Catherine the Great

Russian gains were not purely territorial. The treaty opened the Black Sea to Russian commerce by guaranteeing complete freedom of navigation. The treaty also included the right of Russian merchant ships to unlimited transit through the Bosporus and the Dardanelles into the Mediterranean. Turkey was also to pay to Russia a war indemnity of four and a half million rubles. Persecution of Christians in Moldavia and Wallachia was to cease, and Orthodox believers in Constantinople were to be able to worship at a church of their own. On a grander scale, the war had tipped the balance of power in the region in Russia’s favor; Europe was now aware that predominance in the Black Sea had passed to Russia. In Catherine’s mind, these were achievements to match those of her predecessor, Peter the Great, who, on the faraway Baltic, had first opened a Russian pathway to the world.

55

Doctors, Smallpox, and Plague

THE RUSSIAN PEOPLE considered themselves a national family. The tsar, or emperor, was the Little Father, Batushka. His wife, the tsaritsa, or an unmarried soverign empress such as Catherine I, Anna, Elizabeth, or Catherine II, was the Little Mother, Matushka. Catherine liked thinking of herself this way and took seriously the responsibility of maternal care for her people. If she could not give them a new legal code, she could at least address the problem of their health. “If you go to a village and ask a peasant how many children he has,” she said,” he will say ten, twelve, and sometimes even twenty. If you ask how many of them are alive, he will say, one, two, three, rarely four. This mortality should be fought against.”

In 1763, the second year of her reign, Catherine founded Russia’s first College of Medicine to train Russian doctors, surgeons, and apothecaries. Until a sufficient number of Russian doctors became available, she attempted to recruit western European physicians by offering generous salaries and pensions. In the same year, to discourage infanticide among unmarried and impoverished mothers, she established with her own funds a foundling hospital with an attached lying-in hospital in Moscow. The anonymity of the mother was assured by a system of baskets, pulleys, and bells. When a bell was rung in the street, a basket was lowered from an upper story, the unwanted baby put in, and the basket raised. All children, legitimate or illegitimate, from any class, were accepted, cared for, and educated, with precautions to ensure that when they left, they were, or remained, free. The hospital was five stories high and had two hundred beds. Dormitories were large and airy. Each child had his or her own bed, with a clean gown, clean sheets, and a small bedside table holding a jug of water, a glass tumbler, and a bell to summon assistance. An English visitor wished “that the same attention to cleanliness was given in English hospitals.” The hospital served as a model for similar foundling institutions in St. Petersburg and other places. The empress attacked another problem by creating a hospital for venereal disease, where both women and men were treated. In 1775, Catherine decreed that the capital of every province must have a general hospital, and that every county in the province must have a physician, a surgeon, two surgical assistants, two apprentices, and an apothecary. Since twenty to thirty thousand people lived in some counties, this coverage was thin, but before there had been nothing.

Personally, Catherine did not care for doctors. She was subject to illness; indeed, when she was a grand duchess, her health had frequently worried Empress Elizabeth. Once she reached the throne, Catherine’s ailments had political significance. She felt the burden of absolute power: reports had to be studied, advisers consulted, decisions made. She tried to keep herself healthy through adequate rest, dietary restraint, fresh air, and outdoor walks; nevertheless, she often complained privately of headaches and back pains. In 1768 she wrote to Nikita Panin: “I am quite sick, my back hurts worse than I ever felt since birth. Last night I had some fever from the pain, and I do not know what to attribute it to. I swallow and do everything they [the doctors] wish.” Again to Panin: “It has been four years since the pain in my head has left me. Yesterday I ate nothing the whole day.”