Vladimir Mikhailovic Bekhterev (1857-1927): Strange Circumstances Surrounding the Death of the Great Russian Neurologist

Abstract

The famous Russian neurologist Vladimir Mikhailovic Bekhterev (1857-1927) was ordered to examine Josef Stalin in December 1927 during the First All-Russian Neurological Congress in Moscow. Returning to the Congress after his consultation he told some colleagues that he had 'examined a paranoiac with a dry, small hand'. The next day, Bekhterev died and only his brain was examined postmortem, the body being cremated the same day.

Full text

Fax +41 61 306 12 34
E-Mail karger@karger.ch
www.karger.com
Historical Note
Eur Neurol 2011;66:14–17
DOI: 10.1159/000328779
Vladimir Mikhailovic Bekhterev (1857–1927):
Strange Circumstances Surrounding the Death of
the Great Russian Neurologist
JürgKesselring
Department of Neurology and Neurorehabilitation, Rehabilitation Centre, Valens , Switzerland
‘Die Steifigkeit der Wirbelsäule und ihre Verkrümmung
als besondere Krankheitsform’ (‘The rigidity of the spine
and its curvature as a special form of disease’)
[2] . His
descriptions, however, do not conform to what is now di-
agnosed as ankylosing spondylitis, which nevertheless
has been described by neurologists
[3–5] .
Bekhterev was an important Russian neurologist,
born on January 20 after the Julian, February 1 after the
Gregorian calendar in 1857 in Sorali Vyatka province
( fig.1 ).
After medical school he spent several years of travel-
ling, primarily working in neurological and psychologi-
cal institutes in Germany, among others with Paul Flech-
sig and Wilhelm Wundt in Leipzig, Theodor Meynert in
Vienna and with Jean-Martin Charcot at La Salpêtrière
in Paris. In this period he wrote numerous neurological
articles, especially in German, which he published, for
example, in Pf lügers Archiv für die gesammte Physiologie
des Menschen und der Tiere (Pflüger’s Archive for the En-
tir e Phy siol og y o f Hum an s a nd An im al s) and several times
in the Neurologisches Centralblatt Leipzig [6–8] . He wrote
a great textbook Die Leitungsbahnen im Gehirn und Rü-
ckenmark: ein Handbuch für das Studium des Aufbaues
und der inneren Verbindungen des Nervensystemes [9] on
‘conducting pathways in the brain and spinal cord’, which
Key Words
Bekhterev ⴢ Russian neurology ⴢ Stalin
Abstract
The famous Russian neurologist Vladimir Mikhailovic Bekh-
terev (1857–1927) was ordered to examine Josef Stalin in De-
cember 1927 during the First All-Russian Neurological Con-
gress in Moscow. Returning to the Congress after his consul-
tation he told some colleagues that he had ‘examined a
paranoiac with a dry, small hand’. The next day, Bekhterev
died and only his brain was examined postmortem, the body
being cremated the same day.
Copyr ight © 2011 S. K arger AG, Basel
In rheumatology, the name of Bekhterev (Bechterew)
is usually associated with ankylosing spondylitis, a
chronic progressive auto-immune disease that mainly af-
fects the spine and surrounding structures such as the
sacro-iliac joints, the small synovial joints and the edges
of the discs, resulting in the so-called ‘bamboo spine’.
Bekhterev published first on spondylitis in 1892 in the
St. Petersburg medical journal Vrach [1] and a year later
a translation in the Neurologisches Centralblatt Leipzig ,
Recei ved: January 28, 2011
Accepted: A pril 26, 2011
Publish ed online: June 23, 2011
Prof. Jürg Kesselring
Depa rtment of Neurolog y and Neurorehabilitation
Rehabilitation Centre
CH–7317 Valens (Switzerland)
Tel. +41 81 303 1408, E-M ail kesselr ing.kliva l
 @  spin.ch
© 2011 S. Karger AG, Basel
0014–3022/11/0661–0014$38.00/0
Accessible online at:
www.karger.com/ene

V.M. Bekhterev (1857–1927): Strange
Circumstances Surrounding His Death
Eur Neurol 2011;66:14–17
15
became a standard textbook and earned him the reputa-
tion: ‘Only two know the mysteries of the brain: God and
Bekhterev’ (a quotation which occasionally is attributed
to Friedrich Wilhelm Theodor Kopsch, 1868–1955, the
eminent anatomist).
After his years of travelling Bekhterev was appointed
to the chair of neurology at the University of Kazan, Ta-
tarstan, where he founded a neurological school, from
which emerged, much later, Alexander Romanovich
Luria. A new museum recently opened in Kazan and is
devoted to his memory there
[10] . In 1905, he founded
and led the Psychoneurological Institute in St. Peters-
burg, which in 1925 was named after him. He was partly
in fruitful competition, sometimes in open opposition
with Pavlov, who dominated the faculty
[11] .
Bekhterev was a renowned neurologist, he had also
contributed an article to the Festschrift for the great Swiss
neurologist (of Russian origin) Constantin von Monakow
[12, 13] on occasion of his 70th birthday in 1923 in the
Swiss Archives of Neurology and Psychiatry . He had also
been called to the bedside of Lenin and was co-founder
of the First All-Russian Congress of Neurologists and
Psychiatry, held in December 1927 in Moscow
[14 –16]
( fig.2 ).
Bekhterev was Honorary President of this Congress
and in top health condition as various sources attest. A
few weeks earlier he had received a telegram from Mos-
cow asking (or rather: ordering) him to quickly come to
Moscow for a neurological examination in the Kremlin
[16] . In various newspaper reports and memoirs of the
time , a s we ll as in t ho se of the c ompo ser S host ak ov ich
[17,
18] , it is described that on December 23, 1927, after hav-
ing lectured on child neurology at the Congress men-
tioned, Bekhterev went to the Kremlin to examine Stalin
[14] . About 3 h later he came back to the Congress for an
important meeting and said to some colleagues there: ‘I
have just examined a paranoiac with a short, dry hand’.
On the same evening he was in the theatre [some sources
say it was the Bolshoi Theatre, others speak of Mal’ij (Lit-
tle Theatre)], and in the break 2 unknown young men ap-
proached him and offered him cakes and drinks at the
buffet. After returning to his apartment – when in Mos-
cow, he always used to reside with his old friend, the gy-
naecologist Prof. Plagavoli – violent vomiting started.
The next morning his wife called a doctor for consulta-
tion, and Prof. Burmin (1872–1954) came and made a di-
agnosis of ‘gastro-enteritis’
[19] . Then, on December 24,
1927, two doctors came to his bed uninvited, who were
later identified as doctors Klimenkov and Konstanti-
novski, members of the Secret Service, and later also Mr.
R. Rein, a member of the Central Committee, came for a
visit. Towards evening Bekhterev lost consciousness, res-
piration became irregular and blood pressure was drop-
ping. Resuscitation attempts were made in this house …
and in the evening he was dead ‘from heart failure …’
[16] .
The next day a consultation was convened by 9 profes-
Color versi on available online
Fig. 1. When Bekhterev was sitting for the
sculptor E.A. Block, he modelled himself a
head of a sufferi ng boy out of a piece of clay
which Block then integrated into his own
sculpture. This astonishing combination
symbolizes Bekhterev’s identification with
the suffering of his patients
[6] .
Fig. 2. Portrait of Bekhterev by Il’ ja E. Re-
pin painted in the summer of 1913. Origi-
nal in the Russian Museum in St. Peters-
burg; copy by Repin himself in the
Bekhterev Museum in the Psychoneuro-
logical Institute.
1 2

Kesselring
Eur Neurol 2011;66:14–17
16
sors: of notice, Prof. Scherwinski was present, a formerly
famous internist who had retired in 1911, the previously
mentioned Prof. Burmin, a balneologist was present and
also a well-known neuropathologist, Prof. Abriskov. In
this consilium it was stated that Bekhterev, just before his
death, had wished that no autopsy be performed and that
he had only allowed his brain to be removed. The brain
removal was carried out by Prof. Il’in, the chief physician
of a psychiatric hospital in Moscow, allegedly on the or-
ders of Health Minister Semashko
[16] . He declared in a
report that Bekhterev’s brain was brought ‘within 15 min
from the skull into a pot on the table …’. It is also record-
ed that the body of Bekhterev was sent for cremation the
same day against the will of the members of his family.
In the year 1927, Bekhterev had had the plan to build
a ‘Pantheon of Brains’ in Leningrad
[20] . It is an irony of
fate that exactly at the time when the question of the cre-
ation of the pantheon had been positively resolved, the
initiator of this institution, Bekhterev, died so sudden-
ly … In 1928, the neuro-anatomical laboratory of the
Vogts and their Russian counterparts was re-organized
in Moscow as the Moscow Brain Research Institute
[20] .
It was there where the structured collection and orga-
nization of the brains of famous Russians was set up.
Bekhterev did not live up to the fulfilling of his plans, but
his own brain enriched the collection of the Moscow In-
stitute (with a weight of 1,720 g!). For a long time scien-
tific investigations of skulls and brains of geniuses went
hand in hand with hagiographical celebrations of scien-
tists. Late-eighteenth century anatomists and anthropol-
ogists highlighted quantitative parameters such as the
size and weight of the brain in order to explain intellec-
tual differences between women and men and Europeans
and non-Europeans, geniuses and ordinary persons. Re-
ports about extraordinary brains were part of biographi-
cal sketches, mainly delivered in celebratory obituaries
[21] .
The diagnosis of paranoia in the case of Stalin was, no
doubt, well founded (ICD-10 F60.0: paranoid personality
disorder; excessive sensitivity to rejection; bearing on
slights, suspicion; tendency to distort experiences; neu-
tral or friend ly actions of ot hers misinterpreted as host ile
or contemptuous; recurring unjustified suspicions re-
garding sexual fidelity of spouse or sexual partner; con-
tentious and continued insistence on their own rights;
inflated self-esteem and frequent, excessive self-absorp-
tion). Stalin also had all the signs of what was described
recently
[22] as ‘hubris syndrome’. The neurologist David
Owen, a long-standing Member of Parliament in Engla nd
and twice foreign minister, wrote a book worth reading
on diseases of state leaders in the last 100 years
[23] . He
also proposed criteria for this hubris syndrome and sug-
gested its relationship with cluster B personality disor-
ders in DSM-IV.
It is not clear what Bekhterev could have meant with
the diagnosis of ‘small dry hand’ for his patient: it is
known that Stalin’s left hand, probably the whole left arm,
was slightly atrophic – his left hand is only rarely seen in
pictures and on the few occasions in which it can be seen,
it appears clearly smaller, slightly atrophic. On the few
occasions where Stalin can be seen on film, he is moving
both arms, e.g. when clapping hands or when swinging
arm s wh en w al ki ng, a ce rtain spa stic ity is a ppa rent i n the
left upper limb, so that, in retrospect, syringomyelia
seems to me a diagnostic possibility. It is understandable
that to confirm or refute such a difficult diagnosis the
doctors in Moscow had asked the famous colleague
Bekhterev from Leningrad for a consultation. But it was
the other diagnosis which he had made aside and for
which he most probably had not been asked which caused
his premature death.
After his death the name of Bekhterev was hushed up
in the Soviet Union; one of his sons was exiled and died
soon after his father. His granddaughter, Natalia Pet-
rovna Bekhtereva, later headed the Institute of the Hu-
man Brain of the Russian Academy of Sciences in St. Pe-
tersburg
[24] . She said in an interview that they some-
Color versi on available online
Fig. 3. Tombstone of V.M. Bekhterev in the
Volkovo cemetery in St. Petersburg.

V.M. Bekhterev (1857–1927): Strange
Circumstances Surrounding His Death
Eur Neurol 2011;66:14–17
17
References
1 Bekhterev VM: Oderevenelast’ pozvonochi-
kas isk rivleniemego, kak osabia forma zabo-
levaniia . Vrach (St Petersburg) 1892;
13: 899–
903.
2 Bekhterev VM: Die Steifigkeit der Wirbel-
säule und ihre Verkrümmung als besondere
Krankheitsform . Neurol Centralbl Leipzig
1893 ;
12: 426.
3 Connor B, Marie P: Les rhumatismes défor-
mants. Tribuna Med Paris 1895;
27: 27–30.
4 Marie P: Sur la spondylose rhizomélique .
Rev Méd Paris 1898;
18: 285–315.
5 Von Strümpell A: Bemerkung über die ch ro-
nische ankylosirende Entzündung der Wir-
belsäule und der Hüftgelenke. Lehrbuch der
speciellen Pathologie und Therapie der in-
neren Krankheiten . Leipzig, Vogel, 1884, vol
2, p 152.
6 Pfrepper R, Pfrepper G, Akimenko MA
(eds): Vladimir Michajlovic Bechterev
(1857–1927): Neue Material ien zu Leben und
Werk. Aachen, Shaker, 2007.
7 Bechterew VM: Über die functionelle Bezie-
hung der unteren Oliven zum K leinhirn und
die Bedeutung derselben für die Erhaltung
des Körpergleichgewichtes. Arch Ges Physi-
ol Menschen Thiere 1882;
9: 257–265.
8 Pfrepper G, P frepper R: Publi kationen Vlad-
imir M. Bechterevs in deutscher Sprache; in
Pfrepper R, Pfrepper G, Akimenko MA
(eds): Vladimir Michajlovic Bechterev
(1857–1927): Neue Material ien zu Leben und
Werk. Aachen, Shaker, 2007, pp 115–168.
9 Von Bechterew W: Die Leitungsbahnen im
Gehirn und Rückenmark: ein Handbuch für
das Studium des Auf baues und der inneren
Verbindungen des Nervensystemes. Leipzig,
Arthur Georgi, 1899.
10 Snamentyie Semljaki Vladimir Michailovic
Bechterev. Sbornik statej Elabuga 2007 (Mu-
seum’s catalogue).
11 Akimenko MA: Vladimir Michajlovic
Bechterev. J History Neurosci 2007;
16: 10 0–
109.
12 Bechterew W: Studium der Funktionen der
Praefrontal- und anderer Gebiete der Hirn-
rinde vermittelst der associat iv-motorischen
Reflexe. Schweiz Arch Neurol Psychiatrie
1923;
13: 61–76.
13 Kessel ring J: Consta ntin von Monakow’s for-
mative years in Pfäfers. J Neurol 2000;
247:
200–205.
14 Keitel W: Ein Opfer Stalins? Wladimir Mi-
chailowitsch Bechterew (1857–1927). Z
Rheumatol 2002;
61: 201–206.
15 Lerner V, Margolin J, Witztum E: Vladimir
Michajlovic Bechterev (1857–1927). J Neurol
2006;
253: 1518–1519.
16 Lerner V, Margolin J, Witztum E: Vladimir
Bechterev: his life, his work and the mystery
of his death. Hist Psychiatry 2005;
16: 217–
227.
17 Volkov S (ed): Testimony: The Memoirs of
Shostakovich. New York, Harper Colophon,
1979.
18 Topolyansky VD: Noch’ pered rozhdestvom
v 1927 godu. Ogonyek 1989;
27: 9–10.
19 Demin D: Vrachnebnaya Taina. Moscow,
Manskiy, 2002.
20 Vein AA, Maat-Schieman LC: Famous Rus-
sian brains – historical attempts to under-
stand intelligence. Brain 2008;
131: 583–590.
21 Hagner M: Sku lls, brai ns, and memorial cu l-
ture: on cerebral biographies of scientists in
the nineteenth centu ry. Sci Context 2003;
16:
195–218.
22 Owen D, Davidson J: Hubris syndrome – an
acquire d personality d isorder? A study of US
Presidents and UK Prime ministers over the
last 100 years. Brain 2009;
132: 1396–1406.
23 Owe n D: In Sickne ss an d in Po wer: I llness in
Heads of Government in the Last 100 years.
London, Methuen, 2009.
24 Bechtereva NP: On the scientific school.
Hum Physiol 2004;
30: 379–391.
25 Bekhterev VM: Immortality from the scien-
tific point of view (translation of speech de-
livered at St Petersburg Psychoneurological
Institute in February 1916). Society 2006;
43:
74– 80.
26 Grashenkov NI: Relationship between Brit-
ish and Russian medicine and neurology,
and the role of the National Hospital, Queen
Square, London, in the development of Rus-
sian neuropathology. J Neurol Neurosurg
Psychiatry 1960;
23: 185–190.
times had spoken about the affair of her grandfather in
the family, but that it was never clarified. She could only
confirm that her grandfather had never been a coward
and would have been prepared also to express an unpop-
ular diagnosis.
Much later, during the thaw climate under Khrush-
chev, or even later in the 70s, Bekhterev was rehabilitated
and recognized as one of the great Russian neurologists
[25, 26] . He was honoured in 2007 with a 5-ruble stamp,
and in the 1970s, a sculpture was erected on the cemetery
in St. Petersburg ( fig.3 ).