Zakhar'in

ZAKHAR'IN, Grigoriy Antonovich (1829-1897), director of the Faculty Therapeutic Clinic at Moscow University, an outstanding Russian professor-therapist of the second half of the 19th century. He graduated from the medical faculty of Moscow University in 1852. After defending his doctoral dissertation "De puerperii morbis" (M., 1854), he received a foreign scientific mission and worked in Berlin under Virchow, Traube, and Frerichs, and then in Paris under Claude Bernard, Trousseau, and others. His stay abroad (1858-59) was used by Z. to familiarize himself not only with internal medicine, but also with general pathology, physiology, as well as with gynecology, urology, syphilology, and skin diseases, and with otorhinolaryngology—disciplines that did not yet exist as separate departments at Moscow University. Soon after returning to Moscow, Z. was appointed (1860) adjunct of the Faculty Therapeutic Clinic of the university and began to give lectures on general therapy. In 1862, Z. was appointed ordinary professor of diagnostics and therapy, and soon (after the death of Over)—director and professor of the Faculty Therapeutic Clinic, where he worked almost until his death. A man with an original, independent mind, European-educated in medical matters, Z. could not reconcile himself with the unfavorable position of the Russian clinic at that time and, upon receiving an independent department, immediately began a radical reorganization of the clinical work. Together with his contemporaries Botkin and Ostroumov, Zakhar'in should rightly be called the founder of Russian clinical medicine in general. From them originates not only Russian internal medicine as a scientific clinical discipline, but from it, with the active participation mainly of Botkin and Zakhar'in, other disciplines branched off: pediatrics, neurology, laryngology, and even gynecology. Thus, Z. allocated beds for children's and women's diseases in his clinic, which later served as the nucleus for the organization of corresponding clinics. At his initiative and at his own expense, two Moscow physicians were sent abroad to receive specialized education, who later became the first specialists in diseases of the ear, throat, and nose and in nervous diseases in Moscow. Z. in his activity should be characterized first of all as a physician and as a teacher. The research side in medicine attracted him less. In his medical practice, Z. fought against routine, everywhere introducing the idea of the need to individualize the patient. This method of individualization Z. also instilled in his students. "Assimilation by students of the method and ability to individualize should be the main goal of the teacher." In the process of investigating the individuality of a case, Z. attached great importance to questioning the patient, elevating questioning to the level of an art. Z. was a subtle observer of the semiotics of the disease, bringing to its assessment his strong critical mind and therefore not getting lost in details. Z. was a convinced therapist, believing in the power of drug and climate therapy, and was hostile to the therapeutic nihilism often encountered in his time. In his medical practice, Z. introduced a significant element of healthy, necessary practical psychotherapy, conducted not by template and formulas. Pointing out to his students the importance of suggestion in therapeutic activity, Z. said that often "the prognosis made to the patient coincides with the treatment." Z. attached enormous importance to the study of the patient's lifestyle and working conditions. Being an extremely talented physician and teacher, Z. was still mainly an empiricist. In the last years of his life, Z. sometimes reacted negatively to various new scientific trends and research methods in the clinic, with which he was not sufficiently familiar (e.g., with bacteriology). In connection with this, as well as due to Z.'s unwillingness to consult with the Faculty Council, the student body did not wish in 1895-96 to attend his lectures, which forced Z. to leave the university (1896). Z.'s main work—his clinical lectures in four volumes, which went through several editions in Russian and were translated into English, German, and French.