Anna Karenina Study Guide
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Part Two, Chapter 1

Chapter Summary

At the Shtcherbatsky household, a celebrated physician is summoned to examine the ailing Kitty, whose health has been declining since the winter. The family doctor has already tried several remedies without success. The celebrated doctor conducts a humiliating physical examination of Kitty, then confers with the family doctor in the drawing-room while the anxious princess awaits their verdict. The two physicians discuss the possibility of a tuberculous process and debate whether a trip abroad would benefit the patient.

The celebrated doctor recommends Soden waters and reluctantly concedes to foreign travel at the family doctor's urging. He briefly re-examines Kitty, who, flushed with shame and frustration, angrily dismisses his repetitive questions. After the doctor departs, the princess is relieved, and Kitty, though heartbroken and unconvinced that medicine can help her, pretends cheerfulness and agrees to the proposed journey abroad.

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Original Text
At the end of the winter, in the Shtcherbatskys’ house, a consultation was being held, which was to pronounce on the state of Kitty’s health and the measures to be taken to restore her failing strength. She had been ill, and as spring came on she grew worse. The family doctor gave her cod liver oil, then iron, then nitrate of silver, but as the first and the second and the third were alike in doing no good, and as his advice when spring came was to go abroad, a celebrated physician was called in. The celebrated physician, a very handsome man, still youngish, asked to examine the patient. He maintained, with peculiar satisfaction, it seemed, that maiden modesty is a mere relic of barbarism, and that nothing could be more natural than for a man still youngish to handle a young girl naked. He thought it natural because he did it every day, and felt and thought, as it seemed to him, no harm as he did it and consequently he considered modesty in the girl not merely as a relic of barbarism, but also as an insult to himself. There was nothing for it but to submit, since, although all the doctors had studied in the same school, had read the same books, and learned the same science, and though some people said this celebrated doctor was a bad doctor, in the princess’s household and circle it was for some reason accepted that this celebrated doctor alone had some special knowledge, and that he alone could save Kitty. After a careful examination and sounding of the bewildered patient, dazed with shame, the celebrated doctor, having scrupulously washed his hands, was standing in the drawing-room talking to the prince. The prince frowned and coughed, listening to the doctor. As a man who had seen something of life, and neither a fool nor an invalid, he had no faith in medicine, and in his heart was furious at the whole farce, specially as he was perhaps the only one who fully comprehended the cause of Kitty’s illness. “Conceited blockhead!” he thought, as he listened to the celebrated doctor’s chatter about his daughter’s symptoms. The doctor was meantime with difficulty restraining the expression of his contempt for this old gentleman, and with difficulty condescending to the level of his intelligence. He perceived that it was no good talking to the old man, and that the principal person in the house was the mother. Before her he decided to scatter his pearls. At that instant the princess came into the drawing-room with the family doctor. The prince withdrew, trying not to show how ridiculous he thought the whole performance. The princess was distracted, and did not know what to do. She felt she had sinned against Kitty. “Well, doctor, decide our fate,” said the princess. “Tell me everything.” “Is there hope?” she meant to say, but her lips quivered, and she could not utter the question. “Well, doctor?” “Immediately, princess. I will talk it over with my colleague, and then I will have the honor of laying my opinion before you.” “So we had better leave you?” “As you please.” The princess went out with a sigh. When the doctors were left alone, the family doctor began timidly explaining his opinion, that there was a commencement of tuberculous trouble, but ... and so on. The celebrated doctor listened to him, and in the middle of his sentence looked at his big gold watch. “Yes,” said he. “But....” The family doctor respectfully ceased in the middle of his observations. “The commencement of the tuberculous process we are not, as you are aware, able to define; till there are cavities, there is nothing definite. But we may suspect it. And there are indications; malnutrition, nervous excitability, and so on. The question stands thus: in presence of indications of tuberculous process, what is to be done to maintain nutrition?” “But, you know, there are always moral, spiritual causes at the back in these cases,” the family doctor permitted himself to interpolate with a subtle smile. “Yes, that’s an understood thing,” responded the celebrated physician, again glancing at his watch. “Beg pardon, is the Yausky bridge done yet, or shall I have to drive around?” he asked. “Ah! it is. Oh, well, then I can do it in twenty minutes. So we were saying the problem may be put thus: to maintain nutrition and to give tone to the nerves. The one is in close connection with the other, one must attack both sides at once.” “And how about a tour abroad?” asked the family doctor. “I’ve no liking for foreign tours. And take note: if there is an early stage of tuberculous process, of which we cannot be certain, a foreign tour will be of no use. What is wanted is means of improving nutrition, and not for lowering it.” And the celebrated doctor expounded his plan of treatment with Soden waters, a remedy obviously prescribed primarily on the ground that they could do no harm. The family doctor listened attentively and respectfully. “But in favor of foreign travel I would urge the change of habits, the removal from conditions calling up reminiscences. And then the mother wishes it,” he added. “Ah! Well, in that case, to be sure, let them go. Only, those German quacks are mischievous.... They ought to be persuaded.... Well, let them go then.” He glanced once more at his watch. “Oh! time’s up already,” And he went to the door. The celebrated doctor announced to the princess (a feeling of what was due from him dictated his doing so) that he ought to see the patient once more. “What! another examination!” cried the mother, with horror. “Oh, no, only a few details, princess.” “Come this way.” And the mother, accompanied by the doctor, went into the drawing-room to Kitty. Wasted and flushed, with a peculiar glitter in her eyes, left there by the agony of shame she had been put through, Kitty stood in the middle of the room. When the doctor came in she flushed crimson, and her eyes filled with tears. All her illness and treatment struck her as a thing so stupid, ludicrous even! Doctoring her seemed to her as absurd as putting together the pieces of a broken vase. Her heart was broken. Why would they try to cure her with pills and powders? But she could not grieve her mother, especially as her mother considered herself to blame. “May I trouble you to sit down, princess?” the celebrated doctor said to her. He sat down with a smile, facing her, felt her pulse, and again began asking her tiresome questions. She answered him, and all at once got up, furious. “Excuse me, doctor, but there is really no object in this. This is the third time you’ve asked me the same thing.” The celebrated doctor did not take offense. “Nervous irritability,” he said to the princess, when Kitty had left the room. “However, I had finished....” And the doctor began scientifically explaining to the princess, as an exceptionally intelligent woman, the condition of the young princess, and concluded by insisting on the drinking of the waters, which were certainly harmless. At the question: Should they go abroad? the doctor plunged into deep meditation, as though resolving a weighty problem. Finally his decision was pronounced: they were to go abroad, but to put no faith in foreign quacks, and to apply to him in any need. It seemed as though some piece of good fortune had come to pass after the doctor had gone. The mother was much more cheerful when she went back to her daughter, and Kitty pretended to be more cheerful. She had often, almost always, to be pretending now. “Really, I’m quite well, mamma. But if you want to go abroad, let’s go!” she said, and trying to appear interested in the proposed tour, she began talking of the preparations for the journey.
Source text: Project Gutenberg #1399. Public domain worldwide. Translated by Constance Garnett (1901)
Modern English
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This opening chapter of Part Two functions as a satirical set piece targeting the medical establishment and the social rituals surrounding illness. Tolstoy's narrator adopts a tone of barely concealed irony from the outset, noting that the celebrated doctor maintained, with 'peculiar satisfaction,' that maiden modesty is a 'relic of barbarism.' The phrase 'peculiar satisfaction' quietly indicts the doctor's self-congratulatory rationalism, exposing how professional authority can mask personal arrogance and even prurience. The repetition of 'celebrated' throughout the chapter functions as a deflating epithet rather than a genuine honorific, each recurrence undercutting the physician's prestige.

The chapter is structured around a series of power imbalances. The prince, who alone understands the true emotional cause of Kitty's illness, is rendered powerless by social convention and the mystique of medical expertise. He thinks the doctor a 'conceited blockhead' but cannot say so. The doctor, in turn, dismisses the prince and directs his performance toward the more impressionable princess, deciding 'to scatter his pearls' before her. This theatrical metaphor reveals medicine here as social performance rather than genuine healing, a theme Tolstoy pursues with characteristic skepticism toward institutional authority.

Kitty's own perspective offers the chapter's most penetrating insight. Her comparison of doctoring to 'putting together the pieces of a broken vase' is a central metaphor that articulates the novel's implicit argument: that Kitty's suffering is psychological and moral in origin — rooted in Vronsky's rejection — and therefore immune to pharmaceutical remedy. The image of the broken vase anticipates the novel's broader preoccupation with irreparable rupture, both emotional and social. Her 'peculiar glitter' in the eyes and crimson flush signal that shame, not tuberculosis, is her primary affliction.

The consultation scene between the two doctors is a masterpiece of comic deflation. The celebrated doctor's repeated glances at his gold watch, his casual inquiry about the Yausky bridge mid-diagnosis, and his circular prescription of 'harmless' waters all expose the gap between medical pretension and actual knowledge. The family doctor's 'timid' deference and 'subtle smile' when mentioning 'moral, spiritual causes' suggest that even he senses the inadequacy of a purely physiological diagnosis, yet professional hierarchy prevents him from pressing the point. Tolstoy thus implicates the entire institution rather than one bad actor.

The chapter closes on a note of performative cheerfulness that will recur throughout Kitty's arc. 'She had often, almost always, to be pretending now' — this narratorial aside establishes a pattern of concealment and social compliance that defines Kitty's condition as much as any physical symptom. Her willingness to feign enthusiasm for the foreign tour to spare her mother grief introduces the theme of self-suppression as a specifically feminine burden, one that Tolstoy will develop in contrast to Anna's ultimately fatal refusal to perform contentment.

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✎ Mr. Shifflett's Note
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