Rare Imperial Russian Silver Medical Presentation Plaque to Dr. Alexander Artemyevich Arutinov, Vladivostok & Tiflis, Dated 1916. Mounted on its original leather backing. High relief with a medical allegorical composition featuring the Staff of Asclepius, anatomical skull, medical instruments, books, and apothecary vessels. Inscribed to Dr. Alexander Artemyevich Arutinov from grateful clients in Vladivostok. The design also incorporates the name "Tiflis", likely referencing an important biographical or professional connection. Marked with the Russian 84 silver standard and maker's mark. 3.75 x 8 inches.