenous after the chemical cleaning contained only
operating substances. The supporters of Paracelsus denied the studies of Galen.
Development of pharmaceutical industry assisted opening of new facts that
already did not consist at the scope of alchemic and jatrochemical explanations.
Naturalist of Netherlands Jan Bаptist van Gelmont (1579-1644), was
occupied in jatrochemistry, entered a term "gas" and first put experience from the
study of feed of plants.
A researcher Sаnktorius constructed special chamber-balance, where it
studied metabolism, personally coming forward as an object of experience. A
difficult device allowed to do the quantitative estimation of mastering of food
foods and excretions to the organism by weighing itself. The results of experiments
were presented in a treatise "About medicine of equilibrium"(1614). At the same
time from Sanctorius the fervent opponent of scholastics, mechanic, astronomer
and naturalist of Galileo Galilei (1564-1642), worked on creation of thermoscope.
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The device of large Italian showed a soba a glass bullet with the thin
soldered tube, also executed from glass. When it is put in a free and submerged in
a vessel with the tinted water or wine, a bullet was heated by a human heat, and air
broadened. As far as the cooling-down of bullet water rose upstairs to the certain
mark.
A modern term "microscope" and first application of device are related to
the name of the English naturalist Robert Hooke (1635-1703). Scalene scientist,
experimenter that passed Newton in guess-work about existence of world
gravitation, Hooke perfected the optical system of Galilei, creating a microscope
that increased in 30 times (pic.4). Having a master's degree of Оxford arts to the
university, a scientist invented an air pump, thought of a spring occasion of
mechanism of pocket clock and enormous amount of other useful businesses.
( pic.4) Hooke Microscope
In 1664 a plague raged in England, but a master's degree did not abandon
London, being trapped by scientific experiments. In "History of Royal society" a
record was saved from 1665: "Hooke... between other businesses showed the first
actual microscope and enormous amount of opening done with his help, first irisshutter and a number of new meteorological devices". Then classic work of
master's degree of Hook - book went out in light after the name "Micrography, or
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Physiology description of shallow bodies, investigational by means of magnifying
glasses".
Work showed by itself the story of results of microscope application as a
research instrument: here described 57 "microscopic" and 3 "telescopic"
experiences. In addition, an author opened the cellular structure of fabrics, entered
a term "cage", investigating fabrics of plants, insects and animals. The wonderful
engraving that accompanied text presented both scientific and artistic value.
The most powerful microscope at one time in 1673 was created by naturalist
of Netherlands Antoni Van Leeuwenhoek (1632-1723). A device with a 270multiple allowed to look after and sketch the simplest, spermatozoa, bacteria, red
corpuscles, and also their motion in capillaries. The small living organisms educed
at a considerable increase were described in a book "Secrets of nature”, opened by
Anthony Levenguc (1695).
Czech naturalist Jan Evanhelist Purkine (1787-1869) one of the first who
applied a cellular theory directly to medicine, considering nervous cages in an
ectocinerea. In 1837 a scientist did more stunning opening: describing cages in a
head and spinal brain, he distinguished in a grey substance the measles of
cerebellum large cages, and also able to explain rhythmic work of heart the
presence of fibres of the leading system of this оrgan. The cages of cerebellum and
heart in the specialized atlases are named by the name of Purkine.
In the second half of XVIII - th century a new theory - flogistone theory
appeared. Creator of this theory Johann Bеchеr and George Stal tried on its
founding to give explanation of the phenomenon of burning and оxydizing. The
follower of this theory was the Swedish chemist K. V. Scheele (1742 - 1786).
Scheele opened the row of new substances : organic acids(guilty, lemon, apple,
sorrel, milk, urine), opened glycerin, chlorine, manganese and first got oxygen. At
the same time oxygen was got by English chemist Pristly.
A large contribution in development of chemical science was done by
druggists that the important opening belong to industry of pharmacy.
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Chemist Louis Vauquelin (1763-1829), was first pharmaceutical head in
Paris, founded in 1803, master., conducted more than 200 chemical experiments in
the consequence of that it was open them and distinguished in the free state
chrome, it is open beryllium, palladium, iridium, osmium, got salts of sulfis acid,
sulphuretted hydrogen, cyanic acid.
Chemist B. Courtois (1777-1837) got an iodine, the method of receipt of
zinc bilyl and other compounds is worked out by him.
French druggist Subeyran in 1831opened chloroform and described its
property.
From german druggists, who made opening in chemistry, it follows to
specify Claproth (1743-1817), who discovered connections of uranium, strontium,
titan and other elements. Druggist Thomas Mоr (1806- 1873.) is the founder of
volumetry in chemistry, he had made scales of new type.
Founder of methodology of elementary organic analysis Justus Liebig
(1803-1873) began his activity in a pharmacy. A manual is written by him on
organic chemistry was an application to pharmacy. Liebig offered the vehicle for
incineration of organic compounds and methods of аlkaloids row determination.
In XVIII - th century worked many chemists, scientific activity of which did
not consist of the ordinary charts of consideration of the stages and directions of
science development, and among them the special place belongs to the Russian
scientist-encyclopaedist, the poet, defender of education Mikhail Vasilyevich
Lomonosov (1711-1765).
Lomonosov enriched almost all areas of knowledge opening, and much his
ideas more than on one hundred years passed science that time. Activity of М.V.
Lomonosov, large Russian scientist- encyclopaedist, related to the development of
home medicine, chemistry and pharmacy. In 1745 М.V. Lomonosov was
appointed by the professor of chemistry and academician of Petersburg Academy
of sciences. Draft of the first university was drawn up by М.V. Lomonosov in
1754, there was offered structure of university and teaching program. A university
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was open on January, 25(12) 1755.Now it carries the name of the founder: the
Moscow state university of М.V.Lomonosov.
In 1756 Lomonosov conducted famous experience from the burning-out of
metals in the closed vessel, that gave irrefutable proof of maintenance of substance
at chemical reactions and role of air in the processes of burning, : he looked after
gain in weight at the burning-out of metals before Lаvoisier he explained
connection of them with air. М.V. Lomonosov in 1756 explained the processes of
оxydizing and pawned scientific basis of these for the correct understanding of
breathing process. In a counterbalance he asserted presentations that dominated,
that the thermal phenomena are conditioned by mechanical motion of materials.
The resiliency of gases he explained motion of parts. Lomonosov
distinguished a concept of "corpuscle"(molecule) and "element"(atom), which got
common confession only in a middle of the XIX – th century. Lomonosov set forth
principle of maintenance of matter and motion, excluded flogiston from the
number of chemical agents, pawned bases of physical chemistry, created at
Petersburg Academy of Sciences in 1748 in chemical laboratory, in that conducted
not only scientific works but also practical employment of students. With the name
of М.V. Lomonosov is connected beginning of quantitative analytical chemistry
development, he specified the first on the value of mathematics and physics for
chemical experiments. Large researches were conducted by him in the contiguous
with chemistry areas of knowledge - physics, geology and other.
Greater successes had Joseph Pristly who was protestant priest that engaged
in chemistry attained with gassing and study of their properties. Near Lead
(England), where he served, there was a brewery, from where it was possible to get
in greater amounts the "constrained air"(we know now, that it was to the carbon
dioxide) for realization of experience. Pristly educed that gases can dissolve in
water, and tried to collect them not overwater, but above mercury.
So he managed to collect and learn the oxide of nitrogen, ammonia, chlorine,
sulphur dioxide (certainly, it is their modern names). In 1774 Pristly did the major
opening: he gased, in that substances burned especially brightly. Being the
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supporter of flogiston theory, he named this gas "deflogiston air". Gas opened by
Pristly seemed was the antipode of the "flogiston air"(to nitrogen) distinguished in
1772 by English chemist Daniel Rutherford (1749-1819). In "flogiston air" to the
mouse died, and in "deflogiston"were active enough.
(It should be noted that gas properties, distinguished by Pristly as early as
1771 by Swedish chemist Carl Wilhelm Sheele, described in his report through
negligence of publisher appeared in the press only in 1777) The large French
chemist Аnthuan Laurent Lavuasje estimated the value of opening of Pristly at
once. In 1775 he prepared the article, where asserted, that air simple not substance,
but mixture of two gases, one of them is "deflogiston air" of Pristly, that unites
with blazing or goes across objects that corrode from ores in a charcoal and is a
necessity for life. Lаvuasje named it oxygen, oxygen, id est "outcoming acids".
The second blow to the theories of elements-elements was inflicted since it turned
out that water - it too a simple not substance, but product of connection of two
gases : to oxygen and hydrogen.
All these opening and theories, doing away with mysterious "elements",
entailed rationalization of chemistry. On the first plan those substances that can be
weighed, or the amount of that can be measured to some by another method went
out only. During 80-th years of the XVIII - th century Lavuasje in a collaboration
with other French chemists - Аnthuan Fransua de Furcrua (1755-1809), Giton de
Моrvо (1737-1816) and Claude Lui Bertole the logical system of chemical
nomenclature was worked out; in that more than 30 simple substances were
described with pointing of their properties.
This work, "Method of chemical nomenclature", was published in 1787.
One of followers of М.V. Lomonosov there was a chemist student, and then
large scientist, - Т.Е. Lovits. Russian chemist – pharmacist Т. Е. Lovits (17571804) discovered the adsorption of coal and suggested to use it for water, alcohol
and other substances treatment. He worked out the methods of receipt of absolute
alcohol, an icy acetic acid got by him, vine sugar, and also conducted opening in
area of substances crystallization from solutions.
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By the large figure of scientific pharmacy at the end of XVIII – th century to
beginning of the XIX – th century there was N. М. Maksymovich- Аmbodic
(1744-1812). He is the author of one of the best scientific works about medical
plants. He offered many scientific recommendations about the necessity of clinical
experiments for pharmacology.
To the academician N.Ya. Оzeretskovskiy ( 1750-1827) belonged a
discovery in pharmacy and botany, related to the study of properties of root of
celandine and other medical digister. In 1816 year he gave to the Petersburg
academy of sciences scientific work, that had the described medications from a
digister, that in Moscow and in its fence surrounding village were used for
treatment of certain diseases.
Academician V. M. Severgin (1765-1826) undertook scientific studies
related to the study of mineral waters. He is considered the founder of
pharmaceutical analysis in Russia, he is the author of manual on a pharmaceutical
analysis.
Among the large figures of pharmacy it follows to name І. G. Моdel. The
row of researches of practical character is conducted by him: analysis of water,
receipt and cleaning of borax. І.G. Model was elected by the honoured member of
the Petersburg academy of sciences.
Russian scientist-pharmacist А.P. Nelubin (1785-1858) from 1818 to 1844
was the professor of department of pharmacy of pharmaceutical separation of
Petersburg medic- surgical academy, he combined the pedagogical activity with
large scientifically research work. Scientific activity of А.P. Nelubin touched
various questions from medicine, scientific and practical pharmacy, analytical and
pharmaceutical chemistry, pharmacognosy.
His work: "Pharmacography or physic- pharmaceutical teaching of making
and application of new medications" is an encyclopaedia from Pharmacognosy.
Well-known work of А.P.Nelubin, that represents his research of chemical
composition of Caucasian mineral waters. One of first in Russia А.P. Nelubin
began to lay out the course of organization of pharmaceutical business, and also
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history of general and Russian Pharmacy. In 1843 by him was made program of
pharmacy.
Scientific researches of physic-chemical properties of medicinal substances
belong to the professor of pharmacy department of Moscow university А.А.
Іоvskiy (1796- 1857). In 1838 there was the printed book "Drawing of pharmacy",
in that scientifically reasonable technology of making of medications in the
conditions of pharmacies taking into account of physic- chemical properties of all
ingredients that is included in their composition.
Discovery of narcotin and mixture of salts of Morphin and narcotin in 1802
by Parisian chemist Sharl Derosy (1780-1846) put beginning to research of
аlkcaloids and selection of them in pure form. Peltje and Каventu first got
Strychninum, brucine and other alkaloids from raw materials.
English chemist Davy Humphrey (1778-1829) discovered intoxicated action
of nitrous oxide (1799), got metallic potassium and natrium from hydroxides
(1807), and also amalgam of metals by an electrolytic way(1808), distinguished the
coniferous forest from boric acid(1810).
Second half of the XIX – th century was famous by discoveries in organic
chemistry: French chemist Shevrel (1786-1889) set chemical composition of fats,
distinguished stearin and other fat acids. The synthetic receipt of aniline was put by
Russian chemist N.N. Zinin that began rapid development of pharmaceutical
industry.
Considerable influence of pharmacy development of XIX -th century did
openings of the Lui Paster, Joseph Lister (1827-1912), Paul Еrlih (1854-1915).
Researches of paster exposed the role of microbes in the origin of many illnesses.
Lister worked out the methods of desinfection of wounds. Еrlіh discovered
operating of chemicals on an infectious process in the organism of man. Works of
Lui Paster and development of microbiology did substantial influence on
pharmacy: there are studies about an asepsis and аntiseptics and the group of
antiseptic facilities appears.
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New studies worked out in XVIII – th century, that had the supporters and
nowadays, known under the name that was given to him by a founder, is
homoeopathy. The founder of this studies was german doctor Samuel Ganeman
(1755-1843). "Like cured" similar became basic principle of his studies. Ganeman
came forward as an opponent of drastic therapy, considering her harmful for a
"life-breath". Curative properties of substances, he talked, appear more distinctly,
if to appoint them in very weak solutions, id est "petentiate".
Control questions:
1. Substantive provisions of iatrochemistry.
2. Studies of Paracels in area of iatrochemistry.
3. Essence of theory of flogiston.
4. К.V. Sheele is a follower of the flogiston’s theory, his scientific
discovery.
5. Scientific opening and basic research works of М. V. Lomonosov.
6. Contribution of Т. Е. Lovits in development of chemistry.
7. There is a value of discovery in area of organic chemistry.
8. There is the scientific discovery in area of microbiology.
Tests :
1. Alchemy is:
a) the direction of modern chemistry;
b) art of base metals’ turning into gold by means of " philosopher's stone ";
c) the branch of medicine ;
d) medicinal chemistry.
2. The theory of phlogiston was formed in
a) theXVIII - th c. AD
b) the XX - th c. AD
c) theV - th c. BC
d) 1025
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3. What scientist did obtain aniline synthetically ?
a) Zinin ;
b) Shevrel ;
c) Lomonosov ;
d) Lovitz .
4. Instead of the alchemy came the science:
a) antiseptic ;
b) phlogiston’s theory ;
c) iatrochemistry ;
d) analytical chemistry.
5. The disadvantage of the phlogiston’s theory was:
a) incomprehensibility of the information ;
b) progressive theory’s study;
c) study only qualitative side of phenomena, ignoring the importance of weight’s
relations;
d) attempts to explain the phenomena of combustion and oxidation.
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UNIT 9: "PHARMACY IN RUSSIA (THE SECOND HALF OF
THE XVIII - TH CENTURY- THE BEGINNING OF THE XX TH CENTURY)"
Aim of the lesson: to master the question of further development of
medicine and pharmacy after Petro I reforms: state control system and control after
activity of pharmacies, medical and pharmaceutical education, and also activity of
the Russian scientists of physicians and pharmacists.
Beginning of the XVIII - th century was characterized by the rapid cultural
and economic getting up of the Russian state, that is related to the cultural
transformations conducted by Petro I. In 1701 there was the given out Decree
about opening of "free pharmacies" in Moscow, and in 1721 a decree about
creation of free (private) pharmacies in St - Petersburg, in provinces and provinces.
To the end of XVIII - th century there was a few ten of private pharmacies in
Russia, but their amount increased quickly.
Except pharmacies attendant citizenry, soldiery pharmacies were opened hospital, field, garrison; their activity was regulated by a military charter. The
increase of number of pharmacies resulted in the necessity of establishment of
some rules that regulated their work.
In 1737 the Medical chancellery was given out instruction, on the basis of
that activity of pharmacies, chemist gardens was controlled. In 1763 a senate made
decision about the revision of private pharmacies and edition of chemist rate. In
1783 was made decision to make medications exceptionally after recipes. In 1784
rules are set for the sale of the prepared medications. In 1789 the first chemist
Charter was given out in Russia. Except it, were worked out by the Russian doctors
and pharmacists the first Russian pharmacopoeias are both civil and military.
In 1724 Petro I gave out Decree about organization of Academy of sciences,
it was opened in 1725 with participation of М.V. Lomonosov. There was open
printing-house at Academy, and the first in Russia printed article was a dutchman
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about curative properties of berries of honeysuckle that was printed in "Comments"
of Academy of sciences in 1732.
In 1755 in Moscow on initiative of М.V. Lomonosov the first university was
open; in 1764 at university a medical faculty was created. According to the first
charter of university on a medical faculty the special pharmaceutical department
was not distinguished, and the division of medical and pharmaceutical departments
took place according to the New charter of 1804. To the transceivers of tradition of
school of М.V.Lomonosov it follows to take the Russian scientists that quite a bit
did some work above development of medical science: К.І.Schepin, S. P.
Кrashennikov, N.М. Maksymovych - Аmbodic.
Except the Moscow university in XVIII - th century was opened mеdicsurgical academy in St - Petersburg. In 1808 in an academy a pharmaceutical
department that became another center of pharmaceutical education and science
was opened.
In 1802 there were the created ministries in Russia and to the ministry of
internal affairs the Medical colledge that was engaged in the questions of
pharmacy. A new ministry - ministry of police, that knew medical business in
Russia, was organized in 1810. At the ministry of police from 1811 a medical
department and medical council was created. In medical council chemist entered
next to doctors. There were the incumbent questions related to the supply of
military department by pharm.materials medical advice.
To the medical department a management, control of the mode and revision
of private pharmacies, was incumbent public pharmacies. In 1819 the ministry of
police again entered in the complement of ministry of internal affairs.
In 1801 three pharmaceutical ranks were set: pharmacist, chemist and
(helper of chemist). In 1809 a right for the reception of examinations on a
pharmaceutical rank was given to Petersburg mеdic-surgical academy.
At the beginning of XIX-th centutry the pharm. Charter ratified by a
medical college in 1789 continued in Russia to operate. It consisted of 23 points
and envisaged organization of apartments of pharmacy, storage and vacation of
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poisonous substances. New more detailed pharm. Charter was put in an operation
in 23.12.1836 and lasted to the end of century. It included next divisions: the order
of founding, equipment and transformation of pharmacies, asserted the underlying
structure of pharmacies, order of management, preparing and distributioin of
medications, a pharmacy after recipes, right and duties of druggists.
In 1873 by a government "Rules of opening of pharmacies" were ratified
taking into account a number of population and recipes. Yes, in the capital on a
pharmacy it had to be no less 15 thous. Of population and 30 thousand recipes, in
province cities- no less 10 thousand population and 15 thousand recipes, in a
district- 7 thousand population and 12 thousand recipes. In rural settlements it was
allowed to open a pharmacy after the condition of distance between them in15
versts.
To 1884 the mode of pharm. monopoly, ratified by Charter of 1836,
operated, what envisaged the obligatory consent of proprietors of existent
pharmacies to opening of new pharmacy. Also in 1884 there were made changes to
"Rules of opening of pharmacies": it was allowed to open pharmacies after the
presence of corresponding number of population without the account of number of
recipes, and in rural locality- in the distance no less 7 versts.
In 1789 an only pharm. rate was first printed on medications, and also the set
certain paying for preparation of medications (taxa laborum). The lack of this rate
was absence of regulation of trade margins. New rate that was given out in 1882
describes the order of pricing.
In the second half of XIX - th century the rates of development of pharm.
business were a bit halted, because in the conditions of rapid development of
capitalism this process was broken by a pharm. monopoly, hard competition of
chemists, and also adjusting of the industrial producing of medications.
Zemsc reform was conducted in 1864. For the grant of medical help to the
rural population zemsc pharmacies were opened. The primary purpose of their
opening was approaching of medical help to the rural population that was the least
provided both materially and by a medical help. Free zemsc pharmacies appeared
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on money of zemstvo front-rank intelligence, including pharmaceutical workers,
that were interested not in the incomes of pharmacies, but in the improvement of
medical maintenance of population.
Opening of zemsc pharmacies with the free sale of medications was
complicated, because the rules of their opening were identical with private
pharmacies. In obedience to the new rules of opening of pharmacies in capital and
province cities(in 1864), the norms of number of habitants, amount of recipes, and
also turnover operated on one pharmacy.
In zemsc pharmacies was set less cost on medications, than in private
pharmacies. Every zemstvo independently set principle and size of paying for
tableware and medications. The greater sizes of pays resulted in reduction of visits
sick, it compelled part of zemstvos to give up the penalty of pay from out-patients.
However such vacation of medications can not be named free of charge, because
peasants paid a cost in advance as zemsc tax.
Abandonment of zemstvos from taking of paying for medications caused
from the side of proprietors of private pharmacies the stream of complaints in an
address a government, and "free" sailing was limited to 10 % of the prescribed
recipes.
After 1908 there was expansion of network of zemsc pharmacies. By law, it
was allowed to open pharmacies zemstvos on the basis of decision of zemsc
collections, without regard to the number of population and recipes, taking into
account only set between pharmacies distance is 7 versts.
To zemsc pharmacies an important role belongs on business improvement of
the medical providing of population and approaching of medical help to rural
locality. Zemsc pharmacies were front-rank enterprises that time and became
foundation on that a pharm network was based after 1917.
To development of pharmacy in XVIII - th century and first half of XIX - th
century the scientific opening of the Russian scientists promoted in a great deal.
The large Russian scientist М. V. Lomonosov in chemistry directly influenced on
the wonderful opening of development of medicine and pharmacy in Russia. In the
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articles and expressions he marked that the Russian people needed a doctor and
chemist, that it is necessary to extend the network of curative and pharm
.establishments, improve the guard of maternity and childhood, prophylaxis of
diseases, promote the sanitary culture of cities and settlements.
Speaking about the value of chemistry for development of Pharmacy and
medicine, he wrote: "Physician is not a physician without sufficient cognition of
chemistry". He marked farther, that only with the help of chemistry it is possible to
get useful medications as from plants, so from mineral raw material.
Professor of medicine an academician І. І. Lepechin (1740 - 1802) proved
that much home plants take advantage before foreign.
Prof. К.І.Schepin (1728 - 1770) is a talented physician, gave much energy to
the study of home medical plants. Being the professor of Moscow combat hospital,
he spared large attention to pharmaceutical training of students.
Academician N.P. Sokolov (1748 - 1796) in the works paid attention to
importance of chemical researches for development of pharmaceutical sciences,
learned and suggested to use a juniper in curative aims, worked out the receipt of
lactobiose from suckling wastes.
Academician N.Ya.Оzеrеtskovskiy (1750 - 1827.) left plenty of the
advanced studies from zoology, technology, botany, medicine and Pharmacy.
Considerable interest is presented by his researches related to the study of root of
celandine. In 1816 he showed in the Petersburg academy of sciences "Description
of folk medications that in Moscow and in the fence surrounding villages of their
use by simple people in illnesses".
The most figure of scientific pharmacy of XVIII –th century was N.М.
Маxymovych-Аmbodic (1744 - 1812), author of one of the best books on medical
plants. Offered many valuable scientific recommendations about the necessity of
clinical experiments for industry of pharmacology, taught to treat not illness, but
patient taking into account his individual features.
Academician V.М. Severgin (1756 - 1826) undertook scientific studies
related to the study of mineral waters, and also "Method to feel a cleanness and
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inviolability of chemical works". V.М. Severgin is legally considered the creator of
pharmaceutical analysis in Russia. In 1800 a manual is printed by him on the
pharmaceutical analysis.
Among the large figures of pharmacy it is necessary to name І.G.Моdel. He
had managed for 20 years by a main pharmacy in Petersburg, taught chemistry and
pharmacy at hospital school. Executed row of valuable researches of practical
character them: the analysis of water of Neva and water of Оlоnеtskiy of ferrous
source is conducted, the method of booty and cleaning of borax is worked out and
others. І.G. Model was elected the honoured member of the Petersburg academy of
sciences.
Academician Т.E. Lovits (1757 - 1804) began scientific activity a student in
a pharm. laboratory. The important opening is done by him in area of
crystallization of different substances from solutions, the adsorption of coal is set,
worked out method of receipt of icy acidic acid by freezing and others.
I.Ya. Bindgeym is legally considered the author of industrial method of sugar
receipt in Russia. In 1792 – 1793 years published results of chemical researches of
row of food . Bread, potato, cucumbers, beet, cabbage, pumpkin, bread kvass, tea,
coffee and other was included in the number of the studied food.
Leaning on the scientific discoveries of the XVIII - th century, in Russia
home schools of anatomy, physiology, therapy, surgery and scientific pharmacy
developed successfully. The new original directions in pharmaceutical science,
headed at Petersburg medic-surgical academy of А. P. Nelubin and in Moscow
university of А. А. Іоvskiy, appeared.
Russian scientist-pharmacist А.P.Nelubin (1785 - 1858) from 1816 to 1844
was the professor of department of pharmacy of pharmaceutical department of
Petersburg mеdic-surgical academy, combining pedagogical activity with large
fruitful work. Thirteen years he acted as a student in a pharmacy, then was a
pharmacist and grew to the professor of academy. His work of "Pharmacography
or chemical and pharmaceutical exposition of preparation and use of the newest
medications" was the encyclopaedia of front-rank knowledge from the conduct of
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medications. Scientific activity of О.P. Nelubin touched the various questions of
medicine, scientific and practical pharmacy, analytical and pharmaceutical
chemistry, pharmacognosy. Well-known his large work that is sanctified to
chemical research of Caucasian mineral waters composition.
One of the first in Russia А.P.Nelubin began to read the course of
organization of pharmaceutical business, and also history of general and Russian
pharmacy. He wrote, that "pharmacy was simple art, then also and science ...
Chemist that engages in preparation of medications, knowing neither the action of
process nor reasons, his production, there is a simple artisan". In 1843 there was
made program from pharmacy, in that he included next divisions, them:
determination of pharmacy, description of pharmacy, arranging of pharmacy,
arranging of compounding room, personal dignities of chemist and his duties, state
decrees and positions in pharmaceutical business and others.
Prominent figure of Russian pharmacy А.А.Іоvskiy (1796 - 1857) was the
professor of Moscow university pharmacy department. In 1838 he produced the
book "Essay of pharmacy", in which scientifically reasonable technology of
preparation of medications in pharmacies taking into account physical and
chemical properties of ingredients that is included in medications.
Thus, in XVIII - th century, without regard to the cruel burden of tsar's
autocracy, Russian front-rank pharmaceutical science undertook a stride forward.
Control questions:
1. Opening of "free" and hospital pharmacies.
2. Basic documents that regulate activity of pharmacies.
3. Substantive provisions of the Pharm. Charter (1789).
4. Edition of the first Russian pharmacopoeias.
5. Opening of Russian Academy of Sciences.
6. Opening of Moscow university and Petersburg medic - surgical academy.
7. A role of ministries in a medical administrative department in XIX - th
century.
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8. New Pharm. Charter (in 1836).
9. Pharm. taxes.
10. An order of opening of pharmacies in obedience to a charter (in 1836).
11. Opening of zemsc pharmacies and their value for the improvement of the
medical providing of population.
12. Scientific discoveries of the Russian scientists of the XVIII – th century.
13. Known scientific works of the XVIII – th century.
Tests :
1.The order on the "free pharmacies’ " opening was published in Moscow
a) 1766 ;
b) 1721 ;
c) 1701 ;
d) 1737.
2. In 1763 the Senate took the decision
a) about the audit of private pharmacies and publication of Pharmaceutical taxes ;
b) produce drugs only on prescription ;
c) establishment of the sale’s rules of prepared drugs;
d) to issue instructions in respect of which the activities of pharmacies’ll be
controlled.
3. Pharmacy Statute included:
a) predicted the organization of pharmacy’s premises ;
b) storage and delivery of toxic substances ;
c) establishment procedure , equipment and pharmacy’s management ;
d). a single taxi on medicines
4. Due to the new charter in 1804 :
a) medical and pharmaceutical chairs were separated ;
b) printing was opened ;
c) the first university was opened;
d) the first Medical - Surgical Academy was opened in St.Petersburg.
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5. Point out the document where requirements for pharmacist have been
formulated (1789 ):
a) About the revision of pharmacy ;
b) About the production of drugs strictly on prescription ;
c) Russian Apothecary’s Charter .
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UNIT 10: "PHARMACY IN THE FIRST YEARS OF THE SOVIET
GOVERNMENT"
Aim of the lesson: to learn history of pharmacy’s development in the years
of Soviet power.
Before the revolution in Russia and Ukraine the industrial making of
medicinal facilities was practically absent: medicinal facilities were more often left
from abroad. A medical help to ordinary great masses of workers was almost
inaccessible.
Practically all pre-revolution of pharmacies belonged to the private
possessors. Testified absence of state pharmacies to commercial attitude of all
pharmacies that aimed to get a most income from medicinal facilities that had the
proper quality not always. The idea of exception of pharmacies from the hands of
sole proprietors appeared yet to Great October Socialistic revolution. It was shown
in resolution of the 1- st All-Russian convention of operating druggists, that took
place on August 25-26, 1917 in Petrograd .
Convention admitted the necessity of municipalization of pharm.business for
a country.
Creation of government service of health protection began on the second day
after revolution. On October, 26 in 1917 at a military-revolutionary committee
mеdic-sanitary department was organized. First medical organization in 1917 was
mеdic-sanitary department at Military- revolutionary committee. Organization of
medicare to the workers and soldiers was charged at this department. Pointing on
work a department got from V.І. Lenin. Military- revolutionary committee of
Petrograd Advice, after implementation of the tasks was reorganized on the 5-th
December, 1917.
Its departments were passed in the conduct of different commissariats, and
mеdic-sanitary department was reorganized in the department of Petrograd Advice
of working and soldier's deputies. In January, 1918 Advice of Folk Commissars
135
created Advice of the Medical colleges - supreme organ at Home Government, the
task of that was further work with organization on the places of mеdic-sanitary
departments. The 1- st All-Russian convention of mеdic-sanitary departments
passed in Moscow, in June, 1918. On July,the 11th of 1918 over the signature of
В.І.Lenin was published a decree about formation of the Folk commissariat of
guard healthy' I- first state оrgan of administration of guard healthy' I, that led N.А.
Semashko and its deputy was Z.P.Soloviov.
1. All pharmacies, whoever they belonged to, with all inventory, with all
supplies existing in laboratories and compositions, and also with a floating capital,
become the detail of Russian Socialistic Federal Soviet Republic.
2. The nationalized pharm.enterprises entered into the conduct of the Folk
commissariat of guard healthy 'I and follow according to rules instructions that is
given out by the adopted commissariat.
3. Proprietors and lease holders of pharmacies and their deputies from the
moment of actual transition of their enterprises in the order of town councils were
under an obligation to remain on the places and take measure for correct
functioning of pharmacies.
4. Proprietors and lease holders or their deputies for antiaction of realization
in life of pharmacies nationalization, for shelter and export of commodity, the
inventory passed to the Revolutionary court".
Basic questions in work of people committee were: organization of popular
free and skilled medicare to the population, complete medical service of Red
Army, fight against epidemics. By the first organizers and leaders of guard healthy
'I were N.А.Semashko and his deputy Z.P.Soloviov.
Already of the first days of presence of soviet power in a number of cities
nationalization of pharm.establishments was conducted on initiative of local soviet
government organs till the decree acceptance about general nationalization of
pharmacies, as in the Petrograd province - in December, 1917. On 31 January,
1918 the order of Folk Commissariat of internal affairs of RSFSR was published
136
about a right for local advices to take in the possession pharmacies in future to
edition of general act about nationalization of pharmacies.
At the beginning of 1918 pharm.establishments were nationalized in
Berdiansk, Nizhny Novgorod, Kazan, Saratov, Kursk, Sebastopol and some other
cities. However without system character of pharmacies nationalization, that
touched only separate cities, negatively influenced on the medical providing of
population. In March, 1918 Folk Commissariat of Internal Affairs stopped
nationalization in future to development of measures for nationalization of
pharmacies in a national volume.
On the first convention of medic-sanitary departments(on 15-18 July,1918)
on the basis of lecture ABOUT NATIONALIZATION OF PHARMACEUTICAL
CASE IN RUSSIA resolution was accepted about realization of the preliminary
measures related to preparation to realization of nationalization of pharmacies.
A decree about nationalization of pharmacies was signed by Lenin on 28 of
December, 1918. Already through a day after its statement "Statute was given out
about the nationalized pharmacies and pharm.establishments, about organization of
management by them and organs, that them it is supplied" with. This position
regulated the question of possession and control after activity of pharmacies,
condition of their financing.
For providing of population and guidance medications by pharm .business in
a country the pharmaceutical department of guard was created healthy (1918) and
pharmaceutical subdepartments in the departments of guard healthy local Advices.
So a condominium, control and management of the nationalized
pharm.establishments activity, depended upon a pharmaceutical department.
Guidance on places was passed the nationalized pharmacies pharmaceutical underto the departments of province, municipal and district medic-sanitary departments.
Nationalization of pharmacies pulled out the row of problems for the
discussion of that on it was April, 15-18, 1919 drummed up All-Rssian convention
of representatives of pharmaceutical subdepartments of province Advices.
Convention defined the tasks of the nationalized pharm. service: to do a medical
137
help an ambulance, to revise range of goods ( to withdraw unnecessary
commodities and doubtful medications), to work out only principles of
management, of financing and providing of the nationalized pharmacies
commodities.
It was made decision about the gradual rolling up of productive to the
function pharmacies and transmission of these functions to the specialized
laboratories and packing enterprises. The folk commissar of health protection
N.А.Semashko came forward on convention that marked close connection between
pharmacy and medicine, specifying on the value of this period, as transitional to
the free medical help. The questions of medical help further improvement to the
population engaged in and ensuing from the ride of pharmaceutical
subdepartments.
In the first years of soviet power in a country there was a sharp lack of
medications, supply of them from abroad stopped. The amount of pharmacies
diminished immediately. Reception of population medical help main character
from pharmacies. On 21-25 of July, 1920 in Moscow 2-nd All-Russian convention
of managers of pharmaceutical subdepartments took place that summed up work of
the nationalized pharmacies for period from the moment of the first All-Russian
convention and to this time. For this short time enough experience was
accumulated from the decision of problems of providing of population medicinal
facilities in the conditions of civil war and economic blockade.
On convention a general progress of pharm.business trend was certain in
direction of confluence of establishments of the medical providing with
establishments of hospital character. On convention the norms of sizes of pharm.
network were considered in rural locality in provinces and district cities. Large
attention convention turned on a question of plan distribution of a limit supply of
medications within the limits of province and claim of list of the most essential
medicinal facilities and preparations for the near-term supply of all pharmacies.
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On ІІ convention experience of work of the nationalized pharm.economy
was first generalized, and taking into account this experience in concrete forms the
worked out prospect of further development of pharm.service in countries.
Nationalization of pharmacies was conducted in heaviest for the young
soviet state moment - period of civil war. In a country dominated hunger,
epidemics. In the first years of soviet power a country tested the sharp lack of
medicinal facilities and medical preparations, stopped to bring in preparations from
abroad. An economic blockade was accompanied by unrestrained speculation by
medical facilities at the internal market. Main attention was spared to medical
maintenance of army and medical and preventive establishments that contested
with epidemics.
On 23of April,1919 a pharmaceutical department appealed to all medicsanitary departments with suggestion how quicker all to enter the normative use of
medicinal facilities in connection with their limit amount. The sale of medications
in these years from pharmacies was not conducted. Part of pharm.establishments
was closed. All supplies of medications were concentrated in the pharmacies
passed in the conduct of out-patient's clinics and hospitals.
In spite of difficulties in providing with medications, resolution of Advice of
Folk Commissars of RSFSR from February, 4, 1921 was an anniented pay for sold
after the recipe of doctor medical facilities from pharmacies. Pharmacies at
medical and preventive establishments medicinal facilities began to release to the
patients free of charge, severely on purpose of doctor.
In 1921 position of pharm.business becomes more heavy. Reduction of
supplies of medicinal facilities and preparations, absence of money on repair of
pharmacies, a sharp lack over of skilled shots was brought to the volume, that part
of pharmacies was closed.
Control questions:
1. The medical providing of population in a pre-revolution period.
2. Work on creation of government service of health protection.
139
3. Decrees of Council of People Commissars.
4. The first stage of nationalization of pharm.establishments.
5. Decree about nationalization of pharmacies.
6. Conventions of managers of pharmaceutical subdepartments.
7. Doctor’s aid in the years of civil war.
Tests :
1. Who owned almost all pre-revolutionary drugstores?
a) state
b) regional authorities
c) Private owners
2. In what year did Lenin signed the decree on the pharmacies’ nationalization?
a) in 1918
b) in 1917
c) in 1919.
3. In what year apothecary institutions, were transferred to self-sufficiency
excluding hospitals?
a) 1918
b) 1922
c) In 1920
4. In what year were allowed to open private medical institutions?
a) 1921
b) 1923
c) In 1922
5. In what year was organized General Pharmaceutical Management NKHP
RSFSR (MDM )?
a).in 1934
b).in 1936
c)in 1935
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UNIT 11: "PHARMACY OF THE SOVIET PERIOD".
Aim of the lesson: to learn organization of medical service in the years of
restorative period, proceeding in a pharm.network in a post-war period. To master
of pharmacy’s development in the 60-90 - s of the XX - th century.
Tenth convention of communist party, that took place in March 1921, made
decision passing into NEP (new economic politics). From a transition of country to
proceeding in a national economy the new stage began in activity of pharm.service.
Most establishments of health protection were taken off from a state budget, and
on the basis of economic calculation it was required to rationalize their work.
On19-th December, 1921 Deecre of People Commissars of RSFSR accepted new
resolution about the order of realization requiring payment for medicinal facilities,
that are for sale from pharmacies.
By this resolution sale of medicinal facilities and bandaging materials to the
patients that was served by soviet hospital establishments( hospitals, out-patient's
clinics) after the recipes of doctors of these establishments must be conducted free
of charge due to money of trade unions and health authorities. There was a
requiring payment sale of medicinal facilities in all last cases. The articles of
hygiene and supervision upon patients were given only for a certain pay.
Money from the sale of medical commodities came to the People
commissariat of health protection for acquisition of medications. For renewal and
development of pharm.business an economic calculation was entered. Pharmacies
at out-patient's clinics were closed, and a self-supporting pharmacy became basic
establishment that carried out medical maintenance of population. In 1922 all
pharm.economy, except for hospital pharmacies, passed to self-supporting basis.
The self-supporting pharmacies of the system of local health that engaged in
realization of medications to the insured workers and office workers, authorities
were named only pharmacies. These pharmacies were most attractive and owned
the best and most perfect form of grant of medical help to the population that is
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represented in their name. In the first years of new economic Policy the type of
requiring payment pharmacy appeared with the mixed distribution of medications.
Soon itwas the removed and well-educated type of self-supporting state
pharmacy that lasted on the draught of many next decades. These nationaleconomy establishments, that managed pharmacies, had the names of only
pharmacies. They engaged in the sale of medications and medicinal facilities to the
population and medical organizations, and also to the free grants of medications to
the insured persons and members of their families due to the state system of
insurance .
From middle of 20th in UKRAINE the height of network of only pharmacies
begins: 1925 are 787 establishments, 1926 are 930 establishments, 1927 are 1096
establishments. By the decision of People commissariat of health protection
RSFSR on the 5th of May, 1922 and by the proper resolution of Deecre of People
Commissars of UKRAINE in 1923 were organized national-economy medical
establishments, in the function of that the supply of pharmacies was included by
medicinal facilities, and at a consequence and management pharm.establishments.
Resolution of Soviet People Committee from January, 9, 1922 was allowed
opening of private medical establishments ( hospitals, out-patient's clinics) and
pharmacies. The lease of state pharmacies was allowed, but from permission and
under control of People Committee and local health authorities. This resolution
was caused by the lack of money, necessary for maintenance of all nationalized
pharmacies in the hands of the state. After the acceptance of decree of People
Committee , people that felt strongly about nationalization begin on places a fight
for a receipt in the lease of pharmacies.
That is why by the People commissariat energetic measures were accepted
from transition of maximal quantity of pharm.establishments on economic
accountability, shortening to these same a private sector in pharm.industry.
Presence of private to the sector negatively marked on quality of the medicinal
facilities given from pharmacies . On the 12th August, 1922 People of Medical
Committee of RSFSR pay attention to region Public Health necessity of
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strengthening of control after activity of private and leased pharmacies.
Admittance of private capital was settled for a while.
Already with the second half of 1923 confiscation of pharmacies was begun
for leaseholders and private possessors. To the end of 1925 all private and leased
pharmacies were translated on self-supporting basis and passed to possession of the
state.
From October 1, 1925 a government gave privileges, releasing from tax
collection state pharmacies that were on a national or local budget, and also
operating on beginning of commercial calculation of pharmacy in cities and rural
locality. All net income of self-supporting pharmacies and pharmacies that
submitted to the local departments of health protection came in the appropriate
departments of health protection on an improvement and distribution of medical
help to the population.
In September, 1926 it was conducted All-Russian, in 1927 - the first All
Ukrainian conference of pharmaceutical workers. A conference summed up work,
the necessity of improvement of research and practice and productive activity of
pharmacies and strengthening of control of quality of medicinal preparations
marked out the ways of development of pharm.business :. Also there was
distribution of pharm.network and alteration of pharmaceutical education.
By resolution of Soviet People Committee of RSFSR from December, 1927
the expense of self-supporting pharmacy was expected: 10 in the fund of
improvement of way of life of workers, 20 in operating surplus, part, that
remained, went to the improvement and expansion of medical help in rural locality.
In 1928 for scientific development of questions, of the pharm.establishments
related to activity, at the People commissariat of health protection RSFSR Central
Research Chemist station(CCRS) on the base of that the All-union scientificallyresearch institute of pharmacy was organized.
In the first years of soviet power many persons worked in pharmacies, do
not have pharmaceutical education. It was necessary to change the handicraft
system of training of pharmaceutical personnel creation of higher and middle
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pharmaceutical schools. In 1918 chemic-pharmaceutical department at higher
medical courses (created by the spring of 1917 in Moscow) was regenerated in the
chemical and pharmaceutical faculty of ІІ of the Moscow university. The first
pharmaceutical institute in a country was created in 1919 in Leningrad.
In 1921 pharmaceutical institutes were opened in Odesa, Kharkiv and Kyiv,
in 1922 was pharmaceutical faculty at Tbilisi university. In January, 1918 by
people Committee of health protection a reception was forbidden to the pharmacies
of chemist students. For training of middle pharmaceutical personnel from 1920
were opened 6 - and 9 are monthly courses, and also two years of pharmaceutical
schools. Middle pharmaceutical establishments were created in 1921.
In 1926 on the All-Russian conference of pharmaceutical workers was made
decision about alteration of pharmaceutical education and further ways of
development of pharmacy in a country. The necessity of preparation of specialists
of higher qualification was underlined from all industries of pharmaceutical
business: both for pharmacies and for galena laboratories, pharmaceutical
productive establishments and pharmaceutical syllables.
There were 22 middle pharmaceutical establishments, 4 pharmaceutical
faculties (Moscow, Leningrad, Tbilisi, Perm) on January, 1, 1927 in a country and
independent chemical and pharmaceutical institute was counted in Odessa.
In parallel with nationalization of pharm.economy flowed and process of
transmission in state possession of pharmaceutical industry. This process began in
1918 and came to an end in 1919. In June, 1918 at ARSNK of RSFSR a
management was created industrial pharmaceutical establishments of
"Pharmcenter", reorganized in 1919 in main administration of chemical and
pharmaceutical plants (mainpharmplants), in composition of that entered 62
establishments.
However from the unsatisfactory state of equipment, of lack of raw material,
fuel and shots, to the end of civil war were 45 establishments in slave
mainpharmplants only 15 worked regularly with them. Accordingly the volume of
pharmaceutical products grew short. In 1920 domestic industry satisfied in all 17
144
percents of necessities of people committee of health protection in medicinal
facilities and preparations. On the end of 1921 instead of main pharmplants
Pharmtrest gets organized, in the conduct of that passed 5 great Moscow
pharmaceutical plants.
Other pharmaceutical establishments are passed to the pharm.managements
created at the beginning of 1922.
In 1922 at the People commissariat of health protection Statemedtrade
association is created from the supply of pharmacies and hospital establishments
by the prepared medicinal facilities and preparations, mainly foreign production.
Brought a presence over of two parallel channels of medical supply to
inconsistency in actions and discord in prices. On July, 1, 1925 Statemedtrade and
Pharmtrest united in the joint-stock company of Statemedtradeindustry.
Proceeding in pharmaceutical industry went rapid enough rates and in 1926
domestic enterprises satisfied 2/3 all requirements of country in medicinal facilities
and preparations.
In pre-war years large work was conducted from perfection of guidance of
pharm.service in the scale of area, republic and country.
For an organizational and economic management of pharm.business, that
was in development, status in 1929 in every area and edge regional and regional
pharm.managements, were organized that were provided with wide rights and were
state calculation associations. With the aim of distribution of pharm.network and
providing with medical commodities, in 1931 the Russian Pharm.association was
created in composition to People Committee of health protection RSFSR - RCHO.
Association is operatively- economic organ through that People Committee
of health protection carried out the functions fixed on him in area of planning and
adjusting of pharm.business and organization of medical supply. In composition
associations are included some industrial enterprises at People Committee of health
protection:Central Pharm.Research station and it republican, regional and regional
Chemist management and medtrades.
145
All organizations, except the Chemist management and medtrades, with the
property and capitals, were passed in the direct conduct of association. Chemist
management and medtrades remained in direct subordination of local health
authorities, and submitted to the association only in area of planning, technical
management, control and account of the presence articles of medical supply.
Facilities of RCHО consisted of capitals of inferior to him enterprises, and
from single payments to its Chemist management and medtrades, size of that was
set by People Committee of health protection, that it was also concordantly from
People Committee of finance of RSFSR. Centralization of facilities gave an
opportunity to use considerable assignations on expansion of pharm.network
In 1935 on a base RCHО of main Pharm.Administration to People
Committee of health protection RSFSR ( SCHO OF RSFSR) was organized. In a
submission SCHO were all regional and regional chemist management, balances of
that from January, 1, 1936 joined in only balance of SCHO . On the same principle
of SCHO of the allied republics were in recent year organized. HP of the USSR,
pharm.inspection that carried out common guidance and control after activity of
chemist management of the allied republics began the work in composition of that,
was organized in 1936.
Pre-war five-year are characterized by successes with development and
strengthening of positions of pharm. and hospital business. In the period of 19281932 considerably the network of pharmacies, shops grew on 40 % of prerevolution network. In the years of second five-year the special attention was
spared to expansion of network of pharmacies in rural locality.
Resolution of Council of People Commissars from July, 1935 "About
trading in medicinal facilities" was the anniented distribution and setting of norms
of medications system, and also the sale of medications is entered after a recipe
and over-the-counter doctor. Accordingly with this resolution, pharm.points that in
turn gave an opportunity without problems to get medicare to the population began
in rural locality to get organized. It was also let to open pharmacies to public
organizations of Red cross and departments of working medicine.
146
For years first two five-year a pharm.network was increased on the average
in 3 times. More than the use of medications to the populations increased in two
times.
There is a considerable height of amount of municipal pharmacies and
strengthening of material base of existent pharmacies in the years of third fiveyear. In these years the special attention was spared to the quality of medications.
Control increased after quality of medicinal facilities: as those that came from
industrial enterprises, so in quality of those, that made in pharmacies. Only on the
draught of 1938 70 control-analytical laboratories were open more than.
All in a country to beginning of 1941 in the system of chemistmanagement
were 295 control-analytical laboratories and 1131 control-analytical cabinets and
tables at pharmacies.
In the years of Great Patriotic War it was necessary to reconstruct all
national economy on satisfaction of necessities of army and fleet. Products that
was produced by medical industry, was given, first of all, to the military
department. Many pharmacists went on front. New tasks appeared before
pharm.workers. It was necessary to find new medicinal facilities, produce
replacement of food foods at the production of medications (bases are for
ointments), to organize the production of medications.
In the years of war sharply a question got up about medical raw material.
Before collection of medical raw material there were the attracted schoolchildren,
pioneers, members of the komsomol and wide layers of population. In May of
1942 Main pharmaceutical management (MPM) of Ministries of health RSFSR a
self-supporting office was organized from preparing, processing and sale of
medical plants, providing with the medical raw material of enterprises of galenpharmaceutical industry and pharm.network depended upon that.
Military operations on territory of row of republics of the USSR inflicted a
severe loss to all pharm.economy. 1200 pharmacies were destroyed only in 24
areas and edges of RSFSR.
147
During occupation a population did not get a necessary medical help. After
the release of territory immediate renewal of national economy went from the
German invaders. All pharm. workers of the USSR participated in renewal.
As the medical industry partly destroyed in the years of war could not fully
provide the requirement of country in medications and in a medical equipment,
there was a necessity of concentration for the single center of planning of necessity
and distribution of medical wares that was produced. It was in addition, necessary
to coordinate a process and proceeding in the pharm. network of the allied
republics. To the end in July of 1945 Ministry of health the USSR Main
pharm.administration on that guidance was fixed by pharm.business in a country
and organization of medical maintenance of population was organized. In the years
of fourth five-year there are renewal and further expansion of pharm.network on all
allied republics.
With the aim of approaching of medical help to the population in fourth fiveyear the form of trading in simple medications and articles of sanhygiene got
distribution through trays and booths. On beginning of fourth five-year
pharmaceutical industry was in the conduct of different departments. In 1946
Ministry of medical industry, that united work of pharmaceutical plants of the
USSR and research and chemical and pharmaceutical laboratories and institutes,
formed. There were the renewed enterprises destroyed in the period of war.
The special attention applied on creation of productions from producing of
pharmaceutical preparations in national republics.
The fifth five-year was the period of further development of pharm.network.
From 1951tо 1955 was opened 674 pharmacies, including 618 municipal and 56
rural. In addition, in rural locality at district hospitals and at obstetrics points it was
open 14680 chemist points. To the end in a country it was fifth five-year 5732
municipal and 7017 rural pharmacies and 70766 pharm.points. Expansion of
network of chemist establishments, especially in rural locality, gave an opportunity
to improve maintenance of population a medical help.
148
A characteristic feature in development of pharm.network is an increase of
specific gravity of large pharmacies. For 2years the amount of pharmacies of the
first category increased more than on 40% of the second- on 30% of the third one
about on 20% of the fourth category about 10% of the fifth one about on 5%.
From 1949 to1955 the row of the organizational measures sent to the
improvement of work of pharm.network was accepted. In 1949 the bonus system
was entered for implementation and overfulfilling of plan of commodity turn over,
that created the material personal interest of pharm.workers in the increase of
number of the realized medications and articles of sanitation and hygiene. The
system of up-diffused material responsibility was entered for trade-material values,
that allowed to improve maintenance of commodities.
1955-1960 were the period of further improvement of organizational forms
of management and improvement of work of pharm.establishments of
pharm.business.
Control questions:
1.Оrganisation of medical service in the years of restorative period.
2. Decision of Tenth convention of communist party.
3. Passing of pharm.economy to self-supporting basis.
4. All Ukrainian conference of pharm.workers.
5.Rebuilt of pharmaceutical education.
6.Development of public pharmaceutical industry.
7.Pharmacy in pre-war five-years .
8.Doctor providing of population in the years of Great Patriotic war
(GPW).
9.Renewal and further development of pharm.network in post-war
period.
10.Development of pharm.service in 1950 – 1990
149
Tests :
1. What year was created the Ministry of Health in the Soviet Union?
a) in 1934 ;
b) in 1936 ;
c) in 1935
2. In what year was established the first rural pharmaceutical item in Ukraine?
a) in 1935
b) in 1936
c) in 1934
3. In what year were established the scientific candidates‘ and doctors’degrees by
the government?
a) in 1937 ;
b) in 1936 ;
c) in 1935
4. What contributed to the improvement of medical service for the population
in rural areas in the postwar years ?
a) expanding of pharmacies’ network ;
b) the development of chemical and pharmaceutical industry ;
c) an increase of medicines volumes’ production in pharmacies.
5. What form of medicines’ sale was distributed after the Second World War with
the purpose of bringing medical care to the population ?
a) the trade through the apothecary bases and storehouses
b) the trade through the pharmaceutical factories ;
c) the trade through kiosks and shops.
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UNIT 12: "HISTORY OF UKRAINIAN PHARMACY ‘S BECOMING AND
DEVELOPMENT IN THE-XVI – XVIII-TH
CENTURIES.MEDICARE ON WESTERN-UKRAINIAN SYSTEM
OF MEDICAL AND PHARMACEUTICAL EDUCATION".
Aim of the lesson : to learn history of pharm.business’ development in
different regions of
Ukraine of the period of the XVI - XVIII th centuries; to master the features
of preparation of doctors and chemists.
From the XIII – th century was the heavy period in history of Kyiv Russ,
related to the invasion of khan Batiy. In December 1240 Kyiv was trapped .The
least western Russian earth suffered from nomads- Volyn and Galychina. Later it
formed Galychina- Volyn principality that played a considerable role in
development of culture and medicine. In 1349 Galychina earth was trapped by
Polish feudal lords, and Hungarian feudal lords took Zakarpattia Russ. In 1362 the
incorporated Lithuanian principalities got practically all western Russian earth.
From this period the ways of Kyivshchyna, Podol and Galychina during a
few centuries differ from history of development of slavs that occupied northeastern earth that began to be concentrated round Moscow and afterwards formed
the Moscow centralized state.
In XV – th century Kyiv was destroyed by the troops of the Gold horde on
any time loses the leading role in the culture of Ukrainian earth. In a period of
Mongol-Tatar yoke the special role was played by monasterial medicine: all
Russian medicine that time found shelter in monasteries.
However monasterial medicine on Russ was not a monopolist, existed and
society, mundane. And, without regard to antagonism inter se, they presented the
single system of medical knowledge and medicare.
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City Lviv becomes a cultural and medical center on Ukrainian earth.
Opening of medical schools on the western Ukrainian earth and training of soviet
doctors in Ukraine at the end of the XVI – th century.
In a period from 1576-1578 a prince Kostyantyn Оstroszskiy, Ukrainian
magnate and patron of art, founded an academy on Volyn of Оstroszsk first high
school in Ukraine, that was named by " Оstroszsk of Athena". At an academy there
was an open hospital with a medical class (prototype of faculty of medicine). Jail
became a new cultural center, it had a printing-house. An academy existed to 1640.
For its offense brotherly schools were opened in Lviv, Lutsk.
In 1593 not far away from Lviv, in city Zamosc, there was the founded
academy on initiative and on money of count Jan Zamoyskiy. Jan Zamoyskiy got
education in Pаduan university and opened for example of this university school on
a motherland. Separate medical class (faculty) in Zamosc at the beginning of XVII
– th century organized native to Lviv doctor of medicine Jan Urcin. A medical
faculty trained professional doctors, doctors of medicine most known from them :
Yuriy Drogobich, George Francis Scorina, Pylyp Lyashkovskiy.
Connection of Zаmоstsc of academy from Paduan university was so close,
that she was considered him by a cultural heiress. The students of Zаmоstsc of
academy united in friendly associations: Lithuanian, Russian, Polish. The Russian
group was presented by the graduating students of brotherly schools of Lviv, Kyiv,
Lutsk. On a medical faculty the amount of students did not exceed 45. At an
academy there was a hospital on 40 beds. An academy existed 190 years, Аustrian
power was closed by after the division of Poland in 1784.
An academy played an important role in distribution of scientific medical
knowledge in Ukraine that time. Some it graduating students continued the studies
in the universities of Italy, where they got the degree of doctor of medicine. From
their number: George Drogobich, George Francis Scorina, Pylyp Lyashkovskiy.
Among the Ukrainian scientists more late times it follows to remember
Еpifaniy Slavenetskiy, that became a monk and laid out in the Kiev Mohylan
college. Then he led teaching of "free sciences" at Moscow medical school, open
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in 1654. In training of medical personnel a considerable role was played by
founded in 1632. Kyiv college that got in 1701 by the decree of Petro I title of
academy. The Kyiv academy played an important role in training of medical
personnel in connection with organization of hospital medical schools. During 14
years (1784-1798) from the Kyiv academy 300 graduating students entered into
many medical schools. Later stuff for medical schools trained in Chernihiv,
Pereyaslav, Kharkiv. Elisavetgrad (Kirovohrad) medic-surgical school was only on
Ukraine school of training of doctors for an army. School lasted from 1788 to
1797, trained 153 doctors for this period.
To this period wide distribution was got by handicraft (workshop)medicine
the representatives of that were barbers. The workers of middle-aged cities on
economic and legal reasons united in workshops. Under the name of barbers find
on archives documentary information about such handicrafts from the end of XIV th century, when on the cities of Ukraine it was led to self-organizing, known in
our history under the name of Magdeburg right. They treated, leaning against ageold experience of ethnomedicine and, having near business connections with
graduate doctors, filled up the knowledge. It is known that in XV-th century to
Kyiv city council were inferior 16 handicraft workshops of different specialities,
between them was and workshop of barbers. As a result of the high paying for
treatment, great masses of population were not served for graduate doctors, and
barbers rendered basic medicare to the population. Workshops were for that time
only schools of handicraft. Also workshops of barbers were original only school of
training of medical personnel for great folk masses during many centuries.
At those times it was as early as custom every graduate of authorities¬to
have near himself a few students. An amount of such students was small. Every
master taught a few students (apprentices) that helped him in-process, studied to
execute shallow curative manipulations and acquired skills of supervision upon
patients. In course of time they worked on small towns and large villages
independently. To work on cities, where workshops of barbers were, they had no
authority, under threat of fines.
153
The exemplary and leading workshop of barbers for Ukraine was Lviv
workshop founded in 1512. At first in Lviv masters of different nationalities were
included in the workshop of barbers, but afterwards, with distribution in Poland,
under act of jesuits, religious unbearableness, Ukrainians and jewries to the
workshop both accepted or did not accept. On other cities of Ukraine, except for
Каmjanetsk-Podilsk, to the workshop accepted the persons of different
nationalities.
The charters of workshops distinguished such members of the association: 1)
students that on Ukraine was named "guys"(discipulus), 2) apprentices, - for us
they were named "lads", "chelyadnyaki"(medius socius, servus), 3) masters
(magister). Students were accepted by age of коло12 years, literacy for them was
optional. Every student before an entry brought in certain payment (from 6 pence
to 6 zloty) in a workshop small box. The studies of student in a workshop lasted 3.
Students for one master it did not have to be more than 3-4.
Masters of students taught to do bloodletting, put banks dry and with notches
(bloody), cut boils, pull out teeth, bandage wounds, lay on vises at breaks, to set
dislocations, to make different plaster for treatment of wounds. Master teached the
students of signs of certain illnesses and, necessarily, golyarsc business.
Making off studies, a student brought in certain payment (a circle is 12
zloty) in a workshop small box, and he was written into a workshop book already
by an apprentice, lad. A lad had to do some work for the master yet 6 months,
reaching only a 1 penny for a week. After this term he had a right to pass to work
to other master. After most charters, apprentice, making off science for basic
master, "Traveling" had to begin.
Getting from the workshop a certificate about studies, he passed to other
city, called there shopmaster and, after his setting, began to work as chelyadnic in
one of masters. Ordinary pay to chelyadnic is one third of his making.
"Wandering" had on an aim an acquaintance of lad with facilities of treatment on
other cities. In Lviv, Lutsk, Kyiv and some other cities of Ukraine from the duty of
"wandering" it was possible to get rid of certain payment in a workshop small box.
154
Working 3, id est not early than as in 6 after the beginning of studies of
barber mastery in general, a lad could worry before a workshop about permission
to go in for exam on master. Getting permission, a lad brought in a workshop small
box 10 zloty and got from a workshop materials for making of medications of
examination. For examinations it was needed to make ointments, plaster (the
separate from them consisted of 19 substances), powders, to direct a new razor,
scissors, instrument for bloodletting.
After completion examinations, candidates in masters arranged drawingroom for the workshop. As it costed to 100 zloty that young master could give not
always on the average, then it was sometimes allowed to produce her in a year
after examinations. Non-fulfillment before a workshop was punished new master
of this duty by a fine to 5 pound of beeswax (a circle is 20 zloty).
In any workshop Charter of barbers it is not talked about control of doctors
after activity of workshop. Activity of barbers was controlled only by workshop
Charter, work of students and apprentices was especially controlled. Rights them
limited, in Charter in general of their duties came into question in behalf on master.
Large handicraft workshops had the hospitals. Less workshops had one
general hospital.
On all metropolises of Ukraine except workshop barbers medical practice
many barbers that from that or other reason were not entered to the workshops
engaged in. They were named "partachi". Between two groups of barbers a
permanent fight was conducted. On estates squires had the barbers from serfs, that
was given in science to the doctors or to the municipal barbers.
One of the most widespread methods of treatment, that used large popularity
among an urban and rural population, was bloodletting, he was widely practiced by
barbers in workshops, bath-houses and on houses. Didichi before the beginning of
the spring field works ordered to do bloodletting to the serfs, to release them from
winter "worked" of blood. Considered that bloodletting strengthened durability and
capacity.
155
Barbers, serving great masses of urban and rural population, being close to
them the world view, presented basic shots that treated our people during many
centuries. In course of time, after the reunion of Ukraine with Russia, on cities and
districts it was the first governmental doctors to conduct a large fight with barbers,
to subordinate their work to the control. Actually workshop medicine on Ukraine
lost the influence only in the second half of XIX of century
After distribution of Ukraine on Left-bank and Right-bank from Polish
occupation of Kyiv and Left-bank Ukraine are freed, that then Perejaslav Council
(1654) returned of the framework with Russia. Right-bank remains under power of
Poland to 1793.
At the beginning of the XVIII – th century. Left-bank Ukraine had 2 public
pharmacies: Kyiv and Lubnen. Lubnen pharmacy a considerable role belongs to in
development of pharmacy of the XVIII – th century. It was opened in 1720 with
the aim of the near-term providing of soldiery parts medications and medical
instruments. It was the most pharmacy of Ukraine during all XVIII – th century.
and even engaged in the purveyance of medical raw material for the pharmacies of
Moscow. In addition, Lubnen pharmacy conducted training of pharmaceutical
personnel by the individual studies of students.
Also in the first half of 18с. private pharmacies are opened: in 1728 - in
Kyiv, in 1740- in Nizhyn, in 1743- in Gluhov. In the second half of the XVIII - th a
pharm.network grows considerably, new pharmacies are opened both in a province
and district cities.
In 1778 the first free pharmacy was opened in Kharkiv. She free of charge
gave out medications for servicemen and students of Kharkiv schools. In 1808 a
private rural pharmacy under Kharkiv and first pharmacy was open in city of Sum.
1816 in Kharkiv 5 pharmacies operated already. However in some cities of
Slobozhanschyna there was not a single pharmacy up to the end of the XIX - th
century.
In all Каterinoslavsk province that in that time occupied territory of the
present Rostov, Donetsk, Luhansk, Zaporizhzhya and Dnepropetrovsk areas with a
156
1,5-millionth population, 29 pharmacies were counted in 1881 in all. All of them
were badly equipped, had a limit assortment, and almost all were in cities, and a
witch-doctor and healer prospered in villages. To the end of the XVIII - th century
on the south of Ukraine pharmacies appeared in Kherson, Mykolaiv, Odessa. (In
1865 12 pharmacies were opened in Odessa ).
In 1801 the nobility of Suburb of Ukraine got Olexandr І deed that was
confirmed his privileges. On celebrating this occasion noblemen began collection
of money on a construction in Kharkiv of hospital of the name of Oleksandr І.
Group of well-educated squires at the head with Vasyl Каrasine decided to point
this motion at more wide aim - founding in Kharkiv of university with a medical
faculty. It was collected after subscription for opening of university large for those
times sum - 618 thousand karbovanetses.
Will mark that in those times yet was not to the university neither in
Petersburg nor in Warsaw. Officially the medical faculty of the Kharkiv university
was opened in 1806, but for him it was prepared neither anatomic theatre, nor
laboratories nor clinics. There were not students, as a government did not
distinguish grants for a medical faculty. A question appeared about liquidation in
Kharkiv of medical faculty, what gardian of educational district Pоtotskiy insisted
on, explaining it that in general persons interested to study medicine among local
youth it is not.
However reason of gardian met a denial from the side of department of
education, that in reply ordered to save a medical faculty at an university, as a
ministry answered: "A long ago was already noted in Ukrainian teenagers
inclination to medical sciences, in this is sured that fact, that the most part of
doctors came from Маlorussia".
Medical department was opened in composition of six departments : 1 anatomy, physiology and judicial medicine; 2 - pathologies and therapies; 3 - to
surgery; 4 - midwife business and woman illnesses; 5 - matters of
physician(pharmacy, pharmacognosy, pharmacology); 6 - veterinary science (
cattle treatment).
157
If foreigners managed in the first years of existence of medical faculty most
departments, then already through some ten years almost all departments were
managed by home scientists, pupils of the Kharkiv medical faculty. From the
professors of Kharkiv medical faculty of the first half of the XIX - th century
deserved to be marked professor of anatomy P. A. Naronovich and professor of
surgery М. І. Elinskiy.
From the professors of department of pathology and therapy it is needed to
mark professor Petro Butovskiy, that the special attention was paid, except general
therapy, psychiatry. He wrote the first home textbook of "Psychiatric diseases in
1834” are given to the beginning of nowadays study of psychiatry" in two parts.
On the chair of materia medica a prominent professor was E. S. Gordienko (18121897). The lectures he accompanied always by demonstrations. Gоrdienko
organized a pharmacological laboratory, later obtained the separation of
pharmacology in a separate department.
Slaviansk resort is under an obligation to him to the first scientific studies of
the mineral waters and dirts.
The first producing of doctors of medical faculty of the Kharkiv university
in an amount of 9 persons took place in 1815. In next years the amount of
graduating students increased very slowly. For 10 first yearsl 98 doctors were
produced.
Only in 1834 an university was founded by the "mother of Russian cities " in Kyiv. Its task was exactly determined by a government: to conduct rucificator
activity in a spirit of tzarism of these reasoning for organization of university. A
medical faculty was opened in 6 years. Its organization, creation of anatomic
theatre, laboratories, clinics, took place in far more favourable terms, than in
Kharkiv.
After abolition of serfdom on the right medicare to the rural population from
1864 was concentrated in zemsc justices in that a leading role belonged to the
squires-noblemen. A zemstvo was entered at first only in 34 provinces in that
devoted to tzarism prevailed the Russian nobility. On Ukraine a zemstvo was
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entered only on Left-bankness. On Right-bankness, where most squires were
presented by Poland, zemsc self-government was created only in 1906.
From the orders of the public caring zemstvos accepted province and district
hospitals, mostly in the very unsatisfactory state: they are placed were mainly in
maladjusted old houses, without the due of medical and economic equipment.
District doctors treated in them holding two jobs. Were there, mainly, sick
prisoners in hospitals, soldiery invalids, homeless.
A poor population did not could by them widely to use through the
obligatory paying for treatment that at insolvency of patient was raised from rural
community. On villages governmental hospitals were not in general. There was a
small amount of rural medical assistant's points in separate only provinces.
A permanent presence in the villages of those or other epidemic diseases,
large death rate of population, especially children, compelled new created zemsc
justices in the first years of their work to pay attention to medical business and
invite for maintenance of rural population of doctors. Among these doctors there
were many young people that went to work in villages under act of populist ideas.
Terms of work of doctors in the first years of existence of zemstvo were heavy.
Doctors of tendon in district cities and must arrive in certain days to the
certain villages, having at itself medications and instruments. At such system of
maintenance of population medicare often worldly-wise, that a doctor in the
appointed place did not find patients and patients did not find a doctor. Doctors
named this system not service, but play "hide-and-seek". And it was to conduct a
persistent fight with zemsc organasations, while gradually this departure system
was transferable stationary.
At this system a district was divided into medical areas in the center of that
there was a hospital with an out-patient's clinic and infectious department, for
peripheries were medical assistant's points.
Free of charge grant of medicare was confessed by zemsc justices only at the
beginning of the ХХ-th century. Abolition of pay was sharply increased the appeal
of population after medicare, in separate districts - in 10 times.
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Zemstvo decided the question of grant of psychiatric help rather successfully
. On provinces founded, more often out of cities, large psychiatric establishments,
that had in the order workshops, considerable lot lands. It gave an opportunity to
the zemsc doctors-psychiatrists to reconstruct the mode in these hospitals on
humane bases, without chains, strait jackets and widely to apply work therapy.
The amount of medical areas in provinces, where a zemstvo was, with every
year increased. In 187 it was 536 of them, then in 1980 an amount arrived to 1440,
and in 1910 - 2686.
A standard for all zemstvos of Russia in course of time the Moscow
zemstvo, became sanitary organization of that was headed during 22 by the known
zemsc health-officer E. О. Оsipov (1841- 1904). A sanitary corps in zemstvos was
managed by province sanitary advice with her executive branch - sanitary bureau
that was headed by a province health-officer. There was only one health-officer in
every district.
Its functions were mainly taken to organization of medicare in a district,
developments of medicostatistic of data about morbidity in a district and
organization of antiepidemic measures, hygienical and bacteriological zemsc
sanitary statisticians a statistical commission.
On Right-bank Ukraine the Аustro-Hungarian monarchy held Ukrainian on
settle in the state of political, social and economic backwardness. Ukrainians were
removed from participating in state, economic and cultural life of country. Neither
in Galychina nor in Zakarpattia during almost all XIX – th century was not a single
higher medical school. Only in 1894 in Lviv university it was opened at medical
faculty, prelude of that to Ukrainians limited.
For 25 of existence in the days of Austria-Hungary of this faculty, 544
doctors were produced, among them there were only 40 Ukrainians. In the days of
bourgeois Poland the entry of Ukrainians on the medical faculty of the Lviv
university was admitted to the limits only 5 doctors-Ukrainian, as a rule, could
work only as private doctors. Not having the opportunity to work on permanent
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positions in clinics, hospitals, they could not arrive at high qualification. To
scientifically-pedagogical activity Ukrainians were shut out.
From Doctors-Ukrainians from the western earth, there is a lucky enough
that to work in Russia, it follows to name a professor of N. D. Monastyrskiy (18471888).
On Galychina territory that exist in XVIII – XIX – th centuries under power
of Austria-Hungary, "Sanitary Charter"(in 1773) according to that it was forbidden
doctors to make medications operated, and to the chemists - to treat patients.
The Galychina pharmacies performed the double duty:
1. Trade establishments with an own production and realization of
medications, veterinary preparations, cosmetics.
2. Medical establishments for the grant of elementary medicare.
As a result of government control of pharm.service, in Galychina there were
a few types of pharmacies, that differed in inter se both setting and forms of
organization of work. It: royal pharmacies, domestic, public, circuitous, soldiery,
rural, homoeopathic.
In the days of Austria-Hungary (1771 -1918) neither in Galychina nor in
Zakarpattya it was not built not one hospital on a village. Hospitals were built only
in district cities and then not in all: from 46 povitov cities of hospital were only in
27. Stationary medical aid was requiring payment, exhausting for most peasants,
and that is why the far of beds for them was not used.
Galychina and Zakarpattia were the permanent hearths of such epidemic
diseases, as typhuses, pox, child's infections; in mountain districts the far of
population was ill on tuberculosis and syphilis. Sanitary state of accommodations,
water-supply on villages were extremely unsatisfactory. Regional advice of health
of Galychina in the report of 1889 marked: the "Most villages are such poor, that
construction of public well exceeds financial possibilities of gmin". In mountain
districts there were many poultry houses on villages, without flues.
Actually nothing changed on business of medical service of population of
the western Ukrainian earth in the days of lordly Poland (1919-1939). A stationary
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help remained for a population by requiring payment and inaccessible for
swingeing majority of peasants. There were not even district governmental
hospitals in 25 districts.
Control questions:
1. Reasons of division of Kyiv Russ on separate regions and features of
development
medicine and pharmacy of these regions.
2. Unity of monasterial and society medicine.
3. Workshop medicine.
4. Opening of medical faculty in Kharkiv and Кiev.
5. Preparation of medical specialists in the Ukrainian academies.
6. Opening of pharmacies on Ukraine in XVIII – th century
7. Zemsc medicine.
8. Medicare on the western Ukrainian earth.
Tests :
1. Representatives of the craft medicine were :
a) barbers ;
b) doctors ;
c) monks ;
d) herbalists
2. The model of barbers’ shop in Ukraine was:
a) Galytskiy shop;
b) Kyiv shop;
c) Lviv shop;
d) Ternopil shop.
3. Ukrainian scientist, the XVII - th century . , who became a monk and taught at
KyivMohyla Collegium :
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a) Yuriy Drogobich ;
b) Philip Lyashkovskiy ;
c) Epifaniy Slavenetskiy ;
d) George Francis Skoryna .
4. The single school which prepared physicians for the army in Ukraine was:
a) Kiev Board ;
b) Zamoyski Academy;
c) Kyiv-Mohyla Collegium ;
d) Elisavetgradska medical and surgical school.
5. Formal pharmacies of left-bank Ukraine in the early XVIII - th century were:
a) Kyiv , Ternopil ;
b) Kyiv and Lyubnen ;
c) Kiev, Nizhyn and Glukhiv ;
d) Nizhyn, Lyubnen , Ternopil
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UNIT 13: "THERAPEUTICAL ESTABLISHMENTS. ACTIVITY OF
ZAPORIZHZHYA SICH"
Aim of the lesson : to learn activity of brotherhoods and medicinal activity
of the Zaporizhzhya cossacks.
In history of medicine of Ukraine an important role was played by
fraternities. They existed since olden times, and in XV – XVIII –th centuries
mattered very much in life of people, conducting eleemosynary, educational
activity, gave help poor and sick. Fraternities asserted right the Ukrainian people in
a fight against the Polish burden, assisted maintenance of Orthodox and cultural
traditions, national originality. Fraternities carried eleemosynary character, at them
were to open schools and hospitals.
Round fraternities all progressive public united: from gentlefolks to the
habitants of сел or bridge.
One of large there was Lviv fraternity on Ukraine, the first information
about that belong to 1439. From school fraternities will be nursed by the first
teachers of "free sciences" from Кiev, Lutsk( Еpifaniy Slavensciy is beginning of
18с.).
At Оnufriev monasteries fraternity in 1522 organized a hospital. In suburbs
to Lviv at the Ukrainian churches were opened yet 4 small hospitals. Brotherly
hospitals and schools held out on facilities from parishioners, and also material
help that was given by a tsar Fedir Іоnovich.
The hospitals had and large handicraft workshops in cities. In some cities
hospitals held out on the local facilities got for a move through bridges, ferriage by
a ferry. Except hospitals that existed at public expense, there were on Ukraine
hospitals that held out on money of rich persons, who gave for this village, and
other property. All hospitals had wardship sweep.
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Kyiv fraternity was founded later - in 1615. It had the school and hospital
"for people wretched, old, spiritual, as society so people of knight's", - it was
determined in his charter (to the deed).
An important role in the fight of the Ukrainian people for the national
originality was played by the Ukrainian Cossacks. Zaporizhzhya Sich became
military covering force against hikes on a north troops of Crimean Tatars, that in
XVI – XVII – th centuries quite often reached even to Moscow.
Life of the Zaporizhzhya Cossacks passed mostly in hikes and battle actions.
Medicare at traumas and diseases they rendered facilities of ethnomedicine.
Cossacks were able to move bloodletting, delete teeth, make plasters for treatment
of wounds, to lay on splints for fixing of breaks. From hikes many Cossacks
returned invalids, that is why Cossacks had to have the hospitals.
First such hospital was founded in the end of XVI – th century on an island
between the rivers by Old and New Samara. There were the built houses and
church, surrounded by protective ditches, from Kyiv in a hospital there was the
invited celibate priest Paisiy, the duties of treatment of invalids and wounded
depended upon that. By the main hospital of cossacks at the end of XVI – th
century a hospital becomes in Тrahtemiriv monasteries on Dnepr (below than
Kaniv). Тrahtemiriv arose up on the city of ancient city of Kyiv Russ- Zaruba.
Combat hospitals were in monasteries: Lebedinsciy (near-by Chyhyryn ) and
Levcivskiy (in close proximity of Ovruch). Monasteries gladly assumed caring
about Cossacks, as charges were paid due to the treasury of Army Zaporizhzhya.
Cossack hospitals were the first soldiery curative establishments on Ukraine. From
1672 the hospital located in Меzhgirsciy monasteries near Кiev becomes a main
Cossack hospital. At this monastery there was a large medical library that was a
base for medical preparation of monks of monastery.
A monastery was founded in 988. Hospital in Меzhgirrya in 1755 set to
convert into a public house for invalids, but such establishment was organized in
Кirilivskiy monasteries in Kyiv, and Меzhgirrya in 1787 was destroyed by a fire.
In Cossack hospitals, unlike civil hospitals in cities and villages, cripples found
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shelter not only, но also got treatments injured and sick. These were the first the
family soldiery curative establishments in Ukraine.
Thus, we on Ukraine had wardship first public establishments; therapeutic
establishments arose up for us considerably later. Medicare to the patients, their
treatment, except for homeless, conducted at home and was exceptionally personal
business.
In Sich there were barbers - professionals that rendered urgent medicare at
attacking Cut of the Turkish troops. Graduate doctor on permanent service in the
army of Cossacks long it was not even after the reunion of Ukraine with Russia, in
spite of queries of ataman to Petersburg.
The new historical document of the XVIII - th century is recently found, that
testifies that in Zaporizhzhya Sich there was a medical office that controlled
delivery of medications. An ataman Каlnyshevskiy had the pharmacy with the
supply of medications. Supplies were formed on the order of medical office and
belonged to Army of Zaporizhzhya. Also this document first testifies to activity of
the professional Russian military doctor (Cristofer Figner) in 1760 directly in
Army of Zaporizhzhya.
In course of time, amount of Cossacks Sich grew, and also the enormous
amount of wounded, part from that forever remained invalids, appeared reasons of
opening of Cossack hospitals, considered before.
The feature of medicare in Zaporizhzhya Sich, as a chronicle testifies,
consisted in that treatment of wounded and patients came true due to the treasury
of Army of Zaporizhzhya.
The workers of medieval cities on economic and legal reasons united in
workshops. Under the name of barbers documentary information about such
handicrafts find on our archives from the end of the XIV - th century, when on the
cities of Ukraine it was led selforganisation, known in our history under the name
of Magdeburg right. In XV - th century to Kyiv city council of 16 handicraft
workshops of different specialities were inferior, between them there was a
workshop of barbers. Workshops were for those times only schools of handicraft.
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Workshops of barbers were too original only school of medical shots during
many centuries for our great folk masses.
At those times it was as early as custom to have every graduate doctor near
itself a few students that helped him in-process, studied to execute shallow curative
manipulations and acquired skills of supervision upon patients. In course of time
they worked on small towns and large villages independently. An amount of such
students was small. To work on cities, where workshops of barbers were, they had
no authority, under threat of fines.
The charters of our workshops are distinguished by such members of the
association: 1) students that on Ukraine was named "guys"(discipulus), 2)
apprentices, - for us they were named "lads", "chelyadniki (medius socius, servus),
3) masters(magister). Students were accepted by age of коло12 years, literacy for
them was optional. Every student before an entry brought in certain payment(from
6 pence to 6 zloty) in a workshop small box. Study of the student in a workshop
lasted 3 years. Students for one master have not to be more than 3-4.
Masters of students taught to do bloodletting, put banks dry and with notches
(bloody), cut boils, pull out teeth, bandage wounds, lay on vises at breaks, to set
dislocations, to make different plasters for treatment of wounds. They taught the
students of signs of certain illnesses and, necessarily, golyarskiy business.
Making off studies, a student brought in the workshop small box of exactly
payment (a circle is 12 zloty), and he was written into a workshop book already by
an apprentice, lad. A lad had to do some work for the master yet 6 months,
reaching only a 1 penny for a week. After this term he had a right to pass to work
to other master. After most charters, apprentice, making off science for basic
master, "Traveling" had to begin.
Getting from the workshop a certificate about studies, he transformed
wonders to other city, called there shopmaster and, after his reception, began to
work as chelyadnic in one of masters. Ordinary pay to chelyadnic is one third of
his making. "Wandering" had on an aim an acquaintance of lad with facilities of
treatment on other cities. In Lviv, Lutsk, Kyiv and some other cities of Ukraine
167
from the duty of "wandering" it was possible to give by certain payment in a
workshop small box.
Working 3years , id est not early than as in 6 years after the beginning of
studies of barber mastery in general, a lad could worry before a workshop about
permission to go in for exam on master. Getting permission, a lad brought in a
workshop small box 10 zloty and got from a workshop materials for making of
materials of examination. For examinations it was needed to make ointments,
plaster (the separate from them consisted of 19 substances), powders, to direct a
new razor, scissors, instrument for bloodletting.
After completion examinations, candidates in masters arranged present for
the workshop. As it costed 100 zloty that young master could give not always on
the average, then it was sometimes allowed to produce her in a year after
examinations. Non-fulfillment before a workshop was punished new master of this
duty by a fine to 5 pound of beeswax (a circle is 20 zloty).
The barbers - "partachi" worked on all small towns of Ukraine. On estates
squires had the barbers from serfs, that was given in science to the doctors or to the
municipal barbers.
One of the most widespread methods of treatment that used large popularity
among an urban and rural population, there was bloodletting. It was widely
practiced by barbers in workshops, bath-houses and on houses. Didichi before the
beginning of the spring field works ordered to do bloodletting to the serfs, to
release them from the winter "worked" blood. Considered that bloodletting
strengthened durability and capacity.
Barbers, serving great masses of urban and rural population, being close to
them the world view, presented basic shots that treated our people during many
centuries. In course of time, after the reunion of Ukraine with Russia, on cities and
districts it was the first governmental doctors to conduct from barbers large fight,
to subordinate their work to the control. Actually workshop medicine on Ukraine
lost the influence only in the second half of the XIX - th century
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Control questions:
1. Brotherhoods of Ukraine .
2. Types of medicare of the Zaporizhzhya Cossacks.
3. Curative establishments in Zaporizhzhya Sich.
4. Origin of curative measures in Zaporizhzhya Sich.
5. Founding of Cossack hospitals.
Tests :
1. Brotherhood organized a hospital in 1522:
a) in Kiev;
b) in Lutsk ;
c) at Onufriev monastery ;
d) in cities.
2. In what year was organized Kyiv Brotherhood ?
a) 1890 ;
b) 1777 ;
c) 1615 ;
d) 1522.
4. Who provided medical care into Sich :
a) doctors ;
b) monks ;
c) cossacks ;
d) barbers
5. Was on a regular service a qualified doctor in the army of Cossacks?
a) No, even after the reunification of Ukraine with Russia;
b) Yes, after the reunification of Ukraine with Russia;
c).It was always ;
d) there was not a doctor, but Cossack.
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UNIT 14: "UKRAINIAN PHARMACY IN THE XX –TH СENТURY.
PROSPECTS OF THE NATIONAL PHARMACY’S
DEVELOPMENT "
Aim of the lesson : to systematize knowledge about history of development
of pharmacy in
Ukraine, to learn the general lines of Ukrainian pharmacy to distinguish the
personal touches of development of pharm.business in Ukraine.
In 1913 1067 pharmacies (714 rural and 353 municipal) from that only 43
belonged to the zemstvos functioned on Ukraine, and 1024 to the sole owners.
After proclamation of soviet power in Ukraine (December 1917) the
program of health protection that was based on the transmission of curative and
pharm.establishments in property of the state came true. The process of
nationalization on Ukraine had the personal touches that related to strong not
enough position of Soviet power in a republic. Announcement on December, 28
1918 Soviet People Commitee of RSFSR decree "About nationalization of
pharmacies" of post factum legalized public domain on pharmacies that were
passed in the conduct of People Commitee of health. For example RSFSR, Soviet
People Commitee on 17 of May, 1919 accepted a decree " About nationalization of
pharmaceutical cases in Ukraine". Characteristically, that a "leninist" decree about
nationalization of pharmacies in Ukraine was accepted several times, that is
explained by the specific of local terms and strong not enough position of Soviet
power in a republic. In connection with the repeated encroachment of Denikin
troops in Ukraine (August 1919) new power renewed the ancient regimes. Medical
and pharm. establishments returned to the sole owners. With strengthening of
soviet positions in Ukraine a course recommenced on general nationalization of
pharmacies.
On 14th of March, 1920 SPC of Ukraine accepted the second decree "About
nationalization of pharm.business", in that except the transmission of all
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pharmacies in property of the state the private trading was forbidden medications
with the aim of fight against speculation. Till June 1920 all Ukrainian pharmacies
were nationalized, here their amount diminished to 660. Some proprietors gave
advantage to elimination of pharmacy, than to pass it in property of the state.
In this period the medical providing of population was extremely
insufficient. Instead of trading in medications the system operated them the
centralized distribution on the basis of the ratified coefficients. At PCH of Ukraine
central pharm.composition was organized, where medications had to come. But as
a result of absence of domestic industry and outwardly-economic connections, was
not the receipt. In February of 1920 there was published decree, that obligated sole
owners to hand over in the bureau of laying-in of the private supplies of
medications, knitted materials and articles of supervision upon patients. But the
common amount of procured did not cover the half of their necessities such
unconventional method of medica-militiamen. Near-term was providing of army
medications.
The process of distribution of medications among a population passed
difficult enough. Central pharm.composition periodically distributed medications
between the province departments of health protection, and those, in turn, between
district subdepartments of health protection. Yes, the medical property got after
assessment practically was fully used by province cities, and only his insignificant
part came in district cities. A village got nothing in general.
In spring 1921 Moscow government declared passing to the New economic
policy, but on territory of Ukraine the orders of "military communism" were not
liquidated. The exception of food from a population (so-called food assessment)
drove to 1921-1922 to the mass diseases on soil of chronic malnutrition and to
distribution of epidemics. Realizing the potential danger of distribution of
epidemics the European states that situationed near Ukraine, and international
organizations began supplying with medications on Ukraine from the second half
of 1921through Moscow, and starting from March 1922- directly in Ukraine. A
help was stopped in summer 1923.
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As a result of absence of external economic connections and inactivity of
domestic pharmaceutical industry, receipt of medications on Central
pharm.composition was absent. The purveyance of medications and bandaging
materials was conducted due to a force exception of supplies. From the second half
of 1921 began to come in Ukraine medications from international organizations.
Instead of trading in medications with their centralized distribution system
operated on the basis of the ratified coefficients.
A free medical help to the population of Ukraine was rendered by the
pharmacies of therapeutic establishments.
With the aim of the use of private supplies of medications and improvement
of material base of pharmacies on the May 5-th,1922 People Committee of health
protection permitted on the temporal transmission of some pharmacies in a lease to
the private persons. 9 pharmacies were passed in all on Ukraine. Action of this law
in 1924 was stopped. From the 1st June, of 1922 pharmacies began to be
transformed on self-supporting basis. Medications began to be released free of
charge for medicare in hospitals and policlinics and for a pay for treatment at
home.
Since 1933 1322 pharmacies were counted: (75,5 - in cities and (24,5 in the
villages of Ukraine. In 1935 was conducted classification of pharmacies on 5
groups: self-supporting pharmacies, factories of medications, pharmacy
distributors, pharmacies at TPE, pharmacies- bases.At the beginning of 1935
pharmaceutical points were open at rural therapeutic establishments. In the end of
1935 2670 pharmaceutical points operated in UKRAINE.
In accordance with Resolution of People Committee of the USSR "About
trading in medications" from 02.07.1935 and to analogical Resolution of Ukraine
government from 01.09.35 almost all pharmacies were liquidated curatively prophylactic establishments, and left from them lost independence and right on
trading in medications. In addition, with the aim of approaching of medical help to
the population, from 1935 pharmaceutical points began to be opened at rural
curative establishments. In 1938 by chemist management were passed pharmacies
172
of departments of working medicine. From January of 1939 by chemist
management was also passed pharm.network of society of Red Cross. Majority
from them were transformed on self-supporting basis, other - reorganized in
pharmacies at TPE. The number of pharmacies in the conduct of chemist
management increased: in 1938- on 236, in 1939 - on 455. In 1940 2419
pharmacies (in 1936- 1115 pharmacies) and 5360 pharmaceutical points worked in
Ukraine.
Financial position of pharmacies was difficult, that is explained:
а) of law payment of population;
б) by creation of supplies of medications in case of war;
For fulfiling the plan of commodity turnover through chemist management
the commodities of folk consumption, distant from a medical assortment, were
realized.
In 1930 the Ukrainian institute of experimental pharmacy was opened. On
initiative the scientists of institute for upgrading of medications there was the
unfolded network control - analytical laboratories that increased for period of 1931
- 1939 from 11 to 30.
In November 1941, in comparing to the pre-war period, in the USSR made
only 8,4% of doctor facilities, 44% of surgical instruments, 77% of dressing
materials. At the beginning from December of 1941 on Ural, in Western Siberia, to
Middle Asia the so-called east group of enterprises of medical industry was
organized. In the Great Civilian War-time medical and pharm.property, and also
chemist management of Ukraine were evacuated from the occupied territory.
The use of resources of medicinal facilities was strictly regulated: combat
hospitals were in the first turn provided, the necessities of other medical
establishments were then provided, for free realization to the population
medications did not come practically.
In times of Ukraine occupation by fascist troops it was destroyed and
destroyed 1834 pharmacies (75% of their pre-war amount), 5360 pharm.points
173
(100 almost all galena-packing and control-analytical laboratories, it remained only
13 pharmacists.
The revival of pharmacies on Ukraine began right after a release from
invaders. Already in February of 1943, after liberation of the first districts of
Luhansk and Kharkiv areas, the first pharmacies were opened. On the 1st of
July,1945 in Ukraine worked 1701 pharmacy and 2707 pharm.points ( accordingly
69% and 50% of pre-war amounts). The counters of these pharmacies misbehaved
however. Pharmacy of Ukraine was even more than before war dependent
deliveries from Russia and other republics of the USSR. These deliveries are only
on 15- 30% supplied necessities of Ukraine.
The sharp lack of medications in post-war years was compensated mainly
due to receipt of humanitarian help from the allies of the USSR from AntiHitler
coalition.
The pharmaceutical network of Ukraine was renewed to the end of 40 - th
years: in the end of 1946 renewed work of 86% of pre-war amount of pharmacies,
commodity turnover was fulfiled the plan on 13% butе in 1948, acquisition of
medications to the populations diminished as a result of money reform. With the
aim of implementation of annual plan, there were the liquidated limitations at
distributions.
For the improvement of guidance by a rural pharmaceutical network in 1958
on Ukraine, districting of pharmaceutical network began to be conducted.
It was consisted in transforming of pharmacy that is in a district center, in
CРА status, that the rural pharmacies of this district submitted.
At the end of 60 - th years on Ukraine was only 14,3% of enterprises of
medical industry of the USSR, bulk of medications it was needed to bring in from
limits a republic. Through the unsatisfactory state material-technical base of
enterprises technology of production that resulted in worsening of quality of
products was violated.
The requirements of Ukraine in medications were recovered due to an
import. So in 1966 in the pharmacies of Ukraine 800 names of medications came
174
from the Ukrainian producers, 2300 - from other allied republics and 100 names
after an import. Farther the dynamics of import headily grew: in 1968- 180 names,
there are 350 names in 1976; for the decade (1968 - 1978) of receipt of the
imported products in pharmacies increased in 5 times. In 1980 are those years the
imported deliveries became more large yet.
According to social politics of government, 45years were released to the
population free of charge, the favourable categories of population had a discount to
80 % it more sharpened the problem of deficit yet.
Cardinal political, economic changes at the beginning of 90-th that were
related to disintegration of the USSR, worsened the medical providing of Ukraine
and appeared reason of crisis of pharmaceutical industry. It took place as a result of
violation of economic connections with enterprises that were outside Ukraine: the
supply of the prepared medicinal facilities and raw material diminished for
Ukrainian pharmaceutical industry.
In addition the existed problem of crisis of material and technical base of
industrial enterprises and its disparity to the international standards became sharp
to that.
With the acceptance of market laws in industry the process of
demonopolization and translation of public domain began in other types of
property. These processes purchased different directions: part of pharmacies
passed to community property of cities, the collectives of other pharmacies leased
the pharmacies, some pharmacies stepped back in the submission of TPE. At the
same time intensive penetration began in the sphere of pharmacy of business
corporations. The Uncompetitiveness of state pharmacies in comparing to private
was explained:
1) by overstocked with goods of law demand products;
2) by absences of free choice of suppliers;
3) by absences of the personal interest in the end-point of work and other
The amount of business pharmaceutical corporations grew headily, due to
the flexible pricing and organization of own small retail network.
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The Law of Ukraine "On medicinal facilities", accepted by Parliament of
Ukraine on the 4th of April 1996 became a basic legal document that confirmed
changes in domestic industry.
By the special organ of State control of quality of medicinal facilities the
State inspection was appointed on control of quality of medicinal facilities of МPH
of Ukraine. In obedience to Resolution of Cabinet of Ministers of Ukraine № 707
from 07.07.97 on the base of property liquidated for "Pharmacy" formed the State
stock association "Medications of Ukraine".
With the aim of providing of legality and stability of activity of
pharmaceutical industry on recommendation of WPOH worked out and the
government program of providing of population medicinal facilities was regenerate
in an action; she takes into account interests of all parties concerned of
pharmaceutical market (producers, regulative organs and consumers), has complex
approach and guarantees: availability, quality and rational use of medicinal
facilities.
A program aim is an improvement of health of population by providing of
him by effective, safe and quality medicinal facilities. The basic tasks of the
program are providing:
1. access of population to effective, safe and quality medicinal facilities ;
2. quality of medicinal facilities and pharmaceutical services;
3. rational use of medicinal facilities.
1) Access of population to effective, safe and quality medicinal facilities is
based on:
conceptions of the fixed medicinal assets selection to National List of basic
vitally - necessary medicinal facilities and wares of the medical setting, and also
decline of their cost;
- development of List of medicinal facilities, that is formed by МPH on the
basis of standards of treatment;
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- purchases on tender basis of medicinal facilities for medical and preventive
establishments according to List, rational use of medicinal facilities based on
principles with application of pharmaco-еconomical analysis;
- purchases of medicinal facilities due to the state and local budget, funds of
medical insurance, facilities of enterprises;
- priority of the state financing of purchase of medicinal facilities for
treatment cardiovascular, oncologic, infectious diseases(tuberculosis, AIDS),
psychical, chronic diseases (diabetes mellitus, bronchial asthma), and also for the
vaccination of population;
- to the presence (necessity) of obligatory assortment of medicinal facilities
in a pharm.network;
- providing of equal terms for functioning of pharm.establishments,
regardless of patterns of ownership and submission;
- introduction of the state system of registration of prices on medicinal
facilities according to corresponding List.
2) Providing of proper quality of medicinal facilities requires introduction
of next measures :
- introduction of productive practice : laboratory(GLP), clinical(GCP),
productive(GMP), distributive(GDP);
-government control of turnover of medicinal facilities : of creation,
production, control of quality, import to Ukraine and export, and also realization of
medicinal facilities, that carries out national Inspection from control of medicinal
facilities ;
-an improvement of the system of registration of medicinal facilities by
strengthening of requirements to the registration documents and procedure of
registration in accordance with recommendations of WPOH and EU;
-licensing and inspection of subjects of national economy, that do, will
import, will export and will realize medicinal facilities;
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-realization together with other countries, international organizations and
WPOH of the great scale operating under an exposure and exception of the
falsifyed series of medicinal facilities;
3) For the rational use of medicinal facilities it is necessary:
- to inculcate in medical and preventive establishments the formulars worked
out on the basis of standards of treatment, ratified WPOH ;
- annually to investigate and analyse the use of medicinal facilities ;
- to give to the medical, pharmaceutical workers and population objective
information about medicinal facilities.
The development of science and practice in Ukraine.
Due to scientific system, the science’s establishment that is organized and
funded in a sovereign state in the transition to a market economy and democratic
principles of management was slow. The reasons were, above all, in a deep
economic crisis, which in a relatively short time of New Ukraine’s existence led to
economic losses. The reason for the negative processes that accompanied the
transformation of the national research system was its poor preparedness to the
radical transformation of society and the introduction of new functional
mechanisms. However, despite these reasons, Ukrainian science was able to keep a
full structure according to sectoral division (academic, industrial, university and
factory sectors of science), inherited from the Soviet Union.
The State Agency on Science, Innovations and Informatization of Ukraine ,takes
the Organization of science in Ukraine which defines , together with academic
institutions direction of scientific research and their use in the economy. State
Agency submits the plans of science to the Government or the Parliament of
Ukraine for approval and securing financing from the state budget or other sources.
The state system of organization and research’s management in Ukraine
makes an opportunity to concentrate and to focus on the science performance of
the most important tasks. Management of research activities is based on the
territorial-branch principle. Today research work is governed by:
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• research and design institutions and centers of the Academy of Sciences of
Ukraine(NASU);
• scientific production, research, design organizations, systems of Academy’s
branches;
• research and design institutions and centers of ministries and departments;
• Research institutions and departments of higher educational institutions;
• research and production , design institutions and centers in industry, unions;
The highest state scientific center is the National Academy of Sciences of
Ukraine. It together with the State Agency on Science, Innovations and
Informatization of Ukraine head and coordinate fundamental and applied research
in various fields of science. NAS is a public research institution that unites all areas
of science and maintains international links with research centers in other
countries. Academy of Sciences of Ukraine incorporates separation of the relevant
areas of science, including mathematics, information science, mechanics, physics
and astronomy, earth sciences , chemistry , general biology , economics , history,
philosophy , literature , languages, art etc.
The structure of the National Academy of Sciences consists of academic
institutions from relevant branches which are territorial divisions (Donetsk,
Western , Southern , and others) and territorial branches .
Phased entry of Ukraine into the European Union is connected with a
number of requirements. In particular, one of the priorities of the EU integration is
the harmonization of the legal framework of Ukraine, adapted to the standards and
conditions in accordance with GMP, GDP and GPP EU. The second chapter GMP
ES (Good Manufacturing Practice for Medicinal Products ES) is fully dedicated to
the staff , where the basic principles and general requirements for individual
workers and professional groups are clearly defined. Separately emphasized that
each collaborator must clearly understand the personal responsibility that should be
documented. All personnel must take initial and permanent further training in
accordance with his duties, occupation and job characteristics.
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The pharmaceutical industry is a specific field of activity, the quality of which
depends on the staff his professional knowledge and skills. All this research has
identified the need to justify the development of organizational and methodological
components of modern management techniques, training, retraining , improvement
and certification of the pharmaceutical industry enterprises’ personnel ,
harmonized with the standards and norms of GMP, GDP and GPP EU.
Tasks, responsibilities necessary professional level and qualification
requirements for personnel are determined by qualification characteristics of the
employee’s position and individual professional groups that are legal basis for the
removal of outdated and inclusion in the State Classifier DK 003-95 newly created
professions, jobs.
Training of pharmaceutical personnel in Ukraine have the following
qualification levels and trends:
- Junior Specialists – Training is conducted in medical schools of High
Educational Establishment of accreditation and specialized education in the field
of: "pharmacy" "production of medicines ", " analytical quality control of
medicinal chemical compounds" . Junior Specialists can work as a pharmacist in
manufacturing drugs in the pharmacy, a pharmacist from distribution of drugs and
medical devices ,the head of the 1- st group or pharmacy’s affiliate, a pharmacist
of storehouse, a laboratory assistant of control and analytical laboratories, and so
on.
- Bachelors - can work as adrugstore’s pharmacist, a pharmacist of
storehouse, a pharmacist of pharmaceutical industry, a pharmacists of control and
analytical laboratories. Bachelors cannot hold the head positions .
Specialists – training is conducted at the pharmaceutical faculties of high
educational establishments of III-IV accreditation levels. Specialists-pharmacists
can work as different hierarchical levels in control and analytical laboratories,
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pharmaceutical information offices, the shops of medical equipment, on
pharmaceutical bases, in pharmaceutical companies, etc.
- Masters -the study is conducted at the pharmaceutical faculties educational
establishments of IV level accreditation. The training of Master of Pharmacy is
carried out in conjunction with their study in internship. Masters have the right to
work as scientific collaborators, lecturers, consultants and advisers.
The person who got the "pharmacist" or "pharmaceutical chemist" specialty
is not in Ukraine, can’t work in its territory according to the specialty. The
procedure for admission to pharmaceutical activities such experts are detected in
the order of the Ministry of Health of Ukraine № 118- C from the 19-th of August
in 1994."Procedure for admission to medical and pharmaceutical activity in
Ukraine citizens who had a medical or pharmaceutical training in foreign
countries’ establishments” was adopted by pointed order.
According to this document, the citizens of Ukraine who have been trained
in medical or pharmaceutical establishments abroad may be admitted to the
medical and pharmaceutical activity in Ukraine :
- Doctors and pharmacists - with the permission of the Ministry of Health of
Ukraine ;
- Junior medical and pharmaceutical workers with the permission of the regional
health administrations (municipal ) councils of local government.To work as a
pharmacist are allowed:
- persons who have been trained in high educational establishments of
pharmaceutical profile outside the CIS with training at least 4.5 years with
qualification of “pharmacist”, doctor or master of pharmacy or other equivalent
degree and they have the right to engage in pharmaceutical chemist’s practice
independently;
- persons who trained at higher pharmaceutical educational institutions
(departments) in the CIS up to 1992 or after 1992 and had a one-year internship
with the status of general practice pharmacist.
To work as a pharmacist are allowed:
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♦ people who were trained at the high pharmaceutical institution in the CIS up to
1992 or had an experience in a specialty or persons who underwent 3 -month
postgraduate training later and had the right to self-activity in the specialty;
♦ persons who were trained at pharmaceutical educational institutions with
the period of training not less than 2 years and received a diploma with
qualification of pharmacist, assistant pharmacist , assistant of pharmaceutical
chemist or other equivalent degree, as well as those who had been trained at the
high pharmaceutical institution ( faculty ) or trained in the amount of full 4 courses
(8 semesters).
The list of documents required for granting permission:
♦ a statement in the prescribed form ;
♦ information about the job in specialty ;
♦ notarially certified copies of the original curriculum with the seal of an
educational institution in which the applicant studied , with a translation into
Ukrainian language courses and a list indicating the number of hours of training for
each discipline (for people who have a medical or pharmaceutical training in
educational institutions of foreign countries, except CIS countries) ;
♦ copy of educational diploma, legalized in accordance with applicable law
(it is recognized only the persons’ diplomas who have been trained in schools
officially recognized by the government of the country as pharmaceutical
institutions).
Legalization - is to provide legally binding of documents that were issued in
a foreign country. These documents must be notarized at the place of issue and
translated into Ukrainian language and legalized by the Consulate of Ukraine.
These documents may also be certified by the Embassy of the State of Ukraine and
legalized by the Ministry of Foreign Affairs of Ukraine. You do not need
legalization of documents issued in countries - members of CIS, as well as
Albania, Algeria, Bulgaria, Hungary , Vietnam, Korea, Cuba, Mongolia, Romania,
Poland , Czech Republic, Slovakia and countries that formed the former
Yugoslavia. The correctness of translation from foreign language to Ukrainian is
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notarized .For people who have a medical or pharmaceutical training in
educational institutions of foreign countries except CIS countries, the basis for the
issuance of an expert is the committee set up under the Central methodical study of
higher medical education in the Ministry of Health of Ukraine, which determines
the compliance of the applicant's implementation of the curriculum to the state
standards applicable training in institutions of high medical education of MHS
accreditation of Ukraine . It is not less than 75% of professionally oriented
disciplines must coincide on the list and the amount of hours which are operated in
Ukrainian curricula.
If you find implementation’s discrepancies of the applicant’s curriculum
more than 25% of the national training’s standards of high medical educational
establishments I-IV accreditation levels of MHS of Ukraine the Commission
determines necessary additional training period for the applicant in the relevant
educational institutions of MHS of Ukraine by the applicant’s account.
An admission is done by issuing a certificate in the prescribed form, and
certification isn’t a proof of education, but it only gives the permission to engage in
pharmaceutical activities. If the break in the specialty is more than 3 years for
persons with high pharmaceutical education at the time of consideration of the
issuance of occupation certificate for pharmaceutical activities, the certificate is
issued
after the person’s passing probation period and getting a pharmacist
specialist’s certificate.
Postgraduate education of pharmacists: includes internship’s training, cyclic
training in institutes or improving pharmacists’ faculties, course of information and
probation period. Internship is an initial stage of pharmacists’ postgraduate
education, which is carried out due to the individual plan for a typical curriculum
of postgraduate training. The training in internship is divided into 2 parts: part-time
and full-time.
Attestation of pharmacists. Attestation of pharmacists is carried out with
the aim of the professional mastership’s increase , responsibility of the
performance and quality of work, is an important form of moral and material
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incentives aimed at improvement of pharmacies (companies ) of all forms of
property involved in the pharmaceutical business.
The main task of attestation is to determine the level of pharmacists’ training and
improve their qualification.
There are the following types of attestation:
♦ attestation on the determination of the level of knowledge and practical skills
with assignment (confirmation )of specialty " pharmaceutical chemist- specialist ";
♦ attestation of qualification for the assignment category;
♦ attestation of qualification category’s confirmation.
Attestation on the determination of the level of knowledge and practical skills with
the assignment (confirmation ) of specialty " pharmaceutical chemist- specialist"is
made by commissions created at high medical and pharmaceutical educational
establishments of III-IV accreditation levels and educational establishment of
postgraduate education , conducting pharmacists’ training and re-training .
Attestation of the assignment (confirmation) of qualification categories are
conducted by commissions established under the Ministry of Health of Ukraine
(Central Examination Board), State Inspectorate of Medicines’ Control Quality in
the Autonomous Republic of Crimea, Kyiv and Sevastopol (the attestation
Commissions).
Attestation Commission of State Inspectorate of Medicines’ Control Quality
in the Autonomous Republic of Crimea, Kyiv and Sevastopol carry out the
attestation of pharmacists working in pharmaceutical establishments (factories) all
forms of property involved in pharmaceutical activities in the region.
Pharmaceutical chemists who work in pharmaceutical establishments
(plants), subordinated to the departments that do not have their attestation
commissions are certified in compliance with the requirements of this Regulation
in the Attestation Commission of the Ministry of Health of Ukraine at the location.
Control questions:
1. Pharm.business in the first years of Soviet power.
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2. Proceeding in market relations on Ukraine.
3. Pharmacy of soviet Ukraine in 30-th.
4. Pharm.business in the period of great patriotic war.
5. Proceeding in the destroyed pharm. network
6. Opening of the first free pharmacy.
7. Pharm. service of Ukraine in 1950 - 1980 years.
8. Government program of providing of population medicinal facilities.
9. Pharmacy of Ukraine in 90th of XX th century.
10. Prospects of development of national pharmacy.
Tests :
1. The decree "On the nationalization of pharmacies " was adopted in Ukraine :
a) May the 17th, 1919
b) March the 14th, 1920
c) twice.
2. The decree "On the nationalization of pharmacies " in Ukraine from 14.03.1920
regulated :
a) the transformation of pharmacies in the state’s ownership;
b) the transmission of medical facilities to the state’s ownership ;
c) prohibited private trade of medicines ;
d) all above mentioned .
3. The sources of medicines’accession to the Central Drug pharmacy warehouse in
NKZ (up to 1921) were:
a) abroad distributors ;
b) domestic products ;
c) supplies of medicines.
4. During the Civil War the population received medications from:
a) self-supporting pharmacies ;
b) private pharmacies ;
c) pharmacies of hospitals .
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5. CPC Regulation "On trade of medicines " considers:
a) TPE pharmacies’ transformation into the order of pharmacies’ management;
b) TPE pharmacies’ transformation to self-supporting pharmacies’ supply ;
c) opening of the pharmacies ;
d) all above mentioned .
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UNIT 15 : "PHARMACEUTICAL INDUSTRY OF UKRAINE"
Aim of the lesson : to master the features of pharmaceutical industry’s
development of Ukraine, to distinguish and generalize the stages of its
development.
The first enterprises of off-farm were chemist courts. With organization of the
Chemist order (1581) a court ("old") began to function, and in 1670 it was built
"new". Courts conducted the purveyance of medicinal herbares, their growing
shallow, drying and storage. From medical forms made plaster, ointments, oils,
extracts, syrups, juices, tinctures. Distillation of essential oils and receipt of
alcohols was also conducted.
Rapid development of pharm. business in the XVIII - th assisted not only
expansion of pharm. network but also change of functions of pharmacies:
pharmacies become research, chemical and productive laboratories.
The first large pharmacy of productive type on Ukraine became Lubnensk
pharmacy that was opened in 1720 in Poltava province. It was the center of
purveyance of medications, mainly phytogenous. Except providing of the
Ukrainian population, Lubnensk pharmacy provided the pharmacies of Moscow.
In the first half of XIX – th century a pharmaceutical production,was developed
enough already, was concentrated in a pharmacy. At every pharmacy there were
the equipped laboratories for preparation of galena preparations, receipt of
essential oils, aromatic waters and salts. During the first half of the XIX – th
century pharmacies kept the profile of difficult pharmaceutical enterprise that
functioned on principle of self-service. As at that time there yet was not
pharmaceutical industry, it is possible to draw conclusion that in pharmacies
medicinal facilities prepared not only for compounding distribution and small retail
sale but also for wholesale to trade.
Terms for development of chemical and pharmaceutical industry of Galychina
were more favourable. In 1900 was created a firm "Petro Мikolyash and
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Company", that set partner relationships with such known European enterprises, as
"Shering", "Bayer" and "Lya Rosh". All of them allowed in 1910 to distinguish
one of subdivisions of firm in a separate enterprise "Lаокооn"("Galichpharm" is
adopted in future). Chemico - pharmaceutical industry of those regions of Ukraine
that entered in the complement of Russian Empire, developed slowly enough, and
on that there was a row of the reasons predefined long before birth of industry.
Firstly, a pharm. production in Russia submitted to the dead letters accepted yet at
Petro I. Secondly, chemical industry on the base of that would develop
pharmenterprises was practically absent in agrarian Russia. A pharmaceutical
market was filled with the imported products (to 90% and it quite a bit was assisted
by customs tariffs.
Yes, a duty on the prepared medicinal facilities was tenfold less than, than
duty is on raw material necessary for their making.
On beginning of First World War the supply of medications ceased from
Germany, and war that began pranged the traditional channels of supplies of
medications finally. Trying though as to compensate the catastrophic shortage of
medications, a government accepted the row of resolutions a stimulant
development of industry, in particular, existent prohibitions were anniented on
private pharmaceutical activity.
In January of 1918 nationalization of pharmaceutical industry began in
Ukraine. In 20-th years began the intensive opening of large enterprises and for 3
years producing of products increased more than in 5 times. It was succeeded to
extend the assortment of products and put right the production of medicinal
preparations that was not produced in tsar's Russia (iodine, barbiturates, insulin,
and аnaesthesine, to amidopyrine). A large role in becoming of Ukrainian pharm.
industry was played Ukrainian institute of experimental pharmacy was created in
1920.
Yet from middle of 20th the fate of private production was maximally brief,
and making of medications in a country passed exceptionally within the framework
of government order. But the requirements of population in medications were
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satisfied only on 58 formation of the national system of medical insurance also will
improve and will put in order the existent market of pharmaceutical industry, will
consolidate the producers of pharmaceutical products, and also wholesale and retail
link in a medium-term period.
The primary macroeconomic purpose of next years that the Ukrainian
pharmaceutical companies put before itself is a height of collaboration of the
Ukrainian producers of pharmaceutical products with the producers of analogical
products of countries of EU. Collaboration can come true as joint ventures,
alliances, general marketing and advancement of products, transfer to preparations
without recipes in Ukraine. Basic motivation of this transfer will be not penetration
to the market of Ukraine, but export to the markets of Western, Central and East
Europe.
The modern pharmaceutical industry of Ukraine includes:
• production of medicines and medical devices
• wholesale and retail trade
• specialized storage and distribution ( distribution) by means of an established
network ( pharmacy , drugstore items , etc.)
The pharmaceutical industry in developed countries is one of the most dynamic
and profitable, but at the same time serving as a special segment of the market,
regulated by state authorities as well as controlled by insurance medicine. In recent
years, pharmacy has been integrating with medical services.
The pharmaceutical industry has a significant place in the economy of Ukraine as
an important segment of the national market in many ways it determines the
national security and defense of the country, it differs by a large scientific basis
and a developed cooperation. Over the past five years, industry has demonstrated a
strong tendency to the grow in terms of money at 20% per year. If in 2006-2007
years was considered a great achievement to get closer to the market volume of $ 2
billion USD, then in 2011 the market volume exceeded 4 billion USD.
Ukrainian pharmaceutical industry produces approximately 1,700 products
where 12,000 are sold in Ukraine. Ukraine Pharmaceutical companies produce
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medicines in almost of all forms (solid, liquid, powder, etc.). The main groups are
cardiovascular drugs, analgesics, vitamins, remedies for the treatment of
respiratory and endocrine system, gastrointestinal tract, and antibiotics.
Pharmaceutical substances in Ukraine are produced by 49 registered businesses
where 76 substances are of synthetic origin , 82 are natural. Substances of domestic
production account for only 25% of the total, the rest are imported from China,
Germany, India, Russia and the United States.
In the pharmaceutical products’ market today is presented more than 500 producers
from foreign countries, CIS and Baltic countries as well as 180 domestic
manufacturers, among which 22 enterprises engaged in the production of
medicines in the days of the Soviet Union.
Ukrainian pharmaceutical companies try to diversify their portfolio to meet the
needs of customers, each year improving the quality and range of products. One of
the major factors in the development of pharmaceutical market growth is the
general purchasing power of the population. According to experts, the market has
an increasing tendency toward more expensive drugs and as a rule more effective
drugs by reducing the segment of cheap classic preparations.
There are also subjective reasons for the expensive drugs’ increase: the
buyer, as in other areas of consumption follows the fashion trends. Often it turns
out that people only pay for new packaging and brand.
Now, many Ukrainian companies re-oriented from generics to establish their
own brands in order to increase its market share and increase customers’ loyalty.
.In the group of leading domestic manufacturers of medicines (monthly
output more than 16.4 million USD - 2,000,000 USD) are JSC "FF Darnitsya"
Corporation" Arteryum» (LLC «Kyivmedpreparat" and JSC "Halychpharm ) of
"SC Health I" JSC SPC " Borshchahiv CPP ", PJSC " Pharmak ".
Each of these giants of the pharmaceutical industry holds about 15 % of
domestic drugs’ market. Next, the group more than three dozen companies is
located, each of which takes from 1% to a few percent of the market. Among them
are CJSC “Indar”, PJSC “Kyiv Vitamin Factory”, LLC “Stirolbyopharm " and
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others. The third group includes more than a hundred companies that produce only
1-2 drugs, the most simple and cheap to manufacture: iodine, Brilliant green,
hydrogen peroxide.
Annual growth of Ukrainian pharmaceutical market is about 20% for several
years. Today on the market from registered medicinal products is 32% - of
Ukrainian origin, others are foreign .
In financial terms, imported drugs occupy about 75 % of the market, 25%
are domestic. According to the packaging is on the contrary: Ukrainian products
are 70%, import are 30%.
Experts predict that in the coming years the drugs’ segment value from 3 to
5 USD will develop rapidly, and consumption of drugs worth up to USD 1 will be
significantly reduced. Although cheap medicines will still demand a particular
group of people.
In addition, the so-called hospital consumption of medicines (in state public
hospitals) is characterized by consumption of cheaper drugs.
Today hospital procurement is accounted about 16% of the pharmaceutical market
in Ukraine, and 12 % of the market is to the direct procurement. The rest part retail
pharmacy is occupied. Here, according to research, 55% of sold drugs are
prescription drugs, and 45 % which are remained as unprescribed ones.
Today, about a quarter of drugs consumed in Ukraine are made by domestic
manufacturers, and others - are imported.
The current situation in the pharmaceutical market of Ukraine can be a
powerful incentive for branch’s restructuring, it increases a competition and the
transition to EU technical standards. As a result, we can expect some reduction in
the number of pharmaceutical enterprises in Ukraine.
Those companies that restructured and survived in the competition
successfully are able to compete in international markets.
Formation of a national health insurance system will improve and order the current
market of pharmaceutical industry consolidates pharmaceutical manufacturers and
wholesale and retail sectors in the medium term.
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The main macroeconomic goal of these years that Ukrainian pharmaceutical
companies set by themselves, is growing a cooperation between Ukrainian
pharmaceutical manufacturers of similar products in the EU. Cooperation can be
made in the form of joint ventures, alliances, joint marketing and promotion,
transfer drugs, which haven’t got a prescription in Ukraine. The main motivations
of such transfer will not the penetration to the Ukraine’s market and export to the
markets of Western, Central and Eastern Europe.
Export motivation of multinational corporations in establishing production
in Ukraine will preserve scientific basis to be restructured according to the new
market’s trends.
Saving a scientific base, creating advanced and specialized determinants of
competitive advantage in the state, as well as attracting foreign investment for the
pharmaceutical industry - all this creates a foundation for long-term competitive
advantage and contributes to the reorientation of exports of Ukrainian enterprises
markets of transition countries in Western, Central and Eastern Europe, improving
their competitiveness.
Furthermore, harmonization of the basic technical requirements with the
European Union can simultaneously serve as a measure to protect the Ukrainian
producer of pharmaceutical products from competition with low-quality
pharmaceutical products.
Control questions:
1. Value of chemist courts, as the first industrial enterprises.
2. Pharmacies of productive type.
3. A pharmaceutical market of Ukraine on the border of the XX – th century.
4. Pharmaceutical industry in the first years of Soviet power.
5. Pharmaceutical industry in a pre-war period.
6. Proceeding in a pharmaceutical production in a post-war period.
7. The state of Ukrainian pharm. industry in 60-80th of XX – th century.
8. A crisis of pharmaceutical industry in 90-th.
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9. Requirements of accordance of material and technical base of pharm.
enterprises to the international standards.
10. Modern state of pharmaceutical industry of Ukraine and prospect of its
development.
11.Giving of certificate of Proper practice of distribution.
Tests :
1. The first type of industrial enterprises were:
a) pharmaceutical yards ;
b). pharmacies;
c) hospitals;
d) brotherhoods.
2. What changes in the functions of pharmacies were introduced in the XVIII - th
century.
a) a function of the drugs’ quality control;
b) a function of the first aid;
c) pharmacies become research , chemical and industrial laboratories;
d) enterprises.
3. In 1900 in Galicia industrial enterprise was established :
a) Firm "Peter Mykolyash and Company ";
b) Enterprise " Schering ";
c) Enterprise " Bayer ";
d) enterprise " Galychpharm ."
4. Plants from the production of artificial medicinal mineral waters occured :
a) in the early of the XIX - th century.
b) In the second half of the XIX - th century.
c) At the beginning of the XX - th century .
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UNIT 16: "PHARMACY ABROAD"
Aim of the lesson : familiarize with principles of organization of medical
help in separate foreign countries; to understand a value of foreign experience for
modern Ukrainian pharmacy.
Cardinal political and economic changes that happened at the beginning of
90 - th years on Ukraine entailed and changes in industry of pharmacy. Using
experience of development of pharmacy of other countries, in industry market laws
were set and the process of demonopolization and translation of pharm. enterprises
began from property of the state in other patterns of ownership. Part of pharmacies
passed to community property of cities. The collectives of some pharmacies leased
the pharmacies; in addition, intensive penetration began in the sphere of pharmacy
of private business corporations.
At once the uncompetitiveness of pharmacies of state pattern of ownership
appeared in comparing to own.
1) by absence of overstocked with goods of law demand products;
2) by possibilities of free choice of supplier;
3) by the material personal interest in the end-point of work.
Thus, according to the laws of market, amount of business pharmaceutical
corporations on Ukraine headily tall due to the flexible pricing and organization of
own small retail network.
The development of health protection - one of major tasks of
contemporaneity that promotes all to greater distribution and development of
pharmacy in all states of the world. Every country has the features of decision of
pharmaceutical question that is why if to even the pharmaceutical structure of
Ukraine with other countries, it is possible to find mass general and excellent.
The medical providing abroad has three directions: state, private and
insurance providing of population. In some countries these directions unite inter se,
as for example in the USA, the private and insurance providing takes place. The
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obligatory system of state social security is entered in many countries of Western
Europe (Denmark, Sweden). At the purchase of medicinal means, part of his cost is
paid from the funds of social security.
The sources of social security funds are a contribution of insurance
payments of private persons, contribution of enterprises and state financing.
Pharmacy of Great Britain
In Great Britain a law operates on Government service of health protection,
that shows by itself free hospital, underhospital medical and medical service.
According with this law, all curative establishments passed to property of the state,
but pharmacies and enterprises that engage in making of medicinal facilities,
articles of supervision upon patients and other commodities of the medical setting,
and also wholesale pharmaceutical enterprises remained private.
The system of health protection of Great Britain is headed by National
Service of Health Protection(NHS) that is financed mainly due to the centralized
governmental tax levying and partly by the system of national insurance(NI). In
activity NHS take part also possessors of pharmacies on contractual basis.
Essentially NHS is the regulative system that avouches for availability of
sphere of health protection all population. It is free of charge except for some
aspects: stomatological, ophthalmology service and of long duration supervision
upon people years old. Groups of population, for example childrens, old people
and other favourable categories, dismiss from payment of recipes. Thus,
approximately 80% of recipes in Britain is free of charge. Cost of compounding
medicinal facilities that brought in a list, presents approximately 10% of expenses
of NHS.
The cost of medications makes the small percent of charges also and for the
population of country, because average cost of preparations, that makes 6,1 % of
pound sterlings, it ignores majority of population.
The regional managements of health protection submit national service of
health protection, pharmaceutical subdivisions the chairman of that is a druggist
are included in composition of that. In the function of subdivision common
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guidance is included by pharmaceutical service, local making of medicinal
facilities, control of quality of medicinal facilities, distribution of shots, coordination of activity of different pharmacies and copulas with health authorities.
All pharmacies and all druggists must be registered in the pharmaceutical
union of Great Britain. According to a law, verification of observance of
pharmaceutical laws and positions of pharmacy, proper quality of medicinal
facilities control, is included in the function of union. For this purpose in union is
inspector, that carry out verification of pharmacies.
In Great Britain 5 types of pharmacies are counted:
1) Individual, private;
2) Pharmacies that belong to the small private pharmaceutical companies;
3) Brandname that belong to the private large company;
4) Pharmacies of co-operative unions;
5) Pharmacies at hospitals.
Enumerated the first 4 types belong to the retail pharmacies. The most
English pharmacies are shallow. 25 % of drugstores show a property of large
companies, namely they compose a pharmaceutical network.
Unlike many European countries, except the UK, independent pharmacies,
pharmacy nets are functioning perfectly. The most famous British net of
pharmacies - is «Boots and the Chemist».
Quite a bit proprietors of private pharmacies belong to pharmaceutical
franchising, such as "Unihem", "Load". The most large (brandname or cooperative unions) take place in metropolises and industrial centers. Pharmacies
placing after a country not evenly, although between pharmacies there are not
considerable regional differences. Every pharmacy serves for a day on the average
500 patients and releases medicinal facilities approximately after by 200 recipes.
Approximately 80% of total pharmacy commodity circulation consist recipe and
unrecipe preparations.
Pharmacies at hospitals in Great Britain are open in the most large hospitals
of district, they serve less after sizes hospitals. Hospitals are divided into a few
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groups, for every separate group there was the entered position of group druggist.
In his duties enters: organization of pharmaceutical maintenance of all hospitals in
a group, to the stuff state of druggists, co-ordination of providing of hospitals,
consultation on questions making of medications and them the centralized
maintenance.
Most potent drugs are sold in the UK only on prescription. Instead of the
usual getting a prescription from a doctor , the British are able to get it from a
nurse , dentist, veterinarian (in the case of recipes for animals) and that will come
into
force
in
the
near
future,
from
the
pharmacist.
The value of the prescription in the provision of quality health care in the UK is
very important - it is the first major carrier of medical information document for
accounting and recovery of the costs of pharmacies, primary information about the
course of treatment, patient’s information, as well as statistically valuable
information which is able to plan the health budget in general. And, of course, the
British doctors, pharmacists and the whole system simply could not function
without such an old invention as a recipe.
The electronic system after that recipes and dates of delivery of medications
are registered in the so-called cards operates in Great Britain. The interval of
reception of medicinal facilities, ways of his introduction, dosage, date of
beginning of course of treatment, is noticed in the separate columns of card.
Pharmacist checks up an accordance of given medicinal facilities and recipes every
day.
Nowadays a project has launched to deploy a network of pharmaceutical
trade devices in the UK. In general, it is not anything unusual, we all got used to
the vending machines selling sweets, drinks and others. But the highlight is that
medical machines support the ability to video connection with his personal
physician, who helps to pick up the necessary medication in his working time, and
if you need a prescription, your doctor can " prescribe " it online in the UK.
Naturally, the manufacturers have built a quite complicated, multi-access into these
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machines, which is designed to provide protection from the drug addicts and easily
obtaining a certain type of drugs.
Naturally, manufacturers have built a quite complicated, multi- access,
which is designed to provide protection from the drug addicts and easily obtaining
a certain type of drugs into these machines. It’s a great achievement we may have
it in a future.
In Great Britain responsibility for training of pharmaceutical personnel and
their registration on a law carries the Pharmaceutical union. After 4 - th annual
studies at pharmaceutical school, students must pass one year of practical studies in
a pharmacy, and successfully laying down examination, to get qualification of
druggist.
In the pharmacies of country of 35% of pharmacists are proprietors, and
65% work after apply.
In Great Britain druggists do not have a monopoly on distributions of
medications, that can be released also by doctors or pharmacies of hospitals.
Approximately 12% of total amounts of doctors engage in the sale of medicinal
facilities. There are also other sources of sale of medicinal facilities: internetpharmacies, trade establishments (supermarkets, groceries, filling stations) that can
sell medicinal facilities from the list of products for a general sale.
In the UK, a lot of pharmacies perform many attendant functions. Besides
the fact that you can buy drugs there, you can take also glasses, a personalized
weight loss program and even take out health insurance.
In Great Britain all pharmacies, except the sale of medications, give the wide
spectrum of additional medical services to the population, such as verbal and
writing information, supervision upon patients at home. Druggists also give help to
the practicing doctors during prescribing medicine. They conduct the repeated
review of с the next setting of medications, development of the individual
compounding and recommendations for patients.
198
Countries of Latin America
Brazil
Brazil is a country of contrasts, it remains the leading country for income
inequality: more than half of the national currency owns 10 % of people but the
third part of population lives very poor. It has correspondent impact on Public
Health Service. For example there are three leading diseases which include
"traditional ones" all over the world, cardiovascular and cancer diseases, the
criminal factors. It is unexpected that Brazil is occupied the 9-th place in production
of medicines in the world due to this background. Brazil has 4 large
pharmaceutical companies from 6 ones in the world. According to the Ministry of
Public Health in Brazil, the turnover of the pharmaceutical market in the country is
28 billions of reals in the year, and the market is constantly expanded. Nowadays it
is registered about 540 pharmaceutical companies in Brazil, 90 of them produce
generics. The share of sales of generics is 20.6 % in the pharmaceutical sector in
Brazil.
The authorities try to reduce the price of patented drugs. If a pharmaceutical
company refuses to make concessions, they insist on withdrawal of the patent.
According to Brazilian laws, in certain circumstances, the regulator has the right to
break patents and allows the production of generics . In many other countries, this
practice is considered a rough breach. The justification of these steps is the phrase:
"In the national interests ." It was managed to provide all HIV -infected patients by
antiretrovirals completely.
In addition, Brazil has consistently increases the production of generics,
creating all sorts of barriers to entry of foreign companies. For example, drugs
from South America get to Brazil almost impossible. Others can sell their products
in the Brazilian market only after a long and painful procedure of registration,
which takes 5 years. At the same time, Brazilian pharmacists produce generic with
high speed. It’s about 10 drugs per month.
In a country where the course is taken on "its own, home ", doctors still left
the right to exclude the possibility of replacing the branded drug by generic. The
199
pharmacist, letting the drug is required to warn the patient that there is a cheaper
alternative. The price of the Brazilian generic is 40 % on average of the value of
the brand. Promotion of drugs-analogues is carried out by several government
programs.
One of them is called "Popular pharmacy": it is created the network, which
includes many private pharmacies, they are managed by Fundacao Oswaldo Cruz
fund, which buys medicines exclusively of Brazilian production and ensure their
informative support among the pharmacists and physicians. Buy drugs in the
"Popular pharmacies" you can only on a prescription. Population is promised that
eventually the price of 84 drugs , including the treatment of hypertension , heart
failure , diabetes and other wide-spread diseases’ll be here 50-85 % lower than in
other ones.
In total, there are about 5,800 pharmacies. This amount was enough to give
the job to 17 thousand of pharmacists. Approximately 50 % of pharmacies are
pharmacy networks that practice open display of goods. Small private pharmacies
serve
only
through
the
window.
Brazilian pharmacies provide customers with a variety of additional services. For
example, you can conduct some tests; take injections, measure blood pressure, etc.
Working day, as in most other countries, is declared from 8 to 22. Although
in practice pharmacies serve visitors around the clock
But this discrepancy is just a trifle in comparison with the issues that cause
following to the rules of the drugs’ realizing. According to the WHO’s report, the
rules are meant to be broken in Brazilian pharmacies.
Thanks to the advanced technology of vaccine production Brazil is a global
manufacturer of immunological substances, which are exported to more than 70
countries. One of the leaders of technology is Oswaldo Cruz Foundation (Fiocruz)
fund under the Ministry of Public Health. Its task is to research and product the
most vaccines in the framework of the State Program on Immunization.
For example, according to the rules on narcotic and psychotropic drugs is
adhesived a black label, but on the rest part of the medicines’ group is a red one.
200
However, in order to keep receipts, pharmacies often sell "red" drugs without a
prescription. And it is not too difficult to buy drugs even with black label. Not
having the money to pay for medical services, patients go straight to the pharmacy
and consult with a pharmacist. Then they buy drugs, " right here ", and next time
take those drugs which have been treated before.
But in the past two years, the National Agency on Sanitary Control tries to
break this vicious circle. Mainly due to the discovery of superbacterium KPC
resistant to all known antibiotics in the states of São Paulo, Paraná and the Federal
District (Brasilia). According to the agency’s experts, its appearance is the result of
uncontrolled self-medication, flourishing in the country.
Among the best-selling prescription drugs are antibiotics in Brazilian
pharmacies, and in the OTC group are analgesics, medicines for cough and allergy.
One of the most serious problems of pharmaceutical in Brazil is considered
adulterated and counterfeit money sale. According to some data, the sales of
counterfeit reaches 50 % of the total turnover of drugs. Among the reasons are
named easy and quick patents’ delivery to Brazilian producers and an almost
complete lack of drugs’ control manufactured within the country. But there is
another point of view. The Brazilian government has repeatedly called the WHO
stop working with large pharmaceutical companies due to falsification, as they
correspond generics to the counterfeit and by this mean fight with competitors
which produce cheaper unlicensed generic analogues brands. Who is right perhaps time will tell.
Mexico
Countries of Latin American are known for their contradictions in the sphere
of Public Health Service, but Mexico in this regard, has a special place. Mexico is
managed to compete with such strong neighbor, as the U.S.A. perhaps because in
all these nuances as epidemics, drug wars and poverty.
On the U.S.A. websites devoted to Mexican Pharmacy, there are plenty of
warnings about counterfeit and poor drugs’ quality in this country. Why is the
global market’s leader so concerned of counterfeit in Mexico?
201
The fact is that Mexico "pulls" the part of the U.S.A. citizens’ costs of
medicines. Mainly due to the difference in the price: even by Ukrainian standards
drugs’ cost in Mexico are very moderate, and for all Americans, it is a huge
savings
according
to
the
studies,
it
reaches
102%.
Superloyal cost of drugs is related to several factors in Mexico.
First of all, this is a low level of income per person. The demand creates
supply.In addition, the prices of pharmaceutical products are regulated by the state.
And another important point is that a long time in Mexico, there was no patent
protection, and also the action of the Patent Act hasn’t retroactive and doesn’t
spread to the products that were in development at the time of its entry into force.
As a result, many drugs are still competing with cheap analogues’ products which
have not been patented.
Mexico constantly surprises with new developments in the field of
medicines. Thus, among the most recent messages there is the information about
the development of new preparation for lungs’ cancer, vaccines for scorpion’s bite
and for heroin addiction, agents for increasing potency as chewing gum , etc. by
pharmaceutical Mexican companies.
The annual income of the pharmaceutical industry in Mexico is about $ 11
billion, and on this index, the country takes the 11th place in the world, and the
second one after Brazil which is in Latin America.
Almost 60 % of all produced drugs in Mexico are generics, and their part
constantly
grows.
Recently, the market has become more tightly regulated. In particular, the Federal
Commission for the Protection against Sanitary Risks, acting in the country, has
recently stopped the registration of more than six thousands of drugs. In the result
the interests of the companies producing innovative products have been seriously
affected. In the biotechnology sector the situation is more difficult. There is a
chaos of transition period. The old standards don’t act, and new are still in the
process of development.
202
The Mexican market has several major players whose products are known in
Ukraine.
Recently, there is a tendency to transfer production capacity of major
pharmaceutical companies in Asian countries where the labor is cheaper and the
tax advantages are more.
As for distribution, Mexico went by the through European countries’ way:
medicines are supplied to pharmacies in 2-3 big distributors.
Moreover, the role of distributors in the life of the pharmaceutical sector in
the country is gradually reduced, and often, the large pharmacy chains take their
functions. Pharmaceutical companies are also interested in the sale without
intermediaries, which has a very positive impact on the drug’s cost for the user.
Many Mexican distributors acquire local pharmacy or create alliances,
owning a large pharmacy chain. Another detail of the pharmaceutical business is a
special attention to the needs of the consumer in Mexico. Market leaders point out
that the customer has become more informed on the part of the drug and more
demanded, and we must try to be closer to it.
What does this mean in practice is that each pharmacy decides for itself.
For example, in the NERA report is noted that "many drugs which must be
sold according a prescription, in fact, is said are often sold without a prescription."
Such a choice is defined by the consumer, the nature of the demand leads to more
"price sensitivity" than the one that exists in the medical sector in the U.S.A.,
where doctors write prescriptions without knowing the price of the relevant
product and don’t worry too much about it.
At the same time, the Mexican authorities combat with the neighbors’
considerations actively that the demand in Mexico is determined only by the
consumer, driven by competition and that pharmacies offer products at prices even
lower than those which are set by the government.
To do this, a number of restrictions on the pharmacy’s activities were
recently introduced. Today, even tourists recognize that buy the drug without a
203
prescription in the Mexican pharmacy is not possible, although it was the norm a
few years ago.
Pharmacies in Mexico are everywhere. Several day-night pharmacies
necessarily operate in any area. Most pharmacists are English, especially in the
cities on the border with the United States. In general, Mexican pharmacy
employees provide highly qualified service. The structure of drugstores’
assortment is connected with the tropical climate and other national characteristics.
In particular, it is formed by a part of an epidemic of exotic influenza’s strains, a
wide spread residents’ obese (about 75 million people, representing 70% of the
country’s population). It is very popular the means of gastro-intestinal disorders.
OTC group is presented wide enough though, Rx drugs (e.g antibiotics) are sold
without troubles. It just need to contact a Mexican doctor to confirm that the drug
is really needed in this case.
According to forecasts, the volume of the pharmaceutical market in Mexico
will exceed $ 16 million by 2014.Pharmacy business in the country each year
attracts more foreign investors, which means that those who do not like this
competition, will either have to get used to a strong neighborhood or looking for
new ways of influence and fast-growing market.
Pharmacy of India
To occupy a leading position in the global pharmacy of India is destined. All
the prerequisites are uniformed together: there is a rich history of pharmaceutical
science, a field for the study of specific diseases, various epidemics, cheap labor,
and all this is associated with a rapidly growing economy.
Most countries cannot compete with India on the cost of generics’
production, the most substances are bought in India. India along with China is so
firmly come in our lives that without it isn’t possible any business. Certainly, India
is still far from the U.S.A. markets, 5-top countries in Europe or Japan. But it
grows more rapidly, showing about 13 % growth per year. However, there is a
nuance: actually Indian enterprises are not many. The majority of them are large
Western companies that have moved their production to India, reduced it in 30-40
204
%. They are glad to them and otherwise make their life easier. They are interested
in the foreign capital’s flow into the country.
But, the Indians do not forget about the needs of their country gradually
filling up the planet by their preparations. Therefore, pharmacies’ choice of drugs
is quite wide, prices are loyal in India. At the same time, drugs’ buying here is
specific: the country is directed on generics’course, and finds a familiar brand is
not easy in the Indian pharmacy.
Pharmacies are located in India everywhere, and they are very different: it
may be familiar to us room, or a common street tray outside. But in any case, the
sign with a red cross will be special detail.
What distinguishes the Indian pharmacies, though, is their property. Usually
it is mixed, so called, a public- utility. That is, the company is owned by the state,
but the guidance is passed from father to son. In this way, it is reflected the entire
Indian
culture
based
on
family
values
and
continuity.
Also in India, pharmaceutical alliances are created to combat the hard competition
for the buyer. Association in large organizations facilitated by the fact that small
and medium-sized enterprises pay big taxes and practically there are no benefits.
Despite the saturation of pharmacy institutions the country has the same
problem as Ukraine – is the lack of wanting to open a pharmacy in rural areas. For
this reason, 12 % of people complain of the drugs’ poor availability, while the
other 88 % note an adequate number of pharmacies.
Indian Pharmacy at a Glance
• more than 500 thousand of people work in Indian pharmaceutical industry at
present.
• The home market of the country is estimated at more than $ 16, 32 billion
• In India, 20 thousand drug companies are registered with the aim of
drugs’production but over 70 % of the market is held only 250 companies.
• Total drugs’ sales are projected to increase from $ 19.2 billion in 2012 to $ 54.2
billion in 2019.
• India has more than 200 GMP certificates. This is the largest number outside the
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United States.
• Production of substances ranked third in the world.
• More than 15 Indian institutions conduct clinical research for Western
multinational corporations.
The debate about who is a pharmacist - health care professional or a seller is taking
place in India. The specialist who is called as pharmacist in India may be halfeducated person who is not able to meet even a simple query. In India , instead of
the word " pharmacist " say " chemist Indians themselves refer to local pharmacists
with some prejudice. 44 % of the population say that an employee of Indian
pharmacies is often not able to describe the preparation and characteristics of its
application clearly due to public opinion.
For India, the biggest problem is the dissonance’s growing between the
pharmaceutical production and low level of local professionals’ education. There
aren’t enough of skilled personnel, and this is the main reason why the Indian
medications have not yet taken over the world. Western companies, where the
production of new products is many times more expensive, that proves again
knowledge is a force.
But it is still not a country where it's easy surrender. Let's look at the shelves in the
Ukrainian pharmacies: Indian-made drugs have taken a rather wide gap between
the western and home generics’ brands. Thanks to this , they successfully compete
in both directions , on the one hand not allowing to raise the price of Ukrainian
production’s drugs, on the other hand making revise pricing by foreign companies .
As a result, the consumer gets more choice and adequate price.
For India, the price’s issue is generally the most difficult: from 1.2 billion of
people living in the country, one billion live below the poverty line. Public policy
is built on increasing the availability of treatment. In addition, India is a leader in
the production of biotechnology.
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Pharmacy in Arabic countries.
UAE
An impeccable level of service, professionalism, high prices are the pharmacies in
UAE to tourists’ and expatriates’ sight. The latter is accounted for 75 % of the
population of this country and, therefore, they are the main its labor force. But if in
other professions natives gladly assign their duties to visitors, the situation in the
Public Health Service is complicated.
UAE nationals by virtue of its provision do not want to become the first
table , and among the guests of the country (they refer to the expatriates ).There are
a few pharmacists here and as a rule , the profession is well respected in the world
, and its representatives rarely emigrate. Therefore, this eastern state is
experiencing a constant shortage of pharmaceutical staff at all levels. There isn’t
any competition, according to the WHO, 0.41 of pharmacists is per 1,000
population in the UAE. That is, from 4.5 million of inhabitants only 1,200
dedicated their lives to the pharmacy business.
All is complicated by the fact that, under the law of UAE, pharmacies can
belong only to citizens of the country. Only 4.1 % of pharmacists have this status,
it is understandable why the owners of pharmacies are mainly representatives of
other professions. As a result, an oriented business in the UAE is dominated in
private pharmacy practice, and not the quality of Public Health Service’s basis.
At the same time, Arab law requires that the pharmacy has always been in
the management of a registered pharmacist.
In a country where there are no problems with funding or access to
technologies, the most private pharmacies do not use the electronic systems of
order and do not keep medications’ records. However, every pharmacy makes a
report on the balance of narcotic and psychotropic drugs every month and then it is
presented to regulators.
The state is not too closely monitors the activities of pharmacies, and many
of the rules are effective here only to the pharmacists’ willing to follow them. For
example, the law prohibits the sale of all Rx drugs’ group, if the visitor has not a
207
prescription. In fact, it is strictly followed only in relation to the male sex
hormones, narcotics, hypnotics, tranquilizers and other drugs that can cause
addiction. A wide range of prescription drugs, including antibiotics , 13 asthmatic
inhalers , insulin and other diabetes drugs, antihypertensive and cholesterollowering drugs, in the most cases are given, without a prescription .
Probably the high loyalty to pharmacies in the UAE is associated with a lack
of independent organizations to assess the professional pharmacy practice. But in
neighboring countries they are presented, in particular, in the Saudi Association of
Pharmaceutical Manufacturers and Pharmaceutical Association of Kuwait. The
multifunctioning which is inherented to Ukrainian pharmacists is not welcome in
the UAE. For example, in private pharmacies’ pharmacists perform in general
administrative and managerial functions. A duty of representing diagnosis, storage
and distribution of drugs are put on the technical staff. As for pharmaceutical
guardianship, it looks very gently in the Emirates: usually the pharmacist is limited
by a recommended dosage and frequency of the drug’s administration, but in some
cases, he can tell you about the side effects and interactions with other drugs at the
request of the patient. As a rule, employees of private pharmacies do not advise
any drug or its replacement, and certainly do not try to make diagnosis to the
patient by themselves.
In pharmacies, working at the hospitals, especially those that are managed
by international organizations, pharmacists have more opportunities to experience
their professional skills. Only here they can use their knowledge in clinical
pharmacy.
Due to the deficiency of the own specialists Arab Emirates had to carry on
large expenditures to attract foreign pharmacists for a long time. In addition, the
high school graduates’ number who left to Jordan and Egypt to get a diploma of
pharmacist was constantly growing. The production of drugs is actively developed
in the country, the workers were needed more and more, and the issue of education
has become extremely acute at some point. Thus, College of Pharmacy in Dubai
and the Faculty of Pharmaceutical and Medical Sciences in Aiman University of
208
Science and Technology (founded in 1992 and 1996 correspondently) have
appeared in the United Arab Emirates. All pharmaceutical courses offered in the
UAE, are conducted in English
Separately, the government has taken care of bringing women into a
profession. Therefore, in Dubai Women's College had introduced three-year
program DipPharm, and a little later it was added by the BPharm (which lasts for 1
year). Both programs are offered exclusively to women as a step to increase the
involvement of citizens in pharmacy in the UAE.
UAE can really be proud of the quality of medicines. The authorities pay
great attention to this question since the early 80s of last century, when the Federal
Law number 4 appeared, which regulates the pharmaceutical industry and
pharmacy practice in the UAE. Thanks to this law, in a mere 12 years after the
founding of an independent state only drugs with proven efficacy and safety were
remained in the country's pharmaceutical market.
Plant medicines didn’t stay without the state’s participation. For example,
Office of Complementary and Alternative Medicine of the Ministry of Public
Health Service in the UAE was established in mid-90's, in whose jurisdiction was
the regulation of herbal medicines and licensing of pharmacists and pharmacy
technicians who practiced in this field.
Today UAE pharmaceutical industry is in a state of rapid development, but
there are only 10 companies-manufactures.
More than 45% of the population suffers from obesity. Not surprisingly,
drugs for the treatment of diabetes mellitus (24% of the population), cardiovascular
pathologies, and other non-infectious diseases are in the most demand here.
Pharmacy in Poland
Being a European country and is constantly striving for the best, Poland has
implemented all main approaches in the medical and pharmaceutical industries ,
which
are
used
in
Europe.
So, medical insurance is fully realized here, the wholesale mark-ups on the list of
medicines are set which is to be reimbursated (at 9.9 %). It is acted a strict
209
legislation on pharmaceutical products’ advertising. And taking into consideration
all this Polish pharmaceutical profitability’s retail reaches 9 % , which is even
higher than the average index for other European countries ( 8.1%), not mentioning
Ukraine, where the profitability varies about in the range of 1% .
It is possible to make a conclusion that the Poles often get sick and go to the
pharmacy, due to this they have profit. Poland remains one of the countries with
the highest rates of the incidence of diabetes.
At the same time, the average life longivity is quite high: 76-78 years is for
women and 72 years is in men. According to WHO estimations, it is said about the
high damage of life and good Public Health Service.
The system is composed in such way that people treat more and better, pay
attention to prevention, therefore, they live longer.
The National Health Fund (NFZ) has a great service in this connection, in its
charge such issues as the control of transactions between doctors and patients,
payment for medical services and drugs . Activities of the fund are regulated by the
Ministry of Public Health Service in Poland, which also decides the benefits to
certain drugs.
There are about 13 thousands of pharmacies in Poland. Thus, one pharmacy
serves approximately 2.7 million people. Pharmacy assortment is presented in3-4
thousand names of drugs. A significant part of it is imported products. However,
domestic generics are occupied an increasing share of the market. As local
pharmaceutical companies do not have sufficient research and economic basis for
the creation of innovative products, generics became the basis of the Polish
pharmaceutical industry. They make up 62-63 % in money of the market and about
85-86 % - in packages.
It distinguishes Poland from other European countries, where the share of
generics is much lower.
The most part of Polish pharmaceutical plants’ drugs is exported. In general,
the country produces more than 2 million items of drugs (drug products,
substances, homeopathic preparations, parapharmaceutics, medical devices).
210
There are pharmacies with relatively low extra charges around 18 % (for
comparison with other European countries this index is 25-30 %). In this case, the
standard rate of VAT is 22 % and the rate of the drug is 7%.
If 5 years ago only pharmacist could manage a pharmacy, but today these
restrictions (and many others) were removed. As a result, the market, which until
recently consisted mainly of small private pharmacies, there was redistribution in
favour to large pharmacy chains. Small pharmacies cannot stand the competition,
they close. Competition at the level of a separate pharmacy has created a situation
in which each owner trying to stand out and compete with others in a beautiful
design, courteous and professional service. The design "antique" is very popular in
small pharmacies.
However, regardless of the format and size of the pharmacy, the visitor will
always receive quality advice, especially according to OTC groups and parapharmaceuticals . Due to the law, the patient may get the potent drugs only after
consultation with the doctor. If you come with a recipe you can be served only by a
pharmacist with higher education.
The technic pharmaceutist has such additional functions, as manufacturing
and packaging of medicinal products (mainly in pharmacies, where the
extemporaneous compounding is). But if such an employee wishes to work
independently with visitors, it is necessary to pass the exam on specialty and obtain
the appropriate license. Pharmacy Chamber registers all the country's leading
pharmaceutical professionals. In Poland, there is not any pharmaceutist who would
not speak at least two languages - English and German. It is also very convenient
that many pharmacies adapt to the opening hours of supermarkets, so they serve
visitors 24/ 7.
The main documents regulating the activities of pharmaceutical and medical
treatment facilities in Poland - is the law "On Medical Devices ", " About the
Department ( committee)of Drug Registration ", "On narcotic and psychotropic
drugs’
turnover
,"
"About
the
pharmaceutical
wards."
Recently, the law "On the reimbursement of the drugs’ cost" has a significant
211
impact on the pharmacy market, which entered into force on the 1 st January of
2012. The Distributors are dissatisfied with the established wholesale mark-ups on
medicines from the "insurance" list and they plan to optimize costs, due to
reducing staff, not to be left at a loss. Manufacturers, also, are not glad, according
to marketers’ calculations , the new law has led to the fall of the market last year
on 4%.
The greater resonance in the pharmacy business caused changes in
legislation in the field of advertising, which also are acted from 2012. In this
regard, the State Pharmaceutical Inspectorate together with the NFZ even planning
to make a statement to the Polish pharmacies, which will remind them of the new
rules of advertising.
Pharmacy in Russia
According to several market research Russian market of medicines is growing on
20-25 % every year. However, a newcomer to gain a foothold on it is not easy. The
most active pharmacy trade is in Moscow. The capital’ share in the structure of the
Russian market is about 25 %. It is connected that the pharmaceutical business in
Moscow began to develop earlier than in other cities. However, over the past three
years, the rate of growth of the capital market has slowed down , and now it is 1819% per year. In comparison with large Russian cities, this index is 20-25 % per
year. The reason is that the Moscow market is already has oversaturated with
drugs, the regions still allowed to grow. That is why the major market’s subjects
began to expand into other cities and countries . At the same time, the provincial
pharmacy chains continue to "conquest" Moscow. For example, the St. Petersburg
company "First Aid", which owns 70 pharmacies opened in Moscow some of their
pharmacies. Earlier, in 2004, the St. Petersburg retailer “Nature product " has
acquired the network , " the Public Pharmacy " in Moscow. Several pharmacies of
Samara network "Implosion " work in the capital.
However, Moscow, as a rule, meets the competitors from other cities
unfriendly. Having opened 1-2 pharmacies, many regional companies then close or
sell them without getting the expected profit.
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The major pharmacy chains control 40 % of the capital market. More than
500 pharmacies under the brand name of this or that network function in Moscow.
"36.6", "Rigla", "Doctor Stoletov", "OZ", "Old Doctor", "Biotech", "Pharmir",
"ZEM Pharm" and "Samson –Pharm" have the most part of pharmaceutical
companies.
Very unusual for the pharmaceutical business are pharmacies "on wheels
and network of "People pharmacy M". This structure has its regular customers, but
in recent years the majority of people prefer to buy medicines in in-patient
pharmacies. First of all because “mobile stores" has very limited range .
There are many people wanting to do pharmaceutical business in Russia, but
to enter the market and gain a foothold there, we need a great investment. It is
needed from $ 40 thousand to $ 85 thousand on average, for the pharmacy’s
opening in Moscow. This money goes to rent the premises for a period of 3
months, its repair, purchase of furniture and equipment, obtaining the necessary
licenses and certificates. But in order that pharmacy will bring the profit, it takes
time, during which you have to spend money on the goods’ purchase, the
personnel’s payment. It is needed $ 500 million to fix the market. It is impossible
to make profit in this business instead of popular stereotypes.
One point’s retail trade turnover is about $ 25-30 thousand per month, that is
much lower than in Western countries. Private pharmacy with an open form of
trading in the autumn and winter period brings not more than $ 5 million profit per
month. Net pharmacies with an open form of trade this index is slightly higher - $
6-7 thousand per month. Pharmacies cannot earn more because the prices of many
medicines are regulated by the state. For example, the marginal trade allowance to
the wholesale price is not more than 23 % in Moscow. On average, the Russian
retail markup is 25-30 %. Therefore, prices in pharmacies - both on-line and
independent - are in the same range.
Sales’ volumes with open forms of trade on 20-30 % more than in the trade
over the counter in Russian pharmacies. Choice of trade’s forms depends on the
number of customers that pass by pharmacy every day. If it is 10-15 thousand
213
people, you can open a self-service pharmacy. At a lower flow rate is better to
trade over the counter. The best places to open a pharmacy in the "sleeping" areas.
High rents in the city center takes significant shares of the pharmacies’ profits
which are located are there.
The share of domestic medicines’ production is around 65 %, in Russian
market but in terms of money, they account only 30 % - as incomes rise under the
influence of advertising and the Russians begin to buy more number of imported
drugs.
The growing demand for expensive drugs combined with the traditional
Russian in attention to their health and habit to self-medication. Russians often do
not go to the doctor when they fell ill as usual they go to the pharmacists, hoping to
get the advice on treatment. According to surveys, the client who does not have a
prescription, consult with a pharmacist about treatment in 50 % of cases. And more
than 40 % of visitors would like to consult a doctor straight at the chemist shop.
Therefore the organization of consulting center is an important competitive
advantage in Russian pharmacy.
The Russians, seeking to regain good health with minor problems often
choose "fast" drugs without a prescription. As in many European countries,
Russian pharmacists have a great influence on the choice of OTC drugs. In
addition, Russian citizens choose non-prescription remedy treatment, focusing on
advertising, or their previous experience.
The top list of Russians’ ailments is as follows:
Headache is ( 57% of questioned people)
Common cold is (56 %)
Running nose / nasal congestion is(53 %)
Backache and cough are the most frequent minor diseases which Russians have (to
44%).
Control questions:
1. Advantages of private pattern of ownership in pharmaceutical industry.
214
2. Forms of the medical providing in foreign countries.
3. The state of pharmacy in the economically developed countries.
Tests:
1. How many trends does medical ensuring have abroad a) 2
b) 5
2. In what country the trends of medical ensuring are connected with each other a) the U.S.A.
b) Canada
c) Denmark
d) All above mentioned
3. Which country has private and insurance support:
a) Iran
b) the U.S.A.
c) Ukraine
d) Denmark
4. What system of Public Health belongs to Germany
a) private and social
b) private and insurance
c) insurance and social
g) state and social
5. In a number of which countries are combined private and public forms of
medical care
a) Western Europe
b) Australia
c) Asia
d) Middle East
215
LITERATURE :
1.
Бенюх Н.Ф. Історія фармації Галичини (ХШ-ХХ ст.) // Провізор. -
2000.-№ 8.-С. 28-29.
2.
Блавацька О.Б. Досвід страхової фармації Європи - законодавчі та
організаційні аспекти фармацевтичної діяльності в Австрії // Фармац. журн. 2003. - № 4 - С. 39-46.
3.
Большая медицинская энциклопедия / глав. ред. Б.В. Петровский.
- Изд. 3-є [в 30-ти т.]. - М.: «Сов. энциклопедия», 1980. - Т. 14. Медицина Меланоз. 496с. с ил., 16 л. вкл.
4.
Бородій М.К. До історії аптечної справи на Україні в першій
половині XVIII сторіччя // Фармац. журн. - 1980. - № 1. - С. 77-79.
5.
Бородій М.К. До історії аптечної справи на Україні в першій
половині XVIII сторіччя // Фармац. журн. - 1980. - № 2. - С. 76-79.
6.
Ван Міл Дж., Нельсон І. Громадська фармація в Данії II Фармац.
журн. - 2002.-№ 2 . - С . 15-17.
7.
Гореньков В.Ф. Организация и экономика советской фармации. -
Мн.: Выс. шк., 1984. - 400 с.
8.
Гургула С.В. З історії фармації // Фармац. журн. - 1974. - № 1. - С.
80-83.
9.
Заблудовский П.Е. История отечественной медицины. - М.:
Медгиз, 1960.-400 с.
10.
Заблудовский П.Е. История медицины: методическое пособие. -
М.: Медицина, 1998. - 113 с.
11.
Заичкин И.А., Почкаев И.И. Русская история. - М.: Мысль, 1992. -
12.
Зархин И.Б. Очерки из истории отечественной медицины. - М.:
797 с.
Медгиз, 1956. - 188 с.
13.
Історія фармації України / Р.В. Богатирьова, Ю.П. Спіженко, В.П.
Черних та ін. - X.: Прапор, Вид-во УкрФА, 1999. - 799 с.
216
14.
Карпов В.П. Гиппократ. - М.: Аст, 1994. - 654 с.
15.
Коровкин Ф.П. История древнего мира. - М.: Просвещение, 1982.
- 240 с.
16.
Кос М., Прімозік С., Коговсек В. Фармація у Словенії // Фармац.
журн. — 2002. - № 4. - С. 47-49.
17.
Левинштейн И.И. История фармации и организация
фармацевтического дела. - М.: Наркомздрав СССР- Медгиз, 1939. - 220 с.
18.
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№ 1. - С. 32-35.
19.
Мультановский М.П. История медицины. - М.: Медгиз, 1961. -
20.
Отамановский В.Д. Розвиток аптечної справи на Україні з
346 с.
середини XVII до початку XIX ст. // Фармац. журн. - 1963. - № 5. - С. 48-57.
21.
Отамановский В.Д. Розвиток аптечної справи на Україні з
середини XVII до початку XIX ст. // Фармац. журн. - 1963. - № 6. - С. 56-57.
LITERATURE :
Рекомендована література:
1. Алексеенко И.П. Очерки о китайской народной медицине. –
К.Здоровье, 1959.-256с.
2. Богоявленский Н.А. Древнерусское врачевание в ХІ-XVIII вв. –
М.:Медгиз, -1960.-396с.
3. Бородин Н.К. История медицины новой Запорожской Сечи (17341775гг.) Сов.здравоохранение. -1975. №12. –С.55-60.
4. Бородулин Ф.Р. Истории медицины. М.:Медиздат , 1961.-424с.
5. Бородулин Ф.Р. Лекции по истории медицины. – М.:Медицина,
1959.-С.11-17.
6. Браткис Г.А. Лекарь Л.Г. Теория и организация советского
здравоохранения. -М.:Медиздат. 1961.-441с.
217
7. Брылева Н.И. Лекарственное обеспечение Украины.
Автореф.диссерт.канд. фармац.наук. Харьков, 1964.-С.5-8.
8. Васильев К.Г.Крещение Руси и его значение для формирования
медицинских знаний у древних славян. Журн. АМН України.-2000.-№1.С.200-205.
9. Верхратський С.А. Історія медицини.-К: Здоров’я, 1964, -427с.
10. Верхратский С.А. Медицинская помощь в Запорожской Сечи.
Врачеб.дело,-1954. -№5.-С.451-454.
11. Виноградов Н.А. Здравоохранение в годы Великой Отечественной
войны 1941-1945гг.-М.:Медиздат.1955.-430с.
12. Виноградов Н.А. Здравоохранение в послевоенный период. –
М.:Медиздат, 1955.-290с.
13. Вогралик В.Т., Вызыченский З.С. Очерки китайской медицины .-М.:
Медиздат, 1961,-273с.
14. Грандо О. Ще один погляд на медицину українських козаків .
Агагат, -2001.№13.-С.72-73.
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М.:Медицина,1990.-205с.
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218
Subject Index
Academy of sciences -88, 126
animism -12
antlers-38
arhiatr 60
ausclepions 59
Ayurveda-42,43,44
Barbers-85,107,109,114,153,155
Camphor-38,51
Canon Avesta-62
Chemist Charter – 126
Chemist Order – 106, 107, 108, 109
Demonopolization-175, 194
Disciplines- 8, 19, 83
-general educational – 8
-profile – 8
-special - 9
economic accountability - 142
Emblem:-16,17,18,22,23,24,25
-general medical – 26
-private medical – 27
-pharmaceutical – 27, 28
Fraternity-164, 165
Ginger-38
Ginseng-38
Iliad-11, 58
In - 37
Infirmary - 84
jatrochemistry-87, 88, 89, 116
jatrophysics-87,89
Joo – Dzhi 82
Laws of twelve tables-60
Lemongrass-38
MPM - 147
Medical chancellery - 126
NEP - 141
NHS- 195
Odyssey -58
Pharmaceutical management - 147
Pharmaceutical points - 172
Pharmacist-6,8,14,28,72
Pharmacies nationalization – 136
Pharmaki-14
Pharmakon-8
Pneuma- 41, 61,71
Prana - 41
Primitive society - 9
RCHO – 145, 146
Rig – Veda - 41
Scholastic-83,86,89,116
School-127,163
219
-medical – 61
- pneumatic – 61
- koss – 63
- Salerno – 84, 85
Scythians-91, 92, 93
Symbol-16, 17, 18
Totemism -12
Trypillians - 91
Valentudinars - 60
Yan-37, 81
Zaporizhzhya Sich-166,169
Zemsc pharmacies – 128
Names Index
Abaris - 93
Abu Ibn Sina(Avicenna) – 80, 81
Achaemenids - 51
Achriman - 48
Agapit - 96
Ahameda - 11
Alimpiy - 98
Al-Razi - 79
Anaharsis - 93
Anna Vsevolodovna Kievan princess - 96
Anthony -98,118
Antoine Francois de Furkrua - 121
Apollo-21, 27, 68
Aristotle-52, 83
Ashurbanipal - 47
Ausclepius ( Aesculapius ) – 20, 21, 59
Barzavench - 47
Bertole Claude Lui - 121
Bindgeym I. Ya. - 131
Borodulin F. R. - 26
Brugsh-53, 54,
Byan Tsao-39
Caesarea-76
Chernihiv Efrosiniya - 96
Chiron-21
Chua To-39
Damian-98
Democrite-64
Derosy Sharl - 123
Dioscoride – 52, 92
Dragon-27,64
Drogobich Yuriy - 152
Ebers-53
Ephesus Soranus - 63
Erlich Paul - 123
Fenareta-64
220
Feofrast - 92
Fessal - 64
Frederick II-85
French James - 196
Galen-4, 63, 69, 70, 71, 72, 73
Ganeman Samuel - 124
Geber - 79
Geraclid-63
Gerodot- 45, 93
Gesiod-58
Giton de Morvo - 121
Goethe I. - 19
Gordienko E. S. - 158
Gregory – wonderworker - 98
Hammurapy-45
Hermes-23, 26
Hippocrates-42, 52, 63, 64, 65, 66, 67, 68, 69, 72
Homer-11, 58, 68
Humphrey Davy - 123
Ibn-Al Haisam - 79
Imhotep - 53
Iovskyi A. A. – 123, 132
Kievan Evpraksiya (Zoya) - 96
Kommod – 70
Кrashennikov S. P. - 127
Lavrentiy-98
Lepechin І. І. - 130
Lister Joseph - 123
Lovits T. E. – 121, 131
Lyashkovskiy Pylyp - 152
Maksymovich- Аmbodic N. M. – 16, 18, 122, 127, 130
Manu - 42
Marco Aurelius-69
Medeya - 11
Mithridates VI Eupator-93
Model I.G. - 131
Monastyrskiy N. D.- 161
Monomakh Volodymyr - 96
Mudriy Yaroslav - 96
Nelubin A. P. – 122, 131, 132
Nestor-99
Nichon-69
Nicon-99
Nonn Theophilus - 97
Oribasiy - 93
Osipov E. O. – 160
Оstroszskiy Kostyantyn - 152
Оzeretskovskiy N.Ya. -122, 130
Paracelsus-87, 89, 117
Paster Lui - 123
Pelagoniy-92
Peter Syrian-96
221
Pliniy-92
Plutarch-92, 93
Prochorus-98
Razes-79
Rutherford Daniel - 122
Schepin К.І. – 127, 130
Scorina George Francisk - 152
Seleucides-52
Semashko N.А. – 136, 138
Severgin V. M. 122, 130, 131
Shevrel-123
Sich Simeon - 97
Slavinetsky Epiphany - 114
Smera John - 96
Smith-53
Sokolov N.P. - 130
Soloviov Z.P. - 136
Sushruta-42
Svyatosha Nicholas - 96
Theodosius-98
Toxaris - 93
Ursin Jan - 152
Van Bin - 40
Vesaliy Andreas - 87
Vyazemskiy Аfanasiy - 106
Yacobi Robert - 106
Yung Karl - 24
Zamoyskiy Jan - 152
Zeus-21
Zinin N. N. - 123
222