MAIN ACHIEVEMENTS OF THE NATIONAL MEDICINE DURING THE GREAT PATRIOTIC WAR

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With every year that has passed since the Great Patriotic War, the heroic feat of the Russian people and the mighty army is revealed more fully and brighter, the role of medicine in this victory becomes more and more noticeable and obvious. The events of the Great Patriotic War did not take doctors by surprise, since there was military medical experience in the Far East, Mongolia, where doctors were thoroughly prepared for a new impending military threat.

During the war, doctors returned to service more than 10 million personnel. Therefore, the worthy contribution of surgeons and doctors of all specialties to the Great Victory of our people can hardly be overestimated. And of course, conditions were created that required new proposals and effective solutions in the implementation of therapeutic and preventive measures.

So, A.V. Vishnevsky invented the method of local layer-by-layer anesthesia, which became quite widespread in those years and was used in 85% of cases. The first domestic antibiotic (penicillin), obtained in 1942 by microbiologist Z.V. Yermolyeva, provided excellent universal protection against infectious infections and complications.

Professor A.N. Bakulev introduced a radical surgical treatment of craniocerebral wounds with the imposition of a blind suture, regardless of the timing of the surgical intervention. Soviet scientist F.I. Mashansky made a huge contribution to the surgery of nerve tissues damaged by wounds. And the chief surgeon of the besieged Leningrad F.G. Uglov performed the first successful lung resection.

Hemotransfusiology began to gain its popularity during the Soviet-Finnish war of 1939-1940. One of the outstanding Soviet surgeons, a student of S.P. Fedorov - V.N. Shamov proposed the idea of ​​developing standard sera that determine blood belonging to a certain group, which was successfully implemented by his colleagues I.R. Petrov and N.N. Elansky. That is, even before the onset of the war of 1941-1945. the blood service began to function.

However, the massive use of donated blood for the treatment of, first of all, hemorrhagic shock, and in emergency situations, even direct, from person to person, becomes a common occurrence precisely during the Great Patriotic War. The transfusion of blood and its substitutes was one of the most important needs in the midst of hostilities. Transfusiology with its knowledge has contributed to the preservation of millions of lives.

It is important to note that not only medical staff, but also civic duty, the patriotism of the population developed a new direction. Many citizens of the Soviet Union, realizing the gravity of the situation, donated their blood to save their defenders. During the war, blood transfusion stations began to develop, which led to the development of a donor movement on a large scale. The blood transfusion service saved the lives of many wounded soldiers.

However, the donor service was not formed immediately. It has several periods of its development. The first stage in the formation of donor assistance was associated with its formation and the emergence of the main divisions. In 1941, the Main Military Sanitary Directorate sent the "Instruction on blood transfusion in the Red Army" and a number of rules for safe blood transfusion. The duties of nurses before transfusion included determining the blood group of the wounded. But in the most difficult conditions of intense fighting and the workload of orderlies, the most expedient to save time was the introduction of blood type 1 (universal donor blood).

The management of the organization of blood transfusion was entrusted to the chief surgeon at the front. Since 1941, blood transfusion groups were created in all army units, which included two nurses and a hematologist who monitored the receipt, storage and transportation of blood.

At the second stage, there was an accumulation and implementation of the knowledge and experience gained, as well as the creation of new blood services in various areas and the formation of mobile points for its transfusion, which ensured more efficient operation of the unit.

Thanks to scientific research and discoveries in this area, such as the phenomenon of hemagglutination (gluing of red blood cells that occurs under the action of incompatible blood serum), determination of the blood group and its factors, the mass introduction of blood transfusion has become possible.

In the hospitals of the Red Army, ampoules TsIPK (ampoules developed at the Central Institute of Blood Transfusion), standard banks, funnels and siphons were used as devices for blood transfusion. From such primitive methods of transfusion, in which funnels, Esmarch circles and conventional syringes were used, they gradually switched to the use of CIPC ampoules and standard jars containing blood. In the absence of such devices, preserved blood was collected in ordinary bottles, and the transfusion was carried out using funnels or by siphon using a set of glass and rubber tubes.

The device A.D. was developed at the Leningrad Institute of Blood Transfusion. Belyakova - a more advanced siphon set with a glass dropper and a tee. A feature of this device was the possibility of blood transfusion both by injection (syringe) and drip method. This made it possible to transfuse blood from any vessel in which it arrived at the front. If long-term transfusion was needed, the use of a dropper could be dispensed with using an air drop counter, which was developed by B.V. Petrovsky.

Also during the war, it became necessary to warm the blood to 38 ° C for the seriously wounded with the rapid introduction of the first portions. In other cases, blood was transfused at room temperature. Most often, blood was administered through venipuncture, only in severe cases of shock, when the suction activity of the heart was weakened; intra-arterial transfusion was carried out, which was performed quickly under a pressure of at least 100-140 mm Hg.

Very often, doctors in this difficult time for everyone had to create devices for drip blood transfusion from improvised means. The work of one of the front-line doctors V.S. Yurov, and later the rector of the Volgograd Medical University (in 1951-1963); about the method of creating such equipment in the field is stored in the museum of this university.

Through the efforts of such military transfusiologists as A.A. Bagdasarov, O.K. Gavrilov, N.G. Kartashevsky, I.S. Kolesnikov, I.R. Petrov, P.L. Seltsovsky, A.N. Filatov, V.N. Shamov, S.S. Yudin, the problems of blood conservation, donation, organization of blood services were solved, and technical inventions were made

At the end of hostilities, V.N. Shamov wrote a voluminous work in which he described blood transfusion at different stages of the war. He wrote: “... we must not forget that the blood service, like all military medicine in general, grew and grew stronger in the storm and flames of military events with a huge overstrain of all the material and spiritual forces of the people. Therefore, the shortcomings and defects on this difficult path were possible for the participants in the Patriotic War, but the future generation, taking into account the lessons of history, should and will be able to avoid them.

During the Great Patriotic War, the number of blood donors in the USSR increased to 5.5 million people. About 7.3 million liters of donated blood were donated to the Red Army. As a result, human losses decreased to 10%, while during the First World War the death rate was 65%.

Conclusion. Thus, undoubtedly, medical workers made their significant contribution to the victory of our people in the Great Patriotic War. These merits are so great that they were equated with military ones. In this difficult time for everyone, it was necessary to provide new ways to treat the wounded military, to prevent the occurrence of epidemics, both at the front and in the rear. Medicine took a huge step in its development thanks to the most difficult period of the war, when efficiency, accessibility and versatility were required. Thanks to this, we can say that medicine owes many outstanding discoveries to the war.

The 35-volume work "The Experience of Soviet Medicine in the Great Patriotic War" (1941-1945) presents and systematizes the problems of medicine and the discovery of science that have accumulated during the war years.

The bloodiest war was stopped, including by gratuitous donations. It has become a real mass feat of the Russian people in the face of ordinary citizens and medical workers. The high level of development of modern domestic transfusiology was largely ensured by the widespread research into the problems of blood transfusion in the prewar years, during the war and in the postwar period. Thanks to the greatest efforts of domestic scientists, today the blood service is high-tech, safe and based on the vast experience of the war years.

The achievements of domestic medicine during the Great Patriotic War are invaluable. They found their continuation and development in peacetime. The military experience is instructive not only for technical achievements, but also for the moral principle, the victory of good over evil. Leaving the priority of preventive medicine, I really hope that in the future people will learn to appreciate the world, their health and the well-being of the world around us, which will largely depend on us.

About the authors

Yana Kalashnikova

Author for correspondence.
Email: janakalashnikova1304@gmail.com
ORCID iD: 0000-0003-4443-3732
Russian Federation, 394036, Russia, Voronezh, Studentskaya St, 10

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