What opened the pies. Nikolai Pirogov is a surgeon from God. Pirogov Nikolai Ivanovich

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Every time you go to the hospital, especially to undergo surgery, you involuntarily think about how humanity reached such a science. Everyone knows famous surgeons. Pirogov Nikolai Ivanovich is one of the most famous doctors - an anatomist, the founder of anesthesia, a member of the St. Petersburg Academy of Sciences.

Childhood

The future doctor was born on November 13, 1810 in Moscow. Pirogov's family looked like this: father Ivan Ivanovich was treasurer. Grandfather Ivan Mikheich was a military man and came from a peasant family. Mother Elizaveta Ivanovna is from a merchant family. The youngest Nikolai had 5 brothers and sisters. In total, the parents had 14 children, but many died very early.

He studied at a boarding school for a short time, but due to financial problems he was forced to continue his studies at home. A family friend, doctor-professor E. Mukhin, made a very positive impact.

University

A brief biography of Nikolai Ivanovich Pirogov as a doctor begins with the fact that at the age of fourteen he was enrolled in the Moscow Institute at the Faculty of Medicine. The scientific base was meager, and during his training the future doctor did not perform a single operation. But given the teenager’s enthusiasm, few of the teachers and classmates doubted that Pirogov was a surgeon. Over time, the desire to heal only intensified. For the future doctor, treating people became the meaning of his whole life.

Further activities

In 1828 the institute was successfully completed. The eighteen-year-old doctor went abroad for further studies and received a professorship. Just eight years later, he got what he wanted and became the head of the surgical department of the university in the Estonian city of Dorpat (real name - Tartu).

While still a student, rumors about him spread far beyond the boundaries of the educational institution.

In 1833 he went to Berlin, where he was struck by the lack of modernity of local surgery. However, I was pleasantly impressed by the skills and technology of my German colleagues.

In 1841 Pirogov returned to Russia and went to work at the Surgical Academy of St. Petersburg.

Over the fifteen years of his work, the doctor became very popular among all segments of society. Scientists valued his deep knowledge and determination. The poor segments of the population remember Nikolai Ivanovich as a disinterested doctor. People knew that Pirogov was a surgeon who could treat for free and even help financially those most in need.

Military medical practice

A short biography of Nikolai Ivanovich Pirogov can tell about his participation in many clashes and military conflicts:

- (1854-1855).

Franco-Prussian War (1870, as part of the Red Cross Corps).

Russo-Turkish War (1877)

Scientific activity

Pirogov - medicine! The name of the doctor and science forever merged into one.

The world saw the scientist’s works, which formed the basis for prompt assistance to the wounded on the battlefield. “The Father of Russian Surgery” is impossible to describe briefly, his activities are so extensive.

Teachings about injuries caused by various weapons, including firearms, their cleaning and disinfection, body reactions, wounds, complications, bleeding, severe injuries, immobility of a limb - only a small part of what the great doctor left to his heirs. His texts are still used today to teach students in many disciplines.

Pirogov’s atlas “Topographic Anatomy” has gained worldwide fame.

The sixteenth of October 1846 is a significant date in history. For the first time for humanity, an operation was carried out using a complete hypnotic agent, ether.

A brief biography of Nikolai Ivanovich Pirogov cannot fail to mention that it was the doctor who gave the scientific basis and was the first to successfully use anesthesia. The problem of the inability to relax muscles and the presence of reflexes during surgery has now been resolved.

Like any innovation, ether was tested on animals - dogs and calves. Then on to the assistants. And only after successful tests did anesthesia begin to be used both during planned operations and when rescuing the wounded actually on the battlefield.

Another type of euthanasia was successfully tested - chloroform. Over the course of several years, the number of operations has come close to a thousand surgical interventions.

The intravenous use of ether had to be abandoned. There were frequent deaths. Only at the beginning of the twentieth century were doctors Kravkov and Fedorov able to solve this problem when researching a new remedy - Gedonal. This method of anesthesia is still often called “Russian”.

The most popular method was still inhaling the vapors of a sleeping substance.

The scientist tirelessly trained doctors in all corners of the country he visited. He performed operations right in front of patients, so that they could see with their own eyes the safety of this intervention.

The articles he wrote were translated into major European languages - German, French, Italian, English - and published in leading publications.

At the dawn of discoveries, doctors came even from America in order to learn the newest method.

Triage and treatment

A short biography of Nikolai Ivanovich Pirogov contains information about research and the invention of a device that significantly improves inhalation capabilities.

The great physician also moved from imperfect starch dressings to plaster casts in 1852.

At Pirogov’s insistence, female nurses appeared in military medical institutions. Thanks to the doctor, the training of this type of medical personnel has received powerful development.

Thanks to the influence of Nikolai Ivanovich, triage of the wounded was introduced. There were five categories in total - from hopeless to those who needed minimal help.

Thanks to this simple approach, the speed of transportation to other medical institutions has increased many times over. Which gave a chance not only for life, but also for complete recovery.

Previously, when several hundred people were admitted at the same time, chaos reigned in the waiting rooms; assistance was provided too slowly.

In the nineteenth century there was no established science about vitamins. Pirogov was firmly convinced that carrots and fish oil helped speed up recovery. The term “therapeutic nutrition” was introduced to the world. The doctor prescribed “walks in the fresh air” for his patients. He paid considerable attention to hygiene.

Pirogov also has many plastic surgeries and installation of prostheses. Successfully used osteoplasty.

Family

The doctor was married twice. The first wife, Ekaterina Berezina, left our world early - at only twenty-four years old.

The children of Pirogov Nikolai Ivanovich - Nikolai and Vladimir - saw the world.

The second wife is Baroness Alexandra von Bystrom.

Memory

Nikolai Ivanovich died on November 23, 1881 on his estate near Vinnitsa. The body was embalmed (also Pirogov's discovery) and placed in a glass sarcophagus. Currently, you can pay tribute to the scientist in the basement of the local Orthodox church.

In you can see the doctor’s personal belongings, manuscripts and a suicide note with a diagnosis.

Grateful descendants perpetuated the memory of the genius in numerous congresses and readings named in honor of Nikolai Ivanovich. Monuments and busts have been unveiled in many cities in different countries. Institutes and universities, hospitals and clinics, blood transfusion stations, streets, the Surgical Center named after the surgeon are named after the surgeon. N.I. Pirogov, embankment and even an asteroid.

In 1947, the feature film “Pirogov” was shot.

Bulgaria expressed its memory with a postage stamp in 1977 with the title “100 years since the arrival of the academician.”

Nikolai Ivanovich Pirogov(November 13; Moscow - November 23 [December 5], the village of Vishnya (now within the boundaries of Vinnitsa), (Podolsk province) - Russian surgeon and anatomist, naturalist and teacher, creator of the first atlas of topographic anatomy, founder of Russian military field surgery, founder of the Russian school of anesthesia. Secret advisor.

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Nikolai Ivanovich was born in 1810 in the family of a military treasurer, Major Ivan Ivanovich Pirogov (1772-1826), in Moscow, the 13th child in the family (according to three different documents stored at the University of Dorpat N. I. Pirogov was born on two a year earlier - November 13, 1808). Mother Elizaveta Ivanovna Novikova belonged to an old Moscow merchant family. Received his primary education at home, 1822-1824. studied at a private boarding school, which he had to leave due to his father’s worsening financial situation. In 1824 he entered the medical faculty of Moscow University as a self-employed student (in his petition he indicated that he was 16 years old; despite the need for a family, Pirogov’s mother refused to enroll him as a state-funded student, “it was considered something humiliating”). He listened to lectures by H. I. Loder, M. Y. Mudrov, E. O. Mukhin, who had a significant influence on the formation of Pirogov’s scientific views.

In 1828 he graduated from the course with a doctor's degree and was enrolled in the students of the University of Dorpat to train future professors at Russian universities. Pirogov studied under the guidance of Professor I. F. Moyer, in whose house he met V. A. Zhukovsky, and at the University of Dorpat he became friends with V. I. Dahl. In 1833, after defending his dissertation for the degree of Doctor of Medicine, he was sent to study at the University of Berlin along with a group of 11 of his comrades at the Professorial Institute (among whom F. I. Inozemtsev, D. L. Kryukov, M. S. Kutorga, V. S. Pecherin, A. M. Philomafitsky, A. I. Chivilev).

After returning to Russia (1836) at the age of twenty-six, he was appointed professor of theoretical and practical surgery at the University of Dorpat. In 1841, Pirogov was invited to St. Petersburg, where he headed the department of surgery at the Medical-Surgical Academy. At the same time, Pirogov headed the Hospital Surgery Clinic he organized. Since Pirogov’s duties included training military surgeons, he began studying the surgical methods common at that time. Many of them were radically reworked by him; In addition, Pirogov developed a number of completely new techniques, thanks to which he managed to avoid amputation of limbs more often than other surgeons. One of these techniques is still called “Operation Pirogov”

In search of an effective teaching method, Pirogov decided to apply anatomical research on frozen corpses. Pirogov himself called it “ice anatomy.” Thus was born a new medical discipline - topographic anatomy. After several years of such study of anatomy, Pirogov published the first anatomical atlas entitled “Topographic anatomy, illustrated by cuts made through the frozen human body in three directions,” which became an indispensable guide for surgeons. From this moment on, surgeons were able to operate with minimal trauma to the patient. This atlas and the technique proposed by Pirogov became the basis for all subsequent development of operative surgery.

In 1847, Pirogov left for active duty in the Caucasus, as he wanted to test the operational methods he had developed in the field. In the Caucasus, he first used bandages soaked in starch; The starch dressing turned out to be more convenient and durable than the splints used previously. At the same time, Pirogov, the first in the history of medicine, began to operate on the wounded with ether anesthesia in the field, performing about 10 thousand operations under ether anesthesia. In October 1847, he received the rank of actual state councilor.

In 1855, Pirogov was elected an honorary member of Moscow University. In the same year, at the request of the St. Petersburg doctor N. F. Zdekauer, N. I. Pirogov, who was at that time the senior teacher of the Simferopol gymnasium, D. I. Mendeleev, who had experienced health problems since his youth (they even suspected that he had consumption); stating the satisfactory condition of the patient, Pirogov said: “You will outlive both of us” - this destiny not only instilled in the future great scientist confidence in fate’s favor towards him, but also came true.

Crimean War

While operating on the wounded, Pirogov, for the first time in the history of Russian medicine, used a plaster cast, giving rise to cost-saving tactics for treating limb wounds and saving many soldiers and officers from amputation. During the siege of Sevastopol, Pirogov supervised the training and work of the sisters of the Holy Cross community of sisters of mercy. This was also an innovation at the time.

Pirogov’s most important achievement is the introduction in Sevastopol of a completely new method of caring for the wounded. The method is that the wounded were subject to careful selection already at the first dressing station; depending on the severity of the wounds, some of them were subject to immediate surgery in the field, while others, with milder wounds, were evacuated inland for treatment in stationary military hospitals. Therefore, Pirogov is rightly considered the founder of a special direction in surgery, known as military field surgery.

For his services to helping the wounded and sick, Pirogov was awarded the Order of St. Stanislav, 1st degree.

After the Crimean War

After this meeting, the subject of Pirogov’s activity changed - he was sent to Odessa to the position of trustee of the Odessa educational district. This decision of the emperor can be considered as a manifestation of his disfavor, but at the same time, Pirogov had previously been assigned a lifelong pension of 1849 rubles and 32 kopecks per year; On January 1, 1858, Pirogov was promoted to the rank of Privy Councilor, and then transferred to the position of trustee of the Kyiv educational district, and in 1860 he was awarded the Order of St. Anne, 1st degree.

Pirogov tried to reform the existing education system, but his actions led to a conflict with the authorities, and the scientist had to leave his post as trustee of the Kyiv educational district. Pirogov remained as a member of the Main Board of Schools, and after the liquidation of this board in 1863, he served for life under the Ministry of Public Education.

Pirogov was sent to supervise Russian professor candidates studying abroad. “For his work while a member of the Main Board of Schools,” Pirogov was retained a salary of 5 thousand rubles per year.

He chose Heidelberg as his residence, where he arrived in May 1862. The candidates were very grateful to him; Nobel laureate I. I. Mechnikov, for example, warmly recalled this. There he not only fulfilled his duties, often traveling to other cities where candidates studied, but also provided them and their family members and friends with any assistance, including medical assistance, and one of the candidates, the head of the Russian community of Heidelberg, held a fundraiser for the treatment of Garibaldi and persuaded Pirogov to examine the wounded Garibaldi himself. Pirogov refused the money, but went to Garibaldi and discovered a bullet that had not been noticed by other world-famous doctors and insisted that Garibaldi leave the climate harmful to his wound, as a result of which the Italian government released Garibaldi from captivity. According to everyone, it was N.I. Pirogov who then saved the leg, and, most likely, the life of Garibaldi, who was convicted by other doctors. In his Memoirs, Garibaldi recalls: “The outstanding professors Petridge, Nelaton and Pirogov, who showed generous attention to me when I was in a dangerous state, proved that there are no boundaries for good deeds, for true science in the family of humanity...” After this incident, which caused a furor in St. Petersburg, there was an attempt on the life of Alexander II by nihilists who admired Garibaldi, and, most importantly, Garibaldi’s participation in the war of Prussia and Italy against Austria, which caused the displeasure of the Austrian government, and the “red” Pirogov was relieved of his official duties , but at the same time retained the status of an official and the previously assigned pension.

In the prime of his creative powers, Pirogov retired to his small estate “Cherry” not far from Vinnitsa, where he organized a free hospital. He briefly traveled from there only abroad, and also at the invitation of St. Petersburg University to give lectures. By this time, Pirogov was already a member of several foreign academies. For a relatively long time, Pirogov left the estate only twice: the first time in 1870 during the Franco-Prussian War, being invited to the front on behalf of the International Red Cross, and the second time in 1877-1878 - already at a very old age - he worked at the front for several months during the Russian-Turkish war. In 1873, Pirogov was awarded the Order of St. Vladimir, 2nd degree.

Russian-Turkish War 1877-1878

Last days

At the beginning of 1881, Pirogov drew attention to pain and irritation on the mucous membrane of the hard palate; on May 24, 1881, N.V. Sklifosovsky established the presence of cancer of the upper jaw. N.I. Pirogov died at 20:25. November 23, 1881 in the village. Cherry, now part of Vinnitsa.

At the end of the 1920s, robbers visited the crypt, damaged the lid of the sarcophagus, stole Pirogov’s sword (a gift from Franz Joseph) and a pectoral cross. In 1927, a special commission stated in its report: “The precious remains of the unforgettable N.I. Pirogov, thanks to the all-destroying effect of time and complete homelessness, are in danger of undoubted destruction if the existing conditions continue.”

In 1940, the coffin with the body of N.I. Pirogov was opened, as a result of which it was discovered that the visible parts of the scientist’s body and his clothes were covered with mold in many places; the remains of the body were mummified. The body was not removed from the coffin. The main measures for the preservation and restoration of the body were planned for the summer of 1941, but the Great Patriotic War began and, during the retreat of Soviet troops, the sarcophagus with Pirogov’s body was hidden in the ground and damaged, which led to damage to the body, which was subsequently subjected to restoration and repeated re-embalming . E. I. Smirnov played a major role in this.

Officially, Pirogov’s tomb is called a “necropolis church”; the body is located slightly below ground level in the crypt - the ground floor of an Orthodox church, in a glassed sarcophagus, which can be accessed by those wishing to pay tribute to the memory of the great scientist.

Meaning

The main significance of N. I. Pirogov’s work is that with his dedicated and often selfless work, he turned surgery into a science, equipping doctors with a scientifically based method of surgical intervention. In terms of his contribution to the development of military field surgery, he can be placed next to Larrey.

A rich collection of documents related to the life and work of N. I. Pirogov, his personal belongings, medical instruments, lifetime editions of his works are kept in the collections of the Military Medical Museum in St. Petersburg. Of particular interest is the scientist’s two-volume manuscript “Questions of Life. Diary of an Old Doctor" and the suicide note he left indicating the diagnosis of his illness.

Contribution to the development of domestic pedagogy

In the classic article “Questions of Life,” Pirogov examined the fundamental problems of education. He showed the absurdity of class education, the discord between school and life, and put forward as the main goal of education the formation of a highly moral personality, ready to renounce selfish aspirations for the good of society. Pirogov believed that for this it was necessary to rebuild the entire education system based on the principles of humanism and democracy. An education system that ensures personal development must be built on a scientific basis, from primary to higher education, and ensure the continuity of all education systems.

Pedagogical views: Pirogov considered the main idea of universal education, the education of a citizen useful to the country; noted the need for social preparation for the life of a highly moral person with a broad moral outlook: “ Being human is what education should lead to"; education and training should be in the native language. " Contempt for the native language dishonors the national feeling" He pointed out that the basis of subsequent professional education should be broad general education; proposed to attract prominent scientists to teach in higher education, recommended strengthening conversations between professors and students; fought for general secular education; called for respect for the child’s personality; fought for the autonomy of higher education.

Criticism of class vocational education: Pirogov opposed the class school and early utilitarian-professional training, against the early premature specialization of children; believed that it inhibits the moral education of children and narrows their horizons; condemned arbitrariness, barracks regime in educational institutions, thoughtless attitude towards children.

Didactic ideas: teachers should discard old dogmatic ways of teaching and adopt new methods; it is necessary to awaken the thoughts of students, instill the skills of independent work; the teacher must attract the student’s attention and interest to the material being communicated; transfer from class to class should be carried out based on the results of annual performance; in transfer exams there is an element of chance and formalism.

The system of public education according to N. I. Pirogov:

Family

First wife (from December 11, 1842) - Ekaterina Dmitrievna Berezina(1822-46), representative of an ancient noble family, granddaughter of the infantry general Count N. A. Tatishchev. She died at the age of 24 from complications after childbirth. Sons - Nikolai (1843-1891) - physicist, Vladimir (1846-after 11/13/1910) - historian and archaeologist

Second wife (from June 7, 1850) - Baroness Alexandra von Bystrom(1824-1902), daughter of Lieutenant General A. A. Bistrom, great-niece of the navigator I. F. Krusenstern. The wedding took place in the Goncharov estate Polotnyany Zavod, and the sacrament of wedding was performed on June 7/20, 1850 in the local Transfiguration Church. For a long time, Pirogov was credited with the authorship of the article “The Ideal of a Woman,” which is a selection from the correspondence of N. I. Pirogov with his second wife. In 1884, through the efforts of Alexandra Antonovna, a surgical hospital was opened in Kyiv.

The descendants of N.I. Pirogov currently live in Greece, France, the United States and St. Petersburg.

Memory

The image of Pirogov in art

N. I. Pirogov is the main character in several works of fiction.

A. I. Kuprin's story “The Wonderful Doctor” (1897).
Yu. P. German's stories "Bucephalus", "Drops of Inozemtsev" (published in 1941 under the title "Stories about Pirogov") and "The Beginning" (1968).
Novel by B. Yu. Zolotarev and Yu. P. Tyurin “Privy Councilor” (1986).

Bibliography

A complete course of applied anatomy of the human body. - St. Petersburg, 1843-1845.
Anatomical images of the external view and position of the organs contained in the three main cavities of the human body. - St. Petersburg, 1846. (2nd ed. - 1850)
Report on a trip to the Caucasus 1847-1849 - St. Petersburg, 1849. (M.: State Publishing House of Medical Literature, 1952)
Pathological anatomy of Asian cholera. - St. Petersburg, 1849.
Topographic anatomy from cuts through frozen corpses. Tt. 1-4. - St. Petersburg, 1851-1854.
- St. Petersburg, 1854
The beginnings of general military field surgery, taken from observations of military hospital practice and memories of the Crimean War and the Caucasian expedition. Part 1-2. - Dresden, 1865-1866. (M., 1941.)
University question. - St. Petersburg, 1863.
Grundzüge der allgemeinen Kriegschirurgie: nach Reminiscenzen aus den Kriegen in der Krim und im Kaukasus und aus der Hospitalpraxis (Leipzig: Vogel, 1864.- 1168 pp.) (German)
Surgical anatomy of arterial trunks and fascia. Vol. 1-2. - St. Petersburg, 1881-1882.
Essays. T. 1-2. - St. Petersburg, 1887. (3rd ed., Kyiv, 1910).
Sevastopol letters N.I. Pirogov 1854-1855 . - St. Petersburg, 1899.
Unpublished pages from the memoirs of N. I. Pirogov. (Political confession of N. I. Pirogov) // About the past: historical collection. - St. Petersburg: Typo-lithography by B. M. Wolf, 1909.
Questions of life. Diary of an old doctor. Publication of Pirogovskaya t-va. 1910
Works on experimental, operational and military field surgery (1847-1859) T 3. M.; 1964
Sevastopol letters and memories. - M.: Publishing House of the USSR Academy of Sciences, 1950. - 652 p. [Contents: Sevastopol letters; memories of the Crimean War; From the diary of the “Old Doctor”; Letters and documents].
Selected pedagogical works / Intro. Art. V. Z. Smirnova. - M.: Publishing house Acad. ped. Sciences of the RSFSR, 1952. - 702 s.
Selected pedagogical works. - M.: Pedagogy, 1985. - 496 p.

Notes

Kulbin N. I.// Russian biographical dictionary: in 25 volumes. - St. Petersburg. - M., 1896-1918.
Pirogovskaya street // Evening courier. - November 22, 1915.
Biographical dictionary of professors and teachers of the Imperial Yurievsky former Dorpat University over one years of its existence (1802-1902) Vol II. - P. 261
, With. 558.
, With. 559.
When choosing candidates for the department of the same name at Moscow University, preference was given to F. I. Inozemtsev.
Pirogov Nikolai Ivanovich on the website “Chronicle of Moscow University”.
Chronicle of the life and work of D. I. Mendeleev. - L.: Science, 1984.
Sevastopol letters N.I. Pirogov 1854-1855. - St. Petersburg, 1907.
Nikolay Marangozov. Nikolai Pirogov V. Duma (Bulgaria), November 13, 2003
Gorelova L. E. The Mystery of N.I. Pirogov // Russian Medical Journal. - 2000. - T. 8, No. 8. - P. 349.
Shevchenko Yu. L., Kozovenko M. N. Museum of N.I. Pirogov. - St. Petersburg, 2005. - P. 24.
Long-term preservation of the embalmed body of N. I. Pirogov - a unique scientific experiment // Biomedical and Biosocial Anthropology. - 2013. - V. 20. - P. 258.
Pirogov's last refuge
Rossiyskaya newspaper - Monument to the living for saving the dead
Location of the Tomb of N. I. Pirogov on the map of Vinnitsa
History of pedagogy and education. From the origins of education in primitive society to the end of the 20th century: A textbook for pedagogical educational institutions / Ed. A.I. Piskunova. - M., 2001.
History of pedagogy and education. From the origins of education in primitive society to the end of the 20th century: A textbook for pedagogical educational institutions / Ed. A.I. Piskunova. - M., 2001.
Kodzhaspirova G. M. History of education and pedagogical thought: tables, diagrams, supporting notes. - M., 2003. - P. 125.
He was a professor at Novorossiysk University in the department of history. In 1910 he temporarily lived in

The biography of Nikolai Pirogov, whom his contemporaries dubbed the “wonderful doctor,” is a vivid example of selfless service to medical science. A myriad of discoveries that saved the lives of thousands of people are still used in medicine.

Childhood and youth

The future genius of world medicine was born into a large family of a military official. Nicholas had thirteen brothers and sisters, many of whom died in childhood. Father Ivan Ivanovich received an education and achieved great success in his career. He took as his wife a kind, flexible girl from an old merchant family, who became a housewife and mother of their many children. Parents paid special attention to raising their children: boys were sent to study at prestigious institutions, and girls were educated at home.

Among the guests of the hospitable parental home there were many doctors who willingly played with the inquisitive Nikolai and told entertaining stories from their practice. Therefore, from an early age, he decided to become either a military man, like his father, or a doctor, like their family doctor Mukhin, with whom the boy became strong friends.

Nikolai grew up as a capable child, learned to read early and spent days in his father’s library. From the age of eight he began to receive teachers, and at eleven he was sent to a private boarding school in Moscow.

Soon, financial difficulties began in the family: Ivan Ivanovich’s eldest son Peter seriously lost, and his father had an embezzlement in the service, which had to be covered from his own funds. Therefore, the children had to be taken out of prestigious boarding schools and transferred to home schooling.

Family doctor Mukhin, who had long noticed Nikolai’s abilities in medicine, encouraged him to enter the university at the Faculty of Medicine. An exception was made for the gifted young man, and he became a student at fourteen years old, and not at sixteen, as the rules required.

Nikolai combined his studies with work in the anatomical theater, where he gained invaluable experience in surgery and finally decided on his choice of future profession.

Medicine and pedagogy

After graduating from the university, Pirogov was sent to the city of Dorpat (now Tartu), where he worked at the local university for five years and defended his doctoral dissertation at the age of twenty-two. Pirogov’s scientific work was translated into German, and soon Germany became interested in it. The talented doctor was invited to Berlin, where Pirogov worked for two years with leading German surgeons.

Returning to his homeland, the man expected to get a chair at Moscow University, but it was taken by another person who had the necessary connections. Therefore, Pirogov remained in Dorpat and immediately became famous throughout the area for his fantastic skill. Nikolai Ivanovich easily took on the most complex operations that no one had ever done before, describing the details in pictures. Soon Pirogov becomes a professor of surgery and leaves for France to inspect local clinics. The establishments did not make an impression on him, and Nikolai Ivanovich found the eminent Parisian surgeon Velpeau reading his monograph.

Upon returning to Russia, he was offered to head the department of surgery at the Medical-Surgical Academy of St. Petersburg, and soon Pirogov opened the first surgical hospital with a thousand beds. The doctor worked in St. Petersburg for 10 years and during this time he wrote scientific works on applied surgery and anatomy. Nikolai Ivanovich invented and supervised the production of the necessary medical instruments, continuously operated in his own hospital and consulted in other clinics, and worked at night in the anatomy, often in unsanitary conditions.

This lifestyle could not but affect the doctor’s health. What helped him get back on his feet was the news that the highest order of the sovereign had approved the project of the world's first Anatomical Institute, on which Pirogov had been working in recent years. Soon the first successful operation using ether anesthesia was carried out, which became a breakthrough in world medical science, and the anesthesia mask designed by Pirogov is still used in medicine.

In 1847, Nikolai Ivanovich left for the Caucasian War to test scientific developments in the field. There he performed ten thousand operations using anesthesia, and put into practice the starch-soaked bandages he invented, which became the prototype of the modern plaster cast.

In the fall of 1854, Pirogov and a group of doctors and nurses went to the Crimean War, where he became the chief surgeon in Sevastopol, surrounded by the enemy. Thanks to the efforts of the sisters of mercy service he created, a huge number of Russian soldiers and officers were saved. He developed a completely new system for those times for the evacuation, transportation and triage of the wounded in combat conditions, thus laying the foundations of modern military field medicine.

Upon returning to St. Petersburg, Nikolai Ivanovich met with the emperor and shared his thoughts on the problems and shortcomings of the Russian army. I was angry with the impudent doctor and did not want to listen to him. Since then, Pirogov fell out of favor at court and was appointed trustee of the Odessa and Kyiv districts. He directed his activities towards reforming the existing school education system, which again aroused the discontent of the authorities. Pirogov developed a new system, which consisted of four stages:

primary school (2 years) – mathematics, grammar;
junior high school (4 years) – general education program;
secondary school (3 years) – general education program + languages + applied subjects;
higher school: higher education institutions

In 1866, Nikolai Ivanovich moved with his family to his estate Vishnya in the Vinnitsa province, where he opened a free clinic and continued his medical practice. The sick and suffering came to see the “wonderful doctor” from all over Russia.

He did not abandon his scientific activity, writing works on military field surgery in Vishna, which glorified his name.

Pirogov traveled abroad, where he took part in scientific conferences and seminars, and during one of his trips he was asked to provide medical assistance to Garibaldi himself.

Emperor Alexander II again remembered the famous surgeon during the Russian-Turkish War and asked him to join the military campaign. Pirogov agreed on the condition that they would not interfere with him or limit his freedom of action. Arriving in Bulgaria, Nikolai Ivanovich began organizing military hospitals, traveling 700,700 kilometers in three months and visiting twenty settlements. For this, the emperor granted him the Order of the White Eagle and a gold snuffbox with diamonds, decorated with a portrait of the autocrat.

The great scientist devoted his last years to medical practice and writing “The Diary of an Old Doctor,” finishing it just before his death.

Personal life

Pirogov first married in 1841 to the granddaughter of General Tatishchev, Ekaterina Berezina. Their marriage lasted only four years, the wife died from complications of a difficult birth, leaving behind two sons.

Eight years later, Nikolai Ivanovich married Baroness Alexandra von Bistrom, a relative of the famous navigator Kruzenshtern. She became a faithful assistant and ally, and through her efforts a surgical clinic was opened in Kyiv.

Death

The cause of Pirogov’s death was a malignant tumor that appeared on the oral mucosa. The best doctors of the Russian Empire examined him, but they could not help. The great surgeon died in the winter of 1881 in Vishnya. Relatives said that at the moment of the dying man’s agony, a lunar eclipse occurred. The wife of the deceased decided to embalm his body, and, having received permission from the Orthodox Church, invited Pirogov’s student David Vyvodtsev, who had been working on this topic for a long time.

The body was placed in a special crypt with a window, over which a church was subsequently erected. After the revolution, it was decided to preserve the body of the great scientist and carry out work to restore it. These plans were interrupted by the war, and the first reembalmation was carried out only in 1945 by specialists from Moscow, Leningrad and Kharkov. Now the same group that maintains the condition of bodies, and, is engaged in preserving Pirogov’s body.

Pirogov’s estate has survived to this day; a museum of the great scientist is now organized there. It annually hosts Pirogov readings dedicated to the surgeon’s contribution to world medicine, and hosts international medical conferences.

S. Vishnya (now within the boundaries of Vinnitsa), Podolsk province, Russian Empire) - Russian surgeon and anatomist, naturalist and teacher, founder of the atlas of topographic anatomy, founder of military field surgery, founder of anesthesia. Corresponding Member of the St. Petersburg Academy of Sciences.

Biography

Crimean War

Later years

N. I. Pirogov

Despite the heroic defense, Sevastopol was taken by the besiegers, and the Crimean War was lost by Russia. Returning to St. Petersburg, Pirogov, at a reception with Alexander II, told the emperor about the problems in the troops, as well as about the general backwardness of the Russian army and its weapons. The Emperor did not want to listen to Pirogov. From that moment on, Nikolai Ivanovich fell out of favor; he was sent to Odessa to serve as trustee of the Odessa and Kyiv educational districts. Pirogov tried to reform the existing school education system, his actions led to a conflict with the authorities, and the scientist had to leave his post. Not only was he not appointed Minister of Public Education, but they even refused to make him a comrade (deputy) minister; instead, he was “exiled” to supervise Russian candidates for professors studying abroad. He chose Heidelberg as his residence, where he arrived in May 1862. The candidates were very grateful to him; for example, Nobel laureate I. I. Mechnikov warmly recalled this. There he not only fulfilled his duties, often traveling to other cities where candidates studied, but also provided them and their family members and friends with any assistance, including medical assistance, and one of the candidates, the head of the Russian community of Heidelberg, held a fundraiser for treatment of Garibaldi and persuaded Pirogov to examine the wounded Garibaldi. Pirogov refused the money, but went to Garibaldi and discovered a bullet that had not been noticed by other world-famous doctors, insisted that Garibaldi leave the climate harmful to his wound, as a result of which the Italian government released Garibaldi from captivity. According to everyone, it was N.I. Pirogov who then saved the leg, and, most likely, the life of Garibaldi, who was convicted by other doctors. In his “Memoirs,” Garibaldi recalls: “The outstanding professors Petridge, Nelaton and Pirogov, who showed generous attention to me when I was in a dangerous state, proved that for good deeds, for true science, there are no boundaries in the family of humanity...” After this incident that caused a furor in St. Petersburg, there was an attempt on the life of Alexander II by nihilists who admired Garibaldi, and, most importantly, Garibaldi’s participation in the war of Prussia and Italy against Austria, which caused the displeasure of the Austrian government, and the “red” Pirogov was generally dismissed from public service even without pension rights.

In the prime of his creative powers, Pirogov retired to his small estate “Vishnya” not far from Vinnitsa, where he organized a free hospital. He briefly traveled from there only abroad, and also at the invitation of St. Petersburg University to give lectures. By this time, Pirogov was already a member of several foreign academies. For a relatively long time, Pirogov left the estate only twice: the first time in 1870 during the Franco-Prussian War, being invited to the front on behalf of the International Red Cross, and the second time, in -1878 - already at a very old age - he worked at the front for several months during the Russian-Turkish War.

Activities in the Russian-Turkish War of 1877-1878

Last confession

N. I. Pirogov on the day of death

Pirogov’s body was embalmed by his attending physician D.I. Vyvodtsev using a method he had newly developed, and buried in a mausoleum in the village of Vishnya near Vinnitsa. At the end of the 1920s, robbers visited the crypt, damaged the lid of the sarcophagus, stole Pirogov’s sword (a gift from Franz Joseph) and a pectoral cross. During the Second World War, during the retreat of Soviet troops, the sarcophagus with Pirogov’s body was hidden in the ground, and was damaged, which led to damage to the body, which was subsequently subjected to restoration and re-embalming.

Officially, Pirogov’s tomb is called a “necropolis church”; the body is located below ground level in the crypt - the ground floor of an Orthodox church, in a glassed sarcophagus, which can be accessed by those wishing to pay tribute to the memory of the great scientist.

Meaning

The main significance of all Pirogov’s activities is that with his selfless and often selfless work, he turned surgery into a science, equipping doctors with a scientifically based method of surgical intervention.

A rich collection of documents related to the life and work of Nikolai Ivanovich Pirogov, his personal belongings, medical instruments, lifetime editions of his works are kept in the collections of the Military Medical Museum in St. Petersburg, Russia. Of particular interest are the scientist’s 2-volume manuscript “Questions of Life. Diary of an Old Doctor" and the suicide note he left indicating the diagnosis of his illness.

Contribution to the development of domestic pedagogy

In the classic article “Questions of Life” he examined the fundamental problems of Russian education. He showed the absurdity of class education, the discord between school and life. He put forward as the main goal of education the formation of a highly moral personality, ready to renounce selfish aspirations for the good of society. He believed that for this it was necessary to rebuild the entire education system based on the principles of humanism and democracy. An education system that ensures personal development must be built on a scientific basis, from primary to higher school, and ensure the continuity of all education systems.

Pedagogical views: he considered the main idea of universal education, the education of a citizen useful to the country; noted the need for social preparation for the life of a highly moral person with a broad moral outlook: “ Being human is what education should lead to"; education and training should be in the native language. " Contempt for the native language dishonors the national feeling" He indicated that the basis for subsequent professional education should be broad general education; proposed to attract prominent scientists to teach in higher education, recommended strengthening conversations between professors and students; fought for general secular education; called for respect for the child’s personality; fought for the autonomy of higher education.

Criticism of class vocational education: opposed the class school and early utilitarian-professional training, against the early premature specialization of children; believed that it inhibits the moral education of children and narrows their horizons; condemned arbitrariness, barracks regime in schools, thoughtless attitude towards children.

The system of public education according to N. I. Pirogov:

Family

Memory

In Russia

In Ukraine

In Belarus

Pirogova street in the city of Minsk.

In Bulgaria

The grateful Bulgarian people erected 26 obelisks, 3 rotundas and a monument to N.I. Pirogov in Skobelevsky Park in Plevna. In the village of Bokhot, on the site where the Russian 69th military temporary hospital stood, the park-museum “N. I. Pirogov."

In Estonia

Monument in Tartu - located on the square named after. Pirogov (Estonian: Pirogovi plats).

In Moldavia

A street in the city of Rezina and in Chisinau was named in honor of N.I. Pirogov

In literature and art

Pirogov is the main character in Kuprin’s story “The Wonderful Doctor”
Pirogov is the main character in the story “The Beginning” and in the story “Bucephalus” by Yuri German.
Pirogov is a computer program in the science fiction books “Ancient: Catastrophe” and “Ancient: Corporation” by Sergei Tarmashev.
“Pirogov” is a 1947 film, in the role of Nikolai Pirogov - People's Artist of the USSR Konstantin Skorobogatov.

In philately

Notes

Sevastopol letters of N. I. Pirogov 1854-1855. - St. Petersburg: 1907
Nikolay Marangozov. Nikolay Pirogov v. Duma (Bulgaria), November 13, 2003
Gorelova L. E. The mystery of N. I. Pirogov // Russian Medical Journal. - 2000. - T. 8. - No. 8. - P. 349.
Pirogov's last refuge
Rossiyskaya Gazeta - Monument to the living for saving the dead
Location of the Tomb of N. I. Pirogov on the map of Vinnitsa
History of pedagogy and education. From the origins of education in primitive society to the end of the 20th century: A textbook for pedagogical educational institutions / Ed. A.I. Piskunova. - M., 2001.
History of pedagogy and education. From the origins of education in primitive society to the end of the 20th century: A textbook for pedagogical educational institutions, ed. A.I. Piskunova. - M., 2001.
Kodzhaspirova G. M. History of education and pedagogical thought: tables, diagrams, supporting notes. - M., 2003. - P. 125
Kaluga crossroads. Surgeon Pirogov married a Kaluga woman
According to the rector of the Russian State Medical University Nikolai Volodin (Rossiyskaya Gazeta, August 18, 2010), this was “a technical error of the former leadership. Two years ago, at a meeting of the labor collective, it was unanimously decided to return the name of Pirogov to the university. But nothing has changed yet: the charter, which was amended, is still being approved... It should be adopted in the near future.” As of November 4, 2010, on the RSMU website the university is described as “named after. N.I. Pirogov,” however, among the regulatory documents cited there, there is still the charter of 2003 without mentioning the name of Pirogov.
The only one mausoleum in the world, officially recognized (canonized) by the Orthodox Church
In tsarist times, here on Malo-Vladimirskaya Street there was a Makovsky hospital, where the mortally wounded Stolypin was taken in 1911 and spent his last days (the pavement in front of the hospital was covered with straw). Alexander Solzhenitsyn. Chapter 67 // Red Wheel. - Node I: August the Fourteenth. - M.: Time, . - T. 2 (volume 8th collected works). - pp. 248, 249. - ISBN 5-9691-0187-7
MBALSM "N. I. Pirogov"
1977 (14 October). 100 from prebivaneto to academician Nikolai Pirogov in Bulgaria. Hood. N. Kovachev. P. dulbok. Name G 13. Sheet (5x5). N. I. Pirogov (Russian surgeon). 2703. 13 art. Circulation: 150,000.
Chronicle of the life and work of D. I. Mendeleev. - L.: Science. 1984.
Vetrova M. D. The myth about N. I. Pirogov’s article “The Ideal of a Woman” [including the text of the article]. // Space and time. - 2012. - No. 1. - P. 215-225.

Bibliography

Pirogov N. I. A complete course of applied anatomy of the human body. - St. Petersburg, 1843-1845.
Pirogov N. I. Report on a trip to the Caucasus 1847-1849 - St. Petersburg, 1849. (Pirogov, N. I. Report on a trip to the Caucasus / Compiled, introductory article and notes by S. S. Mikhailov. - M.: State Publishing house of medical literature, 1952. - 358 pp.)
Pirogov N. I. Pathological anatomy of Asian cholera. - St. Petersburg, 1849.
Pirogov N. I. Anatomical images of the external appearance and position of the organs contained in the three main cavities of the human body. - St. Petersburg, 1850.
Pirogov N. I. Topographic anatomy from cuts through frozen corpses. Tt. 1-4. - St. Petersburg, 1851-1854.
Pirogov N. I. The beginnings of general military field surgery, taken from observations of military hospital practice and memories of the Crimean War and the Caucasian expedition. Hh. 1-2. - Dresden, 1865-1866. (M., 1941.)
Pirogov N. I. University question. - St. Petersburg, 1863.
Pirogov N. I. Surgical anatomy of arterial trunks and fascia. Vol. 1-2. - St. Petersburg, 1881-1882.
Pirogov N. I. Essays. Tt. 1-2. - St. Petersburg, 1887. [T. 1: Questions of life. Diary of an old doctor. T. 2: Questions of life. Articles and notes]. (3rd ed., Kyiv, 1910).
Pirogov N. I. Sevastopol letters of N. I. Pirogov 1854-1855. - St. Petersburg, 1899.
Pirogov N. I. Unpublished pages from the memoirs of N. I. Pirogov. (Political confession of N. I. Pirogov) // About the past: historical collection. - St. Petersburg: Typo-lithography by B. M. Wolf, 1909.
Pirogov N.I. Questions of life. Diary of an old doctor. Publication of Pirogovskaya t-va. 1910
Pirogov N.I. Works on experimental, operational and military field surgery (1847-1859) T 3. M.; 1964
Pirogov N. I. Sevastopol letters and memories. - M.: Publishing House of the USSR Academy of Sciences, 1950. - 652 p. [Contents: Sevastopol letters; memories of the Crimean War; From the diary of the “Old Doctor”; Letters and documents].
Pirogov N. I. Selected pedagogical works / Intro. Art. V. Z. Smirnova. - M.: Publishing house Acad. ped. Sciences of the RSFSR, 1952. - 702 s.
Pirogov N. I. Selected pedagogical works. - M.: Pedagogy, 1985. - 496 p.

Literature

Streich S. Ya. N. I. Pirogov. - M.: Magazine and newspaper association, 1933. - 160 p. - (Life of wonderful people). - 40,000 copies.
Porudominsky V. I. Pirogov. - M.: Young Guard, 1965. - 304 p. - (Life of remarkable people; issue 398). - 65,000 copies.(in translation)

Links

Sevastopol letters of N. I. Pirogov 1854-1855. on the Runiverse website
Nikolai Ivanovich Pirogov “Questions of Life. Diary of an old doctor", Ivanovo, 2008, pdf
Nikolai Ivanovich Pirogov. Questions of life. Diary of an Old Doctor, facsimile reproduction of the second volume of Pirogov's works, published in 1910, PDF
Zakharov I. Surgeon Nikolai Pirogov: a difficult path to faith // St. Petersburg University. - No. 29 (3688), December 10, 2004
Trotsky L. Political silhouettes: Pirogov
L. V. Shaposhnikova.

This article about the great Russian doctor, scientist, surgeon and anesthesiologist was sent to us by our friend and colleague prof. Y. Moens. It was written by colleagues from the Netherlands and published in an anesthesiology journal. This is the story of a truly outstanding doctor and scientist.

F. Hendricks, J. G. Bovill, F. Boer, E.S. Houwaart and P.C.W. Hogendoorn.
Postgraduate Student, Executive Board Department, 2. Emeritus Professor of Anesthesia 3. Staff Anesthesiologist and Director of Healthcare Innovation, 4. Dean of the Faculty of Medicine Leiden, Leiden University Medical Center; Leiden, Netherlands. 5. Professor of the History of Medicine, Department of Health, Ethics, Society Studies, Maastricht University; Maastricht, Netherlands.

Summary:
The key figure who influenced the development of anesthesiology in Russia was Nikolai Ivanovich Pirogov (1810-1881). He experimented with ether and chloroform and organized the widespread use of general anesthesia in Russia for patients undergoing surgery. He was the first to conduct a systematic study of morbidity and mortality due to anesthesia. More specifically, he was one of the first to administer anesthesia using ether on the battlefield, where the very basic principles of military medicine he laid down remained virtually unchanged until the outbreak of World War II.

Introduction

On Friday, October 16, 1846, in the operating room of the Massachusetts General Hospital in Boston, William Morton made the first successful demonstration of the use of ether for anesthesia in adults. News of this discovery was reported in the Russian press in early 1847. Although B.F. Berenson on January 15, 1847 in Riga (at that time part of the territory of the Russian Empire) and F.I. Inozemtsev on February 7, 1847 in Moscow, were the first in Russia to use ether anesthesia, Nikolai Ivanovich Pirogov (Fig. 1) was the first surgeon who introduced the widespread use of general anesthesia in this country, adapting it for use in military field conditions.

Rice. 1. Portrait of Nikolai Ivanovich Pirogov. Oil, canvas. The artist and time of execution of the portrait are unknown. Wellcome Library (published with permission)

Nikolai Ivanovich Pirogov was born on November 25, 1810 into a merchant family. Already at the age of 6, he taught himself to read. Later, home teachers were invited to him, thanks to whom he learned French and Latin. At the age of 11, he was sent to a boarding school, but he stayed there for only two years, as financial difficulties arose in the family and education at the boarding school became unaffordable for his parents. A family friend, Efrem Osipovich Mukhin, professor at the Department of Anatomy and Physiology at Moscow University, helped young N.I. Pirogov to enter the Faculty of Medicine, although at that time N.I. Pirogov was only 13 years old, but he was accepted there from the age of 16. Medical training was of poor quality, students studied from outdated textbooks. Lectures were also given based on old materials. By the fourth year of training, Pirogov had not yet performed a single independent autopsy and was present at only two operations. Nevertheless, in 1828 he was awarded the title of physician. N.I. Pirogov was only 17 years old at the time.

After finishing his studies at Moscow University, Pirogov continued his studies at the German-Baltic University of Dorpat (now Tartu, Estonia) in order to expand and deepen his knowledge and skills. He completed his studies in Dorpat in August 1832 and brilliantly defended his dissertation on the topic “Num vinctura aortae abdominalis in aneurismate inhunali adhibitu facile ac turtum sut remedium” (“Is ligation of the ventral aorta an easy and effective method of therapy for the treatment of inguinal aneurysm?”), receiving a doctorate. The University of Dorpat worked closely with many specialists and scientists from educational institutions throughout Western Europe, which helped Pirogov expand and accumulate knowledge to become an international specialist.

After graduating from the University of Dorpat N.I. Pirogov continued his studies in Göttingen and Berlin. At the age of 25, in March 1826, N.I. Pirogov becomes a professor at the University of Dorpat and succeeds his mentor and predecessor, Professor Moyer. In March 1841, he received the position of professor of hospital surgery at the Military Medical Academy and also the position of chief surgeon of the Medical-Surgical Academy of St. Petersburg (until 1917 it remained the capital of the Russian Empire), in which he remained for 15 years, until his resignation. In April 1856, Pirogov moved to Odessa, and later to Kyiv.

In St. Petersburg, he has to face the envy of his colleagues and constant opposition from the local administration. But this did not stop N.I. Pirogov - he continued to engage in private and academic practice and teaching.

From newspapers and magazines such as “Northern Bee”, from medical magazines “Friend of Health”, “St. Petersburg Vedomosti” N.I. Pirogov learns of Morton's demonstration of ether anesthesia.

Initially N.I. Pirogov was skeptical about ether anesthesia. But the tsarist government was interested in conducting similar experiments and researching this method. Foundations were founded to study the properties of ether.

In 1847 N.I. Pirogov begins his research and becomes convinced that all his fears were unfounded and that ether anesthesia was “a means that can transform the entire surgery in an instant.” In May 1847 he published his monograph on this topic. . In the monograph, he gives recommendations that a test anesthesia must first be carried out, since the body’s reaction to the introduction of anesthesia is strictly individual for each person. For patients who did not want to inhale ether vapor, he suggests administering anesthesia rectally.

Figure 2. A device for inhalation of ether vapors, developed by N. I. Pirogov.

Ether evaporation from the flask (m) enters the inhalation valve (h), where it mixes with the inhaled air through the holes in the valve. The amount of mixture, and thus the inhaled concentration of ether, is controlled by tap (i) in the upper half of the inhalation valve. The ether/air mixture was inhaled by the patient through a tightly fitting mask connected to the inhalation valve by a long tube containing a valve for exhaled air. The face mask was developed by N.I. Pirogov for convenient fixation on the patient’s mouth and nose, it was an innovative invention at that time.

N.I. Pirogov studied the clinical course of anesthesia on himself and his assistants before using it on patients. In February 1847, he performed the first two operations using ether anesthesia at the Second Military Land Hospital of St. Petersburg. To put the patient under anesthesia, he used a regular green bottle with a simple rubber tube for inhalation through the patient's nose.

February 16, 1847 N.I. Pirogov performs the same operation in the Obukhov hospital. On February 27, the fourth operation using ether anesthesia took place at the Peter and Paul Hospital in St. Petersburg. This operation was a palliative procedure performed on a young girl with a purulent inflammation of the stump after amputation of her leg. This time the primitive equipment was replaced with a device invented by the Frenchman Charrière. But it did not satisfy N.I. Pirogov, so he, together with instrument maker L. Rooh, designed his own device and mask for ether inhalation (Fig. 2). The mask made it possible to begin administering anesthesia directly during the operation, without the help of an assistant. The valve made it possible to regulate the mixture of ether and air, allowing the doctor to monitor the depth of anesthesia. A year after Morton's demonstration of ether anesthesia, Pirogov performed more than 300 operations using ether anesthesia.

March 30, 1847 N.I. Pirogov sends an article to the Academy of Sciences in Paris, in which he describes his experiments on the use of ether rectally. The article was read only in May 1847. On June 21, 1847, he presented his second publication on the use of ether in animals by rectal administration. . This article became the material for his book, in which he described his experiments in administering ether to 40 animals and 50 patients. The goal was to provide medical practitioners with information about the effects of ether anesthesia and details of the design of the device used for inhalation. This book deserves to be included in the list of the earliest textbooks on general anesthesia compiled by Secher and Dinnik.

Research on the rectal method of administering anesthesia N.I. Pirogov conducted his research mainly on dogs, but his subjects included rats and rabbits. His research was based on the work of the French physiologist François Magendie, who conducted experiments on animals using ether rectally. The ether, introduced in the form of vapor into the rectum using an elastic tube, was instantly absorbed by the blood and soon after that it could be detected in the exhaled air. Patients entered a state of anesthesia within 2-3 minutes from the start of ether administration. Compared to inhalation, patients entered a deeper state of anesthesia with greater muscle relaxation. This anesthesia lasted longer (15-20 minutes), making it possible to perform more complex operations. Due to stronger muscle relaxation, this method of anesthesia is well suited for surgical intervention for inguinal hernia and habitual dislocations. However, this method had disadvantages. Among which it was noted: hot water is always needed for the tube, the rectum must first be cleansed with an enema, after cooling and liquefying the ether, patients often received colitis and diarrhea. At the beginning of his research, Pirogov was full of enthusiasm about the widespread use of this method of anesthesia, but later he was inclined to use this method as an antispasmodic in eliminating stones in the urinary canal. However, rectal ether never became so widely used, although it was used in London by Dr. Buxton, at King's College Hospital in the operations of Sir Joseph Lister and Sir Victor Hosley. There were also reports of the use of ether anesthesia in obstetric practice in the 1930s in Canada. . Also N.I. Pirogov conducted experiments on animals using intravenous anesthesia. He demonstrated that anesthesia occurs if and only if the ether can be detected in the exhaled air: “Thus, the arterial bloodstream provides a transport medium for the vapors, and the calming effect is transmitted to the central nervous system.” Scientific work and innovations of N.I. Pirogov had a huge influence on what in Russia at that time was called the “etherization process.” Although he was convinced that the discovery of ether anesthesia was one of the significant scientific achievements, he was also quite aware of the existing limitations and dangers: “This type of anesthesia can impair or significantly weaken the activity of reflexes, and this is just one step from of death" .

Caucasian War and anesthesia in military conditions

In the spring of 1847, the mountaineers rebelled in the Caucasus. Thousands killed and seriously wounded. Military field hospitals are overflowing with soldiers with terrible wounds and injuries. The Tsarist government insisted that anesthesia be used for all surgical operations for the duration of the military campaign. This decision was made not only based on humanitarian considerations. It was decided that the soldiers, seeing their comrades no longer experience excruciating pain during operations or amputations, would be confident that if they were wounded, they would also not experience pain during surgery. This was supposed to raise morale among the soldiers.

On May 25, 1847, at the conference of the Medical-Surgical Academy N.I. Pirogov was informed that he, as an ordinary professor and state councilor, was being sent to the Caucasus. He will have to instruct young doctors in the Separate Caucasian Corps on the use of ether anesthesia during surgery. Assistants N.I. Pirogov were appointed Dr. P.I. Nemmert and I. Kalashnikov, senior paramedic of the Second Military Ground Hospital. Preparations for departure took a week. They left St. Petersburg in June and went to the Caucasus in a carriage. N.I. Pirogov was very worried that due to strong shaking and heat (the air temperature was above 30 0 C) an ether leak could occur. But all his fears were in vain. Along the way, Pirogov visited several cities, in which he introduced ether anesthesia to local doctors. Pirogov took with him not only ether, in a volume of 32 liters. From a factory for the production of surgical equipment (of which Pirogov was also the director), he also seized 30 inhalers. Upon arrival at the destination, the ether was bottled into 800 ml bottles, which were placed in special boxes closed with mat and oilcloth. . In the city of Pyatigorsk, in a military hospital, N.I. Pirogov organized theoretical and practical classes for local doctors. Together with Dr. Nemmert, he performed 14 operations of varying degrees of complexity.

In the city of Ogly, the wounded were placed in tents in plain sight. N.I. Pirogov deliberately did not carry out operations in closed spaces, giving the opportunity to other wounded to see that their comrades did not experience inhuman pain during operations. And the soldiers were able to make sure that their comrades were simply sleeping throughout the entire operation and did not feel anything. In his report on the trip to the Caucasus, he writes: “For the first time, operations were carried out without the groans and cries of the wounded... the most comforting effect of the etherization was that the operations were carried out in the presence of other wounded men who were not afraid, but, on the contrary, the operations reassured them about their own position."

Then N.I. Pirogov arrives at the Samurt detachment, located near the fortified village of Salta. The field hospital there was the most primitive - just stone tables covered with straw. Operate N.I. Pirogov had to stand on his knees. Here, near Saltami, Pirogov performed more than 100 operations under ether anesthesia. Pirogov writes: “Of the surgical operations performed with the use of ether, 47 were performed by me personally; 35 - by my assistant, Nemmert; 5 - under my supervision by local doctor Dushinsky and the remaining 13 - under my supervision by regimental battalion doctors." Of all these patients, only two received anesthesia by the rectal method, since it was impossible to put them into a state of anesthesia by inhalation: the conditions were very primitive and there was a source of open fire nearby. This was the first time in military history that soldiers underwent operations and amputations under general anesthesia. Pirogov also found time to demonstrate the technical aspects of ether anesthesia to local surgeons.

Over the course of a year (from February 1847 to February 1848), Pirogov and his assistant Dr. Nemmert collected enough data on operations using ether anesthesia in military and civilian hospitals and clinics. (Table 1)

Table 1. The number of patients operated on by Nikolai Ivanovich Pirogov during the period from February 1847 to February 1848, classified according to the types of anesthesia administered and the type of surgical procedure.

Type of anesthesia	Type of surgery		Deaths per surgical type
Ether by inhalation	Big	Small	Big	Small
adults	242	16	59	1
Children	29	4	4	0
Rectal ether
Adults	58	14	13	1
Children	8	1	1	0
Chloroform
Adults	104	74	25	1
Children	18	12	3	0

Of the 580 operations, 108 patients died, resulting in a mortality rate of 1 in 5.4 operations. Of these, 11 patients died within 48 hours after surgery. N.I. Pirogov describes his Caucasian experiences and his statistical analysis in the book “Report on a trip to the Caucasus”, in which he points out: “Russia, ahead of all of Europe, shows the world with its actions not only the possibilities of application, but also the undeniable benefits of the etherization method for the benefit of the wounded on the battlefield . We hope that from now on, etherization will be, like the surgeon’s knife, an indispensable attribute of every doctor during his actions on the battlefield.” This brings together his views on general anesthesia in particular and the importance of its use in surgery in general.

N.I. Pirogov and chloroform

After the return of N.I. Pirogov from the Caucasian War, on December 21, 1847, he performed the first anesthesia using chloroform in Moscow. The test subject was a large dog. He carefully recorded every detail of his operations and experiments with animals. He describes the influence of anesthesia on the postoperative clinical course, in addition to his publications. As well as surgical mortality rates, he reports general anesthesia-induced side effects, which he defines as prolonged loss of consciousness, vomiting, delirium, headache, and abdominal discomfort. He spoke of "anesthesia-related mortality" if death occurred within 24 to 48 hours. At autopsy, no surgical reason or other explanation for the reason for its occurrence could be found. Based on his observations and analyses, he was convinced that mortality did not increase with the introduction of ether or chloroform. This contradicted the observations of French and British doctors (who may have been influenced by the Hannah Groener case) that administration of chloroform could lead to cardiac arrest, or, as Glover suggested, death from toxic blockage of the lungs during anesthesia. N.I. Pirogov suggested that the deaths described by French and British doctors were the result of too rapid administration of anesthesia or improper dosage of anesthesia. Abrupt cardiac arrest, according to N.I. Pirogov, was the result of an overdose of chloroform. He demonstrated this in dogs and cats. In 1852, John Snow reported similar results.

On the battlefield, chloroform had a number of advantages over ether. The amount of the substance was significantly smaller; chloroform is not flammable and did not require complex equipment when used. From start to finish, the anesthesia process was carried out using simple objects: a bottle and a rag. The French medical service used chloroform during the Crimean War, and it was also used by some British Army surgeons.

From the practice of N.I. Pirogov on the use of chloroform, not a single death was associated with anesthesia. There were also no deaths from the use of chloroform in Russian field hospitals. However, five patients developed profound shock during surgery. Of these, one patient died from blood loss, and the remaining four recovered within a few hours. One of these patients underwent a procedure for eliminating knee extension contracture while under deep anesthesia. After a small amount of chloroform was given to induce muscle relaxation, bradycardia suddenly began to occur. The patient's pulse was no longer palpable and breathing was no longer recorded. The patient spent 45 minutes in this condition, despite the use of all existing means of resuscitation. Dilation of the neck and arm veins was noted. Pirogov performed phlebotomy from the middle vein and found the release of gas with an audible hiss, but with little blood loss. Then, when massaging the neck veins and veins of the arms, even more blood appeared with gas bubbles and later - pure blood. And although N.I. Pirogov conducted his observations very carefully; he was unable to explain these extraordinary manifestations in the patient. Fortunately, the patient made a full recovery.

N.I. Pirogov formulated the following directions for the use of chloroform:

Chloroform should always be administered in fractions. This is especially true for severe injuries. Pirogov himself kept chloroform in bottles of one dram (3.9 grams)
Patients should undergo anesthesia while lying down in any case
Anesthesia should not be administered immediately after eating or, conversely, after a long fast.
Induction of anesthesia should be carried out by applying a cloth or sponge soaked in chloroform at a distance from the patient. Gradually this distance is reduced until it reaches the patient. This will avoid laryngospasm or cough.
The patient's pulse should be monitored by an experienced assistant or the surgeon himself, managing the anesthesia process. If bradycardia begins, chloroform should be removed immediately.
Particular care must be taken when administering anesthesia to anemic patients, as they may experience shock if chloroform is administered too quickly if they are in a supine position.

Also N.I. Pirogov gives several recommendations for resuscitating patients, including squeezing the chest and opening the mouth, clearing accumulated phlegm and blood in the throat, and fully protruding the tongue. Although these actions are considered standard in modern practice, during the time of N.I. Pirogov they were an innovation. He also insisted that during surgery, the surgeon should examine the color and amount of blood lost. If the arterial blood was black and its flow was weak, the administration of chloroform should be stopped. Pirogov believed that the amount of the substance should be limited and amount to about 3 drams, although for some patients, in his opinion, higher doses are possible. Even if shock did not occur, there was still a risk of shock occurring if the wrong amount of anesthesia was used or if it was administered too quickly. Pirogov also used chloroform during operations to correct strabismus in children, in newborns, and for diagnostic procedures, such as the diagnosis of hidden fractures.

Crimean War (1853 - 1856)

Pirogov served in the army as a surgeon during the Crimean War. On December 11, 1854, he was appointed chief surgeon of the besieged city of Sevastopol.

During the Crimean War, many operations were carried out in besieged Sevastopol, led by N.I. Pirogov. He was the first who (with the assistance of Grand Duchess Elena Pavlovna Romanova von Wüttemberg, cousin of Nicholas I) began recruiting women for nursing courses, who later became the “Sisters of Mercy”. N.I. Pirogov trained them to assist the surgeon during operations, administer general anesthesia and perform other nursing duties. This group of women became the founders of the Russian Red Cross. Unlike the British sisters of Florence Nightingale, the Russian sisters worked not only in a small area of medical units, but also on the battlefield itself, often under artillery fire. Seventeen Russian sisters died while performing their duty during the Crimean War, and six of them in the city of Simferopol alone.

During the defense of Sevastopol N.I. Pirogov introduced the use of anesthesia and gained invaluable experience by performing thousands of operations. In 9 months, he performed more than 5,000 amputations, that is, 30 per day. Possibly due to overexertion, he contracted typhus and was on the verge of death for three weeks. But, fortunately, he made a full recovery. In the book “Grundzuge der allgemeinen Kriegschirurgie usw” (“Beginnings of general military field surgery” - translator’s note) he described his experiences in the use of general anesthesia. The book was published in 1864 and became a standard in field surgery. The basic principles laid down by N.I. Pirogov, soon found their followers all over the world and remained virtually unchanged until the Second World War. On the Crimean Front, the soldiers were so confident in N.I.’s extraordinary abilities. Pirogov as a surgeon that they once brought him the body of a soldier without a head. The doctor, who was on duty at the time, exclaimed: “What are you doing? Where are you taking him, don’t you see that he has no head?” “Nothing, they’ll bring the head now,” the men answered. - “Doctor Pirogov is here, he will find a way to return her to her place.”

Civil anesthesiology as a medical specialization

Taking into account his personal experience, N.I. Pirogov warned against performing anesthesia by an insufficiently competent assistant. Based on the experience of conducting operations in the Caucasus, he was able to make sure that operations were carried out more effectively with experienced assistants. His main argument was that operations under general anesthesia were more difficult and took longer. Due to this, the surgeon could not fully concentrate on the progress of the operation and at the same time monitor the condition of the patient under anesthesia. Again, after studying the work of health services during the Franco-Prussian War of 1870 and in Bulgaria in 1877–78, Pirogov advocated strengthening the role of new means for general anesthesia during surgery. He also advocated the use of anesthesia for other procedures, particularly wound care.

In December 1938, at the 24th Union Congress of Surgeons in the Soviet Union, a decision was made on special training of anesthesiologists. In 1955, at the 26th Congress of Surgeons of the USSR, this became a reality.

Influence of military anesthesiology on civilian practice

Contribution made by N.I. Pirogov's efforts to expand assistance to medical personnel during the war, including the extensive use of anesthesia, certainly earned him the title of the founding father of field medicine. He applied his extensive experience and knowledge accumulated during the Caucasian and Crimean conflicts to civilian practice. From his notes it appears that his experiments confirm the belief in the usefulness of general anesthesia. It is also true that the widespread use of N.I. Pirogov, general anesthesia in military surgery, together with colleagues in the medical units of the Russian army, was to have the most significant influence on the subsequent development of the principles and techniques of general anesthesia for the bulk of the Russian civilian population.

Traveling from St. Petersburg to the battlefield, he found time to stop in various cities and demonstrate the use of general anesthesia for surgical interventions. In addition, he left there equipment for the rectal method of administering anesthesia, left masks, and trained local surgeons in techniques and skills in working with ether. This has stimulated interest in the use of general anesthesia in these regions. After the end of the Caucasian and Crimean conflicts, news came from these regions about successfully performed operations using general anesthesia. Military surgeons brought into civilian practice the knowledge that they used during the war. And the returning soldiers spread the news of this wonderful discovery.

In conclusion, it must be said that Nikolai Ivanovich Pirogov was the greatest Russian surgeon in the history of medicine. He played a key role in the development of anesthesia in Russia. He had the rare combination of scientific talent, excellent teacher and experienced surgeon. He taught his followers not only in hospitals, but also on the battlefield, where he was the first to use ether anesthesia. He became the creator of an alternative, rectal method of administering anesthesia, and discovered the use of chloroform - first on animals and then on humans. He was the first to systematically process the phenomena of mortality and morbidity. He was sure that the discovery of general anesthesia was the greatest achievement of science, and he also warned about its threats and consequences.

N.I. Pirogov died on December 5, 1881 in the village of Vishnya (now part of the city limits of Vinnitsa, Ukraine). His body was preserved using embalming techniques that he himself developed shortly before his death, and rests in the Vinnitsa church. Many recognitions of his achievements followed this event, including the naming of a glacier in Antarctica, a large hospital in Sofia, Bulgaria, and an asteroid discovered in August 1976 by Soviet astronomer Nikolai Chernykh in his honor. Stamps with his portrait were published in the Soviet Union on the 150th anniversary of his birth. Subsequently, the highest humanitarian award in the Soviet Union became the N.I. Gold Medal. Pirogov. However, we believe that Nikolai Ivanovich Pirogov deserves recognition also outside of Russia for his contribution to the spread of general anesthesia.

Acknowledgments

We are grateful for the endless and selfless help that we received from Lyudmila B. Narusova, President of the Anatoly Sobchak Foundation, for access to the museum archives and libraries in St. Petersburg. We are also very grateful to the administration of the Military Medical Museum in St. Petersburg for their trust, kind support and enthusiasm.

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