Financial support for this project was initially provided by the Hannah Institute for the History of Medicine at the University of Toronto. I presented portions of this article at the annual conference of the Royal College of Physicians and Surgeons, Toronto, 1998, as well as at the annual convention of the American Association for the Advancement of Slavic Studies, Denver, Colorado, 2000. The source for the epigraph is Aristotle, Problems, ed. T. E. Page (Cambridge, Mass., 1937), 2:154-55.

1. Chekhov, A. P., “Skuchnaia istoriia (iz zapisok starogo cheloveka),” Polnoe sobranie sochinenii i pisem v tridtsati tomakh, ed. Bel'chikov, N.et al. (Moscow, 1974-1983)Google Scholar, Sochineniia, 7:282, 307 (hereafter Sochineniia, 1-18, or Pis'ma, 1-12).

2. Ibid., 7:282,291.

3. Smirnov, M. M., “Geroi i avtor v ‘Skuchnoi istorii,'” Vtvorcheskoi laboratorii Chekhova(Moscow, 1974), 219 Google Scholar.

4. Flath, Carol A., “The Limits to the Flesh: Searching for the Soul in Chekhov's ‘A Boring Story,'” Slavic and East European Journal A\,no. 2(Summer 1997): 279, 281Google Scholar.

5. Lev, Shestov, “Anton Chekhov (Creation from the Void),”in Eekman, Thomas A., ed., Critical Essays on Anton Chekhov(Boston, 1989), 11 Google Scholar; Marina, Senderovich, “Chekhov's Existential Trilogy,”in Savely, Senderovichand Munir, Sendich, eds., Anton Chekhov Rediscovered: A Collection ojNew Studies with a Comprehensive Bibliography(East Lansing, Mich., 1987), 84 Google Scholar.

6. Leonid, Gromov, Realizm A. P. Chekhova vtoroipoloviny 80-khgodov(Rostov-on-Don, 1958), 186 Google Scholar. In contrast to these two main lines of interpreting Nikolai Stepanovich's pessimism, several critics have transferred the novella's emphasis on lack and deficiency from his thoughts themselves to character flaws that his self-analysis fails to address. Beverly Hahn, for example, commenting on Nikolai Stepanovich's indifference toward a despondent Katia in her own home, argues that he “fulfills the pattern of unconscious compromise, of which, one way or another, he has been guilty throughout his adult life.” See Hahn's Chekhov: A Study of the Major Stories and Plays(Cambridge, Eng., 1977), 164.

7. See Meve, E., Meditsina v tvorchestve i zhizni A. P. Chekhova(Kiev, 1989), 92-103.Google Scholar

8. Sochineniia, 7:257.

9. Such an exercise in differential diagnosis is not foreign to Chekhov's own scholarly endeavors. Having studied forensic medicine in his fourth year of medical school, he assisted forensic experts several times during autopsies in criminal investigations. Furthermore, during his preparation for an eventually abandoned dissertation on the history of medicine in Russia, Chekhov argued that it was theoretically possible, as the official tsarist version attested, that the tsarevich Dmitrii killed himself with a knife during an epileptic fit in 1591. His investigation of whether the False Dmitrii ever suffered seizures similarly led him to conclude “that the pretender was in fact a pretender, because he did not have epilepsy.” See Maslov, A. V., “A. P. Chekhov-sudebno-meditsinskii ekspert,” Sudebnomeditsinskaia ekspertiza 34, no. 4(1991): 59-60 Google Scholar. Commenting on War and Peace, moreover, Chekhov writes that it is “strange that the wound of Prince [Andrei] … gave off a cadaverous odor … if I had been nearby, I would have cured Prince Andrei.” See his letter to A. S. Suvorin, 25 October 1891, Pis'ma, 4:291. As Leonid Grossman suggests, “even in letters to young writers, as he indulgently and gently examines their purely artistic shortcomings, Chekhov mercilessly chides them for the slightest defect in medical matters in their stories.” See Grossman's, “The Naturalism of Chekhov,”in Robert Louis, Jackson, ed., Chekhov: A Collection of Critical Essays(Englewood Cliffs, N.J., 1967), 33 Google Scholar

10. Indeed, such a reductionism has at times occurred in Russian criticism on Chekhov. Meve, for example, in his highly informative study Meditsina v tvorchestue i zhizni A. P. Chekhova, diagnoses the character Kovrin in “Chernyi monakh” (The black monk) with dysnoia or, “in the modern understanding,” schizophrenia. Dysnoia is a diagnosis with which Chekhov would likely have been familiar from his copy of S. S. Korsakov's 1893 Kurs psikhiatrii. Meve suggests that it was not Chekhov's intention to use the “mystical and decadent ideas of [Fedor] Dostoevskii … to uncover the theme of the story” but precisely to “condemn” these ideas (162). Nevertheless, if mysticism falls under Chekhov's pervasive critical gaze, then this is no less true of psychiatry. When Kovrin is treated for “megalomania“ (maniia velichiia, Sochineniia, 8:251), pardy against his will, his academic career decidedly suffers. If he is not a divinely chosen one, as the black monk suggests, then is he not, as he himself argues during a period of remission, a greater man when he is manic? Meve's diagnosis of dysnoia does not resolve this philosophical question on the relationship between genius and mania. Moreover, this question itself extends to the problem of differential diagnosis. Korsakov writes that it “is often difficult” to distinguish between pure mania and the “maniacal form of dysnoia.” The criteria for distinguishing mania from dysnoia include the manic's “accelerated flow of representations” and “ease of associations,“ two characteristics that might arguably have facilitated Kovrin's academic work. See Korsakov's, Kurs psikhiatrii,2d ed. (Moscow, 1901), 2:826, 909 Google Scholar. Even when drawing on a contemporary psychiatric text, it is not possible to determine categorically the full implications of Kovrin's mental illness in “The Black Monk.” Korsakov's diagnostic dilemma between dysnoia and mania could even be considered a restatement of the story's central philosophical question.

11. Chudakov, A. P., Chekhov's Poetics, trans. Edwinajannie Cruise and Donald Dragt (Ann Arbor, Mich., 1983), 141.Google Scholar

12. Sochineniia, 7:252.

13. Ibid., 7:252, 305.

14. Ibid., 7:252.

15. Ibid., 7:252, 282.

16. Ibid., 7:263.

17. Ibid., 7:301.

18. Ibid., 7:290.

19. Ibid., 7:306.

20. Korsakov, Kurs psikhiatrii, 1:1.

21. For example, Chekhov's “Ivanov” opens a little less than a year after the play's eponymous protagonist first begins to struggle with “psychopathy” ﹛psikhopatiia, Sochineniia, 12:58), and in the first paragraph of “The Black Monk,” Kovrin, already unwell, is advised by a “physician friend” to retire to the countryside for the spring and summer (Sochineniia, 8:226).

22. Sochineniia, 7:284.

23. Ibid., 7:290.

24. In the history of medicine, this conceptual distinction between “disease” and “illness,“ at least in English, belongs to the nineteenth century. See Jackson, Stanley W., Melancholia and Depression: From Hippocralic Times to Modern Times(New Haven, 1986), 12, 13Google Scholar. In a related manner, Chekhov's former classmate, the neurologist Grigorii Rossolimo, records the author as having said, “If I were an instructor, I would try as much as possible to involve students in the domain of the patient's subjective experience.” See Ros solimo, G. I., “Vospominaniia o Chekhove,”in Kotov, A. K., ed., A. P. Chekhov v vospominaniiakh sovremennikov(Moscow, 1960), 670 Google Scholar.

25. Sochineniia, 7:282.

26. Claude, Bernard, Lefons sur le diabète et la glycogenèse animale(Paris, 1877), 70–72.Google Scholar

27. Howship Dickinson, W., Diabetes(London, 1877), 64 Google Scholar.

28. Ibid., 95.

29. Pierre Alexandre, Costes, Des terminaisons du diabète sucrè(Paris, 1872), 8, 9Google Scholar.

30. Flath, “Limits to the Flesh,” 273; Meve, Meditsina v tvorchestueizhizniA. P. Chekhova, 93. Focusing on this episode, Meve draws a suggestive clinical parallel between Nikolai Stepanovich's condition and that of one of his acknowledged prototypes, the embryologist A. I. Babukhin: “In the last years of his life A. I. Babukhin suffered terribly from angina pectoris or, in modern terms, stenocardia. His sufferings and those of the hero of ‘A Boring Story’ were extremely similar.” Unfortunately, Meve does not develop this clinical parallel, nor does he address symptoms beyond those that appear in the “sparrow's night“ episode.

31. Sochineniia, 7:301.

32. See Jean-Jacques, Peumery, Histoire illustrée du diabète: De I'anliquite à nos jours(Paris, 1987), 109 Google Scholar.

33. Bernard, , “Lecons sur le diabète,” Lefons de pathologie expérimentale(Paris, 1872), 338.Google Scholar

34. Thiroloix, J., Le Diabète pancréatique: Expérimentation, clinique, anatomie pathologique(Paris, 1892), 5 Google Scholar.

35. Horst, and Joseph, Schumacher, “Then and Now: 100 Years of Diabetes Mellitus,”in Dietrich von, Engelhardt, ed., Diabetes: Its Medical and Cultural History(Berlin, 1989), 251 Google Scholar(my emphasis).

36. Francis E., Anstie, Neuralgia and the Diseases That Resemble It(New York, 1882), 31 Google Scholar.

37. Sochineniia, 7:280, 302.

38. Costes, Des terminations du diabète sucré, 9,10. Compare, for instance, Nikolai Stepanovich's description of his condition during his stay in a hotel in Khar'kov in the final section: “I felt sick on the train, chilled by the drafts passing through, and now I'm sitting on the bed…. I should really go to see some fellow professors today, but there's no strength or desire” (Sochineniia, 7:304).

39. William, Osier, The Principles and Practice of Medicine: Designed for the Use of Practitioners and Students of Medicine(New York, 1892), 295 Google Scholar.

40. Dickinson, Diabetes, 2, 20, 75.

41. Bernard, Leçons sur le diabète et la glycogenèse animate, 46, 475.

42. Sochineniia, 7:282.

43. Claude, Bernard, An Introduction to the Study of Experimental Medicine, trans. Henry Copley, Greene(New York, 1927), 198-99Google Scholar. In an article on Chekhov's realism, the literary critic Aleksandr Roskin draws an intriguing parallel between the author's aesthetic of “accidentalness“ (sluchainost1)and Bernard's emphasis on the importance of the accidental in medical observation. See Roskin, A., A. P. Chekhov: Stat'i i ocherki(Moscow, 1959), 193-201 Google Scholar.

44. Nikolai Stepanovich is here quoting a maxim of one of Chekhov's own teachers, G. A. Zakhar'in, who sought to impart to his students a patient-oriented clinical methodology. For a discussion of Chekhov's relationship to the “school of Zakhar'in,” see Kataev, Vladimir B., “Ob“iasnit’ kazhdyi sluchai v otdel'nosti,” Proza Chekhova: Problemy interpretalsii(Moscow, 1979), 87-97 Google Scholar.

45. In Émile Littré'sDictionnairede la languefrançaise(Paris, 1873-74), 4:1889, “sémiologie“ is denned as: “Terme de médecine. Partie de la médecine qui traite des signes des maladies.“

46. Quoted in Gerlof Verwey, Psychiatry in an Anthropological and Biomedical Context(Dordrecht, 1985), 27.

47. Wilhelm, Griesinger, Mental Pathology and Therapeutics(New York, 1965), 9 Google Scholar.

48. Sochineniia, 7:307.

49. Sechenov, I. M., “Refleksy golovnogo mozga,”in Iaroshevskii, M. G., ed., Psikhologiia povedeniia: Izbrannye psikhologicheskie trudy(Moscow, 1995), 107 Google Scholar(emphasis in the original). It is interesting to note that Nikolai Stepanovich's eclectic list of “famous friends“ (Sochineniia, 7:251) includes the historian and psychologist Konstantin Ravelin, who defended the duality of body and soul in a public polemic with Sechenov during the 1870s.

50. Sochineniia, 7:307.

51. Ibid., 7:264, 291.

52. Beard, George M., American Nervousness, Its Causes and Consequences(New York, 1881), viCrossRefGoogle Scholar.

53. Edward, Shorter, From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era(New York, 1992), 221 Google Scholar. Daniel Gilles has suggested that Chekhov's first encounter with neurasthenia occurred in 1885, when his acquaintance, the artist Isaak Levitan, hap pened to be diagnosed with the new disease. See Daniel, Gillès, Chekhov: Observer without Illusion, trans. Charles Lam, Markmann(New York, 1968), 70 Google Scholar.

54. The term neurasthenic (nevrastenik)appears, for instance, in “Duel“’ (The duel), which Chekhov began writing before the completion of “A Boring Story” (Sochineniia, 7:374). Ivanov, in the play of the same name, complains about his “weakness” (slabost1)and “nerves” ﹛nervy, Sochineniia, 12:53). And in “Pripadok” (An attack of the nerves), the doctor's use of the catchword exhaustion (pereutomlenie)during his examination of Vasil'ev, as well as his testing of reflexes (refleksy)and skin sensitivity (chuvstvitel'nosl’ ego kozhi), all suggest that he fears his patient may be suffering from neurasthenia (Sochineniia, 7:220, 221). “The Black Monk” focuses mostly on Kovrin's megalomania, but the narrator opens the story with a clear, and lighdy parodic, allusion to neurasthenia: “Andrei Vasil'ich Kovrin, Master [of Sciences], became exhausted and upset his nerves [utomilsia i rasstroil sebe nervy]” (Sochineniia, 8:226). Kovrin's progression from neurasthenia to megalomania follows a pattern outlined by Korsakov in Kurspsikhiiatrii, 2:1015.

55. Beard, George M.. A Practical Treatise on Nervous Exhaustion (Neurasthenia), Its Symptoms, Nature, Sequences, Treatment(New York, 1880), 3Google Scholar. In a popular tract on neurasthenia, Bernard goes so far as to suggest that the five major precipitating causes of neurasthenia are steam power, the periodical press, the telegraph, the sciences, and the mental activity of women: “when civilization, plus these five factors, invades any nation, it must carry nervousness and nervous disease along with it.” See Beard, American Nervousness: Its Causes and Consequences, 96.

56. Letter to Suvorin, 29 March 1890, Pis'ma, 4:50. Regarding Chekhov's interest in the new discipline of social pathology, see G. V Arkhangel'skii, “A. P. Chekhov i zemskie vrachi,” Sovetskoe zdravookhranenie, 1986, no. 3:61-64.

57. Sochineniia, 7:257, 258.

58. Ibid., 7:307.

59. Ibid., 7:282,283.

60. Letter to Suvorin, 17 October 1889, Pis'ma, 3:266.

61. Linkov, V. la., Skeptitsizm i vera Chekhova(Moscow, 1995), 50 Google Scholar.

62. Sochineniia, 7:291.

63. Letter to V. E. Meierkhol'd, October 1899, Pis'ma, 8:274.

64. Sochinmiia, 7:281,282.

65. Sigmund, Freud, “Mourning and Melancholia,”in Philip, Rieff, ed., General Psychological Theory(New York, 1997), 164, 165Google Scholar.

66. Sochineniia, 7:290, 310.

67. Ibid., 7:251,305, 306.

68. Ibid., 7:305, 306.

69. Freud, “Mourning and Melancholia,” 167.

70. Sochineniia, 7:307.