In the Middle Ages, although gynecology was revived, it fell under the influence of mysticism and pseudoscientific ideas. Medicine, and, in particular, obstetrics and gynecology, developed rather poorly due to the fact that science was influenced by the church and religion. Religion planted absolutely fantastic ideas like the dogma "of the Immaculate Conception". Any dissent was persecuted and sometimes accompanied by expulsion from his native country and the Inquisition.

During the period of the classical Middle Ages, when scholasticism dominated in Western Europe and universities were mainly engaged in compiling and commenting on individual manuscripts of ancient authors, the doctors and philosophers of the medieval East preserved and enriched the valuable empirical heritage of the ancient world (Abu Bakr al-Razi, Ibn Sina, Ibn Rushd other).

Yet medicine continued to evolve. So, in Byzantium in the 9th century, for the first time, graduate School in which various scientific disciplines and medicine were studied. However, obstetrics continued to remain at a very low stage of development. Obstetrics in the Middle Ages was considered low and indecent for male doctors. Delivery continued to be in the hands of midwives. Only in the most severe cases, when the woman in labor and the fetus were in danger, did they resort to the help of an experienced surgeon, who most often used a fruit-destroying operation. It is worth noting that mainly women in labor of the wealthy class had the opportunity to use the help of a surgeon. Women in labor of lower origin had to do with the help of "grandmothers". As you know, the Middle Ages were characterized by a disastrous sanitary and hygienic situation. Thus, one should not be surprised that if the elementary requirements of hygiene were not observed, mortality in childbirth and in the postpartum period assumed enormous proportions.

The beginning of the Renaissance was a kind of impetus in the development of various sciences, and medicine was no exception. During the Renaissance, the formation of scientific anatomy and physiological knowledge created the prerequisites for the development of scientific obstetrics and gynecology.

A new direction in medicine appeared in the works of Paracelsus, Vesalius and others outstanding minds that time. Eustachius, a Roman professor of anatomy, very accurately described the structure of the female genital organs, based on mass autopsies in hospitals. The great anatomist Andreas Vesalius in his scientific papers first correctly described the structure of the female uterus. Arantius, a student of Vesalius, described the development of the human fetus in the womb and its relationship with the mother's body. Botallo studied the blood supply to the fetus, and the Italian Gabriel Fallopius described in detail the oviducts, later named after him (fallopian tubes). Trautman owns a reliably successful caesarean section on a live woman in labor. The first comprehensive guide in Western Europe "On Women's Diseases" was compiled in 1579 by Luis Mercado.

Great importance for the development of obstetrics and gynecology, Ambroise Pare had the activity, who returned to obstetrics the forgotten operation of turning the fetus on a leg, introduced gynecological mirrors into widespread practice and organized the first obstetric department and the first obstetric school in Europe at the Hotel-Dieu hospital in Paris. Only women were accepted into it; training lasted 3 months, of which 6 weeks were devoted to workshops.

However, until the 18th century, obstetrics lagged far behind other branches of medicine, since its path of development was accompanied by a struggle against ignorance and prejudice. The only way out of this situation could be a return to the traditions of antiquity, which proved to be useful.

At the turn of the XVII-XVIII centuries in France, the formation of obstetrics as an independent clinical discipline begins. This was largely facilitated by the organization of obstetric clinics. The first of these was opened in Paris at the Hotel-Dieu hospital. The first school of French obstetricians was formed here, a prominent figure of which was Francois Morisot, the author of a major guide on the diseases of pregnant women, who proposed several new obstetric operations and instruments.

The XVIII century was a period of formation of obstetrics in England, Holland, Germany, France, Russia and other countries. So, in 1729, the first maternity clinic in Europe was opened in Strasbourg. In 1751, the first university obstetric clinic was organized in Göttingen, where students were trained.

Gradually, new diagnostic methods began to be developed that made it possible to correctly determine the gestational age, as well as the condition of the fetus. Much attention was paid to the study of such anatomical concepts as the size of the pelvis, which later made it possible to more or less accurately predict the course of childbirth. The invention of the microscope by Leeuwenhoek made it possible to study in more detail the structure of the female genital organs, on the basis of which initial ideas about the functions of various parts of the reproductive system began to take shape. Abortion operations began to improve, although the church still opposed such surgical interventions.

As a result, already in the 19th century, obstetrics and midwives were introduced into the system in special schools. The field of physiology and pathology of the female genital organs has expanded so much that it has become an independent medical discipline - gynecology. In accordance with this, a new specialty appears - doctors - gynecologists. Operative surgery arises, gynecological hospitals are opened, and gynecological departments are opened in hospitals.

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Gynecology as a science and a branch of medicine appeared among the ancient peoples. There are references to it in Old Slavonic, ancient Egyptian and ancient Indian writings. The first scientist to describe female inflammatory diseases was Hippocrates.
This science began to develop in the 16th century, when the structure of the female body and its features were accurately studied and described in books. In the next century, it became an independent science.

In the middle of the 19th century, the first clinics began to appear both in Russia and around the world. By the beginning of the 20th century, scientists and doctors had already learned how to diagnose and effectively treat most gynecological diseases. The surgical direction in this science began to develop, thanks to the emergence of a number of antiseptic agents that prevented complications during surgical interventions. Many diseases in this area at that time were treated precisely through operations, but the situation soon changed. Scientists have proven that in the treatment of a certain disease in gynecology, it is necessary to take into account the state of the whole organism.

Thanks to the development of virology, to late XIX century, it became easy to diagnose and treat gonorrhea. At the beginning of the 20th century, scientists were able to understand the principle of the endocrine glands, which made it possible to find out what hormones they produce.

In the last century, this science has developed constantly. It was in the 20th century that cytological studies began to be used. An operative method was developed for uterine cancer. Also in gynecology at that time, therapeutic techniques for various pathologies and radiation therapy were developed. The 20th century also saw the introduction of most contraceptives.

Read more:

• Gynecologist. Who is this doctor and what does he treat? When do you need to contact the antenatal clinic? The role of the gynecologist in family planning

Let's start with the fact that menstruation in ancient times and now are slightly different phenomena. First of all, because a stable cycle was more of a rarity than the norm. Poor nutrition and lack of vitamins led to hormonal imbalance, and this, in turn, led to a violation menstrual cycle. Menstruation could stop altogether if the woman was severely emaciated.

Tampons and Ancient Egypt

Very often on the Internet you can find a statement that tampons were known to the ancient Egyptians. Hippocrates, the "father of medicine", is also mentioned in this context, who allegedly mentioned small wooden sticks wrapped in soft linen that women inserted into the vagina.

Dr. Helen King, who has devoted many years to studying menstruation historically, claims that the original Hippocratic quote has never been found, and the myth was widely used in advertising campaigns for well-known brands - manufacturers of personal care products for women.

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The same goes for claims about tampons in ancient Egypt and Greece. But there is evidence that the Romans attached subligaculum - absorbent cotton pads - to underwear.

Middle Ages

If you very briefly answer the question of what women did during menstruation until the 19th century, then the answer would be: nothing. Most of the Europeans did not wear underwear, so there was nowhere to fasten the fabric.

However, there were also exceptions. An alternative "for the rich" method was rag pads, which were fastened between the legs with a special belt that was fastened around the waist. For example, we know that Elizabeth I, Queen of England, owned three black silk sashes.

The "civilized" approach to their hygiene also included pieces of tissue that were thrust into the vagina to stop the bleeding. But most women simply let the blood flow naturally. This, apparently, according to the records, did not surprise anyone.

Laura Klosterman Kidd, an expert on the subject, studied 17 women's diaries and letters with recommendations on what to pack on a trip. She did not meet a single mention of objects that could somehow make life easier for a woman during this period.

1800

Nothing changed. A German doctor wrote in 1899: "It is absolutely disgusting to bleed on your shirt and then wear it for four to eight days, it can easily lead to infections."

Yes, some women did use "menstrual tissues", but most women could not afford such an expensive pleasure.

At the same time, women "these days", for example, were forbidden to work in factories, especially food ones - it was believed that they could "poison" products.

1900

Linen was securely attached to the so-called hygienic belt. The first advertisement showing disposable napkins appeared in the USA in 1888. Up to this point, any advertisement that touches on the topic of menstruation was considered taboo.

The product did not attract consumers and was discontinued.

1920

The women also used a hygienic belt, but this time they settled for disposable pads. World War I nurses discovered the absorbent properties of special medical paper - they used it to absorb blood from open wounds, but also to menstrual blood they fit perfectly.

Inspired by this idea, Kimberly Clark invented Kotex, the first disposable menstrual wipes.

1930

The first tampons with a cardboard applicator appear. In 1934, Tampax introduced its product to the market. It was recommended for use only by married women, because it was widely believed that tampons were only suitable for women who had already lost their virginity.

1940

War, women have to move a lot, there is no time for hitches. This is how the first tampon without an applicator appears. Between 1936 and 1943, tampon consumption increased fivefold.

1950

Time ago. And again a hygienic belt, but not a word about menstruation. Women should be silent about this uncomfortable period of their lives. But here's an excuse for giving up homework menstruation should not serve.

1960

Washable rag pads. The time of the struggle for women's rights has changed almost nothing in relation to menstruation.

In the Middle Ages, although gynecology was revived, it fell under the influence of mysticism and pseudoscientific ideas. Medicine and, in particular, obstetrics and gynecology during this period developed rather poorly, like all medical science and natural science in Europe, since science was strongly influenced by the church and medieval religion

Religion planted absolutely fantastic ideas like the dogma "of the Immaculate Conception", church fanatics in the Middle Ages inspired the idea that children could be born from the devil, etc. any critical statements about such wild views on the part of scientists and doctors caused them to be persecuted , expulsion from his native country and torture by the Inquisition. It is quite clear that such a situation had a disastrous effect on the development of obstetric science and gynecology.

During the period of the classical Middle Ages, when scholasticism dominated in Western Europe and universities were mainly engaged in compiling and commenting on individual manuscripts of ancient authors, the valuable empirical heritage of the ancient world was preserved and enriched by doctors and philosophers of the medieval East (Abu Bakr arrazi, ibn Sina, ibn Rushd other.

Yet medicine continued to evolve. So, in Byzantium in the 9th century, a higher school was founded for the first time, in which scientific disciplines and medicine were studied. History has preserved for us the names of the Byzantine doctors Oribasius, Paul (from Aegina) and others, who continued to develop the legacy of their predecessors. At the same time, obstetrics continued to remain at a very low stage of development. Obstetrics in the Middle Ages was considered low and indecent for male doctors. Childbirth continued to remain in the hands of grandmothers - midwives. Only in the most severe cases of pathological childbirth, when the woman in labor and the fetus were threatened with death, "Babki" called for help - a surgeon who most often used a fruit-destroying operation. In addition, the surgeon was not invited to every woman in labor, but mainly to the woman in labor of the wealthy class. The rest, insolvent women in childbirth, were satisfied with the help of "Grandma" and instead of real obstetric care received from them slandered water, an amulet, or one or another ignorant benefit. It is not surprising that with such assistance, in the absence of elementary hygiene requirements, the cleansing rate during childbirth and in the postpartum period was very high. Pregnant women lived under constant fear of death. Correction of the misposition of the fetus by rotation, this great achievement of antiquity, was forgotten or not used by most doctors.

Only the Renaissance gave a new round in the deepening and systematization of all sciences and the building of scientific gynecology. A new direction in medicine appeared in the works of Paracelsus, Vesalius, and others. Innovators of the progressive trend sought to develop medical science on the basis of experience and observation. Thus, one of the greatest doctors - reformers of the Renaissance, Paracelsus (1493-1541) rejected the teaching of the ancients about the four juices of the human body, believing that the processes occurring in the body are chemical processes. The great anatomist Vesalius (1514-1564) corrected Galen's error regarding messages between the left and right hearts and for the first time correctly described the structure of the woman's uterus. Another famous Italian anatomist Gabriel Fallopius (1532-1562) described in detail the oviducts, which received his name (fallopian tubes.

During this period, anatomy began to develop rapidly. This led to a large number discoveries also in the field of gynecology. In the 16th century, the first atlases appeared - manuals for midwives. The scientists who have made a significant contribution to the development of gynecology and obstetrics should be listed.

Eustachius (1510-1574), Roman professor of anatomy described the structure of the female genital organs very accurately, based on mass autopsies in hospitals.
Arantius (1530 - 1589), a student of Visal, opening the corpses of pregnant women, he described the development of the human fetus, its relationship with the mother. He saw one of the main causes of difficult childbirth in the pathology of the female pelvis.
Botallo (1530-1600) described the fetal blood supply.
Ambroise Pare (1517-1590) - the famous French surgeon and obstetrician, restored and improved the forgotten method of turning the fetus on the leg. He recommended using the rapid release of uterine contents to stop uterine bleeding. They first invented the breast pump.
Trautman owns a reliably successful caesarean section on a live woman in labor.

Gynecological surgery revived somewhat earlier: as a department of pure surgery, it separated from obstetrics in the Middle Ages. The works of European anatomists of the 16th and 17th centuries (T. Bartholin, R. Graaf, and others) contain a description of the physiological structure of women. Already in the next century, gynecology as an independent science took shape.

During the Renaissance, the development of scientific anatomy (A. Vesalius, J. Fabricius, G. Fallopius, B. Eustachius) and physiological knowledge created the prerequisites for the development of scientific obstetrics and gynecology. The first comprehensive guide in Western Europe "On Women's Diseases" ("De Mulierum Iiffeclionibus") was compiled in 1579 by Luis Mercado (Mercado, Luis, 1525-1606) - a professor at the University of Toledo (Spain.

Of great importance for the development of obstetrics and gynecology was the activity of Ambroise Pare, who returned to obstetrics the forgotten operation of turning the fetus on a leg, introduced gynecological mirrors into widespread practice and organized the first obstetric department and the first obstetric school in Europe at the Parisian Hotel - Dieu hospital. Only women were accepted into it; The training lasted 3 months, of which 6 weeks were devoted to practical training.

The rapidly developing science and medicine of this period made it possible to carry out rather complex abdominal and gynecological operations. Original methods for removing abscesses from the pelvic cavity, plastic surgery of the female genital organs were proposed. Obstetrics also fell under this influence. For the first time Chamberlain (Chamberlain), and later - L. Geister proposed the use of obstetric forceps in difficult childbirth.

New diagnostic methods were developed to determine the correctness, duration of labor, as well as the condition of the fetus. Such anatomical concepts as the size of the pelvis were studied, which later made it possible to more or less accurately predict the course of childbirth, and, accordingly, be prepared for all the troubles. The invention of the microscope by Leeuwenhoek made it possible to study in more detail the structure of the female genital organs, on the basis of which initial ideas about the function of various parts of the reproductive tract began to take shape. Abortion operations began to improve, although the church greatly interfered with this.

In the 19th century, obstetric and midwifery education was introduced into the system in special schools. However, along with this, ideas about the nature of pathological processes that occur in the female genital organs, as well as their physiological directions, remain. The field of physiology and pathology of the female genital organs has expanded so much that it has become a separate medical discipline - gynecology. In accordance with this, a new specialty appears - doctors - gynecologists. They also pass surgery female diseases; operative gynecology emerges. Gynecological clinics are opened, and gynecological departments in hospitals.

Obstetrics and gynecology. obstetrics and gynecology

Gynecology (from the Greek gyneko- - woman and -logy - study) is a branch of medicine that studies diseases that are characteristic only of a woman's body, primarily diseases of the female reproductive system. Most gynecologists on present stage are also obstetricians. Gynecology is most closely associated with obstetrics, which studies the phenomena in the female body related to pregnancy and childbirth, from the moment of conception to the end of the postpartum period; it is also close to surgery and other departments of practical medicine - nervous, internal diseases, etc.; outstanding representatives of gynecology were in the vast majority at the same time obstetricians or surgeons; but the sex life of a woman is so complex, it so affects the functions of all the organs of her body, and pathological changes her sexual spheres are so numerous and varied that gynecology itself stood out in separate science. Obstetrics is a field of gynecology, a science dealing with theoretical and practical issues of pregnancy, childbirth and obstetrics. Previously, obstetrics included newborn care, which is now separated into neonatology.

obstetrics and gynecology

Obstetrics (French accoucher - to help with childbirth) - the doctrine of pregnancy, childbirth and the postpartum period and gynecology (from the Greek gyne, gynaik (os) - woman; logos - teaching) - in the broad sense of the word - the doctrine of a woman, in the narrow meaning - the doctrine of women's diseases - are the oldest branches of medical knowledge. Until the 19th century they were not separated, and the doctrine of women's diseases was an integral part of the doctrine of childbirth.

The first information about childbirth and women's diseases is contained in the medical texts of the ancient East: Chinese hieroglyphic manuscripts, Egyptian papyri ("gynecological papyrus" from Kahun, 19th century BC, and papyrus G. Ebers, 16th century! BC. e.), Babylonian and Assyrian cuneiform tablets, (II-I millennium BC), Indian Ayurvedic texts. They talk about women's diseases (displacement of the uterus, tumors, inflammation), dietetics of pregnant women, normal and complicated childbirth. In the samhita of a famous surgeon ancient india Sushruta mentions the incorrect position of the fetus in the uterus and the operations of turning the fetus on the leg and on the head, and, if necessary, the removal of the fetus by fruit-destroying operations.

The Hippocratic Collection contains a number of special works: “On the nature of a woman”, “On female diseases”, “On infertility”, etc., which describe the symptoms of uterine diseases and methods for removing tumors using tongs, a knife and hot iron. The ancient Greeks also knew about cesarean section, but they performed it only on a dead woman in order to extract a living fetus (according to mythology, Asclepius, the god of healing, was born this way). Note that the first reliable information about a successful caesarean section on a living woman in labor dates back to 1610, it was performed by the German obstetrician I. Trautmann in Wittenberg. In the final period of history ancient greece- the era of Hellenism, when Alexandrian doctors began to perform anatomical autopsies, obstetrics and gynecology began to stand out as an independent profession. So, the famous obstetrician of his time was the student of Herophilus Demetrius from Apamea (II century BC). He studied the development of pregnancy, the causes of pathological childbirth, gave an analysis of various types of bleeding and divided them into groups. Another Alexandrian physician Cleophantus (2nd century BC) compiled an extensive work on obstetrics and women's diseases.

In the Middle Ages, although gynecology was revived, it fell under the influence of mysticism and pseudoscientific ideas. Medicine and, in particular, obstetrics and gynecology during this period developed rather poorly, like all medical science and natural science in Europe, since science was strongly influenced by the church and medieval religion. Religion propagated absolutely fantastic ideas like the dogma of “immaculate conception”, church fanatics in the Middle Ages inspired the idea that children could be born from the devil, etc. Any critical statements about such wild views from scientists and doctors caused them to be persecuted , expulsion from his native country and torture by the Inquisition. It is quite clear that such a situation had a disastrous effect on the development of obstetric science and gynecology.

Yet medicine continued to evolve. So, in Byzantium in the 9th century, a higher school was founded for the first time, in which scientific disciplines and medicine were studied. History has preserved for us the names of the Byzantine doctors Oribasius, Paul (from Aegina) and others, who continued to develop the legacy of their predecessors. At the same time, obstetrics continued to remain at a very low stage of development. Obstetrics in the Middle Ages was considered low and indecent for male doctors. Delivery continued to be in the hands of midwives. Only in the most severe cases of pathological childbirth, when the woman in labor and the fetus were threatened with death, did the “grandmothers” call for help from a surgeon, who most often used a fruit-destroying operation. In addition, the surgeon was not invited to every woman in labor, but mainly to the woman in labor of the wealthy class. The rest, insolvent women in childbirth, were satisfied with the help of the “grandmother” and instead of real obstetric care received from them slandered water, an amulet, or one or another ignorant benefit. It is not surprising that with such assistance, in case of non-compliance with elementary hygiene requirements, the mortality rate in childbirth and in the postpartum period was very high. Pregnant women lived under constant fear of death. Correction of the misposition of the fetus by rotation, this great achievement of antiquity, was forgotten or not used by most doctors.

History of the development of gynecology. Ancient world

The history of medicine indicates that in ancient times the development of obstetrics, gynecology and surgery went side by side; in the books of Moses, the Prophets, the Talmud, etc., there is clear information about midwives, menstruation, women's diseases and how to treat them. Judging by the books of Hippocrates, the knowledge of gynecology at that time (400 BC) was quite extensive, and in gynecological examinations even then they resorted to palpation and manual diagnosis; manual examination techniques were considered necessary to determine displacement, prolapse and inclination of the uterus, the presence of tumors, and suffering of the uterine cervix and sleeve. In ancient times, gynecological instruments were also used; thus, during the excavations of Pompeii, a three-leaved arm mirror was found, which was opened by means of a screw; Pavel Eginsky mentions the arm mirror. Ways to treat women's diseases were practiced in ancient times - local: smoking, douching, pessaries, banks, poultices, lotions, etc .; and internal: laxatives, emetics, herbs and roots special for women, etc.

Gynecologist in the Middle Ages. Obstetrics and Gynecology in the Middle Ages

In the Middle Ages, although gynecology was revived, it fell under the influence of mysticism and pseudoscientific ideas. Medicine, and, in particular, obstetrics and gynecology, developed rather poorly due to the fact that science was influenced by the church and religion. Religion planted absolutely fantastic ideas like the dogma "of the Immaculate Conception". Any dissent was persecuted and sometimes accompanied by expulsion from his native country and the Inquisition.

During the period of the classical Middle Ages, when scholasticism dominated in Western Europe and universities were mainly engaged in compiling and commenting on individual manuscripts of ancient authors, the doctors and philosophers of the medieval East preserved and enriched the valuable empirical heritage of the ancient world (Abu Bakr al-Razi, Ibn Sina, Ibn Rushd other).

Yet medicine continued to evolve. So, in Byzantium in the 9th century, a higher school was founded for the first time, in which various scientific disciplines and medicine were studied. However, obstetrics continued to remain at a very low stage of development. Obstetrics in the Middle Ages was considered low and indecent for male doctors. Delivery continued to be in the hands of midwives. Only in the most severe cases, when the woman in labor and the fetus were in danger, did they resort to the help of an experienced surgeon, who most often used a fruit-destroying operation. It is worth noting that mainly women in labor of the wealthy class had the opportunity to use the help of a surgeon. Women in labor of lower origin had to do with the help of "grandmothers". As you know, the Middle Ages were characterized by a disastrous sanitary and hygienic situation. Thus, one should not be surprised that if the elementary requirements of hygiene were not observed, mortality in childbirth and in the postpartum period assumed enormous proportions.

The founder of obstetrics in Europe in the middle of the XVIII century is considered. Middle Ages

Medicine during this period was strongly influenced by religion, so it developed rather poorly. The Church propagated absolutely fantastic ideas like the dogma "of the Immaculate Conception". Any critical statements about such views on the part of scientists and doctors caused their persecution, expulsion from their native country and torture by the Inquisition. It is quite clear that such a situation had a disastrous effect on the development of obstetric science. Yet medicine continued to evolve. So, in Byzantium in the 9th century, a higher school was founded for the first time, in which scientific disciplines were studied, including medicine. History has preserved for us the names of the Byzantine physicians Oribasius, Paul (from Aegina) and others who continued to develop the legacy of their predecessors.

Centers higher education, including the medical one, there were universities that began to appear from the 11th century. There were very few university students. Theology was the basis of all sciences. The dominant form of ideology at that time was religion, which permeated all teaching, which proceeded from the premise that all possible knowledge was already taught in the Holy Scriptures.

However, although in the early and middle periods of feudalism (from the 5th to the 10th century and from the 11th to the 15th century) religion and scholasticism were a brake on the development of science, among doctors there were those who not only studied from the books of Hippocrates, Soranus, Celsus, Paul, but also continued the study of nature and its phenomena. And yet obstetrics remained at a very low stage of development. Obstetrics in the Middle Ages was considered low and indecent for male doctors. Midwives were still involved in childbirth. Only in the most severe cases, when the woman in labor and the fetus were threatened with death, did the midwives call for help from a male surgeon, who most often used a fruit-destroying operation. In addition, the surgeon was not invited to every woman in labor, but mainly to wealthy women. The rest were satisfied with the help of the "grandmother" and instead of the actual obstetric care received from them hexed water or an amulet. It is not surprising that with such assistance, if the elementary requirements of hygiene were not observed, the mortality rate in childbirth and in the postpartum period was very high. Correction of the incorrect position of the fetus by rotation - this is a great achievement of antiquity - was forgotten or not used by most doctors.

The founder of gynecology in Russia. Development of domestic obstetrics and gynecology

In Russia, the emergence of obstetrics dates back to the middle of the 18th century, but this was preceded by a centuries-old pre-scientific period. Assistance during childbirth was usually provided by sorceresses and midwives (to give birth meant to receive a baby), who had only random information and primitive skills. The first legal provisions concerning the activities of midwives were issued by Peter I and were caused by the economic interests of the state (huge infant mortality, declining birth rates). The state of obstetric care worried the advanced people of Russia, was reflected in their writings. So the great Russian scientist M.V. Lomonosov, in his letter "On the Reproduction and Preservation of the Russian People" (1761), considered it necessary to "compose instructions in the Russian language" on midwifery, to organize "hospice houses" for illegitimate children. A significant role in the preparation of midwives and the teaching of obstetrics belongs to the outstanding organizer of military medical affairs and healthcare in Russia P.Z. Kondoidi (1720 - 1760). At his suggestion, the Senate was issued, in accordance with which in 1757 the first "woman's" schools for the preparation of midwives were opened in Moscow and St. Petersburg. Teaching in schools consisted of a three-year theoretical course in midwifery and practical classes, conducted in German and Russian. P.Z. Kondoidi created the first public medical library in the country at the Medical Office, obtained permission to send Russian doctors abroad to improve and prepare for teaching. The first obstetric institutions in Russia were opened in Moscow (1764) and St. Petersburg (1771) in the form of midwives for 20 beds. The founder of domestic obstetrics is N.M. Maksimovich - Ambodik (1744-1812). He wrote the first manual on obstetrics in Russian, "The Art of Wives, or the Science of Womanhood" (*1764 - 1786). He introduced the teaching of obstetrics in Russian, conducted classes at the bedside of women in labor or on a phantom, introduced obstetric forceps into practice. In 1782 he was the first of the Russian doctors, was awarded the title of professor of obstetrics. Being a scientist - encyclopedist, he left fundamental works on botany and pharmacognosy, founded Russian medical terminology.

Formation of obstetrics and gynecology as independent clinical disciplines. Obstetrics and gynecology in the Middle Ages and modern times

During the period of the classical Middle Ages, scholasticism dominated Western Europe, and the universities were mainly engaged in compiling and commenting on individual manuscripts of ancient authors. About fifteen centuries lasted a period of oppression of progressive thought in medicine. Numerous wars of the Middle Ages contributed to the development of surgery, academic scholastic medicine was useless during hostilities, doctors were needed there who were able to accumulate experience in surgical activities, use and transfer it to others. However, it was during this period that the first universities began to emerge that trained doctors, and the hospital form of medical care finally took shape.

The valuable empirical heritage of the ancient world was preserved and enriched by doctors and philosophers of the medieval East. Little is known about pre-Islamic medicine in medieval Arab history. In the future, it, like the entire culture of the Arab world, developed in accordance with and within the framework of the ideology of Islam, reaching in the 9th-10th centuries. highest flourishing. Arab and Central Asian doctors enriched practical medicine with new observations, diagnostic techniques, and therapeutics. The literary heritage of Arab and Central Asian doctors contains many quite rational recommendations on the hygiene and nutrition of pregnant women, the care of newborns and infants, and their feeding.

In Russia, not only in a village or city, but also in the capital, royal and boyar wives gave birth in most cases with the help of midwives, the level of medical knowledge of which was low. Foreign doctors invited to Moscow to the royal court also had poor obstetric skills. Many of them went to Muscovy for the purpose of personal gain.

Midwives, or midwives, in Russia were called women helping a woman in labor. In most cases, they were invited during difficult childbirth, in mild cases they were invited after childbirth to tie the umbilical cord and swaddle (swaddling) the newborn. Also, midwives performed established customs and conspiracies from ancient times.

During the Renaissance, the development of scientific anatomy and physiological knowledge created the prerequisites for the development of scientific obstetrics and gynecology. Both of these directions from ancient times to the XIX century. were not divided, the doctrine of women's diseases was an integral part of the doctrine of obstetrics. The first extensive guide in Western Europe "On Women's Diseases" ("De mulieram affectionibus") was compiled in 1579 by Luis Mercado. - Professor at the University of Toledo (Spain). Of great importance for the development of obstetrics and gynecology was the activity of Ambroise Pare, who, without having received a medical education and without a medical title, became a surgeon and obstetrician at the court of the king. The great Frenchman gave new life turning the fetus on a leg after several hundred years of oblivion and resumed the practice of caesarean section at the death of a woman in labor. Pare introduced gynecological mirrors into widespread practice and organized the first obstetric department and the first obstetric school in Europe at the Parisian Hotel-Dieu hospital. At first, only women were accepted into it; The training lasted three months, of which six weeks were dedicated to practical training. A. Pare's students were the outstanding French surgeon and obstetrician J. Guillemot (1550-1613) and the very popular midwife L. Bourgeois (1563-1636) in her time - the author of the book "On Fertility, Barrenness, Childbirth and Diseases of Women and Newborns" (1609).

Gynecology (from the Greek words: gyne - woman and logos - science) is a science that studies the structural features and physiological processes that occur in a woman's body from childhood to old age, as well as diseases of the female genital organs that occur outside of pregnancy and childbirth. Modern obstetrics and gynecology are a single clinical discipline.

The history of the development of gynecology is in close connection with the formation of all medical knowledge accumulated during the existence of mankind. In particular, gynecology is sometimes inseparable from obstetrics and is in close connection with related sciences - surgery, therapy, neurology.

According to written sources, gynecology is the oldest field in medical science. The first mentions of the solution of issues related to gynecology in its modern sense are already found in the most ancient Indian, Greek, Egyptian, Slavic written monuments.

So, references to women's diseases, their treatment, the menstrual cycle are found in such historical sources as the Talmud, the book of Moses. Great attention to gynecology in such ancient times is also explained by the fact that it is directly related to procreation.

Mentions of gynecology are found in the documents of Hippocrates (4-5 centuries BC), doctors of ancient India and Egypt, among Slavic peoples. Hippocrates described the diagnosis and clinical picture inflammatory diseases of the female genital organs. After Hippocrates, gynecology, like all medicine, has been constantly developing, although rather slowly.

In the Middle Ages, although gynecology was revived, it fell under the influence of mysticism and scholasticism, which was dominant at that time. Only since the Renaissance, doctors began to collect material for the construction of the building of scientific gynecology. Gynecology began to actively develop in the 16th century, when the structure of the female body and its features were accurately studied and described in scientific works. Scientists of that time A. Vesalius and T. Bartholin contributed to the development of this branch of medicine by studying the anatomy and physiology of the female reproductive system.

From the 18th century gynecology took shape as an independent science. The Russian doctor N. M. Maksimovich-Ambodik in the first Russian original manual "The Art of Giving" (1784-86) paid much attention to physiology, pathology, diagnosis and prevention of gynecological diseases. The progress of gynecology was greatly facilitated by the opening of gynecological clinics and higher medical institutions. educational institutions in Russia (the first gynecological department was established in 1842 in the obstetric clinic of the St. Petersburg Medical and Surgical Academy) and abroad.

Gynecology received significant development at the beginning of the 20th century thanks to the research of Russian, American and German scientists. In the first half of the 20th century, important steps were taken in the field of diagnosis and treatment of many gynecological diseases. In the middle of the 19th century, the first centers of obstetrics and gynecology began to emerge. At the dawn of the 20th century, the surgical direction in gynecology began to develop.

In Russia, gynecology for a very long time was connected with obstetrics and even childhood diseases; in some medical institutes, these three departments are still connected together. The development of operative gynecology was facilitated by the achievements of anesthesiology, the use of antibiotics, blood transfusions, the development effective fight with shock and terminal states and improvement of operational techniques.

In 1903, Snegirev, the founder of gynecology in Russia, spoke out against the one-sided enthusiasm for surgical interventions. He was the first to express an opinion on the relationship between the local process and the state of the whole organism. Subsequently, this point of view in gynecology has become generally accepted.

The study of methods of radiation therapy made it possible to use it in gynecology in the treatment of malignant neoplasms of the female genital organs. The use of the colposcope, proposed in 1925 by the German physician X. Hinselman, and the method of cytological examination, introduced in 1933 by the American scientist G. Papanicolaou, expanded the diagnostic possibilities in gynecological examinations.

In Russia and abroad, the following issues are being developed: issues of physiology and pathology of female genital organs, gynecological oncology; problems of menstrual dysfunction, endocrine disorders; mechanisms of development and treatment of inflammatory diseases of the female genital organs; issues of operative gynecology, urogynecology and pediatric gynecology.

A method of radical surgery for uterine cancer was developed and spread (by the Austrian scientist E. Wertheim and Russians - A. P. Gubarev, I. L. Braude, S. S. Dobrotin and others). The development of operative gynecology was facilitated by advances in anesthesiology, the use of antibiotics, blood transfusions, the development of an effective fight against shock and terminal conditions, and the improvement of surgical techniques.

Methods that have been widely used in the world of gynecology are widely used in modern medicine and help to avoid the most serious complications of many gynecological diseases.

In the twentieth century great strides have been made in theoretical gynecology. In Russia, the problems of theoretical and clinical gynecology are covered in general medical literature and special journals - Obstetrics and Gynecology (since 1936), Issues of Maternal and Childhood Protection (since 1956), etc.

Since the end of the 20th century, the rapid development of cryosurgery, video endoscopy (sparing "crownless" operations on the pelvic organs in case of infertility, tumors of the ovary, uterus), fetal therapy (surgery on the intrauterine fetus), assisted reproductive technologies (in vitro fertilization in case of infertility) have significantly improved the quality of women's lives. The improvement of drugs used in gynecology allows us to successfully solve problems that were impossible for the 50s of the twentieth century. - correction of the menstrual cycle, safe contraception, radical cure for inflammatory diseases, regression of small benign tumors of the ovaries and uterus.

The introduction of evidence-based medicine (medicine based on controlled randomized trials and meta-analysis) has made it possible to introduce standard diagnostic and treatment protocols into clinical practice that are truly proven, reliable, and safe.