Historiography of epidemic control in Yakutia of the XIX century.

Borisov Andrian Afanas'evich ORCID: 0000-0002-8285-6421 Doctor of History Chief Researcher; Department of History; Institute of Humanitarian Studies and Problems of Small Indigenous Peoples of the North SB RAS 677027, Russia, Republic of Sakha (Yakutia), Yakutsk, Petrovsky str., 1 ali-titova@rambler.ru

Arkhipova Alena Ivanovna ORCID: 0000-0002-2464-0534 PhD in History Senior Researcher; IGIiPMNS SB RAS 677027, Russia, Republic of Sakha (Yakutia), Yakutsk, Petrovsky str., 1 ali-titova@rambler.ru Other publications by this author

Introduction

In history, such terrible phenomena as epidemics have always been significant, which, causing enormous damage to the population of countries, with their harmful consequences affected their historical development in the long term. The emergence of epidemic diseases and the fight against them is an urgent problem that does not lose its scientific significance. Of particular specificity, obviously, is the study of this issue in relation to the marginal regions of such a large country as Russia, in particular, in Yakutia. For the 19th century, in addition to the Yakut region, its designation as the northeast of Asian Russia is also applicable to its designation. From the earliest stages of Russia's presence here, attempts have been made to somehow counter this formidable phenomenon. Outbreaks of such diseases that took on an epidemic character as smallpox, measles, syphilis, leprosy caused irreparable damage to the already small population living in harsh northern conditions. Suffice it to recall how the smallpox epidemics of the XVII century led to the depopulation of the Yukaghir population.

It is not surprising that a considerable place has been given to the study of epidemics in historiography. Despite the different theoretical and methodological approaches, the pages of historical works published in different periods fairly objectively reflected the facts, in particular statistics, but at the same time, it is obvious that the overall assessment of the activities of institutions and structures responsible for combating epidemics could be different.

First of all, it is important to determine the degree of study of the problem, which has a fairly large historiography. Previously, the problem has not been solved in this aspect, there are practically no works of a historiographical nature devoted to the study of epidemic control issues. Meanwhile, finding out what the level of knowledge of this issue is allows us to solve many specific facts, phenomena and trends in the history of activities undertaken by government agencies in such a remote suburb as the Yakutsk region. They give an idea of the development of the regional policy of the state on this particular example, and finally, about the degree of involvement of the territory in the all-Russian processes in the field of socio-cultural development, including such remote provinces as Yakutia.

The problem of combating epidemics at the All-Russian level made it possible not only to make generalizations, but also to determine the theoretical and methodological foundations of research.

The article is of a historiographical nature. The materials for the study were the works of researchers devoted to the history of epidemic control in the XIX century. Actually, as the research materials show, the fight against epidemic diseases in Yakutia obviously began with the creation of a network of medical institutions in the Yakut region at the beginning of the century. At that time, the population of the region - the Yakuts and the peoples of the North, however, as well as the Russian old-timers - overwhelmingly lived in rural areas. The Imperial Law on rural health care was issued in 1897, so it is important to consider how the situation was before that date with the organization of the fight against epidemics. It has become one of the chronological milestones in the history of epidemic control in Yakutia. The authors of this article aim to consider the historiography of epidemic control in Yakutia in the XIX century.

The historical experience of studying the fight against epidemics at the all-Russian level has allowed us to reach the theoretical level of generalizations of this area of our scientific ideas. Thus, a monographic study by K. G. Vasiliev and A. E. Segal, which has passed several editions, is devoted to the issues of the emergence of epidemics in the Russian state. One of the main conclusions of the authors is the position that if in the second half of the XVII century. the fight against epidemics represented the evolution of long-known means of struggle among the people, then since the XVIII century it has been reaching the state level ^{[1; 2]}. One of the important conclusions made by the authors of the monograph is related to the indication that by the end of the XIX century in Russia there was an awareness of the inadequacy of medical and police measures. Attention was drawn to the problem of improving the landscaping of populated areas.

In M. B. Mirsky's seminal work on the history of Russian medicine, a small section is devoted to the fight against "pestilence" in the XVI - XVII centuries. Already at such an early period, the state begins to participate in one form or another in this struggle. Obviously, everything at that time took place within the framework of the providentialist ideas of medieval society. How things stood in the following centuries, and, in particular, in the XIX century. It is considered in the context of such problems as clinical medicine developed from the "enlightened age" to science, metropolitan hospitals and zemstvo medicine ^{[3, pp. 101-103; 263-335]}.

A number of generalizing works related to Siberian historiography have been published at the regional level ^{[4; 5; 6; 7; 8; 9]}. This allowed us to draw important conclusions of a theoretical and methodological nature. "Despite all the problems that existed, it must be recognized that in the second half of the XVIII - first half of the XIX century, following the leading powers of Europe, the attitude of the state to medicine and public health protection in Russia changed dramatically. The transformation of views on the role of medicine in the state and the awareness of the need to establish control over this important area were caused both by significant progress in understanding the causes of the spread of epidemics and the development of new concepts of public administration. The synthesis of the achievements of European scientific medicine and political thought of that period was embodied in the concept of medical police, in one form or another adopted by all major European powers. Despite the specific connotation, the new concept equally provided for the establishment of state supervision over the health of the population and the medical care system, as well as the politicization of medicine as a scientific and practical sphere, its transformation into an instrument of internal state policy and, at the same time, into a significant aspect of internal security. This radical transformation of the state vision of medicine preceded its further evolution into an "instrument of empire" and then into a "soft power" of subsequent eras," writes V. Y. Bashkuev ^{[6, pp. 77-78]}. It is important that these measures were applied regardless of geographical location and ethnic and religious affiliation throughout the territory of the Russian Empire. There are several major research problems in the Yakut historiography of epidemic control in the 19th century.

The formation of a network of medical institutions and the fight against epidemics

Officially, the beginning of the fight against epidemics in Yakutia is associated with the creation of a state network of medical services in the early 19th century. The main milestones were determined by the Decree on the definition of medical ranks in the Yakutsk region in 1805 ("chief physician of the region", five doctors, one for each of the districts), the emergence of the first hospital in 1843 in Yakutsk (although the existence of a "smallpox house" in the city since 1764 is recognized), statistical data from 1863, which testified a slight increase in the medical staff of the Yakutsk region (a regional medical inspector, a veterinarian, a city doctor, five district doctors, a midwife). These facts are noted in many works ^{[10, p. 117-118; 11; 12; 13; 14; 15]}.

The "Commemorative book of the Yakut region for 1863" lists the medical staff of the region in the number of 11 people ^{[12, p. 210]}. Thus, during this period, a certain stage in the development of regional health care was recorded in connection with some expansion of the medical staff, which made it possible to more effectively resist the spread of epidemics in the future.

G. A. Popov, many of whose works did not see the light during the researcher's lifetime, set aside several works in the manuscript, which also found a place for the problem related to healthcare in pre-revolutionary Yakutia. So, in the capital work "The History of the city of Yakutsk: 1632-1917 (short essays)", which was supposed to be published as a monograph in 1932, there is a section "National health". In it, the author stated that although the medical business existed in the city for a long time, "it was almost always not equipped sufficiently" ^{[16, p. 228]}.

He provided valuable information about the medical institutions that were established in the city in different years. The scientist used legislative sources and data from the Archive of the JASSR (now in the RS (Ya)).

It also contains information included in the section "National Health" of an unpublished manuscript about the history of Yakutsk, about medical institutions, including regional hospitals, hospital yurts and houses in some places of the Yakutsk region, "Summary of data on epidemics in Yakutsk".

The table "Medical statistics" is valuable, compiled on the basis of annual reports of the Yakut regional administration from 1866 to 1911. ^[16] It can be used to judge the medical staff of the region by districts.

The history of Yakutia's healthcare is reflected in the works of V. N. Chemezov, P. A. Petrov, N. S. Yagya and V. P. Nikolaev, but its beginning chronologically correlates with the end of the XIX - beginning of the XX centuries – a later period, whereas the first half of the XIX century is characterized by important state policy measures on public health issues ^{[13; 17; 18; 19; 20]}.

In recent years, new aspects of the problem have been revealed. Thus, in the work of A. A. Borisov, devoted to historical and demographic issues, attention is drawn to the problems of combating mortality in the Yakut region in the first half of the XIX century. in the activities of regional management structures ^[21]. In addition to Yakut deaths from hunger strikes and accidents, this work also talks about the damage caused to the Yakut population from diseases.

An example for Yakut historiography is the study of V. Y. Bashkuev, who works in a region close to Yakutia - in Buryatia, whose research focus was on territories inhabited by Mongolian peoples. Moreover, he considered the problems of combating epidemics in new aspects of the evolution of health care in Europe and Russia, epidemics as risk factors and self-organization of urban communities in Transbaikalia ^[6].

The study of the role of individual prominent figures who played a major role in the fight against epidemics.

This problem, which deserves special attention, is reflected in historiography. A bright mark in the history of Yakutia's healthcare was left by its official chief physician of the region, collegiate adviser F. F. Reslein, who performed his duties for many years (in general, he served in Siberia for about 40 years), traveling to the most remote areas of the region. In 1810, when Gedenstrom heard about the spread of leprosy in Kolyma, he ordered him to detach doctors "for research and use." A 70-year-old doctor volunteered to drive himself, after driving 1,500 to Srednekolymsk, caught a cold and died ^[10].

One of the early works devoted to the actual problem is the study of the regional doctor of the Amur region and physician E.F. Shperk "Medical and topographical notes on syphilis in Northeastern Siberia, called "leprosy" there ^[22]. Modern scientists write about the activities of this one of the first doctors of Yakutia ^[23].

V. N. Chemezov noted the role of the first famous doctors who served in the region in the second half of the century, A.M. Brilliantov, Y. M. Bely, N. I. Neopalimovsky and I. M. Petukhov in the fight against smallpox and measles epidemics ^[13]. Also, an overview of historical information about doctors who served in the Yakut region of the XVIII – early XX centuries is presented in the article by V. P. Nikolaev and V. S. Semenov ^{[24; 25]}.

A group of modern Irkutsk researchers examines the problem of the development of leprosy in Eastern Siberia and the activities of medical personnel aimed at eliminating epidemics ^{[26; 27; 28]}. During the period under review, two groups of medical officials left for the Yakutsk region, and their route is indicated on the map. Staff physician F. M. Augustinovich, when examining the residents, emphasized in his report that the problem of the spread of syphilis in Prilenye was exaggerated. In addition, he stayed in Yakutsk and remained there until the end of December 1874 due to the smallpox epidemic. Due to the lack of medical staff, he was engaged in the treatment of patients with smallpox and other diseases. Then he was sent to the Vilyui district to help patients with smallpox and other diseases, including syphilis, and, returning to Yakutsk at the end of February, left for the Kolyma district on March 10 ^[26].

Thus, in historiography, considerable attention is paid to the activities of the most prominent representatives of the medical personnel of the Yakut region, taking into account the specific historical conditions of their activities.

The study of the most characteristic phenomena and striking events in the history of epidemic control in Yakutia.

In historiography, attention was drawn to the diseases to which the indigenous peoples of the North – Paleoasiates were exposed: Yakuts, Evens, Evenks, Yukaghirs, as well as their living and sanitary conditions, and, as a rule, unsanitary conditions, lack of basic hygiene rules and underdevelopment of medicine were noted ^{[12; 29; 30; 31; 32; 33; 34; 35; 36]}. The participants of academic expeditions and RGS expeditions presented specific facts of these phenomena, established during visual observation, mainly of an ethnographic nature.

In the second half of the 19th century, separate works based on documentary historical sources were published. Thus, R. K. Maak, A. F. Middendorf, S. K. Patkanov used in their works some information from the reports of governors and district police officers and materials of the Yakutsk regional statistical committee ^{[37; 38]}.

V. N. Chemezov noted the damage caused to the population of Yakutia from the smallpox epidemic of the 1870s, especially in the Kolyma district ^[13]. The social problems of the population of Yakutia in the historical aspect, including in the period of interest to us, are reviewed in the works of I. A. Argunov, E. N. Fedorova, S. G. Skobelev ^{[39; 40; 41]}.

Yakut researcher I. Ya. Egorov in his doctoral dissertation "Scientific substantiation of the surveillance system for especially dangerous and naturally focal infections in the Far North", defended in 1996. In the paragraph devoted to the regional features of infectious and parasitic morbidity, gives a brief description of the main diseases of the population of the North in the XIX – early XX centuries.

Articles by a team of Irkutsk researchers are devoted to the study of the causes of the development of syphilis and measures of state policy against its spread in Eastern Siberia in the XIX century ^{[42; 43]}. The authors concluded that the Government of the Russian Empire pursued a systematic, persistent policy of combating the eradication of syphilis among non-native communities. The Government's policy was aimed at solving the issues of staffing medical workers, medicines, and the construction of syphilitic hospitals.

Our colleagues working with materials from other regions of Russia, including those close to us, in Western and Southwestern Siberia, have achieved notable success. So, Yakovlev E. V. in his PhD thesis "The impact of emergency situations on the daily life of the population of Tambov province in the second half of the XIX - early XX centuries and the activities of the authorities and the public to prevent and overcome their consequences", defended in 2004, considers measures aimed at overcoming epidemics undertaken by the administration and the public.

The most numerous are studies on the fight against epidemic diseases in the 19th century, mainly against cholera ^{[44; 45; 46; 47; 48]}. Special attention was paid to the South of Russia (Volga region, Orenburg), the gateway of Russia to the East, from where epidemics most often came.

Summarizing the works in this field, the researchers write: "one cannot disagree with Soviet sources, despite a certain degree of their ideological bias, that the fight against cholera, as with all diseases, was possible in pre-revolutionary Russia only after a radical change in the political system and broad social reforms" ^{[49, pp. 1087-1097]}.

The epidemic mortality of the population of Western Siberia at the turn of the XIX – XX centuries is analyzed in a number of articles by S. E. Glushkov ^{[50; 51]}. The author reconstructed the epidemic mortality of the population of Tobolsk and Tomsk provinces, Akmola region at the end of the imperial period (late 1880s - 1916). Data on mortality from measles, smallpox, typhoid fever, scarlet fever, diphtheria, whooping cough, typhus from 1887 to 1914 were considered. The author concludes that in general The region of the late 19th century was characterized by a weak tendency to decrease mortality from acute infectious diseases, and at the beginning of the 20th century, on the contrary, it increased.

The epidemiological history of Yakutia at the time under study had its own peculiarities, in particular, it managed to avoid the spread of such a dangerous infection as cholera, but other diseases, unfortunately, penetrated the region and the historical experience of combating such diseases in other regions is important for Yakut historiography.

Epidemic prevention, vaccination

Already in the early period of historiography, the statistics of smallpox vaccination in the Yakut region were given. The very first information is provided by Petukhov in the Verkhoyansk district. So, in 1843, 83 children were vaccinated against smallpox here, 57 of them "started". There were 10 smallpox vaccinators in the district ^[52]. For a district with a population of 13 thousand people, and considering that the development of the health care system was just beginning here, this can be considered a good result.

Further, in the "Commemorative book of the Yakut region for 1863", an anonymous author reported: according to the data of 1862, 4,962 people were vaccinated against smallpox in the Yakut region, and it was stipulated that only those who "had smallpox" were taken into account. It was also reported in the reporting style that there were 154 vaccinators in the region and that the manipulations were carried out by doctors, medical students, as well as an inspector of the medical unit ^[12]. Subsequently, the issues of vaccination in Yakut historiography were not often addressed ^[53].

T. A. Kolpakova studied the epidemic situation in the Vilyui district of Yakutia on the data collected in 1925-1926. The author analyzed the spread of infectious diseases, taking into account the geographical, economic, social and living conditions of the districts, racial and cultural characteristics. The rich material contains photographs, statistical information about patients of the late XIX – early XX centuries, includes a brief analysis of sources: archival data, legends, materials from commemorative books on the history of smallpox and leprosy in Yakutia ^[54]. This information is useful as factual and comparative material.

Meanwhile, in other regions, a lot of research is being conducted specifically to study the history of smallpox control. Regional peculiarities are noted. If there were successes in Orenburg, then in Bashkiria, on the contrary, due to the resistance of Muslims, the results were more modest. "Thus, at the beginning of the XIX century, a smallpox vaccination system began to function in Bashkortostan. The authorities responsible for the distribution and control of the vaccination process were established, and the preparation of vaccinators was started. However, despite the measures taken to prevent smallpox, it was not possible to radically solve the problem of the occurrence and spread of epidemics. Thus, during the cholera epidemic in 1848, 27,799 people out of 47,397 patients died. The activity of smallpox committees continued until 1865, then, on the basis of the provision "On the introduction of smallpox vaccination everywhere in Russia," the committees were abolished, their functions were transferred to zemstvo institutions" ^{[55, pp. 16-18]}.

Researchers have achieved no less success in studying the history of smallpox control in the Orenburg province in the first half of the XIX century. "Thus, despite the ethnoconfessional and other objective and subjective factors that prevent mass vaccinations against smallpox among the population of the Orenburg Region, the provincial authorities and the medical community have managed to form a positive attitude towards the events held by a significant part of the population. This was made possible by conducting sanitary and educational work among the illiterate mass of the population through the use of visual propaganda - splint pictures popular in the XVIII–XIX centuries. The involvement of representatives of various faiths for explanatory work was of no small importance. In organizational terms, Educational institutions, the Free Economic Society, Smallpox committees, medical students, smallpox vaccinators, free vaccination, and awarding of those who distinguished themselves in smallpox vaccination played an important role. All these multifaceted activities created conditions for reducing smallpox cases and, as a result, reducing mortality in the Orenburg province in the first half of the XIX century" ^{[56, pp. 33-38.]}.

When studying similar historical problems in the Tambov province during the period under study, E. V. Yakovlev comes to the conclusion that the zemstvo played an important role in the prevention of epidemics. Zemstvo doctors became the conductors of culture and health education in the village. They carried out sanitary supervision of schools, were engaged in popularization of sanitary and hygienic knowledge, and the establishment of sanitary guardianship. E. V. Yakovlev writes in the dissertation discussed above that vaccination and revaccination of the population was a radical preventive measure. Thus, it has to be stated that in this direction there is a lag in Yakut historiography from other regions where researchers have achieved significant success.

New problems in historiography. Despite the irregularity and incompleteness of the overall picture of Yakut historiography on the issues of interest to us, let us pay attention to the fact that new aspects of research are emerging these days. Thus, from the latest modern research, it is worth noting the assumption that leprosy could have been imported to the Yakut region not from the European part of Russia, but from East Asia. The authors note that the role of health workers in the 19th century was minimal, while the dispersed accommodation of patients created additional difficulties for everyone ^[57].

Conclusion

Thus, as the historiographical review shows, the problem of combating epidemics in Yakutia in the 19th century was solved in the following directions.

1) The creation of a network of medical institutions and the organization of measures, including to combat the spread of epidemics. Notable progress has been made in this direction.

2) The same can be stated in the direction of studying the role of individual prominent figures who played a major role in the fight against epidemics.

3) The study of the most striking events related to the history of epidemics in specific parts of the Yakutsk region (Yakutsk, Kolyma, Verkhoyansk, Vilyui districts) by type of disease was at the center of the research.

4) It has to be stated that the study of epidemic prevention, in particular, smallpox vaccination, remains the least studied problem of the considered historiography.

Also, aspects such as accounting and the prevalence of epidemic diseases remain unexplored. The second half, and especially the end of the 19th century, remains the most studied, while the first half of it awaits its researcher. In this study, we did not consider the history of dealing with major epizootics.

It is obvious that the epidemiological situation in the vast territory of Northeast Asia, most of which is occupied by Yakutia, its specifics and the first measures of the state to stabilize it remained outside the sphere of scientific research interest and does not have sufficient research experience.