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Banning the Soviet Lobotomy:
Psychiatry, Ethics, and Professional Politics during Late Stalinism

This article examines how lobotomy came to be banned in the Soviet Union in 1950. The author finds that Soviet psychiatrists viewed lobotomy as a treatment of “last resort,” and justified its use on the grounds that it helped make patients more manageable in hospitals and allowed some to return to work. Lobotomy was challenged by psychiatrists who saw mental illness as a “whole body” process and believed that injuries caused by lobotomy were therefore more significant than changes to behavior. Between 1947 and 1949, these theoretical and ethical debates within Soviet psychiatry became politicized. Psychiatrists competing for institutional control attacked their rivals’ ideas using slogans drawn from Communist Party ideological campaigns. Party authorities intervened in psychiatry in 1949 and 1950, persecuting Jewish psychiatrists and demanding adherence to Ivan Pavlov’s theories. Psychiatrists’ existing conflict over lobotomy was adopted as part of the party’s own campaign against harmful Western influence in Soviet society.


psychiatry, lobotomy, psychosurgery, Soviet Union, Pavlov, medical ethics

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On December 9, 1950, the Soviet Minister of Health signed a decree banning lobotomy in the Soviet Union. According to the decree, the radical psychiatric treatment did not meet the standards of Soviet medical practice because it was “theoretically unjustified” and “contradicts the fundamental principles of I. P. Pavlov’s physiological theory.”1 In 1950 the Soviet Union was virtually alone in banning lobotomy. This was the heyday of lobotomy in the United States, Great Britain, and Scandinavia; lobotomy inventor Egaz Moniz had just been awarded the Noble Prize in Physiology or Medicine.2 Why then was lobotomy banned in the Soviet Union? This article explores how Soviet authorities came to the conclusion that lobotomy ought to be banned. It asks what this can tell us about mid-twentieth-century medical ethics and the evaluation of psychiatric therapies. And it seeks to understand what the ban on lobotomy can tell us about the way psychiatry functioned as a profession in the context of Late Stalinism.

Prefrontal leucotomy was first reported in 1936 by Portuguese psychiatrist Egaz Moniz.3 In the operation, Moniz and his assistant severed some of the fibers that connected the prefrontal cortex to the frontal lobes. Moniz reported remarkable results in his first twenty patients: 70 percent (fourteen cases) were either “healed” or “improved”; the rest were unchanged but not worse off.4 Moniz postulated that the operation worked because his patients’ pathological thoughts had become “fixed” in the frontal lobes, and therefore “effective therapy … required the destruction of these abnormally ‘stabilized’ pathways.”5 In 1937 and 1938 Moniz’s technique was adopted by American psychiatrist Walter Freeman and his collaborator, neurologist James Watts. Freeman and Watts went on to modify Moniz’s technique and adopted the term “lobotomy.” (Soviet psychiatrists used both terms.) By the mid-1940s Freeman and Watts’s [End Page 34] operation had become a tool in the therapeutic arsenal of psychiatrists around the world.6 It began to fall out of use only after the 1954 introduction of the antipsychotic drug chlorpromazine, though some surgeries continued into the 1960s.7

History has judged lobotomy and its practitioners harshly. In popular culture it is indelibly associated with such icons as Ken Kesey’s 1962 novel One Flew Over the Cuckoo’s Nest, the sensational case of Rosemary Kennedy, and the Ramones’ 1977 punk anthem “Teenage Lobotomy.”8 Most historians who have written about it treat lobotomy as a cautionary tale about how medical ethics and standards of scientific objectivity were abandoned because of individual careerism and the failure of institutional safeguards.9 This view was complicated in the 1990s by historians Jack Pressman and Joel Braslow, both of whom sought to understand lobotomy in historical context. Most psychiatrists, they argue, genuinely believed that lobotomy worked. Braslow’s study focuses narrowly on the clinical records of California psychiatric hospitals. He shows that working psychiatrists interpreted disruptive patient behavior as a sign of active disease, and came to see calm behavior as a sign of recovery. Lobotomy “worked,” psychiatrists thought, because it demonstrably calmed their patients.10 Pressman’s study places lobotomy in the broader context of the professionalization of American psychiatry. It helped psychiatrists make the case that psychiatry was a legitimate branch of scientific medicine, a specialty that used laboratories and hospital wards, and that could claim to have treatments based on a precise neuroscientific understanding of the brain.11 The results of the operations themselves could be construed as medical progress, Pressman argues, because the dominant psychiatric paradigm of the era conceptualized mental illness as “maladjustment.” If lobotomy helped patients reengage with social life or go back to work, then it was “effective.”12 [End Page 35]

Historians who have studied the history of lobotomy in European contexts have suggested that the scientific orientation of each nation’s psychiatrists determined whether or not lobotomy would be embraced. Greek psychiatrists, for instance, were immersed in psychoanalysis and the psychological traditions of French psychiatry, and they were very hesitant to use lobotomy; Italian psychiatrists, who were more closely allied with neurology, embraced lobotomy almost immediately.13 The Soviet Union does not seem to fit this model. Soviet psychiatry was closely allied with neurology, and virtually all Soviet psychiatrists, including lobotomy’s opponents, were adamant in their belief that mental illness was caused by pathologies of the body. They tended to view psychological theories of mental illness with suspicion, and psychoanalysis itself had been banned in the 1930s.14 Why then did some Soviet psychiatrists oppose lobotomy? And, more important, how were they able to get lobotomy banned?

The Soviet medical system was highly centralized, with a national (“All-Union”) Ministry of Health overseeing a vast network of hospitals and clinics. Based in Moscow, the ministry was responsible for funding and staffing treatment institutions, building new hospitals, and setting standards for treatment and care. At its senior levels, the world of Soviet medicine was small, competitive, and often highly personal. Much of the research and planning for the Ministry of Health was done in elite medical research institutes and university clinics, and the directors and professors who helmed these institutions also sat on the ministerial committees that approved new methods of treatment like lobotomy.15 Funding for medicine and research was in short supply, and thus the researchers who controlled these key positions were able to advance not only their own ideas and careers, but those of their students and subordinates as well. It was a recipe for informal networks based on patronage and clientelism, and it produced intense professional rivalry between elite scientists and their supporters.16 [End Page 36]

The early years of the Cold War were a particularly difficult time for professionals of any kind in the Soviet Union. During this period, as historian Nikolai Krementsov has shown, the Communist Party redefined “patriotism” in Soviet science, “stripping away its wartime internationalist dimensions and restoring the isolationist nationalism of the 1930s.”17 The party organized a series of high-profile “discussions” in which scientists were invited to discuss problems in their discipline and to criticize ideas that were deemed un-Soviet. They began with a discussion in philosophy in 1946, then moved on to biology, physiology, linguistics, and others over the course of 1947 to 1952.18 The most widely known example is the 1948 discussion in genetics, the so-called Lysenko Affair. In that case, Joseph Stalin personally intervened to support Trofim Lysenko’s neo-Lamarckian belief in acquired traits.19 Other discussions did not necessarily follow the same trajectory, however. In some cases, as in mathematics, scientists were able to effectively deploy the rhetoric of patriotic science to defend their discipline. In others, like physics, they were able to invoke their importance to national defense to defend themselves. But in many disciplines, including psychiatry, the ideological pressures of the era transformed existing professional rivalries into bitter conflicts, as scientists with competing research programs accused one another not only of scientific mistakes but also of ideological deviations, lack of patriotism, and ethical corruption.20

In contrast to psychiatry in the United States or Western Europe, Soviet psychiatry remains little studied by historians.21 When it has been studied, the focus has almost always been on Soviet psychiatry’s role in repressing political dissidents,22 or on Stalinist repression of psychiatrists themselves, [End Page 37] especially psychoanalysts.23 In post-Soviet Russia, the ban on lobotomy itself has been portrayed as an instance of Stalinist repression.24 In this article, I seek to understand Soviet psychiatrists on their own terms, not simply as Communist Party members or as victims of Stalinist terror, but as Soviet professionals who sought to advance their own scientific, institutional, and personal goals within the tense and treacherous context of the late 1940s. I argue that the party’s ideological and anti-Semitic intervention in psychiatry took place with the active participation of psychiatrists themselves, and that in order to understand the ban we must understand the social and institutional dynamics of Soviet psychiatry.25

Lobotomy Comes to the Soviet Union

Reports about leucotomy and lobotomy began to appear in Soviet journals in 1936 and 1937,26 followed in 1939 by longer reviews of Freeman and Watts’s early publications. Soviet reviewers were disturbed by the serious complications and high rate of mortality (5 percent) that Freeman and Watts reported, and they questioned lobotomy’s effectiveness, noting that the symptoms it eliminated, such as fear, depression, and agitation, often went away on their own. They concluded that these were “insurmountable obstacles” to recommending lobotomy for use in the Soviet Union. No lobotomies were attempted in the Soviet Union prior to 1944.27

In the second half of the 1930s, however, Soviet psychiatrists were increasingly interested in psychiatric treatments that targeted patients’ bodies. This reflected an important shift in the internal dynamics of Soviet psychiatry as a discipline, which affected how the Soviets responded to new transnational developments. In the 1920s and early 1930s, Soviet psychiatrists had claimed that under socialism, psychiatry would provide expert [End Page 38] guidance at all levels of society, helping schools, factories, government offices, and others to protect the mental health of citizens through such practices as avoiding overwork, improving sleep, and reducing alcohol consumption.28 Joseph Stalin’s “revolution from above” in the 1930s had cast this whole approach into doubt. Rapid industrialization took precedence over all else, and the utopian goals of psychiatrists and other social hygienists ran up against the goals of factory managers and party bosses. Medicine as a whole was reoriented toward industrial workplaces, and psychiatrists were rebuked for interfering with the pace of production.29 Henceforth psychiatry in the Soviet Union would be a field of medicine that was narrowly focused on major mental disorders, not on problems of everyday life.30

It was in this period of transition in the mid-1930s that Soviet psychiatrists began to experiment with radical new psychiatric treatments that were being invented in Europe. Insulin therapy and Cardiazol (Metrazol) shock were tested in Moscow in 1936 and 1937, and they were added to methods already in use, such as malaria therapy.31 Collectively, these methods were referred to as “active therapy,” and the use of “active therapy” became synonymous with modern, scientific psychiatry. By the late 1930s psychiatric hospitals throughout the Soviet Union were using the number of “active treatments” they had done as proof that they were modernizing their institutions. In their public speeches and articles, psychiatrists frequently contrasted their new, treatment-oriented psychiatry with the “therapeutic nihilism” of the recent past, a time when (they claimed) patients had simply been housed in asylums and given palliative care.32 A Moscow psychiatrist succinctly summarized the new orientation at a 1938 conference. “Active therapy of psychoses,” he said, “is a new path, one that raises the level of psychiatry, brings it closer to other medical disciplines.”33 [End Page 39]

The German invasion of the Soviet Union brought “active therapy” to a standstill, as all available resources were directed to supporting the front. Innovations in treatment continued, however, particularly in the field of neurosurgery. Brain injuries were a particular concern, and many of the Soviet Union’s neurologists and psychologists were enlisted to help treat evacuated soldiers. The Soviet government created a special commission to ensure that medical specialists were brought together to aid wounded soldiers, and a special psychiatric ward was created in Moscow to treat “brain injuries and non-skull wounds accompanied by psychiatric disorders.”34 The first lobotomy was performed on this ward at the Gannushkin Psychiatric Hospital sometime late in 1944 or early in 1945.35

The psychiatrist who oversaw this early research on lobotomy in Moscow was Dr. Aleksandr Shmar’ian, the “head psychiatrist” for the Soviet Commissariat of Public Health and deputy director of Moscow’s most prestigious psychiatric research institute. Shmar’ian had risen to prominence in the early 1930s as a fiery young man at the Communist Academy, and in 1936–37 he had taken an active role in fighting to replace social psychiatry with the new physiological approach. In 1942, Shmar’ian was put in charge of organizing psychiatric care for wounded soldiers who were evacuated from the front to civilian hospitals, and by the war’s end in 1945 he had accumulated a series of other important posts within the Soviet health administration and the discipline of psychiatry.36

Shmar’ian had been interested in the intersection of psychiatry and neurosurgery even before the war, and he advocated using the newest advances in neurosurgery to correlate psychiatric illness with specific structures and lesions in the brain.37 In the 1940s, he used his influential new positions to turn this into a major research program, and he spoke frequently about how psychiatry needed to change. He dismissed the old tradition of clinical nosology, in which psychiatrists identified diseases [End Page 40] through careful study of patterns in the development of the signs and symptoms of mental disease.38 This “phenomenological and symptomo-logical approach,” he argued, was no longer enough. Soviet psychiatry needed to study the underlying physiological causes of mental illness, and to do this they needed to “make use of modern achievements in general [pathology] and brain pathology.”39 He articulated these ideas in a series of articles and conference papers through the 1940s,40 culminating in the 1949 publication of what was to prove his only book, Brain Pathology and Psychiatry: Tumors of the Brain and the Theory of Localization of Mental Disorders, Volume One.41

Shmar’ian used his position with the Soviet Ministry of Health to make lobotomy an official part of the medical research portion of the Soviet Union’s Fourth Five-Year Plan (1946–50), and he organized a surgery ward at his research institute.42 Lobotomy held deep appeal for Shmar’ian. Other methods of psychiatric treatment had vague, nonspecific effects on the body. Some, like Cardiazol, induced seizures; insulin therapy put the body into a medically induced coma; prolonged narcosis caused a drug-induced sleep. In all these treatments it was the body as a whole that responded to the treatment, and it was impossible to identify a single part of the body that was responsible for curing (or causing) the symptoms of the disease. Lobotomy, though, unambiguously targeted the brain, and particular parts of the brain at that, and physicians who used it came to conceptualize mental illness as a specifically brain-based disease.43 Shmar’ian was among them. In his research plan for 1945, he described lobotomy not only as therapeutically effective, but also as having [End Page 41] “significance as a method of experimentally studying the pathophysiology of the human brain.”44

At least eighteen research institutes and university clinics performed lobotomies in the Soviet Union between 1945 and 1949.45 The lobotomies were performed by neurosurgeons who worked as consultants to psychiatrists, and the literature of the time describes two main approaches to the surgery. Leningrad neurosurgeons advocated a “closed” method of operation, in which holes were drilled in the skull through which the surgeon inserted the “leucotome,” a metal implement used to sever connections in the frontal lobes.46 Moscow neurosurgeons insisted on using an “open” method instead, actually removing a small piece of skull in order to see which fibers were being cut.47 No Soviet neurosurgeons reported using the transorbital (“icepick”) technique popularized in the United States, which involved entering through the orbit of the eye. The precise number of operations carried out in the Soviet Union is unclear, as neither published papers nor archival documents provide exact figures, but a rough estimate based on available documentation suggests a figure of between 500 and 600 operations.48 At least 100 lobotomies were done by Shmar’ian’s institute in Moscow,49 155 at the Bekhterev Psychoneurological Institute in Leningrad,50 74 at Moscow’s Kashchenko psychiatric hospital,51 and 40 at the Gor’kii Medical Institute.52 Other institutions throughout the country performed small numbers of lobotomies as well.53 [End Page 42]

Soviet proponents of lobotomy argued that its value lay in enabling chronic patients to leave overcrowded psychiatric hospitals. This was no small thing. The Soviet Union, like many other countries in this period, had a large network of asylums, nearly all of them overcrowded and desperately underfunded. In the late 1940s there were about 150 of these in the Soviet Union, with a combined total of 50,000 to 60,000 beds (the number fluctuated). Often there were more patients than beds, and patients sometimes had to sleep two to a bed, or on mattresses on the floor.54 Patients with severe schizophrenia often remained in these hospitals for years, even decades. “The great majority [of patients given lobotomy] had had no remission in the course of 5–7 years,” one psychiatrist wrote, “and spent long years behind the walls of psychiatric institutions for chronics, most often in the wards for agitated patients, despite many different methods of active therapy.”55 Psychiatrists saw this as both an administrative problem and an affront to their therapeutic abilities. Shmar’ian himself made the case for lobotomy as a treatment of last resort, asking rhetorically: “If leucotomy can help even ten percent of such patients return to life, return them to labor—isn’t that humane?”56

Patients on the agitated wards of psychiatric hospitals were unable to engage in even the most elementary forms of work. In the eyes of at least some Soviet psychiatrists, this disengagement with work was synonymous with a disengagement with life itself. “Among our patients,” Shmar’ian’s surgical assistant said, “were some who were animals, not people: these were finished people (konchennye liudi), all the psychiatrists said that nothing could help them. And now a few of those patients are, first of all, working, and second, they are living, helping their families, making money. They are people in the true sense of that word.”57 Even limited results were seen as justifying the risk, as can be seen in a letter written to Shmar’ian by the mother of one of his patients “She lives at home,” the mother wrote. “She does housework, sews, works in the garden. . . . She worked at a workers’ collective (artel’) for invalids for three months as a gluer and made about 300 rubles per month. . . . Of course, she is a sick [End Page 43] person, the operation has not made her altogether well, but partially and significantly there was improvement.”58

The belief in the healing power of work was deeply rooted in the Western psychiatric tradition going back to the “moral treatment” practiced by William Tuke at the York Retreat in the 1790s, but in the Soviet Union it was also encouraged and transformed by Soviet ideology.59 Karl Marx had written of labor as an activity that led to the “enrichment of human nature,” and early Soviet culture was permeated by the idea that labor could transform Russia’s peasant population into disciplined, self-conscious proletarians.60 “Labor therapy” was developed by Soviet psychiatrists as an integral part of their system of treatment, particularly in neuropsychiatric dispensaries.61 “Labor therapy,” a standard textbook explained in 1946, “. . . makes it possible for the patient to retain and strengthen his faculties and to not lose connection with the external world. . . . The work should have some purpose, the patient should feel the usefulness of his labor, only then is it possible to employ that which is ‘healthy’ in him and to suppress (podavit’) that which is ‘ill.’”62 Meaningful labor, in short, was essential to producing mental health in the Soviet citizen.63

Just how lobotomy worked at a physiological level was not certain, but proponents were unified in believing that severing the white matter in a patient’s brain somehow triggered psychological recovery. Shmar’ian speculated that lobotomy worked by stopping a degenerative process that [End Page 44] was causing the patient to steadily become more debilitated. The patient was left with damage from the surgery, but it saved the patient from a fate that otherwise would have been worse.64 Psychologist Bliuma Zeigarnik believed that lobotomy helped in cases where patients’ brains were for some reason overwhelmed by a “kaleidoscope” of perceptions that prevented them from producing an integrated view of reality. In a study of fifty-eight patients who had suffered from long bouts with schizophrenia, Zeigarnik found that “even in the early post-operative stage, the ability of the patient to interact with the external world was striking.” Lobotomy enabled the patient to reintegrate perception, she argued, creating a view of reality that could “begin to formally coincide with ours.” The treatment thus created “the possibility for including the patient in life.”65

Vasilii Giliarovskii and the Soviet Opposition to Lobotomy

The man who emerged as the most outspoken critic of lobotomy in the Soviet Union was psychiatrist Vasilii Giliarovskii. Born in 1875, Giliarovskii enjoyed a high degree of respect from other psychiatrists. He had studied under some of the founding fathers of Russian psychiatry and had himself taught for many years at Moscow’s Second Medical Institute. He was also the author of the standard textbook that Soviet physicians used to study psychiatry in the 1920s and 1930s.66 In 1944 his psychiatric research clinic in Moscow was selected to become a fully fledged institute under the newly created Soviet Academy of Medical Sciences, elevating Giliarovskii to a position of preeminence in the discipline.67 He used this position to promote his own theoretical paradigm for Soviet psychiatry, an approach he called “somatopsychiatry,” which he promoted as a Soviet answer to Western psychosomatic medicine.68 Giliarovskii’s “somatopsychiatry” was strongly influenced by research done in the 1920s and 1930s about the ways in which the autonomic nervous system maintained the [End Page 45] body in a state of equilibrium with its environment. Research done on the “fight-or-flight” response by Harvard physiologist Walter Cannon was particularly important in this, as was research done by Soviet physiologists on related topics.69 For Giliarovskii, the fundamental insight was that mental illness could be caused by processes going on in the whole body, not just in the brain.70

Giliarovskii used these ideas to question the “active treatments” that had defined Soviet psychiatry since the 1930s. In 1946 he spoke out against the use of shock therapy, calling it “inappropriate for Soviet conditions” except in cases of “serious schizophrenics,”71 and as an alternative he promoted a new type of sleep therapy that he called “electrosleep.” Giliarovskii’s method used a mild, rhythmic electric current that allegedly produced something closer to “physiological sleep” than the standard method of prolonged sleep therapy, which used barbiturates.72 At a 1947 meeting Giliarovskii emphasized that his method had been invented in the Soviet Union, not imported from the West, and implied that it was both technically and morally superior: “a method of treatment that is in principle Soviet, one that is Soviet in principle of humaneness (sovetskii po prinsipu gumannosti).”73

Giliarovskii’s emphasis on Soviet values was significant. In 1946 the Communist Party had begun its campaign against “servility to the West,” and this campaign put pressure on psychiatrists to justify their use of “active therapies” in patriotic terms. The campaign, referred to as the zhdanovshchina after Andrei Zhdanov, the party official most associated with it, put pressure on Soviet elites to demonstrably critique their own disciplines in order to show their pride in the unique national and socialist culture of the Soviet Union.74 Giliarovskii’s emphasis on a novel form of sleep therapy fit well with the climate of the zhdanovshchina. Sleep therapy had been studied in the 1930s by the Soviet Union’s most renowned physiologist, Nobel Prize winner Ivan Pavlov,75 and in 1936 in the newspaper [End Page 46] Izvestiia Pavlov had been quoted as saying that he and his colleagues were “stunned by their positive results” and that he believed prolonged sleep would become “a universal method of treating schizophrenia.”76 Sleep therapy thus acquired a reputation as a “Pavlovian” method of psychiatric treatment, capitalizing on the reputation of Pavlov’s physiological research. For psychiatrists like Giliarovskii, invoking Pavlov became a key rhetorical move meant to show that their ideas were free from the taint of Western bourgeois idealism.

Pavlov’s theories are important to the history of Soviet psychiatry in the 1940s and 1950s, and thus worth examining at some length. Around 1904, Pavlov had found that his laboratory dogs could be trained to salivate at the sound of a buzzer. He hypothesized that this was the result of a “conditional reflex” that formed in the brain. (As Pavlov’s biographer Daniel Todes points out, the term “conditioned reflex” was introduced in English translations of Pavlov’s work. Pavlov himself always used the Russian phrase “conditional reflex.”)77 Pavlov believed that such reflexes developed, and were later modified or extinguished, according to immutable physiological laws, and he made it his life’s work to discover those laws. While physiologists in the West like Charles Sherrington and Santiago Ramon y Cajal were researching neurons and the transmission of signals across synapses, Pavlov was painstakingly establishing conditional reflexes in dogs, then studying how those reflexes were attenuated over time, how one interfered with another, and so forth. He developed a model in which conditional reflexes were created and destroyed by two basic processes, excitation and inhibition. Stimuli from the outside world could induce them, and they then spread in “waves,” interacting with each other, “ending normally in a certain equilibrium between them, in a certain balance.”78 Complex behaviors developed over time as many different “centers” of excitation and inhibition became associated with one another. Pavlov referred to this type of formation as a “dynamic stereotype,” a constellation of “centers” on the “grandiose mosaic” of the brain.79

In the late 1920s, Pavlov had found that he could experimentally induce neuroses in dogs by subjecting them to extremes of “excitation” and “inhibition.” He reasoned by analogy that schizophrenia in humans was a “chronic hypnotic state that resulted when a cortex weakened either by heredity or experience was subjected to an ‘overwhelming [End Page 47] excitation.’”80 He established a small psychiatry clinic in his research institute, and hired a psychiatrist named Anatolii Ivanov-Smolenskii to run it. Their working hypothesis was that the symptoms of schizophrenia developed when brain cells tried to defend themselves from a harmful toxin, probably coming from the body itself. This “protective inhibition” helped the nervous system protect itself from damage, suggesting that, at least in the short term, patients could theoretically recover.81 They began to study prolonged sleep therapy in 1935, and Pavlov was optimistic that it might strengthen protective inhibition. He tasked Ivanov-Smolenskii with carrying out tests on patients, and it was these results that were publicized.82

In the atmosphere of the zhdanovshchina in the 1940s, psychiatrists like Giliarovskii began to take pains to show that their work could be justified in Pavlovian terms. In his 1947 presentation on electrosleep, Giliarovskii noted pointedly that Pavlov himself had theorized that “during sleep, inhibitory moments develop in the nervous system,” and that therefore “prolonged sleep should be used particularly during schizophrenia in so far as it can cause the brain to return to a normal state.”83 By hewing closely to Pavlov’s theory, psychiatrists could demonstrate their ideological acumen and their Soviet patriotism.

Professional Politics and the 1950 “Pavlov Session”

Psychiatry’s internal professional politics were further complicated in 1947 when Anatolii Ivanov-Smolenskii, the psychiatrist hired by Pavlov to run his lab, began to challenge the Pavlovian purity of both Giliarovskii and Shmar’ian.84 In 1946 Ivanov-Smolenskii had been at a low point his career. His publications rarely appeared in print, and were not published at all in the Neuropathology and Psychiatry, the main professional journal of the discipline. Ivanov-Smolenskii personally blamed Giliarovskii for his problems. While Giliarovskii now styled himself as a Pavlovian, in the 1930s he, like most Soviet psychiatrists, had been much more openly skeptical. In a 1936 article, for instance, Giliarovskii had praised Pavlov’s careful laboratory [End Page 48] science and urged psychiatrists to adopt similarly demanding techniques in their own work, but at the same time he had advised them to develop their own theories rather than slavishly accepting Pavlov’s.85 Giliarovskii had been particularly critical of Ivanov-Smolenskii’s work, especially his attempt to establish conditional reflexes in human subjects using flashes of light combined with words. (“Conditional reflex hair splitting,” Giliarovskii had called it.)86 After Pavlov’s death in 1936, Giliarovskii and several other senior psychiatrists had attacked Ivanov-Smolenskii’s work as poorly designed and unscientific. Ivanov-Smolenskii had appealed for support to physiologists in senior positions within the Communist Party, but, to his chagrin, they had supported Giliarovskii instead. As a result, Ivanov-Smolenskii’s psychiatry clinic was closed, leaving him without a base of operations.87 He never forgave Giliarovskii, or the people who supported Giliarovskii. After the war, Ivanov-Smolenskii did manage to obtain a new research position as the head of the Moscow branch of the Institute of Evolutionary Physiology, but he remained an outsider.88 This attitude toward him was confirmed as late as 1946, when a committee of experts at the Soviet Ministry of Health voted to deny him the rank of “Honored Scientist.”89

A scandal at the Academy of Medical Sciences in 1946–47 changed Ivanov-Smolenskii’s fortunes and threatened the position of elite psychiatrists like Giliarovskii and Shmar’ian. The so-called KR Affair began when two cancer researchers at the academy were found to have shared promising results with American officials. The Kremlin became directly involved, the Minister of Health and the president of the Academy of Medical Sciences were fired, and the cancer researchers were sent before a “Court of Honor” to answer for their unfaithfulness to the motherland.90 In April 1947, the new Minister of Health ordered a review of all Academy [End Page 49] of Medical Sciences research institutes, bringing both Giliarovskii and Ivanov-Smolenskii to his attention.91

Inspectors found significant problems at Giliarovskii’s institute. They cited him for shabby equipment and an inadequate building and for engaging in research that was more applied than fundamental.92 Worse, however, their report concluded that psychiatry as a discipline did not contribute to medical science in a fundamental way, since psychiatrists simply applied discoveries that had been developed by others. Ivanov-Smolenskii, in contrast, was praised for his fundamental research on the pathophysiology of higher nervous activity. The president of the academy concluded that removing Giliarovskii’s institute from the academy would be no great loss. “The study of higher nervous activity from a physiological point of view is very widely represented [in the academy],” he said. “… we even have the clinical base of the Institute of Higher Nervous Activity in the form of Ivanov-Smolenskii’s department. It follows that psychiatry, modern physiological psychiatry, is represented very solidly in the academy.”93 Ivanov-Smolenskii’s Pavlovian research had gained official support.

Giliarovskii rallied support. Two months later, in December 1947, he chaired a conference where psychiatrists and physiologists spoke out against the idea that psychiatry was not a fundamental part of medical science. The rhetoric at the conference drew much more heavily on ideological language than had been heard in Soviet psychiatry since the 1930s. Ivanov-Smolenskii’s name was unspoken, but all present would have recognized him as the target. A leading psychiatrist, for instance, spoke about unnamed “immoderate adepts of Pavlov’s doctrine” whose “lack of understanding of the regularities of the human psyche” had led them to announce “the creation of an apsychological clinic.” These unnamed “adepts” were not only mistaken in their scientific methodology and their theoretical claims, but also guilty of a “curious deviation” that had “compromised this young theory.”94 “Higher nervous activity and psychological activity,” the conference resolution declared, “are not one and the same. In accordance with this, [the sciences of] physiology of the nervous system and psychiatry are two separate sciences which have their own specifics; they cannot replace one-another.”95 By injecting this ideological rhetoric [End Page 50] into professional debates, the psychiatrists around Giliarovskii put Ivanov-Smolenskii in a position where he would have to defend himself in similar terms. They also alerted political authorities that something was seriously amiss in their discipline, thus inviting intervention.

Ivanov-Smolenskii responded with a review of Giliarovskii’s most recent monograph, accusing him of bad science and a lack of Soviet patriotism. Giliarovskii’s book was full of “mistaken conclusions, incorrect interpretation, and, at times, direct perversion (izvrashcheniiu) of I. P. Pavlov’s pathophysiological conceptions.” Giliarovskii’s “extremely superficial acquaintance with this [Pavlov’s] doctrine” could serve only to “disorient the reader.” Furthermore, Giliarovskii had failed to cite “the fairly broad national literature on the question of the application of I. P. Pavlov’s theories in the psychiatric clinic,” citing instead American and “foreign” authors. Without commentary, Ivanov-Smolenskii listed three names: “Love, Futterman, Goldstein.” He left it to his reader to make the obvious inference that these foreign authors were not only American but Jewish.96

To maintain his status within the profession, Giliarovskii now needed to demonstrate his ideological and scientific bona fides and to show that he was a true Soviet patriot. He did this by portraying lobotomy as the epitome of the inhumane and idealist science of the West, and casting himself as the true crusader against it. Giliarovskii began to publicly attack lobotomy at the Third All-Union Congress of Neuropathologists and Psychiatrists, an important event that was held in May 1948 and where Giliarovskii served as chairman. In an open session he urged caution about lobotomy. “I am not drawing conclusions,” he said, “simply stating my own opinion that this method should be seen as experimental, a method that gives [researchers] a great deal of data about general psychopathology. As a method of therapy it requires great care.”97 Lumping lobotomy together with electroshock, he suggested that both were alien to Soviet values. “One should not forget,” he said, “that the birthplace of this method is America, a bourgeois country where the requirements of treatment are entirely different. In capitalist countries, where there are millions of unemployed, it doesn’t matter if a patient leaves the hospital with a bit of a deficit.”98 Psychiatrist Mark Sereiskii responded to Giliarovskii with a defense of active treatment: “Soviet humanism in medicine consists, not in avoiding the possibility . . . of complications,” he said, “not in sitting with hands folded observing the destruction of the organism under the [End Page 51] influence of the further development of the pathological process, but in using all measures that we have in order to give help today, not waiting for future discoveries.”99 The delegates to the congress agreed that the use of lobotomy should be discussed by a special plenum of their professional organization. This meeting was scheduled for February 1949.100

To Giliarovskii’s dismay, the psychiatrists who gathered at this February 1949 plenum decided not to ban lobotomy. Advocates of lobotomy who spoke at the meeting acknowledged that they did not understand the physiological mechanism that made lobotomy work, but they cast this as a positive: studying the results of lobotomy would help them explain the “pathological anatomy and pathophysiology” of the frontal lobes.101 Leon Orbeli, the physiologist who had succeeded Pavlov and directed his research empire, was in attendance at this meeting, and spoke positively about lobotomy. “The effect that is achieved in this operation is great enough,” he said, “that [the operation] may be considered not only permissible, but entirely indicated in certain cases of mental disease.”102 The meeting’s resolution noted that lobotomy could plausibly be seen as a Russian national invention, since psychosurgery had been experimented with in prerevolutionary St. Petersburg by Vladimir Bekhterev and his assistant, Ludwig Puusepp. Lobotomy was thus not an example of bowing before Western science.103 The resolution went on to declare lobotomy “a relatively effective and comparatively safe method of treatment for several serious forms of schizophrenia,” a “justified and humane attempt . . . to relieve and return to life and labor these permanent residents of psychiatric hospitals.” It called on the Soviet Ministry of Health to develop a list of institutions where the operation could be done and a list of specialists who would be allowed to do it.104

Even as the psychiatrists met to discuss lobotomy, however, the political landscape of Soviet science was continuing to shift rapidly. Unknown to psychiatrists, Orbeli had lost the favor of Stalin, and the Central Committee [End Page 52] of the Communist Party was making plans to remove him from positions of influence. At the same time, the party was putting its full support behind a new campaign against “rootless cosmopolitanism,” a thinly veiled attack on Jewish members of the Soviet elite.105 In the summer of 1949 an anonymous denunciation was sent to the Communist Party alleging that Jews held a “disturbing monopoly” in psychiatry, and the party launched an investigation.106 The archival files preserved from this investigation include personnel lists from psychiatric research institutes; check marks have been placed carefully next to each Jewish name.107 A Central Committee memorandum called for those who were “inactive or without prospects” to be replaced with “capable, well-prepared youths,” a euphemism for young, loyal, ethnically Russian Communists.108 One of their main targets was Aleksandr Shmar’ian, who was Jewish. He was removed from his post as head psychiatrist in 1949, and it was clear that his future had become extremely precarious.109

It was during this period that Giliarovskii escalated his calls for a ban on lobotomy. In November 1949 he made a private presentation to the Soviet Ministry of Health attacking the decision that allowed lobotomy to continue.110 The Ministry of Health agreed to an investigation of the use of lobotomy, and asked Giliarovskii to carry it out.111 In the spring of 1950 Giliarovskii and his staff studied 176 patients who had been given lobotomies in Moscow, Leningrad, and Gor’kii. They concluded that only 8 of these had “more or less good outcomes,” while the rest suffered from serious neurological injuries. Neurological tests found signs of damage to the central nervous system, including injury to “subcortical ganglions, primary motor cortex, and the pyramidal tracts.”112 Psychological testing found that patients suffered from severe memory loss.113 [End Page 53]

Giliarovskii presented these findings to the All-Union Society of Neuropathologists and Psychiatrists in May 1950, and they were discussed by the Directorate on June 23–24. Giliarovskii asserted that the All-Union Society should reconsider its decision to permit lobotomy. He particularly criticized the “administrative” reasoning he found being used to justify lobotomy, in which “the patients are made ‘passive,’ that is, agitated patients become calm and don’t require special observation or any particular chores.” Such a result might benefit the hospital staff, he said, but not the patients themselves.114 His audience was unpersuaded. Their decision, approved twenty-eight to two, stated that lobotomy would continue to be recognized as a useful and justified method.115

While Giliarovskii spent late 1949 and early 1950 positioning himself as the foremost opponent of lobotomy, Ivanov-Smolenskii was promoting himself as the only truly Pavlovian psychiatrist. He met privately in 1949 with the new party science chief, Stalin’s son-in-law Iurii Zhdanov (son of Andrei Zhdanov), and they discussed what Ivanov-Smolenskii saw as major problems in the way that other physiologists were handling Pavlov’s legacy.116 Zhdanov had become convinced that Pavlov’s scientific legacy was not being properly developed by physiologists, and that Pavlov’s successor, Leon Orbeli, had concentrated too much institutional power in his own hands. Ivanov-Smolenskii confirmed these views for him. In September 1949 Zhdanov sent Stalin a long report titled “On the Development of Academic Pavlov’s Doctrine,” arguing that physiologists were ignoring, perverting, or outright attacking Pavlov’s theory of “higher nervous activity.” He proposed “to smash (raznesti) the enemies of Pavlov” and thus enable Soviet scientists to “connect scientific work more closely with medical practice, beginning with the psycho-neurological clinic.”117

The result was a watershed moment in Soviet medicine, the so-called Pavlov Session, a joint meeting of the Soviet Academy of Sciences and the Academy of Medical Sciences held in Moscow in June 1950 that brought together more than a thousand participants.118 Two keynote speeches were given. The first, which primarily attacked Leon Orbeli, was directed at physiologists.119 The second was given by Ivanov-Smolenskii [End Page 54] and extended the criticism to psychiatrists. Ivanov-Smolenskii depicted Soviet psychiatry as a discipline that had been hijacked by followers of Western, anti-Pavlovian psychiatrists. “One cannot remember without sorrow,” Ivanov-Smolenskii said, “that for a long time and even quite recently all attempts to apply Pavlovian theory to the tasks of psychiatry were unfailingly met ‘in arms.’”120 Shmar’ian was the worst, an opponent of Pavlov (and Ivanov-Smolenskii), who was “propagandizing the ideas of so-called ‘brain pathology.’”121 Giliarovskii was little better: his work showed only “declarative acknowledgment of Pavlov’s theory” and demonstrated “a failure to master even basic physiology and pathophysiology of higher nervous activity.”122 Ivanov-Smolenskii included the issue of lobotomy in his speech, describing how one of Pavlov’s researchers had done lobotomy-like experiments on dogs. He was vague about the results, but implied that the surgery disrupted “higher nervous activity,” and thus required “extreme care.” “These experiments,” he said, “are of particular interest because in recent years, in particular in America, but also in a few Soviet psychiatric institutions, attempts have been made to use lobotomy to treat certain psychoses.” He did not call for an outright ban, a fact that suggests that, at least in June 1950, the fate of the Soviet lobotomy had not yet been resolved by either the party or the Ministry of Health.123

Giliarovskii addressed the Pavlov Session on the fourth day. He accepted the validity of Ivanov-Smolenskii’s criticisms, admitted that Pavlov’s theories should guide psychiatrists, and abandoned his claim that psychiatry might be able to produce its own body of theory.124 He then turned to the evils of lobotomy, which he described as “a crude operation that causes great damage.” He invoked Pavlov’s theory that in schizophrenia protective inhibition was saving the brain from a “whole body illness,” and criticized Shmar’ian for claiming that it could be cured simply through “local changes in the system of fibers.” Giliarovskii went further than Ivanov-Smolenskii and called on the Soviet government to ban lobotomy.125 [End Page 55]

Banning the Soviet Lobotomy

In the aftermath of the 1950 Pavlov Session, the conflict over lobotomy became a public campaign. A condensed version of Giliarovskii’s speech appeared in Pravda the next week,126 and the findings of his lobotomy investigation were published in the widely circulated newspaper Meditsinskii rabotnik (the Medical Worker) in September. This article included a list of the psychiatrists who had performed lobotomies, and singled out Shmar’ian.127 The editors of the Medical Worker followed up on Giliarovskii’s article by sending a query to the Minister of Health asking him to report on any measures being taken to rectify the situation.128 The minister began to collect a file of documents relating to the various discussions of lobotomy that had taken place in 1949 and 1950.129

The final discussion of lobotomy came about very suddenly at the end of November 1950. On November 29, the editors of Pravda wrote to the Minister of Health to inform him that a denunciation had been sent to their office by two psychiatrists from the city of Gor’kii. The psychiatrists complained that lobotomies were still being done and that Shmar’ian and others “had still not disarmed.” “In our country,” they wrote, “lobotomy is undoubtedly an accidental, imported phenomenon, and it should be judged decisively.”130 Across the front of Pravda’s memorandum the Minister of Health scrawled a note in pencil: “Why are you going so slowly with instructions on this?”131 The next day, on remarkably short notice, the Ministry of Health convened the Presidium of its Scientific Medical Council for what was to prove the decisive meeting about the use of lobotomy. The coincidence of these events is notable. One possibility is that the meeting had already been planned. Another is that Pravda’s “signal” to the ministry hinted at behind-the-scenes pressure from the Communist Party.132 In support of this theory is the fact that one of the authors of the letter to Pravda, Vladimir Pakhomov, was a longtime family [End Page 56] friend of the Zhdanovs, and thus may have worked through (or with) Iurii Zhdanov to force the issue of lobotomy.133 If the outcome was a foregone conclusion, however, the participants—all of whom were ministry officials, medical professors, or research institute directors—do not seem to have known it. They repeatedly asked the chairman for clarification about the purpose of the meeting, and he instructed them to objectively weigh the evidence for and against lobotomy.134 The five-hour discussion that followed was wide-ranging and often acrimonious. Giliarovskii, Shmar’ian, and most other members of the Moscow psychiatric elite were present. Ivanov-Smolenskii was not.

Giliarovskii and members of his staff presented a range of arguments against lobotomy. One was an argument against localization theory and in favor of a “holistic” and Pavlovian view of the brain. Giliarovskii’s team argued that, according to Pavlov’s model, the brain’s “second signal system” was not localized to any particular structure: the brain worked as an integrated whole. Cutting the brain was therefore ill-advised because it could produce long-term and unforeseeable changes in the whole body.135 Furthermore, Pavlov’s theory suggested that the symptoms of schizophrenia were caused by “protective inhibition” and that, at least in the early stages, patients could fully recover if given nondestructive therapies like prolonged sleep. The surgeon’s knife would destroy parts of the brain, disrupt protective inhibition, and cause irreversible harm.136 The proponents of lobotomy failed to see this because they were “carried away by enthusiasm” and personally “interested” (zainterestovan) in finding a beneficial result.137

Shmar’ian reiterated his claim that in certain cases lobotomy was useful and effective as a last resort. “The facts say that there exists a group of patients with a long lasting process, where all attempted methods of treatment have not given an effect. . . . And among such patients appear those who are given prefrontal leucotomy, and entirely unexpectedly for us they respond well, and the effect is long [lasting].”138 Pavlovian theory, he claimed, actually should be understood to support the use of lobotomy: if “intellect and personality are not narrowly localized in the frontal [End Page 57] cortex,” then it followed logically that the mind could compensate for, and perhaps benefit from, selective neurosurgery.139 Finally, Shmar’ian made an attempt to frame his argument in terms used by Stalin in his recent article on linguistics. “Leucotomy and the problem of treating patients is altogether not superstructure [in Marxist terms],” he said. “There was schizophrenia under feudalism, it existed under capitalism, and to our great shame we are going into communism having not defeated a number of illnesses, schizophrenia among them. Therefore . . . leucotomy is a biological problem, just like penicillin—a biological problem.” This earned him jeers from the audience, and the stenographer recorded a voice interjecting, “That is crude mechanicism.”140

Critics attacked the claim that lobotomy was justified because it helped return people to work. One critic accused lobotomists of purely utilitarian goals: “Is this not the ideal of the American imperialists who are searching for ‘robots’ (robotov)?” she asked.141 Another criticized the notion that a patient would be “more human” if he or she could return to work or to life at home. He lambasted Shmar’ian’s assistant for calling patients “animals” and “finished people,”142 and said that “we need to categorically ban the leucotomy operation . . . precisely to preserve the personalities of the mentally ill who are entrusted to us.”143 Personhood, in this reading, depended on the integrity of the brain. Returning a patient to “life and work” could not be deemed a success if it was achieved at the cost of damaging the brain.

At the core of the meeting, however, was a discussion of the scientific standards used for psychiatric treatment and the role of “empiricism” in medical treatment. For medicine to be “Soviet,” in this view, required physicians to use modern laboratory science to understand objectively how the body worked and thus how to treat it. This was most clearly articulated by Stepan Pavlenko, a prominent Soviet Ministry of Health official, who declared that he was shocked by the lack of scientific rigor at the meeting:

Perhaps in capitalist society you can use whatever method of treatment that seems appropriate, but in socialist society we should use theoretically grounded methods. That is the essence of Pavlovian doctrine. If we don’t follow this rule we end up taking the capitalist position, that is, eclecticism, not scientific medicine. To bring into our socialist society unfounded methods and moreover methods that are extreme, harsh methods—this is absolutely unacceptable.144 [End Page 58]

Neurosurgeon Leonid Koreisha responded by defending his discipline. Neurosurgeons often found themselves working empirically because the central nervous system was still poorly understood. But the conclusion was the same: Soviet medicine needed to establish stricter standards for judging the therapeutic effectiveness of treatments, including more strict clinical examinations, standardized diagnostic categories, and controlled, longitudinal studies of outcomes. Without such standards, a method like lobotomy could not be approved for widespread use.145

An undercurrent of deep resentment for Shmar’ian’s and Giliarovskii’s professional influence ran through the discussion. At one point a psychiatrist, the same man who had written to Pravda denouncing lobotomy, accused Shmar’ian of using his power within the discipline to silence all opposition. He cited Stalin, who had recently attacked prominent Soviet linguists for suppressing freedom of discussion in their discipline, a practice that Stalin had referred to as creating an “Arakcheev regime,” an allusion to an infamous system of early nineteenth-century Russian military colonies.146 The psychiatrist used this new phrase to describe psychiatry. “Involuntarily,” he said, “the thought occurs to me . . . [that] a group of psychiatrists headed by Professors Shmar’ian, Gurevich, and others have created an Arakcheev regime in psychiatry.”147 How else, he asked, could Soviet psychiatrists have tolerated the worst of Anglo-American psychiatry, the “crudest form of the localizationist mechanistic perspective”?148 This accusation provoked an interruption by another participant, who shouted, “And what about professor Giliarovskii—doesn’t he have an Arakcheev regime?”149 The implication was that the conflict over lobotomy was as much about institutional rivalries as it was about science or ethics. The chairman had to intervene to end this line of argument. Having cut off discussion, he told them that the final language of the decision would be decided by the Scientific Medical Council, “the same as we do for other questions.”150

Just over one week later, on December 9, 1950, the Soviet Ministry of Health issued its decree forbidding the use of lobotomy. The decision rested on two points: first, the claim that lobotomy caused harm and, second, that it was “theoretically ungrounded” and “contradictory to the physiological principles of I. P. Pavlov.”151 These propositions became [End Page 59] foundational to the emerging doctrine of “Pavlovian medicine,” which became a new, stifling orthodoxy for Soviet medicine. Over the next three years over a dozen articles on sleep therapy were published in the Soviet psychiatry journal, an increase from only one such article published in 1949.152

Giliarovskii successfully prevented himself from being driven out of the discipline. He did lose his post as director of the Soviet Institute of Psychiatry, but he remained its deputy, and throughout the 1950s he continued to serve as one of the most prominent psychiatrists in the Soviet Union.153 Although Ivanov-Smolenskii continued to push for his ouster, other psychiatrists supported him, pointing in particular to his central role in ending lobotomy.154 When psychiatrists met in Moscow in October 1951 for a special meeting to critically apply Pavlov’s doctrine to their field, it was Shmar’ian who was cast as the agent of Western idealism, and lobotomy was held up as the centerpiece of his anti-Soviet activity.155 The keynote address was given by Andrei Snezhnevskii, a psychiatrist who had been elevated to an important position during the anti-Semitic purge in 1950, and it was he who now took over Shmar’ian’s position as editor of the professional journal. Snezhnevskii went on to dominate Soviet psychiatry for the next thirty years, eventually assuming Giliarovskii’s old position as director of the Institute of Psychiatry.156 Shmar’ian was stripped of his remaining positions in Moscow and ceased to publish. He died in 1961.157

In the institutional and political context of late Stalinism, opposition to lobotomy was tied up with conflict between professionals over control of meager institutional resources as well as principles of medical practice. Soviet psychiatrists were not simply “victims of terror,” they were its beneficiaries and its perpetrators as well, eking out careers within a system where power was established by drawing in ideological authorities in order to exclude other professionals from the community. The Communist Party made it imperative for psychiatrists to defend their practices as patriotic, [End Page 60] materialist, Pavlovian, and non-Western, but it was the psychiatrists themselves who used xenophobic and anti-Semitic innuendo to paint their opponents as enemies. When the Communist Party’s science division turned its attention to psychiatry, it found it already divided into factions and with an already-existing narrative of ideological struggle, complete with its own heroes and villains. Lobotomy easily fit into the larger campaign against the baleful influence of the allegedly immoral, inhumane West. Ironically, in this case the same ideological pressures and professional practices that led the Soviet government to ban formal genetics in the infamous “Lysenko Affair” also led to the banning of lobotomy, one of the twentieth century’s most notorious medical treatments. [End Page 61]

Benjamin Zajicek

Benjamin Zajicek is an assistant professor of history at Towson University, Maryland. He specializes on the history of Soviet Union, with particular focus on the sociology of medical knowledge and the history of psychiatry.

I am grateful to the U.S. Department of Education Fulbright-Hays Doctoral Dissertation Research Abroad Fellowship Program and the Eurasia Program of the Social Science Research Council for generously supporting my research, to the staff of the State Archive of Russian Federation (GARF), the Russian State Archive of the Economy (RGAE), the Russian State Archive of Social and Political History (RGASPI), the Russian State Archive of Contemporary History (RGANI), and the Central State Archive of Moscow (TsGAM) for the use of their materials and their kind advice, and to Sheila Fitzpatrick, the participants at the 2006 Midwest Russian History Workshop, and the three anonymous peer reviewers for their comments on drafts of this article. Any remaining errors are entirely my own.

This research was funded by the U.S. Department of Education Fulbright-Hays Doctoral dissertation Research Abroad Fellowship Program and the Eurasia Program of the Social Science Research Council with funds provided by the US. Department of State under the Program for Research and Training on Eastern Europe and the Independent States of the Former Soviet Union (Title VIII). An early version of this article was presented at the Midwest Russian History Workshop in Bloomington, Indiana, in April 2006.


1. “Prikaz MZ SSSR No. 1053,” Zhurnal nevropatologii i psikhatrii im. S.S. Korsakova 52, no. 2 (1952): 3–8.

2. Agneta Wallin Levinovitz and Nils Ringertz, eds., The Nobel Prize: The First 100 Years (London: Imperial College Press, 2001), 123.

3. Reports of psychosurgery operations go back to ancient times, and physicians throughout Europe had experimented with them in the nineteenth century, including physicians in the Russian Empire. German E. Berrios, “Psychosurgery in Britain and Elsewhere: A Conceptual History,” in 150 Years of British Psychiatry, 1841–1991, ed. German E. Berrios and Hugh Freeman (London: Gaskell, 1991), 180–96.

4. Dominik Gross and Gereon Schäfer, “Egaz Moniz (1874–1955) and the ‘Invention’ of Modern Psychosurgery: A Historical and Ethical Reanalysis under Special Consideration of Portuguese Original Sources,” Neurosurg. Focus 30, no. 2 (February 2011): 1–7.

5. Elliot S. Valenstein, Great and Desperate Cures: The Rise and Decline of Psychosurgery and Other Radical Treatments for Mental Illness (New York: Basic Books, 1986), 84.

6. Ibid., 164–79.

7. Jack D. Pressman, Last Resort: Psychosurgery and the Limits of Medicine (Cambridge: Cambridge University Press, 1998), 401–3.

8. Gretchen J. Diefenbach et al., “Portrayal of Lobotomy in the Popular Press: 1935–1960,” J. Hist. NeuroSci. 8, no. 1 (1999): 60–69.

9. Valenstein, Great and Desperate Cures (n. 5); Jack El-Hai, The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness (New York: John Wiley, 2005).

10. Joel Braslow, Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of the Twentieth Century (Berkeley: University of California Press, 1997), 138.

11. Pressman, Last Resort (n. 7), 182–86.

12. Ibid., 1–22, 32–40, 424–38. Building on Pressman’s work, Mical Raz shows that Walter Freeman was particularly obsessed by lobotomy’s ability to return a patient to work. Mical Raz, “Psychosurgery, Industry and Personal Responsibility, 1940–1965,” Soc. Hist. Med. 23, no. 1 (2010): 116–33.

13. Zbigniew Kotowicz, “Psychosurgery in Italy, 1936–39,” Hist. Psychiatry 19, no. 4 (2008): 476–89; D. Ploumpidis, C. Tsiamis, and E. Poulakou-Rebelakou, “History of Leucotomies in Greece,” Hist. Psychiatry 26, no. 1 (2015): 80–87.

14. Alexander Etkind, Eros of the Impossible: The History of Psychoanalysis in Russia, trans. Noah and Maria Rubins (Boulder, Colo.: Westview, 1997); Martin A. Miller, Freud and the Bolsheviks: Psychoanalysis in Imperial Russia and the Soviet Union (New Haven, Conn.: Yale University Press, 1998).

15. Mark G. Field, Soviet Socialized Medicine: An Introduction (New York: Free Press, 1967); Chris Burton, “Medical Welfare during Late Stalinism: A Study of Doctors and the Soviet Health System, 1945–1953” (PhD diss., University of Chicago, 2000).

16. Nikolai Krementsov, Stalinist Science (Princeton, N.J.: Princeton University Press, 1997); D. A. Alexandrov, “Istoricheskaia antropologiia nauki v Rossii,” Voprosy istorii estestvoznaniia i tekhniki, no. 4 (1994): 3–22.

17. Krementsov, Stalinist Science (n. 16), 130.

18. Ethan M. Pollock, Stalin and the Soviet Science Wars (Princeton, N.J.: Princeton University Press, 2006).

19. Krementsov, Stalinist Science (n. 16), 158–83; David Joravsky, The Lysenko Affair (Cambridge, Mass.: Harvard University Press, 1970).

20. Krementsov, Stalinist Science (n. 16), 254–86; Alexei Kojevnikov, “Rituals of Stalinist Culture at Work: Science and the Games of Intraparty Democracy circa 1948,” Russian Rev. 57, no. 1 (1998): 25–52; Kojevnikov, Stalin’s Great Science: The Times and Adventures of Soviet Physicists (London: Imperial College Press, 2004).

21. Sarah Marks and Mat Savelli, “Communist Europe and Transnational Psychiatry,” in Psychiatry in Communist Europe, ed. Sarah Marks and Mat Savelli (Basingstoke: Palgrave, 2015), 1–26; Irina Sirotkina, Diagnosing Literary Genius: A Cultural History of Psychiatry in Russia, 1880–1930 (Baltimore: Johns Hopkins University Press, 2002); David Joravsky, Russian Psychology: A Critical History (Oxford: Basil Blackwell, 1989), 415–42.

22. Sidney Bloch and Peter Reddaway, Psychiatric Terror: How Soviet Psychiatry Is Used to Suppress Dissent (New York: Basic Books, 1977); Robert van Voren, Cold War in Psychiatry: Human Factors, Secret Actors (Amsterdam: Rodopi, 2010).

23. Etkind, Eros of the Impossible (n. 14); Miller, Freud and the Bolsheviks (n. 14).

24. B. L. Lichterman, “On the History of Psychosurgery in Russia,” Acta Neurochirurgica 125 (1993): 1–4; Leonid Likhterman and Boleslav Likhterman, “Kak v SSSR zapreshchali psikhokhirurgiiu,” Meditsinskaia gazeta, September 1, 2000, 12–13.

25. On the agency of professionals within Stalinist society, see Kojevnikov, “Rituals of Stalinist Culture at Work” (n. 20); and Kiril Tomoff, Creative Union: The Professional Organization of Soviet Composers, 1939–1953 (Ithaca, N.Y.: Cornell University Press, 2006), 2–5.

26. A. S. Peitsik, “Review of E. Moniz and A. Lima, ‘Simatomy prefrontal’noi doli,’ Revue Neurolog., t. 65, no. 3, str. 582, 1936.,” Nevropatologiia, psikhiatriia, i psikhogigiena 5, no. 7 (1936): 1233–34; L. Shevderov, “Review of Egas Moniz. Psikhokhirurgiia. Der Nervenarzt, H. 3. 1937,” Nevropatologiia i psikhiatriia 6, no. 11 (1937): 175.

27. V. Ia. Strazhevskii, “James W. Watts and Walter Freeman. Psikhokhirurgiia …,” Nevropatologiia i psikhiatriia 7, no. 7 (1939): 81–82; Iu. Rakhal’skii, “Watts I.A. Freeman W. Psikhokhirurgiia … ,” Nevropatologiia i psikhiatriia 7, nos. 9–10 (1939): 88.

28. David Joravsky, “The Construction of the Stalinist Psyche,” in Cultural Revolution in Russia, 1928–1931, ed. Sheila Fitzpatrick (Bloomington: Indiana University Press, 1978), 105–28; Benjamin Zajicek, “Soviet Madness: Nervousness, Mild Schizophrenia, and the Professional Jurisdiction of Psychiatry in the USSR, 1918–1936,” Ab Imperio 4 (2014): 167–94.

29. Joravsky, “Construction of the Stalinist Psyche” (n. 28), 115; Burton, “Medical Welfare during Late Stalinism” (n. 15), 69–123.

30. Gregori Diufo, “Vyzov fiziologii: Sovetskaia psikhiatriia v 1930-e gody,” Ab Imperio 4 (2014): 136–66.

31. Benjamin Zajicek, “Insulin Coma Therapy and the Construction of Therapeutic Effectiveness in Stalin’s Soviet Union, 1936–1953,” in Marks and Savelli, Psychiatry in Communist Europe (n. 21), 50–72.

32. M. O. Gurevich, “20 let sovetskoi psikhiatrii,” Nevropatologiia i psikhiatriia 6, no. 10 (1937): 15–22.

33. “V Moskovskom obshchestve nevropatologov i psikhiatrov,” Nevropatologiia i psikhiatriia 7, no. 3 (1938): 150–64, quotation on 160.

34. “Otchet o rabote UMS NKZ SSSR v 1943,” GARF (State Archive of the Russian Federation) f. r-8009, op. 2, d. 580, ll. 4, 19; “Prikaz MZ SSSR No. 679,” December 28, 1943, TsGAM (Central State Archive of Moscow) f. 533, op. 1, d. 1, l. 1.

35. “Stenogramma zasedaniia Prezidiuma UMS MZ SSSR,” November 30, 1950, GARF f. r-8009, op. 2, d. 1498, l. 46.

36. “Protokol no. 38 zasedaniia Biuro OKM AMN SSSR,” December 16, 1947, GARF f. r-9120, op. 2, d. 353, l. 180; “Stenogramma obsuzhdeniia otcheta Tsentral’nogo nauchnoissledovatel’skogo instituta psikhiatrii MZ SSSR za 1951,” April 9, 1952, GARF f. r-8009, op. 33, d. 463, l. 56.

37. T. A. Dobrokhotova, “K Istorii psikhiatricheskoi sluzhby v institute neirokhirurgii im. Akademika N. N. Burdenko RAMN,” Voprosy neirokhirurgii, no. 1 (2000): 34–37; A. S. Shmar’ian, “K patofiziologii opticheskikh psikhosenzornykh rasstroistv,” Sovetskaia nevropatologiia, psikhiatriia i psikhogigiena 4, no. 5 (1935): 23–36.

38. On the Kraepelinian tradition of clinical nosology, see Edward Shorter, A History of Psychiatry: From the Era of the Asylum to the Age of Prozac (New York: John Wiley, 1997), 99–109; and Eric J. Engstrom, Clinical Psychiatry in Imperial Germany: A History of Psychiatric Practice (Ithaca, N.Y.: Cornell University Press, 2003), 123–46.

39. A. S. Shmar’ian, “Osnovnye voprosy kliniki travm golovnogo mozga,” in Biulleten’ nauchnoi konferentsii Tsentral’nogo Instituta Psikhatrii, ed. A. S. Shmar’ian and P. B. Posvianskii (Tomsk, 1942), 17–31, quotation on 17–18.

40. A. S. Shmar’ian, “Dinamicheskaia rol’ ochaga v mozgovoi patologii i psikhiatrii,” Nevropatologiia i psikhiatriia 14, no. 1 (1945): 27–38; A. S. Shmar’ian, “Tri osnovnykh faktora v patogeneze psikhozov,” in Trudy tsentral’nogo instituta psikhiatrii MZ RSFSR, ed. P. B. Posvianskii and A. S. Shmar’ian (Moscow, 1947), 87–108.

41. A. S. Shmar’ian, Mozgovaia patologiia i psikhiatriia: Opukholi golovnogo mozga i uchenie o lokalizatsii psikhicheskikh rasstroistv, vol. 1 (Moscow: Medgiz, 1949).

42. “Stenogramma rasshirennogo zasedaniia Prezidiuma UMS MZ SSSR, September 27, 1946, GARF f. r-8009, op. 2, d. 879, l. 77; Joseph Wortis, Soviet Psychiatry (Baltimore: Williams & Wilkins, 1950), 259–60.

43. Braslow, Mental Ills and Bodily Cures (n. 10), 138–43.

44. “Ob”iasnitel’naia zapiska k planu nauchno-issled. raboty Tsentral’nogo Instituta Psikhiatrii NKZ RSFSR na 1945 god,” GARF f. a-482, op. 48, d. 202, l. 7.

45. “Stenogramma zasedaniia” (n. 35), ll. 80, 90.

46. I. S. Babchin, “Opyt khirurgicheskogo lecheniia nekotorykh form psikhicheskikh zabolevanii,” Voprosy neirokhirurgii 12, no. 2 (1948): 3–11.

47. Iu. B. Rozinskii, Izmeneniia psikhiki pri porazheniiakh lobnykh dolei mozga (Moscow: Medgiz, 1948), 25–26; B. G. Egorov et al., “Khirurgicheskoe lechenie shizofrenii metodom lobnoi leikotomii,” in Trudy tret’ego vsesoiuznogo s”ezda nevropatologov i psikhiatrov, ed. V. A. Giliarovskii (Moscow: Medgiz, 1950), 395–98.

48. Reference was found to lobotomies performed at eighteen institutions, with specific numbers (adding up to 517) given for nine. This estimate correlates with the figure of “over 400” reported in February 1949. “Reshenie plenuma pravleniia vsesiouznogo ob-va nevropatologov i psikhiatrov,” February 4, 1949, GARF f. r-8009, op. 2, d. 1498, l. 130.

49. “Stenogramma zasedaniia” (n. 35), l. 30.

50. R. Ia. Golant et al., “Effektivnost’ dvustoronnei lobnoi leikotomii v lechenii shizofrenii i drugikh psikhicheskikh zabolevanii,” in Trudy vsesoiuznogo s”ezda nevropatologov i psikhiatrov, ed. V. A. Giliarovskii (Moscow: Medgiz, 1950), 398–400, quotation on 398; “Stenogramma zasedaniia” (n. 35), l. 18.

51. “Stenogramma zasedaniia” (n. 35), l. 20.

52. M. A. Gol’denberg, “Lobnaia leikotomiia (terapevticheskii effekt, ego mekhanizm i lokalizatsiia),” in Trudy vsesoiuznogo s”ezda nevropatologov i psikhiatrov ed. V. A. Giliarovskii (Moscow: Medgiz, 1950), 400–401; “Stenogramma zasedaniia” (n. 35), ll. 35, 48.

53. “Preniia,” in Trudy tret’ego vsesoiuznogo s”ezda nevropatologov i psikhiatrov (Moskva 25–31 maia 1948 g), ed. V. A. Giliarovskii (Moscow: Medgiz, 1950), 425; “Spravka o sostoianii psikhonevrologicheskoi pomoshchi i o merakh po ee uluchsheniiu,” November 16, 1950, GARF f. a-482, op. 49, d. 1519, l. 58; “Otchet o rabote kafedry i kliniki psikhiatrii Kirgizskogo Med. Instituta za 1946 god, GARF f. r-8009, op. 5, d. 265, ll. 17–18.

54. “Otchet MZ SSSR o seti, deiatel’nosti i kadrakh meditsinskikh uchrezhdenii SSSR za 1950 g.,” RGAE (Russian State Archive of the Economy) f. 1562, op. 18, d. 545, l. 5.

55. R. G. Golodets, “Klinika ostrogo perioda posle prefrontal’noi leikotomii,” Nevropatologiia i psikhiatriia 17, no. 2 (1947): 26–32, quotation on 26.

56. “Stenogramma zasedaniia” (n. 35), ll. 77–79.

57. Ibid., 29–33.

58. Letter from E. Petrova to Bol’nitsa im. Gannushkina, November 18, 1950, GARF f. r-8009, op. 2, d. 1498, l. 150.

59. Irina Sirotkina, “The Dialectics of Labor in a Psychiatric Ward: Work Therapy in the Kashchenko Hospital” (paper, Continuity and Change in Russian Therapy conference, Oxford, June 5–6, 2014).

60. Richard Stites, Revolutionary Dreams: Utopian Vision and Experimental Life in the Russian Revolution (Oxford: Oxford University Press, 1989), 145–46; David L. Hoffmann, Cultivating the Masses: Modern State Practices and Soviet Socialism, 1914–1939 (Ithaca, N.Y.: Cornell University Press, 2011), 109.

61. Sirotkina, “Dialectics of Labor” (n. 59).

62. M. O. Gurevich and M. Ia. Sereiskii, Uchebnik psikhiatrii, 5th ed. (Moscow: Medgiz, 1946), 110–11.

63. In the 1920s the Soviet approach to labor therapy was highly influenced by German psychiatry, particularly the ideas of Hermann Simon, and by the international mental hygiene movement. It thus shared common roots with the American psychiatry of that era, and with its focus on the creation of a new kind of citizen suited to industrial society. In the Soviet case, however, this was complicated by the Communist Party’s ban on psychotechnics in 1936. Soviet psychiatrists in the 1940s thus spoke of the transformative and healing value of labor, but unlike the American psychiatrists described by Mical Raz, the Soviets no longer promoted their discipline as an adjunct to industrial productivity. Raz, “Psychosurgery, Industry, and Personal Responsibility” (n. 12). On the mental hygiene movement in the Soviet Union, see Zajicek, “Soviet Madness” (n. 28).

64. Shmar’ian, Mozgovaia patologiia i psikhiatriia (n. 41), 136–37.

65. B. V. Zeigarnik and P. Ia. Gal’perin, “Psikhologicheskie izmeneniia posle leikotomii u shizofrenikov,” Nevropatologiia i psikhiatriia 17, no. 4 (1948): 67–70.

66. G. K. Ushakov et al., “Vasilii Alekseevich Giliarovskii (1876–1959),” in V. A. Giliarovskii: Izbrannye trudy (Moscow: Meditsina, 1973), 3–10.

67. Quoted in Galina V. Zarechnak, Academy of Medical Sciences of the USSR: History and Organization, 1944–1959, Public Health Monograph, vol. 63 (Washington, D.C.: National Library of Medicine, 1960), 4.

68. V. A. Giliarovskii, “Zadachi psikhiatrii na novom etape ee razvitiia,” in Somato-psikhicheskie rasstrositva. Sbornik trudov Instituta psikhiatrii AMN, ed. V. A. Giliarovskii (Moscow: Izd-vo AMN SSSR, 1946), 5–10; Giliarovskii, “Voprosy teorii i praktiki nevro-psikhiatricheskoi pomoshchi v poslevoennoe vremia,” Sovetskaia meditsina, no. 7 (1946): 1–4.

69. V. A. Giliarovskii, Starye i novye problemy psikhiatrii (Moscow: Medgiz, 1946).

70. V. A. Giliarovskii, “Puti proniknoveniia dostizhenii fiziologii v psikhiatriiu,” Nevropatologiia i psikhiatriia 17, no. 2 (1948): 3–12, quotation on 10.

71. “Godovoi otchet Instituta Psikhiatrii AMN za 1946 god,” GARF f. r-9120, op. 2, d. 250, ll. 8–9.

72. V. A. Giliarovskii et al., Elektroson (Kliniko-fiziologicheskoe issldovanie) (Moscow: Medgiz, 1953).

73. “Stenogramma zasedaniia Prezidiuma UMS MZ SSSR,” October 9, 1947, GARF f. r-8009, op. 2, d. 1048, l. 31. Giliarovskii acknowledged that others had experimented with electrically induced sleep, and specifically cited the 1902 research of French scientist Stephane Leduc.

74. Krementsov, Stalinist Science (n. 16), 96–98.

75. Daniel P. Todes, “Pavlov and the Bolsheviks,” Hist. Philos. Life Sci. 17, no. 3 (1995): 379–418.

76. Daniel P. Todes, Ivan Pavlov: A Russian Life in Science (Oxford: Oxford University Press, 2014), 648.

77. Ibid., 1.

78. Quoted in Roger Smith, Inhibition: History and Meaning in the Sciences of Mind and Brain (Berkeley: University of California Press, 1992), 200.

79. Douglas L. Grimsley and George Windholz, “The Neurophysiological Aspects of Pavlov’s Theory of Higher Nervous Activity,” J. Hist. NeuroSci. 9, no. 2 (2000): 152–63.

80. Todes, Ivan Pavlov (n. 76), 632.

81. George Windholz, “Pavlov’s Concept of Schizophrenia as Related to the Theory of Higher Nervous Activity,” Hist. Psychiatry 4, no. 16 (December 1993): 511–20, esp. 519–20; Grégory Dufaud, “Quel usage des thèses pavloviennes en médecine? Schizophrénie, incertitudes scientifiques et psychiatrie en Union soviétique,” Cahiers du Monde russe 56, no. 1 (2015): 199–233.

82. Todes, Ivan Pavlov (n. 76), 648.

83. “Stenogramma zasedaniia Prezidiuma UMS MZ SSSR,” October 9, 1947, 13, GARF f. r-8009, op. 2, d. 1048, l. 31.

84. Todes, Ivan Pavlov (n. 76), 640–41.

85. V. A. Giliarovskii, “I. P. Pavlov i psikhiatriia,” Nevropatologiia, psikhiatriia, i psikhogigiena 5, no. 6 (1936): 904–8, quotation on 908.

86. V. A. Giliarovskii, “Retsenziia na kn.: Ivanov-Smolenskii A. G. Osnovnye problemy pato-fiziologii vysshei nervnoi deiatel’nosti cheloveka. M.-L., 1933,” Tsentral’nyi meditsinskii zhurnal, no. 3 (1935): 438–40; for the “conditional reflex hair-splitting” comment, see Giliarovskii’s 1951 apology to Ivanov-Smolenskii in V. M. Banshchikov et al., eds., Fiziologicheskoe uchenie akademika I.P. Pavlova v psikhiatrii i nevropatologii (Moscow: Medgiz, 1952), 77.

87. Diufo, “Vyzov fiziologii” (n. 30), 158; Joravsky, Russian Psychology (n. 21), 388–89; “Spravka,” n.d. [early 1951], GARF f. r-9120, op. 2, d. 1201, ll. 216–17.

88. Joravsky, Russian Psychology (n. 21), 394.

89. “Protokol no. 4 rasshirennogo zasedaniia Prezidiuma UMS NKZ SSSR,” February 21, 1946, GARF f. r-8009, op. 2, d. 868, ll. 46–47.

90. Nikolai Krementsov, The Cure: A Story of Cancer and Politics from the Annals of the Cold War (Chicago: University of Chicago Press, 2002).

91. “Prikaz MZ SSSR no. 130,” April 14, 1947, GARF f. r-9120, op. 2, d. 350, l. 1.

92. “Protokol no. 27 Zasedaniia Prezidiuma AMN SSSR,” October 3, 1947, GARF f. r-9120, op. 2, d. 325, l. 79.

93. Ibid.

94. A. Edel’shtein, “Uchenie I.P. Pavlova v nevropatologii i psikhiatrii,” Nevropatologiia i psikhiatriia 17, no. 2 (1948): 70–73, quotation on 70.

95. Ibid., 73.

96. A. G. Ivanov-Smolenskii, “Review of Starye i novye problemy psikhiatrii by V. A. Giliarovskii,” Vestnik Akademii Meditsinskikh Nauk SSSR, no. 1 (1948): 57–59.

97. “Preniia” (n. 53), 436–37.

98. Ibid.

99. Ibid., 436.

100. “Rezoliutsiia,” in Trudy tret’ego vsesoiuznogo s”ezda nevropatologov i psikhiatrov, ed. V. A. Giliarovskii (Moscow: Medgiz, 1950), 447–49; A. O. Edel’shtein, “III vsesoiuznyi s”ezd nevropatologov i psikhiatrov (Kratkaia khronika s”ezda),” Nevropatologiia i psikhiatriia 17, no. 4 (1948): 78–80.

101. S. V. Kurashov, “Nauchnye zasedaniia: II plenum Vsesiouznogo obshchestva nevropatologov i psikhiatrov,” Nevropatologiia i psikhiatriia 18, no. 3 (1949): 70–73.

102. Ibid.

103. “Reshenie Plenuma Pravleniia Vsesoiuzhnogo Ob-va Nevropatologov i psikhiatrov o primenenii frontal’noi leikotomii kak metoda lecheniia dushevnykh zabolevanii,” February 4, 1949, GARF f. r-8009, op. 2, d. 1498, l. 130.

104. Ibid., ll. 130–32.

105. G. V. Kostyrchenko, Tainaia politika Stalina: Vlast’ i antisemitizm (Moscow: Mezhdunarodnye otnosheniia, 2001).

106. Letter to Secretary TsK VKP(b) G. M. Malenkov, archived November 17, 1949, RGANI (Russian State Archive of Contemporary History) f. 6, op. 6, d. 1556, ll. 12–14.

107. Lists compiled by E. Babian, “Materialy k protokolu no. 462 zasedaniia Sekretariata TsK VKP(b), punkty 1s-27s,” September 17, 1949, RGANI, f. 6, op. 6, d. 1556, ll. 26–47.

108. Kovanov and Larionov to P. K. Ponomarenko and M. F. Shkiriatov, October 11, 1949, RGANI, f. 6, op. 6, d. 1556, l. 11.

109. Kovanov and Larionov to G. M. Malenkov, January 1950, RGANI, f. 6, op. 6, d. 1556, l. 6.

110. “Stenogramma zasedaniia” (n. 35), ll. 14–18.

111. A. Portnov, “Otchet o rabote psikhonev. otdela MZ SSSR za 1950 goda,” GARF f. r-8009, op. 33, d. 263, l. 2; “Stenogramma zasedaniia” (n. 35), l. 17.

112. “Protokol no 52 zasedaniia Prezidiuma UMS MZ SSSR,” November 30, 1950, GARF f. r-8009, op. 2, d. 1498, l. l.

113. “Stenogramma zasedaniia” (n. 35), l. 19.

114. Ibid., l. 18.

115. Ibid., ll. 16–17.

116. Iu. A. Zhdanov, Vzgliad v proshloe: Vospominaniia ochevitdsa (Rostov-na-Donu: Feniks, 2004), 277.

117. Iu. Zhdanov to I. Stalin, “O razrabotke ucheniia ak. Pavlova,” September 28, 1949, RGASPI (Russian State Archive of Social and Political History) f. 17, op. 132, d. 177, ll. 144–62.

118. Pollock, Stalin and the Soviet Science Wars (n. 18), 150.

119. Joravsky, Russian Psychology (n. 21), 407–9; Pollock, Stalin and the Soviet Science Wars (n. 18), 150–58.

120. A. G. Ivanov-Smolenskii, “Puti razvitiia idei I. P. Pavlova v oblasti patofiziologii vysshei nervnoi deiatel’nosti,” in Nauchnaia sessiia posviashchennaia problemam fiziologicheskogo ucheniia akademika I. P. Pavlova: Stenograficheskii otchet (Moscow: Izd. Akademii Nauk SSSR, 1950), 44–81, quotation on 50.

121. Ibid., 50–51.

122. Ibid., 51.

123. Ibid., 55–56.

124. “V. A. Giliarovskii,” in Nauchnaia sessiia (n. 120), 304–9.

125. Ibid., 306–7.

126. V. A. Giliarovskii, “Preniia po dokladam akad. Bykova i prof. Ivanova-Smolenskogo o razvitii idei I.P. Pavlova,” Pravda, July 6, 1950, 4.

127. V. A. Giliarovskii, “Uchenie I. P. Pavlova—osnova psikhiatrii,” Meditsinskii rabotnik, September 14, 1950.

128. Meditsinskaia gazeta to UMS MZ SSSR, September 30, 1950, GARF f. r-8009, op. 2, d. 1498, l. 6.

129. “Povestka zasedaniia Prezidiuma UMS MZ SSSR,” October 12, 1950, GARF f. r-8009, op. 2, d. 1498, l. 124.

130. A. Portnov and V. Pakhomov to the editors of Pravda, n.d., GARF f. r-8009, op. 2, d. 1498, l. 12.

131. Pravda to E. Smirnov, November 29, 1950, GARF f. r-8009, op. 2, d. 1498, l. 11.

132. Likhterman and Likhterman, “Kak v SSSR zapreshchali” (n. 24), 12–13.

133. A. A. Portnov, “Vospominaniia o razvitii otechestvennoi psikhiatrii,” in Voprosy sotsial’noi i klinicheskoi psikhiatrii i narkologii, ed. B. D. Tsygannkova (Moscow, 2000), 266–311, esp. 298–99.

134. “Stenogramma zasedaniia” (n. 35), l. 13.

135. Ibid., l. 13, ll. 53–55.

136. Ibid., ll. 51–52.

137. See, for instance, “Stenogramma zasedaniia” (n. 35), ll. 35–39 (Galachian), l. 67 (Nikolaev), and l. 103 (Giliarovskii).

138. Ibid., ll. 75–76.

139. Ibid., ll. 76–77.

140. Ibid., ll. 79–80.

141. Ibid., ll. 41–42.

142. Ibid., l. 35.

143. Ibid., l. 39.

144. Ibid., l. 88.

145. Ibid., l. 100.

146. Pollock, Stalin and the Soviet Science Wars (n. 18), 126.

147. “Stenogramma zasedaniia” (n. 35), l. 50.

148. Ibid., l. 47.

149. Ibid., l. 106.

150. Ibid., l. 117.

151. “Prikaz MZ SSSR No. 1053” (n. 1), 17–18.

152. “Sistematicheskii ukazatel’,” Zhurnal nevropatologii i psikhatrii im. S.S. Korsakova 53, no. 12 (1953): 965.

153. “V. A. Giliarovskii,” Zhurnal nevropatologii i psikhatrii im. S.S. Korsakova 59, no. 4 (1959): 508.

154. Portnov, “Vospominaniia” (n. 133), 297–98.

155. Snezhnevskii et al., “Sostoianie psikhiatrii i ee zadachi v svete ucheniia I. P. Pavlova,” in Fiziologicheskoe uchenie akademika I.P. Pavlova v psikhiatrii i nevropatologii (Moscow: Medgiz, 1952), 10–41, 13–14.

156. Joravsky, Russian Psychology (n. 21), 425–30.

157. R. G. Golodets, “Aleksandr Solomonovich Shmar’ian (1901–1961): K 90–letiiu so dnia rozhdeniia,” Zhurnal nevropatologii i psikhiatrii im. Korsakova 91, no. 9 (1991): 76–78.