Gesundheit und Krankheit im Spiegel von Petitionen an den Landtag von Baden-Württemberg 1946 bis 1980 by Sylvelyn Hähner-Rombach (review)

This book by Sylvelyn Hähner-Rombach exemplifies the most recent research trend in the history of medicine, the trend toward the experience of illness and not (only) its treatment. Her book offers a systematic survey and, as it were, differential diagnosis of petitions of request or complaint submitted between 1946 and 1980 to the state parliament of the southwestern German state of Baden-Württemberg. Of the 1,530 petitions, between 4 and 10 percent concern health and illness. The largest number comes from prison inmates, and it is on this group that the author focuses her study, a selection that offers a significant as well as manageable sample size. Hähner-Rombach draws from Winfried Schulze the term ego documents (pp. 9, 14) to characterize these primary sources and argues that a prison, as what sociologist Erving Goffman designated a "total institution" (p. 15), offers a type of controlled environment in which to examine behavior, anxieties, values, self-perceptions, experiences, and expectations. This of course would seem a limitation of the book in that most well and ill people are not prison inmates. Hähner-Rombach concludes, however, that "the role of the sick person under the conditions of a 'total institution' . . . was not fundamentally different than that among people who are not lodged in such an institution" (p. 167). But then why focus just on prison inmates? The author concedes that "the question whether there exists a 'medical culture of prisoners'" cannot be answered without recourse to "other sources, such as diaries or memoirs" (p. 167). For all of these reasons, therefore, this book necessarily will, because of its careful analysis of these particular valuable documents, over time become only a part of a larger body of literature on the individual and social experience of illness and health.

Health and illness became especially important during the modern era and during the twentieth century in particular. This was certainly and especially true in Germany, where social, political, military, cultural, and scientific contexts and events created an environment of special concern for body, mind, and self on the part of both the individual and the state. This concern was heightened by a series of events from 1914 through 1945 disastrous for the well-being of tens of millions of Germans—and millions of others. While constraint upon individuals was central to this dangerous and destructive era, there was also significant, if also desperate, agency on the part of individuals and groups when it came to securing and preserving health. Such agency was even more widespread after the Second World War when in West (and East) Germany political and social systems were established that had as one their chief aims the repair and protection of populations grown tired and restive with insecurity over individual well-being. It is within this historical context that Hähner-Rombach offers as her central thesis that these petitions show "the attempt by male and female petitioners to use illness as resource and health as instrument" (p. 19). There are of course changes over time. In the early postwar years there are many petitions for compensation for forced sterilization under the Nazis. In later years petitions from prisoners reflect the greater amount of useful and influential information available even to prisoners through newspapers, radio, and television.

Ironically and unfortunately for a study concerned with experience and perception, most of the material and analysis in Hähner-Rombach's book is structural rather than testimonial. Charts, graphs, institutional history, and accounts by authorities too often take pride of place and space over the actual words and experiences of the petitioners. Even in the third section of chapter 4, by far the longest single portion of the book because it is devoted to the study of the most valuable...