Social Hygiene

SOCIAL HYGIENE. In the common bourgeois understanding, S. h. means 'the doctrine of the effects of social and economic influences on public health' (Wolff). Grothjan distinguishes 'descriptive' S. h., 'which represents the doctrine of the conditions for spreading hygienic culture to the entire given population of people', and 'normative' as 'the doctrine of measures aimed at spreading hygienic culture to the entire population of people'. However, these definitions are essentially a restatement of the words that make up the name of the science ('social hygiene'), they do not indicate the tasks of S. h., do not give an idea of the methodology of this discipline, not to mention the fact that Grothjan operates with concepts of 'populations of people connected by commonality of place, time and social ties', Wolff with the concept of 'average population', etc., i.e., these authors try to strip S. h. of its class content. The formalism of the common understanding of the tasks of S. h. among bourgeois scientists is by no means a偶然 phenomenon. The understanding of S. h. as the science of improving the health of the working classes immediately raises the question of the causes of social pathology of these classes under capitalism, and also raises the question of eliminating these causes. The main cause of social pathology of the working classes in bourgeois countries is capitalist exploitation and therefore the prerequisite for improving the health of the working class is the destruction of capitalism. K. Marx in his works, especially in the I and III volumes of 'Capital', with all sharpness revealed the influence of capitalism on the health of workers. 'In its immeasurable and blind striving for profit, - wrote Marx,-in its wolfish greed for surplus labor, capital overthrows not only moral, but also purely physical maximum limits of the working day. It usurps the time necessary for the growth, development and healthy preservation of the body. It steals the time necessary for the absorption of fresh air and sunlight. It cuts down dinner time and if possible includes it in the production process itself, so that food is given to the worker as a simple means of production, just as coal is given to a steam boiler and fat or oil to machines. The healthy sleep necessary for the restoration, renewal and refreshing of physical strength, capital reduces to so many hours of numbness as absolutely necessary to revive an utterly exhausted organism... Capital does not ask about the duration of the labor power... It leads to the premature destruction of labor power itself' ('Capital', vol. I, p. 190-191). The classics of Marxism gave a brilliant analysis of social pathology in capitalist society: 'Tuberculosis and other lung diseases, - wrote Marx, - are conditions of existence of capital' (K. Marx, Capital, vol. I, p. 374). from Lenin and Stalin with special vividness revealed all the miseries to which millions of workers are subjected in the era of imperialism. Marx, Engels, Lenin and Stalin revealed all the lies and hypocrisy of the bourgeoisie's struggle with social diseases: prostitution, alcoholism, etc. In 'The Housing Question' Engels, connecting the spread of infectious diseases with the housing question in capitalist society, wrote: 'As long as the capitalist mode of production exists, it is foolish to separately solve the housing question, or any other social question affecting the fate of the worker. The solution lies in the destruction of the capitalist mode of production, in the appropriation by the working class itself of all means of life and instruments of labor'. The bourgeois S. h. does not want to draw this last conclusion. That is why the content of Soviet and capitalist science about S. h. is sharply different. Contrary to the doctrine of Marx, confirmed by the entire course of historical development, about the continuously proceeding process of absolute and relative impoverishment of the proletariat and the deterioration of his health in connection with this - bourgeois S. h. asserts that capitalism improves the well-being of the broad masses of people, makes labor conditions more hygienic, improves public nutrition, etc. Grothjan in 'Social Pathology' writes: 'Capitalism with its powerful development of productive forces in the cultural European countries enriches these countries and significantly reduces mortality in them'. This is written contrary to all the well-known facts of the growth of morbidity and mortality among the working class, especially in the era of decay of capitalism. Thus, the science of S. h. even among the most 'left' bourgeois scientists, calling themselves socialists, is entirely in the service of capital. Fischer considers that the most important problem of S. h. as a scientific discipline is the creation of scientific justifications for the right to health of the German people: 'The most important task of it as a sanitary policy lies in strengthening this right with the help of state power and legislation'. Fischer is completely satisfied with that social-hygienic legislation which bourgeois Germany carried out. In the final chapter of his book he writes: 'Above we defined the right to health as the most important goal of social hygiene. This goal is distant, but achievable. The articles of the state constitution of Germany and the state law on the protection of youth show that we are already on the way to this goal'. The social hygienist Flacheck-Hofbauer considers the task of S. h. to be 'equalizing classes in the field of health', thereby promising workers full health while preserving the dominance of the bourgeoisie and the exploitation of the working class. Gotshtein in the article 'On the origin and future of social hygiene' believes that it is precisely during economic crises that social measures should give way to purely medical ones, that a politician who insists on the need to change the socio-economic basis will do less good than a hygienist operating with his technical knowledge; that planning in the organization of health care is little justified. Thus in the most difficult years for the German proletariat, when the bourgeoisie, along with reducing wages, first sharply reduced expenditures on socio-hygienic measures, bourgeois social hygienists theoretically justify this offensive of the bourgeoisie against the proletariat. Teleki, one of the major social hygienists of pre-Hitler social-fascist Germany, in an article that appeared in early 1933 (Ztsch. f. Gesundheitsverwaltung u. Gesundheitsfursorge, 1933, No. 1), timidly stating the need to preserve the remaining socio-hygienic chairs in Germany, motivates this by the need 'precisely during economic need to accustom doctors to economy in the field of health protection'. History of social hygiene. S. h. was always the Cinderella in the family of medical sciences: every, even slightly conscientious and objective socio-hygienic research invariably had to discover the socio-economic roots of diseases among the working classes. Individual socio-hygienic remarks are scattered even in the works of Greek and Roman authors. In particular, we find glimpses of socio-hygienic thought in the works of Hippocrates (see Medicine, history of medicine). Among the Romans, hygiene of military campaigns developed significantly, among the Spartans hygiene of education and physical culture, etc. The first most complete and most objective for that time work on social (more precisely professional) hygiene was the work 'De morbis artificum diatriba' by the famous Ramazzini (whom Marx sympathetically quotes in vol. I of 'Capital') which appeared in 1700. Despite the moderation and caution in describing the condition of workers at that time in this work, the very fact of the appearance of such a work, dedicated to protecting the interests of workers, did not find sympathy among then 'society'. The seed of Ramazzini fell on the stony capitalist soil and withered without giving sprouts. Almost 100 years after this (in 1779) another significant work on S. h. appears - the multi-volume work of Johann Peter Frank 'System of complete medical policy'. In this work the author examines the issues of child rearing, the fight against venereal diseases and sex education, protection of motherhood and infancy, hygiene of marriage, medical statistics, etc. Although in resolving all these issues the author appeals to the enlightened police and police supervision (in accordance with the then widespread doctrine of 'enlightened absolutism'), nevertheless some of the author's reasoning about the causes of social anomalies have not lost their significance to this day. The advanced countries of commercial capital and manufacture of the 17th century - England, Holland, France - become the cradle of statistics - a method that subsequently had colossal significance for the development of S. h.: Graunt in 1662 published in London his 'Natural and Political Observations', based on mortality bills, the physician Petty (Petty, 1623-78), whom Marx in 'Capital' calls 'the founder of statistics', published 'An Essay on Political Arithmetic', Halley, Süssmilch, Malthus - a series of works on population statistics. F. A. Mai in his 'Project of legislation for the most important areas of medical police' (1800) also raised a number of socio-hygienic problems. The development of industrial capitalism in the 19th century was accompanied by an exceptionally high destructive influence on the health of the proletariat.

England at the beginning of the 19th century was the first to embark on the path of development of industrial capitalism. Therefore, the destructive influences of capitalism on the health of the proletariat were first discovered in England, and it was here that they were noted by the most advanced physicians. Articles and works by these physicians, sanitary-police parliamentary acts in which these physicians participated, reports of sanitary inspectors and the like subsequently in the 1840-1850s of the 19th century became the material from which Marx and Engels drew sources for constructing their brilliant doctrine on the destructive influence of capitalism on the health of the working class. About one of these physicians—John Simon, who among others was in the mid-19th century in England a bearer of social-hygienic ideas—Engels wrote in 1881: 'He is the very one whom Marx so often quotes and praises in Capital, perhaps the last of the old, faithful to their professional duty and conscientious officials of the 1840-1860s period, for whom the interests of the bourgeoisie were the main obstacle in the fulfillment of his duty and who was forced to constantly fight against these interests.' The development of capitalism and the destructive influence it exerted on the health of the proletariat led to the struggle of the proletariat for legislative measures to protect labor, sanitary legislation and the like. Under the influence of the unceasing struggle of the working class in England in 1833 a factory inspection was introduced, in 1848—the legislative statute 'For the Protection of Public Health' (Public Health Act). In France in 1822 the 'Higher Sanitary Council' was established, which in 1851 was transformed into the 'Consultative Committee of Public Hygiene' (Comite consultatif d'hygiene pub-lique). In Germany the fresh breezes of the 1848 revolution caused a movement toward a new organization of sanitary affairs as well as the appearance of a number of works on Social Hygiene. In 1839 Hoffmann, director of the statistical bureau in Berlin, pointing to the important role played in the protection of health by well-being and culture, wrote: 'These benefits prolong the duration of human life, which is expressed in mortality figures, insofar as the good influence of the mentioned factors is not destroyed by the action of climate and the bad structure of soils.' Following him in 1847 the Berlin physician S. Neumann in the book 'Protection of Public Health and Property' wrote: '...the greater part of the diseases that poison human existence or carry it prematurely to the grave are explained not by the state of dead nature, but by the prevailing social relations. Medical science in its essence and its internal content is a social science and until this significance is taken into account in practical measures, it will not be possible to utilize all the fruits of medicine.' With similar views also spoke R. Virchow two weeks before the beginning of the 1848 revolution, sent to Upper Silesia to study the epidemic of typhus. The result of this mission was his 'Reports on the Epidemic Prevailing in Upper Silesia'—a brilliant socio-economic and socio-hygienic sketch in which Virchow showed the connection between oppression, poverty, lack of rights, ignorance, social inequality, housing conditions, nutrition and the epidemic of typhus. In the article 'On the striving for unity in scientific medicine' Virchow wrote: 'If medicine really wants to fulfill its great tasks, it must necessarily seize political and social life.' Virchow demanded the establishment in Prussia of a ministry of public hygiene. Thus the ideas of Social Hygiene in the 1840-1850s of the 19th century were vaguely wandering in the teachings of Hoffmann, Neumann, Virchow. However, beyond these ideas the development of Social Hygiene did not go in these years. It took several more decades for Social Hygiene to really become a science only at the very end of the 19th and beginning of the 20th century. This transformation of Social Hygiene into a science was preceded in the second half of the 19th century on the one hand by the flourishing of hygiene as an experimental science, on the other by significant achievements in a number of countries (England, France, Germany) in the area of communal-sanitary measures. The scientific-social justification for the necessity of these measures was given in the sanitary-statistical research of that time. Medical and sanitary statistics played a major role in the development of Social Hygiene as a science. In 1865 in Germany the first textbook on medical statistics appeared (Oester-len), who collected scattered material from all European countries. In 1881 the book of Westergaard, professor of statistics in Copenhagen: 'Doctrine of mortality and morbidity', appeared, in 1899 the work of Newsholme: 'The elements of vital statistics in their bearing on social and public health problem'. In 1906 a book by Prinzing 'Textbook of Medical Statistics' appeared in Germany and was translated into other languages. After the appearance of this last book, numerous works on medical statistics appeared in various medical and economic periodicals in different countries. All these works were closely connected with the developing social hygiene of that time. Huppe, Liebreich, Gotstein (Huppe, Liebreich, Gotstein) in a number of works of this time pointed to the importance of predisposition of the organism to disease and to the role of the social environment in this predisposition. The development of questions of social pathology of tuberculosis and the creation of a special type of practical institutions for the fight against tuberculosis (dispensaries) began. The study of social regularities in pathology and the application of the dispensary method were not limited to tuberculosis alone. The initial stages of imperialism placed before the bourgeois state the problem of the progressive deterioration of the health of the broad masses of workers as a danger to imperialism itself. This and mainly the offensive struggle of the proletariat of this period led to the development of certain hygienic measures of a public nature for the protection of motherhood and infancy, to a certain growth of obstetric care, the opening of consultations for children and the introduction of periodic examinations of schoolchildren, the strengthening of school hygiene and etc. and etc. Thus in these areas a field for joint activity of treating physicians and hygienists was outlined, which led to the theoretical development of questions of social pathology and hygiene. In 1906 the Berlin Society of Social Hygiene was founded. In 1916 a project for the establishment of a German society of social hygiene was developed. For the study of theoretical problems and practical application of Social Hygiene a program was developed which covered: 1) medical statistics and population policy, 2) the fight against social diseases (alcoholism, child mortality, venereal diseases and others), 3) housing hygiene and social measures for the protection of the purity of air and water, 4) care for youth, 5) protection of women, 6) care for the sick, 7) protection of those employed in industry and social insurance, 8) public nutrition, 9) legislation on health protection, 10) hygienic education and upbringing of the population. From 1901 began to appear in Germany under the editorship of Grotjahn and Kriegel a bibliographical annual with detailed reviews of international literature on Social Hygiene 'Jahresberichte tiber die Fortschritte auf dem Gebiets der sozialen Hygiene'; from 1903 began to be published the special socio-hygienic journal 'Monatsschrift fur soziale Medizin'. In 1904 in Germany appeared the book of Weil, the first major textbook on Social Hygiene, a collective work. A few years before the appearance of the book of Weil in France appeared the book of Emile Duclot 'Trait ё d'hygiene sociale', which in 1904 was translated into Russian. After the appearance of the book of Weil a number of major textbooks and monographs on Social Hygiene appeared in German: 'Social Pathology' by Grotjahn (1912), the two-volume 'Social Medicine' by Ewald (1911-1914), the large two-volume 'Handworterbuch d. sozialen Hygiene' edited by Grotjahn and Kaup (1912), 'Lectures on Social Medicine' by Teleki (1914), the four-volume 'Disease and Social Position' edited by Mosse and Tugendreich and a number of other monographs. All this extensive literature of the period of flourishing of Social Hygiene in Germany was written predominantly by radically bourgeois representatives of medicine, who came from the milieu of physicians of sick funds, communal physicians, epidemiologists, pediatricians, striving to win independence for Social Hygiene as a new field of practical and theoretical activity. In 1912 in the Berlin Hygienic Institute a 'Department of Social Hygiene' was established headed by Grotjahn; a similar department arose in the Munich Institute headed by Kaup. During the war in Germany a number of departments of Social Hygiene arose. The imperialist world war, and even more so the advance of capital following the revolutionary upsurge after the war, led to a sharp reduction in social-hygienic measures, as well as to a decrease in work on the theory of Social Hygiene. From 1915 to 1925 only the brief 'Textbook of Social Hygiene' by Fischer and 'Social Biology' by Elster appeared. Only from 1925 begins a certain small upsurge of Social Hygiene in Germany. In 1925 and in the following years appears the six-volume 'Textbook of Social Hygiene' edited by Gottstein, Schlossman and Teleki, the publication of the journal 'Arch. f. soziale Hygiene und Demographie' is resumed, a number of other periodical and separate publications on Social Hygiene begin to appear. Individual social-hygienic institutions and measures are also growing.

However, this period of rise in Social Hygiene was very short. From 1929 to 1932, no major works on Social Hygiene appeared. Fascism, coming to power in Germany, destroyed the pitiful remnants of Social Hygiene that had survived to that point. In theory, it was replaced by racial hygiene. Social hygiene institutions were closed, social hygiene measures were reduced to zero, departments of Social Hygiene were closed; individual workers of Social Hygiene were killed, and major and bourgeois social hygienists were dismissed. The social hygiene academies opened in 1920 in Charlottenburg, Breslau, and Düsseldorf were closed in 1933; in their place, state modern academies were created, which, as stated in the provisions for their organization, were to prepare all those who would serve as state or municipal physicians in the direction of 'new racial-hygienic and national-political tasks.' Social hygiene ideas in pre-revolutionary Russia developed in the works of a number of zemstvo doctors (Kurkin, Tezyakov, Shingarev, Bogoslovsky, Yavenko, Kashchenko, Molkov, Levitsky, and many others), at the Pirogov congresses, and also from the hygiene department of Moscow University, headed by F. F. Erisman (see Hygiene). Separate courses on public hygiene were given by Shingarev, Diatropov, Frenkel, Igumnov, and others. However, all the works of zemstvo doctors, as well as separate social hygiene ideas proclaimed at the Pirogov congresses and in separate courses, were limited to stating the facts of the harmful influence of social conditions (i.e., primarily tsarism) on the health of workers and peasants; only the most radical representatives of the then zemstvo medical thought hinted at the need to overthrow autocracy as a prerequisite for improving the health of the population ('under tsarism even quinine doesn't help against malaria' - a slogan thrown out at one of the Pirogov congresses). Only separate sanitary-statistical works of zemstvo doctors proved useful (as the works of Dementiev, Zhbankov, Tezyakov, and others, which V. I. Lenin used and critically reworked in 'The Development of Capitalism in Russia') for revolutionary analysis. In most cases, these were works written in the spirit of populism, i.e., operating with the famous 'average' indicators that obscured the class stratification of the village and the class struggle then taking place in Russia, denying the development of capitalism in agriculture and the emergence of the proletariat in Russia. Only after the October Revolution in the USSR did the real prerequisites for the development of Social Hygiene emerge. In the years that have passed since the October Revolution, Social Hygiene as a science in the USSR has developed so broadly that no capitalist country can even dream of it. In all republics of the USSR, there are institutes of social hygiene and healthcare. A significant majority of other scientific research institutes of the People's Commissariat of Health have departments of social pathology and hygiene. In all medical educational institutions, there are departments of Social Hygiene at present; the first department of Social Hygiene in the USSR was opened in Moscow at the 1st Moscow University in 1923. Scientific research work in Social Hygiene has grown enormously. Social hygiene theory is most closely linked to social hygiene policy. The basis of social hygiene theory in the USSR became the Marxist-Leninist methodology. Social hygiene ideas have also penetrated clinical medicine, uniting the work of hygienists and clinicians on a common basis of the struggle for the improvement of labor and living conditions of the working population (see Prevention, Dispensary, Dispensaryization). The main sections of Social Hygiene, which are usually included in textbooks and manuals on Social Hygiene, are: 1) subject and history; 2) methods, which mainly include sanitary, medical, and demographic statistics, as well as anthropometry; 3) social pathology and prevention, studying human diseases from the point of view of the influence of socio-economic conditions on the occurrence and spread of these diseases, and measures leading to the prevention and elimination of various diseases; 4) main problems of social hygiene - a) labor, b) rest, c) settlement and housing, d) public nutrition, e) sexual life, f) reproduction, g) motherhood and infancy, h) schoolchildren and adolescents, i) physical culture, j) sanitary culture; 5) healthcare - a) history, b) organization and system, c) institutions, d) legislation. Social Hygiene and related disciplines. Social Hygiene occupies a somewhat special place among medical disciplines, determined to a large extent by the fact that it is more closely connected to social sciences than any other medical discipline. Hence the very close connection of Social Hygiene not only with physiology, experimental hygiene, clinical disciplines (private pathology of internal diseases, skin and venereal, women's and children's, etc.), hygiene of labor, hygiene of upbringing, communal hygiene, psych hygiene, etc., but also with political economy, historical materialism, statistics, demography, etc. Social Hygiene is one of the branches of social policy. Based on normal and pathological physiology, as well as on the private pathology of individual diseases, Social Hygiene ensures in the education of the physician the integrity of the basic concepts of the peculiarities of pathological processes in humans, the role of social regularities in these pathological processes. The closest connection of Social Hygiene with experimental hygiene ensures integrity in mastering the doctrine of the material conditions of habitation, interpreted by general hygiene mainly in the aspect of studying the physicochemical properties of the material environment and the technical conditions of its impact in order to create the most favorable conditions for habitation (sanitation). In social hygiene, the material environment as a factor of social health is studied in the aspect of social conditions. Thus, in the example of housing hygiene, one can see that general (experimental) hygiene gives indications of the suitability or unsuitability of a given dwelling, establishes the cubic capacity of air, standards of lighting, heating, rules of ventilation, gives practical instructions on how to build housing that meets hygiene rules, etc., but it only indirectly deals with the complex of issues known as the 'housing question': studying the housing conditions of various classes of the population and their impact on health; indicating social measures necessary to satisfy housing needs; determining the direction of housing legislation, housing policy from the point of view of Social Hygiene - in short, resolving the 'housing question', guided by hygiene norms and hygiene interests; this task is taken on by Social Hygiene. The same is true in the field of nutrition. General (experimental) hygiene teaches the analysis of food substances, nutritional norms, the fight against adulteration, etc. Social Hygiene continues the study further: it examines the nutrition of various classes of the population depending on their social and economic position; it studies the social pathology of nutrition; it gives guiding instructions for the organization of public catering, etc. The micropediatric clinic studies diseases of infants and measures to combat them; but infant mortality is a social phenomenon, and the fight against it must be carried out first of all in the sphere of social measures. To study this issue from a social point of view, to give guiding instructions for such measures - this is the task of Social Hygiene. Gynecology and obstetrics give sufficient indications for the individual hygiene of the mother-woman, but the protection of the health of the mother, and above all the working woman, is not covered by this. On the contrary, only on the basis of these medical knowledge do social measures begin, aimed at protecting women's labor, protecting motherhood and infancy, etc. Thus, Social Hygiene, developing issues standing on the border between sociology and medicine, broadens the medical worker's horizon toward clarifying the basic social problems. This determines the enormous social significance of Social Hygiene both in the system of medical education and in the practical activity of the physician. In the process of studying the course of Social Hygiene, the student participates in the inspection of factories, plants, in getting acquainted with the housing and living conditions of the working population, with institutions of social hygiene order (dispensaries, institutions for the protection of motherhood and infancy, for physical culture, etc.), which cannot but introduce him to the circle of social issues and not expand his medical outlook. The social hygiene direction expands his understanding of the essence of pathological phenomena and measures for the treatment and prevention of diseases. Socialist construction and social hygiene. The successes of socialist construction in the USSR reveal boundless prospects for social hygiene measures. The industrialization of the country, the construction of new socialist enterprises, the reconstruction of old ones create new, much healthier working conditions for workers and women workers. Mechanization of work, elimination of occupational hazards improve labor in industry and agriculture. The introduction of a shortened working day and a shortened working week - a fact of enormous social hygiene significance. The enormous work on the protection of motherhood and infancy, on the protection of the health of schoolchildren and adolescents is an exceptionally great achievement on the social hygiene front. The collectivization of agriculture leads to the collectivization of living conditions (public catering, public upbringing of children, etc.) - a factor of enormous social hygiene significance.

Huge housing construction is unfolding, new socialist cities are growing. The directive of the XVI Party Congress on the construction of new enterprises on the basis of raw materials (cotton, flax, sugar beets, etc.) gives a powerful impetus to the further elimination of the opposition between city and countryside (see Socialist city, Industrialization and healthcare, Collectivization of agriculture and healthcare). The material and cultural level of the working masses is growing tremendously; millions of collective farm peasants have already moved through Bolshevik collective farms toward a prosperous life, which creates an exceptionally favorable soil for the further implementation of social hygiene measures. The average life expectancy in the USSR in 1926-1927 increased by more than 10 years compared to the pre-war period; 'by 1930, mortality in the USSR had decreased compared to the pre-war period by 36% in general and by 42.5% in childhood' (Stalin), and at the present time 'our country, with a population of 165 million, gives the same annual population growth as 365 million people in capitalist Europe' (Kaganovich). All these powerful social hygiene shifts have been achieved because 'the USSR has been transformed to its roots during this period, shedding the cloak of backwardness and medievalism. From an agrarian country, it has become an industrial country. From a country of small individual farming, it has become a country of large collective mechanized farming. From a dark, illiterate and uncultured country, it is becoming—rather has become—a country of literate and cultured people, covered by a vast network of higher, secondary and primary schools operating in the languages of the nationalities of the USSR... The appearance of our major cities and industrial centers has changed. An inevitable feature of large cities in bourgeois countries are slums, so-called workers' quarters on the outskirts of the city, representing a heap of dark, damp, mostly basement, semi-ruined premises where the poor usually huddle, crawling in the mud and cursing their fate. The revolution in the USSR has led to the disappearance of these slums among us. They have been replaced by newly built good and bright workers' quarters, and in many cases our workers' quarters look better than the city centers. The appearance of the countryside has changed even more. The old village with its church in the most prominent place, with its best houses of the volost clerk, priest, kulak in the foreground, with its half-collapsed peasant huts in the background is beginning to disappear... In its place appears a new village with its socio-economic buildings, with its clubs, radio, cinema, schools, libraries and nurseries, with its tractors, combines, threshers, automobiles. The opposition between city and countryside is disappearing. The city ceases to be, in the eyes of the peasants, the center of their exploitation. The threads of economic and cultural unity between city and countryside are becoming stronger and stronger' [I. Stalin, Report to the XVI Congress of the All-Union Communist Party (Bolsheviks)]. These successes of socialist construction in the city and countryside open further broadest perspectives for the development of social hygiene measures in the USSR and the improvement of the health of the working people of the Soviet Union. Social hygiene thus permeates the theory and practice of healthcare. Social hygiene becomes not a dogma, but a guide to action. Under Soviet conditions, social hygiene becomes the doctrine of the theory and practice of socialist healthcare. Social hygiene, in the words of Comrade Stalin, spoken about the significance of Marxist theory, gives practitioners 'the strength of orientation, clarity of perspective, confidence in work, faith in the victory of our cause'.