How not to discuss the role of alternative medicine during the Third Reich

I really hate to write this post, but I feel compelled. The reason I hate to write it is because someone I admire screwed up. The reason I feel compelled is because of my longstanding interest in World War II and Holocaust history, not to mention my longtime interest in refuting the lies of Holocaust deniers. I had meant to write about it the first time I came across it, but for some reason did not. I don't remember the reason, although it might very well be because of how much I respect the person who wrote it. Again, I don't remember, and today it really doesn't matter why. Whatever the reason, the post sat in my folder of links that I keep as potential blogging material. Last night I was going through that folder looking for material and culling material whose time has passed to the point where I have either lost interest or decided that my window of opportunity to blog about the subject has passed because the material is too old when I came across a post by Professor Edzard Ernst. This post is over a month old, and, rereading it, I was disturbed enough that I decided that if I were going to blog about it, as Elvis would put it, it's now or never.

I chose now.

I'm referring to a post by Edzard Ernst, unfortunately. It's his post designed as material for Holocaust Memorial Day, which was January 27. For those of you not familiar with this particular day of remembrance, the date of Holocaust Memorial Day was chosen based on the date in early 1945 that the Soviet army liberated the most notorious combined death camp and concentration camp, the complex of camps known as Auschwitz-Birkenau. If anyone doubts my passion for this subject, I suggest that he read a post I wrote eight years ago entitled Musings on the 60th Anniversary of the Liberation of Auschwitz: How I discovered Holocaust denial. In that post, I discussed the horror of the Holocaust, the liberation of Auschwitz, a little bit about the horrific medical experiments that Nazis subjected the unfortunate Jews and other untermensch unfortunate enough to fall under the control of the Nazis, and some of the techniques of Holocaust denial. Given my background in this area, longtime readers (and I mean really longtime readers, the ones who were regulars here when I wrote a lot more regularly about Holocaust denial than I do now) would probably not be surprised that, right from the title, I was disturbed by Professor Ernst's post The Holocaust and Nazi (alternative) medicine. Also, given my interest in Nazi medicine, and the multiple posts I've written on the subject over the years, I recognized what appears to be a rather obvious Godwin.

Right from the title, the post goes wrong. I don't know what Professor Ernst's intent was in writing this post, but putting "alternative" in parentheses in the title not-so-subtly ties alternative medicine to the Holocaust and Nazi medicine. As I've discussed before here, the Nazis were undoubtedly into what we would now consider "alternative medicine." Indeed, they were particularly into homeopathy (which is not surprising, given that the founder of homeopathy, Samuel Hahnemann, was German) and naturopathy. My eyes were first opened to this connection when I came across Robert N. Proctor's book Racial Hygiene: Medicine Under the Nazis. Although the book was a more general treatise on medicine as practiced in the Third Reich and how it contributed to the Holocaust through a "biological vision" of the physician as the physician not to individual patients but the "physician to the volk." It was this view of the physician as being more responsible to the abstract German "volk" instead of the more traditional role of the physician as a healer to individual patients that helped the German medical profession justify its participation in atrocities such as the T4 euthanasia program, which was dedicated to the elimination of lebensunwertes leben ("life unworthy of life").

However, in a chapter of Proctor's book entitled The "Organic Vision" I learned for the first time of how a large faction of Nazi doctors came to believe in "volkish" medicine, which turned out in practice to be, in essence, German folk medicine, including herbalism, naturopathy, and the like. And it's true. Proctor discussed it, and so have other historians. Generally, when I mention the propensity of some Nazi leaders for medical woo, I like to use it as a counterexample to counter people who try to tie "alternative medicine" strictly with the left. After all, it doesn't get much more fascist and "right" than the Nazis, and if they were into various forms of "alternative medicine," it's a really good example of how quackery crosses all political boundaries.

Be that as it may, Ernst starts out reasonably when he points out how the German medical specialty of "racial hygiene" led first to discrimination, then to the horrors of the T4 euthanasia program, and then ultimately to the Holocaust. To be fair to Professor Ernst, I have to acknowledge that he is very much correct when he writes:

The T4 units had developed the technology for killing on an industrial scale. It was only with this know-how that the total extinction of all Jews of the Reich could be planned. This truly monstrous task required medical expertise.

Almost without exception, those physicians who had worked for T4 went on to take charge of what the Nazis called the ‘Final Solution’. While action T4 had killed thousands, its offspring would murder millions under the trained instructions of Nazi doctors.

The medical profession’s role in these crimes was critical and essential. German physicians had been involved at all levels and stages. They had created and embraced the pseudo-science of race hygiene. They were instrumental in developing it further into applied racism. They had generated the know-how of mass extinction. Finally, they also performed outrageously cruel and criminal experiments under the guise of scientific inquiry [see below]. German doctors had thus betrayed all the ideals medicine had previously stood for, and had become involved in criminal activities unprecedented in the history of medicine (full details and references on all of this are provided in my article, see link above).

One of the most dismaying aspects of the Holocaust to physicians is just how easily and willingly—nay, eagerly—the medical profession in Germany became complicit in mass murder. Throughout the rest of the vile history of the Holocaust, physicians were intimately involved with the killing. In the T4 program it was physicians who decided which patients were to undergo what was euphemistically called "euthanasia," making up dubious medical justifications and helping authorities hide from the victims' families what really happened. It was doctors who developed medical protocols to slowly starve these patients to death, to dispatch them with lethal doses of opioids, and even later developing a widely used technique to kill using a direct injection of phenolic acid into the heart. From the T4 euthanasia program and beyond, it was physicians who devised, or assisted in devising, virtually every protocol of death. They did this because they believed that eliminating the weak would strengthen the "Aryan" race. Professor Ernst is correct to point out how the Holocaust couldn't have happened the way it did (or couldn't have been as bad as it was) were it not for the active and enthusiastic participation of Nazi physicians. This is documented history; there is no denying it.

I wish that Professor Ernst had stopped there. Unfortunately, he did not. He had to continue and in essence try to Godwinize alternative medicine. Now, I think that through my more than eight years of blogging about these topics I have established myself as a staunch advocate of science-based medicine and an implacable foe of quackery. Indeed, among skeptical bloggers, if anything I'm on the "militant" end of the spectrum. Indeed, I sometimes receive criticism that I'm far too harsh on "complementary and alternative medicine" (CAM), particularly by a certain commenter on another blog where I regularly contribute. Also, don't think that, if there were convincing evidence that the Nazi infatuation with what we now call CAM had anything to do with creating or advancing the Holocaust, I wouldn't use that information. But I try to be intellectually honest, and CAM doesn't have anything to do with the Holocaust any more so than the rest of Nazi medicine. So I don't use it. Let's put it this way. When someone like myself is disturbed by what Professor Ernst writes next, I can only hope that he'll take it to heart. Unfortunately, if his responses to comments pointing out the same sorts of problems that I'm pointing out here are any indication, I fear that he probably won't. It's downright embarrassing to me to see Professor Ernst, rather than admitting that he messed up and gave a message he didn't intend, resort to dodging and weaving about how he put brackets around the words "alternative medicine" in the title in order to de-emphasize it and how he should be judged on his scholarly articles and not his blog posts. Sorry, Professor, but I disagree. If you post something publicly, you're judged on it. I'm judged all the time based on what I post publicly, and I don't try to dodge that. If I write something that reflects poorly on me on this blog or my other blog, I will be judged for it by my readers—and rightly so!

First, Professor Ernst writes about the involvement of German physicians in promoting "natural healing":

Based on a general movement in favour of all things natural, a powerful trend towards natural ways of healing had developed in the 19(th)century. By 1930, this had led to a situation in Germany where roughly as many lay-practitioners of alternative medicine as conventional doctors were in practice.This had led to considerable tensions between the two camps. To re-unify German medicine under the banner of ‘Neue Deutsche Heilkunde’ (New German Medicine), Nazi officials eventually decided to create the profession of the ’Heilpraktiker‘ (healing practitioner). Heilpraktiker were not allowed to train students and their profession was thus meant to become extinct within one generation; Goebbels spoke of having created the cradle and the grave of the Heilpraktiker. However, after 1945, this decision was challenged in the courts and eventually over-turned – and this is why Heilpraktiker are still thriving today.

All of which is true, but one wonders how relevant this is to Holocaust Remembrance Day. My view is that it's not. After this, Professor Ernst engages in what is to me a disturbing logical fallacy, namely guilt by association. After noting how the Nazi government supported research programs to validate The One Quackery to Rule Them All (homeopathy), Ernst writes:

There is,of course, plenty of literature on the subject of Nazi ‘research’ (actually, it was pseudo-research) and the unspeakable crimes it entailed. By contrast, there is almost no published evidence that these activities included in any way alternative medicine, and the general opinion seems to be that there are no connections whatsoever. I fear that this notion might be erroneous.

As far as I can make out, no systematic study of the subject has so far been published, but I found several hints and indications that the criminal experiments of Nazi doctors also involved alternative medicine (the sources are provided in my articles cited above or in the links provided below). Here are but a few leads:

Dr Wagner, the chief medical officer of the Nazis was a dedicated and most active proponent of alternative medicine.

Doctors in the alternative “Rudolf Hess Krankenhaus” [see above] experimented on speeding up the recovery of wounded soldiers, on curing syphilis with fasting, and on various other projects to help the war effort.

The Dachau concentration camp housed the largest plantation of medicinal herbs in Germany.

Dr Madaus (founder of the still existing company for natural medicines by the same name) experimented on the sterilisation of humans with herbal and homeopathic remedies, a project that was deemed of great importance for controlling the predicted population growth in the East of the expanding Reich.

Dr Grawitz infected Dachau prisoners with various pathogens to test the effectiveness of homeopathic remedies.

Schuessler salts were also tested on concentration camp inmates.

This is incredibly thin gruel. In fact, it's downright embarrassing how weak this argument is. Professor Ernst is clearly trying to link alternative medicine to the Holocaust based on essentially no evidence. In fact, he even admits there's no evidence! ("There is almost no published evidence that these activities included in any way alternative medicine";"the general opinion seems to be that there are no connections whatsoever"; "no systematic study of the subject has so far been published.") Perhaps if Professor Ernst is so convinced by his "hints and indications that the criminal experiments of Nazi doctors also involved alternative medicine" he should undertake the first systematic study of this question. Right now, his apparent implication boils down to, "A few Nazi doctors involved in hideously unethical human experiments believed in alternative medicine, and a few of them tested it in some of these hideously unethical human experiments; so alternative medicine is linked with the Holocaust."

Again, there are few people in the skeptical movement who are harsher in their condemnations of "alternative medicine" than I am. In fact, I daresay I'm probably, by and large, harsher in my criticisms than even Professor Ernst himself usually is. (Just look at my posts from the last couple of days if you don't believe me.) However, even I have a hard time with pulling a Godwin on alternative medicine.

Moreover, even if it were true, as Professor Ernst appears to be implying without much in the way of convincing evidence, that alternative medicine was a driving force behind the Holocaust, it would be completely irrelevant to the question of whether there is any scientific support to "alternative medicine" treatments. After all, no one argues that most of the horrifically unethical and just downright horrific experiments carried out by Nazi doctors on prisoners of war, Jews, and others were carried out for purposes other than testing scientific medicine. The sorts of questions tested included the efficacy of treatments for infectious disease, techniques for rewarming pilots subjected to hypothermia from having crashed in frigid waters, and other very practical questions related to military medicine. If there were occasional horrific experiments involving "alternative" medicine on prisoners, there were certainly no worse than the same sorts of experiments carried out in the name of "conventional" medicine. Nor can I think of any purpose to listing some Nazi physicians who were believers in "alternative medicine" other than to Godwinize alternative medicine. The sad thing is that there's no need to do this. Alternative medicine falls quite easily based on its own merits (more specifically, lack thereof). There is no need to play the Nazi card.

The horrors of Nazi medicine are well known, and Professor Ernst is right to do his part to help ensure that they are never forgotten. I've insisted the same thing myself many times and in my way have done my little part to assist the effort to make educate my readers about how medicine went just as crazy as the rest of German society from 1933 to 1945. Actually, it went even more so, because German medicine was consistently at the leading edge of developing Nazi racial dogma, and the medical profession was consistently one of the strongest supporters of the regime, with a higher percentage of doctors belonging to the Nazi party than virtually any other major profession. However, it should be remembered that there was nothing special about "alternative medicine." Nazi medicine itself became rotten to the core, both scientific medicine and conventional medicine, and its very corruption in a huge part contributed to the Holocaust. Moreover, as Proctor himself points out in his book, Nazi support for "natural healing" peaked before the war. After the war started, enthusiasm waned because actual real medicine was required to treat the hundreds of thousands of injured soldiers and civilians. Finally, as Proctor notes, there was a tension between the Nazi biomedical vision to improve the volk and protect it from "degradation" and "contamination," that biomedical vision required modern medicine, and this was at frequent odds with the proclivities of "natural healers," who rejected anthropology, genetics, and other sciences as the basis for healing. Ultimately, the Nazi support for "natural medicine" was subordinated to its search for medicines and surgical techniques that would help it win the war, or, as Proctor put it, the Nazis "supported 'natural medicine' when it suited their purposes," concluding his chapter on the "organic vision thusly:

One should not, however, imagine that the Nazis were more fond of organic than of orthodox medicine or that National Socialism appealed more to natural healers than to orthodox practitioners. There is simply no evidence that this was the case. The Nazis appealed to regular as well as to irregular medicine, and both responded with their services.

One also notes that the T4 euthanasia program and, ultimately the Holocaust itself, started as Word War II was beginning, which was after German interest in "natural medicine" had started to wane.

It would not be inappropriate to use the Nazi embrace of alternative medicine as evidence of a consistent tendency towards magical thinking in Nazi ideology. After all, Nazi interest in mysticism and the occult is even better documented than Nazi interest in alternative medicine, the latter of which was until relatively recently a little known and little appreciated facet of Nazi history. Similarly, racial hygiene itself was largely a pseudoscience, albeit a pseudoscience that was in the early part of the 20th century popular among far more than just Nazi physicians and scientists. Moreover, even Professor Ernst himself acknowledges that he is on shaky ground. Indeed, his own article that he cites as evidence linking alternative medicine to the Holocaust there is no evidence presented that this was so, and Ernst even noted that the "majority of the medical establishment remains sceptical" as a parallel with CAM today. He also correctly notes that CAM in Nazi Germany was concerned more with the health of the volk than with the health of the individual, but that was true for all of Nazi medicine, in which physicians were urged to be physicians for the volk. Certainly, this emphasis on the volk rather than the individual, in which the good of the individual is subordinated to the perceived good of the race, was a major factor that allowed physicians to rationalize the dehumanization of those not considered productive or genetically sufficiently "Aryan," but, again, this was a belief that permeated all of Nazi medicine. It was by no means unique to "natural healers" in the Third Reich.

I'm disappointed to have to say that in the end, I'm left with the impression that Professor Ernst unnecessarily invoked the Nazi card to attack alternative medicine. I say "unnecessarily," because there's plenty of ammunition to show how alternative medicine is pseudoscience and can lead to profoundly unethical clinical trials (such as the trial of the Gonzalez remedy for pancreatic cancer) without a need to play the Nazi card. I also say "unnecessarily" because, if Professor Ernst's true purpose was to remind the world of the horrors of Nazi medicine, there was plenty of ammunition to use without muddying the waters with arguments about alternative medicine that boil down, in essence, to pointing out that some prominent Nazi doctors involved in the Holocaust believed in homeopathy or other alternative medicine and that there was significant Nazi support for alternative medicine, even though he himself cannot provide concrete evidence that it this support contributed to the Holocaust. In contrast, I could flood this post with examples of Nazi "conventional" medicine that contributed to the Holocaust, all part of what then was considered the "modern" biomedical vision, as well as examples in our very own country of a similar biomedical vision leading to horrific (albeit nowhere near as horrific as the Holocaust) outcomes.

In the end, I'm afraid that Professor Ernst's article comes across less as an attempt to memorialize the crimes committed in the name of medicine during the Holocaust than as a ham-fisted attempt to use the occasion of Holocaust Remembrance Day to link alternative medicine with the Nazi regime. As I said, I'm disappointed. I know Professor Ernst is capable of far better than this. He's proven it time and time again.