Vladimir Mikhailovich Bekhterev

Born 1857
Died 1927

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Russian neurologist and psychiatrist, born January 20 (February 20 on the old calendar), 1857, in Sorali, gouvernement of Vyatskaya oblast, between Volga and the Ural mountains, Russia; died December 24 (4?) 1927, Moscow Leningrad? U.S.S.R.

Biography of Vladimir Mikhailovich Bekhterev

Murdered by Stalin

To the lay public Vladimir Bekhterev is known for Bekhterev’s disease, pelvospondylitis. Bekhterev’s most important work, however, was in the study of reflexes and the morphology of the brain. He is the founder of psycho reflexology, transmitting to humans the same pattern of thinking that Pavlov had developed in his work on conditioned reflexes in dogs, and he used similar experiments. Bekhterev is thus a forerunner of behaviourism. His works are epoch-making, but at first received little attention as they were published in Russian.

Vladimir Mikhailovitsj Bekhterev was born in the small village of Sorali between the Volga River and the Ural Mountains. After graduating from the Vyatskaya Gymnasium he enrolled at the Military Medical and Surgical Academy in St. Petersburg in 1873, at 16 years of age. He was in particular a student of J. P. Merzejewsky. After graduating in 1878 he held a position at the psychiatric clinic in St. Petersburg. It was here that he turned to the field that would make him famous: the anatomy and the physiology of the brain.

In 1881 Bekhterev defended his dissertation for the medical doctorate that dealt with the possible relation between body temperature and some forms of mental illness. He was habilitated for Privatdozent of neurology and psychiatry in 1881 and was appointed associate professor - Dozent - that year. He was then awarded a fellowship to study and conduct research abroad. In 1884-1885 he worked with the physiologist and psychologist Wilhelm Wundt (1832-1920) who is generally acknowledged as the founder of experimental psychology, and the psychiatrist and neurologist Paul Emil Flechsig (1847-1929) in Leipzig. He also visited Theodor Hermann Meynert (1833-1892 in Vienna, and in Berlin Karl Friedrich Otto Westphal (1833-1890) and Emil Heinrich Du Bois-Reymond (1818-1896). He also and worked with Jean Martin Charcot in Paris.

In 1895 he returned to Russia to become professor of psychiatric diseases at the University of Kazan. It was in this year he described the superior vestibular nucleus. At Kazan he established the first laboratory for research on the anatomy and physiology of the nervous system. While in Kazan, Bekhterev began clinical research into mental disorders, and completed investigations of the role of the cortex in the regulation of the functions of the internal organs. It was also here that he prepared the first edition of the classic monograph Provodyaschie puti spinnogo i golovnogo mozga - «Passages of the Spinal Cord and Cerebrum, and the two-volume Nervnye bolezni v otdelnykh nablyudeniakh - «Nervous Diseases in Separate Observations”.

In 1893 Bekhterev succeeded his original mentor, Merzejewsky, as professor and head of the department of nervous and psychic disease of the Military Medical Academy in St. Petersburg.

With great sacrifices, spending his private money, in 1907 he was able to establish a psycho neurological institute with his own means. This later had subsidiary institutes and was made into the State Psychoneurological Academy. Bekhterev served as the institute’s first director even after he was forced to resign his medical school appointment under governmental pressure in 1913, and he founded the State Institute for the Study of the Brain, which today bears his name, also in St. Petersburg. He was restored to favour following the Russian Revolution of 1917 - when the school was renamed the State University of Medical Sciences. He then chaired the department of psychology and reflexology at the University of Petrograd from 1918 until his death.

Bekhterev was an academic competitor and faculty colleague of Ivan Pavlov, with whom he was frequently in open conflicts at meetings and there was much acrimonious debate between workers from his laboratory and those from Pavlov’s. Pavlov believed work from Bekhterev’s laboratory was poorly controlled and sloppy at best. This criticism was probably not quite unjust, as Bekhterev seemed to accept his assistant’s experimental findings too readily and uncritically.

Independently of Pavlov Bekhterev developed a theory of conditioned reflexes, studying both inherited an acquired reflexes in the laboratory. He also accumulated a considerable volume of data on skeletal reflexes that was later applied in neurology.

Bekhterev's most lasting work was his research on brain morphology and his original description of several nervous symptoms and illnesses. He discovered the superior vestibular nucleus (Bekhterev nucleus) as well as several previously unknown brain formations. He also described numbness of the spine (Bekhterev's disease) and new forms of syphilitic-sclerosis, motor ataxia and spondylitis.

Bekhterev founded the Nevrologichesky Vestnik, the first Russian journal on nervous diseases, in 1896. His insistence on a purely objective approach to the study of behaviour and his conviction that complex behaviours could be explained through the study of reflexes influenced the growing behaviourist movement of psychology in the United States.

Murdered by Stalin
Ten years after the Revolution, in December 1927, Joseph Stalin called the 70-year old Bekhterev to the Kremlin. Three years after the death of Lenin, Stalin was engaged in the final stages of the struggle for power, his main adversaries being Trotsky and his adherents. Stalin felt depressed. There was nothing strange in his turning to Bekhterev, for the latter was the undisputed psychoneurological authority in the Soviet state and he had also rendered the Revolution "exceptional services." In 1923, the ailing Lenin had twice sent for him.
It is unclear, as perhaps it will always remain, what then ensued. Persistent rumours in the Soviet Union have it that Bekhterev diagnosed Stalin as suffering from "grave paranoia." The same day he had visited the Kremlin he suddenly died (some authors say a couple of days later). According to the rumours, Stalin had him murdered, this being the patient's revenge for the diagnosis.
Bekhterev's frank announcements and the revenge of the despot would entirely agree with what is known today of these two personalities. Bekhterev feared no one; throughout his life he had stared power straight in the face and spoken his mind without prevarication. He had been in the best of health in the days before he suddenly died. Curiously, post-mortem was never held; his body was cremated in accordance, it was said, with his wish expressed shortly before his death.
The day before his death he had chaired a congress of neurologist from all over the Soviet Union in Moscow.

The question of priority
The first known description of Bekhterev’s disease, now a household name, was done by the Irish physician Bernhard Connor (1666-1698) who, during his studies in France, found a remarkable skeleton while exploring a gravesite. This skeleton showed complete ossification and bridging of vertebral disks and several other bones. All together this gave the impression of one massive compound piece of bone. Connor recognised the importance of this finding and wrote a scientific reports in French as well as in Latin and English - in the latter language in the form of a treatise published by the Royal Society in 1695. In it he gives not just a description of the finding of the skeleton, but also set forth a hypothesis that this condition clinically should be associated with a pronounced reduction in mobility and a total dependence on diaphragm breathing.

The first to unquestionably link the pathological-anatomical changes with the typical clinical picture is the English surgeon Sir Benjamin Brodie (1783-1862). In his textbook published 1850 he renders a clinical report of 31-year-old man with an obvious stiffness of the back, episodes of knee-joint exudate and inflammation of the eyes.

Some years later the Austrian pathologist Karl von Rokitansky (1804-1878) published good pathological-anatomical descriptions, and in the 1870’s came a new case report in which clinical and pathological cases were linked. The British physician Charles Fagge (1838-1883) then reported a 34-year-old man who had successively developed ankylosis of the chest, back and hips. The findings from the sections after his death from bronchopneumonia showed, besides suppurative changes of the lungs, also total ankylosis of the invertebras.

In the 1890’s several case reports were presented, of which those of Bekhterev, Strümpell and Marie have become classics. And classic, in its kind, was their conflict over priority. Throughout his life Bekhterev maintained that his original report from 1892 and 1893 was of patients with a type of disease different from that later described by Strümpell and Marie. In retrospect, however, there is no doubt that the publications of Strümpell and Marie concern cases of pelvospondylitis.

In his textbook Lehrbuch der speziellen Patologie und Therapie der inneren Krankheiten Strümpell briefly mentioned two cases with complete ankylosis of the back and hips. But not until 1897 did he present more exhaustive dates in an article in which he also presented the picture of a patient.

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