This is the first monograph to chart the changing health situation in the former capital of the Russian Empire during the first half of the twentieth century. It tells the story of how the Russian - then Soviet - government and public health authorities tried to cope with supplying the population of St. Petersburg with clean water, fresh air, pure food and all the other bare necessities against the backdrop of a crumbling Empire and the rise of a new socialist regime. It explores how these changes were closely connected with social inequality and social and political conflict as the new Soviet state struggled to cope with epidemics and disease whilst fighting for its very existence. It also explores how the new Soviet, and later the Stalinist regime, conceived of health and welfare. Cutting across a variety of disciplines, this book approaches the history of medicine and disease via a case study of St. Petersburg. Taking advantage of declassified and newly accessible Russian archives, it is informed by recent trends in social, economic and political history and offers a major insight into health conditions, health care and relations between the medical profession, state and society in modern Russia.