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2.

The initial stage of development of otorhinolaryngology in Europe and in Russia.

Otorhinolaryngology
as a separate clinical discipline
originated
in Europe in the second half of the nineteenth
century.
It could arise
only when necessary
prerequisites -significant
achievements in the study of anatomy, physiology
and pathology of the sense organs, upper
respiratory and esophageal tracts, and
also at a certain level of development
technology,
including widespread
sources of artificial
lighting, especially electric.
The most important instrument used in
otorhinolaryngology and being
as if a hallmark of ENT
doctor, is
forehead reflector or forehead light
any design.
These devices provide illumination
and inspect
deep sections of ENT organs, i.e.
perform endoscopy.

Appearance
frontal reflector in the clinical
practice is connected
with the name of Hoffmann (Nog.g.tap, 1841) – private
German
a doctor who lived in a small town
Germany. He offered to see
regular mirror, middle part

6

whom
amalgam was removed in the form of a small
mug. In the future, the Hoffmann mirror
has undergone a number of improvements.
The most well-known variant proposed
würzburg otiatrist professor
Anton Troelch (Arm.op v
.
Tgoe11:5sp, 1861) . Troeltsch mirror has
modern concave
surface for focusing
received light
from the source and direct it to the object
examinations. For
convenience of work and release of the second
hand holding
examination mirror, last in
Troeltsch’s performance was strengthened
(as it is currently done)
special
headband (belt, rim).
Essential
milestone in the development of endoscopy as the main
and the most important method of ENT research
bodies have served as successful
autolaryngoscopy experiments carried out
famous spanish
singer and singing professor Manuel
Garcia (Carsla)
in 1855. It should be noted that Garcia
there were predecessors
but the inspection methods they proposed
larynx did not find distribution among
contemporaries (Dobromilsky F.I.,
1959). Using the throat mirror, Garcia
studied on my own
patterns of voice formation, and
results of their observations
detailed and published.

Merits
Garcia have been highly acclaimed by scientific
the public.
Among the many awards received
them from different countries during his celebration
on the occasion of the centenary of
birthday and 50th anniversary of the invention
im laryngoscope,
conducted by the Royal Medical
and surgical
society in London (1905), there was also a large
gold medal for science from Germany. ABOUT
the significance of this award
speaks of the fact that by this time
Only 4 were awarded this medal.
famous scientists – Virchow, Koch,
Erlich and Mommset.

7

Implementation
method of laryngoscopy in medical
practice connected
with the names of Türk (Tig1s), Viennese
neurologist,
and Cermak (Cremma1<), professors physiology from Prague, who quickly appreciated the dignity and perspective of this method for the clinic and since 1857. started promote it vigorously introducing various improvements and expanding its scope. So, in 1859. Cermak applied mirror inspection principle nasopharynx and posterior parts of the nose, calling it rhinoscopy, although it is more correct would be called posterior rhinoscopy.

Taking advantage
rhinoscopy mirror, Cermak in
1860 first
discovered adenoids, and the Danish physician Meyer
(Meyer) in 1868.
performed the first adenotomy. After
study and substantiation
laryngoscopy and posterior rhinoscopy
Cermak turned to the development of a method
currently known research
time as an anterior rhinoscopy. In that
helped him
Slovak Markushovsky (Mag1<:u5ОУ5]<.u) , professor from Pest, who designed the nasal mirror to inspect the front sections of the nose. The basis of this device model was laid ear speculum of a German surgeon XVII century William Gildana 1560-1634). Further dozens of modifications have been proposed nasal mirror, however, their modern form is not much different from instrument Markushovsky.

Russia
became a country where the method of laryngoscopy
quickly found
own supporters. Among the first
domestic laryngoscopists
you need to take the pediatrician K.A. Raukhfus and
therapist
D.I. Koshlakov – assistant to Prof. S.P. Botkin
In Petersburg,
and also N.Ya. Shkotta – assistant to prof.
G.A. Zakharyina
in Moscow.

Founders
Russian therapeutic school S.P. Botkin
And
G.A. Zakharyin organized in their
clinics

8

laryngoscopy
rooms where not only the sick were treated,
But
and taught laryngoscopy.

K.A. Raukhfus,
one of the founders of Russian
pediatrics, very
quickly introduced laryngoscopy in
study of children. In 1861 for the first time in
world performed a dissection operation
thyroid
cartilage to remove a tumor of the larynx,
identified
laryngoscopy. Soon K.A. Raukhfus
described in detail
clinic for stenosis of the larynx, as well as a clinic
acute subglottic
laryngitis (false croup).

United
the efforts of a number of doctors brought the domestic
laryngology
from the initial period to the wide road.
Already in 1861.
(i.e. 2 years after publication
first edition
Cermak’s books about the laryngeal mirror)
appeared dissertation
work of Ivan Turine (Medico-surgical
academy)
Throat mirror and its application
to the recognition of diseases of the larynx,
work of I. T. Zhukovsky “Laryngoscopy
kit for practitioners” and
the work of K.A. Rauchfus
“On cauterization and incision of the larynx”.

TO
among the first Russian laryngoscopists
rightly attributed
and I.A. Zborovsky – intern
therapeutic department of the Moscow
military hospital. He is in Moscow for the first time
in 1864, after returning from a foreign
business trips,
introduced laryngoscopy into clinical practice
and then
spent a lot of medical treatment in the hospital
and pedagogical work
in laryngology.

Although
the beginning of otorhinolaryngology in Europe,
as noted
above, was laid in the middle of the XIX
century,
already in the first
his decades in Russia, a number of major
anatomists, surgeons
and therapists, as well as practitioners
physicians paid significant
attention to the study of anatomy, physiology,
diagnostics
and treatment of those organs that subsequently
have become the subject of a new clinical
disciplines.

.9

So,
at the beginning of XIX
V.
the original Russians were published
manuals and separate works on
anatomy prof. SPb. Moscow Art Academy P.A.Zagorsky
(1764-1847) and prof. Moscow University
E.O. Mukhina
(1766-1850), which already contained valuable
intelligence
in structure and partly in physiology
ear, nose and throat.
It should also be noted that the
Latin language monograph
A. Fisher “Anatomical and physiological
treatise on human hearing” (Moscow,
1825), as well as the Classical Image
auditory
organ” by I.V. Buyalsky (St. Petersburg, 1833).

Significant
the description of the operation is also of interest
on the frontal
sinuses, made by practical Russian
doctor F. Schuller
(“Surgical notes from my
practices”, VMZH, 1826). This
the surgeon removed the anterior and partially posterior
frontal walls
sinuses due to their acute inflammation,
occurring after injury. Despite,
that before the operation the patient had
brain phenomena, intervention passed
successfully and arrived
recovery. Apparently it was
first described
in Russia a case of radical autopsy
frontal sinuses.

Elementary
period of development of otorhinolaryngology
connected in Russia
mainly from the Medico-Surgical
academy (so called
Military Medical Academy until 1881) and
calculated almost from the time
foundations (1798).

Treatment
patients with diseases of the ear, nose and
throat and teaching
separate sections of this
established discipline
was originally distributed among
Department of Surgery
and the Department of Hospital Pathology and
therapy. Chair
surgery from 1800 to 1833. headed by I.F. Bush
(1771-1843),
and with good reason should be considered
founder
Russian otiatry. I.F. Bush at lectures and
practical
classes gave his students the opportunity
get
in-depth knowledge of otiatry and partly
in rhinology.

10

His
capital three-volume “Manual
to the teaching of surgery,
written in Russian, from 1807 to
1823 survived
five editions and for almost half a century
served as the main guide for Russians
surgeons. However, the chapters on
surgical treatment of diseases
ear and partially
nose, occupy over 100 pages. They
set out so
thoroughly and in detail that some
ENT historians,
among which A.M. Puchkovsky (1914) and
B.S. Preobrazhensky
(1960), consider this section the first
domestic
guide to ENT specialty.

Questions
non-surgical diseases of the nose and
throats were detailed
covered in the works of prof. private
pathology and therapy K.F.Uden (1754-1823),
which he regularly (starting with
1818) published in the journal “Academic
reading “. K.F. Uden,
in particular, proposed a classification
angina, which
praised by one of the greatest connoisseurs
pathology of the lymphoid
pharyngeal apparatus acad. B.S. Preobrazhensky
(1960). In this classification, K.F. Uden
isolated angina serous, catarrhal,
phlegmonous, purulent, malignant,
polyposis
and, most interestingly, symptomatic.

Successor
I.F. Bush at the Department of Surgery prof.
H.H. Salomon
(1796-1852) also paid considerable attention
surgical
otorhinolaryngology. This is evident from
presentation of relevant issues in
his manual “Initial Foundation
operative surgery”.

IN
subsequent years teaching individual
issues of otorhinolaryngology moves
to the Department of Theoretical, and then
surgical pathology, which
1852-1867 led
Professor P.P. Zablotsky-Desyatovsky. IN
in particular, he
paid much attention to surgical
diseases of the nose, maxillary
sinuses, oral cavity, etc. Its materials
lectures
set out in a number of printed works: “About
jaw diseases

11

sinuses”
(VMZH, 1854), “On diseases of the mouth and neighboring
parts to him” (Tr.
Russian doctors, 1856), “On diseases of the nose
and nasal cavities
(VMZH, 1857). Interesting ideas of the author
that
chronic diseases of the adnexa
nasal cavities are often asymptomatic.
Expressed in the middle of the 19th century, they remain
relevant at the end of XX
century.
P.P. Zablotsky-Desyatovsky
described not only the symptoms of inflammation
maxillary sinus, but also clinic
and nasopharyngeal fibroma surgery.

special
attention deserves a contribution to the development
clinical otorhinolaryngology
and teaching its individual sections,
made
the great Russian surgeon N.I. Pirogov,
which in 1841-185bgg.
supervised at the Medico-Surgical
academy clinic
hospital surgery. Need to mark,
that N.I. Pirogov
did not conduct a special course of otorhinolaryngology,
however
his interest in this discipline can be
see in one
list of his lectures.

So,
among the lectures given by N.I. Pirogov and
relevant
to otorhinolaryngology, may be
the following are mentioned:
“About plastic surgery in general and
about rhinoplasty
features”, “Tracheotomy and
laryngotomy”, “About fistulous passages
windpipe”, “About the suffering
windpipe and
larynx”, “Language of the external
carotid artery”, “Polyposis growths
in the nasal cavity”, “Cancer operation
maxillary cave”.

N.I. Pirogova
should also be considered a pioneer of domestic
military
ENT traumatology. lon1bus reg
sogriz pitapit
conde S.a’bum 1:r1p11c1 cues’nione uc’bus
Shiz’ba’ba” (“Topographical
anatomy illustrated by cuts,
conducted
through the frozen human body in three
directions”),
published in 1852-1853.

However
teaching individual questions
otorhinolaryngology
in those years there was still no systematic
character.
At the same time, if the teaching of rhinology
and organ anatomy
hearing and upper respiratory tract
until the end of the 60s
Х1Хв. at the Medical-Surgical Academy
more than
or less satisfactory, then otiatry
On the other hand, since the late 1950s, practically
was not taught, and at the academy
there was no special department
for ear patients
(Puchkovsky A.M., 1914).
systematic teaching of basic
sections of otorhinolaryngology and rendering
medical care for ENT patients at the academy
and forming it as a separate
clinical discipline along with
objective reasons were
some random circumstances.

So,
one of the patients of the academic
surgical clinic,
lieutenant Tamara, who was there in 1866
d. being treated for an ear disease,
complained to the military
Minister with a request to transfer him for
treatment in St. Petersburg
Maximilian hospital for
incoming patients, because at the academy he
could not get relief from his illness
due to the lack of ear tools in it
(Spangler A.E., 1898).
Around the same time, in 1866, with
report
addressed a note to the Minister of War
and MD
R.R. Vreden (senior), father of the famous
trauma surgeon
R.R. Vreden (junior). In a note
indicated

13

on
lack of teaching in the Medico-Surgical
Academy and Russian
universities teaching about ear diseases,
the consequence of which
is the lack of specialists in
such an important branch of medical
knowledge in the military medical department,
and between
there are a considerable number of topics in the troops
sick, suffering
ear diseases.

R.R. Vreden
proposed to recognize the unconditional
the need for teaching
otiatricians in academies and institutions in
big military
hospitals of special departments for
ear patients who
trained
medical specialists (Spangler
A. E., 1898) .

Here
it must be recalled that in St. Petersburg in 1850
academy graduate
M.D., a Dutchman
origin, Vanderflaas
(Yap o!er Paaz) a private
clinic for
incoming (i.e. outpatient) patients.
Obviously it was
the world’s first clinic. Soon she
became known as Maximilianovskaya,
in honor of the famous patron
charitable
establishments of Russia Duke Maximilian
Leuchtenberg.
This popular among Petersburgers
polyclinic
has been preserved up to the present. IN
hospital since 1851.
two otiatrists, Germans by nationality,
F.P. Okkelem
and N.L. Glamm an ear cabinet was opened,
which was a great success
among the population. So, only since 1858
to 1861 it was visited by 2776 ear patients.

WITH
1859 joined these experts
and already mentioned
above is a recent graduate of the Medico-Surgical
academy R.R. Vreden,
doctor of the Life Guards Cavalry Regiment. In 1863
on material
Maximilian Hospital R.R. Vreden
defended the first Russian otiatric
dissertation written by
in Russian: “Catarrhal
middle ear inflammation and surgery
artificial perforation of the drum”.
R.R.Vreden arranged
and the first in the military medical department
special

14

otiatric
department for ear patients with increased
infirmary
Life Guards Cavalry Regiment. Later, in
1879 this branch
was transferred to Petersburg
Nikolaev military
hospital, which represents an undeniable
military interest
otorhinolaryngologists.

Conference
(Academic Council) Medical and Surgical
academy,
for the discussion of which, by order
Minister of War
the above
memorandum,
fully agreed with the opinion of R.R. Vreden.
And since 1866.
organized at the academy
teaching systematic
(originally privatdocent) courses
in otiatry and rhinolaryngology. These
courses were taught on the basis of the academic
therapeutic clinic headed by
prof. S.P. Botkin,
who personally played a major role in
development and establishment of the national
ENT discipline. It was his students who
the first ENT professors: laryngology
– D.I. Koshlakov and
otiatrists – A. F. Prussak.

IN
1884 D.I. Koshlakov is elected to the chair
hospital
therapy,
where it allocates “laryngeal compartment”
for 11 beds,
which
led by a disciple and
S.P. Botkina
N.P.Simanovsky. ‘

3.
N.P.Simanovsky
and its role in the development of domestic

Otorhinolaryngology.

WITH
name of N.P.Simanovsky begins
new and important

stage
in the development of domestic otorhinolaryngology.

close
affinity between the sufferings of the organ of hearing
and diseases
larynx and nose put on the agenda
day the need for joint study
and teaching these specialties
in one department. With this in mind, professors
A.F.Prussak
and N.P.Simanovsky in 1890g. excited
petition before
Academy Conference on Connection
these departments in

15

single
and the need to identify clinical
beds for treatment
patients with otorhinolaryngological
profile.

Petition
was satisfied and supported by the military
minister.
For the new merged clinic, it was
room provided
in the old academy building on the corner
Nizhny Novgorod and Samara streets (now
Lebedeva and Botkinskaya streets), earlier
busy
Clinic for Mental and Nervous Diseases.
The hospital had 30
beds, outpatient clinic, operating room and
small audience. Reception
outpatients began on January 8
1893y. (27th of December
1892), and admission of inpatients – 4
April (March 23)
1893 These dates should be noted in
stories /-\
Russian otorhinolaryngology.

By
years of service, Professor A.F. Prussak left
retired and first
Department of Otorhinolaryngology in Russia
headed by professor
N.P.Simanovsky. ENT teaching
disease becomes
mandatory, and the existence of such a joint
ENT department
became a role model and
organization of similar departments
at medical faculties of Russian
universities. 9world war.

Thesis
N.P.Simanovsky for the degree of doctor ⁰
medicine, proposed by S.P. Botkin,
titled “On the Question of the Influence
stimulation of sensory nerves
departure and meals
heart “(1881). It was performed in
physiological laboratory
Department of S.P. Botkin, led by
I.P. Pavlov. In this work, for the first time
experimental data are presented
about the reflex origin as
changes in the rhythm of the heart,
and trophic changes in the heart
muscles under the influence of chronic
annoyances

16

endings
sensory nerves. Scientific, creative
connection and friendship
N.P.Simanovsky with I.P.Pavlov,
continued throughout
throughout their lives, determined not only
physiological
focus of the work of N.P.Simanovsky
and his students, but also
otorhinolaryngological interests
most
I.P. Pavlova. The object of his scientific
attention were auditory
and olfactory analyzers and upper
Airways.
His student L.A. Andreev (1891-1941), a prominent
Soviet surgeon
and physiologist, in the laboratory of I.P. Pavlov
at the Institute of Experimental
medicine, performed well-known
research
on the physiology of the auditory analyzer,
who gave experimental
substantiation of the “resonant theory”
hearing Helmholtz.

First
scientific works of N.P.Simanovsky and his
schools continued
in line with the interests of therapeutic
clinics of S.P. Botkin
and dealt mainly with diseases
lymphoid
pharyngeal ring and larynx. Further
efforts
N.P.Simanovsky and his students discipline
acquires
surgical direction. Successfully
are being developed
and surgical methods are being introduced
throat treatment,
larynx, paranasal sinuses and ear.

Obvious
the success of the young department allowed
N.P.Simanovsky
to the 100th anniversary of the Military Medical
academy to achieve the construction of a new
a separate building of the throat clinic,
nasal and ear diseases, which was
open at the beginning
1902y. in the green zone of the Clinical Academy
street. Clinic
was built with the latest
achievements of world medical
Sciences.

IN
1911 N.P. Simanovsky, taking into account the needs
emerging
aviation, raises the question of the meaning
cochlear function
and vestibular apparatus for aviation.
Research
were entrusted to his student – Privatdozent

17

V.I. Voyachek,
achieved in this direction
impressive results.

N.P.Simanovsky
created a large scientific school. Worthy
mentions
such famous students as
B.V. Verkhovsky, M.F. Tsytovich,
V.I.Voyachek, S.I.Belikov, N.P.Aspisov,
N.S. Orembovsky,
P.P. Shevelev, N.V. Belogolovov, A.E. Spengler,
A.Ya.Galebsky, A.M.Samoilenko,
P.A. Arandarenko, Ya.B. Kaplan. Many
of them headed departments and, in their
queue, created by yourself
their scientific schools. In this, perhaps
one of the most important
merits of N.P. Simanovsky to the national
science.

So,
“first chick” to leave the nest
N.P.Simanovsky,
became B.V. Verkhovsky, who headed the second
in Russia
ENT department in 1904 in Petersburg
women’s medical
institute. He is in 1911. Was assigned
rector of this
institute.

M.F. Tsytovich,
one of the most talented students
N.P.Simanovsky,
sent to them in 1914. manage ENT
department
in Saratov. Clinic for this department at
Saratov University
was built in the likeness of an ENT clinic
military medical
academy with personal funds donated
N.P.Simanovsky.
So on the Volga under the leadership of M.F. Tsytovich
a new powerful scientific center
Russian otorhinolaryngology. Clinic
M.F. Tsytovich, according to one of
his students, Professor I.I. Lukov,
became a “true nursery
oto-rhino-laryngological knowledge for
all extensive
south-east of Russia”. New, now
already the school of prof. M.F. Tsytovich
became one of the most fruitful
scientific branches,
originating in the Military Medical
academy. So,
students of M.F. Tsytovich, who became
professors and heads of departments
and research institutions
are:
L.E. Komendantov, V.K. Trutnev, A.A. Potapov,
T.Ya.Abramov,
I.I. Lukov, B.N. Lukov, A.V. Saveliev,

18

A.
T. Bondarenko, N.A. Karpov, A.A. Atkarskaya,
N.A. Nikolaev, N.N. Lozanov,
I.P. Kutepov, Ya. M. Shapiro, I.V. Goldfarb.
Many of
they left a bright mark in the national
science.

Deserves
special mention and Bulgarian scientist
S.I. Belikov,
defended in 1908 under the guidance
N.P.Simanovsky
dissertation “On the issue of recognition
diseases
ear labyrinth”. and later became
patriarch
Bulgarian otorhinolaryngology.

Most
famous student of N.P.Simanovsky –
V.I. Voyachek took over
from him the baton of the leadership of the ENT department
Military Medical Academy and with dignity
continued the development of the best traditions,
laid down by his teacher in the clinical,
scientific and teaching
department activities.

Grateful
memory of the professor of the Military Medical
academy
– Academician N.P.Simanovsky as a relay
transmitted from
generation to generation, defining the tuning fork
domestic otorhinolaryngology.

Development
national otorhinolaryngology
contributed
organization of scientific and practical societies
by specialty.
The first ENT society in Russia was
organized
in Moscow in May 1897. Dr. N.Ya. Shkott,
second
– in November 1903. Petersburg, which
headed by N.P.Simanovsky.
Soon (December 1905) in St. Petersburg
another society was formed, which
was organized on the initiative
professors of the Clinical Institute
V.N. Nikitin and V.N. Okunev, as well as Dr.
medicine L.T. Levin, who later became
one of the largest domestic
otiatrists. United
in 1930 into a single ENT society, they created
one
of the largest in our country
Leningrad-Petersburg
otorhinolaryngological school,
determining to a large extent
degree person of the Russian ENT specialty.

19

Both
Petersburg ENT society, competing
among themselves, became
to publish the first Russian magazines on
specialty – “Monthly
ear, throat and nose diseases
(1907) and “Messenger
ear, throat and nose diseases
(1909). The publication of these
magazines ceased due to the revolution
1917 Magazines
were able to unite all the color around them
Russian otorhinolaryngology
and play a decisive role in the development
in Russia
new clinical discipline. They were able to
become not only
an important stimulus for its scientific progress,
but also allowed a wide range of doctors
Russia to obtain the necessary knowledge for
orienteering
in difficult cases of their practical
activities.

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