Democracy as medicine the Mail

Depending on whether a biographer reads one, Rudolf Ludwig Carl Virchow’s greatest contribution lies in his studies of cancer, cell pathology, the drive for experimentation, or democracy, or in another of the many fields of which he dealt with throughout his life. His influence on science is colossal, but he also has a relevant presence for the common citizen, as a great promoter of public health and social medicine.

What would be called the father of modern pathology and by his contemporaries ‘Pope of Medicine’ was born on October 13, 1821 in Schivelbein, Prussia, now part of Poland, the only son of the local farmer and treasurer, Carl Christian Siegfried Virchow, and his wife, Johanna Maria Hesse. His demonstrated abilities as a student led his parents to take extracurricular lessons to improve his education, so in 1839 the young Rudolf obtained a scholarship to study medicine at the Prussian Military Academy.

His professional path would be marked by his professors Johannes Müller and Johann Schönlein, who introduced him to experimental laboratory techniques. In 1843 he went to a boarding school in a university hospital in Berlin, where another professor, Robert Froriep, taught him microscopy techniques and exposed him to new ideas about the causes and treatment of diseases.

It was 20 years before Louis Pasteur and Robert Koch would concretize the microbial theory of disease, and much of Medicine was still mired in the belief in the four supposed moods as an explanation of the body’s processes. But, even more, it was believed that the natural world could be understood by looking for its basic principles in philosophical speculation rather than in observations and experiments. Faced with this scenario, Virchow set out to promote the most scientific and data-based approach collected from the real world through systematic and rigorous observations. This made him one of the founders of evidence-based medicine.

Already as a licensed physician, in 1847 he took Froriep’s place at the University of Berlin and founded a scientific journal on Pathological Anatomy and Physiology and Influential Clinical Medicine, which he continues to publish today under the name ‘Virchow Archives as the official ‘newspaper’ of the European Society of Pathology.

A year later, he worked evaluating typhus outbreaks in Silesia, a particularly poor region of then-Prussia. The conclusions of his report were unexpected: the outbreak could not be controlled by treating individual patients with drugs, but could only be achieved with radical action that would promote the social advancement of the entire population, which required “full democracy and unlimited ”as well as“ education, freedom and prosperity ”. Diseases, Virchow argued, were never purely biological, but were derived and propagated through the mechanisms of society.

This experience would mark a new path for Virchow. If, as he thought, Medicine was a social science and doctors were “the natural advocates of the poor,” it was necessary to found a journal, ‘Social Medicine,’ and to take part in the 1848 revolution.

Cell theory

His political activity led to his dismissal as a dissection specialist at Charité University Hospital in Berlin, but he was soon readmitted at the request of his students and colleagues. Virchow continued his scientific work, which translated into more than 2,000 writings, among which a particularly influential was ‘Cell Pathology’, of 1858, considered the cornerstone of modern Pathology. One of his key statements was the defense of cell theory, that is, that all tissues of living things are composed of cells, and that spontaneous generation did not exist because “every cell comes from ‘another cell’, as Pasteur would demonstrate a few years later. The other element that changed the course of Pathology was its concept that the disease does not arise in tissues or organs in general, but mainly in their individual cells. With this, it was possible to diagnose diseases not only by symptoms, but by studying the affected cells.

His conviction that the methods of science were the way of Medicine led him to make important contributions in Anatomy and Physiology, making him the first to describe and name conditions such as leukemia, cordoma, ocronosis. , embolism and thrombosis, already tissues such as myelin that coats nerve fibers in addition to coining necessary terms such as chromatin, agenesis, parenchyma, osteoid, amyloid degeneration and spina bifida. His work in dissection led to his procedure for autopsies, on which he has modeled what forensic pathologists use today. And his study of trichinosis allowed him to discover the transmission of diseases from animals to humans, what we now know as zoonosis. In addition, he found time to take an interest in ethnology, founding anthropological associations that today continue to publish the ‘Journal of Ethnology’ that Virchow founded.

His political convictions further led him to pursue a career as a statesman. He founded the Liberal Progressive Party in 1861, with which he was elected to the Prussian Diet (Congress) in 1862, where he faced Otto von Bismarck directly for his conservative policies, although he gave support for the so-called ‘Iron Chancellor’ in its cultural struggle against religion. In addition, from 1880 to 1893, he was a member of the Reichstag or Congress of the German Empire, assuming as his main task to improve the health conditions of Berliners, especially by promoting modern drinking water and sewer systems.

In 1885 a study of skull measurements was proposed. His conclusions challenged the racist ideas of the time and the concept of the ‘Aryan race’. Virchow denounced “Nordic mysticism” at this year’s Anthropology Congress, while one of his collaborators stated that all Europeans were “a mixture of various races” and that the studies carried out forced them to “fight any theory regarding the superiority of the European race ”.