Unimplemented Reform of the Health Care System for Residents of Peterhof in 1843–1845

Scientific article

DOI 10.28995/2073-0101-2026-1-267-283

For citation

Efimov, A. A. (2026). Unimplemented Reform of the Health Care System for Residents of Peterhof in 1843–1845, Herald of an Archivist, no. 1, pp. 267-283. DOI 10.28995/2073-0101-2026-1-267-283

Efimov, A. A., St. Petersburg Institute of History of the Russian Academy of Sciences, St. Petersburg, Russia

Unimplemented Reform of the Health Care System for Residents of Peterhof in 1843–1845

Abstract

The article addresses one of the historical issues of Peterhof: the problem of providing healthcare to city residents in the mid-19th century. The author notes that in 1843 physician-in-ordinary J. V. Villie who inspected the palace infirmary built in 1823 presented his opinion on the need to build a new hospital due to the insufficient space of the existing one. However, as the article notes, Emperor Nicholas I instead decided to convert the infirmary into an emergency room and transfer treatment to the local military hospital. The author notes that implementing this decision required coordination with both the infirmary's management and the administration of the military hospital of the Life Guards Horse Grenadier and Uhlan Regiments, which resulted in extensive correspondence. At the same time, officials from the Imperial Court Office pointed out that the palace infirmary, which treated not only employees of various departments of the Ministry of the Imperial Court but also ordinary citizens, was essentially a citywide hospital, and the fees collected from patients were used to support the operation of the medical facility. In analyzing the innovations representatives of the Ministry of the Imperial Court noted that the implementation of the proposed idea could lead to negative consequences for both the budget and patients. On the one hand, treatment in a military hospital would be more expensive than in a hospital for both court officials and citizens. On the other hand, the hospital's distance from the city center would complicate travel for patients, which could even encourage them to conceal their illnesses. The article also analyzes an attempt to change the approach to treating patients at home. Instead of preparing medications in the palace infirmary's pharmacy, which was proposed to be closed at the instigation of physician-in-ordinary J. V. Villie, procurement from a private pharmacist was to be resorted to. The idea was also criticized for economic reasons, as the cost of third-party procurement, even with the proposed discount, significantly exceeded the rates stated by infirmary staff, and the proceeds from the medications were used to support the hospital's overall operations. The author notes that, following correspondence, it was decided to maintain the infirmary as an active hospital, undergoing reconstruction, and the idea of switching to third-party procurement was similarly rejected. Moreover, as noted in the article, both the plan for rebuilding the hospital and the subsequent project for constructing a new building were rejected by the Emperor who ordered the hospital to be left in its existing form with patients who did not have enough space being sent to a military hospital. This became the only real outcome of the attempt to transform the system of medical care for the residents of Peterhof.

Keywords

Peterhof, Palace Administration, hospital, Emperor Nicholas I, J. V. Zakharzhevsky, A. A. Avenarius, J. V. Willie.

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About authors

Efimov Andrey Aleksandrovich, PhD in History, St. Petersburg Institute of History of the Russian Academy of Sciences, Scientific and Historical Archive and Source Study Group, Senior Researcher, St. Petersburg, Russia, +7-911-971-59-49, This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Grant information

The research was conducted at the expense of the grant of the Russian Science Foundation no. 24-78-10082 «Palace cities as single-industry towns of the Russian Empire», https://rscf.ru/project/24-78-10082/

The article was received in the editorial office on 26.11.2024, recommended for publication on 20.12.2025.