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The physical symptoms of starvation, suffered in varying combinations by the large majority of Leningraders, were emaciation, dropsical swelling of the legs and face, skin discolouration (‘hunger tan’ in the slang of the time — faces are described as turning ‘black’, ‘blue-black’, ‘yellow’ or ‘green’), ulcers, loosening or loss of teeth and weakening of the heart. Women stopped menstruating and sexual desire vanished. The optical engineer Dmitri Lazarev described how it felt in his diary:

For a long time I have wanted to write down what a person emaciated from starvation experiences. You sleep very little — six or seven hours. Throughout the night you continuously pull up your covers and tuck them in, for you are always cold. The cold pours along your spine and whole body. Your protruding bones ache, forcing you to keep changing position. All the time you are tortured by hunger; you can feel the emptiness of your stomach, and convulsively swallow your own saliva. It’s difficult to perform any sort of physical movement, even the most insignificant. Before turning over in bed, you take a long time to gather your strength. You procrastinate, put it off. In your mind you repeat the necessary sequence of actions over and over again, before actually committing to them. The morning arrives and it’s very hard to overcome your inertia, to get up and get dressed. During the day your movements are slow and careful. Despite wearing warm clothes you feel chilled, and are dogged by an unpleasant sensation of noise in your ears. Your own breathing and speech resonate as if in an empty vessel. Your feet swell, and deep cracks form in the skin of your fingers. . You exist on the sidelines to everything going on around you. In the canteen, for example, you meet a friend, a colleague, and don’t have the energy even to say hello. You look at him expressionlessly, and he returns the same look. Why waste strength on words?12

Lidiya Ginzburg describes starvation as a sort of premature ageing, combined with alienation from the body:

The mind hauled the body along. . Let’s say I move my right leg forward. The other one moves back, pivots on its toes and bends at the knee (how poorly it manages that!) then pulls itself off the ground and moves forward through the air. . You have to watch the way it goes back, otherwise you might fall over. It was the most ghastly dancing lesson.

Even more insulting in its abruptness was losing one’s balance. It wasn’t weakness, nor staggering from exhaustion, but something else altogether. You want to put your foot on the edge of a chair to tie your shoelaces; but at that very moment your temples begin to thud and you are overcome with giddiness. The body has just slithered out of control and wants to fall like an empty sack into some incomprehensible abyss.

A whole series of foul processes went on inside the alienated body — degeneration, drying-out, swelling up, not like good old-fashioned illness. Some of these processes were imperceptible to the person stricken with them. ‘He’s already swelling up, isn’t he?’ they say. . but he hasn’t realised it yet. . Then he suddenly becomes aware that his gums have swollen. He feels them with his tongue, terrified, then prods them with his finger. He can’t leave them alone, especially at night. He lies there with an intense feeling of something hardened and slippery, its numbness especially frightening: a layer of dead tissue inside his mouth.13

In starvation’s final stages, sufferers resembled barely animated skeletons, with hollow stomachs, sunken cheeks, protruding jaws and blank, frightening stares. ‘His legs moved like artificial limbs’, Inber wrote of a man she saw being helped along the street. ‘His eyes stared madly, as if he were possessed. The skin on his face was tightly stretched, the lips half open, revealing teeth which seemed enlarged. . His nose, sharpened as if it had melted, was covered with small sores, and the tip had bent slightly sideways. Now I know what is meant by ‘gnawed by hunger’.14

Through January and February the city Party Committee issued a stream of orders — on the manufacture of burzhuiki, chlorine tablets and vaccines, on the ‘holding to account’ of pharmacy managers, on the sorting of undelivered mail, on the provision of pillows and linen to orphanages, the formation of teams of plumbers to repair the sewage system, the delivery of 13,000 pairs of cotton socks to a hospital. All fell into a void.

Among the many government agencies to cease functioning was the fire service. Set alight by bombardment, home-made stoves or by the twists of paper and splinters of wood used as torches once the kerosene for ‘bats’ and ‘smokers’ ran out, buildings burned for days. The health service was completely overwhelmed. ‘In Hospital 25th Anniversary of October’, ran a report to Popkov, head of the city soviet, of 12 February,