Despite a voluminous historiography on the Third Reich, there is still so much to learn about those twelve years of German history. In The State of Health: Illness in Nazi Germany, Geoffrey Campbell Cocks reveals how little we know about the “experience . . . of health and illness” under Hitler (p. 3). His wide-ranging, eloquently written study aims to remedy that deficit.

Cocks opens with chapters on the Imperial and Weimar years. He charts an “acceleration” of the German state's interventions into health care and the medical profession which, long before Hitler, resulted in a much “enhanced medical surveillance system” (pp. 8, 26). By the time a hypochondriac Hitler became chancellor and established his “State of Health” (chapter three), decades had passed since the state allowed Germans to experience health and illness as largely private matters. Chapter four examines health conditions within the Nazi state; as Cocks puts it, he looks at “the popular and official views, attitudes, discourses, representations, and actions . . . with regard to health and illness” (p. 40). Here he examines everything from fears about cancer to alcohol consumption to the sterilization of the mentally ill. The health of women's and workers' bodies was especially significant to the Nazi regime, so chapter five (“The Body of Life”) and chapter six (“The Body of Work”) focus on these two groups. Increasingly, a kind of ersatz health was created for them and other Germans through the manufacture and sale of pharmaceuticals, the subject of chapter seven.

References to the war years are woven through these earlier chapters, but chapter eight turns explicitly to World War II. In a nutshell, Cocks asserts, the war “radicalized” Nazi health policy (p. 179); unsurprisingly, it also radicalized Germans' experiences of health and illness on the home front, whether during mounting epidemics or due to doctor shortages. Chapter nine, entitled “The Body of Death,” looks at both the Shoah and the Nazis' “euthanasia” campaign. In a ghetto, camp, or asylum, real health among the imprisoned was rare, but relative health mattered a great deal as Cocks poignantly shows. Before death, there was often pain, and chapter ten returns to non-Jewish, non-disabled Germans, particularly soldiers, to examine their physical suffering. The final chapter turns to the last chaotic moments of the war, closing with a glimpse of the war's legacy for German health after 1945.

The State of Health has many strengths. Cocks writes exceedingly well, distilling complex ideas into succinct, memorable turns of phrase. For example, in describing the possible outcomes of illness in a concentration camp, he says simply, “One got sick and worked or one got sick and died or one got sick and was killed” (p. 234). Moreover, his material is never dull; the patient histories of Nazi henchmen fascinate; his investigations into the Nazis' subtle but meaningful language changes (from, for example, the “war damaged” to the “war disabled” to describe wounded veterans) are stimulating. Cocks's research is also admirable. He makes especially thoughtful use of the previously underutilized annual health reports (Jahresgesundheitsberichte) compiled by regional medical officers; his secondary sources are also up-to-date and copiously cited.

Equally impressive is the author's articulation of his position within key historiographical debates about the Third Reich by way of his own case studies. His reading of a polycratic, contradictory Nazi government “divided within itself,” his interpretation of the Third Reich as more “conduit” than “caesura” in German history, and his assessment of the inherent modernity of the Nazi project are compelling and he thus contributes to larger arguments about the nature of Hitler's empire (pp. 159, 19).

Yet there are some criticisms to be made. Some readers may question how useful the techniques of psychohistory—applying “psychoanalytic theory to history”—might be for uncovering experiences of illness and health in the past, but Cocks never lets Freudian concepts overwhelm or distract from his narrative (p. 16). More problematic is his continued reliance on a very limited group of historical actors and their written records to make wider claims. Again and again Cocks turns to the reminiscences of Victor Klemperer, Christa Wolf, Heinrich Böll, and a few others to glean evidence of how they experienced their bodies in the Third Reich. He must return to them, of course, because most “ordinary” Germans left no such sources behind, but these are not the most representative individuals from which to generalize. Moreover, relying repeatedly on the same people's accounts buries the numerous “regional and local variations” in experience that Cocks wishes to explore (p. 237).

Drawing on memoirs is one thing, but using fiction as a source is another. Admittedly, Hans Fallada's Every Man Dies Alone (1947) is based on a true story from the Nazi era, but should it serve as evidence for claims about barbiturate abuse (p. 159)? Is Günter Grass' novel The Tin Drum, not published until 1959, a valid source on the use of Lysol as a disinfectant at Treblinka (p. 171)? Perhaps, but at times Cocks rather elides the differences between the historical record and later fictional creations, although the elusiveness of sources on personal matters of the body make his decision to rely on the latter more understandable.

In sum, Cocks gives us an intelligent, scintillating exposé on the context of health and illness in the Third Reich—what the regime thought, said, and did about it; how local officials responded; how the healthy and sick were depicted; and much more—but there is still work to be done on recovering Germans' actual “subjective experiences of health and illness” under Hitler, apart from those of the better-known diarists, memoirists, and novelists cited here (p. 19). Retrieving those individual, private experiences is naturally a very difficult task for the historian. The State of Health should be lauded for making an impressive first attempt.