As Joseph Stalin ordered his generals to fight off the Nazi invasion of the Soviet Union he may also have been waging a personal battle against gout.
Scientists have suggested that he was undergoing treatment with lithium salts during the Second World War after finding traces in a book he was known to have read in 1942.
Lithium has been prescribed by doctors since the 19th century as a treatment for gout and mental illness but this is the first evidence of a connection to Stalin.
Researchers used acetate film to detect lithium compounds on numerous pages of Stalin’s copy of Tolstoy’s Ivan Grozny, a drama that portrayed the Russian leader Ivan the Terrible as a national hero. The film, which uses charged particles to remove traces of chemicals from the surface of documents without damaging them, showed that lithium salts were present on five pages annotated by Stalin but absent on unmarked pages.
Gleb Zilberstein, an Israeli scientist who has previously used acetate film to identify protein markers for tuberculosis on a shirt worn by Chekhov and evidence of morphine on the manuscript of The Master and Margarita by Mikhail Bulgakov, said that the levels were consistent with those found in the saliva and sweat of patients who had been prescribed lithium to treat bipolar disorder and paranoia.
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The clearest results from the tests, conducted on the book at the Russian State Archive of Literature and Arts in Moscow, came from a blank page at the front of the book that Stalin covered with handwritten annotations. Mr Zilberstein believes that Stalin was either using lithium to improve his mental state or for gout, although the Soviet leader’s medical records do not record any such prescription.
Lithium was first used to treat mania and depression in the late 19th century but had fallen out of use and only experienced a revival after a study by the Australian psychiatrist John Cade in 1949.
“Either Stalin re-read this book after 1949 or he used lithium salts to treat gout,” Mr Zilberstein suggested. “Lithium salts were used to treat gout throughout the first half of the 20th century in the USSR.”
Simon Sebag Montefiore, author of Stalin: The Court of the Red Tsar, said that it was plausible that the Soviet leader had gout. “He certainly didn’t have depression. He could have been given [lithium] for calm. He did have a period when he was very anxious at the beginning of the war, but he wasn’t bipolar. He had a very level personality.”
He added that the leader later became paranoid about his health, meaning that his doctors had to be careful about the treatments they recommended. He added: “I don’t know that he had gout but he could easily have done. He took an enormous interest in food and he was a huge drinker.”
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Orlando Figes, professor of history at Birkbeck College, University of London, said that even if Stalin’s doctors had prescribed lithium for depression, they would have been unlikely to have disclosed this in their notes. “I am not aware of any medical records in Stalin's personal archive suggesting that he was using lithium salts for depression or manic disorders.
“On the other hand, the well-known 19th century use of lithium salts for gout might be relevant to Stalin. His main problem in his final years was a dodgy heart and small strokes.”