Medic. The name of Botkin is forever inscribed in the history of world medicine, because he played a huge role in its development.

Sergei Botkin was born in mid-September 1832, in Moscow. He came from a good family, his father was a merchant, engaged in the tea trade. Sergei had two brothers: Vasily was engaged in literature, and Mikhail was a good artist.

The upbringing of Sergei, for the most part, was handled by his elder brother Vasily, who had a certain fame in literary circles, was friends with Belinsky. In their house one could often see interesting guests - Belinsky, Stankevich and many other famous people of their time.

After graduating from the boarding school, the doors of the institute were opened before Sergei Petrovich. He wanted to study at the Faculty of Mathematics, but mathematicians were not particularly in demand. Due to circumstances, he began his studies at the Faculty of Medicine.

Studying at the Faculty of Medicine once and for all instilled in Sergei Petrovich a love for this science. While studying at the university, he received a solid foundation of basic medical knowledge. Having learned the theory, at the end of the university, Botkin immediately proceeds to practice. He goes to the Crimea, where events are actively unfolding.

Sergey Botkin worked in the Simferopol military hospital for more than three months. The Crimean War is over and he is going back to Moscow. Once at home, he realizes that there is still a lot of theoretical knowledge that he needs. So he decides to continue his medical studies abroad. Botkin spent several years in Germany, then in France.

In 1860, Sergei Petrovich returned to. Here he was immediately offered to work as an adjunct in the capital's Medical and Surgical Academy. A year later, he headed the Department of Therapeutic Clinic. In this position, he worked until the end of his life.

We have already said that Botkin forever inscribed his name in the history of medicine. What is it? Medicine as a science developed only in the 19th century. Sergey Petrovich was one of those thanks to whom today's medicine is what we are used to seeing. After studying abroad, he noticed the peculiarities of healing of that time.

The treatment of people was based on empiricism (by touch), there was no rationalism in the treatment of people. And only in the middle of the 19th century, including, thanks to his research and activities, medicine takes the form of a rational science. He was a scientific innovator. Many of Botkin's thoughts went against the understanding of medicine in his era. But today, many works of the Russian scientist are the main ones in medicine.

All the achievements of Sergei Petrovich cannot be listed in one small article. We present only a few. He talked about the importance of the nervous system in the treatment of heart disease, the role of the body in the course of infectious diseases, and the origin of jaundice. They discovered the role of the spleen in the circulatory system. Botkin suggested that there are several centers in the human brain - sweat, sugar, heat, and others. Today this assumption is an axiom in medicine.

Sergei Petrovich Botkin died in 1889, leaving his descendants a huge legacy of his medical knowledge and experience.

Who is Botkin? - Well, how about ... a famous doctor, "Botkin's disease" - viral hepatitis ... There is also a hospital named after him somewhere in Moscow, so famous ... "So who is Botkin?

Sergei Petrovich Botkin is an outstanding general practitioner, one of the founders of the physiological direction of Russian scientific clinical medicine, a major public figure, court adviser ...

The future first clinician, therapist was born on September 5, 1832 in Moscow into a wealthy family of a merchant and breeder. The head of the family, Father Pyotr Kononovich Botkin, came from free posad people of the city of Toropets, Tver province. In the 1920s, he founded a large tea company in Moscow and had a procurement office in Kyakhta. In the Tula province, he built two sugar factories. He did not interfere in the upbringing of his 14 children, leaving this to his eldest son Vasily. Botkin's mother, Anna Ivanovna Postnikova, also from the merchant class, did not play a significant role in the family.

Until the age of 15, Sergei Botkin studied at his “home university”, where his teachers were: Vasily Petrovich, his older brother, a famous writer, and his friends, T.N. Granovsky,
V.G. Belinsky, A.I. Herzen. Then he got acquainted with the views of the philosophical circle of N.V. Stankevich, Belinsky, Herzen, who gathered in the Botkins' house. A.I. Herzen is a friend of Botkin and in the future his patient, who was treated by him for diabetes. The poet Afanasy Afanasyevich Fet was married to one of Botkin's sisters, and to the other, university professor Pikulin.

T.N. Granovsky, who lived on the lower floor of the Botkins' house, wrote: "... I followed the development of Sergei, I saw outstanding abilities in him ... He impressed Belinsky and me with his great curiosity."

Sergei was preparing to enter Moscow University under the guidance of a mathematics student A.F. Merchinsky, and from August 1847 - in a private boarding house. Having completed only the second year of the boarding school, Botkin decides to quit and take exams at the mathematical faculty of Moscow University, but force majeure arose - a decree of April 30, 1849: stop admission to all faculties, except medical. Botkin did not immediately abandon mathematics in favor of medicine. Hesitating in his choice, he completed the third year of the boarding school and only in the spring of 1850 decided to apply to the medical faculty.

Sergei Petrovich Botkin graduated from the medical faculty of Moscow University in 1855 and soon with the detachment of N.I. Pirogov already took part in the Crimean campaign, acting as an intern at the Simferopol military hospital. France, England and later the Italian state of Sardinia took the side of Turkey against Russia. In the autumn of 1854, more precisely on September 1, hundreds of enemy ships appeared on the horizon near Sevastopol. A few days later, an enemy landing took place near Evpatoria. Fighting broke out on Russian soil, the fortified city of Sevastopol was besieged. The number of wounded was measured in tens of thousands of people.

In 1856-1860, Botkin was on a business trip abroad. Upon his return, he defended his doctoral thesis "On the absorption of fat in the intestines" and in 1861 was elected professor in the department of an academic therapeutic clinic.

In order to appreciate the significance of Botkin, it is necessary to recall the position in which Russian doctors and Russian medicine were during his activity. As the historian of medicine E.A. Golovin, “the medical departments in all Russian universities were occupied by people, the best of whom did not go beyond the level of mediocrity. A scientist was already considered someone who managed to translate from a foreign language into Russian or compile, with sin in half, some kind of guide to the treatment of diseases. Most of the teachers repeated from year to year the same lectures, once and for all memorized, sometimes reporting information that bore a medieval imprint. In their lectures, some clinicians said that the liver is “an intestinal canal that is many times folded”, others talked about milk being absorbed into the blood in the postpartum period, etc.”

There was no scientific medicine, practical medicine was in the hands of hospital doctors, who were mostly Germans, especially in St. Petersburg hospitals. Mournful leaflets were kept in German, and there were cases when doctors found it difficult to communicate in Russian with their patients. The society involuntarily formed the belief that only a doctor of non-Russian origin can treat well. Therefore, not only high society, but, for example, merchants and even wealthy artisans were treated by German doctors.

It couldn't go on like this forever. I.M. were invited to the Medical Academy. Sechenov and S.P. Botkin, the doctors are young (Botkin was 28 years old), but they have already gained some fame for their theoretical work in the medical environment in Germany and France. After a thorough acquaintance with theory and practice during a long stay abroad, Sergei Petrovich Botkin, returning to St. Petersburg, was appointed an adjunct to the head of the academic clinic of internal diseases, Professor Shipulinsky.

Professor S.P. Botkin began with transformations. In 1860-1861, he was the first in Russia to create an experimental laboratory at his clinic, where he performed physical and chemical analyzes and studied the physiological and pharmacological effects of medicinal substances. He also studied the physiology and pathology of the body, artificially reproduced aortic aneurysm, nephritis, trophic skin disorders in animals in order to reveal their patterns. At the same time, he emphasized that the clinician can only to a certain extent transfer data obtained as a result of animal experiments to humans. Research carried out in Botkin's laboratory marked the beginning of experimental pharmacology, therapy and pathology in Russian medicine. This laboratory was the embryo of the largest research medical institution - the Institute of Experimental Medicine.

Sergei Petrovich also made extensive use of laboratory research (biochemical, microbiological) for the first time; introduced the measurement of body temperature with a thermometer, auscultation, percussion, examination of the patient, etc. With the impartiality of a forensic investigator, he collected and analyzed the collected data and gave students a coherent picture of the disease process.

But now the term of service of Professor Shipulinsky had expired, and a worthy candidate began to be looked for in his place. Perhaps the sincere conviction that something worthwhile could not come out of a Russian doctor, perhaps the desire to retain leadership for the Germans, prompted most of the members of the academy to suggest Professor Felix Numeyer. The latter was not averse to coming to St. Petersburg and was even ready to learn Russian.

In the student community, this idea caused a fair indignation. The students said that Sergei Petrovich is a qualified doctor, an excellent teacher, and they want to see him as the head of the clinic. This desire coincided with the mood of the director of the Medical and Surgical Academy P.A. Dubovitsky, his deputy N.N. Zinin and the head of the Department of Physiology and Histology N.M. Yakubovich (1817-1879) to provide an opportunity to finally deploy the national forces. After a heated debate, S.P. Botkin was appointed professor of the academic clinic of internal diseases.

THEM. Sechenov wrote in his diary: “For Botkin, healthy people did not exist, and every person approaching him interested him almost primarily as a sick person. He looked closely at the gait and facial movements, listened, I think, even to the conversation. Fine diagnostics was his passion, and he practiced as much in acquiring methods for it as artists like Anton Rubinstein practice their art before concerts. Once, at the beginning of his professorial career, he took me as an appraiser of his ability to distinguish the sounds of the hammer on the plessimeter 1.

Standing in the middle of a large room with closed eyes, he ordered to turn himself around the longitudinal axis several times so as not to know the position in which he stopped, and then, tapping the pessimeter with a hammer, indicated whether the plessimeter was facing a solid wall, a wall with windows, an open door to another room or even to the stove with the damper open.”

So, a mighty young force, an inquisitive analytical mind, appears on the Petersburg horizon. It goes without saying that the appearance of such a person, who declared war on any routine, was not to the taste of many. As the saying goes, he is not great who is not thrown at with mud. S.P. Botkin had to experience the fate of all innovators: envy, inflating mistakes, unfair slander. And a chance to present S.P. Botkin, almost an ignoramus, soon introduced himself.

Envious people were very happy when Sergei Petrovich diagnosed one patient with portal vein thrombosis, but he lived safely for several weeks, amusing the gloating of ill-wishers. Botkin tried to explain this circumstance, but his opponents did not want to recognize the solidity of his arguments, fearing to part with the hope of proving the charlatan arrogance of the young professor. Soon the patient died, the news of this quickly spread throughout St. Petersburg, which, like the whole academy, froze in agonizing expectation: whether Botkin's diagnosis would turn out to be valid.

When the hour of the autopsy was announced, the anatomical theater instantly overflowed with friends and enemies of Sergei Petrovich and just curious. The pathologist Professor Ilyinsky, in deathly silence, removed the portal vein, which contained a blood clot. S.P.'s detractors Botkin fell silent. After this incident, Botkin's amazing diagnostic intuition was legendary. His name immediately became popular outside the walls of the academy. Invitations to seriously ill patients poured in, both from doctors who sympathized with him, and from those who were hostile. At the beginning of 1872, Professor Botkin was instructed to treat the Empress, who was seriously ill. Sergei Petrovich managed to restore her fading strength and prolong her life for many years. At court, as elsewhere, he soon gained confidence and love and gained free access to the royal family, with whom he enjoyed favor.

To S.P. Botkin, most of the graduates of the academy withered away in the backwoods, he promoted his students to St. Petersburg hospitals. Thus, access was opened for Russian doctors, until then closed or difficult for them to the extreme. One of the most important periods in the development of medicine in general and Russian medicine in particular are the years 1856-1875. Such a relatively short period of time is explained by two important circumstances in the history of medicine. Firstly, it was precisely at this time that the failure of the humoral theory, the theory that almost completely dominated both Western European and Russian medicine from the beginning to the middle of the 19th century, was clearly revealed.

Humoral medicine was vitalistic; the ultimate cause of all life phenomena was proclaimed "life force" - the beginning is weightless, unextended and therefore unknowable; and since it is unknowable, then what sense can disputes about the mechanisms of action of this force have, what is the point in criticizing various interpretations of this or that manifestation of this very force, this or that fact. Criticizing the humoral theory, Fyodor Ivanovich Inozemtsev1 (1802-1869), professor at the Department of Surgery at Moscow University (1846-1859), said that metabolism in cells and tissues cannot take place without the participation of the nervous system. “Blood without the activity of the nodal nerves is only living material in our body, unable by itself to perform physiological operations in the field of nutrition,” said Inozemtsev. The philosophy of humoral medicine taught: “The first agent in our body is the life force that independently forms matter and forms it - this is a weightless, elusive beginning, a manifestation of an ever-active, ever-moving spirit, for which the body is just an earthly shell.”

Secondly, since the failure of the humoral theory was revealed, a need arose for a new theory of medicine, which would more harmoniously generalize the facts that had gradually accumulated within the framework of the old, humoral theory of medicine and came into conflict with it.

And so it happened, moreover, almost simultaneously in two countries at once: in Russia and Germany. In Russia, a new theory of medicine was introduced by Botkin, in Germany - by Virchow. In terms of content, these are two completely different theories. Virchow's theory was based on the doctrine of the cell, Botkin's theory - on the doctrine of the reflex. Both theories formed the basis of two different directions in medicine: Virchow's theory laid the foundation for the anatomical, or "localistic" direction, Botkin's theory for the physiological, or functional.

Sergei Petrovich Botkin outlined his views on medical issues in three issues of the “Course of the Clinic of Internal Diseases” (1867, 1868, 1875) and in 35 lectures recorded and published by his students (“Clinical Lectures of S.P. Botkin”, 3rd edition ., 1885-1891). Professor Botkin was a true innovator who made a revolution in medical science, the creator of the natural-historical and pathogenetic method in diagnosis and treatment. He is the founder of scientific clinical medicine.

In his views, S.P. Botkin proceeded from the understanding of the organism as a whole, which is in inseparable unity and connection with its environment. This connection, first of all, is expressed in the form of metabolism between the organism and the environment, in the form of adaptation of the organism to the environment. Thanks to exchange, the organism lives and retains a certain independence in relation to the environment; thanks to the process of adaptation, the organism develops new properties in itself, which, being fixed, are inherited. He connected the origin of the disease with the cause, which is always determined exclusively by the external environment, acting directly on the organism or through its ancestors.

The central core of Botkin's clinical concept is the doctrine of the internal mechanisms of the development of a pathological process in the body (the doctrine of pathogenesis). He argued that one of the theories, the so-called. The humoral theory of medicine, with its doctrine of movement disorders and the ratio of "juices" in the body, did not solve the problem of pathogenesis at all. Another cellular theory explained only two particular cases of pathogenesis: the spread of a diseased beginning by its direct transfer from one cell to another, and the spread by transferring it by blood or lymph.

Professor S.P. Botkin gave a deeper theory of pathogenesis. He contrasted Virchow's teaching about the body as a "federation" of cellular states, not connected with the activity of the nervous system and the environment, with his teaching about the body as a single whole, controlled by the nervous system and existing in close connection with the external environment. Sergei Petrovich proceeded from the teachings of I.M. Sechenov that the anatomical and physiological substratum of all acts of human activity is the reflex mechanism. Developing this theory, he put forward the position that pathological processes inside the body develop along reflex nerve pathways. Since in the reflex act one or another node of the central nervous system is the main member, Botkin paid great attention to the study of various centers of the brain. He experimentally discovered the center of sweating, the center of reflex effects on the spleen (1875) and suggested the existence of a center for lymphatic circulation and hematopoiesis. He showed the importance of all these centers in the development of the corresponding diseases and thereby proved the correctness of the neurogenic theory of pathogenesis. Based on this theory of pathogenesis, he began to build a new theory of treatment (influence on the treatment of the disease through the nerve centers), but did not have time to develop it to the end.

Neurogenic theory of pathogenesis S.P. Botkin puts in the doctor’s field of vision not only anatomical, but mainly physiological or functional (through the nervous system) connections of the body and, therefore, obliges the doctor to consider the body as a whole, to diagnose not only the disease, but also the “diagnosis of the patient”, treat only the disease, but the patient as a whole. This is the fundamental difference between the Botkin clinic and the clinics of the humoral and cellular schools. Developing all these ideas, he created a new direction in medicine, characterized by I.P. Pavlov as a direction of nervism.

Sergei Petrovich Botkin owns a large number of outstanding discoveries in the field of medicine. He was the first to express the idea of ​​the specificity of the protein structure in various organs; the first (1883) pointed out that catarrhal jaundice, which Virkhov interpreted as "mechanical", refers to infectious diseases; at present, this disease is called "Botkin's disease." He also established the infectious nature of hemorrhagic jaundice, described by A. Weil. This disease is called Botkin-Weil jaundice. Brilliantly developed the diagnosis and clinic of a drooping and "wandering" kidney.

The activities of Sergei Petrovich Botkin were extensive and varied. As a publisher, he is known for publishing the Archive of Professor Botkin's Clinic of Internal Diseases (1869-1889) and the Weekly Clinical Newspaper (1881-1889), renamed from 1890 into Botkin's Hospital Newspaper. These publications published the scientific works of his students, among whom were I.P. Pavlov, A.G. Polotebnov, V.A. Manassein and many other prominent doctors and scientists.

Sergey Petrovich was the first doctor elected to our Duma, he was the deputy chairman of the Public Health Commission. In 1886, he was elected chairman of the Commission on improving sanitary conditions and reducing mortality in Russia. He tried to reform the entire healthcare system, but there were neither people, nor money, nor medicines, nor the necessary statistics for this.

Sergei Petrovich died on November 11, 1889 in France, in Menton, from coronary heart disease. In two marriages (the first wife died at a resort in San Remo), Sergei Petrovich had 12 children. Two sons - Sergei and Eugene - inherited their father's profession. After the death of Sergei Petrovich, Eugene became a life physician at court. When the emperor turned into a citizen, he did not leave the Romanov family, he followed her to Tobolsk. When moving to Yekaterinburg, he was offered to leave for St. Petersburg. He stayed. Two days before his death, they again asked to leave the Ipatiev House. He considered it impossible for himself. Dr. Botkin was shot along with the royal family.

S. P. Botkin had a particularly significant influence on the development of domestic medical science among scientists of the 19th century. The study of his work is of interest for our time.

S. P. Botkin was born in Moscow on September 5 (old style), 1832. His father, Pyotr Kononovich Botkin, carried on a large trade with China. The Botkin House on Maroseyka, in Petroverigsky Lane, was known to the cultural circles of the Moscow Society in the 1940s.

After studying at a private boarding school, S. P. Botkin entered the medical faculty of Moscow University. Among the teachers of Botkin who influenced him, it should be noted the physiologist I. T. Glebov, the pathologist A. I. Polunin, the therapist I. V. Varvinsky.

In 1855, S.P. Botkin, as a military doctor, went to the Crimea to the theater of operations, where he worked under the guidance of N.I. Pirogov. After the end of the war, in 1856, he went abroad, where he visited the clinics and laboratories of the universities of Berlin, Vienna and Paris. Botkin stayed abroad until 1860. During this period, he wrote several scientific papers and his doctoral dissertation "On the absorption of fat in the intestines."

At the end of the 1950s, there was a noticeable revival in the scientific life of the St. Petersburg Medical and Surgical Academy. The President of the Academy N. A. Dubovitsky and his assistant Vice-President I. T. Glebov, striving to improve the pedagogical work, invited new professors, among them - S. P. Botkin. Despite protests from the reactionary professors, the young scientist in November 1861 was approved as an ordinary professor of a therapeutic clinic instead of the departed prof. P. D. Shipulinsky.

Sergei Petrovich worked at the academy until the end of his life. For many years he suffered from gallstone attacks and angina pectoris. In 1889, feeling deteriorating health, Botkin went to France for medical purposes and died in Menton on December 12 of the same year.

The worldview of S. P. Botkin was formed under the influence of the best people of that time - T. N. Granovsky, V. G. Belinsky and others. The works of N. G. Chernyshevsky, as well as personal friendship with I. M. Sechenov and meetings with A. I. Herzen.

According to S. P. Botkin, any pathological process occurs under the influence of external conditions. Disease is not something separate from the body. It is impossible to talk about the clinical picture of the disease in general, without connection with this patient. Diseases always develop in different ways, depending on the characteristics of the individual. Hence the need for a comprehensive examination of the diseased. It is not enough only objective research, it is necessary to study the environment of the patient, to get acquainted in detail with his past. It is known that S. P. Botkin, when analyzing patients at lectures, paid much attention to questioning.

Possessing, like a virtuoso, the method of percussion and listening, applying the necessary laboratory research, S. P. Botkin was distinguished at the same time by remarkable observation. This gave him the opportunity to describe many new, previously unknown signs of disease. S. P. Botkin pointed out a number of symptoms observed in organic heart disease. With great depth he described the clinic of narrowing of the left venous opening. Botkin drew attention to the extreme diversity of symptoms depending on the period of the disease.

Describing the symptoms he discovered for the first time and pointing out their significance, the great clinician, however, warned that the heart, as well as other organs, should not be looked at “with anatomical glasses”, since in the end all organs are under the influence of nerve influences. devices. Exploring, where possible, the anatomical basis of the disease, S. P. Botkin always sought to emphasize the functional connections of organs and systems. Studying the disease, S. P. Botkin delved into the development of the process. The establishment of dynamic diagnostics, which is feasible due to deep penetration into the pathophysiology of the body using the analytical-synthetic method of thinking, opened up the possibility, on the one hand, to foresee the further course of the disease, to draw the correct conclusion regarding prognosis and therapy, and on the other hand, to make excursions into the history of pathology. this patient.

S. P. Botkin’s great merit was the installation on understanding the history of the development of a disease process in a given organism. Describing this or that disease, Botkin refused any ready-made schemes. He understood that it is impossible to study the body in parts. Any one-sided experimentation is harmful if the whole is forgotten. S. P. Botkin argued that clinical medicine is an independent science, which has as its object the most complex thing in the world - a living human body. It is impossible to experiment on patients, and experiments on animals can not always be used by doctors.

On this occasion, S.P. Botkin said: “You must look for ... specific means, and you have the right to also follow the path of theoretical considerations, but only the laboratory, and not the clinic, should be the place for the application of the latter. One cannot afford to experiment, without great caution, on a living person. You must remember that our medicine is far from being based on exact science, and always keep in mind that saving fear so as not to harm the patient, not to worsen his condition in any way.

Pushing the boundaries of symptomatology by identifying new signs of diseases, understood in the aspect of the organism as a whole, S. P. Botkin introduced a lot of new things into private therapy.

Particularly significant are the achievements of S. P. Botkin in the field of studying diseases of the cardiovascular system. Studying the clinic of arteriosclerosis, S. P. Botkin proved that this disease usually leads to damage to the heart muscle with a consistent compensation disorder. In the field of peripheral circulation of the joint venture. Botkin opened a new page in medical science. He pointed out that arteries and veins are not simple mechanical devices for the distribution of blood, but are independent, periodically contracting and expanding blood organs. A student of S. P. Botkin, S. V. Levashov argued that, in addition to normal physiological contractions of blood vessels, they can sometimes occur (for example, with epilepsy) and altered, pathological ones.

Understanding the issues of internal pathology, S. P. Botkin always dwelled especially on the state of the cardiovascular system. Describing the clinic of Graves' disease, he drew attention to shortness of breath of cardiac origin, to uneven atrial contractions, to the contrast between the large filling and sharp pulsation of the arteries belonging to the system of the common carotid artery, and the small, barely palpable pulse of the radial arteries. By the way, one cannot fail to recall that S. P. Botkin considered the most characteristic symptom in the picture of this disease to be the state of the psyche of patients - their fearfulness, anxiety, indecision. “The influence of mental moments not only on the course, but also on the development of this form is no longer subject to the slightest doubt,” he argued. Studying the clinical work of S. P. Botkin, we see that in his desire to understand the origins of diseases as deeply as possible, he invariably came to the importance of the role of the nervous system. “It is very possible,” he wrote, that under the influence of a mental shock, not only functional, but also some kind of anatomical changes in the brain centers suddenly developed, which had a paralyzing effect on the function of the vagus nerve or, on the contrary, excited the accelerating apparatus, which is more probably".

Much has been done by S. P. Botkin for the study of rheumatic diseases. Regarding rheumatic endocarditis, he pointed out to doctors that the diagnosis of this disease should not be approached as lightly as the French clinician Buyo, who found endocarditis in 60% of cases of articular rheumatism. Often the development of systolic murmur is associated with damage to the papillary muscles and their weakening, and not at all with the presence of endocarditis.

In the doctrine of nephritis, S. P. Botkin did not agree with the view that arose in connection with pathoanatomical studies, according to which interstitial and parenchymal forms supposedly constitute different pathological units and have their own special clinical course. S. S. Zimnitsky in the 30s of the XX century wrote on this occasion that it is time for clinicians to return to the views of S. P. Botkin, expressed more than 50 years ago, on the issue of nephritis, and to speak in general about Bright's disease.

The diagnosis of a wandering kidney was known even before the work of S.P. Botkin, but only he brought clarity to the clinic of this disease. Botkin showed the way to correct diagnosis and combined into one whole series of phenomena that were erroneously associated with the heart, liver and other organs. They proposed a special method of examination, in which the abdomen was examined not only in the supine position, but also in the standing position of the patient. “The movable kidney,” wrote S. P. Botkin, “worries patients for the most part due to irritation of the nervous apparatus,” which is why various disorders occur.

S. P. Botkin left a noticeable mark in the study of infectious diseases. Seeing the enthusiasm of doctors for microbiology, he said that one should not forget about the body's defenses. “We in the clinic at every step are convinced of the actual existence of those physiological conditions unknown to us in the body that enable it to fight the disease.” It is hardly necessary to dwell on the well-known fact that gastrointestinal catarrh with mechanical bile retention was correctly understood by an eminent Russian clinician as one of the symptoms of the parenchymal hepatitis he described, now called Botkin's disease.

The diagnostic talent of S. P. Botkin was based on an in-depth analysis of all the signs of the disease found and their subsequent synthesis. In this regard, the case is indicative when, at the beginning of his medical and pedagogical activity, he diagnosed portal vein thrombosis, which was subsequently confirmed by an autopsy. Throughout his scientific career, the great clinician improved diagnostic and therapeutic techniques. Various medicines were investigated in the laboratory at his clinic; some of them were taken from traditional medicine. Along with drug treatment, Botkin drew attention to improving the living conditions of patients, the need for physical and mental rest, and climatic treatment.

The works of S. P. Botkin also influenced the development of military field therapy. In this regard, he relied on the experience of two wars - the Crimean campaign and the Russian-Turkish war of 1877. Being at the headquarters of the commander-in-chief in the Balkans for some time, Botkin inspected hospitals, observed the work of doctors, and the general sanitary condition of the army. As a patriotic doctor, he was deeply impressed by the mediocrity of the highest administration and the predatory work of various trading "private partnerships" to which the Russian army was farmed. He saw how the soldiers were starving, being in a country with rich stocks of bread. Regarding everything he saw, S.P. Botkin wrote: “Let's hope for the Russian man, for his power, for his star in the future. Maybe he, with his indestructible strength, will be able to get out of trouble, despite the strategists, quartermasters and the like.

As chairman of the Society of Russian Doctors in St. Petersburg and as editor of a medical journal that published exclusively original articles, S. P. Botkin contributed to the development of domestic medical science. But the importance of S. P. Botkin as a teacher is especially great. He trained hundreds of physicians and prepared dozens of medical scientists for professorships.

His students were professors of therapy V. G. Lashkevich (Kharkov), M. V. Yanovsky (Petersburg), N. A. Vinogradov (Kazan), V. P. Obraztsov (Kyiv), N. Ya. Chistovich (Petersburg), V. N. Sirotinin (Petersburg), A. A. Nechaev (Petersburg) and many others. Under the influence of the ideas of nervism of the clinic of S. P. Botkin, such medical disciplines as dermatology, otolaryngology, nervous and mental diseases, as well as domestic physiology began to develop. The works of I. P. Pavlov and his students were a direct creative development of those ideas of nervism, which they met in the clinic and laboratory of the great Russian doctor.

Lectures by S. P. Botkin, his outpatient appointments were remembered for a lifetime. Dr. P. Gratsianov wrote: “I was then in my fourth year at the Medical and Surgical Academy, where one of the most popular and most beloved professors was Sergei Petrovich Botkin. There were about 40 of us on the course, but we were not the only students of the brilliant professor; his lectures were also attended by fifth-year students, who were taught the same subject by prof. Eichwald. Physicians were also regular visitors to Botkin's lectures, and in that year (after the Turkish campaign) there were especially many seconded to the academy. Met at the lectures and strangers, not involved in medicine persons. These lectures had the same number of listeners during meetings, when other auditoriums were empty. "I was at Botkin's" - served as a sufficient excuse for not arriving at the meeting. Thanks to the interest that Sergei Petrovich's lectures were, his audience, designed for almost 500 people, was always crowded from top to bottom.

S. P. Botkin was not a speaker, his speech did not shine with beautiful phrases, with which usually clever people compensate for the lack of thought and content. His lectures were filled with a deep analysis of the clinical cases being analyzed, broad scientific and philosophical generalizations, and bold well-founded hypotheses.

Despite the exceptional talent of S.P. Botkin, his life path was not easy. A democrat and humanist, he often encountered obstacles that foreign professors put up for him, who in every possible way sought to impede the development of advanced domestic science. Attempts were made to discredit the work of S. P. Botkin, to deny the significance of his achievements, and thus the achievements of the entire Russian clinical school in later times. At the heart of this "criticism" both during Botkin's life and after his death was a biased, arrogant attitude towards domestic science, mixed with ignorance and admiration for foreign science.

Regarding such attacks that took place at different times, we can recall the words of the Czech scientist Skoda: “Following someone else’s and doubt, spreading to everything one’s own, quite often served as a mask of the mind for weak thinkers.” S. P. Botkin devoted all his energy to the service of the people, he taught the same to his listeners.

S. P. Botkin avoided talking about himself. Only, perhaps, once in letters to his wife from Bulgaria in 1877, he wrote: our doctors during this campaign. I will allow this thought to be expressed only to you, knowing that you will not see in this a trace of self-delusion, which I have never had and will not be characteristic of. Looking at the labors of our youth, at their self-sacrifice, at their honest attitude to work, I have repeatedly said to myself that it was not for nothing that I was not fruitlessly losing my moral strength in various trials that my fate arranged for me.

S.P. Botkin was one of the most prominent representatives of the Russian medical school, which originated in the second half of the 18th century and found solid philosophical and scientific foundations in the activities of the classics of Russian science in the first half of the 19th century. In the conditions of his time, S. P. Botkin continued and developed the achievements of his predecessors. In his work, they found a scientific justification and further development of the idea of ​​early materialistic nervism. In an era when the anatomical direction reached its extreme development in Virchow's cellular pathology, Russian clinical thought opposed this direction with the most fruitful ideas of nervism, substantiated by the research of Russian physiologists.

The main thought of S.P. Botkin as a clinician, which he bequeathed to future doctors, was the idea of ​​the need for a deep, comprehensive study of nature. “We cannot allow,” he said in a speech on December 7, 1886, “that preliminary theoretical knowledge consists only in special branches of medicine proper, for example, normal and pathological anatomy, physiology, etc. For a future doctor of a scientific direction, it is necessary to study nature in in the full sense of the word.

Knowledge of physics, chemistry, natural sciences, with the broadest possible general education of a person, constitute the best preparatory school for the study of scientific practical medicine.

Addresses in St. Petersburg

(September 5 (17), 1832, Moscow - December 12 (24), 1889, Menton) - Russian general practitioner and public figure, created the doctrine of the body as a single whole, subject to the will. N. S. Professor of the Medico-Surgical Academy (since 1861). Member of the Crimean (1855) and Russian-Turkish (1877) wars.

Biography

Sergei Petrovich Botkin comes from a merchant family that traded in tea. As a child, I wanted to become a mathematician, but by the time I entered the university, Emperor Nicholas issued a decree that allowed free access only to the Faculty of Medicine. He studied at the Faculty of Medicine of Moscow University, studied with famous professors - physiologist I. T. Glebov, pathologist A. I. Polunin, surgeon F. I. Inozemtsev, therapist I. V. Varvinsky. During his studies, he was friends with I. M. Sechenov. In the summer of 1854 he participated in the elimination of the cholera epidemic in Moscow. In 1855 he graduated from the university, received the title of "doctor with honors." In the same year, he participated in the Crimean campaign under the command of N.I. Pirogov as an intern at the Simferopol hospital. Already during this period, S.P. Botkin formed the concept of military medicine and the proper nutrition of soldiers:

Received extensive training in various branches of medicine abroad. In the clinic of Professor Hirsch in Königsberg, at the Pathological Institute with R. Vikhov in Würzburg and Berlin, in the laboratory of Goppe-Seyler, in the clinic of the famous therapist L. Traube, the neuropathologist Romberg, the syphilidologist Berensprung in Berlin, the physiologist K. Ludwig and the clinician Oppolzer in Vienna, in England, as well as in the laboratory of the experimental physiologist C. Bernard, in the clinics of Barthez, Buchou, Trusseau and others in Paris. The first works of Botkin appear in the Virchow Archive.

At the end of 1859, Yakubovich, Botkin, Sechenov, Bokkers and Jung were invited to the therapy clinic of the Medico-Surgical Academy (St. Petersburg). On August 10, 1860, Botkin moved to St. Petersburg, defended his thesis for the degree of Doctor of Medicine on the topic: “On the absorption of fat in the intestines” and was appointed acting adjunct at a therapeutic clinic headed by Professor P. D. Shipulinsky. Soon, however, relations between Botkin and Shipulinsky deteriorated, and the latter was forced to resign. However, the conference of the academy did not want to transfer the leadership of the clinic to the talented Botkin, only a letter from students and doctors allowed him to take the vacant position in 1861, and at the age of 29 he received the title of professor.

S. P. Botkin was elected to the Department of Faculty Therapy at the age of 28 and headed it for 30 years. Botkin's daily routine was as follows: he arrived at the clinic at 10 am, from 11 o'clock chemical and microscopic studies carried out by students and young doctors began, as well as research work with undergraduates, from 13 o'clock he lectured to students, after the lecture followed rounds and examinations of outpatients, from 17:00 to 19:00 - evening rounds of the clinic, from 19:00 to 21:00 - lectures for associate professors, to which everyone was allowed. After that, Botkin returned home, where he ate dinner and prepared for the next day, but after 12 o'clock in the morning he paid attention to his favorite thing - playing the cello. In his letter to N. A. Belogolovy Botkin notes:

The first stone of S.P. Botkin's fame as a fine diagnostician was laid in 1862 after his lifetime diagnosis of portal vein thrombosis. After establishing the diagnosis, the patient lived for several weeks. Detractors hoped for a mistake. S. P. Botkin paid much attention to cholelithiasis, which he himself suffered for a long time. He pointed to the role of infection in stone formation. He emphasized the clinical diversity of this disease. The scientist believed that until the doctor found the erupted stone, his diagnosis remained a hypothesis. In his work “On reflex phenomena in the vessels of the skin and on reflex sweat”, S. P. Botkin cites a number of interesting clinical observations, one of which demonstrates that when a stone passes through the bile ducts, the upper and lower extremities become cold, the skin of the chest becomes hot and the temperature in armpit rises to 40°C.

Thanks to outstanding pedagogical abilities, professors left the Botkin clinic, who headed the departments at the medical faculties of Russian universities V. T. Pokrovsky, N. I. Sokolov, V. N. Sirotinin, V. A. Manassein, Yu. T. Chudnovsky, A. G Polotebnov, N. P. Simanovsky, A. F. Prussak, P. I. Uspensky, D. I. Koshlakov, L. V. Popov, A. A. Nechaev, M. V. Yanovsky, M. M. Volkov , N. Ya. Chistovich and others. A total of 87 graduates of his clinic became doctors of medicine, of which more than 40 were awarded the title of professor in 12 medical specialties. S. P. Botkin acted as an official dissertation opponent 66 times.

In 1865, S.P. Botkin initiated the creation of an epidemiological society, the purpose of which was to combat the spread of epidemic diseases. The society was small, but active, its printed organ was the Epidemic Leaflet. As part of the work of the society, Botkin studied the epidemic of plague, cholera, typhoid, smallpox, diphtheria and scarlet fever. Observing liver diseases that occur with a high temperature, S. P. Botkin first described the disease, which before him was considered gastrointestinal catarrh with mechanical bile retention. This disease was manifested not only by jaundice, but also by an enlarged spleen, and sometimes by kidney disease. The disease, as S. P. Botkin pointed out, lasts for several weeks, and in the future can lead to a severe complication - cirrhosis of the liver. Searching for the causes of the disease, S. P. Botkin came to the conclusion that contaminated food products are the source of infection. He attributed this type of catarrhal jaundice to infectious diseases, which was later confirmed (Botkin's disease, viral hepatitis A).

Botkin stood at the origins of women's medical education in Russia. In 1874, he organized a school of paramedics, and in 1876 - "Women's Medical Courses". In 1866, Botkin was appointed a member of the Medical Council of the Ministry of the Interior. An active life position, interest in social activities allowed the medical community to elect S. P. Botkin in 1878 as chairman of the Society of Russian Doctors, which he led until his death. At the same time, he was a member of the main department of the Society for the Care of the Wounded, a member of the St. Petersburg Duma and deputy chairman of the St. Petersburg Public Health Commission. Fame and medical talent played their part, and S.P. Botkin became the first ever Russian life physician of the imperial family. S. P. Botkin laid the foundation for sanitary organizations in St. Petersburg. From the first years of the existence of the Alexander Barracks Hospital (now the Clinical Infectious Diseases Hospital named after S.P. Botkin) became its trustee for the medical part. In many ways, it was thanks to the activities of S.P. Botkin that the first ambulance appeared, as a prototype of the future Ambulance.

He died on December 24, 1889 at 12:30 in Menton. Botkin was buried at the Novodevichy cemetery. At that time, there was a congress of Russian doctors, the work of which was interrupted. The coffin with the body of Botkin was carried in their arms for 4 miles.

Family

Father - Pyotr Kononovich Botkin, merchant of the first guild and owner of a large tea company, mother - Anna Ivanovna Postnikova. In the family of S. P. Botkin's parents there were 25 children, Sergei was 11 children from his father's second marriage.

Brothers: collector D. P. Botkin, writer V. P. Botkin, artist M. P. Botkin. Sisters: M. P. Botkina - the wife of the poet A. A. Fet

Children: Alexander Botkin (naval officer), Pyotr Botkin (c. 1865-1937, diplomat), Sergei Botkin, Evgeny Botkin (1865-1918, medical doctor), Viktor Botkin.

Addresses in St. Petersburg

• 1860-1864 - Spasskaya street, house 1;
• 1878-12.12.1889 - Galernaya street, house 77 (commemorative plaque).

Memory

Botkin hospitals operate in Moscow and St. Petersburg. Also in the city of Orel, a hospital is named after him.

In 1898, in memory of the merits of the outstanding doctor, Samarskaya Street in St. Petersburg was renamed Botkinskaya Street. A memorial plaque was installed on house number 20.

In the square in front of the clinic at the corner of Botkinskaya Street and Bolshoi Sampsonievsky Prospekt, a monument was erected on May 25, 1908 (sculptor V. A. Beklemishev).

In the 1920s, a bust by I. Ya. Guntsburg (1896) was erected on the territory of the Botkin Hospital.

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On the topic: "Sergei Petrovich Botkin"

 Introduction

 Biography

 Contribution to medicine

 References

Introduction

In Leningrad, in front of the building of the Military Medical Academy, there is a monument: on a granite pedestal is the figure of an elderly man in an old-fashioned frock coat. The man is not tall, but broad-shouldered, he slightly spread his legs, put his hands behind his back, in thought bowed his head with a large wise forehead to his chest. When in 1908 the sculptor V. A. Beklemishev completed work on the monument to Professor Sergei Petrovich Botkin, many students and associates of the remarkable doctor and scientist were still alive. They well remembered this pose, so successfully captured by the sculptor...

The old doctor had just finished examining the patient. He questioned him for a long time, delving into every detail of life and illness. Then he listened, tapped his chest with short, senile, but surprisingly sensitive fingers, and, rising from his chair, fell into thought. He weighs the facts, compares them, mentally argues with himself. Now a lot depends on him: health, happiness, and maybe the life of the patient. The diagnosis - the conclusion about the disease - must be accurate. The doctor has no room for error. This great concern of the healer for the patient and the strict demands of the natural scientist on himself were very successfully conveyed by the talented sculptor.

Thousands of patients could say that they were healed by the wonderful doctor Sergei Petrovich Botkin (1832-1889). Dozens of scientists proudly called themselves his students. As a man of great soul and as a public figure, Botkin was highly valued by M.E. Saltykov-Shchedrin, and N.A. Nekrasov dedicated one of the chapters of his poem "Who Lives Well in Russia" to him.

Biography

Sergei Petrovich Botkin comes from a merchant family that traded in tea. As a child, I wanted to become a mathematician, but by the time I entered the university, Emperor Nicholas issued a decree that allowed free access for non-nobles only to the medical faculty. He studied at the Faculty of Medicine of Moscow University with famous professors - physiologist I. T. Glebov, pathologist A. I. Polunin, surgeon F. I. Inozemtsev, therapist I. V. Varvinsky. During his studies, he became closely acquainted with his fellow student I.M. Sechenov, during their stay abroad after graduation from the university, these relations grew into a close friendship. In the summer of 1854 he participated in the elimination of the cholera epidemic in Moscow. In 1855 he graduated from the university, received the title of "doctor with honors." In the same year, he participated in the Crimean campaign under the command of N.I. Pirogov as an intern at the Simferopol hospital. Already during this period, S.P. Botkin developed the concept of military medicine and the proper nutrition of soldiers. He received extensive training in various areas of medicine abroad: at the clinic of Professor Hirsch in Königsberg, at the Pathological Institute with R. Wikhov in Würzburg and Berlin, at the laboratory of Goppe-Seyler, at the clinic of the famous therapist L. Traube, neuropathologist Romberg, syphilidologist Berensprung in Berlin , with the physiologist K. Ludwig and the clinician Oppolzer in Vienna, in England, as well as in the laboratory of the experimental physiologist K. Bernard, in the clinics of Barthez, Buchou, Trusseau and others in Paris. The first works of Botkin appear in the Virchow Archive.

At the end of 1859, Yakubovich, Botkin, Sechenov, Bokkers and Jung were invited to the therapy clinic of the Medico-Surgical Academy (St. Petersburg). On August 10, 1860, Botkin moved to St. Petersburg, defended his thesis for the degree of Doctor of Medicine on the topic: “On the absorption of fat in the intestines” and was appointed acting adjunct at a therapeutic clinic headed by Professor P. D. Shipulinsky. Soon the relationship between Botkin and Shipulinsky deteriorated, and the latter was forced to resign. However, the conference of the academy did not want to transfer the leadership of the clinic to the talented Botkin, only a letter from students and doctors allowed him to take the vacant position in 1861, and at the age of 29 he received the title of professor.

S. P. Botkin was elected to the Department of Faculty Therapy at the age of 28 and headed it for 30 years. Botkin's daily routine was as follows: he arrived at the clinic at 10 am, from 11 o'clock chemical and microscopic studies carried out by students and young doctors began, as well as research work with undergraduates, from 13 o'clock he lectured to students, after the lecture followed rounds and examinations of outpatients, from 17:00 to 19:00 - evening rounds of the clinic, from 19:00 to 21:00 - lectures for associate professors, to which everyone was allowed. After that, Botkin returned home, where he ate dinner and prepared for the next day, but after 12 o'clock at night he paid attention to his favorite thing - playing the cello.

Contribution to medicine

* For many centuries, doctors have mostly acted according to the established tradition: if once a medicine helped one patient, then in all such cases the same medicine was prescribed to others. Doctors did not think about the fact that the body of each person has its own characteristics and, therefore, the same disease occurs in one patient differently than in another.

Botkin was one of the first to prove that each patient must be approached individually, taking into account the characteristics of age, anatomical structure, the state of the nervous system, and living conditions.

Botkin believed that in order for the help of a doctor to be reasonable and effective, he must be engaged not only in medicine, but also in other natural sciences.

Sergey Petrovich outlined his views on various issues of medicine in three issues of the Course of Clinics of Internal Diseases, published in 1867, 1868 and 1875, and 35 lectures, which were recorded and published by his students. In his judgments, Botkin accepted the organism as a single whole, inextricably linked with its environment. He said that this connection is expressed, first of all, in the exchange of substances between the environment and the organism, by adapting the organism to the environment. Thanks to the ongoing exchange, the organism lives and remains independent in relation to the environment, and thanks to the process of adaptation, it forms new properties in itself, which are then inherited. Studying the discoveries of Botkin, you understand that they are clear even to a person who knows nothing about medicine. It was Sergey Petrovich who said that all diseases are from nerves. Today this is an indisputable fact, but then it had to be proved. He paid great attention to the problems of the nerve centers of the body. Many of his guesses were later proven by physiologists. Botkin said that one should not attach so little importance to the nervous system in the interpretation of pathologies in internal diseases. In his opinion, nothing affects the functioning of the heart like the nervous system. All diseases, he believed, are in one way or another connected with the influence of the external environment, acting directly on the diseased organism, or through its immediate or distant parents. Studying the conditions of life, work and nutrition of sick people, Sergey Petrovich formulated the main goals of Russian medicine: “The main and essential tasks of practical medicine are the prevention of illness, the treatment of an advanced disease, and, finally, the alleviation of the suffering of a sick person.” The most important thing he considered the prevention of the disease.

Developing the theory of I. M. Sechenov that the anatomical and physiological substrate of all acts of human activity is the reflex mechanism, he spoke out that all pathological processes inside the human body develop along reflex nerve pathways. Since, in the reflex act, the main role is assigned to any node of the nervous system, Sergei Petrovich paid great attention to the study of the brain.

Back in 1861, he opened the first free dispensary. In 1875, a center of reflex effects on the spleen was discovered and concluded that there were centers of hematopoiesis and lymph circulation. He presented the significance of all these centers in the formation of the corresponding diseases, thereby proving the correctness of the neurogenic theory of pathogenesis. Taking this theory as a basis, Sergei Petrovich began to formulate a new theory of treatment, by influencing the course of the disease through the nerve centers, but did not have time to fully develop it.

Back in 1861, he opened the first free dispensary. In 1880, when Botkin was elected chairman of the Society of Russian Doctors, through his efforts a free hospital for the poor was opened in St. Petersburg, now the hospital named after. S. P. Botkin. It operated a laboratory where clinical observations were carried out. Sergei Petrovich spared neither his strength nor the money that, as the trustee of the hospital, the city allocated to him. Newspapers wrote about him as a sensitive and cordial clinician, showing concern for the suffering of his native land.

Botkin owns many discoveries in the field of medicine. He was the first to speak about the specificity of protein structure in organs; was the first to develop the diagnosis of a "wandering" and lowered kidney.

You can list all the merits of this great man endlessly, but it is necessary to mention that Botkin was an ardent supporter of women's rights to receive higher medical education. In 1872, the first medical courses for women were opened, and Sergei Petrovich was happy to provide women with the opportunity to work in his department. How many women professors, doctors of medical sciences today!

Women, endowed by nature with mercy and a desire to help, have made a huge contribution to science. And all this thanks to the efforts of Sergei Petrovich Botkin.

To study the problems of scientific medicine and physiology, Botkin created at his clinic in 1860-1861. the first experimental laboratory in Russia. Various analyzes were made here, the effect of drugs on the body was studied, and observations were made on animals.

Science owes Botkin and other major discoveries. In the early days of microbiology, he argued that the disease known as jaundice was caused by microorganisms. This prediction came true: scientists have recently found the causative agent of infectious jaundice, which is now called Botkin's disease.

Botkin made many remarkable predictions. In his lectures, he expressed, for example, his confidence that special centers will be found in the human brain that control hematopoiesis, the secretion of sweat, the regulation of heat, etc. Now the existence of such centers has been proven.

The scientist did a lot to organize free medical care for the poor. In 1861, he opened the first free dispensary at his clinic. Thanks to Botkin's perseverance, in the early 1980s, the first free hospitals for the poorest population appeared in St. Petersburg and other cities.

Botkin was deeply worried about the causes of high mortality in tsarist Russia. He repeatedly drew the attention of the government to the need to improve the sanitary condition of the country.

With his work, Sergei Petrovich earned a lot of money, but he did not know their price. He always financially helped those in need. A sensitive friend of Botkin was his wife, who, understanding the importance of her husband's work, was not only an ideal wife for him, but also a wonderful mother of his children. But in 1873, Anastasia Alexandrovna's acute anemia destroyed family happiness and took the life of a beautiful woman. But, despite the pain of loss, Sergei Petrovich continued to work hard. After some time, he again married E. A. Mordvinova, nee Princess Obolenskaya. At the same time, Sergei Petrovich received the post of life physician of His Majesty. But the great doctor was bored with treating the imperial family, and he again began to open free hospitals, invent new methods of treatment, work, work and work.

On November 11, 1889, Sergei Petrovich Botkin, the greatest man who raised more than a hundred students, died of coronary heart disease. But death did not stop the work of his life. His children and students continue to fight terrible diseases in the hope of ever gaining a complete victory.

Bibliography

 White-headed N. A. S. P. Botkin, his life and medical practice. - St. Petersburg, 1892.

 B. V. Gaidar, Yu. V. Lobzin, V. I. Mazurov, etc. Sergei Petrovich Botkin on the occasion of his 175th birthday. / Ed. B. V. Gaidar. - St. Petersburg: Man and health, 2007. - 128 p.

 Union of Philosophy and Medicine. / Ed. N. N. Blokhina, A. N. Kalyagin. - Irkutsk: RIO GOU VPO IGMU Roszdrav, 2009. - 112 p.