Ailing Yeltsin to Play Lesser Role, Kremlin Says

The Kremlin, disclosing that Russian President Boris N. Yeltsin is suffering from a more debilitating disorder than previously acknowledged, abruptly canceled a presidential trip to Vienna on Monday and said Yeltsin will play a lesser role in running the government.

“He will no longer be in charge of all current, daily issues of the economy,” said Yeltsin deputy Oleg N. Sysuyev. “The president will do his best to help the government exercise its powers, but not to the extent as it was before.”

Presidential spokesman Dmitri Yakushkin said Yeltsin, 67, had developed a condition marked by “unstable blood pressure and undue fatigue.” Yakushkin said the president, who already is rarely seen in public, would need rest but not hospitalization.

The acknowledgment that Yeltsin is unable to play the dominant role in governing Russia comes after months of attempts by the Kremlin to assure the public that the president was in charge and actively working. It has become increasingly clear, however, that Yeltsin is incapacitated, and calls have been mounting for his resignation, even from his traditional allies.

“This is a pivotal political event, which signifies that almost everybody in Russia now understands that Yeltsin should ‘gradually’ retire,” said Andrei A. Piontkovsky, director of the Independent Institute for Strategic Studies, a Moscow-based think tank. “Yeltsin’s responsibilities will now be limited to staying in Zavidovo, at his dacha. His engagement in policy in Russia will become minimal.”

Yeltsin’s newly disclosed diagnosis, “neuro-psychological asthenia,” is a grab-bag term for a variety of ailments. Dorland’s Medical Dictionary defines the condition as an “anxiety neurosis” characterized by heart palpitations, difficult or labored breathing, “fear of effort” and “discomfort brought on by exercise or even slight effort.”

Until midday Monday, the Kremlin had insisted that Yeltsin’s health was satisfactory and that he would make a one-day trip to Vienna today to meet with leaders of the European Union and to appeal personally for more Western aid. About 50 journalists arrived from Moscow to cover the presidential visit only to find after their arrival that it had been canceled.

Earlier this month, Yeltsin cut short a visit to the Central Asian nations of Kazakhstan and Uzbekistan after he stumbled during one ceremony and had a coughing fit during another. While it was apparent that Yeltsin was laboring even to put his signature on documents, the Kremlin said he was suffering only from bronchitis.

On Friday, spokesman Yakushkin said the president was as healthy as could be expected for a man of his age and that Yeltsin found persistent speculation about his health hurtful. On Monday, Yakushkin said the bronchitis Yeltsin contracted on the Central Asia trip together with his refusal to get proper rest had brought on the “asthenia.”

Yeltsin’s political enemies immediately seized on the disclosure of his condition as one more sign that the ailing president should resign to clear the way for a new order.

“Yeltsin’s state of health has been quite obvious for a long time,” said Communist leader Gennady A. Zyuganov, who lost to Yeltsin in 1996. “He is tormenting himself, the country, his relatives. He must resign, but he does not have the will or scruples to do that.”

In recent weeks, with the president growing politically weaker, jockeying among candidates to succeed Yeltsin has begun in earnest. Moscow Mayor Yuri M. Luzhkov, who would appear the most likely to succeed Yeltsin, has all but announced that he will run in 2000, when the next presidential election is scheduled.

Yeltsin has been in hospitals or seclusion much of the time since he won reelection in July 1996. Just before the election, he suffered a heart attack, and later he had heart bypass surgery. He has long suffered from bouts of depression.

Dr. Lon Schneider, who teaches psychiatry, neurology and gerontology at the USC School of Medicine, said “neuro-psychological asthenia” is an archaic term and can incorporate a number of conditions, including depression, anxiety, cognitive impairment and extreme fatigue. Heart disease is a frequent cause of both depression and cognitive impairment, especially in older patients, he said.

“It sounds to me like they don’t know whether to say he’s depressed and can’t carry out his functions, or he’s cognitively impaired and can’t carry out his functions, or he just has very low energy,” Schneider said. “My distant impression is that this man is considerably depressed and can’t make decisions.”

Dr. Louis Caplan, a neurologist at Harvard Medical School, agreed that the diagnosis reported by the Kremlin is “a very old-fashioned, very general term. It’s a term they might use when they don’t want to say what’s really wrong with him. . . . Technically, asthenia just means weak. Adding the word ‘psychological’ to it would give someone the impression that there is something wrong with his brain function.”

Sysuyev, the deputy, said that the president is not incapacitated and that he canceled the trip to Vienna because he realized it would put him and his health under enormous scrutiny.

“Believe me, the president found it very hard to cancel the visit,” Sysuyev said on independent NTV’s “Hero of the Day” interview program. “It was very hard for him because he realized . . . the attitude of political leaders toward his temporary indisposition [and] he was aware of all the widespread speculations on the subject.”

Prime Minister Yevgeny M. Primakov, who until recently was foreign minister, will represent Russia at the Vienna meeting. Yeltsin’s schedule had included a meeting with Austrian Chancellor Viktor Klima, the current European Union chairman, to discuss such issues as the Middle East peace agreement, the international dispute over the Serbian province of Kosovo, and Russia’s economic crisis.

Primakov also will take over for Yeltsin in Vienna in a meeting with International Monetary Fund and World Bank officials to discuss economic assistance. Other Russian officials are expected to sign agreements that would bring $600 million in investment to Russia.

“To a large extent, Yeltsin will become a purely token figure now,” analyst Piontkovsky said. “His powers and responsibilities will be confined to merely sticking around, just being around and performing the vague function of a guarantor of the current constitution.”

Times Moscow Bureau Chief Paddock reported from Vienna and staff writer Reynolds from Moscow.

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Yeltsin’s Medical File

Some of President Boris N. Yeltsin’s health problems in the past decade:

* September 1991: Forced to stop work and rest for two weeks because of heart trouble.

* July 11, 1995: Hospitalized for two weeks with acute heart trouble, then recuperates for two weeks at a government sanitarium.

* Oct. 26, 1995: Hospitalized for nearly a month with heart problems, then spends another month recuperating at a government rest home.

* June 1996: Disappears from public view in final week before the presidential election. Aides cite a sore throat, his wife blames a cold, but his doctor later acknowledges it was a heart attack.

* Nov. 5, 1996: Undergoes quintuple heart bypass surgery.

* Jan. 8, 1997: Hospitalized for 12-day treatment of what doctors describe as “double pneumonia,” then spends a month recuperating at his country residence.

* March 13, 1998: Suffers from what is described as acute laryngitis. Doctors advise him to stay in bed.

* Oct. 12, 1998: Cuts short his trip to Kazakhstan and Uzbekistan because of bronchitis.

* Oct. 26, 1998: Kremlin cancels his trip to Vienna because of “unstable blood pressure and undue fatigue.”