Der "Volkskorper" im Krieg: Gesundheitspolitik, Gesundheitsverhaltnisse und Krankenmord im nationalsozialistischen Deutschland, 1939-1945 (review)

In this Munich dissertation Winfried Süß proposes to do two things: examine the institutional history of public health administration in the Third Reich, and provide a social history of German medical culture in World War II, as based on that administration's decisions. Süß claims that the institutional history has been "scantily reviewed to date" (p. 14)—which hardly reflects the truth, considering the plethora of monographs and articles on the subject by authors such as Alfons Labisch, Florian Tennstedt, and, recently, Rebecca Schwoch. Thus in both areas not everything Süß writes is new; the reader benefits, however, from a state-of-the-art accounting and an up-to-date bibliography. The overall character of the book is encyclopedic in the German academic style, yet the often ponderous prose is compensated for with new facts and insights. One of the strengths of the book is Süß's employment of German denazification records; these as well as other original sources and the statistics in appendices are impressive. Conceptually, I wonder why the book is said, in its title, to start in 1939, whereas the author constantly resorts to Nazi prewar, and even Weimar republican, history.

One of the useful things Süß does at the beginning is to explain the character of Nazi rule as polycratic, a well-worn thesis developed by the so-called functionalist school in the interpretation of Nazi structures, led by Hans Mommsen. Süß does right to use this explanatory model in his analysis of public health care, starting with 1933. In this sector, as he explains, Nazi Party forces militated against representatives of the state, so that during wartime at the latest it became apparent that the efficacy of health care was compromised. Again, Süß is not the first to detail friction between the two most important health officials—Nazi Party Older Fighter functionary Dr. Leonardo Conti, the Reich Health Leader, who hailed from the SA, and Reich Health Commissioner Dr. Rudolf Brandt, who came from the SS—but his account strengthens and supplements earlier histories of their infighting. Add to that central relationship (in which Brandt ultimately triumphed) extramedical influences such as those engendered by German Workers' Front leader Robert Ley, who was advocating a new pension scheme for breadwinners with certain implications for health care, and the polycracy in public health becomes palpable.

The everyday consequences for health-care delivery, especially during the war, were high costs, a shortage of physicians (who were increasingly drafted), an increase in medical malfeasance, and the exploitation of women doctors who had to perform stopgap functions under pressure. Süß is especially successful in explaining the resurgence of rare diseases afflicting the civilian population: diphtheria, scarlet fever, and typhoid. As the war intensified and placed ever-heavier burdens on the civilian population called upon to defend the "home front," already well-known disorders multiplied, with hardly a chance of a cure, for medical personnel were chronically lacking; among these disorders the author lists abscesses among miners, various digestive abnormalities, bacterial skin diseases among toddlers, and, particularly toward the end of the conflict, venereal diseases, especially among girls and young women. Constant air raids led to much stress, so that young people's physical growth processes were impeded.

Süß deals with several of the specifically Nazi public-hygiene, health, and disease policies, which historians have learned to trace to the regime leaders' scientistically circumscribed biopolitics. A prime example of this is euthanasia, a phenomenon on which authors long before Süß have done enlightening work: if anything, he once again replicates such information while adding some new details—but he fails to tell the reader, as have other authors, what the defining Nazi characteristics of such phenomena were. As rich as the details of this study are, and as minute the processes that it describes, this points up one of its few annoying weaknesses. The...