At the end of the XVIII - the first half of the XIX century. health care in Siberia made new progress, although on the whole they were still negligible compared to the needs of the vast region. If in the first half of the XVIII century. in Siberia, hospitals appeared in military units and at some factories, then in 1783 and 1784. the first civilian hospitals are opened in Tobolsk and Irkutsk. Since the beginning of the XIX century. the number of hospitals is increasing. The activity of the Irkutsk hospital was developed, in 1807, created at the expense of the merchant Chupalov, hospitals were opened in Tomsk, Verkhneudinsk and a number of other places. By the time of the Siberian reform of 1822, there were 7 hospitals in the cities of Tobolsk province, 6 in Tomsk (including the territory of the not yet separated Yenisei province), and 7 in Irkutsk province. In addition, hospitals were created at some factories. There were several infirmaries under the jurisdiction of the military department. In 1851, there were 30 hospitals in Siberian cities (not counting 2-3 insane asylums), of which 18 were in Western Siberia and 12 in Eastern Siberia. By the middle of the 19th century. the network of general civil medical institutions of the inpatient type was more or less formed and subsequently, for at least the 50s, basically remained the same; the throughput of hospitals increased markedly; in Eastern Siberia, it rose in the 50s of the 19th century. by 25-30%.

Public health was of little interest to the tsarist authorities. State expenses for the maintenance of medical institutions even in the middle of the XIX century. in the Irkutsk province did not reach 0.2% of the expenditure part of the provincial budget. A similar situation was ubiquitous in Siberia. Hospitals were maintained with city funds collected from the population. Hospitals, even with doctors (and they were far from everywhere), were in a terrible state. So, in the Achinsk hospital, the senatorial revision of 1843 noted: "the buildings are dilapidated", the floors are "poorly caulked", the stoves are "bad"; even the kitchen is so cold that "in winter the sourdough freezes." The hospital superintendent is not a doctor, but a Cossack police officer who combines work in the hospital with the position of a quarterly supervisor, in which he is "primarily busy."

Even in the hospitals of the provincial centers, the mortality rate was very high: according to the Tomsk City Hospital, it was 1839-1849 for 1839-1849. ranged from 12 to 25%.

Patients were charged a high fee for treatment, reaching 38 rubles. banknotes per person per month (according to the data of the hospitals of the Yenisei province, 1842), which put those leaving the hospital in an extremely difficult situation.

There were not enough doctors in Siberia. Often they were replaced by medical students and smallpox vaccinators trained from local youth. Even in 1857, there were only 62 doctors in the whole of Eastern Siberia, together with the newly annexed Amur Region and Primorye (only 54 of them were in the service). Epidemics continued to be the scourge of the Siberian population. Typhus, cholera, anthrax, measles and other epidemic diseases covered certain regions of Siberia almost every year. Mortality was enormous. So, in the smallpox epidemic of 1850-1851. 951 Russians and 965 indigenous people fell ill in the Yenisei north. Of these, 189 and 545 people died, respectively. With a general lack of medical care, these figures reflect differences in living conditions. not only by the lack of medical care, but, most importantly, by the lack of culture and poverty of the population.Even P.S. Pallas, describing Achinsk, spoke about the many cockroaches in the huts: they covered all the walls; no products could survive from them, they sleep on the stoves It is known that M. V. Petrashevsky was placed in a similar hut in Minusinsk exile in the 60s of the XIX century. piles of snow.Indigenous non-Russian population of Siberia lived in the worst sanitary and hygienic conditions.There was mud even in the houses of the rich.About the largest Khakass cattle owner the face of Kartina, a man who "does not know the number of his herds, considers most of the Kachintsy his debtors", N. Kostrov wrote that the floor in his Russian-type house "is covered with dust and dirt almost an inch; sheepskin coats are scattered there, baked bread here, felt mats and lassoes here. At Kartina, a samovar will be served for the guest of honor and they will be treated to tea in faience cups; but these cups have hardly ever been washed since the time of their purchase. "In many regions of Siberia, baths were a rarity among the indigenous population (for example, among the koibals, on Abakan, the bath was first built in 1831). Such living conditions contributed to the spread of diseases. eeeeee

There were doctors in Siberia who sincerely wanted to serve the people. Some of them not only treated, but also tried to spread elementary medical knowledge among the masses. Back in the early 1990s. Tobolsk typographer Korniliev published a book by the head doctor Peterson on first aid for people who lost consciousness; it spread throughout urban and rural communities. The Tobolsk doctor Pabst in 1805 wrote a book "A brief description of the reasons why so many babies die in Siberia", in which he gave instructions on caring for newborns. In the 30s of the XIX century. the training of smallpox vaccinators recruited from among young people in the field began. This gave some results in the fight against a terrible disease, although smallpox vaccination ran into a certain resistance from the ignorant masses, especially schismatics, who declared vaccination to be the "seal of the Antichrist."

The best doctors of Siberia also worked on improving the methods of treatment. In this regard, one can point to the use by the Semipalatinsk doctor Yarotsky of his method of preserving smallpox vaccine (1829). The Yenisei physician M. Krivoshapkin, following the Nerchinsk physician M. Robek, began to apply electrotherapy, achieving serious success in curing patients with paralysis, rheumatism, arthritis and other cases. Petrashevets F.N. Lvov explored the Yenisei mineral waters.

FEATURES OF THE PHYSICAL STATUS OF THE ANCIENT POPULATION OF THE NOVOSIBIRSK REGION

SBEE HPE "Novosibirsk State Medical University" of the Ministry of Health of Russia (Novosibirsk)

A classical osteometric study of the skeletal series of the Sopka-2 multilayer burial ground was carried out. The dynamics of osteometric indicators reflects the process of formation of specialized morphotypes that lived in the same area under periodically changing climatic and landscape conditions. Significant differences were revealed in such values ​​as body length, indicators of the massiveness of tubular bones and their shape. The male population of the Eneolithic era had a rather high growth - about 173 cm, the height of women is much lower - 153.5 cm. For men from the Bronze Age, the average height is 162 cm, for women it practically does not change - 154.3 cm.

Key words: anthropology, osteometry.

Introduction. A classical osteometric study of the skeletal series of a multi-layered burial ground located on the territory of the Vengerovsky district of the Novosibirsk region was carried out. The Sopka-2 burial ground was left by the bearers of different cultural societies who lived in this territory for at least 8 millennia. The dynamics of osteometric indicators reflects the process of formation of specialized morphotypes that lived in the same area under periodically changing climatic and landscape conditions.

According to Dobrovolskaya, the ecological aspect of the study of paleoanthropological materials in many ways complements the classical methods of paleoanthropology. Paleoecological research, first of all, sets the task of reconstructing the way of life of the population that left the monument.

Purpose of the study. The main purpose of this work is to identify the features of the physical status of paleopopulations that belonged to the inhabitants of the Eneolithic (Early Metal Age) and Bronze Age.

Materials and methods. In general, 251 skeletons of varying degrees of preservation were examined. The postcranial sections of 52 skeletons of individuals belonging to the Eneolithic era (4th–3rd millennium BC) and 199 skeletons of individuals belonging to the Bronze Age and belonging to the bearers of the Krotov culture (beginning of the 3rd and middle of the 2nd millennium BC) were studied. BC.). To determine the size of the bones and the proportions of the postcranial skeleton, the classical osteometric method, the method of determining indices (proportions), was used. 25 linear signs, 10 proportion indicators were analyzed.

Research results. A significant difference in osteometric parameters was revealed among the inhabitants of the studied epochs. Thus, in the Eneolithic population (in the male and female series), long bones have large longitudinal dimensions (Tables 1, 2), while these indicators are significantly reduced among the inhabitants of the Bronze Age (Tables 3, 4). The femurs, according to the index of platymeria, in men of the Eneolithic era are flattened quite strongly (71%). In the women's series, this indicator slightly decreases (70%). Among the inhabitants of the Bronze Age, these figures are 74% for men and 70% for the female population. Pilaster in the male population of the Eneolithic - 99%, in the male population of the Bronze Age - 105%. In the female population of the Eneolithic era - 100% and in the female sample of the Bronze Age - 98%. Small indicators of the pilaster in the male population of the Eneolithic do not correspond to the real degree of development of the rough line of the thigh. In most individuals, the degree of development of the rough line (place of attachment of the quadriceps femoris muscle) corresponds to the maximum score, and in some cases it has an extremely strong development. At the same time, there is a simultaneous increase in the transverse diameter of the femoral shaft.

The section index (the degree of flattening of the tibia in the sagittal plane) is characterized by mild euryknemia in Eneolithic men (70%) and severe platyknemia in Bronze Age individuals (61%). For the female sample of the Eneolithic era, pronounced euryknemia is characteristic (78%), for women of the Bronze Age - mesocnemia - 68%. The index of bone massiveness in both groups of the male population is more than 23%, i.e. the bones are quite massive. In women's samples, the female population of the Eneolithic era (22%) has a high massiveness index, while women of the Bronze Age have a low massiveness index - 21%. Analyzing changes in body proportions, it should be noted a slight increase in the tibiofemoral index in the male population of the Bronze Age (86%) compared to the male sample of the Eneolithic (80%), which occurs due to shortening of the hip. Body length in male samples of the Eneolithic and Bronze Age, calculated by the method of Pearson and Lee and the formula of G.F. Debets, averages 173.0 cm (Eneolithic) and 162.3 cm for the inhabitants of the Bronze Age. Thus, the inhabitants of the Eneolithic era were quite tall compared to the later population. The growth of the female population practically does not change and is 153.5 cm for the female sample from the Eneolithic and 154.1 cm for the Bronze Age. The level of sexual dimorphism in terms of growth decreases significantly from the Eneolithic era towards the Bronze Age. The osteometric characteristics of the Eneolithic skeletal samples in many respects coincide with the data of S. S. Tur, M. P. Rykun, who studied the population of the Afanasevo culture of Gorny Altai, synchronous with the Eneolithic sample.

Indicators of the long tubular bones of the male population of the Eneolithic

Signs (according to Martin)

Conclusion. Comparison of data on the structure of the skeletal system of individuals from the burials of the Sopka-2 burial ground, left by the carriers of the comb-pit culture (Eneolithic) and carriers of the Krotov culture (Bronze Age), shows significant differences in such values ​​as body length, indicators of the massiveness of tubular bones and their forms. The male population of the Eneolithic era had a rather high growth (about 173 cm), the growth of women is much lower (153.5 cm). In men from the Bronze Age, the body length is less than 10 cm and averages 162 cm. The body length of the female population practically does not change - 154.3 cm.

1. Alekseev V.P. Osteometry. Methods of anthropological research / V. P. Alekseev. - M. Nauka, 1966. - 249 p.
2. Dobrovolskaya M. V. Man and his food / M. V. Dobrovolskaya. - M. Scientific world, 2005. - 368 p.
3. Molodin V.I. Monument Sopka-2 on the Om River / V.I. Molodin. - Novosibirsk. Publishing House of the Institute of Archeology and Ethnography of the Siberian Branch of the Russian Academy of Sciences, 2001. - V. 1. - 128 p.
4. Molodin V.I. Monument Sopka-2 on the Om River / V.I. Molodin. - Novosibirsk. Publishing house of IAET SO RAN, 2012. - V. 3. - 220 p.
5. Tour S.S. Paleoecology of the population of the Afanasiev culture of Gorny Altai. The Epoch of the Eneolithic and Bronze Age of the Altai Mountains. Part 1 / S. S. Tur, M. P. Rykun. - Barnaul. AzBuka, 2006. - 234 p.

MEDICAL EDUCATION, the system of professional training of doctors, middle and junior medical personnel. The first medical educational institution in Siberia was the Kolyvano-Voskresenskaya hospital school, opened in 1758 on the initiative of the chief physician .

The attempts to organize medical education in Siberia include the creation in 1802 of medical classes at the Tobolsk Theological Seminary. However, until the second third of the XIX century. the training of medical personnel for Siberia was carried out mainly in educational institutions of the European part of Russia, in particular in Kazan, where Siberian scholarships were established. In the 1870s in Siberian cities, midwifery and veterinary paramedic schools began to open: in 1878 - a midwife school with a 3-year term of study and veterinary paramedic schools in Tomsk and Tobolsk , Central Medical Assistant School in Omsk , in 1892 the school of paramedics and midwives in Irkutsk, in 1889 - in Krasnoyarsk . In 1884, the medical department of the Ministry of the Interior adopted a resolution according to which people began to be admitted to midwifery schools on the condition that they pass the entrance exam for the progymnasium. Midwifery schools in Tobolsk (1895), Irkutsk (1905) and Tomsk (1906) were transformed into obstetric and feldsher schools with 4-year training, in which, in addition to obstetric specialization, they provided information on other medical disciplines. At the beginning of the twentieth century. 3 private dental schools operated in Tomsk. In 1906 Yakutsk a men's paramedic school was established. In addition to the paramedic schools of the Ministry of Education, in Chita (since 1872) and (since 1880) military paramedical schools operated. The Red Cross Society, which had its branches and communities of sisters of mercy in many Siberian cities, was also involved in the training of junior and secondary medical personnel. At the beginning of the twentieth century. in Siberia, there was still an acute shortage of paramedical personnel and their extremely low qualifications. The Siberian medical community sought the opening of secondary medical schools in large cities. A special issue was the training of medical personnel from the indigenous population.

In the first decade after the October Revolution, the network of medical assistant schools in Siberia, transformed into medical colleges, remained almost unchanged. In the late 1920s - early 1930s. opened medical schools in Novosibirsk, Barnaul and Biysk , pharmaceutical - in Tomsk and Irkutsk. In 1931, about 4,500 people studied at 10 medical technical schools, and the annual graduation was more than 700 people. Technical schools began to provide training in narrow specialties (paramedic, midwife, nurse, sanitary assistant, dental technician, dentist, laboratory assistant). Since 1932, distance learning has been introduced in the medical technical schools of Siberia. In 1935, the technical schools were renamed the feldsher-obstetric school. In 1939, more than 16,000 people studied at secondary medical schools in the region.

In the years Great Patriotic War hospitals were created on the basis of most medical educational institutions in Siberia. To provide the front with medical and sanitary personnel, the training of specialists in the schools of the region was carried out according to an accelerated program. The leading educational institutions of the European part of the country evacuated to Siberia contributed to the strengthening of the pedagogical and methodological base of regional secondary medical education. On the basis of the Military Medical School im. Shchors, the Omsk Medical School arose, now one of the largest educational institutions in the country in this field.

Since 1953, medical technical schools throughout the country have been transformed into schools. In 1950-70, dozens of medical schools were opened in the region in many cities and regional centers. The shortage of nursing staff and the need for their narrower specialization required the creation of several medical schools in regional and regional centers. Schools were created on their basis to provide personnel for the largest hospitals and medical centers. In 1980, more than 60 medical schools operated in Siberia. The oldest secondary medical educational institutions in Siberia received the status of basic ones, they served as coordination and methodological centers, and were engaged in advanced training of nursing staff. So, in 1989, a department for advanced training of specialists with secondary medical education was opened at the Omsk Basic Medical School (now a college), in 1996, an interregional Center for Advanced Training of Teachers of Medical Schools and Colleges in Western Siberia, the Urals and the Far East was created on the basis of the college. Currently, the training of paramedical personnel is carried out in 10 main ones. specialties: general medicine, obstetrics, hygiene, sanitation and epidemiology, dentistry, pharmacy, laboratory diagnostics, orthopedic dentistry, nursing, medical optics, installation and maintenance of medical equipment. There are 63 secondary medical schools in the region, including 29 in Western Siberia and 34 in Eastern Siberia; they train about 60 thousand people. Since the early 1990s as part of the transition to a multi-level system of training nurses, including higher nursing education, schools that implement the first stage of university education received the status of a college. In 1994, the Association of Nurses was established with the participation of medical schools and colleges in Siberia, the Urals and the Far East.

The history of higher medical education in Siberia began with the creation in 1888 of Tomsk University with a single faculty - medical. The opening of the university was accompanied by the construction of auxiliary institutions: faculty clinics, bacteriological and anatomical institutes. The number of medical students initially did not exceed 65-120 people, in the first 10 years the university trained 303 doctors. More than half of the students of the first intakes were graduates of theological seminaries. The first graduation from the medical faculty took place in 1893. 34 people received doctoral diplomas, 31 of them with honors. Until 1913, women were admitted to the medical faculty of the university only as volunteers. In 1899, on the initiative and with the support of the department of obstetrics of the university in Tomsk, the Midwifery Institute of the department of Empress Maria Feodorovna was opened. The Institute trained highly qualified midwives, but due to lack of resources, it ceased operations in 1914. Until the revolution, Tomsk University remained the only higher medical educational institution beyond the Urals. Many of its graduates later became famous doctors and famous scientists who actively participated in the development of medical education in Siberia. During the pre-revolutionary period, scientific schools and directions were formed that predetermined the further development of medicine in Siberia and gained wide popularity not only in the region, but throughout the country.

The network of higher medical educational institutions in the region expanded due to the opening of medical faculties at the Irkutsk University (1919) and the Omsk Veterinary Institute (1920). The latter emerged as an independent institute in 1921. In 1922, more than 3,000 people studied at medical faculties and at the Omsk Medical Institute. An important role in the formation and development of these universities was played by their first leaders: Professor N.D. Bushmakin (Dean of the Faculty of Medicine, then Rector of Irkutsk University), Professor V.T. Shevyakov (Dean of the Medical Faculty of the Irkutsk University) and Professor K.V. Romodanovsky (Rector of the Omsk Medical Institute). For the formation of the personnel and methodological base of universities, the activities of professors and teachers of Tomsk and Kazan and Perm universities evacuated to Siberia were of great importance.

The processes of Sovietization of higher education also affected medical schools. In the 1920s the main changes were associated with a significant increase in the volume of disciplines of the sanitary-hygienic and preventive profile. In order to improve the qualifications of doctors, a one-year internship (post-diplomatic training at clinics and hospitals) was introduced in therapy, surgery, obstetrics, otolaryngology, nervous and childhood diseases. The social composition of both teachers and students of medical universities changed more slowly than others: until the mid-1930s. the children of employees predominated among the students.

As part of the reform of higher education in the late 1920s and early 1930s, which pursued the goal of accelerated training of narrow specialists, the medical faculties of universities became independent institutes in 1930, and the number of faculties increased within the institutes. Beginning in 1931, workers' faculties and postgraduate courses began to operate in medical schools. In 1935, the Novosibirsk Medical Institute (NMI) was opened, created on the basis of the Siberian Institute for the Improvement of Doctors, transferred from Tomsk in 1931. The basis of the teaching staff of the NMI was professors and teachers of the Tomsk and Omsk Medical Institutes, including Professor (later Academician of the USSR Academy of Medical Sciences) V.M. Mouse, Professor N.I. Horizons, G.D. Zalessky (later rector of the NMI). Initially, the NMI consisted of 1 faculty - medical, which in 1935 trained 127 third-year students transferred from Omsk and Tomsk medical institutes, in 1938 the institute graduated the first 120 doctors.

In the late 1930s funds for the development of the higher medical school, especially for the purchase of scientific and educational equipment, have increased significantly. The financial situation of staff and students has improved. By 1940, there were five medical institutes in Siberia (including the Novosibirsk Institute for Advanced Training of Doctors), which since 1918 have trained about 10,000 Siberian doctors. Siberian medical universities played an important role in the organization and conduct of scientific research. At universities there were scientific medical societies, in whose activities students took part. Postgraduate studies worked in Tomsk, Omsk and Irkutsk, at the Tomsk Medical Institute (TMI) there was the only council in the region for the defense of doctoral dissertations, in Omsk (since 1935) - master's theses.

With the beginning of the Great Patriotic War, many employees and students of universities went to the front, the rest had to provide training for medical personnel for the front and health authorities, the operation of evacuation hospitals, etc. The teaching system and research topics changed in accordance with the requirements of wartime. The number of hours for teaching military disciplines, as well as courses in surgery, infectious diseases, etc., has increased. The duration of training has been reduced to 3.5 years. However, it was during these years that the regional system of medical education continued to develop actively. In order to fulfill the recruitment plan for medical schools, since 1942 they began to accept students after 9 classes. The evacuation to Siberia of medical universities from the European part of the country made it possible to expand the network of higher medical education in the region. New faculties were opened at TMI: in 1941 pharmaceutical, in 1942 - dental, in 1944 - pediatric. In 1942, as a result of the merger of the evacuated Voronezh Dental Institute, divisions of the 1st and 2nd Leningrad Medical Institutes, the Leningrad Pediatric Institute, and the Leningrad Dental Institute, the Krasnoyarsk Medical Institute (KrasMI) was created, the first graduates of which immediately went to the front. During the war years, research work in medical universities did not stop, primarily on defense topics: military injuries, the fight against epidemics, and the creation of new medicines. At the end of the war, the 5-year period of study was restored, and from 1948 the duration of study at medical schools was increased to 6 years.

In the 1950s 4 medical institutes were opened in Siberia: in 1953 in Chita (on the basis of the Medical Dental Institute transferred from Perm), in 1955 in Kemerovo, in 1956 - Altai State Medical Institute in Barnaul. In 1957, a medical department was opened as part of the Faculty of Natural Sciences of the Yakutsk State University, which was transformed in 1960 into a Faculty of Medicine, which for the first time made it possible to provide the territory of the north of Eastern Siberia with local medical personnel of the highest qualification. In 1951 from Novosibirsk to Stalinsk (now - Novokuznetsk ) was transferred to the State Institute for the Improvement of Doctors, where he is currently located. The medical institutes of other Siberian cities, primarily Tomsk, provided great assistance in the formation of newly opened universities; many departments of TMI conducted targeted training of scientific and pedagogical personnel through residency and postgraduate studies. The opening of new universities made it possible in 1960-70 to increase the provision of the population of the region with doctors by 1.4-1.8 times (in the edges and regions).

Over the next decades, medical education continued to develop, focusing on the growing needs of the region in medical personnel. Practically in all Siberian medical universities new faculties were opened: dental in Omsk (1957), pediatric in Novosibirsk (1965), sanitary-hygienic (1963) and pediatric (1967) in Kemerovo and others. In 1965, the military medical faculty began to work as part of TMI, which was transformed in 1999 into the Tomsk military medical institute. In 1975, the second Faculty of Medicine and Biology in the country was opened at TMI, which trained biochemists, biophysicists, and cybernetics doctors. The development of higher medical education, its scientific and methodological base was facilitated by the creation in Novosibirsk in 1970 of the Siberian branch of the USSR Academy of Medical Sciences, which was transformed in 1980 into the Siberian branch.

In the 1990s The economic situation of medical universities has deteriorated markedly. One of the sources of existence of medical universities was the recruitment of students on a commercial basis, including newly opened faculties and departments in specialties that are in high demand: higher nursing education, social work, economics and management in health care, clinical psychology, cosmetology, medical law and etc.

In the 1990s the status of Siberian medical institutes has changed, becoming, depending on the number of educational profiles and specialties implemented, either academies or universities. In 1992, the oldest medical university in Siberia, TMI (now Siberian State Medical University), in 1994 - Altai Medical Institute, in 2006 - NMI received the status of a university. The remaining Siberian medical institutes became medical academies. The medical and medical faculty of the Yakut State University was transformed into a medical institute as part of the university. In 2003, the medical faculty of Novosibirsk State University was added to the system of higher medical education in Siberia, orienting graduates primarily to work in the RAMS system.

Currently, 11 medical universities in Siberia train and improve the skills of personnel for the healthcare system in a variety of areas, conduct research in the most relevant areas of medical science and practice. In addition to a significant number of faculties, medical universities have centers for pre-university and postgraduate training, their own clinics and research institutes. In recent years, the quality of the technical equipment of the educational process has improved, computer classes, multimedia support for the educational process and distance learning have appeared. Novosibirsk State Medical University became one of the first holders of a certificate certifying the compliance of the university's management system with the requirements of the International Standard for the provision of educational services in the field of medicine and social work. To date, 80% of specialists working in the field of healthcare and pharmacy in Siberia are graduates of medical universities in the region. In total, over the years of the existence of higher medical education in Siberia, more than 300 thousand doctors have been trained by the universities of the region, hundreds of thousands of practical healthcare specialists have been retrained.

Lit .: Mendrina G.I. Development of Higher Medical Education in Siberia // Higher School and Scientific and Pedagogical Personnel of Siberia (1917-1941). Novosibirsk, 1980; Essays on the history of higher and secondary specialized education in Siberia (1917-1980). Novosibirsk, 1986; Tolochko A.P., Ishchenko O.V., Skovorodina I.S. The development of vocational education in Western Siberia in the late XIX - early XX century. (experience of history in the context of modernity). Omsk, 2005.

E.S. Bannova, I.I. Nikolaev