Recurring Ulcer Lands Yeltsin in Hospital Again

Just days after his spokesman said he was fully recovered, Russian President Boris N. Yeltsin was readmitted to the hospital Saturday after a recurrence of a bleeding ulcer.

The hospitalization, Yeltsin’s third in four months, underscores just how fragile the president’s health remains and undermines his increasingly futile attempts to appear vigorous and in command.

It is also likely to sharpen calls for Yeltsin to step down voluntarily before he is incapacitated or dies.

The Kremlin’s top doctor, Sergei P. Mironov, said Yeltsin began feeling ill Friday and was brought to the Central Clinical Hospital on Saturday for tests. Doctors conducted a gastroscopy, which showed that the ulcer had not healed completely and that there was minor bleeding that might be caused by a blood clot.

“These two circumstances made us recommend that the president be hospitalized for more precise control over the necessary conservative therapy,” Mironov said.

On Wednesday, presidential spokesman Dmitri D. Yakushkin announced that the president’s course of rehabilitation was completed and that he was in good health.

Yeltsin, 68, has been at best a part-time president since the summer.

However, he had increased his pace in the last two weeks, visiting the Kremlin nearly every day. He met with the head of the Federal Security Service on Monday, attended a Defense Ministry ceremony Tuesday, met with Chinese Premier Zhu Rongji on Thursday and took part in a summit Friday with the leaders of Kazakhstan, Belarus and Kyrgyzstan.

It was not clear whether the increased activity played a role in his relapse, although Mironov noted that Yeltsin’s recent trip to Jordan for the funeral of King Hussein added a strain to the president’s recovery.

Yeltsin’s poor health has been a persistent drag on his presidency, especially after his reelection in July 1996. Aides later admitted that he suffered several heart attacks in the final weeks of the campaign, and in November 1996, he underwent a quintuple heart bypass operation.

This fall and winter have been an especially poor time for Yeltsin.

He cut short a trip to Central Asia in October because of bronchitis. Also in October, he canceled a trip to Austria because of “nervous exhaustion.” On Jan. 17, after nearly a month out of public view, he was hospitalized with a bleeding ulcer.

Doctors said the ulcer could be treated without surgery, and the president spent four weeks in treatment, two of them in the hospital and the rest in a rehabilitation center.

Mironov’s remarks suggest that doctors still intend to treat the ulcer without surgery.

In recent months, the country has become used to the president’s absences.

Prime Minister Yevgeny M. Primakov, who departed Saturday for a two-week vacation in the southern resort of Sochi, has no immediate plans to return to Moscow, Yakushkin said.

Some Russians, in fact, feel relief when Yeltsin is in the hospital.

“In his rare hours of public activity, Yeltsin damages the fragile stability in the country by his surprise words, actions and especially his drastic personnel decisions,” said Dmitri Y. Furman, senior analyst at the Institute of Europe. “With Yeltsin in the Kremlin, the country is alert and anxious. It is quite normal for a dying person to show everybody that he still exists and can exceed expectations. This kind of behavior is not dangerous unless the sick person is the president.”

On the other hand, Yeltsin’s death would throw the country into deep turmoil.

He has been the country’s only president since the Soviet collapse, and a sudden succession struggle would strain Russia’s still-weak political system.

That is one reason calls have mounted in recent months for Yeltsin to step down voluntarily and organize an orderly succession of power.

The Communists have taken the lead, but even centrists such as Moscow Mayor Yuri M. Luzhkov have pressed the president to consider the option.

Some have even speculated that Primakov may be preparing the ground for an appeal to Yeltsin to resign.

As part of a political truce he proposed to parliament last month, Primakov asked lawmakers to pass legislation to protect the perks of former presidents and extend their immunity from prosecution into retirement. Many believe that such protections are among the conditions necessary to persuade Yeltsin to resign. The proposed truce is still under discussion.

However, Yeltsin has given no sign that he will ever agree to step down. Although he has already ceded daily control of the country to Primakov, Yeltsin insisted as recently as Thursday that he has no intention of leaving office early.

“I will work until the 2000 election,” Yeltsin said.

Andrei A. Piontkovsky, director of the Independent Institute for Strategic Studies, a Moscow think tank, says that ordinary Russians are largely indifferent to the president’s rotations in and out of the hospital but that anxiety is increasing among political elites.

“The president is obviously not getting any better. His rare public appearances tell us that he is getting worse,” Piontkovsky said. “Political parties and movements are feverishly making and remaking their campaign plans. Each new hospitalization makes this anxiety more and more acute.

“It is now almost certain that we will have a new presidential campaign before the current presidential term expires” in June 2000, he said. “The only question is when.”