Addresses in St. Petersburg
(5 (17) September 1832, Moscow - 12 (24) December 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 Medical-Surgical Academy (since 1861). Participant in the Crimean (1855) and Russian-Turkish (1877) wars.
Biography
Sergei Petrovich Botkin comes from a merchant family involved in the tea trade. 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 medical faculty. He studied at the medical faculty 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 and received the title of “doctor with honors.” In the same year, he participated in the Crimean campaign under the leadership of N.I. Pirogov as a resident of the Simferopol hospital. Already during this period, S.P. Botkin formed the concept of military medicine and proper nutrition soldier:
Received extensive training in various areas of medicine abroad. In the clinic of Professor Hirsch in Königsberg, in the pathological institute of R. Wichow in Würzburg and Berlin, in the laboratory of Hoppe-Seyler, in the clinic of the famous therapist L. Traube, neurologist Romberg, syphilidologist Berensprung in Berlin, with physiologist K. Ludwig and clinician Oppolzer in Vienna, in England, as well as in the laboratory of experimental physiologist C. Bernard, in the clinics of Barthez, Bushu, Trusseau and others in Paris. Botkin's first works are published in the Virchow Archive.
At the end of 1859, Yakubovich, Botkin, Sechenov, Bockers and Jung were invited to the therapy clinic of the Medical-Surgical Academy (St. Petersburg). On August 10, 1860, Botkin moved to St. Petersburg and defended his dissertation for the academic degree Doctor of Medicine on the topic: “On the absorption of fat in the intestines” and was appointed acting adjunct at the therapeutic clinic headed by Professor P. D. Shipulinsky. Soon, however, the relationship between Botkin and Shipulinsky deteriorated, and the latter was forced to resign. However, the academy conference 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.
To the department faculty therapy S.P. Botkin was elected at the age of 28 and led it for 30 years. Botkin’s daily routine looked like this: 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 senior students, from 1 pm he gave lectures to students, after the lecture he followed rounds and examination of outpatients, from 17 to 19 hours - evening rounds of the clinic, from 19 to 21 hours - lectures for associate professors, to which everyone was allowed. After this, Botkin returned home, where he had dinner and prepared for the next day, but after 12 o’clock at night he devoted attention to his favorite activity - 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 the diagnosis was made, the patient lived for several weeks. Ill-wishers hoped for a mistake. S.P. Botkin paid a lot of attention to cholelithiasis, which he himself suffered from for a long time. He pointed to the role of infection in the formation of stones. He emphasized the clinical diversity of this disease. The scientist believed that until the doctor discovered 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 gives a number of interesting clinical observations, one of which demonstrates that when a stone passes through the bile ducts, the upper and lower limbs become colder, the skin of the chest becomes hot and the temperature in the armpit rises to 40°C.
Thanks to their outstanding teaching abilities, Botkin’s clinic produced professors who headed departments at 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, etc. 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 opponent on dissertations 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 society's work, Botkin studied the epidemic of plague, cholera, typhus, smallpox, diphtheria and scarlet fever. Observing liver diseases occurring with high temperature, S.P. Botkin first described the disease, which before him was considered gastrointestinal catarrh with mechanical retention of bile. 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 serious complication - cirrhosis of the liver. Looking for the causes of the disease, S.P. Botkin came to the conclusion that the source of infection is contaminated food products. He attributed this type of catarrhal jaundice to infectious diseases, which was confirmed later (Botkin disease, viral hepatitis A).
Botkin stood at the origins of women's medical education in Russia. In 1874 he organized a school for 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 and 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 management of the Society for the Care of the Wounded, a member of the St. Petersburg Duma and deputy chairman of the Public Health Commission of St. Petersburg. Fame and medical talent played a role, and S.P. Botkin became the first Russian physician of the imperial family in history. 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), he became its medical trustee. Largely thanks to the activities of S.P. Botkin, 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 this time there was a congress of Russian doctors, the work of which was interrupted. The coffin with Botkin’s body 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. There were 25 children in the family of S.P. Botkin’s parents; Sergei was the 11th child from his father’s second marriage.
Brothers: collector D. P. Botkin, writer V. P. Botkin, artist M. P. Botkin. Sisters: M. P. Botkina - wife of the poet A. A. Fet
Children: Alexander Botkin (naval officer), Pyotr Botkin (c. 1865-1937, diplomat), Sergei Botkin, Evgeny Botkin (1865-1918, life physician), Victor Botkin.
Addresses in St. Petersburg
- 1860-1864 - Spasskaya street, building 1;
- 1878-12/12/1889 - Galernaya street, house 77 (memorial plaque).
Memory
There are Botkin hospitals in Moscow and St. Petersburg. Also in the city of Orel, a hospital is named after him.
In 1898, in memory of the services of the outstanding doctor, Samarskaya Street in St. Petersburg was renamed Botkinskaya Street. There is a memorial plaque on house number 20.
On May 25, 1908, a monument was erected in the park in front of the clinic at the corner of Botkinskaya Street and Bolshoy Sampsonievsky Prospekt (sculptor V. A. Beklemishev).
In the 1920s, a bust by I. Ya. Ginzburg (1896) was installed on the territory of the Botkin Hospital.
(1832-1889) Russian doctor and public figure
Sergei Petrovich Botkin was born on September 17, 1832 in the family of a large Moscow tea merchant. Until the age of fifteen he was raised at home.
The Botkin House in the 1830-1850s was considered one of the most famous in Moscow cultural centers. V. Belinsky, N. Stankevich, I. Turgenev visited here, and the historian T. Granovsky lived constantly. Botkin had five sons - Vasily, Mikhail, Peter, Sergei and Dmitry. All of them, except Sergei, were engaged in literature and art, collecting paintings and sculptures. Sergei also received an excellent education at home, and then graduated from a Moscow private boarding school. He dreamed of becoming a mathematician and entering Moscow University. However, at that time, the admission of applicants was extremely limited, since there was a decree according to which only graduates of state gymnasiums were accepted into all faculties, except for medicine, so Botkin only managed to enroll in the medical faculty.
The Crimean War found him a fourth-year student. Having graduated from the university in 1855, he immediately went to Simferopol, where he began working in a hospital under the leadership of the famous surgeon N.I. Pirogov. Even during his student years, the clinical talent of Sergei Petrovich Botkin clearly manifested itself, so he decided to devote himself to studying the extensive science of internal diseases. And after the end of the war, he went abroad, where he enthusiastically worked in the laboratories and clinics of the largest European scientists of that time - the physiologist C. Bernard and the famous therapist R. Virchow. Under their guidance, he not only improved his medical skills, but also gained experience as a researcher. From that time on, Sergei Botkin tried to combine all his life Scientific research with practical work.
In 1860, he returned to Russia and defended his doctoral dissertation in St. Petersburg at the Medical-Surgical Academy. And in 1861, the 29-year-old scientist was elected professor of the department of the academic therapeutic clinic, which he led until the end of his life.
What new did Sergei Botkin bring to the clinic at first? In the history of not only Russian, but also world medicine, many very important undertakings and discoveries are associated with his name. In the work of Sergei Petrovich, the talent of a doctor is amazingly combined with magnificent organizational skills. He was the first to introduce European teaching methods in Russia, in which practice was connected with scientific work. Sergei Petrovich Botkin was also the first to introduce mandatory autopsies of the dead into medical practice.
While researching various diseases, he became the first scientist in world medicine to describe infectious liver diseases, and came to the conclusion that they are caused by even smaller microorganisms than bacteria.
The hypothesis expressed by him was subsequently completely confirmed; researchers established the viral nature of hepatitis, which was called Botkin's disease.
In 1860-1861 he organized a clinical experimental laboratory. There were no clinical laboratories abroad with such a diverse range of work. Here we studied the influence of the central nervous system on the activities of various organs, a method of artificial blood circulation was developed, from here they “began their journey” to hospitals and outpatient clinics healing herbs- foxglove, lily of the valley and many other remedies traditional medicine, tested by Botkin's students. Young Ivan Petrovich Pavlov worked in this laboratory for ten years and conducted his research here.
Modern medicine also owes Sergei Petrovich Botkin the fact that he was one of the first to understand what vital role The central nervous system plays a role in the human body. It turned out that the disease does not affect a single part of the body or organ, but affects the entire body through the nervous system. Only by understanding this can the doctor properly treat the patient. Botkin developed this idea in his works.
The scientist constantly strived to ensure that healthcare in Russia was accessible to the widest segments of the population. On his initiative, charitable hospitals were established in St. Petersburg and Moscow, in which assistance was provided free of charge. For this, Sergei Botkin created a special charitable partnership, where he combined contributions made by the largest Russian entrepreneurs.
The Botkin Clinic has become a real center of medical science. It produced many talented doctors, including the great physiologist I. Pavlov.
In 1873, Sergei Petrovich Botkin was appointed personal physician, that is, a doctor responsible for the health of the reigning family.
He lived an intense, creative, working life, caring not about his own glory, but about ensuring that his works enriched science and benefited the sick.
An outstanding scientist combined his scientific activities with social ones, and responded to many events that worried leading people of that time. Sergei Petrovich warmly supported those who defended women’s rights to higher education medical education, with his active participation in 1872, the first women's medical courses were opened in St. Petersburg. Together with his friend, physiologist I.M. Sechenov, he was the first in Russia to provide female doctors with the opportunity to work in the department he headed.
For many years, Sergei Botkin was the permanent chairman of the Duma commission on protecting people's health, improving the sanitary condition of St. Petersburg and hospital and outpatient care in it. With the society of doctors, he organized a shelter for elderly lonely doctors.
Sergei Petrovich Botkin laid the foundation for Russian medical literature; for many years (1869-1889) he edited and published at his own expense the journal “Archive of the Clinic of Internal Diseases”, and the “Weekly Clinical Newspaper” was published under his editorship.
The outstanding scientist died on December 27, 1889. He was a representative of those tireless energetic figures who never stopped working for the benefit of the Russian people. The famous Botkin Hospital in Moscow is named after the doctor.
“Who is Botkin? - Well, of course... a famous doctor, “Botkin’s disease” - viral hepatitis... There is also a hospital named after him somewhere in Moscow, such a famous one...”
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 advisor...
The future first clinician and therapist was born on September 5, 1832 in Moscow into a wealthy family of a merchant and factory owner. The head of the family, Father Pyotr Kononovich Botkin, came from the free townspeople of the city of Toropets, Tver province. In the 20s of the 19th century, 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 noticeable role in the family.
Sergei Botkin studied at his “home university” until the age of 15, where his teachers were: Vasily Petrovich - his older brother, a famous writer, and his friends - T.N. Granovsky, V.G. Belinsky, A.I. Herzen. At the same time, he became acquainted with the views of the philosophical circle of N.V. Stankevich, Belinsky, Herzen, who gathered in the Botkins’ house. A.I. Herzen is Botkin’s friend 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 ground floor of the Botkin house, wrote: “I followed Sergei’s development, I saw outstanding abilities in him... He amazed Belinsky and me with his enormous curiosity.”
Sergei was prepared to enter Moscow University by mathematics student A.F. Merchinsky, and from August 1847 - in a private boarding school. Having completed only the second year of boarding school, Botkin decides to quit and take exams for the Faculty of Mathematics of Moscow University, but force majeure arose - a decree of April 30, 1849: to stop admission to all faculties except medicine. Botkin does not immediately abandon mathematics in favor of medicine. Hesitating in his choice, he completed his third year at the boarding school and only in the spring of 1850 he 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 a resident of 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 Yevpatoria. Fighting broke out on Russian soil, and the fortress 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 dissertation “On the absorption of fat in the intestines” and in 1861 was elected professor of the department of the academic therapeutic clinic.
To appreciate the significance of Botkin, it is necessary to remember the situation in which Russian doctors and Russian medicine were during his activity. As medical historian E.A. writes. Golovin, “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 considered to be someone who managed to translate from a foreign language into Russian or compile, to a fault, some manual on the treatment of diseases. Most of the teachers repeated the same lectures, memorized once and for all, from year to year, sometimes reporting information that bore a medieval imprint. In their lectures, some clinicians said that the liver is “a many times folded intestinal canal,” others talked about milk being absorbed into the blood during the postpartum period, etc.”
There was no scientific medicine; practical medicine was in the hands of hospital doctors, who were predominantly Germans, especially in St. Petersburg hospitals. The mourning sheets were written in German, and there were cases when doctors found it difficult to communicate in Russian with their patients. Society involuntarily developed 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.
This couldn't go on forever. I.M. was invited to the medical academy. Sechenov and S.P. Botkin, young doctors (Botkin was 28 years old), but who had already gained some fame for their theoretical work in the medical environment of Germany and France. After a thorough acquaintance with theory and practice during his many years of stay abroad, Sergei Petrovich Botkin, returning to St. Petersburg, was appointed adjunct to the head of the academic clinic of internal diseases, Professor Shipulinsky.
Professor S.P. Botkin began with transformations. He was the first in Russia to create an experimental laboratory at his clinic in 1860-1861, where he produced physical and chemical tests and studied the physiological and pharmacological effects of drugs. He also studied issues of physiology and pathology of the body, artificially reproduced aortic aneurysm, nephritis, and 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 to humans the data obtained as a result of experience on animals.
Research carried out in Botkin's laboratory laid the foundation for experimental pharmacology, therapy and pathology in Russian medicine. This laboratory was the embryo of the largest medical research institution - the Institute of Experimental Medicine.
Sergei Petrovich was also the first to widely use laboratory research (biochemical, microbiological); 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 then Professor Shipulinsky’s term of service expired, and they began to look for a worthy candidate to replace him. Perhaps the sincere conviction that something worthwhile could not come out of a Russian doctor, perhaps the desire to preserve leadership for the Germans prompted the majority of members of the academy to propose Professor Felix Numeyer. The latter was not averse to coming to St. Petersburg and was even ready to learn Russian.
This idea caused justifiable indignation among students. 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. The mood of the director of the Medical-Surgical Academy P.A. coincided with this desire. Dubovitsky, his deputy N.N. Zinin and head of the Department of Physiology and Histology N.M. Yakubovich (1817-1879) to finally provide the opportunity for national forces to develop. After heated debates, 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 who approached him interested him almost primarily as a patient. He looked closely at the gait and facial movements, listened, I think, even to the conversation. Subtle diagnostics was his passion, and he practiced acquiring methods for it as much as artists like Anton Rubinstein practice their art before concerts. Once, at the beginning of his professorial career, he hired me as an evaluator of his ability to distinguish the sounds of a hammer using a plessimeter. Standing in the middle large room with his eyes closed, he ordered himself to be turned around the longitudinal axis several times so as not to know the position in which he stopped, and then, knocking on the plessimeter with a hammer, he indicated whether the plessimeter was facing a solid wall, a wall with windows, or open door to another room or even to the stove with the damper open.”
So, a powerful young force, an inquisitive analytical mind, appears on the St. Petersburg horizon. It goes without saying that the emergence of such a person, who declared war on all routine, was not to the liking of many. As they say, he is not great at whom they do not throw dirt. S.P. Botkin had to experience the fate of all innovators: envy, exaggeration of mistakes, unfair slander. And the opportunity to introduce S.P. Botkin, almost ignorant, soon introduced himself.
Envious people were very happy when Sergei Petrovich diagnosed one patient with portal vein thrombosis, but he lived happily for several weeks, entertaining the gloating of his ill-wishers. Botkin tried to explain this circumstance, but his opponents did not want to recognize the soundness of his arguments, fearing to give up the hope of proving the charlatan arrogance of the young professor. Soon the patient died, news of this quickly spread throughout St. Petersburg, which, like the entire academy, froze in agonizing anticipation: whether Botkin’s diagnosis would turn out to be valid.
When the hour of the autopsy was announced, the anatomical theater was instantly filled with friends and enemies of Sergei Petrovich and simply curious people. Pathologist Professor Ilyinsky, in deathly silence, removed the portal vein, which contained a blood clot. Detractors of S.P. Botkin became silent. After this incident, Botkin’s amazing diagnostic intuition became legendary. His name immediately became popular beyond the walls of the academy. Invitations to seriously ill patients began pouring in, both from doctors who sympathized with him and from those who were hostile.
At the beginning of 1872, Professor Botkin was assigned 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 received free access to royal family, whose favor he enjoyed.
Before S.P. Botkin, most of the academy's graduates withered away in the outback, he promoted his students to St. Petersburg hospitals. This opened up access for Russian doctors, which until then had been closed or extremely difficult for them. One of the most important periods in the development of medicine in general and Russian medicine in particular is the years 1856-1875. This relatively short period of time is explained by two important circumstances in the history of medicine. Firstly, it was at this time that the inconsistency of the humoral theory, the theory that almost reigned supreme in both Western European and Russian medicine from the beginning to the middle of the 19th century, was clearly revealed.
Humoral medicine was vitalistic; the final cause of all life phenomena was proclaimed “vital force” - a weightless, unextended and therefore unknowable principle; and since it is unknowable, then what sense can there be in disputes about the mechanisms of action of this force, what is the point in criticism? different interpretations one or another manifestation of this very force, one or another fact. Criticizing the humoral theory, Fyodor Ivanovich Inozemtsev (1802-1869), professor of the Department of Surgery at Moscow University (1846-1859), said that metabolism in cells and tissues cannot occur without the participation of the nervous system. “Blood without the activity of the nodal nerves is only living material in our body, incapable of performing physiological operations in the field of nutrition on its own,” said Inozemtsev. The philosophy of humoral medicine taught: “The first agent in our body is the vital force, which independently forms and shapes matter - this is a weightless, elusive principle, a manifestation of the ever-active, ever-moving spirit, for which the body is just an earthly shell.”
Secondly, since the inconsistency of the humoral theory was revealed, the 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, almost simultaneously in two countries at once: in Russia and Germany. In Russia, the new theory of medicine was presented by Botkin, in Germany by Virchow. In their 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 marked the beginning of the anatomical, or “localistic” direction, Botkin’s theory - the physiological, or functional one.
Sergei Petrovich Botkin outlined his views on medical issues in three editions 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”). Professor Botkin was a true innovator who revolutionized 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 an understanding of the organism as a whole, located in inextricable 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 maintains a certain independence in relation to the environment; thanks to the process of adaptation, the organism develops new properties in itself, which, when fixed, are passed on to inheritance. He associated the origin of the disease with a cause that is always determined exclusively external environment, acting directly on the organism or through its ancestors.
The central core of Botkin’s clinical concept is the doctrine of internal mechanisms unfolding of the 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 teaching about the disorder of movement and the relationship of “juices” in the body, did not at all solve the problem of pathogenesis. Another cellular theory explained only two special cases of pathogenesis: the spread of a disease by its direct transfer from one cell to another and the spread by its transfer by blood or lymph.
Professor S.P. Botkin gave a deeper theory of pathogenesis. He contrasted Virchow’s doctrine of the organism as a “federation” of cellular states not associated with the activity of the nervous system and the environment with his doctrine of the organism 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 substrate of all acts 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 a reflex act the main member is one or another node of the central nervous system, then Botkin great attention devoted 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 lymph 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 (influencing the treatment of the disease through nerve centers), but did not manage to develop it to the end.
Neurogenic theory of pathogenesis S.P. Botkin puts in the doctor’s field of view not only the anatomical, but mainly the physiological or functional (through the nervous system) connections of the body and, therefore, obliges the doctor to consider the body as a whole, diagnose not only the disease, but also “diagnose the patient”, treat not only the disease, but also 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 outstanding discoveries in medecine. He was the first to suggest the specificity of protein structure in various organs; was the first (1883) to point out that catarrhal jaundice, which Virchow interpreted as “mechanical”, refers to infectious diseases; Currently, 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.” He brilliantly developed the diagnosis and clinical picture of a prolapsed and “wandering” kidney.
The activities of Sergei Petrovich Botkin were extensive and varied. As a publisher, he is known for publishing the “Archive of the Clinic of Internal Diseases of Professor Botkin” (1869-1889) and the “Weekly Clinical Newspaper” (1881-1889), renamed from 1890 to the “Botkin Hospital Newspaper”. These publications published scientific works his students, among whom were I.P. Pavlov, A.G. Polotebnov, V.A. Manassein and many other outstanding doctors and scientists.
Sergei Petrovich was the first doctor elected to the Duma, and he was also 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 no people, no money, no medicines, no 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 Evgeniy - inherited their father's profession. After the death of Sergei Petrovich, Evgeniy became a physician at court. When the emperor turned into a citizen, he did not leave the Romanov family and followed them to Tobolsk. When moving to Yekaterinburg, he was offered to go to St. Petersburg. He stayed. Two days before his death, he was again asked to leave the Ipatiev House. He considered this impossible for himself. Doctor Botkin was shot along with the royal family.
He was the 11th child in the family, born from his father’s second marriage and raised under the supervision and influence of his brother Vasily. Already in early age he was distinguished by outstanding abilities and curiosity.
Until the age of 15, Botkin was raised at home; in 1847 he entered the private boarding school Ennes, where he studied for three years and was considered one of the best students.
In August 1850, Botkin became a student at the Faculty of Medicine at Moscow University, graduating in 1855. Botkin was the only one in his class who passed the exam not for the title of doctor, but for the degree of doctor.
After graduating from the university, he, together with the sanitary detachment of surgeon Nikolai Pirogov, took part in the Crimean campaign, acting as a resident of the Simferopol military hospital. Working in a military hospital gave the doctor the necessary practical skills.
In December 1855, Botkin returned to Moscow and then went abroad to complete his education.
In 1856-1860, Sergei Botkin was on a business trip abroad. He visited Germany, Austria, Switzerland, England and France. During a business trip in Vienna, Botkin married the daughter of a Moscow official, Anastasia Krylova.
In 1860, Botkin moved to St. Petersburg, where he defended his doctoral dissertation “On the absorption of fat in the intestines” at the Medical-Surgical Academy.
In 1861 he was elected professor of the department of the academic therapeutic clinic.
In 1860-1861, Botkin 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 questions of physiology and pathology of the body, artificially reproduced various pathological processes in animals (aortic aneurysm, nephritis, trophic skin disorders) in order to reveal their patterns. Research carried out in Botkin's laboratory laid the foundation for experimental pharmacology, therapy and pathology in Russian medicine.
In 1861, Sergei Botkin opened the first free outpatient clinic in the history of clinical treatment of patients at his clinic.
In 1862, he was subjected to a search and interrogation in connection with his visit to Alexander Herzen in London.
Since 1870, Botkin worked as an honorary physician. In 1871, he was entrusted with the treatment of Empress Maria Alexandrovna. In subsequent years, he accompanied the empress several times abroad and to the south of Russia, for which he had to stop lecturing at the academy.
In 1872, Botkin received the title of academician.
In the same year, in St. Petersburg, with his participation, women's medical courses were opened - the world's first higher medical school for women.
In 1875, he married a second time to Ekaterina Mordvinova, after the death of his first wife.
In 1877, during the Russian-Turkish War, Botkin spent about seven months on the Balkan front, where he accompanied Emperor Alexander II. As a physician of Alexander II, he achieved preventive quinization of troops, fought to improve the nutrition of soldiers, made rounds of hospitals, and gave consultations.
In 1878, he was elected chairman of the Society of Russian Doctors in memory of Nikolai Ivanovich Pirogov and remained in this post until the end of his life. He achieved the construction of a free hospital by the society, which was opened in 1880 (Alexandrovskaya Barracks Hospital, now the S.P. Botkin Hospital). Botkin's initiative was taken up, and in other major cities In Russia, free hospitals began to be built with funds from medical societies.
Since 1881, Botkin, being a member of the St. Petersburg City Duma and deputy chairman of the Duma Commission of Public Health, laid the foundation for the organization of sanitary affairs in St. Petersburg and introduced the institute sanitary doctors, laid the foundation for free home care, organized an institute of “Duma” doctors, created an institute of school health doctors, and the Council of Chief Physicians of St. Petersburg hospitals.
Botkin was the chairman of the government commission to develop measures to improve the sanitary condition of the country and reduce mortality in Russia (1886).
By the end of his career, he was an honorary member of 35 Russian medical learned societies and nine foreign ones.
Botkin became the founder of scientific clinical medicine. He outlined his clinical and theoretical views on medical issues in three editions 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 Professor S.P. Botkin”, 3rd issue , 1885‑1891).
In his views, Botkin proceeded from an understanding of the organism as a whole, located in inextricable unity and connection with its environment. Botkin created a new direction in medicine, characterized by Ivan Pavlov as the direction of nervism. Botkin is responsible for a large number of outstanding discoveries in the field of medicine. He was the first to express the idea of the specificity of protein structure in various organs; was the first (1883) to point out that catarrhal jaundice is an infectious disease (currently this disease is called “Botkin’s disease”), developed the diagnosis and clinic of a prolapsed and “wandering” kidney.
Botkin published the “Archive of the Clinic of Internal Diseases of Professor S. P. Botkin” (1869‑1889) and the “Weekly Clinical Newspaper” (1881‑1889), renamed in 1890 the “Botkin Hospital Newspaper”. These publications published the scientific works of his students, among whom were Ivan Pavlov, Alexey Polotebnov, Vyacheslav Manassein and many other outstanding Russian doctors and scientists.
Botkin died of heart disease December 24 (December 12, old style) 1889 in Menton (France) and was buried in St. Petersburg.
BOTKIN Sergey Petrovich
BOTKIN Sergey Petrovich(1832 - 1889) - a classic of Russian medicine, an outstanding therapist, the founder of the functional direction in Russian clinical medicine, a talented teacher, organizer and public figure, the creator of a large school of therapists.
Born in Moscow into a merchant family. At first he studied at home, and from 1847 in a private boarding school.
In 1850 S.P. Botkin entered medical school. Faculty of Moscow University, which he graduated in 1855, receiving the title of doctor with honors. At the university, S.P. Botkin was distinguished by his modesty, diligence and inquisitive mind. Among the university professors, he subsequently singled out the physiologist I. T. Glebov, the pharmacologist N. E. Lyaskovsky and especially F. I. Inozemtsev, who admired him with his commitment to therapy, honesty in life and science and, most importantly, sincere love for Russian medicine.
In 1855, S.P. Botkin voluntarily went to Crimea, to join the active army. For three months he worked as a resident at the Simferopol military hospital under the leadership of N.I. Pirogov.
In 1856, S.P. Botkin went abroad - first to Würzburg, then to Berlin, where he listened to lectures by R. Virchow and visited the Traube clinic; in Vienna he worked (1858) with the physiologist C. F. W. Ludwig and the clinician J. Oppolzer. After a short stay in Switzerland and England, S. P. Botkin moved to Paris, where he visited physiol, Bernard’s laboratory (S. Bernard) and the Trousseau therapeutic clinic (A. Trousseau).
During his years abroad, S. P. Botkin wrote several scientific works published in the journal “Virchovs Archiv...”. During these same years, G. A. Zakharyin and I. M. Sechenov lived abroad, with whom he often met. S. P. Botkin’s strong friendship with I. M. Sechenov began back in 1853 in Moscow and lasted throughout his life.
In 1860, S.P. Botkin returned to St. Petersburg, defended his dissertation “On the absorption of fat in the intestines,” received a doctorate in medicine and was approved as an associate professor at the academic therapeutic clinic of the Medical-Surgical Academy. In this rank as an assistant to Prof. P. D. Shipulinsky S. P. Botkin remained for a year. In 1861, he was approved as an ordinary professor at this clinic and did not leave the academy until the end of his life.
S.P. Botkin was the first in Russia to create laboratories at the clinic: general clinical, chemical, bacteriological and physiological. Physiol, the laboratory was headed by I.P. Pavlov from 1878 for ten years. Pharmakol was studied here. action of new medicines, experiments were carried out on animals in order to reproduce pathological processes and clarify their pathogenesis.
Worldview of S.P. Botkin was formed under the influence of leading figures of Russian culture - V. G. Belinsky, T. N. Granovsky and A. I. Herzen. A major role in the formation of S.P. Botkin’s views was played by his friendship and scientific contact with I.M. Sechenov. Multifaceted scientific activity S.P. Botkin as an experimental pathologist and clinician was largely determined by the direction of his work and the achievements of his compatriots. This is especially true for the general understanding of the pathological process. Even at the beginning of his medical career, he pointed out that illness is not something independent: “It represents ordinary phenomena of life under conditions that are not beneficial to the body.” S.P. Botkin taught that one cannot talk about the clinical picture of a disease in general, without connection with a given organism. The disease always progresses in a unique way, depending on the characteristics of the individual. “That’s why,” pointed out S.P. Botkin, “along with medical knowledge, medical experience must also be valued.” Striving for the most accurate understanding of the patient,
S.P. Botkin resorted to working hypotheses, many of which were later scientifically confirmed. Trying to identify the cause of the disease, its pathogenesis, features of the course of the disease, S. P. Botkin, when examining a patient Special attention paid attention to the state of the nervous system and psyche. Since his student years, he was a master of physics. research methods - palpation, percussion, auscultation, but attached no less importance to a detailed survey of the patient; emphasized the importance of functional connections of organs and systems in the whole organism.
Understanding the pathogenesis of the disease opens up, according to Botkin, the opportunity to foresee the further course of the disease, correctly determine the necessary treatment and prevent complications, as well as draw theoretical conclusions that contribute to the development of the doctrine of internal pathology.
Deep knowledge and exceptional observation allowed S.P. Botkin to develop a number of complex issues in the pathology of internal organs and enrich Russian clinical medicine with important discoveries.
S. P. Botkin established the difference between hypertrophy and dilatation of the heart, described a post-systolic murmur with stenosis of the mouth of the left venous orifice, and indicated that with insufficiency of the aortic valves, diastolic murmur can be heard in the third or fourth intercostal space to the left of the sternum (Botkin’s point, or 5th auscultatory point of the heart). For the first time in the world literature, they gave a clinical description of arteriosclerosis. S.P. Botkin introduced a lot of new things into the doctrine of peripheral circulation. In 1867, he expressed the idea of the activity of arterial and venous circulation, which was later developed into the doctrine of the peripheral heart in the works of his students and followers (M. V. Yanovsky and others). In 1875, S.P. Botkin and his students established the participation of the spleen in blood deposition, which was much later confirmed by the experiments of J. Barcroft.
In the laboratory of S. P. Botkin, Ya. Ya. Stolnikov (1879) first carried out the experiment of applying clamps to the renal artery, which opened up the possibility of obtaining renal hypertension in the experiment. Similar experiments, which contributed to progress in the study of the problem of hypertension, were carried out by N. Goldblatt and his colleagues only in 1934, although on a larger scale.
S.P. Botkin introduced a lot of new things into the clinic of Graves’ disease. He drew attention to the uneven contraction of the atrium and the contrast between the sharp pulsation of the common carotid artery and the small pulse of the radial arteries, as well as the irritability and tearfulness that usually occur with this disease. S.P. Botkin is the creator of the neurogenic theory of the pathogenesis of Graves' disease. He was the first in Russia to describe the clinical picture of myxedema. In the doctrine of nephritis, S.P. Botkin considered it possible to talk about diffuse nephritis with a predominance of the interstitial or parenchymal process. He drew attention to the variety of clinical manifestations of cholelithiasis and the difficulties of its diagnosis. The mobile kidney was known earlier, but only S.P. Botkin gave a comprehensive description of the clinic of this suffering and scientifically substantiated the method of its recognition. S.P. Botkin identified infectious hepatitis as an independent disease (see Viral hepatitis), described its clinic and was the first to point out that sometimes this disease can lead to cirrhosis of the liver. This disease is now often called Botkin’s disease. He introduced a lot of new things into the clinic of such infectious diseases as typhus, typhoid and relapsing fever.
In a number of works by S.P. Botkin there are statements that the body has such physiol mechanisms that give it the opportunity to fight diseases. Even many prominent clinicians of that time, carried away by microbes, forgot about the macroorganism, which S.P. Botkin strongly objected to.
Medicine for S.P. Botkin was “the science of preventing diseases and treating the patient.” First of all, he paid attention to the need to adhere to an appropriate regimen and diet; when prescribing medications, he took into account the characteristics of the patient. He appreciated balneotherapy, but criticized Brandt's method (treatment of typhoid patients with cold baths).
S.P. Botkin demanded from the doctor a careful approach to treating the patient, which reasonably follows from an understanding of the essence of the disease and the pathogenesis of its symptoms. He objected to experiments on patients, because “our medicine is still far from being based on exact science, and we must always keep in mind that saving fear, so as not to harm the patient.”
S.P. Botkin and his students studied many medicines experimentally and clinically. In particular, they found that atropine sulfate acts specifically on the peripheral branches of sensory nerves; in experiments with digitalis, they proved that the substances contained in the leaves of this plant increase, and do not decrease, as previously thought, the strength of heart contractions. Studied to lay down. properties of adonis, diuretic effect of Blattae orientalis, the beneficial effect of Grindelia robusta in angina pectoris was determined, treatment was studied. the effect of potassium salts, tincture of lily of the valley, etc. S. P. Botkin went down in the history of Russian medicine not only as the pioneer of experimental therapy, but also as one of the founders of clinical pharmacology.
As a teacher, S.P. Botkin developed scientific and philosophical thinking among his listeners and encouraged him to critically evaluate the prevailing doctrines. He had a rare talent for conveying his knowledge and experience to listeners. Most of the lectures given by S. P. Botkin in last years his life, was recorded and published by his students (V.N. Sirotinin, M.V. Yanovsky, etc.).
Based on the main provisions of I. M. Sechenov’s work “Reflexes of the Brain” and developing the functional direction in medicine, S. P. Botkin approached the creation of a new, progressive theory of clinical medicine - “nervism”. However, the state of science at that time did not allow him to develop this theory. This was done by the great Russian physiologist I.P. Pavlov. “By nervism,” wrote I.P. Pavlov, “I understand a physiological trend that seeks to extend the influence of the nervous system to the greatest possible number of body activities.” The views of S.P. Botkin had nothing in common with the localistic medicine of the West. He, who highly valued Virchow as a major pathologist, following I.M. Sechenov, E. F. Aristov and other representatives of Russian science criticized his theoretical views.
S.P. Botkin was one of the founders of military field therapy. During Russian-Turkish war(1877 -1878) S.P. Botkin, being a doctor at headquarters, paid a lot of attention to the organization of therapeutic care in war. He pointed out that a military doctor should be not only a surgeon, but also a therapist who can treat and prevent the development of diseases among soldiers. Special meaning S.P. Botkin attached importance to the study of morbidity during the war and issues of anti-epidemics. service, relocation of hospitals, evacuation of sick and wounded soldiers and training of military doctors.
S. P. Botkin's Peru belongs to approx. 75 scientific papers devoted to current problems therapy, infectious diseases, experimental pathophysiology and pharmacology.
In 1867, the “Course of the Clinic of Internal Diseases” was published. In this and subsequent (1868 and 1875) editions of the book, S. P. Botkin showed that domestic medicine is aimed at scientific basis, introduced Russian doctors to the method of his clinical work, and gave descriptions of clinical cases with such power and depth of analysis that these books are still reference books for internists. S.P. Botkin published at his own expense in 1869-1889. 13 volumes of the “Archive of the Clinic of Internal Medicine”, in which numerous scientific works of his students were published.
In 1886, at a ceremony at the Medical-Surgical Academy, S.P. Botkin made a speech in which he outlined his views on the main problems of medicine and outlined its next tasks: “For a future doctor in a scientific direction, it is necessary to study nature in the full sense of this words. Knowledge of physics, chemistry, natural sciences, with the widest possible general education, constitutes the best preparatory school for the study of scientific practical medicine.”
During the time he was in charge of the academic therapeutic clinic, S.P. Botkin and his students wrote more than 100 works devoted only to the problems of treating patients, 40 of which became doctoral dissertations.
The greatness of S.P. Botkin lies in the fact that he was the first of the Russian clinicians, at the cost of hard work and great talent, to create the largest and most advanced school. Of the 106 students of S. P. Botkin, 45 headed clinical departments not only in St. Petersburg, but also in various cities of Russia. Among them are clinical professors N.A. Vinogradov, V.G. Lashkevich, N.Ya. Chistovich, V.N. Sirotinin, M.V. Yanovsky, V.A. Manassein, Yu.T. Chudnovsky, L.V. Popov, M. M. Volkov, V. T. Pokrovsky, Ya. Ya. Stolnikov, S. V. Levashev, S. M. Vasiliev and many others. Under the influence of the clinical views of S.P. Botkin, other branches of medicine also fruitfully developed. knowledge: neuropathology, psychiatry, dermatology, otorhinolaryngology.
In 1866, with the assistance of S.P. Botkin, the Epidemiological Leaflet was founded - a magazine that was published for 2 years. At the same time, he organized an epidemiol society in St. Petersburg. Since 1881, with the assistance of S.P. Botkin, the “Weekly Clinical Newspaper” was published - the first newspaper of domestic clinical medicine.
In 1872, at the conference of the Medical-Surgical Academy, S.P. Botkin was confirmed with the rank of academician.
The social activities of S. P. Botkin are significant and multifaceted. In 1878, he was elected chairman of the Society of Russian Doctors in St. Petersburg and fulfilled these duties until the end of his days. With his assistance, women's medical courses were founded in 1872. In 1881, S.P. Botkin was elected a member of the city duma and deputy. Chairman of the Public Health Commission. On his initiative, a free health care for the "poor classes". At the suggestion of S.P. Botkin, school sanitary supervision was introduced in St. Petersburg.
In 1886, S.P. Botkin was elected trustee of all city hospitals in St. Petersburg and chairman of the Commission under the Medical Council on the issue of improving dignity. conditions and reduction of mortality in Russia. In these public positions, he took part in the organization of healthcare in Russia.
S.P. Botkin was an honorary member of Moscow and Kazan universities, 35 Russian and 9 foreign medical societies.
Essays: On the absorption of fat in the intestines, Voen.-med. zhur., vol. 78, no. 2, p. 443, 1860; On the physiological effect of atropine sulphate, Med. Vestn., No. 29, p. 261, 186i; Course of clinic of internal diseases, c. 1 - 3, St. Petersburg, 1867-1875; About pernicious anemia, Weekly. Klin, gas., No. 6, p. 81, 1884; On kidney mobility, ibid., No. 23, p. 353; Basedow's disease and tired heart, ibid., No. 21, p. 367, no. 22, p. 383, no. 23, p. 399, 1885; General Basics clinical medicine, ibid., No. 37-38, p. 731, 1886; Clinical lectures by S. P. Botkin, comp. V. N. Sirotinin et al., c. 1 - 3, St. Petersburg, 1887-1888; Acute infectious catarrh of the bile ducts, Weekly. wedge, gas., No. 37-38, p. 795, 1888; Letters from S.P. Botkin from Bulgaria in 1877, St. Petersburg, 1893.
Bibliography: Arinkin M.I. and Farber V.B., S.P. Botkin, 1832-1887, M., 1948, bibliogr.; Belogolovy A. N., S. P. Botkin, his life and medical activities, St. Petersburg, 1892; Ghukasyan A. G., S. P. Botkin - the founder of the Russian clinic of internal diseases (On the 50th anniversary of his death), Sov. med., No. 5-6, p. 8, 1940; Molchanov N.S. Development of S.P. Botkin’s ideas in modern clinical medicine, in the book: Botkin Readings 1970, p. 7, M., 1972.
A. G. Lushnikov, D. Ya. Shurygii.