The Life of the Anatomist and Surgeon Nikolai Ivanovich Pirogov (1810-1881)

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Relevance. Nikolai Ivanovich Pirogov (1810-1881) was an outstanding anatomist and surgeon, teacher and public figure with a significant amount of scientific work.

Purpose: on the basis of the analyzed literature sources, to present the main achievements and results of the activities of Pirogov N.I.

Materials and methods. The analysis of Russian and foreign literary sources on the research topic was carried out

Results of his own research: Pirogov was born in Moscow on November 13, 1810. After the sudden death of his father, the family of Nikolai Ivanovich faced enormous financial hardships. Nikolai Ivanovich, with the support of a familiar professor of anatomy and physiology of the Mukhin Medical and Surgical Academy, entered Moscow University.

Pirogov was assigned to Moscow University at a very young age, at the age of 14 [1].

Pirogov's student years were quite difficult - financial difficulties and a very young age. His house was quite far from the place of study, and he had to spend a lot of time to get to the place of study. In winter the hike was more difficult. Education at Moscow University was weak. Therefore, upon graduation, Pirogov did not have proper practical training.

Only two teachers inspired the future great physician at Moscow University - Professors Lode and Mudrov. They trained their students to heal not only the disease, but also the patient himself - a method that is still significant today.

In May 1828, 17-year-old Pirogov received his medical specialization. E.O. Mukhin had a great influence on the formation of the views of young Pirogov and invited him to take an entrance test for admission to the graduate school of the International Institute of Dorpat University (Tartu). Pirogov brilliantly passed the state exams and began to study at the Baltic-German University in Dorpat. Derpt students were not prepared to teach. Pirogov was chosen to study practical anatomy and surgery and worked under the direct supervision of Professor Vakhter. He taught him anatomy on fresh cadavers and specimens preserved in ethanol. At the Department of Surgery, Pirogov studied with Professor Moyer, who was a student of Antonio Scarpa. Nikolai Ivanovich lived for some time in Moyer's house, in fact, as a member of the family[2].

At the age of 22, Nikolai Ivanovich successfully defends his doctoral dissertation and begins to act as a practicing doctor, while he does not stop the process of scientific research and continues to improve himself both in the field of studying human physiology, and in the field of anatomical research and studying the specifics of the structure of the body, which allowed him to carry out successful operations on the inguinal vessels.

Feeling a constant craving for knowledge and realizing the need to acquire new skills and practices, Nikolai Ivanovich undertook a two-year working trip to Germany, which lasted from 1833 to 1835, while, according to his recollections, he was unpleasantly amazed and surprised by the state of German practical medicine, which, according to in his opinion, did not take into account progressive research in the areas of the anatomical and physiological structure of the body [3]. In Berlin, Pirogov began to communicate with Madame Vogelsang, a skilled anatomist, who provided him with materials for an autopsy. Pirogov also worked with Konrad Langebeck, in whose clinic he improved his knowledge.

The successes and talent of Nikolai Ivanovich do not go unnoticed by the scientific community and in 1836 he was elected to the post of professor at the Department of Surgery at the University of Tartu, where he successfully combined practical and scientific activities and was able to make a number of discoveries by publishing them within a dozen of his own scientific works, which were not only posted on the pages of specialized publications, but also enjoyed the constant interest of his colleagues around the world[4].

In 1837, Pirogov introduced a rigid bandage into clinical practice. In 1841, Pirogov was called to the St. Petersburg Medical and Surgical Academy, where the department of hospital surgery was coordinated. The military hospital had poor sanitary conditions for patients, overcrowded rooms with 70-90 beds; patients suffered from various diseases: gangrene, erysipelas and sepsis. Pirogov ran into big trouble: a city journalist was persuaded to spread misinformation, patients were paid to accuse Pirogov of negligence. But Pirogov, in addition to the high democratic nature of his own character, urged practitioners not only to admit their mistakes, but also to bring them up for wide discussion, since it is this approach that allows other specialists to avoid similar mistakes and makes it possible to constantly improve.

In 1841, Pirogov conducted studies of topographic anatomy. He introduced the teaching of microscopy and histology into the medical curriculum, and in 1846 he founded the Institute of Applied Anatomy at the Academy, where, in addition to teaching medical students, a course was opened for the first time in our country to train anatomy teachers for various educational institutions.
During 1843-44, Nikolai Ivanovich was engaged in the creation of a unique atlas of applied anatomy, the essence of the work on which was that he personally developed a methodology for studying various body tissues by making multiple sections of a frozen body, such an approach revolutionized the views on techniques for study of the human body.
Observing the torment of people who underwent surgical intervention, it must be emphasized that at that time all operations were performed on a person who was conscious, Nikolai Ivanovich struggles to solve this problem and in 1847, in a field hospital, for the first time uses ether as a general anesthesia [5].

After 1855 he left the St. Petersburg hospital. Anesthesia, surgical instruments, and a hands-on medical approach were considered out of reach due to low funding. Nikolai Ivanovich could not come to terms with the ignorance of most professors and their lack of proper sympathy for patients.

During the Crimean War in 1854, Pirogov, along with Princess Elena Pavlovna, sent women nurses to treat wounded and sick soldiers, laying the foundation for the formation of the Russian Red Cross. There were three groups of nurses: surgical assistants, housekeepers, and pharmacists. This solution was extremely helpful.

Pirogov and his assistants performed many operations every day. The transportation of patients was inadequate, there were not enough supplies of linen and medical instruments, which prompted Pirogov to pay close attention to the issue of sorting incoming patients into groups, the main criterion for distribution into which was the severity of the injury and the urgency of the surgical intervention.

In 1854, Pirogov introduced a new method of foot amputation through the distal part of the tibia and fibula, while preserving part of the calcaneus. Despite his own method, he acted as a categorical opponent of quick decisions about the need for amputations.

Being a talented scientist and practitioner, Nikolai Ivanovich could not come to terms with the atmosphere of constant intrigues and scandals that surrounded his name while working within the walls of the surgical academy, which prompted him to leave the walls of the academy in 1856 and move on to work as a trustee of educational institutions.

At the age of 71, Nikolai Ivanovich was diagnosed with an extensive lesion of the oral cavity. Moscow professors concluded that the damage was malignant. The operation was deemed necessary, but he refused the proposed procedures, remained on his estate, and died later that year on November 25, 1881.

Conclusion. Based on the analyzed literature data, it can be concluded that Pirogov N.I. was able to introduce the accumulated practical knowledge into scientific research related to anesthesiology and leave a mark on the history of domestic science. Each factor of N.I. Pirogov itself is part of a special scientific study and in-depth study.

About the authors

Kristina Alexandrovna Simion

VGMU named by N.N. Burdenko, Voronezh

Email: fir.cris@yandex.ru
ORCID iD: 0009-0002-6272-4103
SPIN-code: 9952-9815
https://vk.com/f.christina_4

Clinical resident of the first year of the Department of Faculty and Palliative Pediatrics

Russian Federation, Student st., 10, Voronezh, Russia, 394036

Elena Dmitrievna Chertok

VGMU named by N.N. Burdenko, Voronezh

Author for correspondence.
Email: elena.chertock@yandex.ru
ORCID iD: 0000-0002-8398-6033
SPIN-code: 2771-6506

Associate Professor, Department of Faculty and Palliative Pediatrics

Russian Federation, Student st., 10, Voronezh, Russia, 394036

References

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