PREVENTION (Greek prophylaktikos safety, precautionary) — system of the state, social, hygienic and medical measures aimed at providing a high level of health and the prevention of diseases. The item is the leading section of medicine. Level P. reflects character of socioeconomic, scientific and technical and political living conditions of society in the country.
At socialism the main direction of health care (see) becomes preventive, a cut it is expressed in system of social and economic and medical measures for eradication of origins and development of diseases, to creation of optimum conditions for health protection, for education physically and spiritually strong people. It becomes a basis of the social policy in the field of health care pursued by the socialist state for the benefit of health of all people. The Sotsialnoprofilaktichesky direction of health care in such understanding in capitalist society is essentially impossible since contradicts class interests of the bourgeoisie, operation of the fundamental economic law of capitalism, the nature of the most bourgeois state.
The item arose in connection with attempts of empirical search of means of protection from diseases and accidents in the form of elements of individual and personal hygiene (see). Public P.'s emergence is connected with development of the state and obligations of its bodies and institutions in implementation of precautionary measures first of all from mass diseases of the population.
The first signs of personal hygiene on were already in a primitive community; were formulated defined a dignity. the rules and bans observed at p - building of dwellings, at care of purity of a body, burning of clothes of patients and the died people, corpses etc. was carried out. In some tribal communities various ways of variolation were applied to protection from smallpox. Traditional medicine wanted not only various to lay down. means, but also arsenal preventive gigabyte. receptions, including physical methods, preventive drug intake, etc. Gigabyte. recommendations (a day regimen, gymnastics, swimming, purity of a body, a regulation of a dream, meal, sex life, etc.) became current many people, found reflection and in religious establishments (e.g., Moiseyev of a precept and so forth). Compositions of doctors of Ancient Egypt, Mesopotamia, India, China, Ancient Greece, Rome and other countries along with ideas of human nature and treatment of diseases contain also reasonings on P., a cut preference is sometimes given (see Ayurveda, Hippocrates). During a slaveholding era elements of public sanitation appeared. E.g., in Egypt special officials in the markets exercised supervision of foodstuff, rules of burial were regulated; India settled public the sewerage a water supply system; in Sparta there was whole, a system of rules of hygienic and physical training; laws of Ancient Rome («Laws of twelve tables», etc.) measures a dignity were provided. character — prohibition to use water of the contaminated sources, rules of burial, control of foodstuff in the markets; public baths (terms), city aqueducts, etc. were arranged. Supervision of sanitary improvement was exercised by special officials.
In the Middle Ages in connection with a wide spread occurance inf. diseases various anti-epidemic actions — isolation of patients, a quarantine, burning of things, sometimes dwellings of the diseased were developed and legislatively issued, prohibition to bury the dead within the inhabited places, supervision of water sources, the structure of leper colonies and so forth. Gigabyte. councils of the Arab doctors and European physicians ordered moderation in the use of food, maintenance of purity of a body, abstention in the use of wines, a rational way of life. Certain rules of water use, storage and sale of foodstuff worked in the cities of the Arab caliphates.
Value of preventive measures, rules of personal hygiene was highly appreciated by medieval doctors of Armenia, Georgia, Central Asia. Councils and instructions for the prevention of diseases contained works of outstanding physicians of A. Amirdovlat, M. Gerotsi, etc. A specific place in P.'s development is held by Ibn-Xing, in works to-rogo, and first of all in «A canon of a medical natka», the paramount attention is paid to rules of health protection, a gigabyte. to instructions, dietetics. Ibn-Xing attached exclusive significance to physical exercises, a diet and a dream as to the main conditions of preservation of health, protection from diseases.
Traditional gigabyte. rules of Slavic tribes deeply took roots in life of the Russian people. In literary monuments to Kievan Rus', Ancient Novgorod of the Moscow state are available detailed a gigabyte. instructions on preservation of purity of a body, the maintenance of dwellings, on a dietetics, protection from infectious diseases, about advantage of a bath. In doctoring much attention was paid the prevention of diseases, to illnesses medicines of «obereganiye». In 10 — 11 centuries examples of public care about health, protection from diseases such a dignity meet. - a gigabyte. measures, as construction of water supply systems and observance of rules of public water use, carrying out quarantine measures, etc.
In Renaissance amplified a gigabyte. tendency of medicine. The accumulated experience gave an impetus to creation of the preventive medicine based on scientific knowledge. In particular, F. Bacon considered strengthening of health, eradication of diseases, extension of human life the main objectives of medicine.
The need for labor which is especially expressed from the beginning of development of capitalism caused the necessity a dignity. inspections of working conditions and life of workers; businessmen, and also governmental and public authorities were forced to begin implementation of some preventive measures that found reflection in acts. So, In England of the end 18 — the beginnings of 19 century vigorous activity of medical officers of Horner, Grinkhou (E. N. of Greenhow), Smith gained fame (Th. Smith), J. Simon, Chedvik (E. Chadwick), etc. San. inspections, measures for the prevention of diseases by improvement a dignity. working conditions and life, scientific research for the purpose of development of prophylactics of diseases and injuries and improvement of health began to connect with development of preventive medicine, public hygiene. Most closer to this direction in medicine there were G. Agricola, B. Ramazzini, I. Frank's works who were a forerunner of professional pathology and occupational health.
On development of preventive (preventive) medicine the great impact was exerted by the advanced social thought. Gigabyte. instructions and ideas of a primacy of preventive measures to a certain extent reflected physiophilosophical views of many thinkers, including founders of the atomistic doctrine of Levkipp, Democritus, etc., the French materialists of X. De Rua, P. Kabanis, Zh. Lametri, A. N. Radishchev, M. V. Lomonosov's progressive ideas, and also revolutionary democrats A. I. Herzen, V. G. Belinsky, N. G. Chernyshevsky, N. A. Dobrolyubov, D. I. Pisarev.
At the heart of influence of the similar ideas on further formation of public P. there was a development of views about interrelations and unity of an organism and the environment, a ratio biological and social, a paramount role of social conditions and factors, social conditionality of health. Empirical searches, synthesis of experience of traditional medicine, guesses and assumptions gave way to preventive medicine as the natural-science direction. Gigabyte. the science began to be based on the data of a physiological experiment, microbiology, pathology, physics, chemistry and other natural sciences (see. Hygiene , Meditsina ). At the same time increasing influence was received by the ideas of public hygiene, the doctrine about a paramount role of the social environment for health of the population and its protection (see. Social hygiene ).
Emphasis of attention on implementation of preventive measures of individual and public character became tradition of domestic clinical physicians who repeatedly specified that it is easier to prevent development of a disease, than to cure the developed disease.
"The future belongs to preventive medicine" — N. I. Pirogov wrote. G. A. Zakharyin spoke: "It is victorious only hygiene can argue with illnesses of masses" (he understood preventive medicine as hygiene). However the social and political system of pre-revolutionary Russia did not allow to create and develop the social and preventive direction of health care. Also the researches based on hundreds of thousands of observations territorial and factory a dignity could not help a little significantly. the doctors and statisticians (A. V. Pogozhev, E. M. Dementiev, V. A. Levitsky, P. I. Kurkin, I. I. Molleson, E. A. Osipov, D. P. Nikolsky, N. I. Tezyakov, etc.) who showed communication of health of the population with working conditions, life and, thus, public P.'s way, consisting in improvement of conditions of collective life. For this purpose radical, revolutionary changes of social and economic and political system were required about-va. This circumstance was emphasized by V. I. Lenin (see Lenin and health care) in 1895 — 1896, developing «The project and an explanation of the program of Social Democratic Party» in which the tasks of radical restructurings of living conditions, labor protection, the organizations of medical aid were set without what health protection of workers is impossible. In the first RSDRP program adopted at the II congress in 1903 the demands having to creation of conditions for ensuring health protection of workers direct reference were made. Among these requirements — restriction of the working day with eight hours; establishment of weekly rest; a prohibition of night work in all industries, except where it certainly is necessary according to technical specifications; prohibition of work of children and restriction of operating time of teenagers; a prohibition of female labor where it is harmful to a female body; the state old-age insurance and at full or partial loss of working capacity; establishment dignity. supervision at all enterprises; free medical aid; acceptance and the most strict compliance with laws about labor protection, etc. As a condition of health protection of workers and P.'s development acted as propagandists of the Lenin ideas about revolutionary change of a social order of Russia N. A. Semashko's doctors Bolsheviks, 3. P. Solovyov, E. P. Pervukhin, B. A. Obukh, V. M. Bonch-Bruyevich, I. V. Rusakov, A. N. Vinokurov, C. And. Mickiewicz, B. S. Veysbrod, S. M. Efendiyev, N. N. Narimanov, etc. Many of them became the first organizers of the Soviet health care (see. Health care ).
The victory of Great October socialist revolution created conditions for formation and development of the state system of socialist health care and its general direction — preventive, become a basis of social policy of the CPSU and Soviet state in the field of protection and improvement of health of the population. In March, 1919 in the Party program adopted by the VIII congress RCP(b) the basis of problem solving in the field of protection and strengthening of health of workers determined the preventive direction — «... carrying out the wide recreational and sanitary measures aiming at the prevention of development of diseases». According to it the party set the immediate tasks:
«1. Resolute holding broad sanitary actions for the benefit of workers, somehow:
a) improvement of the inhabited places (protection of the soil, water, air);
b) statement of public catering on the scientific and hygienic beginnings;
c) the organization of the measures preventing development and spread of infectious diseases;
d) creation of the sanitary legislation;
2. Fight against social diseases (tuberculosis, venerizm, alcoholism etc.);
3. Ensuring the public, free and qualified medical and medicinal help».
At this P. the part of a basis of a socialist health system was assigned. In resolutions of the Central Committee of the CPSU, Supreme Council of the USSR, the government, in decisions and materials of congresses of the CPSU the paramount attention was steadily paid to the preventive direction of the Soviet medicine, its escalating value as the strategy of the Communist Party and the government in the field of protection and improvement of health of the Soviet people was emphasized. In the Party program adopted by the XXII congress of the CPSU (1961) it was pointed out the leading value P. in social policy in the field of health care, it was noted that only the socialist state carries out wide social and economic and medical measures of public health care for the benefit of all people: «The socialist state — the only state which undertakes care of protection and continuous improvement of health of all population. It is provided with system of social and economic and medical actions. The wide program directed to the prevention and resolute reduction of diseases, elimination of mass infectious diseases on further increase in life expectancy will be carried out».
The preventive orientation of activities of the state and socialist society for public health care found bright to an otrazha ny in a number of resolutions and acts, such as the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About strengthening of nature protection and improvement of use of natural resources» (1972), «Bases of the legislation of USSR and federal republics about health care» (1969), etc. In 1977 there was a resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for further improvement of national health care», representing the comprehensive program on the near-term outlook of activity of all bodies and institutions, public organizations in the field of protection and improvement of health of the population. In it value of prevention of diseases, injury prevention (see), protection of motherhood and the childhood is emphasized (see), improvement of work to lay down. - professional, the institutions which are especially giving the most mass help (out-patient clinics and policlinics, SES, fast and acute management).
The leading role of P. in the general health system is reflected in the Constitution of the USSR (1977), edges are guaranteed to the Soviet people by the right to health protection (article 42).
In many other articles of the Constitution preventive aspects — safety arrangements (see), health of women, the organization of public catering, development of mass physical culture and sport, right to rest, material security in old age, in case of a disease, full or partial disability, a measure for protection and environment protection, etc. are also emphasized (article 18, 24, 35, 41, 67, etc.).
The item as the comprehensive program of health protection of the people it is presented in decisions and documents XXV and XXVI of congresses of the CPSU. «To strengthen work on the prevention of diseases, to increase efficiency of medical examination and to expand coverage with it the population, first of all children» — it is said in «The main directions of economic and social development of the USSR for 1981 — 1985 years and for the period till 1990», accepted by the XXVI congress of the CPSU.
An important role implementation of decisions will play May (1982) Plenums of the Central Committee of the CPSU in P.'s development and improvement of health protection of villagers (see. Food programme). In the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About additional measures for improvement of public health care» (1982), accepted in development of decisions of the XXVI congress of the CPSU, it is indicated the need to concentrate the main attention on further strengthening of prevention of diseases, improvement of the environment, improvement of working conditions, life and rest, education at the Soviet people of a conscientious attitude to preservation and promotion of health, to strengthen preventive activity of out-patient and preventive institutions, to increase quality of routine maintenances and medical examination of the population and other measures for
P. P.'s development as the fundamentals of socialist health care are proclaimed in the state and party documents of the socialist countries. In constitutions and acts of the countries of the socialist commonwealth for health care the preventive nature of health protection of the people is, as a rule, emphasized.
P.'s understanding not only as complex dignity. - tekhn. died, a gigabyte. instructions and personal hygiene means, but also as the social and preventive direction provided with socialist society, and equally in activity of all medical institutions demanded big and persistent work from theorists and organizers of the Soviet health care. In 1927 3. P. Solovyov in the report «Questions of prevention in teaching clinical disciplines» noted that some leading clinical physicians have no clear idea of tasks in the area P. that they do not understand and pervert public P.'s ideas, reducing it to technical, a dignity. to measures and receptions. The big contribution to business of formation and development of the social and preventive direction of medicine was brought created (since 1922) the departments of social hygiene promoting development and implementation in practice of medicine of socialist society of Marxist ideas of theoretical bases of P., its organizational principles and methods. Persistent work of these departments on exposure of ideological, political and theoretical insolvency of the autogenic, eugenical, Malthusian, Freudian and other idealistic and mechanistic views occurring among a part of physicians and preventing them to understand essence and value P was of especially great importance. The preventive direction which is completely repaid in fight against social and epidemic diseases was implemented into work of all to lay down. institutions, before to-rymi the tasks of improvement of working conditions and life, carrying out medical examination, routine maintenances and other measures were set. Among the first clinical physicians who followed P.'s way and engaged in development of the principles and methods of medical examination, studying of a role various etiol, factors in development of diseases, values of working conditions, life and social influences in formation of incidence, questions of identification and elimination of initial forms of diseases and a research of other aspects of P. there were M. P. Konchalovsky, G.F. Lang.
A. A. Kisel, N. N. Burdenko, etc. Emphasizing value P. in clinic, M. P. Konchalovsky said that achievement of a final task of clinic of the prevention of diseases is possible only on condition of deep knowledge of an etiology in a broad sense, studying as endogenous (heredity, etc.). «and exogenous factors, i.e. factors of the environment surrounding the patient. It carried to the last including social factors, and also unfavorable conditions of work.
Advantages of the social and preventive direction of health care in the USSR and other socialist countries gradually became an object of attention of many foreign politicians, physicians, the international medical organizations; in the bourgeois press repeatedly there were statements about need to consider experience of the USSR at regulation of 1 development of health care in the countries.
In reports of WHO the special attention is paid to discussion of a question of need of close connection preventive and a wedge, medicine, elaboration of new strategy of health care for the majority of the countries of the world, P.'s development shall be the basis a cut; need of integration of preventive services with all health system is noted, edges, in turn, shall become a component of the nation-wide organization. to have the state or government character.
With a special force this thought sounded in Alma-Ata (September, 1978 at the International conference on the primary health care which noted achievements of health care of the USSR, especially in the field of preventive activity. The CEO of WHO Mahler (N. of Mahler) spoke: «Success of the Soviet Union in gradual creation of a comprehensive health system of which he by right is proud was in no small measure caused by that attention which was given to primary health care, and in particular its preventive aspects». P.'s role in public health care in the USSR was emphasized also by the director-performer of UNICEF Labuis (N. of R. Labouisse).
Physicians of the capitalist countries even more often connect P. with social aspects of medicine. So, the theorist and the historian of medicine G. Sigerist in the works emphasized that future doctor cannot but be the doctor social, P. V to the book devoted to the organization of health care in the USSR cannot but be engaged, he wrote: «What occurs in the Soviet Union today — the beginning of the new period in the history of medicine. Everything that was reached still, for 5 thousand years of history of medicine, is only the first era — the period of medical medicine. Now the new era, the period of preventive medicine, began in the Soviet Union».
The preventive direction of medicine has strong scientific-theoretical base. It can be considered as specific reflection in the field of health care of progressive dialectic ideas of unity of an organism and the environment, about close interrelation social and biological. Proceeding from a possibility of management vneshnesredovy, and especially social, factors which substantially cause a condition of public health, estimating internal, genetic in the person as transformation (in a chain of generations) vneshnesredovy factors, the preventive direction in the broadest sense it is possible to consider as creation of a social environment, optimum for health of the population. It causes a paramount role of the social and economic measures which are carried out within the state and society. therefore a role of the socialist society transforming on the basis of planned actions the environment for the benefit of health, wellbeing and happiness of the person.
From Marxist positions set of action of social conditions and biol, factors it is necessary to consider a way of life, i.e. life activity, activity of the person or group of people in specific conditions of the place and time. From this point of view the way of life is focus of interaction and a way of use by the person of diverse factors — social, spiritual, natural. K. Marx emphasized that the way of production is not only a way of reproduction of physical existence of individuals, but also «a certain way of activity of these individuals, a certain type of their life activity, their certain way of life» (K. Marx and F. Engels, Compositions, t. 3, p. 19), i.e. it is historically certain type (character) of life activity of people consisting of the corresponding stable forms of life activity.
Such understanding of a way of life opens new opportunities for development of Marxist representations about individual and public health (its obuslovlivaniye) and the powerful social lever of its improvement what the preventive direction of health care is.
The concept of a way of life, in a cut Marxist ideas of a ratio social and biological concentrated, unity of an organism and Wednesday, already today allows to introduce essential amendments in carrying out medical examination (e.g., on social features, and not just for health reasons) and other preventive measures, including elimination of not hygienic habits, traditions, customs (an alcohol abuse, smoking, irrational food, a hypodynamia, a psychoemotional overstrain) as these measures define ways of the prevention of first of all chronically proceeding, not epidemic diseases (cardiovascular, oncological, endocrine, neuromental, etc.).
The item is a duty and makes daily care of all medical institutions of the USSR (hospitals, policlinics, clinics, SES etc.). Preventive activity of bodies and healthcare institutions is expressed in environmental control (see), control of public catering and observance a gigabyte. norms at the industrial enterprises, carrying out mass and individual preventive inoculations, implementation of many other sanitary and hygienic and anti-epidemic actions.
In the USSR actions for protection, improvement of the environment, observance a gigabyte. norms and requirements are obligatory for all organizations and institutions, they are provided by the state legislation (see. Sanitary inspection). Specific actions for environmental control and improvement of working conditions (including on a gigabyte. and ergonomic normalization of work, and also according to the accident prevention) and on prevention on this basis of the incidence connected with production join in comprehensive plans of recreational actions of the ministries and departments and in plans of social development of various industrial, agricultural enterprises, scientific, educational, trade and other organizations; implementation of these plans is obligatory and strictly controlled.
The major method P. — medical examination (see). H.A. Semashko called medical examination the leading method P. and treatments. Selection of persons who are subject to medical examination for health reasons is carried out by policlinics, out-patient clinics, hospitals, special clinics and others to lay down. - professional, institutions in accordance with the established procedure. Every year possibilities of coverage medical examination of the increasing contingents of the population extend.
Synthesis of medical and preventive measures is shown also in a so-called local method of rendering medical aid to the population (see. Medical site). District doctors carry out a number of preventive actions (control of timely carrying out inoculations and performance a dignity. norms, implementation dignity. promotion) for what so-called preventive days are allocated.
In resolutions of the Central Committee of the CPSU and Council of ministers of the USSR «About measures for further improvement of national health care» (1977) and «About additional measures for improvement of public health care» (1982) special attention is paid on strengthening of out-patient and polyclinic service as outpost of primary health care (see). Disaggregation of territorial sites is for this purpose provided.
Aiming to provide participation of workers in scheduled maintenance, the Soviet state cares about a gigabyte. education and sanitary education (see) population. Dignity. education is carried out in the most various forms: in the form of conversations of the doctor at a bed of the patient, special (so-called patronage) visits by medics of families (especially where the birth of the child is expected), by demonstration of special movies, transfers on radio and television etc.
Especially in recent years, National high fur boots (see University of health), in-you and schools of health became very popular. Doctors, experienced specialists, scientists, teachers of medical educational institutions of the special program calculated on one year or for several years give to listeners lectures and give classes; special attention is paid to questions P., rational a gigabyte. education.
Questions P. are considered in all system of medical education (see) not only in teaching preventive disciplines. (hygiene, epidemiology, social hygiene and the organization of health care, etc.), but also at a statement of preventive aspects of clinic, and also other sections of training programs, W. h social. Special attention in an education system is paid to questions of an etiology of various diseases and a role of the surrounding natural and social environment in their origin. Such statement promotes deep acquaintance with the reasons of many diseases and timely prevention of their emergence. Still the great Russian physiologist I. P. Pavlov spoke: «... unless ordinary etiologies do not creep in and do not begin to work in an organism earlier, than the patient becomes an object of medical attention? And knowledge of the reasons, of course, the most essential business of medicine. First, only knowing the reason, it is possible to direct neatly against it, and secondly — and it is even more important — it is possible not to allow it before action, before invasion into an organism. Only having learned all reasons of diseases, the real medicine turns into medicine of the future, i.e. into hygiene in the broadest sense». The item entered a component many scientific directions and disciplines, predetermined creation and development of the recent trends connected with the prevention and treatment not only somatic, but also mental diseases (see. Psychohygiene , Psychoprophylaxis ).
Practical participation of broad masses of the population in implementation of the ideas of P. is diverse. At the Supreme Council of the USSR, the Supreme Councils of federal republics the constant commissions of deputies dealing with issues of public health care work. In all Councils of People's Deputies (regional, city, regional) the commissions on health care consisting of deputies of these Councils actively function. The basic purpose of such commissions consists in assistance to bodies and healthcare institutions, in improvement of protection of national health. The responsible place in involvement of broad masses of workers to implementation of preventive actions belongs to labor unions, their bodies on places and to the institutes of public inspectors organized by them; they bring care of a condition of labor protection, of rest of toilers of the city and village, realize control of observance a gigabyte. norms at the enterprises, etc. The mass public organization helping work of bodies and healthcare institutions is the Union of societies of the Red Cross and Red Crescent of the USSR (see). Its functions include not only the organization of training of the population of first aid in case of accidents, diseases, injuries, but also formation at the industrial enterprises, in collective farms and institutions a dignity. the posts intended for control for a dignity. condition of jobs, rendering medical aid. Members about-va — public a dignity. representatives — observe for a dignity. rather on the street, in the yards of houses etc.
The increasing significance and in other countries is attached to attraction of a general population to participation in work of bodies of health care. Many figures of public health care begin to understand that without active involvement of the population to health protection it is impossible to struggle successfully with diseases, to hold various sanitary and hygienic and preventive events. This thought received bright reflection in decisions of the World assemblies of health care, and also in documents of the International conference on primary health care in Alma-Ata (1978).
The item in socialist society defines future development of medicine and health care which major purpose is a protection and strengthening of health of healthy people.
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