Chipatala chigawo cha m'ma 19. Yoyambirira kuchipatala chigawo

Mpaka m'ma 19 m'zaka mu mankhwala Russian anali nkomwe anakamba, ndi anthu okha amene ali kalasi chapamwamba mukhoza kupeza zina thandizo. Koma zonse zinayamba kusintha pambuyo 1864 pamene panali m'dera wodzilamulira.

Mbiri ya chilengedwe

Mu mu 1581 mu Moscow anaonekera woyamba apothecary chipinda kuti linali chinthu choyamba mu gulu la dongosolo zaumoyo. Komabe, popanga sichinachitikepo, ndi kokha m'zaka za m'ma 18 Peter Ine imachitika mndandanda wa ntchito kudzera amene anayamba kutsegula zachipatala maofesi, pharmacies, masukulu ndi mayunivesite kuphunzitsa madokotala m'tsogolo.

Kenako, pamene Alexander Ine, amakamba za kufunika kwa kulenga midzi chigawo kuchipatala, koma choyamba muyenera kutsegula sukulu zachipatala. Komabe, zonsezi kuti sanathandize kusintha zinthu, ndipo% 0.5 okha a anthu akalandire chithandizo cha mankhwala. Pa 6000 panali dokotala wina pa bedi munali anthu 1,500. Onse akanakhala anapitiriza ngati si chifukwa cha m'dera wodzilamulira anadza kwa ndalama zake inayamba kulinganiza chipatala chigawo, outpatient, umayi ndi zina zotero D..

mabungwe Zemsky kuthandiza nzika za magulu onse, kuti bwino, ndipo aliyense chigawo anali zinthu zake.

dziko dokotala

Pamene anali kuchipatala chigawo cha m'ma 19 (achuluke), zofunika ogwira akanapereka thandizo m'madera osiyanasiyana, kuyambira chimfine ndi matenda aakulu.

Medicine m'midzi, poyamba pa ndalama za chigawocho ndi mzinda madokotala, kenako akatswiri achinyamata poyamba anachoka m'mudzi. Panali chithunzi cha dziko dokotala, amene anali ndi khalidwe zikuyenela makhalidwe, kusadziona kukhala wopambana ena ndi mtima wofuna kuthandiza anthu onse ovutika, amene anali umapangitsa mapangidwe tsogolo la mankhwala.

zipatala Zemsky m'chigawo Moscow

Mu 1869 anayamba kulenga mankhwala zemstvo kuchigawo chimenechi. Pamene 1877 Congress zapita madokotala, izo usilikali pa nsoka wa chigawo m'zigawo zisanu zachipatala, kumene iwo anali kukhala ndi achipatala, mabedi, dokotala, anthu pangozi, mzamba.

Anthu ambiri amakhulupirira kuti chigawo kuchipatala a chigawo Moscow anali chitsanzo zipatala zina m'madera ena. Mapangidwe mankhwala kugawidwa m'mbali ziwiri. Choyamba, kuchokera 1865 mpaka 1876, panali kuwonjezeka mofulumira mu buku la ndalama za kuchipatala, kuwonjezera chiwerengero cha ndodo. Wachiwiri, kuchokera 1877 mpaka 1907, panali zomangamanga zachipatala: congresses zachipatala inachitika kupanga mabungwe thanzi ndi madokotala anazindikira sukulu zachipatala.

Moscow bungwe chigawo anali oyamba, omwe anali kupereka umoyo ufulu ndi pagulu. Zimenezi zathandiza kuti wopindulitsa kwambiri kupewa ndi kulamulira miliri, komanso kuchuluka kukula mu kutengedwa kwa amphawi thandizo. Koma mu magawo oyambirira anali kutsogolera mphamvu zonse mu kupanga wosazindikira mtundu wa ntchito zachipatala. Best thandizo onse dokotala bungwe m'maboma mafakitale monga Bogorodsky ndi Moscow, ndipo choyipitsitsa cha zonse anali mu zigawo kumidzi (Mozhaisk, Volokamsky).

zipatala Zemsky m'chigawo Tver

Mu 1867 panali woyamba kuchipatala Tver St, amene wakhala malo kumene anthu amabwera kuchitiridwa, komanso likulu la moyo pa moyo ndi chikhalidwe.

Mu Tver madokotala Congress mu 1871 anaganiza kuti, asanakhale dokotala wabwino, muyenera kusanthula malo omwe odwala moyo. Nkofunika kudziwa zimene ali zinthu ukhondo, kodi zikhalidwe za moyo, chifukwa zikuthandizani mu ntchito, zidzakhala bwino chithunzi cha mmene anthu amadwala kawirikawiri.

A udindo wapadera mu chitukuko cha mankhwala m'chigawo unachita dokotala, Mikhail Ilyich Petrunkevich, amene anafika ku mzindawo 1874. Iye akanakhoza mwaluso kuphatikiza nchito zawo ngathi anthu, maphunzilo kulera mankhwala mlingo wokweretsa. Mu chipatala kugula atsopano pa nthawi, anagula mabuku kuchokera kunja, kuti akonze laibulale kuti kuphunzira pa chitsanzo cha akatswiri yachilendo.

Zipatala mu dera Samara

Yoyambirira kuchipatala chigawo m'dera Samara zinachitika mu theka lachiwiri la m'ma 19, kwinakwake mu 60s oyambirira. Zisanachitike, m'chigawochi chipatala chimodzi chokha kumene kunali mabedi 12 okha pa 20 000 alionse, ndipo ankapatsidwa kuno matenda onse, osati nzika wamba, komanso usilikali, ndipo akaidi.

Mu 1865, kunja kwa mzinda wa kuchipatala St linatsegulidwa, limene anatenga aliyense, kaya kalasi kapena dziko. Pa nthawi iyi pali 7 madokotala, 26 akuchipatala, anali 360 mabedi. Chifukwa chakuti kuti linatsegulidwa zingapo sukulu zachipatala, mankhwala anayamba mofulumira, ndi kale mu 1899 kuchipatala chigawo anatsegulidwa akumidzi, pali pafupifupi 70 zidutswa.

Ndi 1875 a Provincial Hospital waukulu linatsegulidwa, limene mu 1890 anali 5 wanthawi okhala ndi 9 supernumeraries. Chinthu chofunika kwambiri chimene chinachitika kumapeto kwa zaka za m'ma - anayamba kuchitira osauka mankhwala ufulu ndi ufulu anapatsidwa.

Zikayenda ndi zotsatira za mankhwala zemstvo

Kudzera County chisamaliro Medical inaperekedwa m'zigawo 34, ndipo mankhwala awa ali unachita mwapang'onopang'ono chitukuko mtsogolo. Komanso, anathandizidwa mzinda osati anthu komanso kumidzi, ndipo ankaona sitepe yayikulu mu dongosolo zaumoyo.

Chifukwa cha County anaonekera mfundo mankhwala monga kugula, kupewa, kusamalira free, ndipo pali mabungwe amenewa, omwe kale musaganizepo - osambira matope, zinthu achire chakudya, pogona.

Mu mankhwala, panali "mwapang'onopang'ono" madokotala amene amadziwa kwambiri, akhoza kuthandiza madera osiyana, komanso imachitika kafukufuku ndi kuphunzira matenda, kotero anatsegula mabungwe bacteriological ndi Laboratories ukhondo Bureau, obstetric ndi mankhwala sukulu.

Ngakhale kuti kuchipatala chigawo zambiri amalandira zochepa ndalama, zipangizo, mankhwala, zikamera kwambiri za mankhwala, kumene aliyense, kaya ndi, umakhoza ena andithandize, chinali chiyambi cha chitukuko cha mankhwala.