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p r e f ac e This is an untraditional history of psychiatry: besides describing the key period in the formation of the new specialty in Russia, it focuses on psychiatric discussions of writers and of literature. The reason for this approach is the central role of literature in Russian culture, for doctors as well as for many other people. Literature created the image of Russia both inside and outside the country; it dramatically shaped expression of fears and aspirations .Foreigners came to see the Russia of Tolstoy and Dostoevsky,and Russian men and women modeled themselves on literary characters, from the romantic Tatiana Larina to the laid-back Oblomov. The institutionalization of psychiatry in Russia coincided with one of the most eventful periods of the country’s history,marked as it was by rapid economic , scientific, and cultural changes as well as by wars and revolutionary upheavals.The second half of the nineteenth century is known as the golden age of Russian literature, when writers and literary critics exercised a powerful influence over people’s minds. By writing about literature, psychiatrists wanted to contribute to cultural and political life as well as use the universal love for literature to spread support for their medical activities. Psychiatrists in many countries willingly claimed that they provided insights into human nature similar to those rendered by writers.In Russia,given literature’s exceptionally high standing, such self-presentation was extremely flattering. By comparing their work with the portrayal of human moral failings and pathologies by such famous writers as Gogol and Dostoevsky, psychiatrists embellished their professional image. They went further in using literature to enhance the authority of their views,however,when they attributed the peculiarities of Gogol’s and Dostoevsky’s characters and writings to mental illness. Russian psychiatrists eagerly adopted the genre of pathography —medical biography of famous people, which mixed clinical case study with moral fable and art criticism. The psychiatrists’ encounter with literature was not merely an attempt to “label” famous people. In the Russian case, at least, the relationship between psychiatrists,writers,and the general public was much more subtle and interesting .The genre of pathography met with an ambivalent response from the Russian public. Indeed, when they discussed the supposed mental illnesses of famous writers, some psychiatrists altered their diagnoses in order not to offend the feelings of lovers of literature. And it is noteworthy that the genre of “psychiatric criticism” of literature flourished shortly before and after the 1917 Revolution;further into the Soviet era,pathographies,in their own turn, became a target of criticism. I begin,in the Introduction,by describing the background to Russian psychiatry and the nature of the enterprise of pathography.The first three chapters deal with psychiatric “diagnoses” of Gogol,Dostoevsky,and Tolstoy;one key consequence of these discussions was the eager acceptance of different forms of psychotherapy.The fourth chapter describes the treatment that psychiatrists gave to so-called decadent literature in the context of a developing interest in mental hygiene. In the last chapter, I trace the story of pathography into the early Soviet decades, when there was a strange but significant interest in genius. Taken together, this is the first book-length narrative in English of the history of Russian psychiatry over a half-century decisive for medicine and society alike. My hope is that, by developing the theme of the links between psychiatry and literature, the book will attract historians of Russia and cultural historians as well as those with a more specialized interest in medical history. While working on this book I had the generous support of several institutions and received help and encouragement from many colleagues. I wish to acknowledge the support of the Wellcome Trust, which awarded me a research fellowship and enabled me to spend a year at what was then the Wellcome Institute for the History of Medicine in London. The Science, Technology , and Society Program at the Massachusetts Institute of Technology hosted me for an academic year,and Loren Graham offered his friendly support over a much longer period. The Maison des Sciences de l’Homme in Paris generously awarded me a fellowship and provided a setting in which Serge Netchine and Gabrielle Netchine-Grynberg introduced me to the French language, culture, and scholarship.Thanks to the support of Régine Plas and the Université Paris V (René Descartes), I was able to return to Parisian libraries and archives at the concluding stage of...

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