Gesundheitsfursorge zwischen humanitarem Anspruch und eugenischer Verpflichtung: Entwicklung und Kontinuitat sozialhygienischer Anschauungen zwischen 1920 und 1960 am Beispiel von Prof. Dr. Carl Coerper (review)

This book is a continuation of the groundbreaking work of Gerhardt Baader on medicine, and particularly social hygiene, in the Nazi years. It was Baader who in the late sixties first broke the German taboo on the investigation of this terrible period in German history. His thinking still informs the new work of the group, which includes Sabina Schleiermacher's striking Sozialethik im Spannungsfeld von Sozial- und Rassenhygiene (1996), on Hans Harmsen and the Innere Mission of the German Protestant Church; Robin Maitra's "Wer imstand und gewillt ist, dem Staate mit Hochleistungen zu dienen!" (2001), on the hygiene textbooks of 1920–60; Martin Holtkamp's Werner Villinger (1887–1961) (2002), on the continuity of the concept of worthlessness in social psychiatry; and Michael Hubenstorf's exhaustively detailed (but still unpublished—why?) monograph on social hygiene in Austria. Most of this work originated in the theses of students whose views were formed and whose research techniques were sharpened under the eye of teachers and colleagues in Berlin, and although it is now mainstream historiography, it still shows the pain and anger inspired by the material they deal with. As a group, these scholars have tended to focus upon Germany's Sonderweg in social hygiene.

The closest translation we have for soziale Hygiene is "public health"—but it is not our public health, with its twin roots in Chadwickian sanitation and vaccination. Horst Schütz brings out very well the particularity of the German scene: a population-hygienics, in which the individual is a minor element for which the social hygienist is responsible to the state. His protagonist, Carl Coerper (1886–1960), began life as a school doctor, with a mandate to deal with the tuberculous, the malnourished, and the underdeveloped among the schoolchildren of Cologne. Using this experience, Coerper worked out a constitutional medicine based on a division of children into four types, a common enough concept at the time, empirically linked to the perception of the narrowed chest of the tuberculous child, a sufferer from the tuberculous diathesis. The diathesis was inherited, even if the tuberculosis was not, and offered a pathway to genetic prognosis through constitutional medicine.

The classification into types provided a foothold for a measurement of the potential of children as productive members of society. Constitutional medicine with its types goes back ultimately to the classic four temperaments of body and mind of Galenic medicine—Coerper's best and most productive "muscular" type echoes the Galenic sanguine temperament—but it looks forward equally to the setting up of a cost-benefit analysis of the worth of the individual. It is this field of medical thinking, writing, and professional activism, well developed in the Weimar period, that was to segue so smoothly into Nazi health policies. Coerper, of course, kept his job on the city council under the new regime.

Coerper's ideal social hygienist controls a grouping of linked professionals in the fields of obstetrics, pediatrics, pedagogy, adolescent medicine, and psychiatry, as well as genetic and eugenic counseling, child guidance, and marriage counseling. A systematic guidance and supervision should reach not only the sick but also the healthy; it should be based on the science of constitutional medicine, and through it, the medical profession as a whole should be involved in the renewal of the German Volk. Coerper wanted to set up "constitutional clinics" in which all these aspects of the life of the younger generation would be coordinated. It is questionable, according to Schütz, how much of this program was ever implemented, since there was professional resistance to allowing social hygiene to take control of the medical profession. Yet he suggests that the entire edifice of...