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History of German Medicine: Medicine and Modernity: Public Health and Medical Care in Nineteenth- and Twentieth-Century Germany

History of German Medicine: Medicine and Modernity: Public Health and Medical Care in Nineteenth-... In 10 chapters and a very useful introduction by Geoffrey Cocks, this collection brings together some of the best recent scholarship about the rise and spread of an increasingly professionalized and scientific medicine that has had a profound influence around the world. As indebted as we are to Rudolf Virchow, Robert Koch, et al, the tragedies of two world wars begun by Germany and the horrors of the Holocaust are never far from our consciousness, and to the credit of the scholars represented in this book, those tragic events are not far from their work. Like a black hole, as Geoffrey Cocks notes in the introduction, everything eventually is drawn toward the events during the Third Reich. The essays are arranged in chronological order, beginning with Johanna Blecker's discussion of hospitals and care for the poor, 1820 to 1870. This was the half century before the startling discoveries in bacteriology, but what Blecker shows is that physicians began to make increasing use of hospitals both for practice and for their teaching and research, prior to the advent of the more scientifically based medicine of the late 19th century. Alfons Labisch writes about German health insurance between 1883, when Bismarck coaxed the Reichstag into some social responsibility, and 1931—though, as Henry Sigerist noted more than 50 years ago, Bismarck's motives were more fueled by political control than by social amelioration. In a historiographic article, Richard Evans, the author of an important book about the 1892 cholera epidemic in Hamburg, traces the concept of social Darwinism in Germany. Evans notes two phases. The earlier, in the 1860s and 1870s, was tied to evolutionary thought, in which mutual aid was as prominent as ruthless competition. A later phase, in the 1890s, superseded the earlier version and stressed the struggle for the survival of the fittest. A vulgarized form of this Darwinism came forth as Nazi ideology. But one should certainly not blame the horrors of the Nazis on Charles Darwin. Social Darwinism, Evans notes, was not even popular among most Nazis or the German middle classes. What is interesting for the reader of this essay is that Evans nicely summarizes how contending historical explanations take shape and are defended. Charles McClelland, whose The German Experience of Professionalization: Modern Learned Professions and Their Organization From the Early Nineteenth Century to the Hitler Era (1991) is a standard source, here asks whether there was not also some failure of professionalization and socialization. This question becomes especially important in the 1930s, when many German doctors seem to have been drawn to National Socialism. Were the German doctors more anti-Semitic than those elsewhere? The many Jewish physicians in Germany were deprived of their right to practice in the mid 1930s. While it is tempting to say there was a failure of professionalization because we know how the story ended so tragically, are those American physicians who limited Jewish medical school admissions in the 1930s similarly to be seen as a failure in professionalization? It is an intriguing question. Two chapters about the treatment of psychiatric patients and two about the politics of abortion and sterilization tell us much about the social, political, and economic conditions in which medicine in Germany developed. The whole question of sterilization and euthanasia, their historical and political meaning, as Gisela Bock notes, continues to be contested. Geoffrey Cocks provides a succinct summary of the Nuremburg Trials. He notes that the main ethical lesson we have learned from the Doctors Trial concerns the dangers of social corporatism. By this he means an exaggerated sense of duty and conformity, bordering on fanaticism. It seems the doctors in the camps followed orders with a vengeance. The final chapter of the book is about what Michael Kater, whose 1989 Doctors Under Hitler has become a standard source for medicine and the Third Reich, here describes as the unwillingness of the German medical profession to acknowledge Hans Joachim Sewering's deep involvement with Himmler's SS and the Nazi Party as early as 1933 when he was a medical student. Yet nearly six decades later the Germans pushed for and were successful in Sewering's election as president of the World Medical Association. Kater probes the deftness with which Sewering was able to rise in the postwar German medical establishment. His success, of course, says even more about his colleagues' willingness to look the other way as it does about his own political skills. Alas, the German gift for denial seems unabated. We have, then, very rich fare. Medicine and Modernity brings recent German medical history to life, making it conveniently available for readers not able to read the growing literature in German. If there are any lessons in history, this collection may be a good place to look for them. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

History of German Medicine: Medicine and Modernity: Public Health and Medical Care in Nineteenth- and Twentieth-Century Germany

JAMA , Volume 279 (1) – Jan 7, 1998

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Publisher
American Medical Association
Copyright
Copyright © 1998 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.279.1.87-JBK0107-3-1
Publisher site
See Article on Publisher Site

Abstract

In 10 chapters and a very useful introduction by Geoffrey Cocks, this collection brings together some of the best recent scholarship about the rise and spread of an increasingly professionalized and scientific medicine that has had a profound influence around the world. As indebted as we are to Rudolf Virchow, Robert Koch, et al, the tragedies of two world wars begun by Germany and the horrors of the Holocaust are never far from our consciousness, and to the credit of the scholars represented in this book, those tragic events are not far from their work. Like a black hole, as Geoffrey Cocks notes in the introduction, everything eventually is drawn toward the events during the Third Reich. The essays are arranged in chronological order, beginning with Johanna Blecker's discussion of hospitals and care for the poor, 1820 to 1870. This was the half century before the startling discoveries in bacteriology, but what Blecker shows is that physicians began to make increasing use of hospitals both for practice and for their teaching and research, prior to the advent of the more scientifically based medicine of the late 19th century. Alfons Labisch writes about German health insurance between 1883, when Bismarck coaxed the Reichstag into some social responsibility, and 1931—though, as Henry Sigerist noted more than 50 years ago, Bismarck's motives were more fueled by political control than by social amelioration. In a historiographic article, Richard Evans, the author of an important book about the 1892 cholera epidemic in Hamburg, traces the concept of social Darwinism in Germany. Evans notes two phases. The earlier, in the 1860s and 1870s, was tied to evolutionary thought, in which mutual aid was as prominent as ruthless competition. A later phase, in the 1890s, superseded the earlier version and stressed the struggle for the survival of the fittest. A vulgarized form of this Darwinism came forth as Nazi ideology. But one should certainly not blame the horrors of the Nazis on Charles Darwin. Social Darwinism, Evans notes, was not even popular among most Nazis or the German middle classes. What is interesting for the reader of this essay is that Evans nicely summarizes how contending historical explanations take shape and are defended. Charles McClelland, whose The German Experience of Professionalization: Modern Learned Professions and Their Organization From the Early Nineteenth Century to the Hitler Era (1991) is a standard source, here asks whether there was not also some failure of professionalization and socialization. This question becomes especially important in the 1930s, when many German doctors seem to have been drawn to National Socialism. Were the German doctors more anti-Semitic than those elsewhere? The many Jewish physicians in Germany were deprived of their right to practice in the mid 1930s. While it is tempting to say there was a failure of professionalization because we know how the story ended so tragically, are those American physicians who limited Jewish medical school admissions in the 1930s similarly to be seen as a failure in professionalization? It is an intriguing question. Two chapters about the treatment of psychiatric patients and two about the politics of abortion and sterilization tell us much about the social, political, and economic conditions in which medicine in Germany developed. The whole question of sterilization and euthanasia, their historical and political meaning, as Gisela Bock notes, continues to be contested. Geoffrey Cocks provides a succinct summary of the Nuremburg Trials. He notes that the main ethical lesson we have learned from the Doctors Trial concerns the dangers of social corporatism. By this he means an exaggerated sense of duty and conformity, bordering on fanaticism. It seems the doctors in the camps followed orders with a vengeance. The final chapter of the book is about what Michael Kater, whose 1989 Doctors Under Hitler has become a standard source for medicine and the Third Reich, here describes as the unwillingness of the German medical profession to acknowledge Hans Joachim Sewering's deep involvement with Himmler's SS and the Nazi Party as early as 1933 when he was a medical student. Yet nearly six decades later the Germans pushed for and were successful in Sewering's election as president of the World Medical Association. Kater probes the deftness with which Sewering was able to rise in the postwar German medical establishment. His success, of course, says even more about his colleagues' willingness to look the other way as it does about his own political skills. Alas, the German gift for denial seems unabated. We have, then, very rich fare. Medicine and Modernity brings recent German medical history to life, making it conveniently available for readers not able to read the growing literature in German. If there are any lessons in history, this collection may be a good place to look for them.

Journal

JAMAAmerican Medical Association

Published: Jan 7, 1998

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