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Book Book

Medicine and the German Jews: A History

BMJ 2001; 323 doi: (Published 24 November 2001) Cite this as: BMJ 2001;323:1257

Causes of Anti-Semitism


While in a book review there is often insufficient space to do
justice to a complex issue and provide the reader with a sound historical
analysis for a topic of this kind, yet one still expects a decent attempt
to have been made in that general direction. This book review fails such
an expectation when it claims that, “the public image of Jews as sickly,
fragile, and effeminate, prone to diseases such as tuberculosis and
diabetes (Judenkrankheit, the Jewish disease), and mentally unstable,
encouraged a belief in their biological and racial "otherness," and fed
anti-Semitism,” [1] The sense of ‘otherness’ possessed by Jews in Europe
did not primarily derive from their apparent sickliness; it flowed from
many other aspects of their group identity as a racial sub-class having an
uneasy relationship with their host society. It is similarly inaccurate
when the article further claims that, “The economic downturn in the 1930s,
the overproduction of doctors, and the competition for patients revived
the mediaeval conspiracy theories.” [1]

Whether any alleged ‘sickliness’ encouraged anti-Semitism in Europe,
and whether an overproduction of doctors in the 1930s, revived medieval
anti-Semitism are open questions, which deeper reflection might solve, but
to mention only these reasons as if they are the main causes of German
anti-Semitism in the 1930s, in isolation from any others, is to wield
gross over-simplifications as if they were the central pillars of a proven

The main causes of anti-Semitism in Europe go back a very long way.
There seems to have been a widespread European suspicion that Jews somehow
retained too much racial autonomy, cultural identity and an unwelcome
degree of disconnection from the host societies they joined. This autonomy
revolved about their religious otherness, their social clannishness, their
strong cultural richness and their frequent rise to eminence or economic
success. Resentment against these factors underscored their seeming
failure to dilute away their identity as Jews and a corresponding failure
to integrate sufficiently into becoming non-Jew Europeans. This
‘marginality’ restrained their greater integration and gave them an
ambivalence and a disconnectedness from European cultures. It was also
suggestive of a lack of interest on Jews’ part of ever becoming more truly
integrated Europeans. They often therefore appeared aloof and arrogant.

By failing sufficiently to lose their identity as Jews, and retaining
the ‘otherness’ alluded to above, this demarcated them from other members
of their host societies. An important reason for this is their rich
cultural heritage, their intelligence, their artistic and musical
abilities; their apparent classlessness, or middle-class-ness and their
long-established nomadic nature. Such features combined with their dream
of returning to their homeland; this deep yearning of a mythical future in
Zion, some future peaceful Jewish state; and a belief in a future Messiah,
or saviour of their race. These amounted to exclusive aspects of
Jewishness that conspired against them being seen as anything other than
Jews, and not as integrated Europeans.

The resentment, therefore, against Jews, arose because they were
blatantly non-Christians in a Christian Europe; in Europe but not of it;
footloose; cultured but cultureless – a host of such factors about their
identity as Jews cast doubt on the credibility of any claim they might
make to become more fully absorbed into mainstream European culture.
Though this resentment, this ‘proto-anti-Semitism’, came from Europeans
themselves, it was, from their perspective, a valid concern, a natural
reaction against the Jews’ failure to become more socially absorbed, more
Europeanised. Thus, responsibility for this response was deemed by
Europeans to rest solely with the Jews themselves and not with the Europe
into which they had wandered. Therefore, Europeans regarded the Jews as a
people who had made outcasts of themselves by their own behaviour, by
their social deviance, and by their insistence in retaining such strong
cultural independence and social distance from Europeans.

Jews were first “dispersed after the conquest of Palestine by the
Roman Emperor Titus in AD 70,” [2] Being a “shrewd and gifted oriental
people,” [2] they soon spread themselves throughout the Christian world.
[2] “Always despised, periodically plundered, and in times of public
calamity or fear exposed to the blood lust of murderous and ignorant mobs,
the Jews of Europe endured through the middle ages unspeakable miseries,”
[2] However, “as the sunshine of religious tolerance spread through
central and western Europe the Jews were admitted to civic rights.” [2]
Such hospitality of the Christian State, was soon amply repaid “in noble
contributions to art, science, and literature.” [2] To some degree there
seems little doubt that “the Jew rose to the level of the society around
him, educated himself in its spirit, took on its colour, and ministered to
some of its needs,” [2]

The most shameful attacks upon the Jewish population, such as those
“at Mainz and other German-speaking towns [where Jews] were burned in
their hundreds and thousands by an infuriated mob, in the belief that the
Plague was a malignant disease of the Semitic race for the confusion of
the Catholic creed.” [2; 319] Jews “had fled to Poland in the Middle Ages
from the bitter persecution of the Catholic west and had been accorded the
rights of hospitality, leaving behind them a progeny ever multiplying in
numbers and supplying the main part of such urban acts as Poland
possessed.” [2; 565] Austria enjoyed “that full and exquisite enjoyment of
art and science which may easily be found where Jews are numerous,” [2;
736] Hitler was “half-crazy with anti-Semitism,” [2; 1195] and it was his
expressed objective “to clear Germany of the Jews…and to revive the
military renown of the German people,” [2; 1203]

In the economic chaos after WW1, the rapid spread of “racialist ideas
fostered anti-Semitic forces which at the end of the [nineteenth] century
swept through many European countries. There were anti-Jewish laws and
massacres [pogroms] in Poland and Russia; strong anti-Semitic forces…
transcended political parties, but…became a favourite theme of ultra-
nationalist propaganda…the Zionist and the anti-Semitic movements fed on
one another, and the inflaming of all nationalist feelings by 1914 boded
ill for the future of Jews in Europe,” [3; 441]

The “five million Jews within the Russian Empire,” [3; 482] by 1860,
mostly in the Polish provinces, were greatly restricted in their movements
and excluded “from all professions other than trade.” [3; 482] Irksome
discrimination forced large numbers to migrate, and with violent outbreaks
of Jewish persecution in Bessarabia, “the cause of Jewish nationalism
emerged as yet another element in the kaleidoscope of eastern
separatisms,” [3; 482]. This inevitably meant a deep polarisation between
Jews and European states. For example, in the 1890s “the Pan-German
League…was strongly tinged with anti-Semitism and with anti-
Slavism…[being] a precursor of post-war National Socialism,” [3; 518] Anti
-Semitism, though not new in Germany, soon began to take on “new and
inflamed forms from 1918 onward, stimulated by the immigration of eastern
Jews into Germany during the war and by the desire of nationalists to find
scapegoats for Germany’s ills.” [3; 592]

What incited anti-Jewish hatred most, in all the fascist countries of
the 1930s, was the widespread and growing “economic distress amid periodic
scares of communist revolution, [that] attracted to itself discontented
youths, frightened bourgeoisie, and industrialists who resented the new
strength of their workers,” [3; 594] This slide into desperate poverty,
especially severe in Germany, and the desire to find scapegoats for the
economic meltdown, greatly aggravated anti-Semitic feelings. The almost
universal appearance of fascist groups in Europe in the 1930s was a
consequence of the Great Depression, and drew most of its support from
“officers in the armed services, high officials in the bureaucracy, from
the Church hierarchy and frightened conservatives, from wealthy landowners
and big industrialists…disgruntled ex-servicemen, disillusioned middle-
class people…unemployed workers, and from a younger generation in revolt
against national weakness and humiliation.” [3; 706]

The “peaceful coexistence and assimilation of Jews within the new
nation states,” [3; 440] did not come easily. Though the spread of liberal
democratic principles and institutions should have made assimilation
easier, “to turn Jews into ordinary citizens,” [3; 440] but it proved
impossible to “loosen their special ties to an exclusive religious and
racial community.”[3; 441] While in politics, business and the
professions, “individual Jews assumed great eminence. Disraeli, Durkheim,
Freud and Einstein were all Jews by birth,”[3; 441] yet these very
tendencies “evoked separatist forces by reaction – a nationalist movement
among Jews themselves, and a racialist movement among Gentiles who
resented the prominence and success of Jews in economic and public life,”
[3; 440-1]

One argument claims, for example, that the Jewish failure to
integrate into European societies was largely caused by their
determination to cling onto persistent elements of “Jewish nationalism,”
[3; 482] and an unwillingness to sever their “ties to an exclusive
religious and racial community,” [3; 440], which merely led host societies
to intensify their perception of Jews as aliens, as ‘other’, and to
reinforce separation, alienation and conflict, “evoking separatist forces
by reaction,” [3; 441] and a deepening “resentment against the prominence
and success of Jews in economic and public life,” [3; 441]. This suggests
that integration is chiefly contingent upon them diluting their identity
as ‘other’ until it is invisible.

This argument then proceeds that only through attaining greater
racial, cultural and religious invisibility and lack of public prominence
and lack of success [eminence] could any true integration and assimilation
of Jews ever be achieved. Zionism does the exact opposite, by re-exerting
separate identity and re-emphasising ties to a religious and racial
exclusivity, and so inflaming anti-Semitism through polarising views.
However, is the demand by Europe that Jews achieve greater social
invisibility, in any sense a realistic objective? It seems plainer that
the most realistic path is not the suppression of Jewish identity in the
face of hatred, but to increase the level of tolerance in the host
society, forms of give and take, cultural multiplicity, and true pluralism
that are required by a society as a whole. Some change and dilution on the
side of minority groups do seem desirable, but must be matched by a
corresponding softening of attitudes on the side of the host society.

To wrongly accuse the Jews of failing to become Europeans by not
losing or at least not diluting their natural Jewish sense of racial and
cultural identity is to entirely miss the main point. To do so would be as
absurd as to accuse the first American settlers of failing to become Red
Indians, or the first Europeans in Australia of failing to become
Aborigines. The true failure was a failure of each to be more tolerant of
divergent racial and cultural norms and a failure of one group not to over
-assert its norms on the other - thereby falling guilty of cultural

In this sense it is clear, that both Jews and Europeans failed this
early experiment in multi-culturalism - they both failed to learn from
each other, to tolerate and respect each other, and to accept social and
cultural norms and realities lying beyond the limits of their own.
Seemingly, the lesson to be learned is that each of us is indelibly
imprinted with our own racial and cultural identity which defines us and
gives our life a sense of cohesiveness, meaning and purpose that we feel
our lives derive therefrom, and without which its sense of meaning and
purpose would collapse or at least be seriously threatened.

It is therefore hopelessly unrealistic to expect any people to simply
exchange one long-established and deeply-ingrained cultural identity for
another on a willy-nilly basis, as if somewhat nonchalantly this can be
done in such an easy and flippant manner. It is simply not how people
operate. It goes against very deep cultural grains within us. What can be
expected perhaps, at best, is a greater tolerance of one group for another
and a mutual recognition of the sanctity to each of their own varying but
unique cultural norms.

However, the outcome of this experiment seems to have varied
according to which particular 'soil' the self-same 'tree' was planted in.
For example, the "history of the Jews in Britain since their resettlement
in the mid-17th century seems to bear little resemblance to the history of
the Jews in other European marches to its own drummer, out of
step...with the experiences of other European is
undramatic...pogroms, trials, boycotts...persecutions...were
absent...the absence of violence and turmoil...did not disturb Britain's
Jews, who saw it as a mark of their good fortune." [4]

Endelmann's view that British Jewry has long been a low-key and
unexciting matter, and hardly worthy of historical commentary, might prove
not only profoundly true, but also in quite another sense the 'golden key'
to understanding the bad reactions against Jews in the rest of Europe.
There must be a reason why the Jews were so well tolerated in UK as
compared to France, Germany, and Eastern Europe, where they were massacred
and so terribly despised. Both require explanation. Arguably, these
differences must reside in the natures of those peoples, times, and
societies into which Jews moved, and NOT inherently with the Jews
themselves, who were a pretty homogeneous bunch, in terms of their
identity, beliefs and lifestyles, wherever they ended up. Something in the
differences between these peoples, and these societies must have
determined the very different reception, treatments and fortunes of Jews
in the UK as compared to those in other places.

Certainly it cannot be claimed that British Jews somehow acquired a
'cultural camouflage' that magically cocooned them in a form of cultural
invisibility, which Jews in the rest of Europe failed to acquire. Nor can
it just have been the greater tolerance of the liberal and kindly British
people. One possibility is that some of the characteristics of Jews, so
far as they can be determined, must have chimed better in Britain than
they did in the rest of Europe. For example, their hardworking, thrifty,
intelligent and gregarious natures must have attracted respect with
British people. For example, perhaps it was partly what Endelmann calls
"Jewish drive, separatism and success," [4; 245] that the British easily
accepted and admired in Jews?

Herder defines Jewishness in terms of "land, common language,
tradition, sense of kinship, common law as freely accepted
'covenant'...the bond created by their sacred literature, enabled the Jews
to retain their identity in dispersion...their eyes remained focused upon
their original geographical home...historical continuity, not race, is
what counts." [5] For while these qualities undoubtedly struck a chord in
Britain, yet "the Jews in Eastern Europe felt alienated from the society
in which they lived," [6], where they were largely portrayed solely as
"parasitic money-lenders," [5; 183]. This may explain why the Jews were
often seen as "the eternal critics, the detached, uncommitted judges of
the Christian world," [5; 296]. Yet, according to Moses Hess, "the Jews
had the historic mission of uniting communism and nationality," [6; 585].

Perhaps also the adaptability and intelligence of the Jews and their
obvious willingness to work hard regardless of what stratum of society
they occupied, and always to strive at self-betterment, were attractive
qualities to British people regardless of social class. Certainly one can
argue that the English, apart from being open and tolerant, have always
been 'natural Tories' aware and respecting of differences in social class,
while only rarely prone to demand changes to the 'natural order' as
happened, for example, in both the French and Russian Revolutions, where
the 'natural order' was rejected as a basis for life and government.
Perhaps Jews, like the British, seemed more accepting of the 'way the
world is' rather than desirous of adapting it to their own vision.

Careful examination of such causes of anti-Semitism in Europe might
help us understand the current harsh behaviour of modern Jews in Israel
towards Palestinians, which seems disturbingly similar to that inflicted
on Jews by many Europeans up to 1945. Just as Jews did not choose to
render themselves culturally and racially invisible in Europe, but
retained their cultural ‘otherness’, so, according to this line of
argument, the Palestinians must also be permitted their own racial,
religious and cultural identity in the face of Jewish behaviour that seems
to demand they become more invisible.

If an old pattern repeats itself, then it sadly beggars belief that a
minority who have suffered as much as Jews have in Europe, should then
visit upon Arabs in Palestine similar brutalities, restrictions and
marginalizing and dehumanising treatments as they themselves once
suffered, now the whip has changed hands, then have they learned nothing
about human nature and how to put out rather than stoke the bonfires of
hatred and despair?

Greater tolerance on both sides seems a more sensible route into a
harmonious future of greater mutual respect. For, as Berlin observes, “no
minority that has preserved its own cultural tradition or religious or
racial characteristics can indefinitely tolerate the prospect of remaining
a minority for ever, governed by a majority with a different outlook or
habits. And this may indeed account for the reaction of wounded pride, or
the sense of collective injustice, which animates, for example, Zionism,
or its mirror-image, the movement of the Palestinian Arabs, or such
‘ethnic’ minorities as Negroes in the United States or Irish Catholics in
Ulster.” [7; 251-2] Just as European Jews once did, so Palestinians now,
“demand recognition of their dignity as human beings. They do not wish to
be reduced to human material, to being counters in a game played by
others.” [7; 257] Minorities of all kinds crave to “escape from huge
impersonal authority that ignores ethnic, regional and religious
differences, a craving for ‘natural’ units of ‘human’ size.” [7; 258]


[1] BMJ 2001; 323:1257 (24 November), Reviews, Book, Medicine and the
Jews: A History, by John M Efron, Yale University Press, reviewed by Alex
Paton, retired consultant physician, Oxfordshire

[2] H A L Fisher, A History of Europe, London: Edward Arnold, 1961, 5

[3] David Thomson, Europe Since Napoleon, London: Penguin, 1977

[4] T M Endelmann, The Jews of Britain 1656-2000, Berkeley: Univ.
California Press, 2002, 2

[5] Isaiah Berlin, Three Critics of the Enlightenment, London:
Pimlico, 1997, 183

[6] I Berlin, The Proper Study of Mankind, London: Pimlico, 2000, xi

[7] Isaiah Berlin, The Crooked Timber of Humanity – Chapters in the
History of Ideas, Princeton: Univ. Princeton Press, 1991

Competing interests: No competing interests

25 July 2002
Peter Morrell
freelance researcher, history of medicine, UK