Social Control in Nineteenth Century Britain

ed. by A. P. Donajgrodzki.  London: Croom Helm, 1977
    ‘Social Police’ and the Bureaucratic Elite: A Vision of Order in the Age of Reform (pp. 51-76).

This book is a collection of essays concerned with the application of the concept of social control (borrowed from sociology) to the study of relationships between the classes in nineteenth century Britain.  Although the contributors have different perspectives on social control, all share a fundamental assumption that social order is not only maintained through legal systems (police and prison) but is also expressed through a wide variety of social institutions, both formal and informal.  The book purports to be the first collection of historical essays to make use of this concept.

The essay under consideration here, written by Donajgrodzki, is concerned with examining the common foundations in the thought of Hugh Tremenheere, a traditionalist, and Edwin Chadwick, a Benthamite (in fact he was Bentham’s amanuensis and a devoted adherent).  Both men, he claims, approached the problems of social control from the perspective of social police.  This perspective was characterized by the belief that it was a common morality that produced social order, so that any policy aimed at maintaining it would have to take into consideration not just the legal systems, but also religion, morality, education, leisure activities and even housing and public health.  It further held that if left to themselves, the poor were liable to be led astray, that is they were normless.  They are, perhaps, like a errant children, who do not know any better and must be guided in their moral development as well as in the everyday acts of life.

Donajgrodzki believes that the notion of social police may be an adaptation and intensification of pre-industrial beliefs about the proper relationship between the classes and the control of the poor.  In some parts of the country civil authority was matched by ecclesiastical authority, and this permitted extensive scrutiny of the lives and behavior of the poor and the possibility of social control through the power and influence of the clergy.  With industrialization the poor often gained some measure of economic independence, but this independence was not seen to carry over into a right for individualism, which was seen as incompatible with social order.  Industrialization tended to intensify the feeling that the poor need to be guided and taught, and led to speculations about how this could best be achieved.

Hugh Seymour Tremenheere, the first mines inspector, was a traditionalist whose duties included both reporting on the technical aspects of mining and also on the state of the people in the mining districts.  He felt that the way to maintain social order was to create a controlling and sustaining environment in which all factors, even the most trivial, were carefully considered.  His was a theory of reciprocal obligation, employers had a moral obligation to their employees, and the interests of both were the same.  He did not fear the intellectual and moral development of the poor and felt that it would contribute to social stability, because once they had been properly educated the poor would understand the nature of the proper relationship between themselves and the rich.  Industry would thus play the leading role in creating the proper environment for the working poor, with the state merely ensuring that the socially destructive practices of industry was curtailed.  The state should also contribute to the social welfare of the people by increasing the numbers of schools and staffing them with appropriate role models.  He also wanted an increase in the number of clergy, seeing them as front line enforcers of proper social behavior.

Whereas Tremenheere approached the problem of social control from a paternalistic perspective, Chadwick approached it from a Benthamite one.  They both saw order as being the product of a variety of social processes and thought that it was attainable only if the poor were watched over and guided.  But Chadwick believed that harsher and more coercive measures of enforcement were as important as the benevolent provision of the proper environment.  And unlike Tremenheere he felt that the state should take a much more active role in creating a systematic, humane and efficient social police.  The role of the police was to include not just the apprehension of criminals but also the supervision of public leisure and the enforcement of public health measures.  To offset their role as enforcers, police should also take on humanitarian and benevolent roles in a community, such as acting as fireman.  He felt that Tremenheere placed too much emphasis on the role of the church and that he was not hard enough on the trade unions, whom Chadwick saw as a disruptive force.  While he is often remembered for his advocation of state intervention, he was also enthusiastic about a paternalistic role for the industries for many of the same reasons that Tremenheere was.

Sick and Tired of Being Sick and Tired

 Susan L. Smith, Sick and Tired of Being Sick and Tired : Black Women’s Health Activism in America, 1890-1950, Philadelphia, University of Pennsylvania Press,1995.

As the subtitle of this book implies, it is about the role of black women in black health care.  The time period under consideration, 1890-1950, was a time of legalized segregation, but it was also a time when the American welfare state was expanding.  Unfortunately those benefits generally did not cross the color line.  In response to this, and as part of the political agenda for black rights and equal access to government resources, black activists attempted to draw attention to black health issues.

The creation of a black health movement began as a private crusade instituted primarily by black club women.  These women constructed the infrastructure of their communities through their work in religious and secular groups, groups that included not only church associations, but also female auxiliaries and women’s clubs.  These clubs started day nurseries and kindergartens.  They opened working girls’ homes in the North and the Midwest to help young black migrants from the South with housing, employment information, and moral instruction.  But because segregation and racism prevented African Americans from getting even the most basic health care, these clubs focused most of their interest on public health work.  Despite personnel and monetary limitations, they provided health education and some basic health services to impoverished communities and in Atlanta and Chicago they tried to provide African Americans with the same basic urban amenities that white communities received as a matter of course via tax-supported city services.

In 1915 these reform efforts became part of a national black health movement when Booker T. Washington launched a health education campaign from the Tuskegee Institute in Alabama.  This campaign, known as National Negro Health Week, was seen by black leaders and community organizers as a way for advancing the race through the promotion of black health education and cooperation across racial lines.  The Tuskegee Institute served as the headquarters for the campaign until it was taken over in 1930 by the United States Public Health Service (USPHS) and turned into a year-round program.

In the 1930s the statistical information now available revealed the plight of black Americans in the form of higher mortality and morbidity rates as compared to the white population.  Growing awareness of the problem among health officials did not necessarily lead to better health treatment for blacks, but rather led white officials to blame the African Americans themselves for their illness by saying that it was due to their behavior and, in the case of venereal disease, to their sexual immorality and promiscuity.  In response to these accusations, the black leaders responded with the statement that a population was only as healthy as its sickest members and called for an end to racist practices and the integration of health services, seeing these measures as the only real solution for the health issues facing black Americans.

By the 1940s the medical civil rights movement arose as black health workers struggled to integrate hospitals and medical and nursing schools and associations.  The effort was met by resistance within both the white and black communities.  But in 1950 the USPHS pronounced the end of the National Negro Health Movement and the Office of Negro Health Work on the grounds that the nation was moving towards integration.

The Impact of the Plague in Tudor and Stuart England

by Paul Slack, Routledge & Kegan Paul, 1985

When he wrote this book Paul Slack (at the time a Fellow and Tutor in Modern History at Exeter College in Oxford) was more interested in the social response to the disease than in the disease itself, devoting almost half of the book to this subject.  But he also realized that to understand the social response he needed to understand aspects of the disease itself, such as frequency of occurrence, which social groups and locales were affected and the mortality rates.  The addressing of these questions occupies the first half of the book.  The time period that he is covering, as indicated by the title, is the sixteenth and seventeenth centuries.

Part I of the book gives us an introduction to the disease and its manifestations, as well as an overview of its impact on society and the attitudes and actions that resulted.  The cause of the plague was not known, and it was attributed to both natural and supernatural agents.  Similarly, the treatment of it incorporated both natural and supernatural elements.  Books and pamphlets were published that included both herbal remedies and prayers.  Special sermons were preached during plague outbreaks, and sometimes plague fasts were held.  Diagnosis was not exact and there were other diseases prowling the populations such as typhus, the sweating fever and malaria, leading to further confusion and uncertainty.  The plague itself was manifested in several ways.  There was the bubonic plague with its carbuncles, buboes and spots, which sometimes occurred in a mild form, without marked visible symptoms.  A more deadly variant of the disease was septicaemic plague, in which the bacilli invaded the blood stream, causing death before the external symptoms of plague had time to appear.  A third variety is pneumonic plague, which may begin as a case of bubonic plague that becomes complicated by pneumonia.  This latter variant changes the disease vector from fleas to humans as the bacteria is coughed out in the sputum of the victims and inhaled by the people around them.  It was highly contagious, had a shorter incubation period than bubonic plague, and left untreated was almost 100 percent fatal.

Along with the fear and uncertainty that an outbreak of plague invoked, it also placed a much more practical strain on the society in the loss of its members, sometimes in large numbers (a quarter to a third of a town’s population).  This depressed the economy as well as straining the infrastructure as those as yet untouched by the disease struggled to deal with the dead bodies that needed to be disposed of as quickly as possible.  Knowledge of the plague was passed down essentially unchanged from the time of the Black Death.  The first medical book printed in English was a Little Book on plague, published in 1486 probably as a result of an outbreak of the sweating sickness.  Outbreaks of diseases often seemed to inspire the printing of books on the plague, and in the second half of the sixteenth century a growing number of them were religious tracts and sermons.

Part II of the book examines the frequency and severity of outbreaks using parish records and the number of wills probated as indicators of the presence of plague.  Slack examines the records of Essex and Devon counties in an attempt to understand what kinds of communities were most likely to be affected by the plague.  From there he moves on to the urban settings of Exeter, Bristol and Norwich and then to the metropolitan setting of London.  From his case studies in the counties of Essex and Devon he draws two conclusions: 1) bubonic plague could cause a greater number of mortalities in a shorter time span than any other epidemic disease; and 2) that most communities suffered at least one epidemic during the course of a century and were lucky if they did not suffer more.  The risk was generally greater in towns than in rural areas, although living in the country was not a guarantee of safety.

He finds a more consistent picture when he examines the records of Exeter, Bristol and Norwich.  Although they differ in the timing and severity of the epidemics in all three cities the occurrence of plague was connected with the economic and social conditions of the communities.  Plague was a part of urban life.  It was a regular visitor to all three cities.  It struck Norwich in 1544, 1554, 1579, 1584 and 1589.  The frequency and severity in Norwich may be due to the fact of its nearness to the Low Countries and its large immigrant population.  It struck Bristol in 1565 and 1575 and Exeter in 1570 and 1590.  It tended to be concentrated in fringe parishes that were primarily inhabited by poor laborers.  In urban areas the occurrence of plague had a definite social dimension.

By the sixteenth century London had already gained a reputation as being filthy and plague was seldom completely absent from it.  The best records come from the city itself in the bills of mortality that it published in the seventeenth century.  These documented not only the number of deaths but also their locations, making possible the charting of the progress of the disease through the city.  A fresh outbreak would often begin, as would be expected, in the east, near the river and the docks, although that was not always the case.  Once again, the most affected parishes were on the fringes of the city where the poor resided.

Part III of the book examines the social reactions to the plague and the actions that resulted. The strategies to battle the plague began in London as part of the government’s general pursuit of social policies that might benefit the common man and improve social order.  England lagged behind other countries in their adoption of measures to control the spread of plague and often simply adopted and adapted strategies already in use abroad.  In 1518 Cardinal Wolsey founded the College of Physicians to improve English medical care, which also marked the beginning of public policy regarding plague.  Those policies primarily focused upon separating out the infected to pesthouses or shutting them up in their own homes.  Neither policy was rigorously enforced, the former because of the cost of establishing and running pesthouses and the latter in part because of the humanitarian issues raised and in part because of the difficulty of enforcing the isolation.  It was much better to prevent the outbreak of plague itself, and to that end quarantines were enforced on ships and goods arriving from areas where a plague outbreak was known to have occurred.

The publication of the bills of mortality in London documented for all to see the incidence and location of plague deaths.  The advent of newspapers helped to spread this information outside of the city.  This unprecedented supply of information allowed patterns of infection to be seen and helped to rationalize the reactions to plague, at least among the educated.  Although the carriers of the plague were not identified and without a germ theory of disease its cause remained unknown it did help to destroy the claims of its supernatural origins.

Plague broke down the social order, existing divisions were often exacerbated.  The people resisted the efforts of the officials to impose plague regulations because they saw them to be as threatening as the disease itself.  The public resisted the imposition of the regulations and the plague rate rose, which led the government to go to greater and greater lengths to enforce them.  While the public were concerned with the suffering of themselves and their fellows, the officials were concerned with maintaining order, and they viewed the plague as part of the broader problem of poverty.

Mission and Method

The early nineteenth-century French public health movement
Ann F. La Berge, Cambridge University Press, 1992


Drawing from official archives, this book is more a history of institutions than it is of the people who were affected by those institutions.  Instead it focuses on a select group of men who served on the Paris health council and as editors of the Annales d’hygiéne publique et de médecine légale and how they created and institutionalized the idea of public health and hygiene, as well as how they put those ideas into practice through their work on health councils, in their publications and in their investigations.

Public health measures have generally been dominated by two different missions, emergency measures whose primary purpose is to deal with epidemics and regulations for dealing with public nuisances and waste disposal.  The former measures were usually temporary, enforced only in times of crisis, and the latter measures were applied mainly to larger towns and cities, where the higher population density made such regulations a necessity.  The idea of public health prominent in late-eighteenth-century France was dominated by an Enlightenment approach that emphasized progress, rational reform, education, natural law, empiricism and humanitarianism.  It included preventive medicine as well as practices aimed at improving the quality of life, and reducing mortality and morbidity.

While it had its foundation in the Enlightenment, the public health movement developed amidst the competing ideologies of liberalism, conservatism, socialism and statism, with liberalism and statism dominating.  The liberals wanted a minimal amount of state intervention, preferring solutions that were local and individual with the private practice of medicine, while the statists felt that the state should assume the primary role in public health reform and management and that public health experts should serve as advisors to the state, even proposing a medical civil service.  The debate between liberalism and statism took place within the context of scientism, the idea that science was the key to progress and that the scientific approach was the best way to achieve positive knowledge.

During the Revolution the national government had accepted responsibility for national health, and both Napoleon and the Bourbons had continued the tradition.  By the 1820s several public health programs were in place including a nationwide vaccination program, a national health care program of both epidemic physicians and health officers, a national administration of sanitation and a Royal Academy of Medicine to replace the Royal Society of Medicine.  There were institutions at the national level as well as at the local level with municipal and departmental health councils.  There also arose the idea of a public hygienist.  These were not simply physicians, but rather physicians who were willing to practice empirical science in order to understand the causes of disease and death, who would undergo special training for their job and who would work in cooperation with other specialists including chemists and engineers.

A major component of the mission of public hygienists was to investigate all possible causes of disease and death and to make recommendations for their solution.  In the process they encountered a wide range of health problems and issues.  Not only were they involved in sanitary reform and ensuring the purity of food and drink, but they also examined more complicated social welfare issues such as prostitution, wet nursing, foundlings and child labor laws.  Their approach to such problems varied but they all recommended regulation, inspection, and legislation to help improve public health.

They were aided in their work by the existence of the Annales d’hygiéne publique et de médecine légale, which was unique to France.  It was the first journal in the West devoted to public health and legal medicine.  In it ideas were exchanged and research published.  The journal also reviewed or published most of the major French works on public hygiene and served as an international forum on public health issues, including the coverage of foreign developments and publications.  This commitment to promoting and publishing their ideas was also mirrored by their educational efforts at the local level.  Because many programs were voluntary (vaccination against small pox, for example), their effectiveness depended upon the public understanding the advantages of compliance and the public hygienists were instrumental in that education process by providing reports of their benefits that were based on more scientific foundations.

This period also saw the application of statistics to the effort to understand the contributing factors of disease and death, if not their causes.  Louis-René Villermé did extensive statistical studies of Paris and his findings linking poverty and death contributed to the notion of death as a social disease.

Health Reform in 19th Century America

Ronald Numbers, Prophetess of health : Ellen G. White and the origins of the Seventh-Day Adventist health reform, Knoxville : University of Tennessee Press, 1992

Ellen G. White is one of four nineteenth-century founders of a major American religious sect (the others are: Joseph Smith - Mormon, Mary Baker Eddy - Christian Science and Charles Taze Russell - Jehovah’s Witnesses), but she is not widely known outside of her church.  Yet when she died in 1915 she left behind a legacy that consisted not only of the Seventh-day Adventist Church, but also sanitariums and hospitals located throughout the world.  She also inspired an educational system that is still highly regarded, traveled, lectured, and wrote dozens of books.  She was born Ellen Gould Harmon, along with her twin sister Elizabeth, on November 26, 1827.

Her influence sprang from the visions that she began experiencing in 1844, when she was seventeen.  These trances lasted anywhere from a few minutes to several hours, and during them she received messages about events both in the future and the past, heavenly and earthly.  These visions were accepted as genuine revelations from God, and her followers (with her encouragement) regarded her as a true prophetess on a par with the prophets of the Bible.

On June 5, 1863, in Otsego, Michigan, she received her vision regarding health, in which God revealed to her the hygienic laws that should be followed by Seventh-day Adventists.  They were to give up eating meat and other stimulating food, neither drink alcohol nor use tobacco, and avoid medical drugs.  When they were sick they were supposed to rely on the remedies of Nature, including fresh air, sunshine, rest, proper diet, exercise and water.  Women were to cease wearing the fashionable clothing of the time (including hoop skirts and corsets) and wear “short” skirts and pantaloons.  Followers were also supposed to curb their “animal passions” (masturbation was an especial evil leading to deformity of mind and body, not to mention spirit).

Health reform was not new.  In the early nineteenth century, America was not a healthy or hygienic place.  Americans ate too much meat and not enough vegetables and fruits.  Their food was heavy with grease and fats, and they drank too much Brazilian coffee.  Public sanitation was horribly inadequate, and personal hygiene wasn’t much better.  Most Americans seldom, if ever, bathed.


In the 1830s, Sylvester Graham launched a full-blown health crusade.  In the summer of 1830 the Pennsylvania Society for Discouraging the Use of Ardent Spirits invited him to come and lecture under its auspices.  He accepted and was soon giving lectures featuring his scientific and moral arguments against consumption of alcohol.  Reverend William Metcalfe was also preaching in Philadelphia at this time.  He was the author of the first American tract on vegetarianism and had brought his English congregation over in 1817 and established the vegetarian Bible Christian Church.  Graham added the vegetarianism to his lectures on temperance.  In 1831 he broke away from the Society and was lecturing at the Franklin Institute on a broad range of topics including proper diet and the control of the passions.  The 1832 cholera epidemic thrust Graham and his health reforms into the spotlight.

Another reformer, important partly because he was associated with the Millerites (as was Ellen White) and also because her reforms mirror many of his, was Larkin B. Coles.  His claim to health reform fame lie in two books: Philosophy of Health: Natural Principles of Health and Cure and The Beauties and Deformities of Tobacco-Using.  His view of health reform was a moralistic one, and was not unique among health reformers.  But both Cole and White saw obedience to these laws of health mainly as a requirement for entry into heaven rather than as a means for living a more enjoyable and healthy life on earth.

Science as a Social Construct

Douglas, Mary.  “Environments at Risk” in Science in Context, Barry Barnes & David Edge, eds.  Cambridge, MA, MIT Press, 1982 (pp. 260-75)

Science in Context is a collection of essays focusing on the sociology of science.  The purpose of the collection, as stated in the General Introduction, is to “provide a tolerable indication of what is going on in the sociology of science, and, more importantly, of what kind of social activity science is, and what its significance is.”  The primary focus of the collection is on the relationship between the sub-culture of science and the wider culture that surrounds it, especially as it relates to science as a source of knowledge and competence and as a cognitive authority for evaluating knowledge claims.

Central to the ideas of sociology of science are the writings of Thomas Kuhn, especially his book The Structure of Scientific Revolutions.  From Kuhn, sociologists of science have concluded that science is a social construct, and that even statements of scientific fact have a conventional character.  Because it is constructed and not intrinsic to the natural world, they conclude that it cannot be self-sustaining, and if it cannot be self-sustaining in the sub-culture of science, then neither can it be self-sustaining in mainstream culture.  There is nothing in science that implicitly reveals its correctness and so its standing in society depends upon the degree of trust and authority with which society imbues scientists and institutions.

In her essay, Mary Douglas examines the issue of credibility in the context of the ecology movement.  She is concerned with how beliefs arise and how they gain support.  The approach she takes is of the anthropologist from Mars, an hypothetical being that is agnostic when it comes to beliefs about the Earth’s environment.  In her view this suspension of belief is what allows us to confront the fundamental question of credibility.  She asserts that civilizations throughout history have viewed their environments to be at risk, although the risks they identified were generally not the same, but she claims that all civilizations pin responsibility for the crisis in the same way.  The environment is put at risk by human folly, hate and greed.

In the present, however, we have an added factor: self-knowledge.  Because we can compare our beliefs with those of others we lose the filtering mechanism that those earlier civilizations possessed.  We no longer have anything to restrict our perception of the sources of knowledge.  Credibility is easier in a limited belief system, but how do you determine credibility when opposing sides of an issue both make sense?  This is the question confronting environmentalists in our age.

Through various anthropological examples she endeavors to show that the credibility of a belief regarding how the environment will react to human action depends upon the moral commitment of the community to a particular set of institutions.  For example, bison do not like fratricide (murder within the tribe), so such an act endangers the well-being of the tribe and as a result has special sanctions.  So long as the institutions in question maintain the loyalty of the community, nothing can overthrow the beliefs that support those institutions.  If those institutions lose the support of the community, she claims that the beliefs are easily changed.  A particular view of the universe and the society holding that view are thus interdependent.  They form a single system and neither can exist without the other.  Any given environment that we know thus exists as a structure of meaningful distinctions.

In this credibility debate the role of laymen and social scientists is to examine the sources of our own bias.  Because we lack the moral consensus that gives credibility to ecological warnings we do not listen to the scientists.  Similarly, because we lack a discriminating principle we are easily overwhelmed by our pollution fears.  This discriminating principle comes from social structures and it allows a culture to select which dangers it will fear and also to set up a belief system that will address those dangers.  Without that structure we are prey to every dread and right and wrong cease to exist.  This is the price of full self-consciousness, but it is a price that she feels we must pay.  When we do that the classifications of social life will be gone and we will recognize that every environment is simply a mask and support structure for a certain kind of society.  Understanding both the nature and value of that society is as important as understanding the sources and nature of the pollution that puts our environment at risk.

Mary Douglas deliberately picks an area of science where our understanding is incomplete and in which the debate over competing theories has become politically charged.  Consensus is not the final arbiter of a scientific theory or hypothesis.  Unfortunately in the case of the environment politicians and advocates have created a situation where that is the level at which the discussion of the various theories and hypotheses is taking place.

Michael Kater, "Doctors under Hitler", Chapel Hill: University of North Carolina Press, 1989.

This monograph is a sociohistorical study of the medical profession under the Third Reich and rests on the author’s previous work analyzing doctors and medicine from Wilhelm II to Hitler.  It draws upon documents in the Federal Archive of Koblenz and the Berlin Document Center.  Primary material was also drawn from the student archive in Würzburg and other regional West German archives.  He also drew on the papers of the former panel physicians’ association, the KVD, as well as the predominant professional journals and memoirs of physicians that lived beyond 1945.

 At the dawn of the Third Reich, in 1933, there was a surplus of physicians, inherited from the republican era.  These doctors were at first hopeful that the new regime would address issues left over from the health administration of the Weimar Republic, but their hopes were not fulfilled.  Under the republic medical graduates had to spend three years as an assistant in a hospital where they were poorly paid, and forbidden to seek other sources of income.  Establishing themselves as independent practitioners was almost impossible for a doctor straight out of medical school.  One of the complaints lodged by spokesmen for this group was that medical institutions should stop advertising junior positions for bachelors only.  They also emphasized that, after public school teachers, high school teachers, and jurists, they represented the fourth largest group of academically trained professionals born after 1900.

 But under the Third Reich, the medical profession became a microcosm of the larger Nazi sociopolitical system, governed by the Nazi leadership principle and redefined in National Socialist terms.  Physicians now had to present every private contractual arrangement to the Reich Physicians’ Chamber for approval, register with the Nazi medical agencies and keep them informed of any changes in their family status or medical qualifications.  They also had to report on their patients.  All serious cases of alcoholism, ‘incurable’ hereditary or congenital illness (i.e. imbecilism) and highly contagious diseases such as venereal disorders were recorded and reported to the appropriate authority.

 The doctors themselves were required to undergo continued training.  Partly this was to break down the distinction between general practitioners and medical specialists, but it was also to teach them National Socialist concepts of health and medicine.  The unpopularity of these courses was perhaps offset by another change in their profession implemented by the Nazi legislators, its redefinition.  By stating that the medical occupation was not a business, the Reich Physicians’ Chamber was able to exclude anyone who was not properly schooled or licensed.

 This did not do away with medical quacks, however, for the Nazi conception of medicine favored the lay element over ‘school’ medicine.  Instead they created a new class titled “physician of natural healing” open to anyone who could demonstrate the requisite ability.  Anyone in this group with extraordinary talent could enter a medical facility without the usual professional medical qualification, and could even receive a license as a doctor medici.  The Nazis further required that regular doctors had to assist registered lay healers at the latter’s request.

Under the Third Reich medicine became the preeminent academic discipline, with approximately 30 percent of all university faculty being composed of medical teachers by 1935.  Medical faculty also became dominant in university power politics.  Between 1933 and 1945 the percentage of medical faculty serving as rectors increased from 36 to 59 percent.  Along with this increase in power and significance there was the establishment of a new discipline that became a part of the medical curriculum after 1933, Rassenkunde or Rassenhygiene, race hygiene or eugenics.  This ‘science’ consisted of three parts: anthropological, sociological, and medical, and its goal was to improve the superior race, while eliminating the inferior ones.

Kater thus links the professionalization of medicine in the Third Reich with its corruption.  West German doctors saw these events as a struggle between the forces of freedom and democracy against the totalitarianism of the Nazi regime.  A battle which the latter eventually won.  East German doctors, on the other hand, saw these events as the result of a premeditated conspiracy between fascist-minded German doctors and Nazi political leaders.  Kater feels that the truth is somewhere in between, but that it lies closer to the East German perspective, than the West German one.