Introduction. The bodies of zemstvo self-government, created in 1864 and gradually spreading throughout the territory of the Russian Empire, performed important social functions: the development of education, medicine, assistance in difficult circumstances (crop failure, fires), etc., and this activity was directed primarily on the peasant population. The prevention of epidemics and the provision of medical assistance in the event of their beginning were the most important areas of work of zemstvos. In the provinces, a district network of medical and paramedic points was created which constantly monitored the epidemiological situation in the villages, in a number of provinces special sanitary points were opened. The implementation of anti-epidemiological measures was carried out at the expense of the provincial zemstvo on the proposal of the governor. Special infectious barracks were opened to reduce the number of patients and for seriously ill patients during the epidemic. Employees of zemstvo hospitals carried out work in different directions: conducting explanatory conversations with the population about the observance of sanitary standards, the need for vaccinations for children, vaccinations (mainly for children), examination and prescribing treatment for patients, maintaining medical statistics. Such work yielded results: the number of epidemics and cases decreased, but it was impossible to prevent epidemiological diseases completely until 1917. Methods. The solution of the set research tasks was provided by a complex of interrelated theoretical (analysis of scientific literature, comparative analysis, comparison, generalization, systematization), empirical (study and generalization of sources) and hermeneutic methods. Results. Zemstvo medical activity from 1864 to the end of the 1870s only determined the directions of work, was inconsistent and in the field of combating epidemics was fragmented. In fact, the work was not limited to preventing epidemics but to eliminating those that had already broken out. The state did not provide special assistance to the zemstvos in this direction. Only in 1879, due to the strongest epidemic of diphtheria at the government level, “Mandatory rules on measures to prevent the development of infectious diseases” were introduced. In accordance with which, mandatory sanitary and police measures against the spread of these diseases began to be determined. Conclusion. The selfless work of zemstvo medical workers, the introduction of a system of measures to prevent diseases led to a reduction in both the number of epidemics and the number of cases, but it was impossible to eliminate the epidemics completely until 1917.
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