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Views & Reviews Medical Classics


BMJ 2009; 339 doi: (Published 27 August 2009) Cite this as: BMJ 2009;339:b3395
  1. Boleslav Lichterman
  1. 1Institute for the History of Medicine, Moscow
  1. lichterman{at}

    Chekhov, who qualified as a doctor in Moscow in 1884, occasionally practised medicine during summer vacations as a “zemsky” physician. “Zemskaya” medicine, which emerged after the abolition of serfdom in 1861 and the subsequent creation of elected local councils that became responsible for health care in their area, was based on the principles of free and accessible care and prevention. “Ionych” is an eponymous short story about Dmitry Ionych Startsev, a newly appointed zemsky doctor.

    Most councils had about one doctor for every 25 000 to 30 000 people, who lived in areas as large as 25-30 square kilometres …

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