J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.23.3.185 on 1 August 1960. Downloaded from J. Neurol. Neurosurg. Psychiat., 1960, 23, 185. RELATIONSHIPS BETWEEN BRITISH AND RUSSIAN MEDICINE AND NEUROLOGY, AND THE ROLE OF THE NATIONAL HOSPITAL, QUEEN SQUARE, LONDON, IN THE DEVELOPMENT OF RUSSIAN NEUROPATHOLOGY* BY N. I. GRASHCHENKOV Moscow, U.S.S.R.t The links between Russian neuropathologists and between the Tsar and Lady Hastings. Robert also the National Hospital are only a historical and enjoyed Elizabeth's confidence in equal measure and logical continuation of the fruitful relationships she entrusted him with some very responsible which have long existed between the medical pro- diplomatic missions at the Moscow court. Jacob fessions in the two countries. These are rooted in Robert became so steeped in the Russian life and the distant past. One of the first English doctors to customs of that time that he was even called by a guest. Protected by copyright. visit Russia was Jacob Robert in the sixteenth Russian name, Roman Elizarov. century. He was sent in 1581 by Queen Elizabeth to At the very end of the sixteenth century (1598) the Russian Tsar, Ivan the Fourth, better known during the reign of Ivan the Terrible's son, Theodore, as Ivan the Terrible, as a personal physician for the another English doctor, Mark Ridley, was sent to Tsar himself, his family, and the Court. In Russia serve as the Tsar's personal physician. at that time there were no European-trained A number of features in the historical develop- physicians, although there were "healers", most of ment of England and Russia at that time made the them attached to the monasteries, who, in the treat- seventeenth century less favourable for the continua- ment of their patients, made wide use of the tion of extensive interchanges between the two medicinal herbs in which Russia, with her multitude countries. of different climatic and geographical conditions, From the very beginning of the eighteenth cen- has always abounded. The lore connected with the tury, however, as a result of the changes wrought by preparation and use of these herbs had come from Peter the Great in Russia, particularly his intro- Byzantium and had been considerably extended in duction of the European system of training phy- Kiev Rus. After the fall of Kiev Rus and the sicians, Holland and England were the favourite renaissance of Central Russian Slavdom, this countries from which experienced doctors were experience was inherited by Muscovite Russia. drawn for training Russians in the Russian medical England "discovered" Muscovy in the sixteenth schools, and to which Russians were sent to learn century through the northern sea route and de- medicine or to extend their knowledge of it in the http://jnnp.bmj.com/ veloped extensive trading and, at the same time, universities. Among these Russians, one example cultural relationships with Muscovite Russia. These who might be quoted is Daniel Pischekov, son of a relationships were particularly fruitful and extensive priest. He was to train in the medical school of the at the time of Elizabeth and Ivan the Terrible. It Moscow Hospital founded by Peter the Great. was at this time that the English physician, Jacob After graduation, Pischekov was sent for further Robert, was sent to Russia. He lived there for a training to London, Edinburgh, and Aberdeen, long period and enjoyed great influence over the where he studied obstetrics. Yuri Bakhmetyev Tsar. In addition to his activities as a physician, studied medicine in London and Edinburgh and was on September 25, 2021 by Jacob Robert fulfilled various diplomatic com- given a degree of Doctor of Medicine. missions, including the negotiations for a match Still wider use was made of British universities and hospitals for the medical education and further * This paper was prepared for the celebrations to mark the centenary training of Russian doctors in the first half of the of the National Hospital, Queen Square, London. t In choosing historical material for the article, the author was nineteenth century. As an example, I could give helped by his colleagues, Drs. Vein, Hekht, and Fishman. the names of just a few outstanding Russian 185 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.23.3.185 on 1 August 1960. Downloaded from 186 N. I. GRASHCHENKO V medical men trained in Russia but who went to developed and carried out the idea of training in the England for further study and trained there in Academy scientific research workers from the ranks preparation for work as professors, in the first of doctors and biologists and of giving further instance in Moscow University. Thus Professor training to physicians and to other scientists. This Ilya Gruzinov, the anatomist, at the very beginning new system of training scientific and professorial of the nineteenth century (1801-04) carried on staff within the Academy from among particularly postgraduate studies in England under the famous gifted students who had graduated from it was anatomist, Willis. After this, Gruzinov returned to responsible for the training of a number of out- Moscow and took over and developed the Depart- standing Russian professors of medicine, among ment of Anatomy and Physiology in Moscow them Vladimir Bekhterev, whose name is well known University. Another outstanding medical man was to this audience. Among the pupils of Glebov Ivan Glebov, who graduated from Moscow Uni- while he was still at Moscow University we may versity and then trained for a further three years mention Ivan Sechenov, who subsequently founded abroad in various laboratories, such as Claude modern Russian physiology of the nervous system Bernard's, and in Bouillaud's' clinic in Paris, the (he was a forerunner of Pavlov), as well as the out- laboratory of Johannes Muller in Berlin, and standing clinician, Sergei Botkin. Both were closely Rokitanski's laboratory in Vienna. In 1839, linked by personal friendship and a unity of ideas in Glebov worked in various London hospitals, in their views on science, particularly concerning laboratories of pathological anatomy, in a depart- questions of experimental and clinical proof of the ment of comparative anatomy, and in the laboratory leading role of the nervous system in physiological of the famous Hunter. During his work abroad, and pathological processes in animals and man. particularly in London, Glebov set up what was for They both developed the concept of "nervism" (the that time a wonderful collection of comparative leading role of the nervous system), and the im-guest. Protected by copyright. anatomical preparations covering 500 different portance of reflexes in physiology and pathology, an animals. On his return from abroad, Glebov taught idea which guided the experimental research and human physiology, general and comparative theoretical generalizations of I. P. Pavlov throughout anatomy and histology, and also general and special his life. After three years' advanced training abroad therapy in Moscow University. He was the first and while they were still very young, Sechenov and man in Russia to establish and begin the teaching of Botkin were invited by Glebov to become professors comparative physiology, and he also reformed the in the Medico-Surgical Academy in St. Petersburg. teaching of general physiology. In particular, he They swiftly won great authority and became lead- introduced a more extensive course of practical ing professors, Sechenov in physiology and Botkin training, including training in the physiology of the in clinical medicine. Botkin was the leading nervous system and comparative physiology, and clinician in Russia and not only in Russia, and he brought in the practice of demonstrations being established at his clinic an experimental physio- given at lectures. His contemporaries classed him logical laboratory and called upon the young as an excellent lecturer. Among his many dicta is physiologist, Pavlov, who had only just begun his his statement that the teaching and learning of scientific activities, to run it. For 10 years Pavlov physiology must be based on a knowledge of was head of the laboratory and within its walls he physics, chemistry, and natural history. The completed his first stage in physiology, the study of leitmotiv of his statements and personal researches the physiology of blood circulation. In this was the demonstration of the role of the nervous laboratory, under the direct influence of Botkin and http://jnnp.bmj.com/ system in regulating the animal and human organ- Sechenov, the views of Pavlov on nervism were ism. His doctorial thesis, for example, was on the formed and consolidated. These were reflected in theme of "Mental phenomena from the physio- his experimental physiological research on the cir- logical, therapeutic and pharmacological points of culation of the blood and subsequently in his view". Glebov was subsequently appointed vice- completely new treatment of the physiology of president of the St. Petersburg Medico-Surgical digestion (his second stage in physiology). His Academy, as a result of the need for a sharp im- researches were crowned by his work on the provement in its teaching and scientific activities. physiology ofthe cerebral hemispheres or physiology on September 25, 2021 by He soon made the Academy into a first-class of the higher nervous activity (Pavlov's third stage teaching and research establishment. In particular, in modern physiology). Consequently, the idea of he founded an institute of anatomy and physiology nervism, originated by Glebov, worked upon and and promoted the establishment of various well- developed by Botkin and Sechenov, was provided equipped nervous and mental disease clinics and with extremely firm experimental and theoretical many other teaching and research laboratories. He foundations by the brilliant research of I. P. Pavlov J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.23.3.185 on 1 August 1960.