Reviewed by Paul Lerner, Department of History, University of Southern California.
Published by H-German (October, 2003)

Picturing Health in Imperial and Weimar Germany

Germany's path to modernity--the social and political consequences of its rapid transition into a highly urbanized and industrialized nation in the late nineteenth century--inspired some of the most lively and heated debates among German historians in the 1980s and 90s. What is beyond debate, however, is the way that contemporaries of the period experienced these transformations. Overcrowded and unsanitary cities, sharpening social conflict, perceived epidemics of alcoholism, sexually-transmitted diseases, crime and suicide: such developments alarmed observers and gave rise to new concerns about Germany's collective health and national fitness. In this context, a series of turn-of-the-century movements (nudism, vegetarianism, back-to-nature, non-medical healing) emerged that condemned the allegedly degenerative effects of modern life and the urban milieu, and called for a healthier, more "natural" lifestyle. Along with their condemnation of modern, urban conditions, a number of these groups challenged the authority of established medicine and promoted alternative methods of healing. Many rejected the tenets of scientific medicine in favor of more holistic and romantic approaches to health that were felt to be more attuned to the social and spiritual needs of the time. Because of their revival of early-nineteenth-century ideas and their departures from the methods and conventions of modern science, these movements have often been portrayed as a kind of anti-modern backlash against contemporary trends, a backlash which, in many ways, contributed to the rise of the Nazi regime.

Indeed, the Nazis did pay lip service to alternative medicine, and notably, the regime publicized Hitler's own vegetarian and teetotaling lifestyle. Nazi propaganda, of course, promoted the cult of Paracelsus, and certain Nazi figures even condoned occult practices. (For an appalling depiction, see Unbesiegbar, the recent Werner Herzog film, in which Tim Roth plays Erik Jan Hanussen, the Nazis' favorite clairvoyant.) On another level, the celebration of physical beauty among nudists and other life reform groups does certainly evoke Leni Riefenstahl's Olympia and the sculptured monstrosities of Arno Breker and Josef Thorak, so prominent in the canon of Nazi art. Nevertheless, despite such superficial connections, to treat these early-twentieth-century movements as precursors to the Nazis is to take them out of context and to risk gravely distorting their historical significance.

Michael Hau's The Cult of Health and Beauty in Germany is thus a most welcome contribution to the historical literature on life reform and alternative medicine in Wilhelmine and Weimar Germany. Although some of the material he presents will already be familiar to students of the topic, Hau has provided a sharp, succinct synthesis and a thoughtful and persuasive reinterpretation. One of the book's many virtues is the way that it historicizes life reform and its allied movements. While other works have stressed the radical anti-modernism of life reform and have emphasized its critique of orthodox medicine, Hau is more interested in what alternative and mainstream medicine had in common. Both treated social issues as medical issues, and members of both camps participated in an aestheticized discourse on the body, framing and presenting ideas of health and fitness in terms of shared standards of physical beauty, which they upheld as scientifically objective and culturally-transcendent norms. Significantly, both sought solutions to the same kinds of problems, and, Hau argues, the boundaries between alternative healing and mainstream medicine were far more fluid than has been acknowledged--they competed with each other for patients and adherents in the same crowded medical marketplace. Hau's analytic framework is very much indebted to the work of Detlev Peukert, and this book draws on Peukert's interpretation of the period as a "crisis of classical modernity." In this spirit, Hau recasts the conflict between mainstream and alternative medicine; instead of viewing it as a struggle between modernization and reaction, he sees in it an expression of the tensions within modernity.

Hau is keenly attentive to social class and its intersections with ideas of health and beauty. He shows how life reform was primarily a concern of the middle classes, broadly defined, and the basis of life reform in bourgeois (Hau prefers buergerlich) cultural values is the subject of his first two chapters. Much of the material in these chapters is mined from the autobiographies of key Wilhelmine life reform figures--Louis Kuhne, a health entrepreneur who marketed a bath cure system and advocated vegetarianism, and Richard Ungewitter, a nudism zealot, to cite two examples. These narratives and other sources allow Hau to focus on the subjective experience of illness and to ask what made life reform an appealing option to those turn-of-the-century sufferers for whom traditional medical interventions brought no relief. He attributes the heightened concern with hygiene and the body largely to middle-class anxiety about success. Life reform resonated with the buergerlich sensibility; it offered the possibility of control and a guarantee of success through rational management of the body. Whether it meant forgoing meat, alcohol or tobacco, retreating to a spa, or subjecting oneself to various therapeutic contraptions, life reform responded to middle-class concerns and presented a path one could follow that would, in theory, lead to health and fitness.

Hau invokes Pierre Bourdieu to argue that the body could serve as a marker of distinction and that physical health worked as a positive source of bourgeois identity that distinguished the middle classes of the imperial period from both the nobility--which had become degenerate through idleness--and the working classes, whose bodies had been overtaxed by manual labor and who lacked the leisure time to pursue healthful cures. Both life reform and orthodox medicine associated health with beauty (and hence illness with ugliness), and both used classical imagery to derive and promote allegedly objective scientific standards for health. Within these shared values and discourses, however, there were still important class-based differences. A lower-middle-class life reform wing emerged which valued physicality over the kind of academic cultivation only available to the more prosperous members of the Mittelstand. The former's emphasis on the purely physical compensated for the lack of cultural capital among the lower middle classes and the unattainability of Bildung as it was traditionally conceived.

Both gender and race, which Hau foregrounds in the third and fourth chapters, were also highly aestheticized (and of course intertwined) notions, and both areas provide ample illustration of the overlapping of mainstream and alternative medicine. His treatment of gender in particular redresses a major historiographical gap and makes for compelling reading. The female body became the focal point for concerns over changing gender roles, and observers bemoaned increasing numbers of "ugly," masculinized women, indeed, casualties of the emancipation that began in the late imperial period. Just because life reformers critiqued mainstream medicine, Hau asserts, one should not assume that their views of women's health were any less misogynistic. The ideas of both mainstream and alternative medical practitioners--with the exception of a small minority of avowedly feminist life reformers--used the language of science to reinscribe gender hierarchies and aesthetic norms.

The book's second half is chiefly concerned with the Weimar period, a time in which darker, more pessimistic visions ultimately came to dominate hygienic discourses. This development was due, in part, to the war's staggering impact on German society and the widely held view that the war had reversed the workings of natural selection by killing off Germany's most able and fit men. The Weimar context--postwar economic instability, widespread political violence--figures significantly in this story. Over the course of the 1920s, orthodox, university-trained physicians became more open to alternative therapies and holistic approaches, as many became disillusioned with the promise of scientific medicine and were driven by economic necessity to attract more patients. But rather than amounting to life reform's vindication, this meant that the movements themselves steadily lost ground, as many of their methods and approaches were appropriated by the mainstream. (This of course is a common theme in the history of medicine, as the established profession has oscillated between periods of strict scientism and moments of openness and even eclecticism, usually driven by the need to find effective treatments.)

In tension with the war-induced pessimism, a kind of hygienic optimism, even utopianism was present in the Weimar period, paralleling the technocratic reformism of German industrial and social planners. Like the economy, the factory or even the household, the body could be rationalized, and contemporary social hygiene often depicted it as a kind of machine, and such representations were on display at the era's many hygiene exhibitions, which Hau discusses in some detail. On the other hand, the constitutionalism that came to dominate Weimar public health--the view, central to life reform and later to mainstream medicine as well, that the human organism is a coherent whole--hardened into a more rigid racialism and a growing belief in fixed racial typologies. Again, rather than focusing on the outcome of these ideas under the Nazis, Hau remains attuned to their historical context and to the social bases of these views, and he convincingly argues that Weimar racialism had everything to do with economic conditions and social tensions. Here and elsewhere in the book, Hau is indebted to the work of Paul Weindling, Robert Proctor, and Peter Weingart, among others, for their pioneering scholarship on German eugenics and social hygiene; he is particularly influenced by Sheila Faith Weiss, who treated the German eugenics movement as a discourse on class in her important study of race and national efficiency.

All in all this is an extremely tight and crisply written book, but at times it is not clear whether its focus is on life reform itself or on the aestheticized approaches to health common to life reformers and mainstream doctors. More importantly, in his efforts to deal with the turn-of-the-century context away from the shadows of Nazism and to refute the facile continuities often drawn across periods, Hau may have overcompensated. He often sidesteps questions of continuity with the Nazi years--he somewhat glibly dismisses them in his introduction--and one could almost get the impression that the brand of murderous racial medicine practiced in that regime came out of nowhere. A more detailed and thoughtful consideration of those questions could have added to the depth and appeal of the book without undermining his attempts to treat life reform and aesthetic notions of health in their proper context.