The History of Social Medicine in Berlin

Social medicine belongs to the theoretical-clinical subjects in medicine and as of today it includes Epidemiology and Demography as important disciplines. Read more about the development of the Institute of Social Medicine, Epidemiology and Health Economics at the Charité - Universitätsmedizin Berlin until today.

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Overview

In 1920 the first professorship in social hygiene in Germany was founded at the Friedrich Wilhelm University's Institute of Hygiene. Alfred Grotjahn (1896-1931), the first to be appointed to the professorship, established social hygiene as an academic discipline in Germany and in 1922 became the chief architect of the Social Democratic Party's public health care programme. After the National Socialists took over power in Germany in 1933, the institute was forced to close its doors and many members of its staff emigrated to the United States, Soviet Union, and other countries, where they played a key role in developing the field of public health. In Nazi Germany, sections of the former institute were reopened under the direction of Fritz Lenz, focusing on what was euphemistically referred to at the time as "race hygiene".

In 1947 the professorship for social hygiene was re-established at the Humboldt University's Institute of Hygiene and Microbiology and directed by Alfred Beyer (1885-1961), who reconceptualised and reorganised the field of study. In 1951 social hygiene was officially recognised in the GDR as a program of study leading to the state examination. From 1955 to 1959, Beyer served as the medical director of Charité Hospital in Berlin.

His successor, Kurt Winter (1909-1987), was appointed in 1957. Two years later and under Winter's tenure, the Institute of Hygiene was separated from the Institute of Hygiene and Microbiology and became an independent institute at the Charité with its own Social Hygiene Department.

Following Winter's retirement, Ingeborg Dahm became director of the Department of Social Hygiene in 1977. In 1986 the department became an independent Institute for Social Hygiene, which in 1990 and under the direction of Jens-Uwe Niehoff was renamed the Institute of Social Medicine and Epidemiology. This merged in 1993 with the Department of Occupational Medicine.

In 1995 Stefan N. Willich was appointed to the professorship in Social Medicine and Epidemiology and as director of the Institute of Occupational and Social Medicine and Epidemiology. Initially the institute was part of the building complex at the corner of Dorotheenstraße and Wilhelmstraße.

Between 2012 and 2014 Prof. Willich acted as President of the Berlin Academy of Music Hanns Eisler. During this period Prof. Claudia Witt (April 2012 to December 2013) and Prof. Benno Brinkhaus (January to September 2014) were temporary directors of the institute. In October 2014 Prof. Willich returned to the Institute.

Social Medicine 1920 to 1945

With increasing knowledge about social predictors of diseases, social hygiene developed from the already independent science of "hygiene" towards the end of the 19th century (Schagen 2006). At the same time, the term "social medicine" was born. The independent profile received this subject by Alfred Grotjahn (Schallmeyer 1914). Grotjahn, born in 1869 as the son of a physician family from Lower Saxony, studied medicine at the Universities of Greifswald, Leipzig, Kiel and Berlin from 1890-1896 and initially worked as a practicing physician in Berlin. Here, as well as traveling to London and Paris in 1902, he gained impressions of the health of the urban population. Grotjahn understood as the goal of social hygiene especially the prevention of diseases. He integrated the then popular ideas of practical eugenics into his concept of a population policy application of prevention (Ferdinand 2007). In 1912 Grotjahn became Privatdozent for Hygiene and Head of the Department of Social Hygiene at the Hygiene Institute of the University in Berlin. In 1920, despite the opposition of the overwhelming majority of the Faculty Council, which considered a professor of social hygiene to be superfluous, he obtained the title of professor and was thus the first and only ordinary social hygiene professor in Germany (Grotjahn 1932, Kaspari 1989).

National Socialism interrupted the scientific development of social hygiene for many years. After Grotjahn's death in 1931, the Ministry of Science, Arts and Popular Education vacated the professorship, but gave a teaching assignment to Benno Chajes to continue teaching (Neither 2000). Until the leave of Chajes in 1933 by the ministry, the tribe of Grotjahn students quickly disappeared in the course of political development in Germany. With the law for the restoration of the professional civil service from 7 April 1933 and the "German official law" 1937 officials could be dismissed for political or racial reasons (Reichsgesetzblatt 1, Berlin 1933, 5). As a result, one third of all teachers were replaced by 1938, 45% by 1945, almost all of whom were subsequently forced to emigrate (Samuel and Hinton 1949, Pross 1955). A large part of the participants were members of the Jewish religious community or politically belonging to the left camp. With increasing influence of the National Socialists many of them were arrested, murdered or exiled, as were the Grotjahn students.

In 1933, Franz Schütz was appointed Associate Professor of Social Hygiene and Head of the Social Hygiene Seminar, and until 1940 he took over the courses. Also in 1933 Fritz Lenz was appointed professor of racial hygiene and set up the Institute of Racial Hygiene in the rooms of the Social Hygiene Seminar. He also took over the Department of Racial Hygiene of the "Kaiser Wilhelm Institute for Anthropology" (KWIA). Racial hygiene became a key science with the seizure of power by the National Socialists.

The Jewish scientists Franz Goldmann, Miron Kantorowicz, Alfred Korach and Georg Wollf, former employees of Alfred Grotjahn, worked in various public health areas in the USA and had relatively successful careers.

Goldmann was a Fellow at the "Dept. of Public Health" at Yale University, where he established a new teaching method, recognized as "Medical Care in Modern Social Society and Economic Aspects in Medicine" from 1941. In the United States, he was one of the first to undertake a complex analysis of health care and proposed statutory social security contributions.

Alfred Korach began his teaching career at the "Massachusetts Institute" in Cambridge, USA, and in 1939 joined the University of Cincinnati, Ohio as "Assistant Professor" for Public Health. He published on social and economic factors influencing human health.

Miron Kantorowicz worked in the United States from 1940 as a "research fellow" in the field of "biostatistics" of the "Milbank Memorial Foundation" in New York. In 1942 he moved to the "American University" in Washington, later to the army as "Head of the Slavic and Balkan Unit" at the Department of Preventive Medicine of the "Office Surgeon Generals of the US Dept. Army" and from 1954 as head of the "East European Section, Med. Information and Intel. Div. "

Georg Wollf started public education in the US with a teaching and research job at Johns Hopkins University in Baltimore. From 1941 he worked at the National Institute of Health, NIH in Washington, later at the Carnegie Institution at the Department of Genetic Research at Cold Springs Harbor, Long Island, New York. From 1949 to 1952 Wollf worked for the "Medical Intellegence Branch of the Army Surgeon General's Office". Wollf published in 1952 under the title "The Social Pathology as a Medical Science" a comprehensive analysis of American public health development by taking up Grotjahn's legacy (Willich et al., 2007, Etzold 2007).

Literature:
Schagen U, Schleiermacher S. 100 Jahre soziale Medizin in Deutschland. Gesundheitswesen. 2006;68:85-93
Schallmayer W. Sozialhygiene und Eugenik. Z Sozialmed 1914;V.
Ferdinand U. Der Weg Alfred Grotjahns (1869-1931) zum "faustischen Pakt" in seinem Projekt der Sozialen Hygiene. Gesundheitswesen 2007;69:158-164
Grotjahn A. Erlebtes und Erstrebtes: Erinnerungen eines sozialistischen Arztes/Alfred Grotjahn. Berlin: Kommissions-Verlag. 1932: 284
Kaspari C. Alfred Grotjahn (1869-1931) - Leben und Werk. Dissertation. Bonn. 1989
Weder H. Sozialhygiene und pragmatische Gesundheitspolitik in der Weimarer Republik am Beispiel des Sozial- und Gewerbehygienikers Benno Chajes (1880-1938). In: Winau R, Bleker J (Hrsg.) Abhandlungen zur Geschichte der Medizin und Naturwissenschaft, Heft 87. Husum: Matthisen Verlag. 2000.
Samuel RH, Hinton T. Education and Society in Modern Germany. London. 1949
Pross H. Die deutsche akademische Emigration nach den Vereinigten Staaten 1933-1941. Berlin: Duncker & Humblot. 1955
Willich SN, Etzold K, Berghöfer A. Emigration von Sozialmedizinern der Berliner Charité in die USA - Karrieren der Schüler Alfred Grotjahns. Gesundheitswesen 2007;69:694-698
Etzold K. Dissertation "Exodus der Sozialmedizin in den dreißiger Jahren von Berlin in die USA - das Erbe Alfred Grotjahns". CharitéUniversitätsmedizin Berlin, 2007

Social medicine after the Second World War

Due to the destruction of the Second World War, it was urgently necessary to rebuild the faculties of the universities. At the Humboldt University in Berlin, the chair of social hygiene was re-established during this phase. Alfred Beyer, then vice-president of the central administration for the health service, took over 1947 the office of the Ordinariate for the social hygiene. Following the model of the Berlin model, social hygiene institutes were created at all other faculties in the country.

In the early days, the chair of social hygiene was limited to the essentials and was furnished in the apartment Alfred Beyer. The work topic was characterized by the reconstruction and the reorientation of the subject social hygiene after the Second World War. Based on new insights and ideas, the institute gradually expanded its activities. As a result of the expansion and expansion of the institute, the relocation to the rebuilt buildings on Neue Wilhelmstraße (now Otto Grotewohl Strasse) took place from 1954 onwards.

Already in 1951, social hygiene became a state exam subject and only one year later Alfred Beyer founded a consortium of social hygienists. In 1953, they succeeded in publishing the first textbook of nearly 900 pages. Experienced scientists such as Eva Schmidt-Kolmer, Erwin Marcusson, Karl-Heinz Mehlan, Fritz Oberdoerster and Hermann Redetzky participated in the publication of the guideline. Under Alfred Beyer, 44 candidates received their doctorate. Kurt Winter, Karl-Heinz Mehlan and Elfriede Paul were able to habilitate. Alfred Beyer was dean of the medical faculty in 1948 and 1949 vice rector of the university. From 1955 to 1959 he headed the Charité as medical director. After his retirement in 1956, his senior physician Kurt Winter took over the management of the institute. In 1957 he received the position of full professor.

In order to participate in the development of a democratic health, social and higher education system, the staff of the department dealt with a variety of topics. Great emphasis has also been put on the training of new doctors and university teachers. The College around Alfred Beyer and Kurt Winter devoted themselves to the development of a company health system, the creation of land ambulatories, the health protection of mother and child, the fight against infant mortality and the establishment of an advanced health policy. Above all, Soviet scientific literature was creatively processed and disseminated. At the same time, social hygienists tried to build on the tradition of progressive German medicine. Karl-Heinz Mehlan was particularly involved in the field of health protection in pregnancy, in the care of premature babies and in the problems of pregnancy interruption. He succeeded in creating the first conditions for the later internationally recognized scientific and organizational work in the field of family planning.

Elfriede Paul was dedicated to the health protection of the working population, in particular the working woman and the issues of sick leave.

Karl-Heinz Renker mainly dealt with the scientific basis and the organization of occupational health protection. Eva Schmidt-Kolmer and her co-workers contributed a great deal to promoting equal rights for women. They created a guideline for education in crèches and homes, which became the standard work for crèche educators.

In the mid-1950s, research into the physical development of adolescents came to the forefront of research. Acceleration as an expression of the effect of social changes on the health situation was an important subject of the scientific considerations. On this topic, a large number of dissertations and publications were produced by the staff of the institute.

In a variety of scientific papers, the Institute's College has also made progress in research into the epidemiology of cardiovascular disease, mortality, morbidity and mortality in infancy and childhood, the causes of death and cancer mortality.

In the 1960s, employees increasingly turned to sociological and epidemiological areas. New sociological methods were tested, new lecture material developed and various symposia organized. 1973 appeared the first edition of the textbook sociology for physicians. Bernhard Kreuz saw a systematic expansion of epidemiology as part of social hygiene. This made it possible to make a significant contribution to the development of general epidemiology in the GDR.

Furthermore, the sick leave in the GDR was analyzed and its development was pursued and explored until the mid-1980s. The Institute for Social Hygiene created conditions to theoretically substantiate the largely empirically oriented epidemiology.

Already in 1959, after institutes for medical microbiology and epidemiology as well as for hygiene had already been set up in Halle and Rostock, a reorganization of the institute structures took place in Berlin as well. The Institute for Medical Microbiology and Epidemiology was newly founded, the Hygienic Institute with Kurt Winter as director now divided into four departments. It consisted of the departments for general and municipal hygiene, for hygiene, for the hygiene in the child age and for social hygiene. Director was Kurt Winter. After the retirement of Winter Ingeborg Dahm in 1977 took over the management. From the Department of Social Hygiene was born on February 24, 1986, the independent Institute for Social Hygiene. Ingeborg Dahm was appointed director. In 1990, the institute was renamed Social Medicine and Epidemiology under the leadership of Jens-Uwe Niehoff and merged with Occupational Medicine in 1993.

The new institute continued to engage in extensive training, education, training and research activities. The apprenticeship took place in the basic fields of study Medicine, Dentistry, Medical Education and Diploma Nursing. The training of the students was largely conducted in seminars with the participation of all academic staff. Interns, specialist candidates and external doctoral candidates received extensive support. The institute contributed significantly to disciplinary education and training. This applied to the development of teaching programs, the publication of university textbooks and the creation of detailed seminar materials. At the institute, empirical studies were generally conducted on the study of medicine.

In forty years, there were 25 employees and externals, or received the doctorate B. Furthermore 320 A-promotions were defended and written a variety of diploma theses.

The Institute Today

In 1995 Stefan N. Willich was appointed to the professorship in Social Medicine and Epidemiology and as director of the Institute of Occupational and Social Medicine and Epidemiology. Initially the institute was part of the building complex at the corner of Dorotheenstraße and Wilhelmstraße.

Due to extensive renovation work, however, the institute was relocated to Riedemannweg. In 1999 the institute moved to its present location at Luisenstraße 57.

Since 2000 the institute has been part of the Center for Humanities and Health Sciences, which is made up of ten other institutes from the Humboldt University's and Free University's medical departments. In 2001 the institute was renamed the Institute for Social Medicine, Epidemiology, and Health Economics. In early 2004, the International Health Studies project area, which had grown from the former Institute for Social Medicine at the Free University's Benjamin Franklin Campus after the retirement of Frank-Peter Schelp, became affiliated with the institute. In 2005, as part of the reorganisation of the Charité, the Center for Humanities and Health Sciences was transferred to the CharitéCentrum 1.

The Building at Luisenstrasse 57

The building at Luisenstr. 57 in Berlin Mitte is located between Campus Charité Mitte and Campus Nord of the Humboldt University. It was built in 1840. Between 1879 and 1897 it was the workplace of the Imperial Health Department, which at that time already performed tasks of public health protection, consumer protection and health environmental protection. Robert Koch was employed there from 1880 on and discovered in this house the causative agent of tuberculosis. The building was, so to speak, the founding center for public health in Germany.

In 2003, the building was named "Salomon Neumann House". The Berlin physician Salomon Neumann was a close associate of Rudolf Virchow and co-founder of social medicine. As a Liberal Democrat and health reformer he acted from 1859-1905 Berlin as a city councilor.