VIRCHOW, RUDOLF CARL

(b. Schivelbein, Pomerania, Germany, 13 October 1821; d. Berlin, Germany, 5 September 1902), pathology, social medicine, public health, anthropology.

A strong and versatile personality equally interested in the scientific and social aspects of medicine, Virchow was the most prominent German physician of the nineteenth century. His long and successful career reflects the ascendancy of German medicine after 1840, a process that gradually provided the basic underpinnings to a discipline that was still largely clinical. Armed with great self-confidence, aggressiveness, and a deep sense of social justice, Virchow became a medical activist who engaged vigorously in political polemics and participated in social reforms. His elevation of science to the level of quasi-religious dogma and his utopian view of medicine as the science of man should be interpreted within the framework of his times, a period that witnessed the effective adoption of scientific method in medicine.

Virchow was born in a small town in backward and rural eastern Pomerania; he was the only son of a modest merchant. He expressed an early interest in the natural sciences and received private lessons in the classical languages. Such a background enabled Virchow to become educationally competitive and in 1835 he successfully transferred to the Gymnasium in Köslin, where he received a broad humanistic training and subsequently demonstrated high scholarly abilities.

Because of his promising aptitudes, Virchow received in 1839 a military fellowship to study medicine at the Friedrich-Wilhelms Institut in Berlin. The institution, popularly known as the “Pépiniere,” provided educational opportunities for those unable to afford the costs in return for subsequent army medical service.

Although contemporary German medicine was only slowly shifting away from purely theoretical concerns, Virchow had the opportunity to study under Johannes Müller and Johann L.Schönlein, thereby being exposed to experimental laboratory and physical diagnostic methods, as well as epidemiological studies.

In 1843 Virchow received his medical degree from the University of Berlin with a doctoral dissertation on the corneal manifestations of rheumatic disease. Shortly thereafter he received an appointment as “company surgeon” or medical house officer at the Charité Hospital in Berlin, where he rotated through the various services. In addition, with the hospital’s prosector, Robert Froriep (1804-1861), Virchow carried on microscopic studies on vascular inflammation and the problems of thrombosis and embolism.

In 1845 two forceful speeches delivered by invitation before large and influential audiences at the Friedrich-Wilhelms Institut revealed young Virchow as one of the most articulate spokesmen for the new generation of German physicians. Rejecting transcendental concerns, Virchow envisaged medical progress from three main sources: clinical observations, including the examination of the patient with the aid of physicochemical methods; animal experimentation to test specific etiologies and study certain drug effects; and pathological anatomy, especially at the microscopic level. Life, he insisted, was merely the sum of physical and chemical actions and essentially the expression of cell activity.

Virchow’s rather provocative ideas generated considerable hostility among his older peers, but he passed his licensure examination in 1846 without difficulties and began teaching pathological anatomy. Under the auspices of Prussia’s high military and civilian authorities, he traveled to Prague and Vienna in order to evaluate their programs in pathology. One of the consequences of his trip was Virchow’s strong attack on Rokitansky and the Viennese Medical School, whom he indicted for their dogmatism and support of an outdated humoralism.

After completing his Habilitationsschrift in 1847, Virchow was officially appointed an instructor under the deanship of Johannes Müller at the University of Berlin; he also succeeded Froriep as prosector at the Charité Hospital. In the same year Virchow launched–ostensibly in order to publish his speeches of 1845—a new scientific journal with Benno Reinhardt, a colleague in pathology. The publication, named Archiv für pasthologische Anatomie und Physiologie, und für die klinische Medizin, became one of the most prominent medical periodicals of the time; and Virchow remained its editor until his death.

The typhus epidemic that ravaged the Prussian province of Upper Silesia in early 1848 prompted the government to send a team of physicians to the area to survey the disaster. With the pediatrician and bureaucrat Stephan F. Barez, Virchow visited the afflicted region for almost three weeks and came face to face with the backward and destitute Polish minority, who were struggling precariously to service. According to his own testimony, the impact of that encounter left an indelible mark on his already liberal social and political beliefs. Instead of merely returning with a new set of medical guidelines for the Prussian government, Virchow recommended political freedom, and sweeping educational and economic reforms for the people of Upper Silesia.

Virchow’s gradual alienation from the status quo and his political radicalization led him to participate actively in the uprisings of 1848 in Berlin, where he fought alongside his friends on the barricades. As a result, Virchow was thrown into a full schedule of political activities and became a member of the Berlin Democratic Congress and editor of a weekly entitled Die medizinische Reform. Virchow’s triumph, however, was shortlived. In early 1849 he was suspended from his academic position as prosector at the Charité Hospital because of his revolutionary activities. Although he was partially reinstated as a result of protests from medical circles and students, the defeat of liberalism imposed restrictions on Virchow and created an unfavorable climate for his activities.

Thus, in November 1849 Virchow finally left Berlin and went on to the University of Würzburg in order to assume the recently created chair in pathological anatomy, the first of its kind in Germany. He was temporarily separated from political concerns, and the ensuing years marked Virchow’s highest level of scientific achievement and the establishment of the scientific achievement and the establishment of the concept of “cellular pathology.” He was also deeply engaged in teaching, and among his most famous Würzburg students were Edsin Klebs (1834-1913), Ernst H. P. A. Heackel (1834-1919), and Adolf Kussmaul (1822-1902). Virchow initiated the oublication of the xis volume Handbuch der speziellen Pathologie und Therapie, a mounmental textbook of pathology and therapetics; he also edited the famous Jahres bericht, a German yearbook depicting medical advances.

In 1856 Virchow accepted an invitation to return to Berlin as professor of pathological anatomy and director of the newly created Pathological Institute. Under Virchow the institution became a famous taining ground for a large number of German and foreign medical scientists, including Hoppe-Seyler, Recklinghausen, and Cohnheim. In addition, for almost two decades Virchow remained charge of a clinical section at the Charité Hospital, thereby carrying out the program of medical progress enunciated in 1845.

Two aspects of Virchow the pathologist should be distinguished: his scientific methodology and his activities in the field of cellular pathology. Without being original, Virchow stressed the importance of observation and experiment, strongly condemning his speculative predecessors. He himself, however, fell prey to the still lingering desire for an overall synthesis of medical knowledge and the establishment of first principles. Imaginative and intuitive,. Virchow performed numerous inductive leaps, leaving to others, whose work he often did not acknowledge, the painstaking task of fact collecting.

Virchow expressed an early interest in “pathological physiology” and promulgated a dynamic view of disease processes, which viewed the static structural changes (pathological anatomy) sequentially. Although the idea was by no means novel, with the aid of improved microscopic and biochemical techniques, Virchow applied the concept successfully. For Virchow the microscope became the central tool for reducing pathological processes to altenations occurring at the cellular level. Hence, the cell became the fundamental living unit in both health and disease-a biological rather than a mechanical entity. Virchow’s notion of cellular pathology implied that all the manifestations of disease could be reduced to disturbances of living cells. Moreover, according to Virchow’s famous principle, “omnis cellula e cellula,” all cells originated from other cells. Cellular function, in turn, depended on intracellular physicochemical changes, which were reflected in the varying morphology, Finally, all pathological forms were to be viewed as deviations from the normal structures. Virchow’s cellular pathology demolished the vestiges of humoral and neural physiopathology, and placed the field on its modern basis.

During the early years of Virchow’s second period in Berlin, his interests began to shift gradually from pathology to anthropology, while he was engaged at the same time in a fair amount of political activities. Nevertheless, Virchow published in 1858 his most famous book on turmors, Die Krankhaften Geshwülste.

At the suggestion of an old friend. Virchow was appointed in 1859 to the Berlin City Council, where he concentrated his efforts on matters related to public health. Aided by the mayor of Berlin, Karl T. Seydel, who was his brother-in-law, Virchow was instrumental in achieving improvements in both the sewage system and water supply of the rapidly growing metropolis. In 1861 he was elected a member of the Prussian lower house and represented the new liberal Deutsche Fortschrittspartei (German Progressive Party), which he had founded with some friends. As an early leader of the opposition to Bismarck’s policy of rearmament and forced unification, Virchow brought down on himself the wrath of his opponent and was chalenged by Bismark to a duel, which he was wise enough to avoid. During the ensuing Franco-Prussian War of 1870, Virchow was active in organizing military hospital facilities and establishing ambulance and train services for the wounded.

Following his experiences in Upper Silesia, Virchow stressed a sociological theory of disease, claiming that political and socioeconomic factors acted as significant predisposing factors in many ailments. He even went so far as to declare that certain epidemics arose specifically in response to some social upheavals. Virchow considered a number of diseases as “artificial” or primarily caused by conditions within society and thus liable to cure or elimination through social change. As early as 1848 Virchow insisted on the constitutional right of every individual to be healthy . Society had the responsibility to provide the necessary sanitary conditions for the unhampered development of its members. Here again, through his work in the Reichstag and the city council of Berlin, Virchow not only espoused lofty ideals but fought hard to achieve the necessary reforms in school hygiene, sewage treatment, pure water control, and hospital construction.

In proclaiming that medicine was the highest form of human insight and the mother of all the sciences, Virchow was following in the footsteps of French social thought and also expressing a postulate of the German philosophers of nature. Although his utopian hopes for medicine as the unified science of man did not materialize, Virchow’s efforts were helpful in associating the rapidly developing natural science with medical concerns. His attempts to derive an ethical framework from the biological sciences laid the foundations of bioethics.

In his later years Virchow’s skeptical attitude toward bacteriology was based, to a large extent, on his belief that there was no single cause of disease. He did not consider any germ to be the sole etiologic agent in an infectious illness. The bacterial agents were, in Virchow’s view, only one factor in the causation of disease among a variety of environmental and sociological factors clearly discernible during the typhus and cholera epidemics of 1847-1849. Such broad considerations did not originate with Virchow, but they gained greater attention and significance with his prestigious support.

From 1870 onward, Virchow rather assiduously cultivated another science: anthropology. Cofounder of the German Anthropological Society a year earlier and author of several studies dealing with skull deformities, he studied the physical characteristics of the Germans, especially the Frisians. After performing a nationwide racial survey of schoolchildren, Virchow concluded that there was no pure German race but only a mixture of differing morphological types. On another matter, he questioned Darwinism as an established fact, viewing it rather as a tentative hypothesis in search of adequate proof.

The Darwinian stimulus to archaeological research also affected Virchow, and in 1870 he began his own excavations in Pomerania. His later friendship with Schliemann lent some legitimacy to this enthusiastic dilettante and eventually helped to attract the treasures to Berlin. In 1879 Virchow himself traveled with Schliemann to Hissarlik, where Homer’s Troy was being excavated, and in 1888 he participated in another archaeological dig in Egypt.

In 1886 Virchow was instrumental in the erection of the Berlin Ethnological Museum, followed by the Museum of German Folklore in 1888. Throughout the 1880’s he continued to play a key role in the budgetary matters of the Reichstag, and he remained chairman of the finance committee until his death.

Virchow’s eightieth birthday in 1901 became the occasion for an unprecedented worldwide celebration. A torchlight parade in Berlin and numerous receptions in the leading scientific centers, even as far away as Japan and Russia, gave testimony to his unparalleled international reputation. Never seriously ill throughout his longlife. Virchow suffered a broken hip in early 1902 after falling from a streetcar in Berlin. Although seemingly on the mend, the long period of inactivity seriously undetermined his health, and died several months later of cardiac insufficiency.

Virchow’s great fame made him a widely respected authority in his numerous fields of endeavor. His penchant, however, for polemics and acrimonious exchanges with colleagues exerted unfavorable influences for the development of certain medical ideas and methods. An example was his opposition to the prophylactic hand washings of Semmelweis for the prevention of puerperal fever. In his later years Virchow displayed a stifling dogmatism and a certain pedantry, which in some measure detracted from his earlier popularity. In spite of these traits he was overwhelmingly self-confident and untiringly persuasive in popularizing his views. Few great men have been privileged to perceive more clearly the fruits of their labors in the autumn of their lives than Virchow. In less than half a century Germany had progressed from speculative and philosophical healing to become the world center of modern scientific medicine, and Virchow had played a decisive role in this crucial transformation.

BIBLIOGRAPHY

I. Original Works. Most of Virchow’s important medical and anthropological writings are enumerated chronologically in a small “Festschrift” edited by J. Schwalbe on the occasion of the physician’s 80th birthday: Virchow-Bibliographie 1843-1901 (Berlin, 1901), which covers close to 2,000 titles, and contains a valuble subject index. Pertinent archival material can be found in the “Nachlass Rudolf Virchow” of the Literatur-Archiv, Institute für deustsche Sprache und Litgeratur Deutsche Akademic der Wissenschaften, East Berlin. Thor Jager (Wichita, Kansas) has to large collection of Virchow’s original MSS and letters, with many pamphlets and books.

Prominent among Virchow’s publications were Die Cellularpathologie in ihrer Begründung auf physiologische und pathologische Gewebelehre (Berlin, 1858). representing 20 lectures that he delivered at the Pathological Institute in Berlin between February and April 1858. The 2nd ed. of the work was translated into English by F. Chance, Cellular Pathology as Based Upon Physilogical and Pathological Histology (London, 1860). Two important collections of Virchow’s writings are Gesammelte Abhandlungen zur wissenschaftlichen Medizin (Frankfurt, 1856), which contains, among others, articles on white cells and leukemia, thrombosis and embolism. gynecological subjects, and thr pathology of the newborn; and Gesammelte Abhandlungen ausdem Gebiet der oeffentlichen Medizin and der Seuchenlehre, 2 vols. (Berlin, 1879), dealing with medical reform and public health; epidemics and mortality statisics; hospitals, military and urban sanitation; and legal medicine.

A collection of 30 lectures on tumors given at the University of Berlin during the winter semester 1862-1863 is in Die krankhaften Geschwiilste, 3 vols, (Berlin, 1863 - 1867). For other lectures on general pathology, see Die Vorlesungen Rudolf Virchows über allgemeine pathologische Anatomie aus dem Wintersemaster 1855-56 in wüurburg, E, Kugler, ed. (Jena, 1930).

Some of Virchow’s more philosophical essays and socipolitical speeches have received wider diffusion and have been translated into English. Die Freiheit der Wissenschaft im modernen Staat (Berlin, 1877) appeared as The Freedom of Science in the Modern State (London, 1878). Morgagni und der anatomische Gedanks (Berlin, 1894) was translated by R. E. Schlueter and J. Auer, “Morgagni and the Anatomocal Concept,” in Bullentein of the Histroy of Medicine, 7 (1939), 975-989. A series of talks are in Disease, Life and Man, Selected Essays by Rudolf Virchow, trans and with an introduction by L. J. Rather (Standford, 1958), including (1847, 1877), which also appeared in Bullentin of the Histrory of Medicine, 30 (1956), 436-449, 537-543.

For Virchow’s critique of Rokitansky’s pathology. L. J. Rather, trans., “Virchow’s Review of Rokitansky’s Handbuch’ in the Precussiche Medizinal Zeitung. Dec 1846,” in clio medica, 4 (1969), 127–140, Virchow’s Croonian lecture delivered at the Royal Society of London in 1893 was translated into Enhlish and published as “The Place of Pathology Among the Bilogical Sciences,” in Proceedings of the Royal Society, 53 (1893), 114– 129. Virchow also gave the second Huxley lecture at the opening of Charing Cross Hospital Medical School, London, in 1898, which appeared first in English as: “Recent Advances in Sciences and Their Bearing on Medicine and Surgery,” in British Medical Journal (1898), 2. 1021-1028.

Virchow’s early studies and relationships with his parents are contained in an extensive corresponddence, Rudolf Virchow, Briefe an Seine Eltern, 1839 bis 1864, M. Rabl, ed. (Leipzing, 1906).

Virchow’s most notable anthropological writings are Beiträge zur physicichen Antropologie der Deutschem mubesonderer Berücksichtigung, der Friesen (Berlin, 1877), and Crania Ethnica Americana, Sammlung auserlesener amerikanischer Schädeltypen (Berlin, 1892). See also Menschen tend Afferschädel (Berlin, 1870), a lecture that was translated as The Cranial Affinities of Man and the Ape (Berlin, 1871). For an English version of Virchow’s review, see C. A. Bleismer, ”Anthropology in the Last Twenty Years,” in Report of the Board of Regents of the Smithsonian Institution (1890), 550-570. “Regents of the Smithsonian Institution” (1896) was translated as “Rassenbildung und Erblickeit” (1896) was translated as “Heredity and the Formation of Race,” in This Is Race, E. W. Count. ed. (New york, 1950), 176–193.

II. Secondary Literature. The most important work on Virchow is Erwin H. Ackerknencht, Rudolf Virshow, Doctor, Statesman, Anthrolopogist (Madison, Wis., 1953), which is not primarily a biography but rather an analysis of Virchow’s ideas, works, and accomplishements. Among some of the more recent biographical works in German are Ludwig Ascholf, Rudolf Virchow (Hamburg, 1948); Hellmuth Unger, Virchow, ein Leben Fur die Forschaung (Hamburg, 1953); Curt Froboses, Rudolf Virchow (Stuttgart, 1953); Kurt Winter, Rudolf Virchow (Leipzing, 1956); and Ernst Meyer, Rudolf Virchow (Wiesbaden, 1956).

In 1921 a large number of speeches and articles appeared in Germany to commemorate Virchow’s 100th birthday. For a list of these work, see Virchows Archiv fur pathologiasche Anatomie und Physilogie und fur klinische Medizin, 235 (1921), and the Deutsche medizinisches Wochenschrift, 47, no. 40 (1921). 1185-1195. Several letters written by the young Virchow appear in G. B. Gruber, “Aus der Jungarztzeit von Rudolf Virchow,” in Virchows Achiv…, 321 (1952), 462–481. Brief biographical sketches of Virchow in English are the opbituray by F. Semon in British Medical Journal. (1902), 2, 795–802; O. Isreal, “Rudolph Virchow, 1821-1902,” in Report of the Board of Regents of the Smithsonian Institution (1902), 641–659; James J. walsh. Makers of Modern Medicine (New York, 1915), 357–430; and Henry E. Sigerist, Grosse Ärzte, eine Geschichte der Heilkunde in Lebensbildern (Munchi, 1932), English trans. by E. and C. Paul, The Great Doctors (Garden City, N. Y., 1958), 319–330.

Recent German works dealing with Virechow’s achievenments are Felix Boenheim, Virchow’s Werk und Wirkung (Berlin, 1957); Wolfgang Jacob, Medizinische Anthropologie im 19. Jahrhundert; and Gerhard Hiltner, Rudolf Virchow, ein weltgeschichtlicher Brennpunkt im Werdegang von Naturwisswenschaft und Medizin(Stuttgart, 1970). Also noteworthy is K. Panne, “Die Wissenschaftstheorie von Rudolf Virchow” (unpublished doctoral dissertation, Univ of Düsseidorf, 1967). Numerous articles dealing with aspects of Virchow’s work are W. Pagel, “Virchow und die Grundlagen der Medizin des XIX. Jahrhunderts,” in Jenaer medizin-historische Beiträge, 14 (1931), 1-44; P. Diepgen, “Virchow und die Romantik,” in Deutsche medizinische Wochenschrift, 58 (1932), 1256-1258; L. J. Rather, “Virchow und die Entwicklung der Entzündungs-frage im 19. Jahrhundert,” in Verhandlungen des XX. Internationalen Kongresses für die Geschichte der Medizin (Hildesheim, 1968), 161–177; and H. M. Koelbing, “Rudolf Virchow und die moderne Pathologie,” in Münchener medizinische Wochenschrift110 (1968), 349–354.

Other valuable references to Virchow are L. S. King, “Cell Theory, Key to Modern Medicine,” in The Growth of Medical Thought (Chicago, 1963), 207–219; and W. H. McMenemey, “Cellular Pathology, With Special Teachings on Medical Thought and Practice,” in Medicine and Science in the 1860’s. F. N. L. Poynter, ed. (London, 1968), 13–43.

Important journal articles are W. Pagel, “The Speculative Basis of Modern Pathology. Jahn, Virchow, and the Philosophy of Pathology,” in Bulletin of the History of Medicine, 38 (1945), 1–43; J. W. Wilson, “Virchow’s Contribution to the Cell Theory,” in Journal of the History of Medicine, 2 (1947), 163–178; P. Klemperer, “The Pathology of Morgagni and Virchow,” in Bulletin of the History of Medicine, 27 (1953), 24–38; D. Pridan, “Rudolf Virchow and Social Medicine in Historical Perspective,” in Medical History, 8 (1964), 274–284; and L. J. Rather, “Rudolf Virchow’s Views on Pathology, Pathological Anatomy and Cellular Pathology,” in Archives of Pathology, 82 (1966), 197–204.

Guenter B. Risse