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Last week I worked on an article on Lenin's syphilis with Chris Chivers of the Moscow Bureau of the New York Times It was in response to an article by three Israeli scholars in the June issue of the European Journal of Neurology (posted above). The "smoking gun" (despite what Professor Freeze says) was the fact that eleven of Lenin's doctors during his last days agreed to prescribing Salvarsan. Several of the doctors were well-known syphilologists, including Max Nonne, a student of the famous nineteenth century syphilologist Wilhelm Erb. The authors stated this in the article published in Israel but left it out in the European Journal. They told Chris who told me; I emailed Israel to confirm, which they did, just in time for Chris's deadline; he left out that it was ELEVEN doctors who concurred. The toxic Salvarsan was discontinued because of side effects. The article is cut in below:
June 22, 2004
A Retrospective Diagnosis Says Lenin Had Syphilis
By C. J. CHIVERS
MOSCOW, June 21 - Whispers have circulated for decades that Lenin, founder of the Bolshevik Party and the totalitarian Soviet state it ushered to power, was afflicted with syphilis throughout his career. Now a new study turns that speculation into a retrospective diagnosis.
In an article this month in The European Journal of Neurology, three Israeli physicians sift through historical references to build what they regard as a probable diagnosis that Lenin contracted the sexually transmitted disease in Europe years before he led the October Revolution in 1917. Not long after the socialists' victory, the authors write, the illness strengthened its grip, leading to an agonizing decline and, in 1924, his death.
The idea is not entirely new. Despite the former Soviet Union's efforts to preserve a near theology around its central political figure, Lenin was long rumored to have suffered from the disease. The new thesis is not so much a breakthrough as a historical rumor revived and reframed.
To do so, the authors quote the journals of doctors who treated Lenin in Europe and the Soviet Union and review materials related to his medical condition and autopsy, which they suggest was a propaganda job.
They ask a question of enduring importance to civic life. Do modern societies know enough about the health of their political leaders? In Lenin's case, they strive to show, the answer is a resounding no.
"If you take Lenin's case and you cancel Lenin's name on the file and you give it to a neurologist who is an expert in infectious disease, the expert will say, 'Syphilis,' " said Dr. Vladimir Lerner, head of the psychiatry department at the Be'er Sheva Mental Health Center in Israel and an author of the study.
Reviews have been mixed. Some scholars of the early Soviet period are skeptical, saying the talk of syphilis circulated for decades, to little effect. "There has been a vague rumor of this," said Dr. Robert Conquest, a research fellow at the Hoover Institution at Stanford. "But of course in Russia, as you know, you have rumors about most everything."
Dr. Gregory L. Freeze, a professor of history at Brandeis, was direct. "They don't have the smoking gun," he said.
The study's authors concede this point but insist that they have a strong circumstantial case. They also propose a possible way to settle the question, further testing of Lenin's brain material, which is stored in Moscow.
" 'Skeptical' is a healthy position," said another author of the study, Dr. Eliezer Witztum, a professor of psychiatry at Ben-Gurion University of the Negev. "But the point is that there are a lot of medical questions that have to be answered."
Lenin was 53 when he died, after battling an erratic but progressively debilitating illness. His death has been variously attributed to cerebral hemorrhage, stroke, syphilis, exhaustion or cerebral arteriosclerosis, which had killed his father.
The difficulty with a diagnosis of syphilis is that the symptoms are common to other ailments, so much so that it is called "the great imitator."
The infection, caused by a bacterium called the Treponema spirochete, first appears as an ulcerous sore, from which it spreads throughout the body, including the brain. Fever, an extensive rash and malaise typically follow. After initial infection, a syphilitic can spend years alternating between bouts of illness and apparently fine health.
When they occur, symptoms can be severe, including headaches, nervous disorders and gastrointestinal, muscle or joint pain.
In late stages, often 20 or more years after infection, the victim can experience mood swings and bursts of creativity, as well as depression, lethargy and dementia. Cardiovascular damage can lead to paralysis, aneurysm or stroke.
Until the advent of therapeutic penicillin in World War II, the disease was incurable.
Lenin's illness at least mimicked the progression of syphilis, afflicting him for months with occasional seizures and excruciating headaches, as well as bouts of nausea, sleeplessness and partial paralysis. As Stalin plotted for control of the Communist Party, Lenin was alternately lucid and incapacitated. Sometimes, he was unable to walk without assistance or to speak.
The worst spells were horrific. According to "Lenin: A Biography," by Dr. Robert J. Service, professor of Russian history at St. Anthony's College, Oxford, he twice asked for poison with which he might end his life, remarkable requests from a man whose name was synonymous with struggle.
Communist Party orthodoxy required suppression of the deterioration, and many details were kept secret. But time has unlocked some of the confidences, and the authors combed the disparate evidence, some from archives available only after the collapse of Communism, to render their diagnosis.
Among the supporters of their conclusion is Deborah Hayden, author of "Pox: Genius, Madness, and the Mysteries of Syphilis" (Basic Books, 2003).
"A number of Lenin biographers have reported that the doctors attending him at his death suspected syphilis, but until this article no one has pulled the relevant information together in one place," Ms. Hayden wrote in an e-mail message. "The authors argue convincingly that Lenin was suffering from meningovascular syphilis on his deathbed."
Ms. Hayden, who playfully calls herself a "syphilographer," said she was impressed by evidence that prominent syphilis specialists examined Lenin. And she noted that in previous work, listed in the footnotes, the authors found that Lenin was briefly treated with salvarsan, a drug that was used specifically to combat the disease. Salvarsan had powerful side effects. In a telephone interview, Ms. Hayden said there would be no reason but syphilis to give it to him.
Dr. Frances Bernstein, an assistant professor at Drew University who specializes in sexuality and public health in the Soviet period, also called the theory plausible. "I think the science does support, or could support, a diagnosis of syphilis," she said.
Dr. Bernstein pointed to a potentially curious context. Venereal disease was an acute problem under the tsars. After the revolution, the Soviet Health Ministry reversed the imperial position of suppressing sex education and launched a campaign to treat syphilitics and ease the stigma of the disease.
In light of that campaign, Dr. Bernstein said, "it would have been the height of irony if Lenin died of syphilis."
Disagreement over the merits of the theory seems unlikely to end soon.
Dr. Freeze found two factual errors in the article that he said undermined its credibility. Lenin survived an assassination attempt in 1918, not 1919, as the authors wrote, and the Soviet Union collapsed in 1991, not 1992. (Dr. Witztum said the errors came from sources quoted in the study.)
Dr. Freeze also described Lenin as a dynamo of activity in the years after the October Revolution and added, "The massive amount of documents he wrote in that period do not suggest a man who was suffering from syphilis."
Ms. Hayden said that many syphilitics did not lapse into full paralysis or dementia and that some experienced intense periods of creativity not long before dying. "People think that if you have syphilis you get to be feeble minded, but the opposite is true," she said.
Although Lenin's stature has been eroded by the terror he relied on to build the Soviet state and by its eventual collapse, he remains a colossus. Eight decades after his death, his corpse still lies in state outside the Kremlin. In some circles, reverence clings to his name.
Importantly, for those seeking an answer to the syphilis question, his brain tissue remains at the Moscow Institute of the Brain, where in early Soviet times it was sliced into wafers in an effort to find anatomical explanations for genius.
The authors end their article by suggesting that an examination of the tissue might find the DNA of syphilis and yield a definitive answer. Dr. Freeze said he would support a conclusive test. "That would settle it," he said.
But like much of the discussion, the suggestion is subject to disagreement. A representative of the brain institute declined even to discuss syphilis last week.
"We don't have any wish or time to discuss this," he said, adding that the theory had been reviewed in the past and proved wrong. "We simply don't want to rake over the dust and ashes of the past."
Ms. Hayden also cautioned that even if tests were conducted, the results might not close the case. In late-stage syphilis, she said, the spirochete was not always found in the brain.
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