Twentieth-century psychiatry was transformed in the 1950s and 1960s by the introduction of powerful psychopharmaceuticals, particularly Chlorpromazine (Thorazine). This paper examines the reception of Chlorpromazine in the Soviet Union and its effect on the Soviet practice of psychiatry. The drug, known in the USSR by the name Aminazine, was first used in Moscow in 1954 and was officially approved in 1955. I argue that Soviet psychiatrists initially embraced it because Aminazine enabled them to successfully challenge the Stalin-era dogma in their field (Ivan Pavlov’s ‘theory of higher nervous activity’). Unlike in the West, however, the new psychopharmaceuticals did not lead to deinstitutionalisation. I argue that the new drugs did not disrupt the existing Soviet system because, unlike the system in the West, the Soviets were already dedicated, at least in theory, to a model which paired psychiatric hospitals with community-based ‘neuropsychiatric dispensaries.’ Chlorpromazine gave this system a new lease on life, encouraging Soviet psychiatrists to more rapidly move patients from in-patient treatment to ‘supporting’ treatment in the community.

The ‘death’ of the social history of medicine was predicated on two insights from postmodern thinking: first, that ‘the social’ was an essentialist category strategically fashioned in the course of the nineteenth and twentieth centuries; and second, that the disciplines of medicine and history-writing grew up together, the one (medicine) seeking to objectify the body, the other (history-writing) seeking to objectify the past. Not surprisingly, in the face of these revelations, historians of medicine retreated from the critical and ‘big-picture’ perspectives they entertained in the 1970s and 1980s. Their political flame went out, and doing the same old thing increasingly looked more like an apology for, than a critical inquiry into, medicine and its humanist project. Unable to face the present, let alone the future, they retreated from both, suffering the same paralysis of will as other historians stymied by the intellectual movement of postmodernism. Ironically, this occurred (occurs) at a moment when ‘medicine’ – writ large to include the biosciences and biotechnology – could easily be said to be the most relevant and compelling subject for understanding contemporary life and politics (global, local, and individual) and, as such, the place to justify the practice of history-writing as a whole. God knows, legitimacy has never been more urgent. But how can this be effected? Political action seems more likely than prayer. But let us begin by reviewing the nature of the problem that demands this response.