One of the features of the state policy of the Soviet regime was the priority development of the network of health care institutions, in particular, the concentration of the best hospitals and unique institutes on the territory of the RSFSR, primarily in the cities of Moscow and Leningrad (now St. Petersburg). Sanatoriums and resorts of the Ukrainian SSR were divided into all-Union, republican and local. All-Union included the best establishments in the industry, which were directly subordinated to the central resort management in Moscow and served mainly the privileged classes of the RSFSR. Medical and treatment institutions of a mass nature made up the second group and served the underprivileged majority of the population.
As of 1940, there were 7 medical institutes on the territory of the Ukrainian SSR, a total of 13 higher medical institutions of education (where 22 thousand students studied); 219 schools for secondary medical personnel with over 58,000 students; 43 research institutes; 4 institutes for the improvement of doctors; 450 sanitary and bacteriological laboratories; 321 disinfection points, etc. The network of maternal and child health care institutions in 1940 included 5,194 beds in city maternity homes, 5,469 beds in rural hospitals, 496 beds in rural maternity homes, and 10,700 beds in collective farm homes. In 1940, the Ukrainian SSR had 928 consultations for mothers and children, 528 milk kitchens, 105 children’s polyclinics, dispensaries and dispensaries, 2913 permanent and 27,800 seasonal nurseries. The network of institutions for combating social diseases has grown significantly. 1940 there were 274 anti-tuberculosis dispensaries, offices and independent points; 458 anti-allergic dispensaries, offices and points; 9 psycho-neurological dispensaries and 56 departments and offices. The network of pharmacies also grew, which in 1938 was 1,873 (1,080 rural and 793 urban). The number of hospital beds more than doubled: 1940, 1869 hospitals on the territory of the Ukrainian SSR had 106,800 beds. There were 2,070 outpatient polyclinic institutions, 2,856 dispensaries, and 5,289 first aid stations in the cities. In 1940, 21,323 doctors, 3,101 dentists, dentists, and 78,000 representatives of secondary medical personnel were employed in the system of the People’s Commissariat of Health of the Ukrainian SSR.
The reorientation of the nature of their activity became more important than the general growth of medical and treatment facilities (although their number did not meet the needs of the population). The role of the doctor, who acted as an official in the polyclinic system, was primarily limited to monitoring idle workers. The personal responsibility and task of the doctor was not so much the treatment of patients as the supervision of employees, so that no one missed working days or even working hours without a valid reason. In the fight against tuberculosis and venereal diseases, doctors often abused forced hospitalization, which in many cases was completely unnecessary. In these conditions, mass health care facilities became not curative, but controlling in function. This led to a decrease in appeals and a deterioration in the health of the population. Medical care of the rural population was significantly worse than that of the urban population. In particular, in 1940, the rate of provision of hospital care for the urban population was 6.6 beds per 1,000 population, while for the rural population it was 1.4.
The pre-war period of the development of the health care system in Ukraine is generally characterized by the establishment of a preventive direction in its activities, the wide implementation of the dispensary method, the development of the district-territorial principle, the combination of medical care at the place of residence with the care of industrial workers at enterprises. However, even a complete reorganization of the health care system, in particular the transition to state management, the introduction of socially oriented legislation, partial free medical care (in the 1930s, free medication was abolished, free access to sanatorium treatment was reduced), the development of the preventive direction – all this is not gave the desired result in terms of improving the state of health care of the population of the Ukrainian SSR before the Second World War. The main reason was the domestic domestic policy of the USSR towards Ukrainians, manifested not only in the low economic, social, and everyday living standards of the population, but above all in the physical destruction due to the Holodomor and repression. Millions of political prisoners in concentration camps were virtually deprived of any medical care. The ruling vertical built an exploitative system, in which the basic principles of public health protection and the development of medicine were mostly declarative, and the realities were the opposite of the declared ones. With great difficulty, it was possible to overcome the epidemic, instead, social diseases became widespread. A notable feature of this period is the spread of mental and nervous illnesses, an increase in the number of suicides, and illegal abortions. In the pre-war 1930s, as well as in the post-war period, working conditions deteriorated significantly. Yes, the two-week vacation is no longer mandatory; teenagers began to be attracted to schools of factory and other training, (which actually canceled the corresponding norm regarding work), women — to the most difficult physical jobs.
At the same time, during the Soviet era, the development of medical science did not stop, which achieved notable successes. Among the distinguished scientists and organizers of science is M. Strazhesko (1876–1952), known as a therapist, doctor of medicine, professor, honored scientist of the USSR, academician of the Academy of Sciences of the USSR (since 1934), academician of the Academy of Sciences of the USSR (since 1943). Pupil of V. Obraztsov. He worked in Kyiv as a professor of women’s medical courses (1907–1919), Kyiv Medical Institute (since 1922), director of the Ukrainian Institute of Clinical Medicine, founded by him in 1936 (now the National Scientific Center “Institute of Cardiology named after M. D. Strazhesk”). Together with V. Obraztsov, he published the work “To the symptomatology and diagnosis of thrombosis of the coronary arteries of the heart” (1909; 1910), in which for the first time in the world various clinical forms of the disease were described, which made it possible to recognize myocardial infarctions throughout life and to take the necessary medical measures. Made a significant contribution to the development of cardiology, gastroenterology, hematology, allergology, widely used the clinical and experimental method. Justified the theory of rheumatism as an infectious-allergic disease of streptococcal etiology, revealed the connection between sepsis, endocarditis and rheumatism. Together with V. Vasylenko, he created the classification of circulatory insufficiency. The signs and symptoms of diseases are named after him: “Strazhesk’s cannon tone” – for complete atrioventricular blockade, “Strazhesk’s phenomenon – for perigastritis. He studied pathologies of blood circulation, rheumatism, sepsis and diseases of the gastrointestinal tract.
Other famous scientists include V. Ivanov (1892–1962; clinical physiology and functional pathology of digestive organs), M. Gubergritz (1886–1951; studied physiology and pathology of blood circulation, diseases of digestive organs), M. Yasinovsky (1899–1972; cardiologist). , the initiator of dispensation for patients with rheumatism) and others.
Ukrainian scientists have also achieved considerable success in the field of surgery. M. Volkovich (1858–1928) — surgeon, doctor of medicine, professor, academician of the Academy of Sciences of the USSR (since 1928). Head of the surgical department of Oleksandrivska Hospital (now Oleksandrivska Clinical Hospital, Kyiv), professor of the hospital’s surgical clinic, head of the Faculty Surgery Department of the Medical Faculty of St. Volodymyr’s Kyiv University (from 1921 — Kyiv Medical Institute). Pupil of V. Karavaev and F. Bornhaupt. During his dissertation research, he discovered the causative agent of rhinoscleroma (the Volkovich-Frisch bacillus). He described atrophy or atony of the muscles of the right half of the abdomen in chronic appendicitis (Volkovich’s symptom), proposed an oblique incision in the right iliac region for appendectomy (McBurney-Volkovich-Dyakonov incision). For the first time, I noted the need for cholecystectomy in all cases of calculous cholecystitis. He made a significant contribution to traumatology, invented a splint for immobilizing the limb (Volkovich’s splint), described the forced posture of a patient with a fracture of the anterior part of the pelvis (Volkovich’s symptom), proposed knee joint resection for purulent or tuberculous gonitis (Volkovich’s resection).
O. Krymov (1872–1954) — surgeon, doctor of medicine, professor, academician of the Academy of Medical Sciences of the USSR, honored scientist of the Ukrainian SSR (since 1940). Head of the department of hospital surgery (1912–1922) of the University of St. Volodymyr, head of the department of the faculty surgical clinic of the Kyiv Medical Institute.
V. Filatov (1875–1956) was an ophthalmologist, professor at Odesa University, director of the Odesa Experimental Institute of Ophthalmology (1911–1956). Created new methods of reconstructive surgery, proposed an original method of skin plasticity with a round skin stem (Filatov stem), developed the problem of corneal transplantation (1927), created special tools — trephines for cutting a hole in the bilma, began to use preserved, cooled cadaver cornea for transplantation (1931) . Developed a fundamentally new method of treatment — tissue therapy (1933), discovered the formation of biogenic stimulators in tissues at low temperatures. Proposed and put into production a number of tissue medicines. On the initiative of V. Filatov, the Ukrainian Institute of Experimental Ophthalmology was established in Odessa in 1936 (now the V. P. Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Sciences of Ukraine).
P. M. Buyko (1895–1943) — surgeon, scientist, obstetrician surgeon, doctor of medical sciences, professor of the Department of Obstetrics and Gynecology, organizer and head of the Kyiv Research Institute of Maternal and Childhood Protection (1933–1938), head of the Department of Obstetrics and Gynecology of gynecology at the Kyiv Dental Institute, colonel of the medical service, Hero of the Soviet Union (1944, posthumously).
A new page in the development of hematology became the works of V. M. Shamov (1882–1962) — a surgeon, scientist, doctor, full member of the Academy of Medical Sciences of the USSR (since 1945). He headed the surgical clinic of the Kharkiv Medical Institute, the Department of Experimental Surgery of the Ukrainian Institute of Experimental Medicine, the Ukrainian Institute of Blood Transfusion and Emergency Surgery. Received standard serums for determination of blood groups (1919), developed the scientific foundations of blood transfusion. Justified the possibility of transfusion of cadaver blood (1928). Proposed an original method of creating an extrasternal artificial esophagus (Shamov’s operation). Developed ways to stop bleeding from liver wounds, pancreatoduodenectomy, and pneumonectomy. He proposed rational methods of treating brain abscesses and encephalitis, and was one of the first to start performing major neurosurgical operations, particularly on the ventricles of the brain. Conducted experimental and clinical studies of blood transfusion.
M. Sytenko (1885–1940) — orthopedic surgeon, traumatologist, corresponding member of the Ukrainian Academy of Sciences (since 1936), honored scientist of the USSR. He played an important role in the creation of the Ukrainian Center of Traumatology and Orthopedics — the Kharkiv Research Institute of Orthopedics and Traumatology (now the Institute of Spine and Joint Pathology named after Prof. M. I. Sitenko of the National Academy of Sciences of Ukraine), whose director he was appointed in 1926. Under his leadership, the a modern system of providing orthopedic and traumatological care to the population (children and adults) of the Ukrainian SSR. In particular, a network of orthopedic and traumatological institutions and scientific and organizational points of the Institute was organized in many regions of Ukraine, the department of orthopedics and traumatology. In 1927, on the initiative of the institute, the only magazine in the USSR at that time, Orthopedics and Traumatology (in Russian), began to be published. In 1940, the institution was named after Professor M. I. Sitenko. The scientist’s works are devoted to bone plastic surgery, treatment of pseudarthrosis, congenital deformities, etc. Later, the specialists of the institute developed a number of scientific recommendations in the field of prevention of non-production and production injuries in agriculture, machine-building, metalworking, mining and metallurgical industries. At the Institute, fundamentally new equipment was created for the correction of disorders of the musculoskeletal system due to diseases of the orthopedic profile, a method of prosthetics was developed directly on the operating table after amputation of the lower limbs.
The research of O. Bogomolets (1881–1946), a pathophysiologist, member (since 1929) and president (since 1930) of the Ukrainian Academy of Sciences (since 1936 — Academy of Sciences of the Ukrainian SSR), academician (since 1932) was of great importance for solving the most important problems of human physiology and pathology. and vice-president (since 1942) of the Academy of Sciences of the USSR, academician of the Academy of Sciences of the USSR and the Academy of Sciences of the USSR. The scientist created one of the leading schools of Soviet pathophysiologists, made a significant contribution to the main fields of pathological physiology, gerontology, endocrinology, oncology, etc. He substantiated the doctrine of the physiological system of connective tissue. On his initiative, the Research Institute of Experimental Biology and Pathology of the Ministry of Health of the Ukrainian SSR and the Institute of Clinical Physiology of the Academy of Sciences of the Ukrainian SSR were created.
In pre-war times, the contribution of a cohort of domestic scientists (V. Danylevsky, V. Chagovets, M. Melnikov-Razvedenkov, O. Leontovych, etc.) to the development of physiology was significant. V. Danylevsky (1852–1939) was a physiologist, head of the Department of Physiology of Kharkiv University and Kharkiv Medical Institute, founder and director of the Organotherapeutic Institute (now V.Y. Danylevsky Institute of Endocrine Pathology of the National Academy of Sciences of Ukraine), academician of the Academy of Sciences of the USSR. One of the first electrophysiologists in Ukraine. Professor of medical chemistry at Kharkiv University, author of textbooks, popular science articles and brochures, about 220 scientific works on the physiology of the nervous system, parasitology. He studied neurophysiology, the effect of insulin on the nervous system, scientifically substantiated the possibilities and ways of industrial production of various hormonal preparations.