Земская и горнозаводская медицина Пермской губернии в 1870–1880-х годах: начало взаимодействия

Abstract

The initial experience of the interaction of zemstvo institutions and factory directorates in the medical field of the Perm province in the 1870-1880s is analyzed. This cooperation has contributed to the processes of medicalization of the local population in the framework of a more global trend of modernization of Russia. Particular attention is paid to the inconsistency of the regulatory framework of the organization and activities of both mining and zemstvo medicine. This predetermined the complex nature of the relationship between zemstvo institutions and factory directorates. A classification of interaction in the Perm province is proposed in four main areas: a joint discussion of the problems of the medical sphere in various deliberative bodies of the county and provincial levels; admitting of zemstvo patients for inpatient treatment in factory hospitals; organization of joint feldsher's courses; combining zemstvo and mining medicine through the creation of two types of medical sites. According to the agreements concluded in the zemstvo-factory sections, the organization of medical assistance to the entire local population was transferred to the zemstvo, and the factory-zemstvo - to factory administrations. By the end of the 1880s, 11 combined sections were functioning in Yekaterinburg, Verkhotursky and Perm counties: four zemstvo-factory and seven factory-zemstvo. It is proved that it is possible to date the completion of the formation stage in the interaction of zemstvo and mining medicine in the Perm province by this time.