Abstract

For Nazi ideologues, science needed to undergo an enormous shift, a metamorphosis of sorts, in which research into natural phenomena was accompanied by a commitment to spirit, experience, and intuition. In this essay from the University of Heidelberg—one of Germany’s oldest and most prestigious universities—physician Hanns Löhr explores the possibilities of what such a transformation could mean for German medical science. Löhr was critical of existing medical training practices, which he believed were too heavily focused on imbuing doctors with an obsession with objective facts, which, he argued, robbed them of their capacity to appreciate the deeply personal relationship that doctors were supposed to share with their patients. He blamed this pattern on medical school admissions processes, which had shown preference, in his mind, to “racially inferior” students. In particular, he blamed “Jewish” doctors for the supposed dehumanization of medicine, because Jewish doctors allegedly pursued a “mechanical” approach to medicine by treating patients as “cases” on which to advance personal careers.

Hanns Löhr, “The Physician Must Come to Terms with the Irrational” (1935)

Source

We National Socialists are of the opinion that the physician, leaving his “ivory tower” work at a university clinic far behind, must first of all, in close contact with the Volk community, come to terms with the “irrational” which forms the bridge between the physician and man if the patient is not to be only a “case” or “material” for study.

Hence the National Socialist state is not interested in stuffing a medical student with a great mass of individual, disconnected facts and imparting anemic bits of knowledge which he usually learns ad hoc—that is, only for his examination—and entirely forgets four weeks later. Rather, it wishes to lead him, through a knowledge of the great biological interconnections to a deep reverence for life. []

By no means are we against science. Indeed, we demand from the future physician a great measure of scientific knowledge. However, this can be achieved only by reinvigorating the course of instruction with considerably more emphasis on its relationship to human biology than it has received heretofore through the transmittal of purely abstract and dead subject matter. It is precisely here that a truly rational reform of studies must be inaugurated.

Johannes Stein[1] correctly points out that the medical student comes into contact with the living human being—that is, the patient—much too late. If he has no experience with a sick person until after he has passed his first examination, frequently a profusion of regulations and preconceived notions stands between him and his patient. Let no one misunderstand us. We have no intention of imitating the medical schools of France or even their specific method of instruction, which from the very beginning puts the student in contact with patients, concentrating almost exclusively on medical techniques and methodology and, for the average student, putting no great emphasis on theoretical knowledge.

We believe, however, that it would certainly be useful to require service as a nurse and orderly as a precondition for medical studies. While performing this selfless service for his fellow men, the young student will soon find out whether or not he has chosen the right profession.

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In former years standards of selection sank progressively lower as the number of medical students increased, and more particularly as the medical schools received individuals who neither racially, ethically, nor philosophically were suitable for the medical profession. Consequently, the personal relationship between teacher and student was lost, and with it, naturally, the living model of leadership. The greater the influx of the multitude, the lower the individual accomplishment. In addition, Jewish lecturers occupied the chairs of medicine and despiritualized the art of healing. [According to Reich Physician Leader Gerhard Wagner]: “They have imbued generation after generation of young physicians with their mechanically oriented spirit.”

A culture ideal prevailed in the liberalistic period, now definitely overcome, that entirely disregarded the character education of the individual.

Hence the building of character and personality, through our teachers, must again be placed in the foreground; next to scientific training, this is the main task of our teachers. Only thus can we return to the ethics and high moral status of an earlier generation of physicians (one has only to read the Hippocratic Oath), which stood on solid philosophical ground and had no peers in terms of its professional knowledge. []

Enemies of National Socialism have for years spread the lie that National Socialism by nature stands for an anti-intellectual attitude and has no understanding of the uniqueness of genuine scientific inquiry. Thus the National Socialist movement is considered anti-intellectual and alien to the spirit of learning. Allegedly National Socialism would rob science of its inheritance and would restrict all scientific thought in such a way that, in the words of Heinrich Hasse,[2] “the proud mountain ranges of former German culture are leveled into swampy lowlands, fit only to serve as a refuge for intellectual castrates.”

Literary émigrés especially tried to make it appear that in Germany today all culture and civilization are endangered—as if a horde of un-leashed savages threatened the ideals of all mankind. []

The concept of an “unbiased and objective” science, aiming at “absolute truth” based on pure reason, which arose in the liberalist period, has today entirely lost its reason and justification for existing, since we have now come to understand that a realistic science is always based upon a personal contemporary-historical premise. Science can project itself into reality only out of the mainstream of the specific present. Volk community and science are not opposed to each other. The concept of Volk community, heretofore regarded only as a political concept, has now also become a basic scientific principle. []

Since the ultimate process of life can never be fully explained through causal-mechanical analyses, the question arises whether the physician, aside from his diagnosis based on the methodology of natural science, may not also have at his disposal some other means of knowledge. At once such concepts as empirical knowledge, consideration of the whole, and intuition spring to mind.

Unquestionably the physician cannot dispense with empirical knowledge, yet, as Hippocrates said, experience is deceptive. Many items of knowledge based solely on experience, no matter for how long they have been considered valid, may one day be discovered to be fundamental errors.

Another question is whether intuition is really a new kind of knowledge, whether or not there is a difference between purely emotional comprehension and the ordinary thought processes. Without a scientific foundation, without a thorough knowledge of biology, there would certainly be no room for intuition in medical science. But what differentiates the truly brilliant, intuitive researcher from his average colleague is that he suddenly receives great, trail-blazing insights which would never occur to the other. According to Bumke,[3] intuition is an exceedingly great concentration; it is the eye for the “essential which puts not only a great number of single observations and numerous recollections into focus, but at the same time is able to gather the great interconnections into a single thought.”

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A further cause for the distortion of the concept of the physician in recent times has unquestionably been the progressive Judaicization of our profession. Jewish colleagues soon managed to become the leaders of our professional associations and medical groups. According to Gerhard Wagner: “They debased the concept of professional honor and undermined the ethics and morals intrinsic to our racial stock.” Anyone who follows the collection of statistics which show how our profession, especially in the big cities, is dominated by Jews—and they were gathered according to religious and not ethnic or racial principles—will be able to appreciate fully the National Socialist counter-reaction. Reich Physician Leader Gerhard Wagner, in his sweeping report at the Reich Party Convention in 1934 dealing with race and national health, called attention to the fact that in February 1934—that is, a full year after the National Socialist revolution—in Berlin alone 46.8 per cent of the physicians participating in the State Sick Benefit Fund were Jews. In other big cities the situation is essentially the same. In the light of these facts one can no longer speak of brutal persecution and annihilation of Jews in the medical profession.

But the great influx of Jewish physicians also brought with it a parallel intrusion of Marxist-liberalist thought, which in turn distorted the concept of the physician ever further. The physician became a businessman; moreover, as a servant of the social security and insurance systems, he frequently did shoddy work if he did not want to suffer economically. The art of healing was solely valued in figures and fees!

Simultaneously, the medical practitioner was deprived of what remained of his professional pride by Marxist-oriented insurance administrators and fiduciary physicians.[4] They ordained—and he had to submit—what medicines he could prescribe for his patients.

What was the consequence of all this? The prestige of the medical profession sank lower and lower in the eyes of the people. Because of its dogmatic rejection of all lay medical thought, medical science became alienated from the Volk—simply because it ignored reality. To regain the confidence of the people, it would have been much more correct to submit the ideas and suggestions of Volk medicine to objective study and examination rather than to reject them out of hand. []

The social upheaval of the present time will help us to turn from an undue concentration on individual symptoms and organs to the consideration of the “whole” human being, and thus will lead to truly medical-biological thinking. This change in viewpoint has already been reflected of late in numerous contributions to medical publications by leading physicians in all specialized areas of medicine. []

The National Socialist physician has the holy obligation to the state not merely to induce patients with congenital diseases to undergo voluntary sterilization but also to report such cases to the authorities. Many a physician may perhaps ask: “But what becomes of the confidence between physician and patient? I for one have no intention of ruining my practice.” But the fact is that under the law for the unification of the public health system of July 3, 1934, this crucial problem of medical practice has already been transferred to the public health agencies soon to be established in city and rural districts.

But this does not free the physician from his most important obligation, namely, to do his duty as an alert biological soldier. It is his foremost task to defend the state and its people and their future against asocial elements. I need not emphasize here that the National Socialist physician occupies a basically different position from that taken by the physician of the Marxist-liberalistic period with respect to the problem of artificial interruption of pregnancy. We know of no social need for the destruction of the fruit of the womb.

What tremendous tasks are open to the physician and medical science in the National Socialist state! Our responsibilities and our obligations are greater than ever before. As a Volk physician in the truest sense of the word, the medical practitioner will be able to regain a great deal of his importance as well as the confidence of the people. []

Adolf Hitler and his associates have shown the way to the German medical profession.

We university teachers, however, are obliged to teach the student that the health of the Volk stands above the health of the individual as the ultimate aim of the art of medicine, hence to be a doctor to the people is more important than science itself!

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Notes

[1] Johannes Stein was professor of internal medicine (from 1934) and Director of the University Hospital at the University of Heidelberg (from 1936).
[2] Author of Schopenhauers Religions Philosophie (1932) and of works attempting to define the tasks of learning in the Third Reich.
[3] Oswald Bumke was the author of Das Unterbewusstein (The Subconscious) (1926).
[4] Those physicians who administered the state medical insurance system.

Source of English translation: Hanns Löhr (1935), “The Physician Must Come to Terms with the Irrational.” From Nazi Culture: Intellectual, Cultural and Social Life in the Third Reich by George L. Mosse © 2003 by the Board of Regents of the University of Wisconsin System. Reprinted by permission of the University of Wisconsin Press.

Source of original German text: Hanns Löhr, Über die Stellung und Bedeutung der Heilkunde im nationalsozialistischen Staate. Berlin: Nornen-Verlag, 1935, pp. 19–23, 26–29, 32–35.