From World War I through the Great Patriotic War: Early 20th century medicine

From World War I through the Great Patriotic War: Early 20th century medicine
Left: Chief Red Army Surgeon Nikolai Burdenko, a member of the USSR Academy of Medical Sciences, performs an operation. Photo credit: B. Ignatovich. Moscow, 1941
Why did surgeons use table knives and joiners’ saws? What were the practical applications of moss and wires? How did a captured German flashlight make a real medical feat possible? discusses the impact of the October 1917 Bolshevik Revolution and two world wars on the development of Russian medicine and the evolution of one of the most effective healthcare systems in the world.  it made another medical feat possible suggests that you revisit the Medicine History Museum at 2/3 Bolshaya Pirogovskaya Street and recall the development of medical science and practices in the first half of the 20th century.

Respected undergraduate doctors and frontline souvenirs of World War I

The Museum’s Hall of Glory features a badge with the abbreviation ZV, meaning Zauryad Vrach or Undergraduate Doctor. During World War I, senior undergraduate medical students were promoted to doctors and sent to the front. This was a forced measure, as the Russian Armed Forces did not have enough professionals capable of coping with the massive influx of wounded soldiers. Although these undergraduate doctors were expected to resume their studies after the war, few of them were able to do so.

Medical personnel faced numerous problems at the front. For example, the lack of chloroform made surgery difficult. Before the war, Russia received most of its chloroform from Germany, and deliveries stopped after the hostilities began. In 1915, biochemist Professor Boris Zbarsky (1885–1954), the future director of the Lenin Mausoleum Laboratory, solved this problem by inventing a method for launching commercial chloroform production at the chemical plants of business tycoon Savva Morozov in the Ural region. In fact, he helped master production of the anaesthetic at those plants during the war. Some modest exhibits, including a field-hospital anaesthetic mask and a chloroform flask, show how Russian scientists helped mitigate the pain of wounded soldiers.

A nearby stand attracts attention with its field table-set made from multi-calibre artillery-shell casings. Undergraduate doctors who were fortunate to survive returned home with some unusual-looking souvenirs in hand.

Enthusiasm versus famine and posters versus germs

The October 1917 Bolshevik Revolution ushered in a new era of Russian history, and it also influenced the development of science. In just a few years, almost 20 leading professors resigned from Moscow University’s Medical Department. Some of them emigrated, while others failed to adapt to the rigours of Bolshevik rule. The 1917/1918 academic year’s schedule shows that lectures and seminars continued unabated. Photos of that period show professors and students sitting in lecture-rooms dressed in overcoats and hats, because heating systems did not work at the time.

Enthusiasm triumphed over cold weather, famine and other everyday problems. By the mid-1920s, the Moscow medical school had reached its pre-revolution levels. Workers’ faculties were opened to spread scientific knowledge, with professors lecturing to those who wished on weekends.

In 1928, experts of the Institute of Sanitary Culture, renamed ten years later as the Central Research Institute of Sanitary Education, began to oversee this sector. They teamed up with famous poets and artists, including Demyan Bedny and Vladimir Mayakovsky, and turned out postcards, leaflets, posters and booklets with a large print run. All this printed matter aimed to raise public awareness of medical issues and provided some common-sense advice, such as “Wash your hands before eating,” “Drink only boiled water,” etc. These posters, now adorning a museum wall, used to hang almost everywhere, including in schools, Young Pioneer camps, industrial plants and factories, as well as restaurants and cafeterias.

The Medical Department at Moscow University continued to expand, with 25 new faculties opening in several years. It became necessary to change the University’s format, and in 1930, the Medical Department was singled out as the First Moscow Medical Institute.

Preventive treatment, the pillar of healthcare

The country’s medical education and healthcare systems had to be overhauled. Professor Nikolai Semashko (1874–1949), who headed the People’s Commissariat (Ministry) of Healthcare of the RSFSR from 1918–1930, became one of the reform’s main authors. He borrowed some of its principles from pre-revolution Russia. For example, various districts were subdivided into sectors, each controlled by one doctor. This system virtually replicated the country’s division into Zemstva (district councils), introduced during the reign of Emperor Alexander II (1818–1881, ruled 1855–1881-Ed.). For example, Anton Chekhov and Mikhail Bulgakov were district-council doctors.

Mr Semashko’s innovative methods focused on preventive treatment. The professor introduced annual medical checkups for detecting the first signs of health disorders and promptly treating them at early stages. Patients were treated at specialised clinics, subsequently relaxing at sanatoriums, after-work clinics and holiday hotels. The multi-tier system quickly proved its worth, virtually eradicating tuberculosis in the Soviet Union by 1941.

In 1930, Mr Semashko established the State Central Institute of Public Catering, affiliated with the People’s Commissariat (Ministry) of Healthcare of the RSFSR, now called the Research Institute of Nutrition at the Russian Academy of Medical Sciences. This Institute oversaw research projects nationwide.

In 1937, the International Health Organisation of the League of Nations, now the World Health Organisation, recognised Mr Semashko’s system as the best in the world. Many Western countries, including the United Kingdom, moved to introduce similar methods after World War II.

Hard work and everyday feats during the Great Patriotic War

An exhibition on the Museum’s second floor is dedicated to Soviet medicine during the Great Patriotic War of 1941–1945. Opened in 2015 in the run-up to the 70th Victory Day anniversary, the exhibition features numerous multimedia devices, including interactive panels and multifunctional monitors. Visitors select their own guided tours, with the guide creating the appropriate atmosphere by controlling sound and visual effects by a tablet computer. This concept attracts young people and makes it possible to accommodate a large amount of information in a small area.

But traditional stands provide the strongest impressions. A military hospital located in the central section of the Frontline Hall symbolises the effective medical assistance system streamlined by Soviet military doctors. All Soviet medical personnel had their own clear tasks. Orderlies and nurses bandaged soldiers and evacuated them from the frontline as quickly as possible. Doctors examined wounded soldiers at medical battalions and acted according to the situation. Emergency onsite surgery was performed, some soldiers were treated at medical battalions and others were sent to large hospitals behind the lines or received disability retirement. This system made it possible to return up to 70 percent of wounded service personnel to active duty.

Here you can see a 50-mm German anti-personnel mine inside a tent. In 1942, military surgeon Arkady Razdyakonov, a graduate of the First Moscow Medical Institute, removed the mine from a machine gunner’s leg. Operations like this were extremely rare during the entire war. As the mine could explode anytime, an orphan nurse volunteered to assist. The operation proved successful, combat engineers defused the mine, and it became a family relic. In 2013, Mr Razdyakonov’s son gave it to the museum.

This captured German flashlight seems out of place at a stand dedicated to female doctors at the front, but it made another medical feat possible. A Red Army soldier used the flashlight to illuminate the abdomen of his friend who was wounded in Berlin after its capture by Soviet forces, while doctor Yelena Makeyeva operated on her patient on a local street. Her hospital was about to redeploy, and the wounded soldier was fortunate, because doctor Makeyeva had her medical bag on hand.  The soldier recovered and wrote to his saviour many times, thanking her, and she kept the German flashlight for many years.

Another stand has no authentic exhibits, but nevertheless reflects historical truth. Table knives served as scalpels, joiners’ saws were used for amputations and moss and wires helped to effectively dress wounds. All this was recreated through the recollections of Doctor Sergei Altayev, another First Moscow Medical Institute graduate who spent almost the entire war at a camp for prisoners of war and who continued to treat other inmates there.

The museum’s exhibits can tell about many miraculous recoveries and heroic feats. But many heroes would simply shrug off these stories because, in their opinion, they were simply doing their job.

Photos and documents courtesy of the City's Main Archive Directorate