The German Genius

Congress and editor of a weekly entitled Die medizinische Reform . This was heady, but in 1849 he was suspended from his academic positions. He quit Berlin and took up the recently created chair in pathological anatomy at the University of Würzburg, the first of its kind in Germany. While there he was for a time distanced from political activity, and it was then that he achieved his greatest scientific contributions, establishing in particular his concept of “cellular pathology.” In 1856 Virchow returned to Berlin as professor of pathological anatomy and director of the newly created Pathological Institute.
    T HE F OUNDATION OF B IOETHICS
     
    Now that he was back in Berlin, however, Virchow’s old political instincts began to revive. He became a member of the Berlin City Council, where he concerned himself with public health and was instrumental in improving both the sewage system and the water supply of the city. Emboldened by these successes, he was in 1861 elected a member of the Prussian lower house, representing the liberal German Progressive Party, which he helped to found. Most notably, the Progressives opposed Bismarck’s policy of rearmament and forced unification, a resistance that provoked Bismarck so much that he challenged Virchow to a duel. Virchow had the sense not to rise to the bait, and in the Franco-Prussian War of 1870–71 proved himself no mean nationalist, helping to organize hospital facilities and hospital trains for the wounded.
    Virchow had a very modern view of epidemiology, believing that some diseases are “artificial,” stressing their sociological side, arguing that political and socioeconomic factors were significant etiological elements. He even argued that epidemics could arise in response to social upheaval and could only be eliminated or alleviated through social change. No less controversial (then) was his argument that it is “the constitutional right of every citizen to be healthy.” Society, he insisted, had the responsibility “to provide the necessary sanitary conditions for the unhampered development of its members.” 3 This, a kind of medical Bildung , is now regarded as the foundation of bioethics.
    He made some mistakes. He was skeptical about bacteriology. Germs, he was convinced, could not be the sole etiological agent in an infectious illness, environmental and sociological factors being clearly responsible in his view for the typhus and cholera epidemics of 1847–49.
    Toward the end of his life, from about 1870 on, he turned to another science: anthropology. Co-founder of the German Anthropology Society (in 1869) he made several studies of skull shapes and carried out a nationwide racial survey of schoolchildren. From this, he concluded that there was no “pure” German race, a highly controversial result.
    Anthropology led to archaeology and in 1870 he began his own excavations in Pomerania. In 1879 he traveled with Heinrich Schliemann to Hissarlik, where Troy was being excavated (see Chapter 21), and he subsequently helped to attract antiquities to Berlin, for which the city became known. 4
    His eightieth birthday in 1901 was celebrated as far afield as St. Petersburg and Tokyo. In Berlin there was a torchlight parade. His taste for public argument, and his dogmatism, had some unfortunate side effects, most notably his opposition to Ignaz Semmelweiss’s insight that hand-washing by doctors between patients would prevent puerperal fever. But Germany had progressed in less than half a century from speculative and philosophical healing to become the world center of modern scientific medicine, and Virchow was probably the most important figure in that transformation.
    N EW K NOWLEDGE ABOUT I NFECTION
     
    As important as Virchow, and perhaps more so, was Robert Koch (1843–1910), the man who devised so many of the basic principles and techniques of modern bacteriology. 5 It was Koch who isolated the causes of anthrax, tuberculosis, and cholera, and in his many travels he also influenced authorities in several countries to introduce public health legislation based on new knowledge about the microbial origin of infection. 6
    Robert was one of thirteen children (two of whom died in infancy). He grew up with an intimate knowledge of animal and plant life and the new art of photography. By the time he was ready for the local primary school, he had taught himself to read and write. At Göttingen he first thought of studying philology (as he also considered