Rudolf Virchow

German pathologist and statesman

• Born: October 13, 1821
• Birthplace: Schivelbein, Pomerania, Prussia (now Swidwin, Poland)
• Died: September 5, 1902
• Place of death: Berlin, Germany

Virchow received worldwide recognition for his contributions to medical science, anthropology, archaeology, and public health. His greatest contribution to medical science was in establishing the principles of cellular pathology.

Early Life

Born in a small eastern Pomeranian city, Rudolf Ludwig Karl Virchow (FIHR-koh) was the only child of a minor city official and farmer. He began his formal education in the gymnasium at Coslin, where he distinguished himself by his linguistic abilities; he soon mastered Latin; learned Greek, English, and French; and was a good Hebrew scholar. In October, 1839, he entered the medical school of the Friedrich-Wilhelms-Institut, in Berlin. Johannes Müller, a physiologist, anatomist, and pathologist, and Johann Lucas Schönlein, an outstanding German clinician, influenced Virchow as he began his research activities while still an undergraduate. In 1843, he presented his thesis “De rheumate praesertim corneae” (rheumatic disease, particularly of the cornea), received his doctorate in medicine, and was given the position of assistant at the Charité Hospital. In the following year, he obtained the post of prosector of anatomy to the Charité Hospital, acting as assistant to Robert Froriep, whom he eventually succeeded only three years later, in 1846.

Froriep assigned to his young assistant, as a theme for independent investigation, the study of phlebitis. Virchow’s thorough and brilliant studies outlining the principles of thrombosis and embolism formed a new chapter in pathology. In addition, his observations on leukemia opened new points of view on the origin and nature of white blood corpuscles. In 1847, at the age of twenty-six, with Benno Reinhardt he started the Archiv für pathologische Anatomie und Physiologie, und für klinische Medizin (archives for pathological anatomy and physiology and clinical medicine), a journal he continued to edit alone after his colleague’s death in 1852.

In 1848, a singular event occurred that Virchow, in later life, regarded as the most decisive in his life. Sent on an official mission to study an epidemic of “hunger typhus” (relapsing fever) in famine-ridden Upper Silesia, a Prussian province occupied by a Polish minority, he published a scathing report indicting the government, insisting that the causes of the epidemic were social as much as—if not more than—medical. His antigovernment stance, coupled with the fact that, on his return, he had allied himself with the ultraradical party and founded a medico-political journal, Die medizinische Reforme (medical reform), resulted in his dismissal from all professional posts in Berlin. His fame as a pathologist had spread, and the University of Würzburg seized the opportunity and offered Virchow the professorship of pathology and the directorship of the newly founded Pathological Institute, where Virchow dedicated himself to research work.

As a young man, Virchow presented a small professorial figure. He was short, thin, blond, and dark-eyed, and was accorded the nickname Der Kleine Doktor (the little doctor). He was quick in mind and body, often transfixing inattention or incompetence with a flash of sarcasm. However, he was approachable, hospitable, and particularly warm and friendly to the sick and poor.

Life’s Work

As professor of pathology at the University of Würzburg, Virchow entered the most creative period of his life. For the next seven years, his systematic and methodical research culminated in outlining the fundamental principles of cellular pathology. For centuries before Virchow, the origin of life and the seat of disease were the subjects of many theories and controversies. Medieval anatomists localized disease to one of the larger regions or cavities of the body, such as the head, chest, or abdomen. During the mid- to late eighteenth century, anatomists, led by Giovanni Battista Morgagni, attempted to find the actual diseased organ, and Marie François Xavier Bichat showed that in the same organ, sometimes one and sometimes another tissue might be the seat of disease.

In the third decade of the nineteenth century, the microscope had disclosed the existence of cells, and in the next decade the study of pathological anatomy was directed to their study. Research in this area was faced with two major hurdles: First, cells could not be demonstrated in several tissues, even in their most developed state; second, the origin of new cells was completely unknown. The answer to the latter question was heavily prejudiced by the so-called cell theory of Theodor Schwann, who asserted that new cells arose from unformed, amorphous matter, which he termed “cytoblastema.”

When Virchow arrived at the University of Würzburg in 1849, he had already brought with him some ideas about the principles of cellular pathology. Here, he proceeded to demonstrate the existence of cells in bone and in connective tissue, where their existence had hitherto been doubtful. This discovery of cells of connective and other allied tissues offered him the possibility of finding a cellular matrix for many new growths. These studies led to his coining the aphorism omnis cellula e cellula (each cell stems from another cell), which became the recognized hallmark of the biological cell theory. Virchow’s conception of disease rested on four main hypotheses: first, that all diseases are in essence active or passive disturbances of living cells; second, that all cells arise from parent cells; third, that functional capacities of the cells depended on intracellular physicochemical processes; and finally, that all pathological formations are degenerations, transformations, or repetitions of normal structures.

Internationally famous for his research and teaching at Würzburg, Virchow was called back to the University of Berlin in 1856. Virchow agreed to return on the condition that a pathological institute be founded. The government agreed, and Virchow arrived to continue work with indefatigable zeal and published his Die cellular Pathologie in ihrer Begründung auf physiologische und pathologische Gewebelehre (1858; Cellular Pathology as Based upon Physiological and Pathological Histology , 1860), describing his work on the subject. Virchow’s own aphorism omnis cellula e cellula is the basis for his work on tumors during 1863-1867, which treats these formations as physiologically independent new growths of cellular structure.

Virchow continued to write and edit his medical journal and enjoyed the satisfaction of celebrating its jubilee in December, 1897. Under his direction, the department of pathology at the Charité Hospital became a model for other institutions. He personally supervised the establishment of one of the best pathology museums in the world. In addition, he delivered lectures regularly, which were attended by an international audience. He was not a great orator; his voice was weak and his speech simple, but once on the platform the small man with the sharp dark eyes commanded attention.

Virchow once again entered politics and was elected member of the municipal council; in 1862, he took his seat in the Prussian Diet, and by his sheer ability was recognized as leader of the opposition Radical Party. He led a desperate fight against Otto von Bismarck’s dictatorship, and it is said that Bismarck became so annoyed with Virchow that he challenged him to a duel, which was averted by behind-the-scenes negotiations through Bismarck’s intermediaries, who were determined to prevent it.

Virchow was also president of the German Geographical Society and the Society of Anthropology and Ethnology. He even had his own anthropological collection, mainly consisting of crania of the different human races. An accidental shelling of the Museum of Natural History in Paris during the war prompted the publication of an indignant pamphlet stating that the Prussians were not a Germanic but a barbaric race. That stirred Virchow’s patriotism to the extent that he instigated a colossal public census of the color of the hair and eyes in six million German schoolchildren, concluding that there was no evidence of a predominant “German type” among them. He was interested in archaeology and worked in excavation sites of ancient Troy in Greece and Egypt; he also conducted his own fieldwork in the Caucasus in 1894.

Virchow remained at the forefront of international medicine and was showered with honors from scientific academies in Germany, France, and England. In 1891, his seventieth birthday was celebrated and a gold medal was presented to him by the emperor in recognition of the immense services Virchow had rendered to science. On January 5, 1902, he fell when exiting a tram car but, although he fractured a leg in the accident, he recovered and was able to move about on crutches. He then went to Harzburg to recuperate, but he became weaker. Three weeks prior to his death, his friends decided to take him back to Berlin; Virchow did not tolerate the journey well, lapsed into a coma from which he never recovered, and died on September 5, 1902. Virchow was given a public funeral with honors and laid to rest in the cemetery of St. Matthew.

Significance

Rudolf Virchow, one of the founders of modern biomedicine, was also a proponent of social reform. According to Virchow, medicine was to be reformed on the basis of four principles: First, the health of the people is a matter of direct social concern; second, social and economic conditions have important effects on health and disease; third, the measures taken to promote health and to combat disease must be social as well as medical; and fourth, medical statistics should be the standard of measurement. Virchow’s contribution to the improvement of public health was monumental; his discovery of the pathophysiology of the parasitic disease trichinosis led a successful ten-year campaign to establish compulsory meat inspection in Germany. At the request of the Berlin city council, he designed and supervised a sewage-disposal system that set the pattern for similar systems in Germany and elsewhere. He organized the ambulance service for the army and, recognizing the importance of nurses to medical care, he opened a nursing school.

Although Virchow made significant contributions in many fields, he became world-famous for his work in cellular pathology. The fundamental principles of cellular pathology outlined by him, particularly the dictum omnis cellula e cellula, forever closed the last loophole for opponents of this system and secured a position of great importance in physiology. Virchow was the first to systematize the theory of cellular pathology and to give medicine a common denominator for all diseases. Virchow’s success may be attributed to the quality of his research, his prolific publications, his single-minded determination, and the growth of his influence on medicine. His work on cellular pathology had far-reaching consequences, contributing to progress in medicine and in surgery. It is therefore a fitting tribute that cellular pathology has been hailed as one of the great achievements in the history of medicine.

Bibliography

Ackerknecht, Erwin H. Rudolf Virchow: Doctor, Statesman, Anthropologist. Madison: University of Wisconsin Press, 1953. The first full-length study of Virchow, covering 240 pages. Although the author introduces the book with a brief life history, this is primarily an analysis of Virchow’s work in medicine, politics, and anthropology. An extensive bibliography, strictly confined to items quoted in the text, is supplemented by an exhaustive biographical glossary. This book contains one sketch and two portraits of Virchow, including the first published portrait of Virchow as a septuagenarian.

Boyd, Byron A. Rudolf Virchow: The Scientist as Citizen. New York: Garland, 1991. One of the few English-language biographies of Virchow, adapted from the author’s doctoral thesis.

Carr, James G. Rudolph Virchow. Chicago, Ill.: Northwestern University Bulletin, 1938. This concise twenty-three-page biography of Virchow contains translated excerpts of letters from Virchow to his parents that shed light on his early years, family life, and customs. No bibliography or illustrations are provided.

Creedon, Jeremiah. “Dr. Virchow’s Cure.” Utne Reader, no. 111 (May, 2002): 79. An overview of Virchow’s career, contributions to modern public health, and ideas about the link between poverty and disease.

Jacobi, Abraham. Rudolf Virchow. New York: Trow, 1881. This thirty-five-page booklet is packed with information. Emphasizes Virchow’s work in pathology and the work leading to the establishment of the principles of cellular pathology. Bibliography is not provided.

Virchow, Rudolf. Diseases, Life, and Man: Selected Essays. Translated by Lelland Rather. Stanford, Calif.: Stanford University Press, 1958. Contains selected essays by Virchow on a range of subjects, including cellular pathology, scientific medicine, and philosophy. An excellent introduction by the translator covers Virchow’s place in history and explores his role in the establishment of the principles of cellular pathology and the foundations of modern medicine. An appendix contains the German titles and sources of articles translated, including an extensive biographical glossary.

Welch, Henry. “Rudolph Virchow, Pathologist.” Boston Medical and Surgical Journal 125 (1891): 453-457. An article written on the occasion of Virchow’s seventieth birthday celebrations at Johns Hopkins University. This essay gives a thorough and scholarly review of Virchow’s work in the field of pathology.