CC BY
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УДК 94(470.5)08
T.Y. Shestova
The problems of the childhood in the Ural provinces medicine
of the post-reform period
Проблемы детства в медицине уральских губерний в пореформенный период
Children are an important part of the family. By the beginning of the 20th century both the working and the growing up population had been served by public medicine. This research is based on the documents of zemstvos and the governors' reports.
Дети являются важной частью социального института семьи. К началу ХХ в. на Урале дети обслуживались общественной медициной. Настоящее исследование основано на документах губернских земств и отчетов губернаторов.
Key words: Infant mortality, morbidity, history of the healthcare, Perm, Orenburg, Vyatka provinces.
Ключевые слова: детская смертность, заболеваемость, история
здравоохранения, Пермская, Оренбургская, Вятская губернии.
The population of mining and melting areas of the Ural turned to the help of maternity nurses but the peasants ignored them [11. L. 116]. A maternity nurs had 15-20 parturitions annually, midwifes served 5% of the population. Therefore 17% of the babies at the age of one month died [10, p. 225; 13, p. 71].
The problem of the relationship between the maternity nurses and the widwifes was constantly there. Obstetrical courses were opened in Vyatskaya and Permskaya provinces. Only in 1915 the situation in countryside has improved due to the extending of medical service.
At the same time there were paramedic schools and maternity wards opened at the hospitals. But women turned to the official medicine service only in difficult cases. Maternity wards have become popular with the railways development [9, p. 134]. From the beginning of the 20th century maternity and specialized wards started their work in uyezds.
The health of a child in his first year of life depended on the residence and religion of his family. Too young mothers couldn’t have healthy babies [10, p. 220]. This was especially typical of Muslim families.
© Shestova T.Y., 2015
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Some rites of peasants were dangerous for life. For example in Vyatskaya province the baby had his head given a “beautiful” shape by a midwife. That increased the number of insane people [7, p. 103].
For the first days mother and baby lived in banya (bathhouse). Mothers ate only bread and kvass and babies were given ritual bread [12, p. 14]. After the third fast, mothers gave up feeding babies with their milk. Then during the fast children were given a red wine as tonic [10, p. 220, 215]. The ration of a peasant child consisted radish with sour kvass, herring, potatoes, cabbage soup [1, p. 69]. Wrong feeding led to the scrofula, consumption, etc. Another reason of the child mortality was living in the insanitary conditions of the country houses.
The main factor of the child’s life protection was vaccination (smallpox), the coverage of such vaccination reached 75% in mining and melting areas. As for the peasants, they opposed: they washed off vaccination, bribed those who vaccinated them, asked for fake registers. This led to the fact that 40 % of vaccinations required re-vaccinations, Permskaya province's authorities considered that smallpox vaccination of the whole province was impossible, so they refused to do it at once.
The second half of the 19th century was characterized with such family disease as primary and inherited syphilis, the rate of syphilis infection among the children reached 70%. They were infected with syphilis through the nipples, foster mothers, maids and so on [8, p. 132]. Children with inborn syphilis might infect the whole family [2. L. 58]. While the population of mining areas was quite healthy (because they were examined regularly and used hospitals service), the situation in ethnic and peasant areas was far worse. At the beginning of the 20th century the outpatient treatment of syphilis gave way to the hospital medical care, regarding children as well.
The problem typical of The Urals was goiter. The disease rooted in the childhood often led to the cretinism in the adulthood [4, p. 22].
First medical (ophthalmic) aid groups frequently faced the trachoma infection in uyezds; seven years old children (about 18%) needed the surgical operation, many teenagers were already blind. The reasons of this disease were divided by nationality. The Udmurts lost sight because of high headdress, the Kirghises - due to the dust, the Russians - by the reason of injuries they got during the working process [14, p. 75].
Zemstva faced the epidemics of childhood diseases: diphtheria, measles scarlet fever. In Vyatskaya province they developed some measures of fighting these diseases in peasant environment: the isolation, the revaccination, the destruction of the infected things, closing of schools. Permskaya province focused on the sera production and founded a bacteriological station in 1895 [15, p. 76].
The doctors of zemstvo could control children’s health only at schools and had some influence on the family hygienic through the
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pupils. The pupil were provided with free medicines, their health was monitored, but actually there were no regular school doctors in the Urals.
Children in hospitals accounted for 10% of the all the patients. Peasants did not bring small children to hospitals - they were afraid of the infection with other diseases. In Orenburg province only the children from the orphanages were served by the public hospitals. The authorities of Perm refused to open a children department afraid of increasing the death rate.
Mortality rate among babies in Ural provinces exceeded that in Europe many times. In Permskaya and Vyatskaya provinces it was 60%, in Orenburg province - 70% (Kirghis population excluded). The death rate among children depended on the season of year and the welfare of a family. Children in Udmurt and islamic families died for religious reasons more than for any other reasons.
The Association "Day nurseries" appeared in Russia in 1893, intended for the children of workers, but it was funded by the state [12. L. 13-14]. In a year after the opening of “Society for struggle against children’s death in Russia” (1908) its departments appeared in Permskaya and Vyatskaya provinces; as for Orenburg province, this kind of work was most important there. The Association of the physical development of children also functioned in that region, it widely included doctors and teachers [3. L. 2-3].
Day nurseries were the fist institution of the children protection. In Permskaya and Vyatskaya provinces they combined the state and the charitable funding, but the amounts were small.
In Orenburg province day nurseries depended on the personal initiative of the doctor M.M. Kenigsberg who introduced new approaches of work with children: nurseries, orphanages for the starving, sanatoria. Nurseries adopted weakened children up to 7 years. They laid stress on balanced nutrition of the children. At the same time they struggled against reprocessing of milk into butter, because there was not enough of a whole milk for peasant children [5, p. 92-94].
In 1907 there was a department of the society “Milk Drop” established in Orenburg. During the very first year the nurseries lowered the death rate of the neighboring villages children by 16 times. In 1896 there were 6 nurseries founded in Orenburg province, in 1897-11, in 1898-12, in 1903-16.
There were some more kinds of the teenagers' health protection. By the beginning of the 20th century country houses kept by the Women’s gymnasia, the Technical school, Bogoroditskaya parish school functioned in Permskaya province, near the Kama river. In 1895 the sanatorium for weakened teenagers was opened in the place Fileiskoe of Vyatskaya province. The summer sanatorium for weakened children from poor families worked for 10 years, beginning from the 1898th. Teenagers from Moscow and Tula came there, too.
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Thus, questions of medicine and demography initiated special attention to the problems of childhood in the Urals provinces situated in the difficult climatic zone.
References
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