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Unethical behavior of Nazi doctors

Article in Journal of the Royal Society of Medicine May 1994

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246 Journal of the Royal Society of Medicine Volume 87 April 1994
alike. After all it only means a teacher, and to a greater or
lesser extent, we all have to teach.
GEORGE E RAY Old 28 Ringshall
Hertfordshire HP4 1ND, UK
Non-sexist grammar in medical literature
Finn (March 1993 JRSM, p 184), sadly, was quick to 'stand
corrected' for apparently not knowing that sex-neutral
pronouns somehow are good and sex-positive pronouns are
bad, or so the feminists have decreed. However, the
improvements they have in mind for the English tongue
would make your hair stand, assuming you care something
about the language. Words (to use the term loosely -
barbarisms would be more accurate) that no caregiver but
only a mother could love. 'Themself' is one particularly
atrocious example. Orwell's Newspeak and Bowdler rolled
into one.
William the Conqueror had more respect for the English
language than these modern worshippers of the epicene.
JAMES KALIVAS 12300 Pawnee Lane
Leawood, Kansas 66209, USA
George Frederic Still
While delighted to learn that medical students are interested
in the history of medicine (June 1993 JRSM, p 369), I could
hardly believe my eyes when the first English paediatrician
is described as George Frederick Still.
I have before me Common Disorders and Diseases of
Childhood by George Frederic Still'.
That 'Frederick' is not merely a typing error is evident
from the fact that it occurs three times on the same page.
On a more personal note, I am indebted to Frederic Still -
when someone commented adversely on my bachelor status
implying that I should not be a paediatrician, the late John
Peter Mills Tizard remarked: 'And so was Still'.
THOMAS STAPLETON The Foundry Cottage
Lane End, High Wycombe
Buckinghamshire HP14 3JS, UK
Reference
1 Still George Frederic. Common Disorders and Diseases of
Childhood, 3rd edn. Oxford: Oxford Medical Publications, 1915
Health promotion
In a recent issue, pride ofplace was given to a paper by ILord
Butterfield in which he extolled Health Promotion and uiged
occupational physicians to join the campaign (December 1993
JRSM, pp 683-4). He surely could not have overlooked those
real problems of occupational health, which still beset the
workforce and which can be effectively resolved only by those
practitioners who are specially and, might I add, uniquely
trained and experienced for dealing with them. In this
process, their recommendations may call for significant
changes in the pattern of operations, possibly incurring,
initially at least, some interference with productivity. No
wonder that the response on the part of management is not
always enthusiastic.
On the other hand, the demands made by health promotion
are financially minimal, seldom intrude directly into
working activities and tend to create a caring image for the
organization concerned. Manament, therefore, is supportive.
Yet before already overburdened occupational physicians
have their energies dissipated in this way, would it be
unreasonable to enquire to what extent these schemes for
Health Promotion have been critically and objectively
appraised for the modifications they actually make to the
morbidity and mortality among those engaging in them? In
the same issue of the Journal, Brodie and Dugdill (December
1993 JRSM, pp 694-6) describe their efforts among a small
group of motivated volunteers in Liverpool, for whom the
changes achieved have been, in all conscience, minimal and
not always sustained, while the modifications achieved in
their chosen parameters for any real effect upon health are
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no more than conjectural. Likewise, Vickers et aL (December
1993 JRSM, pp 697-8) report impressively on their findings
from a breast cancer screening exercise, though they are
honest enough to admit that 'The long-term effects of the UK
swreening p a me on breast cancer mortality are not known'.
Today, in the National Health Service, the slogan is 'audit'.
It might be timely to apply this discipline to health
promotion in all its various facets, heeding the cautionary
words of Robert Boyle, that 'Sceptical Chymist', when he
wrote of those who:
were carried along by the genius of the age in which they lived, being
satisfied with assertions instead of proofs, or, at least, often admitting
as proofs the slightest degree of probability, unsupported by that
strictly rigorous analysis which is required by modern philosophy.
RoY GOULDING Keats' House, Guy's Hospital
London SE1 9RT, UK
Unethical behaviour of Nazi doctors
The paper by Drobniewski (September 1993 JRSM, pp 541-3)
about the unethical behaviour of Nazi doctors asks, amongst
others, the question why there was so little resistance from
peers against medical atrocities. Several possible answers
are given but one is neglected.
It seems important to understand that many of the peers
were 'exchanged' when the Nazi regime took over. For
instance, in the medical faculty of Vienna more than 70%
of all members were fired the moment the Nazi troops
marched into Vienna in 1938. Obviously this change-over
had very profound effects. It goes almost without saying that
the 'replacements' of the former peers were chosen not
according to medical quality but according to political
'trustworthiness'. After these drastic events, which in many
cases ended with the death of the former faculty member,
there were no more peers in the true and traditional sense.
In other words, the evildoers amongst the medical profession
had not just little resistance from above but rather much
support from the newly instituted, high level 'superiors'.
In view of this, the lack of peer intervention was an
inevitable result. The events that took place in the medical
faculty of Vienna of 1938 not only opened the door to
atrocities taking place, but had additional sequelae which
unfortunately lasted much longer than the Third Reich. The
loss of peers meant an unprecedented loss of knowledge and
authority which cannot possibly be filled in one or even two
generations. Even after the war, faculty members instituted
by the Nazis did everything to remain in place; the return
of the survivors of the former colleagues was actively
discouraged. Thus, the Nazi regime meant the end of the
once famous school of medicine in Vienna and the persistence
of a spirit that can be felt even today.
E ERNST Department of Physical Medicine and Rehabilitation
Formerly: University of Vienna
Wahringer Gurtel 18-20
1090 Wien, Austria
Present address: Postgraduate Medical School
University of Exeter, Barrack Road
Exeter, UK
Exclusion diets
Dr Hodson's letter (August 1993 JRSM, p 493) I regard as
important, not only for its intrinsic merit but because,
reporting one case only, you, Sir, had the percipience to
publish. I approved his discussion paper (September 1992
JRSM, p 566) which I urged him to offer for publication, for
his conclusions were very similar to my own. Although I have
known him for more than a decade as a result of our shared
interest in allergy, I remained ignorant of his own food
intolerance, the publication of the details of which I regard
as important as his objective studies of his patients, since
I believe there is much to be learned from doctors reporting
their own symptoms and their management.
I am an allergic of long standing, having had recurrent
'bilious attacks' as a child, and frequent respiratory
infections and occasional acute otitis media. In early adult
life I developed recurrent sino-bronchitis, with in late life
mild asthma, nasal catarrh, deafness, blepharitis and
conjunctivitis, irritable colon, pruritus ani, and other