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Proctor, Robert N. Racial Hygiene, Medicine under the Nazis. Harvard University Press. 1988. Pp. viii + 414. Price £11.95. This book is yet another attempt to answer some questions which have puzzled and disturbed liberals for nearly half a century. Why did so many German physicians work enthusiastically for the Nazi regime? Why did they do so little to protect their Jewish colleagues? How could members of a caring profession act in that way? People like to think that the medical profession is made up of dedicated healers who work ceaselessly with little regard for their own financial or professional status. So what went wrong in Nazi Germany? In one sense the answer is that since there were at least 90,000 physicians active in Germany between 1931 and 1945 it is hardly surprising that some were over-ambitious, some were unscrupulous, and some were simply evil. Although people would like their physicians to be saints few of them actually are — they are just human. It is all too easy for armchair critics years after the event to say how other people should have acted under a totalitarian regime. They were not there, they can have no real idea of the pressures on physicians and other professional groups to conform or suffer. It is perhaps to the credit of the German medical profession that no more than half of them joined the Nazi party although to do so meant advancement and personal safety. Other attempts to answer the question posed above have concentrated on the coercion of physicians and the corruption of medicine and medical education by the Nazis. What is new about Proctor’s approach is that he believes that a substantial section of the German medical profession provided the impetus for Nazi racial theories, that the Nazi party simply took over and tried to put into effect ideas which were already part of the German medical establishment’s orthodoxy in pre-Nazi times. If Proctor’s hypothesis is correct, and I think it does have some validity, then there was clearly a ready-made constituency in German medical circles for Nazi racial theories. On the other hand nearly a quarter of the physicians in Berlin in 1936 were Jews, which would seem to indicate that even though there may well have been an anti-Semitic element in the German medical establishment’s hierarchy it can hardly have been in control if so many Jews managed to qualify and practise before the Nazis came to power. Although physicians with racist views certainly provided the Nazi party with some intellectual camouflage, I suspect that more jumped on the party’s bandwagon when it started to roll. It is an interesting book and its author has clearly delved deeply into the archives of the time. Yet, perhaps because it is itself propagandist, it is not without some serious flaws. To describe Fritz Lenz as a co-author of "the most important genetics textbook of the interwar years" reduces the level of argument towards that of the tabloid press. The book, the title of which translates to "Outline of Human Genetics and Racial Hygiene," is not one that I suspect many geneticists would have nominated then or now. This example reveals Proctor’s greatest difficulty with his material. He is not a biologist and has not taken the trouble to enlist one to check his facts. Had he done so he would have learned that biology has been a profession separate from medicine for much longer than he supposes. In spite of its flaws this is a book well worth reading. It is informative, often thought-provoking, sometimes irritating, and occasionally wrong, but it is rarely dull. Above all it is a reminder of the harm which can result from an unholy alliance between science and politics, between Lenz and his colleagues and the Nazi party in Germany or Lysenko and his friends and the Communist party in the Soviet Union. Proctor himself does not always seem to see the moral of his story. He writes admiringly of "socialist medicine" as if the political views of the practitioner affect the efficiency of his treatment. Perhaps the truth is that the best physicians are more interested in medicine than in politics. Physicians and scientists are, of course, entitled to hold political views. What they should not do is distort scientific facts to fit in with those views as some clearly did in Nazi Germany. It is worth remembering that such distortion is not unique to Germany or to regimes of the extreme right. Human beings are not angels. In any barrel containing about 100,000 apples some are always going to be rotten. JOHN TIMSON | ||||||