Urals factory hospitals and surgeons at the dawn of the nineteenth century.

INTRODUCTION: THE INDUSTRY AND ITS PROBLEMS AT THE BEGINNING of the nineteenth century 128 mines and metallurgical factories were in operation in the Ural Mountains. Many had been destroyed in Pugachev's rebellion (1773) but they had been quickly rebuilt. As a result of periodic changes in government policy in the previous century, when private enterprise was alternately encouraged and discouraged, twenty-four of the factories' belonged to the Crown and the rest (the ownership of one is not clear) were privately owned. The 128 factories were spread over a territory about equal in area to the entire United Kingdom. They depended for their communications on rivers which were frozen for half the year and on post roads which were frequently impassable. The metallurgical industry was semi-military in character and was administered on military lines. Recruiting the labour force in the sparsely populated and remote region of the Urals was always a difficult problem and various solutions were tried. The Ukase of 18 January 17212 empowered the nobility and merchants to purchase villages to obtain serf labour for factory work, with safeguards to ensure that peasants thus obtained were in fact used for that purpose. Otherwise convicts were employed, supplemented by a steady influx of children and by a leavening of skilled workers and "masters", who were often foreigners or foreign-trained. This system, inefficient and wasteful of manpower, made it necessary to have an enormous population of permanent and seasonal workers, with their families, at the factories and, consequently, it increased the need for some form of health service.3 The factory population was further increased by the military garrison needed both to maintain internal order and to protect the factory and its inhabitants against external attack by hostile neighbours. The naturalist P. S. Pallas (who was also medically qualified) visited nearly a hundred factories in the whole of Siberia in 1768-1774 and described some of the medical problems.4 At some of the more remote factories scurvy was rife. At Petro*Basil Haigh, M.A., M.D., F.I.L., 28 Roman Hill, Barton, Cambridge CB3 7AX. This paper is based on material collected for an unpublished thesis (M.D., University of Cambridge) entitled "The early development of industrial medicine in Russia", submitted on 18 April 1974. 1 For brevity, the mines, furnaces, forges, mints, etc., are collectively described as factories. ' Polnoe sobranie zakonov rossiiskoi imperii [Complete collection of laws of the Russian Empire], first series (to 1825), VI, No. 3711, St. Petersburg, 1830 (title hereinafter abbreviated to PSZ-1). ' At the 1794-1796 census there were 312,218 ascribed peasants at the Urals factories, the majority at factories owned by the Crown. See V. I. Semevskii, Krest'yane v tsarstvovanie Imperatritsy Ekateriny II [Thepeasants during the reign ofEmpress Catherine III, St. Petersburg, 1903, pp.304-305. 4 P. S. Pallas, Voyages de M. P. S. Pallas, en diffirentes provinces de l'Empire de Russie, et dans l'Asie septentrionale, translated from German by Gauthier de la Peyronie, Paris, Lagrange, 1788, vol. II, pp. 173-438.