The Nazi war on cancer Robert N. Proctor Princeton, NJ: Princeton University Press; 1999 380 pp US$49.50 (cloth) ISBN 0-691-00196-0 US$16.95 (paper) ISBN 0-691-07051-2
But if we fail, then the whole world … will sink into the abyss of a new Dark Age made more sinister … by the lights of perverted science.
— Sir Winston Churchill, June 18, 1940
Historians of Nazi medical science, that “unfolding monstrosity,” in Robert Proctor's words, that worked its way from “racial hygiene, sterilization, and racial exclusion to euthanasia, abusive experimentation, and the Final Solution” are faced with the unanswerable question of how such evils were possible. But at least they have the comfort of an unambivalent moral response. In The Nazi War on Cancer, an impressive sidebar to his Racial Hygiene: Medicine under the Nazis (1988), Proctor grapples with a more slippery demon: Nazi programs in health promotion that are oddly consonant with the values of today.
What are we to do with the fact that it was under Hitler's regime that a causal link between smoking and lung cancer was first made, that Nazi anti-tobacco campaigns were ahead of their time, that Nazi physicians identified and attempted to control exposure to carcinogens such as asbestos, pesticides and food additives, advocated an organic, vegetarian diet high in fibre and low in fat, were the first to promote breast examination and that, the destruction of the Jewish intellectual and scientific community notwithstanding, managed to conduct a certain amount of “good” science, notably in epidemiology?
Of course, as Proctor reminds us, “Nazism took root in the world's most powerful scientific culture.” By the 1930s Germany was in the lead of cancer research, and the German language was its lingua franca. Germany also had the highest cancer rates in the world, and the Reich disliked the implications of this for economic productivity, military prowess and the protection of the “germ plasm” of a master race. Thus, “Cancer to many seemed to be a political disease, requiring a political solution.”
Solutions were attempted on the front of public health, in education campaigns, disease registers, mass screening programs and legislation. All of these efforts drew on the essence of Nazi ideology, which might be described as a counterfeit of reasonable desires: beauty, freedom, health, vitality. Proctor calls Nazism “a vast hygienic experiment designed to bring about an exclusively sanitary utopia ... . [A]sbestos and lead were to be cleansed from Germany's factory air and water, much as Jews were to be swept from the German body politic.” The metaphors were powerful and replicated themselves in false and murderous equivalences: Judaism was a cancer, cancer was like the Jews. Survellaince, detection, control, eradication: these were activities applicable to diseases and to people equally.
Proctor's account is a disquieting case study of how public health concepts are tied to ideology and, with apparent innocence, can support malign sociopolitical agendas. It also demonstrates, as Churchill was aware on the eve of the Battle of Britain, that science is blind to the motivations of its practitioners. Serving any master, any purpose, it marches on.