SURGERY

From Big Medical Encyclopedia

HIRURGYYa (Latin chirurgia; Greek cheir a hand + ergon work, action) — the medical clinical discipline directed to prevention, diagnosis, treatment and scientific research of diseases and disturbances at to-rykh the major defining importance have bloody or anemic operative measures by hands of the surgeon by means of tools and devices.

It is possible to call surgery one of ancient types of activity of the person what numerous archeological finds (monuments) of ancient culture testify to. In centuries-old history of surgery it is possible to allocate four main periods conditionally. The first period — before opening of an anesthesia, antiseptics and an asepsis, i.e. to the second half of 19 century. The second period (the second half of 19 century) is connected with opening and implementation in practice of an anesthesia (see), antiseptic agents (see) and asepsises (see). It is possible to call the third period (the beginning of 20 century) fiziolo-ge-experimental in connection with the defining influence on development of surgery at this stage experimental fiziol. I. M. Sechenov, I. P. Pavlov, K. Bernard's researches, etc. These researches created conditions for origin of the recent surgical trends and development of anesthesiology (see), resuscitation (see) and transfusiology (see). From surgery narrower specialties — urology (see), neurosurgery were gradually distinguished (see) etc. The fourth (modern) period — the period of plastic and reconstructive surgery (see. The plastic surgery) is characterized by profound scientific search of the new ideas in development of diagnostic methods and the treatments based on widespread introduction in scientific research and practice of surgery of microsurgery, new devices and devices physical, pharmakol. and other methods of impact on a human body at various diseases, and also organ transplantation and fabrics, use of artificial organs and fabrics. Convention of such periodization is obvious since in the history of surgery these periods accumulated one on another, took place not only the periods of blossoming, but also slow rates of the movement, stagnation and even regress when a lot of things, already reached, were lost over time to revive and gain recognition and distribution.

According to historical documents and archeological finds, rudiments of surgery at the ancient people appeared long before our chronology. So, the weight of evidence suggests, that the Neanderthal person owned technology of opening of abscesses and other superficial inflammatory suppurative educations, suture on a wound, and it is possible also other surgical receptions. The tools which were available at the disposal of the primitive person (scraped, leaflike cutters, a knife from trailer zatesky) already allowed to execute it. The Neanderthal person had also suitable tools for a craniotrypesis (see Medicine).


Fig. 3. The schematic diagram of expansion (option) of specialized surgical field mobile hospital for struck in a hip and large adjacent joints in the period of the Great Patriotic War.


Ancient Egyptians owned technology of amputation of extremities, lithotomies, a craniotrypesis and castrations. At excavation of the Egyptian tombs stone knives, probes, tires for treatment of changes are found; it was applied almost for

5 thousand years BC. In a bronze age in Assyria and Babylonia (2 thousand years BC) made extraction of arrows, deleted foreign bodys and cut fabrics by means of bronze knives.

The high level of development was reached by surgery in Ancient India where for 1 thousand years BC used the heated metal objects for cauterization of fistulas, stopped bleeding by means of a compressing bandage or the boiling oil, made a craniotrypesis, a laparotomy, were able to put stitches on edges of a skin wound. To a crust, time did not lose the value a so-called Indian way of skin plastics — substitution of defect of a nose the piece of leather on a leg moved from a forehead (see. Skin plastics, Rhinoplasty). In Ancient India there were professional surgeons familiar with anthropotomy. Special tools various for those times were at their disposal (needles, knives, saws, chisels, trepans, troakara, Bougie, syringes, etc.) * Tools disinfected juice of plants, hot water, carrying out through a flame and calcinating on fire. As a dressing material served cotton, vegetable fibers and silk. Doctors of Ancient Egypt and Ancient India applied opium, juice of the Indian hemp, extracts of a mandrake for the purpose of anesthesia.

Among monuments of ancient Chinese culture there are also documents testimonial of development of medicine and surgery. Among the first scientific doctors of Ancient China there was a B Yen Qio (the 6th century BC) which was engaged in studying of internal diseases, surgery and a balanced diet. Along with all-medical receptions it used acupuncture (see Acupuncture) and cauterization, i.e. achievements of ancient and original Tibetan and Chinese medicine. The famous Chinese surgeon Hua Tuo (141 — 203) using drugs of the Indian hemp and opium for anesthesia made without serious consequences and, on - visible mu, in some cases successfully a laparotomy. Washing of an abdominal cavity the anesthetizing liquids warned pains, and operation came to an end with mending of a belly wound with threads and imposing of a plaster. Hua Tuo knew about a craniotrypesis, treated changes.

In spite of the fact that separate methods of the Chinese medicine remained for a long time, its theoretical bases, also as well as medicine of other countries of that time, were shaky and naive. Religious prejudices, and also many customs consecrated with religion slowed down development of medical science.

Rudiments of surgery were available for Scythians. On the Scythian bowl relating to 4 — 3 centuries BC and found at excavation near Kerch there is a drawing representing doctors, one of to-rykh carries out bandaging of a wound, and another extracts tooth to the tribesman.

Doctors of ancient civilizations of America made opening of abscesses, splintage at changes, stripping of a cataract by means of edges from splinters of volcanic glass. Drawings remained, on to-rykh the craniotrypesis and amputation of an extremity are represented. During the performing surgeries applied special bronze scalpels (tsvetn. the tab., Art. 368, fig. 7), a form of an edge to-rykh repeats in the modern cutting surgical instruments (see. Surgical tools).

For several centuries BC Ancient Greece became a cradle of many sciences. The initial foundation of practical surgery was laid by Hippocrates. He developed a way of treatment of wounds, rational for the time, described tetanus (see), allocated and described sepsis (see) and an empyema of a pleura (see Pleurisy), was able to treat an empyema of a pleura by means of a thoracotomy. With completeness and care Hippocrates stated methods of treatment of changes and dislocations. At treatment of changes he paid attention to need of extension of an extremity, preservation of its axis and reposition of bone fragments. The detailed description of the extension of extremities made in the manual way and by means of the elementary devices is provided in its treatise «About Changes». To a crust, time the way of reposition of dislocation of a shoulder according to Hippocrates kept the value.

Successfully the surgery in the period of Hellenism (330 — 23 BC) developed. In Alexandria, in particular, bandaging of blood vessels was for the first time entered, and the doctor of Ammonius for the first time carried out crushing of stones in a bladder.

After a gain of Ancient Greece Rome became Romans the most important center of development of science. In compositions of the outstanding Roman doctor A. Tseljs scientific provisions of Hippocrates are propagandized, it is told about ways of a stop of bleeding and bandaging of blood vessels with their section between two ligatures. Tsels provides data on treatment of wounds, bandaging of blood vessels, a lithotomy, plastic surgeries and states fundamentals of field surgery. To a crust, the way of treatment of aneurisms offered by other Roman surgeon Antyllus is known to time. Doctors of Ancient Rome widely used bloodletting. K. Galen applied silk and filar ligatures, and also thin strings to bandaging of blood vessels, for the first time studied formation of a bone callosity at changes and made some other important scientific observations. After disintegration of the slaveholding Roman Empire the center of medicine moved to Byzantium where medical schools were created and large surgeons — Ori-basius Pergamenus, Aetius, Paul Aeginensis, etc. moved forward.

In the Middle Ages in Europe there occurred decline of science. Domination of church, scholasticism, magic and neglect live experience resulted in stagnation in many industries of knowledge. The religion formally prohibited shedding of blood and opening of corpses. The surgery deprived of natural-science bases could not develop. However at this time the defined success in practical surgery was achieved by the Arab doctors, to-rye well knew the Greek and Roman surgery. The Arab doctors of Abu-Kasim (936 — 1013), Strike (apprx. 865 — 925), Huneyn Ibn-Iskhak (809 — 873), etc. were able to treat wounds, using for these purposes of a grass and wine, and for elimination of purulent complications of wounds, apparently, for the first time began to apply alcohol. For the purpose of a stop of bleeding used the heated iron. The lithotomy borrowed doctors of antiquity gained distribution, also lithotripsy was applied. The Arab doctors, apparently, opened the recipe of the stiffening proteinaceous bandages and used fenestrated bandages at fractures of bones; probably gypsum was known to them.

At the beginning of the current millennium wide recognition was gained by Ibn-Sina's works which brought a lot of new in surgical science. The practical orientation of «A canon of medical science» first of all testifies to it (see), in Ibn:-Xing's Krom laid the foundation of a method of drainage, entered the receptions preventing accumulation in a wound of «moisture», recommended to create outflow from a wound by giving to a body of special situation or applied special cuts (counteropenings), tampons and drainages. Distinguishing wounds slow and with overdevelopment of granulations, Ibn-Xing allocated the complications which are hard reflected in the general condition of the patient. In such cases he suggested «to cut along with the general antiinflammatory therapy a muscle across», widely, crucial incision. It is rational offered Ibn-SI-ache a technique of sewing up of wounds of an abdominal wall a continuous matratsny eight-figurative suture. At loss from a wound of a gut and an epiploon he suggested to wash a gut a warm salt water and to set, and an epiploon to resect, close wounds a bandage to protect them from pollution. Proceeding from the correct assessment of danger at manipulations on a cancer tumor, he offered a full burning out of a tumor or its excision.

In the period of the Middle Ages earlier, than in other countries of Europe, development of surgery began in Italy and France, and then in England and Germany. In 829 g in Paris Hotel - Dieu — the oldest medical, including surgical, establishment of Europe was open. The important role in development of surgery was played by creation of high fur boots, the first of to-rykh are high fur boots in Bologna (1158), Oxford (12 century), Cambridge (1209), Montpellier (1220), Padua (1222), Salerno (13 century), Prague (1348), Vienna (1365), Heidelberg (1386), Cologne (1394) and other cities. However in the majority of high fur boots teaching medicine and surgery had scholastic character and consisted in studying of compositions of Hippocrates, Ibn-Sina and nek-ry other scientists, the authority to-rykh was recognized by church.

The circle of surgeries was at that time limited to amputations, a lithotomy, a stop of bleedings, opening of abscesses and phlegmons, a section of fistulas. However and these operations often came to an end with death of patients in connection with development of purulent complications.

Suppuration of wounds reckoned with formation of granulations as a happy sign since it gave hope for an otgranicheniye of inflammatory process. Large surgeons of that time Roger and Roland always tamponed fresh wounds in hope to get «benign» suppuration and to prevent development of a putrefactive infection. However cases and smooth healing of fresh wounds were observed that allowed de Longobourgo (V. of de Longobur-go, apprx. 1250) for the first time to give definition of healing of wounds first and second intention (prima et secunda intentio). During the same period of Borgonyoni (Th. Borgognioni) insisted on treatment of wounds without use of tampons. Already in the ancient time the advanced doctors formulated requirements to purity and neatness. These rules of thumb received scientific justification only in 19 century thanks to outstanding opening of microbiology.

Surgeons long since tried to find the simplest and well-tried styptic remedies. Already in Ancient China, Egypt, Greece, India nek-ry ways of fight against bleeding were known. «Doctors of Kievan Rus' were able to appease blood». In the very ancient time in various countries bandaging of vessels at bleedings was applied. However in the Middle Ages this idea was forgotten. Cauterization by red-hot iron or the boiling oil became the main means of a stop of severe bleeding.

In 15 century success in the field of plastic surgery in Italy was achieved. Branca was one of creators of a method of the Italian rhinoplasty. He suggested to find a rag on a leg from skin of a shoulder and to sew it to the refreshed surface of the disfigured nose. Despite achievements of modern surgery and variety of plastic receptions, this method within five centuries it is successfully applied by surgeons of the whole world.

The proposal original for those times was made by also fr. surgeon De Mondevil (H. de Monde-ville, apprx. 1320): to sew up fresh wounds in order to avoid contact with air, to-ry it considered a source of the infectious beginning. At de Mondevil's amputations drew an extremity fabric for the purpose of reduction of pain and fight against bleeding (it was five centuries prior to emergence of a styptic plait of Esmarkh). In the history of surgery

Guy de Chauliac ranks high. Its work «Big Surgery» (1363) within several centuries was considered in France and beyond its limits as the classical composition on surgery. Gui de Choliac carried out an extension per continuitatem at fractures of a hip. It as well as doctors of an extreme antiquity and the Middle Ages, did attempts (apparently, unsuccessful) imposings of an intestinal seam.

In other countries of Europe development of surgery went more slowly. The official science in the Middle Ages recognized only internal medicine, and the surgery was reduced to the level of craft. Barbers, bathhouse attendants or handicraftsmen were engaged in it preferential, to-rye adopted surgical receptions from each other or reported on the family line.

Kievan Rus' was usually treated at monks-doctors, various bone-setters, lechts, internal affairs of masters, herbalists. The positive role in development of medicine and surgery in Russia was played by Shestodnev in Old Slavic language (1263) — a collection of various, including anatomic and medical data, written by the exarch Ioann Bolgarsky (10 century). Shestodnev even several centuries later, in the period of the Russian centralized state, did not stop being one of the most popular books of the Russian readers.

In chronicles and literary works 11 — 13 centuries belonging to Illarion Kiyevsky, Nestor, the chronicler Kirill Turovsky, Vladimir Monomakh, Luka Zhidyat, Ilya Novgorodsky, Serapion Vladimirsky, Danila Zatochnik and many other, most often remained unknown, quite often meet short descriptions of symptoms of various diseases, judgments

of such questions of doctoring as cauterization, bloodletting express, ways of cleaning and sewing up of wounds are given. imposings on a wound of a privuza — bandages and plasters. By this time emergence of a new type of literature with medical - biol belongs. contents: lutsidariya, psevdoaristote-

the left compositions and other works, in to-rykh attempts of theoretical justification of questions of applied medicine became. The centers of correspondence of medical books, their accumulation, storages and distribution became nek-ry of northern monasteries. The Belozersk monastery belonged to their number, from to-rogo there is a remarkable manuscript of the first half of 15 century of «Galinovo on Ipok-rat». The founder of the Belozersk monastery monk Kirill writer was her copyist. Keeping of «Galinovo on Ipokrat» on the structure is not similar to usual Old Russian doctor books with their practical advice on case of this or that disease. It is rather short system of medicine and surgery stated on fundamentals of antique physiophilosophy.

In Russia Kosma and Demian were considered as patrons of smiths and doctors. The attributes indicating their belonging to medicine were at one — a medical box, at another — a bird's feather in a hand. Long since was considered that the bird's feather of ancient lechts served for greasing struck a century. But further it turned out that used a feather not as a brush — it played a role of a surgical instrument. In one of the most ancient doctor books published by M. Yu. Lakhtin operation on centuries at a trichiasis with exact transfer of drugs, provisions of the patient at operation is in detail described, desmurgichesky receptions and surgical instruments, among to-rykh the main place occupied a core of a feather with a split. It served for cuts of a conjunctiva a century and removals of incorrectly growing eyelashes.

Since And century Old Russian lechets made nek-ry small surgeries, the equipment of surgical bandages (privuz), initial bases of treatment of changes, massage was well developed. Chronicles are rich with descriptions of the most various injuries household and, in particular, military character. In the same place original methods of treatment of ulcers, changes, reductions are given to consciousness of wounded. At treatment of outside defeats lechets widely applied applying of fresh plants — cabbage, flax, mustard, a hazel grove, a noputnik or their juice. Ulcers washed out extracts of onions, garlic, beet, horse-radish. Resorted to this way of treatment at hron. the cankers which were followed by release of pus and off-flavor. At long not healing ulcers applied also birch sap. In very ancient doctor books for the same purpose infusion of a wormwood or juniper was recommended, mentioning about Krom can be found also in the manuscript of the Novgorod Sofia relating to 14 century.

Different ways of transportation of patients and wounded are mentioned in chronicles, there is a message on the manual lock. As the improvised stretcher outerwear, ponyava, carpets, ubrusa (towel) and other improvised materials were applied. On a long distance of wounded transported most often the cartage — in carts and in tilt carts (rattletraps). Sick Alexander Nevsky was transported from the Horde in a closed sleigh with the covered top and side windows. Approximately the same type of the vehicle with the covered top and a quadrangular peephole in the forefront of crew was available in a marching wagon train of the grand duke Vasily Vasilyevich (1455).

In Russia from 12 century transportation of patients on a two-horse stretcher was applied (boundaries a horse). Thus the seriously ill patient Yury Dolgorukiy Mikhalko Yuryevich's son was transported from Moscow to Vladimir. The way of transportation of seriously ill patients and wounded on sledge and drag harrows was eurysynusic in the Russian North, in the countries of Europe it was not applied.

In the Charter of the Kiev prince Vladimir it is told about hospitals, in to-rykh gave help to patients and a shelter with crippled. From ancient chronicles it is possible to learn that in 1091 in Pereyaslavl «the bathing structure» was based and it is arranged-tsa for free doctoring of people of any rank.

Thus, cannot raise doubts that doctors of Kievan Rus' owned nek-ry surgical methods and made operations. It is confirmed by the numerous instructions found in Old Russian literature. The most convincing of them are brought in «Izbornikakh Svyatoslav» (1073, 1076). Judging by «Izbornikam of Svyatoslav», any doctor shall have first of all surgical knowledge. In competence of doctor-hirur-hectare, in addition to ability to cut fabrics, to amputate extremities, entered to lay down. cauterizations by the heated iron. The main tool of the doctor-surgeon was iron, a cut he skillfully used on advantage of the patient.

On a high level in the Middle Ages there was a medicine and surgery in Georgia. In ancient Georgian books (karabadina) written in 11 — 12 centuries there are nek-ry data on anatomy and physiology and an important wedge, data are provided. E.g., in ancient Georgia manufactured reposition of hernias, were able to set dislocations, to treat burns the ointments containing, e.g., quicklime. At changes it was required «well and to skillfully put fragments of bones» then applied an immobilization of extremities. Wounds sewed up by means of iron needles with silk threads. At a varicosity and hemorrhoids applied a section and excision of expanded sites of veins. There are data and on ligation on vessels linen thread.

In Hodzhi Kopili's book of «sa-akimy Tsigiya» (13 century) are instructed in performing tracheotomy at asphyxia, hernias are described. An edema of covers of a small egg of Hodge Kopili recommended to treat a puncture, and abscesses and phlegmons — to cut. In 13 century in Georgia manufactured nek-ry eye operations (concerning torsion and an ectropion a century, opening of the lacrimal channel, etc.). In Zaza

Fanaskhertelya's karabadena (15 century) the chrevosecheniye is mentioned.

On rather high level of development there was a surgery also in Armenia where knew the Arab medicine and Hippocrates's works.

It is known that only in the first half of 18 century in Europe surgeons acquired the identical rights with doctors, doctors and formally began to admit scientific. This fact is paramount in the history of surgery.

In Renaissance in 16 century new medical and surgical schools were created, the European doctors began to study works of ancient physicians, there were works on anatomy that was especially noticeable in France. A. Paré who published a meeting of the works in to-rykh it was the most famous surgeon of that time, in particular, offered a ligature of vessels, a styptic plait, a burning out of purulent wounds the boiling oil, operation of a lithotomy, removal of a cataract, etc. The Parisian Medical faculty opposed it with charges of incompetence. However public opinion was on the party of the famous surgeon. He is considered by right the father of surgery in France. Also other fr. surgeons of 16 century —

the pupil A. Paré J. Guillemeau are known, to Ruse (F. Rousset), Colot, etc.

In 17 century offered Fabri [W. Fabry (Latin of F. Hildanus)] new tools for removal of urinary stones, tooth nippers, etc. Also Dutch surgeons N. Tulpius and P. Barbette gained popularity. The fr. surgeon Dionysus (R. of Dionis) in 1707 published «A course of operations», in Krom described, e.g., amputation of an extremity by means of the heated iron. Most often at that time surgeons, as well as all doctors, applied bloodletting.

In 17 century and the beginning of 18 century the provision of surgery belittled to craft remained. E.g., the doctor considered to manufacture in Germany below the advantage vulgar operations and procedures (to do cuts, cauterizations, bloodlettings, etc.). The doctor had to know anatomy and surgery and to participate in operation, giving advice, and the surgeon had no right to appoint drugs. In France Zh. Pti the first refused a so-called oath, edges obliged the surgeon to be on position of the pupil of doctors of faculty that made it a target for attacks. Zh. Pti's works were progressive for those times, especially in the field of treatment of changes, a removing calculus of a gall bladder. The organization in 1731. Royal academy of surgery, connected with activity of the royal

surgeon G. Marechal, put an end to the belittled provision of surgery. The academy had the status and submitted to the king of France. She organized surgical communities in the country. Professors of this academy gave lectures on anatomy of ii of osteology, about surgical diseases and operations, knew many methods of ancient physicians (bloodlettings and cauterizations, banks, etc.), successfully wounds and suppurations of wounds for those times treated.

The tendency to independence of surgery as medical specialty was shown also in other European countries — England, Denmark, Italy, Germany. In Austria the Vienna school of surgery was created, the similar school appeared in Copenhagen. In Italy there were known works of the scientist-surgeon D. Anel. To a crust, time the technique of treatment of aneurisms of arteries according to D. Anel kept the value. In 18 century in England brilliant surgeons worked: Gunter (VV. Hunter), the made contribution to anatomy and surgery of vessels, A. Monro, P. Pott.

In Russia in 1707 at the Moscow general hospital (nowadays Main clinical military hospital of H. N. Burdenko) founded dissecting room and hospital school for training of doctors — surgeons (on 50 people), the cut directed H. J1. Bidloo. Peter I who had own set of surgical instruments took active part in anatomic researches and surgical manipulations. Thanks to other court surgeon of Tor-montu he learned bloodletting, bandaging of wounds, an exodontia. In 1733 hospital schools (see) were open at two St. Petersburg military hospitals and at the Admiralty hospital in Kronstadt. In addition to the invited foreign surgeons and anatomists, in them the famous Russian surgeon and the scientist K. I. Shchepin taught. At hospital schools I. Shreyber was appointed professor of surgery. In 1755 in Moscow the first Russian of un-t about medical f-volume and clinics opened. In 1783 at Kalin-kovsky in St. Petersburg it would be founded Medicochirurgical in-t (school), existed till 1802. In 1786 hospital schools were transformed to medicochirurgical schools (see). Moscow and St. Petersburg medico-hi-rurgicheskiye schools in 1798 were transformed to medicochirurgical academies (see Army medical college).

Professor of the St. Petersburg physician - surgical academy I. F. Bush who published in 1807 — 1808. «The management to teaching surgery», was an ancestor of the Russian surgical school. His pupils of X. X. Salomon, P. N. Saven-Co, I. V. Buyalsky, I. V. Rklits-ky and V. V. Pelikan continued business of the teacher. I. V. Buyalsky who wrote a number of books on anatomy and surgery and especially much made in the field of surgery of vessels became the brilliant surgeon. He offered a number of surgical instruments (Buyal-sky's rake, etc.) *

Progress of the European surgery in 18 — 19 centuries is reflected in fr. scientific G. Dyupyuitrena' works, Zh. Lis-franka, German — B. Langenbeka, Gref (Page F. Graefe), F. Esmarkh, etc. Special fame was gained by T. Biljrot's activity, to-ry one of the first with success executed a resection of a stomach and developed the techniques of this operation (Billroth

of I and II) applied in modern surgery. Also famous English doctor E. Cooper is known, to-ry offered methods and tools for bandaging of arteries, and also for an operative measure concerning the restrained hernia. Progress amer. surgeries it was connected with development of surgical schools of Europe. Among an amer. surgeons of 18 — 19 centuries it is necessary to mark out V. Mott who performed the first bandaging of an ileal artery, J. Wardrop who made bandaging of a carotid artery, Hamilton (F. N of Hamilton), etc., from French — Velpo (A. A. L. M of Velpeau), known for works on pathology of veins and mammary glands, Shassenyak (S. M. E. Chassaignac) developing questions of drainage of wounds, D. L are yard, the chief surgeon of Napoleonic army, etc.

However despite emergence in various countries of brilliant representatives of medicine and virtuosos of surgery, operative measures on internals were accompanied by big risk. Sufferings of the person during operation without anesthesia, terrible danger of shock, blood loss and infection saddened a way of surgery and forced surgeons to refuse interventions at diseases of bodies of belly and chest cavities.

The second period of development of surgery is connected with opening and implementation in practice of antiseptics, an asepsis and anesthesia. The scientific foundation of modern surgery was laid at the end of 19 century, thanks to a number of outstanding opening in biology, chemistry and medicine, and also to achievements of the equipment. Improvement of a microscope, development by R. Virkhov, J1. Ashoff and other pathologists of methods patogistol. researches allowed surgeons to make more exact diagnosis to a disease and it is correct to estimate results of treatment. Soon there were conditions and for an urgent gistol. researches during operation that began to be used for differential diagnosis of tumors, tuberculosis and other diseases.

Opening of antiseptics of an asepsis by J. Lister, E. Bergmann and K. Shim-melbush was a new stage in surgery. The way to surgery of abdominal organs, neurosurgery, etc. was laid. This opening was preceded by N. I. Pirogov, L. Pasteur and I. Zemmeljveys's works.

Progress of domestic surgery is connected with activity and fundamental versatile works in the field of medicine, anatomy and surgery of the ingenious Russian surgeon N. I. Pirogov. Nek-ry historians compare N. I. Pirogov to A. Paré and J. Lister. However justice demands to tell what other such versatile scientist costing a cut above contemporaries, the surgery and medicine of 19 century did not know.

The founder of scientific surgery, the innovator and the courageous fighter against the old, become obsolete representations, the enthusiast of surgery N. I. Pirogov the first organized rational training of medical students and created department of hospital surgery. Its insight, mind and energy allowed to establish root causes of a surgical infection that was new for those times and preceded opening of listerov-sky antiseptics. Considerably enriched science of a research of N. I. Pirogov in the field of operational surgery and topographical surgical anatomy, fundamental works on topography of vessels of internals, muscles, bones, etc. Historical value was gained by N. I. Pirogov's works on field surgery, about use of a plaster bandage at changes, epidemiology, fight against cholera, training of surgeons. But they could not be estimated by the despotic imperial government. N. I. Pirogov lived difficult life. He early retired and the last 20 years of the life spent preferential in the manor in the village Cherry (nowadays Pirogovo) under Vinnitsey where he is buried in 1881. In the village of Pirogovo the memorial memorial estate of N. I. Pirogov where in a sarcophagus the embalming body of the great compatriot, the father of the Russian surgery is based (tsvetn is created. tab., Art. 368, fig. 8).

N. I. Pirogov's pupil P. P. Pe-lekhin in Russia introduced in clinic at operations antiseptics for the first time. Other pupils of N. I. Pirogov V. A. Karavayev and P. Yu. Nem-mert, and also E. I. Bogdanovsky working in this clinic,

S. P. Kolomnin, JI. JI. Levigin, P. F. Lesgaft, etc. made a big contribution to development of domestic surgery.

In addition to P. P. Pelekhin merits of practical implementation of antiseptics in Russia belong to Derptsky's surgeons un-that E. Bergmanna and K. K. Reyer. This problem was successfully studied by N. V. Sklifosovsky who much made for formation of domestic surgery and creation surgical about-va and also for the organization and successful holding surgical congresses. The brilliant scientist and the organizer N. V. Sklifosovsky created large school, from a cut there were professors I. S. Tauber, I. K. Spizhar-ny, and also practical surgeons I. D. Sarychev, M. P. Yakovlev,

A. P. Levitsky, etc. During this period the Moscow

schools A were created. And. Bobrova, P. I. Dyakonov;

St. Petersburg — N. A. Velyaminova and S. P. Fedorov; Odessa —

B. L. Pokotilo; Kazan —

V. I. Razumovsky, etc.

In 19 century much attention was paid to prevention of a putrefactive infection, hospital gangrene (see), peritonitis (see), sepsis (see) and other catastrophic complications which were very often observed in the doantiseptichesky period. The antiseptics and an asepsis passed a difficult way of fight and improvement in a number of the countries. Slightly quicker they began to be used in a number of clinics and BC of Russia that was connected with N. V. Skli-fosovsky, P. I. Dyakonov, M. S. Subbotin and A. V. Martynov's vigorous activity.

Opening in the field of physics, especially x-ray emission (see) and the phenomena of radioactivity were of great importance for this stage of surgery (see). These largest opening quickly were implemented into practical life of BC and clinics that considerably improved diagnosis and treatment of many surgical diseases.

Huge influence on surgery and medicine in general rendered opening of an anesthesia. For the first time inhalation etherization was applied in 1842 by W. Clark at an odontectomy at the patient. The same year Long (Page W. Long) Udapoured a tumor of a neck under etherization. However U. Morton got glory of an opener of etherization, to-ry made extraction of tooth under etherization only in 1846. In 1847 for the first time in Russia

F. I. Inozemtsev successfully used etherization. And meanwhile N. I. Pirogov applied etherization many wounded and the patient, defined it fiziol. impact on a human body, improved the equipment, created new techniques and by that made a big contribution to development of anesthesiology. In 1847 J. Simpson offered chloroform for an anesthesia. In 1844 H. Wells for the first time applied nitrous oxide (laughing gas) to an anesthesia.

The positive role in development of a local anesthesia was played by inventions in 1845 of a hollow needle F. Rynd and the syringe in 1853 Wood and Pravats (A. Wood, Ch. G. Pravaz), and also opening

by V. K. Anrep in 1879 of mestnoanesteziruyushchy properties of cocaine. Further progress of anesthesiology, a radiology, equipment defined many large achievements of modern surgery, edges in 20 century becomes discipline along with therapy, obstetrics and the pediatrics conducting a wedge. Pilot studies and opening noted above allowed surgeons to expand a circle of operative measures and is successful, for advantage of the patient, to interfere in those areas, to operate those bodies, interventions on to-rykh a long time were considered incompatible with life the patient.

The third period of development of surgery — the physiologist - experimental. K. Bernard, I. M. Sechenov, I. P. Pavlov's ideas, At. Kennona, numerous experiments on animals in many laboratories of the world, and also universal use in clinics of an asepsis and antiseptics, an anesthesia, injection of liquids, in particular in a vein, allowed to expand sharply indications to operative measures and to reduce their risk. Exclusively big role was played at the same time by opening by K. Landshteyner, Ya. Yansky and W. L. Moss of blood groups and implementation practice of transfusion of the whole, stabilized and stored blood [L. Ago-te, V. N. Shamov, etc.] that allowed to fight against effects of blood loss and shock. The undoubted benefit was brought also by improvement of many tools, designing of devices for an anesthesia and an artificial respiration, sterilizers, shadowless lamps, etc. All this provided emergence and development of the emergency surgical help. Immediate surgeries at appendicitis, perforated stomach ulcer, impassability of intestines and the restrained hernia were widely used during this period. The resection of a stomach for the first time executed in 1880 by the Polish surgeon of JI. Rhee-digerom developed by T. Bilro-t, H. Finsterer,

S. S. Yudin, etc. found broad application at a carcinoma of the stomach, a peptic ulcer of a stomach and a duodenum.

Improvement of anesthesiology (see), and also hemotransfusion (see), a hypothermia (see the Hypothermia artificial), methods of controlling with a surgical infection reduced risk of operations on vitals.

In the first third of 20 century when the first successful lung operations — removal of a share and the whole lung [P. A. Herzen, R. Nissen, E. Graham] were executed, also evidence-based other interventions on bodies of a chest cavity became possible. It was promoted by studying of open pheumothorax, the managed breath, antibacterial therapy. The vascular surgery, methods actively developed and applied a cut many surgeons of the last centuries, especially during wars, also became on strong scientific bases to what promoted improvement of a vascular seam [A. Karrel, I. F. Sabaneev, Kraford (S. to Sga-foord), Gross (R. E. Gross), Dyubo (Ch. Dubost), M. De Becky, D. A. Cooley, etc.], use of synthetic vascular materials and atraumatic needles, special tools, anticoagulants, etc.

The significant role in medicine and especially surgery was played by opening and industrial production of antibiotics (see). In surgery there were changes in approach to prevention of an infection, the concept «operate under protection of antibiotics» appeared. Quantity production of antibiotics, emergence of many semi-synthetic drugs of a broad spectrum of activity expanded their use in surgery even more. At the same time the complications connected using antibiotics, accustoming to them, stability of a number of bacterial strains began to be noted (see. Medicinal stability of microorganisms) and other problems studied in a crust, time.

The heart surgery began to develop in the 40th and especially the 50th actively (see Surgery cardiovascular). Important role played opening of methods of angiocardiography in development of a heart surgery [A. Mu niches, 1936; A. Castellanos, 1938] and cardiac catheterizations (V. Forssmann, 1929), and also use of antibiotics. Exclusive value development in 1920 — 1925 had S. S. Bryukhonen-co of a method of artificial circulation. In 1965 for development of this method of S. S. Bryukhonenko it was posthumously conferred the Lenin award. In the 30th of H. N. Terebinsky and

S. S. Bryukhonenko developed and successfully executed by means of cardiopulmonary bypasses in experiments on animals the first operations at modelirovanny defects of valves of heart. The first successful operation at coarctation of an aorta in a wedge, practice was executed in 1944 by the Swedish surgeon Kraford, and at an open bo-tall channel — in 1939 an amer. surgeon Gross. Open heart operations at the person began to be performed by means of cardiopulmonary bypasses from 50th [Lillikhey (Page W. Lillehei), M. De Becky, Gross, Bailey (Page P. Bailey), Allen (Page W. Allen), Dyubo, P. Val-doni, A. Doljotti, A. N. Bakulev, P. A. Kupriyanov, A. A. Vishnevsky, B. V. Petrovsky, E. N. Meshalkin,

V. I. Burakovsky, H. M. Amosov, etc.]*

Actively developed neurosurgery (see), urology (see), traumatology (see), gynecology (see).

After Great October socialist revolution in our country public service of the emergency surgical help which became further a prototype of the same service in the socialist countries was created (see Emergency medical service). In postrevolutionary military and peace years, developing progressive traditions of domestic surgery, there were schools of the Soviet surgery — S. P. Fedorova, I. I. Grekov, V. A. Oppel,

A. V. Martynov, P. A. Herzen, H. N. Burdenko, H. N. Petrova,

B. N. Shamov, S. I. Spasokukotsky,

V. M. Mysh, S. R. Mirotvortsevag N. I. Napalkova, Yu. Yu. Dzhanelidze, A. G. Savinykh, to G. M. Mukhad-za, etc.

By the beginning of the Great Patriotic War Soviet surgeons I got stronger, was enriched with new methods of treatment of wounds, fight against shock and blood loss, created system of preparation and improvement of surgeons of the country. Therefore World War II did not take unawares surgical services of Red Army and civil institutions. The military surgery was headed the chief surgeon of Red Army H. N. Burdenko and visible scientific countries P. A. Kupriyanov, A. N. Bakulev, M. N. A.Khu-tin, S. S. Girgolav, BB. 10. Dzhanelidze, V. S. Levitte, etc. A merit of the domestic surgery having the international value is return to a system of St. 72% of wounded. In post-war years the Soviet doctors who got military experience recovered health care and carried out huge work on a share-chpvaniyu of many millions of wounded. After war are published the multivolume work «Experience of the Soviet Medicine in the Great Patriotic War of 1941 — 1945.» reflecting large achievements of the Soviet surgery, and also the multivolume guide to surgery in 12 volumes, the leading surgeons of the country (editor B. V. Petrovsky)

the Soviet medical higher education institutions and institutes of improvement of doctors participated in creation to-rogo (see), such as the 1st and 2nd Moscow, the CCP,

the 1st Leningrad, Kiev, Minsk, Tashkent, Novosibirsk, Tomsk, Kazan, Yerevan, Kharkiv, Lviv, Tartu, Baku, Ryazan and many others, considerably got stronger and created solid base for training of practical surgeons and specialists for scientific research in the field of surgery (see. Medical institutes, M editsinsky shots).

For achievements in the field of surgery Lenin awards were awarded for development and deployment in practice of a method of preparation and use of fibrinolizny blood (V. N. Shamov and S. S. Yudin), oncological works (H. N. Petrov), development of a heart surgery and vessels (A. N. Bakulev, A. A. Vishnevsky, P. A. Kupriyanov, E. N. Meshalkin, B. V. Petrovsky, V. I. Burakovsky with sotr.), pulmonary surgery (H. M. Amosov, N. V. Antelava, L. K. Bogush, I. S. Kolesnikov, B. E. Linberg,

B. I. Struchkov, F. G. Uglov). The state awards of the USSR noted works of many surgeons conducting researches in the field of renal transplantation, operational treatment of diseases of a trachea and bronchial tubes, vessels in the field of microsurgery, hyperbaric oxygenation, etc. Awards of the USSR Academy of Medical Sciences on surgery of N. I. Pirogov, are annually awarded by H. N. Burdenko,

C. I. Spasokukotsky and A. N. Bakulev.

Wide popularity in our country and abroad was gained large multi-profile and specialized scientific in-you: All-Union scientific center of surgery of the USSR Academy of Medical Sciences, Ying t of surgery of

A. V. Vishnevsky of the USSR Academy of Medical Sciences, Ying t of cardiovascular surgery of

A. N. Bakulev of the USSR Academy of Medical Sciences, Ying t of neurosurgery of H. N. Burdenko USSR Academy of Medical Sciences, Moscow city Scientific Research Institute of Emergency Medicine of N. V. Skli-fosovsky, Leningrad Scientific Research Institute of Emergency Medicine of Yu. Yu. Dzhanelidze of M3 of RSFSR, Central scientific research institute of traumatology and orthopedics of H. N. Priorova and other scientific institutions and large clinics of a surgical profile (see research centers).

The fourth period — the period of a reconstructive and plastic surgery is connected with further progress of surgery, its specialization, implementation in medical practice of modern pharmaceuticals, polymeric materials, devices of monitor overseeing by the patient in time and after operation, development of anesthesiology (see), resuscitation (see), transfusiology (see), reconstructive intervention, to apply a plastic method, the replantation, autotransplantation, a gomoperesadka of fabrics and bodies, to fit a prosthesis vessels, valves of heart, to enter plastic materials, artificial organs into an organism which allowed to replace even more often in practice removal of body, an extremity, fabric. Surgery of 20 century, using all opening and progress of last years, develops as reconstructive, plastic, physiological surgery. Humanity, preventive orientation, fight against pain, asepsis and antiseptics, active reanimatol remain its philosophy. actions in time and after operation (tsvetn. the tab., Art. 368, fig. 9 and 10), reasonable use of the modern medical equipment and pharmaceuticals, and also blood, its ingredients and drugs, vaccines, the sparing surgical equipment and a hemostasis, the good organization of departments and training of surgeons, in-depth pilot studies and implementation in practice of new diagnostic methods, treatments and rehabilitations.

The prevention which is fundamentals of socialist medicine gains the increasing value in early detection of many surgical diseases (see Prevention). At the same time the CPSU which is carried out according to decisions and the Soviet government medical examination of the population allows to put this problem on real bases (see Medical examination, Prevention primary).

In surgical institutions methods biochemical, immunol are used., mikrobiol., gistol. and others lab. researches. The increasing value is gained by modern methods of a X-ray, radionuclide, ultrasonic and endoscopic inspection.

In the 80th the commonwealth of a technical and medical thought allowed to implement in a wedge, practice the computer tomograph, gamma cameras of new type, the computer scan-nery and locators, etc., with the help to-rykh it is possible to reveal minor changes in bodies and fabrics, to make more exact preoperative diagnosis.

Development of a radiology caused emergence of X-ray surgery (see P entgenoendovaskulyarny surgery), by means of methods a cut it is possible to carry out obstruction of the bleeding vessels of internals, to expand the narrowed vessels, to delete blood clots, etc. in essence without section of fabrics. The endoscopic equipment simplified removal of polyps of bronchial tubes, a stomach, gullet, intestines, allowed to cauterize ulcers, to broaden bilious channels, etc.

Progress in all fields of surgery in 70 — 80 20 century is characterized by reduction of risk of operation, especially at patients of advanced age, and improvement of the short-term and long-term results, development of reconstructive surgery (see. Plastic surgery) and methods of transplantation (see). For a section of fabrics and coagulation of vessels electricity, ultrasound, the laser, cold, heat and various surgical instruments are widely used. Rescue of life by the patient who is in a condition of clinical death became a reality.

Special perspectives received methods of operative measures by means of an operative microscope, microsurgical instruments and atraumatic threads with needles. Methods of microsurgery with success make replantation of extremities, brushes, fingers. There was a recent trend of surgery — autotransplantation of bodies and fabrics (see Microsurgery). Gain distribution if necessary autotransplantation of toes on a hand, autoplastichesky substitutions of extensive defects of the person, autotransplantation of nerves, plastic of fallopian pipes and other reconstructive plastic surgeries (see).

The precision equipment, use of a microscope considerably expanded possibilities of connection of the thinnest fabric structures — walls of hollow bodies, circulatory and limf, vessels, nerves, etc. that improved their regeneration after operative measures. Thus, the technique of microsurgery puts all plastic and plastic surgery on new, more perfect level, is implemented into all other its areas.

In surgery one more recent trend — a barotherapy (see an iper the baric oxygenation), and also operations in pressures chamber arose (tsvetn. tab., Art. 384, rice. I) that considerably reduced risk of operations, especially at people of advanced age, at anemia, ischemia, vitals. The most wide spread occurance was gained by open heart operations by means of the cardiopulmonary bypass (see. Artificial circulation). For the purpose of reconstruction of body patients with the acquired and inborn heart diseases, coronary heart disease, with postinfarction aneurisms of heart are operated.

Serious researches are conducted in the field of creation of artificial heart in the USSR, the USA, Czechoslovakia, GDR, France and other countries. Operations of temporary connection of an artificial left ventricle of heart at the person are begun. Further development is gained by the emergency surgery, transplantology, pulmonology, reconstructive operations on the bilious ways, a liver and a pancreas, a gullet, a stomach and intestines, vessels, purulent surgery.

During this period the particularly important became communication of surgeons of all countries of the world, a cut is carried out during the international and national congresses, congresses, conferences, symposiums. Organized in 1902. International about-in surgeons since 1905 regularly convokes the international congresses (the last XXX congress took place in 1983 in Hamburg). The XXIV international congress of surgeons went over with great success in 1971 in Moscow.

In a crust, time in various countries more than 80 magazines of a surgical profile are issued. The USSR is published «The messenger of surgery of nanometer. I. I. Grekova», «Clinical surgery)), «Surgery», «Chest surgery», etc. Editorial boards of these magazines carry out a lot of work, informing the medical

public on achievements in the field of surgery, will organize discussions, publish resolutions of the congresses, congresses, conferences. The detailed list of periodicals on surgery — see the bibliography and article Medical periodicals.

Bibliography: History — And N of the h e l e-

in and V. D's h. Outstanding figures of the Soviet surgery, Irkutsk, 1975; Belogorsk P. A. Hospital surgical clinic at imperial Military-medical (byvsh. Medicochirurgical) academies 1841 — 1898, Materials for history of surgery in Russia, a yew., SPb., 1898; A. N. Golden eagles and d river Nikolay Nilovich Burdenko, JI., 1977; B of ides of l oo H. JI. Manual for studying surgery in dissecting room, the lane from Latinas., M., 1979; B about Goya in l e N with to and y N. A. Hirurgiya of ancient Russia, Vestn. hir., t. 81, No. 7, page 132, 1958; B about r about d and y N. K. K of history of fir-tree-savetgradsky medicochirurgical school, Owls. zdravookhr., No. 7, page 61, 1979; Bratus V. D. Development of surgery in Ukraine in continuous communication with activity of Academy of Sciences. (To 250-year anniversary of Academy of Sciences of the USSR), Klin, hir., No. 5, page 1, 1974; D zhumayev V. K. Hirurgiya Abu Ali ibn Cynna and its historical sources, Tashkent, 1979; Zabludov-sky A. M. Fifty years Hirurgiche-

sky about-va Pirogov in Leningrad, Is new. hir. arkh., t. 26, book 3, page 243, 1932;

it, Sketches of history of the Russian surgical literature, Hirurgiya, No. 10, page 3, To 12, page 9, 1947, No. 1, page 3, No. 2, page 7, No. 3, page 18, 1948; To about l e with about in V. I. Pages from history of domestic surgery, M., 1953; it, Surgical schools of St. Petersburg — Petrograd — Leningrad, Vestn. hir., t. 78, N ° 6, page 7, 1957; Krakow N. I. and Anichkov M. N. Achievements of the Soviet surgery in days of the Great Patriotic War (1941 — 1945), Owls. medical, No. 5, page 9, 1975; M. I. Uspekhi's Cousins and perspective of development of the Soviet surgery, Vestn. USSR Academy of Medical Sciences, No. 12, page 42, 1977; Land-shevsky And. Historical sketch of department of the academic surgical clinic imperial Military-medical (former imperial Medicochirurgical) academies (1798 — 1898), yew., SPb., 1898; Levit V. S. The Soviet surgery to the fortieth anniversary of Great October socialist revolution, Hirurgiya, No. 10, page 7, 1957; L M. M. e-Vit, Savelyev V. S. and Short R. V. Shkola of S. I. Spasokukotsky, Works of the 2nd Mosk. medical in-that, t. 21, century 4, page 13, 1973; Matya-

sh and N And. M. «Hirurgiya on a crossroads»

S. P. Fedorova and progress of modern surgery (To the 50 anniversary of the publication of article), Klin, hir., No. 8, page 6, 1976; About p-

p e l V. A. Istoriya of the Russian surgery, Vologda, 1923; it, Sketches of surgery of war, L., 1940; Pirogovsky readings, M., 1969; Razumovsky V. I. Medicine and surgery in the XIX century, the 8th Pirogovsk. congress, century 7, page 9, M., 1903; With about p to about V. S. The Transcarpathian workshops of barbers and their role in the surgical help to the population in the XV—XVII century, Klin, medical, t. 51, No. 7, page 147, 1973; Jacobson S.A. Reflection of development of territorial surgery in the surgical press, Hirurgiya, No. 4, page 73, 1946; I am a N about in with to and I am M. I. Ochen a long way (From history of surgery), M., 1977.

Textbooks, the guides, the reference media — Astapenkov. And Malinovsky H. H. Practical guidance by surgical diseases, Minsk, 1979; The bibliography of the Russian surgery and its bordering limits, under the editorship of E. Hesse, century 1 — 10, M., 1926 — 1934;

Vishnevsky A. A. Chosen works on surgery and bordering limits, t. 1 — 2, M., 1970; Voznesensky V. P. and Ivanov V. A. Operational surgery and topographical anatomy, M., 1959; And r about l and in S. S., Levitte V. of Page and III and and to V. A. The textbook of a specialty surgery, M. — L., 1940; Children's surgery, under the editorship of D. Arnaudov, the lane with bolg., Sofia, 1978; 3 and l at d about in-sky A. M. Kurs of the general surgery, L. — M, 1931; Isakov Yu. F. and D au l e c to and y S. Ya. Children's surgery, M., 1978; The Short course of operational surgery with topographical anatomy, under the editorship of V. N. Shevkunenko and A. N. Maksimenko-va, L., 1951; To at to and N of H. N and G. F is greedy. Ways of surgery, M., 1964; The Multivolume guide to surgery, under the editorship of B. V. Petrovsky, t. 1 — 12, M.,

1959 — 1968; M y sh G. D. and d river. Sketches of clinical surgery, Novosibirsk, 1979; Napalkov P. N., From m and districts A. V. and Schreiber M. G. Surgical disease, L., 1961; The General surgery, under the editorship of E. R. Hesse, etc., t. 1 — 2, M. — L., 1928; Experience of the Soviet medicine in the Great Patriotic War of 1941 — 1945, t. 1 — 35, M., 1951 — 1955; Petrovsky B. V. Chosen lectures on clinical surgery, M., 1968; about N e, Surgical diseases, M., 1980; it, Basic bases of a reconstructive and plastic surgery, Hirurgiya, No. 9, page 3, 1982; about N e, Reconstructive surgery, Vestn. USSR Academy of Medical Sciences, No. 1, page 20, 1983; The Guide to an urgent surgery of abdominal organs, under the editorship of V. S. Savelyev, M., 1976; The Management of practical surgery, under the editorship of S. S. Girgolava, etc.,

t. 1 — 9, M. — L., 1929 — 1936; Russian surgery, iod of an edition of P. I. Dyakonova, Pg., 1916; R at f and N about in I. G. General surgery, M., 1957; With and l and Hz e in V. E. Voprosy of a specialty surgery. M, 1952; Struchkov V. I

. Purulent surgery, M., 1967; about N e, the General surgery,

M., 1983; Struchkov V. I., Gosti-Shch e in V. K. and Struchkov Yu. V. Guide to purulent surgery, M., 1984; Khromov B. M. of Hirurgiya in last, real and future, L., 1961; Buttocks S. Gnoyno-septichn's ditch surgery, Sofia, 1971; Bier A., Braun H. u. Kiimmel H. Chirurgische Operationslehre, Bd 1 — 6, Lpz., 1969 — 1976; Die Chirurgie, hrsg. v. M. Kirscnner u. O. Nordrnann, Bd 1 — 7, Wien, 1939 — 1948; Handbuch der plastischen Chirurgie, hrsg. v. E. Gohrbandt a. o., Bd 1, T. 1, B. u. a., 1972; Heberer G.

u. a. Chirurgie, B. u. a., 1977; Hill G. J. Outpatient surgery, Philadelphia, 1980; Kirschner M. Allgemeine und spe-zielle Operationslehre, B., 1980;

L e-ger L. u. Nagel M. Chirurgische Diagnostik, B., 1978; Operative surgery, ed. by C. Rob a. R. Smith, v. 1 — 10, L., 1976 — 1978; Ro b C. S m i t h R. Atlas of general surgery, L., 1981; Walker W. F. A color atlas of general surgical diagnosis, L., 1976.

Periodicals — the Messenger of surgery to them. I. I. Grekova, L., since 1934 (1885 — 1894 — the Surgical messenger, 1895 — the Russian surgical archive, 1896 — 1901 — the Chronicle of the Russian surgery, 1902 — 1909 — the Russian surgical archive, 1910 — 1917 — ■ Surgical archive of Velyaminov, 1922 — 1934 — the Messenger of surgery and bordering limits); Chest surgery, M., since 1959; Clinical surgery, Kiev, since 1962 (1921 — 1941, 1955 — 1962 — New surgical archive); The Medical abstract magazine, the Section IV — Hirurgiya, anesthesiology and resuscitation, traumatology and orthopedics, M., since 1957; New surgery, M. — L., 1925 — 1931; Surgical chronicle, M., 1891 — 1895; Hirurgiya, M., 1897 — 1914; Hirurgiya, M., since 1937 (1926 — 1931 — the Magazine of modern surgery, 1931 — 1937 — the Soviet surgery); Experimental surgery and anesthesiology, M., 1961 — 1976 (1956 — 1960 — Experimental surgery); Acta chirurgiae plasticae, Praha, since 1959; Acta chirurgica Academiae Scientiarum Hungaricae, Budapest, since 1960; Acta chirurgica Austriaca, Vienna, since 1968; Acta chirurgica Italica, Padova, since 1945; Acta chirurgica Iugoslavica, Beograd, since 1954; Acta chirurgica Scandi-navica, Stockholm, since 1869; Aktuelle Chirurgie, Stuttgart, since 1966; American Journal of Surgery, N. Y., since 1891; American Surgeon, Washington, since 1935; Annales chirurgiae et gynaecologiae Fenniae, Helsinki, since 1946; Annales de chirurgie. P., since 1947; Annali italiani di chirurgia, Bologna, since 1922; Annals of Surgery, Philadelphia, since 1885; Archiv fiir japanische Chirurgie, Kyoto, since 1924; Archives of Surgery, Chicago, since 1920; Archivio italiano di chirurgia, Bologna, since 1919; British Journal of Plastic Surgery, Edinburgh, since 1948; British Journal of Surgery, Bristol, since 1913; Brun’s Beitrage zur klinischen Chirurgie, B. — Char-lottenburg, since 1883; Chirurg, V., since 1928; Chirurgia, Bucure^ti, since 1951; Chirurgia italiana, Verona, since 1948; Chirurgia Plastica, N. Y., since 1971; Chirurgische Praxis, Wien, since 1957; Clinics in Plastic Surgery, Philadelphia, since 1974; Current Problems in Surgery, Chicago, since 1964; Excerpta medica, Section IX — Surgery, Amsterdam, since 1947; Journal de Chirurgie, P., since 1908; Journal of Surgical Research, N. Y., since 1961; Langenbecks Archiv fiir klinische Chirurgie, V., since 1860; Minerva chirurgica, Torino, since 1946; Surgery, St Louis, since 1937; Surgery Today, L., since 1980. B. V. Petrovsky.

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