The scientific and political movement of “racial hygiene” is on many levels linked to the development of Nazism and Fascism with their racist medical philosophies, the segregation and sterilization laws, as well as later the murderous Nazi euthanasia program. Largely conceived and popularized through the German physician and anthropologist Alfred Ploetz (1860-1940), the term “racial hygiene” (Rassenhygiene) was a special notion of eugenics in the German-speaking countries. While it specifically sought to attribute eugenics assumptions about the inheritability of human social and biological traits to a background understanding of “race” and “racial degeneration,” this particular form of eugenics was influential not only in Germany, Switzerland, Austria, and Hungary, but throughout much of northern Europe.

The international exchanges between scientific and political racial anthropologists were however not limited to the German-speaking, Scandinavian, or other European countries, but included also the United Kingdom, British dominions and colonies, as well as the United States. Yet other than in Europe the notion of “race hygiene” did not replace that of eugenics in the English-speaking countries. While building particularly on the British eugenic thought of the later 19th century and emulating the forced sterilization programs of the early 20th century in the United States, the Third Reich radically surpassed these during the 1930s with its large-scale race laws and forced sterilization programs. With the onset of the Second World War, in medicine, these developments became also part of the so-called euthanasia program with its active forms of patient murder. Transformed through the contemporary progress of biomedical science (e.g. anthropological measurements, psychiatric shock therapies, and the pharmacological availability of new medical drugs and substances), the Nazi euthanasia program (Action T4) ventured into the deliberate killing of the “unworthy,” “demented patients,” and “degenerate children” at the wake of the Holocaust.

Racial hygiene as the basis of Nazi race laws and eugenics
The German physician and anthropologist Alfred Ploetz had laid out major assumptions and definition of “racial hygiene” in his book, entitled “Foundations of a Eugenics, Part I, The Efficiency of Our Race and the Protection of the Defectives” (Grundlinien einer Rassenhygiene. Band I, Die Tuechtigkeit unserer Rasse und der Schutz der Schwachen) (1895). It has often been interpreted as the starting point of the eugenic doctrine in 20th-century German medicine and philosophy, and its importance cannot be underemphasized when drawing attention to the fact that Adolf Hitler (1889-1945) had studied the book thoroughly while he was incarcerated at Landsberg prison in 1924 (following the first Nazi uprising in the city of Munich). From Ploetz, Hitler received the idea of a selective role in the general competition among the nations, which would lead to the survival of the fitter races (Rassen) over the unfit races. In fact, racial anthropologists like Alfred Ploetz, and the more medical bent of the racial hygienist as with Eugen Fischer (1874-1965), had a most profound influence on Hitler during the time that he wrote his foundational book of National Socialism: “Mein Kampf” (“My Struggle;” 1925). In the book he particularly emphasized that war would be the best means to secure the white races from being flooded by other races, so that they may further expand and secure their general survival for all times. And like Ploetz before, Hitler endorsed Galtonian notions of eugenics as the science of the best stock (or race) that should be applied to eradicate all social ills from the healthy body of the people (“Volkskoerper”), such as the (assumed inheritable) conditions of “alcoholism,” “addiction,” “prostitution,” or “criminal behaviour.”

While some direct exchanges existed at the beginning of the 1920s between the racial hygienists in their scientific or intellectual circles on the one hand and the early Nazi movement on the other hand, these were at first rather sporadic and depended on particular individuals, who belonged to parallel social groups. It was their similar intellectual and social views that made the ideas of German eugenicists appealing to Nazi agitators. The eugenicist critique of modern society was shared by both––as could be found in the psychiatrist Auguste Forel (1848-1931) or the racial anthropologist Alfred Ploetz––who increasingly perceived social ills in terms of the sickly, degenerate, or moribund strains in society. The virulent views of the Munich circle were later integrated into the “Expert Council for Population- and Racial Politics” that the Nazi politician Wilhelm Frick (1877-1946) inaugurated in 1933. Ploetz, the Berlin anthropologist Fritz Lenz (1884-1967), the Freiburg anthropologist Hans F. K. Guenther (1891-1968) along with Munich psychiatrist Ernst Ruedin (1874-1952), were active members of a subcommittee of this council, the “Division on Racial Hygiene and Racial Politics.” It was affiliated with the government-funded German Research Council that was the major deferral research funding institution of the country. The example of the activities of the “Division on Racial Hygiene and Racial Politics” show that by the end of the 1920s and the beginning of the 1930s, the core of the eugenic assumptions comprised a social diagnostic and likewise therapeutic approach.

From racial anthropology to the Nazi euthanasia program
Major changes occurred with the seizing of power through the Nazi party (1933), which also led to the enactment of the “Law for the Reestablishment of a Professional Civil Service” (Gesetz zur Wiederherstellung des Berufsbeamtentums) on April 7, 1933, and shortly after the establishment of the Nuremberg Laws (September 15, 1935). The first drew thousands of scientists, academics, and medical doctors–––of Jewish decent or politically opposed to Nazism–––out of their government-funded offices. At the same time, many of the larger-scale public health and scientific approaches (Gemeinschaftsaufgaben) received their funding from the German Research Council with specific Nazi prescriptions and directions, particularly when they required expensive investments such as in the fields of atomic physics, aviation engineering, modern experimental medicine, or public health and eugenic programs. One such funded group was the above-mentioned “Arbeitsgemeinschaft II” for Racial Hygiene and Racial Politics, which included representatives from all major biological, medical, and psychiatric institutions. Its tasks were meticulously laid out in the founding policy paper, which included programs for the education of the public, basic medical research, clinical investigations, research into sterilization practices, and demographic statistics. Members of the advisory committee met first in 1930; among them were the Berlin racial anthropologist Eugen Fischer (1874-1967), Berlin surgeon August Bier (1861-1949), Freiburg military pathologist Ludwig Aschoff (1866-1942), Munich public hygienist Friedrich von Mueller (1858-1941), and racial hygienist Ludwig Schmidt-Kehl (1891-1941) from Wuerzburg. The multiple funding activities were not limited to the aims of these self-declared and stern racial hygienists, as Stanford historian of science Robert Proctor has pointed out through his thesis on the “corruption or abuse” of medical science in Nazi Germany. According to him, these forces hostile to democracy led to a decrease of good science and rise of “political ideology” resulting in the marginalization of patients, the forced-migration of Jewish and oppositional academics and physicians––and eventually Nazi sterilization and Nazi euthanasia.

It would be inadequate, however, if these medical and scientific activities were only equated with “pure ideology”. The claim must rather be made that while the racial hygiene movements, along with the field of medical genetics, were strongly internationally oriented with the exchanges of German, Scandinavian, British and US researchers involved, the Third Reich radically surpassed these with its widespread forced sterilization programs and active patient murder. These led to the unprecedented horrors of the Holocaust. Transformed through the contemporary development of biomedical science, the Nazi euthanasia program (T4) reinterpreted Binding and Hoche’s dictum of “life not worth living” (1920) as a deliberate killing of the “unworthy” and “demented patients” in orphanages, care institutions, mental asylums, and psychiatric clinics.

Children with mental illness and physical handicaps, along with people who were chronically hospitalized in state asylums and psychiatric hospitals, lost their civil rights due to the new Nazi eugenics and racial legislation. Often, whey also became the target of human subject experimentation. Ernst Ruedin at the German Research Institute for Psychiatry (in Munich), Ottmar Freiherr von Verschuer (1896-1969) at the Kaiser Wilhelm Institute for Anthropology, Human Heredity and Eugenics (in Berlin), along with the SS physician Josef Mengele (1911-1979) at the Institute for Hereditary Biology and Racial Hygiene (in Frankfurt) approached Nazi officials to pursue their medical research likewise in those individuals and populations that had been selected to be murdered in the euthanasia program or the extermination camps. Von Verschuer and Mengele, for example, began their twin studies in psychiatric asylums and concentration camps, during the same time period as the T4 program had started.

Discussion
The development of “racial hygiene” in the German-speaking countries provides an insightful example to understand the relationships between the internationalization of research, political ideology, the dehumanizing aspects of the biomedical research endeavours, and the public health system of the time. When the racial hygiene movement and Nazi medicine are simply downgraded as “ideological”, “perverted”, or “pseudoscientific”, then an important perspective on the intrinsic mechanisms of modern medical science is missed. Even the atrocious war crimes (e.g. military–related research in pharmacology, aviation physiology, and chemical warfare) need to be contextualized within the framework of the deadly Nazi medical philosophy. In many respects, the human experiments in mental asylums, penitentiaries, and in the concentration camps (such as those experiments on malnutrition, stress, and siblings research) were based on widely entrenched eugenics and racial thinking. Far from being passive pawns in the new social and political system of the Nazi period, physicians, academics, politicians, and administrators became actively involved in bringing the racial hygiene programs to their full life, as intellectual planners, scientific protagonists, and beneficiaries from research grants, program support, and social awards in the transformed German and Austrian societies after 1933 and 1938. The secret police (GeStaPo and SS), the military, the pharmaceutical industry, right-wing physician groups, and racial hygiene researchers acted as important stakeholders in developing this increasingly murderous research and health care system, where the healing of the sick and extinction of the weak coincided with barbarous approaches by doctors and health care professionals–––that Alexander Mitscherlich/Fred Mielke pointedly described in: “The Death Doctors” (Medizin ohne Menschlichkeit!) (1949).

Overall, there were visible differences, but also strong similarities between Nazi racial hygiene and the eugenics movements in North America, while they both saw their roots in Galtonian thinking of the principle inheritability of human biological psychosocial traits, and the control thereof, and while they also made considerable use of negative eugenics measures, it was particularly the encompassing population-based (“voelkisch”) dimension that sat the Nazi example apart from the North American one. Eugenically-trained, physicians, nurses, public health workers, and politicians focused in many perspectives more on the population effects on the Aryan race and the German nation, than on the individual level as in the United States or Canada. Racial hygiene was thus more concerned with the health of the German nation than with the economic burden on the national economy or the particular family interventions typical for the North American programs. While the shear size of the Nazi sterilization and Nazi euthanasia programs widely out-passed even the eugenics programs in the United States, it must be emphasized that personal relationships between eugenicists, a free flux of eugenic ideas and practices, as well as a great interest in the activities on each side of the Atlantic continued all along the high time of European and North American eugenics.

-Frank Stahnisch

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