The Struggle for Viability
Collectivism Through Blood Exchange
By: Alexander Bogdanov, translated by Doug Huestis
Douglas W. Huestis
Alexander Bogdanov was a polymath, a man learned in many disciplines. This extraordinary Russian was a physician, economist, philosopher, natural scientist, writer of utopian science fiction, poet, teacher, politician (unsuccessful), lifelong revolutionary, forerunner of what we now call cybernetics and organizational science, and founder of the world's first scientific institution devoted specifically to the field of blood transfusion. No mere theoretician, although that seemed to be his favorite occupation, Bogdanov spent years as an active revolutionary. He helped establish the Bolshevist Party, practiced medicine, and engaged in scientific medical experiments. And he was canny enough to convince Stalin to support and fund his Institute of Blood Transfusion in 1926.
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Bogdanov was born Alexander Alexandrovich Malinovski in 1873, in Russian Poland, his father a provincial schoolteacher. He was the second of six surviving children. It was a bourgeois background remarkably like Lenin's. "Bogdanov" was one of Malinovski's many revolutionary pseudonyms. Like Lenin, Trotsky, and others, he continued to use his pseudonym after the revolution. Expelled from Moscow State University for political agitation, Bogdanov attended the University of Kharkov as a medical student and graduated as a physician in 1899. In 1900, he married a fellow revolutionary who had been his partner and lover in Tula for several years. She was Natalia Bogdanovna Korsac ("Nata"), eight years older than he. Bogdanov's pseudonym probably derives from her middle name, or patronymic.1
Bogdanov devoted most of the ensuing decade to revolutionary activity and to writing (mostly philosophical). He spent time in prison again, and was sentenced to three years internal exile in the city of Vologda, northeast of Moscow (1900-1903). In that city, he worked as a physician at a mental hospital. Vologda was where Bogdanov's paternal family had originated and some of them were there with him.
Bogdanov and Medical Science
After completion of his term of exile, Bogdanov helped Lenin organize several revolutionary congresses in Western Europe. He was imprisoned yet again after the 1905 revolution. In the ensuing years, he vied with Lenin for Bolshevik leadership. Bogdanov lost, and the party expelled him in 1909. He never rejoined it. During this turbulent period of his life, he wrote two very popular science-fiction novels set in a utopian society on Mars, Red Star and Engineer Menni (1907, 1912). Bogdanov and others also, including the writer Maxim Gorky, formed a group called "Vpered" [Forward], and, in opposition to Lenin, ran party schools for émigré Russian workers at Capri and Bologna in Italy. These organizations promoted versions of Bolshevism different from Lenin's. Later, Bogdanov served as a medical officer at the front in World War I, and was invalided home to Moscow with a nervous breakdown.
After the revolution, Bogdanov and Anatoly Lunacharski, his brother-in-law, founded and were heavily involved with a program of proletarian education, Proletcult, a program Lenin greatly mistrusted. When Proletcult grew rapidly (to nearly a half million members) and more and more bore Bogdanov's stamp, Lenin's adamant opposition prevailed. Bogdanov was removed from his position of leadership (December 1920). Over the next couple of years, Proletcult shrank, lost its intellectual basis and soon disappeared. Bogdanov's writing and other work were not suppressed, but he was deprived of his mass audience. He continued to be active as a member of the Communist Academy and increasingly turned his attention to science and medicine.
Alexander Bogdanov was a person of phenomenal intellect, the kind who seemed to know everything and forget nothing. I suspect that his personality did not endear him to others, and probably made him a difficult man to know or to like. For years, he had irritated, even infuriated, Lenin. Somehow, he also managed to antagonize his old friend, writer Maxim Gorky, who had initially supported him over Lenin.
Bogdanov's primary field of interest was the philosophy of science, in which he wrote his first book in 1899, to be followed by numerous others right up to the time of his death. His great work Tektology: Universal Organizational Science appeared in three volumes between 1912 and 1922. In it, he set forth the foundations of what we know today as systems (or organizational) science and cybernetics. What with the first World War, the Russian Revolution, and the postrevolutionary Russian Civil War, Bogdanov's Tektology was unfortunately timed. Perhaps for that reason, as well as the difficult topic, the author's pedantic prose, and Stalin's suppression, it languished in obscurity. Decades later, others (e.g., Norbert Wiener, L. von Bertalanffy, and Ross Ashby) independently re-discovered the same principles, which are widely applied today in the fields of cybernetics and systems or organizational science.
Bogdanov's socialist philosophy and support of collectivism was by no means limited to theory and politics. He thought political socialism could be supplemented by a kind of physiological collectivism through mutual exchange of blood. He had incorporated this theme years earlier into his novel, Red Star,2 and amplified its biological rationale in The Struggle for Viability, which was published in 1927, the year before his death.
Red Star is the story of a utopian socialist society on Mars, and of an Earthman transported there. In it, the Earthling (Russian) protagonist asks how the Martians manage to preserve their youth so long. The Martian's reply, given in detail in Chapter 12 of The Struggle for Viability, expresses Bogdanov's notion, based on his incomplete knowledge of protozoan behavior, that an exchange of blood between two persons increases their resistance to disease and generally strengthens their viability. The Martian explains further that the procedure is entirely safe.
The Earthling then asks whether they are able to revive old people by transfusing them with young blood. The Martian replies that this is partly true, but points out that the body also affects the blood. Thus blood from an old person does not age a youngster, because the young body quickly alters any weak or seBogdanov and Medical Science
nescent characteristics, while absorbing from the older blood substances it needs to increase its own flexibility and energy.
And why doesn't Earth medicine use this procedure? The Martian answers by citing the possibility of organic factors in humans that might make the method ineffective. He also says that human psychology may be so very individualistic and isolating that the idea of such a fusion would not even occur to humans. He adds:
"Blood transfusion in your medicine has a kind of philanthropic nature: the person who has a lot gives to the one who is in acute need, such as after severe blood loss from injury. We have that as well, of course, but we regularly have the other kind too, which is in character with our whole way of life. That is the comradely vital exchange that goes beyond ideology to the physiological sphere." [DWH translation]
In this piece of fiction, Bogdanov has put his philosophy of blood transfusion succinctly into the mouth of his Martian. He theorized that, by exchanging a fluid tissue like blood, humans could possibly achieve the kind of bodily renewal that single-celled animals do by fusing together. In Bogdanov's mind, the main idea of transfusion was that of a mutual exchange of blood to strengthen and enrich the life processes and reverse degenerative changes; the secondary goal, mentioned only in passing, was that of the replacement of blood elements that were lost through disease or injury. Bogdanov did not dismiss the second, which predominates in world medicine today, but he regarded it as more mechanical and less interesting than the other.
In 1921-2, Bogdanov was sent to London as an economics consultant. While there, he studied the practice of blood transfusion. There is no record of exactly where he did this. However, both in The Struggle for Viability and The First Year's Work of the Institute of Blood Transfusion, he frequently mentions Geoffrey Keynes (later Sir Geoffrey, and brother of famed economist, Maynard Keynes). Dr. Keynes, who published the first edition of his book on blood transfusion in 1922,3 worked at St. Bartholomew's Hospital. One may reasonably suppose that Bogdanov visited there, although the records of that hospital make no mention of him.
When Bogdanov returned to Russia from England, he attempted to persuade Lenin to support the idea of an institute of blood transfusion. Lenin, having just dismantled Bogdanov's Proletcult, was probably only too happy to have him involved in something non-political. But Lenin was ill, not far from death at the time, and facing a host of more serious problems. He consented in principle, but provided no money. So Bogdanov could do nothing yet. A couple of years after Lenin's death, Bogdanov persuaded Stalin not only to support the project, but also to provide government funding. I have found no record of what arguments he used to move Stalin to support the concept. But Bogdanov's notion of mutual transfusion as a form of "physiological collectivism" may have impressed Stalin, much as Lysenko's Lamarckian genetics impressed him later on. Stalin may also have been thinking of the importance of transfusion to military medicine. Bogdanov had pointed out the ways transfusion had helped the Allies and how the lack of it had hindered the Germans during World War I.
In March 1926, the appropriate governmental decree was issued, establishing the State Institute of Blood Transfusion, with Bogdanov as its director. Over the years since then, the scope of the institute's activities broadened to include general hematology and it served as the central nidus for daughter institutes in the various Soviet republics. Bogdanov's institute still exists today as the National Research Center for Hematology of the Russian Academy of Medical Sciences.
In March of 1928, a group of students volunteered to take part in blood exchanges for the sake of general mental and physical stimulation (exams were coming). Institute doctors ruled them all Bogdanov and Medical Science
out as candidates for one reason or another. But Bogdanov contacted one of them, named L.I. Koldomasov, who had inactive tuberculosis and residual malaria, and proposed a mutual blood exchange, on the grounds that Bogdanov, as an old physician, would be immune to tuberculosis. Transfusion might transfer the immunity and rid Koldomasov of his disease. Soon afterwards, nearly a liter of Koldomasov's blood was transfused to Bogdanov, while Koldomasov received a like amount of Bogdanov's blood.
Both patients had reactions. Koldomasov survived and his lung lesions cleared. He was reportedly still alive in 1983 at age 76. Bogdanov did not fare as well. He had chills and fever, intestinal distress, hemolysis and oliguria, then jaundice. His treatment was aggressive and appropriate for the times. Despite temporary improvement, he died on 7 April 1928.
One of Bogdanov's colleagues, Professor M.P. Konchalovski, recorded the whole story of his two patients, with details of their progress and treatment.4 He pointed out the paradox of incompatibility occurring despite both donor and recipient being of the same blood group. Repeated blood grouping tests and crossmatches had indicated compatibility. The autopsy report found that death had been caused by the toxicity of kidney failure, in turn brought about by blood destruction from an incompatible transfusion.
The circumstances of Bogdanov's death aroused controversy. His son, Alexander Alexandrovich Malinovski (1909-1996), believed his father had been murdered by a functionary at the institute. But there is no evidence to support that contention. Several writers have claimed that Bogdanov committed suicide. There is no evidence for that either. In addition, the suicide theory is unlikely, bearing in mind Bogdanov's excitement over his work at the new institute, and the increased governmental support he had received. In Konchalovski's report, we see a clear picture of a severe reaction to incompatible blood, often a fatal complication in those days and even today. The crossmatches in use in 1928 were of a type that could not detect certain incompatibilities, and Bogdanov's history of eleven earlier transfusions greatly increase the likelihood of such incompatibility.
Retrospectively, in the light of modern transfusion medicine, one can agree with Konchalovski that Bogdanov died from a blood transfusion accident.5
The Scientific Importance of Bogdanov's Medical Research
As we follow a path through the history of science, we encounter many cul-de-sacs, blind alleys that were often followed laboriously for years, or even centuries, without important outcome. Such divagations may have followed empirical observations, theories or hypotheses, but, at the time, they may be indistinguishable from what later turns out to be the true path. Energy expended following them either produces no useful outcome, provides limited information out of proportion to the effort expended, or yields negative results. Some apparent cul-de-sacs, of course, may represent work that is simply ahead of its time. Later it may turn out to be very useful; early theories and trials of flight, and Alexis Carrel's experiments with transplantation come to mind.
Biomedical science has had its fair share of developmental blind alleys. One need only look at the centuries of vigorous application of bloodletting in conditions where it did nothing but further weaken already sick patients. A blind alley in Soviet science was T.D. Lysenko's espousal of the long-discredited Lamarckian theory of the inheritance of acquired characteristics. This, backed by Stalin, set Soviet genetics back for decades. Then, of course, all over the world, we have countless ineffective cancer cures.
Although many of my Russian colleagues would take issue with me on this, I believe that much of the work and theory expounded in The Struggle for Viability falls into the category of a medical blind alley. For several years, Alexander Bogdanov carried out experimental mutual blood exchanges, as described by his Martian in Red Star. The scientific rationale for those experiments is based on what can only be described as a leap of faith.
Bogdanov had read about studies on various single-celled organisms (protozoa), showing how these minute beings renewed Bogdanov and Medical Science
themselves by fusing together. Based on what he had read, he theorized that a modified version of the same process might be possible in higher organisms. Obviously, two animals as complex as human beings could not simply fuse together like paramecia. But Bogdanov reasoned that something like that could possibly be accomplished through an exchange of the liquid tissues of higher animals—namely, blood or lymph. Based on this astonishing over-simplification of complex protozoological processes, he was willing to proceed directly to humans without preliminary animal experimentation.
Bogdanov made it quite clear in The Struggle for Viability that his concept, which he called "physiological collectivism," was theoretical. He did not present it as fact, but rather as something worthy of investigation. But it is equally clear in his presentation that he firmly believed that his experiments would demonstrate the validity of his theory. Unfortunately, all this was done long before the advent of controlled clinical trials, and none of his studies were controlled.
In fairness, Bogdanov asked nothing of his human subjects that he was unwilling to undergo himself. In twelve of those experiments, he himself was one of the participants. The last led to his death.
Bogdanov was a first-class clinician and an excellent observer. And his associates were equally competent. They worked on a meager budget. As described in The First Year's Work at the Institute of Blood Transfusion, the government allowed them 80,000 rubles starting money (a bit more than $380,000 in 1998 dollars), and 60,000 rubles operating funds for the first year (about $286,000). They started with virtually nothing and had to acquire most equipment and supplies from foreign sources at a time when import permits were slow and hard to get. Once they were under way, they seem to have had laboratory support similar to what was available at good, contemporary, European hospitals.
Many of their patients suffered from a condition Bogdanov referred to as "Soviet burnout." Living conditions during the post-revolutionary Russian civil war and the early years of the Soviet state must have been appalling. Soviet burn-out seems to have been a type of general exhaustion associated with overwork (two or three jobs, or full-time work plus studies), undoubtedly compounded by bad living conditions and malnutrition. It must have been aggravated by the uncertainties of a country still in political turmoil. From the standpoint of clinical science, such an ill-defined syndrome would make it difficult to draw any conclusions, even in carefully controlled circumstances.
For blood exchange, these patients were generally paired with someone younger and healthier, selected according to blood group. Usually, not more than a liter of blood was exchanged. The subject would be an in-patient at the institute for a few days of observation. In evaluating the effects of these exchanges, Bogdanov and his associates recorded the patients' subjective responses to treatment and the results of physical examination and pertinent laboratory tests. All this seems to have been done with due care and diligence. They were aware of the possibilities of auto-suggestion in their patients and did their best to avoid it.
The kind of thing Bogdanov and his co-workers did not do, which would be obligatory in a present-day clinical trial, was to have a control group of patients, treated essentially the same as the trial group, but without the blood exchange. An even stricter arrangement would have been to give the control patients a mock exchange, e.g., by removing some of their own blood and giving it back to them unaltered. However, in the mid 1920s, such controlled clinical studies were still far in the future.
Of course, one could argue that many successful modern therapies, including regular blood transfusion itself, have never been subjected to controlled clinical trials. Still, mutual blood exchange is a more complex clinical application than a simple transfusion of blood or red blood cells. Lack of controls in Bogdanov's experiments allows the interpretation that apparent improvement in the patient's condition could also have been due to other factors, such Bogdanov and Medical Science
as hospital care, dietary improvement, time off work, and placebo effect.
The last is the auto-suggestive effect, mentioned above, by which patients feel better simply because they expect the treatment to make them feel better. It can be a very real force. In the context of Bogdanov's experiments, transfusion was something new in Russia, and blood exchange not only new but unique. It must have been enormously impressive to a patient to undergo such a treatment. Consequently, the likelihood of a placebo effect was great, particularly in clinical conditions prone to spontaneous remission, or where improvement could result from hospitalization and general medical care. We have seen such effects in other uncontrolled therapeutic trials.
Apologia pro Vita Eius6
In almost all respects, Bogdanov was an original and creative thinker. In fact, one could say that, whenever he put his mind to a topic, he would come up with some new approach to it that nobody else had thought of. Nowhere did this show more impressively than in his concepts of organizational science, as expressed in his book Tektology: Universal Organizational Science. There he anticipated modern ideas of cybernetics by several decades. For a short version of tektology in English, the reader may consult Bogdanov's Essays in Tektology, translated by Professor George Gorelik of the University of British Columbia.7
Others had already expressed certain aspects of what we now call organizational or systems science, but Bogdanov devised an entire system of this "science of science." He felt that the scientific disciplines had become too specialized or compartmentalized, and sought the common methodology that must underlie all scientific endeavor. Thus he attempted to identify the general laws by which systems are established and work, i.e., a synthetic rather than analytic approach. Moreover, Bogdanov seems to have been the first to express the thought that organizational science could be extended to the structure of social systems.
Nowadays, we think of Ludwig von Bertalanffy, Ross Ashby, and Norbert Wiener as having established cybernetics and systems science. There is no direct evidence that any of them knew of Bogdanov's work, and none of them cited his book on tektology. Yet surely the Austrian, von Bertalanffy, must have known of it. Bogdanov's treatise, Tektology: Universal Organizational Science, was published in the German language over twenty years before von Bertalanffy's first article on systems theory (1950).8 9
The old tsarist order had given way to revolutionary upheaval, and Bogdanov wanted to apply the principles of science (i.e., tektology, or systems science) to the social structure to build a rational, functional society. Since the Soviet Union conceived of itself in the 1920s as re-inventing society, one might have expected Bogdanov's organizational approach to have been enthusiastically received. But that was far from the case. Most critiques were negative. Marxist philosophers condemned his work, sensing in it the odor of revisionism. As Stalin's grip tightened, Bogdanov's work was suppressed and forgotten.
Tektology remained in limbo until the 1970s and 1980s, when a scattering of cautious and tentative articles began to appear in the Soviet scientific literature. Eventually, Western systems specialists rediscovered Bogdanov's work, and today it is best known in that field.
History today sees Bogdanov as a minor player in revolutionary politics, largely in terms of his conflicts with Lenin. In the end, his political efforts were unsuccessful. Bogdanov was a constructive Marxist, who could never accept the ossification of Marxism into an orthodox, quasi-religious dogma. Lenin, on the other hand, took whatever parts of Marxism he thought could be understood by the masses and essentially "sloganized" them. To him, any ideas about developing Marxism and building on it, were revisionist, hence anathema. Lenin's vituperative response to Bogdanov, in the book Materialism and Empirio-criticism (1909, and much Bogdanov and Medical Science
reprinted), is the shriek of a preacher who sees his tower of dogma undermined by the equivocations of the devil. Bogdanov was his devil.
Bogdanov wrote constantly all his adult life, regardless of whatever else he was involved in at the time, whether it be revolution, teaching, politics, medicine, or war. His literary output in the fields of socialism, biology, organizational science, economics, psychology, and sociology was nothing short of phenomenal. His biographer, Dietrich Grille, estimated Bogdanov's total literary productivity at some two hundred volumes, about three times that of his rival, Lenin.10 And one must bear in mind that much of Lenin's later output was in the form of minutes and Party memoranda. I refer the interested reader to the excellent bibliography compiled by Biggart, Gloveli and Yassour.11
In the end, of course, Lenin's single-minded persistence and political skill won out. The World War and the 1917 revolution toppled the tsar and, through a series of flukes, the Bolsheviks came to power.12 Then Lenin's ruthless exterminatory policies stamped out opposition. After Lenin's death in 1924, Stalin enshrined and further tightened Leninist dogmatism. Meanwhile, Lenin's long-predicted world revolution failed to take place and the Soviet Union turned in on itself. The result was the xenophobic Soviet state we came to know so well and understand so little.
In the 1930s, aided by such sycophants as Yezhov, Molotov and Vyshinski, Stalin liquidated virtually all the remaining old Bolsheviks who were still at hand, including Kamenev and Zinoviev, Bukharin, and most of the senior military officers.13 He even managed to have his bête noire, Trotsky, murdered with an ice pick in Mexico (1940). Had Bogdanov not died in 1928, his name would undoubtedly have been among those sacrificed on the altar of Soviet orthodoxy.
