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112 CHAPTER 4 Fig. 4.3. Martin Nordmann and Adolf Sorge, pathologists at the University of Hanover, used this device to show that inhaled asbestos dust could cause lung tumors in mice. The team also chided their English and American colleagues for failing to recognize a human asbestos cancer hazard. Both men were in the Nazi party; Sorge was an officer in the SS. Source; Martin Nordmann and Adolf Sorge, "Lungenkrebs durch Asbeststaub im Tierversuch," Zeitschrift fur Krebsforschung 51 (1941): 170. like I. G. Farben--had recognized the cancer hazard by the early 1940s;154 popular health manuals also advertised the link.155 Why, then, did it take so long, outside Germany, for the lung cancer-asbestos link to be taken seriously? What we have to reckon with is both the conservatism built into postwar epidemiology and the postwar political disregard for all things German, the stigma of Nazism. This latter point is fairly straightforward; as Philip Enterline suggests in his history of as bestos cancer: "German literature and German laws were not very popular in 1943,"156 and for some time thereafter. The epidemiologic point, however, is more subtle. To begin with, the science of epidemiology as developed in the 1950s re OCCUPATIONAL CARCINOGENESIS 113 quired large numbers of "cases" (e.g., of lung cancers among peo ple working with asbestos)--which were not always available to early asbestos researchers. Even after Nordmann's 1938 study, the sum total of all the world's known asbestos cancers was only six (Nordmann had added two new cases). Epidemiologists were not impressed. As late as 1956, American epidemiologists could claim there were "too few cases and too little epidemiologic data to establish a significant relationship" between lung cancer and as bestos; the prestigious Journal of the American Medical Association even in 1961 concluded there was still "no epidemiological evi dence" of an association.157 The difficulty was not just industrial obstinacy or epidemiologic myopia or distrust of German science (though all of these were involved); the difficulty was also in the new methods of obtaining scientific proof. The Nazi scholars who, two decades earlier, had claimed to have established the link re lied not on epidemiology but on clinical and pathological in sights. Clinicians examining patients and pathologists dissecting corpses had noticed asbestotics coming down with the disease, but also that lung cancers were most often found in those parts of the lungs where the inhaled fibers tended to concentrate (espe cially the lower lobes). Detailed study of individual cases was sufficient, for these early scholars, to generate reliable conclusions about causality. Postwar epidemiologists and biostatisticians set little store by evidence of this sort. (Richard Doll even today ridicules Nord mann's claim to have "proven" the asbestos-cancer link by ex amining only two individual cases.)158 The "higher" standard of proof required by the new field of epidemiology prejudiced schol ars against the insights gained through clinical investigations, a loss Chris Sellers has characterized as "the vanishing clinician's eye."159 The net effect in the field of cancer research was to slow recognition of the asbestos hazard: the consensus achieved in Ger many in the early 1940s would not obtain in Britain or the United States until more than two decades later. Science and political stigma thus conspired--at least for a time--to confine the truth to shadows.