Tuning fork and pump organ: Medical tools in the 19th century

Origins of medical science

It is hard to believe, but before the mid-18th century there was no medical education in Russia. Doctors were either self-trained or studied abroad. The faculty of medicine at the Emperor’s Moscow University (now Lomonosov Moscow State University), established in 1755, was the first of its kind in Russia. It was initially located near Red Square on the spot currently occupied by the History Museum.

Philosophy was a fundamental discipline for all students who studied there for three years. The first medical lectures only took place in 1758, the year that is considered the beginning of the Sechenov Moscow Medical Academy, the successor of the medicine faculty. The academic schedule for 1758 is one of the first exhibits at the Museum of Healthcare History.

‘Import substitution’ in science

Future doctors studied three main courses: anatomy, chemistry and medicinal substance studies, a combination of botany and mineralogy. The courses were taught by foreign professors; textbooks such as anatomical charts were in foreign languages, usually Latin. However, the development of domestic science was impossible without original sources of knowledge, which means localisation was required.

Verbal training was the easy part. The first lectures in Russian were read in the 1770s. One of the first written tutorials of the time and one of the most valuable exhibits in the museum’s collection was the translation of a pharmacopeia from Latin done by a medical student in 1802 (the official publication came out much later, in 1866). This description of medicinal drugs and their uses was unique in world practice as it was the first ever pharmacopeia in a national language.

The exhibition also displays a volume of the Anatomy Course by Professor Yefrem Mukhin. In addition to his huge scientific contribution based on vast surgical experience, the surgeon made another invaluable  input to Russian medicine. As a family doctor and a friend of the Pirogov family, he helped 14-year-old Nikolai Pirogov get accepted to the university. As students had to be at least 16 years old, Pirogov’s papers were forged. It was a desperate measure. The young man’s father was on the verge of bankruptcy and he wanted to make sure his son had a future.

Eventually, Pirogov continued the research started by Mukhin and worked on so-called ice anatomy, the study of human body tissues with sections of frozen bodies. The research produced an in-depth anatomical atlas and provided the foundation for MRI, a technology based on layer-by-layer images of internal organs.

Another prominent Moscow medical scientist from the middle of the 19th century was Alexei Filomafitsky. In 1836, he published the first physiology textbook in Russian. In 1848, he published a dissertation on blood transfusion where he described trial operations and equipment. A transfusion tool is displayed at the museum next to the dissertation opened on the page with a graphic illustrating its use. The tool looks a bit scary but without it there would be no modern IV lines.

Tobacco, tuning fork and pump organ

The museum has many exhibits that seem out of place. For example, what do smoking pipes and a tobacco recipe have to do with medicine? A lot, apparently. In the 18th and early 19th centuries, doctors prepared special mixes from medicinal plants and fumigated their clothes and patient wards during epidemics in order to prevent infections from spreading. This means they were already aware of the need to disinfect and sanitise.

What about the tuning forks? These musical tools can be used in healthcare too. Otolaryngologists used tuning forks to examine individual specifics of a patients’ hearing. According to research, even in the mid-20th century, doctors still used tuning forks in their daily practice.

Another rare tool resembles a piano with several rows of keys. It is a small pump organ, or harmonium, a manually-pumped wind instrument with a keyboard. The instrument used to be in an acoustic room in a Moscow clinic and was used for the same purpose as a tuning fork but only in the 19th century.

GPs and specialists

Today, medical professionals are usually called doctors. However, in the 19th century the term “doctor” only applied to an academic degree awarded after defending a dissertation. Regular graduates from the medical faculty received the qualification physician (Vladimir Serbsky’s diploma, the future genius of Russian psychiatry, can attest to this). Despite the title, physicians of the time had encyclopedic knowledge and could do almost anything that patients might need, from diagnosis to labour assistance and other complicated operations.

Specialisations first appeared when Professor Fyodor Inozemtsev initiated an education reform in 1846, during which the medical faculty of Moscow University merged with the Academy of Medicine and Surgery. The latter, at the time located in a building on Rozhdestvenka Street (the current location of the Moscow Institute of Architecture), initially opened its training clinics for general practice and surgery. Later, in the 1870s, prominent physician Grigory Zakharyin started using wards for treatment and the study of children’s conditions, skin diseases and neural disorders.

Specialisation was inevitable. The development of science and technology significantly expanded the scope of knowledge and it was impossible for one person to fully grasp the entire range of information. All doctors received basic training and then selected an area which they wanted to study in depth. Doctors with specialised knowledge could help patients faster and more efficiently.

A man’s profession

As guests walk through the exhibit on healthcare in the 19th century, one thing becomes clear. All the portraits and names belong to men. Female doctors were an exception and they usually studied abroad. Most women who wanted to help patients worked as nurses.

This is not surprising, considering that the first university for women, Moscow Women’s Higher Training Courses, only opened in 1872. The medical faculty (currently the Russian National Research Medical University) did not open until 1906.