The Science of Human Perfection: How Genes Became the Heart of American Medicine by Nathaniel Comfort (review)

Nathaniel Comfort’s book is a product of the Oral History of Human Genetics Program, a joint project of UCLA and Johns Hopkins, started by Edward McCabe in 2001 as a “multi-institutional collaboration dedicated to the documentation and preservation of the history of the field of human genetics.” The project has collected a large archive of oral histories from the second part of the twentieth century, and a matching bibliography of primary and secondary sources to go with them. Comfort, at the project’s Hopkins end, has made very good use of this rich collection to argue for a new view of eugenics.

He starts with a Hopkins story and four Hopkins men: three from the hospital and one from the university: Victor McCusick from Medicine, Barton Childs from Paediatrics, Abraham Lilienfeld from Epidemiology, and Bentley Glass from Biology (p. 1). In 1950, they met to start a journal club on medical genetics, and they named it the Galton–Garrod Society, after two founding figures of the nineteenth century—Francis Galton, a Darwin cousin who coined the name “eugenics” for the genetic improvement of human populations, and Archibald Garrod, who proposed the first “inborn error of metabolism,” when he analyzed a baby’s nappy that had turned black from the presence of alcaptonuria and found it running in families. Comfort, like his Four Doctors, takes these two iconic figures as the connecting thread of his argument: eugenics as population genetics, and biochemical genetics to represent the individualized or medical strain. He is pretty bold in invoking Galton: eugenics has had a very frightening history. It is hard to find a social historian who can look at it without shuddering—Devon Stillwell’s article in the 2012 summer Bulletin is a just-published example. But it is Comfort’s position that both strains are present in the modern synthesis that is medical genetics.

From the early twentieth century, Comfort argues the intertwining of eugenics and public health, integrating a medical eugenics into Progressive health reform. His history shows the personal and institutional connections between the old Eugenics Record Office at Cold Spring Harbor, founded by the wild eugenists Charles Davenport and Harry Laughlin in 1910, through the development of the network of medical Heredity Clinics, beginning in the late thirties, to the 1968 takeover of the Cold Spring Harbor Laboratory by the iconic James Watson. The Eugenics Record Office had ended as a eugenics operation in 1939, and efforts to revive it after Davenport died in 1944 failed. Watson had found it “[b]roke, decrepit and almost empty,” in Comfort’s words, but he remade it in his own splendidly modern image (p. 220). Comfort sees an odd resemblance between Davenport and Watson: they both, he says, though greatly respected by contemporaries, had a reputation for dramatics, for being a bit of a loose cannon (p. 236). Both had a sophisticated, up-to-the-minute understanding of their field—and both enthusiastically promoted genetics as the “most powerful weapon” (p. 238) for eliminating disease from the human race.

Comfort has stuff on everyone—scientists, clinicians, even the students who went to their seminars. With the help of wide and detailed archival research, he has worked out exactly who studied where, who knew whom, who were the institution builders who developed the networks, and what they said about each other, in public and private. In the thirties and forties, the push to get human genetics into medical schools was led by Madge Macklin of Western Ontario (p. 87), and blood-grouper Laurence Snyder of Harvard. Snyder designed the first medical genetics course for medical students, and several medical genetics programs. He lectured and wrote, promoting the field as essential to medicine; he started the professional society in 1948 (p. 86). But from an interview of 1939 in the archives of the Carnegie Corporation...