The value of Tula provincial county hospital for county medicine of the Tula province in the end of 19th - the beginning of 20th century

The source of Soviet and modern Russian health care system is the rural and urban medicine, the formation of which began in the mainstream of Russian modernization processes, related to the conduct of the Great reforms. In the second half of the 19 century in Russia for the first time created a system for the provision of skilled care not only to the urban population, but also the most distant from the provincial centers of rural areas. In fact, it is the local structure of medical institutions "aid stations and medical areas - district hospital - provincial hospital and specialized agencies of the provincial center," became the basis for the modern structure of medical institutions. In this article we are interested in the third element of the prerevolutionary structure of the provincial hospitals and the problem of the value of the medical institution of its kind in the Tula province in the late 19 - early 20 centuries. After the formation of county institutions their first step in the formation of the medical system was the creation of provincial hospitals, whose task was specialized aid to the population of highly qualified medical personnel. Such institutions had become a provincial centre of health and development of medicine as a science. However, by the beginning of the 20 century the value of the provincial hospitals, including Tula, steadily. The decision of the Tula province county was the reorganization, which, in the end, was unable to rectify the situation. The main sources of this problem are the documents of the State archive of the Tula region, concentrated in the funds 4 (the Tula provincial county), 511 (Tula county bureau) and 1889 (Tula provincial county hospital). In addition, a major role in the analysis of the issue are the Reports of the Tula province county Council, Journals of the Tula provincial county meetings and proceedings of the Congresses of county physicians of the province.