Red Medicine: The West Looks at the Soviet Experiment in the 1930s

By Paul Theerman, Associate Director, Library and Center for the History of Medicine and Public Health

Last month marked the 100th anniversary of the Great October Revolution, whereby the Bolsheviks in Petrograd overthrew the Russian government and took power.[1] Immediately after, the Revolution’s leader, Vladimir Lenin, consolidated his rule by suppressing competing political parties; withdrawing Russia from World War I; and fighting a bitter Civil War. By the early 1920s, the country had obtained a modicum of peace, albeit isolated from the rest of the world. Through wars and purges, technological advance and political suppression, the Bolsheviks, renamed the Communist Party, held control in Russia for almost 75 years.

In a Hospital Waiting Room, Moscow

Margaret Bourke White, “In a Hospital Waiting Room, Moscow,” 1932. Red Medicine, endpaper.

Lenin was aware of Russia’s backwardness compared with the West. He saw Communist rule as a way to make up for that deficiency. His oft-cited definition of communism made this belief explicit: “Communism is Soviet power plus the electrification of the whole country.” Soviet power meant political rule that flowed from ostensibly democratic workers’ councils (the Russian word for “council” is “soviet”), with the aim of basing governance in the working class; electrification meant providing the latest means of technological development. Soviet rule and technological development, together, would enable the country to leap-frog its capitalist neighbors and become the vanguard for humanity’s future development, both social and economic.

The socialist left hoped this vision would be realized. Early accounts were enthusiastic—sympathetic American journalist Lincoln Steffens gushed in 1919: “I have seen the future, and it works!”

By the 1930s, as the United States and Europe slid into the Great Depression, Soviet Russia was held out as a more workable and more equitable society than those in the West. In the field of medicine and public health, two observers set out to see if that were true. Sir Arthur Newsholme (1857–1943), and John Adams Kingsbury (1876–1956), a Briton and an American, traveled through the Soviet Union in August and September 1932.[2] Their account was published the following year as Red Medicine: Socialized Health in Soviet Russia.[3]

Itinerary of the authors

“Itinerary of the authors, who traveled 9,000 miles within Soviet Russia.” Red Medicine, p. 19.

Newsholme and Kingsbury travelled over 9,000 miles throughout the Soviet Union. Entering Russia from Poland, the two traveled to Moscow, took a trip up to Leningrad and back, and then headed east to Kazan, south to Samara and Stalingrad, and jogged back to Rostov-on-Don before journeying to Tiflis (Tbilisi) in Soviet Georgia. They traveled back to Moscow by way of Sochi, Sevastopol (in Crimea), and Kharkov in Ukraine, and from Moscow, they returned to Poland. Their book chronicled their trip with an overlay of commentary. It was in part a look at Soviet institutions, such as residential and non-residential treatment, physician training, maternity care, and tuberculosis sanitaria. Beyond this, the authors provided social and political observations on life in the Soviet Union, with chapters on “The Background of Russian Life,” “Stages in the Introduction of Communism,” “Women in Soviet Russia,” and “Religious and Civil Liberty and Law.”

Though clear-eyed about the authoritarian nature of the Soviet government, Newsholme (the acknowledged author of most of the work) nonetheless focused on one question:

Does the Soviet organization—including all that is implied in the unification of financial responsibilities and control of the entire resources of the country—assist to an exceptional extent a complete medical and hygienic service for the entire community? To this question we can at once give a definitely affirmative answer. [4]

Though the “civilized countries” had variously tended toward socialized medicine, he thought that the U.S.S.R. had surpassed them all, both in delivery of health care and in prevention, in social services as well as medicine more narrowly defined. As one reviewer of Red Medicine understood Newsholme’s claim:

“[In the] organization and practice of medicine . . . the present government has made truly great progress, and seems to have only fairly gotten under way. The authors clearly perceive that Russia has laid a more adequate basis for up-to-date public health than any western nation; also, that we have arrived at a stage of cultural development when medical services must be provided on a sound basis for all, regardless of ability to pay.”[5]

Traveling dental station

Soviet Photo Agency, “Traveling dental station in rural district near Moscow,” [1932]. Red Medicine, p. 223.

This level of public support was seen as the inevitable goal of social development, so much so that, as Newsholme put it, “Even if the Communist experiment fails, Russian government cannot be expected to revert entirely to capitalist conditions.”

Did the Soviet experiment work? The new system of medicine and public health was initially very successful in dealing with infectious disease and extending care more widely through the country. Nonetheless, as Newsholme had envisioned, the initial impetus could not be sustained. Fifty years after Red Medicine, the system was broken; while citizens could usually get access to health care, quality lagged. After the collapse of the Soviet system in 1989–91, the new Russian government attempted reform and adopted a mixed public-private economic model, mandating compulsory health insurance while continuing a guaranteed right to free care. Fifteen years on, though, an OECD report concluded that “Russia continues to struggle with a health and mortality crisis.”[6] One could fairly state that our country faces such as crisis today as well, and in both cases, the resolution is yet to come.

A note: Red Medicine includes several photographs by noted photojournalist Margaret Bourke-White, taken during her own 1932 trip to the Soviet Union, and provided freely to the authors for their use.[7]

[1] Yes, it took place in November! In 1917, Russia still used the Julian calendar, according to which the day of the Bolshevik coup was October 25. The rest of the West, using the Gregorian calendar, called that day November 7. Most of Catholic Europe had switched to the Gregorian calendar in 1582, with the Protestant countries adopting it in the 17th century and the British domains in 1752. Russia made the change in early 1918, one of the last countries in Europe to do so.

[2] Newsholme was an eminent British public servant and advocate of state intervention in public health, while Kingsbury, a Fellow of The New York Academy of Medicine, was formerly Commissioner of Public Charities for New York City, and at that time, Executive Director of the Milbank Fund, a foundation supporting research in health policy.

See “Sir Arthur Newsholme, K.C.B., M.D. (LOND.), F.R.C.P.,” American Journal of Public Health 33(8) (August 1943): 992–94; John M. Eyler, Sir Arthur Newsholme and State Medicine, 1885–1935, Cambridge History of Medicine (Cambridge: Cambridge University Press, 1997); Arnold S. Rosenberg, “The Rise of John Adams Kingsbury,” The Pacific Northwest Quarterly 63(2) (April 1972): 55–62; “Biographical Note,” The John Adams Kingsbury Papers, Manuscript Division, Library of Congress, accessed November 7, 2017.

[3] Sir Arthur Newsholme and John Adams Kingsbury, Red Medicine: Socialized Health in Soviet Russia (Garden City, NY: Doubleday, Doran, 1933). Note that, despite the title, the work was about more than Soviet Russia. The two men’s travels took them to the Georgian and Ukrainian Soviet Republics as well.

This work was conceived as in some ways completing Newsholme’s previous three-volume survey of medical practice in Europe, which he undertook with the support of the Milbank Foundation: Medicine and the State: The Relation between the Private and Official Practice of Medicine, with Special Reference to Public Health. London, Baltimore: George Allen and Unwin, Williams and Wilkins; 1932. The Academy Library holds the third volume.

[4] Newsholme and Kingsbury, Red Medicine, “Concluding Observations” (for this and subsequent statements).

[5] Frank H. Hankins, “[Review of] Red Medicine: Socialized Health in Soviet Russia. By Sir Arthur Newsholme and John Adams Kingsbury,” Social Forces 14 (1) (1 October 1935), 155–56, accessed November 7, 2017. Hankins (1877–1970) was a prominent American sociologist.

[6] William Tompson, “Healthcare Reform in Russia: Problems and Prospects,” Organisation for Economic Co-operation and Development, Economics Department Working Papers, No. 538 (Paris, January 15, 2007), 5.

[7] Gary D. Saretzky, catalog for “Margaret Bourke-White in Print: An Exhibition at Archibald S. Alexander Library, Rutgers University, New Brunswick, New Jersey, January–June 2006,” item 23, Red Medicine, accessed November 7, 2017.

Three Days in Baden-Baden: On the Enchantments of Soviet Biography

Johanna Conterio, a Ph.D. candidate in the History Department at Harvard University specializing in modern Russia, wrote today’s guest post.

It is notoriously difficult to find biographical information about people who lived in the Soviet Union. Personal papers, the kind that historians of the United States rely on, are rarely found in state archives in Russia. Russian intellectuals historically tried to keep their materials out of state archives, associating these with policing rather than with preservation—reasonable enough, as archives were mainly acquired during police raids! But that does not mean that biographical information is impossible to find. When getting into a story in the Soviet past, certain names keep coming up, and information comes from unexpected places. A person may have written an article. If their position is given in the byline, one can figure out where they worked and perhaps find the archive of that organization, or a published history. One checks the stacks for books and brochures they have written. Perhaps they gave a talk at an international conference and left a trace in conference volumes. The more one learns, the more curious one becomes about the course of a life in the past, at first seen only in fragments.

Nikolai Ivanovich Teziakov

Nikolai Ivanovich Teziakov

I first encountered Nikolai Teziakov in a source from the Central Scientific Medical Library in Moscow. In 1923, he published a small book, Health Resorts in the Russian Socialist Soviet Republic. When the librarian delivered the book, I was surprised to find that it was in German and had been published in Berlin (in the card catalogue, the title was given in Russian).1 I had it photocopied and didn’t think about it again for some time. But as I continued my research, I started to see the name Nikolai Teziakov again and again. He was the second director of the Main Health Resort Administration, the state organ that organized Soviet health resorts, and part of the People’s Commissariat for Public Health. He worked during the Russian Civil War (1918-1922) in rural Saratov, 500 miles southeast of Moscow, heading the regional health department fighting infectious diseases and setting up sanatoria for tuberculosis patients. But some very basic questions about who he was remained unanswered. Was he a member of a political party? How did he progress from rural physician in Saratov to top official in Moscow? What was his family background? Where did he study medicine? Did he ever travel abroad? And what did he look like?

Some basic information comes from The Great Soviet Encyclopedia, and I’ve filled in some more details. Nikolai Ivanovich Teziakov was born in 1859 into a peasant family in a village outside of Sverdlovsk, in the Ural Mountains. He finished secondary school in 1879, and studied medicine in Kazan, finishing in 1884. Teziakov was enormously active in public health in Russia before the October Revolution of 1917. Following the cholera epidemic of 1892-1893, he became a sanitary physician and began to collect statistics and conduct epidemiological research. He worked to lower the rates of infant mortality through the organization of free day care for agricultural families, and to fight infectious diseases through disinfection and immunization. He was also active in training medical workers in the new field of hygiene. He attended the famous International Hygiene Exhibition in Dresden in 1911. While working in Kherson province, he wrote about the increasing rates of landlessness among the peasantry. His statistics were used by Lenin in his work On the Development of Capitalism in Russia. During the years of the Civil War, he wrote the slogan “Health Resorts for the Workers!” He was convinced that health resorts were important for the improvement of the health of the workers, an opinion shared by Lenin and Commissar [Minister] of Public Health, Nikolai Aleksandrovich Semashko, powerful patrons of Soviet health resorts, who oversaw the development of the first health resorts for workers in Europe. He died in 1925 at age 65.

But it is Teziakov’s German connections that emerged as an intriguing story, told through the official journal published by the Main Health Resort Administration, Health Resort Affairs [Kurortnoe delo], in the New York Academy of Medicine’s rich collection of Soviet medical journals.  Teziakov’s Berlin publication was meant to be a conference paper, originally to be presented at the 38th German Balneological Congress in 1923 in Aachen.2 He travelled to Germany in 1923 for the conference, but due to the French occupation of Aachen (these were eventful years in Europe!), the conference was abruptly cancelled. Nonetheless both the director and the secretary of the German Balneological Society gamely hosted him and his small Soviet entourage for ten days in Berlin. Add two new names to the historical index: Eduard Dietrich and Max Hirsch.

Teziakov was eager to see the health resorts of Germany. Together with the Soviet physician [S. V.] Korshun and a German secretary, Binger, and carrying with them a letter of introduction from Dietrich, from April 12 to 30 Teziakov visited the German health resorts Baden-Baden, Wildbad, Bad Homburg, Bad Kissingen, Wiesbaden, Bad Nauheim, and Bad Eichhausen.3 Upon his return to Moscow, Teziakov published two detailed accounts of his travels in Health Resort Affairs. Although he was impressed by the beautiful parks and gardens, clean streets, and brilliant architecture of the German baths, Teziakov was disappointed to find that these were only accessible to what he called the “grand bourgeoisie,” and deplored what he called the “commercial” organization of health resort care. Exceptions to this rule were a few charitable organizations that he visited during his three days in Baden-Baden, but Teziakov called these “pathetic.” He contrasted German with Russian medicine: “Medical help at the health resorts is in the hands of private physicians, united into unions. The organization of state or public, municipal health care such as we, Russian physicians, understand it, does not exist.”4 Teziakov’s reports were republished in a brochure for a mass audience, and reviewed by Commissar Semashko on page one of the newspaper Izvestiia. Reprising a common theme among the new Soviet leaders, Semashko wrote that the country needed to combine “German” technology and “iron discipline” with the Soviet approach to social questions. “What a fantastic order we might then establish in health resort construction,” he wrote.5

The German balneologists were also interested in developments in the Soviet Union. The director of the German Balneological Society, Eduard Dietrich, was invited to the Soviet Union in 1924, as a delegate to the Fourth All-Russian Balneological Congress in Moscow (although it remains unclear whether he attended).6 The Society’s secretary, Max Hirsch, developed an ongoing fascination with Soviet balneology and health resorts. He wrote a number of articles about Soviet balneology in the German press in the 1920s, particularly in the Journal for Scientific Balneology [Zeitschrift für wissenschaftliche Bäderkunde]7 and provided reports on various balneological conferences and proceedings to Health Resort Affairs. Hirsch’s relationship with the Soviet Union had begun, and was continued by further meetings with Teziakov in 1923 and 1924, when Teziakov returned to Germany to attend the balneological congress. Of Jewish heritage, Max Hirsch emigrated to the Soviet Union in 1933, fleeing his native Germany via Czechoslovakia. My next task is to find out what happened to him when he arrived in the USSR. Through detective work in the journals, I’ve learned not only more about Teziakov’s career, but discovered the surprising interplay of German and Soviet public health in the 1920s and 1930s, mirroring political developments of those decades.

1. N.J. Tesjakow, Das Kurortwesen in der Russischen Sozialistischen Räterepublik (Berlin: Verlagsbuchhandlung von Richard Schoetz, 1923)

2. Balneology is the science of baths or bathing, especially the study of the therapeutic use of thermal baths.

3. N.I. Teziakov, “Po germanskim kurortam (12-30 apr. 1923 g.)” Kurortnoe delo 1 (No. 6, 1923): 19.

4. N.I. Teziakov, “Po germanskim kurortam (12-30 apr. 1923 g.)” Kurortnoe delo 1 (No. 6, 1923): 30.

5. Izvestiia, August 3, 1923.

6. Christine Böttcher, Das Bild der Sowjetischen Medizin in der ärztlichen Publizistik und Wissenschaftspolitik der Weimarer Republik (Pfaffenweiler: Centaurus-Verlagsgesellschaft, 1998), 52-53.

7. This journal is also held in the collections of the New York Academy of Medicine Library.