with notions of German diligence and cleanliness circulated at the time. The physician used the unhygienic behaviors and indolence of Upper Silesians to point to the cultural connections that linked the region to Poland, or the Polish lands, and that separated it from Germany. Some of the images that Virchow used in his report remind us of the “swinishness” that Georg Forster referred to when he was traveling through the Polish-Lithuanian Commonwealth at the end of the eighteenth century. Yet, unlike Forster and many other scientists, Virchow refused to portray the negative images of Poles as national and racial essences.59 He deemed it unfair “to place the true cause of these traits in the Polish nation,” and attempted to find the roots of such backward behaviors elsewhere.60
For Virchow, the continued use of the Polish language was part of the problem under Prussian rule. The territory had been cut off from the “mother nation” (the Polish-Lithuanian Commonwealth) for a long time but was unable to receive the benefits of German culture. The efforts to Germanize the lands by using the school system had failed to achieve the purpose of connecting the province to the national progress of the other German lands. In Upper Silesia, the colonizing process was reversed. Rather than teaching their Polish pupils to speak German, German teachers ended up learning Polish. Virchow noticed that there were numerous families with German surnames and German “physiognomy” that did not speak German. It is important to note that while Virchow refused to use racial and national explanations of the disease, he admitted that there was a particular German manner and physiognomy that contrasted with the Polish manner and physical appearance.
Another main factor that Virchow used to explain the dire conditions of Poles in Upper Silesia was the excessive power that the Catholic clergy exerted over the local population. When someone became ill, they immediately called a priest rather than a physician. In Virchow’s view, Upper Silesians waited for death calmly, and many of them did not believe in the powers of medical treatment. He considered people’s excessive confidence in religion and religious authority extremely dangerous, given the serious threat the epidemic posed to entire communities. Moreover, he accused government officials of encouraging such passive behavior and pointed out that, at a time when the educated class of the territories was urgently demanding physicians, the response usually received from authorities was that people did not need or want them.61
Virchow also criticized the general indifference that the upper classes and Prussian authorities showed towards Polish suffering: “This habituation to misery, this hardening of feeling toward the sufferings of others is so general in the districts, that I would be the last to attack the local authorities because they did not attend to the dispatch of their partly quite serious and urgent reports with greater urgency and determination. What Prussian civil servant would not be silenced when always getting negative replies and regular refusals from Oppeln, from Breslau, from Berlin?”62
Clearly, the health care of Upper Silesians was not considered a priority among central state authorities. In fact, the Prussian government responded rather slowly to an epidemic that had been ravaging the lands for several months and had caused the death of 1,315 people in the first three months of 1848. Furthermore, the disease had taken hold of the territory in the middle of a terrible famine, which led people to call it “hunger-typhus.” Given the official apathy, the inhabitants of the province were forced to take care of their own well-being while the majority of the “Polish” population died of hunger and the dreadful disease.
The recommendations that Virchow gave to the Prussian government to avoid further epidemiological disasters lay outside the traditional scientific realm of medicine. Instead of prescribing therapeutic measures to contain the typhus disease, the physician deemed it necessary to transform completely the political approach towards the lands. He suggested a greater degree of political participation in local matters, measures to increase the income levels of the inhabitants, who lived in a quasi-serfdom system, and effective educational policies. Furthermore, Virchow recommended the total separation of church and state, official recognition of Polish as an official language, extensive agricultural reform, and less taxation on the poor. He even implied that the territories would be in much better shape if they were returned to the “mother nation.” The proposals also included the employment of “a better-trained corps of physician-reformers, acquainted with epidemiological principles, who could produce ‘long, detailed studies of local conditions.’”63
Although the Prussian state initially ignored Virchow’s recommendations, his report served to highlight many of the pressing problems affecting the Polish lands, especially in those areas with an overwhelming majority of Polish-speaking inhabitants. Virchow’s work was also useful in shaping the new Germanizing approach that imperial authorities took in Prussian Poland during the 1870s and 1880s. This new version of Germanization policies emphasized German education and the mobilization of German physicians to the provinces, two methods that Virchow had recommended, from a liberal stance, to culturally uplift the Polish population and improve its living conditions. During the process of forming the German Empire, the government ignored the suggestion of making Polish the official language in the region, but sought ways to integrate Upper Silesia, which had been forgotten by both German and Polish nationalist movements.64
The typhus epidemic confronted Prussians with a part of the kingdom that overturned every claim made about German progress and development and provided the ground for many Poles from other Polish provinces to rediscover Upper Silesia as a common cultural and national space. In a speech given in 1881, Franciszek Chłapowski, the first practicing Poznanian physician in Upper Silesia, reminded the members of the political party, Polish Circle (Koło Polskie), in Posen that “no one among us has bothered about Upper Silesia until now. We hardly knew that over a million kinsmen lived there, whose language, customs, and traditions were the same.”65 This cultural recognition came from the physician at a time when other members of the Polish Circle still viewed Upper Silesians as “merely one of the other peoples of the Empire.”66 The medicalization of the Prussian-Polish provinces and the mapping of typhus incidence and other diseases, in the context of political revolutions and Germanization policies, were certainly key elements in bringing about this national consciousness.
Chłapowski spent a considerable part of his medical and political career in Upper Silesia. His first encounter with the people of the region was as a military doctor during the Franco-Prussian War. He served in the Third Upper Silesian Regiment of National Defense, where he found out that most of the soldiers could not speak German and that “under a thin layer of Germandom in Silesia, live[d] authentic Poles.”67 This revelation made Chłapowski admire the population and consider them hardworking people who loved their language and religious beliefs above all. For him, it was precisely the close relationship between Polish culture and Catholicism that allowed Upper Silesians to preserve their Polishness. According to Chłapowski, “every German feels called to bring [German] culture, i.e., the extermination of everything that is Polish, while the Upper Silesian knows how to resist it, and his only point of support is the Catholic faith.”68 The physician was one of the earliest Polish intellectuals to propose a marriage between science and religion to combat Germanization policies in the Prussian-Polish provinces. He also believed that liberal Poznanians and Galicians had a great deal to learn from the Upper Silesian experience. While Virchow in 1848 considered religion to be detrimental to the progress of the region, Chłapowski deemed a few decades later that those religious beliefs were key to supporting the Polish nationalist movement.
Cholera and the Office of Imperial Health
Immediately after unification in 1871, authorities of the new German Empire initiated plans to found an institution that would oversee the overall health of the population. In 1876, they created the Office of Imperial Health (Kaiserliches Gesundheitsamt), the main goal of which was to study and keep statistical records on diseases, births, and mortality rates in Germany. It was also responsible for proposing public health laws based on experience and scientific research.69 A director and an advisory council of sixteen members from various states of the empire constituted the administrative body of the office. The first
