In 1899, the government established the Hygiene Institute in the province of Posen. As Justyna Aniceta Turkowska recounts, this marked the start of a new era in German efforts to integrate the province and its sizable number of Polish-speaking inhabitants into a unified national body constructed from Berlin. Such efforts at “elevating” and “modernizing” the region were not new, the author notes, as the province bordering the Russian Empire had long been viewed as “backward,” in large part because of the strong Polish representation there. What Turkowska's research brings to light, however, is the extent to which these efforts to remake the region in order to further integrate it into the still relatively young German Reich increasingly took place in the realm of medicine and social hygiene after the turn of the century.
As Turkowska argues, the realm of social hygiene—and especially measures designed to combat tuberculosis, venereal disease, and alcohol-related illness—presented a ripe field for the expansion of the state's efforts to integrate Posen. She reveals in the first of five (unnumbered) body chapters how the state's efforts to colonize such arenas looked to many Berlin officials like a good opportunity; they thought this would allow them to assume control not only of the scientific discourse around these issues but also over the region's populace through the increasing supervision which the proposed social hygiene measures granted to authorities over individuals' bodies. Not surprisingly, the establishment of the Hygiene Institute was followed by that of a Medical Examination Office in 1906. Organizations, such as regional branches of the German Society for the Combating of Veneral Diseases and the German Association against the Misuse of Alcoholic Beverages, were founded in the province to spread knowledge and combat particular concerns, a topic addressed in the second chapter. Exhibits, the focus of the fourth chapter, were also created to inform the public about social hygiene issues. Some individuals had an even closer encounter with the expanding social hygiene net cast over the province when they checked in as patients into one of the many sanatoria and clinics popping up in the region after the turn of the century, as Turkowska's focus on institutions of healing conveys in the fifth chapter.
As promising as the intended integration plans may have looked from Berlin, by extensively reconstructing the process of organizational proliferation and popularization of social hygiene principles in the province, Turkowska shows that the reality was more mixed. While a net of German-backed initiatives expanded over Posen, the author shows how this also engendered the rise of Polish counterparts that undertook—usually in the Polish language—their own efforts at medical messaging designed to integrate people into the Polish nation. Indeed, the two publics created in this process of the popularization of social hygiene principles only grew more divided over time, as the pivotal third chapter devoted to analyzing the discourses disseminating social hygiene principles shows. While tuberculosis might be addressed by the joint founding of the Provincial Association for the Combating of Tuberculosis as a Widespread Illness in 1900, just a few years later the push to create organizations to address venereal disease and alcoholism led to the establishment of separate Polish associations. Indeed, as Turkowska argues, the public temperance efforts exemplified the greatest division between German and Polish discourses.
At the same time, Turkowska carefully nuances the account to show not only diverging national narratives but also points of collegiality and cooperation among those involved, especially among German and Polish physicians. Moreover, the book shows how national divisions were not the only ones created by the popularization of medical knowledge. Tuberculosis commonly highlighted class; venereal disease frequently did the same for gender. Even beyond looking at the narratives created, Turkowska rightly cautions the reader from assuming unity among those purportedly representing one dominant narrative. For example, the ability of Berlin to enforce a unifying narrative was hampered by the infighting between two of the most important representatives in the province, director of the Hygiene Institute Erich Wernicke and Otto Lubarsch, who headed its pathology and anatomy wing. Personnel shortages and financial constraints did not help either. Even if the state-supported German efforts had the upper hand, Turkowska shows that this was not a zero-sum situation. Instead, she emphasizes that Polish actors could and did use the situation to their advantage at times. Furthermore, while a lot of the German narrative in Posen merely repeated general points crafted for the entirety of the Reich, the regionally tailored Polish discourse could be more explicit in its national themes. As Turkowska aptly points out, this meant Polish actors involved could be “deprived” of the ability to speak with governmental authority, but at the same time the situation “freed them from state constraints” concerning what they could say (356).
Nonetheless, Turkowska's thorough research reveals that often the mere choice of what language to communicate in did more than enough to further create two separate publics aligned with the two national lines. She comes to the surprising conclusion that in terms of content the two discourses often sounded quite similar in many ways. What differences there were tended to be reflected in heavier recourse to morality and religion in Polish narratives. Another interesting distinction Turkowska notes is that the German discourse usually referenced the “Volkskörper” (national body) while the Polish one called upon the “nation.” Perhaps Turkowska could have pushed her analysis of these differences in narrative further in some cases. Yet this is a small issue concerning a book that is based upon extensive research and adds valuable insight to the existing historical literature.
