Providing civil medicine in the East Siberian region by lower medical ranks in the 19th century

In the qualification registers of medical positions of the Russian Empire of the 19th century the lower medical ranks included medical students, paramedics, midwives and paramedics-midwives. In this list, the appearance of the term “medical student” is associated with the opening of the Moscow General Hospital and hospital school in 1707. The concept of “medical student” simultaneously denoted both the status of a student at a hospital school and the position of a doctor’s assistant. In the military department (army, navy) the complete transformation of the concept of “medical student” into the term “paramedic” dates back to the 40-s. In the 18th century, when garrison schools appeared, the students of these schools were sent to military hospitals for “exercises in supervising the sick”: dressing wounds, bloodletting, chiropractic care, etc. According to the data of the professor of the St. Petersburg Medical-Surgical Academy, the author of the first work on the history of medical education in Russia, Y.A. Chistovich, the most capable in training, after a 5-year term, were promoted to medical assistants, the remaining students were sent to receive the title of barber in military units. From the middle of the 18th century paramedics became a mandatory unit in every military hospital. However, for civilian medicine, the process of training paramedics was significantly extended in time and had variable content. In this article we will consider the features of the formation of paramedics in Eastern Siberia in the 19th century, we will determine the main measures to provide the region with lower medical ranks for civil (command) medicine, based on a wide range of sources introduced into scientific circulation for the first time, we will give a comparative description of the effectiveness of the measures.

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