Dr R Virchow: pathology, science, politics ....................... by guest blogger

Prussian Rudolf Virchow (1821-1902) was the only child of a farmer and always had a strong interest in natural science. In 1839, he received a scholarship from the Prussian Military Academy to study medicine at Berlin’s Friedrich Wilhelm Institute University. He grad­uated in 1843 and was preparing for a career as an army physician.

Rudolf Virchow with skeletons

Science Photo Library

At the Charité Hospital he studied pathological histology and in 1845 published a paper des­cribing one of the earliest reported cases of leukaemia. He became hospital anat­omist, and in 1847 he and Dr Benno Rein­hardt started a new journal Virchow’s Archives which still goes on as a leading pathology journal. He asked students to use microscopes and had a major impact on medical education in Germany. He taught several men who became famous scientists, including William Welch & William Osler, 2 physicians who founded Johns Hopkins Hospital.

Dr Virchow was appointed by the Prussian government to in­ves­tigate a typhus epidemic in Upper Silesia; his strong report blamed the outbreak on social conditions that were tolerated by the government. The government was annoyed, but it had to deal with the revolution in Berlin! After the 1848-9 Revolution, Virch­ow wrote and published a weekly paper, Medical Reform, but the government didn’t like his progressive views.

Having already established a reputation as a crusading social reformer, he’s since been identified as much with social medicine as pathology. His regular writings on topics of pathology included many essays and lectures on social medicine and public health. His writings and teachings recommended ways of improving people’s health by improving their economic and social conditions.

The doctor was soon appointed to the newly established Chair of Path­ological Anatomy at Würzburg University, Germany’s first. During his successful years there, Virchow published many papers on pathological anatomy, and began publishing his 6-volume Handbook of Special Pathology and Therapeutics (1854). He also began to formulate his theories on cell­ular pathology with studies of the abnormal skulls of those affected by neonatal hypo­thyroidism.

Dr Virchow giving a Pathology lecture

Science Photo Library

Virchow disliked the majority view that phlebitis of a vein caus­ed most diseases; he de­monstrated that mass­es in the blood vessels resulted from thromb­osis and that portions of a thrombus could detach to form an embolus. An embolus set free in the circulation could be trapped.

Virchow’s greatest success was his observation that a whole organism does not get sick, only groups of cells. In 1855 at 34, he published his now famous aphorism every cell stems from another cell. Virchow thus launched the field of cellular pathology. He stated that all diseases involve changes in normal cells i.e all pathology ultimately is cellular pathology. This insight led to major progress in medicine. It meant that disease entities could be defined much more sharply. Diseases could be characterised not merely by a group of clinical symptoms but by typical anatomic changes.

In 1856 he was given the Chair of Pathological Anatomy established at Berlin Uni; and a new pathological institute was built which he used until retirement. His main statement of his cellular pathology theory was given in a lecture series in 1858 and published as his book Cellular Path­ol­ogy as Based upon Physiological and Pathological Histology. Virchow lectured on the inflammatory process, introducing the modern con­cep­t­ion of starchy degeneration. The pathology of tumours was important, as was his work on the role of animal parasites in causing disease in humans.

Interestingly Virchow became actively engaged in politics. In 1859 he was elected to the Berlin City Council, foc­using on pub­lic health issues eg meat inspection and school hygiene. He super­vised the design of two large new Berlin hospit­als, opened a Nursing School and designed the new city sewer system. Then in 1861 he was elected to the Prussian Diet/Assembly under Otto von Bis­marck. In the wars of 1866 and 1870, Vir­ch­ow was involved in building military hos­pitals and equipping hospital trains. In 1874 the doctor introduced a standardised technique for perform­ing aut­opsies, to examine the whole body in detail.

Dr Virchow supervised autopsies closely

ThoughtCo.

It was interesting that this talented doctor campaigned vigorously for soc­ial reforms and contrib­uted to the development of anthropology and archaeology. These were Virchow’s­ main interests in 1865 when he discovered hill forts in North­ern Germany. In 1869 he co-founded the German Anthropological Ass­ociation and in 1870 he founded the Berlin Society of Anthropology, Ethnology & Prehistory and continued to edit its journal. And in 1873 Virchow was elected to the Prussian Academy of Sciences. He excavated wall mounds in Wollstein with Dr Robert Koch in 1875 and edited Koch’s papers. [For his discovery of tuberculosis bacterium, Koch won a Nobel Prize in Medicine, 1905].

Pathologic anatomy had major practical consequences. If the physician was able to find out what anatomic changes had occurred in a patient, he could make a much more accurate diagnosis of the disease than he could previously. This also empowered physicians to give more precise treatment and prognosis. In his speeches Virchow advocated that medicine in Germany should a] study microscopic pathological anatomy, b] do research performed by physicians and c] make systematic clinical observations

Virchow’s many discoveries included finding cells in bone and connective tissue and describing substances eg myelin. He was the first to recognise leukemia and the first to explain the mechanism of pulmonary thromboembolism. He showed that blood clots in the pulmonary artery can originate from venous thrombi. While Virchow in Germany was creating the new science of cellular pathology, Louis Pasteur in France was developing the new science of bacteriology. Virchow and  Pasteur’s germ theories were somewhat different.

He served in the German Reichstag (1880–93) while also directing the Pathological Institute in Berlin. Even though Virchow was opposed to Bismarck’s excessive budget, which angered Bismarck sufficiently to challenge Virchow to a duel, Virchow helped to shape Bismarck’s health care reforms. Not bad for a pathologist, public health activist, social reformer, politician and anthropologist!

by Dr Joseph

neoclassical sculpture was created to honour Dr Virchow

by Fritz Klimsch from 1906, 

On Karlplatz in Berlin-Mitte, 

Wiki