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The Cult of Health and Beauty in Germany. A Social History, 1890?1930 by Michael Hau

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Abstract

Michael Hau, Professor of Modern European History at Monash University in Melbourne, makes a number of interesting and controversial claims regarding the history of medicine and psychiatry in his book on the “cult of health and beauty in Germany.” While discussing the discourses concerning mental health and somatic medicine, ideals of aesthetics and beauty, or assumptions regarding mind-body healing in the context of industrialized modernity, physicians and psychiatrists are located by the author in an essential tension between patient empathy and an assumed “crisis of medicine” during Weimar Germany. While giving an outline of Hau’s line of argumentation, concentration here shall be laid upon the habitus of medical and psychiatric actors under conditions of socioeconomic change that increasingly affected the radius of medical and psychiatric practice.
[This typescript is a post-print version of the journal article: Stahnisch, F. W.,
Michael Hau. The Cult of Health and Beauty in Germany. A Social History, 1890
1930. Chicago: University of Chicago Press, 2003. 272 pp. $US22.00; 27.99EUR
(paperback). ISBN: 978 0226 31976 6. In: Journal of the History of the Neuro-
sciences” 19 (2010), pp. 277-280. Page numbers related to the original journal article
are inserted in bolded brackets [p. x] directly in the text DOI:
10.1080/09647040903197156]
Book Review
Michael Hau. The Cult of Health and Beauty in Germany. A Social History, 1890
1930. Chicago: University of Chicago Press, 2003. 272 pp. $US22.00; 27.99EUR
(paperback). ISBN: 978 0226 31976 6.
Michael Hau, Professor of Modern European History at Monash University in
Melbourne, makes a number of interesting and controversial claims regarding the
history of medicine and psychiatry in his book on the “cult of health and beauty in
Germany.” While discussing the discourses concerning mental health and somatic
medicine, ideals of aesthetics and beauty, or assumptions regarding mind-body healing
in the context of industrialized modernity, physicians and psychiatrists are located by
the author in an essential tension between patient empathy and an assumed “crisis of
medicine” during Weimar Germany. While giving an outline of Hau’s line of
argumentation, concentration here shall be laid upon the habitus of medical and psych-
iatric actors under conditions of socioeconomic change that increasingly affected the
radius of medical and psychiatric practice: Hau’s approach brings together views
about mental life and physical health within the wider sociocultural developments of
“lifestyle reform” (Lebensreform), eugenics, social medicine (Sozialmedizin), and
“racial hygiene” (Rassenhygiene). His main argument is that the various reform tradi-
Book Reviews
2
tions had common denominators in the unifying project of Wilhelmine modernity, in
which they were significantly reshaped and modified.
The book comprises eight chapters, of which the first two deal with lifestyle
reform movements as these emanated from new bourgeois social values. Hau refers
general attraction to naturopathy, psychosomatic cures for neurasthenia, and nudist
gymnastics (Freikörperkultur) back to wider Wilhelmine concerns with individual
health and collective approaches that sought to defy “degenerative” processes
endangering the societal hierarchies of the recently unified Germany (1871). A
beautiful and healthy body served as guarantor of socioeconomic success, whereas
malformed bodies were equated with disease and degeneration processes. Focusing on
such antagonist views, Hau situates bourgeois concerns with the body, mental
equilibration, and temperance behavior in rationalistic views regarding body and
health. These developments also represented changing societal roles and new states of
identity during the Wilhelmine period (p. 4f.). While representatives of the lower
middle classes promoted physical discipline and agricultural health ideals, members of
the upper middle classes advanced hygienic and temperance concerns by pointing to
the dangers of alcoholism, neurasthenia, and mental degeneration.
In the following two chapters, Hau discusses issues of gender and race
aesthetics. Male representatives of Wilhelmine society perceived the growing number
of working women and spreading sociopolitical demands for emancipation as a threat
to the traditional gender order. It is revealing that neither in the lifestyle reform
movement nor in discourses on neurasthenia could balanced and progressive stances
towards female emancipation be [p. 278] found. The trenches were even deeper in the
psychiatric and medical communities that rejected birth control and the possibility of a
professional life for women by alluding to the dangers of increasing “masculinization”
in modern society. The succeeding two chapters trace those threads further back to
issues of “holistic constitutionalism” and the supposed “crisis of medicine.” Hau
focuses on the self-doubts of Weimar doctors as they were con- fronted with changes
of living conditions in a modern, industrial society, as well as on the reforming of new
medical practitioners, neurologists, and psychiatrists as “humane experts” (p. 128):
“The relation between a modern, industrializing society and the life reform movement
was therefore not primarily one of modernization and protest against modernization as
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some authors argue. Rather the contemporary explosion in people’s attention to their
health was an expression of the contradictions and tensions characteristic of the period
of classical modernity” (p. 3).
Following from this central point, the argument, however, becomes somewhat
opaque at various stages: Hau scrutinizes the “crisis of medicine” (cf. Klasen, 1984)
by following discourses on the healing legitimacy of Weimar medical men vis-à-vis
their patients and the broader public. It is unclear from the beginning of this
argumentation which particular instances of Weimar medicine are taken as the main
subject of discussion. Prima facie, Hau’s approach seems to aim at medical practice in
general when using the term “physician” (Mediziner) in discussing various medical
disciplines (p. 129), such as surgery, psychiatry, and family medicine. But Hau makes
strong references to representatives of academic medicine: for instance, the Tübingen
psychiatrist Ernst Kretschmer (18881964), the Berlin surgeons August Bier (1861
1949) and Ferdinand Sauerbruch (18751951), and the Heidelberg psychiatrist Karl
Jaspers (18831969).
The picture drawn here is that of an academic community that came under
increasing pressure through the interest of patients in alternative health movements,
medical sects, and miracle healers. As an expression of an overall uncertainty that
disenchanted the medical establishment, Hau considers two particular developments:
first, the rhetorical approaches of medical men who sought to regain the terrain of
healing legitimacy in scientific and public talks, presentations, and through hygiene
exhibitions; and second, prevailing assertions of professional “doubt” (p. 66) that rose
to the fore in lectures, textbooks, and theoretical treatises. As described by Hau, the
common point of these reactions resulted in the strong embracement of the idea that
physicians needed to become empathic healers (p. 128). He clearly interprets the
second development as responsible for the medical community’s reaction but does not
specifically inquire into the explanatory options of the first, which views the responses
of Weimar doctors and “Nervenärzte” as rhetorical strategies in regaining their former
healing hegemony.
There are two further observations that cast doubt on the solidity of Hau’s
depiction in this part of the book. First, many of the medical men referred to are
outstanding psychiatrists or doctors with a primary interest in psychiatry or
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psychological approaches. An analysis of the works of people such as Kretschmer or
Jaspers cannot be sufficient to corroborate claims about general developments in the
medical profession. German psychiatry in the 1920s was still in the process of
emerging from its infancy since the pioneering programs of Wilhelm Griesinger
(18171868) and Emil Kraepelin (18561929) (cf. Engstrom, 1991). Second, Hau
does not fully integrate the medical context with the general experiences of German
society since the First World War, the enormous social crises, and the postwar
depression; a period in which talk of “crisis” was widely en vogue and individual
psychological states of Angst reflected broader cultural pessimism
(Kulturpessimismus) about the impact of an “Americanization” of society at large.
[p. 279]
With respect to the naturopathy movement, Hau argues much more clearly that
during the 1920s “fringe healing” developments had a strong bearing on mainstream
academic medicine; yet this development did not stop in 1933 with the demise of the
Weimar Republic. Rather, National Socialist medicine similarly encouraged natural
therapies and alternative forms of health care as developed since the Weimar epoch
(cf. Bleker & Jachertz, 1992). The Danzig surgeon Erwin Liek (18781935) can be
seen as a protagonist of such positions. Medically active and very influential during
the 1910s and 1920s, he approved of Nazi medical ideology and was even proposed as
director of the central naturopathic Rudolf Hess Hospital in Dresden; a position he
relinquished because of health problems. It is quite striking, as Hau demonstrates,
how the approaches of “fringe medicine” spread during the Weimar Republic. But
whether these developments really made academic medicine “feel” the symptoms of
crisis, or whether medical professionals simply tried to eject their competitors from the
healing market remains to be established. An objection that might easily be raised
against an assumption of general “crisis of medicine” was the remarkable progress in
the medical sciences, even during the Weimar period. This progress went almost
undisturbed by the First World War, and it connected rapidly to the achievements of
the late 19th century, as represented by the two Nobel Prizes for Physiology or
Medicine to German medical leaders: in 1922, to the Kiel physiologist Otto Meyerhoff
(18841951), and in 1932 to the Berlin biochemist Otto Heinrich Warburg (1883
1970). These prizes serve as indicators that academic medicine continued to be
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fruitful, progressive, and high in self-esteem. Some prudence must therefore prevail
when discussing a “crisis of medicine” and further specification of its meaning is
certainly required.
Similar to the case of Liek as propounded in chapters six and seven another
dubious referent is the Berlin surgeon Sauerbruch. Focusing on his public talk at the
1926 international GESOLEI exhibition for health (GEsundheit), welfare
(SOzialfürsorge), and physical exercise (LEIbesübungen) in Düsseldorf, Hau stresses
the former’s leaning to naturopathy and the question of the healing art exclusively in
terms of Sauerbruch’s self-doubts but does not analyze the surgeon’s rhetoric
(p. 145f.). What appears somewhat remarkable is the characterization of one of the
leading German surgeons who developed the negative pressure chamber, pioneered
thoracotomic surgery, and invented important skin plastics as having lost his self-
esteem. It would have been enticing if Hau had given more attention to clarifying his
beliefs, which contrasted strongly with the image purveyed of Sauerbruch as a furious
animal when operating in his theatre and seeing him as an undifferentiated follower of
Nazism (Kudleen & Andree, 1980).
The final chapter of Hau’s book draws further on what he sees as “authenticity”
in health care (i.e., the empathic orientation of the physician towards patients’ needs
and the increasing introduction of psychosomatic, “holist” therapeutic approaches),
examining particularly the development of humane expertise in the medical field
where doctors now appeared as individual actors rather than distant executives of an
impersonal and pathology-oriented health care system. “Empathy” arose as a central
medical concept, and the “crisis of medicine” assumed the form of a general societal
situation. The point can easily be conceded that naturopathy and “fringe medicine,” in
this respect, played major roles in Weimar health care, but it remains unclear whether
this influenced academic medicine in the way depicted by Hau. Alluding to members
of the naturopathy movement, such as Erwin Silber (18691955) and Erwin Liek, he
acknowledges that fringe approaches had themselves undergone a certain state of
“crisis” through the recognition that academic medicine had regained lost terrain at the
end of the 1920s as it successfully integrated central holistic approaches (p. 135).
[p. 280]
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In conclusion, Hau has contributed with The Cult of Health and Beauty in
Germany an important book to the growing literature on early twentieth-century
medicine. Although scholars of this specific period in the history of medicine might
not find much here that is highly original, it is the synopsis provided of the significant
conceptual and social similarities between the emerging themes of neurasthenia,
degeneration, naturopathy, and holistic medicine, etc. that makes the book thought-
provoking and renders it a practical tool for teaching in the history of psychiatry and
neuroscience, history of medicine, and German history. The distribution of medical
actors, healing approaches, and perceptions within the lay public during the Weimar
Republic is solidly described. By the end of the book, however, the question of the
precise mechanisms that instigated the construction of new forms of medical expertise
remains open. It appears that the boundary between academic medical men on the one
hand and so-called naturopaths and holist physicians on the other had never been
really clear-cut, and the actors mentioned could often be found on both sides. The
historical disputes in German medicine between 1890 and 1930 might be rephrased as
a “trading zone” (Galison, 1999) of interests, power, and claims of legitimization
between the various medical actors in the field. Nevertheless, what Hau has to say
about the undercurrent developments in the Weimar medical community is still
relevant to many contemporary debates about medical, psychiatric, and neuroscientific
knowledge, and this points to important changes that have reshaped the role of medical
expertise in society and new forms of medical practice in the context of postindustrial
societies.
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References
Bleker J, Jachertz N, eds. (1992): Medizin im “Dritten Reich” (2nd ed.). Köln, Deutscher
Ärzteverlag.
Engstrom E (1991): Emil Kraepelin: Psychiatry and public affairs in Wilhelmine Germany.
Hist Psychiat 2: 111–132.
Galison P (1999): Trading zone. Coordinating action and belief. In: Biagioli M, ed., The
Science Studies Reader. London, Routledge, pp. 137–160.
Klasen EM (1984). Die Diskussion über eine Krise der Medizin in Deutschland zwischen
1925 und 1935. Mainz, Diss. med.
Kudleen F, Andree C (1980): Sauerbruch und der Nationalsozialismus. Medizinhist J 15:
201–222.
Frank W. Stahnisch
Department of Community Health Sciences
Faculty of Medicine & Department of History
Faculty of Arts
University of Calgary, Canada
ResearchGate has not been able to resolve any citations for this publication.
Article
Thesis (Doctoral)--Johannes-Gutenberg-Universität Mainz, 1984. At head of title page : Aus dem Medizinhistorischen Institut der Johannes-Gutenberg-Universität Mainz. Bibliographies : p. 157-169.
Article
Much has been said and written about Emil Kraepelin's psychiatric theories and nosology, but next to nothing about his sociopolitical engagement after assuming the directorship of the university clinic in Munich in 1903. This engagement took various forms, ranging from caustic confrontations in his battles against alcoholism and syphilis, to subversive activities aimed at toppling the German chancellor Bethmann-Hollweg in 1917, as well as to overt attacks on the fledgling democratic roots of the Weimar Republic. This paper explores the origins and extent of Kraepelin's public engagement and points toward ties linking it with clinical reality and psychiatric theory.
Medizin im " Dritten Reich Köln, Deutscher Ärzteverlag Emil Kraepelin: Psychiatry and public affairs in Wilhelmine Germany
  • J Bleker
  • Jachertz
Bleker J, Jachertz N, eds. (1992): Medizin im " Dritten Reich " (2nd ed.). Köln, Deutscher Ärzteverlag. Engstrom E (1991): Emil Kraepelin: Psychiatry and public affairs in Wilhelmine Germany. Hist Psychiat 2: 111–132.
Medizin im " Dritten Reich
  • J Bleker
  • N Jachertz
Bleker J, Jachertz N, eds. (1992): Medizin im " Dritten Reich " (2nd ed.). Köln, Deutscher Ärzteverlag.
Stahnisch Department of Community Health Sciences Faculty of Medicine
  • W Frank
Frank W. Stahnisch Department of Community Health Sciences Faculty of Medicine & Department of History Faculty of Arts University of Calgary, Canada