PUBLIC HEALTH
The state responded more systematically in this century to the continued outbreaks
of disease that we saw in Chapter 1 for the Muscovite period. The general instruc-
tion to regional governors of 1728 created a model for the rest of the century,
synthesizing the measures used in the seventeenth century (creating guard posts,
quarantining infected people, destroying infected homes, property and livestock,
and the like) and expanding them across the realm more systematically. To protect
against a 1738–9 epidemic in Ukrainian lands and the Black Sea coast, a“plague
commission”was formed in Moscow to coordinate preventative measures; from the
1740s the state created a network of permanent quarantine stations, staffed with
doctors, at major cities and border crossings. They were initially placed near the
southern border in Kyiv and in Smolensk gubernia in 1755, in the Baltic near
St. Petersburg in 1786, in Irkutsk in 1788, and in 1793 in the Ekaterinoslav
gubernia and Crimea. These were generally effective in keeping disease confined to
the perimeter of the country. In reaction to the 1770–3 plague epidemic, the state
created a centrally organized series of commissions and practices tofight epidemic;
it inaugurated the formal study of epidemiology in Russia, providing specially
trained doctors for quarantine posts. In July 1800 the state issued a lengthy
(179-clause) instruction on quarantines at all border crossings and ports.
Nevertheless, the familiar diseases attacked. Typhus, for example, ravaged
armies in 1715–17, 1738, 1758–9, and 1769. Although the government prepared
handbooks for the military to check the disease’s spread through good hygiene, the
first significant success in this regard came only in 1792 when General Suvorov
systematically implemented such practices in the Polish campaign. Civilians also
suffered from typhus, as in 1718 in St. Petersburg, in the 1730s in the north-
western corner of the empire, and in 1743 and the 1760s in the center. These
outbreaks were, however, usually regionally limited, kept in check by quarantine
and even, some say, by the hygienic benefit of the peasants’customary weekly
sauna baths (bani).
Plague also hit Russia hard. In thefirst decades of the eighteenth century Russia’s
massive armies fell victim to contagions in Turkish campaigns and in wars with
Swedish and Polish troops. A wave of plague hit the Baltic lands where Russian
troops were encamped in 1710–11 and spread into the Pskov and Novgorod areas
and south into the Grand Duchy and Ukrainian lands. Plague continued to rage in
1711 – 12 in Poland, Ukraine, and the Black Sea area, and reappeared in 1718 in
Kyiv, Azov, and the Black Sea steppe in 1718. Preventative measures kept it from
penetrating to Moscow, but Astrakhan lost half the city’s population to plague in
- Similarly, an outbreak of plague in Ukrainian lands and Crimea in 1738– 9
during the war with Turkey did not expand farther northward. Moscow, however,
was hit with plague seriously in 1770–3, originating apparently with the Ottoman
army in Moldova. From there it quickly spread, reaching Kyiv in August 1770,
Sevsk southwest of Moscow in September, and Moscow in December. In Moscow
it reached its height in September 1771, when almost 20,000 people died and the
population rioted in rejection of public health measures. By the time the epidemic
346 The Russian Empire 1450– 1801