"Fundamentals of Medical Knowledge" - Relevance and significance: The innovative potential of the project. Expected results: Developed teaching materials and curriculum for the course "Fundamentals of medical knowledge and child health protection." Project name: continuation of the 2007 project. Organization - main contractor: Total number performers. Commercial perspective of the project.

"Medical Psychology" - Study of the psychology of family relationships. Study of changes in individual mental functions in somatic and mental diseases. Lesson To make an analysis of the components of health: bodily, mental, social. He introduced the term "somatopsychic", emphasizing the priority of the bodily in the occurrence of certain diseases.

"Children at Risk" - Children's Clinic. Correction socio-psychological service at the children's clinic. Prevention of SOP. Women of fertile age. Intraschool accounting. Outreach work. Social worker of the antenatal clinic. Early diagnosis of fetal malformations. System of work on early prevention of SOP.

"The quality of medical care" - Relevance of the problem. The need for an ambulance. QoL of elderly people. Main complaints: By education level. Family status. Total respondents - 206 people Average age 68.37 ± 5.49 years, men - 40, women -166. Age structure of the population of Astana. The average number of diseases per person is 3.41 ± 0.18.

"Clinical death" - Clinical death. Indirect cardiac massage. Precardiac beat. The first health care with cardiac arrest. Combination of chest compressions and mechanical ventilation. Mouth-to-mouth method. Artificial ventilation of the lungs. The mouth-to-nose method. If the blow is struck within the first minute after cardiac arrest, the chance of revival is greater than 50%.

"Suicide prevention" - The fourth level is tertiary prevention. The first level is general prevention. Intentional self-harm with fatal outcome (taking one's own life). M .: MGPPU, 2006. The second level is primary prevention. Burmistrova E.V. And if suicidologists are right, then the main “killer” of adolescents is suicide.

There are 12 presentations in total

Cleanliness and caring for your body were not always welcomed. This was often considered demonic and spiritless. This picture was clearly seen in the Middle Ages. According to some opinions of that time, after washing, evil spirits could enter the pores of the body. And this is not strange, since people could wash in dirty water. At the same time, the whole family washed in the same water, and after that the servant and slaves. However, gradually the attitude towards cleanliness changed. Therefore, it will be interesting to follow some historical facts in relation to cleanliness and washing.

Cleanliness in the Middle Ages

If we talk about the bathing traditions, then they are rooted far in the past centuries. For example, in Russia the bath was held in high esteem. Those who disliked the bath were considered strange. For example, Dmitry the Pretender was not a supporter of the bath, so he was considered non-Russian. But if you look deep into history, you can see that for the Slavs the bath was not just a means of hygiene, they found a certain sacred meaning in it. Without fail, people had to visit the bathhouse twice a week, as it was assumed that in it they could wash away their sins.

In Europe, by comparison, the bath was treated with suspicion. Then they believed that it was enough to wash a person at baptism.

The reasons that people were afraid of water are rooted in the prevailing opinion on the spread of plague by means of water. In fact, this could be so, because they did not take hot baths, but warm ones, using water several times. Of course, diseases could develop in such an environment.

Isabella of Castile in the 15th century proudly said that she washed only twice in her life - at baptism and before the wedding.

Another interesting case recorded in history happened with Louis XIV. Throughout his life, he washed only twice, and then for medical purposes. And at the same time, he was very sick every time. Based on this and other similar cases, it becomes clear that cleanliness and hygiene faded into the background.

When underwear began to be used in the 13th century, there was no need to take a bath at all. Underwear was easier and cheaper to wash than outerwear made from expensive fabrics. Thus, the body did not come into contact with the outer dress. To save themselves from ticks and fleas, the nobility wore silk underwear.

Hygiene in Ancient Rome and Paris

If you look into the history of Ancient Rome, then here the attitude to cleanliness and washing was so elevated that they made a cult out of it. Every day, Roman baths were visited for bathing procedures. In these rooms, they not only washed, but also went in for sports, artists were invited there. It was a truly cultural event.

There were toilets in such premises. They were located around the perimeter of the room, so people could communicate normally with each other. In the 4th century A.D. there were 144 public toilets in Rome.

If you look into Paris, the picture here was quite the opposite. As contemporaries said, there was a terrible stench here. Toilets were not built here, so feces from the pot could be poured out directly from the window. It was from here that the fashion of hats began with wide stripes so as not to get your expensive clothes dirty. After a while, a law was introduced, which required to warn before pouring out the pot with the exclamation "Caution, water."

Russia and hygiene

Comparing this attitude to cleanliness in Europe, Russian customs were strange. After all, it was here that baths were widespread. As the historical facts testify, Louis XIV sent spies to find out what they were doing in the Russian baths. And this is not surprising, because it did not fit in his head that you can wash regularly. But, despite such an attitude to cleanliness, there was an unpleasant smell on the streets, because in the 18th century there was a sewage system in only ten percent of Russian cities.

From all it follows that in the Middle Ages in Europe they were not particularly friendly with cleanliness and hygiene. As for Russia, it was able to get rid of the plague only thanks to the Russian baths.

Until 1743, women and men washed in the baths at the same time. In the same year, a decree was issued prohibiting this. But it was not observed everywhere!

Those foreigners who have lived in Russia for a long time brought the custom of the bath to Europe. They appreciated all its benefits. Gradually, in European countries, the attitude towards cleanliness and hygiene has reached a new level.

If we recall the years already close to us, then in the USSR they were engaged in hygiene at the state level. Television carried on active propaganda even among children. It is worth remembering at least the well-known cartoon "Moidodyr".

Subject, content and tasks of hygienic science. The importance of hygienic measures in the activities of a medical doctor.

Hygiene is a science that studies the laws of the influence of the environment on the human body and public health in order to substantiate hygienic standards, sanitary regulations and activities, the implementation of which provides optimal conditions for life, health promotion and disease prevention.

The subject of hygiene is human health and the environment.

The main goal of hygiene is to maintain and improve human health.

Tasks hygiene science:

Study of natural and anthropogenic factors environment and social conditions affecting human health.

Study of the regularities of the influence of factors and environmental conditions on the human body or population.

Scientific substantiation and development of hygienic standards, rules and measures for the maximum use of environmental factors positively affecting the human body and the elimination or limitation of unfavorable factors to safe levels.

Implementation of the developed hygienic recommendations, rules and standards through sanitary legislation into the practice of health care and the national economy, verification of their effectiveness and improvement.

Forecasting the sanitary situation for the short and long term, taking into account development plans National economy, determination of the corresponding hygienic problems arising from the predicted situation, scientific development of these problems.

Caring for health is the most important task of medical and practical health care. The solution to this problem is achieved in two ways:

Preventive, i.e. by promoting health and preventing disease

Restorative, or by treating a sick person.

Both paths are carried out simultaneously, however, the priority and more effective, and therefore the priority in the activities of a medical worker of any profile, should be the preventive path.

2. The history of the formation and development of hygiene. The most important details of hygienic science and sanitary affairs.

Hygiene as a science took shape only in the second half of the 19th century, but its roots go back centuries. Already among the peoples of the Ancient East, in Ancient Greece and in Ancient rome we find traces of a fairly developed sanitary and hygienic culture. Like any culture, it has a social character since its inception, since it expresses the needs of various groups of people, and not one person. However, the development of hygiene is also influenced by other factors - established customs, the development of scientific knowledge, everyday experience, religious cults, and the social composition of society.

Sanitary and hygienic culture of Ancient Greece. The Spartan state arose as a result of the conquest of large territories, where the local population was turned into slaves belonging to the entire Spartiat community. Since the Spartans were a minority of the population, in order to maintain their domination they needed strong and dexterous warriors who could participate in battles, suppress slave uprisings. This, along with other reasons, contributed to the development of the cult of strength and physical health and was reflected in hygienic customs. Babies in Sparta were not swaddled, kept naked until the age of one. It hardened some, it brought death to others. When the boys grew up, they were forced to run, ride, play ball. Fist fights, fencing, discus throwing, javelins were encouraged. These exercises were considered mandatory for the future warrior.

In Athens and other Greek states, where the problem of military suppression of the exploited was not so acute, the personality of the ancient citizen developed more harmoniously. Military exercises did not play a dominant role, the main focus was on the acquisition of knowledge and sports.

In Greece in 776 BC. the first sports games took place in Olympia. Gradually they became all-Greek. The tradition of holding these games was subsequently adopted by most of the states of the world. The Olympic Games are currently the largest international competition.

Sanitary and Hygienic Knowledge in the Works of Greek Philosophers. Like most sciences, the first sanitary and hygienic ideas were formulated in the works of philosophers. Thus, the great Greek philosopher Pythagoras (VI century BC) was known not only as a mathematician who discovered the relationship between the hypotenuse and the legs of a right triangle, but also as a hygienist. He believed that a person should eat simple food, drink clean water. Pythagoras fought against overeating, forbade the consumption of wine, he was one of the first to understand the significance of the daily regimen, cleanliness of the body, and exercise. In his writings, we find some information about mental hygiene, in particular about the influence of music on performance and mood.

The works of the founder of medicine Hippocrates (460-377 BC) were of great importance for the development of hygiene as a science. He was the first physician who began to study the effect of soil and water in a given area, as well as dietary habits on the health of people living in this area. He was the first to establish that there are common causes of diseases associated with the change of seasons, sudden changes in the weather, temperature fluctuations, quality of water, soil, etc., as well as individual reasons: violation of diet, regimen, etc.

The works of Aristotle (384-322 BC) made a great contribution to the development of hygiene. He investigated the conditions that prevent the birth of healthy children, and came to the conclusion that too early and too late marriages lead to the appearance of weak and sick children, complicate childbirth, which often ends in death.

Works of Claudius Galen. For the development of the sanitary and hygienic culture of Ancient Rome great importance had the works of the Roman physician Claudius Galen (130-200). Unlike his predecessors, Galen believed that hygienic recommendations should be derived from anatomical and physiological knowledge. To some extent, Galen can be considered the founder of school hygiene. He was the first to indicate the age of children (7 years) from which they can begin their systematic education, recommended how to protect children from bad habits, for the first time expressed the idea that training should be carried out under the supervision of a doctor.

Sanitary and hygienic culture of the Ancient East. Even in ancient Indian and ancient Chinese legislation, it was said about the need to maintain cleanliness of the body, about the diet, work and rest, and rules were given for the burial of corpses. In Egypt, more than 1500 years ago, swamps were drained, irrigation systems were created, and an organized disposal of sewage was carried out. The culture of the Ancient East had a significant impact on the development of later civilizations.

Among the great scientists of the Ancient East, Abu Ali Ibn Sina occupied a special place. He was born in 980 near Bukhara (on the territory of the present Uzbek SSR).

After Louis Pasteur proved that microbes were involved in infectious diseases, new branches of hygiene appeared - epidemiology and sanitary bacteriology, which made it possible to develop a number of effective measures to curb epidemics.

In parallel with epidemiology, experimental hygiene developed, the founders of which are the English scientist Parke and the German scientist Pettenkofer. They developed methods for determining the concentration of carbon dioxide in a room, revealed the effect of the composition of soil, air, and water on the human body, carried out engineering and hygienic work in the field of ventilation and heating, for the first time established hygienic standards for the sanitary assessment of the quality of air, soil, water, dwelling, and clothing.

Hygiene as an independent science took shape only in the second half of the 19th century, but the need to introduce sanitary legislation was realized much earlier. So, the first sanitary council in Europe was held in 1802 in France, but its influence was small, and by the beginning of the 20th century. there has been a fairly significant discrepancy between the achievements of hygiene and its practical use. Hygienists could determine what standards housing, labor, human nutrition should meet, but they were powerless to provide people with work, reduce rent, etc.

Sanitary and hygienic culture of ancient Russia and pre-revolutionary Russia.

Sanitary and hygienic reforms of Peter I. The growth of sanitary culture in Russia in the 18th century. is associated primarily with the reforms of Peter I, in which great attention was paid to sanitary legislation. Under Peter 1, decrees were issued on the protection of troops from disease, the rules of food trade, it was forbidden to sell fallen cattle, to trade in the meat of sick animals. The pavements were improved.

An important contribution to the development of hygienic science in Russia was made by M.V. Lomonosov. In the work "On the Reproduction and Preservation of the Russian People", published after the author's death, the causes of diseases of children in orphanages, in the families of peasants and poor townspeople were analyzed. An abridged edition of the book was published in 1818, a complete edition in 1871.

An experimental direction of hygiene in Russia. With the development of capitalism in Russia, new branches of industry appear, and along with them the problems of labor protection are growing. In the 30-50s. of the last century, they acquire such an acute character that many progressive cultural figures draw the attention of the people to them: V.G. Belinsky, D.I. Pisarev, N.G. Chernyshevsky, N.A. Nekrasov, other raznochintsy democrats. To some extent, this was facilitated by successes in the field of military hygiene, which was continued by N.I. Pirogov and A.P. Dobroslavin.

A.P. Dobroslavin was the first in Russia to create a hygienic laboratory, where he conducted a number of experimental studies. He organized an analytical station for the study of the good quality of food. With the name of A.P. Dobroslavin is connected with the introduction of a sanitary examination. Prior to that, there was virtually no systematic sanitary supervision in the country, although attempts were made to introduce it, starting with the decrees of Peter I.A.P. Dobroslavin is the founder of the experimental direction in domestic hygiene.

Development of school, social and communal hygiene in Russia. F.F. Erisman (1842-1915).

F.F. Erisman found that when sitting at a desk (of course, provided that the desk is matched for height), a rational posture is provided during reading, writing, lectures, which contributes to the normal development of the skeleton and muscles, prevents postural disorders and myopia in students.

Much credit belongs to F.F. Erisman in Social and Occupational Health. He researches in detail the working conditions at various enterprises in Moscow and in its environs, St. Petersburg and creates a book "Professional hygiene or hygiene of mental and physical labor." Using methods of factor analysis external environment, G.V. Khlopin continued the research begun by A.P. Dobroslavin, and made a significant contribution to theoretical basis communal hygiene. The methodology he created for the study of suitability for food consumption is still used today. He worked on water issues, fought against industrial pollution in rivers, and worked on occupational health and nutrition.

Hygiene practices. The relationship of hygiene with other disciplines.

Hygiene methods are divided into:

I Methods of studying the environment

II Methods of studying the influence of the environment on the body and human health

Methods for studying the environment include:

Sanitary description method

Instrumental and laboratory methods

The task of the sanitary description is to assess the sanitary state of an object of the environment by external signs. All objects of the environment, living and working conditions of the population - water sources, soil, air, food products, housing, places of rest and work of the population, hospitals, schools, etc. are subject to sanitary description. Using the method, it is possible to identify the harmful effect on the body of one or another environmental factor, to establish the presence and nature of the influence of these factors on the health and sanitary conditions of the population. The description is given to those signs or properties of an object that can directly or indirectly harm human health. This method allows you to characterize the environmental factor only indirectly (subjectively).

For a quantitative (objective) assessment of the factor, the sanitary description must be supplemented with instrumental and laboratory studies. Depending on what factors are being studied, the following instrumental and laboratory research methods can be used:

Physical - with the help of them they determine temperature, humidity, air velocity, atmospheric pressure, noise, vibration, radioactive radiation, etc. These methods include thermometry, barometry, noise measurement, vibrometry, etc.

Chemical - used to determine the chemical composition of food, soil, water, air.

Physicochemical - using these methods, either physical or chemical components are determined. These methods include polarography, spectrography, etc.

Biological - determine the presence and amount of biological objects in the air, water, soil, food products - microorganisms, helminths, viruses, insects, etc. These include microbiological, helminthological, virological, and other research methods.

Sanitary and statistical - used to quantitatively characterize environmental objects. These include methods for calculating averages, indicators of distribution and visibility, other extensive and intensive indicators, correlation, regression or analysis of variance.

Geographic methods are used for the quantitative and qualitative characteristics of environmental objects on the territory of large regions. These primarily include the cartographic method. There are cards chemical composition soil, water, air, dynamics of pollution, etc.

Methods for studying the effect of the environment on human health and the body include:

Field observation methods

Experimental research methods

The following field observation methods are used:

Clinical - used to determine the clinical signs of environmental impact on human health. These include: examination, auscultation, palpation, percussion, radiography, etc.

Physiological - used to register preclinical changes in the functional indicators of organs and body systems. This group of methods includes thermometry, methods for determining performance, fatigue, functional state of the central nervous system, sweating, blood pressure, audiometry, etc.

Biochemical - used to determine the chemical composition of body fluids and tissues. These are, for example, determining the content of oxyhemoglobin, glucose, glycogen, chlorides, calcium, vitamins, enzymes and other physiological components of the blood, as well as the content of toxic substances in it - lead, mercury, methemoglobin, etc.

Sanitary-statistical methods are used to quantitatively characterize the state of health (methods for calculating average, extensive and intensive indicators) and to quantify the dependence of changes in human health on the influence of the environment (methods of correlation, regression, variance, factor analysis).

Medical and geographical methods - used to image and assess the spatial distribution in the territory of a particular region of such indicators of public health as the levels of morbidity, disability, mortality, establishing causal relationships between the spatial distribution of the intensity of parameters of various environmental factors and values ​​of health indicators ...

Experimental research methods include:

Laboratory experiment on animals - is carried out in special chambers, on stands or installations to study the effect on the animal organism of chemical, biological, physical environmental factors in order to establish their safe values ​​or levels. Most often, this experiment is carried out for the purpose of hygienic regulation of environmental factors - the establishment of MPC and MPL.

A laboratory experiment on human volunteers is allowed only in cases where there is complete proven safety for human health. Most often, such studies are carried out for the purpose of scientifically substantiating hygienic standards and other hygienic regulations. For example, with the hygienic substantiation of the maximum one-time MPC (study of thresholds for the detection of odor, irritating effects, reflex reactions in conditions of short-term exposures).

An experiment with modeling natural conditions is carried out on specially created laboratory models that simulate the processes occurring in the environment. For example, this is how the processes of accumulation of exogenous chemicals in soil and plants, such as pesticides, mineral fertilizers, heavy metals, etc., are studied.

The origins of hygiene as a science go back to ancient times. Historical documents indicate that the ancient peoples of Egypt, India, China had the simplest hygienic rules for body care, nutrition, the choice of water supply sources, and the prevention of infectious diseases.

Hygiene was significantly developed in ancient Greece, where supervision was exercised over the construction of houses and the sale of food products, the installation of a sewage system, etc. For hygienic purposes, the Greeks widely used different kinds physical exercise and hardening. The thinker, scientist, physician of Ancient Greece Hippocrates (460-377 BC) created the first works on hygiene: the treatises "On a healthy lifestyle", "On air, water and soil."

In ancient Rome, sanitary measures were carried out even more widely. In the cities, water pipes, public baths, baths, sewerage were arranged. Control over the work of these structures was carried out by specially hired officials - aediles. However, in ancient Rome and Greece, where class inequality was clearly expressed, the main focus was on protecting and promoting the health of representatives of the ruling classes. Therefore, among the poorest strata of the population, there was a high morbidity and mortality.

In the Middle Ages (endV- middle XVII in.) during the period of feudalism, hygiene fell into decay. This was largely facilitated by religious views, contributing to the complete oblivion and denial of hygienic rules. In the cities, almost no sanitary facilities were built. All this was the cause of devastating epidemics of smallpox and plague. For example, in XIV in. in Europe, 25 million people died from the plague epidemic, that is, a quarter of its entire population.

During the Renaissance (Xv- XVIIcenturies) in connection with the change in socio-economic conditions, the development of natural science, interest in hygiene is again manifested.

In subsequent periods, there is a gradual revival of hygiene knowledge. In Russia, hygiene developed in an original way, and our ancestors learned how to carry out sanitary measures earlier than other peoples. Historical materials indicate that even in Ancient Rus some information was known about hygienic rules for the prevention of infectious diseases, body care, nutrition, and urban improvement. For example

in ancient Novgorod already inXIin. water supply and sewerage were built.

IN XIX in. hygiene began to develop at a rapid pace, which was due to a number of reasons: the rapid growth of industry in cities, the harsh exploitation of workers, unfavorable living conditions, etc. In the course of the struggle for its rights, the working class put forward demands to improve the sanitary conditions of work and life.

This stimulated the development of hygiene, which was also greatly facilitated by the successes of natural science, physics, chemistry and other sciences. The use of physical, chemical and microbiological methods in hygiene has opened up an opportunity for the scientific substantiation of hygienic norms and rules, as well as for the development of effective sanitary measures. Thus, the stage of accumulation of empirical hygienic knowledge was completed and the stage of development of experimental (scientific) hygiene began. In the second half XIX in. hygiene has developed into an independent science.

The founders of scientific hygiene are considered in Germany M. Pettenkoffer, in Russia - A. P. Dobroslavin and F. F. Erisman, in England - E. Park. Prominent representatives domestic medicine, natural science and culture constantly expressed progressive ideas about the need to develop the preventive direction of medicine. This greatly contributed to the development of hygiene in Russia. Laureate Nobel Prize Academician IP Pavlov wrote: "Only after knowing all the causes of diseases, real medicine turns into the medicine of the future, that is, hygiene in the broad sense of the word."

A.P. Dobroslavin (1842-1889) and F.F. Erisman (1842-1915) determined the social direction

hygiene, began to lead experimental research took care of training. A.P. Dobroslavin organized in Military Medical Academy Petersburg (1871) the country's first department of hygiene and opened an experimental hygiene laboratory. He spent Scientific research in many areas of hygiene and fruitfully carried out pedagogical and social activities... He published a two-volume hygiene course.

FF Erisman headed the Department of Hygiene at Moscow University in 1882 and organized a city sanitary station with it.

In 1892 FF Erisman created the Moscow Hygienic Society.

- Source-

Laptev, A.P. Hygiene / A.P. Laptev [and others]. - M .: Physical culture and sport, 1990.- 368 p.

Post Views: 26

Empirical observations from everyday experience in the field of personal life, and later from social practice, were the basis of hygienic knowledge already in ancient times. Based on the instinctive desire of people to preserve life and health, these observations were gradually expanded. Depending on the natural and climatic conditions in which a person lived, on the way of life and the social structure of society, hygiene measures, capturing ever wider areas of life, were improved, although no scientific and theoretical foundations for their improvement did not yet exist: practice was significantly ahead of theory, as is often the case in other areas of human knowledge.

The simplest hygienic rules, some of which have survived to this day, were known to many ancient peoples 3000-4000 years BC. In ancient Chinese medical books hygienic rules and tips were discovered regarding proper nutrition, work schedule, rest and sleep, as well as the beneficial effects of natural factors on human health. During excavations in ancient Chinese cities, discoveries were made, indicating the presence of sanitary facilities in them. No less valuable finds concerning the improvement of populated areas were found during excavations of ancient Indian settlements (for example, it was possible to find the remains of a city sewage system in one of the Indian cities). Ancient Indian medicine is rich in hygiene advice. Most of them related to nutritional issues (recommendations on the consumption of milk, plant foods, honey), diet and personal hygiene (oral care, changing clothes, bathing, etc.). Hygiene measures were widespread in Ancient egypt(1500 BC). Huge structures for water supply to cities were found here, there were rules for keeping streets and houses clean, removing sewage and waste, soil drainage, etc.

The experience of the Egyptians was adopted by many peoples who lived in ancient times.

During archaeological excavations on the territory of the present Central Asian republics, comfortable cities with rationally arranged sanitary facilities. Therefore, the most ancient culture the principles of using hygienic measures not only of a personal, but to a certain extent also of a public nature to strengthen health and preserve life were inherent.

Hippocrates (460-377 BC).

These principles were expressed in an even more perfect form later, in ancient Greece and ancient Rome. The development of sanitary culture in Ancient Greece is associated with the name of the genius doctor, as he is called, the "father of medicine" Hippocrates, who was the first to put forward the idea of ​​the importance of the external environment for the human body. Hippocrates wrote a treatise "On air, waters and localities", in which these natural factors are considered from the point of view of their impact on human health. In the future, the observations and reasoning of Hippocrates were widely developed in the works of ancient Greek scientists of a later period and served as the basis for sanitary and technical measures carried out in the cities of Ancient Greece. So, in Athens, a water supply and sewerage system was built to remove liquid wastewater, constant supervision was organized over the sale of food products and housing construction, the simplest disinfection was carried out in the form of fumigating with sulfur the premises in which infectious patients were located, there were public baths and baths. In Sparta, for the first time, they began to widely use physical education with the aim of developing physical strength and creating a powerful army, and these activities were closely related to the observance of sanitary rules.

The Romans largely borrowed from the Greeks hygienic knowledge, sanitary facilities and other sanitary measures aimed at protecting public health. In Rome, more than 30 water pipelines were built, giving 500-1000 liters of mountain spring water per person per day, there was a common underground sewage system to remove liquid sewage outside the city to fields and vegetable gardens, and careful monitoring of the sale of food products and the construction of dwellings was organized. Sanitary engineering in the Roman Empire was carried out even to a greater extent than in Greece, and special attention was paid to military sanitation (rules for feeding troops, supplying them with good quality drinking water, requirements for the arrangement and location of camps, physical training personnel and etc.).

Despite, however, the widespread use of sanitary measures to protect human health, epidemics of plague, smallpox, typhus and other infectious diseases accompanied by high mortality did not stop in the ancient world. The mortality rate among slaves was especially high, since under the slave system, all sanitary equipment was mainly aimed not at maintaining public health (it did not concern slaves at all), but at ensuring favorable conditions for personal health for the existence of a privileged class (slave owners, priests, military leaders, merchants) and create convenience and personal comfort for them. It could not have been otherwise, given the class character of the slave system. At the same time, it should be noted that all the successes in strengthening and maintaining health in the ancient world were achieved only thanks to the generalization of the accumulated by mankind personal experience, for hygiene as a science did not exist at that time.

However, in the future, these few achievements in sanitary practice among the ancient cultural peoples disappeared with the transition to the feudal system. Even the rudiments of previously existing hygienic measures were deliberately abandoned, since the predominant religious views of Christian teaching in the Middle Ages were based on the preaching of a complete disregard for human health. Christianity called people to an ascetic lifestyle for the salvation of the soul. Schema ascetics who lived in caves, deliberately endured hunger and cold, who had not used water to care for their bodies for years, were considered saints. Naturally, in such conditions, there could be no question of compliance with any requirements of not only public, but even personal hygiene. The sanitary culture was at such a low level that nothing could prevent the spread of epidemics. Plague (as it was called at that time "black death"), leprosy, smallpox, trachoma, syphilis gripped huge masses of people. Attempts of the feudal lords to fence themselves off with fortress walls and ditches in medieval castles did not save them from impending danger. As an example of the consequences to which this neglect of basic sanitary practice has led, it can be pointed out that in the 14th century in Europe about 25 million people died from plague.

Cities in the Middle Ages were built without taking into account the planning rules and without sanitary facilities, with narrow streets, sewage was thrown directly into the streets, personal hygiene rules were not followed. Thanks to the domination of the clergy and feudal feudal lords, the sanitary culture ceased to exist altogether. True, in some countries there have been attempts by some advanced scientists to promote the rules of sanitary practice of the past. So, at the turn of the XII and XIII centuries in Italy, the essay of Professor John of Mediolansky was published, containing only the rules of dietary nutrition, and later there were essays in which descriptions of the epidemics raging at that time were given. But all these works, until the end of the 15th century, essentially did not help in improving the sanitary condition of populated areas, except that, starting from the 14th century, fumigation with sulfur and disinfection with chlorine began to be used to disinfect contaminated homes and belongings of patients.