Social Medicine As One Of The Basic Foundations Of Social State

Abstract

In the times critical for the society, institutionalization of social medicine often takes the shape of the state policy. Thus, the father of all reformers, Pharaoh Amenhotep IV began his reforms aimed at improving public health of the nation with the destruction of the caste of priests, and all kinds of magicians, sorcerers and other hunters for souls and manipulators of public consciousness. The victory of small Spartaover powerful Athens in Peloponess war became possible only due to sanitary policy of king Likurg, who created a special body of management — gerucies, consisting of the king, the doctor and a representative of the masses. The Sparta society, which was the healthiest society in the history of mankind, during the period of Likurg's role, managed to overcome the domination of pythoness oracles over their souls (Apollo cult) and to reject mass pythoness games, the main point of which was in the manipulation of huge masses of people by means of «musical» and narcotizing influence on masses. Hippocrat, who made rational conclusions from Peloponess war (he stood for Athens side), carried out a grand reform, which ensured the control of doctors over the activities of the authority elite, under the pretext of negative effects of climatic factors on the health and moral state of Athenians. Hippocrat's system of the protection of public health turned out to be much more effective than the Spartans' one. In 1940 king of England George VI addressed the House of Lords with the claim of urgent creation of the institute of social medicine. The institute attached to Oxford university was created within several weeks. It was both pedagogical and research institute. J.A. Rail, sociologist and psychiatrist, was at the head of the institute. At the head of departments there were sociologists, economists and doctors. The institute had time to carry out a conference, in the course which the first program of social medicine was elaborated and the main task was clearly formulated: to analyze how the events, which take place in the society, affect public health. Public health was understood in two senses: medical and moral. The institute didn't exist long: the second World war began and it turned into military hospital. While working in the archives of Oxford institute in the beginning of the last decade we found the digest of the first conference on social medicine, issued by this institute. Our colleagues from the University, who knew that we were going to organize in Russia a social institute (research and pedagogical) kindly presented to us one of the two copies of the materials of this conference. Now these materials are in the State medical library in Moscow. Only since 1946 social medicine has begun to develop first of all in the countries of Western Europe and also in the USA, Canada and Japan. Now practical, pedagogical and research institutes as well as the centers of social medicine exist in practically all the countries of the world, even in the developing countries such as Honduras and Ethiopia. In Russia the first department of social medicine was created in 1997 in Moscow State Social University (MSSU) by the author of this article and his colleagues. Nowadays the departments of social medicine are open in many institutes of Russia, including technical institutes. There have been published textbooks, which won the recognition in many countries of the world. We consider social medicine as a branch of sociology, its object of study and practice is a public man. Social medicine, which elaborates norms of healthy way of life in a healthy society and according to these norms realizes social control over the individual, group of individuals, whether it is a family, a working group, or a school, legislative and executive structures of authority, judicial bodies, penal institutes or the army, is not something alien, which stands above the individual and the society. It is a reflection of healthy tendencies of the society as a whole in knowledge and practice, as well as the method of implementing these tendencies and securing their viability. Social medicine does not diagnose and consequently it does not treat people, groups of people, or the society. For a social doctor a person is not a patient but a client as well as a social doctor as a particular person is a client for example for his hairdresser or lawyer. Patients (from the Latin word patio — suffering) are those people who seek help from clinical doctor or clinician: physician, gynecologist, psychiatrist or sexopatologist. Clinical doctor must diagnose a patient before starting to treat him. Only after diagnosing it is allowed to prescribe the intake of medicines (which nowadays as it was at the times of Paracels remain to be poisons and one may take them only according to the doses, which are necessary for sick organism in order to overcome a disease). Social medicine considers disease as a particular case of a special situation, and the social doctor helps his client to find a way-out from this situation with the optimal preservation of social functions (but he does not treat him!). Because of illness a person may partly or completely lose his social functions owing to, for example, decompensation in «hot points of biography» (age parameters of a person are paramount reference points in sociometric measurements of a social doctor). Prognostic sociometrics is another case, when a social doctor helps his client (for example: may the parents, who have mental diseases in their anamnesis have children? what is the probability of their own mental diseases?). Genealogical and biographical sociometrics also belongs to the main methods of work of the social doctor. In particular he can reveal the presence of inborn inclination for delinquency. Social doctor not only helps his client to find a way-out from a difficult situation, but he also equips him with knowledge, owing to which a client may exercise control over the work of his organism and, what is important, to forecast his physical, intellectual and creative abilities. And certainly healthy way of life turns from the abstraction of popular advice into life formula of the concrete person. While for the clinician it doesn't matter what social or microsocial environment his patient comes from, the social doctor singles out the most important parameters of a person, according to which his problem is considered. Public social doctor adheres to strongly individual approach to a concrete person, but family social doctor even when he looks at the problems of one member of the family, deals in fact with the concrete microsocial group, and that is why he uses the categories of social medicine.