Rudolf Ludwig Karl Virchow

Rudolf Virchow is considered the most prominent German physician of the 19th century, his long and successful career reflecting the ascendancy of German medicine after 1840. Virchow pioneered the modern concept of pathological processes by his application of the cell theory to explain the effects of disease in the organs and tissues of the body. He emphasized that diseases arose, not in organs or tissues in general, but primarily in their individual cells. Moreover, he campaigned vigorously for social reforms and contributed to the development of anthropology as a modern science. He worked vigorously to make the methods of natural science supreme in the medical sciences.

Rudolf Virchow was born in the small town of Schievelbein, south of Köslin, in backward and rural eastern Pomerania, now the city of Koszalin in northwestern Poland. He was the only son of a modest merchant. He attended the school of his native town, where he expressed an early interest in the natural sciences. He also received private lessons in Greek, Latin and French from clerics. Such a background enabled Virchow to become educationally competitive and on May 1, 1835 he entered the Gymnasium in Köslin, where he received a broad humanistic training and subsequently demonstrated high scholarly abilities, passing the Abitur at Easter 1839.

Virchow first considered the study of theology, but chose medicine because he thought his voice would not bear from the pulpit. Because of his promising aptitudes, he received in 1839 a military fellowship to study medicine at the Friedrich-Wilhelms-Institut in Berlin to receive training as a military physician. The institution, popularly known as the “Pépinière,” provided educational opportunities for those unable to afford the costs in return for army medical service.

Although contemporary German medicine was only slowly shifting away from purely theoretical concerns, Virchow had the opportunity to study under Johannes Peter Müller (1801-1858) and Johann Lukas Schönlein (1793-1864), thereby being exposed to experimental laboratory and physical diagnostic methods, as well as epidemiological studies.

On October 21, 1843, Virchow defended his dissertation, on the corneal manifestations of rheumatic disease, for the medical doctorate. The essence of his dissertation is that rheumatism is actually a state of irritation and not an inflammatory disease or a simple inflammation. He proposed that the irritant itself is not an acid, but rather of an albuminous nature. To his parents he wrote that he received his degree from “the dean of the medical faculty, the world’s most famous physiologist, Johannes Müller.” He then became a subordinate physician, but in the autumn of 1844 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).

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 aetiologies 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 travelled 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 Karl von Rokitansky (1794-1878) and the Viennese Medical School, whom he indicted for their dogmatism and support of outdated humoralism (Preussische Medizinal Zeitung, December, 1846; Cleio medica, 1969, 4: 127-149).

In 1845 Virchow published a treatise on thrombosis and haematosis as delineated in his triad, describing one of the two earliest reported cases of leukaemia. This paper became a classic.

Virchow was relieved of military duty in 1847 to be habilitated as Privatdozent and, after having completed his Habilitationsschrift; he was officially appointed an instructor under the deanship of Johannes Müller at the University of Berlin. In 1846 he had also succeeded Froriep as prosector at the Charité Hospital, after Froriep moved to the position of director of the Weimarischer Landes-Industrie-Comptoir.

Virchow’s Archiv
Dissatisfied with the editors of journals that refused to accept some of his papers, Virchow, with his friend Benno Ernst Heinrich Reinhardt (1819-1852), in 1846 founded a new journal, Archiv für pathologische Anatomie und Physiologie und für klinische Medizin ("Archives of Pathological Anatomy and Physiology and of Clinical Medicine"). He wrote that the aim of the journal was a close union of clinical medicine, pathological anatomy and physiology and this remained his lifetime objective. He strongly propounded the concept that unproved hypothesis is an anathema for the practice of medicine and that no man could be regarded as infallible with regard to knowledge, judgement or supposition.

This journal became one of the most prominent medical periodicals of the time. After Reinhardt's death in 1852, Virchow continued as sole editor, now known as Virchows Archiv, until his own death 50 years later.

Early in 1848 Virchow, aged twenty-seven, was sent by the Prussian government to investigate an outbreak of hunger typhus epidemic prevalent in the weavers of Upper Silesia.

With the paediatrician and bureaucrat (Geheimer Ober-Medicinalrath) Stephan Friedrich Barez (1790-1856), 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 survive. 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 the usual humanitarian, hygienic phrases and medical guidelines for the Prussian government, Virchow recommended political freedom, and sweeping educational and economic reforms for the people of Upper Silesia.

Virchow quickly appreciated that the epidemic was largely due to the dreadful living conditions. His report and its severe indictment of the government for allowing this type of misery to occur and his emphasis on social injustices and poor hygienic regulations that were currently operative made him very unpopular with the government. The report was in part politically motivated; it stated inter alia “the proletariat is the result, principally, of the introduction and improvement of machinery” . . . “shall the triumph of human genius lead to nothing more than to make the human race miserable?”.

The government was annoyed, but it had to deal with the revolution of 1848 in Berlin. Eight days after his return from Silesia Virchow helped construct some of the barricades in Berlin during the uprising and participated in a movement by doctors to appoint a minister for health and secure greater rights. Virchow recommended the establishment of a Reichsministerium für öffentliche Gesundheitspflege and the abolishment of the Friedrich-Wilhelms-Institut.

After the revolution Virchow embraced the cause of such medical reforms as abolition of the various grades of physicians and surgeons, and from July 1848 to June 1849 he published a weekly paper, Die Medicinische Reform, much of which he wrote himself.

In 1848 he had to turn down a call as the representative of a Prussian borough, because he was not still of legal age for such a position.

On March 31, 1849, minister Von Ladenberg suspended Virchow from his academic position as prosector at the Charité Hospital. Although two weeks later he was reinstated as a result of protests from medical circles and students, with the loss of certain privileges.

Help from prominent personalities, in particular the obstetrician Friedrich Wilhelm Scanzoni von Lichtenfels (1821-1891), in 1849 made possible Virchow’s appointment to the newly established chair of pathological anatomy at the University of Würzburg, the first chair of that subject in Germany.

Here he was temporarily separated from political concerns, and here he gained a reputation as an outstanding teacher and investigator. During his seven fruitful years in that tenure, the number of medical students in the university increased from 98 to 388. Many men who later attained fame in the medical field received training there from him, among them were Edwin Klebs (1834-1913), Ernst Haeckel (1834-1919) and Adolf Kussmaul (1822-1902).

In 1850 Virchow married Rose Mayer, with whom he had three sons and three daughters.

In 1852, on assignment from the Bavarian government, Virchow investigated the famine in Spessart. The Würzburg years marked Virchow’s highest level of scientific achievement. At Würzburg Virchow published many papers on pathological anatomy. He began there the publication of his monumental, six-volume textbook Handbuch der speziellen Pathologie und Therapie ("Handbook of Special Pathology and Therapeutics"), most of the first volume of which he wrote himself. He also edited the famous Jahresbericht, a German yearbook depicting medical advances. At Würzburg he also began to formulate his theories on cellular pathology and started his anthropological work with studies of the skulls of cretins (dwarfed, mentally deficient individuals) and investigations into the development of the base of the skull.In 1856 Virchow accepted an invitation to return to the University of Berlin as professor of anatomy, general pathology, and therapy, as well as director of the newly created Pathological Institute.

This invitation reached him despite tough competition from among others the surgeon Theodor Billroth (1829-1894), and was made possible because the King had asked the medical faculty to disregard Virchow’s political views.

Virchow accepted the call subject to certain conditions, one of which was the erection of a new pathological institute, which he used for the rest of his life. Under Virchow the institution became a famous training ground for a large number of German and foreign medical scientists, including Ernst Felix Immanuel Hoppe-Seyler (1825-1895), Friedrich Daniel Recklinghausen (1833-1910), and Julius Friedrich Cohnheim (1839-1884). In addition, for almost two decades, Virchow remained in charge of a clinical section of the Charité Hospital, thereby carrying out the program of medical progress enunciated in 1845.

During much of this second Berlin period, Virchow actively engaged in politics. In 1859 he was elected to the Berlin City Council, on which, for the rest of his life, he focused on public health matters, such as sewage disposal, the design of hospitals, meat inspection, and school hygiene. He supervised the design of two large new Berlin hospitals, the Friedrichshain and the Moabit, and opened a nursing school in the Friedrichshain Hospital. Aided by the mayor of Berlin, Karl T. Seydel, who was his brother-in-law, Virchow was instrumental in achieving improvements in the sewage system and water supply of the rapidly growing metropolis.

In 1859 Virchow undertook a journey to Norway, invited by the Norwegian government, in order to investigate an epidemic of lepra (Hansen’s disease) on the western coast of Norway, probably the Bergen area.

In 1861 Virchow was elected to the Prussian Diet – the lower house – representing the new liberal Deutsche Fortschrittspartei (German Progressive Party), which he had founded with some friends. Virchow was an early, determined and untiring opponent of Otto von Bismarck’s policy of rearmament and forced unification. Virchow brought down upon himself the wrath of the “Iron Chancellor”, who in 1865 challenged him to a duel, which he wisely declined.

As a member of the board of the Berliner Hilfsverein für die Armee im Felde in 1866, 1870, 1871, Virchow, under great personal efforts, organized the first hospital trains and contributed to the building of the Barackenlazaret on the Tempelhof field near Berlin. In the Franco-German War he personally led the first hospital train to the front.

Medical investigations
By 1848 Virchow had disproved the then-prevailing view that phlebitis (inflammation of a vein) causes most diseases. He demonstrated that masses in the blood vessels resulted from "thrombosis" (his term) and that portions of a thrombus could become detached to form an "embolus" (also his term). An embolus set free in the circulation might eventually be trapped in a narrower vessel and lead to a serious lesion in the neighbouring parts. He was the first to recognise lung-and cerebral embolism.

Virchow's concept of cellular pathology was initiated while he was at Würzburg. Until the latter part of the 18th century, diseases were supposed to be due to an imbalance of the four fluid humours of the body (blood, phlegm, yellow bile, and black bile). This was the "humoral pathology," which dated back to the Greeks.

Contrary to the humoral pathology and kraselære of the Vienna school Virchow saw the causes of disease in changes of the cells. To Virchow the body is a “cell state in which each cell is a citizen,” and he considered disease to be simply “a conflict between the citizens of the state, caused by outer forces.” He crushed the old doctrines of humors and crases, and because of this was particularly brutal in his attack on Rokitansky’s first textbook Handbuch der pathologischen Anatomie (3 volumes, 1842-1846). In the second edition of this book (1855-1861) Rokitansky had removed all references to this type of speculative thinking.

At Würzburg Virchow began to realize that one form of the cell theory, which postulated that every cell originated from a pre-existing cell rather than from amorphous material, could give new insight into pathological processes. In this he was influenced by the work of many others, notably by the views of John Goodsir (1814-1867) of Edinburgh on the cell as a centre of nutrition. Virchow dedicated the first edition of his Cellularpathologie to Goodsir. He was also influenced by the investigations of the German neuroanatomist and embryologist Robert Remak (1815-1865), who in 1852 was one of the first to point out that cell division accounted for the multiplication of cells to form tissues. By that year Remak had concluded that new cells arose from existing cells in diseased as well as healthy tissue. Remak's writings, however, had little influence on pathologists and medical practitioners. Thus the idea expressed by Virchow's omnis cellula e cellula ("every cell is derived from a [preexisting] cell") is not completely original. Even this aphorism is not Virchow's; it was coined by the French natural scientist and politician François Vincent Raspail (1794-1878) in 1825. But Virchow made cellular pathology into a system of overwhelming importance. His main statement of the theory was given in a series of 20 lectures in 1858. The lectures, published in 1858 as his book Die Cellularpathologie in ihrer Begründung auf physiologische und pathologische Gewebenlehre (Cellular Pathology as Based upon Physiological and Pathological Histology), at once transformed scientific thought in the whole field of biology.

Virchow shed new light on the process of inflammation, though he erroneously rejected the possibility of migration of the leukocytes (white blood cells). He distinguished between fatty infiltration and fatty degeneration, and he introduced the modern conception of amyloid (starchy) degeneration. He devoted great attention to the pathology of tumours, but the importance of his papers on malignant tumours and of his three-volume work on that subject (Die krankhaften Geschwülste, 1863-1867) was somewhat marred by his erroneous conception that malignancy results from a conversion (metaplasia) of connective tissue. His work on the role of animal parasites, especially trichina, in causing disease in humans was fundamental and led to his own public interest in meat inspection. In 1874 he introduced a standardized technique for performing autopsies, by the use of which the whole body was examined in detail, often revealing unsuspected lesions.

Virchow's sceptical attitude to the new science of bacteriology was complex, based, to a large extent, on his belief that there was no single cause of disease. He resisted the idea that any germ was the sole etiological agent causing disease, and he rightly argued that the presence of a certain microorganism in a patient with a particular disease did not always indicate that that organism was the cause of the disease. He suggested, long before toxins were actually discovered, that some bacteria might produce these substances.

Following his experiences in Upper Silesia, Virchow stressed a sociological theory of disease, claiming that political and socio-economic 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 “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.

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 universal science of man did not materialize, Virchow’s efforts were helpful in associating the rapidly developing natural sciences with medical concerns. His attempts to derive an ethical framework from the biological sciences laid the foundations of bioethics.

Work in anthropology
It was in the early years of his second period in Berlin that Virchow’s interest began to shift gradually from pathology to anthropology. In 1865 he discovered pile dwellings in northern Germany, and in 1870 he began his own excavations of hill forts in Pomerania. In 1869 he was cofounder of the German Anthropological Society, and in the same year he founded the Berlin Society for Anthropology, Ethnology, and Prehistory - Deutsche Gesellschaft für Anthropologie, Ethnologie und Urgeschichte, of which he was president from 1869 until his death. During the whole of that period, he edited its Zeitschrift für Ethnologie ("Journal of Ethnology").

In 1874 Virchow, the enthusiastic dilettante, met Heinrich Schliemann, the discoverer of the site of Troy, and in 1879 he accompanied Schliemann to Hissarlik, where Troy was being excavated, and in 1888 to another dig in Egypt. In 1881 and in 1894 Virchow made expeditions to the Caucasus.

Virchow was the organizer of German anthropology. In 1886 he was instrumental in the erection of the Berlin Ethnological Museum, followed by the Museum of German Folklore in 1888. It was due largely to Virchow that Schliemann gave his magnificent collection to Berlin.

Virchow was the 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 different morphological types.

The man
Virchow was described as a small, mobile figure with a quick wit and somewhat of a martinet in the autopsy or lecture room. He would often be extremely sarcastic in dealing with incompetence, foolishness or inattention; on the other hand he could be extremely generous and helpful and always remembered those who had made contributions. For example, despite his virulent attack on Rokitansky, he highly praised the best features of his work. The clinics and those of his colleagues in Berlin must have been entertaining to visit because he, Remak, and others often hurled abuse at the speaker during the lecture courses. He was particularly virulent with the clinician Friedrich Theodor von Frerichs (1819-1885) - many would say unjustly so - whereas he was kindly disposed towards Ludwig Traube (1818-1876), who many felt was over-respectful to Virchow, fearing that he might come under the great man’s ire.

His strength of conviction and character is perhaps best illustrated by his consistent political activity in a society that was at the pinnacle of authoritarianism. He nonetheless was an extreme patriot and during the Franco-Prussian war organised the Prussian ambulance corps and superintended the erection of an army hospital on the Tempelhof. Indeed when he heard of a pamphlet of the French prehistorian A. de Quatrefages written following the accidental shelling of the museum of natural history in Paris, stating that Prussians were not a Germanic, but were a barbaric Mongolian destructive race, Virchow organised a colossal public census of the colour of the hair and eyes of 6 million German school children!

It is sometimes said that Virchow was antagonistic to Charles Darwin's theory of the origin of species by natural selection. The fact is that he accepted the theory as a tentative hypothesis but maintained throughout his later years that there was insufficient scientific evidence to justify its full acceptance. He also could not accept the views of Robert Koch (1843-1910) and Emil Behring (1854-1917) concerning toxins and antitoxins.

He wrote a number of interesting historical and biographical essays on Schönlein, Morgagni, and Müller, the latter whom he greatly admired and regarded as one of his inspirations in science. The exceptionally active and at times controversial man died of a road accident. He leapt at the age of 81 from a moving tram and broke his hip.

In 1873 Virchow was elected to the Prussian Academy of Sciences. He declined to be ennobled as "von Virchow," but in 1894 he was created Geheimrat ("privy councillor"). During a visit to England to give the Croonian lectures, he was conferred doctor of honour - Doctor of Common Law – and received numerous honours, including Commander of the Legion of Honour.

Virchow was a member of the Reichstag from 1880 to 1893, and during the 1880’s played a key role in the budgetary matters of the Reichstag, and he remained chairman of the finance committee until his death.

At the international congresses in Rome and Moscow, 1894 and 1897, respectively, Virchow lectured on Morgagni and the continuity of life as the basis for modern biological outlooks.

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 centres, even as far away as Japan and Russia, gave testimony to his unparalleled international reputation. Never seriously ill throughout his long life, 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 undermined his health, and he died several months later of cardiac insufficiency.

Virchow’s great fame made him a widely respected authority in his numerous fields of endeavour. His penchant, however, for polemics and acrimonious exchanges with colleagues exerted unfavourable 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 popularising his views. Few great men have been privileged to perceive more clearly the fruits of their labours 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 centre of modern scientific medicine, and Virchow had played a decisive role in this crucial transformation.

Most of Virchow’s important medical and anthropological writings are enumerated chronologically in a small “Festschrift” edited by Julius Schwalbe on the occasions of Virchow’s 80th birthday: Virchow-Bibliographie 1843-1901. Berlin, 1901, which covers close to 2,000 titles, and contains a valuable subject index. Pertinent archival material can be found in the “Nachlass Rudolf Virchow” of the Literatur-Archiv, Institut für deutsche Sprache und Literatur, Deutsche Akademie der Wissenschaften, East Berlin. Thor Jager (Wichita, Kansas, U.S.A.) has a large collection of Virchow’s original manuscripts and letters, with many pamphlets and books.

His son, Hans Virchow (born 1852) was teacher of anatomy at the Königliche Hochschule für die bildenden Künste and professor at the University of Berlin.

A cell state in which every cell is a citizen.
Die Cellularpathologie

Marriages are not normally made to avoid having children.
Quoted by F. H. Garrison in Bulletin of the New York Academy of Medicine, 1928, 4: 995.

Has not science the noble privilege of carrying on its controversies without personal quarrels?
Quoted by F. H. Garrison in Bulletin of the New York Academy of Medicine, 1928, 4: 995.

Ever since we recognized that diseases are neither self-subsistent, circumscribed, autonomous organisms, nor entities which have forced their way into the body, nor parasites rooted on it, but . . . the course of physiological phenomena under altered conditions . . . the goal of therapy has had to be the maintenance or the reestablishment of normal physiological conditions.
Disease, Life, and Man, “Standpoints in Scientific Medicine,” Translated by L. J. Rather.

Belief has no place as far as science reaches, and may be first permitted to take root when science stops.
Disease, Life, and Man, “On Man,” Translated by L. J. Rather.

There can be no scientific dispute with respect to faith, for science and faith exclude one another.
Disease, Life, and Man, “On Man,” Translated by L. J. Rather.

Where a cell arises, there a cell must have previously existed (omnis cellula e cellula), just as an animal can spring only from an animal, a plant only from a plant.
Cellular Pathology, Lecture II. Translated by Frank Chance.

If only people would finally stop finding points of disagreement in the personal characteristics and external circumstances of investigators! It does not matter at all whether someone is a professor of clinical medicine or of theoretical pathology, whether he is a practitioner or a hospital physician, if only he possesses material for observation. In addition, it is not of decisive significance whether he confronts an overwhelming or a modest amount of material, if only he understands how to exploit it. And to do this he must know what he wants: in other words, he must be in a position to put the right questions and to find the right methods for answering them.
Disease, Life, and Man, “Cellular Pathology.” Translated by L. J. Rather.

Humanism, therefore, is neither atheistic nor pantheistic, for it knows only one formula for everything lying beyond the bounds of knowledge: I do not know.
Disease, Life, and Man, “On Man,” Translated by L. J. Rather.

Practical medicine is never the same thing as scientific medicine but rather, even in the hands of the greatest master, an application of it.
Disease, Life, and Man, “Standpoints in Scientific Medicine.” Translated by L. J. Rather.

If popular medicine gave the people wisdom as well as knowledge, it would be the best protection for scientific and well-trained physicians.

I uphold my own rights and therefore I also recognize the rights of others.
Cellular Pathology, Preface. Translated by Frank Chance.

Pathology also has its place in the science of biology, certainly a very honorably one, for to pathology we owe the realization that the contrast between health and disease is not to be sought in a fundamental difference of two kinds of life, nor in an alteration of essence, but only in an alteration of conditions.
Disease, Life, and Man, “The Place of Pathology Among the Biological Sciences.” Translated by L. J. Rather.

Pathology has been released from the anomalous and isolated position which it has occupied for thousands of years. Through the application of its doctrines not only diseases of man, but also to those of even the smallest and lowest of animals, and to those of plants, it helps to deepen biological knowledge, and to light up still further that region of the unknown which still envelops the intimate structure of living matter. It is no longer merely applied physiology - it has become physiology itself.
Disease, Life, and Man, “The Place of Pathology Among the Biological Sciences.” Translated by L. J. Rather.

Only those who regard healing as the ultimate goal of their efforts can, therefore, be designated as physicians.
Disease, Life, and Man, “Standpoints in Scientific Medicine.” Translated by L. J. Rather.

You can soon become so engrossed in study, then professional cares, in getting and spending, you may so lay waste your powers that you find too late with hearts given away that there is no place in your habit-stricken souls for those gentler influences that make life worth living.

Medical instruction does not exist to provide individuals with an opportunity of learning how to make a living, but in order to make possible the protection of the health of the public.
Address to medical students at the Pathological Institute, Berlin.

Imprisoned quacks are always replaced by new ones.
Quoted by F. H. Garrison in Bulletin of the New York Academy of Medicine, 1928, 4: 995.

Laws should be made, not against quacks but against superstition.
Quoted by F. H. Garrison in Bulletin of the New York Academy of Medicine, 1928, 4: 995.

From the basic error that specific remedies were created for particular diseases came the notion that the whole course of a disease, or even its separate stages, could be annihilated by a single remedy. It was reserved for the ablest physicians of all times to perceive that identical remedies are good only for identical phases of different diseases and that for different phases of the same disease, different remedies are necessary.
Quoted by F. H. Garrison in Bulletin of the New York Academy of Medicine, 1928, 4: 994.

The task of science, therefore, is not to attack the objects of faith, but to establish the limits beyond which knowledge cannot go and to found a unified self-consciousness within these limits. Disease, Life, and Man, “On Man,” Translated by L. J. Rather.

Science in itself is nothing, for it exists only in the human beings who are its bearers . . . the idea “science for its own sake” . . . recalls the non-human conception in which man regards his soul as the true reality, as his real essence, where he “knows himself only as a spirit and has yet come to value his corporeal part.”
Disease, Life, and Man, “Standpoints in Scientific Medicine.” Translated by L. J. Rather.

The touchstone of true science is power of performance, for it is a truism that what can, also will, and thus attains to real science.

Medicine is a social science in its very bone marrow . . . No physiologist or practitioner ought ever to forget that medicine unites in itself all knowledge of the laws which apply to the body and the mind.
Disease, Life, and Man, “Scientific Method and Therapeutic Standpoint.” Translated by L. J. Rather.

Should medicine ever fulfil its great ends, it must enter into the larger political and social life of our time; it must indicate the barriers which obstruct the normal completion of the life-cycle and remove them. Should this ever come to pass, Medicine, what ever it may then be, will become the common good of all. It will cease to be medicine and will be absorbed into that general body of knowledge which is identifiable with power. Then will Bacon’s prediction be accomplished fact: what seemed casual in theory will become established rule in practice.
Die Einheitsbestrebungen in der wissenschaftlichen Medizin.

The physicians are the natural attorneys of the poor and the social problems should largely be solved by them.
Quoted by Erwin H. Ackerknecht in Rudolf Virchow, “The Doctor”

There are circumstances in which the split between scientific and practical medicine is so great that the learned physician can do nothing, while the practical physician knows nothing. Lord Bacon has said, scientia est potentia. Knowledge which is unable to support action is not genuine, and how unsure is activity without understanding! This split between science and practice is rather new; our century and our country have brought it into being.
Disease, Life, and Man,
“Standpoints in Scientific Medicine. ”Translated by L. J. Rather.

What is dark and incomprehensible attracts some minds more than what is clear and understandable.
Quoted by F. H. Garrison in Bulletin of the New York Academy of Medicine, 1928, 4: 994.

As long as vitalism and spiritualism are open questions so long will the gateway of science be open to mysticism.
Quoted by F. H. Garrison in Bulletin of the New York Academy of Medicine, 1928, 4: 994.

Brevity in writing is the best insurance for its perusal.
Quoted by F. H. Garrison in Bulletin of the New York Academy of Medicine, 1928, 4: 994.

The conjunction “and” commonly serves to indicate that the writer’s mind still functions even when no signs of the phenomenon are noticeable.
Quoted by F. H. Garrison in Bulletin of the New York Academy of Medicine, 1928, 4: 994.

In my journal anyone can make a fool of himself.

Rudolf Virchow was the editor of Handbuch der speciellen Pathologie und Therapie. 6 volumes, Erlangen, 1854-1876. From 1866, with Franz von Holtzendorf, he published the Sammlung gemeinverständlicher wissenschaftlicher Vorträge.
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With Gottfried Eisenmann (1795-1867) and Johann Joseph von Scherer (1814-1869), Virchow from 1852 edited Karl Friedrich Cannstatt’s (1807-1850) annual reports, Jahresbericht über die Leistungen und Fortschritte der gesammten Medicin (Berlin). From 1867 these were published by Virchow under the title of Jahresbericht über die Leistungen und Fortschritte in der gesamten Medicin. From 1894 published with Carl Posner (1854-). Below, the Archiv für pathologische Anatomie und Physiologie und für klinische Medicin, Berlin, is referred to as Virchows Archiv.

• De rheumate praesertim corneae.
  Doctoral dissertation, Berlin, 1843.
• Weisses Blut. [Froriep’s] Notizen aus dem Gebiete der Natur- und Heilkunde, 1845, 36: 151-156.
  Only six weeks after John Hughes Bennett (1812-1875), Virchow independently published a report on the necropsy of a case of leukaemia. He gave the condition its present name.
  J. H. Bennett:
  Case of hypertrophy of the spleen and liver, in which death took place from suppuration of the blood.
  Edinburgh Medical and Surgical Journal, 1845, 64: 413-423.
• Ueber die Standpunkte in der Wissenschaftlichen Medicin.
  Virchows Archiv, 1847, 1: 3-19-
• Zur Entwicklungsgeschichte des Krebses.
  Virchows Archiv, 1847, 1: 94-201.
• Ueber die Reform der pathologischenund therapeutischen Anschauungen durch die mikroskopischen Untersuchungen. Virchows Archiv, 1847, 1: 207-255.
• Sarcine. Virchows Archiv, 1847, 1: 264-271.
• Ueber die acute Entzündung der Arterien. Virchows Archiv, 1847, 1: 272-378.
• Die pathologischen Pigmente.
  Virchows Archiv, 1847, 1: 379-404, 407-486.
  One the origin and chemical composition of extracellular and intracellular pigments, and on the supposed formation of new cells by the membranous envelopment of pigmented blood corpuscles or pigment granules.
• Zur pathologischen Physiologie des Blutes. a) Veränderungen des Blutplasma's. b) Weisses Blut. c) Faserstoffarten und fibrinogene Substanze.
  Virchows Archiv, 1847, 1.
• Mittheilungen über die in Oberschlesien herrschende Typhusepidemie. Berlin, 1848.
• Die Einheitsbestrebungen in der wissenschaftlichen Medicin. Berlin 1849.
• Die naturwissenschaftliche Methode und die Standpunkte in der Therapie. Virchows Archiv, 1849, 2: 3-37.
• Der Staat und die Aerzte. II.
  Die medicinische Reform, 1849, 38: 217 ff.
  
• Der Staat und die Aerzte.
  III. Die medicinische Reform, 1849, 39: 221-223.
• Ueber eine im Gehirn und Rückenmark des Menschen aufgefundene Substanz mit der chemsichen Reaction der Cellulose.
  Virchows Archiv, 1854, 6: 135-138.
  Discovery of the neuroglia.
• Empirie und Transscendenz. Virchows Archiv, 1854, 7: 3-29.
• Cellular-Pathologie. Virchows Archiv, 1855, 8: 3-39.
• Gesammelte Abhandlungen zur wissenschaftlichen Medicin.
  Frankfurt am Main, 1 Meidinger, 1856; 2nd edition, Berlin, 1862.
  Reprints of papers covering a wide spectrum of clinical pathology published between 1846 and 1853. Contains, among other things:
  Thrombose und Embolie. Gefässentzündung und septische Infektion. Pages 219-732.
  Ueber farblose Blutkörperchen in Leukämie. Pages 147-218. Includes his paper on "Weisses Blut" and three later papers on lekcaemia.
• Beiträge zur Lehre von dem beim Menschen vorkommenden pflanzlichen Parasiten. Virchows Archiv, 1856, 9: 557-593.
  First description of pulmonary aspergillosis.
• Untersuchungen über die Entwicklung des Schädelgrundes.
  Berlin, 1857.
• Die Cellularpathologie in ihrer Begründung auf physiologische und pathologische Gewebelehre.
  Berlin, A. Hirschwald, 1858;
  Dritte, neu bearbeitete under vermehrte Auflage, Berlin, 1861. 4th edition, 1871.
  Translated into almost every European language.
  Representing 20 lectures that he delivered at the Pathological Institute in Berlin between February and April 1858. The 2nd edition was translated into English by F. Chance, as Cellular Pathology as Based Upon Physiological and Pathological Histology. London, 1860. The English translation has been reprinted several times.
  The work was dedicated John Goodsir (1814-1867), the Scottish anatomist and investigator in cellular physiology and pathology who insisted on the importance of the cell as the centre of nutrition and declared that the cell is divided into a number of departments.
  One of the most important books in the history of medicine, and the cornerstone of cellular pathology. Omnis cellula e cellula.
• Physiologische Bemerkungen über das seebaden, mit besonderer Rücksicht auf Misdroy. Virchows Archiv, 1858, 15 (1/2): 70-115.
• Ueber die Natur der constitutionell-syphilitischen Affectionen.
  Virchows Archiv, 1858, 15: 217-336.
  Virchow's great work on the pathology of syphilis confirmed the fact that it was a disease which involved all organs and tissues of the body and showed that the causal organism was transferred throught the blood to the various organs and tissues. Issued as offprint, 1859.
• Die Besetzung der Assistentenstellen am Berliner pathologischen Institut mit Beziehung auf das Gleubensbekenntniss der Bewerber.
  Virchows Archiv, 1868, 44: 138-144.
• Ueber die Reizbarkeit. Eine Oaratio pro domo. Virchows Archiv, 1868, 44: 145.171.
• Ueber interstitiell Encephalitis. Virchows Archiv, 1868, 44: 472-476.
• Johannes Mueller. Eine Gedächntnissrede. Berlin, 1858.
• Goethe als Naturforscher. Berlin, 1861.
• Vier Reden über Leben und Kranksein. Berlin, 1862.
  Contains: Atome und Individuen, pp. 35-76.
• Die krankhaften Geschwülste. 3 volumes, Berlin, 1863-1867.
  This classic work on tumors was never completed. Intended to consist of thirty lectures, Virchow stopped after the twenty-fifth. It is a very important work on cancer, but records Virchow's erroneous conclusion that the origin of cancer is in the connective tissue, a theory that was almost immediately refuted by Heinrich Wilhelm Gottfried Waldeyer-Hartz (1836-1921) in a paper appearing in Virchows own journal (1867, 41: 470-523; and 1872, 55: 67-159): Die Entwicklung der Carcinome.
• Ueber die nationale Entwicklung und Bedeutung der Naturwissenschaften.
  Berlin, 1865.
• Die Erziehung des Weibes für seinen Beruf. 1865.
• Gedächtnissrede auf Johann Lucas Schoenlein. Berlin, 1865.
• Lehre von den Trichinen. Berlin, 1865. 3rd edition, 1866.
• Ueber den Hungertyphus und einige verwandte Krankheitsformen. Berlin, A. Hirschwald, 1868.
  English translation, London, 1868.
  In the above report on the reappearance of typhus in Berlin and East Prussia, Virchow showed the connection between famine conditions and typhus outbreaks and strongly emphasised the social element in the generation of typhus.
• Ueber die Canalisation von Berlin.
  Viertejahrsschrift für gerichtliche und öffentliche Medicin, Berlin, 1868, n. F: 1.43.
  Virchow advocated a canal sewer system for Berlin.
  Such a system was constructed by James Hobrecht (1825-1902).
• Canalisation oder Abfuhr? Eine hygienische Studie.
  Virchows Archiv, 1869, 45: 231-298.
• Ueber gewisse, die Gesundheit benachtheiligende Einflüsse der Schulen. Virchows Archiv, 1869, 46: 447-470.
  English translation, New York, 1871.
  Improvements in school hygiene and the regular inspection of school children were brought about by the efforts of Virchow.
• Die Juden und die Hospitäler. Virchows Archiv, 1869, 46: 470-475.
• Ueber Gesichtsurnen.
  Lecture at the Gesellschaft für Anthropologie, Ethnologie und Urgeschichte. 1870.
• Die Siamesischen Zwillinge.
  Lecture at the Berlin Medical Society, 1870.
• Menschen und Affenschädel. Lecture, Berlin, 1870.
  Translated as The Cranial Affinities of Man and the Ape. Berlin, 1871.
• Die Aufgabe der Naturwissenschaften in dem neuen nationalen Leben Deutschlands. 1871.
• Ueber Lazarette und Barracken.
  Berliner klinische Wochenschrift, 1871, 8: 109-111, 121-124, 133-135, 157-159.
• Ueber die Chlorose und die damit zusammenhängenden Anomalien im Gefäss-Apparate, insbesondere über Endocarditis puepereralis.
  Lecture at the meeting of the Berliner geburtshilfliche Gesellschaft, June 12, 1870.
  Beiträge zur Geburtshülfe und Gynäkologie, Berlin, 1870-1872, 1, 323-359.
  Virchow first described the aortic hypoplasia with contracted heart in chlorotic maidens.
• Ueber die Chlorose und die damit zusammenhängenden Anomalien im Gefässapparate, insbesondere über Endocarditis puepereralis.
  Lecture at the meeting of the Berliner geburtshilfliche Gesellschaft, June 12, 1870. Berlin, 1872.
• Generalbericht über die Arbeiten der städtischen Deputation zur Reinigung und Entwässerung Berlins. 1873.
• Ueber einige Merkmale niederer Menschenrassen.
  Abhandlungen der königlichen Akademie der Wissenschaften zu Berlin, 1875.
• Die Sections-Technik im Leichenhause des Charité-krankenhauses.
  1876; 2nd edition, 1883.
  Vierte Auflage, Berlin, A. Hirschwald, 1893: Die Sections-Technik im Leichenhause des Charité-krankenhauses, mit besonderer Rücksicht auf gerichtsärztliche Praxis.
• Beiträge zur physischen Anthropologie der Deutschen, mit besonderer Berücksichtigung der Friesen.
  Abhandlungen der königlichen preussischen Akademie der Wissenschaften, Physisch-mathematische Klasse, Abt. I, 1: 1-390. Reprint, Berlin, 1877.
• Die Freiheit der Wissenschaft im modernen Staate. Berlin, 1877. English translation: The Freedom of Science in the Modern State. London, 1879.
• Gesammelte Abhandlungen aus dem Gebiete der öffentlichen Medicin und der Seuchenlehre.
  2 volumes; Berlin, 1879. Dealing with medical reform and public health; epidemics and mortality statistics, hospitals, military and urban sanitation; and legal medicine.
  
• Beiträge zur Landeskunde in Troas. 1879.
• Über die neueren Fortschritte in der Pathologie mit besonderer Beziehung auf Öffentliche Gesundheitspflege und Aetiologie.
  In: Gesammelte Abhandlungen auf dem Gebiete der öffentlichen Medicin und der Seuchenlehre. Volume 1. Berlin, 1879: 96-107.
• Krankheitswesen und Krankheitsursachen.
  Virchows Archiv, 1880, 79: 1-19, 185-228.
• Der Aussatz auf der iberischen Halbinsel. Virchows Archiv, volume 84.
• Die Craigentinny Farm bei Edinburg. Virchows Archiv, volume 96.
• Alttrojanische Gräber und Schädel. 1882.
• Abhandlung über den Schädel des jungen Gorilla.
  Monatsberichte der königlichen Akademie der Wissenschaften, 1880.
  Sitzungeberichte der Königlich Preussischen Akademie der Wissenschaften zu Berlin, 1882.
• Ueber den Werth des pathologischen Experiments.
  Virchows Archiv, 1881, 85: 373-378.
• Der Kampf der Zellen und der Bakterien. Virchows Archiv, Berlin, 1885, 101: 1-13.
• Die Anstalten der Stadt Berlin für die öffentliche Gesundheitspflege und den naturwissenschaftlichen Unterricht.
  With Albert Guttstadt (1840-1909). Berlin, 1886.
• Descendenz und Pathologie. Virchows Archiv, 1886, 103: 1-14, 205-215, 413-436.
• Ueber Myxodema. Berliner klinische Wochenschrift,, 1887, Heft 8: 121-126.
• Über die von Dr. Mackenzie exstirpirten Theile aus dem Kehlkopfe Seiner K.K. Hoheit des Kronprizen.
  Berliner klinische Wochenschrift, 1887, Heft 25 : 445.
• Gutachten über ein aus dem Kehlkopfe Sr. K. K. Hoheit des Kronprinzen entleertes Gewebsstück.
  Berliner klinische Wochenschrift, 1888, Heft 8: 137-138.
• Zur Diagnose und Prognose des Carcinoms.
  Virchows Archiv, Berlin, 1888, 111: 1-24.
• Crania Ethnica Americana, Sammlung auserlesener amerikanischer Schädeltypen.
  Berlin, A. Asker, 1892.
• Vorstellung der Knaben Dobos Janos.
  Berliner klinische Wochenschrift, 1892, 29: 517.
  Seckel's bird-headed dwarfism.
• Die Gründung der Berliner Universität und der Uebergang von dem philosophischen in das naturwissenschaftliche Zeitalter.
  Rectoral address, Berlin, 1893.
• Morgagni und der anatomische Gedanke.
  Lecture at the international congress in Rome 1894. Berlin, 1894.
  English translation by R. E. Schlueter and J. Auer: Morgagni and the Anatomical Concept. Bulletin of the History of Medicine, Baltimore, 1939, 7: 975-989.
• Hundert Jahre allgemeiner Pathologie.
  Festschrift zum 100jährigen Stiftungsfest der Kaiser-Wilhelm-Akademie, 1895.
• Kontinuität des Lebens als Grundlage der modernen biologischen Anschauung.
  Lecture at the international congress in Moscow 1897.
• Die Huxley-Vorlesung über die neueren Fortschritte in der Wissenschaft und deren Einfluss auf Medizin und Chirurgie.
  London, 1898. Berlin, A Hirschwald, 1898.
  English translation in Disease, Life and Man. Selected Essays by Rudolf Virchow. Selected, translated, annotated, and introduced by L. J. Rather, Stanford, 1959.
• Unser Jubelband. Virchows Archiv, Berlin, 1897, 150: 1-4.
• Die Continuität des Lebens als Grundlage der modernen biologischen Anshauung.
  Virchows Archiv, 1897, 150: 4-15.
• Nachruf an Ernst Reimer. Virchows Archiv, 1897, 150: 388-390.
• Die neue Folge der Bände des Archivs für pathologische Anatomie.
  Virchows Archiv, No. 151.
• Traumaticismus und Infection.
  Nach einer Rede, gehalten in der ersten allgemeinen Sitzung des XIII. intenationalen medicinischen Congresses zu Paris am 2. August 1900. Berlin, 1900. 26 pages.
• Über das Bedürfnis und die Richtigkeit einer Medizin vom mechanischen Standpunkt.
  Rede, gehalten zur Feier von Görcke's Geburtstag am 3. mai 1845 in dem med.-chir- Friedrich-Wilhelms-Institut zu Berlin. Mit Vorwort von J. Orth. Virchows Archiv, 1907, 188: 1-21.
  Address on the occasion of the birthday of Johann Goercke (1750-1822).
  J. Orth is Johannes Orth (1847-1923), Virchow's successaor in Berlin.
• Die Vorlesungen Rudolf Virchows über allgemeine pathologische Anatomie aus dem Wintersemester 1855-56 in Würzburg.
  Edited by E. Kugler. Jena, 1930. Virchow's papers on public health were collected, annotated, and translated into English by L. J. Rather as:
  
• Collected Essays on Public Health and Epidemiology.
  2 volumes. Canton, Massachusetts, 1985.
• L. J. Rather:
  A Commentary on the Medical Writings of Rudolf Virchow.
  San Francisco, Norman Publishing, 1990. Virchow-Bibliographie 1843-1901. Hrsg. von Julius Schwalbe (1863-1930). Berlin, 1901. With more than 2000 of Virchow's printed works. Works on Rudolf Virchow and his time
• W. Becher:
  Rudolf Virchow. Berlin, 1891. Auswärtige Presstimmen über den Tod Virchows.
  In: Berliner Tageblatt und Handels-Zeitung, Jg. 31, Nr. 453, v. 6.9. 1902.
• W. Ebstein:
  Rudolf Virchow als Arzt. Stuttgart, 1903.
• W. von Waldeyer:
  Gedächtnisrede auf Rudolf Virchow. Abhandlungen der königlichen preussischen Akademie der Wissenschaften aus dem Jahre 1903. Berlin, 1903, pp. 1-52.
• R. Drilll:
  Virchow als Reaktionär. In: Das freie Wort, Frankfurter Halbmonatsschrift, 1903, 2: 402-467.
• J. Pagel:
  Rudolf Virchow. Leipzig, 1906.
• C. Posner:
  Rudolf Virchow. Berlin, 1921.
  Rudolf Virchow 1821-1902. In: Geschichte der Mikroskopie, hrsg. von A. Freund, A. Berg, Frankfurt am Main, 1964, volume 2, pp 423-433. Virchow. Briefe an seine Eltern 1839-1864.
  Hrsg. von M. Rabl. Leipzig, 1906, 1907.
  (Virchow’s letters to his parents 1839-1864).
• R. Beneke:
  Rudolf Virchow. Jena, 1921. (=Beiträge zur pathologischen Anatomie und zur allgemeinen Pathologie, published by L. Aschoff, supplement No. 19.)
• Karl Sudhoff:
  Rudolf Virchow und die deutschen Naturforscherversammlungen. Leipzig, 1922.
• Hans Virchow:
  Die Abstammung Rudolf Virchows. Mitteilungen zur Geschichte der Medizin, der Naturwissenschaften und der Technik, 1933, 32: 220-222.
• Henry E. Sigerist:
  Grosse Ärzte, eine Geschichte der Heilkunde in Lebensbildern. München, 1932.
  English translation by E. and C. Paul: The Great Doctors. Garden City, New York, 1948: 319-330.
• Erwin H. Ackerknecht:
  Beiträge zur Geschichte der Medizinalreform von 1848.
  Sudhoffs Archiv für die Geschichte der Medizin, 1932, 25: 61-183.
  Rudolf Virchow, Doctor, Statesman, Antrhopologist. Madison, Wisconsin, 1953. Less a biography than an analysis of Virchow’s ideas, works, and accomplishments.
  Rudolf Virchow. Arzt, Politiker, Anthropologe. Stuttgart 1957.
• P. Diepgen, E. Rosner:
  Zur Ehrenrettung Rudolf Virchows und der deutschen Zellforscher.
  Virchows Archiv, 1941, 307: 457-489.
• Ludwig Aschoff:
  Rudolf Virchow. Hamburg, 1948.
• Hellmuth Unger:
  Virchow, ein Leben für die Forschung. Hamburg, 1953.
• Curt Froboese:
  Rudolf Virchow. Stuttgart, 1953.
• E. Meyer:
  Rudolf Virchow. Wiesbaden, 1956.
  Rudolf Virchow, Arzt, Politiker, Anthropologe. Stuttgart, 1957.
• Felix Bogenheim:
  Virchow, Werk und Wirkung. Berlin, 1957.
• P. Diepgen:
  Rudolf Virchow 1821-1902. In: Die grossen Deutschen. Deutsche Biographie, hrsg. von H. Heimpel, Th. Heuss, B. Reifenberg, Berlin, 1957, volume 4, pp. 28-36.
• Wolfgang Jacob:
  Medizinische Anthropologie im 19. Jahrhundert.
• R. Bieling:
  Der Hygieniker Virchow. In: Jubilee-Volume. Rudolf Virchow Medical Society. 100 Anniversary. Festschrift z. 100-Jahr-Feier. Hrsg. von J. Berberich u.a. Basel, New York, 1960.
• K. Panne:
  Die Wissenschaftstheorie von Rudolf Virchow.
  Unpublished doctoral dissertation, University of Düsseldorf, 1967.
• Gerhard Hiltner:
  Rudolf Virchow, ein weltgeschichtlicher Brennpunkt im Weredegang von Naturwissenschaft und Medizin. Stuttgart, 1970.
• E. W. Kohl:
  Virchow in Würzburg. Pattensen (1976). (= Würzburger Med hist Forsch., volume 6.
• C. Andrée:
  Rudolf Virchow – Theodor Billroth. Leben und Werk. Kiel, 1979. Obituaries/biographical sketches:
  
• Sir Felix Semon (1849-1921) in British Medical Journal, 1902, 2: 795-802.
  vOskar Israel (1854-1907), Rudolph Virchow, in Report of the Board of Regents of the Smithsonian Institution, 1902: 641-659;
  
• James Joseph Walsh (1865-1942), Makers of Modern Medicine. New York, 1915: 357-430
• Sticker, Geschichte des medizinischen Facultäts Würzburg, pp. 647-646.

We thank Rudolf Kleinert, Bad Reichenhall, Germany, for information submitted.