Tuesday, January 29, 2013

Rudolf Virchow






Okay, so you might be asking yourself why Rudolf Virchow is today's unlikely science hero.  He is after all, often referred to as "the father of modern pathology" and is credited with a slew of other accolades, like suggesting the cell is the basic unit of life, having a clutch of anatomical/pathological terms bearing his namesake, and helping to found what we today think of as social medicine.  Heck, the Society for Medical Anthropology even gives an award each year in his name to a distinguished article written "in his spirit."  (If you're wondering, the award in 2011 went to Sharon Abramowitz for her article about open mole syndrome in Liberia.  Open mole syndrome, if you're wondering, is a unique "culture-bound disorder," to use Abramowitz's language, that is likened to PTSD or other afflictions of traumatized populations.  But I digress...)  So if it seems like Virchow has done all kinds of amazing things and gotten proper credit for it, then what makes him so unlikely?

There are a few reasons I decided to write about Virchow.  For one, he is barely written about in comparison to other figures in science whose contributions were comparable to Virchow's.  This might have something to do with the fact that Virchow was really a polymath in disciplines that many folks wouldn't normally think of together, but in fact are closely interconnected.  Paul Farmer was quoted in his biography Mountains Beyond Mountains as being deeply influenced by Virchow's marriage of "pathology, social medicine, politics, [and] anthropology."  I love this, because even now bringing these factors together and trying to wrap our collective heads around what this means for health and human rights is very hard to do. Most of us specialize in one field and it's very hard for us to see how inextricable the fate of our field is from the consequences of others, and how we may not be able to solve our own specialized problems in say, public health, without looking at the consequences of a fascist regime that might be limiting access or worse.  

This is in fact the central tenet of what we call social medicine.  It's a very well known concept- to consider how socioeconomics make us healthier or sicker, and in theory seems like a cut and dry concept- make people's social and economic lives better, and they will be healthier.  What's great about Virchow is that he was a specialist in many fields, and so was able to make astute observations, that were both groundbreaking at the time, and also led to his own pragmatic solutions to improve health outcomes in unprecedented ways and weren't limited by a lack of knowledge in disparate areas. The best known story about this is when Virchow was sent to the Silesia region of Europe (that's now Poland, Czech Republic and a little Germany for the rest of us) to address an epidemic of relapsing fever.  To the dismay of the German government, Virchow did not have a scientific answer for them, but instead blamed the oppressive politics and poverty imposed on the region for the epidemic, which was revolutionary at the time.

Despite being extremely prolific himself- he penned likely more than two thousand papers in his lifetime- very little was written about him.  It seems like if you're interested in learning more about Virchow, this Ackerknecht book and this book by B.A. Boyd are the best options.  I also found what appears to be a book published just last year that I can't speak for but appears to be written in much the same spirit of this blog so might be more accessible than the other dusty old tomes (It could also be bad.  Who knows.) 

Since Virchow was such a renaissance man, he is credited with a slew of one-off terms and concepts.  But what is kind of interesting is that many of Virchow's most "famous" discoveries were made simultaneously with other researchers.  This could speak in part to the collaborative nature of science and discovery, but it could also speak to Virchow being kind of a ham and looking for credit.  For instance, you could reasonably argue that Theodor Schwann actually is the father of cell theory along with Schleiden, and Virchow just had better marketing with his Omnis cellula e cellula.  (In fact, Virchow didn't even really believe in cell division until he heard a really great argument from Robert Remak, and then he published Remak's work as his own!  Maybe this entry should be about Remak!  That's a really shady move, Rudolf.)  Or that Virchow's Node is really just Troisier's Sign?  Or Virchow-Robin Spaces should be Robin-Virchow?  Or Virchow-Seckel Syndrome should be Seckel-Virchow?  Though the Virchow Method of Autopsy is fully his own, and is in large part still in use today.  I am actually very amused by all of this, and I think I might plan to read Virchow's Eulogies before the end of this Winter to honor his spirit of collaboration :)

Some other fun Virchow facts:
-Bismarck once challenged Rudolf to a duel because he was so over being voiciferously criticized by the medical anthropologist.  Legend has it that as Virchow was to select the weapons, he selected two sausages, one of which was laced with Trichinella.  And the elder statesmen chickened out.
-Virchow published the "Virchow Archives" for much of his life, supporting groundbreaking research and writing that went against the the prevailing romantic speculation of German medicine at the time.
-Virchow had no qualms mixing politics and medicine and saw political action as a road to health equity.  He was a member of the Reichstag and co-founder of the German Progress Party. 


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