OSTROUMOV Alexey Aleksandrovich

From Big Medical Encyclopedia

OSTROUMOV Alexey Aleksandrovich (1844 — 1908) — the domestic therapist, the founder of large clinical school.

OSTROUMOV Alexey Aleksandrovich

In 1870 ended medical f-t Moscow un-that. Since 1871 the intern of faculty therapeutic clinic G. A. Zakharyina; in 1873 protected dokt, the thesis on «About an Origin of the First Cardiac Sound» executed under the direction of A. I. Bab cinchona. It was sent for improvement abroad, listened to lectures of the leading European therapists, studied patol, anatomy, was engaged in pilot studies. Since 1879 the associate professor, then professor, and since 1880 the director of hospital therapeutic clinic Moscow un-that.

In 1901 for health reasons retired, spent the last years of life to Sukhumi where advised in local to lay down. institutions; on own means and collected donations would construct also a maternity home.

A. A. Ostroumov is fairly carried to number of coryphaeuses domestic a wedge, by meditsitsa. Its many-sided scientific, pedagogical and public work exerted a great influence on formation of scientific outlook of the whole generation of domestic doctors. A. A. Ostroumov's views were developed not only by the closest pupils — D. A. Burmin, V. A. Vorobyov, A. P. Langova, S. M. Melky, etc., but also D. D. Pletnev, A. V. Martynov and other large domestic clinical physicians.

A. A. Ostroumov one of the first among the leading domestic clinical physicians raised a question of value of the general biology for development of medicine, emphasizing that though «the medicine was born from the practical need to help the patient, but these cannot limit its purposes as science... Progress of medicine will go in parallel with achievements of natural sciences when it uses the same methods and to be directed the same purposes». The foreground it put forward a problem of constitutional features and heredity of the patient, considering that they quite often play the defining role in formation of pathology. During an era of domination monokauzalizm (see) A. A. Ostroumov pointed to danger of one-sided approach, at Krom «except a microbe, nothing is seen», and demanded the accounting of features of an organism, «in Krom there lives this microbe».

After S. P. Botkin it developed scientific kliniko-eksperimen-talnoye the direction of internal medicine and proved as the first works as the talented experimenter. In experiences with desalination of heart and electric irritation of a cardiac muscle (1873) showed preferential valve origin of the I cardiac sound as opposed to the so-called muscular theory of its origin dominating at that time supported by one of the largest physiologists K. Ludvig. Experimental work of A. A. Ostroumov about an innervation of sweat glands (1876) was highly appreciated by Yu. Kongeym. In the research devoted to an innervation of veins (1876), A. And. By Ostroumov it is shown that in the mixed nerves there are two sorts of fibers (the irritation of one leads to narrowing, others — to vasodilatation) and that representations of a number of physiologists, for to-rykh vessels — «dead elastic tubes», are wrong. A. A. Ostroumov was a supporter of implementation of methods of the exact sciences and at the same time the primacy upheld a wedge, a visual angle on problems of pathology and objected to a tendency «to estimate everything exclusively from the point of view of dog and lyagushechy physiology and pathology». So, in work «About a tympanic sound of lungs» (1875) physical explanation of the nature of a clinical phenomenon are based on kliniko-anatomic comparisons.

Proceeding from understanding of an organism as whole where «frustration of one part is reflected in all organism change of life activity of other parts it», A. A. Ostroumov attached special significance to a condition of a nervous system, its role in a pathogeny of a disease. To A. A. Ostroumov domestic a wedge, medicine it is in many respects obliged by development of the ideas of a nervosism and funkts, the directions in general. It found reflection and in the doctrine developed by it about the diagnosis (see. Diagnosis ), to-ry as he considered, shall be under construction taking into account etiol., morfol, and funkts, data: at a formulation of the diagnosis the doctor shall aim not «call» a disease, but also answer, whenever possible, «why this subject got sick in the conditions of the environment surrounding it why painful change happened in that, but not in other body why the disease accepted that, but not other current». For this purpose noobkhodimo a comprehensive investigation of the patient, including careful collecting the anamnesis (it included in it also data about health of parents and other relatives — the family anamnesis) and use funkts, tests with loading. Aiming at causal, evidence-based treatment, he at the same time warned «against hobby of a preconception idea and a template of specific therapy», quite often preferring clinically checked empirical method of treatment.

Particular interest of A. A. Ostroumova to questions of out-patient practice and prevention of diseases it is connected about his wedge, the doctrine about relationship of an organism and Wednesday. In this doctrine 3. P. Solovyov saw sources of «synthesis of medical and preventive medicine». However in interpretation of a problem of adaptability of an organism to conditions of the environment, including social, A. A. Ostroumov did not avoid an unilaterality, exaggerated a role of inborn constitutional inferiority («degeneration») and a circle of the diseases inherited in «a ready look».

A. A. Ostroumov's activity as head of hospital therapeutic clinic began in difficult conditions. On personal means he had and equipped rooms for laboratory (1884), achieved improvement of conditions for medical and pedagogical processes, and with transfer of department from Novo-Eka-terininskoy-tsy to again built building in the clinical town Moscow un-that on Maiden Paul (1891) created clinic, model for the time, with laboratory and well equipped physiotherapeutic department. Here the formation its wedge, schools was completed.

A. A. Ostroumov's clinic at the end of 19 century played the defining role in development of a therapeutic thought in Russia, enjoyed exclusive popularity among territorial doctors, to-rykh fixed scientific views, a wedge, a method and personal qualities of the head known for the uncompromising stand, justice, self-criticism, performances in protection of students. Within 10 years he was a chairman Moscow medical about-va. Together with N. V. Sklifosovsky was one of organizers of Pirogovsky congresses.

Name A. A. Ostroumova it is appropriated to a row Soviet to lay down. institutions, including hospital therapeutic clinic of the 1st MMI and Moscow clinical-tse No. 33.

Works: About an origin of the first cardiac sound, yew., M., 1873; Archive of clinic of the prof. Ostroumov (1892 — 1900), century 1 — 2, M., 1903 — 1904; Chosen works, M., 1950.

Bibliography: Burmin D. A. Memories of the prof. A. A. Ostroumov, Russian clinic, No. 24, page 503,1926; At to and with I A. G. N, A. A. Ostroumov and his kliniko-theoretical views, M., 1950; 3 and l at d about in-skiyp. E., And, A. Ostroumov, Value of its clinical heritage, Klin, medical, No. 3, page 139, 1971; P l of e of t of N of e in D. D. The Russian therapeutic schools, Zakharyin, Botkin, Ostroumov — founders of the Russian clinical medicine, M. — Pg., 1923.

V. I. Borodulin.