Charlotte E. Henze, Disease, Health Care and Government in Late Imperial Russia: Life and Death on the Volga, 1823–1914

Extract

For better or worse, tragic stories often make for good history, and Charlotte Henze has written an important and often compelling account of one of late imperial Russia's saddest episodes: its dreadful encounters with cholera in the century before the First World War. Focusing especially on the southern Volga city of Saratov, Henze weaves together medical, urban and political history to produce a convincing explanation of why epidemics of cholera were repeatedly so deadly in the Russian empire, especially in Saratov, and why Russian institutions in particular were so ill equipped to deal with them. In an analysis which is never shy of the bigger picture and which engages robustly and consistently with the comparative literature, she shows explicitly how the micro-study of one city's struggle with this terrible disease adds to our understanding of the institutional failure of late imperial Russia, and thus the revolution.

The book is divided into five chapters. Chapter 1 provides an overview of the Russian experience of cholera and the medical responses to it in the decades before Henze's principal case study, the Saratov epidemic of 1892. In the next chapter, she describes living conditions and structures of power in Saratov, concluding that the arrival of the disease in the summer of 1892 ‘found perfect conditions to produce a local medical, social and economic disaster’ (p. 50). This account of life in Saratov is drawn in a highly engaging way. Chapter 3 is a discussion of the 1892 epidemic in Saratov, throwing light on how the epidemiological and institutional contexts combined to produce coercive and ham-fisted policies of quarantine enforcement: policies that generated despair, confusion and riots, even when more measured and effective reactions to the disease were already evident elsewhere in Europe. The first three chapters especially are driven by a sense of narrative urgency that is delivered in a smooth and economical writing style. In Chapter 4, Henze shows how the 1902 epidemic created a more rational official response than before, with sanitary and other social reforms in Saratov, but argues that the partial character of these measures was insufficient to prevent further outbreaks of cholera in the years just before the First World War. Chapter 5 then outlines this ‘revival of cholera’ in more detail: a story marked once more by institutional failure at the highest levels in St Petersburg. At the heart of the book, therefore, is an argument about ‘the strains inherent in Russia's process of modernization’ that helped to create the conditions for revolution; this was a country so badly run that ‘the achievements of bacteriology could not eradicate cholera’ (pp. 155–6).