Doctor surgeon n and pies. Pirogov nikolay ivanovich - biography, photo, medicine, personal life of the surgeon

Pirogov and sisters She walked next to a tall wagon loaded with wounded. Quite recently, the dead were brought to the Grafskaya pier in the same wagons, and then the non-commissioned officer, nicknamed Charon, transported them to the North side - to bury ... Now between the South and North sides

" The people who had their own Pirogov have the right to be proud,
since a whole period of development of medical science is associated with this name.
Principles introduced into science (anatomy, surgery) by Pirogov,
will remain an eternal contributionand cannot be erased from its tablets,
as long as European science exists,
until the last sound of rich Russian speech stops at this place".
N.V. Sklifosovsky

"Like all great people Pirogov, already at the earliest stage of his life, felt ina broad program of his existence and fulfilled it all to the end, despite its complexityness and sizes. Throughout his life, he showed an extraordinary, persistent, unremitting deedfitness. Gifted with colossal self-control, he was firm, patient, courageous, cheerfully carried
forces blows of fate. Unbreakable will was the main nerve of his nature and gave him the opportunity to lay and build a building where the soil was not yet ready. With rare willpower, he combined the depth and insight of a gentle heart, which gave him the opportunity to feel the pulse of life and events where the gaze of an ordinary person did not notice anything. "
I.A. Sikorsky

N ikolai Ivanovich Pirogov was born in Moscow on November 13 (25), 1810 in a strong, pious (the family strictly and with conviction observed all religious rites) and patriarchal large family (the family had fourteen children, most of whom died in infancy) family. The grandson of a serf peasant, he recognized the need early. His father, Ivan Ivanovich, served as treasurer, major in the provision depot, was a commission agent of the 9th class. Nikolai Ivanovich's parents firmly instilled the system-forming qualities of his personality: true religiosity, sincere patriotism, and deep love for Russia. This was due to the fact that religious education left a deep imprint on the boy's soul and, undoubtedly, to a large extent determined the shape of his further views. And patriotism was based on the stories of his father - a participant in the Patriotic War of 1812. Pirogov carried the image of his father's saber in an old sheath throughout his life. In 1815, a collection of cartoons was published - “Gift for children in memory of 1812”. Each caricature was explained by verses. From these cartoons, Nikolai learned to read and write. I read with pleasure and a lot. One of his first books - "Spectacles of the Universe": pictures with explanations in Russian, in German, in Latin. This little encyclopedia included stories about the earth and the sky, about metals and stones, about animals and plants, about human activities and about inanimate bodies. Nikolai liked the adventures and travels of Vasco da Gama, Don Quixote, Robinson Crusoe, and enjoyed reading Zhukovsky, Derzhavin, Krylov.

An acquaintance of the family, a well-known Moscow doctor, professor of Moscow University, E.O. Mukhin, who noticed the boy's abilities and began to study with him individually. At the age of eleven, Nikolai entered Kryazhev's private boarding school. The course was paid there and lasted for six years. The students of the boarding house were prepared for the civil service. Ivan Ivanovich hoped that his son would receive a good education and be able to achieve a “noble” noble title. He did not think about his son's medical career, since at that time medicine was the occupation of commoners. Nikolai studied at the boarding school for two years, then the family ran out of money for education.
When Nikolai was fourteen years old, he entered the medical faculty of Moscow University. To do this, he had to add two years to himself, but he passed the exams no worse than his older comrades. Pirogov studied easily. In addition, he had to constantly earn extra money to help the family. The father died, the house and almost all the property went to pay off the debts - the family was immediately left without a breadwinner and homeless. Sometimes Nikolai had nothing to wear to lectures: his boots were thin, and his jacket was such that it was a shame to take off his overcoat. Finally, Nikolai managed to get a job as a dissector in the anatomical theater. This work gave him invaluable experience and convinced him that he should become a surgeon.
At Moscow University, the teenager Pirogov found himself involved in the activities of the free-thinking student social literary "circle number 10" (in a dorm room). And although the views of Pirogov himself invariably remained quite conservative, his student years led to the addition of two important features of his personality: they instilled a deep and unchanging interest in public life, and also predetermined the broad democracy that so distinguished him in subsequent years. But at the same time, all this student atmosphere for a long period caused his cooling towards religion. He becomes a materialist.
At the age of 17 and a half after graduating from Moscow University and becoming a first-class doctor, Pirogov decided to enter the Professorial Institute opened at the Imperial Dorpat University (at that time he was considered the best in Russia). Exams for applicants had to be taken at the Imperial St. Petersburg Academy of Sciences. In 1828 he successfully passed the tests and was accepted for training.
To understand the peculiarities of educational institutions in Russia, one should touch on some of the innovations of the Russian emperors. In the first decades of the XVIII century. Peter I is considering various options for the development of science and higher education in Russia, in the last years of his life he made an extraordinary decision. On January 28 (February 8), 1724, by order of Emperor Peter I, the Senate established the Academy of Sciences and Arts with a gymnasium and a university attached to it, where the decision of Peter I was announced to establish an Academy, in which they would study languages, and other sciences. Peter I contributed to the creation of the Russian Academy of Sciences, proceeding from the interests of the state, so that not only glory spread, but the development of sciences and their education took place. It is important to note that the Academy of Sciences and Arts was created, and with it a university, and not vice versa. The regulations of the Academy were prepared by the Emperor L.L. Blumentrost, who also became the first president of the Academy.
Almost a century passed, and in 1811 Emperor Alexander I made a decision to create a special educational institution to train the elite of society in the system of government. On October 19, 1811, the Tsarskoye Selo Lyceum was opened. This is a new kind educational institution, which represented a compromise between the gymnasium, the cadet corps and the university. Its peculiarity was that the pupils had to receive an encyclopedic versatile education, serve in the higher institutions of the Russian State.
A decade later, the idea of \u200b\u200btraining a professorship in medicine is being developed. It should be noted that initially the preparation of Russian scientists for professorship was carried out individually at various universities in Russia and abroad. But then, in connection with the progress of the higher education system and the organization of new universities, it was decided to improve the training of new professors and teachers and create a special Professorial Institute for this.
The idea of \u200b\u200borganizing the Professorial Institute dates back to the late 20s of the 19th century. It originated in St. Petersburg at the Russian Academy of Sciences. It was then that the famous physicist and teacher, Academician Georg Friedrich (Yegor Ivanovich) Parrot (formerly rector of the University of Dorpat) developed a project to create an institute that would train highly qualified teachers and scientists, teachers and professors for all Russian universities. The idea was to select from all universities about two dozen best students or young graduates - "natural Russians" - and send them to Dorpat for five years so that they can complete a full course of study in their chosen specialty, and then go for another two years. abroad for further improvement. This is necessary to prepare "a class of natural Russian professors, true scientists worthy of this name."
This project was supported by progressive-minded scientists and public figures, in particular the outstanding navigator I.F. Kruzenshtern. After detailed consideration by various authorities, the opening was finally accepted. It was decided to organize the institute at the University of Dorpat - the most capable and gifted graduates of both the oldest Moscow and Vilnius universities, as well as the relatively young Petersburg, Kharkov and Kazan universities, were to study here.
Over the ten years of its existence, the Professorial Institute (1828-1838) trained and educated specialists who played an essential role in the development of science. Suffice it to recall the names of professors Alexander Petrovich Zagorsky (1805-1888), Ignatiy Iakinfovich Ivanovsky (1807-1886), Fedor Ivanovich Inozemtsev (1802-1869), Karl Fedorovich Kessler (1815-1881), Stepan Semenovich Kutorg (1805-1861) , Petr Grigorievich Redkin (1808-1891), Alexei Matveevich Filomafitsky (1807-1849), Alexander Ivanovich Chivilev (1808-1867), full members of the Imperial St. Petersburg Academy of Sciences (ISPbAN) Mikhail Semenovich Kutorga (1809-1886) and Alexei Nikolaevich Savich (1810-1883). The development of the scientific center around the University of Dorpat was facilitated (as always in Russia, by the way) by the goodwill of the "top officials" - Emperors Alexander I and Nicholas I.
On October 4, 1827, Nicholas I approved the creation of the Professorial Institute - "There are worthy professors, but they are few and they have no heirs, they must be trained, and for this the best students should be sent ... to Dorpat, and then to Berlin or Paris, and not alone, but with a reliable boss for two years; all this must be done immediately. ”The applicants were to be examined at the Imperial St. Petersburg Academy of Sciences.
Three doctors, two candidates (among them the rector of St. Petersburg University, senator and member of the State Council Peter Redkin) and two students - Alexander Shumansky and Nikolai Pirogov were selected at Moscow University. In August, the group arrived in the capital at the checkpoints to conduct tests in order to determine the level of their training. Doctors were examined by two venerable professors of the Imperial Medical-Surgical Academy (IMHA). The first was the physiologist and anatomist Danilo Mikhailovich Vellansky (1774-1847), a philosopher (he was often called "Russian Schelling"), the author of the first Russian textbook on physiology.
The second examiner was the surgeon Ivan Fedorovich Bush (1771-1843), who created a scientific school, the author of the first Russian manual on surgery, which went through five editions and for many years was a reference book for students and doctors. In 1832, one of his students, St. Petersburg obstetrician Andrei Martynovich Wolf (? -?), Using the apparatus and technique of obstetrician James Blundell (J. Blundell, 1790-1877), carried out the first successful blood transfusion in Russia, which saved the life of a woman in labor with bleeding.
The first group of applicants took exams in June 1828, and in July they left for Dorpat. Teachers N.I. Pirogov at the Professor's Institute were - surgeon I.F. Moyer (1786-1858) - a major surgeon from the school of the Italian anatomist A. Scarpa, physiologist and pathologist I.F. Erdmann (1778-1846), anatomist, embryologist, pathologist, physiologist M.G. Rathke (1793-1860). In Derpt (now Tartu) Pirogov rolled up his sleeves and got into practice. He listened to the lectures of the professor of surgery Moyer, was present at operations, assisted, sat up until dark in the anatomical, dissected, performed experiments. In his room the candle did not go out even after midnight - he read, took notes, extracts, tried his literary strength. After 3 months of stay in the clinic I.F. Moyer, he sent to Moscow for publication his first work "Anatomical and pathological description of the femoral-inguinal part relative to hernias ..." (Herald of natural sciences. 1829. Part 2, No. 5. P. 68-69).
Such a quick and fruitful beginning of research activity was immediately distinguished by N.I. Pirogov from among the cadets and revealed his tendency towards anatomical and physiological substantiation of surgical activity, which remained throughout his life. At the university, Nikolai met Vladimir Ivanovich Dal, who in those years studied at the medical faculty of the University of Dorpat. He was older than Pirogov and had already managed to retire (it was said that the caustic satire on the admiral helped the early retirement). At the clinic, they worked a lot together and became great friends. In the surgical clinic N.I. Pirogov worked for five years.
At the Professorial Institute N.I. Pirogov prepared his doctoral dissertation on the topic "Is the ligation of the abdominal aorta for aneurysms of the groin area an easy and safe intervention?" Its originality lay in the experimental substantiation of the expediency of such interventions and was later used by Pirogov himself in a clinical setting.
On June 9, 1832, the work was presented for publication, on August 31, 1832, a thesis for the degree of Doctor of Medicine was defended, and on November 30, 1932 N.I. Pirogov was approved for the degree of Doctor of Medicine. The dissertation analyzed the structure and function of the abdominal aorta, its position in relation to neighboring organs, methods of exposing the abdominal aorta, painful changes that cause the need for ligation, the consequences of ligating the abdominal aorta. In the dissertation, as in other works of N.I. Pirogov, the initial idea, methods of solving a fundamental problem, methods with which it is possible to achieve results in solving applied problems of clinical medicine are clearly formulated.

Pirogov defended his doctoral dissertation. Hood. V. Pirogov.

After defending his doctoral dissertation, he was sent to Germany. The young professor came abroad, able to take what is needed, to discard what is unnecessary, confident in his abilities. While in Berlin, he was shocked that "practical medicine is almost completely isolated from its main real foundations: anatomy and physiology." For example, K. Grefe, during the operation, inquired from the anatomist F. Schlem, who was standing nearby: "Does the trunk or branch of an artery pass through here?" D. Dieffenbach did not believe in the serious complications that the surgeon who did not know the anatomy "presented" to the patient. Its principle was simple: "Saw bones, cut soft tissues, bandage bleeding vessels." But in Göttingen, Pirogov was delighted with the technical perfection of the operations of Konrad Langenbeck (Bernhard Langenbeck's uncle). Here he learned "... not to hold the knife with a full hand, with a fist, not to put pressure on it, but to pull, like a bow, along the cut tissue."

N.I. Pirogov and K.D. Ushinsky in Heidelberg. Hood. A. Sidorov.

During his studies and practical activities N.I. Pirogov at the University of Dorpat and in Germany, there is an important internal stage in the formation of his worldview. There are undoubtedly two important factors here. First of all, the great German philosophy of the early nineteenth century, literally permeated with universal human ideas, striving for the Absolute, high idealism, as well as the works of German idealist teachers, had a deep influence on the young man. It was in the enlightenment and romantic thought of Germany of that time that the ideal was formed as a special concept of value, in particular, moral consciousness and ethical reasoning. All this later laid the foundation for Pirogov's philosophy of education. At the same time, the humanistic ideal of N.I. Pirogov was closely linked with the development of a whole direction in pedagogy - with "humanistic pedagogy", the essence of which is attention to the pupil as an integral unique person striving for the maximum realization of his capabilities (self-actualization), the use of his abilities aimed at the expedient resolution of life situations.
One cannot but emphasize one more important circumstance. It is impossible to understand the nature of all the moral qualities that were organically characteristic of Pirogov and so amazed his contemporaries - internal freedom, human dignity, respect for the individual in all spheres of life, firmness in his moral convictions and selflessness of the soul without understanding that these traits were formed during his life in the West (included into the Russian Empire Dorpat is also, undoubtedly, a phenomenon of Western civilization), and not in Nikolayev's Russia, where a person with such moral qualities could not take place and would sooner or later be broken by the bureaucratic machine.
Returning home, Pirogov fell seriously ill and was left for treatment in Riga. Riga was lucky: if Pirogov hadn't been ill, it would not have become a platform for his rapid recognition. As soon as Pirogov got up from the hospital bed, he undertook to operate. The city had heard rumors of a promising young surgeon before. Now it was necessary to confirm the good fame that had fled far ahead. He started with rhinoplasty: a noseless barber carved out a new nose. Then he recalled that it was the best nose he ever made in his life. Plastic surgery was followed by the inevitable lithotamiya, amputation, removal of tumors.
From Riga he went to Dorpat, where he learned that the Moscow department promised to him had been given to another candidate. But he was lucky - Ivan Filippovich Moyer gave his student his clinic in Dorpat. In 1836, at the age of 26, N.I. Pirogov was elected head of the clinic for theoretical, operative and clinical surgery at the University of Dorpat. It was not easy: "Most of the theologians rebelled against me. They said that ... only Protestants could be university professors." The new "Herr Professor" is strict, he has already seen enough of the Germans who do not know. A student who passed anatomy with a "C" did not have the right to take a scalpel in his hand. For each student there is a hundred questions and one, the last one, "Why?" shows tremendous diligence in surgical activity.Two years before the start of his work in the clinic, only 92 operations were performed, and under his management over the next 2 years - 326, and for all 4 years of his work 1391 people received surgical treatment on an outpatient basis - 656 patients.

A wonderful doctor. Hood. K. Kuznetsov and V. Sidoruk.

He subjected his surgical activity to a serious critical analysis in two issues of the "Annals of the Surgical Department" published during this period (1837 and 1839), which, in his words, "put his finger in the wounds of many clinical teachers." This caused bewilderment and indignation among some of the professors, and only a few sympathized. In them, he "by the correct open admission of his mistakes and by means of revealing their intricate mechanism, he wanted to save his students and novice doctors from repeating them." He already wrote then that “... when I first entered the department, I made it a rule not to hide anything from my students, and if not immediately, then immediately disclose to them the mistake I made, whether it would be in the diagnosis or treatment ". In 1907 I.P. Pavlov noted in this regard: "Such a merciless frank criticism of himself and of his activities is hardly found anywhere in the medical literature, and this is a great merit."
In addition, being the head of the surgical clinic in Dorpat, N.I. Pirogov continues to work on the study of anatomy, physiology and surgical approaches to operations on large vessels. A year later, in 1837, he published the work "Surgical Anatomy of the Arterial Trunks and Fibrous Fascia" - an atlas in Latin, a text in German. These works soon became known not only in Russia, but also abroad. Before Pirogov, they did not deal with fascia: they knew that there were such fibrous fibrous plates, membranes surrounding muscle groups, stumbled upon them during operations, cut them with a knife, not giving them any importance. Pirogov studied the direction of the fascial membranes, their position, discovered certain anatomical patterns. Pirogov's monograph "On the transection of the Achilles tendon as an operative-orthopedic means of treatment" (1837) is admired by specialists.
In 1838 for six months N.I. Pirogov went to study in France, where five years earlier, after the professorial institute, his superiors did not want to let him go. In Parisian clinics, he gets acquainted with teaching and hospital practice in the clinics of the famous French surgeons D. Lisfranc, F.-J. Roux, D. Amyussa. He meets with the famous surgeon and anatomist A. Velpeaux (Paris), a student of the outstanding French anatomist and physiologist M.F. Bisha. When N.I. Pirogov in A. Velpo's office, the latter was busy studying the book "Surgical Anatomy of the Arterial Trunks and Fibrous Fascia" and gave it a very high rating. He said: "It is not for you to learn from me, but to me from you."
N.I. himself Pirogov wrote that "... from the very first entry into the educational and practical field, he put anatomy and physiology at the foundation at a time when this direction - now common - was still new, ... not recognized by all and even by many significant authorities denied. ... My works could not fail to attract attention. " They "... showed for the first time with precision and visualization the relation of the fascia to the arterial trunks and pointed out the methods most convenient and accurate for the production of operations."
Direct confirmation of the clinical orientation of the anatomical studies of N.I. Pirogov in studying the possibilities of ligation of large vessels and the anatomy of their fibrous fascia is his exceptional experience in ligation of large arteries in 69 patients with aneurysms, malignant neoplasms, telangiectasias and bleeding, and success was achieved in 32 people ("The beginning of general military field surgery" , 1866). It seems that the study of the surgical anatomy of the arterial trunks and fibrous fascia by N.I. Pirogov formed the basis for the development of many operations in world surgery, and especially in the development of vascular and military field surgery, as well as other areas. Even at present, the principles of N.I. Pirogov are also used in the development of modern methods for the isolation of vascular formations in the liver gate during hemihepatectomy.
On April 17, 1841, an extraordinary meeting of the Academy of Sciences was held to analyze the essays submitted to the Demidov competition. "Half prize was awarded to NI Pirogov for his work" On the surgical treatment of arteries "(St. Petersburg, 1839). His work" Surgical anatomy of arterial trunks and fascia "was published in 1837 in Latin, in 1840 it was translated NI Pirogov received four Demidov prizes - in 1841 and 1844, and then back in 1850 and 1860 he was awarded these high awards.
On January 18, 1841, Nicholas I approved the transfer of Pirogov from Dorpat to St. Petersburg to the post of head of the clinic of hospital surgery and pathological anatomy of the St. Petersburg Medical-Surgical (now - Military Medical) Academy, which he headed until 1856. To the audience where he read a course of surgery , there were about 300 people crowded. Not only doctors were crowded on the benches, students from other educational institutions, writers, officials, military men, artists, engineers, even ladies came to listen to Pirogov. Newspapers and magazines write about him, compare his lectures with the concerts of the famous Italian Angelica Catalani: his speech about cuts, sutures, purulent inflammations and the results of autopsies is divine singing! Despite the hostility of the management, Nikolai Ivanovich is seeking to implement his ideas - he expands the clinical base of the department to 2000 beds, introduces new methods of teaching anatomy and surgery - clinical rounds with a detailed analysis of patients' illnesses, student duty. Organization at the suggestion of N.I. has become extremely important in teaching medicine. Pirogov, the world's first hospital surgical clinic, where, first here, and then in other educational institutions, students began to be taught directly in the treatment of patients.

Demonstration operation in the Pirogov clinic. The artist is not known.

Nikolai Ivanovich was appointed director of the Tool Factory. Now he comes up with tools that any surgeon can do the operation well and quickly. He is asked to accept a consultant position in one hospital, in another, in a third, and he agrees.
In the literature there are references to the election of N.I. Pirogov to the Russian Academy of Sciences, but it was of undoubted interest to find the original documents concerning his election, a more complete understanding of the conditions of this event. In the St. Petersburg branch of the RAS Archive, it was possible to find many documents written by N.I. Pirogov, materials related to the award of the Demidov Prize to him, the original minutes of his election as a corresponding member. On Wednesday, November 27, 1846, a secret ballot was held for the elections to the Imperial St. Petersburg Academy of Sciences of the members of the Department of Physical and Mathematical Sciences. The Branch of the Academy included 18 academicians, the following took part in the voting: K.M. Baer, \u200b\u200bP.A. Zagorskiy, A. Ya. Kupfer, M.V. Ostrogradsky, V. Ya. Struve, E.H. Lenz, B.S. Jacobi, Yu.O. Fritzsche, H.P. Peters, G.P. Gelmersen and others. There were 7 candidates on the secret ballot list, among them number 7 is the name of N.I. Pirogov. 14 members of the Academy voted for Pirogov and he was elected.
December 5, 1846 N.I. Pirogov at the age of 36 was approved as a corresponding member of the Imperial St. Petersburg Academy of Sciences. Below are archival data not only about the elections of Nikolai Ivanovich, but also how life at the Academy was organized according to the Charter of the 19th century, which made the ordinary academician and corresponding member different from the modern understanding of these academic titles, as in the 19th century. and at the beginning of the XX century. evaluated the role of Nikolai Ivanovich in the development of fundamental science. The life of the Academy was subordinated in the first years of its organization in the 18th century. Regulations, and then the Charter of the Academy was prepared. The election of N.I. Pirogov took place in accordance with the Charter of the Imperial St. Petersburg Academy of Sciences, which was approved in 1836 and operated until 1927, when it was formed on the basis of the Russian Academy of Sciences in the new country of the USSR Academy of Sciences and a new Charter was adopted - the Charter of the USSR Academy of Sciences. According to the Charter of 1836, the Academy of Sciences was recognized as "the leading academic estate in the Russian Empire." The number of ordinary academicians was determined at 21 people - all of them must have worked at the Imperial Academy of Sciences. However, “in addition to the full members, it also elects honorary members and correspondents,” who sit in public and general meetings with academicians if they are in St. Petersburg. This provision was included in the Charter of 1836 and it must be remembered in order to understand the differences in the semantic content of the title of Corresponding Member of the Academy of Sciences in the 19th century. and XX century. It consisted in the fact that the number of vacancies for full members was limited in the 19th century. not only by the number of places (this has survived to the present), but also by the indispensable provision of a permanent place of work at the Imperial St. Petersburg Academy of Sciences, elections for this position took place only when a vacancy was opened for work at the Academy of Sciences.
In accordance with §4 of the Charter of 1836, the sciences, the improvement of which the Academy should be engaged in, included: Pure and applied mathematics; Astronomy; Geography and Navigation; Physics; Chemistry; Technology; Mineralogy; Botany; Zoology; Comparative Anatomy and Physiology; History; Greek, Roman literature; Eastern literature; Statistics, political economy. According to the voting results, Nikolai Ivanovich was elected a corresponding member in the category of biological sciences of the Department of Physical and Mathematical Sciences of the Imperial St. Petersburg Academy of Sciences, the field of scientific interests is a medical surgeon, anatomist. Among those who participated in the voting was Karl Maksimovich Baer (1792-1862), academician, zoologist. He highly appreciated Nikolai Ivanovich's contribution to science and wrote that the applied anatomy of N.I. Pirogov is an important in its plan, completely original and independent creation, such a feat cannot be marked by anything other than a full wreath. The field of knowledge in accordance with the Charter, according to which the election of N.I. Pirogov, - comparative anatomy and physiology. Many years later, on December 1, 1901, I.P. was elected a corresponding member of the Academy of Sciences in the same specialty. Pavlov. In 1904 he received the Nobel Prize, enjoyed exceptional respect in the scientific community, but only on December 1, 1907 I.P. Pavlov became an ordinary academician (comparative anatomy and physiology) at the Imperial St. Petersburg Academy of Sciences in the same Department as N.I. Pirogov. This became possible when the vacancy of a full member of the Academy opened after the death in 1906 of Acad. F.V. Ovsyannikov.
Following the election results of 1846, together with N.I. Pirogov on the same day, December 5, 1846, in the Department of Physical and Mathematical Sciences, Bischoff and Edwards were approved by foreign members - corresponding members in the biological category of the Imperial St. Petersburg Academy of Sciences. Theodor Ludwig Wilhelm Bischoff, anatomist, embryologist, physiologist. Described the process of breaking an egg (1838). Anri-Milne Edwards - zoologist, physiologist.
Since the creation of the Academy of Sciences in 1824 and up to the present day, its key importance in the Society consists in the development of problems of fundamental science, which plays a special role in the arguments in the election of its members. By the middle of the 40s. XIX century, i.e. by the time of his election to the Academy, N.I. Pirogov made the most significant contribution to human anatomy, he proposed a method and obtained unique results in the development of problems that can be formulated as three-dimensional anatomy. N.I. Pirogov made an invaluable contribution to a number of branches of medicine - the introduction of ether anesthesia, a plaster cast, the principles of sorting the wounded, and some other areas in surgery. These works were highly appreciated not only by contemporaries, but also by outstanding minds of the 20th century.
N.I. Pirogov has repeatedly made reports at meetings at the Academy of Sciences. On April 2, at a meeting of the Physics and Mathematics Department in 1847, K.M. Baer presented an article by N.I. Pirogova "A new method of conducting ether vapors for surgical operations". June 11, 1847 at a meeting of the Physics and Mathematics Department of K.M. Baer presented a brochure to N.I. Pirogov "Practical and physiological studies on etherization". On April 17, 1851, the Demidov Prize for 1850 was awarded to N.I. Pirogov for the work "Pathological anatomy of cholera, with an atlas". On April 17, 1860, the Demidov Prizes for 1860 were awarded - N.I. Pirogov was awarded a prize for his work "Topographic Anatomy".
The deepest impact on the entire personality of N.I. Pirogov was influenced by his ardent appeal to God, which happened in 1848 during the plague epidemic. In the "Diary of an old doctor" he recalled this: "I needed an abstract, unattainable high ideal of faith. And starting to the Gospel, I found this ideal for myself."
So in the personality of Pirogov there was an individualization of the universal ideal - he took on personified forms, transforming into a personal ideal. At the same time, this ideal was concretized in the image of God, while maintaining its absolute characteristics.
In a state of deep spiritual renewal, Pirogov again thinks about higher substances and categories as values \u200b\u200bthat reveal wider perspectives for a person. Gradually, the idea of \u200b\u200beducating "true people" with developed mental abilities, moral freedom of thought and beliefs, who sincerely love the truth and are ready to stand up for it like a mountain, capable of self-knowledge and self-sacrifice, begins to crystallize in him.
This is especially evident in his letters to his future wife, Baroness A.A. Bistorm (1849-50). It is no coincidence that the full title of his famous article is "Questions of Life, an excerpt from forgotten papers published by the unofficial articles of the Marine Collection on education."
Since the duties of N.I. Pirogov included the training of military surgeons, he began to study the surgical methods widespread at that time. So, in 1854 Pirogov published in Russian and German the article "Osteoplastic lengthening of the shin bones during foot peeling" - the advantage of this work is that "a piece of one bone, being in conjunction with soft parts, grows to the other and serves ... to the lengthening of the limb ", making it possible to use its support function. Thus, he laid the foundation for osteoplastic operations in the world of surgery, which served as one of the grounds for performing organ-preserving operations for wounds of the limbs with damage to the bones. N.I. Pirogov emphasized that earlier such injuries served as an indication for amputations, and he, in addition to the principle of osteplastic interventions, suggested, according to appropriate indications, strive to treat open fractures by immobilizing the limbs in a "starch" bandage, i.e. by imposing even a deaf plaster bandage in 1847, and thereby improved the possibility of healing bone and soft tissue wounds and began to preserve the function of the limbs.
All this became possible due to the fact that, less than six months after the report on the first ether in anesthesia, N.I. Pirogov in February 1847 in St. Petersburg began to use "etherification" in surgical interventions, while about 400 out of 600 he made himself. (Note - The world's first operation under ether anesthesia was performed on October 16, 1846 in a Boston clinic (USA) by William Morton. A submandibular tumor was removed).

After operation. Hood. L. Koshtelyanchuk.

But not only well-wishers surrounded the scientist. He had a lot of envious people and enemies who hated the doctor's zeal and fanaticism. In the second year of his Petersburg life, Pirogov fell seriously ill, poisoned by hospital miasms and the bad air of the dead. I couldn't get up for a month and a half. Then he met Ekaterina Dmitrievna Berezina, a girl from a noble, but collapsed and severely impoverished family. A hasty, modest wedding took place. Having recovered, Pirogov again plunged into work, great things were waiting for him. He "locked" his wife in the four walls of a rented and, on the advice of acquaintances, furnished apartment. I didn’t take her to the theater, because he disappeared until late in the anatomical theater, I didn’t go to balls with her, because he’s idle balls, he took her novels away from her and slipped scientific journals into her place. Pirogov jealously removed his wife from his friends, because she had to belong entirely to him, as he entirely belongs to science. And the woman, probably, was too much and too little of one great Pirogov. Ekaterina Dmitrievna died in the fourth year of marriage, leaving Pirogov two sons: the second cost her her life. Nikolai Ivanovich's health is upset. He runs from his native walls, where everything reminds of the loss. In March 1847 N.I. Pirogov leaves for Western Europe. He spends all his time in clinics, noting the achievements of K. Langenbeck and D. Dieffenbach in Germany, G. Dupuytren and A. Nelaton - in France, E. Cooper - in England, for whom he was already a recognized authority.
However, in the difficult days of grief and despair for Pirogov, a great event happened - his project of the world's first Anatomical Institute was approved by the highest. Working on its basis, he carried out absolutely exceptional topographic and anatomical (the term was proposed by the author himself) developments, which led to the creation of "sculptural anatomy" by cutting a frozen human body in three directions. As a result of using a special method, sketches of these preparations were made in full size (NI Pirogov was helped by 3 artists). Then, from these drawings, the images were transferred to special printing stones (some of them are still stored at the Military Medical Academy), and then printed in the form of certain tables in special notebooks produced from 1848 to 1856. In total, 995 such drawings were made, to which 4 notebooks of the explanatory text of N.I. Pirogov "Illustrated topographic anatomy of cuts ..." (782 p.). The author wrote that on the basis of this atlas (later in the literature it was called "Ice Anatomy"), he spent 8 years. At the same time, he began to use the method of freezing corpses back in 1842 when publishing a course on applied anatomy (mainly on the image of joints and the head) "Otechestvennye zapiski" in 1860.
At the same time, the publication of "Applied Anatomy" brought N.I. Pirogov has a lot of bitter minutes. The publisher of the Northern Bee magazine F. Bulgarin accused him of plagiarism, claiming that the materials were borrowed from the English surgeon Charles Bell. Nikolai Ivanovich insisted on a judicial investigation, but the case ended with Bulgarin's written apology. The scientist asks for resignation, even the lines of this official paper characterize Pirogov's personality: "... is it possible to be a true doctor and a good mentor without having convictions about the high dignity of his art? Here is a frank statement of the reasons prompting me to leave the service at the academy ... I have never looked for personal gain and therefore I will leave it as soon as my view of my own dignity, which I used to cherish, requires it. " Nevertheless, Nikolai Ivanovich was persuaded not to leave the academy.
In 1847, Pirogov went to the Caucasus to join the active army, as he wanted to test the operational methods he had developed in the field. In the Caucasus, he first applied dressing with bandages soaked in starch. Starch dressing turned out to be more convenient and stronger than the splints used before. Here, in the village of Salta in July 1847, N.I. For the first time in the history of medicine, Pirogov began to operate on the wounded under ether anesthesia in the field. He used ether anesthesia in 100 wounded (in 98 by inhalation through a specially created apparatus and in 2 people by rectal "esterization"). There, instead of amputation, he performed resections of the shoulder (4) and elbow (6) joints. All this was soon published in St. Petersburg and in Paris at the French Academy.

Nikolai Ivanovich Pirogov with his sons. 1850 g.

After the death of Ekaterina Dmitrievna Pirogov was left alone. "I have no friends," he confessed with his usual bluntness. At home, boys, sons, Nikolai and Vladimir were waiting for him. Pirogov twice unsuccessfully tried to marry for convenience, which he did not consider necessary to hide from himself, from his acquaintances, it seems, as well as from the maidens planned for the bride. In a small circle of acquaintances, where Pirogov sometimes spent evenings, he was told about the twenty-two-year-old Baroness Alexandra Antonovna Bistrom, who enthusiastically read and reread his article about the ideal of a woman. The girl feels like a lonely soul, thinks a lot and seriously about life, loves children. In conversation, she was called a "girl with convictions." Pirogov proposed to Baroness Bistrom. She agreed. Going to the estate of the bride's parents, where it was supposed to play an inconspicuous wedding. Pirogov, confident in advance that the honeymoon, disrupting his usual occupations, would make him hot-tempered and intolerant, asked Alexandra Antonovna to pick up crippled poor people in need of surgery for his arrival: work would delight the first time of love!
Not without effort, Corresponding Member. Petersburg Academy of Sciences Pirogov obtained permission to participate in the Crimean War, and in November 1854 he arrived in besieged Sevastopol. Operating on the wounded, Pirogov, for the first time in the history of world medicine, used a plaster cast, giving rise to the saving tactics of treating wounded limbs and saving many soldiers and officers from amputation. During the siege of Sevastopol, to care for the wounded, Pirogov supervised the training and work of the sisters of the Exaltation of the Cross community of sisters of mercy.

N.I. Pirogov and sailor Peter Koshka. Hood. L. Koshtelyanchuk.

The most important merit of Pirogov is the introduction in Sevastopol of a completely new method of caring for the wounded. The wounded were subject to careful selection already at the first dressing station: depending on the severity of the wounds, some of them were subject to immediate operation in the field, while others, with lighter wounds, were evacuated inland for treatment in stationary military hospitals. Therefore, Pirogov is justly considered the founder of a special direction in surgery known as military field surgery.
During the year, about 10,000 "significant" operations were performed, most with the use of anesthesia. For merits in helping the wounded and sick N.I. Pirogov was awarded the Order of St. Stanislav, 1st degree.

Pirogov in Simferopol. The artist is not known.

In October 1855 in Simferopol there was a meeting of two great scientists - N.I. Pirogov and D.I. Mendeleev. A well-known chemist, author of the periodic law of chemical elements, and then a modest teacher of the Simferopol gymnasium, turned to Nikolai Ivanovich for advice on the recommendation of the St. Petersburg physician N.F. Zdekauer, who found Mendeleev's tuberculosis and that, in his opinion, the patient had several months to live. This was obvious: the huge overloads that the 19-year-old boy had shouldered on his shoulders and the damp climate of St. Petersburg, where he studied, had a negative effect on his health. N.I. Pirogov did not confirm the diagnosis of his colleague, appointed necessary treatment and thus brought the patient back to life. Subsequently D.I. Mendeleev spoke of Nikolai Ivanovich with enthusiasm: "That was a doctor! He saw right through the person and immediately understood my nature."

N.I. Pirogov examines the patient D.I. Mendeleev. Hood. I. Tikhiy.

From the theater of military operations, he brought out contempt and hatred for the bureaucracy, to the constant substitution of the form of the present case. And also a deep conviction that the cardinal disadvantage of people is the absence of a spiritual and moral core, high human ideals, which in turn is a consequence of the lack of true preparation of a person for life.
It is characteristic that, returning to Petersburg, at a reception with Alexander II, Pirogov sharply criticized the emperor about the problems in the troops, and also told about the general backwardness of the Russian army and its weapons, which forever spoiled relations with the emperor. This once again confirms the presence of a clearly expressed ideal in the worldview of N.I. Pirogov, which was associated with the presence of unshakable convictions, absolute faith in the correctness of the chosen ideas. The tsar did not want to listen to Pirogov. Moreover, straightforwardness, adherence to principles, exactingness not only to oneself, but also to others create many enemies. The struggle for the truth brings Pirogov difficult moments. "What am I to blame and before whom, that in my heart all impulses for the high and holy have not yet died out, that I have not yet lost the willpower to sacrifice happiness ..." - he wrote. After reflection, and the journey from Sevastopol was long, 45-year-old Nikolai Ivanovich, in his prime of strength and talent, submits a report on leaving the academy. "... Moral weariness in the struggle with people for whom the goals of scientific and moral truth are not well understood ..." outweighed all the arguments.
S.P. Botkin, a contemporary of Pirogov, said: "The feeling of envy towards this big man turned into anger. Adored by his students and everyone who knew Nikolai Ivanovich closely, he was hated by a well-known part of our medical corporation, who did not forgive him for his moral superiority and the truthfulness that he was distinguished ... ".
At this time, the goal-oriented basis of his pedagogical system was finally formed. The reasons for the doctor's turning to pedagogical activity were succinctly and figuratively written by N.P. Sakulin "Under the oppressive impression of the Sevastopol war, NI Pirogov plunged into a mournful civil thought. A citizen wins a doctor and a scientist in Pirogov. He comes to the deep conviction that we" can achieve true progress alone, the only way education "that education after religion, the highest side of our social life."
External impulse of N.I. Pirogov's approach to pedagogical problems is of a private and, to a certain extent, random nature. The editorial board of the "Morskoy Sbornik" magazine invited the scientist to write an article about possible changes in the content of education and the educational process in the naval cadet corps. The result of this was the programmatic article by Pirogov "Questions of Life" published uncensored in the July 1856 issue of the journal, in which he pointed to the big discord between class education, school and reality, and convinced that before a young man receives special knowledge, he must acquire " general human "education. "Let the inner man work out and develop! Give him the time and means to subjugate the outer, and you will have merchants, soldiers, sailors, and lawyers; and most importantly, you will have people and citizens!" The article immediately attracted a lot of public attention and caused a huge response.
Why did this happen? After all, both before Pirogov's article and after it, various pedagogical articles were published on the pages of the "Sea Collection", including those on broad universal topics. Their authors were famous scientists - teachers, prominent figures of that time, for example V.I. Dahl - but no one paid much attention to them.
And to the central problematics of Pirogov's article - general human education - before Nikolai Ivanovich, many not only outstanding Western, but also domestic teachers have already addressed. Their articles appeared in various magazines and went almost unnoticed. There was a real sensation here. According to N.S. Kartsova, "a first-class surgeon is immediately a deep teacher-thinker."
The loud public response that took place was caused by a combination of a number of circumstances. First of all, of course, by the name of the author. The Crimean War, the heroism and tragedy of Sevastopol, in the defense of which the surgeon Pirogov took the most effective part, made him, in fact, a national hero and attracted great public interest to the personality of Nikolai Ivanovich.
Undoubtedly, it also influenced the publication of this article. At first glance, a special magazine of the maritime department is not the best place for publishing program pedagogical manifestos. But such a conclusion can only be drawn by a superficial person. At that time, "Sea Collection" was personally patronized by the Grand Duke Constantine, a very progressive statesman, a staunch reformer. And thanks to this, the publication of Pirogov's article in such a significant journal immediately gave it a state, almost imperial status. Moreover, the article was immediately reprinted in the appendix for 1856 in the pedagogical officialdom - the "Journal of the Ministry of Public Education" (No. 9) with a significant footnote "is published by order of the Minister of Public Education." All this gave "Questions of Life" almost official status pedagogical concept, a new state philosophy of education, which teachers needed not only to study, but also to implement.
Well, and finally introduced "Questions of Life" into the circle of the most discussed publications, an article by N.А. Dobrolyubov's "On the Importance of Authority in Education", published in the May 1857 issue of the most famous and popular then public-literary magazine "Sovremennik", which gave the most favorable assessment of Pirogov's article. The publication noted that none of the previous articles on education "had such complete and brilliant success as Questions of Life." They amazed everyone with the lightness of their eyes, and the noble direction of the author's thought, and the fiery, lively dialectics, and the artistic presentation of the issue raised. " Actually, thanks to Dobrolyubov and through Dobrolyubov, the widest circles of readers, far from such special editions as "Morskoy Sbornik" and "Journal of the Ministry of Public Education", got acquainted with the content of "Questions of Life". On the whole, Voprosy Zhizn received a high assessment from another then ruler of thoughts - N.G. Chernyshevsky.
However, it was not these, albeit very significant, circumstances that played a leading role in the enormous effect produced in society by the article "Questions of Life". The most direct impact was the difficult socio-political situation that developed in Russia after the defeat in the Crimean War and the humiliating Paris Peace. Both in society and in government circles there was a growing conviction that "it is impossible to live like this", that cardinal reforms were necessary. And these Great Reforms of the 1860s, which began with the liberation of the peasants in February 1861, will soon follow.
But with the growing conviction of the need for reforms in the summer of 1856, their ideology and program were still absent. And the great merit of N.I. Pirogov is that he was able to offer the humiliated and confused Russian society such a program in the field of education. According to N.P. Sakulin, “Pirogov appeared in the face of Russian society as a publicist-thinker when the spiritual awakening of the country began; with harsh directness and invincible sincerity, he posed the questions: do we live the way we need to? What do we want? confessions to your conscience, to a fundamental revision of the foundations of life. "
It was the sincerity of the article, along with its fundamental nature, depth, integrity and comprehensiveness, that finally determined the public resonance unprecedented in Russian pedagogy, neither before nor after. She immediately became a major social phenomenon. And as a result, she changed the fate of Nikolai Ivanovich Pirogov himself in a very significant way.
N.I. Pirogov, at the suggestion of the Minister of Public Education A.S. Norov, who followed on September 3, at the beginning of October 1856, took the post of trustee of the Odessa educational district. This appointment took place at the insistence of the Grand Duchess Elena Pavlovna and Grand Duke Constantine who supported Nikolai Ivanovich.
For N.I. Pirogov, this was, of course, a very serious decision. After all, not only was the sphere of his professional activity radically changed - pedagogy for medicine, but its content also changed. Instead of the usual scientific, teaching, medical practice N.I. Pirogov was to engage in serious administrative activities as a general. As N.P. Sakulin, "the famous surgeon was imbued with a purely evangelical faith in upbringing and decided on a real life feat: he abruptly breaks with his glorious past and becomes a teacher."
The letters of Pirogov have been preserved, where he describes his state of mind in connection with the appointment. He wrote to the Grand Duke Constantine: "As a father and as a Russian, I understand the importance of education for our land and sincerely wish to see it based not on the temporary needs of the country, but on the principles of deeper and more faithful ones."
And in a letter to his faithful friend, Baroness F.E. He is happy, he stated his credo: “I don’t give up my independence and my convictions. And I’m not looking for anything. If they really want me to be useful, then let them not stop me halfway; I have followed these halfways many times already: now I no longer want to act against my conscience and my convictions; for this I may be too good, I may be too stupid. "
As A.N. Ostrogorsky, "Pirogov went to his post of teacher-administrator, feeling like a missionary, a teacher of life, a preacher of a lofty and holy idea drawn from the lessons and from the earthly life of the God-man."
I will also cite the opinion of N.S. Derzhavin: "In the pedagogical field, Pirogov appeared as a public figure with a clear, precise and definite world outlook, with ready-made decisions on all the smallest questions of pedagogical practice and, moreover, with decisions that were not stereotyped, but deeply thought out and original."
However, the decision of N.I. Pirogov to agree with the proposal to take the post of trustee of the educational district to a certain extent logically followed from all previous events. As early as January 4, 1856, shortly after returning from the Crimean War, Nikolai Ivanovich filed a letter of resignation from the Medico-Surgical Academy, citing his "upset health and home circumstances." In July 1856, an order was signed to dismiss Pirogov, which surprisingly coincided with the publication of Questions of Life. So the proposal of the Minister of Public Education to a certain extent resolved the resulting official and personal conflict. Moreover, this appointment gave a very high rank of privy councilor, which corresponded to the rank of colonel-general.
The results of N.I. Pirogov at the post of trustee, first of Odessa, and after his resignation from this position from September 1858 to March 1861, the trustees of the Kiev educational district are always evaluated in two ways. On the one hand, there is an unconditional powerful personal contribution of Pirogov, as he called himself a “guardian - missionary,” to the development of enlightenment and education on the territory of these educational districts, which manifested itself literally in everything. As noted in this regard, A.A. Musin-Pushkin, "he was a rare Trustee - a thoughtful philosopher who always carried out a serious pedagogical reform, thoroughly thought out in advance, which is the result of not an accidental thought, but a whole pedagogical system that he strictly pursued."
At the same time, if you look at this from the side of his personal career, then his work, indeed, can hardly be considered successful. The reasons for the resignation of N.I. Pirogov from the posts of trustee of educational districts, of course, are explained by the tough opposition that he met from the entire bureaucratic apparatus, which instantly sensed in him a dangerous stranger. The charges brought against N.I. Pirogov, were quite traditional for reformers in the field of education of the second half of the 19th - early 20th century. Strong discontent on the part of influential Russian nationalists was caused by his desire to create equal conditions for education for Poles and Jews. This, of course, saw not only dangerous political consequences, but also "oppression of the interests of the Russian people."
The activity of the trustee to educate the broad strata of the working people, which was expressed, in particular, in supporting the opening of the first Sunday school in Kiev, was considered extremely dangerous. These schools immediately fell under suspicion, frankly not unfounded, of spreading revolutionary ideas.
But the bureaucracy was especially irritated by N.I. Pirogov, his desire to resolutely support various forms of amateur organizations and associations of students, high school students. In this the bureaucracy saw exclusively the danger of the spread of "free-thinking and nihilism."
Of course, all these radical trends had nothing to do with Pirogov himself. In his socio-political views, Nikolai Ivanovich was never a radical. He always respected the supreme power, was a statesman in the highest sense of the word. He certainly had a negative attitude to the revolutionary movements of the 60s and 70s, he was hotly indignant at the terrorist actions of the "seditious", and he considered socialism "a pure utopia that threatens individual freedom."
The immediate reasons for the resignations themselves are simply striking in their ridiculousness. So from the post of the trustee of the Odessa educational district, N.I. Pirogov had to leave because of the party he had approved of the students of the Richelieu Lyceum, who noisily noted the message in the Belgian newspaper "Independence Belge" that preparations for the abolition of serfdom had begun in Russia. That is, in fact, they warmly and loyally supported the actions of the supreme power.
As for the reasons for the resignation from the post of the trustee of the Kiev educational district, here, undoubtedly, a complex of still unclear circumstances played a role. Among them were both direct discontent with the authorities and slanderous denunciation. But, of course, the problem was more complex. Pirogov wrote about it this way: “No matter how extensive and beneficial the activity of the person who is entrusted with the education of the region could be, but in fact, when the government focuses all its attention on, in essence, the inevitable troubles of the corporate life of the student generation, this activity takes on the character purely police. "
The immediate reason was the decisive refusal expressed by N.I. Pirogov, at a personal meeting with Emperor Alexander II, to carry out supervisory and police functions in relation to students, which from the beginning of 1861 were entrusted to the trustees of educational districts.
All these circumstances led, according to the decree of March 13, 1861, to the dismissal of Pirogov from the post of trustee of the Kiev educational district. He also refused the offered position of a member of the council of the Ministry of Public Education. Pirogov was again "stopped halfway." As Nikolai Ivanovich wrote with bitterness in a private letter to Baroness Reden, "I lack something that must be possessed in order to be pleasant and seem useful." Regarding the dismissal of N.I. A.I. Pirogova Herzen wrote: "It is impossible to see ... the fall of a man of whom Russia is proud, and not to blush from ear to ear with shame."
One way or another, immediately after the abolition of serfdom and the beginning of the stage of progressive development of all parties public life, especially education, N.I. Pirogov, paradoxically and unfairly, was out of work, although his historical time was just approaching. As noted by N.S. Derzhavin, "Pirogov brought up the best ideals of the great era, the era of broad humanism and educational ideas, and introduced them into his pedagogical activity. He wanted to raise the school of his day to the level of his high ideals, and if he did not always succeed in achieving this, then, of course, not because he lacked enough energy, will, perseverance and character, not because his ideals were too far from the real needs of modern school life. Pirogov could not fulfill the ideals of life in the sphere of his school work, because that in the life around him these ideals were only just outlined. "
Fed up with civil service, Nikolai Ivanovich leaves for his estate - in the village of Vishnya, Kamenets-Podolsk province (now Vinnitsa region). Here he was mainly engaged in administrative and pedagogical work - he opened, for example, Sunday schools. But he didn't leave medicine either. By this time, Pirogov had become a convinced Christian, and his professional skill reached its peak. On his estate, he opened a free hospital and planted various medicinal plants for her needs. In this paradise, planted with linden trees and permeated with the smell of a thousand herbs, the treatment gave one hundred percent results, because there were no various hospital infections and stealing quartermasters.

Tchaikovsky at Pirogov's. Hood. A. Sidorov.

The government twice turned to Nikolai Ivanovich with offers to serve in the pedagogical field. First, the new Minister of Public Education A.V. Golovnin suggested that Pirogov conduct a kind of revision of the setting of the educational process at the medical faculties of Russian universities in order to improve this activity. But this project never got its practical implementation.
But another proposal was accepted. In the spring of 1862 N.I. Pirogov was sent abroad "to perform various works on the educational and pedagogical part." The main assignment of the Minister of Public Education was "in the direction and direction of young people preparing for professorship." And here N.I. Pirogov showed his abilities and responsibility so inherent in him. He visited 25 European universities, got acquainted with the construction of the educational process in them, skillfully directed the scientific work of young scientists and supported their aspirations and undertakings. Pirogov compiled the characteristics of the professors for whom they worked. He studied the state of higher education in different countries, presented his observations and conclusions. In his last official post, Nikolai Ivanovich earned great respect from scientists, many of whom left their mark on Russian and world science - A.N. Veselovsky, V.I. Gerrier, V.I. Lamansky, I.I. Mechnikov, A.A. Potebnya and others.
In October 1862, Pirogov consulted the wounded national hero of Italy D. Garibaldi. None of the most famous doctors in Europe could find the bullet stuck in his body. Nikolai Ivanovich determines the location of the bullet and asks not to rush to remove it - a little later it can be easily removed. And so it happened.

N.I. Pirogov at Giuseppe Garibaldi's. Hood. K. Kuznetsov.

On behalf of the Society for the Care of Sick and Wounded Warriors (later the Red Cross Society), Pirogov travels to the Franco-Prussian front in Alsace and Lorraine, Bulgaria and Romania to monitor the activities of military medical institutions and develop measures to streamline assistance to the wounded.
However, in 1866, after D.V. Karakozov on Alexander II and the beginning of a change in the political course associated with the gradual curtailment of reforms, N.I. Pirogov was recalled to Russia and dismissed on June 17, 1866. Again, on the ridiculous external occasion, set forth by the Minister of Public Education D.A. Tolstoy in his report to Alexander II as follows: "Taking into account that our universities mainly need professors in philological sciences, I find that N. Pirogov's stay abroad, as a specialist in medical sciences, does not seem essential for our professor candidates." ...
After that, N.I. Pirogov never returned. He was dismissed from public service altogether, even without the right to retire. In the prime of his creative powers, Pirogov retired to his small estate in the village of Vishnya, where he organized a free hospital. He briefly traveled from there only abroad, and also at the invitation of St. Petersburg University to give lectures.
By this time, Pirogov was already a member of several foreign academies. For a relatively long time, Pirogov only left the estate twice: the first time in 1870 during the Prussian-French War, being invited to the front on behalf of the International Red Cross, and the second time, in 1877-1878. - already at a very old age - worked at the front for several months during the Russian-Turkish war.
When Emperor Alexander II visited Bulgaria in August 1877, during the Russian-Turkish war of 1877-1878, he remembered Pirogov as an incomparable surgeon and the best organizer of medical service at the front.
Despite his advanced age (then Pirogov was already 67 years old), Nikolai Ivanovich agreed to go to Bulgaria, provided that he would be given complete freedom of action. His desire was granted, and on October 10, 1877, Pirogov arrived in Bulgaria, in the village of Gorna-Studena, not far from Plevna, where the main apartment of the Russian command was located.
Pirogov organized the treatment of soldiers, care for the wounded and sick in military hospitals in Svishtov, Zgalev, Bolgarena, Gorna-Studena, Veliko Tarnovo, Bokhot, Byala, Plevna.
From October 10 to December 17, 1877 Pirogov drove over 700 km in a chaise and a sleigh, over an area of \u200b\u200b12,000 square meters. km., occupied by the Russians between the Vit and Yantra rivers. Nikolai Ivanovich visited 11 Russian temporary military hospitals, 10 divisional infirmaries and 3 pharmacy warehouses, deployed in 22 different settlements. During this time, he was engaged in treatment and operated on both Russian soldiers and many Bulgarians.
In early January 1881, the surgeon complained to his wife that he had some kind of painful ulcer in his mouth. To prevent him from smelling of tobacco (Nikolai Ivanovich was a heavy smoker), he rinsed his mouth with hot water - and considered it a burn. Alexandra Antonovna said: “I examined the alleged place of the burn and noticed behind the right upper canine on the hard palate, not far from the dental hollow, a small grayish-white bobble the size of a lentil; when pressed, it caused pain, and a brick-colored circle the size of a dime formed around it "Pirogov said:" In the end, it's like cancer. "
Doctor of the Kiev military hospital S.S. Shklyarevsky, who observed the patient for a long time, associated the onset of the disease with the loss of N.I. Pirogov of the third molar of the upper jaw in the spring of 1880. By that time, Nikolai Ivanovich had almost no teeth and categorically refused the proposal to insert artificial ones. His food was mostly porridge, almost all his life he suffered from intestinal "catarrh", "earned" in the Dorpat period, and tried to follow a diet, from time to time quit smoking cigars, drank alkaline waters "Essentuki No. 17" and "Vichy".
During this period, Nikolai Ivanovich completed his work on visiting the theater of military operations in the Balkans and on November 5 (old style), 1879, he began "The Diary of an Old Doctor".
Between the photographs of N.I. Pirogov in the late 60s and early 80s. XIX century there is a huge difference: old age came in a hurry. The scientist did not hear so well, did not remember names well. The gray hair - even, white as snow, softened the sharp line of eyebrows that supported the high forehead, the beard covered the determined chin - now his stubborn features were only guessed. But he did not look like an old man. Even static photographs did not hide the indomitability of his spirit. There is always some kind of striving in the face. This is how he looks in the painting by I. Repin.

Portrait of the surgeon N.I. Pirogov. Hood. I.E. Repin. (1881. State Tretyakov Gallery. Moscow. Russia).

The 70-year-old doctor continued to operate in his Vishnya, consulted a lot, kept up a lot of correspondence with friends, managed to take care of the vineyard, the peaches that he bred in greenhouses, the rose garden - more than 300 varieties of the queen of flowers. Ukrainian nature, the beauty of the garden had a calming effect on the surgeon who was tired of everyday hardships.
In old age, people usually think about the meaning of life. Pirogov did not hide the fact that he often saw in her a manifestation of higher reason: "In the secret places of the human soul, sooner or later, but inevitably, the realized ideal of the God-man had to develop and finally come." Religious and mystical views determined the attitude of Nikolai Ivanovich to his illness, he believed: what to be - that is inevitable. Everything must be patiently accepted.
The sore on the upper jaw could also be associated with the fact that, according to S.S. Shklyarevsky, the right maxillary alveolar process turned out to be slightly larger than the left - due to uneven atrophy associated with the loss of teeth at different times. Permanent injury could lead to a focus of inflammation.
The sensation and appearance of a painful place, according to Pirogov, at first resembled just an abrasion or a minor burn of the mucous membrane in the palate, but “then the abrasion rather quickly took the form of a hole and seemed like an entrance to a dental fistula, which is quite possible in this place, but no channels or discharge there was no positive pus. "
An experienced doctor, N.I. Pirogov realized that a malignant process was developing, but he did not tell or write to anyone about it. Even in conversations with his wife, he avoided this topic, did not complain of a painful sensation, but continued to work calmly. It seemed to those around him that Pirogov was completely healthy. Many sick people gathered, besieged his house. He did not know how to refuse advice and help. However, the thought that the pathological process was progressing was disturbing. The doctor eliminated irritating substances, alkaline waters, wine from food, avoided solid foods. He drank up to 8 glasses of milk a day through a straw.
On the way to Odessa, doctor I.V. Bertenson (friend and biographer of N.I. Pirogov). After examining the oral cavity, he said in an indifferent tone: "All this is nothing, and he will soon heal again ..." But in Odessa he did not hide from his friends that the nature of the disease was cancerous.
Instead of one ulcer on the mucous membrane of the palate, two have already formed. Pirogov takes various methods to protect the foci of ulceration from injury: he uses pieces of oilcloth and Lister's protector (thin silk soaked in a 5% solution of carbolic acid in resinous substances). He still does not feel a breakdown.
He found a method that he used for the rest of his life: he took filter paper, moistened it in a thick broth of flaxseed and applied it to the ulcers. Sometimes he added 2 drops of carbolic acid to the broth, and later - opium tincture and even a solution of acetic acid morphine. A gradual increase in the dose of morphine indicated increasing pain. To drown them out, he made these stickers at night. However, the ulcer grew larger. Attempts to cover it with pieces of filtered paper, oiled and soaked in a thick decoction of flaxseed, did not produce any healing or analgesic effect.
Nevertheless, the fiftieth anniversary of the scientific, medical and social activities of N.I. Pirogov. It is not so easy to organize celebrations for a person in disgrace who has not been dismissed but removed from his duties. N.V. Sklifosovsky turned directly to the tsar with a request to organize the celebration, for which he received "the highest permission."

Arrival of N.V. Sklifosovsky to the Vishnya estate. Hood. A. Sidorov.

The message about the upcoming anniversary of the great scientist appeared in newspapers as early as 1880, so some individuals and organizations sent congratulations to Pirogov in Vishnya. At the kayevsky station, see N.I. Pirogov gathered doctors, representatives of the medical faculty of the university.
He arrived in Moscow on May 22, 1881. The carriage in which the surgeon and his wife were traveling was decorated with garlands of flowers.

Arrival of Nikolai Ivanovich Pirogov to Moscow for the 50th anniversary of his scientific activity. Hood. I. Repin.

At the train station in the capital, he was greeted by a huge crowd. People shouted: "Long live the patriarch of Russian surgery!", "Glory to the Russian luminary Pirogov!" In excitement, Nikolai Ivanovich said: "Is I still so important to them. And do they need me? .." Ilya Repin, who was present at the jubilee, wrote: "It was an extraordinary celebration. And how else, after all, Pirogov is a genius! Yes, undoubtedly a genius! This will remain for us, and for those who are, and forever and ever!" Repin showed a deep interest in the personality of Pirogov and sought to recreate the image of the great scientist on canvas. During the celebrations, the artist painted a portrait of the hero of the day. In addition, Repin made sketches to work on the bust of the scientist, which he then sculpted.
The celebrations were held on May 24 and 25, 1881 in the assembly hall of Moscow University. Delegations from all over Russia arrived to congratulate the hero of the day. Greetings were received from Russian societies, departments and cities, universities of Western Europe (Paris, Strasbourg, Edinburgh, Prague, Munich, Vienna, Padua, Brussels).
The speech at Moscow University, brilliant in form and deep in content, is dedicated to the predestination of a doctor. Russia paid tribute to the great son. The City Duma appropriated N.I. Pirogov the title of "Honorary Citizen of the City of Moscow". He was the fifth to be awarded this honorary title. THEM. Sechenov called Nikolai Ivanovich "a glorious citizen of his land." Russia paid tribute to the great son. This was the last meeting of the great scientist with his colleagues, students. Exciting experiences for a short time distracted from the disease.
The first consultants for Nikolai Ivanovich's illness were N.V. Sklifosovsky and I.V. Bertenson.

Nikolai Vasilyevich Sklifosovsky (1836-1904) - Professor Emeritus, Director of the Imperial Clinical Institute of the Grand Duchess Elena Pavlovna in St. Petersburg.

Having examined Pirogov, N.V. Sklifosovsky told S. Shklyarevsky: "There can be no doubt that the ulcers are malignant, that there is an epithelial neoplasm. It is necessary to operate as soon as possible, otherwise a week or two will be too late ..." This message struck Shklyarevsky like a thunderbolt, he did not dare to tell the truth even to Pirogov's wife, Alexandra Antonovna. Of course, one can hardly assume that N.I. Pirogov, a brilliant surgeon, a highly qualified diagnostician, through whose hands dozens of cancer patients passed, could not make a diagnosis himself.
On May 25, 1881, a council was held in Moscow, consisting of Professor of Surgery at the University of Dorpat E.K. Valya, professor of surgery at Kharkov University V.F. Grube and two St. Petersburg professors E.E. Eikhvald and E.I. Bogdanovsky, who came to the conclusion that Nikolai Ivanovich has cancer, a serious situation, it is necessary to operate faster. The chairperson of the council N.V. Sklifosovsky said: "Now I will delete everything clean in 20 minutes, and in two weeks it will hardly be possible." Everyone agreed with him.
But who will find the courage to inform Nikolai Ivanovich about this? asked Eichwald, given that Pirogov was in close friendship with his father and transferred his attitude to his son. He categorically protested: "Me? .. No way!". I had to do it myself.
This is how Nikolai Sklifosovsky describes the scene: "... I was afraid that my voice would falter and my tears would give out everything that was in my soul ..." - Nikolai Ivanovich! - I began, staring intently into his face. - We decided to offer you to cut Calmly, with complete self-control, he listened to me. Not a single muscle on his face trembled. It seemed to me that the image of a sage of antiquity rose up before me. Yes, only Socrates could listen with the same equanimity to the harsh sentence of impending death! silence. Oh, this terrible moment! .. I still feel it with pain. ”“ I ask you, Nikolai Vasilievich, and you, Val, ”Nikolai Ivanovich told us,“ to perform an operation for me, but not here. We just finished triumph, and then suddenly a funeral! Can you come to my village? .. Of course, we agreed. The operation, however, was not destined to come true ... "
Like all women, Alexandra Antonovna still hoped that salvation was possible: what if the diagnosis was wrong? Together with his son N.N. Pirogov, she persuaded her husband to go to the famous Theodore Billroth in Vienna for a consultation and accompanies him on the trip together with his personal doctor S. Shklyarevsky.

Theodor Billroth (1829-1894) - the largest German surgeon.

On June 14, 1881, a new consultation took place. After a thorough examination, T. Billroth admitted the diagnosis was correct, but given the clinical manifestations of the disease and the patient's age, he reassured that the granulations are small and flaccid, and neither the bottom nor the edges of the ulcers have the appearance of a malignant formation.
Parting with an eminent patient, T. Billroth said: "Truth and clarity in thinking and feeling, both in words and in deeds, are the rungs of the ladder that lead mankind into the bosom of the gods. Follow you, as a brave and confident leader, on this not always safe path has always been my deepest aspiration. " Consequently, T. Billroth, who examined the patient, was convinced of the serious diagnosis, but realized that the operation was impossible due to the severe moral and physical condition of the patient, so he "rejected the diagnosis" made by Russian doctors. Of course, many people had a question, how could the experienced Theodore Billroth overlook the tumor and not perform the operation? Realizing that he must discover the reason for his own holy lie, Billroth sent D. Vyvodtsev a letter, in which he explained: “My thirty years of surgical experience taught me that sarcomatous and cancerous tumors starting behind the upper jaw can never be radically removed ... I would not have received a favorable result. I wanted, having discouraged, a little to cheer up the patient who had fallen in spirit and incline him to patience ... ".
Christian Albert Theodore Billroth was in love with Pirogov, called him a teacher, a brave and confident leader. At parting, the German scientist presented N.I. Pirogov his portrait, on the back of which the memorable words were written: "Dear maestro Nikolai Pirogov! Truthfulness and clarity in thoughts and feelings, in words and deeds are the steps of the staircase that leads people to the abode of the gods. Be like you, brave and As a convinced mentor on this not always safe path, to follow you unswervingly is my zealous endeavor. Your sincere admirer and friend Theodore Billroth. " Date June 14, 1881 Vienna. His assessment of the portrait and the feelings generated by the heart inscription, N.I. Pirogov expressed compliments, also recorded on Billroth's gift. “He,” wrote N.I., “is our great scientist and outstanding mind. His work is recognized and appreciated. May I be allowed to be just as worthy and highly useful as his adherent and reformer. " Nikolai Ivanovich's wife, Alexandra Anatolyevna, added to these words: "What is written on this portrait of Mr. Billroth belongs to my husband. The portrait hung in his study." Pirogov's biographers do not always pay attention to the fact that Billroth also had his portrait.
Cheered up, Pirogov went to his place in Vishnya, staying all summer in a cheerful state of mind. Despite the progression of the disease, the belief that it was not cancer helped him to live, even to consult patients, to participate in the anniversary celebrations dedicated to the 70th anniversary of his birth. He worked on a diary, worked in the garden, walked, received patients, but did not risk operating. He methodically rinsed his mouth with a solution of alum and changed the protector. This did not last long. In July 1881, while resting at I. Bertenson's dacha on the estuary in Odessa, Pirogov again met S. Shklyarevsky.
It was already difficult to recognize Nikolai Ivanovich. "Gloomy and focused on himself, he willingly gave me a look at his mouth and, keeping his composure, with a gesture said several times meaningful:" Doesn't heal! .. Doesn't heal! .. Yes, of course, I fully understand the nature of the ulcer, but, Agree yourself, it’s not worth it: a quick relapse, spread to neighboring glands, and moreover, all this in my years cannot promise not only success, but can hardly promise relief ... ". He knew what awaited him. And being convinced of the near sad outcome, he refused the recommendation of S. Shklyarevsky to try electrolysis treatment.
He looked quite old. The cataract robbed him of the bright joy of the world. Through a dull veil, it seemed gray and dull. To see better, he threw his head back, squinted piercingly, thrusting forward his overgrown gray chin - impetuousness and will still lived in his face.
The more severe his suffering was, the more persistently he continued "The Diary of an Old Doctor", scribbling the pages with an impatient, sweeping handwriting that became larger and more illegible. For a whole year he pondered on paper about human existence and consciousness, about materialism, about religion and science. But when he looked into the eyes of death, he almost dropped philosophizing and began hastily describing his life.
Creativity distracted him. Without wasting a single day, he hurried. On September 15, he suddenly caught a cold and went to bed. The catarrhal condition and the enlarged lymph glands of the neck aggravated the condition. But he continued to write lying down. "From the 1st sheet to the 79th, that is, university life in Moscow and Dorpat, I wrote from September 12 to October 1 (1881) in the days of suffering." Judging by the diary, from October 1 to October 9, Nikolai Ivanovich did not leave a single line on the paper. On October 10, he picked up a pencil and began like this: "Will I make it to my birthday ... (until November 13). We must hurry with my diary ...". As a doctor, he clearly understood the hopelessness of the situation and foresaw a quick outcome.
Prostration. He spoke little, ate reluctantly. He was no longer the same, not knowing boredom, non-school person, constantly smoking a pipe, smelling through and through of alcohol and disinfection. A sharp, noisy Russian doctor.
He relieved pain in the facial and cervical nerves with palliative drugs. As S. Shklyarevsky wrote, "ointment with chloroform and subcutaneous injections of morphine with atropine are Nikolai Ivanovich's favorite remedy for the sick and seriously wounded in the first time after injury and when driving on dirt roads. Finally, in the last days Nikolai Ivanovich almost exclusively drank kvass, mulled wine and champagne, sometimes in significant quantities. "
Reading the last pages of the diary, one is involuntarily amazed at the enormous will of Pirogov. When the pains became intolerable, he began the next chapter with the words: "Oh, rather, rather! .. Bad, bad ... So, perhaps, I will not have time to describe half of Petersburg life ..." - and continued on. Already completely illegible phrases, strangely abbreviated words. "The first time I wished for immortality - the afterlife. This was done by love. I wanted love to be eternal; - it was so sweet. To die at the time when you love, and die forever, irrevocably, it seemed to me then, for the first time in life, something unusually terrible ... Over time, I learned from experience that not only love is the reason for the desire to live forever ... ". The manuscript of the diary ends in the middle of the sentence. On October 22, the pencil fell out of the surgeon's hand. There are many mysteries from the life of N.I. Pirogov is kept by this manuscript.
Completely exhausted, Nikolai Ivanovich asked to be taken out onto the veranda, looked at his beloved linden alley on the veranda and for some reason began to read Pushkin out loud: "A vain gift, an accidental gift. Life, why are you given to me?" He suddenly drew himself up, smiled stubbornly, and then clearly and firmly said: "No! Life, you were given to me for the purpose!" These were the last words of the great son of Russia, a genius - Nikolai Ivanovich Pirogov.
A note was found among the papers on the desk. Skipping letters, Pirogov wrote (spelling preserved): “Neither Sklefasovsky, Val and Grube; neither Billroth recognized me as ulcus oris men. mus. cancrosum serpeginosum (lat. - creeping membranous mucous oral cancer ulcer), otherwise the first three would not recommend surgery, and the second would not dismiss the disease as benign. " The note is dated October 27, 1881.
Less than a month before his death, Nikolai Ivanovich diagnosed himself. A person with medical knowledge treats his ailment in a completely different way than a patient who is far from medicine. Doctors often underestimate the appearance of the initial signs of the disease, do not pay attention to them, are treated reluctantly and irregularly, hoping that "it will pass by itself." The brilliant doctor Pirogov was absolutely sure: all attempts were in vain and unsuccessful. Distinguished by great self-control, he worked courageously to the end.
The last days and the minutes of N.I. Pirogova was described in detail in a letter to Alexandra Antonovna by Olga Antonova, sister of mercy from Tulchin, who was incessantly at the bedside of the dying: "1881, December 9, metro Tulchin. Dear Alexandra Antonovna! ... The last days of the professor - 22nd and 23rd I am writing to you. On Sunday 22nd, at half past one in the morning, the professor woke up, they carried him to another bed, spoke with difficulty, phlegm stopped in his throat, and he could not cough up. He drank sherry with water. Then he fell asleep until 8 am. with increased wheezing from stopping sputum; lymph nodes were severely swollen, they were smeared with a mixture of iodoform and collodion, camphor oil was poured onto cotton wool, although with difficulty, he rinsed his mouth and drank tea.At 12 days he drank champagne with water, after which he transferred it to another bed and changed all clean linen; pulse was 135, breathing was 28. At 4 days the patient became very delirious, they gave camphor with champagne one gram each as prescribed by Dr.Schavinsky and then every three quarters of an hour they gave camphor with champagne. At 12 o'clock in the morning the pulse was 120. On Monday 23rd, at 1 am Nikolai Ivanovich completely weakened, the delirium became more incomprehensible. They continued to give camphor and champagne, after three quarters of an hour, and so on until 6 in the morning. Delirium intensified and became more indistinct with each passing hour. When I served the last time at 6 o'clock in the morning, wine with camphor, the professor waved his hand and did not accept. After that, he did not accept anything, was unconscious, severe convulsive twitching of his arms and legs appeared. The agony began at 4:00 am and this state continued until 7:00 pm. Then he became calmer and even deep sleep slept until 8 pm, then the contractions of the heart began and therefore several times the breathing was interrupted, which lasted for a minute. These sobs were repeated 6 times, the 6th was the professor's last breath. Everything that I wrote down in my notebook I pass on to you. Then I testify my deep respect and deep respect for you and your family, ready to serve you. Sister of mercy Olga Antonova ".
On November 23, 1881 at 20.25 the father of Russian surgery died. His son, Vladimir Nikolaevich, recalled that immediately before Nikolai Ivanovich's agony, "a lunar eclipse began, which ended immediately after the denouement."
He was dying, and nature mourned him: suddenly an eclipse of the sun came - the whole village of Vishnya plunged into darkness.
Not long before his death, Pirogov received a book by his student, a famous surgeon from the St. Petersburg Medical-Surgical Academy, an embalmer and anatomist, a native of Vinnitsa D. Vyvodtsev, "Embalming and ways of preserving anatomical preparations ...", in which the author described the method of embalming he had found. Pirogov praised the book.
Long before his death, Nikolai Ivanovich wished to be buried in his estate and just before the very end he reminded about it again. Immediately after the death of the scientist, the family submitted a corresponding request to St. Petersburg. Soon an answer was received in which it was reported that N.I. Pirogov can only be satisfied if the heirs give a signature to transfer the body of Nikolai Ivanovich from the estate to another place in the event of the transfer of the estate to the new owners. Family members of N.I. Pirogov did not agree with this.
A month before the death of Nikolai Ivanovich, his wife Alexandra Antonovna, most likely at his request, turned to D.I. Vyvodtsev with a request to embalm the body of the deceased. He agreed, but at the same time drew attention to the fact that for the long-term preservation of the body, permission from the authorities is required. Then, through a local priest, a petition is written "to His Eminence the Bishop of Podolsk and Brailov ...". He, in turn, applies for the highest permission to the Holy Synod in St. Petersburg. The case in the history of Christianity is unique - the church, taking into account the merits of N. Pirogov as an exemplary Christian and a world-famous scientist, allowed not to betray the body to the earth, but to leave it incorruptible, "so that the disciples and followers of the noble and godly deeds of the servant of God N.I. his light appearance ".
What made Pirogov refuse burial and leave his body on the ground? This riddle N.I. Pirogov will remain unsolved for a long time.
DI. Vyvodtsev embalmed the body of N.I. Pirogov and cut out the tissue affected by the malignant process for histological examination. Part of the drug was sent to Vienna, another was transferred to the laboratories of Toms in Kiev and Ivanovsky in St. Petersburg, where they confirmed that it was squamous cell epithelial cancer.
In an effort to implement the idea of \u200b\u200bpreserving her husband's body, Alexandra Antonovna ordered a special coffin during his life in Vienna. The question arose, where to keep the body permanently? The widow found a way out. At this time, a new cemetery was being laid near the house. She buys a plot of land for a family crypt from a rural community for 200 rubles in silver, encloses it with a brick fence, and the builders begin to erect the crypt. It took almost two months to build the crypt and deliver the special coffin from Vienna.
Only on January 24, 1882, at 12 noon, an official funeral took place. The weather was cloudy, frost was accompanied by a piercing wind, but, despite this, the medical and pedagogical community of Vinnytsia gathered at the rural cemetery to see the great doctor and teacher on their last journey. An open black coffin is placed on a pedestal. Pirogov in the dark uniform of the Privy Councilor of the Ministry of Public Education of the Russian Empire. This rank was equivalent to the rank of general. Four years later, according to the plan of the academician of architecture V. Sychugov, the construction of the funeral-red brick of the ritual church of St. Nicholas the Wonderworker with a beautiful iconostasis was completed over the tomb.

Glass sarcophagus with the body of N.I. Pirogov in the necropolis church on the territory of his family estate in the village of Vishnya.

And today the body of the great surgeon, constantly rebalanced, can be seen in the crypt. There is a museum of N.I. Pirogov. During the Second World War, during the retreat of Soviet troops, the sarcophagus with Pirogov's body was hidden in the ground, while damaged, which led to damage to the body, which was subsequently restored and re-embalmed. Officially, the tomb of Pirogov is called the "necropolis church", consecrated in honor of St. Nicholas of Mirliki. The body is located below ground level in the funeral hall - the basement of an Orthodox church, in a glazed sarcophagus, which can be accessed by those wishing to pay tribute to the memory of the great scientist.
It is now obvious that N.I. Pirogov gave a powerful impetus to the development of scientific medical thought. "With the clear eyes of a genius at the very first time, at the first touch of his specialty - surgery, he discovered the natural scientific foundations of this science - normal and pathological anatomy and physiological experience - and in a short time he established himself so much on this basis that he became a creator in his field ", - wrote the great Russian physiologist I.P. Pavlov.
Take, for example, "An Illustrated Topographic Anatomy of Cuts Made in Three Dimensions Through a Frozen Human Body." To create the atlas, Nikolai Ivanovich used an original method - sculptural (ice) anatomy. He designed a special saw and sawed frozen corpses in three mutually perpendicular planes. Thus, he studied the shape and position of normal and pathologically altered organs. It turned out that their location was not at all the same as it seemed during the autopsies due to the violation of the tightness of the closed cavities. With the exception of the pharynx, nose, tympanic cavity, respiratory and alimentary canals, there was no empty space in any part of the body in a normal state. The walls of the cavities were tightly attached to the organs enclosed in them. Today, this wonderful work of N.I. Pirogov is experiencing a rebirth: the drawings of his cuts are surprisingly similar to the images obtained with CT and MRI.
Many of the morphological formations described by him are named after Pirogov. Most are valuable guidelines for interventions. A man of exceptional conscientiousness, Pirogov was always critical of inferences, avoided a priori judgments, supported every thought with anatomical research, and if that was not enough, he experimented.
In his research, Nikolai Ivanovich was consistent - at first he analyzed clinical observations, then conducted experiments, and only then proposed an operation. His work "On the transection of the Achilles tendon as an operative orthopedic means of treatment" is very indicative. Before him, no one dared to do this. "When I was in Berlin," Pirogov wrote, "I had not yet heard a word about operative orthopedics ... I carried out a somewhat risky undertaking when, in 1836, I first decided to cut the Achilles tendon in my private practice." tested on 80 animals. The first operation was performed on a 14-year-old girl who suffered from clubfoot. From this deficiency he saved 40 babies aged 1-6 years, eliminated contractures of the ankle, knee and hip joints. He used an extension apparatus of his own design, gradually stretching (back flexion) feet with steel springs.
Nikolai Ivanovich operated on a cleft lip, cleft palate, tuberculous "cartilage", "saccular" tumors of the extremities, "white tumors" (tuberculosis) of the joints, removed the thyroid gland, corrected convergent squint, etc. The scientist took into account the anatomical features of childhood, were under his scalpel newborns and adolescents. He can also be considered the founder of pediatric surgery and orthopedics in Russia. In 1854, the work "Osteoplastic lengthening of the shin bones when the foot was removed" was published, which marked the beginning of osteoplastic surgery. Anticipating the great possibilities of organ and tissue transplantation, Pirogov with the students of K.K. Strauch and Yu.K. Shimanovskiy was one of the first to perform skin and corneal transplants.
The introduction of ether and chloroform anesthesia into practice allowed Nikolai Ivanovich to significantly expand the range of surgical interventions even before the beginning of the antiseptic era. He did not limit himself to the use of well-known surgical techniques, he proposed his own. These are operations for rupture of the perineum during childbirth, with prolapse of the rectum, nose plastic, osteoplastic lengthening of the lower leg bones, the cone-shaped method of amputation of the extremities, isolation of the IV and V metacarpal bones, access to the iliac and sublingual arteries, the method of ligation of the nameless artery and much more. ...
To assess the contribution of N.I. Pirogov in military field surgery, you need to know her condition before him. Assistance to the wounded was chaotic. The mortality rate reached 80% and above. An officer of the Napoleonic army F. de Forer wrote: “After the end of the battle, the battlefield of Borodino was a terrible impression, with almost complete absence of sanitary service ... All the villages and living quarters were packed with wounded from both sides in the most helpless position. The villages perished from incessant chronic fires. .. Those of the wounded, who managed to escape the fire, crawled in thousands along the high road, looking for means to continue their miserable existence. ”An almost similar picture was in Sevastopol during the Crimean War. 24 hours after the injury The rule was: "By missing the time for the initial amputation, we lose more wounded than we save our arms and legs."
His observations of the military surgeon N.I. Pirogov outlined in his "Report on a travel in the Caucasus" (1849), reporting on the use of ether for pain relief and the effectiveness of an immobilizing starch dressing. He proposed to expand the entrance and exit holes of the bullet wound, excision of its edges, which was experimentally proven later. The rich experience in the defense of Sevastopol was described by Pirogov in The Principles of General Military Field Surgery (1865).
Nikolai Ivanovich emphasized the fundamental difference between general and military field surgery. “A beginner,” he wrote, “can still heal the wounded, not knowing well either the head, chest or abdominal wounds; but in practice his activity will be more than hopeless if he does not comprehend for himself the meaning of traumatic concussions, tension, pressure, general stiffness , local asphyxia and violation of organic integrity ".
According to Pirogov, the war is a traumatic epidemic, and the activity of doctors-administrators is important here. "I am convinced from experience that it is not so much scientific surgery and medical art that is needed to achieve good results in a military field hospital, but rather efficient and well-established administration." It is not for nothing that he is considered the creator of the medical and evacuation system that was perfect for that time. The sorting of the wounded in the European armies began to be carried out only after a few decades.
Acquaintance with the methods of treatment by the gakims (local doctors) of the highlanders in strengthening Salta convinced Nikolai Ivanovich that some gunshot wounds heal without medical intervention. He studied the properties of bullets used in the wars of 1847-1878. and came to the conclusion that "the wound should be left as quiet as possible and not to expose the damaged parts. I consider it my duty to warn young doctors against examining bullet wounds with their fingers, removing fragments and generally against any new traumatic violence."
To avoid the danger of severe infectious complications after traumatic operations, Pirogov recommended dissecting the fascia to weaken the "tension" of the tissues, believing that it is harmful to tightly sew the wound after amputation, as advised by European surgeons. Long before he spoke of the importance of wide drainage in suppuration for the release of "miasmatic ferments". Nikolai Ivanovich developed the doctrine of immobilizing dressings - starch, "molded alabaster" (gypsum). In the latter, he saw an effective means of facilitating the transportation of the wounded, the bandage saved many soldiers and officers from mutilation.
Already at that time, Pirogov spoke about "capillaroscopic", and not about the hygroscopicity of the dressing, believing that the better it cleans and protects the wound, the more perfect. He recommended English lint, cotton wool, cotton, peeled tow, rubber plates, but required a mandatory microscopic examination - checking for purity.
Not a single detail escapes Pirogov the clinician. His thoughts on the "infection" of wounds essentially anticipated the method of D. Lister, who invented the antiseptic dressing. But Lister sought to hermetically close the wound, and Pirogov proposed "through drainage, carried to the bottom and through the base of the wound and connected with constant irrigation." In his definition of miasms, Nikolai Ivanovich came very close to the concept of pathogenic microbes. He recognized miasms as organic, multiplying and accumulating in overcrowded hospitals. "The festering contamination spreads ... through the surrounding wounded, objects, linen, mattresses, dressings, walls, floors and even medical personnel." He proposed a number of practical measures: to transfer patients with erysipelas, gangrene, pyemia to special buildings. This was the beginning of the departments of purulent surgery.
Having studied the results of primary amputations in Sevastopol, Nikolai Ivanovich concluded: "Hip amputations do not give the best hope for success. Therefore, all attempts at saving treatment of gunshot wounds, hip fractures and knee injuries should be considered a true progress in field surgery." The surgeon's interest in the body's response to injury is as much as in the treatment. He writes: "In general, trauma affects the whole organism much deeper than is usually imagined. Both the body and the spirit of the wounded become much more susceptible to suffering ... All military doctors know how strongly the state of mind affects the course of wounds, how different the mortality rate is. between the wounded among the defeated and the victors ... "Pirogov gives a classic description of shock, which is still quoted in textbooks.
The great merit of the scientist is the development of three principles for treating the wounded:
1) protection from traumatic influences;
2) immobilization;
3) anesthesia during surgical interventions in the field. Today it is impossible to imagine what and how can be done without anesthesia.
In the scientific heritage of N.I. Pirogov's works on surgery stand out very clearly. Medical historians say so: "before Pirogov" and "after Pirogov." This talented person solved many problems in traumatology, orthopedics, angiology, transplantology, neurosurgery, dentistry, otorhinolaryngology, urology, ophthalmology, gynecology, pediatric surgery, prosthetics. Throughout his life, he convinced that one should not be isolated within the framework of a narrow specialty, but endlessly comprehend it in an inextricable connection with anatomy, physiology and general pathology.
He managed to selflessly work 16 hours a day. It took almost 10 years only to make preparations for a 4-volume atlas on topographic anatomy. He worked at the anatomical theater at night, lectured to students in the morning, operated in the clinic during the day. His patients included both members of the royal family and poor people. Healing with a knife the most severe patients, he achieved success where others gave up. He popularized his ideas and methods, found like-minded people and followers. True, Pirogov was reproached for not leaving the scientific school. The famous surgeon Professor V.A. Oppel: "His school is all Russian surgery" (1923). It was considered honorable to be the pupils of the greatest surgeon, especially when it did not lead to harmful consequences. At the same time, the sense of self-preservation, which is quite natural for homo sapiens, obliged many to give up this honorable privilege in case of personal danger. Then came the time of apostasy, as eternal as the human world. Many Soviet surgeons did this when, in 1950, the publishing house of the USSR Academy of Sciences published an abridged version of N.I. Pirogov, deprived of its former core, which was the spiritual heritage of the "first surgeon of Russia." None of the apostates came out in defense of the mentor, caring more about themselves and deviating from the heritage of the founder of the Russian surgical school.
There was only one Soviet surgeon who saw it as his duty to protect Pirogov's spiritual heritage. A worthy student and follower of N.I. Pirogov, Archbishop Luke (Voino-Yasenetsky) showed himself in the Crimean period of bishop and professorial activity. At the turn of the 50s of the last century, in Simferopol, he wrote a scientific and theological work entitled "Science and Religion", where he paid significant attention to the spiritual heritage of N.I. Pirogov. For many years this work remained little known, like many achievements of Professor V.F. Voino-Yasenetsky in his medical and scientific activities. Only in recent decades, "Science and Religion" by Archbishop Luke has become public property.

Valentin Feliksovich Voino-Yasenetsky, Archbishop Luke (1877-1961) - a great Russian surgeon and clergyman.

What new can you learn about N.I. Pirogov, reading "Science and Religion" nowadays, a work half a century ago, when many Soviet surgeons for many reasons, including a sense of self-preservation, refused to recognize the spiritual heritage of "the first surgeon of Russia"?
“The works of the genius doctor-humanist Professor NI Pirogov, - wrote here Archbishop Luke, - both in the field of medicine and in the field of pedagogy are still considered classic. Pirogov to religion is diligently hidden by modern writers and scientists. " Further, the author quotes “silenced quotations from the works of Pirogov”. These include the following.
"I needed an abstract, unattainable high ideal of faith. And taking on the Gospel, which I had never read myself, and I was already 38 years old, I found this ideal for myself."
"I consider faith to be the psychic ability of man, which more than any other distinguishes him from animals."
"Believing that the basic ideal of Christ's teaching, in its inaccessibility, will remain eternal and will forever influence souls seeking peace through an inner connection with the Divine, we cannot even for a moment doubt that this judgment is destined to be an inextinguishable beacon on the winding the way of our progress ".
"The unattainable height and purity of the ideal of the Christian faith makes it truly lagodat. This is revealed by the extraordinary calmness, peace and hope that penetrates the entire being of the believer, and short prayers, and conversations with oneself, with God," and also some others.
It was possible to establish that all the "hushed up quotations" belong to the same fundamental work of N.I. Pirogov, namely "Questions of life. Diary of an old doctor", written by him in 1879-1881.
It is known that the most complete and accurate (in relation to the original Pirogov manuscript) was the Kiev edition of "Questions of Life. The Diary of an Old Doctor", which was published on the occasion of the 100th anniversary of N.I. Pirogov (1910), and therefore in pre-Soviet times.
The first Soviet edition of the same Pirogov work under the title "From the" Diary of an Old Doctor "was published in the collection of works by N.I. Pirogov" Sevastopol Letters and Memories "(1950). The content of the first Soviet edition shows that it is compared with the editions of the pre-Soviet era (1885, 1887, 1900, 1910, 1916) was the only one from which, for censorship reasons, several large sections were excluded for the first time.This included not only the philosophical section that was included in the first part of Pirogov's memoirs, which he called "Questions of Life" , but the theological and political sections given in the "Diary of an old doctor", which represented the second part of this work. In particular, the theological section and belonged the same "silenced quotations" that were mentioned by Archbishop Luke in his scientific and theological work entitled "Science and religion. ”All these censorship exemptions were partially restored only in the second Soviet edition of Voprosy Zhizn. Diary of the old doctor "N.I. Pirogov (1962), which was published after the earthly days of Archbishop Luke ended.
Thus, Nikolai Ivanovich Pirogov is not only the priceless past of our medicine, but its present and future. At the same time, it is important to emphasize that the activities of N.I. Pirogov does not fit only within the framework of surgery, his thoughts, beliefs go far beyond its limits. If there was a Nobel Prize in the 19th century, then N.I. Pirogov would surely become its multiple laureate. On the horizon of the world history of medicine N.I. Pirogov is a rare embodiment of the ideal image of a doctor - an equally great thinker, practitioner and citizen. So he remained in history, so he lives in our understanding of him today, being a great example for all new and new generations of doctors.

Monument to N.I. Pirogov in St. Petersburg ... I. Krestovsky (1947).

In 2015, at the XII Congress of Russian surgeons, held in Rostov-on-Don, it was decided to approve the Day of the surgeon on the birthday of Nikolai Ivanovich Pirogov - November 25.

The great surgeon and scientist Nikolai Pirogov was once nicknamed "the wonderful doctor". There were true legends about cases of amazing healing and his unprecedented skill. The doctor did not see the difference between the rootless and the noble, the poor and the rich. He operated on absolutely everyone, and devoted his whole life to this vocation. The activities and biography of Nikolai Ivanovich Pirogov will be presented to your attention below.

First idol

The biography of Nikolai Pirogov began in November 1810 in Moscow in a large family. Among the brothers and sisters, the future surgeon was the youngest.

My father worked as a treasurer. Therefore, the Pirogov family has always lived in abundance. The education of offspring was done more than thoroughly. The head of the family has always hired the best teachers. Nikolai first studied at home, and then began to receive education in one of the private boarding schools.

Not surprisingly, as an eight-year-old boy, the future surgeon was already reading. He was impressed with the works of Karamzin as well. In addition, he was fond of poetry, and also wrote poetry himself.

The famous doctor, a friend of the family, Efim Mukhin, often visited the Pirogovs' house. He began to heal even under G. Potemkin. I somehow cured my brother Nikolai from pneumonia. The future surgeon watched his actions and began to play the good doctor Mukhin, imitating him in everything. And when young Nikolai was presented with a toy stethoscope, Mukhin himself drew attention to the child and began to study with him.

To be honest, the parents thought that this childhood hobby would pass over time. They hoped that the son would choose a different path, more noble. But it so happened that it was medical activity that turned out to be the only way of survival not only for the impoverished family, but also for Nikolai himself. The fact is that a colleague of Pirogov Sr. stole a huge amount of money and disappeared. The father of the future surgeon, as treasurer, had to compensate for the shortfall. I had to sell most of the property, move from a large house to a small apartment, limit myself in everything. A little later, my father could not stand such tests. He was gone.

Student body

Despite the deplorable situation of the once wealthy family, Nikolai's mother decided to give him an excellent education. All the family's remaining money, in fact, went to training the future surgeon.

Fourteen-year-old Nikolai became a student of the medical faculty of Moscow State University, adding 2 years to himself upon admission.

At the university, Pirogov succeeded in literally everything - he absorbed knowledge with enviable ease and managed to earn money in order to help the family. I got a job as a dissector in one of the anatomical theaters. Working there, I finally understood that he wanted to become a surgeon.

When the young doctor was already graduating from the university, he realized that the authorities did not need domestic medicine. He was disappointed. For all the years of study at Moscow State University, he did not perform a single operation. And so he hoped that he would come to grips with surgery and science.

Dorpat-Berlin-Dorpat-Paris

Having brilliantly graduated from the university, Pirogov went to Dorpat. He started working in a surgical clinic at the university. Note that this university was then considered one of the best in the country.

The young specialist worked in this city for five years. He finally took up a scalpel and practically lived in the laboratory.

Over the years, Pirogov wrote his doctoral dissertation and defended it magnificently. He was then only twenty-two.

After Dorpat, the scientist arrived in the capital of Germany. Until 1835 he again studied surgery and anatomy. Thus, Professor Langenbeck taught him the purity of surgical methods. By this time, his dissertation had also been translated into German. Rumors about a talented surgeon began to spread throughout all cities and countries. His fame grew.

From Berlin, Pirogov again went to Dorpat, where he headed the department of surgery at the university. He operated independently then. The young man managed to show his excellent skill as a surgeon. In addition, he published a number of his scientific works and monographs. These works strengthened his great authority as a scientist.

During this period, Pirogov also visited Paris, examined the best metropolitan clinics. Note, he was disappointed with the work in such institutions. Moreover, the death rate in France was very high.

In Petersburg

As the short biography of Nikolai Ivanovich Pirogov testifies, in 1841 he began to work at the University of St. Petersburg at the Department of Surgery. In general, I worked there for ten years.

His lectures were attended not only by students, but also by students from other universities. Newspapers and magazines constantly published articles about the talented surgeon.

After a while, Pirogov became the head of the Tool Factory. From now on, he himself could invent and design medical instruments.

He also started working as a consultant in one of the St. Petersburg hospitals. The number of clinics to which he was invited grew rapidly.

In 1846, Pirogov completed the project of the Anatomical Institute. Now students could study anatomy, learn to operate and observe.

Anesthesia test

In the same year, anesthesia was successfully tested, which began to conquer all countries with enviable speed. In just one year, 690 operations were performed in 13 Russian cities under ether anesthesia. Note, 300 of them were made by Pirogov!

After a while, Nikolai Ivanovich arrived in the Caucasus, where he participated in military clashes. Once, during the siege of an aul called Salty, Pirogov had to perform operations on the wounded under anesthesia in the field. This was the first time in the entire history of medicine.

War in Crimea

In 1853, the Crimean War began. A short biography of the doctor Nikolai Ivanovich Pirogov contains information that he was sent to the active army in Sevastopol. The doctor had to work in terrible conditions, in huts and tents. But nevertheless, he performed a huge number of operations. In this case, surgical interventions were carried out only with ether anesthesia.

It was also during this war that a physician first used a plaster cast. In addition, thanks to him, the institution of "sisters of mercy" appeared.

The surgeon's popularity grew steadily, especially among ordinary soldiers.

Opal

Meanwhile, Pirogov returned to the capital. He reported to the sovereign about the illiterate leadership of the Russian army. However, the autocrat did not heed the advice of the famous doctor at all. And he fell out of favor. Pirogov left the St. Petersburg Academy, became the trustee of the Kiev and Odessa educational districts.

Pirogov Nikolai Ivanovich (a brief biography of this) tried to change the entire education system in schools. But in 1861, such actions led to a serious conflict with the local authorities. As a result, the scientist was forced to resign.

Over the next four years, Pirogov lived abroad. He headed a group of young specialists who went there for academic qualifications. As a teacher, Pirogov helped a lot of young people. So, it was he who was the first to guess his talent in the famous scientist I. Mechnikov.

In 1866, Pirogov returned to his homeland. He came to his estate near Vinnitsa and organized a hospital there. And it's free.

Last years

A short biography of Nikolai Ivanovich Pirogov for children contains information that he lived on the estate almost without a break. Only sometimes I went to the capital and to other countries. The famous surgeon was invited there to give his lectures.

In 1877, the Russian-Turkish war began. And Pirogov again found himself in the thick of terrible events. He arrived in Bulgaria and, as always, began to operate on the soldiers. By the way, as a result of the military campaign, the famous surgeon published his next work on "military medicine" in Bulgaria at the end of the 70s of the nineteenth century.

In the spring of 1881, the public celebrated the half-century anniversary of Pirogov's scientific work. Famous people from different countries came to honor the scientist. It was then, during the celebrations, that he was diagnosed with a terrible diagnosis - oncology.

After that, Nikolai Ivanovich went to Vienna to be operated on. But it was too late. At the very beginning of December 1881, the unique scientist was gone.

By the way, shortly before the death of Pirogov, he discovered a new way of embalming the deceased. By this method, the body of the surgeon himself was also embalmed. It is buried in a tomb on his estate.

Surprisingly, this territory during the Great Patriotic War was one of the Fuhrer's headquarters. The invaders did not disturb the remains of the great doctor.

Nikolai Pirogov: biography, personal life

Nikolai Pirogov was married twice. The first wife of the surgeon was Ekaterina Berezina. She was born into a noble but severely impoverished family. She lived in marriage for only four years. During this time, she managed to give Pirogov two sons. The wife died giving birth to her youngest son. For Pirogov, the death of his wife was a terrible and heavy blow. By and large, he blamed himself for a long time and believed that he could save his wife.

After the death of his wife, Nikolai Ivanovich Pirogov, a brief biography of which is presented to your attention in the article, tried to get married two more times. All these cases were unsuccessful. And then he was told about a certain 22-year-old girl. She was nicknamed "the lady with convictions." We are talking about Baroness Alexandra Bistrom. She admired the scientist's articles and, in general, was very interested in science. Thus, Pirogov found a woman who was close in spirit.

The scientist proposed to Bistrom, and she, of course, agreed. After the marriage, the couple began to operate on the patients together. Pirogov supervised the process of the operation itself, and the baroness assisted him. The great surgeon was then forty years old.