Rudolf Ludwig Carl Virchow ( ; ; 13 October 18215 September 1902) was a German physician, anthropologist, pathologist, prehistorian, biologist, writer, editor, and politician. He is known as "the father of modern pathology" and as the founder of social medicine, and to his colleagues, the "Pope of medicine".
Virchow studied medicine at the Friedrich Wilhelm University under Johannes Peter Müller. While working at the Charité hospital, his investigation of the 1847–1848 typhus epidemic in Upper Silesia laid the foundation for public health in Germany, and paved the way for his political and social careers. From it, he coined a well known aphorism: "Medicine is a social science, and politics is nothing else but medicine on a large scale". His participation in the Revolution of 1848 led to his expulsion from Charité the next year. He then published a newspaper Die Medizinische Reform (The Medical Reform). He took the first Chair of Pathological Anatomy at the University of Würzburg in 1849. After seven years, in 1856, Charité reinstated him to its new Institute for Pathology. He co-founded the political party Deutsche Fortschrittspartei, and was elected to the Prussian House of Representatives and won a seat in the Reichstag. His opposition to Otto von Bismarck's financial policy resulted in duel challenge by the latter. However, Virchow supported Bismarck in his anti-Catholic campaigns, which he named Kulturkampf ("culture struggle").
A prolific writer, he produced more than 2000 scientific writings. Cellular Pathology (1858), regarded as the root of modern pathology, introduced the third dictum in cell theory: Omnis cellula e cellula ("All cells come from cells"), although this concept is now widely recognized as being plagiarized from Robert Remak. He was a co-founder of Physikalisch-Medizinische Gesellschaft in 1849 and Deutsche Gesellschaft für Pathologie in 1897. He founded journals such as Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin (with Benno Reinhardt in 1847, later renamed Virchows Archiv), and Zeitschrift für Ethnologie (Journal of Ethnology). The latter is published by German Anthropological Association and the Berlin Society for Anthropology, Ethnology and Prehistory, the societies which he also founded.
Virchow was the first to describe and name diseases such as leukemia, chordoma, ochronosis, embolism, and thrombosis. He coined biological terms such as "neuroglia", "agenesis", "parenchyma", "osteoid", "amyloid degeneration", and "spina bifida"; terms such as Virchow's node, Virchow–Robin spaces, Virchow–Seckel syndrome, and Virchow's triad are named after him. His description of the life cycle of a roundworm Trichinella spiralis influenced the practice of meat inspection. He developed the first systematic method of autopsy, and introduced hair analysis in forensic investigation.
Opposing the germ theory of diseases, he rejected Ignaz Semmelweis's idea of disinfecting. He was critical of what he described as "Nordic mysticism" regarding the Aryan race. As an anti-Darwinist, he called Charles Darwin an "ignoramus" and his own student Ernst Haeckel a "fool". He described the original specimen of Neanderthal man as nothing but that of a deformed human.
Early life
Virchow was born in Schievelbein, in eastern Pomerania, Prussia (now Świdwin, Poland). He was the only child of Carl Christian Siegfried Virchow (1785–1865) and Johanna Maria née Hesse (1785–1857). His father was a farmer and the city treasurer. Academically brilliant, he always topped his classes and was fluent in German, Latin, Greek, Hebrew, English, Arabic, French, Italian and Dutch. He progressed to the gymnasium in Köslin (now Koszalin in Poland) in 1835 with the goal of becoming a pastor. He graduated in 1839 with a thesis titled A Life Full of Work and Toil is not a Burden but a Benediction. However, he chose medicine mainly because he considered his voice too weak for preaching.
Scientific career
In 1839, he received a military fellowship, a scholarship for gifted children from poor families to become army surgeons, to study medicine at the Friedrich Wilhelm University in Berlin (now Humboldt University of Berlin). He was most influenced by Johannes Peter Müller, his doctoral advisor. Virchow defended his doctoral thesis titled De rheumate praesertim corneae (corneal manifestations of rheumatic disease) on 21 October 1843. Immediately on graduation, he became subordinate physician to Müller. But shortly after, he joined the Charité Hospital in Berlin for internship. In 1844, he was appointed as medical assistant to the prosector (pathologist) Robert Froriep, from whom he learned microscopy which interested him in pathology. Froriep was also the editor of an abstract journal that specialised in foreign work, which inspired Virchow for scientific ideas of France and England.
Virchow published his first scientific paper in 1845, giving the earliest known pathological descriptions of leukemia. He passed the medical licensure examination in 1846 and immediately succeeded Froriep as hospital prosector at the Charité. In 1847, he was appointed to his first academic position with the rank of privatdozent. Because his articles did not receive favourable attention from German editors, he founded Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin (now known as Virchows Archiv) with a colleague Benno Reinhardt in 1847. He edited alone after Reinhardt's death in 1852 till his own. This journal published critical articles based on the criterion that no papers would be published that contained outdated, untested, dogmatic or speculative ideas.
Unlike his German peers, Virchow had great faith in clinical observation, animal experimentation (to determine causes of diseases and the effects of drugs) and pathological anatomy, particularly at the microscopic level, as the basic principles of investigation in medical sciences. He went further and stated that the cell was the basic unit of the body that had to be studied to understand disease. Although the term 'cell' had been coined in 1665 during the English scientist Robert Hooke's early application of the microscope to biology, the building blocks of life were still considered to be the 21 tissues of Bichat, a concept described by the French physician Xavier Bichat.
The Prussian government employed Virchow to study the typhus epidemic in Upper Silesia in 1847–1848. It was from this medical campaign that he developed his ideas on social medicine and politics after seeing the victims and their poverty. Even though he was not particularly successful in combating the epidemic, his 190-paged Report on the Typhus Epidemic in Upper Silesia in 1848 became a turning point in politics and public health in Germany. He returned to Berlin on 10 March 1848, and only eight days later, a revolution broke out against the government in which he played an active part. To fight political injustice he helped found Die Medizinische Reform (Medical Reform), a weekly newspaper for promoting social medicine, in July of that year. The newspaper ran under the banners "medicine is a social science" and "the physician is the natural attorney of the poor". Political pressures forced him to terminate the publication in June 1849, and he was expelled from his official position.
In November 1848, he was given an academic appointment and left Berlin for the University of Würzburg to hold Germany's first chair of pathological anatomy. During his seven-year period there, he concentrated on his scientific work, including detailed studies of venous thrombosis and cellular theory. His first major work there was a six-volume Handbuch der speciellen Pathologie und Therapie (Handbook on Special Pathology and Therapeutics) published in 1854. In 1856, he returned to Berlin to become the newly created Chair for Pathological Anatomy and Physiology at the Friedrich-Wilhelms-University, as well as Director of the newly built Institute for Pathology on the premises of the Charité. He held the latter post for the next 20 years.
Cell biology
Virchow is credited with several key discoveries. His most widely known scientific contribution is his cell theory, which built on the work of Theodor Schwann. He was one of the first to accept the work of Robert Remak, who showed that the origin of cells was the division of pre-existing cells.Lois N. Magner A history of the life sciences, Marcel Dekker, 2002, , p. 185 He did not initially accept the evidence for cell division and believed that it occurs only in certain types of cells. When it dawned on him in 1855 that Remak might be right, he published Remak's work as his own, causing a falling-out between the two.
Virchow was particularly influenced in cellular theory by the work of John Goodsir of Edinburgh, whom he described as "one of the earliest and most acute observers of cell-life both physiological and pathological". Virchow dedicated his magnum opus Die Cellularpathologie to Goodsir.Gardner, D. John Goodsir FRS (1814–1867): Pioneer of cytology and microbiology. J Med. Biog. 2015;25:114–122 Virchow's cellular theory was encapsulated in the epigram Omnis cellula e cellula ("all cells (come) from cells"), which he published in 1855. (The epigram was actually coined by François-Vincent Raspail, but popularized by Virchow.) It is a rejection of the concept of spontaneous generation, which held that organisms could arise from nonliving matter. For example, maggots were believed to appear spontaneously in decaying meat; Francesco Redi carried out experiments that disproved this notion and coined the maxim Omne vivum ex ovo ("Every living thing comes from a living thing" — literally "from an egg"); Virchow (and his predecessors) extended this to state that the only source for a living cell was another living cell,Virchow, R. (1858). Cellular pathology: As based upon physiological and pathological histology, 20 lectures delivered in the Pathological Institute of Berlin, during Feb. Mar. and Apr. 1858. New York: De Witt. and the notion became popularly known as the theory of "biogenesis".
Cancer
In 1845, Virchow and John Hughes Bennett independently observed abnormal increases in white blood cells in some patients. Virchow correctly identified the condition as a blood disease, and named it leukämie in 1847 (later anglicised to leukemia). In 1857, he was the first to describe a type of tumour called chordoma that originated from the clivus (at the base of the skull).
Theory of cancer origin
Virchow was the first to correctly link the origin of cancers from otherwise normal cells. (His teacher Müller had proposed that cancers originated from cells, but from special cells, which he called blastema.) In 1855, he suggested that cancers arise from the activation of dormant cells (perhaps similar to cells now known as stem cells) present in mature tissue. Virchow believed that cancer is caused by severe irritation in the tissues, and his theory came to be known as chronic irritation theory. He thought, rather wrongly, that the irritation spread in the form of liquid so that cancer rapidly increases. His theory was largely ignored, as he was proved wrong that it was not by liquid, but by metastasis of the already cancerous cells that cancers spread. (Metastasis was first described by Karl Thiersch in the 1860s.)