Clinical Reference / Dermatopathology: Practical & Conceptual / Apr – Jun 1995 | Vol. 1, No. 2 / Dermatology and Dermatopathology Under the Swastika

Dermatology and Dermatopathology Under the Swastika

Apr – Jun 1995 | Vol. 1, No. 2
Weyers, Wolfgang

Part II. The new leaders of German dermatology

The vast majority of German physicians in the mid-1930s were not reluctant to accept the new political realities. An extremely high percentage of them embraced National Socialism; nearly half of German physicians were members of the Nationalsozialistische Deutsche Arbeiter-Partei (NSDAP), and this despite the fact that the party, trying to preserve its elitist character, was not even open to enrollment between 1934 and 1936, in 1938, and between 1942 and 1945. A formidable number of German physicians also belonged to Nazi organizations other than the party: between 1933 and 1935, membership in the National Socialist Union of German Physicians rose from 2,786 to 14,500, and it continued to increase until about one third of all German physicians belonged to that league. Twenty-six percent of all male physicians were members of the storm troops (“Brown Shirts,” SA) and 7% were members of the defense corps (“Black Shirts,” SS). The numbers exceeded by far those of other learned professions in these organizations, e.g., 11% of teachers belonged to the SA and only 0.4% to the SS.

The extraordinary receptivity that the Nazis found among physicians was a consequence of several factors, the most important being the influences of home and school – most physicians having been raised by parents who were highly conservative and indoctrinated by teachers who created a climate of nationalism and militarism. After the chaos during the years of the Weimar Republic, those authority figures welcomed the restoration of an autocratic regime, and those of their charges who became physicians were particularly receptive to authoritarianism. They had succeeded at home and at school because, in part, they paid obeisance to authority and never challenged it.

Another important reason for the inclination of German physicians to Naziism was the difficult social and economic circumstances of young German physicians at that time. Every graduate of medical school was compelled to spend three years as an assistant physician in a hospital, earning just enough money to subsist. Because of lack of means, most assistant physicians could not afford apartments, being housed instead in small rooms in the hospital, for which rent was deducted automatically from their pay. These trying conditions prevented young doctors, who usually did not obtain their medical licenses until about age 27, from getting married and starting families. Even had they wanted to do so, their contracts stipulated immediate dismissal if they married against the will of their chairman. Furthermore, a surplus of physicians in Germany had resulted in substantial unemployment of doctors. Residencies at universities were difficult to come by, and establishment of private practices was almost impossible because the system of insurance fund panels permitted only one new doctor per 600 patients. For these several reasons, seemingly compelling at the time, young physicians were receptive to opportunity for change.

As a consequence, those who became “movers and shakers” among Nazi physicians were recent graduates of medical school and who, in the last years of the Weimar Republic, had been excluded professionally by their older, well-established colleagues. After the assumption of power by the Nazis, the possibilities for young Nazi physicians were enhanced greatly consequent to dismissal of Jews from the medical service. Young German physicians who had joined the SA before January 30, 1933, learned that they were eligible for immediate placement on the panels of the insurance funds. Admission to the panels of these funds turned on allegiance to Naziism, e.g., registrants who could boast Old Fighter laurels were granted favoritism by the German Panel Fund Physicians’ Union, whereas registrants whose record in regard to National Socialism were not impeccable nearly always were bypassed.

At the universities, the situation was similar. Prior to Hitler’s assumption of power, young scientists had had to face not only humble living conditions, but an uncertain future: teaching positions were difficult to find, and chances for further advancement thereafter were small. According to statistics published in 1932, only one of seven lecturers in medical schools could expect an offer of a full-time, tenured post. After the elimination of Jews from the universities, the future suddenly became brighter, especially for younger members of the faculty who were active in the party.

These various circumstances provided the stage for a bizarre scenario of unbridled opportunism. Within a matter of weeks, German physicians began a run on party membership. In teaching clinics and university departments, assistant physicians and lecturers with an eye on a permanent position suddenly began to flaunt formal affiliation with the Nazis, a posture that only weeks before might have caused them considerable embarrassment. Although the time-honored white smock remained the usual garb in a hospital, doctors in their offices dressed more and more commonly in the apparel of the SA or SS. Even on the smock, the party badge, a symbol of fealty to Naziism, often was displayed prominently by doctors. Knowing that ordination by the SS was a shrewd tactic for ensuring professional success, aspiring physicians took care to enroll not only in the party, but also, and especially, in the Black Shirts. At the University of Tübingen, the entire corps of assistants at the medical faculty joined the storm troops in May 1933, and at the University in Berlin, at the end of the same year, enthusiastic assistant physicians glorified Hitler by comparing him in a Christmas celebration to the ancient god Wotan. At the same time, care was taken to avoid scrupulously even a hint of political disloyalty. Previous ties to organizations not aligned with National Socialism, whether political or religious ones, had to be concealed in order to prevent a candidate from being denied an appointment, or, even worse, dismissed summarily, as was the case for Georg Alexander Rost, Philipp Keller, Rudolf Maximilian Bohnstedt, and many other dermatologists.

At the time that the Nazis assumed power, they were highly suspicious of the universities, which were considered by them to be bastions of democratic ideas and ideals. Even though most academics turned out to be cooperative and docile, the Nazis left no doubt that they still were dissatisfied with the composition of the faculties. They stated, unambiguously, that “National Socialism denies the current professorship the right and the claim to the political and ideological guidance of the nation” until “complete spiritual and ideological change at the universities” was achieved. The exact nature of that change was never made clear; there was merely the vague idea of a National Socialist university in which different faculties were not to be separated from one another, but unified on the basis of race and nation, and in which all fields of science were to be imbued with the thinking of the people. To create this new type of university required an entirely new generation of “academics,” one that was suckled, from grade school through university, with Nazi ideology, the “open sesame” for installation in teaching positions. Soon after Hitler’s assumption of power, steps were initiated to promote assiduously students who had been imbued with National Socialism. Prior to their inauguration, all newly appointed lecturers were compelled to attend, for several weeks, a political training camp in which they were indoctrinated with Naziism. In order to effect change immediately, the Nazis counted on several long-standing members of the party who already held leading positions at universities, e.g., Karl Zieler, the chairman of dermatology in Würzburg and new president of the German Dermatological Society.

The rest of the task was accomplished by gradual dissolution of hitherto existing faculties, through dismissal, retirement, or death. As a rule, professors who had reached retirement age were denied the traditional right to continue teaching and examining. Exceptions were made only for professors who were known “to guarantee that . . . their political attitude does not jeopardize the National Socialist education of academic youth.” The ability to carry out this kind of education unquestioningly also was a requirement for promotion. Retirement or death of chairmen led inevitably to passive politicization of faculties, including many departments of dermatology, e.g., in Leipzig, where the Nazi Bodo Spiethoff succeeded Johann Heinrich Rille, and in Giessen, where Walther Schultze succeeded Albert Jesionek.

Besides passive politicization, there also was a more obvious active form of politicization, namely, replacement of academic teachers who had been dismissed for political or racial reasons. Within a few months of the Nazis’ coming to power, dozens of new professors had to be appointed and, in dermatology alone, seven chairs were vacant because those who had held them had been dismissed for racial or political reasons, to wit, the chairmen of dermatology at the universities of Bonn, Breslau, Frankfurt, Freiburg, Heidelberg, Munich, and Tübingen.

When the names of the dismissed chairmen are compared with those of the new ones, marked incongruity is apparent immediately. In the former group are men such as Hoffmann, Jessner, Gans, and von Zumbusch, each of whom is remembered to this day by dermatologists around the globe. In the latter, apart from Heinrich Adolf Gottron, all are forgotten (Figs. 13).

Fig. 1

Dermatologists dismissed from their positions at German universities

Fig. 2

“New leaders” of German dermatology

Fig. 3

Old and new chairmen of dermatology in Germany, 1933-1937 (R= racial reasons; P=political reasons)

This disparity derives directly from application of new criteria by which chairmen were to be appointed: ability, competence, and promise professionally were of little or no importance; vigorous support for the new National Socialist (NS) state was of prime importance. The traditional system in Germany for appointment of chairmen, based as it was mostly on the judgment of the directors of other departments, was reversed entirely by the Nazis. In order to undermine the influence of the faculties on appointment of new chairmen, the authorities undertook several measures. One of them was development of a network of party organizations within and around the universities, among them the NS Union of German Physicians, the NS Union of German Students, and the NS Union of Lecturers. Each of these unions tried to influence decisions of the faculties in favor of fellow party members. According to a decree by the Prussian Ministry for Science, Culture, and People’s Education, issued in the summer of 1933, the faculties no longer were allowed to offer their own lists of candidates for chairmanships, but were obliged to respond to those proffered by the ministry. In November 1933, the “deputy of the Führer,” Rudolf Hess, “requested” that all medical faculties consult Gerhard Wagner, the “leader” of all German physicians, before any new professor of medicine was appointed. Because the faculties did not adhere strictly to this request, Wagner established the post of “confidants of the NSDAP at the medical faculty,” and chose as chief confidant one of his oldest and most loyal Nazi compatriots, Franz Wirz, extraordinary professor of dermatology at the University of Munich. In July 1934, Rudolf Hess founded the party’s own Commission on Higher Education, which soon was controlled by Gerhard Wagner and Franz Wirz. Although the commission’s mandate was to manage all university faculties, for Wagner and Wirz the major concern was the medical schools, and, particularly, influencing favorably the appointment of the party’s own candidates to positions in them. In the autumn of 1934, Wirz proudly reported that “within a short period of time, 34 appointments have been declared according to the suggestions of the Commission on Higher Education.”

The political reliability of candidates for a chair of medicine was difficult to assess; professors who had joined the Nazi party after its assumption of power could have done that merely as a matter of expediency, a prudent move in order to preserve a chance for a career. Judgments about such reliability, which had to be integrated into every candidate’s personnel file, were highly subjective and arbitrary, often dictated by strong likes and dislikes. The fact that most of these judgments remained secret and the judges anonymous exaggerated feelings of powerlessness and of complete dependency on the part of apolitical physicians who were desirous of a university career. Candidates who felt that they had been rejected on political grounds often tried to emphasize their affiliations with Nazi organizations, the authenticity of their conviction to the ideas of National Socialism, and their allegiance to Naziism. In individual cases, the legitimacy of these asserted attributes even was defended in court, e.g., by Egon Keining (Fig. 4), the assistant medical director of the department of dermatology of the University of Hamburg. Although Keining had been a party member since May 1933, his appointment as director of a university department was delayed for several years because his political attitude was considered moderate and because he had never served as a soldier. Keining finally decided to institute legal proceedings against the chairman of dermatology in Marburg, Alfred Ruete, and against Ruete’s former assistant, Martin Schubert, on grounds that they, as consultants of the party, had disqualified him unfairly and repeatedly. After having refuted all accusations of political disloyalty, Keining was given the chance to prove himself as temporary substitute for the chairman of dermatology at the University of Rostock. In October 1944, he was made chairman of dermatology in Greifswald, and, after the war, he became chairman of dermatology in Mainz. Keining is remembered for his work in clinical dermatology, e.g., the description of the thickened, rough, hyperkeratotic cuticle of nails in patients with dermatomyositis, known also as the “Keining sign,” and for a popular textbook on dermatology, written with his disciple, Braun-Falco, and published in 1961. Keining died at age 80 in 1971.

Fig. 4

Egon Keining (1892-1971)

Subjectivity of political evaluations was not the only problem that hampered efforts by Gerhard Wagner and Franz Wirz to gain control of the universities for the Nazis. Another was that the role of the Commission on Higher Education had not been clearly defined. Formally, the universities and the ministries of education were responsible for commenting on the scientific qualification of a candidate for a new professorship, whereas organizations of the party were empowered to render a judgment about political suitability for such a position. In reality, scientific and political aspects were intermingled in the statements of all these institutions, and each of them tried to expand its own influence at the expense of the others. Of course, these maneuvers resulted in continuous conflicts; the ministries of education, although also directed by knee-jerk Nazis, generally followed less radical political guidelines than those advocated by Wagner and Wirz. The conflicts between the ministries and the organs of the party are illustrated neatly in negotiations that took place regarding the appointment of a new chairman of dermatology for the University of Leipzig.

In the early 1930s, the skin clinic of the University of Leipzig was one of the most important dermatology centers in Germany. The list of candidates to be successor of the previous chairman, Johann Heinrich Rille, was compiled by the medical faculty of the university. Originally, it included Bruno Bloch from Zürich, who, among other contributions, had first recognized the melanocyte for what it was and had described the mechanism of formation of melanin; Otto Kren from Vienna; Alfred Stühmer; Walther Schönfeld; Paul Mulzer; Leo Kumer; and Hermann Werner Siemens, who described dystrophic epidermolysis bullosa, known eponymically today as the “Hallopeau- Siemens” type of that disease. Because of intervention of high-ranking Nazis, the Prussian Ministry of Education added another name to the list, that of Bodo Spiethoff (Fig. 5).

Fig. 5

Bodo Spiethoff (1875-1948)

Spiethoff had belonged to the NSDAP since January 1931. Not only was he involved prominently in remodeling the German Society for the Fight against Veneral Diseases, but he also belonged to an elite committee of the German Ministry of the Interior devoted to the politics of population and of race. In spite of these political merits, Spiethoff’s nomination was disregarded by the ministry and the medical faculty. On the basis of scientific considerations, both institutions agreed instead on Hermann Werner Siemens (Fig. 6) to be the new chairman of dermatology and actually informed him of that decision. Siemens, however, was not a party member. Furthermore, his research activities were not to the taste of the Nazis. Although he worked primarily on hereditary diseases – a very fashionable subject at that time – he was criticized for not directing enough attention to racial aspects of genetics. The Commission on Higher Education went into action. Although the decision of the ministry had already been announced, Gerhard Wagner and his colleagues forced the appointment of Bodo Spiethoff as chairman of dermatology in Leipzig. On April 1, 1934, Spiethoff succeeded Johann Heinrich Rille. He remained director of the skin clinic of Leipzig until 1942, when he retired prematurely for reasons of health. He died in 1948. Hermann Werner Siemens, who had prepared himself for a move to Leipzig, received a short note that read: “A leading office outside our ministry, whose approval had to be obtained and from whose decision we cannot diverge, has declared itself against your appointment.”

Fig. 6

Hermann Werner Siemens (1891-1969)

The party also took good care of other loyal followers. In October 1933, Ernst Heinrich Brill, an acolyte of Spiethoff, was appointed chairman of the department of dermatology at the University of Rostock (Fig. 7). He was a member of the Nazi party, the storm troopers, and the Death’s Head Units of the Defense Corps, and district leader of the NS Union of Lecturers. Scientifically, however, his record was much less impressive. After having reviewed the documents of the two candidates for the chair of dermatology, namely, Ernst Heinrich Brill and Julius Mayr from Munich (Fig. 8), the medical faculty of Rostock University came to the conclusion that “on the basis of study of their scientific publications and on the basis of comments of representatives of their specialty, the faculty cannot undertake the responsibility to recommend either of the two gentlemen to the ministry.” Nevertheless, Brill got the chair of dermatology and, on October 12, 1934, took the oath of office to remain “loyal and obedient” to the “Führer of the German Reich and People, Adolf Hitler.” Three years later, Brill became rector of the university. He committed suicide in 1945.

Fig. 7

Ernst Heinrich Brill (1892-1945)

Fig. 8

Note of Julius Mayr to the administration of the University of Munich certifying that he had been active as a political leader (leader of the National Socialist Union of Lecturers)

Julius Mayr (Fig. 9), Brill’s competitor for the chair of dermatology in Rostock, also had been a member of the NSDAP since 1933. When the Nazis assumed power, he was still an assistant in von Zumbusch’s department in Munich. Only a few months later, however, after the dismissal of Georg Alexander Rost, he became temporary chairman of the skin clinic in Freiburg. When Alfred Stühmer was called from Münster to Freiburg to fill Rost’s chair, Mayr succeeded him in Münster.

Fig. 9

Julius Mayr (1888-1965)

According to his personnel file, Mayr was recommended to the university as “an honest, open, nationally thinking, true German man.” His character was classified as “excellent” and “beyond any doubt.” This estimation, however, was not shared by everybody. Because of Mayr’s reputation of being a convinced Nazi, all but one of Stühmer’s former assistants resigned their positions and left the skin clinic of Münster. From February 1936 to November 1937, Mayr was leader of the National Socialist Union of Lecturers in Münster. In November 1937, he was called to Munich to succeed Leopold Ritter von Zumbusch.

Julius Mayr remained chairman of the department of dermatology at the University of Munich until the collapse of the Third Reich in 1945. After his dismissal by the military government, he presented several statutory declarations by colleagues affirming that he had been a strict opponent of the Nazis and that he had been “unable to conceal his anti-Nazi attitude.” On the basis of these statements, procedures against Mayr were quashed; however, he never reassumed his academic career. Mayr died in 1965, at the age of 77.

After von Zumbusch’s removal as chairman of dermatology in Munich in 1935, his position had been filled temporarily by his assistant, August Poehlmann (Fig. 10). Poehlmann had been a member of the SS since 1933; however, according to a judgment by the leader of the NS Union of Lecturers in Munich, Dr. Hettche, he had “only slowly adjusted himself to the Third Reich.” In regard to scientific ability, character, and ideological-political attitude, Hettche considered Poehlmann to be unsuitable for a full professorship. In 1938, Poehlmann left the department of dermatology at the University of Munich to become director of the dermatology unit at the Munich-Schwabing Municipal Hospital. He died in 1954.

Fig. 10

August Poehlmann (1882-1954)

The NS Union of Lecturers, founded in 1928, represented all academic teachers who were affiliated with the party. The organization was highly influential in internal affairs of universities, including supervision of the political attitudes of employees and disciplinary measures against colleagues who did not act in strict conformity with regulations by the government. Sometimes, the NS Union of Lecturers also was able to influence the appointment of chairmen, e.g., in Göttingen, where a new chairman of dermatology was sought upon the retirement, in March 1935, of Erhard Riecke.

Originally, the medical faculty of the University of Göttingen put forward as possible successors to Riecke the names of Walther Schönfeld, Heinrich Adolf Gottron, and Egon Keining. The NS Union of Lecturers, however, pushed through the appointment of Walther Krantz from Cologne (Fig. 11), a man of much lower stature and reputation. Krantz did not belong to the party, but was a member of the “Stahlhelm,” a right-wing organization of former World War veterans which, in 1934, was incorporated into the SA. Furthermore, he was cozy with the leader of Göttingen’s NS Union of Lecturers, anatomist Werner Blume. These connections assured his career: only four months after his appointment as director of the skin clinic, Krantz was made vice-dean. In 1937, he became dean of the medical faculty of the University of Göttingen.

Fig. 11

Walther Krantz (1891-1970)

Under Krantz’ stewardship, the skin clinic of the University of Göttingen spiralled downward toward a vortex; Krantz himself referred to it as an “expanse of rubble.” After Krantz had been fired at the end of the war, the registrar of the university wrote to the new minister of culture: “Had Professor Krantz not been dismissed by order of the military government, I would have filed a claim to institute proceedings against him for culpable negligence of the duties assigned to a director of a clinic.” In 1946, Krantz was granted an ordinary emeritus status by the British military government. He died in 1970.

In Jena, Josef Hämel, a disciple of Karl Zieler, was appointed chairman of dermatology in 1935. He became dean of the medical faculty about four years later. Hämel had joined the Nazi party on May 1, 1933. His political attitude, however, was reserved; in 1944, he was removed from the office of dean of the medical faculty for having concealed a political offense, namely, the smashing by students of a bust of Adolf Hitler. Because of this delinquency, Hämel even had to spend several weeks in custody. In December 1945, Hämel was dismissed as chairman of the department of dermatology by the allied military government, but 14 months later, after more thorough examination of his behavior during the Nazi regime, he was reinstituted into his old position. From 1952 to 1959, Hämel was rector of the University of Jena. He then succeeded Walther Schönfeld as chairman of dermatology in Heidelberg, and, in 1961, was elected dean of the medical faculty of the University of Heidelberg. Hämel died in 1969.

Walther Schultze (Fig. 12), an assistant of Albert Jesionek in Giessen, had belonged to the NSDAP since 1931, and used to crow that his number in the book of the party was lower than 100,000, an evidence of his having been an advocate early. In 1934, Schultze succeeded Spiethoff as chairman of dermatology in Jena. Only a few months later, after Jesionek’s retirement, he was appointed chairman of the department of dermatology in Giessen.

Fig. 12

Walther Schultze (1893-1970)

The first list of candidates for successor to Jesionek had included three names, to wit, Walther Schultze, Heinrich Adolf Gottron, and Paul W. Schmidt. As usual, the university made inquiries about the scientific capability and the political suitability of these candidates. In regard to Paul W. Schmidt, an associate professor at the skin clinic of the University of Freiburg, the “strictly confidential” judgment of the leader of the students of medicine of the University of Freiburg was devastating: “As a teacher, Prof. Schmidt is incapable of keeping the students together in a disciplined fashion and to be a leader of them. In regard to his character, it is – as we have heard – dubious. Politically, he is absolutely indifferent.”

The judgment about Schultze was very different from that about Schmidt. According to Prof. Pfahler, rector of the University of Giessen from 1934 to 1937, Walther Schultze had been “involved prominently in the penetration of the revolution into the realm of the university so that further inquiries were unnecessary.” Pfahler added that he had not yet collected enough material about Gottron. In regard to Paul W. Schmidt, however, he was certain “that Mr. Schmidt does not correspond to the course of university politics that I have followed for new appointments within the medical faculty. Therefore, I want to ask the Reich’s Minister of Culture to offer the chair to Professor Schultze; otherwise to Mr. Gottron, but Mr. Schmidt should not be considered.”

Pfahler’s arguments proved to be convincing. Paul W. Schmidt did not receive a chair of dermatology until 1943, when, in a time of shortage of physicians, he was appointed director of the skin clinic in Kiel. Schmidt died only seven years later, at the age of 54. Heinrich Adolf Gottron also was passed over for the chairmanship in Giessen, but, only a few months later, he received a call to the University of Breslau. In Giessen, Walther Schultze was nominated primo et unico loco, i.e., he, himself, alone, and in the summer of 1935 he succeeded his teacher Albert Jesionek as chairman. Besides his new duties as chairman of dermatology, Schultze also was active in the NS Union of Lecturers, being its leader in 1936 and 1937. Parenthetically, six of the seven leaders of Giessen’s NS Union of Lecturers between 1933 and 1945 were physicians, an incontrovertible example of the dominant role of physicians in helping to achieve the aims of National Socialism at the universities. Under the direction of Schultze, every single physician at the skin clinic of the University of Giessen belonged to the NSDAP. In 1945, Schultze was dismissed from his position as chairman of dermatology. He died in 1970.

Another former assistant of Jesionek, Willy Engelhardt, also a member of the Nazi party, had left Giessen in 1930 to become assistant medical director of the department of dermatology in Düsseldorf (Fig. 13). In 1934, Engelhardt was appointed extraordinary professor; two years later, in 1936, he assumed the chair of dermatology at the University of Tübingen. Engelhardt was dismissed by the military government in 1945, continued to work in a private practice in Rottweil, and died there in 1977.

Fig. 13

Willy Engelhardt (1895-1977)

In Frankfurt, a successor was needed for Oscar Gans, who had been dismissed as chairman of dermatology in December 1933. The medical faculty of the University of Frankfurt considered six candidates, among them 38-year-old Martin Schubert, an assistant of Alfred Ruete in Marburg (Fig. 14). Schubert was by far the youngest of the candidates, and his scientific contributions were less than negligible. Nevertheless, he was chosen, because, as stated in a letter by the dean of the medical faculty, he had “proved himself as an inspiring, vivid teacher, who is able to impart to the students, by practical teaching and personal ideas, medical knowledge in the spirit of the National Socialist ideology.”

Fig. 14

Martin Schubert (1896-1964)

Schubert had joined the NSDAP as early as February 1932. He also was a member of the storm troops, in which he had acquired a leading rank (“Obersturmführer”), and belonged to several other Nazi organizations. In 1938 and 1939, he was deputy leader of the NS Union of Lecturers in Frankfurt. After the fall of the Nazi regime, Schubert was dismissed by the military government, his home was seized, and he was denied the right to work as a physician. After a few years, the latter measures were revoked. Schubert was considered by a denazification trial tribunal to be only slightly incriminated, and was given an ordinary pension. Although still young, he never reassumed an academic career. He died in Cologne in 1964.

The chairman of dermatology in Halle, Carl Grouven, a longtime member of the “Stahlhelm,” died in 1936. Among the candidates to succeed him were Carl Moncorps and Egon Keining, both at that time associate professors, the former at the University of Munich, the latter at that of Hamburg. Neither of them was especially active in the National Socialist movement. The ministry, therefore, selected a younger colleague of much lower scientific repute, a 37-year-old named Julius Dörffel (Fig. 15), an associate of Walter Scholtz in Königsberg. Dörffel had been a member of the Nazi party since February 1933. Two months later he joined the SA, and, in October 1933, he became leader of the NS Union of Lecturers in Königsberg. Furthermore, Dörffel was a member of the Office for Race Politics. Because of these credentials, Dörffel was assured a career in National Socialist Germany. In 1937, he succeeded Carl Grouven as chairman of dermatology in Halle, and, two years later, he was appointed deputy vice chancellor of that university. During the war, Dörffel was medical officer in an SA brigade, responsible for managing cutaneous disorders of hard laborers from foreign countries who had been brought to work in Central Germany. After the war and after he was dismissed by the Soviet military government, he opened a private practice of dermatology in Heidelberg. He died in a car accident in 1953.

Fig. 15

Julius Dörffel (1900-1953)

Josef Vonkennel (Fig. 16) had been a member of the NSDAP since April 1933. As early as the days of the Weimar Republic, he had been arrested for agitation against Jews. When the Nazis assumed power, he was an assistant in the skin clinic of München-Schwabing, never having worked in a university department. Nonetheless, he was considered to be superbly suited for the “fight for the National Socialist university” and, in 1934, assumed the chair of dermatology at the University of Kiel, where he proved to be capable. In 1937, he succeeded Spiethoff as chairman of dermatology in Leipzig. Vonkennel was a prominent member of the defense corps and the consulting dermatologist of the armed SS squadrons (“Waffen-SS”). After the war, he continued his academic career as chairman of dermatology in Cologne.

Fig. 16

Josef Vonkennel (1897-1963)

Splendid connections to the highest members of the party also determined the career of Wilhelm Richter (Fig. 17), who, in 1933, was just the director of a small private skin clinic in Berlin. His attempts to become affiliated with the university had been dashed by objections from several leading German dermatologists, who had criticized the inadequacy of his scientific work. Because of intercession by the deputy of the Führer, Rudolf Hess, Richter became professor at the University of Bonn, then assumed temporarily the chair of dermatology there, and, in 1935, he was appointed chairman of dermatology at the University of Greifswald. In 1937, he was appointed director of the section of “war medicine” of the Reich’s Office of Research, and, from October 1939 on, he was the highest medical officer of the district of Warsaw, where he also was responsible for medical matters in the ghetto there. He died at the front in March 1944.

Fig. 17

Wilhelm Richter (1892-1944)

Despite the new political realities and priorities that dictated the policy of the universities, the medical faculties occasionally succeeded in appointing a chairman who was a distinguished scientist, and not a Nazi party hack. This happened in Freiburg after the dismissal of Georg Alexander Rost as chairman of dermatology. The ministry strongly supported the nomination of Gerhard Wagner’s choice, Franz Wirz. In the official call to nominate candidates for the vacant chair of dermatology, Freiburg’s medical faculty was asked specifically by the ministry to declare its position on the possible appointment of Wirz. However, no expert consulted recommended Wirz, not even his own chairman, Leopold von Zumbusch. The faculty, therefore, disregarded the suggestion of the ministry and nominated as first choices Walther Schönfeld and Alfred Stühmer.

On April 1, 1934, Alfred Stühmer (Fig. 18), who at that time was not a member of the party, was appointed chairman of dermatology at the University of Freiburg. This extraordinary success of a university against a proposal of the ministry was possible only because Stühmer was known to be a conservative nationalist and a former member of the “Stahlhelm.” Furthermore, Freiburg’s medical faculty presented an additional, very embarrassing argument against Wirz, namely, his prior marriage to a sister of the Jewish chairman of internal medicine at Freiburg University, Siegfried Thannhauser. Despite his excellent connections, Franz Wirz never obtained a chair of dermatology. Instead, he stayed in the headquarters of the NSDAP in Munich. As a close collaborator of Wagner and Conti, and leader of the party’s university section, Wirz, for many years, had great influence in the affairs of all German universities.

Fig. 18

Alfred Stühmer (1885-1957)

Of course, even those who were responsible for the new policy at the universities, including men such as Wirz and Wagner, had to be aware of the fact that use of political criteria for appointment of professors was bound to impair the quality of scientific work at those institutions of higher learning. Moreover, this dire consequence was emphasized repeatedly by a few prestigious academics. Erich Hoffman, for example, wrote many letters to the Reich’s Ministry of Education about the inevitable result of such a policy, and sought to mobilize his colleagues in an attempt to save the system employed traditionally for appointment of chairmen. Leopold Ritter von Zumbusch made the following declaration in a letter to the government:

Because of my age and academic experience, I consider it to be my duty to emphasize that German science will lose, irrevocably, its worldwide recognition if appointments are based on criteria by which mediocrities are nominated to protect and preserve it. It also will be detrimental to the German people if bad professors educate bad physicians.

And this is precisely what happened: Germany’s universities became populated by countless medical pseudo-scholars who, aware of their innate mediocrity and seeking to overcome difficulties they experienced as a consequence of that ineptness, took shortcuts in their science in order to collect easy rewards. Some of the new professors were so inadequate that they had to be removed, e.g., the surgeon Kurt Strauss, a good friend of Leonardo Conti, who was described by his erstwhile assistant, the Nobel Prize winner Werner Forssmann, as a butcher who always was flirting with litigation, a habitué of wild parties, and a woman-chaser. As a rule, the worse a man was as a scholar, the better he was as a Nazi.

It was inevitable that medical students would notice the decline in the quality of their professors, and before long they refrained from attending lectures of those who were incompetent. The decline in quality was accompanied and aggravated by a decrease in quantity: whatever solid medical teaching remained was pressed into fewer hours in order to make room for absurd subjects such as biology of race. Following directives by Gerhard Wagner, the number of compulsory lectures in the minor specialties of medicine was reduced by 30%. The progressive curtailment of legitimate medical content was concurrent with the increasing Nazi preoccupations with student participation in party activities such as parades and demonstrations. For Walter Lever, the author of the textbook Histopathology of the Skin, which appeared in seven editions over a period of 40 years, beginning in 1949, that preoccupation of the Nazis was one important reason that prompted him to emigrate to the United States. His wife Gundula Schaumburg-Lever recalled after the death of her husband that Walter Lever had left Germany “because he wanted to have an academic career and he did not think he could do this in Nazi Germany. When he was an intern in Cologne and studied in the library, he was told to go out and march for Hitler instead of reading.”

Last, there also was a marked decline in the ability and interest of students of medicine. Ferdinand Sauerbruch, the famous surgeon, who, among other innovations, had developed the “iron lung” for surgery within an open chest, characterized the “intellectual state” of the contemporaneous crop of medical students as appalling. He averred that they “are picked because of their low membership card numbers, and preference is given to those with fathers in the party, and mothers in the National Socialist Womanhood. Five times weekly they have to attend marching and combat exercises, and lectures on the theory of race. Next morning they sleep through class, if they show up at all.”

Taken together, all of these factors resulted in a substantial decline in the quality of German medicine, which was aggravated markedly by consequences derived from the mass exodus of brilliant Jewish scholars. The decline already was evident in the first years of the National Socialist regime, when “Aryan” patients refrained from consulting physicians newly appointed to insurance-fund panels. Despite massive propaganda and pressure by employers and party organs, those patients continued to visit their old and trusted Jewish doctors. Ironically, for a limited period of time, Jewish insurance-panel-fund physicians had more patients and made more money than ever before. During the war, ironically, the consequences of badly flawed medical education affected the German army. Wounded soldiers frequently were treated by badly trained physicians, knowledgeable about current theories of race, but unable to properly perform rudimentary surgical procedures. And after the fall of the Third Reich, it took decades for medicine in Germany to recover from the Nazis. It may be that, like some other fields, it never will recover fully.

From the Center of Dermatology and Andrology, Justus-Liebig-University, Gaffkystr. 14, 35385 Giessen, Germany. This article is one chapter of a book to be published under the same title.