Consolidation of zemstvo medicine and modernization of sanitary infrastructure in Bessarabia (1870-1875)

Abstract

The article analyzes the process of reorganization and modernization of the Gubernatorial Hospital in Chisinau and the provincial pharmacy during the first five years of Zemstvo medicine in Bessarabia (1870–1875). The study highlights the institutional transfer of the facility from the Order of Public Charity to the Zemstvo administration and the impact of this reform on sanitary infrastructure, administrative organization, clinical practice, and pharmaceutical services. The architectural and hygienic-sanitary transformations of the hospital, the development of the technical-surgical base, the modernization of medical instrumentation, and the introduction of therapeutic technologies advanced for that era are examined. Special attention is devoted to the provincial pharmacy, organized within the Gubernatorial Hospital and transformed into a regional logistics hub for supplying the medical institutions of the district (uezd) zemstvos. The article provides a detailed analysis of the therapeutic protocols employed in treating the primary pathologies encountered in hospital practice, including dysentery, respiratory disorders, pneumopathies, pleurisy, diphtheria, acute gastritis, neurological conditions, and gynecological pathologies. The use of modern pharmacological preparations, the introduction of antiseptic techniques, and the role of Zemstvo medicine in expanding public access to free treatment are emphasized. The study’s conclusions demonstrate that the Gubernatorial Hospital and its pharmacy constituted the core of the medical modernization process in Bessarabia, contributing decisively to the professionalization of the therapeutic act, the centralization of the pharmaceutical service, and the integration of regional medicine into the 19th-century European scientific circuit.