The work and writings of the outstanding clinicist and thinker, the great innovator in science S. P. Botkin, form one of the most brilliant pages in the history of Russian medicine during the second half of the XIX century. The true efflorescence of Russian medicine, both theoretical and practical, as well as the foundation of the remarkable Russian school of therapeutists is closely connected with the name of Botkin.

The work and writings of the outstanding clinicist and thinker, the great innovator in science S. P. Botkin, form one of the most brilliant pages in the history of Russian medicine during the second half of the XIX century. The true efflorescence of Russian medicine, both theoretical and practical, as well as the foundation of the remarkable Russian school of therapeutists is closely connected with the name of Botkin.

The work and writings of the outstanding clinicist and thinker, the great innovator in science S. P. Botkin, form one of the most brilliant pages in the history of Russian medicine during the second half of the XIX century. The true efflorescence of Russian medicine, both theoretical and practical, as well as the foundation of the remarkable Russian school of therapeutists is closely connected with the name of Botkin.

S. P. Botkin was born on September 17, 1832. Having finished his schooling at one of the Moscow boarding-schools he entered the Medical Faculty of the Moscow University. With all the ardour of his gifted nature Botkin devoted himself to the study of medicine at the University and soon became the best student of his year, for he very fortunately combined brilliant capacities with remarkable assiduity and an exceptional avidity for knowledge.

On graduating the Medical Faculty in 1853 Botkin left for the theatre of war in the Crimea where he worked as a physician at the Simferopol Military Hospital under the direct guidance of the eminent Russian surgeon N. I. Pirogov.

In 1860 Botkin began working at the Medico-Surgical Academy in Petersburg. In 1861 he was elected professor to the Chair of the Therapeutic Clinic at the Academy. Having taken up the post he devoted himself ardently to his work. He set himself the task of having a model clinic at the Academy.

His activities coinciding with the epoch of the most rapid progress made in natural science and physiology, he made every effort to turn clinical medicine into the exact science, a branch of natural sciences. Botkin believed that to gain this object it was indispensable to follow the course of natural sciences. “If practical medicine” – he said – “is to rank among natural sciences, it is evident that the methods to be used in practice for examining, observing and treating a patient should be those used by natural scientists”.

Botkin considered it impossible for a clinic to do without a scientific laboratory, and therefore equipped a physiological laboratory which was to serve the purpose of clinical investigations. A large number of his most valuable scientific papers originated in this laboratory. For a period of 10 years the laboratory was headed by the famous Russian physiologist I. P. Pavlov, who conducted there some of his valuable scientific investigations.

All the work of the Botkin’s clinic testified to the fact that he was a true innovator who introduced radical changes in clinical medicine. Botkin constantly pointed to the close connection existing between physiology and clinical medicine, and emphasized the importance of clinical experience in studying the physiology of men. Pavlov said: “Botkin was the best possible embodiment of the lawful and fruitful union of medicine and physiology, these two kinds of human activity, which are erecting before our very eyes the edifice of a science that deals with the human organism and promises to secure in future man’s greatest happiness – his health and his life”.

Botkin was an exceptional therapeutist and a brilliant diagnostician. His generalizations in the field of pathology resulted in scientific deductions which proved to be real discoveries. Suffice it to mention such of Botkin’s statements as those on the primacy of nerve centres in the origination of fever, on “the floating kidney”, on the peripheral heart, on collapse. Botkin also described one of the forms of infectious jaundice which came to be known as “Botkin’s disease”. In his lectures on various diseases he advanced the assumption of the existence in the cerebrum of special centres (such as the heat, the sweat, the blood-forming centre, etc.), which has now come to be a generally acknowledged fact.

The views and ideas advanced by Botkin on problems of physiology and clinical pathology have retained their validity and importance up to the present, while in his time they were truly revolutionary in science.

One of Botkin’s greatest scientific achievements was his theory of nervism, which is the most progressive theory in clinical medicine. Sechenov’s brilliant work “The Reflexes of the Brain” could not have failed to influence Botkin. It is generally known that in his later work Sechenov proved “all acts of both conscious and unconscious life to be by nature reflexes”.

Contrary to Virchov, Botkin advanced the idea that a living organism should be considered as an entirely directed by the nervous system and closely connected with its environment. He criticized Virchov’s reactionary idealistic theory of cellular pathology based on the notion that a living organism is a federation of cells.

Being an outstanding scientist Botkin was an excellent teacher as well. His lectures were an unprecedented example of clinical thought based on a scientific analysis of clinical data. He introduced into the teaching of medicine the principles of the natural history method and indicated the course to be followed to secure further progress in clinical medicine. Many of his pupils came to be famous physicians: all the Russian Universities have had a number of eminent professors who were Botkin’s former students.

Loving his people and trusting their abilities Botkin ardently struggled for the promotion of Russian physicians to leading scientific and teaching posts, many of which were then occupied by Germans.

Botkin should duly be regarded as one of the founders of military therapeutics. During the Russian-Turkish war he worked at the front giving much of his time and energies to the organization of medical aid which he considered to be a task of no lesser importance than that of medical treatment. In this respect he closely followed in the steps of Pirogov. In his “Letters from Bulgaria” written in the course of the war Botkin exposed his views on the organization of the medical service in the army. He estimated highly the services rendered by medical officers and believed the latter to be called upon to serve their people with self-denial.

In the field of medicine and health protection S. P. Botkin was an outstanding public figure. For many years he was President of the Association of Russian Physicians being at the same time in charge of medical service in the metropolitan municipal system. He was also chairman of the committee appointed to work out the measures improving the sanitary conditions of the country and to fight the high morbidity and mortality rate in Russia.

The activities of this great scientist were extraordinarily varied and efficient. He was one of those indefatigable public men who never ceased toiling for the benefit of the Russian people. The name of S. P. Botkin is one of the most famous in the field of medicine and will always be highly honored and duly remembered in the history of Russian medical science.