Mitteilungen der Fachgesellschaften

Strahlenther Onkol 2014 ∙ 190:607–620 Redaktion: DOI 10.1007/s00066-014-0673-6 Prof. Dr. Rolf Sauer, Erlangen © Springer-Verlag Berlin Heidelberg 2014

Adressen Deutsche Gesellschaft für Medizinische Physik, www.dgmp.de Prof. Dr. K. Zink, Institut für Medizinische Physik und Strahlenschutz, IMPS TH Deutsche Gesellschaft für Radioonkologie e.V., www.degro.org Mittelhessen, Wiesenstr. 14, D-35390 Gießen, Telefon (+49/641) 309 2574 DEGRO-Geschäftsstelle, Hindenburgdamm 30, D-12200 Berlin, Telefon (+49/30) 8441-9188, Fax -9189 Hellenic Society of Radiation Oncology, www.eeao.f2s.com Präsident: Prof. Dr. M. Baumann, Klinik für Strahlentherapie und Radioonkologie Dr. P. Pantelakos, Karneadou Str. 44–46, GR-10676 Athen, und OncoRay-Zentrum für Medizinische Strahlenforschung und Onkologie, Telefon/Fax (+30/1) 7244117 Dresden Romanian Society of Radiotherapy and Medical Oncology, Österreichische Gesellschaft für Radioonkologie, Radiobiologie www.srrom.ro und Medizinische Radiophysik, www.oegro.com Prof. Dr. N. Ghilezan, 34–36, Republicii Str., 400015 Cluj-Napoca, Univ.-Prof. Dr. K.S. Kapp, Universitätsklinik für Strahlentherapie-Radioonkologie, Rumänien, Telefon (+40/264) 598361 (ext. 106), Auenbruggerplatz 32, 8036 Graz, Fax (+40/264) 598815, E-Mail: [email protected] Telefon (+43/316) 385-12639 Slovak Society of Radiation Oncology, www.srobf.szm.com Scientific Association of Swiss Radiation Oncology, www.sasro.ch MUDr. Pavol Dubinský, PhD.; Východoslovenský onkologický ústav, a.s.; PD Dr. Damien C. Weber, Service de radio-oncologie, Rastislavova 43, 04191 Košice, Slowakei; Hôpital Cantonal Universitaire, CH - 1211 Genève Telefon (+421/55) 6135-501(-511, -502), Fax -504; E-Mail: [email protected] Hungarian Society of Radiation Oncology, www.oncol.hu Dr. J. Lövey, National Institute of Oncology, Berufsverband Deutscher Strahlentherapeuten e.V., www.bvdst.de Ráth György u. 7–9, H-1121 Budapest Prof. Dr. F.-J. Prott, Radiologische Gemeinschaftspraxis am St.-Josefs-Hospital, E-Mail: [email protected] Beethovenstr. 20, D-65189 Wiesbaden, E-Mail: [email protected]

Jubilare Symposium BENIGN RELOADED 2 „Strahlentherapie nichtmaligner Erkrankungen“ Die Fachgesellschaften von der AG Gutartige Erkrankungen der Deutschen Gesellschaft für Strahlentherapie und Onkologie gratulieren zum Geburtstag: Radioonkologie e.V. Bad Hersfeld, 18.10.2014 10.06.2014 Gelsenkirchen: 11.06.2014 Bedburg: Ort der Veranstaltung: Dr. Marlis Martin-Malberger Dr. Udo Brückner Stadthalle Bad Hersfeld, 65 Jahre 85 Jahre Wittastr. 5, 36251 Bad Hersfeld

12.06.2014 HB Nijmegen: 15.06.2014 München: Wissenschaftliche Leitung und Organisation: Prof. Dr. Jan Willem Leer Dr. Annemarie Wuttge Prof. Dr. med. O. Micke PD Dr. med. R. Mücke 65 Jahre 89 Jahre Prof. Dr. med. U. Schäfer Prof. Dr. med. M. H. Seegenschmiedt Prof. Dr. med. H. J. Feldmann PD Dr. med. H. D. Weitmann Information und Anmeldung: Kongresssekretariat Anmeldung Strahlentherapie Klinikum Bad Hersfeld, Seilerweg 29, 36251 Bad Hersfeld Tel.: 06621-881370, Fax: 06621-881375 E-mail: [email protected] Kursgebühren (inklusive Pausenverpflegung): Facharzt: 80,- € Arzt in Weiterbildung: 50,- € MTRA, MPE: 30,- € Anmeldung erbeten bis spätestens: 30. September 2014

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Aggressive B-Zell Lymphome: Internationale Studie bestätigt bessere Ergebnisse Personalia durch eine ergänzende Strahlentherapie zur allgemein üblichen Chemotherapie München bei ausgedehnten Tumoren Prof. Dr. med. Stephanie E. Combs, bisher leitende Oberärztin an Besonders aggressive B-Zell- rapie überhaupt verzichtet wer- der Klinik für Radioonkologie und Strahlentherapie am Univer- Lymphome, eine Untergruppe den kann. sitätsklinikum Heidelberg, leitet seit 1. April dieses Jahres die Kli- der Non-Hodgkin-Lymphome, Bei 166 Patienten mit ag- nik für RadioOnkologie und Strahlentherapie am Klinikum rechts die vor allem bei älteren Men- gressiven B-Zell-Lymphomen der Isar der TU München. Sie trat damit die Nachfolge von Herrn schen auftreten, wurden lange wurde auf die Strahlentherapie Prof. Dr. med. Michael Molls an, der nach 22 Jahren als Leiter Zeit mit einer Kombination aus verzichtet. Dieser Verzicht er- der Klinik in den Ruhestand ging. Nach ihrem Medizinstudium Chemo- und Strahlentherapie höhte trotz Rituximab die Rate in Heidelberg, San Antonio (Texas, USA) und Norfolk (Virginia, behandelt. In letzter Zeit wur- an lokalen Rückfällen im Ver- USA) promovierte Frau Combs im Jahr 2003 in der Neuroanato- de auf die Radiotherapie aller- gleich mit den bestrahlten Pa- mie. 2009 schloss sie ihre Facharztausbildung für Strahlenthera- dings immer häufiger verzich- tienten deutlich erhöht. Umge- pie ab und habilitierte sich im Fach Radioonkologie und Strahlen- tet, stattdessen setzten die inter- kehrt wurde der Anteil an Pa- therapie. Aus Heidelberg bringt Frau Combs jahrelange Experti- nistischen Onkologen vielver- tienten, bei denen der Krebs se in der Behandlung mit Partikelstrahlen (Schwerionen, Proto- sprechende neue Medikamen- in den ersten drei Jahren nicht nen) mit, von der auch die Patienten am Klinikum rechts der Isar te ein. Zwar konnten monoklo- weiter fortgeschritten war, profitieren sollen. nale Antikörper Ergebnisse ver- durch die Radiotherapie von 62 bessern. Jedoch wurde in einer auf 88 % gesteigert. Der Anteil aktuellen Studie (Held et al.) ge- der überlebenden Patienten er- Gabriele Moser zeigt, dass vor allem bei ausge- höhte sich von 65 auf 90 %. Die Institute for History and Ethics of Medicine, University of Heidelberg, dehnten Tumoren die Lang- teilnehmenden Zentren haben Heidelberg, Deutschland zeiterfolge durch eine zusätzli- bereits die Konsequenzen gezo- che Strahlentherapie noch wei- gen und bieten für die meisten ter optimiert werden können. Patienten mit „bulky disease“ Bei aggressiven Varianten wieder eine Strahlentherapie Radiology in the des B-Zell-Lymphoms kommt an. Eine Dosis von 36–40 Gy ist es häufig zu einem ausgedehn- zwar relativ niedrig, wird damit Nazi era: part 3 ten Befall der Lymphknoten, aber gut vertragen. bei dem die Tumorgröße von Prof. Michael Baumann, Roentgen studies and national mehr als 7,5 cm als „bulky di- der Präsident der DEGRO, sease“ bezeichnet wird. Hier hat stellt fest: „Der Verzicht auf die health: radiology and roentgenology der Tumor häufig die Grenzen Radiotherapie in RICOVER- der Lymphknoten überschrit- noRTh hat die Verträglichkeit in the Nazi eugenics policy ten. Die Therapie bestand lan- nicht verbessert. Die Stu­die ge Zeit nur in einer Chemothe- zeigt, dass die Radiotherapie rapie mit CHOP. Patienten mit bei ausgewählten Patienten mit In addition to promoting, sum- of national hygiene [Volkshy- „bulky disease“ erhielten teil- malignen Lymphomen auch in marizing and evaluating spe- giene] in mass screenings and weise aber auch eine Bestrah- Zukunft einen hohen Stellen- cialist scientific work, the arti- to prevention of detrimental ef- lung. Vor einigen Jahren wurde wert haben wird.“ cles of association of the Ger- fects in the area of eugenics.”1 In CHOP durch den monoklona- man Roentgen Association this way, traditional medical ac- len Antikörper Rituximab er- Berlin, März 2014 (DRG) defined one of the DRG’s tivity—focused on curing indi- gänzt, der gezielt B-Zellen an- tasks as “consulting and support viduals—was extended by a per- greift. In einer früheren Stu- Literatur for the Reich Physicians’ Cham- spective involving population die (RICOVER-60) konnte fest ber in the use of Roentgen stud- medicine. Section 1 of the Reich 1. Held, G. et al.: “Role of Radiothera- gestellt werden, dass mit die- py to Bulky Disease in Elderly Patients ies and radiological research to- Physicians’ Regulations, dated ser Therapie die Behandlungs- With Aggressive B-Cell Lymphoma” in: wards serving national health.” December 13, 1935 (Reichsge- ergebnisse deutlich verbessert JOURNAL OF CLINICAL ONCOLOGY, However, this technical support Published Ahead of Print on February wurden. Es ergab sich deshalb explicitly related not only to in- 3, 2014 as 10.1200/JCO.2013.51.4505, 1 Deutsche Röntgen-Gesellschaft: die Frage, ob auf eine Radiothe- http://jco.ascopubs.org/content/ear- dividual radiodiagnostic and ly/2014/02/03/JCO.2013.51.4505 Geschäftsbericht für das Kalender- radiotherapeutic patient care jahr 1936. Satzung und Mitglieder- in free medical practice and at Verzeichnis, Stand vom Juli 1937, hospitals, but also “to purposes Leipzig 1937, p. 6.

608 | Strahlentherapie und Onkologie 6 · 2014 setzblatt, RGBl, Reich Law Ga- On this count, the Ordinance sures like commitment of the cidents and even fatalities oc- zette I, p. 1433) codified this of the Reich Ministers of the so-called “hereditarily dis- curring quite frequently. Since outlook for members of medi- Interior and Justice pertaining eased” to asylums, the ban on implementation of the GzVeN, cal professions with the formula to implementation of the Law marriages and particularly by which was considered to be the “service to the health of the in- for the Prevention of Offspring the elimination of the ability of “biopolitical basic law” of Na- dividual and of the entire [Ger- with Hereditary Diseases (Ge- persons with certain psychiatric tional Socialism and was to be man] people.” setz zur Verhütung erbkranken illnesses deemed to be heredi- kept from falling into public In the field of medicine Nachwuchses, GzVeN) dated tary to reproduce. Sterilization disrepute at all costs, the search and public health, this princi- December 5, 1933, decreed the as a means of qualitative pop- had been was underway for an ple materialized as the “main- following: a person whose ster- ulation policy was discussed alternative form of sterilization. tenance of health of the peo- ilization had been decided “may in Germany prior to 1933—not ple as a whole taking prece- be dismissed or granted leave only in publications such as the Sterilization by dence” over the protection of of absence from the institution Deutsche Ärzteblatt, but also in radiation—sterilization individuals’ health and welfare, only if the sterilization of said expert committees4—and was or castration? as stated by the Reich Court on person is completed or if the practiced in the United States June 19, 1936. The implementa- decision regarding sterilization and some European countries Based on the Fifth Ordinance tion of measures related to he- has been reversed.”3 This im- such as Denmark, Sweden and pertaining to Implementa- reditary health (eugenics) and plicit equation of highly infec- Switzerland (. Fig. 1). tion of the Law for the Pre- racial policy not just at the level tious diseases with the so-called The special features of the vention of Offspring with He- of public law and social policy, “hereditarily diseased” as po- sterilization policy as it was reditary Diseases dated Febru- but also in terms of medicine, tentially “threatening the com- implemented in the Nazi state ary 25, 19366 (. Fig. 2), diag- fundamentally reorganized the munity” was aimed at underlin- were the possibility of applying nostic radiologists and radio- entire society within the Na- ing the justification for margin- police force to compulsorily therapists were also integrated zi state. In an unprecedented alizing this group of people— summon the person to be ster- into sterilization (“making in- manner, National Socialism an undertaking that seems ab- ilized to undergo the medical fertile”) programs to perform managed to entrench the sig- surd against the backdrop of the procedure, and the quantita- radiotherapy on racial hygien- nificance of the state as a living usually related medical indica- tive dimension: during the Na- ic as opposed to medical-ther- “national (or people’s) body,” a tion of “congenital feeble-mind- zi period, a total of more than apeutic grounds; as a result, ev- state in which—to cite a legal edness.” Representing a propor- 300,000 persons were steril- eryday roentgenology and ra- formulation from 1934—“the tion far exceeding 50 % of clini- ized in the German Reich; in diology were now also entan- value of the individual can be cal presentations, feeble-mind- 1934 alone, the first year fol- gled in unethical medical prac- measured only by that individ- edness ranked ahead of all oth- lowing passage of the GzVeN, tices. At this time, many years ual’s degree of use to the nation er illnesses that were clearer to the number of sterilized peo- of experience with “temporary in its entirety.”2 define medically and psychiat- ple amounted to 56,244.5 The sterilization” (menolysis, per- rically—such as schizophrenia, operative procedure posed no manent exovulation, perma- The “Law for the manic-depressive insanity, epi- difficulties in the case of men; nent X-ray amenorrhoea) with Prevention of Offspring lepsy and Huntington’s chorea; however, the opening of the the roentgen and radium rays with Hereditary followed by hereditary blind- abdominal cavity for opera- used particularly in gyneco- Diseases” dated ness, deafness or physical mal- tive sterilization of women in- logical therapy for various ill- July 14, 1933 formation and severe alcohol- volved a certain risk, with in- ism. Similar to the dealings with The “hereditary health” of 4 Cf. Die Eugenik im Dienste der diseases designated as “danger- the German people was to be Volkswohlfahrt. Bericht über die ous to the public” because of shaped by measures involving Verhandlungen eines zusammen- their transmissibility, the argu- both positive and negative eu- gesetzten Ausschusses des Preußi- schen Landesgesundheitsrats vom ment with respect to the circle genics. Various kinds of incen- 2. Juli 1932, Berlin 1932; ibid. “‘Ent- of persons slated for steriliza- tives aimed at increasing birth wurf eines Sterilisierungsgeset- tion was also based on the “ne- rates stood at the center of pos- zes’ und Begründung,” pp. 107–112. cessity” to isolate this group as itive eugenics; negative eugen- Hans Holfelder attended the delibe- indicated by the health police. ics was summed up by mea- rations as a member of the (Prussi- an) State Health Council. 2 Deutsches Reich: “Begründung 5 Pohlen, Kurt (ed.): Gesundheits- 6 Pfundtner, Hans/Schlegelber- zum Gesetz über die Vereinheit- 3 Quoted in Seyfarth, Carly: Der statistisches Auskunftsbuch für das ger: “Fünfte Verordnung zur Ausfüh- lichung des Gesundheitswesens “Ärzte-Knigge.” Über den Umgang Deutsche Reich. Ausgabe 1936 (= rung des Gesetzes zur Verhütung vom 3. Juli 1934,” in: Reichsgesund- mit Kranken und über Pflichten, Veröff. a. d. Gebiete d. Medizinalver- erbkranken Nachwuchses. Vom 25. heitsblatt 9 (1934), no. 32, p. 665 f., Kunst und Dienst der Krankenhaus- waltung, vol. 46, no. 4), Berlin 1936, Februar 1936,” in: DAeBl 66 (1936), p. 665. ärzte, Leipzig 1935, p. 67. p. 160. no. 10, p. 276.

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Göttingen) and Carl Joseph association did indeed issue.9 Gauss (1875–1957, Würzburg; In the form of its “Committee . Figs. 3 and 4). They unani- for Economic and Professional mously stated that “the dan- Questions,” chaired in 1936 by ger of genetic damage by ra- the Hamburg specialist in radi- dium or roentgen rays must ation medicine, Prof. Dr. Fedor be taken for granted based on Haenisch (1874–1952), the DRG animal and plant experiments was probably also involved available to date.” Therefore, in setting the charges for per- when administering radiation forming sterilization by roent- to male and female gonads ex- gen or radium rays10. Similar to treme caution was imperative other radiodiagnostic and ra- “out of consideration for the diotherapeutic services, these risk to the germinal make-up charges were payable by social of our people.”8 One remark- insurance providers or welfare able facet of this resolution is associations according to the the fact that it is based entirely rate negotiated jointly with the on the orientation towards the German Association of Statu- national body and not towards tory Health Insurance Physi- the individual and his or her cians (KVD; . Fig. 5). For the personal genetic damage. On procedure, the Reich and Prus- the other hand, this joint state- sian Ministry of the Interior set ment by geneticists and DRG the fees at 50 RM (reichsmark) members practicing diagnos- in the case of sterilization by ir- tic radiology and radiotherapy radiation with roentgen rays, or also served to determine med- 40 RM if irradiation was per- ical expertise as the basic pre- formed using radium; three requisite for performing the ra- follow-up examinations were diological application. The aim obligatory, each remunerated was to have only proven and with 3 RM. trained medical experts prac- The radiation treatment, in- Fig. 1 8 Erbhygiene (hereditary hygiene or eugenics). Poster at the 1939 Swiss National Exhibition. From: Fritz de Quervain: “Die ärztliche Wissen- tice in this field; if possible, per- cluding completion of the no- schaft,” in: Die Schweiz im Spiegel der Landesausstellung 1939, Zürich sons with sound knowledge in tification form, cost 50 RM for 1940, p. 361, with kind permission the areas of gynecology and ra- the roentgen procedure and diology/roentgenology. 40 RM using radium. The re- As the 1936 annual report 7 nesses were already available. germ cells,” therefore warning indicates, the DRG—as the pro- 9 Deutsche Röntgen-Gesellschaft: However, since the beginning against “careless” indications fessional association organiz- Geschäftsbericht für das Kalender- of the 1930s, the emerging ge- by medical practitioners. The ing medical-scientific exper- jahr 1936. Satzung und Mitglieder- netic research community crit- importance Nazi biopolitics at- tise in these specialist fields— Verzeichnis, Stand vom Juli 1937, icized this type of radiother­ tached to questions of “hered- was requested to provide an ex- Leipzig 1937, p. 4. Further apprais- als were produced on the draft of apy as potentially “harmful to itary care” and racial hygiene perts’ statement on the subject a roentgen ray act, employment of rendered a fundamental dis- of sterilization, which the au- (female) roentgen assistants, safety regulations and standardization of 7 Cf. e.g. Schneider, Georg Hein- cussion of these contradicto- thorized experts named by the image projectors (ibid.). rich: Grundriss der Röntgensteril- ry scientific approaches urgent. isierung. Beobachtungen an 315 At a gathering of autho- 10 “Kosten für Unfruchtbarma- Fällen (…), Berlin 1931; the work rized experts in March 1933 chung durch Strahlenbehandlung. also contains a “Compilation of in Göttingen, geneticists met Rundlass des Reichs- und Preussi- sterilization tables”. An impor- schen Minister des Innern vom 24. tant volume for specialist history with radiation researchers and April 1936– IV A 5293/1079 f,” in: is Frobenius, Wolfgang: Röntgen- radiologists. The latter group 8 Quoted in Gerstengarbe, Sybille: DAeBl. 66 (1936) p. 616. By compar- strahlen statt Skalpell. Die Univer- was represented by profes- Paula Hertwig—Genetikerin im 20. ison: In 1938, a 6-day further train- sitäts-Frauenklinik Erlangen und sors and DRG members Hans Jahrhundert. Eine Spurensuche (= ing course in roentgenology (for die Geschichte der gynäkologisch- Holfelder (1891–1944, Frank- Acta Historica Leopoldina, vol. 58), surgeons and internists) in Frank- en Radiologie von 1914–1945 (= Halle/Saale, Stuttgart 2013, p. 113. I furt/Main cost 60 RM; the 8-day fur- Erlanger Forschungen, Reihe B, furt/Main), Hermann Holthu- would like to express sincere thanks ther training course in Hamburg Naturwissenschaften und Medizin, sen (1886–1971, Hamburg), to Alexander von Schwerin for this on “Radiotherapy (especially deep vol. 26), Erlangen 2003. Heinrich Martius (1885–1965, important bibliographical reference. therapy)” was 80 RM.

610 | Strahlentherapie und Onkologie 6 · 2014 Fig. 3 8 Heinrich Martius (1885– 1965). (Photo: Deutsches Röntgen- Museum, with kind permission)

Fig. 4 8 Carl Joseph Gauss (1875– 1957) (Photo: Deutsches Röntgen- Museum, with kind permission)

muneration for each follow-up examination was 3 RM. Surgical sterilization was permitted at any hospital, as well as on the sick wards of sanatoria, mental hospitals and prisons, provided a surgeon fa- miliar with the procedures was working there.11 Circumstanc- es differed, however, with re- spect to radiation treatment, Fig. 2 8 Based on the Fifth Ordinance pertaining to Implementation of the GzVeN dated February 25, 1936, diagnos- tic radiologists and radiotherapists were also integrated into sterilization programs by radiotherapy on racial hygienic due to the complicated consid- grounds. Article 3 refers to the cost schedule (. Fig. 5) and the licensing of institutions and physicians for sterilization eration of the applicable radia­ by X-ray or radium radiation (. Fig. 7). The Fifth Ordinance pertaining to Implementation of the Law for the Prevention tion dose (. Fig. 6). In contrast of Offspring with Hereditary Diseases came into effect on May 1, 1936. It supplemented operative sterilization—hith- erto solely approved and still primarily applicable—with sterilization by roentgen or radium irradiation. Sterilization by 11 means of radiation treatment, use of which was only permitted for women, was subject to special regulations and in- The operative methods were tended for application in exceptional cases only: the requirement was that the woman to be sterilized had reached at presented with illustrations in the least 38 years of age (i.e. approaching the menopause) or that an operation was ruled out on health grounds because legal commentary to the GzVeN, for life-threatening consequences had to be expected. The woman’s consent to the sterilization, or the consent of her care- which the KVD had ordered obliga- giver if she was unable to comprehend the meaning of the procedure, was necessary. Other obligatory elements were tory subscription; cf. Gütt, Arthur et three follow-up examinations and possible follow-up treatments to ensure success of the sterilization. Only medical al. (ed.): Gesetz zur Verhütung erb- specialists experienced in radiation applications and working in institutions with appropriate equipment were autho- kranken Nachwuchses vom 14. Juli rized to administer the procedure (see lists in . Fig. 8). (Source: DAeBl. 66 (1936), p. 276, with kind permission) 1933 (…), Munich 1934, pp. 219– 223 (male), pp. 224–227 (female).

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medical conditions”12 had to be accepted, as stated by Prof. Dr. Ernst Rüdin when describ- ing the crux of the technical di- lemma faced by the radiologi- cal discipline.

“Enablement” to sterilize by radiation

With a total of 111 facilities “enabled” to carry out radi- ation-based sterilization, the total number of institutions was significantly smaller than the number of clinics conduct- ing operative sterilizations, as indicated by the “directory of institutes approved and physi- cians enabled to conduct ster- ilizations by radiation” dat- ed July 1, 1936.13 In each in- stance, the specialist train- ing of the doctor licensed for the procedure determined the method: the list of physicians from the year 1936 names 49 roentgen specialists (“on- ly roentgenologists”). In addi- tion, there were four gynecol-

12 Rüdin: “Einführungsbeitrag,” in: “Sachverständigenbeirat für Bevöl- kerungs- und Rassenpolitik im RMdI: Niederschrift über die Sit- zung der Arbeitsgemeinschaft II am 11.3.1935,” in: Schubert, Wer- ner (ed.), Ausschuss für Rechtsfra- gen der Bevölkerungspolitik (1934– 1940) (…) (= Akad. f. Dt. Recht 1933–1945. Protokolle d. Ausschüs- se, vol. 12), Frankfurt/Main 2001, vol. XII pp. 352–388, p. 360. 13 The lists were published both in the Reichsmedizinalkalender and Fig. 5 8 Circular by the Reich and Prussian Minister of the Interior dated April 24, 1936. (Source: DAeBl. 66 (1936), in the Deutsche Ärzteblatt; cf. “Ver- p. 616, with kind permission) zeichnis der deutschen Ärzte und Heilanstalten.” Reichs-Medizinal- Kalender für Deutschland, Part II, to therapeutic administration, vey among 60 radiologists the so-called “castration dose vol. 58, Leipzig 1937, pp. 66–70 and what mattered now was the re- and gynecologists initiated (300 R.E.),” in which case “cas- “Verzeichnis der zur Durchführung liability of the sterilizing ef- by the Reich Health Office in tration consequences with all der Unfruchtbarmachung durch fect, which was no longer in- 1934 showed that compatibili- Strahlenbehandlung zugelassenen tended to be only temporary ty of these two goals was hard- Institute und ermächtigten Ärzte. Runderlass des Reichs- und Preus- but permanent, and, if possi- ly feasible: certain sterilization sischen Minister des Innern vom ble, without the health conse­ was achievable only by using a 1. Juli 1936– IV A 8969/1079,” in: quences of a castration. A sur- higher dose of roentgen rays, DAeBl. 66 (1936), no. 34, pp. 856– 860.

612 | Strahlentherapie und Onkologie 6 · 2014 In 75 % of cases, age was speci- = ion dose) was above the usu- fied as the reason for the meth- al roentgen dose, but he never- od chosen, but preselection by theless preferred sterilization the Health Office played a role by roentgen rays because it was as well. Irradiation with roent- least reminiscent of an opera- gen rays and the use of radi- tive procedure or one that re- um showed great differences sembled an operation. Pickhan regarding the number of ses- doubted the certain incapacita- sions and the dose required tion of ovarian functionality by to achieve sterility. Negative “normal” doses, recommend- effects on the ability to work ing great caution by stress- were not observed, as Gauss ing that the amounts of radia- emphasized. In addition, the tion required for effectiveness hereditary disease prompt- would involve the risk of dam- ing the sterilization was hard- aging adjacent organs and the ly ever worsened by the radi- entire organism. ation treatment and rather ap- In summary, one can as- peared changed for the bet- sume that fewer than 2 % of ap­ ter. This caused the speaker to proximately 360,000 persons reach the assessment that ir- forcibly sterilized were subject- radiation in connection with ed to sterilization by radiation the GzVeN constituted “an ex- treatment,16 since the meth- ceedingly important and ben- od was approved only in the eficial addition to operative third year after the GzVeN first sterilization.”14 took effect. There are only a few From the Cecilienhaus Gy- clues regarding the number of necological Clinic in Berlin, women subjected to radiation Chief Physician Prof. Dr. Ar- treatment for sterilization. Ev- tur Pickhan reported 32 “he- idence that sterilizations were reditarily diseased” women, carried out on eugenic grounds 23 of whom had been sterilized and not for medical indications Fig. 6 8 Eine Röntgenuntersuchung in dem Münchener Krankenhaus links der Isar (1933). Bild-ID: 00041252, SZ Photo/Scherl, with kind permission surgically and 9 by means of can be gathered from prelimi- roentgen rays. Pickhan was not nary psychiatric diagnoses ogists authorized exclusively the thematic header of “steril- able to detect any impairment for the radium application, as ization by radiation,” its jour- of their ability to work either, 16 Estimated figure based on new well as 97 additional medical nal Fortschritte auf dem Ge- and described the effects on studies in medical history, such specialists who had probably biet der Röntgenstrahlen (to- psychological behavior in the as Grimm, Jana: Zwangssterilisa- tionen von Mädchen und Frau- qualified in both disciplines, day: RöFo) presented two pa- case of different basic ailments en während des Nationalsozialis- permitting them to sterilize by pers by Prof. Dr. Carl Joseph as positive. The speaker also mus—eine Analyse der Kranken- both roentgen rays and radi- Gauss (1875–1957, Würzburg) found it remarkable that co- akten der Universitäts-Frauenkli- um packs (“also roentgenol- and Prof. Dr. Artur Pickhan ercive measures “such as con- nik Halle von 1934 bis 1945 (the- ogists”). Therefore, 150 phy- (1887–1969, Berlin; . Fig. 8). straining, anesthesia, drugs and sis in medicine), Halle-Wittenberg 2004 and Doetz, Susanne: Alltag sicians altogether—none of Gauss had inquired at all the like”15 had turned out to be und Praxis der Zwangssterilisation. whom were female—were au- 111 institutions authorized to unnecessary. For reasons of re- Die Berliner Universitätsfrauenkli- thorized for sterilizing by radi- perform sterilization by radi- liable sterilization, the dose ad- nik unter Walter Stoeckel 1942– ation treatment in the German ation about their experience. ministered by Pickhan of ap- 1944, Berlin 2011. In Munich there Reich; comparison with the In summary, the result of the proximately 360r (= roentgen were reportedly 64 sterilizations by radiation overall under the super- 1940 DRG membership direc- 109 answers was as follows: vision of Prof. Dr. Heinrich Eymer; in tory showed that 77 or about three quarters of the institutes 14 Würzburg, 111 under Prof. Dr. Carl half of these authorized phy- used operations and radiation Gauss, Carl Joseph: “Die Joseph Gauss (Frobenius, Wolfgang: Unfruchtbarmachung durch sicians were members of the side by side, operative steril- “BGGF-Ehrenmitglieder und das Strahlen,” in: Strahlentherapie 66 DRG (. Fig. 7). ization accounting for 95 % of ‘Dritte Reich’,” in: Anthuber, Chris- (1939), pp. 545–560, p. 560. toph et al. ed., Herausforderungen. The year 1939 saw an ini- the procedures and radiation 15 Pickhan, Artur: “Unfruchtbar- 100 Jahre Bayerische Gesellschaft tial stocktaking of experience for only 5 %, of which roent- machung durch Strahlen,” in: Strah- für Geburtshilfe und Frauenheil- to date in Stuttgart at the 30th gen irradiation made up 80 % lentherapie (66) 1939, pp. 561–569, kunde, Stuttgart, New York 2012, Conference of the DRG. Under and radium irradiation 20 %. p. 0564. pp. 115–137, p. 128).

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Fig. 8 8 Artur Pickhan (1887– 1969) (Photo: Deutsches Röntgen- Museum, with kind permission)

od17 on the whole, withhold- ing in this context that it con- stituted castration with all of the undesired, adverse health effects. Compiling a systemat- ic survey of victims subjected to forced sterilization by radi­ ation remains a desideratum of research.

The original German version of this ar- ticle was published in the March 2014 issue of RöFo—Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren.

17 Although relying on a tentative database, Stürzbecher establish- es a “substantial decrease in fatal- ities among sterilized women” for certain regions of Prussia based on Fig. 7 8 Directory of institutes approved and physicians enabled to conduct sterilizations by radiation. Source: the observation of 72 deaths in the DAeBl. 66 (1936), p. 856–860, printed here on p. 856, with kind permission. The circular dated July 1, 1936 does first half of 1936 and 41 deaths in not differentiate according to medical or eugenic indications, but the reference to the Fifth Ordinance pertain- the second half of the same year, ing to Implementation of the Law for the Prevention of Offspring with Hereditary Diseases clarifies that it was a when the possibility of steriliza- measure of “Erbgesundheitspflege” (hereditary health care). On May 24, 2007, the GzVeN was ostracized by the tion by radiation treatment became German Federal Parliament as an unjust Nazi law available for the first time; for the year 1936, the author assumes a total of 129 roentgen-based castra- noted on referral documents. tensive number of medical dis- as a positive addition to the tions of women (Stürzbecher, Man- Since radiotherapeutic meth- sertations prove. Similar to the operative sterilization meth- fred: “Der Vollzug des Gesetzes zur Verhütung erbkranken Nachwuch- ods were very new in the 1930s, two speakers at the 30th Roent- ses vom 14. Juli 1933 in den Jahren interest in accompanying them gen Congress in 1939, contem- 1935 und 1936,” in: Das Öffentliche scientifically through research porary theses assessed steril- Gesundheitswesen (1974), pp. 350– work was substantial, as an ex- ization by radiation treatment 359, p. 356).

614 | Strahlentherapie und Onkologie 6 · 2014 bers22 and in terms of disease preventive measures more ef- Radiology in the severity; TB took second place fective. in the cause-of-death statistics As touched upon in the pre- Nazi era: part 4 behind cardiovascular diseases, vious article, National Socialist and thus even ranked ahead of legislation in the area of pub- Combating tuberculosis between cancer. Similar to most indus- lic health services had funda- trialized nations, the first three mentally changed the position “Volksröntgenkataster” and decades of the twentieth centu- of the individual within Nazi ry had seen a decrease in mor- society, causing the so-called “SS-Röntgensturmbann” talities caused by “pulmonary “common good” to take prece- consumption” in Germany. dence. During the time of the “The Reich Physicians’ Lead- ert Janker20 and the equipment However, the overall number of Weimar Republic, the inten- ership, cooperating with the manufacturing industry led to infected persons, the insidious tion was to implement pub- German Roentgen Society, has the development and produc- course of the disease and, in lic protection against health been working for about 2 years tion of “outstanding small in- many cases, the high costs re- risks, while still respecting in- on a plan to utilize roentgen strumentation” for conduct- sulting from years of treatment dividuals and their civic rights technology more intensively at ing roentgen mass screenings. in sanatoria or lengthy inabili- to the greatest possible extent. the service of national health,”18 Blome voiced dissatisfaction ty to work ensured that doctors By contrast, the primary inter- reported Deputy Reich Health only with respect to the pricing and health care politicians were est in the Nazi state was the in- Leader Dr. Kurt Blome in 1938. of these devices, although ex- fearful of TB. For these reasons, cidence of disease affecting the Blome explicitly expressed his pressing confidence “that the the incidence of infections and “national body.” Tuberculosis thanks to the executive board limit of what is feasible has not illnesses was subject to regular inflicted damage on that na- of the German Roentgen So- been reached yet (. Fig. 9).”21 monitoring by state and mu- tional body in different ways: it ciety for their “cooperation nicipal health authorities. As reduced the productive and re- to date on the great issues,”19 Roentgen mass early as the mid-1920s, Franz productive capacity of the liv- which had obviously worked screenings and the Redeker, a very committed ex- ing population and it impaired, well in the area of fighting tu- “Volksröntgenkataster” pert on combating TB, had de- as a supposed “genotoxin,” the berculosis (TB). Within the (People’s Roentgen manded the establishment of a quality of the genotype, thus short period of 2 years, the Cadastre) “Volksröntgenkataster” (Peo- causing the German people to jointly developed strategy of ple’s Roentgen Cadastre).23 The inherit a deteriorated genetic comprehensive roentgen mass In the mid-1930s, TB of the re- aim of this was to record and makeup in the future. screenings apparently succeed- spiratory organs was at the top scientifically evaluate TB-relat- The 1935 article entitled ed in uncovering previous- of the list of communicable dis- ed data in a central and long- “Die Tuberkulose als Volksk- ly unidentified infections—an eases, both in terms of num- term format, in order to make rankheit” (Tuberculosis as a achievement Blome attributed national disease) by the Düs- to a considerable extent to tech- seldorf hygienist Friedrich Er- nological progress. According 20 Robert Janker (March 12, 1894– 22 Pohlen, Kurt: “Die örtliche Glie- hard Haag shows in an exem- to Blome, joint work by radi- Oct. 22, 1964), roentgenologist. derung der häufigeren anzeige- plary way the altered priori- ologists such as Prof. Dr. Rob- From 1928 in Bonn. He obtained pflichtigen Krankheiten im Deut- tization in terms of fighting his postdoctoral qualification in schen Reich in den Jahren 1931 bis causes: “Combating social ad- 1930, in 1933 a part-time lecture- 1934,” in: Reichsgesundheitsblatt versity”—the most important ship for roentgen therapeutics and 1936, no. 15, pp. 305–315, p. 312. radiotherapeutics, in 1937 he man- On average, the number of TB cases central theme of TB health aged his own roentgen institute in reported was ten times higher than care in the Weimar Republic, Bonn, cf. Zoske, Horst: “Janker, Rob- that of other notifiable diseases; cf. aimed at improving working, ert,” in: Neue Deutsche Biographie abdominal typhus and dysentery housing and nutritional condi- 10 (1974), p. 336. From May 1933 a with approximately two to three tions—was now only in third member of the NSDAP, the National cases per 10,000 inhabitants (ibid., Socialist German Lecturers’ League, p. 311 and p. 312). (and last) place. It was preced- the German Labor Front (Deutsche ed by “Combating the patho- 23 Redeker, Franz: “Zentrale Len- Arbeitsfront, DAF) and the Nation- kung der Röntgen-Reihenunter- genic agent,” by which the au- alsozialistische Volkswohlfahrt. suchungen,” in: Gesundheitsfüh- thor meant “the most severe (Nazi welfare organization—NSV), rung 1939, no. 3, pp. 90–98. Rede- punishment of careless germ 18 cf. Forsbach, Ralf: Die Medizinische Blome, Kurt: “Die Aufgaben ker used the term “roentgen cadas- Fakultät der Universität Bonn im spreaders (withdrawal of as- der Röntgenologie im Rahmen der tre” to describe a general roentgen “Dritten Reich,” Munich 2006, p. 250, sistance, compulsory isola- Gesamtarbeit an der Volksgesund- card index for “overall healthcare ftn. 1027. heit,” in: DAeBl 68 (1938), no. 28, on the homogenous national body tion)” and also “concern that pp. 491–495, p. 492. 21 Blome 1938 (same as ftn. 1), [Volkskörper] of an entire district” everyone suffering from open 19 Ibid., p. 495. p. 492. (ibid., p. 91). tuberculosis has an individu-

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sicians qualified in roentgen- effort.”29 In contrast to the ar- ology at the health offices. On chivable images taken by con- the other hand, mass produc- ventional X-ray units and the tion and the use of newly devel- one-time optical perception oped photofluorographs made in case of X-ray examinations, it possible to organize early di- the new development stood agnosis of TB cases more effi- out due to several features. A ciently. In conjunction with ac- less expensive, quick-to-im- cess to the personnel resources plement radiographic proce- of numerous members of Na- dure, it was based on substan- tional Socialist German Work- tially improved photographic ers’ Party (Nationalsozialist- recording of the fluoroscopic ische Deutsche Arbeiterpartei, screen image. NSDAP) formations, which were active in an honorary ca- The “SS-Röntgensturm­bann” Fig. 9 8 X-ray exam of members of the Hitler Youth. (Source: Bundesar- pacity and tightly organized, chiv, with kind permission, image 183-J08974. Photo: Hoffmann, Janu- the head of the Berlin Health ary 1944) Department, Franz Redeker, The “transportable roentgen even considered the “compre- series imager according to al bed and separate bedroom.” murdering actions targeting hensive roentgen registration” Abreu–Holfelder”30 took shape “Combating inferior genetic the sick during World War II.26 of the German population to be after the Frankfurt specialist in makeup” ranked at the very top With the Law for the Stan- a task now feasible.27 radiation medicine, Prof. Dr. of the author’s catalog of mea- dardization of the Health Care Following the First Great- Hans Holfelder, returned from sures towards TB prevention: System (Gesetz über die Ver- er German Radiology Conven- Argentina in the fall of 1937. “Sterilization of all patients suf- einheitlichung des Gesund- tion in Munich (1938), Kurt Both Holfelder and Prof. Dr. fering from progressive or ad- heitswesens) dated July 3, Blome, acting as commissioner Manuel de Abreu had already vanced tuberculosis. Limited 1934, TB was defined as a no- of the Reich Physicians’ Lead- been interested in X-ray mass capacity to work and necessity tifiable disease. Based on this er responsible for medical fur- screening for some time, join- of public assistance may serve law, the Health Office was des- ther training, issued an invita- ing forces to work on techni- as a criterion.”24 Only a few ignated as the central report- tion “to inspect the new tech- cally advancing devices made years later, an even more severe ing authority not only for Na- nique of photofluorography at by Siemens. This new appara- marginalization was meted out zi hereditary health policy; the Professor Janker’s institute in tus was used for the first time at to so-called “asocial tuberculo­ same applied to any area of in- Bonn.”28 Scientists and repre- the Nuremberg Rally in 1938, sis patients”25 who refused any tervention relating to the pub- sentatives of the X-ray device where it was possible to take attempts at therapy, despite in- lic health care system, includ- and photochemical industries chest X-rays of some 10,500 SS fectiousness. Labeled as psy- ing the fight against TB. Even convened and the aftermath men within 6 days. Holfelder chopaths, they were committed though 80 % of health offices saw “high-quality photoflu- and his colleagues declared by force to special TB wards af- had an X-ray unit at their dis- orographs constructed by al- about 1 % of these active SS filiated with sanatoria and hos- posal for examining patients most all German X-ray com- members, who had already pitals for the mentally ill, where suspected of tuberculosis soon panies in a very intensive work passed medical fitness exams, they shared the fate of their in- afterwards, factors limiting the as being suspected of having mates during the course of the maximum number of possible active TB. X-ray examinations includ- 27 Redeker, Franz: “Zentrale Len- SS-Standartenführer (SS ed not only the time required kung der Röntgen-Reihenuntersu- Regiment Leader) Prof. Dr. for each X-ray image, but al- chungen,” in: Gesundheitsführung Hans Holfelder was highly 1939, no. 3, pp. 90–98, p. 92. so the small number of phy- motivated by the first success- 24 Haag, Friedrich Erhard: “Die 28 Knothe, Werner: “Die Röntgen- Tuberkulose als Volkskrankheit,” in: schirmbildphotographie,” in: DAeBl. MMW 1935, no. 35, pp. 1389–1391, 29 Redeker, Franz: “Zentrale Len- 26 Wolters, Christine: “Der 68 (1938), no. 36, pp. 593–595, p. 1392 (emphasis in the original). kung der Röntgen-Reihenuntersu- Umgang mit therapieverweigern- p. 593 (emphasis in the original). Cf. chungen,” in: Gesundheitsführung 25 Ickert, Franz: “Asoziale Tuberku- den Tuberkulosekranken im Natio- also Janker, Robert: “Röntgenologie 1939, no. 3, S. 90–98, p. 93. löse,” in: Pommersche Wohlfahrts- nalsozialismus,” in: Gesundheitswe- und Volksgesundheit. Die Leucht- blätter 15 (1939), no. 1, pp. 4–7, sen 70 (2008), p. 55, as well as Wol- schirmphotographie” (= Kriegsvor- 30 Holfelder, Hans: “Der Volks- and Kihn, Berthold: “Zur Frage der ters: Tuberkulose und Menschen- träge der Rhein. Friedr.-Wilh. Univ. röntgenkataster in Mecklenburg Unterbringung asozialer Kranker,” versuche im Nationalsozialismus. Bonn a. Rh. Vortragsreihe: Wissen- und seine Bedeutung für die plan- in: Der Öffentliche Gesundheits- Das Netzwerk hinter den Tbc-Expe- schaft im Kampf für Deutschland, mäßige Tuberkulosebekämpfung,” dienst, issue B 3 (1937/38), pp. 415– rimenten im Konzentrationslager issue 27), Bonn 1941 (with nume- in: DAeBl 69 (1939), pp. 733–736, 420. Sachsenhausen, Stuttgart 2011. rous illustrations). p. 734.

616 | Strahlentherapie und Onkologie 6 · 2014 ner32, checked over the small gen mass screening had taken format images taken by the place here (. Fig. 10).33 SS-Röntgensturmbann. In the In the summer of 1939, the case of any conspicuous pre- “motorized roentgen platoon” liminary finding, the partici- that Holfelder had put together pant identified in the roentgen from SS medical staff in the fall mass screening was referred to of 1938 completed a large-scale other authorities for clarifying mission lasting several weeks, the diagnosis and for possibly conducting X-ray examina- initiating therapy. These au- tions of the entire population thorities might have included in the state of Mecklenburg34. the statutory health insurance Designated as the “Röntgen- physician/family doctor in con- sturmbann SS-Hauptamt” sultation with a roentgenolo- (Roentgen Assault Unit SS gist; however, because this was Main Office), the mobile X- a group-oriented procedure, ray unit was already operating the conspicuous first finding that year “to deploy the photo- would more often have been fluorographic method for com- transferred to the physician in piling roentgen mass screen- charge at the corresponding in- ing images in the large-scale stitution—the company doctor battle against tuberculosis,”35 in the case of so-called “Gefolg- as Holfelder put it. Howev- schaftsuntersuchungen” (“ex- aminations of followings”), the 33 Cf. Ekhart, W.: “Tuberkuloseab- Hitler Youth unit physician in wehr bei fremdvölkischen Arbei- the case of examination of Hit- tern,” in: Risak, Erwin (ed.), Aus Fig. 10 8 In einem motorisierten Bereitschaftslazarett des DRK in Lodsch ler Youth units, the medical of­ dem Aufgabenkreis des Lager- werden "heim ins Reich" geholte Umsiedler aus Ostpolen, sog. Wolhynien- ficer of the relevant military betriebsarztes (…) (= Schriften- deutsche, ärztlich betreut. Hier eine Untersuchung mit einem Röntgenge- reihe für Arbeits- und Leistungs- rät (12.2.1940). Bild-ID: 00366272, SZ Photo/Scherl, with kind permission unit, or the camp physician at medizin, issue 10/12), Stuttgart forced labor, POW or concen- 1944, pp. 73–80; the “SS-Röntgen- tration camps when the roent- sturmbann” is addressed explicit- ful use of the new X-ray mass Gau Köln-Aachen, and the Gau ly (p. 77). Ulrich Herbert gives an screening technique. An ex- Kurhessen.”31 account of roentgen mass scree- nings of 28,402 camp prisoners at tended circle of collaborators In contrast to individual- 32 For reasons yet unexplained, Buchenwald concentration camp and the new spatial mobility of ly arranged X-ray diagnostics, SS-Hauptsturmführer (Chief Assault in May 1944 and of 11,102 priso- the roentgen installation now mass screening aimed at close- Leader) Friedrich Berner interrupt- ners at Dora concentration camp in broadened the operational ar- ly examining the largest pos- ed his university career as a radiol- June 1944 (Herbert, Ulrich (ed.): Die ogist with postdoctoral qualifica- eas: “The winter 1938/39 saw sible groups of people, ideally nationalsozialistischen Konzentra- tion in 1941, taking on the medi- tionslager, vol. 1, Göttingen 1998, construction of several addi- the entire population, for pre- cal direction of the Hadamar Eutha- p. 183). tional experimental devices, a viously undiscovered TB infec- nasia Center. In 1943, he first fol- 34 A small state, Mecklenburg number of which were put at tions; consequently, evaluating lowed Holfelder and his “SS-Rönt- apparently suited statistical stud- the author’s disposal. Select- the huge amounts of image gensturmbann” into occupied Poland to continue the TB inves- ies particularly well; cf. also Blome, ed SS men from the medical material that accumulated now tigation among the local popula- Kurt/Carl Hermann Lasch: “Kreb- corps served to form a motor- also required a new approach. tion. Cf. now Benzenhöfer, Udo: skrankenstatistik in Mecklenburg” ized roentgen platoon deployed At the University Roentgen In- “Friedrich Berner—Radiologe in (lecture at the convention of the “Reichsarbeitsgemeinschaft für in the fall of 1938 for screening stitute in Frankfurt, a trained Frankfurt, leitender Arzt des NS- Krebsbekämpfung” (Reich work- recruits in the Wehrmacht, SS, team of physicians directed by ‘Euthanasie’-Zentrums in Hadamar,” in: Benzenhöfer, Udo (ed.), Menge- ing group for combating cancer), and Arbeitsdienst [Reich Labor the head of the evaluation de- le, Hirt, Holfelder, Berner, von Ver- Karlsruhe, Dec. 10, 1937), in: DAeBl Service], as well as subsequent- partment, Dr. Friedrich Ber- schuer, Kranz: Frankfurter Univer- 1938, no. 6, pp. 95–98. ly for extended mass screen- sitätsmediziner der NS-Zeit, Müns- 35 Holfelder, Hans: “Der Einsatz ings of the “followings” [trans- 31 Ibid. Cf. also Köhler, Sven: Ein- ter 2010, pp. 61–78, on Hadamar cf. des Röntgensturmbann-SS-Haupt- lator’s note: i.e. company staff] satz und Leistungen der Röntgendi- Engler, Melanie: “Endstation Hada- amt zur Erstellung eines Volksrönt- agnostik in Wehrmacht und SS unt- mar. Die Ermordung von Menschen genkatasters und die Einsatzmög- at larger and smaller compa- er besonderer Berücksichtigung des mit Behinderungen und psychi- lichkeit der gleichen Truppe als nies in the Gau Hessen-Nas- von Prof. Holfelder geleiteten Rönt- schen Erkrankungen in der Landes- Feldröntgentruppe,” in: Der Deut- sau, the Gau Düsseldorf, the gensturmbannes (thesis in medi- heilanstalt Hadamar (1941–1945),” sche Militärarzt 4 (1939), no. 11, cine), Leipzig 1999. in: Nurinst 6 (2012), pp. 93–108. 493–495, emphasis in the original.

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ing as Deputy Leader of Main Office for National Health within the Nazi Party. Greiser planned far in ad- vance, inquiring in the spring of 1942 with the Reich Leader of the SS, among other things, whether he had any objec- tions to the “special treatment” (meaning murder, G.M.) of persons seriously ill with TB that was underway among the Jewish parts of the popu- Fig. 11 8 A roentgen platoon with three roentgen vans of the Röntgensturmbann-SS-Hauptamt. (Source: Der Deutsche Militärarzt 4 (1939), Fig. 1, p. 493, Springer-Verlag, with kind permission) lation. By the fall of 1942, the state of affairs had been clari- fied: Himmler had given his er, the roentgen vans did not vice, 36 technical and admin- dangerous. There was no con- consent, the Einsatzkomman- only travel through the Ger- istrative leaders, 108 Unter- sideration of treating the TB do Lange [translator’s note: a man Gaue, but also followed führer (squad leaders) and 663 patients following their iden- special operations comman- the German Wehrmacht on its men. The aim was to integrate tification “according to the do, i.e. death squad] stood by, campaign of conquest toward the existing Röntgen-Sturm- method of Professor Dr. Hohl- but now Kurt Blome expressed the east. In this connection, the bann comprised of 4 leaders felder [sic], who has been de- doubts as to whether the tim- roentgen platoon equipment and 250 men into this new for- ployed during these weeks here ing—this soon after the offi- not only made it possible to car- mation, which continued to be in the Gau with his Röntgen- cially decreed cessation of the ry out TB diagnostics by means headed by SS-Standartenfüh- sturmbann.” Correspondence “euthanasia” action—was such of roentgen mass screening, but rer (SS Regiment Leader) of the between political decision- a wise choice. According to with the available technical in- General SS, Prof. Dr. Holfelder/ makers at the Reich and Gau Blome, foreign countries were stallation, personnel could be Frankfurt a. M. At the same levels reveals this facet very watching Nazi Germany close- used as a roentgen field unit at time, the mission of mobile clearly.38 Among 230,000 Pol- ly, not missing any opportuni- the same time (. Fig. 11). combat of TB was extended be- ish persons suffering from TB, ty for “atrocity propaganda.” However, until the end of yond the frontiers of the Reich: estimates assumed approxi- He did not plead against kill- the Second World War, track- “The assignment of the “Rönt- mately 35,000 patients with ing sick Polish persons “of alien ing down persons suspect- gensturmbann beim SS-Füh- open TB, whose fates were ne- ethnicity” out of principle, but ed of having TB remained rungshauptamt” is to record gotiated in 1942 by Reich Gov- he found the “radical solution” the main operational purpose the German People and oth- ernor Arthur Greiser, Heinrich of shooting them inappropri- of the unit, which was sup- er peoples by means of roent- Himmler and Kurt Blome act- ate for tactical political rea- posed to receive “its orders for gen mass screenings using the sons. Instead, Blome suggested

these assignments by the Reich system of Prof. Dr. Holfelder— 38 “establishing a reservation of 36 37 Correspondence relating to Health Leader.” In 1941, the Frankfurt a. M.” (. Fig. 12). the killing of Polish citizens poten- the type well known from lep- SS Leadership Main Office This wording also cov- tially infected with TB has been the rosy patients,”39 where the pa- even increased the maximum ered mass screening for TB topic of historical research in sever- tient’s entire family should be number of troops in what was of the Polish population in al instances; cf. particularly Dressen, interned as well; family mem- Willi/Volker Riess: “Ausbeutung und now designated the “Rönt- the German-occupied west- bers could then care for their ill Vernichtung. Gesundheitspolitik gen-Sturmbann beim SS-Füh- ern part of Poland, which took im Generalgouvernement,” in: Frei, relatives until their death. rungshauptamt” (Roentgen place in 1942. The so-called Norbert (ed.), Medizin und Gesund- To date, researchers have Assault Unit assigned to the “Warthegau” territory not heitspolitik in der NS-Zeit, Munich not produced conclusive stud- SS Leadership Main Office) only served as an area for the 1991, pp. 157–171, as well as Aly, ies on the extent to which this Götz: “Tuberkulose und ‘Euthana- to 40 leaders in medical ser- German Wehrmacht to march proposal was implemented, or sie’,” in: Peiffer, Jürgen (ed.), Men- through on its way eastward schenverachtung und Opportu- on whether the fight against TB 36 “Schreiben des SS-Füh- into the Soviet Union; as a for- nismus. Zur Medizin im Dritten took place through different rungshauptamtes vom 7.1.1941. merly German territory, it was Reich, Tübingen 1992, pp. 131– means of murdering Poles that Betr.: Aufstellung eines Röntgen- also intended for resettlement 146. The letters themselves have suffered from this disease. Sol- Sturmbannes” (Bundesarchiv, Bes- been published, among other plac- by Germans, but the TB situa- id evidence is available, howev- tand Reichsführer SS, NS 19/4073, es, in Dörner, Klaus et al. (ed.): Der Bl. 54). The Reich Health Leader was tion was assessed as extremely Nürnberger Ärzteprozess 1946/47, SS-Obergruppenführer (SS Senior Munich 2000, microfiche 137, Bl. 39 Dörner et al. (ed.), see ftn. 38, Group Leader) Dr. Leonardo Conti. 37 Ibid. 1206–1220. Bl. 1220.

618 | Strahlentherapie und Onkologie 6 · 2014 er, concerning the activities of the SS-Röntgensturmbann in some of the German-occupied countries of Eastern Europe. Prof. Dr. Hans Holfelder, sci- entifically recognized and win- ner of numerous awards, died in action as SS-Oberführer (Senior SS Leader) and com- mander of the SS-Röntgen- sturmbann on December 15, 1944 near Budapest/Hungary. On January 3, 1945 SS-Haupt- sturmführer (SS Chief Assault Leader) Dr. Weißwange, Hol- Fig. 12 8 Prof. Dr. med. Hans Holfelder. (Source: Deutsches Röntgenmuse- um, with kind permission). Born on April 22, 1891 in Noeschenrode, Wer- felder’s former Assistant Med- nigerode County administrative district; father was state medical council- ical Director from Frankfurt or. March 1910 school-leaving exam at Wernigerode Gymnasium. Start- University Hospital, was ap- ing in the summer term of 1910, study of medicine at the universities of pointed Holfelder’s successor Tübingen, Munich, Giessen and Marburg. 1916 state exam and approba- as commander of the SS-Rönt- tion in Marburg. 1917 doctoral exam with highest distinction of “summa 40 cum laude” in Halle. Special research fields: medical radiation research, di- gensturmbann. agnostic radiology and radiotherapy. In May 1923 in Frankfurt/Main, post- The original German version of this arti- doctoral qualification in surgery and roentgenology. October 1, 1926 di- cle was published in the April 2014 issue rector of newly established and expanding radiotherapeutic institute of RöFo—Fortschritte auf dem Gebi- (Roentgen Institute of the Surgical University Clinic in Frankfurt/Main). Au- et der Röntgenstrahlen und der bildge- gust 26, 1927 appointment to non-civil servant adjunct professor. Febru- benden Verfahren. ary 16, 1929 appointment to full professor with civil-servant status. 1931 president of the German Roentgen Society. June 22, 1933 member of the Prussian State Health Council. 1931 board member of the Reich Commit- tee for Combating Cancer (RAeK). July 14, 1933 member of the scientif- Corresponding address ic committee of the RAeK. From the 1943/44 winter term onward, at the Reich University of Posen (roentgenology). 1931 Golden Mackenzie David- Dr. G. Moser son Medal of the Royal Society of Medicine, London. 1938 Albers-Schön- Institute for History and Ethics of berg-Medal of the German Roentgen Society. Honorary memberships: Oc- Medicine tober 28, 1932 Vereinigung deutscher Röntgenologen und Radiologen- University of Heidelberg C.S.R. (Association of German Roentgenologists and Radiologists in the Im Neuenheimer Feld 327 Czechoslovak Republic); July 1, 1933 Nordische Vereinigung Medizinisch- 69120 Heidelberg er Radiologen (Nordic Association of Medical Radiologists); 1936 Socie- [email protected] dad Argentina de Radiología (Argentine Society of Radiology) in Buenos Aires/Argentina; 1936 American College of Radiology, Romanian Society Acknowledgement. Translator: of Roentgenology and Electrotherapy, corresponding member of the Wie- Dr. Erwin D. Fink (Univ. of Toronto) ner Gesellschaft für Röntgenkunde (Viennese Society of Roentgenology) [email protected]. and of the Società Italiana di Radiologia Medica (Italian Society for Medi- cal Roentgenology). Combatant in World War I (August 4, 1914–January 6, 1919), Iron Cross 1st Class and Iron Cross 2nd Class, Wound Badge in black, Honor Cross for Combatants, Clasp for the Iron Cross 1st Class. March–De- cember 1919 Free Corps Halle, member of the Reichshammerbund (Reich Hammer League, a Völkisch organization; no. 3378), member of the Ver- band gegen die Überhebung des Judentums (League against the Pre- sumption of Jewry; no. 963), temporarily, member of the Deutschnatio- nale Volkspartei (German National People’s Party). From 1933, member of the SS (no. 101658), member of the NSDAP (no. 1592030). Sources: Per- sonalakte Prof. Dr. Hans Holfelder, Reich University of Posen (Archiwum Universytet A. Miekiewicza, Poznan/PL, Sygn. 78/354). Klee, Ernst: Das Per- sonenlexikon zum Dritten Reich. Wer war was vor und nach 1945, Frank- furt a. M. 2003, p. 267 and Weiske, Katja: “Hans Holfelder—Radiologe in Frankfurt, Nationalsozialist, Gründer des SS-Röntgensturmbanns,” in: Ben- zenhöfer, Udo (ed.): Mengele, Hirt, Holfelder, Berner, von Verschuer, Kranz: Frankfurter Universitätsmediziner der NS-Zeit, Münster 2010, p. 43–60 40 “Befehl des Reichsführers-SS, betreffend den SS-Röntgensturm- bann” (Bundesarchiv, Bestand Reichsführer SS, NS 19/170, Bl. 34).

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