Medical Professionals and Public Health in Russia to 1770

Abstract The Russian medical profession in 1770 was only half-prepared to cope with any public health emergency. Nevertheless, in fighting the plague of 1770-72 professional medical practitioners were more numerous, more active, and more influential than they had ever been in Russia. Their vigorous antiplague efforts exemplified the comparatively recent, rapid introduction to Russia of European standards of public health and professional medical care. Beginning in the seventeenth century, two powerful stimuli, incessant warfare and recurrent epidemics, expedited the formation of public health institutions in Muscovy and its Europeanized successor, the Russian Empire. War and disease often interacted to cause widespread crises. By threatening the armed forces in particular, epidemics imperiled Russia’s foreign and domestic policies in general, as seen in the coincidence of plague, warfare, and internal disarray in 1654-56, 1709-12, 1727-28, and 1738-39. Military needs and military personnel therefore dominated Russia’s new medical institutions. In the eighteenth century, the bureaucratized medical administration and profession devoted even greater attention to communicable disease as it affected the reorganized, standing army, the newly created navy, and the population at large. All these institutional developments enabled medical professionals to assume prominent roles in the Russo-Turkish War of 1768-74 and the plague that it provoked. Together, the plague and the war assaulted the empire’s emergent public health institutions, disclosing weaknesses that temporarily overshadowed the many medical developments since 1700.