Pirogov Nikolay Ivanovich(1810-1881) - Russian surgeon and anatomist, teacher, public figure, founder of military field surgery and the anatomical and experimental direction in surgery, corresponding member of the St. Petersburg Academy of Sciences (1846).

Member of the Sevastopol defense (1854-1855), Franco-Prussian (1870-1871) and Russian-Turkish (1877-1878) wars. For the first time, he performed an operation under anesthesia on the battlefield (1847), introduced a fixed plaster cast, and proposed a number of surgical operations. He fought against class prejudices in the field of education, advocated the autonomy of universities, universal primary education. Pirogov's atlas "Topographic Anatomy" (vols. 1-4, 1851-1854) received worldwide fame.

The future great doctor was born on November 27, 1810 in Moscow. His father served as treasurer. A well-known Moscow doctor, professor of Moscow University E. Mukhin noticed the boy's abilities and began to work with him individually.

When Nikolai was fourteen years old, he entered the medical faculty of Moscow University. To do this, he had to add two years to himself. Pirogov managed to get a job as a dissector in the anatomical theater. After graduating from the university, Pirogov went to prepare for professorship at Yuryev University in Tartu. Here, in the surgical clinic, Pirogov worked for five years, defended his doctoral dissertation, and at the age of twenty-six became a professor of surgery.

He chose as the subject of his dissertation the ligation of the abdominal aorta, which had been performed only once before by the English surgeon Astley Cooper. When Pirogov, after five years in Dorpat, went to Berlin to study, renowned surgeons read his dissertation, hastily translated into German.

One of Pirogov's most significant works is the Surgical Anatomy of the Arterial Trunks and Fascia, completed in Derpt. Everything that Pirogov discovered, he needs not in itself, but in order to indicate the best methods for performing operations, first of all, "to find the right way to ligate this or that artery," as he says. Here begins a new science created by Pirogov - surgical anatomy.

In 1841, Pirogov was invited to the Department of Surgery at the St. Petersburg Medical and Surgical Academy. Here the scientist worked for more than ten years and created the first surgical clinic in Russia. In it, he founded another branch of medicine - hospital surgery.

On October 16, 1846, the first test of ether anesthesia took place. In Russia, the first operation under anesthesia was performed on February 7, 1847 by Pirogov's comrade from the professorial institute, Fedor Ivanovich Inozemtsev.

Soon, Nikolai Ivanovich took part in hostilities in the Caucasus. Here, in the village of Salty, for the first time in the history of medicine, he began to operate on the wounded with ether anesthesia. In total, the great surgeon performed about 10,000 operations under ether anesthesia.

Pirogov in the anatomical theater sawed frozen corpses with a special saw. With the help of cuts made in this way, Pirogov compiled the first anatomical atlas, which became an indispensable guide for surgeons. Now they have the opportunity to operate, causing minimal injury to the patient.

When the Crimean War began in 1853, Nikolai Ivanovich went to Sevastopol. Operating on the wounded, Pirogov for the first time in the history of medicine used a plaster cast.

Pirogov introduced sorting of the wounded in Sevastopol: some were operated on directly in combat conditions, others were evacuated deep into the country after first aid. On his initiative, sisters of mercy appeared in the army. Thus, Pirogov laid the foundations of military field medicine.

Nikolai Ivanovich Pirogov is one of the most prominent personalities of the 19th century. The contribution that he made to the development of science in our country is so great that it is quite comparable with the achievements of such great geniuses of science and politicians of our history as, for example, D.I. Mendeleev, M.V. Lomonosov.

Many streets in many cities of our country are named after him. Pirogov's name is given to the Leningrad Surgical Society, the 2nd Moscow and Odessa Medical Institutes. After the death of Pirogov, the "Society of Russian Doctors in Memory of N.I. Pirogov" was founded, as well as the "Pirogov Congresses" that were regularly convened.

Nikolai Ivanovich Pirogov is a domestic doctor and scientist, an outstanding teacher and public figure; one of the founders of surgical anatomy and anatomical and experimental direction in surgery, military field surgery, organization and tactics of medical support for troops; member corr. Petersburg Academy of Sciences (1847), honorary member and honorary doctor of many domestic and foreign universities and medical societies.

The contribution of N. I. Pirogov to military field surgery huge and recognized all over the world. He revealed the main features of military field surgery in comparison with peacetime surgery. By defining the war as a "traumatic epidemic" Pirogov gave a clear idea of ​​the scale of medical and evacuation measures in the war and brought to the fore in military field surgery the importance of organizing medical support for troops. The main tool for organizing the provision of surgical care to the wounded. Pirogov considered triage with the determination of the severity of injuries and the sequence of assistance. Pirogov used anesthesia for the first time in the war. He widely introduced plaster cast for the treatment of gunshot fractures of bones in the wounded and, on this basis, formulated the idea of ​​“saving treatment” instead of the prevailing opinion at that time about the need for early amputations of limbs. Pirogov gave detailed recommendations on the use of temporary and final stop bleeding in the wounded. He attracted women to help the wounded in the war, thereby laying the foundation for the institute of nurses. Pirogov's merits in the study of the pathology of combat injuries are great. His description of traumatic shock became a classic and is mentioned in all modern manuals. Brilliantly predicting infectious nature of purulent complications in the case of the wounded associated with pathogenic organic agents ("miasma"), Pirogov proposed specific measures for the prevention and treatment - the system of "scattering the wounded in the warrior." In general, the role of N. I. Pirogov in the history of domestic medicine can be characterized by the words V. A. Oppel: “Pirogov created a school. His school is all Russian surgery.”

N. I. Pirogov was the first among domestic scientists to come up with the idea of ​​plastic surgery (a trial lecture at the St. Petersburg Academy of Sciences in 1835 "On plastic surgery in general and about rhinoplasty in particular"), for the first time in the world put forward the idea of ​​bone grafting, publishing in 1854 .the work "Osteoplastic elongation of the bones of the lower leg during exfoliation of the foot". His method of connecting the supporting stump during amputation of the lower leg due to the calcaneus is known as the Pirogov operation, it served as an impetus for the development of other osteoplastic operations. The extra-abdominal access to the external iliac artery (1833) and the lower third of the ureter proposed by N. I. Pirogov received wide practical application and was named after him.

The role of N. I. Pirogov in the development of the problem of anesthesia is exceptional. Narcosis was proposed in 1846, and the very next year, N. I. Pirogov conducted a wide experimental and wedge test of the analgesic properties of ether vapors. He studied their effect in experiments on animals (with various methods of administration - inhalation, rectal, intra-jejunal, intratracheal, suo-arachnoid), as well as on volunteers, including on himself. One of the first in Russia (February 14, 1847), he performed an operation under ether anesthesia (removal of the mammary gland for cancer), which lasted only 2.5 minutes; in the same month (for the first time in the world) he performed an operation with rectal ether anesthesia, for the implementation of which a special apparatus was designed. He summarized the results of 50 surgical interventions carried out by him in the hospitals of St. Petersburg, Moscow and Kyiv in reports, oral and written communications (including in the Society of Doctors of St. Petersburg and the Medical Council of the Ministry of Internal Affairs, in the St. Petersburg and the Paris Academies of Sciences) and the monographic work "Observations on the action of ether vapors as an analgesic in surgical operations" (1847), which were of great importance in promoting the new method in Russia and introducing anesthesia into wedge practice. In July-August 1847, N. I. Pirogov, sent to the Caucasian theater of operations, where he first used ether anesthesia in the conditions of active troops (during the siege of the fortified village of Salty). The result was unprecedented in the history of wars: operations took place without the groans and cries of the wounded. In his Report on a Journey through the Caucasus (1849), N. I. Pirogov wrote: “The possibility of broadcasting on the battlefield has been undeniably proven ... The most comforting result of broadcasting was that the operations we performed in the presence of other wounded did not frighten us but, on the contrary, they comforted them in their own fate.

The activity of N. I. Pirogov played a significant role in the history of asepsis and antiseptics, which, along with anesthesia, determined the success of surgery in the last quarter of the 19th century. Even before the publication of the works of L. Pasteur and J. Lister, in his wedge, lectures on surgery, N. I. Pirogov made a brilliant guess that suppuration of wounds depends on living pathogens (“hospital miasm”): “Miasma, infecting, itself and is reproduced by an infected organism. Miasma is not, like poison, a passive aggregate of chemically active particles; it is organic, capable of developing and regenerating." From this theoretical position, he drew practical conclusions: he allocated special departments in his clinic for those infected with "hospital miasms"; demanded "to completely separate the entire staff of the gangrenous department - doctors, nurses, paramedics and attendants, to give them dressings (lint, bandages, rags) and special surgical instruments that are special from other departments"; recommended that the physician "of the miasmic and gangrenous department pay special attention to his dress and hands." Regarding the dressing of wounds with lint, he wrote: “You can imagine what this lint must look like under a microscope! How many eggs, fungi and various spores are in it? How easily it becomes itself a means of transferring infections!” N. And, Pirogov consistently spent antiputrefactive treatment of wounds, applying iodine tincture, solutions of silver nitrate, etc., emphasized value of a gigabyte. measures in the treatment of the wounded and sick.

N. I. Pirogov was a champion of the preventive trend in medicine. He owns the famous words that have become the motto of Russian medicine: "I believe in hygiene. This is where the true progress of our science lies. The future belongs to preventive medicine."

In 1870, in a review of the "Proceedings of the Permanent Medical Commission of the Poltava Provincial Zemstvo", N. I. Pirogov advised the Zemstvo to pay special attention to honey. organizations for hygiene and sanitation. sections of its work, as well as not to lose sight of the food issue in practical activities.

The reputation of N. I. Pirogov as a practical surgeon was as high as his reputation as a scientist. Removal of a mammary gland or a stone from the bladder, for example, N. I. Pirogov carried out in 1.5–3 minutes. During the Crimean War, in the main dressing station of Sevastopol on March 4, 1855, he performed 10 amputations in less than 2 hours. The international medical authority of N. I. Pirogov is evidenced, in particular, by inviting him for a consultative examination to the German Chancellor O. Bismarck ( 1859) and the national hero of Italy G. Garibaldi (1862).

Military medicine owes to N.I. Pirogov the creation of the scientific foundations of domestic military field surgery and a new section of military medicine - the organization and tactics of medical. services. In 1854–1855 during the Crimean War, N. I. Pirogov twice went to the theater of operations and directly participated in the organization of honey. ensuring the combat operations of the troops and in the treatment of the wounded, was the initiator of attracting women ("sisters of mercy") to care for the wounded at the front. To get acquainted with the work of dressing stations, infirmaries and hospitals in the conditions of hostilities, he also traveled to Germany (1870) and Bulgaria (1877). N. I. Pirogov summarized the results of his observations in the works "The beginnings of general military field surgery, taken from observations of military hospital practice and memories of the Crimean War and the Caucasian expedition" (1865–1866), "Report on visiting military sanitary institutions in Germany, Lorraine and Alsace in 1870." (1871) and "Military medicine and private assistance in the theater of war in Bulgaria and in the rear of the army in 1877-1878." (1879). The practical conclusions set forth by N. I. Pirogov, in the form of "provisions", formed the basis of the organizational, tactical and methodological principles of military medicine.

The first position of N. I. Pirogov reads: "War is a traumatic epidemic." This definition of war from a medical point of view has firmly entered the military medical literature. It stems from the fact that the combat operations of the troops are characterized by mass character and extreme unevenness of sanitary losses, and hence the uneven receipt of victims in the field honey. institutions. Already during the Crimean War, the shortage of doctors at dressing stations and in field hospitals was so great that there was sometimes one intern for 100 or more seriously wounded. Irregularity dignity. losses in subsequent wars manifested itself even more clearly, exerting an ever greater influence on the organizational principles of building the military medical service, on the tactics of its work and on the combat training of personnel.

N. I. Pirogov did not consider combat damage as a simple mechanical violation of the integrity of tissues; he attached great importance in the occurrence and course of combat injuries to general fatigue and nervous tension, lack of sleep and malnutrition, cold, hunger and other unavoidable adverse factors in the combat situation that contribute to the development of wound complications and the occurrence of a number of diseases in soldiers of the active army.

The second position of N. I. Pirogov says: "The property of wounds, mortality and the success of treatment depend mainly on the various properties of weapons and, in particular, firearms." The views of N. I. Pirogov on surgical interventions, on preventive operations at dressing stations and in field hospitals have changed throughout his career. In the beginning, he was a strong supporter of preventive operations. After a thorough analysis of the wedge, the outcomes of wounds, which gave especially high mortality from complications of wounds by putrefactive processes, as well as mortality among patients operated on in hospitals and in private practice, P. I. Pirogoy concluded that preventive operations at dressing stations and impotence were inappropriate surgeon in these conditions in the fight to reduce mortality and disability among the wounded. Having become acquainted during the Russian-Turkish war with honey. ensuring the combat operations of the troops and with the organization of surgical work at the main dressing stations in hospitals (and in particular, with the results of applying the Lister method of fighting infection during operations), N. I. Pirogov changed his attitude to the role of surgical interventions in the prevention of complications of gunshot wounds. In his last work, "Military Medical Business...", he already spoke of two ways of developing surgery (especially military field surgery): expectant-saving and active-prophylactic. With the discovery and introduction of antiseptics and asepsis into surgical practice, surgery began to develop along the second path, about which N.I. Pirogov wrote: "A vast field of the most energetic activity at the dressing station opens up for field surgery - primary operations in hitherto unknown sizes."

The third position of I. Pirogov, closely related to the first, reads: "Not medicine, but the administration plays the main role in helping the wounded and sick in the theater of war." According to the atom of the situation, the success of honey. ensuring the combat operations of the troops depends on the organizational structure of the honey. institutions, their number, subordination, purpose, mobility and relationships between them, which, in turn, should be determined by the characteristics of the theater of operations, the nature of the war and the methods of combat operations, on the one hand, and the achievements of medical. science and practice of health care, on the other.

N. I. Pirogov recognized the need to regulate the appointment and tasks of honey. institutions, the rights and obligations of officials, but emphasized that for the success of honey. affairs in a war with all its many surprises, a quick change in the combat situation, forcing, in the interests of the case, to violate these regulations, but at the same time emphasized that skillful leadership of the military medical service is of particular importance, which must be authoritative, medical from top to bottom, capable of being responsible for the entrusted matter of substance, not of form.

N. I. Pirogov considered the main task to ensure the interconnectedness of treatment and evacuation, while he proceeded from the decisive importance of the combat situation in solving the main tasks of honey. ensuring combat operations of troops, in particular when establishing the deployment and grouping of honey. institutions, as well as the volume of medical care provided in them to the injured and sick.

P. I. Pirogov - the founder of the doctrine of honey. sorting. He argued that the sorting of the wounded according to the urgency of rendering and the volume of surgical care and indications for evacuation is the main means of preventing "confusion" and "confusion" in medical institutions. In this regard, he considered it necessary to have in medical institutions intended for receiving the wounded and sick and providing them with qualified assistance, a sorting and operational dressing unit, as well as a unit for the lightly wounded ("weak teams"), and on evacuation routes (in area of ​​concentration of hospitals) - "sorting" - sorting hospitals.

Of great importance not only for military field surgery, but also for a wedge, medicine as a whole were the works of P. I. Pirogov on the problems of immobilization and shock. In 1847, at the Caucasian theater of military operations, for the first time in military field practice, he used a fixed starch dressing for complex fractures of the limbs. During the Crimean War, he also for the first time (1854) applied a plaster cast in the field. N. I. Pirogov owns a detailed description of the pathogenesis, a presentation of methods for the prevention and treatment of shock; the wedge described by him, the picture of shock is classical and continues to appear in manuals and textbooks on surgery. He also described a concussion of the brain, gaseous swelling of the tissues, singled out "wound consumption" as a special form of pathology, now known as "wound exhaustion".

A characteristic feature of N. I. Pirogov, a doctor and teacher, was extreme self-criticism. Even at the beginning of his professorship, he published the two-volume work "Annals of the Derpt Surgical Clinic" (1837–1839), in which a critical approach to one's own work and an analysis of one's mistakes are considered as the most important condition for the successful development of medical science. science and practice. In the preface to the 1st volume of the Annals, he wrote: "I consider it the sacred duty of a conscientious teacher to immediately publish his mistakes and their consequences in order to warn and edify others, even less experienced, from such errors." I. II. Pavlov called the publication of the "Annals" his first professorial feat: "... in a certain respect an unprecedented publication. Such merciless, frank criticism of himself and his work is hardly found anywhere in the medical literature. And this is a great merit!". In 1854, the "Military Medical Journal" published an article by N. I. Pirogov "On the difficulties of recognizing surgical diseases and on happiness in surgery", based on the analysis of Ch. way, own medical errors. This approach to self-criticism as an effective weapon in the struggle for genuine science is characteristic of N. I. Pirogov in all periods of his versatile activity.

N. I. Pirogov, a teacher, was distinguished by a constant desire for greater clarity of the material presented (for example, widespread demonstrations at lectures), the search for new methods of teaching anatomy and surgery, conducting a wedge, detours. His important merit in the field of honey. education is an initiative to open hospital clinics for 5th year students. He was the first to substantiate the need to create such clinics and formulated the tasks facing them.

N. I. Pirogov's speeches on upbringing and education had a great public resonance; his article "Questions of Life", published in 1856 in the "Sea Collection", was positively evaluated by N. G. Chernyshevsky and N. A. Dobrolyubov. From the same year, N. I. Pirogov's activity in the field of education began, which was marked by a constant struggle against ignorance and stagnation in science and education, with patronage and bribery. N. I. Pirogov sought to spread knowledge among the people, demanded the so-called. autonomy of high fur boots, was a supporter of competitions that provide a place for more capable and knowledgeable applicants. He defended equal rights to education for all nationalities, large and small, and all estates, strove for the implementation of universal primary education and was the organizer of Sunday public schools in Kyiv. On the question of the relationship between "scientific" and "educational" in higher education, he was a resolute opponent of the opinion that high fur boots should teach, and the Academy of Sciences should "move science forward", and argued: "It is impossible to separate educational from scientific at the university. But scientific and without educational still shines and warms. And educational without scientific, no matter how tempting its appearance, only shines. In assessing the merits of the head of the department, he gave preference to scientific, rather than pedagogical abilities. Pirogov was deeply convinced that science is driven by method. “Be a professor at least a dumb one,” wrote P. I. Pirogov, “and teach by example, in fact, the real method of studying the subject - it is for science and for those who want to do science, more expensive than the most eloquent speaker ...” Ah, I. Herzen called P. I. Pirogov one of the most prominent figures in Russia, who, in his opinion, brought great benefits to the Motherland not only as the "first operator", but also as a trustee of educational districts.

(1810-1881) - a great Russian doctor and scientist, an outstanding teacher and public figure; one of the founders of surgical anatomy and anatomical and experimental direction in surgery, military field surgery, organization and tactics of medical support for troops; corresponding member Petersburg Academy of Sciences (1847), honorary member and honorary doctor of many domestic and foreign universities and medical societies.

In 1824 (at the age of 14) N. I. Pirogov entered the medical department. Faculty of Moscow University, where among his teachers were the anatomist X. I. Loder, clinicians M. Ya. Wise, E. O. Mukhin. In 1828 he graduated from the un-t and entered among the first "professorial students" in the Derpt Professorial Institute, created to train professors from "natural Russians" who successfully graduated from the high fur boots and passed the entrance exams at the St. Petersburg Academy of Sciences. Initially, he intended to specialize in physiology, but due to the lack of this profile of special training, he chose surgery. In 1829 he received a gold medal from Derpt (now Tartu) University for the work done in the surgical clinic by prof. I.F. Moyer competitive research on the topic: “What should be kept in mind when ligating large arteries during operations?”, In 1832 he defended a doctorate, a dissertation on the topic: “Is ligation of the abdominal aorta with inguinal aneurysm easy and safe intervention. In 1833-1835, completing his training for a professorship, N. I. Pirogov was on a business trip in Germany, improved in anatomy and surgery, in particular in the clinic of B. Langenbeck. Upon his return to Russia in 1835, he worked in Dorpat at the clinic of prof. I. F. Moyer; since 1836 - extraordinary, and since 1837 ordinary professor of theoretical and practical surgery at Dorpat University. In 1841, N. I. Pirogov created and until 1856 headed the hospital surgical clinic of the St. Petersburg Medical and Surgical Academy; at the same time was Ch. doctor of the surgical department of the 2nd military land hospital, director of the technical part of the St. Petersburg instrumental plant, and since 1846 director of the Institute of Practical Anatomy created at the Medico-Surgical Academy. In 1846, N. I. Pirogov was approved as an academician of the Medical and Surgical Academy.

In 1856, N. I. Pirogov left the service at the academy (“due to illness and domestic circumstances”) and accepted the offer to take the post of trustee of the Odessa educational district; from that time began the 10-year period of his activity in the field of education. In 1858, N. I. Pirogov was appointed trustee of the Kiev educational district (in 1861 he resigned for health reasons). Since 1862, N. I. Pirogov was the leader of young Russian scientists sent to Germany to prepare for professorial and teaching activities. N. I. Pirogov spent the last years of his life (since 1866) on his estate in the village of Vishnya near Vinnitsa, from where he traveled as a consultant on military medicine to the theater of operations during the Franco-Prussian (1870-1871) and Russian-Turkish (1877 -1878) wars.

The scientific, practical and social activities of N. I. Pirogov brought him world medical fame, undeniable leadership in domestic surgery and put him forward among the largest representatives of European medicine in the mid-19th century. The scientific heritage of N. I. Pirogov belongs to various fields of medicine. He made a significant contribution to each of them, which has not lost its significance until now. Despite more than a century ago, the works of N. I. Pirogov continue to amaze the reader with their originality and depth of thought.

The classic works of N. I. Pirogov “Surgical anatomy of arterial trunks and fascia” (1837), “A complete course of applied anatomy of the human body, with drawings (descriptive-physiological and surgical anatomy)” (1843-1848) and “Illustrated topographic anatomy of cuts, carried out in three directions through the frozen human body” (1852-1859); each of them was awarded the Demidov Prize of the St. Petersburg Academy of Sciences and became the foundation of topographic anatomy and operative surgery. They outline the principles of layer-by-layer preparation in the study of anatomical regions and formations and present original methods for preparing anatomical preparations - sawing frozen corpses (“ice anatomy”, which was initiated by I. V. Buyalsky in 1836), carving individual organs from frozen corpses (“sculptural anatomy”), which together made it possible to determine the relative position of organs and tissues with an accuracy inaccessible with previous research methods.

Studying the materials of a large number of autopsies (about 800) carried out by him during an outbreak of cholera in St. Petersburg in 1848, N. I. Pirogov established that with cholera, zhel.-kish is primarily affected. path, and made a correct guess about the ways of spreading this disease, indicating that the causative agent of the disease (according to the terminology of that time, miasm) enters the body with food and drink. N. I. Pirogov outlined the results of his research in the monograph “Pathological Anatomy of Asiatic Cholera”, published in 1849 in French. language, and in 1850 in Russian and awarded the Demidov Prize of the St. Petersburg Academy of Sciences.

In the doctoral thesis of N. I. Pirogov, devoted to the technique of ligation of the abdominal aorta and elucidation of the reactions of the vascular system and the whole organism to this surgical intervention, the results of an experimental study of the characteristics of collateral circulation after surgery and ways to reduce surgical risk were presented. The monograph of N. I. Pirogov “About transection of the Achilles tendon as an operative-orthopedic remedy” (1840) also refers to the Derpt period, in which an effective method of treating clubfoot is described, biol, properties of a blood clot are characterized and it is determined to lay down. role in wound healing processes.

N. I. Pirogov was the first among Russian scientists to come up with the idea of ​​plastic surgery (a trial lecture at the St. Petersburg Academy of Sciences in 1835 “On plastic surgery in general and about rhinoplasty in particular”), for the first time in the world put forward the idea of ​​bone grafting, publishing in 1854 . work "Osteoplastic elongation of the bones of the lower leg during exfoliation of the foot." His method of connecting the supporting stump during amputation of the lower leg due to the calcaneus is known as the Pirogov operation (see Pirogov amputation); he served as an impetus for the development of other osteoplastic operations. Proposed by N. I. Pirogov, Extraperitoneal access to the external iliac artery (1833) and the lower third of the ureter received wide practical application and was named after him.

The role of N. I. Pirogov in the development of the problem of anesthesia is exceptional. Anesthesia (see) was proposed in 1846, and the very next year N. I. Pirogov conducted a wide experimental and wedge test of the analgesic properties of ether vapors. He studied their effect in experiments on animals (with various methods of administration - inhalation, rectal, intravascular, intratracheal, subarachnoid), as well as on volunteers, including on himself. One of the first in Russia (February 14, 1847), he performed an operation under ether anesthesia (removal of the mammary gland for cancer), which lasted only 2.5 minutes; in the same month (for the first time in the world) he performed an operation under rectal ether anesthesia, for which a special apparatus was designed. He summarized the results of 50 surgical interventions carried out by him in the hospitals of St. Petersburg, Moscow and Kyiv in reports, oral and written communications (including in the Society of Doctors of St. Petersburg and the Medical Council of the Ministry of Internal Affairs, in the St. Petersburg and the Paris Academies of Sciences) and the monographic work “Observations on the action of ether vapors as an analgesic in surgical operations” (1847), which were of great importance in promoting the new method in Russia and introducing anesthesia into wedge practice. In July-August 1847, N. I. Pirogov, seconded to the Caucasian theater of operations, first used ether anesthesia in the conditions of active troops (during the siege of the fortified village of Salty). The result was unprecedented in the history of wars: operations took place without the groans and cries of the wounded. In the “Report on a trip to the Caucasus” (1849), N. I. Pirogov wrote: “The possibility of broadcasting on the battlefield has been undeniably proven ... The most comforting result of broadcasting was that the operations performed by us in the presence of other wounded did not in the least frighten, but, on the contrary, they reassured them in their own fate.

The activity of N. I. Pirogov played a significant role in the history of asepsis and antiseptics, which, along with anesthesia, determined the success of surgery in the last quarter of the 19th century. Even before the publication of the works of L. Pasteur and J. Lister, in his wedge, lectures on surgery, N. I. Pirogov made a brilliant guess that suppuration of wounds depends on living pathogens (“hospital miasm”): “Miasma, infecting, itself and reproduced by an infected organism. Miasma is not, like poison, a passive aggregate of chemically active particles; it is organic, capable of development and renewal. From this theoretical position, he drew practical conclusions: he allocated special departments in his clinic for those infected with "hospital miasms"; demanded "to completely separate the entire staff of the gangrenous department - doctors, nurses, paramedics and attendants, to give them dressings (lint, bandages, rags) and special surgical instruments special from other departments"; recommended that the physician "of the miasmic and gangrenous department pay special attention to his dress and hands." Regarding the dressing of wounds with lint, he wrote: “You can imagine what this lint must be like under a microscope! How many eggs, fungi and various spores are in it? How easily it becomes itself a means of transmitting contagions! N. I. Pirogov consistently carried out antiseptic treatment of wounds, using iodine tincture, solutions of silver nitrate, etc., emphasized the importance of gigabytes. measures in the treatment of the wounded and sick.

N. I. Pirogov was a champion of the preventive trend in medicine. He owns the famous words that have become the motto of domestic medicine: “I believe in hygiene. This is where the true progress of our science lies. The future belongs to preventive medicine.”

In 1870, in a review of the “Proceedings of the Permanent Medical Commission of the Poltava Provincial Zemstvo,” N.I. Pirogov advised the Zemstvo to pay special attention to honey. organizations for hygiene and sanitation. sections of its work, as well as not to lose sight of the food issue in practical activities.

The reputation of N. I. Pirogov as a practical surgeon was as high as his reputation as a scientist. Even in the Dorpat period, his operations were striking in their boldness of conception and mastery of execution. Operations were carried out at that time without anesthesia, so they were sought to be performed as quickly as possible. Removal of the mammary gland or stone from the bladder, for example, N. I. Pirogov carried out in 1.5-3 minutes. During the Crimean War, at the main dressing station in Sevastopol on March 4, 1855, he performed 10 amputations in less than 2 hours. The international medical authority of N. I. Pirogov is evidenced, in particular, by his invitation for a consultative examination to the German Chancellor O. Bismarck (1859) and the national hero of Italy J. Garibaldi (1862).

Of great importance not only for military field surgery, but also for a wedge, medicine as a whole were the works of N. I. Pirogov on the problems of immobilization and shock. In 1847, at the Caucasian theater of military operations, for the first time in military field practice, he used a fixed starch dressing for complex fractures of the limbs. During the Crimean War, he also for the first time (1854) applied a plaster bandage in the field (see Plaster technique). N. I. Pirogov owns a detailed description of the pathogenesis, a presentation of methods for the prevention and treatment of shock; the wedge described by him, the picture of shock is classical and continues to appear in manuals and textbooks on surgery. He also described a concussion, gaseous swelling of the tissues, singled out "wound consumption" as a special form of pathology, now known as "wound exhaustion".

A characteristic feature of N. I. Pirogov - a doctor and teacher - was extreme self-criticism. Even at the beginning of his professorship, he published the two-volume work Annals of the Derpt Surgical Clinic (1837-1839), in which a critical approach to his own work and an analysis of his mistakes are considered as the most important condition for the successful development of honey. science and practice. In the preface to the 1st volume of the Annals, he wrote: “I consider it the sacred duty of a conscientious teacher to immediately publish his mistakes and their consequences in order to warn and edify others, even less experienced, from such errors.” I. Pavlov called the publication of the Annals his first professorial feat: “... in a certain respect an unprecedented publication. Such ruthless, frank criticism of oneself and one's activities is hardly found anywhere in the medical literature. And this is a huge merit! In 1854, the "Military Medical Journal" published an article by N. I. Pirogov "On the difficulties of recognizing surgical diseases and on happiness in surgery", based on the analysis of Ch. arr. own medical errors. This approach to self-criticism as an effective weapon in the struggle for genuine science is characteristic of N. I. Pirogov in all periods of his versatile activity.

N. I. Pirogov, a teacher, was distinguished by a constant desire for greater clarity of the material presented (for example, widespread demonstrations at lectures), the search for new methods of teaching anatomy and surgery, conducting a wedge, detours. His important merit in the field of honey. education is an initiative to open hospital clinics for 5th year students. He was the first to substantiate the need to create such clinics and formulated the tasks facing them. In the draft on the establishment of hospital clinics in Russia (1840), he wrote: “Nothing can contribute to the dissemination of medical and especially surgical information among students as an applied direction in teaching ... Clinical teaching ... has a completely different goal from practical teaching in in large hospitals, and one alone is not enough for the full education of a practical doctor ..., a professor of practical medicine, a hospital one, directs the attention of listeners during his visits to a whole mass of identical painful cases, showing at the same time their individual shades; ... his lectures consist of a review of the main cases, comparing them, etc.; he has in his hands the means of advancing science.” In 1841, a hospital surgical clinic began to function at the St. Petersburg Medical and Surgical Academy, and in 1842, the first hospital therapeutic clinic. In 1846 hospital clinics were opened in Moscow un-those, and then in Kazan, Derpt and Kiev high fur boots with the simultaneous introduction of the 5th year of study for medical students. f-comrade. So an important reform of higher medical education was carried out. education, which contributed to the improvement of the training of domestic doctors.

N. I. Pirogov's speeches on upbringing and education had a great public resonance; his article “Questions of Life”, published in 1856 in the “Sea Collection”, was positively evaluated by N. G. Chernyshevsky and N. A. Dobrolyubov. From the same year, the activities of N.N. Pirogov in the field of education, which was marked by a constant struggle against ignorance and stagnation in science and education, with patronage and bribery. N. I. Pirogov sought to disseminate knowledge among the people, demanded the so-called. autonomy of high fur boots, was a supporter of competitions that provide a place for more capable and knowledgeable applicants. He defended equal rights to education for all nationalities, large and small, and all estates, strove for the implementation of universal primary education and was the organizer of Sunday public schools in Kyiv. On the question of the relationship between “scientific” and “educational” in higher education, he was a resolute opponent of the opinion that high fur boots should teach, and the Academy of Sciences should “move science forward”, and argued: “It is impossible to separate educational from scientific at the university. But scientific and without educational still shines and warms. And educational without scientific, - no matter how ... its appearance is alluring, - it only shines. In assessing the merits of the head of the department, he gave preference to scientific rather than pedagogical abilities and was deeply convinced that science is driven by the method. “Be a professor at least a dumb one,” wrote N. I. Pirogov, “and teach by example, in fact, the real method of studying the subject - it is for science and for those who want to do science, more expensive than the most eloquent speaker ...” A. I. Herzen called N. I. Pirogov one of the most prominent figures in Russia, who, in his opinion, brought great benefits to the Motherland not only as its “first operator”, but also as a trustee of educational districts.

N. I. Pirogov is rightly called the “father of Russian surgery” - his activities led to the entry of domestic surgery to the forefront of world medical science. sciences (see Medicine). His works on topographic anatomy, on the problems of anesthesia, immobilization, bone grafting, shock, wounds and wound complications, on the organization of military field surgery and the military medical service as a whole are classical and fundamental. His scientific school is not limited to direct students: in essence, all the leading domestic surgeons of the 2nd half of the 19th century. developed the anatomical and physiological direction in surgery based on the provisions and methods developed by N. I. Pirogov. His initiative in attracting women to care for the wounded, i.e., in organizing in-that sisters of mercy, played an important role in attracting women to medicine and contributed, according to A. Dunant, to the creation of the international Red Cross.

In May 1881, the 50th anniversary of the versatile activity of N. I. Pirogov was solemnly celebrated in Moscow; he was awarded the title of honorary citizen of Moscow. After his death, the Ob-in of Russian doctors was founded in memory of N. I. Pirogov, who regularly convened the Pirogov congresses (see). In 1897, in Moscow, in front of the building of the surgical clinic on Tsaritsynskaya Street (since 1919, Bolshaya Pirogovskaya), a monument to N. I. Pirogov was erected with funds raised by subscription (sculptor V. O. Sherwood); in the State Tretyakov Gallery there is his portrait by I. E. Repin (1881). By decision of the Soviet government in 1947, in the village of Pirogovo (former Cherry), where the crypt with the embalmed body of the great figure of Russian science was preserved, a memorial estate museum was opened. Since 1954, the Presidium of the USSR Academy of Medical Sciences and the board of the All-Union Society of Surgeons have been holding annual Pirogov readings. N. I. Pirogov are dedicated to St. 3 thousand books and articles in domestic and foreign press. The name of N. I. Pirogov is carried by the Leningrad (former Russian) surgical society, the 2nd Moscow and Odessa medical in-you. His works on general and military medicine, upbringing and education continue to attract the attention of scientists, doctors and educators.

The museum is located in the Vishnya estate (at present, within the city of Vinnitsa), where N. I. Pirogov settled in 1861 and lived, intermittently, for the last 20 years of his life. In addition to the estate with a residential building and a pharmacy, the museum complex includes a tomb, in which the embalmed body of N. I. Pirogov rests.

The proposal to create a museum in the Vishnya estate was first put forward in the early 1920s. Vinnitsa Scientific Society of Physicians. This proposal found support and development at the ceremonial meeting of the Pirogov Surgical Society (December 6, 1926), as well as at the I (1926) and II (1928) All-Ukrainian Congresses of Surgeons in the speeches of H. M. Volkovich, I. I. Grekov , N. K. Lysenkova. In 1939-1940. in connection with the approaching 135th anniversary of the birth of N. I. Pirogov People's Commissar-zdrav of the Ukrainian SSR and medical. the public again raised the issue of creating a memorial complex in the Pirogovo estate. It was supposed to carry out the main work in the summer of 1941. However, the war prevented the implementation of the developed plan.

The organization of the museum began soon after the liberation of Ukraine from the Nazi invaders (October 1944) in accordance with the decision of the Council of People's Commissars of the USSR to establish a museum in the estate of N. I. Pirogov and to take measures to preserve his remains. A huge merit in the organization of the museum belongs to Academician of the USSR Academy of Medical Sciences E. I. Smirnov, at that time the head of the Main Military Sanitary Directorate of the Red Army.

The invaders caused great damage to the estate and the tomb. The coffin with the body of the scientist was on the verge of destruction. The commission appointed in May 1945, consisting of professors A. N. Maksimenkov, R. D. Sinelnikov, M. K. Dahl, M. S. Spirova, G. L. Derman and others, managed to slow down the process of tissue breakdown and restore the appearance of N. I. Pirogov. At the same time, repair and restoration work was carried out in the estate. The development of expositions was undertaken by the Leningrad Military Medical Museum (see). On September 9, 1947, the grand opening of the museum took place.

The collection of museum exhibits reflects the medical, scientific, pedagogical, social activities of N. I. Pirogov. The museum presents the works of the scientist, memorial items, handwritten documents, anatomical preparations, surgical instruments, pharmacy equipment, recipes, photographs, paintings and sculptures. The number of exhibits exceeds 15,000. The museum's library contains several thousand books and magazines. In the garden and park of the estate, trees planted by N.I. Pirogov have been preserved.

In recent years, a team of scientists and practitioners consisting of S. S. Debov, V. V. Kupriyanov, A. P. Avtsyn, M. R. Sapin, K. I. Kulchitsky, Yu. I. Denisov-Nikolsky, L. D. Zherebtsov, V. D. Bilyk, S. A. Markovsky, G. S. Sobchuk carried out restoration and restoration work in the tomb and reembalmed the body of N. I. Pirogov. For the restoration of the museum-estate of N. I. Pirogov and its use for the wide promotion of the achievements of domestic medical science and the practice of Soviet health care, a group of scientists and museum workers was awarded the State Prize of the Ukrainian SSR (1983).

The museum is a scientific and educational base of the Vinnitsa Medical Institute named after V.I. N. I. Pirogov. More than 300 thousand people get acquainted with the expositions of the museum every year.

Compositions: Num vinctura aortae abdominalis in aneurysmate inguinali adbibita facile ac tutum sit remedium? Dorpati, 1832; Practical and physiological observations on the effect of ether vapor on the animal organism, SPb., 1847; Report on a journey through the Caucasus, St. Petersburg, 1849; Military medical business, St. Petersburg, 1879; Works, vol. 1-2, St. Petersburg, 1887; Collected works, vols. 1-8, M., 1957-1962.

Bibliography: Georgievsky A. S. Nikolai Ivanovich Pirogov and "Military Medical Business", JT., 1979; G e with e l e-in and h A. M. Chronicle of the life of N. I. Pirogov (1810-1881), M., 1976; Gesele-in and h A. M. and Smirnov E. I. Nikolay Ivanovich Pirogov, M., 1960; Maximenkov A. N. Nikolay Ivanovich Pirogov. L., 1961; Smirnov E. I. Modern value of the main provisions of N. I. Pirogov in military field surgery, Vestn, hir., t. 83, No. 8, p. 3, 1959.

Museum-estate of N. I. Pirogov- Bolyarsky H. N. N. I. Pirogov in the estate "Cherry" of the Vinnitsa district of the Podolsk province, Nov. hir. arch., v. 15, book. I, p. 3, 1928; Kulchitsky K. I., Klantsa P. A. and Sobchuk G. S. N. I. Pirogov in the estate of Cherry, Kyiv, 1981; Sobchuk G. S. and Klanz P. A. Museum-estate of N. I. Pirogov, Odessa, 1986; Sobchuk G.S., Kirilenko A.V. and Klantsa P.A. Monument of national gratitude, Ortop. and traumat., No. 10, p. 60, 1985; Sobchuk G. S., Markovsky S. A. and Klanza P. A. On the history of the museum-estate of N. I. Pirogov, Owls. health care, Jsft 3, p. 57, 1986.

E. I. Smirnov, G. S. Sobchuk (museum), P. A. Klantz (museum).

In 1838 N.I. Pirogov was sent to Paris, where he arrived as a well-known scientist in Europe, a rare connoisseur of anatomy, the creator of surgical anatomy.

In 1839 N.I. Pirogov received an invitation to the post of professor of theoretical surgery at the Medico-Surgical Academy. He presented his project for the reorganization of the teaching of surgery, putting forward two proposals: to establish a new department at the academy - hospital surgery and to turn the 2nd military land hospital with 2000 beds into a hospital clinic.

In October 1840, a decree was signed appointing N.I. Pirogov as a professor at the Medico-Surgical Academy. He was appointed Professor of the Hospital Surgical Clinic, Pathological and Surgical Anatomy and Chief Physician of the Surgical Department with 1000 beds. In addition, N.I. Pirogov was appointed a member of the Medical and Surgical Council (he remained so until the end of his life) under the Ministry of Internal Affairs, a member of the medical commission under the Ministry of Education, and technical director of a tool factory. He was also a consultant in hospitals - Obukhov, Petropavlovsk and Mary Magdalene.

In 1843, the capital work of N.I. Pirogov “A complete course of applied anatomy of the human body with drawings (descriptive, physiological and surgical anatomy). The grandeur of the work can be judged from the atlas, where 500 pathoanatomical preparations were drawn from life and 100 anatomical drawings were presented. For this work he was awarded the Great Demidov Prize of the Russian Academy of Sciences.

Being the technical director of the tool plant, N.I. Pirogov did a lot to equip hospitals, especially to provide the army with good surgical instruments. The plant at that time produced the best surgical instruments in the world.

From the first days of work at the academy N.I. Pirogov was convinced that the teaching of anatomy was done incorrectly, students memorized anatomical terms without preparation, without dissection of corpses. According to his idea, an anatomical institute was created, where anatomists were to be trained for all universities in Russia. N.I. was appointed director. Pirogov.

1846 - the year of birth of anesthesia. N.I. Pirogov, only after numerous experiments on animals, applied ether anesthesia in the clinic on February 14, 1847. He showed great energy in popularizing anesthesia, operated in Moscow, Kyiv, Warsaw, Odessa, Tiflis and other cities. On June 8, 1847, he went to the Caucasus to study the possibility of using anesthesia on the battlefield. For the first time in the world, on the battlefield (during the siege of the village of Salty), the scientist used ether anesthesia on 110 wounded.

In 1849, the first major work of N.I. Pirogov on military field surgery "Report on a journey through the Caucasus, containing complete statistics of operations performed on the battlefield in various hospitals in Russia with the help of anesthesia, experiments and observations, etc."

N.I. Pirogov wrote: “Russia, ahead of Europe by our actions during the siege of Salta, showed the entire enlightened world not only the possibilities, but also the direct effect of etheromania on the wounded on the battlefield.”

In 1850, the anatomical atlas of N.I. Pirogov "Topographic anatomy illustrated by cuts made in three directions through human corpses". It contains 995 life-size drawings and explanatory text on 768 pages, contains unsurpassed factual material based on the application of the method of sawing frozen corpses. The Atlas has gained worldwide fame, and its author has been awarded the Great Demidov Prize of the Russian Academy of Sciences.

In 1851 N.I. Pirogov published work on osteoplastic amputation of the foot. He wrote: "A piece of one bone, being in conjunction with soft tissues, adheres to another and serves both to lengthen and to send a member." Osteoplastic amputation had a tremendous impact on the development of Russian and world science. A new chapter of surgery has been opened - bone grafting. The work was awarded the Grand Demidov Prize of the Russian Academy of Sciences.

In 1854 N.I. Pirogov used an alabaster bandage in the treatment of simple and complex fractures. For the first time in the world he used a plaster cast in the field.

During the defense of Sevastopol, the great surgeon could not help but be where thousands of people died without proper medical care. With difficulty, he obtained permission and left for the Crimea on October 29, 1854. The whole situation in Sevastopol was described by N.I. Pirogov in “Sevastopol Letters”: “The heart stops when you see before your eyes in what hands the fate of the war is, when you get to know the people standing in your forehead”, “There are no funds, there are no tents, there are few horses and fodder, where to take, more often it’s still good they don’t know, all the nearest hospitals are already overcrowded, they steal everywhere, ”etc.

In the Crimea, N.I. Pirogov took shape as a military field surgeon, here he had the idea of ​​\u200b\u200ba military field doctrine, which, with certain changes, is still used today. Here the teaching of N.I. Pirogov about sorting the wounded.

With extraordinary strength of character, N.I. Pirogov broke the established tradition of disregard for the care of the wounded on the part of the command, achieved a quick removal of them from the battlefield, the best premises were given over to hospitals, transport was properly organized.

During the defense of Sevastopol, N.I. Pirogov led the organization of nurses, first created in the history of wars, operating on the battlefields. With the help of nurses N.I. Pirogov managed to arrange for the care of the wounded, their food, and the precise fulfillment of assignments. The sisters courageously fulfilled their duty, 17 of them died in Sevastopol, all of them, including N.I. Pirogov, had been ill with typhus.

For a year of work at the front, N.I. Pirogov grew into a talented organizer and military field surgeon, who later summarized all previous experience of military field surgery and personal experience of four wars and created the theoretical foundations of military field surgery.

N.I. Pirogov returned from Sevastopol to Petersburg on December 24, 1855, at which time he had already decided to leave the academy. He was only 45 years old, but the term of service at the academy was estimated at 25 years (each month in Sevastopol was considered a year), and the professorial service was 32 years old. On April 29, 1856, he filed a petition, and on May 28 a decree was signed on the dismissal of N.I. Pirogov from the Academy in connection with the length of service. The second period of activity of N.I. Pirogov - Petersburg. This is the most brilliant period of his life.

Favorable conditions contributed to the formation of a scientist and scientific work, which gave amazing results, subsequently awarded prizes, including four Demidov Prizes of the Russian Academy of Sciences. N.I. Pirogov writes in his diary that after his arrival in St. Petersburg, in a very short time, at his suggestion, an anatomical institute was created for the first time in the world, which made it possible to develop a huge amount of work, in addition, over 1000 hospital beds were placed at his disposal, which served as the basis for his surgical activities.

Thus, contrary to the wishes of individual officials and bureaucrats, contrary to the wishes of those who would like to prevent N.I. Pirogov, his proposals, meeting the needs of the country, the Medical-Surgical Academy, the Russian army, were always taken into account, the outstanding surgeon was given such opportunities for medical, surgical, scientific work that no foreign surgeon had (B. A. Petrov).

By the time of leaving the Medical and Surgical Academy, an article by N.I. Pirogov "Questions of Life", which said: "The school should prepare conscious members of society who are able not to adapt to evil, but to fight it." This article was enthusiastically received by the advanced Russian public. She obviously played a significant role in the fact that on September 30, 1856, N.I. Pirogov was appointed trustee of the Odessa educational district. He spoke in the newspaper with a program to transform the school, raised the issue of transforming the Odessa Lyceum into a university, and at the same time wrote about the need for wide access to the university for representatives of all nationalities and classes.

N.I. Pirogov did not work well with the governor-general of the region. On June 18, 1858, he was transferred as a trustee of the Kiev educational district. But here, too, he defended progressive views on teaching. In his diary, he wrote: "I established my fundamental principle, according to which the trustee is obliged to exercise only moral influence on students and teachers, while the authorities tried to impose secret police supervision on me."

Being a trustee, N.I. Pirogov did not stop his medical practice. We found materials in the archives showing that he often visited the clinic of V. A. Karavaev, consulted patients and operated. As a trustee, he remained a physician.

March 13, 1861 N.I. Pirogov was dismissed from the post of trustee, allegedly for health reasons. In reality, the principled trustee of those in power did not like it.

In April 1861, N.I. Pirogov left Kyiv with his family for his estate Cherry. Before leaving N.I. Pirogov gave university students his portrait with the inscription "I love and respect youth because I remember my own."

Life in the village proceeded slowly and measuredly, but already on March 17, 1862, N.I. Pirogov was appointed head of the professorial institute for the training of young scientists. He went to Germany, where he stayed for 4 years (Heidelberg, Berlin). In Heidelberg, N.I. Pirogov, a decision arose to generalize his military field experience. In 1864, in German and in 1865 in Russian, “The Beginnings of General Military Field Surgery, Taken from Observations of Military Hospital Practice and Memoirs of the Crimean War and the Caucasian Expedition” were published in two parts: In this fundamental work, N. AND. Pirogov and in the later work “Military Medical Care and Private Assistance in the Theater of War in Bulgaria and in the Rear of the Army in 1877-1878.” for the first time in the history of medicine, the foundations of military field surgery were formulated.

In 1866 N.I. Pirogov returned to Cherry, where he built a hospital with 8 beds and a pharmacy. He operates a lot in his village and, judging by the diary, is very pleased with the results.

In 1870, at the request of the Red Cross Society, he went to the theater of the Franco-Prussian War, where he got acquainted with the organization of assistance to the wounded.

After 7 years of living in the village in 1877, N.I. Pirogov went to the theater of the Russian-Turkish war, where he was from September 1877 to March 1878. Upon returning to Vyshnya, N.I. Pirogov within 1 year wrote the fourth classic work on military field surgery: "Military medical business and private assistance in the theater of war in Bulgaria and the rear of the army in 1877-1878." With this book, the scientist completed his work on military field surgery. It defined war as a traumatic epidemic. Here the main conclusion was clearly voiced - the observance of the principle of saving treatment with the rejection of the large-scale production of primary amputations, a new proposal was put forward on the evacuation of the wounded by rail.

May 5, 1879 N.I. Pirogov began his last work, The Diary of an Old Doctor. A person at the end of his life path re-views his life, speaks frankly about his mistakes.

A critical attitude to his activities, to his works is one of the most remarkable features of N.I. Pirogov as a scientist and clinician.

Philosophical views of N.I. Pirogov, his worldview has repeatedly been the subject of analysis in connection with the "Diary of an Old Doctor". The scientist himself was aware of the inconsistency of his judgments: “I know that my worldview does not have that factual lining, which in our time is required from any serious reflection.”

“Time,” wrote N.I. Pirogov, - will discuss and evaluate better than ours both our convictions and our actions, and we console ourselves with the fact that here on earth, where everything passes, there is one indestructible thing for us - this is the domination of ideas. And therefore, if we faithfully served the idea, which, according to our firm conviction, led us to the truth through life, science and school, then let's hope that the stream of time will not carry it away with us.