Between banishment and treatment: leprosaria in the Russian Far East as an instrument of sanitary policy (late 19th – early 20th century)

This article examines the history of leprosy control in the Russian Far East from the late 19th century through the first third of the 20th century. Drawing on archival materials, periodicals, and eyewitness accounts, it reconstructs two distinct models of isolation that emerged during the imperial period. The punitive‑isolation model is exemplified by the Nikolaevsk leprosarium in the Amur region, which functioned as a penal institution characterized by police supervision and a criminalized staff. By contrast, a less repressive labor‑based model emerged at Rakovaya Bay in Kamchatka, where patients perceived the leprosarium as a refuge. The article demonstrates that prerevolutionary sanitary policy perpetuated a medieval logic of stigma and exclusion, ultimately resulting in an epidemiological failure. In the early Soviet period a gradual shift occurred from mere exclusion toward systematic registration and the search for therapeutic methods, although isolation remained the primary measure for containing the infection for decades to come. It concludes that punitive approaches to leprosy control exhibited profound inertia and that leprosaria evolved only slowly from de facto penitentiaries into medical institutions.