Trauma surgery and traffic policy in Germany in the 1930s: A case study in the coevolution of modern surgery and society

Bulletin of the History of Medicine

Volumn 80, Issue 1, 2006, Pages 73-94

  Schlich, Thomas ^a  

^a MCGILL UNIVERSITY   (Canada)

Author keywords

Medicalization; National Socialism surgery; Orthopedic surgery; Traffic policy; Trauma surgery

Indexed keywords

ARTICLE; CAR; GERMANY; HISTORY; HUMAN; LIFESTYLE; ORTHOPEDICS; POLITICAL SYSTEM; SOCIAL CONTROL; STATISTICS; SURGERY; TRAFFIC ACCIDENT;

ACCIDENTS, TRAFFIC; AUTOMOBILES; GERMANY; HISTORY, 20TH CENTURY; HUMANS; LIFE STYLE; NATIONAL SOCIALISM; ORTHOPEDICS; SOCIAL CONTROL, FORMAL; SURGERY;

EID: 33645686151     PISSN: 00075140     EISSN: None     Source Type: Journal    
DOI: 10.1353/bhm.2006.0039     Document Type: Article

References (248)

1. Martin Kirschner, "Der Verkehrsunfall und seine erste Behandlung," Verhandlungen der Deutschen Gesellschaft für Chirurgie/Archiv für klinische Chirurgie, 1938, 193:230-302
2. , quotation on p. 299. Martin Kirschner (1879-1942) is said to be one of the most important surgeons of his time. From 1924 to 1934 he created a modern surgical hospital at the University of Tübingen. Subsequently he moved to the University of Heidelberg, where a new surgical hospital was built under his directorship. Among other things he is famous for his technique of skeletal traction for fracture treatment. The "Kirschner wire" bears his name. His biographer characterizes him as an upright and stubborn man who was not scared by the Nazis; see Hans Killian, Meister der Chirurgie und die Chirurgenschulen im deutschen Sprachraum (Stuttgart: Thieme, 1951), pp. 62-63.
3. For the historiography of the automobile see, e.g., Theodore C. Barker, "Slow Progress: Forty Years of Motoring Research," J. Transport Hist., 1992, 14: 142-65;
4. Kurt Möser, Geschichte des Autos (Frankfurt: Campus, 2002), pp. 13-17;
5. Uwe Fraunholz, Motorphobia: Anti-automobiler Protest in Kaiserreich und Weimarer Republik (Göttingen: Vandenhoeck & Ruprecht, 2002), pp. 18-21;
6. Christoph Maria Merki, Der holprige Siegeszug des Automobils, 1895-1930 (Vienna: Böhlau, 2002), pp. 24-28.
7. On the history of traffic more generally, see Christopher Kopper, Handel und Verkehr im 20. Jahrhundert (Munich: Oldenbourg, 2002), pp. 85-120.
8. Scan O'Connell, The Car in British Society: Class, Gender and Motoring, 1896-1939 (Manchester: Manchester University Press, 1998), p. 112.
9. See also William Plowden, The Motor Car and Politics, 1896-1970 (London: Bodley Head, 1971).
10. Merki, Der holprige Siegeszug (n. 2), p. 20.
11. Early examples of a cultural history of the motorcar in the United States are James J. Flink, America Adopts the Automobile (Cambridge: MIT Press, 1970);
12. Flink, The Car Culture (Cambridge: MIT Press, 1974);
13. Flink, The Automobile Age (Cambridge: MIT Press, 1988).
14. See also Clay McShane, Down the Asphalt Path: The Automobile and the American City (New York: Columbia University Press, 1994).
15. For an international perspective, see Theodore C. Barker, ed., The Economic and Social Effects of the Spread of Motor Vehicles (Basingstoke: Macmillan, 1987).
16. For a recent survey, see Thomas Schlich, "The Emergence of Modern Surgery," in Medicine Transformed: Health, Disease and Society in Europe, 1800-1930, ed. Deborah Brunton (Manchester: Manchester University Press, 2004), pp. 61-91.
17. Ulrich Tröhler, "Surgery, Modern," in Companion Encyclopaedia of the History of Medicine, ed. William F. Bynum and Roy Porter (London: Routledge, 1993), 2: 984-1028;
18. Hans-Jörg Oestern and Jürgen Probst, eds., Unfallchirurgie in Deutschland: Bilanz und Perspektiven (Berlin: Springer, 1997);
19. Fritz Povacz, Geschichte der Unfallchirurgie (Berlin: Springer, 2000), pp. 408-15.
20. See, e.g., Christopher Lawrence, "Democratic, Divine and Heroic: The History and Historiography of Surgery," in Medical Theory, Surgical Practice: Studies in the History of Surgery, ed. Lawrence (London: Routledge, 1992), pp. 1-47.
21. Peter Voswinckel, Arzt und Auto: Das Auto und seine Welt im Spiegel des Deutschen Arzteblattes von 1907 bis 1975 (Münster: Murken-Altrogge, 1981);
22. Roger Cooter and Bill Luckin, eds., Accidents in History: Injuries, Fatalities and Social Relations (Amsterdam: Rodopi, 1997).
23. The use of the word "coevolution" is inspired by the notion of coevolution of science and society, as proposed by, e.g., Bruno Latour, Science in Action: How to Follow Scientists and Engineers through Society (Milton Keynes: Open University Press, 1987);
24. and SheilaJasanoff, The Fifth Branch: Science Advisers as Policymakers (Cambridge: Harvard University Press, 1990).
25. Möser, Geschichte (n. 2), pp. 172-82.
26. How far this enthusiasm was really established within the whole population remains a disputed point among historians: see Möser, ibid., p. 173; but the difference from the preceding period is generally acknowledged.
27. Fraunholz, Motorphobia (n. 2).
28. According to Uwe Fraunholz's recent study of this phenomenon of "motorphobia," the rejection of cars declined noticeably with the increase of automobile traffic in the 1920s and ceased completely with the NS regime: Fraunholz, Motorphobia (n. 2), pp. 16, 93-97.
29. Thus, resistance to motorization was replaced by a general acceptance decades before mass motorization became reality: see Merki, Der holprige Siegeszug (n. 2), pp. 109-31, 194-96.
30. Ministerialblatt, 1931, 92: col. 991 (up to 1936, published under the title Ministerialblatt: Ministerialblatt für die Preußische innere Verwaltung, from 1936, Ministerialblatt des Reichs und Preußischen Ministeriums des Inneren);
31. Dietmar Fack, Automobil, Verkehr und Erziehung: Motorisierung und Socialisation zwischen Beschleunigung und Anpassung 1885-1945 (Opladen: Leske & Budrich, 2000), pp. 34, 117-285, 448;
32. Robert Braunschweig, "Der Wandel der öffentlichen Meinung über motorisierte Fahrzeuge," in Die Einflüsse der Motorisierung auf das Verkehrswesen von 1886 bis 1986,
33. ed. Hans Pohl, Supplement 52 to Zeitschrift für Unternehmensgeschichte (Stuttgart: Steiner 1988), pp. 79-93, on p. 82.
34. Ministerialblatt, 1926, 87: col. 603;
35. Ministerialblatt, ibid., 1927, 88: cols. 265-68;
36. Ministerialblatt, ibid., 1930, 91: cols. 197-202;
37. Ministerialblatt, ibid., 1932, 93: col. 747;
38. Fack, Automobil (n. 13), pp. 246-64.
39. On the peculiar combination of technological modernism and a politically reactionary stance in NS and German culture, see Jeffrey Herf, Reactionary Modernism: Technology, Culture and Politics in Weimar and the Third Reich (Cambridge: Cambridge University Press, 1984), quote on p. 195.
40. Hans-Joachim Braun, "Konstruktion, Destruktion und der Ausbaus technischer Systeme zwischen 1914 und 1945," in Energiewirtschaft, Automatisierung, Information seit 1914, ed. Hans-Joachim Braun and Walter Kaiser, Propyläen Technikgeschichte, vol. 5 (Berlin: Propyläen, 1997), pp. 11-279, on p. 109.
41. For a comparison between different countries, see Hans-Joachim Braun, "Konstruktion, Destruktion und der Ausbaus technischer Systeme zwischen 1914 und 1945," in Energiewirtschaft, Automatisierung, Information seit 1914, vol. 5 1997 ibid., pp. 103-26.
42. Which, as pointed out below, never went into mass production before the 1950s: Kopper, Handel und Verkehr (n. 2), pp. 33-34;
43. Möser, Geschichte (n. 2), pp. 208-20.
44. See, e.g., A. F. Napp-Zinn, "Die Entwicklung der Verkehrspolitik im nationalsozialistischen Deutschland 1935-39,"Jahrbücher für Nationalökonomie und Statistik, 1939, 150: 441-64, on pp. 451-54.
45. On the tax policy, see Vierteljahreshefte zur Statistik des Deutschen Reichs (henceforth VSDR), 1936, 45: II.3-11;
46. Peter Borscheid, "Auto und Massenmobilität," in Pohl, Einflüsse der Motorisierung (n. 13), pp. 117-41, on p. 119.
47. On the autobahn, see Thomas Zeller, Strosse, Bahn, Panorama: Verkehrswege und Landschaftsveränderung in Deutschland von 1930 bis 1990 (Frankfurt: Campus 2002), pp. 44-76.
48. The effects of the motorization policy were, however, dampened by the contradictions and inconsistencies of NS traffic policy: see Kopper, Handel und Verkehr (n. 2), pp. 19-38, 91-101.
49. Historians have also highlighted the irrational character of the motorization program, which contradicted other important goals of the regime, such as independence from imports and war preparations: see Möser, Geschichte (n. 2), pp. 174-75.
50. Fack, Automobil (n. 13), pp. 328-29.
51. The German army, for their part, saw no strategic value in the autobahn and preferred the modernization of the existing road network. According to Zeller, Strasse (n. 18), pp. 57-58,
52. the majority of historians no longer believe that the autobahns were built for their military usefulness. See also Kopper, Handel und Verkehr (n. 2), pp. 91-93;
53. Möser, Geschichte (n. 2), p. 180-82.
54. Zeller, Strasse (n. 18), pp. 41, 56;
55. Kopper, Handel und Verkehr (n. 2), pp. 31-33.
56. Braun, "Konstruktion" (n. 16), p. 114;
57. Fack, Automobil (n. 13), pp. 301-4;
58. Wirtschaft und Statistik (henceforth WS), 1937, 17: 727-29.
59. WS, 1935, 15: 632-33;
60. VSDR, 1936, 45: II.5-6;
61. WS, 1937, 17: 810-13;
62. WS, 1938, 18: 670-71.
63. WS, 1937, 17: 662-63;
64. VSDR, 1938, 47:111.61.
65. However, in 1935, Germany with 16.1 cars per 1,000 inhabitants was still way behind the United States (204.4), France (49.0), the United Kingdom (45.2), Denmark (41.6), and Switzerland (21.7): Zeller, Strosse (n. 18), p. 51.
66. WS, 1936, 16: 46-53.
67. MS, 1938, 18: 6.
68. But even in 1929 the German automobile market had lagged behind the American one by eighteen years, as a study group from the U.S. producer General Motors reported: Zeller, Strosse (n. 18), p. 45.
69. WS, 1938, 18: 6;
70. Braun, "Konstruktion" (n. 16), p. 114.
71. On the history of governmental promotion of automobile traffic in different Western nations, see Volker Hentschel, "Staat und Verkehr: Motive, Ziele und Mittel der Verkehrpolitik westlicher Industriestaaten seit 1880," in Pohl, Einflüsse der Motorisierung (n. 13), pp. 53-76.
72. The notion that building the autobahn itself reduced unemployment directly has been recognized by historians as a popular myth: the effect was too small and too short-term to be important in the big picture; see Zeller, Strosse (n. 18), p. 62.
73. In 1936 one motorcar was counted per 53 inhabitants, whereas in the previous year it had been 64; the numbers for France in those years were 20 and 22, and for Great Britain, 26 and 23: VSDR, 1936, 45: III.47-48.
74. In 1938 the numbers were 44 for Germany and 19 for both France and Great Britain: VSDR, 1938, 47:111.62.
75. Thus, as measured by these relative numbers, Germany had not really caught up with its rivals. Altogether the real effects of Hitler's motorization policy clearly fell short of the grandiose claims made by NS propaganda. The effects that could be observed were also largely due to a general improvement of the economic situation after the depression years; see Möser, Geschichte (n. 2), p. 174.
76. VSDR, 1937, 46:111.29.
77. VSDR, 1936, 45:111.49;
78. Fack, Automobil (n. 13), pp. 316-28.
79. Borscheid, "Auto" (n. 18), p. 119;
80. Zeller, Strasse (n. 18), p. 52.
81. I wish to thank the anonymous "Reviewer C" for this insight.
82. See, e.g., Frankfurter Zeitung, 21 February 1937: Adolf Hitler's speech on the inauguration of the motor show is printed on pp. 1-2, and the rest of the issue is full of articles in praise of motorization.
83. WS, 1936, 16: 835-39.
84. See also the statistics in WS, 1935, 15: 858-50;
85. WS 1937, 17: 201-2, 968;
86. WS 1938, 18: 1019-20.
87. Germany consistently had the highest mortality rate per capita up until the 1960s: see James Foreman-Peck, "Death on the Roads: Changing National Responses to Motor Accidents," in Barker, Economic and Social Effects (n. 4), pp. 264-90, on pp. 265-67.
88. WS, 1935, 15: 858-60.
89. In 1935, traffic accidents accounted for 38 percent of all fatal accidents, and they were again responsible for the further increase of the total number: WS, 1937, 17: 968.
90. In 1936, traffic accidents were again responsible for the increase: WS, 1938, 18: 1020.
91. WS, 1935, 15: 968;
92. WS 1936, 16: 835-39;
93. WS 1938, 18: 1019.
94. Kirschner, "Verkehrsunfall (n. 1), pp. 232-38, 283-84.
95. See also the coverage in the Deutsches Ärzteblatt, as analyzed in Voswinckel, Arzt (n. 8), pp. 50-57.
96. Fack, Automobil (n. 13), p. 340.
97. Different statistics varied somewhat - e.g., sometimes the most frequent cause of accidents was ignorance of the right of way, sometime speeding was more significant - but the general trend was similar. See also WS, 1936, 16: 835-39;
98. WS, 1937, 17: 201-2, 614;
99. WS, 1939, 19: 160;
100. VSDR, 1937, 46: 111.51-55;
101. Ministerialblatt, 1939, 100: col. 200;
102. Kirschner, "Verkehrsunfall" (n. 1), pp. 233-35.
103. Kirschner, "Verkehrsunfall" (n. 1), p. 235.
104. WS, 1935, 15: 859;
105. WS 1936, 16: 839.
106. Dr. E., "Fortschreitende Motorisierung," Germania, 18 October 1936, p. 17.
107. Fack, Automobil (n. 13), pp. 328-29.
108. See Herf, Reactionary Modernism (n. 15), pp. 189-235.
109. Ministerialblatt, 1935, 96: col. 1095;
110. Ministerialblatt ibid., 1936, 97: cols. 94-95.
111. In 1936 they were supplemented by a weekly "Schnellstastistik": Ministerialblatt ibid., 1936, 97: col. 103;
112. Fack, Automobil (n. 13), p. 337.
113. Ministerialblatt, 1938, 99: cols. 1497-1500.
114. Ministerialblatt, 1935, 96: cols. 779-80;
115. Ministerialblatt ibid., 1937, 98: cols. 1306-10;
116. Ministerialblatt ibid., 1938, 99: col. 422;
117. Ministerialblatt ibid., 1939, 100: col. 199.
118. Ministerialblatt, 1937, 98: col. 1138;
119. Ministerialblatt ibid., 1938, 99: col. 1705;
120. Fack, Automobil (n. 13), pp. 353, 357-59.
121. Ministerialblatt, 1939, 100: cols. 1049-50;
122. Pack, Automobil (n. 13), p. 353.
123. Möser, Geschichte (n. 2), p. 174.
124. Quoted in Fack, Automobil (n. 13), p. 341.
125. Ministerialblatt, 1939, 100: cols. 199-200, 1049;
126. Pack, Automobil (n. 13), pp. 357-59.
127. Stephen Hilgartner, "The Social Construction of Risk Objects: Or, How to Pry Open Networks of Risk," in Organizations, Uncertainties, and Risk, ed. James F. Short, Jr., and Lee Clarke (Boulder: Westview Press, 1992), pp. 39-53, on p. 45.
128. Dr. E., "Fortschreitende Motorisierung" (n. 41), p. 17.
129. Fack, Automobil (n. 13), p. 464.
130. See, e.g., Martin Allgöwer, "Cinderella of Surgery - Fractures?" Surg. Clin. North America, 1978, 58: 1071-93;
131. Lorenz Böhler, Technik der Knochenbruchbehandlung im Frieden und im Kriege, 2 vols. (Vienna: Maudrich, 1943), 2: 1510;
132. Ruscoe Clarke, F. G. Badger, and Simon Sevitt, "Organization of Accident Services," in Modern Trends in Accident Surgery and Medicine, ed. Clarke, Badger, and Sevitt (London: Butterworth, 1959), pp. 1-8;
133. Roger Cooter, Surgery and Society in Peace and War: Orthopaedics and the Organization of Modern Medicine, 1880-1948 (Basingstoke: Macmillan, 1993), pp. 81, 206.
134. Böhler, Technik (n. 55), 2: 1534-35.
135. Lorenz Böhler, "Die volkswirtschaftliche Bedeutung der Unfallchirurgie," Münchner Medizinische Wochenschrift (henceforth MMW), 1930, 77: 326-27.
136. Hermann Matti, Die Knochenbrüche und ihre Behandlung: Ein Lehrbuch für Studierende und Ärzte (Berlin: Springer, 1918), p. vi;
137. Fritz Steinmann, Lehrbuch der funktionellen Behandlung der Knochenbrüche und Gelenkverletzungen (Stuttgart: Enke, 1919), p. 2;
138. Friedrich Lorenz, Lorenz Böhler: Der Vater der Unfallchirurgie (Vienna: Maudrich, 1955), p. 10;
139. Lorenz Böhler, "Die Entwicklung der Unfallchirurgie - medizinisch und volkswirtschaftlich gesehen," Ciba Symp., 1958, 6:178-90, esp. pp. 181-87 (with numerous references to other surgeons' statements on the subject).
140. Roger Cooter, "Die medizinische 'Entdeckung' von Unfällen und die Industrial-isierung medizinischer Sozialbeziehungen in Grossbritannien um die Jahrhundertwende," in Gesundheitsrisiken, Industriegesellschafl und soziale Sicherungen in der Geschichte, ed. Dietrich Milles (Bremerhaven: Wirtschaftsverlag NW, Verlag für neue Wissenschaft GmbH, 1993), pp. 85-100;
141. Cooter, "The Moment of the Accident: Culture, Militarism and Modernity in Late-Victorian Britain," in Cooter and Luckin, Accidents (n. 8), pp. 107-57.
142. Böhler, Technik (n. 55), 2: 1535;
143. Jürgen Probst, "Aus der Geschichte der Unfallchirurgie: Die Entstehung der Deutschen Gesellschaft für Unfallchirurgie," in Oestern and Probst, Unfallchirurgie in Deutschland (n. 6), pp. 3-62, on pp. 31-32;
144. Povacz, Geschichte (n. 6).
145. Fritz König, "Von Wesen und Bedeutung der Unfallheilkunde, " MMW, 1937, 84: 721-23;
146. Böhler, Technik (n. 55), 2: 1538-39.
147. Probst, "Aus der Geschichte" (n. 60), pp. 16-25.
148. Böhler, "Die volkswirtschaftliche Bedeutung" (n. 57), p. 326;
149. Böhler, Technik (n. 55), 2: 1530.
150. König, "Wesen" (n. 61), pp. 721-23;
151. Georg Magnus, "Ziele und Aufgaben der Unfallchirurgie," MMW, 1938, 85: 1697-702, on p. 1697.
152. MMW, 1931, 78: 429;
153. Probst, "Aus der Geschichte" (n. 60), p. 45.
154. Kirschner, "Verkehrsunfall" (n. 1), p. 238;
155. Böhler, Technik (n. 55), 2: 1530.
156. Dr. Jungmichel - München, review of Fr. W. Lohmann, "Gesundheitliche Schädigung durch den Automobilverkehr und deren Verhütung," MMW, 1935, 82:1809.
157. When speaking about medical issues of automobile traffic, doctors were careful not to contradict official motorization policy. They acknowledged that the boosting ("Ankurbelung") of the German economy after the national uprising ("nationale Erhebung" - the official euphemism for the NS seizure of power) had started with an increase in motorization, and that an integral part of this was the abolishment of regulations that were too restrictive and were causing reluctance ("Unlust") and annoyance, such as medical examinations for obtaining a driver's license; see, e.g., B. Mueller, "Die Gefährdung der Verkehrsteilnehmer durch gesundheitlich ungeeignete Kraftfahrer im Rahmen der gegenwärtig gültigen gesetzlichen Bestimmungen," MMW, 1937, 84: 214-17, on p. 214.
158. Kirschner, "Verkehrsunfall" (n. 1), pp. 297-98.
159. On the general enthusiasm of the German medical profession for automobiles, and the acclaim of the NS motorization policy in their official professional journal, Deutsches Ärzteblatt, see Voswinckel, Arzt (n. 8).
160. Kirschner, Verkehrsunfall (n. 1), p. 299.
161. See, e.g., Steve Sturdy, "The Industrial Body," in Companion to Medicine in the Twentieth Century, ed. Roger Cooter and John Pickstone (reprint; London: Routledge, 2003), pp. 217-34.
162. See, e.g., Bruno Pfab and Wolfgang Schosserer, "Die Straßenbahnunfälle der I. Chir. Unfallstation der Universitätsklinik in Wien," Archiv für Orthopädische Chirurgie, 1927, 27: 445-55, on p. 445;
163. G. Jorns, "Ueber die Häufigkeit der Unfallverletzungen, insbesondere der Verkehrsunfälle," MMW, 1932, 79: 68-70;
164. Fe., "Gegensatz zwischen Straßen- und Eisenbahnunfällen in England," Deutsche Medizinische Wochenschrift (henceforth DMW), 1935, 61: 479-80;
165. Kirschner, "Verkehrsunfall" (n. 1), pp. 233-35.
166. See Fraunholz, Motorphobia (n. 2);
167. Fack, Automobil (n. 13);
168. Braunschweig, "Wandel" (n. 13).
169. Jorns, "Häufigkeit" (n. 71), p. 70;
170. Fack, Automobil (n. 13), primarily on education.
171. See, e.g., Fack, Automobil (n. 13), pp. 34, 117-285, 448;
172. Braunschweig, "Wandel" (n. 13), p. 82;
173. Voswinckel, Arzt (n. 8), pp. 65-75.
174. Kirschner, "Verkehrsunfall (n. 1), pp. 287-300.
175. Böhler, Technik (n. 55), 2: 1530.
176. Jorns, "Häufigkeit" (n. 71), p. 68.
177. Kirschner, "Verkehrsunfall" (n. 1), p. 299.
178. Dr. S. Ch., "Der Chirurg bei Verkehrsunfällen: Die deutschen Chirurgen tagten mit den Unfall- und Versicherungsärzten," Kreuzzeitung, 24 April 1938, p. 4;
179. Berliner Tageblatt, 24 April 1938, p. 22.
180. On the social construction of the category "accident" in general, see Judith Green, "Accidents: The Remnants of a Modern Classificatory System," in Cooter and Luckin, Accidents (n. 8), pp. 35-58.
181. Roger Cooter and Bill Luckin, "Accidents in History: An Introduction," in Cooter and Luckin, Accidents (n. 8), pp. 1-16.
182. For the notion of jurisdiction, see Andrew D. Abbot, The System of Professions: An Essay on the Division of Expert Labor (Chicago: University of Chicago Press, 1988), p. 20.
183. Cooter and Luckin, "Accidents" (n. 81), p. 7.
184. On the naturalization of injury and illness in industry, see Sturdy, "Industrial Body" (n. 70), pp. 226-27.
185. On naturalizing the social through medicine, see Patrick Joyce, The Rule of Freedom: Liberalism and the Modern City (London: Verso, 2003), esp. pp. 62-93.
186. I am using the term "medicalization" lo describe the tendency toward reframing social and other issues as medical problems. For a brief survey of the notion of medicalization, see Robert E. Nye, "The Evolution of the Concept of Medicalization in the Late Twentieth Century," J. Hist. Behav. Sci., 2003, 39: 115-29.
187. Other examples, besides Kirschner, are, in 1935,Jungmichel, review (n. 67), p. 1809;
188. or, just before the NS period, in 1932, Jorns, "Hä ufigkeit" (n. 71), pp. 68-70.
189. Dr. S. Ch., "Der Chirurg bei Verkehrsunfällen" (n. 79), p. 4;
190. Berliner Tageblatt, 24 April 1938, p. 22.
191. Ministerialblatt, 1927, 88: cols. 1091-92;
192. Fack, Automobil (n. 13), p. 244.
193. Hans Mannheim, "Der Transport Unfallverleuter," DMW, 1932, 58: 452-54;
194. Kirschner, "Verkehrsunfall" (n. 1), pp. 237-38.
195. This is also reflected in the coverage of the Deutsches Ärzteblatt, see Voswinckel, Arzt (n. 8), pp. 50-52.
196. Fack, Automobil (n. 13), pp. 340-41.
197. See Monatsschrift für Unfallheilkunde und Versicherungsmedizin, 1938, 45: 266-67.
198. Magnus, "Ziele" (n. 64), p. 1698.
199. MMW, 1932, 79:739.
200. Ministerialblatt, 1937, 98: cols. 1656-58.
201. Ministerialblatt, 1938, 99: col. 215.
202. E.g., F. Otto, "Die Versorgung der Unfallverletzten unter besonderer Berücksichtigung der ländlichen Verhältnisse und der landwirtschaftlichen Berufgenossenschaften," MMW, 1934, 57:612.
203. MMW, 1932, 79: 739.
204. Probst, "Aus der Geschichte" (n. 60), p. 31.
205. Kirschner, "Verkehrsunfall" (n. 1), pp. 238, 302. In reality, the problem was solved in a different way by imposing compulsory liability insurance for motorcar drivers.
206. F. König, "XI. Tagung der Deutschen Gesellschaft für Unfallheilkunde, Versicherungs-und Versorgungsmedizin," MMW, 1936, 83: 2069-70.
207. Road accidents became the most common cause of fractures mentioned in surgical case histories: see Thomas Schlich, Surgery, Science and Industry: A Revolution in Fracture Care, 1950s-1990s (Basingstoke: Palgrave 2002), p. 10.
208. Braun, "Konstruktion" (n. 16), pp. 116-17;
209. Möser, Geschichte (n. 2), pp. 216-17.
210. Probst, "Aus der Geschichte" (n. 60), pp. 35-49;
211. Povacz, Geschichte (n. 6), p. 412.
212. On the continuity of the profession's positive attitude toward the growth of automobile traffic, see Voswinckel, Arzt (n. 8).
213. Donald Trunkey, "Trauma," Sci. Amer., 1983, 249 (2): 20-27, quotation on p. 26.
214. "Memorandum zur Stellung der Unfallchirurgie an den deutschen Universitäten," published by the Deutsche Gesellschaft für Unfallchirurgie e.V. in 1994, reprinted in Probst, "Aus der Geschichte" (n. 60), pp. 40-44. The other subspecialties were visceral surgery, thoracic surgery, and vascular surgery.
215. Trunkey, "Trauma" (n. 102), p. 26;
216. "Memorandum" (n. 103), p. 40;
217. Povacz, Geschichte (n. 6), p. 415.
218. Herf, Reactionary Modernism (n. 15).
219. See, e.g., Barker, Economic and Social Effects (n. 4), esp.
220. Foreman-Peck, "Death" (n. 34).
221. See also Flink, Car Culture (n. 4);
222. Flink, Automobile Age (n. 4);
223. O'Connell, Car (n. 3);
224. Plowden, Motor Car (n. 3).
225. In general, developments in traffic policy in different countries exerted a strong influence on each other; see, e.g., Merki, Der holprige Siegeszug (n. 2), p. 19.
226. Even the fact that symbolic qualities lay at the heart of the growing popularity of the car was by no means specific to Germany; see, e.g., O'Connell, Car(n. 3), p. 6.
227. See, e.g., Fe., "Gegensatz" (n. 71);
228. Fe., "Eine Stadt ohne tödlichen Autounfall," DMW, 1935, 61: 1213;
229. Kirschner, "Verkehrsunfall" (n. 1), p. 284.
230. When motorcar traffic was restricted in Italy during the Abyssinian conflict in 1934-36, the number of traffic accidents dropped by 35.5 percent: VSDR, 1938, 47: IV.132.
231. In 1929, 30,061 Americans died from car accidents, which was almost as many as the American casualties in the First World War (37,568): MMW, 1931, 78: 984.
232. On the United States, see, e.g., Flink, Automobile Age (n. 4), pp. 382-86.
233. On the United Kingdom, Sweden, North America, and the Netherlands, see David Maddison et al., eds., The True Costs of Road Transport (London: Earthscan, 1996).
234. Plowden, Motor Car (n. 3), pp. 389-90.
235. I am grateful to the anonymous "Reviewer C" for pointing out this important aspect.
236. Plowden, Motor Car (n. 3), p. 389.
237. Trunkey, "Trauma" (n. 102), p. 20.
238. Allgöwer, "Cinderella" (n. 55), pp. 1072.
239. Sawnie R. Gaston, "The Role of Leadership in the Quality of Fracture Care," Bull. Amer. Coll. Surg., 1975 (11), 60: 16-23, quotation on p. 16.
240. On naturalizing accidents, see Cooter and Luckin, "Accidents" (n. 81), p. 7;
241. O'Connell, Car(n. 3), p. 114.
242. However, the fact that in 1936 the Swiss surgeon Ludwig Gepke exhorted his colleagues to avoid appearing to welcome the increase of accidents as beneficial for their field, indicates that people may have suspected this: see Voswinckel, Arzt (n. 8), p. 50.
243. See also Peter Voswinckel's argumentation along those lines: Arzt (n. 8), pp. 75-76.
244. This means that the social construction of the risk objects was focused more on the individual driver, and on the means to repair the damage on the individual level, than on the political decision to support automobile traffic. For the general notion, see Hilgartner, "Social Construction" (n. 52).
245. On issues of fairness in risk creation and distribution, see, e.g., James F. Short, "Defining, Explaining, and Managing Risks," in Short, Jr., and Clarke, Organizations, Uncertainties, and Risk (n. 52), pp. 3-23, on pp. 10-13.
246. For the notion of modern auto-based transportation as a network, see Hilgartner, "Social Construction" (n. 52), p. 44.
247. On the issue of redefining social and cultural issues as belonging to the biomedical sphere and making them susceptible to a technological fix, see, e.g., Paul Starr and Ellen Immergut, "Health Care and the Boundaries of Politics," in Changing the Boundaries of the Political, ed. Charles S. Maier (Cambridge: Cambridge University Press, 1987), pp. 221-54;
248. Zygmunt Baumann, Mortality, Immortality and Other Life Strategies (Oxford: Polity Press, 1992).