Rudolf Virchow, 
BY 
WILLIAM H. WELCH, M. D., 
BALTIMORE, 
PROFKSSOR OF PATHOLOGY, JOHNS HOPKINS UNIVF.RS1TY. 
Reprinted from the Boston Medical and Surgical Journal of 
October 2g, i8gi. 
BOSTON: 
DAMRELL & UPHAM PUBLISHERS, 
No. 283 Washington Street. 
1891- S. J. PARKHILL & CO., PRINTERS 
BOSTON ' RUDOLF VIRCHOW, PATHOLOGIST.1 
WILLIAM H. WELCH, M.D., BALTIMORE, 
It is fitting that of Virchow’s manifold activities 
that side which represents nearly fifty years of aca- 
demic work should be a special theme upon this occa- 
sion. My contribution, therefore, will relate only to 
Virchow, the pathologist, the broad view of his career 
and work in other departments having already been 
presented to you. 
It is as an investigator and teacher of pathology 
that Virchow ranks as one of the great reformers in 
medicine. 
To appreciate the character and extent of an ad- 
vance made by scientific discovery, it is necessary to 
know something about the ideas which have bqpn dis- 
placed or overthrown by the discovery. The younger 
generation of students are in danger of forgetting that 
facts which are taught to them and which seem to 
them the simplest and most natural, may have cost 
years of patient investigation and hard controversy, 
and possibly have taken the place of doctrines, very 
different or even contradictory, which long held sway, 
and which seemed to other generations equally simple 
and natural. If then, we wish to understand the 
nature and extent of the reforms in pathology, which 
we owe to Virchow, we must consider the condition in 
which he found medicine, and more particularly path- 
ology, in the fourth decade of this century, when he 
began his scientific work. 
1 Address delivered at a meeting of the Johns Hopkins University, 
Baltimore, to celebrate the Seventieth Birthday of Professor Vir- 
chow, on October 13,1891. 
Professor of Pathology, Johns Hopkins University, At that period medicine in one country was much 
less influenced by its condition in other countries than 
is the case at the present time. Medical journals and 
other means of interchange of ideas were fewer then 
than now. Medicine was more distinctly national, 
less cosmopolitan, than it is to-day. 
France unquestionably held the leading position in 
medicine during the early part of this century. The 
first three decades mark the most splendid period of 
French medicine. At the very beginning of the cen- 
tury Bichat laid the foundations of general anatomy 
by his studies of the tissues. He opened the way for 
the study and classification of morbid changes accord- 
ing to the tissues affected. This is in some respects 
the most important contribution to pathological anat- 
omy from the time of Morgagni to that of Virchow. 
Morgagni showed that the purpose of pathological 
anatomy is not simply the collection of curious and 
interesting cases, but is to teach us the seats of dis- 
ease as is indicated by the title of his great work, “ De 
Sedibus et Causis Morborum per Anatomen Inda- 
gatis.” He, however, was not able to trace the seats 
of disease further than to the organs affected. Bichat 
took a long step forward when he substituted the tis- 
sues composing the organs, as the seats of morbid 
changes, and in this particular direction no distinct ad- 
vance in pathological anatomy was made for fifty 
years, when Virchow taught us to go still further 
back than the tissues, to seek in the cells the seat of 
disease. 
But so far as the gross appearances of diseased or- 
gans and tissues are concerned, pathological anatomy 
was most enthusiastically cultivated in France, and 
this, together with the development of the methods of 
physical diagnosis by percussion and auscultation, was 
made the basis of a new clinical medicine by such men as Corvisart, Lgennec, Bayle, Piorry, Louis, 
Andral. Tlie sound and healthy traditions of this 
French clinical medicine of the first third of the cen- 
tury, have been continued to the present day, and were 
early brought to our own country by distinguished 
pupils of Louis and Trousseau. But the studies in 
pathological anatomy were fruitful only in certain 
directions, mainly in diseases of the heart and lungs, 
and in the elucidation of typhoid fever. They were 
pursued by clinicians chiefly as a basis of clinical diag- 
nosis. False and exaggerated ideas as to the kind of 
knowledge to be derived from pathological anatomy, 
led to the establishment of unfounded systems of med- 
ical doctrine, such as that of Broussais, regarding 
irritation and gastro-enteritis, so fatal in its practical 
consequences. The use of the microscope was even 
decried by some of the leading pathological anato- 
mists, and when employed led to little of any value. 
Pathological histology did not exist. Experimental 
physiology was developed, one can almost say, was 
originated, by Magendie, but the importance of experi- 
ment and clinical observation for the development of 
pathological physiology, was not generally recognized. 
In Great Britain there existed the fructifying influ- 
ence of the name and teachings of that great investi- 
gator in pathology, John Hunter. In some respects 
Virchow is to be regarded as the immediate successor 
of John Hunter in the history of pathology, although 
his work began fifty years after Hunter’s death. Both 
men discarded philosophical speculation and went 
back to nature, to observation, to experiment for 
facts on which to build their doctrines. Both made 
use of all allied sciences at their disposal, of anatomy 
in the broadest sense, of physiology, in their investiga- 
tions, but of course much more was available for the 
later investigator. Both kept constantly in view the problems of practical medicine, together with the 
broadest interests and direct participation in science. 
Both recognized pathological physiology as the found- 
ation of scientific medicine and that this is to be con- 
structed not from anatomical investigations alone, but 
with the aid of physiology, of experiment and of clini- 
cal observation. Hunter was the first to give a broad 
scientific basis to surgery. Virchow took up many 
problems just where Hunter had left them. The time 
had come when he could build deeper and stronger 
and broader on the foundations of scientific medicine. 
In the year of John Hunter’s death, his nephew, 
Matthew - Baillie, published his work on “Morbid 
Anatomy,” which is the first one based upon indepen- 
dent systematic observations. The plain, purely ob- 
jective descriptions, free from the prevailing tendency 
towards unwarranted generalizations, have given a 
permanent value to this work. Sound observations 
continued to be made by such men as Abernethy, 
the Bells, Abercrombie, Cooper, Howship, Monro, 
Addison, Gulliver, Bright, Hope, Carswell, but much 
as they enriched the storehouse of pathological anato- 
my, the fundamental principles of pathology remained 
the same, although commendably free from many of 
the speculative tendencies of the Continent. 
It was in the third and fourth decades that the great 
Vienna school of pathology came to the front under 
Rokitansky and Skoda. As a purely descriptive path- 
ological anatomist, Rokitansky is the greatest who 
ever lived. The General Hospital of Vienna afforded 
him an enormous material for observation. When he 
retired from his professorship at the age of seventy 
years, he is said to have possessed over 100,000 proto- 
cols of autopsies made by himself or his assistants. 
The industry, acuteness of observation and purposeful 
character of his work are marvellous. His descrip- tions of the gross appearances of diseased conditions 
serve now and will probably continue to serve for a 
long time as models of clearness, accuracy, concise- 
ness and vividness. As Virchow has said, he is for 
pathology what Linnaeus is for botany. But in the 
interpretation of the morbid changes which he de- 
scribed so objectively and in the deduction of general 
pathological principles, Rokitansky was singularly un- 
fortunate. His attempt to construct out of pathologi- 
cal anatomy a general pathology or pathological physi- 
ology, is a lamentable failure in the first edition of his 
great work on Pathological Anatomy. Bound in the 
trammels of humoral pathology, he elaborated his doc- 
trine of erases which was at first received so enthusi- 
astically by his followers. It is fair to say that 
no one was more open to conviction by facts than 
Rokitansky, and that he threw overboard his whole 
complicated system of erases after the destructive 
criticism which it received from Virchow. It was 
mainly by the teachings of Rokitansky and of his 
pupil, the great clinician, Skoda, that the nihilistic 
school of therapeutics developed and dominated for so 
many years- the Vienna school of medicine. With 
their attention fixed continually upon the post-mortem 
table and the gross anatomical changes produced by 
disease, these observers could not comprehend how 
such changes are amenable to treatment, and they fell 
into the error of those who make pathological anat- 
omy the exclusive basis of clinical medicine. Those 
who do this forget that the changes found in the dead 
organ give only partial, although valuable, information 
as to the process of disease in the living organ, as to 
remote effects upon other parts of the body, as to 
causes of disease, as to disturbances of function. 
In Germany proper medicine presented in the early 
part of this century a less edifying spectacle than in the other countries mentioned. Although in this period 
work of fundamental importance was done in allied 
sciences, such as comparative anatomy and embryology, 
medicine presented a succession of systems and schools 
of doctrine founded largely on speculation. The minds 
of physicians were possessed by such doctrines as those 
of vitalism, of Brownianism, of the philosophy of 
nature. Here and there a good observer in pathologi- 
cal anatomy such as J. F. Meckel and Lobstein or 
an enlightened physician stands out in contrast to the 
dominant speculations, hypotheses and mysticism. 
The controversy, centuries old, as to whether disease 
affects primarily the solids or the fluids was still kept 
up with fruitless dialectics. A healthier direction was 
given to clinical medicine by the teachings of Schbnlein, 
but he did not break with the prevailing ontological 
conception of disease as an entity, as something apart 
which enters the body and lives there like a parasite. 
Medical works published in Germany as late as the 
fourth decade of this century are still full of such 
terms as “ natur-philosophische, natur-historische, ra- 
tiouelle, physiologische ” systems of medicine, to say 
nothing of the ultramontane, theological system of the 
professor of medicine in Munich. 
In the third decade discoveries in microscopical 
anatomy were made, surpassing in number and import- 
ance all which had come before, and forming the basis 
of modern histology. In Johannes Muller’s work 
“ On the Intimate Structure and the Forms of Morbid 
Tumors ” published in 1838, we meet the first fruitful 
application of the microscope to the study of patholog- 
ical anatomy, and this work may be regarded as the 
beginning of pathological histology in the modern 
sense. In the same year Schwann promulgated the 
cell theory as applied to animals. The fundamental 
error of Schwann as to the origin of cells by spoutan- 7 
eons generation out of a primitive blastema exerted, 
for many years, an unfortunate influence upon path- 
ology and led many a good investigator to spend his 
force in a will-o’-the-wisp search for the development 
of cells out of unformed material. The blastema 
theory for a time dominated pathology. The plastic 
substances of John Hunter, various pathological exu- 
dates were resolved to a large extent into blasteraata 
and the problems which seemed most urgent were to 
determine the characters of these blastemata, their 
metamorphoses and the exact mode of formation of 
cells out of them ; and to these delusive problems micro- 
scopists set themselves to work. 
Surrounded by such ideas in the year 1844, one 
year after his promotion to the doctor’s degree, Virchow 
began his work first as assistant and then as prosector 
in the Charite Hospital in Berlin. He must have re- 
ceived more inspiration from Johannes Muller, the 
greatest physiologist of the first half of this century in 
Germany, than from any other of his teachers, but he 
has acknowledged his indebtedness also to Schbnlein, 
that remarkable man, who, without having ever pub- 
lished half-a-dozen pages after his graduating disserta- 
tion, became the most popular, influential and inspir- 
ing clinical teacher in Germany. Doubtless many an 
impulse must have come from association with that 
company of ardent young investigators in medicine 
assembled in Berlin in the early forties, from such 
men as Franz Simon, Reinhardt, Leubuscher, Joseph 
Meyer, Remak, Traube, DuBois-Reymond, Briicke, 
Helmholtz. The spirit of reform was no less in the 
medical than in the social and political atmosphere of 
the time. All of these influences of his teachers, of 
his co-workers, of the “ Zeitgeist ” must have had their 
effect upon the young man, but, from the beginning, 
Virchow’s published work marked him as an original 
and independent genius. 8 
In 1846, at the age of twenty-five, Virchow read 
before the Society for Scientific Medicine in Berlin 
the paper entitled “ Concerning Points of View in 
Scientific Medicine,” which was soon after published 
as the leading article in the first volume of the Archive 
for Pathological Anatomy and Physiology and for 
Clinical Medicine, founded by himself and Reinhardt. 
This short article is in a sense the programme of the 
author and of the journal in which it appeared. Here 
is emphasized the idea that disease is not an inde- 
pendent being, but is life under changed conditions. 
Scientific medicine is the investigation of these changed 
conditions and of the means of removing them. Halt 
is called to dogmatism and speculative systems of med- 
icine. The limits of pathological anatomy are deter- 
mined. The methods investigation and the assist- 
ance of other natural sciences must be employed in 
medicine. Progress can come only by experiment 
and observation. The immediate task is to discard 
philosophical systems and to set to work in collecting 
facts. Permit me to quote the last paragraph of this 
remarkable article: 
“ Let us not deceive ourselves about the condition 
of medicine. Minds are unmistakably exhausted by 
the many hypothetical systems again and again cast 
aside only to be replaced by new ones. A few more 
invasions perhaps and this time of unrest will have 
passed by and it will be recognized that only quiet, 
industrious and persevering work, the true work of 
observation or experiment, possesses enduring value. 
Pathological physiology will then gradually be devel- 
oped, not as the production of a few heated brains, but 
as the work of many patient investigators; that path- 
ological physiology, which is the citadel of scientific 
medicine, of which pathological anatomy and the clinic 
are only out-works.” Brave words and true are these uttered by a young 
physician only three years after receiving his doctor’s 
degree, words significant now, but many times more 
significant when they were spoken. But they were 
not the words of a dreamer or an idle talker. He who 
wrote them had already begun that “ quiet, industrious 
and persevering work, the true work of observation 
and experiment,” which was destined to introduce a 
new epoch in the history of medicine. 
By a fortunate chance Robert Froriep assigned to 
his young assistant as a theme for independent investi- 
gation, the study of phlebitis. It would lead too far 
into historical detail for me to attempt to explain the 
position which phlebitis then occupied in pathology. 
Some idea may be gathered from Cruveilliier’s sen- 
tence, La phlebite domine toute la pathologic. So firmly 
established at that time was Cru veil bier’s doctrine 
that the essence of inflammation is coagulation of the 
blood in the veins and capillaries, that it seemed neces- 
sary to work out only certain details, such as, whether 
or not in suppurative phlebitis the pus is secreted by 
the wall of the vein. But it at once became clear to 
Virchow that the general doctrine rested upon no 
sure foundations and it was upon the foundations of 
the doctrine that he began to work. His preliminary 
studies were upon the morphology and chemistry of 
fibrin and the conditions for its coagulation both 
within and outside of the body. At the same time 
his attention was turned to the morphological elements 
of the blood, more particularly the white blood 
corpuscles, and here his observations on leukaemia 
opened new points of view on the nature and origin of 
the white corpuscles, so that in 1846, he could say, 
“ Herewith I vindicate for the colorless corpuscles of 
the blood a place in pathology.” His powers of criti- 
cal analysis and correct interpretation of pathological 10 
facts were at this time brilliantly exhibited in the view 
which he took as to the nature of leukaemia, the same 
view essentially which is still held, in contrast to 
Bennett’s conception of the disease as an hsemitis, a 
suppuration of the blood. But it was in the epoch- 
making articles on “ Plugging of the Pulmonary 
Artery and its Results ” (1846 and 1847) and on 
“Acute Inflammation of the Arteries” (1847), that 
the best fruits of Virchow’s studies of subjects sug- 
gested by phlebitis appeared. Here, for the first time, 
was there a clear insight into an important group of 
pathological facts which had been the favorite study 
of John Hunter and which had exercised the minds of 
the succeeding generation of pathologists. The doc- 
trine of thrombosis and embolism as it was here and 
subsequently elaborated by Virchow formed virtually 
a new chapter in pathology, well rounded as it left the 
hands of its founder, a monument of brilliant scientific 
investigation in pathological anatomy and experimental 
pathology. The important articles on “Pathological 
Pigments,” and “ The Pathological Physiology of the 
Blood ” belong also to the same period and the same 
line of investigation. The fundamental part of these 
researches, together with investigations in many other 
directions in pathology, belong to the first Berlin 
period of Virchow’s activity (1844-1849). 
The Wurzburg period, extending to 1856, was one 
of great and fruitful scientific work. Already in 
Berlin, by his investigation of degenerative cellular 
changes in Bright’s disease and of inflammation of 
muscle, Virchow had reached new views as to the nutri- 
tive alterations of cells in inflammation ; but it was in 
Wurzburg especially that his doctrine of inflammation, 
which has exerted such a reformatory influence upon 
pathology, was worked out by himself and his pupils. 
In the article on “ Parenchymatous Inflammation ” 11 
(1852), and in that of the same year on “ Units of 
Nutrition and Localizations of Disease,” he has already 
conquered a large tract of cellular pathology. He has 
a firm grasp upon the nutritive and functional disturb- 
ances of cells. Further researches were necessary to 
reveal clearly their formative activities. In the light 
of the most recent views concerning inflammation, it 
is significant to note that in the first of these articles 
Virchow clearly recognizes suppuration as secondary 
to necrosis of tissue, and in this connection says, “ Here 
there is certainly an inner, parenchymatous process, 
and if the subsequent suppuration be regarded as the 
outcome of inflammation, one need not hesitate to re- 
gard the degeneration of the parenchyma as an integral, 
neither consecutive nor accidental, part of the inflam- 
matory process.” And again at the close of the arti- 
cle, “ not hypersemia and not exudation, nor redness, 
nor swelling, nor pain, do I put first, although I recog- 
nize their importance, but degeneration — I vindi- 
cate, therefore, before all for inflammation the char- 
acter of degeneration.” 
But the brightest lustre of this period of Virchow’s 
scientific work comes from those investigations which 
laid the foundations of cellular pathology. Like all 
of his contemporaries, Virchow at the beginning was 
under the dominion of Schwann’s theory as to the spon- 
taneous origin of cells from blastema. His researches 
upon the origin and structure of the connective-tissue 
group of substances, published in 1850, were reform- 
atory for both pathological and normal histology. 
There followed a series of investigations which laid 
broad and firm the foundations of cellular pathology. 
Already in 1854 Virchow cast aside definitely the 
blastema theory of cell formation. 
To describe further in detail these and the other in- 
vestigations of Virchow in pathology up to the presen t 12 
time is impossible within the limits of an address. To 
do this would require a book covering nearly the whole 
ground of pathology. Into what corner of special pa- 
thological anatomy and of general pathology should 
we not be led if we attempted to follow the many hun- 
dred articles which he has written on these subjects ? 
We cannot include here the consideration even of such 
a monumental work as that which he has written upon 
tumors. 
I must content myself in the limited time remaining 
by directing your attention to a few salient points in- 
tended especially to show the reformatory character 
of Virchow’s work in pathology. 
In his beautiful oration on Johannes Muller, Vir- 
chow says, “ There is no school of Muller in the sense 
of dogmas, for he taught none, but only in the 
sense of methods.” The same may be said of Virchow’s 
school. His school means not the propaganda of cer- 
tain dogmas as meant the schools of the great leaders 
in medicine of olden times. It is the method and not 
dogma which characterizes it, and the method is that 
of the natural and physical sciences. In 1849, in the 
article on “ The Scientific Method and Points of View 
in Therapeutics,” Virchow wrote : “ In fact, that is true 
which Asclepiades of Bithynia, the father of that old 
school of methodistic physicians, emphasized; the 
method of investigation is that which is essential and 
determining. It is the method which distinguishes 
the Harveys, the Hallers, the Bells, the Magendies, 
and the Mullers from their smaller contemporaries. 
This is the soul of the natural' sciences.” 
Observe ; experiment; seek the aid of allied sciences, 
chemistry, physics, general biology ; collect by system- 
atic and purposeful investigation, in which the “ Frage- 
Stellung ” is correct and clear, a body of facts, and 
from them deduce general pathological principles and 13 
laws. It is along these lines that Virchow has worked 
and taught. The proper uses of hypotheses in scien- 
tific investigation he has always recognized; but im- 
portant as are these uses, hypotheses are not to serve 
as the foundation of pathological doctrines. His early 
opponents, the adherents of the philosophy of nature 
and the so-called rationalists, accused him of leading 
medical science into the barren collection of facts, of 
letting the broad river of science waste itself in count- 
less little streams. But both by precept and example 
no one has demonstrated more clearly than Virchow 
that the scientific mind, in the investigation of details, 
should not lose sight of the higher aims, the orderly 
classification of the facts, the search after new and 
loftier points of view, the establishment of general 
principles and laws. 
This method of investigation is none other than the 
Baconian. Virchow did not originate it. Many be- 
fore him had recognized its importance, and had ap- 
plied it to medicine. Before Virchow it had already 
become the powerful lever of comparative anatomy, 
embryology and physiology. But one purpose of the 
historical remarks with which I began this address 
was to show that in pathology this method had not 
gained full sway when Virchow’s work began, and 
that speculation and the construction of philosophical 
systems of medicine based upon speculation, were still 
in vogue. The application of the scientific method to 
pathology could not have been long delayed, but to 
Virchow more than to any other man belongs the credit 
of introducing into pathology the scientific method of 
investigation by the employment of which this depart- 
ment of knowledge has gained its rank as one of the 
natural sciences. 
It is another great merit of Virchow to have made 
clear the kind of knowledge to be gained by the study 14 
of pathological anatomy. In the enthusiasm of the 
rapid development of pathological anatomy in the early 
part of this century, false and exaggerated ideas were 
entertained as to the relations between this subject and 
practical medicine and as to the kind of information 
to be derived from the examination of diseased organs 
after death. The attempt was made to construct out 
of pathological anatomy alone, systems of pathological 
physiology. This led in France to such exclusive 
systems as Broussaisisra and in Vienna to the craseolo- 
gical system of Rokitansky and to the nihilistic school 
of therapeutics, less dangerous than Broussaisism but 
equally unfounded. Rokitansky expressed and en- 
forced upon his followers “ the conviction,” to quote 
his own words, ‘‘that pathological anatomy must be 
the foundation not only of medical knowledge but also 
of medical treatment, yes, that it contains everything 
that there is in medicine of positive knowledge and of 
foundations for such knowledge.” Against this view 
Virchow pointed out that each department of medicine 
has its own field and must be investigated by itself and 
cannot be constructed entirely out of another. As he 
said, “ Pathology cannot be constructed by physiolog- 
ists, therapeutics not by pathological anatomists, medi- 
cine not by rationalists.” 
Pathological anatomy .shows us simply the morbid 
changes in the organs, tissues and cells as they exist 
in one phase or in a series of phases. It does not 
show us the morbid process as it goes on in time. It 
does not reveal the alterations in function. Pathologi- 
cal anatomy is essential to pathological physiology, 
but the relations which these branches of knowledge 
bear to each other are similar to those between normal 
anatomy and physiology. General pathology or path- 
ological physiology, as Virchow likes to call it, rests 
also upon experiment and clinical observations. It 15 
never has been and never can be successfully built up 
from pathological anatomy alone. Its methods are 
those of normal physiology. In one of his earliest 
publications in 1846, Virchow said: “It would be 
sad indeed if anatomical investigation were compelled 
to confine itself to the dead material, to the recogni- 
tion of the completed conditions of isolated and deter- 
mined products, if the entire outcome were only the 
description and classification of certain objects in na- 
ture. Pathological experiment remains ever the sure 
control for the pathological anatomical conclusion, and 
it will seldom be employed without disclosing to us 
new and valuable sources of knowledge.” These 
words appropriately introduced the description of 
Virchow's admirable anatomical and experimental 
work on “ Plugging of the Pulmonary Artery and its 
Results.” All this needed to be said when Virchow 
said it, and it has not lost its force to-day. 
John Hunter and Magendie were the pioneers in 
experimental pathology, and Virchow and Traube es- 
tablished pathological experiment in its impregnable 
position as the most powerful aid in the development 
of pathological physiology. 
The establishment of cellular pathology is one of 
the greatest events in the history of medicine. That 
Virchow’s share in this was decisive and controlling 
cannot be successfully contested. The historical points 
pertaining to the development of the principles of cel- 
lular pathology have been often and much discussed. 
Virchow’s investigations leading to the development of 
this great thought in his mind are briefly referred to 
in chronological sequence in the article at the begin- 
ning of the one hundredth volume of his Archiv. On 
this occasion 1 cannot enter into the history of the 
question, save to emphasize one point which is lost 
sight of by some of those who have written on the 16 
matter. The discoverer of a scientific fact is not he 
who has divined it, but he who has proved it. The 
opportunities for the study of the development of ani- 
mal cells are furnished chiefly by embryology and by 
pathology. The demonstration that all cells are de- 
rived from pre-existing cells was easier to bring by 
the embryologist, starling with the ovum, a single cell, 
than by the pathologist. Hence it is not strange that 
embryologists, such as Reichert, Kblliker and later 
Remak, had discarded the blastema theory, so far as 
the development of the embr}'0 is concerned, at a 
period when the same theory prevailed in pathology. 
But so long as it was not proven that in pathological 
formations the new cells also come from pre-existing 
cells, this general principle of cell development could 
not.be considered proven. It was not until Virchow 
had brought this part of the evidence, more difficult to 
obtain than-the erabryological and equally important, 
that the truth, which he was the first to frame in the 
words, omnis cellula e cellula, was fully established. 
The nutritive, the functional and the formative dis- 
turbances of cells became in his hands the ground-work 
of cellular pathology; and although this ground-work 
was laid before the publication of his “ Lectures on 
Cellular Pathology,” in 1858, nevertheless these came 
as a revelation to most physicians throughout the 
world. 
The principles of cellular pathology have become to 
such an extent an integral part of medical thought 
that we can hardly estimate to-day all that this dis- 
covery meant a generation ago. To do this we must 
put ourselves back in thought to a time when all or- 
ganized pathological products, pus, tubercle, cancer 
and all tumors were supposed to be formed out of a 
primitive blastema, an exudation of some kind. Think 
of trying to come, under the influence of such ideas, 17 
to any coherent or intelligent opinions as to the nature 
and development of morbid processes. 
The never-ending strife between humoralism and 
solidism would probably be going on to-day had it 
not received its death blow from cellular pathology. 
The termination of this strife does not mean that we 
are not the heirs of great truths which came out of 
it, or that there is any contradiction between cellular 
pathology and humoral or nerve pathology in the 
proper sense of the terms. In 1855 Virchow said, 
with a cast of thought perhaps derived from his politi- 
cal opinions : “ While we contend for the Tiers etat of 
the many little elements, it may seem as if the aris- 
tocracy and the hierarchy of blood and nerve were to 
be destroyed to their very roots. But it is here only 
usurpation which we attack, monopoly which we wish 
to overthrow; and once again we emphasize it that we 
fully recognize blood and nerve as equally authorized 
factors together with the other parts ; yes, that we do 
not in the least question their predominant importance, 
but that we concede their influence upon other parts 
to be only a stimulating and moderating, not an abso- 
lute, one.” 
With the recognition of cellular pathology, it became 
clearer than ever before that the laws working in dis- 
ease are not different from those in operation in health, 
but that they are subject to different conditions. The 
ontological conception of disease passed out of the 
horizon of scientific medicine. 
Cellular pathology is not a system, a doctrine; it is 
a biological principle, as has been said by its founder. 
Its foundations have been attacked, but never have 
been shaken. The discoveries of karyokinesis, of 
wandering cells, of the migration of leucocytes from 
the vessels, and of the specific cellular germs of dis- 
ease have only widened our views of cell pathology. 18 
Cellular pathology is one of those great principles in 
science which, when established, disclose new points 
of view, open up limitless fields for investigation, and 
receive the new results without a tremor in the founda- 
tions. How different this from the era of speculative 
systems and schools of medical doctrine, when every 
new discovery threatened the overthrow of the domi- 
nant system! 
With Virchow’s return to Berlin, in 1856, he had 
secured from the government the concession of a new 
pathological institute, to be constructed according to 
his own ideas and plans. In any estimate of the re- 
formatory influence of Virchow upon pathology, his 
share in bringing about the general recognition of the 
importance of establishing pathological institutes should 
not be overlooked. In 1858 he wrote: “As in the 
seventeenth century anatomical theatres, in the eigh- 
teenth clinics, in the first half of the nineteenth physi- 
ological institutes, so now the time has come to call 
into existence pathological institutes, and to make them 
as accessible as possible for all.” His ideas as to the 
general organization of such institutes have been the 
controlling ones for most of those since constructed in 
Germany, and for many in other countries. The im- 
portance of such institutes for the instruction of stu- 
dents and physicians and for the progress of pathology 
cannot easily be overestimated. A pathological insti- 
tute, constructed and conducted like the one in Berlin, 
requires a very considerable outlay of money, which 
Virchow said must come in general from the govern- 
ment. In this country, however, we must look in 
general to private beneficence to endow hospitals and 
medical schools with such pathological institutes as 
have made Germany for many years the Mecca of 
those from other countries who wish to study patho- 
logical anatomy. 19 
Virchow, like his teacher, Muller, and like one of 
his great predecessors in Wurzburg, Dolliuger, has 
been one of those teachers who have attracted pupils 
in large numbers, and have exercised a powerful influ- 
ence upon their thought and development. The pro- 
fessorships of pathological anatomy in Germany are 
occupied to a very large extent by those who have 
been under the inspiration of his personal teachings, 
and many in other lands are proud to call him master. 
Nearly forty years ago, Virchow wrote: “ There 
are also those who, if they do not create the current, 
still give to it its direction and force. These men are 
not always the happiest. Many go down in the move- 
ment, or by it. Many grow weary after they have 
given to it their best forces. Much power and great 
tenacity are necessary if the individual shall not only 
live to see his triumph, but also to enjoy it.” 
He who wrote these words has lived to see and to- 
day enjoys his triumph. May health and happiness 
be his for many years to come! Two Volumes yearly, beginning with the first Nos. in January and July. But 
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