Virchow's Eulogies: Rudolf Virchow in Tribute to his Fellow Scientists

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Brian L. D. Coghlan Leon P. Bignold

Virchow’s Eulogies Rudolf Virchow in Tribute to his Fellow Scientists

Birkhäuser Basel · Boston · Berlin

Authors: Brian L. D. Coghlan 12 Vansittart Place Beaumont SA 5066 Australia

Leon P. Bignold University of Adelaide Inst. Med & Vet Sci Div. Tissue Pathology POB 14, Rundle Mall Adelaide, SA 5068 Australia

Library of Congress Control Number: 2008927813 Bibliographic information published by Die Deutsche Bibliothek. Die Deutsche Bibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data is available in the Internet at http://dnb.ddb.de

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Table of contents Preface and Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Translator’s notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Chapter 1: Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1

Chapter 2: Johannes Müller, Physiologist (1801–1858): a Eulogy delivered in the Hall of the University of Berlin by Professor Rudolph Virchow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Chapter 3: Memorial speech for Johann Lucas Schönlein (1793–1864) given in the Great Hall of the University of Berlin on the 23rd January 1865 – the first anniversary of his death . . . . . . . . . . .

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Chapter 4: Memorial address for Carl Mayer (1795–1864) given on the 25th June 1868 by Rudolph Virchow . . . . . . . . . . . . . . . . . . . .

135

Chapter 5: Morgagni and the anatomical concept by Rudolph Virchow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Chapter 6: Other tributes 6a. Benno Ernst Heinrich Reinhardt (1819–1852) . . . . . . . . . . . . . . . . . . . 6b. Otto Carl Hermann Beckmann (1832–1860) . . . . . . . . . . . . . . . . . . . . 6c. Siegfried Reimer (1815–1860) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6d. Carl Pagenstecher (1824–1865) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6e. Ludwig Traube (1818–1876) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6f. In Memory of Nicholas Friedreich (1825–1882) . . . . . . . . . . . . . . . . . . 6g. Theodor Schwann (1810–1882) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6h. Friedrich Heinrich Roloff (1830–1885) . . . . . . . . . . . . . . . . . . . . . . . . 6i. Richard von Volkmann (1830–1889) . . . . . . . . . . . . . . . . . . . . . . . . . . . 6j. Hermann von Helmholtz (1821–1894) . . . . . . . . . . . . . . . . . . . . . . . . . 6k. Emil du Bois-Reymond (1818–1896) . . . . . . . . . . . . . . . . . . . . . . . . . . . 6l. August Hirsch (1817–1894) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6m. In Memory of Felix Hoppe-Seyler (1825–1895) . . . . . . . . . . . . . . . . . . 6n. A Memoir of Ernst Heinrich Reimer (1833–1897) . . . . . . . . . . . . . . . 6o. Obituary for Ernst Julius Gurlt (1825–1899) . . . . . . . . . . . . . . . . . . . .

177 184 191 197 206 210 216 221 225 228 232 237 242 246 249

Table of contents

Appendix 1 Virchow’s last year a. The celebration of Rudolph Virchow’s 80th Birthday. A personal impression by Sir Felix Semon. . . . . . . . . . . . . . . . . . . . . . . b. Pages in thanks for my friends. By Rudolph Virchow. . . . . . . . . . . . . . . c. Some personal reminiscences. By Sir Felix Semon. . . . . . . . . . . . . . . . . d. Obituary (The Lancet, September 1902) . . . . . . . . . . . . . . . . . . . . . . . . . e. Obituary (The British Medical Journal, September 1902) . . . . . . . . . . f. Virchow as Pathologist (The Lancet, September 1902) . . . . . . . . . . . . .

251 259 270 280 286 288

Appendix 2 a. Bibliographies of Virchow’s writings . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. A bibliography of writings about Virchow . . . . . . . . . . . . . . . . . . . . . . .

293 294

Literature cited . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

309

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Preface and Acknowledgements This book presents translations of eulogies written by Rudolf Virchow (1821–1902) – the most remarkable medical man in nineteenth century Germany – concerning some of his famous teachers, pupils and colleagues. Virchow’s achievements were unquestionably outstanding and contributed especially to the fields of medicine, politics, public health and anthropology. To give some indication of Virchow’s works – they are the subject of many books and articles many of which are listed in Appendix 2b of this book – the following highlights may be noted. After graduating in medicine in 1843 and gaining wide-ranging experience in academic pathology, Virchow published “Cellular Pathology” (1858), in which he elaborated the fundamental idea that disturbances in the cells in the body are the mechanisms by which pathological lesions form. In addition, Virchow – while remaining primarily Professor of Pathology at the University of Berlin – founded and edited the pathology journal which bears his name; edited other serials, including the former Canstatt’s Yearbooks; and maintained a clinical practice, in the form of responsibility for a ward at the Charité Hospital in Berlin. Virchow influenced many of those – his Assistenten – who came to train with him towards outstanding careers of their own. Rudolf Virchow’s second major area of activity was politics, in which his views were consistently liberal. He actively supported the Revolution of 1848 and for this was effectively banished from Prussia for the period 1850–1857. After his return to Berlin he was elected as a liberal to the City Council of Berlin in 1859 and the Prussian Landtag in 1861. Although his opposition to Bismarck’s policies of illiberalism and militarism ultimately had little effect on the course of Prussian history, Virchow remained an important figure in Prussian politics until the end of his life. In the field of public health: in the early 1860s Virchow discovered the life cycle of the parasite responsible for trichinosis and began a successful campaign for the measures necessary to eliminate this disease. Further, through his membership of the Berlin City Council, Virchow was important in implementing the construction of the city sewerage system. In the fields of physical anthropology, paleontology and archaeology, Virchow founded a journal, was president of a relevant learned society and made many contributions to the scientific basis of these disciplines. Because of the nature of the man and the importance of his contributions, as well as the distinction of the persons about whom he wrote, the present volume is not difficult to justify. Each eulogy is an historical document concerning the particular individual. All the works are accurate in detail – Virchow was “nothing if not precise” wrote Semon (see Appendix 1c) – and some of them also cast

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Preface and Acknowledgements

light on events, in medical history as well as on European history generally, in the nineteenth century. Moreover, because the tributes were intended for a wide range of the academic and well-educated (gebildet) sections of German society, they often contain simpler and more concise explanations of Virchow’s own views than are to be found elsewhere in his writings. We have prepared an introduction which focuses on the major issues raised in the texts; in addition we have added notes to explain allusions and historical events which were well-known in Germany in Virchow’s time, but may be obscure to some modern readers. At the end we include contemporaneous English-language material relating to Virchow at the time of his death, to stress how much he was appreciated throughout the world (Appendix 1). Finally, we supply bibliographies of Virchow’s own works and works about him (Appendix 2). In the main, the eulogies were identified in the bibliography prepared by Schwalbe (1901) (see Appendix 1a). However, neither the eulogy for Traube (chapter 6e) nor the address for Helmholtz (1892) are included in that bibliography and was found by the authors of the Berlin. klin. Wochenschr. The other exceptions are items on the Kaiserin Augusta, von Langenbeck and Schroeder. All these are listed in Schwalbe (1901) as being written by Virchow, but were found either to have been written by someone else, or the author’s name was not given at all. These eulogies have not been included here. Virchow may have written additional eulogies for medical men of which we are unaware. We are extremely grateful to our Editor (Dr Beatrice Menz) for continuous patience and support. Dr Han Baltussen translated the Latin passages and assisted with particular references. Professor Anthony Comin translated the Italian passages in chapter 5. Dr Axel Schmidt supplied us the meaning of a pharmaceutical term (chapter 3). Dr. Mary Peterson gave outstanding assistance during all phases of the preparation of this book. We are also grateful to the staffs of the Barr-Smith Library, University of Adelaide, and of the Library of the Royal Adelaide Hospital and Institute of Medical and Veterinary Science in Adelaide. Elizabeth Goodwin typed all of the English articles re-published here; Mr Peter Dent of the Department of Photography at this Institute prepared many of the illustrations. Individuals in Germany whom we must thank are Dr. Dorothee Boeckh, Heidelberg University Library; Dr. Sybille Mauthe, Heidelberg University Library; Fr. Cornelia Gräff, University of Würzburg Library; Fr. Helga Seifert Librarian and Dr. Bernhard Puppe, Institute of Pathology, University of Würzburg; Klaus Möschel, Administrator and Technical Director, Inter-Faculty Institute of Biochemie, University of Tübingen; Dr. Robert Diensberg, Archivist at the Görres-Gymnasium, Koblenz; Dr. Matthias David, Campus Virchow-Kli-

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nikum, Charité Hospital, Berlin; Prof. Dr. Werner Taegert, Director, Bamberg State Library and the staffs of the City Archives in Bamberg and Koblenz. Sybil Coghlan, as well as James and Monica Bignold, gave invaluable support during all the difficult periods of manuscript preparation. Brian L. D. Coghlan Leon P. Bignold

Adelaide, South Australia, April 2008

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Translator’s notes Most nineteenth century German scientific authors of Manuals, Handbooks and Textbooks etc on specific subject areas wrote in simple styles, and their books were often translated and published in English: – for example by the Sydenham, later New Sydenham Societies in England, as well as by other publishers in the United States of America. However, when German authors attempted to invent ‘Systems’ and describe theories and mechanisms of biological processes – and especially when they attempted to apply philosophical concepts to biology and medicine – their writing styles tended to become complex, wordy, and difficult to render into good English. Good examples of translators who have mentioned these these difficulties are those of Rokitansky (1852), Henle (1853) and W. Roux (1888). Virchow’s style in these eulogies can be placed perhaps toward the easier end of this spectrum of difficulty. However, some of the usual Germanic nineteenth century stylistic habits – of long sentences, clauses-within-clauses, and failure to repeat the subject or verb in consecutive clauses – are relatively common. Further, eulogies by their nature demand some ‘elevation’ of style, and literary phrasing. Thus there are examples of complex flourishes of imagery which are not intelligible by literal translation into English. These have been rendered with corresponding English expressions. To make other parts of the texts more easily readable, in the main, we have made only three additional types of changes. First, we have broken up sentences where a clear change of topic occurs. This is particularly where a change of topic in the original is indicated by a semi-colon. Second, the clauses-withinclauses have been marked off by dashes, and dashes in the original usually have been changed to the start of a new paragraph. Third, where a noun or verb applies to more than one clause, but is not present in the original, we have repeated the word. Apart from these changes, we have limited ourselves mainly to changes of sequence (especially bringing verbs forward in sentences), together with occasional simplifications of expressions such as the removal of double negatives. Items in Sperrdruck have been rendered in Bold. The German professorial titles: Ordinarius for full professor and Head of Institute, and Extraordinarius for adjunct or associate professor are used, because they have not exact counterparts in English. Privatdocent is rendered as ‘lecturer’ or ‘private lecturer’. The German word Assistent(en) has been retained throughout, because there is no precise English word for the position which it implies – of a ‘doctoral student and Professorial registrar / training Fellow’ in the American or British systems. Also retained is the phrase Dr habil. which carries more specific significance as an academic credential in Germany

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Translator’s notes

than does ‘Ph D’ currently in the English-speaking world. Similarly, Geheimrat is retained, because it was an honorary title which was not as important as its literal translation – ‘Privy Councillor’ – would suggest.

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Chapter 1 Introduction Rudolph Virchow (1821–1902) was a leading figure in the medical and political affairs of Germany in the second half of the nineteenth century. Born in Schivelbein (now Swindin, near Stettin and part of Poland, Figs 1.1, 1.2), he attended – from 1839 to 1843 – the Friedrichs-Wilhelm Institut (military medical school in Berlin) where he was taught by Johannes Müller (chapter 2) and Johan Lucas Schönlein (chapter 3). Müller had taught Theodor Schwann (chapter 6g), on whose work Virchow based much of his own early thinking on Cell Theory. After graduation, Virchow (Fig 1.3) worked as a junior doctor at the Charité under Schönlein, but when not appointed an Assistent in Schönlein’s clinic, Virchow became assistant to Froriep (1804–1861), the hospital Prosector (responsible for the post mortem examinations at the hospital). Under Froriep’s guidance, Virchow began his phenomenal scientific output, and was appointed to succeed Froriep as Prosector at the Charité in 1846. At this time Virchow gave his first series of (very popular) lectures in pathological anatomy at the Charité. At the same time, he joined the campaign in Germany to replace philosophy-dominated consideration of the natures of disease with a rational scientific approach. He was involved in the newly-formed Society for Scientific Medicine, and the Society for Obstetrics, both in Berlin. He was briefly associated with Reinhardt (chapter 6a) and Traube (chapter 6e) in the publication of the latter’s Beiträge (1846–7) but it was with Reinhardt alone that Virchow founded (1847) the journal now known as Virchow’s Archive. Throughout his lifetime the journal was published by the Reimer Company (chapter 6c, 6n). In 1848 Virchow was briefly at the barricades during the revolution in Berlin, and also published a stridently-pro-revolutionary journal ‘Medical Reform’ (1848–9). In 1849 he married Rosalind (Fig 1.4), daughter of the obstetrician Carl Mayer (chapter 4). In 1850, because of his political activities, Virchow was dismissed from his post at the Charité and forced to leave Berlin. He accepted a Chair in Pathological Anatomy at Würzburg (Figs 1.5–1.9), where his Assistenten included Beckmann (chapter 6b), Friedreich (chapter 6f), and also Ernst Haeckel (see Haeckel, 1923). During his time in Würzburg, Virchow consolidated his ideas on the cellular basis of pathology (see Bignold et al, 2008). Two years after his return to Berlin (Fig 1.10) in 1856, Virchow published his approach to his discipline as the “Cellular Pathology” (1858, Fig 1.11). In this book he argued for a system of pathology based on the abnormalities and responses of the cells at the site of the anatomic lesions of diseases (Bignold et al, 2008). He argued that if the types of cell in tissues are responsible for the

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Introduction

Figure 1.1. (above) Silhouettes of Virchow’s father and mother. (From Rabl, 1907). Figure 1.2. (below left) Virchow’s birthplace in Schivelbein. (From Rabl, 1907). Figure 1.3. (below right)Virchow as a young man. (From Rabl, 1907).

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Introduction

Figure 1.4. (left) Virchow and his wife about 1859.

Figure 1.5. (below) The Julius Hospital, Würzburg. By courtesy of the Bamberg State Library.

Figure 1.6. (bottom) Medical School,Würzburg. By courtesy of the Bamberg State Library.

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Introduction

Figure 1.7. (above) The Professors of Würzburg Medical Faculty in the early 1850s. (From Rabl, 1907). Figure 1.8. (below left) The building for Anatomy and Pathological Anatomy, Julius Hospital, Würzburg (Photographed in 2007). Figure 1.9. (below right) Virchow’s desk while Professor in Würzburg. (Courtesy Fr. Helga Seifert, Institute of Pathology, University of Würzburg; photographed 2007).

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Introduction

Figure 1.10. (left) Institute of Pathological Anatomy (since demolished) in Berlin built in 1856 at Virchow’s request. From Virchow’s Archive, vol 235, 1921.

Figure 1.11. (below left) Title Page of Virchow’s “Cellular Pathology”, 1858.

Figure 1.12. (below right) Virchow in early middle age.

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Introduction

Figure 1.13. (above) Cartoon relating to the challenge to a duel which Bismarck issued to Virchow in 1863. The legend reads: “A Frankfurt newspaper thinks it knows the two duel-addicted persons who are being watched at every step in order to prevent them from killing each other. For the one, the patriot Behrends and for the other, the tavern-owner Schulze must answer with their heads”. “Schultze” refers to Schulze-Delitzsch, a fellow-member of the Progress Party. “Behrends” was presumably the delegate in the Reichstag from Danzig who assisted Bismarck in his dealings with Russia in the crisis of 1863 (see Lord, 1923). The cartoon seems to mean that Behrends and Schulze would be guilty of the crime a abetting a duel, but there are numerous other possible ironic interpretations. The cowls may be a reference to the secret tribunals of vigilantes. Figure 1.14. (below left) Berlin streets during construction of the sewerage system. Figure 1.15. (below right) Virchow’s study at the Institute. From Virchow’s Archive, vol 235, 1921. Original held in the Stadtmuseum Berlin.

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Introduction

Figure 1.16. (above) Virchow at the Festschrift for his 70th birthday. Figure 1.17. (below left) Virchow in old age. Figure 1.18. (below right) Virchow’s apartment building in Berlin. From Virchow’s Archive, vol 235, 1921.

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Introduction

characteristics of those structures in the human body, then those types of cell in the lesions of diseases may account for the features of such lesions of those same diseases. This concept has come to be understood as fundamental to all pathology ever since and thus Virchow has become known as the ‘Father of Pathology’. In the early 1860s his medical works included studies of the life-cycle of the causative organism of trichinosis leading to effective prevention of the disease, and his work on tumours. His students in pathology at the time included Pagenstecher (chapter 6d) while Hoppe-Seyler (chapter 6m) worked on biochemical projects in his Institute. In the same period, Virchow – then in his forties – entered the political arena of Prussia (Fig 1.12). In 1859 he was elected to the Berlin City Council and in December 1861 he was elected to the Landtag (Prussian House of Assembly) as part of a substantial liberal majority. The most important political period of Virchow’s career followed. The liberals had won this election (December 1861) on the basis of their opposition to the King’s proposed enlargement and modernization of the Army. In September 1862, after several months of deadlock with the Landtag, the King summoned Bismarck to the position of MinisterPresident (Prime Minister). Bismarck then governed without approval of the Landtag – i.e. illegally – by ignoring the provision in the constitution of 1850 that such approval was necessary for bills to become law. In 1863 Virchow’s opposition to Bismarck’s breaches of constitutional government was sufficiently persistent for the latter to challenge Virchow to an unaccepted duel (Fig 1.13). Virchow remained a member of the Berlin City Council, and made important contributions to public health, especially in the improvement of living conditions, which diminished epidemic typhus; and the provision of a sewerage system for Berlin (Fig 1.14), which diminished the incidence of cholera. In politics Virchow opposed the expansion of Prussia and expenditure on the military, but Bismarck’s successes in the wars respectively with Denmark (1864), with Austria (1866) and with France (1870), together with the rise of left-wing political groups – such as the Social Democrats – weakened Virchow’s position. His support for Bismarck’s anti-Catholic policies (1870s–1880s) – which Virchow referred to as Kulturkampf (“culture struggle”) – led to Virchow losing the support of many liberal Catholics. Virchow also became interested in anthropology and founded the Society for Anthropology, Ethnology and Prehistory / Gesellschaft für Anthropologie, Ethnologie und Urgeschichte which was very influential in coordinating and intensifying German anthropological and archaeological research. His archeological works included participating in Schliemann’s famous first excavations of the Ancient Greek city of Troy, as well as an extensive journey to the ancient sites in Egypt. In this later period of his life Virchow maintained his interest in medical matters and his colleagues included Roloff, Helmholtz, Du Bois-Reymond, Hirsch and Gurlt (chapter 6h, 6j, 6k, 6l, 6o), and he had wide contacts, including

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Cultural context

the famous surgeon von Volkmann (chapter 6i). In later years (Figs 1.15–1.18) Virchow was considered the ‘Father’ of modern pathology, and was invited to give numerous addresses on various occasions, including international meetings (for example in Rome in 1893 – chapter 5). It can be noted here that Virchow as head of the Institute of Pathological Anatomy had several Assistenten at almost all times. Thus Hansemann was initially appointed 3rd Assistent in 1886, rising to 1st Assistent by 1893 (Bignold et al, 2007). Further, until late in life, Virchow continued to practice as a physician at the Charité. He was responsible for the so-called ‘combined ward’ (Köhler, 2005) in that hospital and was supported by clinical Assistenten in that capacity. Among these was Obermeyer (also spelled ‘Obermeier’, see Appendix 1b) and Semon (Appendices 1a and 1c). Thus Virchow’s direct influence on young doctors was wider than just on the undergraduates of the Medical School and his Assistenten in pathological anatomy. This introduction is directed mainly at the issues mentioned in the texts of the tributes: – the cultural context; sectarian issues; pathology and ‘scientific medicine’ in Germany in the early nineteenth century; in addition to the origin and meaning of ‘Cell Theory’ (1830s and 1840s). The details of his life are sketched in the obituaries and other material given in Appendix 1, and provided in detail in numerous books (e.g. Ackerknecht, 1953a; Schipperges, 1994; Dhom, 2001; Andree, 2002; Goschler, 2002) and articles (see Appendix 2b), and are not discussed further. Virchow’s eulogies for anthropologists are not included here, nor are any significant accounts given of his contributions to the worlds of either politics (see Ackerknecht, 1953a) or public health (see Rather, 1985). Virchow’s interest in the history of medicine (see Ackerknecht, 1953a; Rather, 1990) – will not be mentioned further. We recognize that some aspects of Virchow’s contributions to specific topics in pathology have been controversial, mainly because of suggestions that he made several doubtful claims to originality in relation to ‘Cell Theory’, and also because of accusations that in later life, he persisted in asserting the supremacy of Pathological Anatomy as a medical science, to the detriment of others, especially microbiology (Gortvay and Zoltán, 1965; see also Bignold et al, 2008). However, in our view, none of this detracts from the fact that Virchow’s work contributed enormously to the transformation of condition of medical science in the early nineteenth century – that is to say, from post-medieval, confused, speculative and often subjective theorizing to the rational, mechanistic and evidence-based condition of today. Cultural context Germany in the late eighteenth century consisted of over 300 separate and virtually independent states and principalities, each with its own system of taxation, weights and measures and so on. Of the rulers of these political units, vari-

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Introduction

able numbers, but usually eight to eleven, were ‘Electors’ of the Emperor of the (to give its full name) ‘Holy Roman Empire of the German Nation’. This ‘Empire’ was in fact a loose Confederation serving legal purposes and little else. Thus the ‘Empire’ had no established capital city and had rarely proved strong enough to prevent its members warring between each other or forming alliances with non-German Powers. One third of the land area of Germany was effectively ruled by the Catholic Church through bishops and archbishops. The remainder had either Catholic or Protestant secular rulers. Almost all rulers were ‘absolute’– i.e. despots governing with no democratic institutions and few legal hindrances. This explains the various references in chapter 3 (Schönlein) to imprisonment without trial, and Virchow’s own departure from Berlin in 1849. Since the Middle Ages there had been frequent wars between the German states. Changes of rulers occurred through success in battle and also through marriages between members of Royal Houses. In wars with foreign powers (for example, with France and Sweden) the various German states had frequently fought on opposing sides. In all this – as Virchow notes in chapter 2 – the Germans had only one persisting and reliable cultural institution in common: their Universities (Paulsen 1895; Flexner 1968; McClelland 1980). The notable academic orientation of the Germans – and it may be suggested, their deep involvement with philosophy and philosophers against which Virchow had to struggle – may well be traced to this. In Germany, the Enlightenment at its best was characterised by precise, rational and secular critical-but-tolerant habits of thought – best represented perhaps by Kant (1724–1804) and Lessing (1729–1781; see Mauser and Sasse, 1993). However, the German Enlightenment then developed in two ways. The first was a tendency in philosophy to excessive intellectualization and thoroughness, especially in the ‘systems’ of thought of Hegel (1770–1831). The second was the change in mode of thought (Roberts, 2002) characterized by the German Romantic movement – perhaps starting with Herder’s (1744–1803) ideas of tribal cultural characteristics, but definitely characterized by the Sturm und Drang literature of the 1770s. This ‘romantic mode’ saw the development and expression of individualism with great importance being given to personal, subjective, and even emotional experience. The totality of this view is indicated in German by Innerlichkeit, which is only incompletely rendered as ‘inwardness’. In the early nineteenth century this ‘romantic mode’ of thought came to be applied to the sciences including medicine (Cunningham and Jardine, 1990; Poggi and Maurizio, 1994; Roberts, 2002). In an important respect, the romantic movement complicated German thinking enormously by adding ‘subjective versus objective’ to the already-existing polarities in thought among German philosophers of ‘liberal versus conservative’ (traditions) and ‘secular versus liberal religious versus clerical-revivalist’ (religious convictions) – see Gottfried (1979). Also at the end of the eighteenth century, the political conditions of the German people varied enormously from state to state – from ‘free’ cities such

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Sectarian issues

as Hamburg and Frankfurt, with their own local governments – to states in which serfdom persisted little-changed from the Middle Ages. Two thirds of Germans lived in rural areas. Travel was on foot, horses or river boats. Thus movement from one University to another was difficult, and few ‘conferences’ of academics were possible. Letter-writing was generally the only means of communication between separated friends or academics at different Universities. Music was usually composed by commission at the behest of clerical or secular rulers. The institution of the ‘court composer’ illustrates this, e.g. Mozart in Salzburg, Hadyn in the employ of Prince Esterhazy. Both were typical for their times, and were literally liveried Court employees. The contrast can now be made with the situation in Germany at the end of the nineteenth century. The German-speaking world had been resolved into the ‘German Empire’ (based on Prussia) and the ‘Austro-Hungarian Empire’ with a small component in Switzerland. Rule was by (limited) constitutional monarchies, serfdom had been abolished, and two-thirds of Germans now lived in towns, most of which were connected to the national system of railways. The population had increased approximately threefold and university students had increased in number to an even greater extent (Jarausch 1982; Cocks and Jarausch 1990). National and international academic conferences were commonplace. Philosophy as a method of establishing truth in scientific questions had been almost completely replaced by rationalistic/mechanistic consideration and experimentation. The pride of particularly the Prussians in their achievements was considerable, and military sayings entered the German language to greater degrees as militarism entered its culture. Composers were free spirits and usually secular, who wrote for themselves and for the public. Among them, Wagner, Richard Strauss, Johann Strauss and Lehar were particularly popular in Germany. In all of this, we must remember that there was no telephone, radio, television or other electronic aids. Individuals communicated with each other faceto-face or in writing, and individuals heard from their leaders in public meetings or in the newspapers. Hence orations, particularly the longer ones (chapters 2–5) were a major means of communication in the academic world, and happened much more frequently and on a much greater scale than has occurred in the later twentieth century. Thus in reading these chapters, it should be remembered that they were all primarily speeches at large meetings of academics and other learned people. Sectarian issues In the context described in the preceding section, it is not surprising that secular issues should arise in Virchow’s eulogies. The Reformation, Counter-Reformation and associated wars had not resulted in either Catholic or Protestant supremacy in Germany, as had happened in England and France. The German

11

Introduction

Enlightenment was associated with greater secular questioning of faith and a drift of the German Catholic Church towards liberalism. There was also a general acceptance by the German Catholic Church of secular authority over some church matters, such as the appointment of bishops (‘Febronianism’). However, during this period, ideas of re-establishing the social order of the Middle Ages (‘Millenarianism’ – see Gottfried, 1979) were retained by some clergy. During the whole of Virchow’s lifetime and the period relevant to these tributes, significant changes occurred which resulted from the effects of French Revolution and Napoleonic Wars. In particular, Napoleon abolished most of the German monasteries and abbeys. Further, all the ecclesiastical principalities and almost all the smaller secular political units were consolidated into thirty-nine secular states. Napoleon also closed a large number of German Universities (e.g. Bonn and Bamberg) during the secularization, perhaps because they contained faculties of theology for training priests as well as being centres of resistance to French domination. After the fall of Napoleon and the Restoration of the monarchies in Europe, the ‘Millenarian’ and other conservative elements in the Catholic Church sought to reverse the liberal and political progress of the secular rulers during the Enlightenment and Revolutionary-Napoleonic period. Significant in this was the re-establishment in 1814 of the Jesuit Order (which had been abolished in 1772 by Pope Clement XIV under pressure particularly from the Bourbon sovereigns of Europe). In Prussia there were particular factors exacerbating secular strains. At the end of the Thirty Years War (1618–1848) Prussia was predominantly German and predominantly Protestant. However, in three partitions (1772, 1793 and 1795) of the previously independent state of Poland (the ‘Polish-Lithuanian Commonwealth’), a significant Slav-Catholic population was acquired in eastern Prussia. There, Junker administration was established over mixed German-Protestant and Slav-Catholic populations. Then in 1815, by the Congress of Vienna, Prussia gained extensive western territories – including much of what is now ‘North Rhine-Westphalia’ – which contained mainly German Catholics. Although the Prussian Government continued to exclude the Jesuit Order (after the latter’s re-establishment in 1814) from its territories, a revival of Catholicism occurred among those German Catholics not under Prussian control. The timing and driving forces behind this revival are controversial (see Clark, 2003), but by 1844, there had been sufficient revival for 500,000 Catholics (it is alleged – p 187 in Gross, 2005) to make a pilgrimage to Trier (population then 20,000). Church-State relationships altered again in Prussia after the Revolution of 1848. The Catholic Church had supported the Protestant Prussian king against the (mainly secular) revolutionaries of 1848, and was seen as a force for social order and established rule. Thus when the Constitution of 1850 came into force, the exclusion of the Jesuits from Prussia was ended, and further, the Church found that it could control elected representatives in the new Prussian Landtag (House of Assembly).

12

Aspects of pathology and ‘scientific medicine’ in Germany in the early nineteenth century

After 1850 (if not before) the Church’s strategy was two-pronged. First, Jesuit priests were sent on ‘missions’ to all areas of the new Prussia, to preach morality, piety and the Wages of Sin mainly among the lower socio-economic groups. Secondly, in what became known as ‘Ultramontanism’ (i.e. greater power north of the Alps for the Church of Rome), the Catholic Church began to reclaim its old influence over regional churches and – most importantly for the events described in this book – demanded the return to the Prussian Catholic church its traditional areas of responsibility, such as the appointment of bishops, financial dues and authority in doctrinal matters. This second programme – again using the agency of the Jesuit Order – culminated in the declaration of ‘Papal Infallibility’ by Pope Pius IX in 1864. Finally, the additional annexations of territories after the Austro-Prussian War of 1866 and the absorption of Alsace and Lorraine into Prussia after 1872, added another large number of German Catholics to Prussia’s population. Thus, the leaders of Prussia saw the continuing activities of the Catholic Church as a clear threat to the process of integration of the new territories into the German Empire (Second Reich), if not an attack on Prussian Protestantism itself. No doubt ‘Papal Infallibility’ resembled the dictus Papae and the Papal Bull of 1302 (in which the Papacy had claimed temporal sovereignty over all Christendom) too strongly for the spectre of a new Counter-Reformation by the Catholic Church not to be raised in Protestant minds generally. In the 1870s, the Prussian Government enacted anti-Catholic, and in particular anti-Jesuit measures in a campaign to which Virchow gave the name Kulturkampf. The detailed history of this is available in many books (e.g. Ross, 1998; Clark, 2003; Gross, 2005), but we may observe that Virchow – a liberal – joined with Bismarck in all of this legislation, probably for several reasons. The first was probably because of the anti-Catholicism to which he had been exposed since childhood in Pomerania (see Virchow’s letters to his parents, Rabl, 1907). Second, there are clear statements of his perception that the Church was opposed to rationalism, science and progress both in the late 1840s (Rather, 1990) as well as in his account of the arguments between Ringseis and Schönlein (chapter 3). Third, as a nationalist, he would have been opposed to any threat to Prussian interests, and particularly the integrity of the German Empire. This development split the Fortschrittspartei, and hence damaged Virchow’s standing in politics, particularly among liberals, Catholics and secular regional groups such as the Poles (Ackerknecht, 1953a). Aspects of pathology and ‘scientific medicine’ in Germany in the early nineteenth century In these tributes there are many examples of Virchow’s major concern to establish ‘science’, and particularly the anatomic sciences, as the proper basis of medical practice (see Rather, 1962; Bignold et al, 2008). In Germany the issues

13

Introduction

which may have underlain the whole problem of irrationalism in medical theory were mainly the growing appreciation – through careful observation of scientific analysis – of ‘developmental changes’ in biological and medical processes; the failure of mechanistic explanations of these phenomena; the ‘intrusion of the philosophers’ and finally, the example of the French. Virchow gives an excellent brief account of this in chapter 3 (Schönlein). ‘Developmental changes’ began to be recognized as an essential biological process when, in the early eighteenth century, it became understood that ‘preformationism’ (all anatomical structures appear by simple growth of pre-existing miniature ones) was untenable (Nordenskiold, 1928; Gasking, 1967; Farley, 1982; Churchill, 1991). After that, all biological study had to contend with the fact that embryological development occurs by processes (‘epigenesis’) which meant specifically that earlier, simpler structures give rise to new and especially more complex structures. From this conceptual shift grew the interest in comparative anatomy and comparative embryology of plants and animals. The most prominent studies of these processes include Harvey’s (1651) investigations of the development of the chick, and those of Caspar Wolff, the elder and younger J. F. Meckel, Oken, Pindar, von Baer and others (Garrison, 1929; Hall, 1983; Churchill, 1991; Gilbert, 1994). Goethe took up this idea in finding that the whole individual plant develops from the leaf (in his ‘Metamorphosis of Plants’, 1790), and that the skull develops entirely out of vertebral bones (Virchow, 1861). Of note here is that early in his career Schönlein had an interest in the subject (chapter 3). However, only with the advent of better microscopes in the 1830s, did the whole field became susceptible to further fruitful investigation. This opportunity accounts for Müller’s intense interest in the subject in later life (chapter 2). In medicine, ‘the development of disease-phenomena’ became the conceptual basis of the “Natural Historical” / naturhistorische school of which Schönlein was a major representative (see chapter 3 and Bleker, 1983). For Virchow, the concept became important because through his studies of diseases of bones, he determined that one type of cell could develop from another (a process referred to by him as ‘histological substitution’ from which he later separated a subtype which he called ‘metaplasia’ – Virchow, 1871; 1884). The second issue to be considered is the results of the failure of mechanistic explanations for pathological processes. This was most significant because scientists of the time had inherited from the Ancient Greeks the assumption that simple overarching explanations of natural phenomena are possible, and can be achieved with minimal knowledge of underlying physics and chemistry. Thus, in the eighteenth century, European scientists were faced – after the abandonment of the ‘Humoral Theory’ of disease – with only meager advances in the physical sciences (mainly magnetism and electricity) and in the biological sciences (mainly in nutrition, the circulation of the blood, and the actions of nerves) to support any new theories. The response of many scientists of the time was, unfortunately, in the Ancient Greek tradition, which was to dream up

14

Aspects of pathology and ‘scientific medicine’ in Germany in the early nineteenth century

new theories of diseases according to these meager new findings. The result was that many alternative approaches to theory of disease – none of which were convincing – appeared, including: “Metaphysicians, Idealists, Iatromechanists, Iatrochemists, Experimental Physiologists, Natural Philosophers, Mystics, Magnetizers, Exorcisers, Galenists, modern Paracelsian Homunculi, Stahlianists, Humoral-pathologists, Gastricists, infarct-men, Broussaisists, Contrastimulists, Natural Historians, Physiatricists, Ideal-pathologists, German-Christian theosophists, Schönleinian epigones, Pseudo-Schönleinians, Homoeobiotics, Homoeopathists, Isopathists, Homoeopathic Allopathists, Psorists and Scorists, Hydropathists, Electricity-men, Physiologists after Hamberger, Heinrothians, Sachsians, Kierserians, Hegelians, Morisonians, Phrenologists, Iatrostatisticians”. (Jahn, cited by Pagel, 1945).

As examples in this book, we note that Müller (chapter 2) spent much time on the concept of the ‘Life Force’, which his Assistenten Helmholtz, Brucke and Du Bois-Reymond would confidently declare did not exist on existing evidence. Virchow gives a good account of this in chapter 2, and as a side-light, Virchow himself gives the amusing example of a Professor of Physiology at Würzburg who believed that the ‘magnetism’ of certain chairs could cause disease in anyone who sat in them (chapter 2, Document Note 21). We note also that Broman (1996) gives an excellent general account of German Academic Medicine in the period. The third point to consider is not just the following of Ancient Greek traditions in natural science (above), but the attempt to establish new philosophies by which to arrive at truths. This ‘intrusion of the philosophers’ probably occurred as a result of both the increasing complexity of the discovered scientific facts (especially facts of development, see above) in combination with the concurrent failure of any known basic science to explain them. Essentially in Germany, the process involved the application of the new ‘Romanticism’ (Cunningham and Jardine, 1990; Poggi and Maurizio, 1994; Pinkard, 2002; Roberts, 2002) to biology and medicine. As an early – and perhaps extreme – example, Schiller, in his (unsuccessful) medical doctoral thesis entitled “The Philosophy of Physiology”, included the Romantic passage: “Amongst the organs (of senses) which change the object, the eye is the broadest, most beautiful, most noble; I see bodies when I perceive the vibration of light on their surfaces. And now, inasmuch as my spirits of nerves (Nervengeist) could not exist on the surfaces of these bodies, therefore the subordinate power of the eye must have made the light vibrate on the spirit of the nerves when it vibrated on the surface of the bodies”. (Slightly adapted from Schiller, 1779).

Subsequently, the tendency to romanticism was increased by authors who combined the work of Schelling (1775–1854) – ‘Ideas to a Natural Philosophy’ (1797) / Ideen zu einer Philosophie der Natur – with previous inclinations to ‘Systems’ (as in Hegel). As a result, in the first decades of the nineteenth century, many doctors in Germany began to create new systems of medicine to make names for themselves. Thus Schönlein (chapter 3) is noted in his Inaug-

15

Introduction

ural Dissertation to have used ‘Romantic’ language, but in later life, avoided writing on medical issues at all. Virchow gives an account of this in chapter 2, and Cunningham and Jardine (1990) as well as Roberts (2002) present excellent detailed studies. The final point to consider here is that for German medicine, there was the example of the French. The French Revolution (1789–1793) had destroyed the French Monarchy, much of the aristocracy, the Royal Academies and all but one of the individual French Universities. On the other hand, it encouraged the sciences, so that in a short period of time, there were major improvements, such as the introduction of the metric system of weights and measures. In medicine the ‘Parisian School’ which had developed in the middle of the eighteenth century, was enhanced by new original thinkers such as Cuvier (1769–1832), Broussais (1772–1838), Dutrochet (1776–1847), Bichat (1771–1802) and Laennec (1781–1815). These authors introduced new approaches to the study of organs and tissues and new techniques for physical examination with the newly-invented stethoscope respectively. The pace of scientific research continued in post-Napoleonic France, when great progress in biology and medicine was achieved by the work of Cruveilhier (1791–1874), Raspail (1794–1878 – Weiner, 1968), Andral (1797–1876) and others (Ackerknecht, 1953b; Klemperer, 1957, 1958, 1961; 1963; Rather, 1966, Hannaway and La Berge, 1998). But in Germany, the French advances in medicine and biology were not being absorbed. The techniques of microscopy in France (La Berge, 1994) and in some respects in England were more advanced than the corresponding practices in Germany. Valentin and Gruby (see Kisch, 1954) had noted the appearances of cells, as also had Raspail, who on the basis of studies of normal botanical specimens declared omnis cellula e cellula (Weiner, 1978). Robert Brown (1773–1858) had described the constant presence of the nucleus in plant cells in 1830. And in clinical medicine too, French developments were overlooked. Thus the stethoscope and the diagnostic techniques of percussion and auscultation, which had been developed by Laennec (see above), was hardly used in Germany. For example, in the 1830s, Schönlein was said to be the only German practitioner using these methods (chapter 3). Thus in summary, when Virchow began his medical career, Germany could be seen to be leading in the fields of comparative anatomy and embryology, but behind other countries in scientific and clinical medicine. German medicine was also obviously distracted by irrational and Romantically-influenced overdeveloped philosophies. The origin and meaning of ‘Cell Theory’ (1830s and 1840s) The invention of the achromatic lens for microscopes was the major technical development which placed the Germans on the road to leadership in scientific investigation of disease (Bracegirdle, 1978) – and set Virchow on his life’s mis-

16

The origin and meaning of ‘Cell Theory’ (1830s and 1840s)

sion. These instruments provided magnifications of 300x, compared with those of approximately 100x which could be achieved by the best simple lenses. This magnification was too slight for chromosomes to be seen, so that microscopy as it is known today had to wait until the discovery of apoachromatic lenses in the 1870s. Together with the staining methods developed previously (using iodine solutions, by Raspail, see Weiner, 1968) these lenses allowed for the discovery of the primary importance of cells in the formation and development of the tissues (see, for example, Vogel, 1847; Kölliker, 1853). Virchow in his eulogy for Schwann (chapter 6g) and in his address on Morgagni (chapter 5) attempted to portray the issue of ‘Cell Theory’ in terms of the origin of cells, and claimed priority for discovering ‘all cells from other cells’ for himself. The matter is not straightforward, and Virchow’s claim is controversial. The roles of other workers (Raspail, Remak, Valentin, Purkinje and others) and the details of Virchow’s actions are discussed particularly by Rather (1962; 1971), Rather et al (1986, pp 1–55), Harris (1999) and Otis (2007) but relevant considerations are also given by Cameron (1952a), Kisch (1954), Hughes (1959) and Schmiedebach (1990). The assessment of priority in ‘Cell Theory’ perhaps really revolves around which component of ‘Cell Theory’ is under consideration.Thus the part-issues are: (i)

the discovery of ‘cells’ in the sense of structures 5–20 micron in size in tissues;

(ii) the realization that some cells come from pre-existing cells under some circumstances; (iii) the realization that all cells come from pre-existing cells in all normal circumstances; (iv) the realization that all cells come from pre-existing cells in all pathological conditions as well; (v) the realization that all cells come from cells like themselves (omnis cellula e cellula ejustum generis); (vi) that the metabolism of the tissues occurs in cells (i.e. not in the interstitial tissues), and all interstitial materials are the products of the cells’ activities, as well as, (vii) that pathological lesions arise and have appearances according to the disturbances (of actions, or in reactions or ‘degenerations’) of the normal metabolism of cells – and in which the interstitial material is passive, or plays only the simplest mechanical or chemical roles. Rather et al (1986), Harris (1999) and Otis (2007) concur that Virchow did not ‘discover’ that normal cells (which can reasonably be credited to Swammerdam –

17

Introduction

Cameron, 1952a) nor that cells come from one another (earlier by Raspail – Weiner, 1968), nor even that they are the basis of local tissue metabolism (Schwann, chapter 6g). Thus Virchow’s claim that he himself discovered ‘all cells from other cells’, without any qualification, may be confusing. Nevertheless, Virchow certainly proclaimed effectively that all cells come from other cells in all pathological conditions, and that the lesions of disease represent the outcomes of the actions, reactions and degenerations of cells at the local sites of disease. This concept – because it could be linked to symptoms, signs and biochemical disturbances in the patients – ultimately became the greatest advance, because it laid the foundation of modern medicine. Conclusion Virchow was a leader in the advance of rational medicine in Germany and the world through the second half of the nineteenth century. Evidence of this is in the number of international lectures which he was invited to give, and the topics which he chose for those lectures, as well as the direct judgments of his contemporaries as described in their obituaries for him (chapter 7). His arguments for Cellular Pathology swept away the myriad speculative and ill-founded ‘systems’ and ‘philosophies’ of disease which had sprung up in the vacuum created in European medical thought after the demise of the Ancient Greek and Roman ‘humoral’ theories. It is true that his forays into German politics and the whole field of anthropology were less important aspects of his life’s work than were his efforts in medicine. Further, some aspects of his enunciation of Cellular Pathology were dogmatic, and his claims to priority of some particular ideas were controversial. Nevertheless, it is reasonable to suggest that these issues were details which did not matter so much as the success of the overall aim of his work, which was to foster rational study of disease for the benefit of us all.

18

Chapter 2 Johannes Müller, Physiologist (1801–1858): a Eulogy delivered in the Hall of the University of Berlin by Professor Rudolph Virchow Published by A. Hirschwald, Berlin, 1858. With some notes from an earlier translation by A. Mercer Adam, M. D., printed in the Edinburgh Medical Journal 4: 452–63, 527–44 (1858–9). Editors’ comments Müller was undoubtedly the most prominent biological scientist at the University of Berlin at the time, and many notable individuals began their careers as Assistenten under him. Virchow’s eulogy is in the formal style, with an account of Müller’s scientific achievements, his scientific approach to medicine as well as his personal life – including humble origins – resistance to religious dogma and political inclinations. In politics, Virchow and Müller seem to have been on opposite sides. There is little mention of Müller’s relationships with Virchow or his other Assistenten, – probably because these matters were too recent for discussion (see Otis, 2007). Müller is usually recorded as a ‘physiologist’ at the University of Berlin, although he was actually responsible for teaching physiology, comparative anatomy and embryology as well as pathological anatomy. His early interests were neurophysiology and what would now be recognised as ‘cognitive psychology’ (his name is still used for the ‘Müller-Lyer phenomenon’). However later, most of his studies were in the new fields of comparative anatomy and comparative embryology, both based on microscopy. Numerous famous German anatomists, such as Caspar Wolff (1733–1794), the elder J. F. Meckel (1724–1774) and the younger J. F. Meckel (1781–1733), Oken, Pindar and von Baer had preceded him (chapter 1). However, like other biological scientists of the late 1830s, Müller had the advantage over his predecessors of achromatic-lens microscopy and iodine-staining of cells. Thus it was understandable that he devoted his efforts to resolving the long-considered issues in these areas with the new microscopic techniques. Discovery of the Müllerian duct was one of the great results of Müller’s efforts. Overall, however, Müller’s ambition was to develop a ‘System’ of Anatomy in line with contemporary German philosophical tendencies (see chapter 1). Virchow notes (document page 42) that Müller rejected Artistole’s concept of a ‘Ladder of Nature’. However, not noted by Virchow is that Müller also specifically rejected the idea put forward by J. F. Meckel the Younger in the 1820s that the development of higher animals is a summary of the ‘ancestral stages’ of the forms of lower organisms (Garrison, 1929). It may be noted here first that Meckel’s idea was taken up by Haeckel as his ‘Biogenic Law’ – “Ontogeny recapitulates Phylogeny” – in support of Darwinian evolution and second, that Virchow was opposed to Darwinism throughout his life. Müller was not very interested in either pathological anatomy or clinical medicine. One reason why he was so interested in Virchow’s returning to Berlin may have been that the latter could take over the teaching of that subject. On Müller’s death, his position was filled by two Professors – Du Bois-Reymond (chapter 6k) in Physiology, and Reichert (1811–1883) in Comparative Anatomy.

19

Johannes Müller, Physiologist (1801–1858): a Eulogy There is a suggestion that there was no particular warmth in the relationship between Müller and Virchow. However, in the period 1856–58, when they were both Professors in the medical faculty in Berlin, Müller seems to have been absent on biological expeditions. Thus there may have been little opportunity for contact between them. A longer eulogy on Müller was written by Du Bois-Reymond in the same year as this one – 1858. Rather et al (1986) and Harris (1999) provide discussions of Müller’s role in the development of Cell Theory. A volume on Müller at the time when Virchow was his Assistent has been published recently (Otis, 2007). Otis has also provided an on-line article for the website of the Max Planck Institute for the History of Science, Berlin. Additional articles on Müller include Haggard and Smith (1938), Lohff (2001) Zimmer (2006). The earlier translation of this work by Adam (1858) contains only a few errors, and we have retained some of that author’s notes in this translation – indicated as “Adams”. Our annotations are indicated as in other chapters by “e”.

Editors’ summary of points Main text: P 3–5 Introduction; 4–8 early life, Görres; 8 Catholic religion; 9 University of Bonn; 10–11 begins interest in imagination images; 12 German universities at the time; 13 Müller’s studies; 14–16 the state of the sciences at the time; 17–18 Müller goes to Berlin, Rudolphi; 19 return to Bonn, multiplicity of research interests; 20–21 Müller suffers a nervous breakdown (1827); 22–23 further work on imagination images; 24 returns to experimental methods in physiology, especially of reflexes; 25 comparative anatomy and embryology of the genital tracts and other investigations; 26 called to the Chair of Physiology in Berlin; 27 Rudolphi’s views; 28–29 begins work on the “Handbook of Physiology”, approach to subject, nature of his contributions; 30 works in comparative anatomy and embryology; 31 begins Müller’s Archives; 32 microscopy and work on tumours; 33 Müller’s pupils, the Cell Theory, lack of interest in pathology; 34–36 further researches into comparative anatomy, especially of marine life; 37 rising tension with work, role as Rector of the University during the revolution of 1848; 38 effects of shipwreck, declining health and death. Notes: These are almost all citations of references or short comments. On p 41 is a long quotation concerning Müller’s philosophy, excerpted from his preface to “Developmental History of the Genitalia” (1830). On p 44 is a description of Müller as a lecturer. On p 47 there is a long account of Müller and the revolution of 1848.

Nearly three months have passed since that spring morning when the shattering news of Johannes Müller’s sudden death spread throughout Berlin. Since then new buds have burst forth, new life has unfolded, and fresh activity has pressed in us from every side – but on no single day have we been able to forget the memory of that dead man, whose body we have returned to the bosom of mother-earth. Standing at his coffin, we listened to those words of consolation which, according to the custom of our land, are offered by the clergyman to family and friends. The Academy of Sciences, in open session, has paid fit homage to the memory of its late eminent member, through the voice of that scholar who had longest been his colleague. And pupils and friends from far and near1 have gathered together the long list of scientific distinctions which our unforgettable teacher had earned by the most assiduous of labour. But no praise can bring back him whom we have lost; and ever more painfully do we recall him whose sturdy manhood gave promise of a long life.

20

Johannes Müller, Physiologist (1801–1858): a Eulogy

With each day that passes, we feel more deeply how in him so many threads ran together which bound us to each other; and ever more consciously does each of us realise that not only has his family lost its protector, but that with him the world of learning has lost one of its exalted chiefs. Here we stand e1 – representatives of the great family of medicine, teachers and students, practitioners and researchers – joined in lamenting that neither cares by day, nor labours by night, can soften in our minds the sorrow, the loss, which we feel. We are met here in order to tie again that bond of unity which the mere existence of this man – on whom we all look back now – had established in our thoughts; and to realise in as vital a way as possible, the memory of this ideal Head, the mere sight of whom filled us with feelings of veneration, such that may never be lost to us. My feeble powers have been summoned to execute this great work. If the will constituted the deed, how gladly would I attempt the task! For few have been privileged, as I have myself, to have this great Master beside them at every stage of their development. It was his hand which guided my first steps as a medical student; his words proclaimed my doctorate; and from that spot, whence now his cold image looks down upon us, his kindly eyes beamed warmly upon me when I delivered my first public address as a Lecturer under his Deanship. Out of the large number of his pupils, in later years I was the only one who, by his own proposal, was selected to sit beside him within the narrow circle of the Faculty, and to whom he voluntarily passed an important part of his whole influence. But can one voice adequately praise a man who presided over the whole territory of the science of animal life? Or can one tongue describe

4

e1 This has a potent resonance of Luther’s words “Here I stand, I cannot do otherwise …” spoken at the Diet of Worms (1519).

the intellect which extended the limits of this great territory, until it became too large for a single government? Is it possible in a few short minutes to sketch the history of a conqueror, who in restless campaigns, through more than a generation, used every new conquest as something to stand on, in order with bold gaze to spy out the thus newly-visible land for fresh glory? Can any later imitator of this model gain any overview of the inner developmental progress of a man who concealed within himself his objectives and the stimuli to his researches? Yet such is the task which one has to fulfil. We have to inquire what it was that raised Müller to so high a place in the estimation of his contemporaries; by what magic it was that envy became dumb before him; and by what mysterious means he contrived to chain the hearts of beginners to him, and so to keep them captive through many long years? Many have said – and not without reason – that there was something demonic about Müller, for his whole appearance bore the stamp of the unusual. But to believe that his commanding influence depended only on his extraordinary natural talents, accords but little with what we know of the history of intellectual greatness. Müller’s external form

21

5

Johannes Müller, Physiologist (1801–1858): a Eulogy

bore, in striking fashion, the particularities of his family, and yet, within the same family, it was specifically he who towers up to such an extent. Let us seek, then, what was so remarkably stimulating in his development; and perhaps at the same time we may be able to trace his influence upon the times in which he lived. 6

Johannes Müller was born at Coblenz on the 14th of July 1801, in a stormy epoch of European history. For only a few months previously the Emperor and the Empire – both tottering to their downfall – had ceded the left bank of the Rhine to the French Republic by the treaty of peace signed at LunévilleAdams1. The archiepiscopal dominions of Trier – whose Electors had so long resided at Coblenz – were removed from the list of the German states. What that proud spirit of Sickingene2 had failed to do, had now become easy for a foreign race to accomplish due to the weakness of the Holy Roman Empire. And at this place, where an insolent emigration2 had a short time before established its court, now there presided French Préfêts of the Rhine and Moselle Departments. A strange fate! Georg Cuvier – the French researcher with whom Müller has been most frequently compared – was born at Mümpelgard in Alsace at a time when that small territory still belonged to Württemberg. Müller was supposed to study theology in Tübingen, and only necessity compelled him to enter the Carlsschule at Stuttgart, which has since become so famous. It was there that the seed for his interest in the natural sciences was first planted in him3, and from then onwards a German spirit of research and a knowledge of German literature remained with him. May we not venture to say that the restless spirit, the readiness for quick action, the impetuous strivings after fame or gain, which since that time have so often been manifest in the politics of transRhenishe3 Germany, were also early awakened in young Müller by foreign influences, and continued to be visible throughout his (Müller’s) life? May we not believe that, from the events which he witnessed – the breaking up of an empire which had lasted for a thousand years – the ecstasy of freedom, the violent downfall of the greatest conqueror, and the triumphant rising of a whole nation – all compressed within a decade, in the brief years of one boyhood – he heaped up within himself ferment (Gährungsstoff) enough for a lifetime, and that thus, even this early, he had outgrown the thought of authority? Adams1

At the Treaty of Lunéville, on the 9th February 1801, the Emperor of Austria (with the concurrence of the Empire) ceded to the French Republic all the Austrian possessions on the left bank of the Rhine. (These included Fricktal and Bad Zurzach, both now part of Switzerland. See http://www.napoleon-series.org/research/government/diplomatic/c_luneville.html. – eds).

e2 Franz von Sickingen (1481–1523) was a typical Imperial Knight in the Reformation, whose castle was near Kreuznach, not far from Coblenz. He was a leader of the loosely-termed “Knight’s Revolt” against clerical princes, and was ultimately defeated. There is much Romantic tradition, e.g. Goethe’s Götz von Berlichingen (1773) and in the literature of the early nineteenth century. The reference would have appealed to local Rhenish tradition and anti-clerical individualism. e3 This refers to the traditional feeling in the population west of the Rhine, in favour of separation and independence from Prussia, and even at times, union with France.

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Johannes Müller, Physiologist (1801–1858): a Eulogy

We are in possession of no direct evidence as to what circumstances first stimulated the young mind of Müller. The only man of consequence at that time, whom the history of our science remembers in Coblenz, was Joseph Görres who, as Professor in the Secondary School (Secundärschule), published treatises on Natural Philosophy, in the departments of Organonomy and Physiology, in the years 1802–5. But it does not appear that he exercised any direct influence on Müller; the latter first entered the Secundärschule in 1810e4, while Görres resigned his professorship in 1814, soon after the re-conquest of the country, and was afterwards obliged to flee to France, in consequence of a work he published, called “Germany and the Revolution” / Deutschland und die Revolution. But it is quite certain that his official successor, John Schultze – who for several years, in the capacity of Crown and Consistorial Councillor and Director of the schools in the Rhenish provinces – advised Müller’s father to direct his remarkably gifted son to studies. Among Müller’s teachers there was only one – the mathematician V. Leutzinger – to whom, in his dissertation, he attributed any special part in his mental development. We may therefore conclude that the course which was taken by his youthful spirit was not directed either by the example or influence of any specific personality. And so it becomes all the more necessary for us to consider the events of the time as the principal circumstances which determined his career. How early are dispositions and inclinations, which powerfully influence his later life, implanted in the mind of a child! And how difficult it is e4

7

see note to text page 9.

for the education of later years, or the strength of the self-conscious will, to efface those impressions which have been strongly stamped on the pliant mind of boyhood! The precepts of parents, the examples of his playmates4, the dealings with neighbours, experiences at home and around the town, the views of nature, and stories of the past or present – these are the mighty forces which early on fill us with images, with yearnings and with thoughts which we afterwards relinquish only with the utmost reluctance and difficulty. The particular type of practice determines the capabilities of any organ at least as much as the original endowment. Müller’s father was a shoemaker. His family, from the Mosel region, lived in a small house in the Jesuitenstrasse, Coblenz. In spite of his limited means he bestowed every care upon the education of his boy; and after his early death, his wife continued to carry out his intentions towards their son. But what results could she expect? A son whose education has raised him far above the usual achievements of the home circle, must necessarily become estranged from his family; – and he will be obliged to go outside the family to find the means for satisfying most of his wishes and aspirations. Müller feels that it must be himself alone who could support the family; – that he must lead! The further he advances, the more richly can he repay the love and unselfish sacrifices of his

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Johannes Müller, Physiologist (1801–1858): a Eulogy

parents. His father was dead, and therefore he must become the head of the family; so a religious feeling, of a deeper intensity than mere filial affection, bound him from now on to his mother. Müller was brought up in the faith of the Roman Catholic Church. Protestantism had never penetrated the Trier region which had been so recently an ecclesiastical state. Catholicism had reigned paramount here for a thousand years, in all the glory of dominion; and, permeating and encompassing all things, it early took the children into its embrace. It is little wonder, then, that 9

Johannes (as his oldest school-fellow and friend relates) – when about seven or eight years old – talked of wishing to become a Catholic priest. The heart of his mother must have been rejoiced by her son’s idea, and no doubt his wishes received her support and encouragement. So, at ten years old we find him entering the Secondary School – an old Jesuit Latin school, of which one part remained in their (the students’) possessione5 while another was occupied by the French. Here, at times under very unfavourable conditions of instruction, he completed a secondary education which was still partly fixed in the scholastic forms of the Middle Ages. To a certain extent he made up for these defects by reading. By good fortune he was led to the works of Goethe. The beauty of natural history in his native district attracted him, and he began to collect plants and animals. Nature and Goethe! How long their impressions remained with Müller! His splendid book on imagination imagese6 – which he published in 1826, while an Extraordinarius professor – as well as his large monograph on Physiognomy, both breathe Nature and Goethe in every line. It is not easy to part with first beliefs. How long must it have fermented in the youth’s breast – indeed in the boy’s too! How much development must have been already behind him therefore, when, in the autumn of 1819, Müller went to the University of Bonn! For meanwhile he had served for a year as a volunteer in the Pioneer Company of the Eighth Section (Military Division) and, although he had abandoned himself to the freshness and distractions of the soldier’s life (which was then less separate from civilian life), when he now entered the University he hesitated (we are told) for three whole days, as to whether or not he should study theology. Then, suddenly, he declared to a friend: – “I have decided: I shall study medicine. There, after all, is something tangible and I know whom I am serving.” To which his friend adds: – “At that time the influence of the French e5 This could refer to the school now known as the Görres Gymnasium in Coblentz. Becker (1982) records that during the French Revolutionary Wars, the school was initially occupied by the Austrian army, and later partly by the French, but then entirely occupied by the French Army 1813–1814. In the latter period, teaching occurred in the houses of the teachers. The school now (2008) has no student records from before 1820 (personal communication from Dr Diensberg, archivist). e6 see Virchow’s address on Goethe (1861).

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Johannes Müller, Physiologist (1801–1858): a Eulogy

Revolution flowed through the minds of educated persons, and attacked everything which was religious. The materialism of the kingdom of science wrenched him to its side.” So, like Cuvier once upon a time, and Boerhaave earlier, Müller was lost to theology. Certainly the importance of the change which thus came over him, although very slowly, can never be over-estimated. For the shoemaker’s son was on the high road to become a dreamer and visionary. Let us hear how he himself describes his circumstances. He says: “This plasticity of imagination images5, both in light and dark areas of vision (Sehfeld), often tormented me in my childhood years. I remember one instance very distinctly. From the window of the living room in my father’s house, I looked out into the street at a house of older appearance, on which the lime was in some places very much blackened, while in others it had flaked away in many-shaped patches, so that probably the oldest coating could be seen. At times, when I was confined to the house, and was occupied at the window for several hours a day with all sorts of work, it happened that, in looking out at the sootily-decayed wall of this dwelling, I could recognise numerous faces in the gaps left by the fallen lime, which, on repeated observation, assumed an almost living facial expression. As the walls of this neighbouring house were for many hours the only object on which my eyes rested, and one which always returned again in its unbroken sameness, it is little wonder that these imagination images at length endowed the monotonous landscape with a sort of life. When I tried carefully to demonstrate to others how one was obliged to recognise all sorts of

10

faces in the fallen lime, I could get no one to agree with me. But, notwithstanding this, I saw them quite distinctly. The refusal of others to recognise my imagination images only rendered me more obstinate in my belief. I cherished my revelation of the faces as something mysterious, although the imagination images existed only in my own mind. In later years – although the recollection of these figures was quite fresh in my memory – I could not discover them any longer in the crevices where they had formerly appeared.” And, in another place6 in the same work, Müller says: “It is seldom that, in closing my eyes before going to sleep, I do not see numerous luminous figures in the dark field of vision. I have seen these appearances since my early youth, and I have always been perfectly able to distinguish them from the peculiar forms seen in dreams, and I have often lain thinking about them for a long time before going to sleep. By practice, I became able to call up these images and to hold them fast after they appeared; and sleepless nights became shorter when, lying awake, I could thus commune with these peculiar creations of my eyes. Whenever I wish to behold these luminous figures, I look with completely closed and reposing eyes into the darkness of the field of vision, and with a feeling of total relaxation and perfect rest of the ocular muscles, I allow myself to sink completely into this state of psychical quiescence of the eyes, or into the darkness of the field of vision. I diligently exclude

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Johannes Müller, Physiologist (1801–1858): a Eulogy

all thoughts and opinions, and – while the eyes as well as the whole body are in a state of complete repose as far as external impressions are concerned – I only observe what may chance to appear in the darkness of my vision as a reflex of internal organic conditions in other parts.” Here we see in Müller, the dreamer developing into an observer, and the almost monkish visionary into a physiologist. It was a happy metamorphosis, which became complete, as will be 12

shown, in the open field of academic freedom, and in the fresh air of the stimulating and eventful student-life of the period. At this time the German universities were certainly in a very critical condition. When, through a national uprising – unequalled in the history of the world – Germany had driven her cruel enemies beyond her borders, the German Confederation (Deutscher Bund) was laboriously constructed from the ruins of the Holy Roman Empire. The best efforts of the nation – repulsed in their drive for constitutional freedom, and in face of the rapidly-growing Reaction – took shelter in the universities, which were the last remains of ancient glory. The Wartburg Festival had given the Russian denunciations a welcome opportunity for manipulatione7. Following this, the dismissals of the professors had begun with Oken; E. M. Arndt and the two Welckers of Bonn were under arrest; Görres had fled; the Carlsbad Decrees had come into force; and also – before the end of 1819 – Boyen, Wilhelm von Humboldt and Beyme7 had been dismissed. But the students remained in opposition, and their forbidden political associations (Burschenschaften) survived not only in their songs but also as the transparent secret of their student-unions. At this time Johannes Müller was a rollicking Bursch; and it is told of him that he would ride from college, sword in hand, to the neighbouring villages, in order to preside over Burschenschaft meetings. But this only lasted a short while. Like Goethe, Müller was no lover of politics; and his love of knowledge, stimulated by his rich imagination, impelled him irresistibly to the investigation of Nature. Under the special guidance of Mayer, he applied himself zealously to the study of anatomy; e7

The Russian (Tsar’s) denunciations were of German liberalism and nationalism generally and the Wartburg Festival (1817) was for celebrations of these ideas by German students. Hence the Tsar denounced the festival.

13

and so enthusiastic did he soon become in this science, that he gaily exclaimed: “Whatever is not demonstrated by the scalpel does not exist.” Physiology followed, into which he was introduced by the witty and learned expositions of Friedrich Nasse, and where he felt at home thanks to Philipp von Walther’s experience in method of practice. How much of a hurry he was in! When in 1820 the young Rhenish Universitye8 established its first-prize essay topic – for a paper on respiration in the foetus – he seized on the difficult subject, although

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Johannes Müller, Physiologist (1801–1858): a Eulogy

he was then only just completing his first-year studies. Animals were procured in every possible way for his experiments; and it really does sound strange when a companion – who accompanied him on the merry journey – tells how he once returned to Bonn from a ride up the Ahr Valley, with a pregnant cat which he had captured, sewed up in a sack, bound tight behind his saddle and then robbed of its kittens by Caesarean section. Müller received the prize; and in 1823 published his work8, in which the extent of its learning, and the number and boldness of the experiments compete with each other. About a year before this he had published, in Oken’s Isis, his laborious observations on the laws and ratios of motion in the different classes of animals; and at the end of 1822, he was awarded Doctor Medicinae on the basis of his Inaugural Thesis, “The Science of Motion of Animals” / De Phoronomia Animalium. From this time onwards he may be said to have stood almost entirely aloof from the public life of the nation. The words with which, thirteen years later, he spoke of the Germans in his “Eulogy for Rudolphi”9, apply very well to him: – “The limitations which our circumscribed geographical position have imposed on us had the effect of specially directing our minds to what is at present hidden from us, and has therefore made us so much the more expert in the investigation of the inhabitants of a whole concealed world in the (bodies of the) fellow creatures of our homeland (Heimat), and in the examination alike of the structure of natural bodies and of their internal vital processes.” The young doctor, now twenty-one years of age, found himself in the midst of the scientific e8

i.e. the re-established University of Bonn.

movement. Who had led him there? He had certainly had valiant (wacker) teachers. In Philosophy, he had Calker and Brandis; in the Arts, Schlegel and Delbrück; in the Natural Sciences, Kastner, Nöggerath, Goldfuss, and the subsequently much-tried President of the Imperial Leopold and Charles AcademyAdams2 Nees van Esenbeck. In Medicine, besides Mayer, Nasse, and Walther, he had been instructed by Weber, Harless, Bischoff, and Stein. To which of all these teachers belongs the merit of having guided and encouraged his efforts in the right direction? Neither his contemporaries nor his successors have been able to tell.10 And in fact he resembled none of them in tendency, aspiration, or action. Certainly too, however, we are wrong if we describe his development as having been wholly unassisted and independent. He was a child of his time, and it is because he was so, and also it was because – from the adverse conditions in which he was placed – he pressed irresistibly forward, that his influence became so great and so persuasive. His graduation as Doctor constituted a sharply defined watershed in his life; from this time the earnest active life of his manhood begins, from which he became a man who attracted world-wide admiration. From this point on we see the Müller we knew, and we may be permitted to pause for a little, so that we may briefly glance at the history of an epoch to

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Johannes Müller, Physiologist (1801–1858): a Eulogy

which we owe so much, and of which the recollection is gradually becoming less and less distinct in our memory. Throughout the whole of the Middle Ages, Aristotle and Galen had been the unquestioned sources of all knowledge in medicine and natural history. But when – at the time of the Reformation – the authority of Galen was brought down by the bold investigations of Vesalius, and by the coarse, but often mystical criticisms of Paracelsus and Van Helmont, Aristotle also receded into the Adams 2

Adams wrote (1858–9): This is one of the oldest academies in Germany. It was founded in 1652 by Dr Bausch, a Franconian physician. It derives its name from the Emperors Leopold I (1640–1705). and Charles VI (1685–1740), both of whom granted it valuable privileges. It belongs to no particular district, but chooses its presidents from any part of Austria, Prussia, or the German States. The president for the time being is the keeper of the Society’s archives, and also of its library, which is large and extensive. Originally it was a purely medical society, but owing to the influence of Nees van Esenbeck, it became chiefly an institution for the cultivation of natural science. It has numbered many of the most distinguished men of Germany among its members.

15

background. Anatomy became the sure foundation of biological perception; and the slowly-maturing sciences of chemistry and physics furnished the means for a mechanistic explanation of life processes. The banner of philosophy was raised higher and higher by Bacon, Descartes, Spinoza and Leibnitz; and the more extensively the kingdom of man’s knowledge grew, the bolder the flights of the human intellect became. Finally, the entire treasury of knowledge of natural history and medicine became centred in one man – Hermann Boerhaave – who has justly been styled the teacher of all Europe. Then divisions began among his pupils. Albert von Haller had already made such a vast collection of empirical discoveries in physiology that his Elementa deserves to be regarded as one of the greatest works of all time. Life, in its particularity as opposed to the rest of world’s phenomena; and life processes taken one by one, increasingly became the objects of his most zealous thought and investigation. The irritability-theory of Haller soon produced the stimulation-doctrine initiated by Cullen, and fully developed by Brown. Numerous disciples arise; mechanistic doctrines were more and more successfully combated by the partisans of Vitalism; the discovery of galvanism perplexed the intellect; and philosophy – which had become all-mighty by the glorious constructions of Kant – completed the ruin of natural science. From the darkness of this barren age there shone forth, like a meteor, the experimental researches of a man, who – throughout fully sixty years and to the present day – has always been the unshakeable herald of unprejudiced thought. To him will in future be applied the beautiful words which his unfortunate predecessor Forstere9 said of Franklin: “With incorruptible fidelity he continued to the last to preach freedom, justice, peace, brotherly loyalty, charity, and mutual forbearance, while he himself set a most noble example in the practice of e9 Georg Forster (1754–1794) was a prominent German author and scientist who wrote on the American writer, scientist and statesman Benjamin Franklin (1706–1790) (Kahn, 1958). Forster

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Johannes Müller, Physiologist (1801–1858): a Eulogy accompanied Captain Cook on the voyage to Australia, and was on the side of the revolutionaries in Mainz in 1792 (Bodi et al, 1990).

all these virtues.”11 But even Alexander von Humboldt could not prevail against the decay. To his astonishment, speculation floundered still deeper into the meshes of philosophy; and it became the fashion to develop physiology too out of mere abstractions. And, in the presence of such science, even the dreary mysticism of animal magnetism strutted abroad of its own accord, pretending to be an advancement made in empirical knowledge of the world! The natural philosophy of Schelling had taught men to deduce all phenomena from the idea of “The Absolute”. Great investigators like Oken, Döllinger, and Walthere10 associated themselves with this error. But – although they have the indisputable merit of having recognised a series of the most important facts by careful observation; and although, in particular, under Döllinger’s direction, there arose at Würzburg that celebrated school of embryologists, among whom Pander, d’Alton, von Baer, and Agassiz were the most distinguished – still all this was not sufficient to produce a real return to true science. For the mass of people it was easier and more convenient to sort out the system without taking the trouble to make investigations. Is it not painful for us (scientists) to be obliged to relate that it was a poet who gave the beautiful example of self-mastery (Enthaltsamkeit) in so frivolous an age? Should we (scientists) not be ashamed to confess that it was Goethe who had been obliged to rescue, for natural science, the true principles of observation? It was a strange time indeed in which general revolution – and anarchy in its worst form – was the rule! The Treviranus’, the Blumenbachs, the Sömmerings, and the Meckels stood at almost-forsaken posts.e11 Such was the epoch in which Müller became a Doctor of Medicine. Indeed, like Oken and Döllinger, he had diligently questioned nature; and he had early got to know and to model himself on Humboldt and Goethe. But he was stuck in the antitheses of natural philosophy, which sounded e10 e11

16

see chapter 3 for more details on these scientists. auf verlassenem Posten – a military saying.

so clever. Yet he believed that he had discovered something of great importance when – based on the experiments of Ritter – he denoted the stretching and bending of the muscles as the poles of the organic column – in which the latter strove towards becoming a circle – while the former diverged in the form of a straight line. His description revelled in all manner of half intelligible analogies12, whose clarity was not increased by the Latin language. One could perceive here how a hoary, mystic, fantastic impulse is struggling to break out. How easily might the whole of this great development have come to grief at this point! But salvation was already at hand. Müller was obliged to go to Berlin to pass the state-examination for a physician’s licence, and was absent from the

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Johannes Müller, Physiologist (1801–1858): a Eulogy

atmosphere of Bonn for almost a year and a half. When he returned to Bonn he was quite changed – so important to a young man is the experience he learns abroad. While in Berlin he had the good fortune to come into close contact with Rudolphi, who was then engaged with the publication of his “Elements of Physiology”; and whose tendencies in this science – as Müller himself says – were predominantly anatomical and sceptical.13 Let us hear how Müller judged this new relationship14: “We may often observe, in the most learned men, a certain reticence, which prevents them from communicating their methods to others, and which also prevents them from cultivating talents in others which might replace their own. Rudolphi had great merit in this respect, for both his teachings and his zeal were transferred to his pupils. He was easily accessible to young men; and, although letters of recommendation procured from him no special assistance, anyone who commended himself to Rudolphi by his good qualities, could always get ready access to all that he possessed, without any introduction whatever. Local and foreign students, physicians and naturalists were all quite at home in his library; and as the young men were fired by his counsels – and attracted by his teachings, as well as by his library, by the aids 18

provided in the anatomical museum, and by the private collection which he had himself formed – with the liberality of a (Joseph) Bankse12 – so there was never any lack of zealous students, who developed into anatomists under his special guidance. His enthusiasm for science, his love of truth, his noble and unselfish character, and his vigorous opposition to all false tendencies were irresistible attractions. Such qualities as these in a teacher gave to the youthful minds of his pupils an imperishable impulse and life-long inspiration. I cannot forget the impression which Rudolphi made on me; for he established and determined forever my inclination to anatomy. For a year and a-half I had the privilege of the benefits of his instruction, advice, and fatherly friendship. When I left Berlin he presented me with various pieces of scientific equipment. In later years he continued to take much interest in me – even when our views were often widely different – but he did not like to see me engaged in the abstract province of the physiology of the senses, and would rather have seen me busy with investigations into the anatomy of the organs of sense – such as the eyes of insects and spiders.” The following passage is also very characteristic.15 “Rudolphi opposed the long dominant system of Naturphilosophie. At every opportunity he expressed himself most forcibly against the study of nature being connected with misunderstood philosophy, which had made pronouncements so arrogantly, because there was a lack of any exact methods, and because of the existing forceful tendency towards generalisation. What Rudolphi says on this subject in his biography of Pallas – by way of a warning to the young – is moving, and cannot fail to have a good effect.”

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Johannes Müller, Physiologist (1801–1858): a Eulogy

Neither did it fail to have an effect on Müller, who henceforward zealously applied himself e12

Georg Forster had accompanied Captain Cook and Joseph Banks on their voyage around the world in 1769–71, during which Cook discovered the east coast of Australia. Banks had paid for most of the voyage from his own pocket. (See also note e9 on document page 15).

to the area of painstaking anatomical investigation. The first fruits of this appeared in 1825 in a comparatively little-known work on the micro-anatomy and the development of insects.16 In the introduction to this book Müller again declares that Rudolphi’s particularly kind ways have made his period in Berlin most instructive and pleasant; and acknowledges that in many respects he felt himself under perpetual obligation to his teacher. The copy of this work, which was available to me, chanced accidentally to contain a very interesting note in Müller’s handwriting. It was: “To Professor Hegel, these pages are offered in token of the gratitude felt by his deeply-indebted pupil, Dr Johannes Müller.” We learn from this the little-known fact that Müller had also continued his philosophical studies during his term at Berlin – a circumstance which is confirmed by private accounts, and one which was quite to be expected in so ardent an admirer of Aristotle17, Bacon, and Giordano Bruno. But Müller’s connection with natural philosophy was at an end. The great turning-point had been passed and we may safely assert that it was our University (Berlin) which won him over to strict science. He now returns to Bonn. On the 19th October 1824, he established himself as a lecturer (Privatdocent). Here, in his public lectures he laid down his new confession of faith. Through them he exposed the “poverty of a physiology founded on a philosophical view of nature.” Müller showed that neither the mythic nor the mystic treatment of physiology; nor the “false natural philosophy,” nor the rationalistic – nor, as he said, the “intellectual” – physiology constituted true science. He maintained that only in the close alliance between a progressive Physiology – that is, one progressing

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by observation and experiment – and philosophy does our security against all such one-sided systems lie.18 As he has said splendidly19: “Research into Nature has a kind of religion of its own; by that I wish to say, it has its habits of worship (Kultus). I believe we may say further: it has its permanent priests. There is an experience which is only formed of ideas; and from such experiences further ideas directly arise, because the former act like the institutions of religious practice. This simple and undemanding view of nature, which constrains itself to recognising only the rights of all things – and the truth of their appearances – is the sense of the natural philosopher, and particularly of the physiologist. Let such a spirit examine whatever it chooses, it always perceives more in the thing itself than is probably recognisable by the senses; and – because its experiences and views proceed from ideas – so also to ideas they

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Johannes Müller, Physiologist (1801–1858): a Eulogy

return. I want to recall how, in the “Views of Nature” by Alexander von Humboldt, and in Goethe’s treatise on natural scientific work, experience becomes the seminal ferment of the intellect. Abstract meditation about nature is not the province of the physiologist. The physiologist investigates nature in order that he may think about it.” Now began a most restless and exasperating period of Müller’s life, in which he not only lectured on general and comparative anatomy, but also on general pathology and pathological anatomy – indeed, even on diseases of the eye and ear. His earliest scholars have described his delivery as uneven and difficult. In fact, if we examine all his works from his Dr habil. to his great “Physiology”, everywhere we see evidence of a mode of presentation, which was markedly over-burdened by masses of facts, carefulness in quotation, and the pressures of thought. It does 21

indeed fascinate us by the warmth of sensibility, earnestness of effort, and truthfulness of perception, – but in the end exhausts the most willing of us! No peace! No rest!e13 His little book on “Imagination Images” appeared like a pleasant idyll in this time of breathless labour – behind which, in classic calm – the “physiological document of Aristotle” brooded over the dream. The work is everywhere excellently organised; the matters in it are well worked through and concisely drawn together; observations and experiments are in perfect unity; and the prevailing strand of thought rises to a retrospective consideration of world history. This was the book which this wonderful man offered as a present to his love – the gift of the future bridegroom. But his exertions had been too great. The poor Privatdocent had widened the area of his researches under conditions of difficulty and anxiety; and he had sacrificed his hard-earned means to the cause of science. The time which it had taken him to achieve this would not have been sufficient for a man of inferior ability to do a fraction of the work involved. He had taught, read, investigated, experimented, and at first had even practised as a physician.20 And then, exhausted from the day’s work, he was in the habit of taking coffee as a stimulus, to enable him to prosecute the still more arduous and difficult researches on subjective vision. He had scarcely been created Extraordinarius (in 1826), and had hardly brought home his bride (in 1827), when his strength broke down. He felt himself exhausted; his nights were sleepless and his mind was uneasy and despondent. Philipp von Walther, his loyal teacher, used his influence with his old friend John Schultze, obtained leave of absence and assistance for him from the Government. He went up the Rhine, accompanied by his young wife, first of all in order to visit Tiedemann, at Heidelberg; then he wandered through Southern Germany; and finally, he returned to his usual actives, reinvigorated in e13

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this is the reverse of the common idiom: Nicht Rast, noch Ruh / “No rest, no peace”.

Johannes Müller, Physiologist (1801–1858): a Eulogy

health and enriched by many new views. But he was no longer the Müller of former days. The great internal catastrophe had transformed his mistrust of imagination images into a positive dislike. Previously fully conscious of his own merits, he now lacked confidence in himself. He became outwardly cold and cautious in every sense. At this point in his career, the period of glittering success and celebrity may be said to have been inaugurated: being nominated as Ordinarius in the University of Bonn. But the path of investigation was never seen by him to be so certain of success – however full of courage, or lofty in aim he might have been at this time. Later on he achieved greater things, but he never again wished to do so much. His two books on “Comparative Physiology,” and “On Imagination Images,” are most interesting documents to those who devote attention to the development of the human mind. Here, for the first time, we see a true flesh-and-blood natural philosopher exploring all the paths of knowledge, and seizing every method of observation, in order that the great problems of the most important senses of sight and hearing might be rendered accessible to science. Animals of all classes were assembled, so that he might fathom the structure of the eye; mathematics and physics were used to establish the laws which govern light and sound. Poets and sculptors of every age were pulled before the judgment-seat of Physiology by the hand of the philological interpreterse14 to render account of the wondrous diversities of the human gaze. And ecclesiastical and secular historians were summoned before Philosophy in order that mankind might forever be delivered from the mysticism of visions and from the spookery of witches and devils. Now gazing freely around nature, now in the homely recesses of literature, and now in the privacy of his own ocular observations – the fiery inquirer reaches out for the veil which conceals e14

22

i. e. literary interpreters

the inner workings (Vorgänge) of the special senses from his conscious mind, and he openly declares that he seeks the way to the soul through the senses.21 “The present inquiry”, he says, “treats of the sense of sight in its higher social relations to the organs, whose form of life we call psychical or spiritual. For the author believes that the soul is only a special type of many forms of life, all of which are the subject of physiological research. And therefore he entertains the conviction, that the physiological investigation must eventually be psychological in its ultimate results. The doctrine of the life of the soul, as a special form of the life of the organism, is therefore only a province of physiology in the wider sense of the word. This province – in opposition to physiology – is in the narrower sense called psychology. But in contrast what we generally term psychology occupies the same relation to the future doctrine of the life of the soul, as the ordinary physiology of the various functions does to the true physiological science.” And Müller makes the further important remarks: “Were the author, in short, called upon to declare what he considered to be a scientific

33

23

Johannes Müller, Physiologist (1801–1858): a Eulogy

physiological treatise on psychology – even while carefully guarding himself against the suspicion of Spinozisme15 – he would unhesitatingly name the three last books of Spinoza. These deal with the Passions, but their psychological content may be regarded as quite independent of the other teachings of this writer. Because even if these are not the correct doctrines concerning life in the passions – and if they be not the true explanation of life in this form – there can at least be no doubt whatever that they constitute a concise and methodical exposition of life; which cannot be said of most psychogic (sic) researches.” e15

i. e. rationalism and probable atheism. Spinosa’s last three works (including posthumous publicatons) were Ethics, Tractatus Theologico-Politicus and Tractatus Politicus, but earlier his works discussed Descartes’ philosophy, which included works on physiology. (Encyclopaedia Britannica).

24

Thus Müller was trying to give vitality to the idea which he had already put forward in two propositions in his Inaugural Dissertation: – that only the physiologist can be a psychologist, and that beyond nature, there was no philosophy. In fact he had established a basis for the philosophy of the senses wholly from nature; and by him the doctrines of Goethe22, Steinbuch, and the revered, deeplythinking Purkinje, had been confirmed and completed. But all that was now past. Müller, who had so energetically defended observation vis à vis experimentation23, now himself turned to experimenting, which he had practised so single-mindedly as a young student. Having had the opportunity – while with Rudolphi in Berlin24 – of witnessing experiments on the functions of the trigeminal and facial nerves, while testing Bell’s dogmase16, he finally succeeded in establishing an easy way of performing experiments on the anterior and posterior roots of the spinal nerves.25, Adams3 As is also well known, it was he who introduced to the general awareness of physiologists and physicians the doctrine of reflex-actions, which had been already expressed by Prochaska, and which was later simultaneously discovered by Marshall Hall and Müller himself.26 Thus he had the great privilege of establishing, for all time, two of the greatest practical discoveries for the physiology of the nervous system. Next in importance to the nerves, the blood became the subject of his researches; not only did he establish for German medicine a more precise knowledge of the fibrin and blood corpuscles –which Hewsone17 had studied so fruitfully in English literature – but he also managed, by simple experiments, to demonstrate the particular composition of the vital fluid.27 Insight into the correct methods of investigation was always close at hand for his clear and cultivated intellect. And he knew full well that there were cases in which Adams3

See Müller’s “Physiology”. Dr Baly’s translation, vol. i., p. 642.

e16 This

probably refers to the ideas of Charles Bell (1774–1842), perhaps especially those concerning facial expression (Cummings, 1964). e17 William Hewson, a member of the Hunterian School in London, see Bignold et al (2007).

34

Johannes Müller, Physiologist (1801–1858): a Eulogy

neither experiments nor the scalpel could answer a question, and where the truth could only be elicited by means of chemical reagents and physical instruments. Thus he discovered the peculiar gelatinous substance called ‘chondrin’ in cartilage;28 and it was thus that he determined not only the organs and the laws concerned in the production of the human voice29 but also proved the existence of lymph hearts in the Amphibiae.30 Here we have somewhat anticipated our historical narrative in order to summarise some of the more important of Müller’s labours, which – taken as a whole – belong to a specific period of his life. The actually reforming researches of the Bonn epoch are those on the microscopical structure and developmental history of the glands31 which ended the controversy that for so long had existed between the adherents of Malpighi and Ruysch, concerning the saccular extremities of the glandular follicles – and provided us with definite knowledge of these important organs throughout the whole animal kingdom. Likewise, his researches on the development of the genitalia32 – which have inseparably connected Müller’s name with the structure which transforms itself into the (Fallopian) tube (‘Müller’s Thread’), and which is so decisive in explaining hermaphroditism. To these were added somewhat later, his important works on the organic nerves of the erectile organs33, on the structure of these organs in the ostrich34 and on the arteriae helicinae35 (spiral arteries). From 1833 he began to assemble his vast knowledge in the great “Manual of Human Physiology”/ Handbuch der Physiologie des Menschen which went through four editions, and which – in the form of several translations – became the basis of the education of all of us. It was a book in which was concentrated the whole of our knowledge of the forms and processes of animal and human life for the first – and perhaps for the last – time since the days of Haller; and which established its author as the senior living authority in the field of physiology. His star had already risen alongside that of

25

Cuvier – whom political French writers have called the honour of their country, even the honour of our century.36 Seldom has a scholar deserved his reputation more than Müller. But seldom too were the lucky stars of celebrity more favourable to the acquisition of fame. Cuvier died – a Peer of France – in the spring of 1832, and Rudolphi in the autumn of the same year. Müller was 31. Which of the German anatomists and physiologists was more entitled to aspire to the Chair thus falling vacant in the Berlin Faculty? Presently all was astir. On such occasions, candidates rise on every side and those who were the least qualified considered themselves the best fitted to be chosen. Even a Minister such as the late renowned Baron Stein von Altenstein could not resist these influences, and negotiations were opened with Tiedemann. Müller then determined on taking a rather unusual step, which, however, well illustrates the decisiveness of his character and intentions. He declared that he would yield his claims to no one but Joh. Fr. Meckel. With only

26

35

Johannes Müller, Physiologist (1801–1858): a Eulogy

this exception, he added, he considered himself the pre-eminent physiologist in Germany. Through the intercession of Johannes Schultze, a letter from him was laid before the Minister, in which Müller specified his qualifications for the office. This letter – which unfortunately appears to have been lost – is described as having been one of his most remarkable and splendid documents; and so powerful was the impression which it made on the Minister that he immediately appointed the writer to the vacant Chair. And in fact, who was better fitted than Müller to hold the pre-eminent anatomical post in Germany? To give him more free time, Müller was not only allowed a prosector, but a second Professor of Anatomy (Schlemm) was appointed to assist him. For it was considered that 27

simple anatomical instruction – however important it may be – did not require to be given by so eminent a teacher, but that the young and rapidly growing sciences of physiology and comparative anatomy demanded – at the pre-eminent University of Germany – the undivided energies of a professor Adams4. Fortunate choice! The best man was in the highest place. Next, Müller busied himself with the completion of his “Handbook of Physiology;” and with it his own development as a physiologist in the stricter sense of the word was also concluded. It has been said that in this work he actually established an experimental physiology. But this is not correct; Müller was no more an experimentalist than Haller; indeed, he himself heartily detested the direction which experimental physiology had taken in France through the works of Legallois and Magendie. This repugnance was based on the strong objections which he had against both the methods of the experimentalists and the reliability of the experiments themselves. Yet it can hardly be doubted that a great deal of this aversion was purely aesthetic. He says of Rudolphi37: “He looked upon physiological data as having no bearing on the certainty of anatomy, so it is no wonder that this admirable man – who took every opportunity to express his antipathy to vivisection – took up a hostile position against all hypotheses and ill-established physiological observation. We could not have failed to share his justified indignation, had we seen how many physiologists expressed their efforts to make physiology an experimental science by poorly planned live-dissections and agonies of innumerable animals, yielding often only insignificant and imperfect results. To see the inside of a wounded animal is to see as little how it lives as to look at it from the outside.” Adams4

Adams (1858–9) wrote: Surely in this arrangement, there was sound practical wisdom, from which we may take a useful hint in the present discussion of the Scottish University question. The rough drudgery of all kinds of preliminary instruction should be done by assistants; and so, the Professors would have more time at their disposal, not only for the cultivation and advancement of learning, but also for rendering their pupils more highly educated men. What can we expect from the present system of University education which compels some of the finest scholars in the kingdom, – such men as Lushington, Blackie, Ramsay, Pillans, Kelland and others, – to teach raw country lads the elementary knowledge which they should have acquired in the schools, or from tutors?

36

Johannes Müller, Physiologist (1801–1858): a Eulogy “Why,” asks the “Illustrated London News” of October 9th, in an admirable article on the subject, “should a steam-engine of a hundred horse power be employed to draw up a few buckets of water from a well, while the paper-mill or mining-work for which that steam-engine was constructed, is left unperformed?” If our Professors must spend their session in such employment, it is truly little wonder if the standard of scholarship in Scotland be so miserably low.

Müller clearly shared Rudolphi’s views. Indeed the question is: were they not his own? At least it is certain that he continued to devote himself more and more to observation, and especially to anatomy. So finally he became once more estranged from physiology; and there seems little doubt that in his last period, he – who had always been considered so particularly a physiologist – contemplated handing over his teaching that science to someone else. In my opinion, there are two qualities in his “Handbook of Physiology” which have particularly enhanced the value of the book. They are its strictly philosophical method and its completeness as a compendium of facts.38 Since the time of Haller no one had so thoroughly mastered the entire literature of Natural History, or collected so many personal experiences on so many topics. No one had been, at the same time, familiar with medical practice, as well as with the remotest areas of zoology. But another speaker has commented very accurately that while Haller often, on doubtful issues, espoused the side which was eventually proved wrong, Müller almost always had the luck (if we may call something “luck” when preceded by so much intelligent activity) sooner or later to discern the party later to be found correct. He was wonderfully fitted for being a critic by his comprehensive knowledge. He knew how to distinguish the true from the false, the essential or real from the adventitious or accidental. And in surveying the whole series of forms – often widely different – among which a well-determined plan of nature39 seemed to be realised, he knew the changes which, not infrequently, considerably altered the arrangement and composition of the substances within these forms. In Müller, as a physiologist, it is not so much the genius of the discoverer40, nor the ground-breaking (bahnbrechenden) insights of the visionary, but rather more the methodical precision

28

of investigation, the measured judgment, the confident tranquillity, and the per- 29 fect completeness of his knowledge. Thus the reforming effect of newer views became embodied in him; and, in spite of the almost monastic isolation of the scholar, his influence was not limited to physiology, but continued to spread beyond it in ever-widening circles. Through him, too, mystical and imaginative factors in the organic kingdom were vanquished; and with total clarity he was most definitely opposed to every dangerous direction – whether it was pursued under the pretext of philosophy, or belief, or merely in accordance with suppositions.41 He did not discover, but he firmly established, the “precise” method of investigating natural science. Therefore there is no ‘Müller School’ in the sense of Dogma – for he taught none – but only in the sense of Method.42 The school of natural science which Müller

37

Johannes Müller, Physiologist (1801–1858): a Eulogy

created knows no commonality of doctrine, but only commonality of facts, and still more of methods. He cannot be held responsible for the growth of any excrescences which springs from this school, and still less for its having preached a Materialism, which was almost as dogmatic as the Spiritualism and Orthodoxy against which he had struggled. Like all of us, Müller regarded intellectual existence as one of the forms of life, but he was far too rigorous with himself – and far too measured in the use he made of his own observations – to have permitted himself to exclude the authority of those thinkers whose views were not directly based on natural experience.43 He openly recognised the rights of imagination images and of philosophy, and he even left a path free for all positive religious faith. And here he knew how to preserve the balance. Feeling convinced 30

that religion was a matter of individual belief, he never alluded to the subject either in his writings or in his lectures. Yet he himself was – as he characterised one of his greatest predecessors – a perpetual Priest of Nature. The religion which he served also fascinated and fettered his pupils to him as if with a sacred bond; and the earnest priest-like manner of his speech and gestures44 completed the feeling of veneration with which every one looked up to him. With a quality of severity around his mouth and compressed lips; with an expression of the most earnest thought on his brow and eyes; and with the memory of a completed work in every furrow of his face – thus this great man stood before the altar of nature. He was freed by his own power from the trammels of his early training and tradition – a noble testimony of personal independence! Even before his “Physiology” was published, Müller read in the Academy a series of discourses on the comparative anatomy of the Myxinidae45 – a work such as, at that time, had never been equalled in its comprehensiveness. By selecting as the point of departure in his comparisons, animals which belonged to the lowest type of fishes – and consequently of the Vertebrata – it was possible to demonstrate the vertebrate animals generally with greatest simplicity, and to trace their evolution from there upwards to that of man. Thus did he satisfy the uncertainties of the natural scientists who had hitherto lacked knowledge of the finer structure of the borderline animals in the great vertebrate kingdom. This simultaneously facilitated – partly by confirmation, partly by anticipation through comparative anatomy – the development of what the study of embryology teaches by longer and much less accessible paths. That is to say paths via the chorda dorsalis and

31

the structure of the vertebrae, via interpretation of the various parts of the brain and skeleton, and via the correct understanding of the muscles and intestinal canal. Here, also, a beginning was made for the foundation of a system of comparative histology. To his researches on the Myxinidae, Müller added a vast series of investigations on fishes. He showed that the least degree of known development in the

38

Johannes Müller, Physiologist (1801–1858): a Eulogy

brain existed in branchiosteous fish46; and he restored to notice the ‘smoothshark’ of Aristotlee18, which had escaped the attention of physiologists for two thousand years47, and in the yolk of whose ova a peculiar feature was first observed, which was afterwards proved in greater detail.48 Then, in conjunction with Henle, he gave a description of the Plagiostomata49; and finally – following in the path of Agassiz – he published the celebrated work on the Ganoidea and on the systematic classification of fishes50, which has been so important for all later research. Meanwhile as a continuation of the journal edited by Reil and Meckel, he had established the Archives which bore his name so gloriously until his death. And he had even begun to write articles on all the various branches of anatomical and physiological science. These, as also the valuable collection which came to the University through Walther, stimulated his zeal for pathological anatomy, which had for a long time been somewhat diminished. In his Annual Reports for 1834 and 1836 he speaks out plainly on this, and vigorously attacks those physicians who do nothing themselves for the advancement of physiology, and yet expect everything from it. “May the genius soon appear,” he exclaims, “who – being an investigator in the chemical, pathological, and microscopical analysis of morbid forms – will establish a system of general pathology worthy of the condition of medical and natural sciences, securely based upon a more serious foundation of e18

a species of dog fish in which the young have a gestational phase involving placentation in utero.

philosophical examples of natural science, history, medicine, and physiology. From the pure physiologist we cannot expect this achievement. It is a problem for physicians, and one worthy of the highest talents. A certain share of the work, being the general anatomy of pathological tissues, must indeed fall to the anatomist and physiologist; and this demand upon them they are certain to fulfil, according to the present spirit of our science.”51 And Müller lost no time in beginning this work. In an oration which he delivered on the 2nd August 1836 as Professor of the Military Academy52, he communicated a series of important discoveries which he had made on the minuter structure of tumours – as for instance, of enchondroma. And two years afterwards appeared the first part of a large work on the finer histology of tumours53, which unfortunately was never completed. It was just about at this time that the use of the microscope as a means of investigation for anatomical purposes had begun to play such an unexpectedly large part, through the influence of Treviranus, Ehrenberg, Purkinje, and others. Müller had for a long while worked with the microscope – at first with an instrument presented to him by Rudolphi54 – but he had several times expressed his opinion that it was only of real use in the examination of individual pieces, or of thoroughly transparent tissues.55 Even at this time he could not be

39

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Johannes Müller, Physiologist (1801–1858): a Eulogy

convinced that any necessity existed for physicians to acquire for themselves the ability of making microscopical examinations.56 Purkinje’s discoveries on the structure of the bones induced Müller to repeat his observations, and to study microscopically the layers of the lime in the bones. On his advice Miescher began to investigate inflammation of these structures57. Robert Froriep and his pupils, Gluge, G. Simon and 33

others, had enthusiastically embarked on the new path (of microscopy), and had begun to render it accessible to medical practice. Schleiden’s great success in the theory of plant cells stimulated Schwann – Müller’s assistant in the Museum – to make those comprehensive and very useful investigations on the cellular structure of the animal tissues, on which our recent progress in pathological science so essentially depends. It was Müller himself who followed up these discoveries and who, particularly, first demonstrated the agreement between the pathological and the embryonic development of tumours.e19 It was a physiological observation of the highest importance, which, as we now know, is the key to the whole doctrine of morbid new formations.e20 Only the blastema-theory, with which it was associated, prevented it from being fully successful early on; and the doctrine of the specific nature of the elements of tumours, which arose soon afterwards – in direct opposition to Müller’s unimpeachably correct views – led to long false paths.e21 Of this much, however, we are certain: Müller’s labours gave the strongest impulse to the employment of the microscope in pathological investigation. But in spite of all his zeal, pathology was too remote for Müller. He was after all unable to come to terms with a classification of tumours. He said that the principle of such a division could be solely based neither on the details of their structure, nor on their chemical qualities, but in contrast, that their physiological nature and curability must be taken into account.e22 Thereby, naturally, any scientific classification – which must necessarily be an anatomical one or more precisely a histological one – was impossible. Müller failed utterly because of the fact that physiological histology itself was lacking any satisfactory classification. He did indeed continue to lecture e19

This ignores Royer-Collard’s work in Paris in the 1820s. See Wolff (1907). is one of the embryonic theories of tumours. At the time this was written, Virchow was not convinced of the cell-type-of-origin specificity of tumour formation. e21 ambiguous in the original e22 A wonderfully modern statement. e20 This

34

on pathological anatomy, although always with great disinclination; and it is certainly a significant fact, that when he died he left behind him nothing that was unfinished, unarranged, or incomplete, except the long-awaited conclusion of his book on tumours.58 From 1839 onwards we find him devoting himself exclusively to comparative anatomy. In 1841 he abandoned – for a short time – the vertebrate king-

40

Johannes Müller, Physiologist (1801–1858): a Eulogy

dom, and investigated Pentacrinites59 and star-fish60. Meanwhile – partly by accident and partly of necessity – he was led to see that the fossil world had not yet been fully explored; so he became a palaeontologist, and studied fossil fishes, mammals, and sea cucumbers.61 In his last years, he paid individuals to be on the look-out for fossil remains in the quarries of the Eifele23. But he was led back again and again to the sea, in order to investigate its more primitive inhabitants. His vacations became, particularly, his working time; he himself fished, and dragged out of the hidden depths of the ocean wholly new and unknown races of animals. He passes from one class of life to another; from seacucumbers and starfish to Infusoria and Polycystines62, whose sequences he was the first to describe. What a wonderful series of works! The whole territory of animal life and ‘being’ was spread out before him. Was he satisfied? Did he find repose in the investigations which – ever since the catastrophee24 which befell him at Bonn – he had unceasingly pursued? Alas, no! His expression remains darkly brooding; two deep angry furrows lay between his eyebrows; and his dark gaze bored into the far distance. He says he hears the persistent ‘pounding of the waves’. He thinks about the fact that for many years he had neglected botany. Thus he purchased large and expensive works so as e23 e24

Mountains between the Rhine and the Mosel rivers. The nervous breakdown, see text page 21.

to start his studies from the beginning. But his breast knows no peace. Ever new forms of life, but no connecting bond; ever new developments of ideas, but no development of substance: What an agonising riddle! Two Nordic investigators – first Sars, and afterwards Steenstrup – showed a new mode of propagation among the lower animals: the generational (alternating) change. The child did not resemble the father or mother; nor was the grandchild, in turn, like the child. Müller enthusiastically followed this new track: he found that the same animal could propagate similar-type and dissimilar-type generations; and he also demonstrated, by a great number of new discoveries, the metamorphoses of the Echinodermata.63 Honour and praise were heaped upon him, and his face wore a more friendly smile. And now, quite unexpectedly and as suddenly as lightning, new thoughts flashed into his soul which revived old memories and the traditions of natural philosophy. “In the Bay of Muggia, near Trieste, there are found large numbers of the Holothuria, of the type Synapta.”64 Müller discovered exceptional peculiarities in their germinal vesicles (Keimschläuche), which are internally connected with the vascular system, and in which ova, spermatozoa, and finally young snails develop. Snails in Holothuria! Müller became highly excited at this discovery, and strove vigorously to keep a hold of himself, but it gripped him too mightily. He wrote about it as calmly as he could; but whilst writing it, it

41

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Johannes Müller, Physiologist (1801–1858): a Eulogy

tears at him. Is this an alternation of generation? Can snails beget worms, and worms in return beget snails? “It will amply reward us,” he says65, “briefly to examine the various probabilities. The alternatives are either that the snail-begetting tube is itself an animal, or that it is an organ of the Holothuria; in either of these cases, we have to deal with a most extraordinary phenomenon. If this tube is an animal – a worm not begotten by the Holothuria, but proceeding out of a snail – we have to deal with a wholly unexpected example of alternate generation. But still, either way, we could, all the same, better explain and understand the marvel. 36

But in this area we are accustomed to much that is miraculous but which must still submit to the same law, and we had to be ready for something really extraordinary. Or, however, if there be no alternation of generation but rather a metamorphosis instead, then the snails become transformed into a parasitically living worm, which again brings forth snails – a wholly unexpected, but yet not irrational circumstance. If, however, the vesicle is a worm, but begotten by the Holothuria, then the matter is still more wonderful and incomprehensible, and far surpasses all the known circumstances of alternate generation. But if the vesicle is neither an animal nor a worm, but an extraordinary organ of the Holothuria, then it is wholly inexplicable; and the inexplicable must then itself become the prototype of other similar things in nature, or, in other words, a fundamental fact. The entrance of various kinds of new animals into the world, at different stages of Creation, is rendered certain by the facts of palaeontology; but remains supernaturalistic if this genesis has not been actually seen in the act of happening and observed in intimate detail. As soon as this becomes possible, the supernatural element will cease, and it joins a higher series of phenomena for which observation will eventually discover laws.e25 Like Gottfried’s shield, which broke the spell of Armida’s sorcerye26, the shield of alternate generation and of metamorphosis must be resolutely held against all apparent magic of nature, so long as there is any trace of hope of solving it. As far as the last and most extreme alternative is concerned, every one knows what is against it. As yet we know of no single reliable case in which such primitive reproduction occurs in the actual world, neither in organic nor inorganic bodies; and many regard it as quite certain that all the creations of the real world have been preceded by others. e25 The

Holothuria here are sea cucumbers, but what Müller describes is not clear. Because on p 37, Müller refers to ‘conchilious organisms’ he must have seen snails (the same German word is used for ‘slug’) which are parasites of sea cucumbers. Nevertheless, certain nematode parasites commonly infest the gonads of sea cucumbers (Jangoux, 1987). Moreover, in a few species of sea cucumbers, fertilisation occurs internally and some development occurs in an internal non tubular structure before the young leave the mother’s body (Barnes, 1994). e26 This may refer to the poem by Torquato Tasso Gerusalemme liberate (completed in the 1570s). A particularly fine edition was apparently shown to Goethe’s father in Italy in 1740 (British Library / Chris Michaelides). Alternatively, the reference may simply be to Goethe’s play “Tasso” (1788).

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Johannes Müller, Physiologist (1801–1858): a Eulogy

Certainly, however, the results obtained through the most elegant observations by Philippi on mollusc fauna of the Tertiary Period and of today in Lower Italy stand opposed to this. The relevant facts are that the transition from the tertiary period to the present has taken place quite gradually, and without the occurrence of any great revolution to make any sharp division. Rather, in this process of transition, individual species became extinct by degrees, and others have come in their place until we arrive at the present-day fauna. That in the present instance we have to deal with a conchilious animal only heightens its incomparable interest, which connects this case with the weightiest questions in zoology, physiology, and geology. Unfortunately I must leave the topic, in the midst of all the tension associated with an unparallelled instance of extreme intricacy, without having arrived at any conclusion; and I leave it to the contradictions and vacillating ambiguities of general perceptions which it stimulates.” The tension and the problem both remained; Müller fell into despair. He said he must solve the problem; when he failed in this – when all labour was useless and he should have calmed himself down – he withdrew into himself exhausted, sad, and discontented. Now difficult days came upon him. The Revolution of 1848 occurred when he was head of this University.This same Great Hall was the headquarters of the armed student-corps during his Rectorate, and the noise of conflicting parties raged around these walls. Müller was no politician.66 He depended on the judgment of others and prejudices of his own, and was opposed to the Movement. He and I were at that time on different sides, but this never, I think, lessened the esteem in which we held each other. Müller as Rector was an impartial man, and not the adherent of any particular party. Deeply depressed, he laid down the sceptre of Rector, and retired to the seacoast; but residence there did not wholly reinvigorate him.

37

Several years later that dreadful shipwreck occurred on the Norwegian coast – the story of which has been so often related and the horrors of which none could tell so vividly as him, who had had such a narrow escape there. The prolonged period in peril of death, the loss of his excellent pupil and also so many hapless companions, all bowed his spirit down. Müller thereafter was afraid of the sea; yet it always attracted him again to its shores. He became timid but he had no peace, no holidays or recreation, no rest and recovery. His toil became more difficult and once, when exhausted by one of his last labours, he exclaimed in a sorrowful tone: “My work is stained with my blood.” His health now began to fail; his disposition became wayward and capricious; he was irritable; and complained of pains in the head, and sleepless nights. A presentiment of death overshadowed him. He arranged all his affairs, private and public; he telegraphed to Cologne for his son, made a medical appointment for himself for the next day – but when the morning of the 28th of April came, his wife found him: a corpse!e27

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Johannes Müller, Physiologist (1801–1858): a Eulogy

The dark eye, which looked out so broodingly when it was deep in thought; the eye which could flash so brightly when he wanted to smile, was now dimmed forever. The deep furrows on the face of the philosopher were now obliterated. The broad powerful shoulders lay rigid (starr) forever. And the massive head – which seemed like that of some warrior of Antiquity – told us that a sublime worker of the intellect had fallen. Peace to his ashes! Berlin, October 1858. e27

39

Otis (2007) gives a thorough analysis of Müller’s death and the rumours concerning it.

Notes 1

E. Brücke in the Wiener med. Wochenschr. 1859. No 24 -

2

Goethe: “Campaign in France”. ‘Complete Works’, 1840. vol. 25, p. 146. Thiers: “French Revolution” vol. 1., chap. 6; vol. 2., chap. 1, 2. “It was at Trier, at Koblenz that the (French) émigrés had been received and organised; it was from there that their phalanxes were charged with humiliating, defaming and dismembering France. France, instead of being vanquished, was victorious. It profited from it, not by returning the evil which people had tried to inflict on her, but to indemnify itself for the war which had been declared on it by exacting a true border – the Rhine frontier”. – (vol. ix, chapter 6.)

3

Müller himself indicates this: – “The Germans can say proudly that Kielmeyer was the first who understood Comparative Anatomy from this, its innermost aspect. He who brought it into life also gave to it this intellectual aim. Cuvier afterwards traced the corporeal metamorphoses of the different organs throughout the whole animal kingdom.” – “On the Comparative Physiology of Vision”. Leipzig, 1826, p. 29.

4

In the curriculum vitae, attached to his Inaugural Dissertation, Johannes Müller says: “From my childhood days there was nothing to hold back the care and affection of my outstanding parents so that I could take in everything of life’s instruction which suits the mind of a child” / “Inde a tenera aetate parentum optimorum cura et caritate nil impedimento erat, quominus omnibus, quae puerili animo conveniunt, imbuerer doctrinae alimentis.” (Dr Baltussen).

5

J. Müller „On the imagination images“ / Phantastische Gesichtserscheinungen. Coblentz, 1826, p 45.

6

Ibid. p 20.

7

K. Hagen. “History of the Most Recent Times, from the Fall of Napoleon to the Present” / Geschichte der neuesten Zeit vom Sturze Napoleons bis auf unsere Tage. Braunschweig, 1848, vol 1, p. 146–237, 446.

8

Joannis (sic) Müller. Physiological commentary on the respiration of the foetus, honoured with a prize in the academy of Borussia -Rhineland, Leipzig 1823 with table. Inaugural Dissertation in physiology containing a commentary on the laws of motion in animals, written and defended by J. Müller Dec 1822 in Bonn. / De respiratione foetus, commentatio physiologica, in academia borussica rhenana praemio ornata, Leipzig, 1823. c. tab. – Inaug Dissertation physiologica sistens commentarios de phoronomia animalium, quam scripsit et defendent Joannes (sic) Müller IX (XIV) December 1822. Bonnae. (Dr Baltussen).

44

Notes 9

Memorial Address for Carl Asmund Rudolphi, given at the public session of the Academy of Sciences in Berlin on the 6th August, 1835 / Gedächtnissrede auf Carl Asmund Rudolphi in der öffentlichen Sitzung der Academie der Wissenschaften zu Berlin, am 6 Aug. 1835, gehalten von J. Müller. Berlin, 1837, p 12.

10

According to later information, Nesse and v. Esenbeck had founded a natural history club among the students. Müller seems to have become its secretary. According to the testimony of one participant the most zealous enthusiasm prevailed. From his Franconian homeland Nesse had preserved the – for that time – so fruitful direction of the Würzburg school which, with a certain eclecticism, allied the natural philosophical inclinations of the era with a genuine scientific empiricism. Just how lasting these initiatives were is seen from the story which von Baer gives in the Introduction to one of his large embryological works.

11

Georg Forster, “The Natural Scientist of the People” / Der Naturforscher des Volkes by Jacob Moleschott. Frankfurt am Main, 1857, p 70.

12

“Next stretching and extending are the poles and limit of motive life, the one as it were of the limiting skin, the other of an unfolded languishing flower. Night with regard to both, pregnant with life. But multiform life, holding a middle course, thrives going up and down. The path from the one to the other continuous limit by mutual motion, varies by a ceaseless change of flexing and extending, and our organic column does not cease again and again to strengthen (?) it. Respiration proves this, divided (as it is) into parts of inhaling and exhaling, locomotion of animals is testimony to it more than anything else”. Inaugural Dissertation on the laws of motion in animals, written and defended by J. Müller Dec 1822 in Bonn. From the Prolegomena of “The Science of Motion” / Phoronomia.

13

Memorial Address for Rudolphi / Gedächtnissrede auf Rudolphi, p 17.

14

Ibid. p. 9.

15

Ibid. p 14.

16

Joh. Müller, On the development of the ova in the ovary of the Phasmids, and a newly discovered connection of the dorsal vessel with the ovaries in insects. / Über die Entwicklung der Eier im Eierstock bei den Gespenstheuschrecken und eine neuentdeckte Verbindung des Rückengefässes mit den Eierstöcken bei den Insecten. Mit 6 Kupfertaf. With six engravings. Nov. Act. Acad. Car. Leop. Nat. Cur. Vol. xii., p. 2.

17

Throughout life Müller remained loyal to Aristotle. In his lectures he was able to inspire his students with an admiration of this ancient natural researcher. It is to his stimulus that we owe the new translation of the four books of Aristotle on the parts of animals, published at Leipzig in 1853, by A. von Frantzius.

18

Müller “On the Comparative Physiology of Vision” / Zur vergleich. Physiologie des Gesichtssinnes, p 18.

19

Ibid. p 34.

20

Müller himself explained that he renounced medical practice because of the unfortunate experience that one of his first patients – a young friend – had died from peritonitis, occasioned by perforation of the bowel.

21

“On Imagination Images”. Foreword / Phantastische Gesichtserscheinungen. Vorwort / p iii.

22

In the year 1828 Müller had an opportunity of conversing on this subject with Goethe who was himself very interested in it. The latter had the ability to summon up subjective images of an arbitrarily chosen theme with eyes closed, which Müller could not do. To this, he (Goethe) made the

45

40

Johannes Müller, Physiologist (1801–1858): a Eulogy somewhat strangely stylized remark: “A difference between two natures, the one possessing the greater poetic power of formulation, the other being directed to the investigation of what is real and what is what is actually happening in nature. “Handbook of Physiology” 4th edn, vol 2 p 567.Adams5 23

“On Comparative Physiology of Vision” / Zur vergleich. Physiologie des Gesichtssinnes, p 20.

Adams5

Adams, 1858–9, quotes the passage from the relevant edition of “Handbook of Physiology”: “He knew that I frequently saw different figures in the field of vision, when I lay quietly down to sleep, with my eyes closed, but before sleep had actually come on; and he was very desirous of learning what forms these images took in my case. I explained to him that I had no voluntary power over either the production of these images or their changes of form, and that they never presented the slightest tendency to a symmetrical and vegetative development. Goethe, on the contrary, was able to give the type for the phantasm, and then the different variations ensured in it, as it seemed, independently of the will, though with regularity and symmetry. This difference accorded well with the characters of our minds, of which the one had all the creative power of the poet, while the other was engaged in the investigation of the actual phenomena of nature”. (“Müller’s Physiology” – Dr Baly’s Translation, 4th edn vol. ii, p. 1395). 41

24

Memorial Address for Rudolphi / Gedächtnissrede auf Rudolphi, p 18.

25

“Handbook of Human Physiology”, 4th edn, Coblenz, 1844, vol I, p 561. His method of experimenting on frogs.

26

Ibid. I, p 609.

27

E. F. Burdach’s Physiologie als Erfahrungs-Wissenschaft./ “Physiology as Science of Experience” 1832, vol. iv.

28

Poggendorf’s Annalen. vol 38, p 295.

29

“On the compensation of strengths in the human vocal organ” / Ueber die Compensation der Kräfte am menschlichen Stimmorgan Berlin, 1839. “Handbook of Human physiology” II, p 149f Ueber die bisher unbekannten typischen Verschiedenheiten der Stimmorgane der Passerinen / On the hitherto unknown typical differences of the vocal organs of passerines. Abhand. d. Berlin Acad. 1845–46. [See also Physiology. Baly’s Trans., vol. ii, p. 1002. ]

30

Poggendorf’s Annalen. 1832, Aug. – Also Philos. Transact., 1833, p 1, and Abhand, der Berlin Academie, 1839.

31

Joh. Müller, “On the Innermost Structure of Filtering Neck-glands and their First Formation in Humana and Animals”, Leipzig 1830 / De Glandularum secernentium structura penitiori earumque prima formatione in homine atque animalibus. Leipzig, 1830.

32

Joh. Müller, History of the formation of the genitalia from anatomical investigations in human and animal embryos, together with an appendix on the surgical treatment of hypospadia / Bildungsgeschichte der Genitalien aus anatomischen Untersuchungen an Embryonen des Menschen und der Thiere, nebst einem Anhange über die Chirurgische Behandlung der Hypospadie. Düsseldorf, 1830. With four plates.

33

J. Müller, On the organic nerves of erectile male sex organs in humans and mammals / Ueber die organischen Nerven der erectilen männlichen Geschlechtsorgane des Menschen und der Säugethiere. Three plates. Berlin, 1836.

34

J. Müller, On two different types in the construction of erectile male sex organs in ostrich-type birds and on the developmental forms of these organs amongst vertebrate in general / Ueber zwei

46

Notes verschiedene Typen in dem Bau der erectilen männlichen Geschlechstorgane bei den straussenartigen Vögeln und über die Entwickelungsformen dieser Organe unter den Wirbelthieren überhaupt. Three plates. Berlin, 1838. 35

Müller’s Archiv. 1835.

36

Louis Blanc, “History of the Decade 1830–1840”. Translated by Buhl. Berlin 1844, vol III, p 160.

37

Memorial Address / Gedächtnissrede. p 18.

38

Müller himself spoke very plainly about his effort in the preface to his “Developmental History of the Genitalia” / Bildungsgeschichte der Genitalien. He says (p viii) – “I have certainly always been friendly to a methodically arranged, thoughtful, well-digested, or (what is the same thing) a philosophical treatment of a subject. For I look upon philosophical insight and rational perception as equally important. I do not thereby mean a kind of knowledge which arrives at results without an adequate empirical basis, nor the so-called method of the natural philosophers, which I have already attempted to characterise, when I described it as a false system of natural science, which yields to the seductions of past ages, and would fain carry us back to the times of a Jonischen philosophy.” e28 And then: “What I term a philosophical method has nothing in common with that dogma. I demand, first of all, that one is untiring in observation and experience: this is the principal duty which I impose on myself, and continually strive to fulfil.” And again: “I hold that our observations, when they are sufficiently extensive and accurate, should not merely be bundled all together, but that – just as nature proceeds in the development and presentation of organic beings – we should endeavour to move from the whole into the various parts, provided that, by analytical means we have recognised the individual (parts), and have succeeded in comprehending the whole.”

e28 Ionian Philosophy, as used by Ritter (1791–1869) in his “History of Jonian Philosophy” / Geschichte der jonischen Philosophie (1821).

He then refers to Caspar Friedr. Wolff, Goethe, Sniadetzki, and Treviranus; he demands the ‘good’ experiment, which confirms itself, he wants to have the real separated from the merely chance, and emphasises again the need of ‘true observation’. Finally, he says: – “I need scarcely remark, that it is the duty of a scholar to master anything which happens in his science among other nations; and this is now possible, and, moreover, quite indispensable in these days of progress. A purely German, French, or English School of medical science is barbarism. In Germany, we would consider the idea of an isolated English or French system of natural history, physiology, or medicine, just as barbarous as the notion of Prussian, Bavarian, or Austrian medicine or physiology.” In the Annual Report for 1833 (M.’s Archiv 1834, p 2) we read: – “This tendency, which some call the philosophical method, was inevitable, after such great discoveries in developmental history. For, as is shown to us by the natural formation of organs from matter possessed of productive powers, or the invariable development of separate parts from a Whole – in which these parts did not pre-exist ready formed, but (the Whole) only possessing the power of their creation – so it is also shown to us that the theory of anatomy need not be found first in fruitless speculations.e29 Meritorious men, who deny philosophising intellect the ability to fathom the secrets of nature, must finally note – on the quiet – that Nature herself reveals the plan of her thoughtful operations in developmental history and feel that the progress of observation, in such cases, is part of the work of the meditative mind.” 39

John Fr. Meckel (“System of Comparative Anatomy” Halle, 1821, vol I p 8, 14, 350) had explained very perceptively and wide-rangingly the laws of diversity and reduction. On the other hand he remained – in his essence – in accord with the opinions of the natural philosophers: – that there

47

42

Johannes Müller, Physiologist (1801–1858): a Eulogy is a possibility of tracing back the diversities of form to certain invariable fundamental Types, whence it followed that each of the higher animals must have successively passed through the developmental forms of those lower in the scale of existence. This bold cosmogonistic thought had already been opposed by Müller in the fundamental point of his Inaugural Dissertation, “The ladder of animals does not exist” (Non datur Scala Animalium).e30 Moreover, he later rejected in his remarks on Rudolphi: – “The idea that man passes through the other lower types of animals in the course of his development was objectionable to him (Rudolphi) and therein he was correct.” (Memorial Address, p 18). It was only by the experience of the alternation of generations that analogous thoughts were evoked in Müller. (cf p 36). 40

Müller himself says, in the Annual Report for 1833 (M’s Archive 1834, p 1): – “Great discoveries have hitherto been extraordinarily rare in the history of physiological science; and if we reckon those who have brought about a total reform in our previous notions of physiology and pathology, we will find in the history of physiology that two only discoveries can be regarded as of primary importance, viz: – the discovery of the circulation, and of the different functions of the anterior and posterior roots of the spinal nerves,

e30

i.e. the useless speculation of preformationism need not be repeated in any theory of anatomy. The ‘ladder’ referred to is Aristotle’s ‘Ladder of Nature’. which is the greatest glory of modern times. To these may be added the most important discovery in animal chemistry – namely the observations of Wöhler on the artificial composition (synthesis) of urea – which is a fact promising to prove of infinite importance to physiology.”

43

41 “Phenomena

of a higher or lower order cannot reveal themselves by direct external effect, but only through the inner revelations of our own organs. And so, the God-Head reveals itself in various ways to different people full of Grace in the whole of creation. It reveals itself to those who are highly imaginative, in the form of imagination. To the pious, it manifests itself in goodness of disposition; to the wise, in wisdom; and to the strong, in the greatness of His works, just as also the Divine is honoured differently in all of these ways.” (“Imagination Images” / p 63) e31: “Imagination is the organ of the mind, through which arise most of the errors in natural science; for it spoils at their very beginning not only the results, but also our observations. All the same, it is an indispensable quality, for by means of it new combinations are created which lead to still more important discoveries. A power of discriminating things in their isolated meanings, as well as an extending imagination striving to the general, should both – in the breast of the natural scientist – act together in a harmonious reciprocity. If this balance of power between them be disturbed, imagination converts the natural scientist into a dreamer, while the proper use of these gifts enables the talented investigator to make most important discoveries.” (M’s Archive 1834, p 3).

42

To illustrate how effectively he worked, let the following example suffice. In 1846, when I was Prosector at the Charité Hospital, I repeatedly encountered a pathological condition of the spleen, which I afterwards named ‘sago-spleen’. I had long tried to discover the meaning of this appearance, but without being able to ascertain more than that large homogeneous clumps of granules occupied the place of the Malpighian bodies. Some considered that they might be dependent on the follicles. I showed such a spleen to Müller, in hopes that – because he had made a special investigation of the structure of this organ – he might be able to give me some opinion as to the follicular origin of the granules, as well as some explanation of the nature of the changes which were present. Müller did not know this pathological condition, and was doubtful as to whether it arose from follicles; and he said – “It is very strange, you must investigate this!” When I told him at another time that I had done so, but that I was not satisfied with the results, he said: – “You must investigate this still further, it is certainly very interesting!” Only seven years afterwards did I succeed in demonstrating the iodine-reaction of these bodies, and in including it among the amyloid-substances which have since been shown to be so numerous. (Acad. des Sciences, Dec. 1853).

48

Notes 43

In the sixth book of his “Physiology” – which deals with the life of the soul – he speaks first of all of the soul of animals: “Everything which feels and moves voluntarily in accordance with its desires is endowed with a soul, just as Aristotle teaches in his ‘Treatise on the Soul’.” (Vol II, p 506). Then Müller points out how the soul coincides with the vital principle, and shows that it must exist throughout the whole of the organism, although the soul only works through (i.e. has effect via) the brain.

e31 cf. In “Faust I”, in the Religious Conversation / Religionsgespräch: Faust and Gretchen: similar thoughts are expressed. See also Faust’s attempt to translate the Old Testament in the Bible scene / Im Anfang war das Wort …. Im Anfang war die Tat” – “In the beginning was the deed”.

Hence he concludes that the soul is capable of being divided in the body, and that the soul (acting as) the life principle, must exist in a latent state in all matter (p 509). He then says, “Investigation of the relationship between the life principle and the soul and the organisation of material cannot be further conducted by examining our experiences. From here onwards the investigation moves away from the field of empirical physiology, and passes into that of hypothetical speculation and philosophy. In the whole development of the physiological doctrine hitherto, we have carefully avoided all considerations of the latter kind – my object having been much more to present what is more probable from a philosophical anatomising of the whole empirical process. Moreover, because it appears to me completely inappropriate to confuse this method with any other mode of inquiry in our science, including to pass arbitrarily between the strictly inductive method and that of mere speculation, I shall in the following pages, confine myself to a speculative exposition of the two alternatives – the idealistic and the pantheistic World Views – without favouring either the one or the other. I shall not follow exclusively any particular form of philosophy, but shall explain both systems in as pure a way as possible without getting involved in the consideration of physiological facts, though, at the same time, I shall endeavour to make their bearing on those facts as evident as possible.” (cf. p 513). Adams6 44

I must confess that Müller in his lectures and in his oracular manner reminded one of a Catholic priest. Old impressions from early childhood may have been the defining factor here. When as Dean of the Faculty, he mounted the cathedra superior (high lecturn) dressed in his official robes, and pronounced the Latin formula of the proclamations of the Doctors of Medicine in short, clipped and constricted words; even when he began his ordinary lectures in almost murmured words; or when, with religious earnestness, he was discussing any of the fundamental questions of physiology: – everything – his tone and manner, his gestures and look – all betrayed the traditions of the Catholic clergy. His early study of the human facial expression had not been made in vain. And yet there were moments when he could forget them. “It is remarkable,” he says (“On the Comparative Physiology of Vision”, p 269), “how, in the strong emotions of envy, contempt, and abhorrence, the movements of the eyes are in a straight line, and how the glance of punishment or disgrace are distinguished by the fact that the object is regarded in a measured, direct way, and whereby the eye, contrary to (its manner in) the contemplating gaze, denies the overall pleasing expression of the whole facial appearance. Men do not like to be fixed or measured by the eyes, but only to be noticed.” Yet he sometimes fixed his eye upon some unfortunate student with this direct gaze, till the student timidly disappeared from the session. What a contrast it was, when the face – so darkly threatening or even cold face at other times – was lit up by an expression of sincere benevolence – when his eye laughed more than his face and it was as if a warm sunbeam broke through the dark clouds! At such times Müller was fascinating, for then his intellectual greatness was most revealed. After all, his entire physiognomy showed the contrast between his wonderfully large head, and his bodily

Adams6

See Dr Baly’s Translations, (of Müller’s “Physiology”) vol. ii., p. 1337.

49

44

Johannes Müller, Physiologist (1801–1858): a Eulogy 45

frame in which only the breadth of his shoulders was distinctive. His rump and limbs had not the nimbleness and agility which derive from natural predisposition or are acquired by early habits; they were more elastic and deliberate, as from gymnastic and anatomical exercises. It is well known that Müller had educated almost every one of his muscles to obey his will, and that he could make the iris, the ears, and even the small bones of the ear, move in obedience to his volition. He must have made great progress since the year of his military service. An eye-witness relates the following anecdote: “Once, when we were at company parade, and the command, ‘order arms,’ had been given, he amused himself by inserting one finger after another into the muzzle of the firelock, until at last his middle finger got fairly wedged into it. Then, when the order of ‘attention’ was given, Müller could not obey it. The captain and major exploded at him and paraded him in front of his comrades who laughed at his ridiculous position. He was sent home, and the surgeon had no little trouble in liberating the thickly-swollen finger.” 45

J Müller. Comparative Anatomy of the Myxinoids of Cyclostomas with perforated Palate / Vergleichende Anatomie der Myxinoiden, der Cyclostomen mit durchbohrtem Gaumen. – I. Osteologie und Myologie. (Abh. der Acad. von 1834). Berlin, 1835. – II . On the peculiar construction of the auditory organ in Cyclostomas, with remarks on the unequal formation of the organs of sense of Myxoides / Ueber den eigenthümlichen Bau des Gehörsorgans bei den Cyclostomen, mit Bemerkungen über die ungleiche Ausbildung der Sinnesorgane bei den Myxinoiden. (Abh. 1836) Berlin, 1838. – III. Comparative neurology of the Myxinoids / Vergleichende Neurologic der Myxinoiden. (Abh. of 1838), Berlin, 1840. – IV. Vascular System / Gefäss-System. (Abh. 1839 and 1841), Berlin, 1841.

46

J. Müller On the construction and life appearances of Branchiostoma lubricum Costa, Amphioxus lanceolatus Yarrel / Ueber den Bau und die Lebenserscheinungen von Branchiostoma lubricum Costa, Amphioxus lanceolatus Yarrel (Abh. of 1841) Berlin, 1844.

47

J. Müller On the smooth shark of Aristotle and on the differences among sharks and (sting)rays in the development of the egg / Ueber den glatten Hai des Aristoteles und über die Verschiedenheiten unter den Haifischen und Rochen in der Entwickelung des Eies. (Abh. of 1839–40). Berlin, 1842.

48

Virchow. On the yolk plates in fish and amphibia / Ueber die Dotterplättchen bei Fischen und Amphibien. Zeitschrift. f. Wiss. Zoolog. 1852. vol. IV, p 236.

49

J. Müller und J. Henle. Systematic description of Plagiostomas / Systematische Beschreibung der Plagiostomen. Berlin, 1838–41.

50

J. Müller On the structure and limits of Ganoids and on the natural classification of fishes / Ueber den Bau und die Grenzen der Ganoiden und über das natürliche Systeme der Fische. (Acad. Abhand 1844). Berlin, 1846.

51

Müller’s Archiv. 1836. p 176.

52

Joh. Müller Address for the ceremony of the Forty-Second Foundation Celebration of the Royal Medical-Surgical Friedrich Wilhelm Institute, Berlin / Rede zur Feier des 42. K. Med. Chir. Friedrich-Wilhelms-Institut. Berlin, 1836.

53

Joh. Müller On the detailed structure and forms of disease-causing tumours. First part. / Ueber den feineren Bau und die Formen der Krankhaften Geschwülste. Erste Lieferung. Berlin, 1838.

54

Preface to item in note 31, p. 3.

55

Ibid. p. 23.

56

as for 53, p 2.

50

Notes 57

F. Miesher. On the inflammation of bones and their general anatomy. Added are observations on the canalicular corpuscles of the bones and on the manner, in which matrix matter is contained in them, by Johannes Müller, Berlin 1836.

58

Perhaps it should be mentioned here that Müller expressly forbade any post-mortem examination of his body. He took a passing interest in parasites, having been stimulated by Schönlein’s discovery of the fungal nature of Favus; he first found the Psorosperms (Muller’s Archive, 1841)Adams7 which have become so remarkable by Lieberkühn’s researches. Soon afterwards he described with Retzius the fungal growths found in the respiratory passages of birds (Archiv., 1842) – the occurrence of which I have also demonstrated in man (Virchow’s Archiv., vol. ix., p. 557). Our studies met at another point. He had at one time accurately investigated microcephalic skulls (Med. Zeit. Des Vereins. f. Heilk. in Preussen. 1836). The visit of the so-called ‘Áztecs’ turned his attention again to this subject. This was the last pathological study which he undertook after his work on osteoid growths (Archiv. 1843).

59

J. Müller. On the Pentacrinus caput medusae / Ueber den Pentacrinus Caput Medusae. (Acad. Abh. 1840–41), Berlin 1843.

60

J. Müller und F. H. Troschel. System of the Asterides / System der Asteriden. Braunschweig, 1842.

61

J. Müller et L. Agassiz. Note on the vertebrate of living and fossil sharks / Note sur les vertèbres de squales vivans (sic) et fossiles. Neuchâtel, 1834. – Müller, On the foot bones of the fossil armadillo Glyptodon clavipes / Ueber die Fussknochen des fossilen Gürtelthieres, Glyptodon clavipes Owen / Akad Abh. 1847. – Fossilised fish collected during Middendorf’s Siberian Journey / Fossile Fische gesammelt auf Middendorf’s sibirischer Reise. Leipzig, 1848. – On the fossil remains of Zeuglodonts of North America with reference to the European remnants of this Family / Ueber die fossilen Reste der Zeuglodonten von Nord-America mit Rücksicht auf die europäischen Reste dieser Familie. Berlin, 1849. – On new Echinoderms of the Eifel chalk hills / Ueber neue Echinodermen des Eifeler Kalkes. Akad Abh. 1856. On some Echinoderms of the Rhenish grey stone and the Eifel chalk / Ueber einige Echinodermen der Rheinischen Grauwacke und des Eifeler Kalkes. Akad. Monatsbericht März, 1858.Adams7

62

These works occupied primarily the last three years of his life. His last great work was: On the Thalassicoles, Polycystines and Acanthometes of the Mediteranean / Ueber die Thalassicollen, Polycystinen, und Acanthometren des Mittelmeeres / (Akad Abhand. 1856–58). Berlin, 1858. Even on the day before his death, around about midday, he himself went to the zoological museum of Professor Peters, and obtained some Polythalamacea.

63

Joh. Müller. On the larvae and the metamorphosis of the Ophiurs and Sea Cucumbers / Ueber die Larven und die Metamorphose der Ophiuren und Seeigel. (Akad Abh. 1846). Berlin, 1848. Zweite Abtheil. / Second part, Berlin, 1849. – On the general plan in the development of the Echinoderms / Ueber den allgemeinen Plan in der Entwickelung der Echinodermen. (Akad. Abh. 1852). Berlin, 1853. On the structure of the Echinoderms / Ueber den Bau der Echinodermen. (Akad. Abh. 1853). Berlin, 1854.

64

J. Müller. On the creation of snails in Holothurias / Ueber die Erzeugung von Schnecken in Holothurien. / Archiv. f. Anat. Phys. u. Wiss. Med. 1852.

65

Ibid. p 27

66

It is hardly to be doubted that the great political upheavals which dominated Müller’s earliest recollections caused in him thoughts of great uncertainty vis à vis state and political affairs. I still

51

46

Johannes Müller, Physiologist (1801–1858): a Eulogy have a lively memory of what he said when I visited him to say goodbye on the 19th of February 1848, on the eve of my departure for Upper Silesia. He was astonished that I should wish to expose myself to the dangers of hunger-typhus, whereupon I replied that in the face of threatening proximity of a Revolution in France, one did not know here at home either how things would turn out. He was much moved by this thought Adams7 Adams 1858–9, had a note at this point: psorosperms occurred in the form of a peculiar morbid parasitic growth, with specific organised seminal corpuscles, which Müller first observed in the cellular tissue in the orbit of a young pike. This diseased growth consisted of delicate cysts, from 1/5th to 1/2 line in diameter, filled with a whitish substance, which was composed of small granules with molecular motion, and of motionless corpuscles with an oval body and tail, resembling spermatozoa. Müller considered it to be a curious instance of disease propagated by living seminium morbi, and to hold an intermediate place between the acknowledged parasitic entozoa and epizoa. See Edin. Monthly Journal, July 1842.

47

and said that “That would be terrible, because Socialism aimed at nothing but general robbery from anyone owning anything”. He was, moreover, by no means in accord with the Government, and when finally the revolution broke out in Berlin too, he gave the State up for lost. Quite early on, the student movement had lost the support of the University Faculty members. On the 11th of March the first student gathering in the large auditorium No 6 had taken place (Berlin Revolutionschronik. Berlin 1849, I p 42). On the 16th there was a meeting in the Great Hall, where for the first time the call to arms was made (ibid, p 88). From then on the Great Hall became a political place. On the 18th the students sent from there a deputation to the King, to which both Rector and Senate (of the University) attached (their support) (ibid p 154). The answer which was brought back was received with disquiet in the Great Hall, and when the struggle began, the Senate was supposed to provide weapons. In the great disorder which now followed, the Great Hall always remained the centre of the student movement. On the 20th Count Schwerin, the new Minister of Education, appeared and gave a speech to the student body gathered there (ibid p 290). Immediately thereafter the latter constituted itself as the armed Student Corps (ibid p 334). Müller, as Rector, took command.They drilled and took up a sentry post in the Royal castlee32 and at the Prince of Prussia’s Palacee33. On the 22nd of March a solemn procession, with the Rector of the University at its head, followed the coffins of the fallen to Friedrichshain cemetery. The armed Student Corps was already led then by the new Commandant, Professor Hecker, but he too did not keep command for long. Disputes arose rapidly and the meetings in the Great Hall became more and more unruly (ibid vol II p 131). There were discussions on summoning the state assemblies to a combined meeting. On the 27th of March the Rector summoned the entire teaching body to vote on this. A minority of 7 (which included me) voted for the proposal of the right of the State to a constitutional assembly (ibid, vol I p 404), with 98 against. The student body could no longer be held together. On Maundy Thursday the 20th of April the first parade of the Armed Corps and a great drinking party took place in the Kastanienwäldchen (ibid vol I p 233). It was the last general meeting, still at a time when enthusiasm for Schleswig-Holsteine34 – whose just rights Müller loudly recognised – kept so many people together. Confusion increased more and more in the time after this (ibid II ps 500, 545). The Rector became extremely worked up. He trembled for the security of the University, for whose treasures he believed he had to be responsible. He was drawn there day and night, as if he himself had to keep guard. He tore down provocative placards, and in personal danger he opposed the most violent amongst the students. On the day of the great parade of the Citizens Corps (23rd of May) which was intended as a people’s demonstration, he took down with his own hands the black flag which had been stuck out from the balcony of the University building (ibid vol III p 26). But the Great Hall moved further and further away from the authority of the academic jurisdiction.Already on the 2nd of June the student body held a gathering there of all clubs and in which it was decided to process to Friedrichshain (ibid vol III ps 120, 124). Also within the teaching body itself, annoyance grew.

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Notes e32 This was the Berliner Schloss, the King’s residence in Berlin. The structure was damaged in WWII, and demolished in 1950, with re-construction underway at the time of writing (2008 – see Schloss website). e33

The official residence of the Prince in Berlin, on the Unter den Linden, close to the University.

e34

i.e. the recovery by Prussia of these German-speaking provinces. The political history of the area is complex. Although they were historically German duchies, Denmark had taken them under its general control in 1721. Later Austria had a role in their government. In 1849, the Danes had seized Holstein outright, defeating a German force initiated by the Frankfurt Parliament. In April, the Minister of Education had demanded proposals for the form of the Universities, and had called together the full professors (Ordinarien) for consultation (ibid vol I, p 172). The Extraordinarien and lecturers made vain efforts to be heard, and a committee of them was set up (ibid II, p 340), to which I later belonged. There was very unpleasant correspondence with Rector and Senate, which was even printed in public newspapers. Thus everything conspired to make the most exposed position of the Rector (Müller) into a burden of torment. It was to his great relief when – at the end of the University year – he was able to surrender to other hands the office which he had accepted with great reluctance and a sense of premonition. It was the unhappiest Rectorate since the foundation of the University; the man who perhaps possessed the least political inclinations of all was called upon – in a time when everything was driven by the current of politics – to lead that body which – because of its natural lack of rules – was least suited to unified leadership. Lost effort! The Rector was able to save only the honour of personal courage.

53

48

Johannes Müller, Physiologist (1801–1858): a Eulogy

Figure 2.1. (above left) Müller’s birthplace. (Photographed 2007). Figure 2.2. (above right) Town Administration buildings in Coblenz. In Müller’s time, the ground floor was used as a primary school. By courtesy of the Coblenz Tourist Bureau.

Figure 2.3. (below) Building (erected 1693–1700) of the Gymnasium (now the Görres Gymnasium) in Coblenz (Photographed 2007).

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Johannes Müller, Physiologist (1801–1858): a Eulogy

Figure 2.4. (left) Müller’s doctoral thesis (1822). By courtesy of the Coblenz City Archives.

Figure 2.5. (below left) Portrait of Müller in 1826. By courtesy of the Coblenz City Archives.

Figure 2.6. (below right)Title page of English translation of Müller’s “Handbook of Physiology” (1840).

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Johannes Müller, Physiologist (1801–1858): a Eulogy

Figure 2.7. (above left) Portrait of Müller in 1858. Figure 2.8. (below) Photograph of the unveiling of Müller’s statue in Jesuitenplatz, Coblenz. By courtesy of the Coblenz City Archives. Figure 2.9. (above right) ‘Head and shoulders’ of the statue of Müller (photographed 2007 by Dr. Peterson).

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Chapter 3 Memorial speech for Johann Lucas Schönlein (1793 –1864) given in the Great Hall of the University of Berlin on the 23rd January 1865 – the first anniversary of his death Published by August Hirschwald, Berlin, 1865 With Supplementary Information for the Notes, Virchow’s Archive 33: 170–171 (1865). Editors’ comments Because of the length of this eulogy – with its notes and supplements to the notes – a short summary is provided here. Schönlein was an important figure in German medicine in the nineteenth century. Born in Bamberg in 1793 (Figs 3.1–3. 4) and receiving his medical education in Landshut and Würzburg, Schönlein graduated in 1816. After brief study in Göttingen, he returned to Würzburg, becoming Privatdocent (1817) (Fig 3.5). In 1819 at the age of 26, he was promoted to head of internal medicine at the Julius Hospital (Fig 3.6), over the head of Johann Nepomuk Ringseis (1785–1880) who later was a prominent physician in Bavaria (Gottfried, 1979), and who was never to forgive Virchow (see especially Virchow’s text note 61). Schönlein’s talents were essentially his simple mastery over all medicine, his ‘up-to-date’ medical practice and his excellence as a teacher. He was one of the first to use the new French methods of physical examination – especially use of the stethoscope – and to insist on routine autopsies – (Ackerknecht, 1964). These talents attracted students from all Germany to his clinic. Notes taken by students in his lectures were later edited and published (without his consent) in several popular editions (Figs 3.7, 3.8, 3. 10). These remarkable books each amount to 800–1000 pages of closely-printed text, with no illustrations. Hence they reflect the enormous knowledge which he imparted – or at least offered – to his students. However, in the political unrest of 1830 Schönlein was forced to flee Würzburg, and in 1833, he took up a Chair in Medicine in Zürich, where he was equally successful. Herman Lebert (1813–1838) and Wilhelm Griesinger (1817–1868) were amongst his pupils. In 1840 Schönlein was called to the Chair of Medicine at Berlin (Fig 3.12) where he rapidly became Physician to the King. He continued his masterly teaching, insistence on autopsies, and in addition espoused microscopy and chemical studies for clinical purposes – especially through his pupils, including Traube, J. Meyer, Güterbock, Remak and Virchow. Schönlein served Prussia well during the crisis of the King Friedrich III’s invalidity, and remained in his various positions until retirement due to ill health in 1859. Then Schönlein returned to the city of his birth where he built a house (Figs 3.13–3.15) in the same street as and only a few hundred metres from his birthplace. Early in his medical career Schönlein was influenced by Naturphilosophie and his early lecture notes contain Romantic terminology and include a classification which seems to be close to that of

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Memorial speech for Johann Lucas Schönlein (1793–1864) Pinel (1813). Schönlein espoused, but did not write on, a philosophy of disease which was referred to as ‘Nature Historical’ Naturgeschichte, meaning that each disease manifests itself in a characteristic sequence of clinical features, which – in the philosophically-inclined medical circles of the day – was seen by some as analogous to the progression in changes which occur in embryonic life (Bleker, 1981). In later life Schönlein seems to have lost interest in the idea, probably even abandoning it entirely. It is said that “Schönlein brought German medicine back to the facts” (see text, and Ackerknecht, 1964). In politics Schönlein was a ‘liberal Catholic’ and thus endured the early suspicions of the Protestants and the later hostility of the ‘conservative/clericalist’ Catholics of the post-French Revolutionary period (see chapter 1). In retirement Schönlein apparently attended Mass only occasionally; this was at the Augustinian church of St Gangolf on the other side of the Steinweg from his own house (Fig 3.16). Schönlein seems to have been personally genial, comfortable and easy-going (i.e. gemütlich – see catalogue of Bamberg City Library exhibition, 1993) and a Schönlein Platz with statue (Fig 3.20) is close to the centre of Bamberg. His grave is well kept but not elaborate (Figs 3.18, 3.19). In relation to Virchow’s essay it may be reasonable to consider the possible reasons why this work is so detailed, and so much longer than any of his other memorial addresses. Moreover, the amount of detail in the Notes is greater than is necessary to support a simple account of Schönlein – the Notes almost form a biographical history of German Medicine in the period. The reason is unlikely to lie in warmth of personal relationship. Schönlein was Virchow’s main clinical teacher, but when the possibility arose in 1847, Schönlein did not appoint Virchow to the position of his Assistent – which would have led Virchow to a career as a physician – but preferred instead Remak and Traube. Between 1856 and 1859 Schönlein and Virchow were Professors in the Medical Faculty at the University of Berlin, but Virchow does not suggest that there was any closeness between the two. On the contrary, Schönlein seems to have been at the peak of his career at that time, and fully occupied with his large private practice and duties at Court. Nor does Virchow exhibit any particular admiration for Schönlein as a scientist. Of other possible reasons, Schönlein was certainly extremely popular as a person, but such attributes do not seem to have usually won automatic respect from Virchow. Perhaps a major reason for the length of this work is that there was only one other biographical document available (by Bach, see document); and Virchow may have wanted to correct the versions of Schönlein’s teachings which had been presented in books by Lehrs, Scharlau and Most (see document). Virchow probably also wanted to reply to the attacks on Schönlein published by Ringseis (see document note 61) and defend his own views on sectarianism in medicine. Finally, Virchow may have been influenced to write this detailed work from sentiments of the honour of the University of Berlin, of German medical science, and for posterity. An excellent summary of Schönlein’s life, with copies of his letters to Jäck and Stenglein, as well as a bibliography, are given in the catalogue of a Schönlein exhibition (City of Bamberg Library, 1993). A recent article on Schönlein has been published by Kietel (2007).

Editors’ summary of points Main Text: P 1–2 Introduction; 3–6 early life including Catholic parentage, anti-Ultramontane views, history of Bamberg region including influence of French Revolutionary Wars, and prominent medical and other personages there at the time; 7 University studies in Landshut; 8 developments in medical science at the time, Brownianism; 9 Naturphilosophie; 10 von Walther and other teachers there; 11 moved to Würzburg in 1813; 12 the Julius Hospital, Siebold; 13 developments in rational medicine, approval of Darwin; 14 influence of Döllinger; 15 doctorate; Dr habil. appointments in Würzburg; 16 interest in pathological anatomy; 17 Lecturer (1817), Extraordinarius (1820) Ordinarius (1824); increasing reputation of the Würzburg medical school; 18 staff of school, Schönlein as a teacher; 19 naturhistorische philosophy, Schönlein as clinician; 20–22 his contribution

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Memorial speech for Johann Lucas Schönlein (1793–1864)

Figure 3.1. (above) View of Bamberg in 1830. By courtesy of the Bamberg State Library.

Figure 3.2. (left) Schönlein’s birthplace (narrowest house in photograph, 2007).

Figure 3.3. (below) Plaque on Schönlein’s birthplace (photographed 2007).

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Memorial speech for Johann Lucas Schönlein (1793–1864)

Figure 3.4. (above) Probable Gymnasium attended by Schönlein. The building on the right of the photograph (now known as ‘U7’ of the University of Bamberg) was used for this purpose in Schönlein’s time. (Courtesy Bamberg State Archive). Figure 3.5. (below left) Title Page of Schönlein’s Dissertation (1817). Figure 3.6. (below right) Schönlein as Professor of Medicine in Würzburg. By courtesy of the Bamberg State Library.

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Memorial speech for Johann Lucas Schönlein (1793–1864)

Figure 3.7. (left) Title page of pirated version of Schönlein’s lectures (1832). Figure 3.8. (below left) Title page of pirated version of Schönlein’s lectures (1834).

Figure 3.9. (below right) Schönlein as Professor of Medicine in Zurich. By courtesy of the Bamberg State Library.

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Memorial speech for Johann Lucas Schönlein (1793–1864)

Figure 3.10. (above left) Title page of pirated version of Schönlein’s lectures (1839). Figure 3.11. (above right) Schönlein medallion, Zurich, 1839. By courtesy of the Bamberg State Library. Figure 3.12. (below) Schönlein’s house in Berlin. By courtesy of the Bamberg State Library.

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Memorial speech for Johann Lucas Schönlein (1793–1864)

Figure 3.13. (above) Schönlein retirement house in Bamberg. The upper storey to the right was added later. (Photographed 2007).

Figure 3.14. (left) Schönlein family group in the garden of his retirement house. By courtesy of the Bamberg State Library. Figure 3.15. (below) Garden of Schönlein’s retirement house (photographed in 2007).

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Memorial speech for Johann Lucas Schönlein (1793–1864)

Figure 3.16. (above) Front of St. Gangolf’s Church opposite Schönlein’s retirement house (photographed 2007). Figure 3.17. (left) Schönlein shortly before his death. By courtesy of the Bamberg State Library. Figure 3.18. (below) Schönlein’s burial site (photographed 2007).

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Memorial speech for Johann Lucas Schönlein (1793–1864)

Figure 3.19. (above left) Schönlein’s grave stone (photographed 2007). Figure 3.20. (above right) Statue in Schönleinplatz, Bamberg (photographed 2007). Figure 3.21. (below) Schönlein’s son Philip. By courtesy of the Bamberg State Library.

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Memorial speech for Johann Lucas Schönlein (1793–1864) to the naturhistorischen School; 23 his publications; 24 opposition to the conservative/clericalist Catholics; 25 Revolution of 1830 and his activitites; 26 proposed transfer to Passau and his escape from Würzburg; 27–29 in Frankfurt a. M., then in Zürich; 30 called to Berlin (1839); 31 teaching in Berlin; 32 research in microscopy and chemistry; 33 continuing attacks from clericalists; 34 personal tragedies; 35 death. Notes: P 41 family data; 42 his Catholicism; 43 as a schoolboy; 44 family, medical student; 45–46 Bamberg Library, hospital etc in Bamberg, elder Marcus; 47 Textor, University of Landshut, Röschlaub; 48 Tiedemann; 49–51 (von) Walther, Bertele; 52 Brownianism, Röschlaub versus Hufeland; 53 Schönlein as a university student; 54 history of the University of Würzburg Medical School; 55–57 biographical details of Döllinger; 58 criticism of Schönlein’s youthful work; 59–60 details of travel in 1816; 61 Schönlein’s Assistenten at the Julius Hospital; 62 His clinical diary, and his clinic; 63 premature reports of death, his methods of physical examination; 64–67 beginnings of interest in fossils, botany, paleo-ontology etc; 68 transition from natural philosophy to natural history of disease, Siebert; 69–70 books of his lectures published by others; 71 Virchow’s version of Schönlein’s ideas on pathology; 72–74 Ringseis and his Catholicism; 75 Schönlein in Zürich; 76 notes on the persecution of the Würzburg liberals; 77 Schönlein’s escape from Frankfurt, his political position; 78–79 biography of younger C F Marcus, who succeeded Schönlein at Würzburg; 80 biography of Griesinger; 81 Schönlein on the significance of crystals in urine disease; 82 discovery of fungal diseases; 83–85 experiences in Zürich; 86 history of the Medical Clinic at the University of Berlin; 87 relations with the Court of the King of Prussia; 88 Güterbock’s book of Schönlein’s lectures, and ideas represented in it; 90 staffing issues in Schönlein’s clinic during the 1840s; 91–95 Virchow’s lack of personal contact with Schönlein despite both in Berlin, Würzburg and later in Berlin again, also Virchow’s records of Schönlein’s lectures; 96 Schönlein’s life in Berlin; 98–100 Ringseis’ further attacks on Schönlein (including a long quotation); 100 Schönlein’s Christian medicine; 101–104 attacks on Schönlein by Görres, Solbrig and Wunderlich, Conradi, Lehrs and Scharlau, Graf and Pauli; 105 Richter and Stiebel support Schönlein, fate of wife and son; 106–7 effect of son’s death on Schönlein, University marks Schönlein’s death; 108–110 Schönlein’s life in retirement in Bamberg, interest in numismatics, history etc; 111 gifts and bequests made by him at the end of his life; 112 final illness. Supplements to the Notes: P 170 wife’s family, Schönlein’s involvement in religion, school life; 171 list of Schönlein’s papers found after his death; 172 details of his move from Frankfurt to Zürich; 173 details of negotiations leading to his appointment to the Chair in Berlin; 174 the design of the house which he built for his retirement in the Steinweg in Bamberg, activities there, other gifts, death.

Honoured guests We are gathered here to renew in ourselves the memory of the dear man, who, faraway from us, departed this life a year ago. We who were not able to accord our last respects to his mortal remains wish today in solemn memory, to pay that tribute of honour to his spirit with which our hearts are full. Not the honour which his high position in the State would allow him to claim; nor that which his decorations and offices already indicate, but the honour which is appropriate to the man himself – that honour which he won by work, achievement and character. A year has passed since his death. Calmer judgment replaces pain, and even if mourning the loss of him has not yet fallen silent; we feel the necessity to fix in our minds the picture of the man himself – in the broad sequence of events, and amongst the ever changing aspects of daily life – as it (that picture) now

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Memorial speech for Johann Lucas Schönlein (1793–1864)

stands, still fresh in our memory, and yet heightened by the breath of the passage of time. For nineteen years we saw him working with and influencing us while still in his maturity. In the long sequence of celebrated names which adorn the annals of this University over the first fifty years of its existence, his is one of the most celebrated. But that is not the only reason – not the primary reason – why we mourn him. For this is not the place where he taught contemporaries who looked up admiringly to him – this is not the place to which posterity will look when it wishes to bring the master before its eyes in his actual workplace. He did not come from the Berlin School, and he has left no Berlin School behind. Like so many of his professional companions, who are gathered here from the various states of Germany at the call of the State government – he came to us as an already fully formed man. During his time with us, many a new leaf was woven into the laurel wreath which he had brought with him, but he did it almost effortlessly. His time of hardest struggle lay behind him and yet his heart was not here with us, but in the region where, to all appearances, he had lost the battle. The laurel was and remained for him an outward thing, because he was selfsufficient. Even if it may have filled him with justified pride that one recognition after another fell to him, he yet never forgot that external honour is no yardstick of true merit – and that it is much more the sign of a lowly or limited spirit if one feels exalted because of the fortune of outward success. At no time – except when perhaps conceit allied with ignorance crossed his path – did he allow his colleagues to feel that fate had raised him above them: at no time did he set up an artificial barrier between himself – the great Master – and his pupils, who were perhaps only beginners.

2

He never shut himself off in the pride of knowledge from the influence of new research, even if it emanated from as yet unknown researchers, and contradicted treasured convictions. When he was already personal physician to the King of Prussia, he had no reservations about visiting his old pupil Eisenmann in his cell in the fortress at Rosenberg (1845).e1 He remained intellectually young, even when work was no longer a new experience for him. Thus he remained a colleague to his colleagues, a friend to his friends; thus he became a model of true humanity and liberality, in the correct classical sense of the word. Nothing human was foreign to him.e2 In this lies his more immediate claim on our hearts; from this has grown the warm recognition which was to be expressed in such sincere fashion when at last he realised his long-cherished intention and withdrew to his beloved native place (Heimat). And with this feeling, honoured guests, let us now celebrate his memory and seek out the individual facts which made his life so significant. Johann Lucas Schönlein was born in Bamberg on the 30th of November 1793.1 Who does not, having seen it once, gladly recall the old ‘bishop’s town’ on the

3

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Memorial speech for Johann Lucas Schönlein (1793–1864)

Main (River), with its precious memories of German history! There it lies with its rich jewels of towers – one climbing up above the other – around the grapeand hop-covered slopes of the hills. The Franconian valleys open on three sides; downstream to Würzburg, upstream to Kulmbach, to the side towards Erlangen and Nürnberg: in the most real sense, the garden of Germany.A long range of blue e1

Johann Gottfried Eisenmann (1795–1867) doctor, politician and political activist. There is little literature about him in English. In German, Wikipedia has an entry, and Burwick (1969) includes some material. Dating from the 13th century, the Fortress Rosenberg is in Kronach, the former seat of the Bishop of Bamberg, and is one of the oldest mediaeval castles in Germany. e2 a very Goethean sentiment. 4

mountains forms the frame of this beautiful painting. It has long been a land of old German culture (Kulturlande3), and thus a bishop’s land. Wealth and culture were at home here from an early time and even Catholicism here has taken on but little of the Ultramontane character. The town and the land itself had grown together. There, in the old cathedral, is buried the body of Clement II, who was once – by a powerful German King from a Franconian line (Henry III, 1046) – taken from the Bishop’s See of Bamberg to be installed as Pope in Rome. His body lies once more in his homeland, as a sign that he was more a human being than a priest. Schönlein too was born of Catholic parents,2 and he remained in their religion up to his death.3 But Ultramontanism – which is everywhere without a homeland – early on gained in him a bitter enemy. He hated it instinctively – I should say hereditarily. His youthful heart was open to quite different influences. There before him was the Franconian garden spread out with all Nature’s treasures. There were mountains with wonderful rock formations, meadows and valleys with the rarest plants. The boy’s feeling for understanding them4 was opened early. But there, also, was the evidence of a thousand years of human activity. Trade, Art, Science and Religion had worked together in order to raise the metropolis of the bishopric to become such a considerable city. That not only sharpened his reflection on human nature and significance; it did not merely fill his comprehension, but also his heart. But just as it early awoke the inclination to history and Natural Science, at the same time it put into that young breast that ineradicable seed of love of homeland. It finally led him to return to the place where his cradle had stood, just as e3

5

this term invokes a mystical great German past.

once upon a time, it had led the Bamberg Pope back home. Schönlein’s father5, a prosperous rope-maker, followed the tendency of the time and probably the urging of his wife, in deciding that his only son should undertake tertiary study. It was still the time, after all, of the so-called Enlightenment. The terrors of the Revolution had not yet given rise to the thought – which only the most recent period has tried to exploit – that too much educa-

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tion damages the human being, and that knowledge must be turned back. On the contrary, since Kant, philosophical ideas had permeated all circles of people up to and including the princes, and even ecclesiastical rulers had no objection to granting free passage to freedom of thought. Above all others, the PrinceBishop of Würzburg and Bamberg, Franz Ludwig von Erthal (1779–95) – one of the noblest and free-thinking rulers of his time6 – had applied his special attention and sympathy to education. The fact that a priest could lecture on Kantian philosophy at Würzburg University certainly throws clear light on the state of Intellect in his Principality. At the prince’s side stood Carl Friedrich von Dalberg – subsequently Prince-Primate of Germany – at that time Cathedral Prebendary at Würzburg and who, like his sovereign, was a zealous admirer of philosophy. From that time, date the remarkable edicts which made one year’s study of philosophy compulsory for all tertiary students. Exception was made only for those students who attended law classes only “the more easily to prepare themselves to be employed as officials or as clerks”. The edicts demanded that even theologians would study mathematics and practical philosophy for a year before beginning their special courses. Just how strictly the caring prince watched over the implementation of these edicts is best made clear by the sharp rejection which he handed out to the celebrated Würzburg surgeon Caspar von Siebold when the latter wished to induct his son Elias – subsequently first Professor of Obstetrics at our University – into medical studies but without proof of the completion of the course in philosophy and physics. “Basic philosophy”, as recorded in the Prince’s document, “is the signpost to all other sciences. Anyone who dares to enter too early the area of the other sciences will at most be a superficial dabbler or certainly only a scholar without a complete education”. But the highly perceptive prince understood that studies such as he demanded also demand great material support. Not satisfied with improving the Universities, with founding schools, with equipping the Bamberg library7 – still celebrated today – he also thought of the medical institutions. From olden times – as we know from documents dating at least from the beginning of the thirteenth century8 – Bamberg had possessed various kinds of smaller hospitals. Now, in addition however, the great general hospital was built, and – under the directorship of the Prince-Bishop’s personal physician, the elder Marcus – was developed into one of the most distinguished hospitals and medical schools of the time.9 The medical faculty bloomed; alongside Marcus, Dorn, the two Gotthards and Sipple, there was soon one of the most influential celebrities, the gifted Röschlaub. Certainly the war, with its widespread destructive effects, threatened to destroy these well-planned institutions. The French invasion was already steam-rolling across the land.

6

In 1796, scarcely a year after the noble Franz Ludwig had closed his eyes forever, the French and Austrian armies clashed on the Main at the bloody Battle

7

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Memorial speech for Johann Lucas Schönlein (1793–1864)

of Würzburg. Secularization followed and the Prince-Bishopric was incorporated into Bavaria (1802). But once sown, the seeds of development proved powerful enough to survive the storm, and the Bavarian government entered – at least for the time being – upon its inheritance in a liberal way.10 It was in these circumstances that the young Schönlein completed his gymnasial education (1804–1811). In the autumn of 1811, he enrolled at the University of Landshut, which his later closest colleague Textor11 had left a few years previously. Landshut was at that time one of the most enterprising universities in Germany.12 In all faculties famous men were teaching; and especially the medical faculty was at the centre of this progress. They were struggling over the fundamentals of science itself; not merely about the principles of the doctrine of life and disease, but even about the actual method. The turning point from old to new medicine in Germany had arrived. It was to be determined whether medicine was to be built on observation or on speculation; whether it was to be built scientifically or philosophically. Let us pause for a moment with these developments which were epoch-making for all time to come. At the beginning of the eighteenth century, the struggle had been opened between the two Halle professors: Georg Ernst Stahl and Friedrich Hoffmann. Although not as a clear-cut matter of principle, it certainly tended in the same direction as was later taken up. Stahl’s “Animism” – 8

which proposed the soul as the guiding principle of physiological processes too, and therefore attributed all events in disease and cure to particular impulses of the soul – had opened up the path of speculation. But this School gained little ground. Fr. Hoffmann’s calm clinical observations found the powerful support of the great Leyden master Boerhaave. In all areas of medicine and science he (Boerhaave) used the same method – that of analysis – with rigid logical progression; in his synthesis he never ignored anything which had been actually observed. This path seemed too long for restless spirits, and for the complacent it was too uncomfortable. A certain unease concerning the gaps in knowledge and the infinitely varied nature of experience spread into people’s minds. Then, in approximately 1780 appeared the Elementa Medicinae by the Scottish doctor John Brown. He traced all life processes to stimulability – indeed life for him was merely a consequence of this stimulability. Certain stimuli set the irritable parts in motion, and their stimulability then expresses itself in two basic forms – that of strength (Sthenie) or in that of weakness (Asthenie).According to Brown, diseased stimuli too had no other forms; the actions of the practical doctor therefore followed quite simply, in that they could only be effective in two main directions, (namely) to modify great strength, or to improve weakness. This so simplistic and all too comfortably formulated theory – in which nevertheless a certain truth was indisputable – rose like a meteor. Brownianism very soon became the prevailing

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School in Germany and in Italy. Never before had a school of medical thought spread so rapidly. Its main proponent in Germany was Joh. Andreas Röschlaub13, who was from the same region as Schönlein. Like his special colleague Adalb. Fr. Marcus he accepted Brownianism most warmly, but soon they gave it a new direction, the philosophical – or more precisely the speculative – one. Kant had prepared men’s minds; everyone thought that he could equal his success if only he used the critical method. Schelling completed the confusion when he constructed Nature from the idea of the Absolute. Natural Philosophy had become a mania. Marcus himself – with Schelling – published “Yearbooks of Medicine as a Science” 1806–1808, but his position at the great hospital, which was overflowing with patients during the difficult war years, forced him again and again to return to observation. It was different with Röschlaub who had meanwhile become Professor in Landshut. In his head, the amalgamation of Brownianism with speculative philosophy was shaped into the so-called irritation theory. He had no hesitation “in establishing the initial metaphysical bases of medicine a priori”, and formulating the bases of medicine in thirty laws which essentially centred on the relationship of stimuli to irritability. Once familiar with these laws, the doctor should do without all supporting sciences, and within a short time learn a simple and easy Medicine. Even Hufeland’s authority receded for a short time in the face of these prophecies. But in Landshut there were better men than Röschlaub. There was Tiedemann,14 the great comparative anatomist – later famous as an experimental physiologist – and above all others there was Philipp von Walther,15 who at that time was still quite a young man and himself in

9

no way free from natural philosophical prejudices. However, Walther was equipped with all the positive knowledge which could be offered by a careful study of anatomy and physiology and by observation and practice of surgery using the best analytical methods. His influence on the coming generation and thus on the shaping of Medicine in Germany was decisive: through his two more celebrated scholars – in Landshut Schönlein, and a decade later Johannes Müller16 in Bonn – Walther became the founding father of the regeneration of our science. It was he who demanded from medicine that it become a natural science. He made a demand that it should use all supporting methods of objective observation. “Medicine can” he said “only make true progress if it applies the whole of physics, chemistry and the natural sciences to itself. That is, (medicine can only make progress) when medicine is brought to the presentlyachieved heights of those sciences, and when it is brought into accord with the brilliant achievements in them.” Schönlein completely understood this. Enrolled as a student in philosophy, he most zealously attended lectures on the natural sciences, especially on mineralogy by Bertele,17 on botany and zoology, physics and chemistry. Then, hav-

10

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ing transferred to Medicine, he turned for preference – under Tiedemann’s direction – to comparative anatomy, but without neglecting the real medical disciplines. He remained in Landshut for only eighteen months. Caught between the conflicting opinions of his teachers and influenced by both sides, he decided – with his tendency to the positive direction – on the path of observation.18 But the speculative direction too – the path of artificial constructs – did not remain foreign to him; indeed it would not be wrong 11

to say that the Golden Calfe4 of natural philosophy certainly pleased his heart for a very long time, and that perhaps he was never wholly successful in tearing out of himself, with all its roots, his tendency – taken up in early youth – to speculation. In the full bloom of his teaching career the outer form of his mode of presentation – the structure of his system – was often concealed behind a speculative covering which was so beautifully done that it had a magical effect on all his listeners. Unfortunately we cannot deny that many people, seeing this outer part, forgot what was hidden under it: – the whole rich content of positive knowledge and the painstaking assembly of innumerable individual observations. In general pathology the influence of Röschlaub – as is shown particularly in the theory of reactions – remained permanent. In special pathology, the ideal example of Walther maintained itself and was developed into a more complete form. Because what Walther only wished for – namely the full inclusion of the sciences in medicine – Schönlein actually achieved for his time. e4

the Idol (false god worshipped by the Israelites when Moses ascended Mount Sinai to receive the Ten Commandments).

I have tarried longer over this description than one usually does when one is supposed to describe a man’s deeds. I have done this because nothing is of higher significance for knowledge of individual human beings – as well as for entire generations – than that one clearly reviews the conditions of their development and the basic direction of their thinking. However and on the whole, these latter were essentially established when, at Easter 1813, Schönlein left Landshut and went to Würzburg.19 Since its re-establishment by Bishop Julius (1582) the University of Würzburg had enjoyed the quite particular advantage among German Universities of having a great hospital 12

at its disposal – namely the Julius Hospital. This hospital had been equipped with Princely munificence, and has become famous in German Medicine. At an early date all other medical institutions – including the Anatomy theatre – were brought into close connection with the hospital. Thus a concentration of studies was achieved here such as existed in no other place. And at the same time, a more extensive range of material was available for study to a university

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teacher than anywhere on German soil except for Vienna and Prague. At that time the Charité in Berlin was, after all, only available for use in teaching for the (medical school of the) military academy. In Würzburg too, however, scientific use of this great range of material only began rather late because the men who understood how to use it were lacking.20 Only from the appointment of Caspar von Siebold in 1767 – who was responsible simultaneously for anatomy, surgery and midwifery – do we date the flowering of this School which since then has only been interrupted for short periods. Not only surgery – which honours Siebold as one of its most distinguished representatives – but the other branches of medicine too, developed here on the basis of objective experience in logical fashion. It was somewhat different with theoretical medicine. Medicine had not known how to avoid the influences of the irritability theory and especially that of natural philosophy. Voltaism and mesmerism had been added; especially in physiology and general pathology nowhere more strikingly did a certain tendency to speculative or mystic transcendentalism manifest itself, right into modern times.21 On the other hand, quite specifically natural philosophical thinking made increasing use of an inductive method, which until that time had had little validity in medicine. This was because it drew all of Nature into its ambit, and to individual phenomena of form and processes, applied analogies from all areas – not merely from the animate, but also from the inanimate areas. Along with many arbitrary and inappropriate analogies, there were quite a number of legitimate and appropriate ones. Even if people had for the most part set themselves tasks which were too ambitious for the one generation, nevertheless great things were achieved at that time. I would like to remind us of the fact that the enormous question of the origin of species – which Darwin has taken up so successfully in our time – was regarded by the German School of Natural Philosophy as having been solved philosophically. It had been settled a priori: “It could not be otherwise”. And to many an earlier natural philosopher, it would have seemed foolish and superfluous labour if we now still went on painstakingly working on the problem to test the theory a posteriori – to prove or disprove it. In one point, however, a very fortunate avenue was found even then. This was destined to be of greatest significance for the subsequent development of knowledge. Albrecht von Haller, Casp. Fried. Wolf and John Huntere5 had directed attention to the development of the chick in the egg, and therewith had seen many diseased formations as parallels. Johann Friedrich Meckel had taken up these comparative investigations and had established quite secure foundations for what was then the most difficult area of pathological anatomy; namely that of teratology (the e5

Hunter (1728–1793) studied development of chicks in goose eggs, but added little new knowledge.

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Memorial speech for Johann Lucas Schönlein (1793–1864) 14

subject of monstrosity). Tiedemann had followed him. Thus in place of what was at that time the completely unanswerable question of the primum movens – much more there came into science the question of the primum motum.e6 One became accustomed to investigating first the phenomenon and then the reason for the phenomenon; to evaluate the analogy not as motif for the answer, but as the motif for the way the question was put. In associating the beginning of the history of human life, as also animal life, with the development of the egg – and in trying to discover by direct examination (in the egg) the long sequence of events from fertilization right through to the formation of the individual organs – one gained not only a clear idea of developmental processes but also a sense of the importance of the autopsy; an understanding of the scientific method. It was perhaps a special stroke of luck that the man under whose direction this innovation gained solid form – and embryology developed into a science – was again a regional compatriot of Schönlein. Ignatius Döllinger22 was Professor of Anatomy and Physiology at Würzburg when the young Schönlein entered the Alma Julia. As Schönlein himself reported, he was “so happy to attend Döllinger’s genetical brain demonstrations” and under his supervision to dissect a large number of human and animal brains; adult as well as of embryos. Out of this came his inaugural treatise “On the Metamorphosis of the Brain”, a work written in German and simultaneously the only work which was ever published by him. On the basis of this treatise he gained his doctorate on 24th February 1816. Throughout e6

15

i.e. not the first cause, but the first thing moved (in Aristotle, the ‘heavenly spheres’).

this entire manuscript – which was unusually voluminous for its purpose: 140 pages accompanied by two detailed copper plates – there blows a fresh lively spirit, and in spite of an almost oppressive mass of quotation, the overall effect is one of surprising clarity and independence (of thought). A certain natural philosophical tinge is present; indeed the first sentences are pure natural philosophy: “Light marries water and with it begets the organic. Whilst the spherical shape of the Priestleyishe7 green material becomes algae, the individual Infusorium forms itself into a zoophyte”. But that is only an old reference – I should say background – with which, later, the actual presentation is contrasted all the more strikingly. There is certainly still much that is arbitrary in the ordering and interpretation of the facts – as was appropriate to the historical period and the youth of the writer – but nowhere is upright striving for actual truth to be denied.23 Schönlein pronounces the main thought of his direction – as he has now established it – quite unambiguously at the end of his preface: “After a heavy storm, the conviction finally presses in from all sides that only observational knowledge – only (knowledge gained by) scrutinising something honestly – delivers the truth”.

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A year after gaining his doctorate – after he had meanwhile undertaken a scientific journey to Göttingen and Jena, and had been inducted into medical practice in Bamberg by Marcus’ successor Christian Pfeufer24 – he registered at Würzburg for the higher doctorate (Dr. habil.). On 24–26th of August 1817 he gave his trial lectures, and was appointed on the 28th. He thus e7

Misspelt “pristleyschen” in the text. The reference is to the work of Joseph Priestley (1733–1804) on photosynthesis using algae (see Meidner, 1985).

– in the good old manner of the German Universities – began at the bottom of the ladder, and in order to show that he was serious about the principle that only observation contains truth and validity, he chose for his lectures that discipline which – in the whole area of the disciplines termed “medical” in the narrowest sense, and which is most based on observation – pathological anatomy. He began as Laennec, Dupuytren and John Hunter had begun. Pathological anatomy became the basis of his diagnostic methods, and this became the foundation of his fame. For right to the end of his teaching career, he never ceased to recognize and to use pathological anatomy as the source of new knowledge. With progress in pathological anatomy the acuity of his diagnostic abilities grew. Every new fact from the mortuary table became for him a new weapon for clinical perception. After all, he had no hesitation in publicly declaring, in the Prologomena25 to his “Special Pathology and Therapy”, that every illness is a local one, even if it is not bound to one single organ. And to the objection that one could still not prove changes in the “stuff” – morphological, physiological, biochemical material – for all illnesses, he answered: “That is a superficial objection in a science which reckons only in decades. After all, physiological anatomy needed thousands of years and has still not come to any end. A fool could ask more (questions) than a thousand clever men could answer”. Certainly, he confessed that therapy following from this knowledge does not always have direct use, but he believed: “Knowledge of disease must always precede treatment. Let our generation first collect the observations for knowledge; a later one will use it. Where one has not sown, there one cannot reap”.

16

Thus spoke the mature teacher in May 1841, after more than twenty years of clinical practice. For the lecturer of 1817 was soon transformed into a clinician. The chairman of the medical clinic at the Julius Hospital at that time, Nicholas Friedreiche8 – a universally honoured and acclaimed doctor – fell victim to a serious eye disease. On 29th April 1819 Schönlein was provisionally entrusted with the direction of the clinic, and in 1820 was appointed Extra-ordinarius. Then, on 15th January 1824 – after he had rejected a call to the University of Freiburg – he was nominated Ordinarius in Special Pathology and Therapy, and Director of the clinic. Although the faculty had not proposed him, it had nothing to complain of the choice. He was always a man of truly collegial attitude and his relations with the faculty in general – as also particularly with his spe-

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cial colleagues at the Julius Hospital, and with Textor, who in 1816 had been appointed Professor of Surgery – developed in the most positive way. From that time onwards, a stream of students flowed ever more strongly to Würzburg. If one considers that simultaneously d’Outrepont represented Obstetrics; and Döllinger represented – although after his departure it was Heusinger – anatomy and physiology, it becomes understandable what zeal must have possessed these young men in their efforts – through working with so many teachers who were themselves still youthful, or at least unjaded by work. Around such a group of teachers, there gathered a similar group of pupils, who wanted not only to learn but to work on their own.26 There was a ferment of spirits which had not previously existed in one place in Germany. It was comparable to that which – once upon a time – had been e8

father of the Nicholas Friedreich in chapter 6e.

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aroused by Boerhaave in Leyden. To the works of the embryological school – to which belong the names of d’Alton, Pander, Carl von Baer – there were now joined the more practical works of a whole generation which soon occupied professorial chairs in all areas of Germany. They became personal physicians and hospital doctors, and found recognition in medical practice and in the literature. From a large number of names, I mention only Adelmann (Dorpat), Balling (Kissingen), Canstatt, Demme (the father) Dieffenbach, Eisenmann, Fuchs, Jos. Heine, Herz, Jahn, Marcus (the son), Mohr, Pfeufer (the son), Philip (all in Berlin); Röser (Bartenstein), Schneemann (Munich), Sichel, Siebert, Volz, Wilhelm (all in Munich), Rud. Wagner.27 Above all, however, it was Schönlein who knew how to arouse the youthful spirits with enthusiasm for their new career. “Has he not, after all”, one of his pupils exclaimed “made Würzburg the place of pilgrimage for German doctors, such as Rome is for artists? Has he not spellbound, by his mode of lecturing, foreigners from all nations, amongst them the sons of the most eminent of men? Have not his words – even when mangled to an enraging extent by the ignorant – evoked the most wonderful response? Schönlein bequeaths nothing written, but his word will remain immortal; no honours and titles glorified him, and yet we will speak for a long time of the limitless love, of the enthusiasm, which his pupils devoted to him. His word was great and true; his lips were never desecrated by the mean or the common”. Those words were written in 1835, on the fortunately false news of his death.28 At least they have the merit of not being the words of a flatterer. Perhaps one can assign to them, too,

19

the greater merit of being a fresh expression of the enthusiasm which suffused his circle of pupils. Some of these pupils have now long since died; some before the master, who, himself still a young man, had set them on the path to honours. But hardly one of them was disloyal to him, and denied the master.e9

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With a word apparently borrowed from Stark, Schönlein himself named his school the naturhistorische school; under this name it will stand in the book of our history. Like its predecessor – the naturphilosophische school – it bears the name of its method: “We go back”, said Schönlein “to those bases, those pillars from which medicine went forth: to support ourselves on the book of nature (Naturbuch) – that is our intention; that is a natural historical direction. The natural sciences should be our leader and show how one must observe in order to make deductions from them, and shape these deductions completely into deeds. Thus above all, the method”. None of his numerous opponents has disputed Schönlein’s merit in that he, first of all, established the method of the German clinic.29 It was he who made the rich material of the great hospital so available to students that by his own observation, every individual could follow the course of the diseases, and each individual could gather real (practical) experience. For him, (teaching in) the clinic was not merely a kind of lecture associated with demonstrations, but in contrast it was practical guidance of the trainee doctor. What Krukenberg achieved almost at the same time for the polyclinic, Schönlein did for the hospital clinic. Both chose the more laborious, e9

cf. Peter and Jesus.

but at the same time more rewarding, work of clinical education of individuals, and therefore their work lived on in these pupils. The individual student did not see the patient just once, but daily. Regularly he observed the course of the illness through to cure or to death, and in the latter case, the teacher was untiring in distinguishing from the mortuary findings – by careful retrospective thinking – accuracy and error in diagnosis, prognosis and therapy. The new clinic shone even more brilliantly, however, in the method of examination (practiced there). If, as a student, Schönlein himself had come to know the theoretical requirement of accepting physics and chemistry in medicine, he now applied it in practice as well. His clinic was the first in Germany which drew into regular use the so-called physical aids (to diagnosis), particularly percussion and auscultation. Whilst elsewhere, practitioners still assessed heart and lung diseases according to the pulse and all sorts of “rational” symptoms, he – following the great example of Laennec – established the actual condition of the inner organs themselves. He used the microscope and chemical reagents in order to examine the various specimens – e.g. the blood and the diseased part itself. He followed up the atmospheric conditions at the time in order to establish their influence on the history of the diseases; even electricity played a great role in his nosology for a long time. Whilst with great zeal he continued with highly particularized observations, he did not neglect study of the illness as a whole. From the very beginning, he spent considerable sums of money on his library – not simply to possess the

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Memorial speech for Johann Lucas Schönlein (1793–1864)

books, but in order to read them. He knew his predecessors in detail; he often talked about Autenrieth, Reil, Pieter Frank, and he always had 21

something new and positive to say about them. But as he often said, the sequence of symbolic books for him had not ended with Pieter Frank: – each new appearance in the literature gripped his attention and was evaluated. Most of all, he was interested in the history and the spread of illnesses and diseases, because from knowledge of them he could develop new points of view for assessing the individual case. His epidemiological knowledge was perhaps unequalled. He knew how to bring the history and geography of diseases so close to his students, that not a few of them made these subjects the topics of special studies. And with all this, he still found leisure to continue his scientific collections30 and to keep abreast of advancing knowledge through the most important new publications in related areas. The result of these combined activities was an uncommonly deeper insight into the principles underlying the normal progressionse10 of diseases than had ever been dreamed of by earlier – on the whole Humoral pathological – medicine. Since Hippocrates, medical judgment had been based mainly on two things – the symptoms and the crises. Schönlein neglected neither the one nor the other. On the contrary, seldom indeed has a clinician applied more zeal to the studies of those things – but with him, the symptoms and the signs were gradually transformed into (scientific) phenomena which gripped his attention when they were indispensable for scientific discovery, even when they appeared unimportant for the practical purposes. From placing the phenomena alongside each other – phenomena which did not merely follow each other chronologically, but also proceded causally one from the other – there finally resulted knowledge of the disease process. e10

22

i.e. the ‘natural histories’ of diseases.

Today this appears to be as natural and self-explanatory as the circulation of the blood, but once upon a time it had to be discovered and won for the human race. We speak now of processes without any further qualification as if this word had originally been made for medicine. But no writer in Antiquity knew it in this sense; none of the living Romance languages is, at this moment in time, yet able to utter it without explanation and without interpretation. It is a purely German invention;31 it is at one and the same time the imprimatur of Schönlein’s teaching. Thus under his leadership the Natural Historical School originated and grew. It was not a School in the narrower sense of the word – there is no actual specific teaching in it – it was only a methodological school32. That did not suit its opponents at all. They wanted tangible theoretical principles which they could tear to pieces – a definite system which they could annihilate. In reality, Schönlein did make systems and put forward principles, but he himself never

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reached any conclusion, as he wanted to, and as others presupposed he had. The system which he wanted should be, in his view, a natural one, such as botany and zoology had acquired, but it never came to pass. Each year brought new changes. For, because he continued to make further observations, he could not publish the results until his observations achieved consistency. Thus it happened that individuals amongst his listeners had his lectures printed. Some lectures were published in their entirety33 and some in fragments, and they were often brought into print in part in the most imprecise form. He allowed this to happen unwillingly, but without feeling the urge to publication himself.e11 Nothing had created a greater stir than his classification of the typhuses (Familie e11 ‘pirating’ of lectures was common in Europe at the time. Boerhaave’s lectures (see Editors’ Comments to chapter 5) were taken and published in this way.

Typhus). It too was published as a separatim34 by one of his listeners. But he continued to make (clinical) observations. “At the moment”, he writes from Zürich in 1835, “I am particularly occupied with observations of abdominal typhus because, specifically at this moment, a small epidemic of the disease offers abundant opportunity. Much that is new has been found, as a result of which my earlier views on the pathogeneses – as also the therapy for this disease – will undergo not inconsiderable modifications”. Thus vis à vis Nature, he remained the pupil. He was always ready to sacrifice an old conviction to new experience. Whence, here, could dogma arise! Only one view in his system has remained immutably permanent. That is, the basic division of all illnesses into three general groups according to three basic organic tissues. His basic tissues were animal material (Zoogen), the blood (vessel) and the (spinal) marrow (nerve); from this division he derived the disease groups of: (i) the morphs, (ii) the haematoses, and (iii) the neuroses. If this classification was attacked, and indeed not without reason, the unprejudiced critic must nevertheless recognize that it is wrong only in the fact that it was applied to the aggregated diseases of special pathology, and that it is essentially correct as soon as one limits it to the elementary processes of general pathology. Here the groups correspond to the well-founded subdivisions of formative, nutritive and functional disturbances.35 Let it never be forgotten that Schönlein himself never attached to the system any other value than that of bringing related processes closer to each other and granting points in support of a scientific overview. For us his services are greater in relation to what he derived from the

23

system than to what he left in it. He clarified for all time the fevers which Peter Frank and Reil still represent as a very large group, and which he comprehended as merely reactive processes of the body in Röschlaub’s sense, but no longer as actual types of disease. Internally, that was the greatest innovation he made to the doctrine. It was a change which, with the help of pathological

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anatomy and of better methods of (physical) examination, he carried through wholly in logical sequences, and which gave him the yardstick for his confident and precise method at the patient’s bedside. All these changes were spread via word of mouth; and it is to be excused that he himself did not publish his views and make them accessible to those in distant places. Indeed, it was nothing unusual at that time in the rebuilding of (the theory of) medicine. Like Schönlein’s, the special type of nosology of Autenrieth – the great clinician at Tübingen – was only known anonymously.36 Also from his colleague Kielmeyer – the founder of comparative anatomy and Cuvier’s teacher – we possess nothing but the testimony of his (Kielmeyer’s) pupils and his contemporaries.37 In spite of this, Schönlein’s literary silence was a weakness and those who envied and opposed him knew how to exploit it. They attacked not only his scientific achievements, but in all kinds of things, they sought reasons for suspicion. The Ultramontanists declared him heretical, as a Pantheist; the reactionaries as a republican, and their words had significance, because they reached right up to King Ludwig.e12 After all, the King’s personal physician – Ringseis38 – was at the head of the attackers. Schönlein was little troubled by this opposition. Verbally, he gave full vent to his well-practised satire or occasionally unleashed his sublime coarsenesse13 vis à vis his opponents; but e12

King Ludwig I of Bavaria (1786–1868) ascended the throne in 1825 and abdicated in 1848. He was extravagant and unpopular. In the late 1840s, Ludwig came into conflict with the Jesuits and the Ultramontanists because of the influence at Court against them of Ludwig’s mistress Lola Montez (1821–1861). e13 göttliche Grobheit, refers to the rhetorical technique of using crude common phrases in the middle of formal speech. 25

outwardly no one noticed any hint of the threatening danger. He held his clinic and his lectures as usual; he gathered his Assistenten and pupils around him, and he discussed with them scientific developments. He sought relaxation in his family circle, and with a few friends. But even that gradually aroused suspicion. The July Revolution of 1830 had inflamed the long-repressed popular agitation, specifically in southern Germany. Since the Wars of Liberatione14 the student associations (Burschenschaften) had continued; specifically in Würzburg they had achieved special strength because of the coming together of so many nonBavarians. The population of Würzburg itself – under the leadership of Mayor Behr – had taken on a very determinedly liberal attitude. The University had delegated the leader of the opposition, Professor Seufert to the (legislative) Chamber, and one of Schönlein’s most enthusiastic pupils, Eisenmann, published the most progressive newsletter (The Würzburger Volksblatt) in ‘thissided’ Bavaria.e15 Schönlein himself never emerged from his seclusion, but neither had he broken off contact with those men. Indeed, he made no attempt to conceal his free-thinking inclinations. Near the Julius Hospital, in the Kühgasse,

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in a tavern which still exists today, a company of friends assembled almost daily, which, in addition to Behr, Seufert and Schönlein, Textor, Friedreich (the son) and Hoffmann from the medical Faculty, included Brendel, Lauck and Cucumus from the Law Faculty. Finally, these gatherings gave the government the pretext to intervene in the hardest e14 e15

Napoleonic Wars after 1812 (Prussia only rejoined the anti-Napoleonic alliance after 1812). diesseitigen i.e. south of the Main River

fashion. Immediately after the Hambach Festival (1832), Eisenmann was imprisoned and all the Professors named were removed from office. Schönlein was supposed to go to Passau (on the border with Austria) as District Medical Officer; he preferred to be definitely dismissed. At the beginning of 1833, negotiations began with the Great Council of Zürich, which offered him a Chair at the newly-established University.e16 Schönlein travelled there personally, was satisfied, interacted well with the local committee, and he decided to accept the invitation.39 But even before the matter had been concluded, a new blow struck him in his home state. Misfortune decreed that he happened to be in Würzburg with Seufert when the well-known assassination (sic) occurred in Frankfurt on the 3rd of April 1833.e17 As a result, it was decided to arrest them. Schönlein escaped this by being taken quickly by canoe down the River Main to Zell,e18 to his old friend König – the well-known inventor of the rapid press. From there, he hurried to Frankfurt.40 Thus ended this phase of his career. The government press41 at that time spread remarkable things about him, for example that according to the Burschenschaft plan, he wanted to be elevated to Duke of Franconia in the new Germany. My enquiries have nowhere yielded anything in support of this statement. His closest friends42 all describe this wretchedly libelled man as a very measured constitutionalist, who never sought political influence beyond his circle. The Bavarian Government, however, put in his place one of his pupils and compatriots, the son of the Bamberger Marcus,43 whom the same government had imprisoned nine years previously for thirteen months on similar suspicions, and then set free without judgment! And the Council of the city of Würzburg – which had e16

The University of Zürich was founded in 1833 by merging the three existing colleges of theology (founded by Huldrych Zwingli in 1525), law and medicine with a new Faculty of Philosophy. This institution was the first University in Europe to be founded by the state rather than a monarch or church. (Souce: University of Zürich website). e17 This was a plot of the Germaniabund against the German Confederation, and was followed by prolonged suppression, especially directed against the Burschenschaften (Lutz, 1976). e18 A village 5 km from Würzburg. This version was probably untrue, see supplementary notes.

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so recently been so liberal; which also owed so much of the well-being of the city to Schönlein; and which in 1827, when the news came that Berlin wanted to attract Schönlein there, had made him a freeman of Würzburg – this same Council could find no other way of helping itself – also after Behr had been imprisoned – than to demand the return of Schönlein’s certificate (of freemanship). Schönlein sent it to them immediately, with the note on the envelope, “papers without value”. We can now be more brief. The actual flowering of his life lies behind him. The exile may now well have many happy days ahead, but he was no longer his old self. A withdrawn quality came into his being: I would say “all buttonedup”. After the hard blow from Würzburg he never again, as far as I know, made such a large circle of friends: even though he described the subsequent period of calm family life and the happy enjoyment of Nature as the happiest of his life. He remained in Frankfurt as a popular practitioner for only a short period of time. He then went to Zürich. The new conditions had a completely stimulating effect on him.44 Right at the beginning, at the festive banquet which was given at the opening celebrations for the new Hochschule, he won the hearts of those present by his eloquent and witty address. In his inaugural lecture as clinician – before a large audience comprising not only students – he described the aims and methods of his teaching. But his clinical material was severely limited. Only twenty-four beds in two wards were at his disposal. Therefore he soon initiated, like Marcus earlier in Bamberg, the building of a new hospital, and although he did not have the joy of participating in its opening, he could congratulate himself all the same, on having led and supervised both the

28

plan and execution of this institution. The new hospital has since become a nursery for the most efficient doctors, and three of his pupils (Pfeufer, Lebert, and Griesinger) taught there after him. But the old hospital, small as it was, had nonetheless been the place of the greatest glory for the Zürich Hochschule. Even though the German governments forbade students from attending the new University, pupils still came secretly, and anyone who was prevented from being a student there, came for employment (at the hospital) as a young doctor after gaining his Dr med. That gave the whole system of teaching a higher, I should like to say – more rigorous – character. Even if the, naturally, shorter stay of the young men no longer permitted – as in Würzburg – their forming as an actual School, they still took deeper inspiration away with them. Amongst the pupils at Zürich there were many who later achieved great honours, but in them the scientific method achieved incomparably greater quality. I remind us here, above all, of Lebert45 who stands closest to the natural historical school, and who exerted decisive influence as to its meaning on the younger French investigators. Indeed one can say of him that he brought the natural historical principle into the more specific

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histological arena – into the theory of the specific elements. How Schönlein was as a teacher in Zürich was subsequently described precisely for us by one of his pupils at that time – later his successor in the Chair – Griesinger46. He says: “Who having seen him would not, above all, remember here his calm, serious, confident personality, his thorough examination, and his reserve in judgment until he thought that he had fully studied the case. But then too, however, who would not remember his firm, measured clearly-expressed pronouncements? He was in the habit of giving the results of his physical examination in short, terse summary, but omitting nothing essential. He did this in powerful, colourful language, which did not scorn the more down-to-earth popular expressions of the South Germans, where they were appropriate. He had courage in his convictions, and never covered over anything. He gave more assurance when he demonstrated or when he went into detailed proofs; it was more the Magister (teacher) than the Minister naturae (servant of Nature) who came to the fore.To the student, his pronouncements often seemed to be those of Nature itself. At that time, it seemed to me that he knew everything; and that he could do everything at the bedside!” And yet this omniscience was only a façade, because quite specifically at this time, he was intensely preoccupied with new studies. Indeed the only things that he published apart from his dissertation, were from this period. These were two short notes which Johannes Müller published in his Archive (1836, 1839).The one concerns the so-called typhus crystals;47 the other is on the vegetable nature of impetigo of the head.48 Both works – small as they are (the one is three pages, the other scarcely one printed page) – gave significant stimulus to further research, and especially the latter led to a whole area of parasitic diseases being discovered. For Schönlein himself they had the significance of a public justification, because the old ideas surviving from the natural philosophical period contained in them – even if in an uncommonly limited form – gained substance. For us they have the value that they again show us the mature master – who

29

had apparently concluded his work – as a researcher in whom the idea of finding specific differences in diseases is still alive and active. The last of these publications falls already in the year 1839 when, at the instigation of our medical faculty, he received the call to Berlin. His fame had grown greatly in these years. Already in 1834 he had been offered a Professorship at the newly-founded Hochschule in Bern, which he refused. In 1835, he had been summoned to Brussels in order to assist the young Queen in her first confinement, and great efforts had been made in vain to hold him there as Royal Physician. After a short visit to London and Paris, he had returned to Switzerland. But the most contented family life, the most prestigious recognition as a teacher, could not replace for him the loss of his German homeland. Even at that distance he was always preoccupied with the responsibility of

30

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Memorial speech for Johann Lucas Schönlein (1793–1864)

equipping Bamberg with all the treasures which he had acquired, and even though he could expect nothing from the Bavarian Government, he could not forget his home town.49 He had never felt completely at home in Zürich. After all, to the Zürichers, he was – as a German – a foreigner for whom they were prepared to accord citizenship rights only in return for payment of a large sum of money. His house was therefore – like Oken’se19 – open more to the Germans. And if amongst these latter, pronounced liberals such as Herweghe20 were to be found, it was nonetheless certainly much to the honour of the Prussian Government at that time that it accorded the highest summonse21 to this fugitive. Dieffenbach, as a former student in Würzburg, conducted the negotiations. Schönlein accepted.50 At Easter 1840, after he had undertaken a holiday in Upper Italy – in order to study the e19

Lorenz Oken (b. ‘Okenfuss’) (1779–1851) was a medical graduate who made important contributions to embryology and comparative anatomy, as well as in mineralogy. His work was marred by his ‘transcendental’ philosophical musings, with unusual classifications of species and anatomical parts, particularly those in the ‘nature-philosophical’ (naturphilosophische) mode. He began a journal, Isis, and became involved in a dispute with Goethe over originality of the ‘vertebral theory’ of the skull (see Virchow’s essay on Goethe, 1861). e20 Georg Herwegh (1817–1875) journalist and revolutionary, spent much time in Zürich. Later there he was an associate of Richard Wagner. e21 ‘the highest summons’ refers to an invitation to a Chair at the University of Berlin. 31

exanthematous typhus there – he began his lectures here (in Berlin) amidst quite unusual and lasting crowds of students and doctors. Although he was very soon claimed by the fatal illness of the King – and was subsequently much preoccupied with Court business – he was nonetheless able to repay this recognition by energetic teaching activity. Repeatedly, in his year-long courses, he went through a great part of Special Pathology and Therapy. Little system, many facts: that was the verdict. Never before had an internal physician51 had such effect here. He was the first not only to lecture without notes, but to do this in the best form of cultivated modern language. At times his goitre ailment – although at that time still of moderate extent – made speaking rather difficult for him. He then appeared to hesitate, as if the flow of speech was lacking, but he never left a sentence incomplete. He always ended his sentences in regular, often unexpected fashion. His presence of mind, his orderliness of presentation, his carefully planned divisions, the completeness of the individual sections, the balance in treatment (of the topics) were truly admirable. But gradually his interest in theoretical lectures abated. The great number of clinical consultations, work at the Ministry and attendance at Court,52 did not – as shown by earlier experience in other cases – aid his Professorial activities. On the other hand, he devoted all the more zeal to the clinic. Here too, he brought with him the immediate innovation that lectures hitherto conducted in Latin were to be now in German. Some time later there was another

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innovation – namely that the Assistantships – hitherto available only to military medical graduates – were occupied by civilian doctors. Diagnostic aids were soon extended. The microscope, the chemical reagent, the little-used stethoscope and other things appropriate for this – all hitherto unknown in the “Latin clinic” – came into their own. From all sides, young but already well-tried forces pressed forwards to assist in this work. Güterbock published – this time not without Schönlein’s knowledge – a volume of clinical lectures. Franz Simon organized a sequence of chemical and microscopic demonstrations in conjunction with the investigation of individual cases, which opened up many kinds of new viewpoints, particularly on excreta. After Simon’s early death, Remak and Heintz took his place in order to take on – in a still more methodical manner – microscopic diagnostics, the more refined pathogenics, and clinical chemistry. Traube began his thermometric studies and – closely collaborating with Joseph Meyer – extended the application of physics to the exploration of the organs of the chest.53 Schönlein himself had participated most actively in all these works. He not only liked to know about them and to use the results from individual patients – for the improvement or for the finishing of his pathological opinion – but he also directly stimulated these works in that he allocated the tasks and posed the questions. Amidst all changes of personnel he remained the focal point of the clinic. If, as indeed happened less and less frequently, he sometimes stepped back from the patient’s bedside and sat down comfortably on a chair in order to give a well-constructed lecture on this or that disease – and especially when it had reached its conclusion by an autopsy,54 – everyone regarded that as a treasured gift, in fact as a favour worth

32

particular gratitude. If he had remained at the peak of his position as a clinician, he had also – in the eyes of his colleagues – won still more as a consultant doctor. (This was because) parallel cases from his great experience were never lacking; his excellent memory and the finely organised system of his knowledge always enabled him to use (his experience) rapidly – moreover, he was accustomed to giving his advice in the most charming fashion. In this habit too – which after all so easily ruins the manners of great doctors – he never failed to acknowledge superior information from others. Even if the Bavarian Ultramontanists criticized him for being a Dalai Llama of medicine, he at least never let his Prussian colleagues feel it.55 In his favoured position at the Ministry, too,56 he never attacked the rights of outsiders. The right of the Faculties to make proposals still existed undiminished at his time but the Ministry did exert influence on the final decisions.e22 It would certainly have been in his power to favour his supporters; on the contrary, he often demonstrated a certain shyness in advancing those who were particularly close to him.

33

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Memorial speech for Johann Lucas Schönlein (1793–1864)

Meanwhile, the highest titles and orders were accorded to him. But this did not make his later age any happier; the number of his opponents did not diminish. Again and again, the Munich Ultramontanists – with Ringseis,57 and Görres58 in the lead – attacked him in the sharpest way. In addition to this, there were the objections of his purely literary opponents. Wunderlich59 never wearied of praising in ever new form the physiological method of healing vis à vis natural historical medicine, hunting down the sins of the pupils and attributing them to the master. e22

Probably refers particularly to University appointments.

34

Güterbock’s publication raised a storm of criticism.60 The master’s pupils, above all the tireless Siebert,61 ‘entered the lists’ on his behalf. Schönlein himself remained silent. But his heart was struck more deeply by other losses. First, in 1846, typhus tore his charming wife away from him – she who had made the house such a dear haven. 62 His only son, who showed such promise – and who had followed the scientific inclinations of his father – died on a botanical expedition in West Africa.63 These heavy blows struck the otherwise strong man at his most vulnerable time. More and more he shut himself off in his Tiergarten villa; evermore frequently he withdrew for periods to Bamberg. At the Ministry they became accustomed to the idea of losing him soon.64 Thus, finally, the decision to retire ripened in him. For a little while he resisted honourably; then, however, his endurance was at an end. At the beginning of 1859, in spite of the opposition of the faculty and the pleadings of his colleagues, he sought and received his release.65 With his two daughters, all that were left to him, he returned to his native place where he had long since built and furnished a house for himself. There he lived like a wise sage, withdrawn but not shut off, in comfortable peace, occupied with house and garden.66 His spirit certainly still ranged far and wide, but only to friends. His real activity now belonged to his home city and to Science. The history of his home region (Franconia), the coins of the old Princes, regional and district folklore, the history of discoveries, the literature of epidemics: those were the goals towards which he strove almost to

35

his last day. But it was not for his own sake. What he collected was for others. What he cared for were things beyond the grave. He felt indeed that his time was coming to an end. His house was put in order. The treasures of his books – which he had continued to increase by purchases – he gradually transferred to the Libraries of Bamberg and Würzburg.67 And when – on the 23rd January 1864, precipitated by an increase in his goitre – a rapid death came to him,68 he died calmly in the knowledge that his work was done, rightly and justly. May his memory be holy for us.

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Introduction to the Notes

Introduction to the Notes The following notes have become rather extensive, because the text of my address did not permit the writer to include all points relating to the life and influence of Schönlein, and still less the details available to the author. However, it seemed to be absolutely necessary to discuss these points and details insofar as without them, full insight into the developmental history and the intrinsic essence (Wesen) of this significant man is not possible. To this we must add that seldom does the life of a German scholar offer such numerous and intimate relationships vis à vis his most significant contemporaries and the history of the German intellect. Thus, many kinds of explanation concerning contemporaries and contemporary events are unavoidable for our full comprehension. Nothing is more interesting than that period of transition through which the German intellect passed; from the later decades of the previous century up to the middle of the present century. And in scarcely any other area of human activity have been such sharply-drawn representative people than in the sciences, and particularly in medicine. Our human feeling for the representatives of this newly-developing view of nature and of the human being is heightened by the perception of how almost all of them are young men scarcely out of school, who become teachers themselves, and soon they too see new teaching capacities developing in their own pupils. In this is a fresh, youthful flowing together as can only occur in a springtime of a science, and which for precisely that reason, shows outwardly too the uninhibited – yes, I would like to say cheerful indeed fragrant – character of youth. Their works grow forth, luxuriant in abundance like the buds of Spring, and the language of these young scholars is full-flowered and decorative, like the meadow in May. Frozen spirits are awoken out of the barren winter of scholasticism and dogmatism – first through the sun of philosophy which Kant made to shine forth, and the methods of the new age surge towards them ‘on the waves of song’ with Goethe leading the melody. From Kant to Walther, from Goethe to Döllinger, and again from Walther and Döllinger to Schönlein, an ever more powerful, but always integrated excitement goes forth, towards the complete and total recognition of Nature. Just as the gaze of the natural scientist is gradually widened, and his step becomes ever firmer; so too nevertheless does he always retain the philosophical sense and the poetic verve, which his first experiences made a part of him. That is the character of the new School. From the rear, from time to time, the resentful heads of the Mystics loomed up, like the ominous clouds which threaten to kill the young spring seed with snow and hailstones. In this sometimes Heaven grows dark, lightning flashes down, the storm chases across the fields, but it soon passes, and just as the much-tried worker looks around him in the evening of his life, behold – everywhere a new race is coming into its own to prepare the work of the new age of science in its own sense, and with even better methods.

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Memorial speech for Johann Lucas Schönlein (1793–1864)

It would perhaps have been preferable to reshape the whole according to these principles, and in a more internally consistent way, and thus to unroll before the eyes of the unoriginal successors a piece of the history of German science which, as a whole, is still so little known. The history of those three Universities which at that time were the focal points in the history of the development of Medicine – Bamberge23, Landshute24 and Würzburg – is important enough to represent it (the history of the development of all German Science). But at present, the author does not have the time necessary to complete such a task; he hopes to achieve his aim, at least for the attentive reader, by the form chosen here. The division of the material to be recorded into individual notes even has the advantage of greater objectivity. The author believes, at least, that he may be confident of recognition for the fact that in the completeness and accuracy of what is produced here of the actual material, he has satisfied strict demands. e23 e24

41

closed 1803. moved to Munich in 1826.

Notes 1

On p 3. Some earlier writers give Schönlein’s year of birth as 1796. According to the baptismal register he was born on the 30th of November 1793, and baptized on 1st December in the parish of St Martin. At his baptism he was given the name Johann from his godfather, Johann Göller, a cooper, [vietor (Latin) in the baptismal register]. Subsequently, it seems, he added the additional “Lucas”, perhaps because the evangelist Luke is described as “doctor and painter”. He was his parents’ only child. e25

2

On p 4. The information, previously very widespread, that Schönlein came from a Jewish family, seems to be based on confusion with Marcus. The Schönlein family is an old-established Bamberg line, which exists in various sublines. His father Thomas was a rope-maker (Restiarius in the baptismal register), and lived in what is now Königsstrasse Distr. II, No 1151. Today, too, the house belongs to a master rope-maker (Daniel Schmitt). Ludwig Rumph (b. 22nd of Nov 1793), a school comrade of Schönlein – subsequently Professor of Pharmacy and Mineralogy at Würzburg, and as such later on my colleague – used to tell stories of their youthful escapades. He faithfully retained in his memory, how the old rope-maker Schönlein had often chased his son with a piece of rope across the bridge, and how old Rumph had called across to him from his chemist’s shop: “Neighbour, give mine a few swipes too!” Bach* reports how Schönlein was initially destined to become a rope maker, and that he himself, long afterwards, in Zürich, related – in the course of a clinical lecture on the causes of tuberculosis – how he, “when he was still a manual worker”, had suffered significantly because of the dust, and had been in danger of becoming consumptive. His mother Margarethe née Humer came from Vilseck (in the Upper Palatinate, three hours from Amberg – sic). She was a sister of the Frau Göller, who was mother of Franz Göller (b. 17th March 1790, d. 6th December 1853), later an important philologist

*

Bach. “Joh. Luc. Schönlein”, A eulogy presented at the Spring Session of the Medical Surgical Society of the Canton of Zürich, April 1864, p 5.

e25

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Virchow revises this whole section in his Supplements to the notes, “p 41, Notes 1 and 2”.

Notes and Professor in Cologne. His correspondence with Friedrich Jacobs was recently published by H. Düntzer.* Göller’s father owned a brewery “At the Sign of the White Rose”, likewise in Königsstrasse. 3

42

On p 4. A certainly competent witness, the Cathedral Dean of the Chapter, Johan Rothlauf**, Bamberg, says in his memorial address on Schönlein: “Science had not inflated him, or drawn him away from Christianity. He was and remained a benevolent Christian; he was and remained Catholic. The principles of the Catholic faith – which he had absorbed at a young age and which was deeply imprinted – never left him. They remained dear and prized by him – as he showed on so many occasions, and as he proved particularly in his will which was drawn up during his active period in Berlin”. In the last years of his life – on Sundays and feast days – he attended St Jacob’s church in the city, where the Franciscans were responsible for Divine Servicee26, 27; here too, every year he made his Easter Confession and Communion. He also supported this church with generous donations. Schweitzer, the city parish priest, was his preferred intermediary for these charitable donations, and it was to the parish church itself – in which parish he was born – that he made considerable donations.*** When in 1863 this church celebrated its eight hundredth anniversary, he paid a large part of the feast expenses from his own pocket, lent his opulent dinner service and gave wine to the festival banquet, in which the archbishop with twelve priests took part, and in which Schönlein, as the only layman, was included. Each year, at the feast of Christmas, he provided twelve children of the parish with Christmas gifts. On the other hand he seldom visited the parish Church of St Gangolf – which was closer to his house – because the congregation consisted almost entirely of (market) gardening folk, and he feared that he would attract attention by appearing there.e26 During his time in Berlin he had an especially close relationship to Cardinal Diepenbrock

*

“Miscellaneous Essays” by Fr. Jacobs IX, Leipzig, 1862. The 27th Report on the activities and the state of the Historical Society in Bamberg. 1864, p 148. *** cf Note 63. **

e26

Virchow revises this whole section in his Supplements to the Notes, p 42, Note 3. ‘Easter duties’, ‘E D’, the minimum observance for all Catholics; annual Confession, Mass and Holy Communion. e27

(sic), whom he greatly esteemed because of his mild ecclesiastical attitudes. In 1852 King Friedrich Wilhelm IV sent him to Silesia, in order to visit the seriously-ill Prince of the Church, with a letter in his own hand.* 4

On p 4. Bach – of whom Rothlauf reports that his account is based for the most part on personal information from Schönlein – records: “His first teacher – whom he always remembered with particular love and gratitude e28 – awoke in him early on, by leading him to collecting stones, plants and insects, his feeling for Nature”. I have not been able to find out who this teacher was. I am told that one of his teachers was Lichtenthaler, the late Senior Librarian at Munich, with whom later on, he was still in contact. Furthermore, Bach tells: “The young Gymnasiast spent his holidays for the most part in the country with his grandparents, who owned a mill in Lohndorf, a small hamlet in the Franconian Jura. Later on, this grandparent who was his sponsor at Confirmation, often took him on walking trips in the hilly country in Franconia (Fränkische Schweiz), and the magnificent landscape had a powerful effect on his young, receptive spirit: – the picturesquely grouped mountains, the pleasant valleys drained by brooks containing plentiful fish. These excursions, moreover, were used primarily to search for and collect natural specimens, particularly fossils in which those valleys are so rich.

5

On p 4. If in my text, I have almost exclusively dealt with his father, it would not be in Schönlein’s spirit if I were not expressly to mention the perhaps greater significance of his mother. Bach says

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Memorial speech for Johann Lucas Schönlein (1793–1864) of her: “His mother, a straightforward bourgeois woman, full of life and understanding who, in her essence, reminded one in a very vital way of Goethe’s mother, and whom he strongly resembled physically – loved the boy beyond expression, and had the most pronounced influence on his education and character formation. She reached a great age; Schönlein was attached to her with moving respect right to the end of her life. For her sake he later built a house in the same street where his parents had had their business and where he had been born; a house in which she ended her life and in which he too spent his last days”. *

Förster. “Biography of Cardinal Diepenbroek”. 1859, p 248. Rothlauf as above, p 153. Note.

**

e28

44

see Supplements to the Notes, p 43, Note 4.

And later (p 7): “Almost the whole of Schönlein’s time at University fell in the difficult war years, and he could only finish his studies because of his excellent mother – she with the energy and practical sense who lived only for her son, and who seemed to sense his future greatness. To her he owed the fact that he was able to complete his studies”. In recompense for this, the worthy lady had the good fortune of being able to see her good son’s glittering career right up to its climax. And he, for his part, appreciated the joy of being able to offer – by his most loving care and by repeated visits, and stays in Bamberg – his much-loved mother, his thanks in fullest measure. 6

On p 5. Franz Ludwig von Erthal, b. 16th of September 1730, d. 14th of February 1795, Prince Bishop of Bamberg and Würzburg, Duke of Franconia, has been increasingly celebrated in various biographies*. His instructions concerning philosophical studies, which were collected by Ruland**, justified recognition as a model of insightful regal solicitude. How he intervened in the development of medicine through his support of talented young men is shown by the following notes. Here I will only mention that he sent Professor Matern Reuss to Königsberg, at his own expense, in order to hear Kant; and from familiarity with the philosopher, to obtain for himself, an explanation of any obscure parts in Kant’s system and then to present this system at the University of Würzburg, which in this was in advance of all other Catholic universities.***

* “History of the Würzburg Bishops according to Gropp”. Würzburg, 1849, vol II, pp 502–60. “Franz Ludwig’s Life Story”, by Bernhard. (Pseudonym for H. Reuchlin). Tübingen, 1852. Wegele, “The Reformation of the University of Würzburg: Commemorative address for the anniversary of the University”, Würzburg, 1863 p 10. ** A. Ruland.“Prescriptions and Rescripts, On the Study of Philosophy”, University of Würzburg, 1852. *** 27th Report of the Historical Society, note on p 65.

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7

On p 6. The Bamberg library* was founded in 1609 when Prince Bishop Joh. F. v. Aschhausen summoned the Jesuits in order to transfer to them the public institutions of instruction. In 1773, after the order was dissolved in Bamberg as well as elsewhere, the greater part of the Order’s library came to the University. It was only via Franz Ludwig – who not only increased the collection of books, but also had the new magnificent annexes built – that the Library gained the significance which it still retains. Schönlein had already used it fully as a high school student. As Professor Emeritus he was one of its main users, and up to his death, he continued to donate to it generously. According to information from the librarian (Stenglein) it has 101,551 individual volumes; 199,206 occasional writings, programmes and dissertations; 4,403 manuscripts – mostly on parchment; – 5,621 paleotypes and incunabula; 3,588 maps; 62,780 paintings, drawings, watercolours and the like; and 4,366 bronze coins.

8

On p 6. The first mention of a hospital is in 1224** when bishop Ekbert, the uncle of St Elizabeth, gave hospitality in the Women’s Sick House on-the-Sand to the first three missionaries sent by St Francis of Assissi.e29

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Notes 9

On p 6. Adalbert Friedrich Marcus (previously Mark or Marx; b 1753 in Arolsen, d 1816) had studied medicine in Göttingen at the same time as Ackermann and Blumenbach; continued study in Würzburg under Siebold, and had come to Bamberg in 1778. Very soon he entered into closer relations with Franz Ludwig. After the elder Professor Döllinger had been ousted, he became Franz Ludwig’s personal physician. And after he had had himself baptizede30 by the Prince Bishop in 1781, he was entrusted with the highest medical offices. In 1789, on his initiative,

* Jäck. “Complete description of the public library in Bamberg”, published in Nurnberg 1831–35; Petzholdt, “Description of German Libraries”, 1853. ** Fr. Wunder, 16th report of the Historical Society, 1853, p 169; and Virchow’s Arch IX, pp 156 and 312. e29

Bamberg was at the very edge of Roman Germany. from being a Jew. Joseph II’s Judenpatent – which removed many civic, social and professional restrictions on Jews – was issued in 1782.

e30

the noble prince established the new hospital of 120 beds, where soon afterwards clinical instruction was introduced with so much success that students streamed in from all directions, so that their number soon exceeded a hundred. Educated in the teachings of Cullen, Marcuse31 soon went over to Brownianism, then to the irritation theory, and finally to Naturphilosophie and to the phlogiston doctrine. It is a warning as to how even the most intellectual of men can, without reliable methods, become the plaything of strange theories. At that time these changes did not damage his reputation: – the most important men of that time, such as Hufeland, Reil, Schelling, both Schlegels and Steffens, came to Bamberg in order to witness the clinical activity of the famous teacher. The practical effects of this inspired man were admirable. When in 1802 the small principality of Bamberg became part of Bavaria, Marcus – who had been placed at the head of medical services in this newly-acquired Bavarian province – was successful in establishing a whole series of new institutions. The monastery on the Michelsberg was transformed into a general house of care: a special house for incurables, a mental asylum, a labour ward, and a nurses’ institute were all founded. In 1803 the University was dissolved, but Marcus was able to convince the government to establish a medical-surgical school. This, too, rapidly blossomed with the collaboration of the newly-appointed Professors Kilian and Phil. Walther*. This was the time during which the young Schönlein was preparing for study. I have not been able to establish whether he was ever directly influenced by Marcus. (The social relationships of the much-sought after medical director were so predominantly devoted to the upper classes, especially the nobility, that the specifically bourgeois middle class Schönlein family was scarcely touched by it). But a great indirect influence is certainly not to be doubted. 10

46

On p 7. This effect was especially mediated by Count Thuerheim as was described by Wegele** in more detail in his commemorative address.

* J. H. Jäck. “Adalbert Fr. Marcus, Described According to his Life and Character”, Erlangen, 1813. Speyer and Marc, “Dr A. F. Marcus, Described After His Life and Work”, Bamberg and Leipzig, 1817. ** Wegele op cit p 12. e31

11

Virchow revises this section in his Supplements to the notes, “p 46, Note 9”.

On p 7. Cajetan Textor (b 1782; d 1860) attended the University of Landshut from 1804–08. After he had defended his inaugural dissertation on lung consumption on the 21st of May 1808, under the chairmanship of Philip von Walther, and had been awarded his doctorate, he undertook various longer journeys through France, Italy and Germany. In 1816 he became Professor of Surgery at Würzburg*. Here, Schönlein was amongst his first pupils, and soon became a colleague.

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Memorial speech for Johann Lucas Schönlein (1793–1864) 12

On p 7. A certainly accurate testimony for this period is given by von Ringseis. He says: “At that time, at the University of Landshut, there was a group of excellent teachers and young men. In the Faculty of Medicine, apart from Bertele, Tiedemann and Schmidt-Müller, were the incorruptibly upright, loyal and truthful Röschlaub, with his minutely-dissecting dialectical sharpness; in the Faculty of Theology alongside Zimmer and Winter, and Seiler, who breathed love and mildness, and found a grain of gold in everyone and everything; in the Faculty of Law, following the departure of Feuerbach,e32 Gönner and Hufeland, there were Friedrich Carl von Savignye33 – a most noble presence, already radiant with the crown of his youthful fame – and followed by his charming family; and the brother-and-sister geniuses, Clemens and Bettina Brentanoe34 who were related to him. These men – all surrounded by a great number of eager apostles hanging on their words – formed the central foci of teachers and studious young men, and exerted even greater beneficial influence through their personal interactions than they did through their lectures”**.

13

On p 8. Joh. Andreas Röschlaub, b 1768 at Lichtenfels near Bamberg, initially studied theology but then medicine in Würzburg and Bamberg. Just when the Brownian system had come to Germany, he became Professor at the University in Bamberg, where, in association with Marcus, he brought about the real blossoming of medical studies. However, in 1800 he accepted a call to

*

Rubach, Memorial address for Textor. Würzburg Med. Zeitschr, 1860 vol I, p XXXIV. – Obituary for Textor in the Archiv für klin. Chirurgie 1861, vol 1, p 493. ** Joh. Nepomuk von Ringseis. Address in memory of Philip von Walther. Munich 1851, p 31. e32

Father of the philosopher Ludwig, Paul Johann Feuerbach was also responsible for introducing psychology into law. He took up the famous case of Caspar Hauser – an apparently disabled adolescent who was found wandering the streets of Nürnberg and who died of a sword wound while in care. Paul Johann Feuerbach himself died under mysterious circumstances, possibly poisoned by the Royal House, following his critique of the death of Hauser. e33 1779–1861, Professor of Laws at Landshut, later at Berlin. e34 Major authors of the German Romantic Movement. Landshut. After experiencing there, too, the flowering of the University, he was pushed into retirement in 1824. However, when the University was transferred to Munich, he – at the instigation of Ringseis – recommenced teaching as Professor of the Medical Encyclopaedia and Methodology. He died in 1835.* Cf. note 18.

48

14

On p 9. Friedrich Tiedemann (b 1781 in Cassel, d 1861 in Munich) studied medicine in Marburg 1798–1802, and then “went to Bamberg in order to complete his education in practical medicine under Marcus’ direction. There he made the acquaintance of Döllinger, who was doctor for the poor and who allocated to him the practice of a whole district of the city”**. In the autumn of the same year, he returned to Würzburg and under Thomann and Caspar von Siebold, attended the clinical institutions at the Julius Hospital. After he had spent more time in Marburg he returned again to Würzburg in the autumn of 1804, and made preparations of nerves under Hesselbach and heard Schelling on Naturphilosophie. From there via Frankfurt, where he visited Sömmering, he went to Paris. But in 1805, at the young age of 25, he became Professor of Zoology, as well as of Human and Comparative Anatomy in Landshut. In autumn 1811, and hence immediately before the time when Schönlein came to the university, he undertook a journey to the Adriatic Sea, the fruit of which was his famous treatise on the anatomy of Holothuria, starfish, and sea urchins, which was honourede35 by the French Institute. This was followed in 1813 by a treatise on anencephalic abortuses; and in 1816, by two important embryological works on the anatomy and development of the brain: – of which the former had greatest significance for pathology, while the latter was the direct predecessor of his works on embryology in Würzburg. Their close relationship to Schönlein’s development is obvious.

15

On p 9. Philipp Franz Walther (later ennobled von; b 1782 at Burweiler in the Rhine

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Notes * Jäck, “Second Pantheon of Literati and Artists in Bamberg from the 11th century to 1844”. Bamberg, 1844, p 105. Leupoldt, “History of Medicine”. Berlin, 1863, p 510. ** Th. L. W. Bischoff. “Memorial Address for Fr. Tiedemann”, Munich 1861, p 5. e35

probably means “awarded a prize”.

Palatinate, d 1849 in Munich); studied medicine in Heidelberg and Vienna, where he was introduced to practical medicine mainly by the two Franks – Johann-Peter and Joseph – and by Beer.* In 1803 he was awarded his doctorate at the University of Landshut. Shortly beforehand he had made the acquaintance of Marcus in Munich, who – as newly-appointed Director General of Medical Services – had gone there to collect information on the then-recently acquired Franconian principalities.e36 Marcus recognized the qualities of the young man, and by the 28th of February 1803** he had received, by rescript of the Electoral Franconian General Commissariat, his appointment as assistant at the Bamberg medical directorate, “so that – since he has completed his theoretical and practical studies in Vienna in an excellent way, and has acquired rare skills in the treatment of eye diseases – he should have the opportunity of further developing his talents and acquiring knowledge in the best interests of the electoral hereditary princely estates”. Soon afterwards he was nominated Medical Councillor, Senior Surgeon at the hospital, and Professor of Surgery at the newly-founded Medical and Surgical School. In this post he founded an ophthalmological institute associated with the general hospital, which soon attracted patients from far and wide.*** But after only two years – in 1805 – during which moreover, he undertook a long journey to Paris, Walther took over the Chair of Physiology and Surgery in Landshut. Concerning this period, let us now hear from Ringseis, who was his pupil for many years and who later became his most dangerous opponent. “Here in Landshut” says von Ringseis# “(it was) the epoch of his greatest and most youthfully fresh energy; here(was) the brilliant apex of his long

49

*

Obituary for Philipp Franz von Walther, in the Neuen medicin.-chir Zeitung. 1850, No 12. Strangely, Walther himself in his memorial address for Döllinger, p 74, gives the year 1801. However, according to all my other information, this is an error. *** Speyer and Marc, op cit, p 71. # Joh. Nep. von Ringseis, Address in Memory of Philipp Franz von Walther, Munich, 1851, p 30. **

e36 This was part of the Napoleonic reorganization of the German states and principalities. The administrative organ was the Reichsdeputationsschluss.

literary and active life in medical practice; here indeed too, (it was) the place of his most dear memories. The author (Ringseis) – like probably no one else – was for seven years Walther’s pupil, and still remembers with love and enthusiasm his life in Landshut”. Then, in the place noted above (note 12), Ringseis gives an overall picture of conditions at the University at that time and continues: “Into the circle of these younger and older men – all aglow in their enthusiasm and knowledge and for Germany’s true honour – there stepped now the 22 year old Walther. He was still blooming in youthful strength and beauty. Enthusiastic himself, he enthused younger people, and seemed to them like a Heros, sent by Heaven in order – as a new Hercules – to liberate the world from the most potent monsters of disease. And just as – almost 300 years before – French soldiers sallied joyfully into battle if they knew Ambrosius Paré, their great surgeon, was accompanying them; so surgical and eye patients came now from near and far, even from non-German lands, to Landshut, in the certain and joyous hope of finding the help they were seeking”. While in Landshut, in rapid succession, there came from him the “Treatise on Purulent Inflammation of the Eye” (1805), “The Physiology of the Human Being with continuous reference to the Comparative Physiology of Animals” (1806–1808); “A Presentation of Bichat’s System” (1807); the “Treatises on the area of Practical Medicine, particularly in Surgery and Ophthalmology” (1810) and the “Annual Reports on the Clinic” (1812–1818). Certainly Walther* was initially a zealous supporter of Schelling’s Naturphilosophie. However, in 1806, in a report on

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50

Memorial speech for Johann Lucas Schönlein (1793–1864) scientific culture in France with particular reference to medicine and surgery, he said “Medicine forms a part of the entire natural science. Medicine is constructed from the natural historical processes. The sequences in the families of diseasese37 are just as little without rules as those of animals and plants. And healing arises necessarily according to the same laws of nature *

“German Medicine in the nineteenth century. A commemorative address at the 40-year service jubilee of Ph. Franz von Walther”. Munich 1843. p 51. Also B. Eble, “An Attempt at a pragmatic history of anatomy and physiology 1800–1825”. Vienna, 1836, p 97.

e37

51

thought to refer to the ‘surgical sieve’ used as a diagnostic ‘thought plan’ in clinical medicine.

as does every other physical process”. But he immediately adds: “How little the art of healing – notwithstanding the richest and most extreme use of all the attributes which the most careful application of chemistry, natural history and physics offers to it – can do without the supporting pillar of philosophy, is shown clearly in the organisation of French practice”. 16 e38

On p 10. In my memorial address for Johannes Müller* I had left it open which of his teachers exerted the most definitive influence on our great physiologist (i.e. Müller). Now, with my more detailed knowledge of Walther, and with respect to the great sympathy which he applied to the budding destiny of Müller, I have no hesitation in according the credit to him. I also remember that when I visited the ageing surgeon in Munich in 1846, he enquired with particular sympathy after Müller, whilst he spoke of the “Geheimen Räthen” e39 in Berlin with a certain reserve.

17

*

On p 10. Georg Aug. Bertele (b 1767 at Ingolstadt, d 1818), son of the botanical gardener at the University of Ingolstadt, had initially had a military medical post, but in 1792 – at government expense – he had been sent on a scientific study tour. First of all, in Würzburg, he studied chemistry under Pickel and surgery under Caspar von Siebold; then in Freiberg he studied mineralogy under Werner, Charpentier and others. At the University of Landshut he taught chemistry, mineralogy, botany, zoology, pharmacology and various other things. Walther** accords him the testimonial of being a teacher as thorough and as clear as he was hard-working. He says “He brought together disparate facts under general points of view; in these summaries and with these higher insights, these facts were more easily understood and remembered by the young fresh spirits”.

Virchow, “Memorial Address for Johannes Müller”, Berlin 1858, p 14. Ph. Fr. von Walther, “Address in memory of Berthele”, Landshut, 1818.

**

e38 e39

See Supplements to the notes, “p 51, Note 16”. probably a sardonic expression for the group of leading medical men there.

A particular influence on Schönlein seems to have been exerted by Schultes, who is well known for his natural historical expeditions. Schönlein particularly admired his writings. On the other hand, the young man’s (Schönlein’s own) private study probably had as great an effect on his development as did his teachers’ influence. From an early age Schönlein studied the works of Linnaeus and always retained a great interest in this pioneering natural scientist. Through him, the Bamberg library gained an extensive collection of books relating to Linnaeus. Amongst Schönlein’s few posthumous papers two more folio volumese40 – little written in, however – have been found, of which one contains descriptions of minerals, the other chemical notes from his student days.e41

52

18

On p 10. One must admit, however, that this was not a (constant) personal quality in Schönlein. Röschlaub’s star was already waning. Calmer observers had long since pronounced their doubts about the direction he was taking. In 1802, Hufeland* – the most hostile enemy of Brownianism and also Röschlaub’s tireless opponent – had said: “Only Brownianism is true stimulation theory, that is to say, the theory which deduces everything from the concept of stimulation. And because

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Notes this had been abandoned – because Schelling deduces phenomena only according to higher principles of Naturphilosophie, and even Mr Röschlaub, (who now idolizes Schelling just as much as he once did Brown without understanding him and, as he abandons the Brownian teaching, worries himself sick trying to force his previous phrases into naturphilosophische garb) – since all this, then no irritation theory exists any more either”. But at that time, Röschlaub was still fighting victoriously against his opponents. Only in 1805 did he recognize the one-sided and erroneous quality of his path, and hid himself in silence, filled with the thought of publishing his theory as a great work rejuvenated by an improved form. But somehow the project did not seem to advance properly; thus in 1811 he decided with laudable courage, to acknowledge himself defeated on the main points of pathological opinion, in an open *

Hufeland, Neues Journal der praktischen Heilkunde. 1802, vol VIII p 136.

e40 e41

‘Folio’ refers to the size of bound books comprising blank pages for writing in notes etc. There were many posthumous papers – see Supplements to the notes, “p 52, Note 17”.

letter to his great opponent Hufeland.* At the same time he announced his intention of continuing his new investigations and of publishing them in entirety later on. But the feeling of having lost his way apparently weighed cripplingly on his spirit. Nowhere is this more clearly pronounced than in his preface** to his favourite pupil Ringseis’ first treatise, in which the thought is spelled out which Röschlaub had already expressed in the letter to Hufeland – namely that Brown’s theory was not fundamentally distinguishable from that of Hippocrates. Röschlaub’s great work, however, remained only a manuscript and will probably remain so in spite of Ringseis’ wishes. 19

53

On p11. An anecdote, probably referring to this period, was told to me by a reliable source. As a student Schönlein – when staying with his mother on holiday – often visited the neighbouring place Lohndorf, 3 hours from Bamberg (p 43). The parish priest at the time – a relation of Schönlein – cleared a little room (sometimes, too, the so-called ‘state-room’) for him. One day, he comes up unexpectedly and finds the young researcher amongst chopped-up frogs, lizards and so on. Naturally there was a scene, and the student’s visits became less frequent from then on. At the same time I note here that apart from the teachers from the Landshut and Würzburg time listed by Bach (Tiedemann, Walther, Leveling, Röschlaub, Berthele, Feiler, Schultes, Fuchs, Döllinger, Friedriech the elder, Horsch and Marcard), we should also mention, from Würzburg: Textor, Heller, Pickel (Chemistry), Ruland (Materia Medica), d’Outrepont (Obstetrics) and Hesselbach (Surgery).

* Hufeland, Journal der praktischen Heilkunde. 1811, vol XXII issue 1, p 9. The interesting opposing declaration by Hufeland is in the same volume, issue 2, p 3. Cf also 1837, St I, p 33. ** J. N. Ringseis, “On the Hippocratic and Brownian Doctrine as Agreeing with Each Other and being Mutually Explanatory”. Nürnberg 1813, p 10 and p 19. 20

On p 12. The earlier history of the Würzburg School from the original documents has been given by Scherer* in a Rectorial Address. Amongst the first and most original medical teachers of that time, he mentions Adrianus Romanus, whom Bishop Julius summoned from Louvain in 1593. We shall mention later (note 66) a treatise which was defended under his presidency.

21

On p 12. At the beginning of the century Dömling had the chair of Physiology. Dömling was one of the first pupils of Schelling.** However he attacked Röschlaub rather sharply, and supported Humoral Pathology in a somewhat doctrinaire way***. Walther testifies to him being a talented and thoughtful man who died too soon. After him came Döllinger and Heusinger, who were representatives of a healthy, empirical direction in physiology. But after the reorganisation (Epuration) of the University, Hensler followed and was there long enough for me to sit with him in

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54

Memorial speech for Johann Lucas Schönlein (1793–1864) the Würzburg faculty. He was one of the last and most unshakably convinced of those believing in animal magnetism#. At sittings of the medical faculty he could not be persuaded to sit down, because he was worried that in his opinion, disease stimuli might pass into his body from the poorly-constructed chairs. In general pathology I mention Spindler## and Schönlein’s colleague Carl Richard Hoffmann###, who can be seen as warnings of the speculative path. *

Scherer, “Outline of a history of the first two centuries of the University of Würzburg, with particular reference to the development of the Medical Faculty”, Würzburg, 1852. ** Eble, “Attempt at a Pragmatic History of Anatomy and Physiology”. Vienna, 1836, p 87. *** J. Jos. Dömling. “Are there Original Diseases of the Fluids? Which are and which are not”. Bamberg and Würzburg, 1800. # Philip Ignatius Hensler. “On the Various Kinds of Animal Magnetism”. Würzburg, 1833. ## Johan Spindler. “General Nosology and Therapy as Science”. Frankfurt am Main, 1810. “On the Principle of Human Magnetism”. Nürnberg, 1811. ### Karl Richard Hoffmann, “Comparative Ideal-Pathology. An Attempt to Present Diseases as Regressions of the Idea of Deeper Normal Phases of Life”. Stuttgart, 1839. 55

22

*

56

On p 14. Ignatius Döllinger. This adornment of German Science was born in Bamberg on 24th May 1770. He was the son of the earlier-mentioned (p 45) personal physician to the Prince Bishop, and Professor whom Marcus edged out. After he had conscientiously absorbed Kantian philosophy he began medical studies in Bamberg; between 1789 and 1793 – supported most generously by Franz Ludwig – he continued studies in Würzburg, Pavia and Vienna. He heard (lectures by) Siebold, Pickel, Thomann, Barth, Prochasca, and above all by both Peter Frank and Scarpa in Pavia, where, at that time young men eager to learn, gathered together. In precisely the year Schönlein was born, Döllinger returned to Bamberg, almost immediately took his doctorate, and then became Professor. He was second consulting doctor at the Hospital after Röschlaub was called to Landshut. As such he worked for nine years, until the dissolution of the University, but in 1803 – immediately after the reorganisation of the Würzburg University – he entered this institution as Professor. Walther* says of him: “Döllinger became the architect and founder of the new anatomical-physiological school at Würzburg, which has achieved such great and splendid things. These researches were wholly in accord with the progress in the natural sciences occurring at the same time, and were solidly founded on them. This was really his most brilliant period – the period of his intellectual maturity and of his most successful activity and greatest impact. Döllinger’s school became the centre of medical studies in Würzburg, on which all the scientific thinking of his graduates was based, and to which they referred later on. He truly knew how to enthuse his listeners for anatomicalphysiological research, so that they lived it completely, not only in the School, but outside. Hence they made research the predominant topic of their social conversation too. The number of his pupils was uncommonly great. Students flooded in – from all parts of Southern and Northern Germany, from Poland, Courland, Livland and other areas of the Russian Empire and

Philip Friedrich von Walther, “Memorial Address for Döllinger”, Munich, 1841, p 38. from Greece – in ever larger numbers. They were attracted by Döllinger’s school, by the clinical institutions in the Julius Hospital, by the maternity hospital – which had been newly-erected under the Royal Bavarian Government – and by the excellent teachers appointed to it.” But Döllinger was also a teacher of unusual knowledge. His first printed work was mineralogical – on the metamorphosis of soil and stone types from the pebble sequence (1803). While still in Würzburg he gave lectures on zoology and experimental chemistry, led botanical expeditions and held seminars on pathology and therapy. Only gradually did he concentrate on anatomy and physiology. He was the main person to firmly establish the use of the microscope for more detailed anatomical studies in Germany. An anecdote is related about him that when a

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Notes young medical student consulted him about buying a library, he (Döllinger) suggested that he first acquire a microscope and that then – should any money be left over – he should buy the library. But it was above all he who taught a stricter method of investigation and a new path in empirical research. It was the path which Goethe* e42 was the first to sketch out – the path of the “developing-unfolding method” which bore its first fruit in the theory of the Metamorphosis of Plants, and in the Vertebral Theory. It was our greatest poet who, for Döllinger too, saved us from the paths of Naturphilosophie, in which, like all his contemporaries, he had walked for a while.** Walther*** describes the circumstance as follows: “Döllinger knew how to enliven even the driest part of anatomy – osteology – through the witty way in which he treated it, hence making this otherwise intimidating study attractive for the beginner, thus breathing life and movement into the rigid skeleton. He had understood the deeper significance of Goethe’s ideas on morphology, and proceeding from the spinal column as the basis of the entire formation of bones in vertebrate animals, he described in a very attractive way, their leaf-shaped development *

Virchow, “Goethe as Natural Scientist”, Berlin, 1861, p 83 and 103. Eble, cited before, p 95 *** Walther, “Address on Döllinger”, p 29, cf. p 84. **

e42

see also Virchow’s essay on Goethe (1861).

and broadening out in the skull and pelvic bones, as also the branching and further branching of the bone stem in the hollow bones of the extremities growing forth from the spinal column”. Now he allied himself with d’Alton, who, by closer contact with Goethee43 over many years, had been inducted into his ideas, and led into new researches in embryology.* Two young students joined them: Pander and Carl von Baer, of whom the latter admittedly, left Würzburg before these studies were concluded. The three others, however, continued these investigations in the most enthusiastic way. Innumerable experiments were carried out involving brooding hens, so that in the Würzburg market the price of hen eggs rose, and finally the whole population followed this new beginning (of research) with most active interest. This was in 1816, the same year in which Schönlein published his inaugural thesis. The preface to the thesis bears the date: “Bamberg, in December 1815”. This bears witness to the fact that it was not, for instance Pander – who finally published the results of the investigations carried out with Döllinger and d’Alton – who should have the merit of original authorship. Schönlein himself recalls gratefully Tiedemann and Döllinger, and he particularly praises the latter for passing on to him “with rare generosity a great number of mammalian embryos from his collection”. Pander came to Würzburg only in 1816. At that time Döllinger had founded a zoological-physiological society in which, “under his direction, capable work would be carried out according to ideas laid down by him and within the firm guidelines of his supervision”.** And it can scarcely be doubted that Schönlein too was not far distant from this influence. Walther*** says of him: “Schönlein was a genius who at first was only Döllinger’s pupil, but who later – over a long period – became his highly esteemed colleague. Without a doubt, Schönlein also received from Döllinger’ school stimuli and enlivening impulses for the establishment of his inspired system of the healing arts, which was from the outset founded on physiology and thereby based also on the entirety of science itself”. Walther says expressly: “Also received in Döllinger’s school”, because he knew full well that Schönlein had received them also in his own school (i.e. that of the great Walther).

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*

H. Meyer, Archiv f. physiol. Heilkunde, vol III, p 48. Walther, op cit, p 60. *** ibid, p 40. e43 see also Virchow’s essay on Goethe (1861). **

Döllinger’s fame grew rapidly at that time. In 1816, under the name “Eustachius”e44, he was accepted as a member of the Leopold-Caroline Academy*, and soon nominated as Adjunct. In

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Memorial speech for Johann Lucas Schönlein (1793–1864) 1819 he became a member of the Munich Academy; as such, was finally called to Munich, where in 1841, after long and productive efforts, he died. 23

On p 15. Criticism has been very sharp against this work too. Burdach** begins his account of its content with the following words: “Schönlein’s youthful work confidently postulates strange ideas as a view of nature. Especially in the (section on) history of culture, there is no talk of a harmonious development where the individual limb, by virtue of its essence, accords with the other one, and everything becomes what – according to its essence – it should become. But, in contrast, there is a war of all against all; where one crowds the other out, nothing is in its real place; almost the whole notion of the history of culture is in terms of turning things upside down; things crashing down on one another; and the crushing inwards of one thing by another”. This opinion relates more, I should say, to the lively, personalizing language of the young man himself, rather than the matter itself. For in fact nothing is to be found which would overall contradict the thought of things proceeding according to laws; (there is) nothing to contradict the idea of typical progress in the development of the brain and of the nerves. On the contrary, this presentation is everywhere a matter of actually showing this obedience to laws right through the entire range of animals. Originality in the facts themselves is on the other hand, only apparent on a few points. On the other hand, however, completeness in the review of the literature is the more laudable for the fact that, simultaneously, his own analysis of the value of this literature undoubtedly shines forth. The two copper plates – the originals of which are signed by Hesselbach – prove this in a striking way. They provide – the one as a full drawing, the other

* I might as well mention here that in 1852, on the occasion of its centenary, the Academy nominated me as a member with the name “Döllinger”. ** cf Burdach “Concerning the Construction and Life of the Brain”. Leipzig, 1822, vol II, p 240. e44 It was common for academic societies in Germany at the time to provide a Latin name for members. This may have been under some influence of secret societies but perhaps more likely it was a continuation of the early Renaissance habit of all biological scientists to take such names – e.g. “Paracelsus”, “Fallopius” and “Linnaeus”.

59

as a linear schema – pictures of a 3-month human embryo, the cerebellum of the sheep, the brain of a goose, and the cerebellar region of the bovine embryo. But Burdach’s reproach is unfounded in yet another way. Schönlein is quite rightly not simply intent on establishing the type of development. He has in mind, as well, the higher idea of finding – from the relationships of the developing individual parts to each other – the basis of the type which presents itself in the individual classes and types of animals.e45 The naturphilosophische ‘idea of the organism’ no longer satisfies him; he is not satisfied with the idea “that everything becomes what it should become according to its essence”. On the contrary, he finds that not everything becomes that which, according to its basic proclivity, it might become, and he tries to show, through the genetical (comparative embryological) sequence in stages of the various animal brains, how the more powerful development of individual parts hinders others from making the same more powerful development, or even from reaching the usual development. It was to be expected that he did not succeed in clearly demonstrating this reciprocal influence of the parts on each other. But that he dared the attempt at all is certainly to be highly recognized. Incidentally, the doctoral award took place during the presidency of the Dean at that time, Professor Heller. Those appointed to oppose the doctorate were Profs Döllinger and Horsch, as also the senior medical student, Heller. 24

On p 15. This period is difficult to clarify. Bach says about it: “In 1816 the young doctor made a journey which led him via Jena and Berlin to Göttingen and then he returned to his parental home in Bamberg. Here Dr Pfeufer, famous as doctor and scholar, was at that time director of the large and well-equipped hospital there, and introduced him to practice.” This may be correct

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Notes overall; but is it is incorrect in detail. We have already seen that the preface to his dissertation is dated from Bamberg, 15th of December 1815. He was probably at home for Christmas, and then returned to Würzburg for the doctoral ceremony. From there he apparently went first to Göttingen, above all to make the acquaintance of Blumenbach. We learn something of this from the correspondence between the famous philologist Jacobs in Gotha, and Schönlein’s e45 Hansemann used the same concept of the representative type (Bignold et al, 2007); it is a preDarwinian attempt to make sense of comparative embryology – see also Haeckel’s writings on Evolution.

previously mentioned (p 41) cousin Göller with whom already, as a student in Landshut, he had been in continuous correspondence. Göller writes to Jacobs from Bamberg on 31st August 1816 “I cannot deny my friend and closest relative, Dr Schönlein, the pleasure and joy of seeing and getting to know you in Gotha, which city he is passing through on his journey from Göttingen to Berlin. Thus he is the deliverer of this letter”. He continues further: “My cousin has acquired uncommon knowledge in the sciences and anatomy, and I am convinced that it will be a pleasure for you to make the acquaintance of this young man in his great efforts towards a scientific education. He will have the pleasure of showing you the test piece (thesis) which he will be defending in Würzburg”. Jacobs answers this from Gotha on the 25th of October 1816: “I have made the pleasant acquaintance of your compatriot, Dr Schönlein. He stayed for quite a while here with us, because he liked it here, and he has now gone on to Jena, where he will meet my second son. My elder son left Würzburg in September, and is now in Munich in order to go on from there to Vienna, to gain experience in the medical institutions there.”* From these letters, it is definitely clear that Schoenlein first went to Göttingen, and from there to Jena, where at that time, Oken and the naturphilosophische school, especially Kieser, enjoyed the highest reputations. Probably the relationship with Stark also dates from this period. However, it seems that the originallyplanned continuance of the journey to Berlin did not take place; at least I have not been able to find any record of it. I found just as little evidence of Schönlein being in Tübingen – which some people have assumed occurred around this time. On the contrary, it was still 1816 when he returned to Bamberg, where the elder Marcus had died and Pfeufer had taken over the direction of the general hospital. Neither can I find anything about a visit to Vienna in this period. However, I will mention here that, according to information from Richter**,

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*

Fr. Jacobs. “Miscellaneous Writings”, vol IX, pp 141, 146. C. A. W. Richter. “Dr Schönlein and His Relationship with More Up to Date Arts of Healing”. Berlin, 1843, p 15. **

Schönlein’s first presence in Viennae46 came at the time when Wagner was responsible for pathological anatomy there, and where Rokitansky was his Assistent and Prosector. The same reliable source also reports that from then on, Wagner maintained a very close and friendly relationship with Schönlein, and came to know and esteem his theories and views – more than any other German scholar of the time – partly from direct contact with him, and partly from Schönlein’s well-edited lecture notes which had been obtained for him from Würzburg. For this reason, Richter attributes the upswing of the pathological anatomical school in Vienna to the school in Würzburg. In any case, it can be taken from this that Schönlein’s first visit to Vienna probably occurred in the 1820s. 25

On p 16. I provide these notes – as also some later ones – from my own lecture notebooks, which I myself wrote down with great care in Schönlein’s lectures in 1841–2.

26

On p 17. At this point is it justified to give the names of Schönlein’s Assistenten at the Julius Hospital in chronological order.

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Memorial speech for Johann Lucas Schönlein (1793–1864) 1) Carl Weikard from Gersfeld, 2) Carl Fr. Marcus, from Bamberg, 3) Carl Medicus, from Königshofen, 4) Joh. Bapt. Herz from Würzburg, 5) Conr. Heinrich Fuchs from Bamberg, 6) Fried. Mosthaff from Würzburg, 7) Carl Pfeufer from Bamberg, 8) Erh. Schauer from Bamberg, 9) Bernh Mohr from Würzburg. Of these, Marcus – Schönlein’s successor in the Würzburg chair – Fuchs and Pfeufer are well known as clinicians. Mohr was later Professor of Pathological Anatomy at Würzburg, and my immediate predecessor there. Herz and Mosthaff were active, esteemed doctors in Würzburg and Munich: the former died as these pages were being printed. Schauer died early as a practicising doctor in Bamberg; he wrote the treatise “On the Connection between the Catarrhs, Rheumatisms and the Acute Exanthemata”, Würzburg, 1830, which, like Herz’ inaugural lecture on “The Pustule (Fliesel) and its Treatment”, Würzburg, 1827, provides valuable insights into Schönlein’s clinical comprehension at that time. e46

The Bamberg Library possesses the clinical diary – eight to nine hundred pages of large folio – in which Schönlein recorded in his own hand all patients treated by him in the clinic from May 1819 to December 1829, documenting name, class, age, illness, admission and discharge, and whether cured, improved or died and so on. It is exclusively a summary table, the extent of which is easily appreciated when it is understood that every page has 33 lines. To this diary is attached the diploma by which the Faculty of Philosophy in Würzburg awarded Schönlein an Honorary Doctorate on the 26th of January 1826 – while Döllinger was Rector.

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27

On p 18. If I do not include Rudolph Wagner in this, it is because at least at the beginning, he belonged strictly to the naturhistorischen school. This is proved by his inaugural lecture: “The World-Historicale47 development of epidemic and contagious diseases and the laws concerning their spread”, Würzburg, 1826. – I should note here that a very lively description of conditions in the Würzburg clinic in 1826 has been left for us by Siebert.*

28

On p 18. The quotation in the text is taken from an obituary in September 1835, which Dr Philipp in Berlin had written about his teacher – believing him to have died – in the Vossischen Zeitung.e48 When Mr Philipp, after the news was established as false, sent the obituary to Schönlein, the latter replied “Your letter of the 9th of September gave me all the more joy, because it proved to me that I shall go on living at least in the memory of some of my listeners”. The news of the death became very widely known at that time. Schönlein had just returned from a journey to England (p 30), and from Bern, where he had stayed for quite a long time. He announced that between the 25th and 27th of August he would arrive in Zürich, where his mother, wife and two children should soon join him. On the 31st of August, they left Würzburg; on the same day, the Frankfurter Journal announced his death as a result of a stroke. And although on

*

A. Siebert, “Schönlein’s Clinic and its Opponents”. Erlangen, 1843, pp 21–24.

e47 e48

63

see Supplements to the Notes, “p 61, Note 24”.

This is quite specifically a Hegelian phrase. A moderately liberal newspaper, which continued into the twentieth century.

the 1st September, the Würzburger Zeitung published the correction – he had written to the paper in his own hand on the 30th of August – the news nonetheless circulated even more widely. There

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Notes still exists a letter from Schönlein to the Bamberg Librarian Jäck, dated the 5th of September, which stated:“I have just learned via the Allgemeine Zeitung that I have died. In order to spare you the – for the moment unnecessary – trouble of an obituary, you are now receiving from your living and life-loving Schönlein.” He wrote to the same address on the 16th of October 1837: “In the last parcel, you will also find some numbers of the ‘Homeopathic Newspaper’ from Allentown, in North America, which I am telling you about, because you can find in it a detailed description of my funeral ceremony, with a eulogy in French. What is piquant about the whole farce, however, is that this proof of sympathy went forth from a Homeopathic Society”. 29

*

On p 19. It may be sufficient here to refer to the judgment of one of his sharpest opponents. Wunderlich,* at that time in open opposition to Schönlein, said in a review of Schönlein’s clinical lectures: “Schönlein – Autenrieth’s pupil and successor in spirit – understood how profitably to equip German Science with advances made abroad, and to complement his own knowledge with foreign material. Auscultation and pathological anatomy were accepted in his clinic; his nosology was based on the material changes in illnesses – on the definite, provable anatomical lesions. The progress of more modern times to objective factuality – to material definitiveness – was first clearly understood in Germany by him, and clinical procedure was changed accordingly. Thus Schönlein has transplanted into Germany that positivity which was already general knowledge amongst our neighbours. Everything which made sense to our neighbours streamed into his Würzburg clinic, in which they (the staff) not only taught and professed authoritatively as in other places, but in which one learned to use one’s senses to monitor concrete cases, and in which one learned to trace phenomena back to material disturbances. Thus he shaped a whole generation of practising doctors, who in a few years took away with them more experience than

Wunderlich, Archiv f. physiol. Heilkunde 1843, vol II p 292. the old dynamists had done in fifty years of practice. His descriptions of disease owed their famous – and since-then unparallelled – fully rounded quality and their acuteness to the same tendency. And if, nevertheless, a certain naturphilosophische flavour of the Würzburg and Jena schools still adhered to the whole man, one gladly overlooked this as not an intrinsic part of his quality, or benevolently took it as a witty and peculiarly German arabesque around the prosaic text. Schönlein’s merit was to lead things back to the facts. This was the achievement of his clinic and his school, which, however, soon began to be sought and esteemed just as much as for the magic attraction of it fame as for its real achievement”. Pfeufer* – earlier Schönlein’s Assistent and successor in the Zürich Chair – says of him: “When Schönlein proceeded to review pathology, he found that the ‘inflammation theory’ was very generally-accepted as a basis of explaination for the most various pathological processes. Thus his mission was to prove the differences between the disease processes – a mission which he based particularly on work by Autenrieth. He not only succeeded in this, but also – on account of the energy of his intellect – used it as a battle-winning weapon vis à vis the philistine assumptions which vainly hid their lack of inner life under learned (meretricious) rubbish (Plunder). It never occurred to Schönlein – who best of all knew the difficulty of the task – to regard his work on this mission as something complete in all aspects. Indeed, perhaps he regarded this ‘completion’ as not even necessary, and therefore he resisted the many kinds of demands which were made on him from opposing sides. What was possible for Schönlein to achieve with his system he did so fully, and he is not to be blamed if the foam bubbles of his intellect – which are given off by all significant fermentation processes – have been hawked around by blind supporters and ugly opponents as the fruits which might typify him. Not the least of his merits was the foundation of a clinical school at a time when the name (“clinical school”) was scarcely known.

*

C. Pfeufer. Zeitschift f. rationelle Medicin, 1844, vol I, p 54.

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Memorial speech for Johann Lucas Schönlein (1793–1864) 65

30

On p 21. As far as I am aware, the natural scientific objects which Schönlein collected were mainly palaeontological specimens. Professor Alexander Brown informs me that when he visited Würzburg he found Schönlein in possession of fossilized plants from the Keuper (Red Marl) formation there. He had pictures made (by Hohe) of the most interesting pieces. Later on, he presented part of the collection – perhaps even all of it – to the Mineralogical Museum at the University of Berlin. The pictures he gave to Count Kaspar Sternberg for scientific use; the latter used several of them in his “Flora of the Primeval World”*. In it, there is an Equistites Schönleinii Sternberg – a gigantic horsetail of which, in 1829, Schönlein distributed pictures at the Conference of Natural Scientists in Heidelberg. Two ferns described by him as belonging to the Crepidopteris Schönleinii Prezel and Taeniopteris Schönleinii from Ettinghausen, belong – according to Schenk – to the previously-described Taeniopteris marantacea Brongn. (Thaumatopteris marantacea Schenk). Later on Schönlein willingly passed these pictures to Professor Schenk in Würzburg, for his studies of the fossil flora of the Keupers, although – as the latter tells us – in the last years of his life, he (Schönlein) had the idea of publishing them himself. At the moment Mr Schenk is engaged in publishing these plates and adding the missing text. Nothing in writing relevant to them has been found apart from some fragmentary notes which were probably written during his (Schönlein’s) time in Zürich. According to Schenk’s report, there are 13 splendidly executed plates, which he says will fill a considerable gap in the literature of Keuper plants. Indeed one could maintain without hesitation that they are the first more exact pictures which illustrate a large number of plants from this formation. In the Berlin Museum there are still a few more presentations from Schönlein, in

*Count

Kaspar Sternberg, “Attempt at a Geological-Botanical Representation of the Flora of the Primeval World”. Prague, 1838, ps 45 and 119. particular some interesting pieces from the Tertiary brown coal layer of the Zürich region. Next to the palaeo-ontological collection, his pathological-anatomical collection was of greater significance. In 1849–50 I found individual items from it still in Würzburg when I undertook the task of systematically organising the treasures of the collection, which had been neglected for many years. Most of it, however, went with him to Zürich, where it was set up as the basis of the museum which was about to be founded; and where it remains. According to a report from Professor Rindfleisch, in the collection there are particularly rare gall and urinary stones, aneurysms and preparations of intestinal diseases, as also a collection of forty different skulls. The latter, as far as I know from other sources, were collected partially in Switzerland itself from old ossuaries. Apparently the driving concern in this seems to have been the study of cretinism, as I have already set out in detail in another place.* Investigations of this kind had already begun in Franconia, especially in the ossuary of Iphofen. A pair of cretinous skulls from there – later described by Stahl** – are now in the Zürich collection. The best evidence for the Würzburg period is given by the treatises of Sensburg and Herm. Demme.*** In 1829–30 the latter – later Professor of Surgery in Bern – at Schönlein’s instigation conducted the autopsies at the Julius Hospital in Würzburg. In Switzerland these researches understandably received a new impetus, and it is probable that Guggenbühl’s efforts too achieved a certain encouragement from this. I do not know whether Schönlein assembled any other scientific collections, apart from

66

*

Virchow, “Collected Essays on Scientific Medicine”, Frankfurt, 1856, p 893. F. C. Stahl, “New Contributions to the Physiognomy and Pathological Anatomy of Endemic Idiocy (cretinism)” Erlangen, 1848, pp 35–38. *** Sensburg “Cretinism with particular reference to its incidence in the Lower Main and Rezat district of the Kingdom of Bavaria”. Inaugural lecture, Würzburg, 1825, note on pp 38. – H. Demme “Concerning Unequal Size of the Skull-Halves”. Pathological Anatomical Inaugural Treatise, Würzburg, 1831, note 7 on p 19. **

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Notes the paleo-ontolotical and pathological specimens. The only thing which is quite clear is that he obtained an amount of specifically zoological material from different parts of the world – and sometimes at considerable expense. In this respect, the way in which he cared for the natural historical collections in Bamberg will be clear from various letters which are noted below (Note 49). Here I will only mention that in many cases he supported young men who were undertaking journeys to distant parts of the world, so that they could bring new specimens back to him.e49 Thus Erichson* reports on a collection of insects from Angola which Schönlein presented to the Berlin Entomological Museum. This had been assembled by Ed. Grossbendtner who – primarily through Schönlein’s support – accompanied a Portuguese trade expedition, but thereby met an early death. 31

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On p 22. The expression “illness-” or “disease-process” originates in the time of transition from the naturphilosophischen to the naturhistorischen School. In the literature this appears first clearly and sharply defined in Stark**, who has frequently been included in the Schönlein School, when, after all, since 1815 he had given lectures in Jena on pathology in which, as he himself says, “He tried to establish validity for the naturhistorische significance of the disease process”.*** All the same, later on he had a very close relationship with Jahne50 who was quite definitely one of Schönlein’s pupils. But he cannot quite be denied the credit for the fact that he – to a great degree – worked out, independently, the views which took practical form in the naturhistorischen School, and in Schönlein’s general pathological doctrine itself. At least, when reading Jahn’s writings, I have always gained the impression that many a particular idea which goes under the label of the Würzburg School can actually be attributed to him.

* W.

F. Erichson, Wiegmann’s Arch f. Naturgeschichte, 1843, vol IX, p 201 Wilhelm Stark, “Pathological Fragments”. Weimar 1824. *** K. W. Stark, “General Pathology, or General Nature Theory of Disease”. Second edition, Leipzig, 1844, Preface. ** Karl

e49

Cf. Wallace and Darwin. Also Walter Rothschild (1868–1937) filled his museum at Tring, U.K. in this way. e50 see Pagel (1945). 32

On p 22. This peculiarity was most sharply defined by Schönlein’s favourite pupil, Fuchs. At the Natural Scientists’ Meeting in Braunschweig (1841) Häser* gave a lecture on the parasitic aspect of disease, and on the relationship of this concept to the tendencies of the so-called naturhistorische School. After it had concluded, Fuchs observed that the description naturhistorische School must be regarded as mistaken, insofar as the matter involved is not one of a system, and (involved) least of all of an exclusive idea held by a School. It was much more a matter of creating – for the present moment in the natural historical method in medicine – the same mode of application as in the other sciences.

33

On p 22. Siebert** – one of Schönlein’s most loyal pupils and subsequently Professor in Jena – expresses himself on these publications as follows: “Anyone wishing to acquaint himself with Schönlein’s teachings should not read the “Pathology and Therapy” published by several students. Indeed, in 1831 and 1832, two printings (Auflagen) by Etlinger appeared in Würzburg; and then reprints from the reprinte51 by various publishers in the Rhineland, in Austria and in Switzerland. In 1838 there was a third edition (Ausgabe) in Herisau, and an English translation and a French translation in Paris via Dupuytren’s nephew. But they are all valueless and the lamentable circumstance arises, that many true and good teachings from Schönlein’s mouth appear with fatal misunderstandings, corruptions and nonsenses all mixed up together”. Furthermore, Siebert refers to a man “who, next to Schönlein, must be the best informed” – apparently Fuchs in Göttingen. Fuchs relates: “The students R and H (not Schönlein’s pupils but in Würzburg in the first semester of 1831) took on the task in order not to have to write the booklet themselves.

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Memorial speech for Johann Lucas Schönlein (1793–1864) They undertook a printing of one hundred copies for students, at a subscription price of seven florins, (of material) from notebooks which they borrowed from various student comrades (especially K., H. and A.) and dating from the most various times. e51

thought to refer to the 1832 printing.

69

As soon as he heard through me about these publications, Schönlein stepped in and threatened legal action. The student R. promised to cease publication after 25 pages, but sent the remainder of the manuscript to Erlangen, Bamberg and Nürnberg. A few weeks later this scribble left the press and was distributed to one hundred students, but R. and H. had left town. Etlinger got hold of one of the first copies and reprinted it (as a second edition); no one considered corrections by any actual medical person. Schönlein’s legal case with Etlinger began. The third and fourth printings are reprints of the earlier one with only typographical errors in part corrected”. Mr Eisenmann gave me a rather similar account. According to him the relevant students had given the manuscript to the printer Thein. Then Eisenmann – who heard about the matter from Thein – drew Schönlein’s attention to the fact that individual students had paid up to sixty to eighty florins for a complete copy of his lecture notes. Eisenmann proposed to Schönlein that the latter might like to undertake the editing of these books himself. And he further proposed that after Schönlein had checked them, Eisenmann should publish them under Eisenmann’s own name, but in such a way that the royalties came to Schönlein. But the latter declared decisively that he could not enter into this “as his achievements hitherto are still so insufficient for them to he laid before the greater medical public”. Thus it came to a reprint from Etlinger, who did indeed lose his case against Schönlein, but who at the same time made a great profit from it. The later reprints too, seem to have happened with Etlinger’s involvement. At least, in 1833, Schönlein writes in a letter from Switzerland: “Here too Etlinger continues his tricks, but with little success. I have thus had the enclosed explanation printed in the Swiss press and I should be very grateful to you if you would send it also to the Nürnberger Correspondenten and to the Frankfurter Journal”. The Würzburg edition bears the title: “General and Special Pathology and Therapy, Written Down from J. L. Schönlein’s Lectures, and Published by one of his Listeners”. Four

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vols, second improved edition. Würzburg; commissioned by Etlinger’s Bookshop, 1832”. The student R. – noted in the previously mentioned letter – is, according to information received by me, the same Carl Ludw. Reinhard, who later also had Autenrieth’s lectures reprinted (note 36). Apparently he made a business of this. In 1841, moreover, there appeared in Moscow a Russian version by Gregor Sokoljskenny (sic) of Schönlein’s nosography according to his lectures in Würzburg, Zürich and Berlin. Most* attempted an extensive – but more learned than fruitful – presentation of the fundamental views in the earlier lectures. Bach** reports, by the way, that during his Zürich period Schönlein seriously considered publishing his “Pathology and Therapy”. A contract was evidently concluded with Reimer’s bookshop in Leipzig, or was close to being concluded, and the book was announced with the title “Natural History of European Diseases” at the Leipzig Fair.e52 But apparently the matter proved abortive. 34

On p 23. This book appeared with the title “Dr J. L. Schönlein’s (Professor in Berlin), The Typhus Group of Diseases. Written Down and Published According to his Lectures by one of his Listeners”. Zürich, 1840. This book is very likely based on lectures which were given in Zürich; at least the phrase “here in Zürich” (p 15) occurs repeatedly. Also mentioned are crystals in the gut and its expulsions (vomitus and diarrheal fluid). To that extent it is of some interest for the characterisation of a particular period. For the Würzburg period Magnus’*** inaugural lecture is of incomparably greater significance. Schönlein’s marked concern with the Typhuses is probably

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Notes *G. F. Most, “On

Old and New Systems of Theory in general, and particularly on Dr J. L. Schönlein’s most recent Natural System of Medicine in particular”. Leipzig, 1841, p 283. **Bach op cit, p 21. *** Martin Magnus, Inaugural Dissertation. Med. “On the Typhus Abdominalis”. Wirceb. 1828. e52

Leipzig has had a major trade Fair, including books, since the Middle Ages.

explained in part by the circumstance that great epidemics of wartime typhus occurred specifically while he was a student, which gave him opportunities for practical experience in them*, and that – in particular through the elder Marcus – discussion of the inflammatory nature of this disease had become very lively. 35

On p 23. I have propounded the distinction mentioned in the text between formative, nutritive and functional disturbances, in that – guided by the study of the more-detailed life processes – I** was led to the necessary separation of simple phenomena of the cellular elementary-organism, according to the three fundamental directions of their activity. A similar interpretation must necessarily have been basic to Schönlein’s classification. For the blood will always seem to be the representative of the nutritive and the nerve the representative of functional processes. And if Schönlein, in addition, proposes indifferent animal material – the zoogen – as the representative of the formative (“morphotic”) processes, then one can recognise (his idea) all the more, because he apparently regards the formational mass in the fertilized egg as a type of the zoogen. For after all, Döllinger had already nominated the granular primal tissue as the beginning of all organic formation, in which the grains (our present “cells”) are held together by a simple mucous material.***

36

On p 24. Johann Hermann Friedrich von Autenrieth (1772–1835), Professor and Chancellor of the University of Tübingen, published various physiological and practical writings, but he never published his lectures on special pathology and therapy. According to Häser# however, a two volume work by Reinhard## – appearing likewise in Etlinger’s bookshop and thus probably

71

* Güterbock, “Schönlein’s ** Virchow, Archiv

Clinical Lectures”, Berlin, 1842, p 451. f. path. Anat. etc, 1858, vol XIV, p 13. “Cellular Pathology”. 3rd edn, Berlin 1862,

p 268. *** Ph. von Walther, Address on Döllinger, p 90. # Häser, “Textbook on the History of Medicine and of People’s Diseases”. Jena, 1845, p 730. ## “Special Nosology and Therapy. According to the System of a famous German Doctor and Professor”. Edited by Dr Carl Ludwig Reinhard, Würzburg, 1834. without authorization – is to be attributed (to Autenrieth), and for this there is much factual evidence. In many details Schönlein followed Autenrieth’s procedure. The theory of abdominal typhus – from neurophlogistic inflammations, from scabious metastases (Krätzmetastasen) – has passed from Autenrieth to Schönlein without one being able to say anywhere by which path. As mentioned earlier, Schönlein was not actually a pupil of Autenrieth, but only a follower; at the time when I heard him he still held Autenrieth in high regard. Mr Eisenmann believes that Schönlein was able to obtain Autenrieth’s lecture notes and that he zealously followed up the Tübinger Blätter für die Naturwissenschaften und Arzneikunde (1815–1817; edited by Autenrieth and Bohnenberger), and also noted the dissertations produced under Autenrieth’s supervision. 37

On p 24. In my little piece on Goethe,* e53 I wrote about Kielmeyer – Schiller’s fellow pupil, Goethe’s friend and Cuvier’s teacher. Recently Mayer** published something of his own experience.

38

On p 24. Earlier on we mentioned Joh. Nepomuk Ringseis, b 1785 in Cham in the Upper Palatinatee54 (ps 49 and 53). We let him tell us how for seven years he was, Walther’s pupil in Landshut. He was there at the same time as Schönlein. I do not know whether the two of them

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Memorial speech for Johann Lucas Schönlein (1793–1864) interactede55 significantly or not. I can only say that while Schönlein followed in Walther’s footsteps, Mr Ringseis followed Röschlaub’s. As was mentioned earlier, in 1813 the latter wrote the Introduction to Ringseis’s first work, “On the concordance of the theories of Hippocrates and Brown”. The words at the end of the teacher’s Introduction are significant: “In regard to these one could hardly make a more worthy introduction than that which, created by the ingenious author of this book, is transmitted to readers” (original in Latin). Mr Ringseis lived up to these expectations at least with respect to Röschlaub’s person, in *

Virchow, “Goethe as Natural Scientist” (1861) p 123. Mayer. Archiv der Heilkunde, 1864, p 353.

**

e53

See also chapter 6 in Roberts (2002) (on Kielmeyer). Part of current Bavaria near the Czech border and including part of the Bavarian Forest. e55 gerathen means “to get into” something (usually of a negative type). e54

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that – after the dissolution of the University at Landshut – he obtained for his teacher (Röschlaub), who had aged even more intellectually than he had bodily – a comfortable position in Munich (p 48). Much less happily, however, did the relationship with his other teacher – Walther – develop. In 1830 the latter had been called back from Bonn to Munich. Ringseis – who had meanwhile accompanied Crown Prince Ludwige56 on his journeys to Italy, and who had been with him during all the latter’s various stages of development, and who had gradually become Professor, Senior Medical Councillor and personal physician of the King, entered – with Görrese57 – into the front ranks of the Ultramontane campaigners. It was especially in the State Assembly of 1837, in which he sat as a deputy for the University, that he openly revealed his views which were directed towards a Medieval “Restoration”.e58 With Ringseis in this position Walther soon became powerless and in 1837 he found himself forced to give up the surgical clinic and thus to acknowledge defeat. The (Napoleonic) reformation in Munich had to yield to the restoration.e59 Indeed when Walther, tired out by his labours, finally closed his eyes, Ringseis could not resist giving his memorial address in the Academy (p 49). He used this opportunity in order to depict the modern direction of science – which was so essentially a work of the deceased – as completely wrong and unsuccessful. Only the living are right! The “Prince in Art and Science” – as with hypocritical emphasis he called the great surgeon – had gone. But they had still not been successful in chucking down the “Grand Prince”. Indeed in 1833 Schönlein had had to flee their common fatherland, and there was a moment when Mr Ringseis was able to blow his trumpet loudly and proudly in triumph. On the 18th of December 1833, as newly-appointed Rector of Munich University, he gave his inaugural address: “On the Revolutionary Spirit in German Universities”. It was here that he raised on high the banner of faith over State and Science. He did not speak like the merely conservative and reactionary party-members; he went so far as to say: “Princes and peoples, with their Estates (in the sense of the ‘Three Estates’ of society in medieval times), are there by the grace of God; Princes and peoples have their rights and duties from God”. In his sense the State should be ordered as a corporation, and in it both Princes and commoner, should be subject to the Church. e56

Became King Ludwig I, see editors’ note on text p 24, and Gottfried (1979). See chapter 2. e58 This is an emotionally-charged phrase because it refers to the fact that between 1815 and 1848, European governments abandoned the ideas of the Revolution and the Napoleonic reforms in favour of the old ideas of monarchical despotism. 1837 was the same year as the affair of the ‘Göttingen Seven’ (academics there being dismissed for political views). In Virchow’s style here there is much controlled rage. e59 of the despotism of monarchy and the Church. e57

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Notes “Since the spirit of unbelief – in getting hold of all theory and practice – has brought forth disobedience in the form of innumerable misbegotten excremental progeny (Aftergeburten), only belief in teaching and in life can awaken obedience and destroy the snakes’ spawn of disobedience”. The actual representatives of this snake-spawn, were for him, Rotteck and Schönlein, who had now been driven out of their Professorships. How indeed he triumphed! Unfortunately the triumph was short-lived and incomplete. Resentment grew when he saw that the fugitive teacher in Zürich was once again able to attract a large circle of pupils around him, whilst the University of Munich became ever more isolated year by year. And when, finally, the invitation to the University of Berlin accorded his hated opponent the greatest medical influence in Germany, then the chalice of Ringseis’ spite overflowed. But here we do not want to anticipate too much the text which will soon give us the opportunity to return to Ringseis. It may be sufficient here, for the sake of the opposite view, to quote a passage from an address by Phil. von Walther*, because what it says about the despot also applies to the Hierarchy: “Tyrants, and the contemptible tools of their hated power, usually honour the sciences with their fear and persecution of its admirers and practitioners. It is well known what influence they have on free thinking, and that every free development of the human spirit threatens their power with total destruction. The Tyrant of Corsica too, after he had brought the European continent under his rule by force, gazed with a kind of fearful anxiety at all institutions of learning. The German universities particularly – because of their predominating free scientific spirit – were striking anomalies in his realm of comprehensive killing of the intellect. He had certainly only destroyed one of theme60; but all of them would have died slowly had not divine Providence released the physical and moral forces of the world against him”. 39

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On p 26. I take these little-known facts from two private letters of which I was most kindly

*Ph.

von F. Walther. Address for Bertele, p 29.

e60 Virchow

may be referring to the University of Halle (see text p 86), but many other German universities, including Bonn, Landshut and Mainz, closed in the same period. informed. His father-in-law reports that on the 30th of January 1833 Schönlein had received a call to the Chair at Zürich, and thereupon had asked for his release (from the University in Würzburg). On the 21st of February 1833 Schönlein himself wrote from Baden in the Aargaue61: “Life in Zürich pleased me more and more with every day, and it was only with difficulty that I was able to tear myself away in order to use the leisure granted to me for a spa cure. The Hospital is large and well-funded, but will need to be enlarged because of the (social and political) changes offered by the political reformation.e62 In this all parties are united, so that I do not fear encountering any great hindrance. The proofs of respect and trust which are given to me by people of all political colours are most encouraging, and constitute a screaming contrast to the brutality with which I was treated in Bavaria. I have told you earlier that essentially I am really happy about recent events, and everything confirms me in this view. Removed from the little political irritations, I hope here to live a fruitful scientific life. Zürich is rich in excellent, stimulating and highly sociable men, for example the historian Hottinger, the world circumnavigator Dr Horner, the philologist Orelli, as well as Gerlach, Linth and Escher”. In a postscript he adds; “The enclosed article is from the Aargauer Volksblatt edited by Troxler. Contrary to this, the Baselers have already given me a little kick, as one who ‘smells of demagogy’”. The Zürich government had been negotiating with Seufert too.

40 e63

On p 26. Bach* says somewhat ambiguously: “Even if Schönlein was at that time, one of the numerous sacrifices claimed by the ‘Reaction’e64, the widespread and much believed assumption that he went to Switzerland as a political refugee is incorrect. It is quite possible that he too, had he stayed longer in Bavaria like many of his friends, would have been drawn along with them into the complicated rats’-nest of political processes in Bavaria at that time. But he was never directly

107

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Memorial speech for Johann Lucas Schönlein (1793–1864) accused or persecuted”. What is true about this account is that Schönlein did not flee to Switzerland, but to Frankfurt. There he waited for the situation in Zürich to be organised, and thus, literally-interpreted, did not go directly as a political fugitive to Switzerland. But I have heard from various contemporaries that he did flee Würzburg in the manner given here. The *

Bach, as cited before, p 16.

e61

This is a part of Basel Canton in Switzerland Switzerland was suffering increasing internal religious/political tensions at the time culminating in 1847 in a war between the Catholic and the (Zwinglian) Protestant cantons (mainly Basel, Berne, Zürich). This was resolved only in 1848 by the creation of the Confederation which continues to the present day. e63 This section is extensively revised in Supplements to the notes, “p 76, Note 40”. e64 A common term for the “conservative/clerical reaction against liberalism after 1815”. e62

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ugliness of the persecution of the Würzburg liberals stems mainly from the Minister for the Interior at that time, Prince von Oettingen-Wallerstein – subsequently head of the Bavarian opposition (during the revolution of 1848). It is said, however, that the denunciation itself emanated from Würzburg. In particular, a member of the University – Professor F. – was accused (of the denunciation). On the other hand, it would probably be true to say that Schönlein would have been removed from the Chair even if his presence in Frankfurt during Rauschenplatt’s assassination attempt had not created the suspicion that he and Seufert (in 1831 Vice President of the Chamber of Deputies, and then transferred to the Court of Appeals) had taken part in the attempt, and were even its instigators. Thus the order for their arrest was issued, but Schönlein avoided it by flight. That in spite of this flight – which he never attempted to conceal later on – he had a clear conscience (in relation to the attempt) is shown by the fact that he remained in Frankfurt, where the Senate – which at that time was very compliant (vis à vis Bavarian authorities) – would not have given him any protection had anyone taken the accusation seriously. For judgment of the circumstances at that time, however, a letter of the 23rd of April 1833 from State councillor Hefner in Würzburg – Schönlein’s father-in-law – is very typical, in so far as it immediately bears unimpeachable witness to the great reputation which Schönlein already had at that time: “I am sorry that Schönlein could not come here. The same horses which waited for him to board (the stage coach), brought him to Mannheim. It was a result of two letters which he had received at the moment of his departure. One was from Prince Wittgenstein and contained the urgent request to visit his sick wife in Mannheim, and to spend a few days there. The other – from an anonymous friend – was the most pressing request not to expose himself to any vexations from the Bavarian police and courts. He had been, namely, in Aschaffenburg on two occasions – visiting the sick Mr Bolongaro – and wanted now, during his journey, to call there again. Annoyed and warned verbally from embassies (in Frankfurt), he departed for Mannheim.e65 In Frankfurt, as people at the Fair related, the coaches drew up in front of his inn at the e65

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This account is significantly altered in the Supplements, see document page 172.

early hour of eight in the morning, as if a great Prince were living there. And if had he gone out on foot, he would have been surrounded – as previously Hohenlohe had been – by a crowd of people. Rothschild – whose niece had been cured by Schönlein, not by Hohenlohe – is said to have paid him a more than princely sum. On this day at half past five in the morning his wife along with her child, and with Miss S. and a maid, took off in good weather for Zürich, where, a month later, Professor Seufert will visit them. This was not yet to stay there, but only to scout the lie of the land”. When, later on, Schönlein received the call to Berlin, King Ludwig of Bavaria did indeed say to a deputation – headed by State Councillor Heffner – which had come to Brückenau from Würzburg; “Schönlein did not really need to run away from Bavaria so suddenly”.

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Notes 41

On p 26. Concerning these times, compare Bruno Bauer’s “History of Party Conflicts in Germany”, and especially, by the same author, “History of Constitutional and Revolutionary Movements in Southern Germany”. Charlottenberg, Berlin, 1845, vol II ps 110, 126, 197, 218, 243; and vol III, ps 59, 86, 95, 256.

42

On p 26. Mr Eisenmann writes to me concerning Schönlein’s political position: “In his political attitudes, Schönlein was decidedly liberal in the constitutional-monarchist area. He made no secret of this attitude and it was generally known, even if he did not position himself in the foreground as the leader of a party. He did not write anything for the Bayerische Volksblatt, but he gave moral support to my enterprise and had close friendly relations with the two law professors Seufert and Brendel who did much for the Volksblatt, as he also had with Mayor Behr, who, however, produced only a few articles on the problems of the city”. Mr Eisenman adds that he himself had only occasionally visited the Geist beer house in the Kühgasse – partly intentionally and partly because he was already ill – but that nonetheless, the group was denounced to King Ludwig as being a revolutionary club associated with the Volksblatt.

43

On p 26. Carl Friedr. von Marcus was born on 2nd September 1802 in Bamberg*. His relationship to Adalb. Friedr. Marcus is not quite clear. According to suggestions of the biographers** he seems to have been an illegitimate son of the latter. At any rate, shortly before his death, old Marcus legally adopted him. In 1817 he entered the University of Würzburg. Even before his doctorate he obtained the post of Assistent with Schönlein, which he occupied for fully three years. In 1822 he obtained his doctorate under Döllinger, but soon afterwards he was hit by political persecution. Edel*** says of this in his memorial address: “The prevailing patriotic trend of youthful enthusiasm at that time led Marcus to the nationwide German Burschenschaft, where as spokesman for the Würzburg Burschenschaft he proved his eloquence in those youthful circles. More by the efforts of others than by his own, his name became associated with the leadership of the newspapers of the (liberal) parties. As a consequence he was subjected to a criminal investigation because of participation in a treasonable society. This led to his arrest, his transfer to Munich, and thirteen months imprisonment in the Neuthor Tower there. The investigation ended without result”. From 1825–1827 he was Assistent at the General Hospital in Munich under Grossi and Ringseis, then for a short time police surgeon, and then, on the 30th of October 1832, he was nominated successor to Schönlein. “It was painful to Marcus’ sentiments and sense of justice”, says Edel “to take the place of a teacher with whom he was friendly and whom he honoured (because) this post had become available to him by arbitrary political force”. Jäck reports that Marcus often assured Schönlein that he was “suffused by life-long gratitude in spite of contrary rumours”. Certainly, under such circumstances it was difficult to assert himself in the chair which he had obtained in such a way without arousing mistrust. For Schönlein’s zealous

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* Wegele (“The Reformation of the University of Würzburg”, p 20), probably erroneously, gives Würzburg as the place of birth. ** Marcus and Speyer, op cit, p 20, note. Jäck. “Second Pantheon”, p 82. *** Edel, Würzburg Med. Zeitschr. 1863, vol IV, p XXXVII.

supporters did not hesitate to cry open treachery. Siebert* exclaims: “O! There was many a false apostle in Schönlein’s clinic at Würzburg, who held the still blank career card in his pocket. And the extent of future promotion – still to be inscribed upon it – depended on the zeal with which he betrayed the master. When Passion time (the week before Easter) approached, one after the other, they announced themselves, and vied with each other in denying him (Schönlein) – and to the same degree as they had lusted for the crumbs which fell from their (previous) master’s table.e66 But those who were thus blessed did not only deny, but also gave witness against him whom they had betrayed, and made a paraphrase of Mr von Ringseis’ words: “These Nature Worshippers mistreat the same Nature just like a cheap harlot – impudently experimenting with

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Memorial speech for Johann Lucas Schönlein (1793–1864) human lives as if human beings exist because of their so-called Art and Science, and not the latter on account of the human beings”. A paraphrase of Ringseis’ words came from a speaker in the same lecture theatre where some years previously he (the speaker) caught up the words from Schönlein’s mouth and wrote them down zealously, but where now he bore witness against Schönlein to whom he owed the only good rags in his whole patchwork of rubbish”. How much of this reproach is fact I cannot judge. Probably the most immediate suspicion was directed at Marcus because after his release from gaol he had been Ringseis’ Assistent. From my own knowledge, I can only say that Marcus always spoke of Schönlein with the greatest recognition and respect. 44

On p 27. Nothing describes this new state of his spirit better than the letter which Schönlein wrote from Zürich to Bamberg on the 5th of December 1833, and which we will quote later (note 49).

45

On p 28. Hermann Lebert from Berlin, presently Professor in Breslau, belongs to the earliest phase in the Zürich period. In 1834 Schönlein wanted to send him with Dr Jäger (from Stuttgart) on a scientific expedition to Mozambique. The plan failed because of Jäger’s death in Paris.

*

Siebert. Häser’s Arch. 1842, vol II, p 239. This religious analogy has a particularly Lutheran/Biblical ring.

e66

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46

On p 28. Wilhem Griesinger, at present Professor in Zürich, soon intervened actively in the disputes between the medical schools. In the Archiv f. physiologische Heilkunde – which he founded and supported with Wunderlich, Roser, and Vierordt – the youthful opposition entered the lists. This opposition was immediately directed against Schönlein too, and they presented a front against the naturhistorische School in the form that had been propagated during the Würzburg period. Mr Griesinger’s article “Mr Ringseis and the naturhistorische school” simultaneously struck at both sides, and after he had criticised both as unsatisfactory, he turned from the naturehistorical school to the master himself, in order to condemn his method too.* It is not to be denied that this criticism was provoked by the often immoderate eulogies of the “School”. But at that time, it appeared doubly sharp because it was aimed mainly against the nosological systematist. In this it targeted that side of Schönlein’s essential thinking which those who had seen him at the sick bed and as teacher must have realised was trivial.e67 Later on, Mr Wunderlich** himself firmly emphasised this.

47

On p 29. The essay has the title: “On crystals in the alimentary canal in typhus abdominalis. From letters to the editor”. A table with excellent diagrams is added as amplification.*** It contains at the same time, under figures 13–17, uric acid crystals from diabetic urine. Schönlein had not clarified for himself the chemical nature of these ‘typhus crystals’ – he was inclined to take them as calcium phosphate, as is supported from reading the anonymously-published lectures#. He says as follows concerning their significance: “The discovery of a particular crystal system in the process of typhus disease widens the circle of pathic processes, for

*Arch

f. physiol. Heil. Edited by Roser and Wunderlich, Stuttgart, 1842, vol I, p 81. Arch f. physiol. Heil. 1843, vol II, p 294. *** Arch f. Anat. Physiol. u. wissschaftl. Medicin by Johannes Müller, 1836, p 258, Plate IX. # Schönlein’s “Diseases of the Typhic family”. **

e67 i.e. Because the topic of attack was trivial, the attack was presumably a personal one directed at Schönlein.

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which crystal formations are characteristic, in a way which is all the more pleasing for me. This is because this new part in the sequence of crystal-building processes seems to allow us to see in a new light especially, the relationship of the latter to the former – for which formation of epi- and

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Notes endozoa, as well as epi- and endophytes is indicative and characteristic.e68 – Thus he writes on the 23rd of November 1835. In a postscript on the 15th of April 1836 he adds original details, and points quite particularly to the diagnostic significance of his finding. Nothing can be more characteristic than this little note. Primarily it is always the clinician who is seeking stricter diagnostic characteristics. In doing this, he brings in the more refined aids of microscopic and chemical study. Of secondary importance, the theoretician – educated in the nature historical school – appears; he compares the form of these crystals with that of other mineralogical formations, and is inclined to evaluate his findings for the purposes of completing the natural system of diseases. Certainly, both have been found to be not quite accurate. Further examination of the crystals showed that they consist of phosphoric acid-ammonia-magnesia (the so-called triple phosphate). Their significance for the diagnosis and classification of typhus has been especially shaken by Gustav Zimmermann*, who provided the proof that – even if these crystals occur more frequently in typhus than normally – they still belong more to the decay of animal substances in general than to any particular disease process. Nonetheless, their discovery will always have validity as a praiseworthy sign of the care with which the “natural history” of diseases was studied at that time in Zürich. 48

*

On p 29. The small note on the Porrigo fungus** is so characteristic that I give it here in toto. It has the title: “On the pathogenesis of the impetigines. Excerpt from a Letter to the Editor”. It reads as follows: “You doubtless know of Bassi’s fine discovery on the true nature of the Musardinese69.

Zimmermann, Caspar’s Wochenshr. 1843, no 42. Archiv für. phys. Heilk. 1846, vol V, p 631. Schönlein, in Müller’s Arch, 1839, p 82, Plate III, Fig 5.

**

e68 e69

this is part of blastema theory – see Rather et al (1986). particular fungal diseases of insects.

To me this fact seems to be of greatest interest for pathogenesis, although, as far as I know, not one doctor has hitherto honoured it with his attention. Therefore, I had numerous silkworms which were suffering from the Muscardines – sent to me from Milan – and my experiments on them not only confirmed Bassi’s and Audouin’s data, but also yielded some other not unimportant results. Thereby I was again reminded of my view of the plant-like nature of some impetigines – a view which earlier had been greatly supported by Unger’s fine work on plant exanthemata. Because fortunately just at that time I had some cases of Porrigo lupinosa W. in the hospital. I set about closer studies and the first experiments at once left no doubt of the fungal nature of the so-called pustules. Enclosed is an illustration of the microscopic findings of a piece of pustule. At the same time I am sending some scrapings of Porrigo pustules – obtained with the greatest ease – from the upper layer of the corium of the skin from a patient. I am very busy with further examinations of this specimen, the result of which I intend to publish”. The attached picture is even today a perfect example, just as the observation was convincing in every respect. Mr Remak* later gave the fungus the name of Achorion Schönleinii. Schönlein’s hope that he would succeed in comparable fashion in fathoming the fungal nature of other skin diseases was not fulfilled, but other investigators following his path have been more fortunate. One can say that he has become the actual founder of the theory of dermatomycoses. Thus, specifically the study of Botany bore the greatest fruit in him. 49

On p 30. Let the following letters prove his mood. On the 23rd of July 1833, he writes from Zürich to the Librarian Jäck in Bamberg: “Sincere thanks for the news of our home town which you have

*

R. Remak, “Diagnostic and Pathogenetic Investigations in Geh. Dr Schönlein’s Clinic, Carried out at his Instigation”. Berlin, 1845, p 205.

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82

Memorial speech for Johann Lucas Schönlein (1793–1864) been good enough to send me from time to time. I must regret that you have recently got behind (in writing). Perhaps you would like to tell Lindner (Inspector of the Bamberg Natural History Museum Ex-Benediktinere70) that in the last few days a large collection of specimens – consisting of three crates and a barrel – has arrived from the Celebes. Most of it is already here, (or) sold in Turin, Vienna and Stuttgart, but some things will be left for our Bamberg collection. I have just one worry – that at some time, the Government could get the idea of plundering the collection as State property, and taking whatever they want to Munich. I would like to know that my donations are safe. Therefore, would you advise me. My idea is to make the newly-instituted Natural Historical Society the owner, and to demand that an inventory of my gifts is made – with the caveat that if the museum is ever dissolved, these specimens should pass to the hands of the Natural History Society, (and) concerning which I am also asking you for some news. I wish the same circumstances to pertain to the books which I deposited in the Library. I am still intending to add to them. Have you received the crates of books sent from Würzburg? Be so good as to prepare a catalogue of them and to get a stamp at my expense, with which all the books can be impressed. Thus stamped as my property, they may always find their place, for better use, amongst the books of the Public Library. These books, too, I wish to belong to the City, and especially to the Natural Historical Society. Will you be good enough to give me your opinion on this? Oken and Orelli send their warmest greetings. Please visit us for a few weeks in this splendid (city of) Zürich. Your obedient servant, Schönlein”. And on the 5th of December of the same year, when he again announces gifts for the Bamberg collections, he says: “If you read the newspapers, you will believe that at the University here everything is in ferment and uproar, and that the Institution is in danger of collapsing. Take the opposite of all that, and you have the truth. It is precisely the flourishing growth of the new institution which arouses this alarm and noise on the part of the opponents. The medical

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e70

an ex Benedictine monk.

institutions are advancing rapidly towards the greatest improvement possible, and the number of medical students is increasing so much that within a year I hope to see the amount of honorariae71 equal to that which they reached in the most rewarding period of my last year in Würzburg. And now above all, the free alpine air – what can equal this enjoyment! And in order properly to enjoy the rapture of my stay here, I take the excellent Bavarian Landbötine72 in order to remain in touch with the Learned Institutions, the just judgments, the paternal measures and in general, the good fortune and splendor of my previous home country.e73 You write that you have made a submission to the Government in the matter of my gifts. That was – to put it mildly – a little foolish. In this, they will again spot mockery and heaven knows what else on my part, and you may count yourself lucky if you receive no answer at all. I, at least, will not wait for the information, but will send off, in the near future, a box with Chinese and African insects as a Christmas present, which will soon be followed by a larger crate with natural history specimens and some smaller things for you. I would gladly send a letter for Lindner with them, if I only knew that this worthy man would not have some anxiety (about the contact with Schönlein), which – given his hope for the Ludwig’s Ordere74 – I indeed find very natural. Therefore I will wait for the right moment, when the honourable gentleman has nothing more to hope nor fear, and then write to him. My heartfelt thanks for Rüttinger’s (Lyceum Director in Bamberg and my former fellow student) masterly speech. By continuously sending documentation of the loyalty and attachment of the open and solid Bambergers, you will keep those monarchical attitudes ever fresh and alive in me, which do not always find the necessary nourishment and care from the activities and life of the inhabitants of my present place of sojourn. Oken and Orelli send their greetings, which are as warm as mine, Yours most obediently (ergebenst), Schönlein.

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50

On p 30. Bach* who, as a Swiss and a Zürcher, is a particularly competent witness for this

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Notes *

Bach cited before, p 22. This probably means fees (Hörgelder) paid by the students via the University to the Professor. e72 “State Messenger” newspaper e73 Probably sardonic. e74 A Royal Bavarian Government honour. e71

period, reports as followse75: “Schönlein’s Zürich friends wanted to bind him even more firmly to their city. To this man, to whom the Hochschule owed so much, and who – by refusing two very complimentary invitations (to Chairs) following rapidly on each other – had given the most appropriate proof of his attachment, they wanted – by the presentation of honorary citizenship – to give him a sign of recognition (not just from themselves but) also from the representatives of the entire citizenry. They seriously pursued this matter with the city authorities, and did indeed, in June 1836, persuade the city council to present a request with this purpose to the citizens’ Assembly. Quite against expectations, and to general astonishment, this request was rejected by a small majority – because Schönlein was a Catholic! It is possible that this disappointing result may be regarded as a preliminary tremor in the profound ecclesiastical-political earthquake which shook the Canton of Zürich so violently some years later.e76 But it is certain that Schönlein was deeply offended – and also equally certain that such an anachronism would be impossible in Zürich today”. That may be the case, but certainly being treated like this could not strengthen Schönlein’s feelings of being at home. In this one must not overlook the fact that he was told that a Catholic must pay 1,800 guilders for citizenship rights and that no exception could be made for him! In addition it should be noted “that the political storms – which were at that time raging through the Canton of Zürich – even threatened the existence of the University itself”. * And one can now understand how, when the summons came from Berlin, the decision would not be in doubt for long. The Royal Order of Cabinet, which proclaimed Schönlein’s appointment to Berlin, is dated the 14th of April of 1839. According to usual custom, he should have taken up his new appointment at St Michael’s Feast (Michaelmas)e77 but scarlet fever in his children, and his own pharyngitis delayed him for the winter. Finally he returned to his mother in Bamberg for several weeks. 51

85

On p 31. After its foundation in 1810 the medical clinic at the University of Berlin had initially

* Bach

cited before, p 23.

e75

The version is revised in the supplements to the Notes p 85 note 50. The reference is to the War between the Cantons (1847). e77 The 29th of September in Christian calendar. e76

been directed by Reil, who had lost his position at the University of Halle through Napoleon’s dissolution of that University. The medical clinic was formed in the house No 101, Friedrichstrasse.* Reil died soon afterwards of war-typhus and only in 1815 – with the summons of Berends from Breslau – was the institution reestablished at Nos 5 and 6 Ziegelstrasse. Berends died in 1826. After his death Sunderlin and von Stosch temporarily directed the clinic for a while, until Bartels arrived from Marburg in 1828. He had the merit of achieving the transfer of the institution to the Charité (1828) where, hitherto, only a clinic of the Military Academy (subsequently the so-called German Clinic) had existed. But he, like his predecessor, conducted the clinic in Latin, and in the old dogmatic style. Indeed, this custom was so deeply ingrained in him that – as he admitted himself – he dreamt in Latin. After his death Schönlein was invited to fill the chair. One can understand what changes his arrival brought about there. His reception was quite unusual. On the 6th of May 1840, he began his clinical lectures in the Charité. Even before 11 am – the usual starting time – the room in the Latin clinic was so crowded that the lecture was moved to the amphitheatre operation hall, which was soon full to the roof. Schönlein appeared to loud applause, accompanied by Dieffenbach and other friends. In his inaugural address, he tried to

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Memorial speech for Johann Lucas Schönlein (1793–1864) moderate the excessive expectations which had been made of his prowess, and indicated that the goal of his work was the return of medicine to its alliance with the natural sciences and philosophy. A few days later, on the 10th of May, a banquet was held for him in the Jagor Hall at which Joh. Müller – as Pro-Rector – gave the toast. At the same time the students organised a torchlight procession e78 with music, and sent a deputation to the feast. 52 *

On p 31. Relations with the Court began uncommonly quickly. The serious illness of King

R. Köpke. “The Foundation of the King Friedrich-Wilhelm University at Berlin”. 1860, p 257.

e78

A traditional German form of public approval or ceremonial celebration. See Haeckel (1923) for descriptions of such processions in Würzburg in the 1850s. 87

Friedrich-Wilhelm III brought this about quite naturally. After he had been suffering from a severe cold (Grippe) for a fortnight, on the morning of the 3rd of June the King had an attack of choking. Schönlein was added as consulting doctor to his two personal physicians, von Wiebel and Grimm. The entire Royal family gathered around the sick bed – even the Empress of Russia arrived.e79 It was natural that all eyes turned to Schönlein who was the most famous doctor of his time. Even the trust of the king himself – who was otherwise so unapproachable, and who withdrew shyly from any new, especially bodily, contact – was won over to Schönlein. But the strength of the invalid diminished very rapidly, and on the afternoon of the 7th of June, Whitsunday, he died. For quite a long time Schönlein withdrew to his ordinary position, but in the autumn of 1842, following Rust’s death, he was definitively appointed to the post as personal physician to Friedrich Wilhelm IVe80 and accompanied the King on his coronation journey to the Rhine and Neuenburg.e81 From this time onwards he was often claimed by service at Court. Initially he does not seem to have been quite free from the temptation to attempt political influence. At least it was he who brought about the much-discussed meeting between the King and Herweghe82. Later on, Schönlein kept a lower profile. All the same, like Alexander von Humboldt, he always had the reputation of being a representative of liberal views. It is known – although not discussed in more detail here – how subsequently his personal relations affected the views current at the Court in various ways. This was especially the case since the mental illness of the King necessitated a decisive intervention by the doctors in the destinies of the State. Bach* says about this: “During the King’s last illness, the situation of the doctors became extremely delicate because decisions concerning the most important legal and political questions of State depended on their opinion. This is not the place to go more closely into these things – here we shall just say that here too, Schönlein’s character again proved its sterling quality. He was simply * Bach

op cit, p 26

e79 The

Empress was born Princess Frederica Louise Charlotte Wilhelmina of Prussia (1798–1860), eldest surviving daughter of Fredrick-Wilhelm III (1770–1840); and became Alexandra Feodorovna after her wedding to the Russian Crown Prince Nicholas (1796–1855). e80 Friedrich Wilhelm IV (1795–1861). The constitution which he accepted after the revolution of 1848 remained in force unil 1918, after which it was markedly amended. e81 now Neuchâtel. It was then a small Hohenzollern possession in current Switzerland. e82 see editors’ note document page 30. 88

a man of honour. He was not a courtier; just a doctor and neither a diplomat nor a politician. Indeed, he received few thanks or recognition from the party which – in the name and under the Seal of the mentally impaired King – would only too gladly have continued to arrange matters according to their own lights and to serve their own interests. He, however, was able to maintain the upright stance of duty honestly done, and with head upright, withdraw from the scene”.e83 In Berlin, Schönlein’s social relationships did not in general develop to the extent which could have been expected in the great city, and there was not the intimacy (with anyone) which

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Notes one might expect from his earlier mode of life. Here I will only touch upon the particularly close relationship to the (now deceased) Meyerbeer and his familye84. For the rest, Schönlein always maintained a certain connection with Catholic circles, just as he was amongst the most enthusiastic and active supporters of the newly-built Catholic hospital. 53

On p 32. The clinical lectures* published by Güterbock relate in the main to the first two years (1840–1842) of Schönlein’s teaching activity in Berlin. They contain in their essence, highly particularised material; namely forty-two selected cases, the courses of which are presented in great detail. The teacher’s observations which concern diagnosis, prognosis and cure; on pathogenesis and aetiology, mostly refer to individual days of the disease, but are also often added in an organized overview. At the end of the work there is a series of more aphoristic remarks on individual points of special interest. This is the only larger and more coherent – I would prefer to say representative – account of Schönlein’s method of clinical practice. Although Schönlein himself – according to Siebert’s assurance** – had no direct part in the work,

*

“Schönlein’s Clinical Lectures in the Charité Hospital in Berlin”, edited and arranged by Dr L. Güterbock, Berlin, 1842, 480 pages. ** A Siebert, “Schönlein’s Clinic and its Opponents”, Erlangen, 1843, p 15. e83 Virchow used the archaic phrase aufrechten Hauptes konnte er von dannen ziehen – evoking the image of a medieval knight of old honourably withdrawing from the scene. e84 The composer Giacomo Meyerbeer (1791–1864), was a patient of Schönlein’s (see Diaries of Giacomo Meyerbeer – Google Books).

it will always remain an interesting document for those who want to familiarise themselves with the path taken by this celebrated doctor in actual practice. But one must not be deceived as to the nature of this material before us.As with all such accounts written by an uninvolved observer – who at the same time does not wish in any way to be an independent reporter – these accounts are in no way suited to giving a complete picture; they in particular give no idea of the actual method of (physical) examination. The patient lying before the clinician and his pupils is absent. The view is lacking which in and for itself provides so much material for judgment. The actual process of the diagnostic technique is missing. Thus the reader gets a picture which is alternately unclear and then distorted. And however much I have to recognise the editor’s care as an unprejudiced reporter, I myself – since I was present during a part of the period of time in question – cannot do anything but maintain that the impression made directly (on me) by this instruction was substantially different from that which is produced by reading the printed lectures. One finger pointing out (the features of) an object in front of one is often worth more than a long description, and even if the description itself – as is mostly the case in a teaching demonstration – is short, then it is possible that the whole method seems – to the reader – to be inadequate and full of holes. From my own experience I know how difficult it is for even very capable listeners – even when they do not wish to mix their own description with that of the teacher – to reproduce a demonstrational lecture in such a way that the actual report coincides even only to some extent with the actual proceedings. The mistake of repeating only what Schönlein actually said, or even developed more extensively, characterises Mr Güterbock’s book. So the critics who subsequently attacked Schönlein on the basis of Güterbock’s text therefore found it easy to demonstrate their superiority over Schönlein. In the extensive guidance which he gave to the young men whom he employed in his clinic, one can clearly discern the Master’s essentially scientific nature. My account above shows that, from the beginning, it was especially microscopic and chemical investigations to which

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Schönlein had directed his attention. Schönlein’s teachers and subsequent colleagues – Döllinger and Pickel – early on directed him onto this path, although they themselves had never attempted to apply these techniques to medical practice. Right up to his Berlin period, Schönlein had mainly used the microscope in person. In Würzburg, for chemical investigations he sometimes

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Memorial speech for Johann Lucas Schönlein (1793–1864) used Heller, sometimes capable apothecaries, and very probably also turned to Gmelin in Freiburg. In Zürich, Mr Löwig had helped him, and from this individual we have particularly, an analysis of the secretion in elephantiasis of the scrotum.* In Berlin, at first the worthy – but unfortunately so soon deceased – Franz Simon did the microscopic and chemical tasks. Simon’s investigations dating from his time at Schönlein’s clinic are partly described in his great medicalchemical work, and partly in individual articles in Müller’s Archiv or in his own Beiträgen.** More detailed examinations of urine were undertaken. Prominent among these were the so-called ‘critical excretions’ as well as, particularly, albuminuria and the development of Bright’s disease. The so-called urine ‘cylinders’e85 were found and (were) regularly observed. After Simon died in 1843, Mr Remak took over the microscopic investigations and Mr Heintz the chemical studies. The former published the most important events of the period from Michaelmas 1843 to Easter 1845 in a book of his own.*** It clarifies what things were of most interest at the time. I mention only the ever-growing attention to the effluvia which had *

F. Koller, Inaugural Dissertation, “On the anomalous milk-like secretion from the scrotum” (original in Latin). Zürich, 1833. – Virchow, “Disease-related Tumours”. Berlin, 1863 vol 1, p 323. ** Joh. Franz Simon, “Handbook of Applied Medical Chemistry”, 2 vols, Berlin 1840–1842. – “Studies on Physiological and Pathological Chemistry and Microscopy”, Berlin, 1843. – Müller’s Archiv. 1843. p 28 and p 30. *** R. Remak “Diagnostic and Pathogenet. Investigations”. Berlin, 1845. e85

i.e. ‘casts’ of tubular lumina in urine.

already led* to the discovery of the so-called croupous sputum in the course of pneumonia. With the advent of Mr Traube,e86 – which became possible thanks to the effect of the changes brought about by the May revolution of 1848 – Schönlein gained a civilian clinical Assistent. Hitherto, the military-medical authorities had ensured that all the posts of house doctor and Assistenten at the Charité were filled by young military doctors. However much Mr Traube was inclined to independent experimentation and strictest methodological observation, he also accepted guidance from Schönlein. Here I should like to remind you of Traube’s investigations on the effect of digitalis, which – without Schönlein’s long preference for this remedy and without its frequent use in the clinic – would perhaps have not eventuated. Schönlein’s favourite diseases (Lieblingskrankheiten) – typhus and pneumonia – were the main objects of investigation** which were first carried out here with the hand-held (in der Hand) thermometer, according to G. Zimmermann’s procedure.

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On p 32. At this point I may indeed include a few remarks on my personal relationship with Schönlein. Although I mentioned this earlier*** vis à vis Mr Wunderlich’s false statements, I can now do it more openly since one of those involved is dead. I left the Gymnasium just as Schönlein received the call to the University of Berlin (Hochschule) at Easter 1839. Because I was pursuing my medical studies in Berlin, I also had the good fortune to hear the new Professor when he was still in the full flush of enthusiasm, and I gratefully acknowledge that I received the mightiest encouragement from him. From Easter

*

Güterbock, op cit p 468. L. Traube, Annalen des Charité-Krankenhauses zu Berlin. 1850, Vol 1, ps 244, 436, 622. *** Virchow, Archiv f. pathol Anat etc, 1858, vol XV, p 393. **

e86 Additional information is provided in the Supplementary Information “On p 91, note 53”. See also chapter 6e this book.

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1841 through to 1842 I attended his lectures on theory of special pathology and therapy. They began with the question: “Whence and whither?” In the prologue they gave a historical-method-

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Notes ological survey of more recent efforts, and then immediately dealt with the individual “pathic processes”. At that time, the haemorrhagic process was treated with the subdivisions, lung- and brain-haemorrhage; – the phlogistic process with the subdivisions meningitis, arachnoiditis, insolatio encephalitis, delirium tremens, pericarditis, carditis, endocarditis, pleuritis, pneumonia, gastritis, peritonititis; – the neurophlogistic process with the subdivisions of angina gangrenosa et membranacea and dysentery; – the typhus process with the subdivisions of typhus abdominalis and typhus petechialis; – the intermittens process; – the catarrhal process and indeed, especially, the respiratory catarrhs (simple, influenzal, measles and whooping cough) and the catarrhs of the chylopoetic system (gastric fever and here again, the simple, the bilious, and the mucous fever); – the rheumatic process; – the podagric in association with the haemorrhoidal forms; and – the erysipelatous in combination with scarlet fever. In the previous year moreover, there were lectures on the cyanotic disease process – with the subdivisions morbus maculosus Werlhofii et peliosis, scurvy and chlorosis. I present this overview because it simultaneously gives a view of the “system” as far as it was still valid at that time. On the whole, the form of treatment resembled what is to be found in the printed “Lectures”; but the detailed depiction was incomparably more accurate and all embracing, especially as far as the therapeutic part – which was treated with special preference – was concerned. Immediately after that I attended the Latin Clinic and indeed, during the winter semester 1842–3, as a practitioner-in-training (Praktikant). In the course of this we went through the treatment of eighty-nine cases in detail, amongst which eight forms, especially typhuses, pneumonias, erysipelas, scarlet fever and rheumatisms, were predominant. I did not develop any close personal relationship with Schönlein. In contrast, for a while, there was an apparently unfriendly relationship. It had become recognized that there was a need to place someone at the disposal of the clinical teachers who was to have the task of the specific scientific investigations – especially microscopical and chemical ones. In 1844 I was proposed (for this) by the military medical staff which, as already mentioned, still made all junior medical appointments. Schönlein opposed this, and in fact with such success that for his clinic, Messrs Remak and Heintz were appointed, while I was given the task of assisting the other supervising doctors and clinicians. At the same time I took over the Assistent position at the PathologicalAnatomical Institute under R. Froriep. However, when at Easter 1846 the latter left and proposed me as his successor, the conflict (with Schönlein) was renewed. Schönlein who, as spokesman-councillor in the Ministry, had an important voice in this matter, preferred other candidates, and only with difficulty did he decide to accede. One day, in fact, he asked me to see him, and told me that he had now advised the Minister to appoint me. He added that he hoped to obtain the best service from me, and that I would see from his method that for him it was always a matter of the case itself, and not the persons involved. Indeed, from then on our relationship developed in the friendliest way. As prosector I had to carry out the dissections of deceased patients. Schönlein, who was almost always present – sometimes in the formal dress in which he intended to go to Court immediately afterwards – took a lively part in these examinations, and always showed himself inclined to accept and evaluate new information. Just recently I was reminded of how once in 1848 – in a case in which he had expected a haemorrhagic apoplexy, I had demonstrated an embolism of the brain arteries – he called out, half annoyed and half friendly: “You see barricades everywhere!” All the same, our relationship was limited to meetings at the dissecting table. When in 1849, because of my actions during the elections, first I was removed from my post as prosector, and subsequently re-installed under severe restrictions, he remained passive. And when, a short time

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Memorial speech for Johann Lucas Schönlein (1793–1864) later I received the call to Würzburg and asked for his advice, his final decision was: “Don’t sit between two stools”. It is thus incorrect to assume that he had exerted influence on this invitation. At that time he had still not regained any influence in Munich. In the Würzburg Faculty, it was Mr von Nadherny – at that time Proto-medicus from Bohemia and Kiwisch’s father-in-law – who had initiated my invitation. I left Berlin in autumn 1849, and joined the Würzburg Faculty. Memories of Schönlein were still very much alive there. There was the senior member of the Faculty – the aged Textor, who had been Schönlein’s teacher, colleague and fellow-sufferer;e87 – and there were as well his pupils, above all Marcus his immediate successor. My predecessor, Bernhardt Mohr, had been Schönlein’s Assistent. The old Anatomy building, in which I now had to work, was still in the same condition as when it was much visited by Schönlein as student, lecturer and Professor. Another of his Assistenten, Johan Bapt. Herz, had meanwhile become the leading practitioner in the town, and everyone honoured him for his own great experience as well as for being a pupil of the universally-renowned master. The closest relatives of the deceased Frau Schönlein – especially her brother Dr Heffner (now police doctor at Klingenberg-am-Main and who had been my student contemporary in Berlin) – lived in Würzburg. Schönlein still had his reputation as a representative of liberalism; and his enemies – Mr von Ringseis and the Ultramontanists – were still powerful in Bavaria. They had also worked with all their power against my appointment, especially through their main organ, the historical-political Blätter. Certainly, circumstances soon changed. Mr von Ringseis was awarded – as he himself says – “unrequested and unearned leisure” and Schönlein’s pupil and co-regionalist Pfeufer became Medical Clinician and Senior Medical Councillor in Munich. Mr von Ringseis’ anger was also turned on me. In a leading article in 1849, I had made only a passing reference to him and now I found myself forced* – following a violent attack from him** – to defend myself vigorously. Things developed more and more in such a way that Schönlein’s friends became my friends too, and his enemies became mine.

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*

Virchow. Archiv f. path. Anat. u. Physiol. etc. 1854 vol VII, p 4. Dr Ringseis’s riposte to a review is in the Zeit. der k. k. Gesellsch. der Aerzte in Wien. p 5. e87 thought to indicate ‘political sufferer’. **

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Nonetheless, no personal relationship developed from this. I visited him occasionally in Berlin. Sometimes he sent me a less-accessible article on epidemiology concerned with lower Franconia. The only case in which more sensitive observers thought that they had discovered the ‘shadow of a coming event’ is provided by an open letter* which I addressed to Schönlein in January 1855, in which I discussed the theories on the cholera epidemic which had emerged at that time, as also theories concerning leucin and tyrosin. Mr Pfeufer and also Mr Wunderlich saw in this an application for a Chair in Berlin. To calm these gentlemen down I will repeat here, that they were mistaken. Between Schönlein and me, neither directly nor indirectly, were there ever any negotiations about such an invitation. Indeed, it is not even correct that he had a significant part in my later summons to Berlin. The form and the address of my letter are very simply explained. Mr von Liebig had sent his first letter on cholera to London, Mr Frerichs had sent his (on leucin and tyrosin) to Vienna; I had all the more reason to address mine to Berlin and specifically to the most experienced clinician and epidemiologist in Germany – namely to Schönlein – because the cholera question in Würzburg was connected quite specially with his name. In 1856 I was recalled to Berlin at the unanimous proposal of the Faculty, with Johannes Müller’s especially active and liberal-minded support. I entered the Faculty in which almost all members had been my teachers, and where none were my student contemporaries. It is not yet the time to write the internal history of the Faculty, but I can certainly say that there was scarcely a question on which Schönlein’s opinion and mine did not coincide, even when it was a matter of

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Notes ‘dissenting’ votes. The only substantial point of difference emerged, if I am not mistaken in 1858, when Mr Wolff resigned from the ‘German Clinic’ and this (position) was given to Schönleine88 without a vote in the Faculty having been taken. I then presented a protest to the ministry and explained the necessity for two *

Deutsche Klinik, 1855, No 4.

e88

i.e. Schönlein came to hold both staff positions in Medicine by himself

staff (consultant) clinicians, at such a large university. Schönlein cut off the discussion by saying for his part, he would complain to the Minister – who had made this decision without asking him officially – since he (Schönlein), after all, had the right, by Royal Cabinet order, to be heard on every development in the medical faculties of the country. For the moment he was victorious, but this somewhat diplomatic victory did not bear him any sweet fruit. This was because it was not long before he was ready to resign. I was even in the deputation which was commissioned to present to him the memorial presentation from the doctors of Berlin. Then he left Berlin, and I did not see him again. But I certainly know that he remembered me in a friendly way and I may be allowed to say at the conclusion of this personal excursus that several times – whenever he presented one of my publications to the Bamberg Library – he added with a certain emphasis “He was my prosector”. 55

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On p 33. On Schönlein’s life and the way he did things in Berlin, there are two lots of notes, which are of a very minor nature and in part are unlikely to be accurate. One lot is in a book published by Siebert under the pseudonym “Kornfeger” (grain sweeper),* the other, which is quite unreliable, is in Herczegy’s** memoirs, of whom it is certainly characteristic that he reports inter alia how Schönlein had written in his album for him the witty and equally modest words: “Rp. Spiritus Sancti q. s. detur”.e89 Here I will solely add to the description in the text of my address that Schönlein was sometimes reproached for greediness and coarseness. Both are untrue. A man who made such princely gifts to scientific institutions, and who had such a great income, cannot have been covetous. In Berlin Schönlein was very busy, but no longer physically robust and by nature inclined to a comfortable and more peaceful life. Thus it happened that

* Kornfeger. “Impressions

at Home and Abroad by an Over-imaginative Medical Man”. Bamberg, 1838–1842. ** Mor. Herczegy. “Memoirs from the Travel Journal of a Hungarian Doctor with particular reference to Austria and Hungary: How it was and Provisionally Is”e90. Vienna, 1850, p 48. e89

a modification of an abbreviation used for medicinal prescriptions. The modified version (probably ironic) means “To be taken with as much Holy Spirit as necessary”. (Dr A. Schmidt). e90 Formalised in 1867, the Dual Monarchy had been preceded by a looser confederation of all Habsburg possessions from the sixteenth century. he did not, indeed, always comply with – and could not always comply with – the numerous and often shameless claims made on him. And if outstanding personalities caused him the more readily to emerge from his quiet way of life, there are certainly other psychological reasons for this than greed. For it is certain that wealth or riches alone could not win him. The reproach of coarseness is perhaps less unfounded. On the other hand it seems to be based mainly on the well-known anecdote that he is supposed to have said to an older doctor – who was very impressed by his own experience and who, during a consultation fell back on this experience, and, after a violent discussion, pointed to his own grey hair – “Donkeys are grey too”. But the veracity of this anecdote is not quite beyond doubt. Göschen* and Posner** declare the general judgment of the Berlin colleagues in their respective obituaries.

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Memorial speech for Johann Lucas Schönlein (1793–1864) 56

On p 33. Schönlein was appointed public councilllor in the Ministry for Ecclesiastical, Educational and Medical Affairs in 1841. He accepted it with the express assurance that in all matters concerning the medical faculties, his vote would be requested. The title of Senior Medical Geheimrat, which was accorded to him in 1857, did not cause any change in his official position. It was, all the same, a very dubious circumstance that the same man was simultaneously Professor, Public Councillor in the Ministry, and personal physician to the King. Under Altenstein’s Ministry such an accumulation of offices had always been opposed, because earlier experience had taught something which can be overlooked at the outset – that such a man’s influence may easily grow simultaneously beyond the ministry and the faculties. If in Schönlein’s case this danger did not quite materialise, then a particular personal virtue should be ascribed to him. In questions of personnel he was very impartial. In practical matters he liked paperwork so little that many an official paper found its way back with simply “vide” on it, without him in any way trying to form an opinion on the matter raised in the paper. One may applaud this as a

* Göschen, **

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Deutsche Klinik, 1859 No 8 Posner, Berlin. klin. Wochenschr. 1864, No 6.

justified aversion to bureaucracy, or condemn it as indolence, but all the same, such a method – from the point of view of administration – does not seem permissible, and to that extent, one can say that Schönlein’s retirement cannot, on this account, have caused any great pain. But it seems to me that if reproaches are to be made, they should be aimed at both sides. A well-organised administration should as a principle hold firm against (any person holding) incompatible offices. If it abandons this principle, then the reproach applies to it more than it does to the person who has been put in such a position. But neither can the person who accepts such a position be completely blameless.e91 57

On p 33. Mr Ringseis – who had meanwhile been ennobled – rose to make such an open outburst of rage only when Schönlein’s summons to Prussia revealed to all eyes the triumph of his opponent, whom up to then he had persecuted only in a secretly-conducted war. It was in 1841 when Ringseis presented to the public his first – and still only – volume describing his system of medicine, which was laid down on the broadest foundation of Ultramontanism*. Dedicated to Röschlaub’s memory, almost every line breathes a glowing hatred of his old student comrade. Already in the preface we read: “It was not an immature itch to authorship which drove me. Indeed for a long time I was silent when individual parts of the teachings which follow were trumpeted far and wide by others – who were the hangers-on of the so-called Nature (?) Historical (?) School (!) (sic) – in whole volumes and had been distorted into veritable monkey’s grimaces”. Further in the text (p 384) an overview is given of the general pathological principles according to the version of Schönlein’s lectures printed in Herisau, in order to show thereby that “such scribblings could not possibly be by Schönlein – who is as colossal in Medicine as Rotteck is in History”. But in truth, the author (Ringseis) nevertheless means that it (the scribbling) is by him (Schönlein), because somewhat later (ps 415 and 538) he does not hesitate to challenge him personally. Sometimes there is some restraint, but at the end of the volume, there is a flood of most vulgar ‘eloquence’ – such as is fortunately found only seldom in medical literature –

*

Joh. Nep. v. Ringseis. “A Sytem of Medicine. A Handbook of General Pathology and Therapy, Simultaneously an Attempt at Reformation and Restoration of Medical Theory and Practice”. Regensburg, 1841.

e91 Virchow was not entirely faithful to this principle in his own later career. See Hansemann’s difficulty in obtaining a pathologist’s position in Berlin in the 1890s (Bignold et al, 2007).

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which is directed against pupils as well as against the master. Of the school itself, he says (p 547): “Those who gesture as if they are satisfied only with nectar and ambrosia; – they stuff themselves

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Notes full to bursting with thistles and stubble from the fields, just like the majority of mammals to which, according to most natural scientists, Man belongs too. Yes, they even stuff themselves full to busting with Dalai Lama excrement”. Finally, by way of wrapping it up, he then turns to “the Grand Prince of Medical Science” with the words “Extraordinary man! Do not delay any longer with the publication of your veritable teachings. Your modesty and self-denial whereby you hold most marvellous things from us almost borders on cruelty when you withhold your most magnificent things from the hungering and thirsting – those who are indeed starving and dying from lack of water. Do not let us completely pass away from hunger and thirst; show your envious and small-minded opponents at once that your reputation is not merely faked up by students and liberals. Strike down and shame all who doubt your greatness – which only the envious and the pygmies in this field call ‘would-be genius’– with that unique type of coarseness which is yours; refute the fairy tale attributed to you of a cerebral and ganglious (gangliösen) typhus; show that several assertions made under your imprimatur – for example the frivolous assertions published in the Leipzig Medical Journal – are so trivial that they cannot be by you. For what beginner in medicine would be so ignorant as the author of the categorical expression made in your name that the tongue in exanthemata is rough and in nervous fever is smooth – since everyone knows that in exanthematous as well as in nervous fevers, it is alternately smooth and rough; or can be partly smooth and partly rough. Or much more, show that you – as limitlessly overlording medical Caesar, mightier than that mighty Caesar who wanted to place the masculine stamp on the feminine – can make what has happened not happened, and what has not happened, as though it has happened!”e92 In the Prologue to his lectures in winter 1841–42, Schönlein expressed himself very openly on so-called Christian medicine. What had earlier on been spoken softly in conventicles e93, was now to be brought out into the sun-light. He who had been so brazen was the Royal e92

Ringseis is using the traditional quasi-liturgical language of miracles. ‘in conventicles’ means mentioned only in restricted circles – the image implies Church members alone. e93

Bavarian Senior Medical Councillor, von Ringseis, who had greeted him (Schönlein) as medical Grand Prince and medical Dalai Lama, but himself was preparing the way for the authority of the Medical Pope. If medicine could really only flourish in combination with the ‘Church’, that is to say the Roman Catholic Church, then soon (Papal) Bulls would have to come across the Alps explaining how one should cure syphilis. If it were true that Adam and Eve were the pathogenetic elements through whose Appetitus spurii disease had come with Original Sin into the world, then it would follow logically that both could be eliminated by redemption in the form of the Sacraments, and the first act of the doctor at the sick bed should be as Ringseis demands, that he receive the Holy Sacraments. Similar tendencies – which emerged in other regions too – were well-designed to unite scientists in setting up a wall against these aims. The doctor is certainly to be distinguished from the average human being. To wish to apply Dogmatics to Medicine is contrary to the Christian direction, for the essence of this direction is to distance mankind from any demonic interpretation of its nature. Exorcism of spirits, the driving out of the Devil, incantations, prayers and amulets – to bring these to the sick-bed is to mock what is most Holy, and to make it a caricature. This perfidious unifying of two completely different things is the most unpleasant phenomenon of modern times. To found medicine on Holy Writ is a veritable profanity. It is quite specifically Christianity which separated ‘Ethical Man’ from ‘Physical Man’. Now some people wish to bring the dogma, which embodies the supernatural, into the area of bodily conditions again. Naturally from this, the tendency arises to put the corporeal side of man in a lower category, and by this, the struggle between Church and State is extended to Science. 58

On p 33. Anyone wishing to obtain a picture of orthodoxy in its worst forms is advised to read the writings of Görres* and Solbrig** on Ringseis’ system. I believe that I owe it to Schönlein’s

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Memorial speech for Johann Lucas Schönlein (1793–1864) *

J. v. Görres, “On Ringseis’ System of Medicine”, Regensburg, 1841. Aug. Solbrig, “The Opposites in Medicine, Discussed with Particular Reference to Dr von Ringseis’ System of Medicine and his Opponents. A Contribution to the History of Medical Science”. Nürnberg and Fürth, 1841. **

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memory not to quote here any of these abusive writings – the tone of which shows no connection with civilized society. Görres who, as Schönlein said, had thrown away the Jacobin’s cap and donned the Jesuit’s cloak, competed with the old Capuchin preachers in his choice of gutter-language and images.e94 Mr Solbrig – of whom Siebert* observed at that time was a young Massserver e95 without the priestly vows – did not yet participate in the Mysteries (of faith), and was still working rather aimlessly. He (who is, as far as I know, the same Mr Solbrig who they recently wanted to summon to Berlin in order to improve the treatment of the mentally deranged) as a Protestant, naturally took another path. Indeed he even tried to twist and gloss over von Ringseis’ main ideas. His polemic was concealed behind the ‘psyche’, but the sinfulness of human nature is nevertheless for him the basis of pathological doctrine. Siebert describes his (Solbrig’s) writing very characteristically when he says: “He fills his book with more than a hundred words of abuse, among which are some which have not before made their debut in literature.” 59

On p 33. Mr Wunderlich’s polemic is in completely different territory from that of the previouslynamed opponents. It is in no way to be compared with that of the representatives of Bavarian Orthodoxy. It is the polemic of the scientifically progressive school. I gladly recognize that. Nonetheless, I must say that I regard it as extremely unjust. Initially indeed, it keeps within the limits of factual opposition. In the introduction to the newly-founded journal Archiv f. physiologische Heilkunde – where the task of the physiological school is defined as being “to shape scepticism into an organized system” – the new School turned the whole weight of its artillery against “Ontology”, as being the actual character of the older medicine and particularly of the NatureHistorical School.** With this attack, they overshot the target; and also, with that

* Siebert, **

Häser’s Archive, 1842, vol III, p 48. Arch f. Physiol. Heilkunde, 1842, year 1, p III.

e94

The Capuchins were originally a branch of the Franciscan Order, and wore a cowl with a hood. They had a long tradition of being the ‘monks of the people’ or ‘bare-foot friars’, and used the argot of the common people. See for instance the tirade by the Capuchin monk in Schiller’s “Wallenstein’s Camp” (1799). e95 means ‘excessively pious’. 102

‘scepticism shaped into an organized system’, they did not arrive at any positive content, although they were formally correct. A year later, Mr Wunderlich* directed a more personal attack on Schönlein in a critique of Güterbock’s book. His opinion read thus: “Schönlein’s importance for the development of German medicine is without doubt historically secure, and the reviewer is as much convinced of it as anyone. But the present (volume of) clinical lectures strengthen the supposition that that importance is already in the past”. In support of this**, the completely unfavourable judgment of an English journal*** is later added to support his view. Now, some decades later, his criticism sounds much more evil#. Although Mr Wunderlich admits that in Schönlein “the sober, practical direction – which does not accept authority – predominated”, although he emphasizes, that in Schönlein’s Zürich period, there was no longer any talk of disease-parasitism. Although by this, he suggests that Schönlein continued to develop further in scientific progess, he nevertheless, says of him: “The positivism which was still admired in Zürich, has become sparse and too incomplete for it to be able still to keep up with the progress of this age”. Earlier, I have shown the injustice of this opinion.## Here I repeat a sentence of Mr Wunderlich himself. He says: “Given the improvement in medical circumstances elsewhere, (Schönlein’s) margin of excellence, which had hitherto brought so many admirers to his clinic, decreased”. Now – when the contrast had not merely diminished,

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Notes but had completely disappeared – would that not be high praise indeed? If a clinician – after he has administered the office of clinical teacher for almost forty years; after he has educated generation on generation of *

Arch f. physiol. Heilkunde 1843, vol XX, p 290 and 305. ibid, 1846, vol V, p 461 *** British and Foreign med. Chir. Review, January, 1846. # Wunderlich, “History of Medicine”, Stuttgart, 1859, p 343, 341. ## My Archive, vol XV, p 393. **

clinicians; and after some of these clinicians have given way to younger men – still has a clinic which does not have to fear comparison with other clinics, then it is quite specifically the historian who should have least hesitation in awarding the palme96 to him. And that this comparison really is appropriate to Schönlein, I could prove to Mr Wunderlich, by a competent testimony which was given voluntarily by a colleague in Leipzig – who had visited Schönlein’s clinic in Berlin shortly before the latter’s retirement. Moreover in a letter to me,* Mr Wunderlich rejected any thought that with his words he had intended to be insulting. However, let me be allowed on this occasion to remind the somewhat unreasonable younger critics of some words from the old Philipp von Walther.** He says: “A dangerous time in the life of the natural scientist is when he is ageing; when in the face of gradually declining energy and powers of intellect, he will soon not be able to follow sufficiently the rapid progress of science, and will be less able to participate in it. Formerly, when that progress proceeded more slowly – but perhaps precisely for that reason, more securely – the ageing scholar could be happy with the intellectual possessions which had piled up in the course of a long active life. He could rejoice in the evening of his life in the well-earned celebrity gained, and he could calmly hand over his concluded days’ work to younger and more active hands, with the certain prospect of seeing it carried on in the same direction and according to his own firmly-held intentions. At the present time, this is no longer the case. Science rolls rapidly over the aged, the exhausted and the weary. Others harvest in the field which we have made fertile, and have sown with golden grain. He who cannot keep up with their rapid pace is soon left unknown and without fame at the side of the road. The ageing scholar is like the ancient hero, finally unable to wield the sword and the lance. If he tells of his former deeds, he scarcely finds any attentive listener, and no one will *

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My Archive vol XVI, p 207 Walther, Address for Döllinger, p 105.

**

e96

the prize for the best – as in Ancient Olympiads.

believe the state of science forty years ago when he took over its care. For the man who is filled with the true spirit of science it is consoling and uplifting when his personal fame is lost in an ever-increasing sea of light: – so long as the sun of science moves on!” I may indeed add that such things only occur in Germany.e97 60

On p 34. Apart from Wunderlich, the following should be especially mentioned: Conradi*, Professor in Göttingen; Lehrs and Scharlau** in Stettin; as well as Graf*** and Pauli# in Landau. All these support in the main the individual facts communicated by Mr Güterbock, to which – sometimes correctly, sometimes incorrectly – there were all manner of objections. Although the tone is often violent, and the judgments unjust, one must at least grant that in toto they were at pains to deliver a factual and sober commentary. They certainly provide material to evaluate Schönlein which, however, should be used very cautiously.

61

On p 34. Siebert from Nymphenburg (now suburb of Munich) studied medicine in Würzburg, later practised in Bamberg, and died as Professor at the medical clinic in Jena. He was one of the most witty, intellectually alive and skilful pamphleteers of that time. After he was supposed to

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Memorial speech for Johann Lucas Schönlein (1793–1864) have written the biographical notice on Schönlein in Brockhaus’ Conversations-Lexikon (1847, vol XII p 742), he defended his teacher, first against Ringseis##, then against Görres and Solbrig###, and finally against Conradi, Lehrs and Scharlau*#. *

J.W.H. Conradi, Göttinger gelehrte Anzeigen. 1832, Nos 130–136. “Concerning Schönlein’s Clinical Lectures”, Göttingen, 1843. ** Lehrs and Scharlau. “Dr Schönlein as Doctor and Clinical Teacher, from Dr Güterbock’s Description and Submitted to an Irrefutable Critique”. Berlin, 1842. *** Graf, Neue med.-chirurg. Zeitung, 1843 Nos 38–40. # Fr. Pauli, “Critical Illumination of Schönlein’s Clinical Lectures in the Charité Hospital in Berlin”, Landau, 1844. ## Siebert, Aesculapius’ Snake and the Snake of Paradise, Häser’s Arch, 1842, vol II, p 165. ### Siebert, Critique of conflicts in medicine. ibid 1842. vol III, p 35. *# A. Siebert. “Schönlein’s Clinic and its Opponents, Drs Conradi, Scharlau and Lehrs”. Erlangen, 1843. e97 This sounds a little critical of the culture of German scientists. However, this booklet was written as Virchow had been forced to abandon the last volume of his “Tumours” / Geschwülste, because his earlier ideas had become out of date. These writings in defence of Schönlein are amongst the most interesting products of the history of that time. In addition, a worthwhile article against Ringseis is in the Hallische Jahrbücher.* This, it seems, has been incorrectly attributed here and there to Siebert. In the dispute over Güterbock’s publication, both Richter** and Stiebel*** also declared support for Schönlein.

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62

On p 34. Schönlein’s wife Theresa, was the daughter of Government Councillor Heffner, in Würzburg, who has a noted place as a historian of Franconia. He had married her in August 1827. She died of typhus in Berlin on the 13th of September 1846, while her husband happened to be absent on a journey to Bavaria. The marriage seems to have been completely happy.

63

On p 34. Philipp Schönlein, the only son, was born in Zürich on the 9th of February 1834. After attending the Friedrich Werder Gymnasium in Berlin, he entered University at the age of 15 and a half. He studied in Berlin and Göttingen – mainly mathematics and the sciences – and at the latter place he prepared himself – especially in the matter of geographic place definitions – for a long scientific journey. In 1855 he went to England, in order to learn Arabic and to obtain information on travel to Africa. By chance he was able to depart before the predetermined date, on a small merchantman which was sailing to Bonny at the mouth of the Niger to load palm oil. In August, before he had obtained his father’s consent, he set sail from Liverpool – after he had arranged a rendezvous with Messrs Bolle and Seemann – and then proceeded from Sierra Leone along the African coast. The ship set out at the beginning of September for Cape Palmas on the coast of Upper Guinea, where he was immediately involved in collecting plants and seeds. He sent a note

* Hallische

Jahrbücher 1841, Nos 131, 134. Hippocrates in the clerical cowl.e98 C.A.W. Richter, “Dr Schönlein and his Relationship to the Modern Art of Healing, Taking into Account his Opponents”. Berlin, 1843. *** Stiebel. Häser’s Arch. 1842 vol III, p 532. **

e98

106

Pfaffe: derogatory term for a priest, implying ‘Popery’.

about a settlement of free Negroes on Cape Palmas to the Geographical Society in London.* In a note to his home he announced the dispatch of a crate of plants and his imminent return home. But almost immediately afterwards, the news of his death arrived which had occurred on the 8th of January 1856 after an illness of six weeks. He had suffered sunstroke on his botanical expedi-

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Notes tions. Thus this talented young man, who was justified in having the highest hopes, ended pitifully, not yet quite twenty-two years old.e99 The crate of plants which he had sent did not arrive at its destination. All of his botanical specimens which were found after his death, and which ultimately reached his family, consisted of some seed collections and fourteen dried plant types. Klotzsch** described these; “There were nine new kinds of plants amongst them; two of them bear the name Acrolobus schönleinii and Gomphia schönleiniana Kl.*** The family was completely unprepared for the sad news. Schönlein happened to be in Bamberg and had intended to give a great banquet on the first day of the Easter celebrations. Then, on Maundy Thursday, the news of the death came from Berlin by telegraph. The purchases already made were presented to the poor, and for several weeks, the hapless father shut himself off from all company. He only relieved his heart by charitable deeds, and it gave him a certain consolation to do this in the traditional form of pious gifts. In particular, he established generous foundations in Bamberg in memory of his beloved son. On the 21st of October 1856 he assigned almost ten thousand florins to the Aufsee Seminarye100 “In memory of my son, who died on the 8th of January 1856, at Cape Palmas in Guinea as a sacrifice to scientific zeal, I herewith found two free places in the Aufsee Seminary with the intention that it is for students of lesser means. Interest amounts of four hundred florins (at two hundred florins a time), from the families of Schönlein * Proceedings

of the Royal Geographical Society of London, 1856, May and June, p 100. F. Klotzsch. “Philipp Schönlein’s Botanical Expedition to Cape Palmas”. Berlin, 1857. Pl III–IV. *** Already earlier, Klotzsch (in Hayne’s “Medicinal Plants” XIV) had named a genus of Rubiaceae “schönleinia”. **

e99

see Supplementary Information “On p 106, note 53”. clerical training college preparing pupils for the Erzbischöflich-geistliches Seminar.

e100

or Heffner (are to be paid). The remainder should be used on my deceased son’s name daye101 for a feast for the teachers and pupils of the institute. Prayers should be said for the peace of my son. Donation of these free places will occur via the magistracy of my home town, and I reserve the right of choosing them during my lifetime. The pupils should also receive pocket money of forty florins for payment of laundry, small needs and holiday excursions. Should the Seminary be dissolved, my foundation capital falls to the Bamberg City magistracy in order that scholarships from the City of Bamberg should be created up to university- or Lyceum-age. Two hundred florins should be donated immediately to the parish of St Gangolf to establish a Mass for the soul of my deceased son Philipp. The pupils of the seminary or the scholarship holders are obliged to pray for the deceased”. In the same way, he presented two hundred florins to the sick fund of the Bamberg Gymnasium, in pious remembrance of his only son. 64

On p 34. I pass over these proceedings, because they concern circumstances which are still too recent.

65

On p 34. The medical faculty expressed its regret in a ceremonial Latin document. In March 1859 the doctors presented him with a precious vase with the following address, the composition of which was entrusted to me: “More than forty years have passed since the name of Schönlein was first entered into the memorial books of the history of medicine. Two decades have almost passed since you – much honoured man, adorned with laurels from Würzburg and Zürich – first stepped up the clinical chair of our University to the jubilant cries of old and new pupils. Everyone knows – and the envious too cannot deny – that throughout this long period you always helped in all directions of research, in order to make these researches useful in the highest tasks of the doctor – these being the recognition and healing of disease. It was you who knit-

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Memorial speech for Johann Lucas Schönlein (1793–1864) ted back together the rent which had been torn in the bond between medicine and the entirety of science, this bond which enriched the German clinic with all aids of the new research; which gave the signal to that unprecedented upsurge of endeavour in the history of medicine, and which, e101 i.e. St Philipp’s Day, a Catholic tradition of celebrating the feast day of the saint of the same name.

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going forth from Germany, permeates all the medical schools in the civilised world. After such a long and glorious career – long enough to exhaust a less powerful man – you are still vital and active, but now you have acted on your decision to lay down your offices. We – your colleagues and your pupils – have unfortunately no means of changing this decision which we honour, but mourn. We can only say to you how painful it is for us to lose you; how very much your experienced counsel and your manly example will be missed by us; in what intense veneration we shall always remember you as the most worthy representative and protector of the medical profession; and how our heartfelt wishes follow you. May it long be granted to you to see those fruits ripen which you have strewn forth with such a generous hand! May the thanks of science – progressing ever more actively – renew that happy feeling that it was your mighty word which consecrated the new age!” 66 e102

On p 34. In Bamberg, Schönlein’s way of life was extremely orderly. He did not as a rule leave his home before eleven in the morning. He had had his house built close to the railway station in what was then a suburb earlier named Theuerstadt.e103 As already mentioned, it was opposite the parish church of St Gangolf, in the Königsstrasse, which in earlier times had been the so-called Steinweg.e104 The side towards the road contains the corridors, whilst all the living rooms face the garden and the open ground around the city. Immediately on entering, one comes into a long well-lighted corridor, the walls of which are decorated with likenesses of celebrated natural scientists and doctors in bronze medallions. On the ground floor is the spacious, richly-decorated reception room, in which Schönlein liked frequently to give hospitality to a select circle. From here, one enjoys a magnificent all-round vista of the city and the fertile fields and meadows beyond, though which flows an arm of the Regnitz River. On the middle floor is the reception room in which stands the vase presented by the Berlin doctors; next door is Schönlein’s study and sleeping quarters; and beyond that the family (bed-) rooms. From the upper floor there is a stairway to a tower which has three small rooms, of which one has a wide view

e102

See also supplementary Information “On p 108, note 66” – on the other side of the Regnitz river from the Old City (Altstadt), the Cathedral etc. The name is still in use (2008). e104 the name is still in use for city maps (2008). e103 ‘Deartown’

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over the beautiful surrounding area. That is the tusculum where the much-tested man sought his otium cum dignitate. e105, e106 Here, his days passed in a quiet and orderly way. In the morning, from eight to ten, after his coffee, he would read the Augsburger Allgemeine Zeitung, and carry on more serious studies. From ten to eleven he received his friends and acquaintances. Throughout this time, heavy cigars were smoked quite continuously. At eleven a.m. he went out to make his visits, and at least two or three times each week he appeared at about eleven-thirty in the library, in order to inspect the new acquisitions, to take out books himself, and to determine what he wanted to present to the library. At half past twelve he regularly went to the reading room of the ‘Harmonie’e107 where among other things, he would find the Berliner Nationalzeitung, but he also regularly waited for the Kreuzzeitunge108 which only arrived by the afternoon post. At two he went home, had lunch, then slept for a while, and at five o’clock, he went for a walk in the open air. In the evening he always stayed at home. In the summer he occupied himself particularly with tending fruit, grapes and

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Notes melons in his garden. Nothing gave him greater pleasure than when he – which happened almost regularly – won prizes at the Bamberg Fruit Show. His hobby during this period was numismatics.* On the one hand he collected medallions of doctors and natural scientists; on the other hand, he collected Bamberg coins which he passed on in entirety to the collection of the Historical Association. The greatest part of the coins from classical antiquity belonging to this society is also his gift. He had his agents far and wide; he did not shy from any price in order to acquire rare pieces. As well as these interests, he directed his attention to the local history of Franconia and Bamberg. He was amongst the first honorary members of the Historical Association, and he was unceasing in giving it his most conscientious attention. He regularly attended its meetings, encouraged the Association’s efforts, and enhanced its collections.** *

Gutenäcker, in the 27th Report of the Historical Association of Bamberg, p 9, Note. Rothlauf cited before, p 146.

**

e105

See also supplementary information “On p 108, note 66”. sein Tusculum is a reference to Cicero’s villa to which he withdrew when things became difficult for him politically (or personal circumstances forced him). It is a byword for a quiet place, far away from the hustle and bustle of the big city, in other words, where one can experience one’s “deserved break” (otium cum dignitate, literally “leisure with dignity”) (Dr Baltussen). e107 A common name for a social club in Germany. Haeckel (1923) refers to one in Würzburg. e108 A very influential, high quality paper with strong conservative values, and sometimes, later on, Ultramontanist leanings. e106

How he cared for the natural history exhibits, and was also very concerned to ensure that they remained in the city rather than falling into the possession of the statee109 in the future – all this is evident from the letter detailed earlier (p 83). All communal affairs, especially improvement of the town’s school and charitable institutions, claimed his involvement in high measure, and he was everywhere ready to assist with his purse. But he also maintained interests beyond the borders of his most immediate home territory. His long and deep interest in local history and folklore never left him right up to his death. He acquired the latest works – at his own expense – for the library. But it was the older works which appealed to his historical interest even more. Literature on the discovery of the route to the East Indies, on the discovery of America, on the Holy Land – these he acquired to an extent which a private citizen rarely achieves. It is most characteristic that his favourite book, to a certain extent – and with which he was most occupied during the last months of his life – was Hernandez’* “Botanical and Mineralogical Description of Mexico”. Certainly, however, this book held an additional interest in that – amongst the various essays contained in it – was one by a learned Bamberger. This had the title “Images and names of other animals from the new Spain of Nardus Antonius Recchus and of Johann Faber, Lynceus of Bamberg, philosopher, physician, public professor in Rome, esp. by the highest exposition of the Pontifex from herbal studies” (original in Latin).e110 This Johann Schmidt (Faber) was born in Bamberg in 1571, had studied in Würzburg, and under the supervision of Adrianus Romanus (p 54) had defended a “Medical Dissertation on Putrid Fever and Fever brought on by contagious disease”. Würzburg, 1597, 4°. The reputation of his anatomical and botanical knowledge was such that he was called to the Academy in Rome as Professor of Medicaments, and particularly, as Simpliciarius. *

“New Investigation into Mexican plants and minerals” by Franciscus Hernandes, outstanding physician in the Indies , first compiled, and then printed in bookform by Nardus Antonius Recchus. Illustrated with Lyncean notes and most learned additions by Johan Faber and Fabio Colonna. Rome 1651. e109

i.e. Bavaria. This would have meant its likely loss to Munich.

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Memorial speech for Johann Lucas Schönlein (1793–1864) e110

Botany and natural history were subjects of considerable interest in early seventeenth-century Rome. Fabio Colonna, a leading botanist and botanical illustrator, was a member of the Accademia dei Lincei, founded in Rome by Prince Federico Cesi whose own botanical interest Colonna encouraged. Colonna’s interest in describing and illustrating hitherto unknown plants extended to local as well as exotic specimens. His work is dedicated to Cardinal Odoardo Farnese. http://www.ibiblio.org/expo/vatican.exhibit/exhibit/g-nature/Nature_in_city.html. (Dr Menz). In Zürich Schönlein had presented Hernandez’ work to the library, but he had acquired a goldcute111 additional copy which he used for his private studies. On particular inserted sheets – fortyfour in number – he added more recent literature, notably specialised writings on epidemics; these he appended to the appropriate folio pages. As late as a month before his death he was comparing the two copies with each other. In specialised medical literature, it was epidemiology which he pursued with most zeal, and for which his book collection is probably the richest and most valuable in the whole world. He constantly examined the medical catalogues, placed purchasing orders immediately, paid any price, and thus gradually came to possess the rarest writings, which he not merely collected but also and always studied very carefully.

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On p 35. Two years before his death he bequeathed his epidemiological collection in toto to the University Library in Würzburg. Indeed, he even took back items which he had presented earlier to the Bamberg Library in order to add them to the total collection. By his last will of the 6th of January 1858 – while still in Berlin – he had already legally bequeathed to the Bamberg Library all other medical works from his book treasury. If one includes the dissertations and writings for specific occasions, there are at present almost twenty-five thousand works of various kinds in this library which he presented over the years from 1843; these have an estimated value of more than sixty-thousand florins. Amongst them are the rarest and most precious works; he is famous for the fact that his personal knowledge of the literature stretched from the formal aspects of incunabulae to the best editions of the oldest works on local, regional and folk history etc.e112

68

On p 35. For many years – apparently as a result of the endemic influencese113 in Würzburg – Schönlein had a goitre, which had progressively developed inwards, and was perhaps in part, retrosternal. His speech was thus somewhat affected: – he often hesitated while lecturing, cleared his throat, and continued in a lower voice. When he bent down while examining patients,

e111

referring to gilt edging in book leaves. see also Supplementary Information “On p 111, note 67” e113 Now known to be iodine deficiency. e112

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cyanosis of the face occurred rapidly which at times persisted when he was upright. As a result of this, auscultation became very difficult for him; many a reproach for insufficient examination of patients should perhaps be dismissed in consideration of this physical condition. Good and well-proven Assistenten were able indeed to make up for this deficiency, but it is certain that the goitrous disease was one of the reasons for him withdrawing from public life. In Bamberg the struma seems to have become more enlarged. His breathing became more difficult; he himself said that he puffed like a locomotive. When he had climbed stairs, he looked quite blue, and took a little while to recover. To this was now added a slight chill, which first appeared on the twenty-first of January as an insignificant bronchial catarrh. Schönlein took no notice. On the 22nd of January, he was still in the reading room of the “Harmonie”, but other visitors were struck by his pale and depressed appearance. For the 23rd a large dance had been announced in his house. Invitations had gone out for a start at seven o’clock, but his condition had worsened so much that on the 22nd the invitations were cancelled. He said to a colleague: “I feel like that Italian of whom it is said that the walls of his house had closed in on him more and

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From Schönlein’s Life: Supplementary information to the Notes more until they finally crushed him”.e114 In spite of this he still remained moving about until the afternoon of the 23rd. Only then did he take to his bed, refusing medicaments, and said: “Don’t plague the old man anymore”. He took the Last Sacraments and, as it seems, without any severe death throes died painlessly towards half past nine in the evening.e115 He was buried on the 26th of January. Almost the entire population of Bamberg took part in the funeral procession which was at three o’clock in the afternoon. Everyone felt that the first citizen of the town had departed from them. At six o’clock in the evening there was, again, a procession of friends and acquaintances to the grave. By torchlight, with music and song, they conducted the first mourning ceremony. Dr Rapp, medical officer for the district court, evoked the memory of the great deceased doctor with heartfelt words. e114 e115

a common German idiom for claustrophobic feelings. Of the 23rd. See also Supplementary Information to the Notes “On p 112, note 68”.

From Schönlein’s Life: Supplementary information to the Notes Virchow’s Archiv 33: 170–174 (1865). Editor’s Comments These are important because they modify several of the anecdotes recounted in the original Notes.

Following the presentation of the material – partly in my memorial address on Schönlein, and partly in the Notes attached to it (above) – a number of observations reached me which I here pass on to the public, in order to establish the historical truth as soon as possible. These remarks originate from such good sources that I must regard them as more reliable than my earlier facts, which were all based on the words of certain authoritative colleagues. I therefore hope all the more that in reproducing them here I shall be doing a service to all the friends of the late Schönlein. In this, I am adding to the Notes to my essay (above). On p 41 Notes 1 and 2. Schönlein’s mother, Margaretha, née Hümmer, came from Lohndorf, three hours (sic) from Bamberg. His godfather Göller owned a brewery, “The Lucas” (not “The White Rose”). Whether this is why Schönlein latter used the name Lucas is uncertain; the name first appears on the Dissertation for his Doctorate. On p 42 Note 3. Much erroneous data – in part from Bamberg itself – have reached me concerning the relationship which, in his later years, Schönlein had to the Catholic Church and its representatives. This information could easily throw false light on the character of a man who, up to his death, was youthful in spirit, highly principled and who acted according to these priniciples. Even in the last phase of his life he was never a religious zealot nor a clerical ‘train-

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bearer’ (Schleppträger). His religious persuasions were more in active love for poor people and the sick, whom he was always happy to support and help. At the Jubilee of the Parish Church various other lay people were there as well as himself; at the festive banquet he had given nothing apart from his payment for the meal, just as neither during his life, nor through his will, did he bequeath any money to the Church. He never attended the Franciscan church (i.e. St Jacob’s), but only his parish Church (St Gangolf’s), and this only seldom. This was because he feared catching cold – and not because he was worried about attention from the humbler people (Gärtner) (in the congregation), who loved him as a child of their part of the city, were proud of him, and knew him very well. When he took his evening walk through their fields, they came up to him to ask for favours. Incidently, many merchants and local officials also belonged to the parish community. On p 43, Note 4. Schönlein’s first teacher was named Megner. On p 46, Note 9. As a poor high school student, Schönlein took on the coaching of the young Marcus and therefore – during his time at the Gymnasium – was often in the latter’s father’s 171

house. Thus it is scarcely to be doubted that the latter, for his part, exerted a direct influence on the educational path of the young man. On p 51, Note 16. Certainly the most reliable witness – Geh. Rat Schulze – confirmed for me that when Johannes Müller was in Berlin to complete his State Examinations, he took every appropriate opportunity to show his unambiguous gratitude to his noble teacher von Walther, just as the latter always offered him the most sensitive and tender sympathy. On p 52, Note 17. The handwritten posthumous papers – which are still in the hands of the family– consist of the following: Approximately six hundred quarto sheets of notebooks for his lectures – presumably from the 1820s. Forty quarto sheets, again part of his lectures, but much more carefully written and worked out. Perhaps for that reason, not intended for publication (not logical to us – eds). Ten folio sheets, being a completely worked out monograph on whooping cough. Six folio sheets of extracts from Autenrieth. Pages from a medical diary. Mortality lists from Würzburg, with data on the various diseases; observations on temperature and weather, arranged according to months; influence of the same on the character of the diseases in some months; sketch of the predominant forms of illness, or short descriptions of the same. The year 1828 is complete; individual pages from other years. Patient reports from the medical clinic in Zürich, written by the Assistant Medical Officer, in many instances by Schönlein himself, particularly the autopsy results.

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From Schönlein’s Life: Supplementary information to the Notes

Numerous notes and excerpts from journeys and from medical works on the distribution of goitres and of cretinism world-wide, begun in Würzburg, presumably continued in Zürich, because notes on the distribution in the Swiss valleys seem to be based on his own observations. Numerous excerpts from old and more recent works on the geography of disease in Europe and the other continents. Notes on epidemics, and notes from old chronicles relevant to them. Geognostic, mineralogical and botanical excerpts from journeys and from other works. Observations, questions and tasks which he set himself. All written on small sheets. He had a great interest in spas. He had analyses of the springs sent to him. He visited many of them in Germany, but also particularly in Switzerland. In his last years he was very interested in the Tarasper springs, which he also visited from Zürich – as is clear from a short travel diary – even if he was not there to ‘take the cure’. The written posthumous papers are mostly from the Würzburg time, a few are from the Zürich period; nothing at all is from his time in Berlin. P 61, Note 24. The journey to Pest and Vienna, which was for scientific purposes, was undertaken in 1830. P 76, Note 40. In November 1832 Schönlein was removed from his post of Professor, and appointed District Medical Officer in Passau. Marcus (the Younger) took over clinical instruction. Schönlein still had the official function of Senior Medical Officer at the Julius Hospital until he was informed by government memorandum that the functions of Senior Medical Officer were transferred to Marcus on the 20th of December 1832. Negotiations with Zürich were almost concluded when, via ministerial memorandum of the 24th of January 1833, he was instructed to take up his position in Passau without delay. Thereupon, on the 25th, he asked for his release from the Bavarian State Service. For some time previously, he had noticed that he was being watched, especially from the University building opposite his apartment. This, together with all sorts of rumours circulating in the town, and warnings which came to him directly, caused him to leave Würzburg in secret. One evening at the end of January his friend Bauer from Zell took a small consignment of luggage with him. Next day, Schönlein went on foot to Zell, where a coach was ready, and he began his journey to Zürich. His departure was kept so secret that even his parents-in-law first knew about it only when he had already been able to reach Freiburg (i. B.). After his Zürich affairs had been completely set in order, he went to ‘take a cure’ at Baden im Argau. Acceding to the wishes of some of his friends – in particular the request of his father-in-law, for whom his secret flight was very embarrassing – he wanted to return to Würzburg for the Easter holidays, in order to take his family to his new home. He went via Freiburg – where the students serenaded him (the government had forbidden their torchlight procession) – to

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Frankfurt. In that city he was held up for longer than he had intended by numerous consultations; he was still there at the time of the Rauschenplatt rebellion. Return to Würzburg was now out of the question. Seufert – who had intended to bring him back – returned alone. Schönlein went directly to Zürich, and only entered Bavaria again on his journey to Berlin as a Prussian State official. In Zürich – at the request of the Bavarian government – he was interrogated on account of his possible involvement in the Frankfurt affair. P 85 (cf. p 31), Note 51. Concerning Schönlein’s invitation to Berlin, Geh. Regierungsrat Johannes Schulze has given me the following interesting details: “Negotiations on Schönlein’s summons to Berlin were – this I as referee can guarantee –not in any way conducted by Dieffenbach. In the summer of 1839, after Minister von Altenstein had delayed the relevant decision for a year or more, he approached me in Schöneberg (suburb of Berlin) – where I gave a lecture each week for him at his country property – with the remark ‘We shall really have to get on with filling the clinical teaching position: if I come to my gardener then he calls out “Schönlein”. And if I want to go into the town, the coachman cries “Schönlein”’. To 173

this, I answered ‘Your Excellency may deduce, vox populi, vox dei!’ ‘Quite right’ the Minister continued, ‘but I am concerned that the King (Fr. William III) will not accept Schönlein’s being invited. On this, I believe that in a few days – and with Wiebel’s mediation, if you permit me to talk with him – I will be able to inform you of the probable result’. ‘Well try it then’ the Minister replied. On the very same day, I hastened to Wiebel and tried to arouse his interest in an invitation for Schönlein by pointing out the great benefit which would accrue for the education of military medical officers. By the following morning – in conversation with the King – Wiebel mentioned the long-established clinical teaching post and the plan to fill it with Schönlein.The King asked ‘Where has he been; where is he now?’ Wiebel replied: ‘In Bamberg, in Würzburg and now in Zürich’. The King ended the conversation with the words: ‘Unpleasant places to be – doesn’t concern me – Altenstein’s affair’. Thus certainty was attained that the King placed no obstacles in the path of Schönlein’s invitation, and Minister Altenstein sent the letter of invitation to Schönlein without delay. Schönlein’s duties at Court began on his first day in Berlin; Prince Wittgenstein organized an event a few days later, at which Schönlein was presented to the King on the Terrace in Sans Soucie116. In the presence of Prince Wittgenstein and Wiebel, he heard the King’s words – which were scarcely flattering – ‘Actually, after Hufeland’s death, don’t want any Personal Physician’”. On p 91, Note 53. The expressions used in the text (p 32) suggest that it was the author’s opinion that Mr Traube’s studies of diseases of the mammary glands had been carried out with Mr Joseph Mayer. This is not the case: each of

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From Schönlein’s Life: Supplementary information to the Notes

them worked in Schönlein’s clinic independently and at different times. Only to a certain extent were the topics of their work similar. On p 106, Note 63. Schönlein’s son Philipp died after an illness of six days. The sad news reached Bamberg on Holy Saturday. Because no meal was planned, there was no food to be given awaye117. Not two but only one free place was established by the donation of some meadows and mortgages, valued at 5,700 florins. The second free place arose by accumulation of assets, because for several years there was no applicant. The banquet consisted of wine and cake – which on the son’s Saint’s Day is distributed to teachers and pupils as dessert – together with the request to commemorate the deceased in the Grace after the meal. If neither a Schönlein nor a Heffner is available, then two talented but poor boys – one from Bamberg, one from Würzburg – have claim on the free places. If the College is dissolved, the capital falls to the Bamberg Magistracy which would then create scholarships for students. The Church of St Gangolf receives 2,000 florins to endow a Mass for the Holy Souls. e116 e117

official Royal summer residence in Potsdam. Holy Saturday, being the last day of Lent, is a day of fasting.

On p 108, Note 66. The dining room and the daughters’ rooms are on the ground floor; on the first floor are the hall (in which stands the vase presented by the Berlin doctors) with Schönlein’s living room, bedroom and study alongside. On the other side of the hall are the guest rooms. On the second floor, which only covers a part of the house, there are additional guest rooms. In the morning after coffee, or rather tea, he read the newspapers – some Berlin ones amongst them. In general he smoked three cigars a day; these were only light, because he no longer tolerated the heavy ones. Very seldom did he visit anyone during the winter – he feared over-heated rooms. In summer many strangers came to consult him whom he subsequently, as a rule, attended. Every day he drove to the Theresienhain where in good weather he went for a short walk. Scarcely four weeks before his death he brought home – as a notable object – a blooming primrose which he had found during his walk. He had a collection of Bamberg coins from which he presented the doubloons to the Historical Society. He visited the Collections of this Society, but never attended their meetings. He wanted to write a biography of Johann Schmidt (Faber). He had all relevant books sent to him, in which he hoped to find something about this scholar, who interested him both as a doctor and a Bamberger. This work occupied him right up to the last days of his life; the extra pages which had been inserted – as already mentioned – are mainly concerned with this. For this purpose he used an old – and for him no-longer-necessary – index of his epidemiological writings. In his calendars from 1859 there are notes on temperature and climatic conditions, the coming and departure of the swallows, the progress of vegetation,

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storms, shooting stars, first frosts, icing up of the river, floods – in short, all natural phenomena which he observed with the greatest intensity.e118 On p 111, Note 67. A year before his death, he presented his epidemiological collection to the University of Würzburg, with the condition that it should be set up on its own, and continued. The last instruction in his Will dates from the 6th of June 1853 (sic). On p 112, Note 68. He accepted with the greatest willingness everything which was given to him. He had so little notion of (the seriousness) of his condition that even at half past six on the day he died, he ordered a glass of mineral water with milk. Soon after he fell into complete unconsciousness from which he did not awaken. The doctors declared the seriousness of his condition only when he was unconscious; therefore only then could he receive Extreme Unction (last rites). e118 As part of the anti-contagionist medical thinking of the early nineteenth century, climatic disturbances of various types were blamed for epidemics (Garrisson, 1929). The same habit of noting everything to do with climate etc and of omni-curiosity was demonstrated par excellence by Goethe in the last years of his life.

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Chapter 4 Memorial address for Carl Mayer (1795–1868) given on the 25th June 1868 by Rudolph Virchow Published by A. Hirschwald, Berlin, 1869 Separatim from the Jubilee issue of the Proceedings of the Society for Obstetrics. Editors’ comments Virchow met his wife through his association with Carl Mayer (then a practicing obstetrician in Berlin) with whom he was instrumental in founding this Society. Mayer seems to have the characteristics which Virchow admired: scientific approach to medicine and liberal social and political views. A biography has been provided by Ebert and David (1991), and other relevant works include Rose (1939) and Simmer (1993).

Editors’ summary of points Main text: P 4 Introduction; 5 parents and early life; 6 school life; 7 as soldier in late Napoleonic Wars; 8 undergraduate studies at University of Berlin; 9 Assistent to Siebold, state of midwifery at the time; 10 Siebold’s Institut, Mayer pays fees for his Doctorate (1821), relations with Rudolphi’s sons; 11 Mayer’s work on polyps of the uterus, virtues as a clinician; 12 develops practice in gynaecology; 13–14 acquires obstetric practice, personal appearance and personality; 15 his household, wife; 16 hobbies, associates; 17 poetry club, his position on medical fees; 18 arrangements for the care of the poor, use of Assistenten; 19 Mayer as a teacher, first publications; 20 happy family life and interest in microscopy; 21 policy on wet nurses, swimming event and illness following; 22 travel to Vienna, appointment as Health Councillor; 23 increasing practice, liberalisation in Prussian politics; 24 his liberal views but without direct involvement in politics, changes to his household; 25 incurs fractured ankle, gives up most of his practice; 26–27 foundation of the Obstetric society; 28 as an obstetrician, his scientific orientation; 29 Virchow’s relations with Mayer, Mayer’s illnesses; 30 worsening health, produces booklet of pathology of vaginal diseases; 31 Mayer’s sons. Notes: P 32 facts and references concerning wife’s family; deaths of S Reimer and B. Reinhardt; Mayer’s sister, Wilhelm Schütz, Mayer himself and his younger son.

Where much is learnt, much is also forgotten! That is a principle of experience which is as valid for individuals as for people en masse. Ever-increasing knowledge reveals new connections to our way of thinking; progress leads to new points of view; our yardsticks for judgment alter; and much which seemed significant becomes smaller and smaller, so that it finally disappears from sight. Much that was once little heeded looms ever larger the more it becomes the object of our contemplation. Thus change our evaluations of things and people.

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Figure 4.1. Carl Mayer (Courtesy Dr med. Matthias David, Campus Virchow-Klinikum, Charité Hospital, Berlin).

Only too easily do we become unjust, as we evaluate the past with the measuring rod of the present. Certainly, it is appropriate to compare the past with the present. However, a comparison in the clearer light of the advanced present will only be a fair one if it is carried out in full knowledge of earlier circumstances – in unprejudiced evaluation of newly-achieved circumstances – if we measure it with the yardstick of impartial history. How difficult it is to find and use this impartial measuring rod can only be judged by him who, in earnest struggle, has made the attempt to conquer his own forgetfulness and the forgetfulness of people at large, and (made the attempt) to re-establish in a clear light memory of 4

things past. Almost every attempt of this kind remains in part unsuccessful. So quickly does the darkness of the past spread itself even over one’s own experiences, that only individual things – often not even the most important individual things – remain standing in their undamaged entirety. Myth begins in our

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own memory, and many a story of our contemporaries already belong to the realm of the fable. Today, when my task is to awaken memory of a man who stood so close to me, today I feel it as doubly difficult: how little we are in a position without special aids, to reproduce faithfully the picture of the past. Here, where it is not a matter of evoking for members of the family the memories of past happiness and unhappiness; and also where, among the members of the society which the dear departed founded (a body of specialist colleagues who are imbued with the wish to see unrolled before them the picture of their long-serving chairman) – Here I cannot quite escape my responsibility by using that dutiful partiality which should reign within the family and towards which the charming nature of this family’s head particularly urges me. Here I must openly confess that I hold it quite impossible to demonstrate perfectly clearly the development of a man who was so little determined by the chances of external circumstances; but who on the other hand was so much formed by his own instincts. Only his own personal notes can help us here. But however much he was a model in recording impartially his medical diaries, just as little did he think of recording diaries of his personal experiences. It is no longer possible to present adequately what is most instructive for the thinking observer – and that which is most appealing to our human interest and is therefore most likely to be permanent in our memory: – a knowledge and understanding of the course of development of his personality as it changed during its history. This Society itself may provide me with justification. Scarcely twenty-five years have passed since it was founded; only next year will its first Jubilee be observed. The man whose memory we celebrate today was its founder and, until his death a few months ago, its continuous President. But how few of the members of the Society today and attending its sessions, also took part in its foundation! The Society is still here and, it is to be hoped, will continue for a long time. However within itself, it has become something different. Death has carried some of us away, some have left the Society; still others have found other places to concentrate their efforts. But others have taken their places. Those who remain have changed as well. The first great zeal has somewhat abated. The objects of scientific interest have changed; other persons and questions have moved into the foreground. What efforts would be required to write a complete and objective history of our society and find the right yardstick for every phase of its development! Let us be content with sketching a picture of the past in broad outline: the history of a man who – being as much a part of the progress in his own particular Art and Science as he was specifically a part this Society – this history offers, at least in these respects, a certain guarantee of truth. Carl Wilhelm Mayer was born in Berlin on the 25th of June 1795. He was only two when he lost his mother. Then partly when he was at a more tender age,

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partly when he was at a more mature age, several of his siblings followed. Thus from this mother, only one sister survived: Caroline, subsequentlye1 Court Gardener Finkelmann in Charlottenburg. His father – City Surgeon of Berlin, operator and midwife, a respected and charming man – therefore exerted decisive influence on the early education of his son which actually increased when he remarried several years later. From this marriage, came the younger brother Louis, Court Gardener in the New Garden at Potsdam, with whom Carl Mayer was bound in close affection right up to his death. Carl Mayer spent his early school years at the French Gymnasium in Berlin, the so-called e1

something missing in text, probably “wife of”.

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Collège but in his eleventh year he transferred to the Gymnasium of the Graues Kloster, which at that time – under the headmaster Bellermann – included such excellent teachers as Spalding, Delbrück, Heindorf, Fischer, Köpe, Ritschl,Walch, Heinsius. Of these, Mayer mentioned Bellermann himself most frequently – with whose family he maintained continuous friendly relationships – as also Pastor Weisser, whose particular merit in respect of his education he esteemed most warmly. Although perhaps not the most hard-working pupil, Mayer was still able – thanks to his wholly innate talents – to acquire at this excellent school, a solid foundation of Classical and General Humanist education, which kept his heart and mind open to every higher interest and for every true advance of the intellect. The boy’s wonderful personal charm gained for him the affection of teachers and pupils, amongst whom Romberg – our much esteemed colleague – remained close to him in ever-loyal affection. In this period too, his father’s influence was of great significance. On frequent excursions into the neighbourhood, into the Jungfernheide, the Grunewald and other places, the boy’s eyes became practiced in the specimens of nature, and his enthusiasm for collecting was awakened early. Later on, the son was even taken into his father’s medical practice, particularly to operations, and in old age, he still had a clear memory of a scene where he had fainted during a difficult eye operation. Thus his time until 1813 was passed in learning. A difficult time! As a little child, he had seen the state collapse under the blows of the Frankish conqueror. As a maturing school boy, he got to know the pressures of foreign rule. The spark of liberty which was laid down in so many breasts at that time, early awoke in this ambitious youth the noble feeling of patriotic love. He was still not seventeen, when, in 1813 he passed the matriculation examination with glittering success, and then hastened immediately to Breslau, to follow the King’s call to arms. He joined

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the First Guards Regiment as a volunteer Jaeger.e2 But the great exertions of this campaign, especially the battles of Möckern and Leipzig, as also the subse-

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quent tiring marches to the Rhine, exhausted the strength of this still tender youth. Shortly after the occupation of Frankfurt am Main, he fell into a severe nervous fever, which brought him close to death. In old age he still talked, with an expression of horror, of those weeks which he spent in the most wretchedlyequipped military hospital there. A stroke of good luck took him, as a convalescent to the Bunsen home, where he not only enjoyed devoted care, but also the joys of the most agreeable family circle, with which he retained the closest relations over many long years. When his strength had finally returned, he found occupation in a military office there. Soon thereafter, the capture of Paris concluded the victorious campaign, and in restored health, and with the most splendid feeling of duty done, Mayer returned to Berlin in July 1814. Over many years, he carefully maintained newly-won friendships with many a loyal wartime comrade; and even when, one after the other, they passed away, and when he felt more and more isolated, then the story of those days still lit up his eyes with a new gleam. Even last winter, when his sick body kept him to his room, and his weakened eyesight prevented him of an evening from doing any work, he listened with ever eager attentiveness to the loyal readere3, who related to him the memorable events of the Wars of Liberation.e4 He was still able to experience the fact that a new and mighty war had put the Fatherland in danger, and that once again, the victorious army returned home after the most glittering deeds of arms, greeted by the applause of the people relieved from greatest care and worry. But his heart hung on the experiences of his own youth which, in voluntary sacrifice, he had placed itself at disposal (of the King), and had offered the highest achievements of civic virtue as self-sacrifice. The campaign medal remained his dearest decoration just as, except e2

mobile infantry, similar to “Scouts” in the British Army in the nineteenth century. feminine, presumably wife or daughter. e4 refers to the Austro-Prussian War of 1866. e3

for the fine feeling of duty done, it was his only reward. Who would interpret it as vanity and pride on the part of this brave man when he held a campaign medal in highest honour, which had taken on something like a fraternal band for all men of noble spirit! Indeed, other goals stood in front of the young victor. Directly after his return he applied for entry to the University, and in August 1814 he was accepted by the then-Rector, the much-honoured Rudolphi, to membership of our University. In the winter semester, he began medical studies, initially of Anatomy under Knape and Rudolphi, and of the Sciences under Ermann, Hernbstädt, Lichtenstein and Link. The new war of 1815 caused a short interruption; a greater and longer interruption was brought about in 1816 by the death of his father, who left a large family almost without means. Carl was forced to earn for himself the means to further study by teaching. It was difficult enough for him to carry out both tasks, but this too turned out best for him.

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His lucky star opened the best houses to him, in which he learned the finer manners of higher society – ease in dealing with people, confidence in language, charm of manner – which so much underpinned his future. Especially in the family of Count Bernstorff, he met the most pleasant and appreciative reception. Because of this, his period of study lengthened to five years. He had successively studied Pathology, under Horn, Materia medica with Berends and Ossan, and then Therapy under Hufeland. Over three years he gained clinical experience under Gräfe and Rust, under Elias von Siebold, under Hufeland, Horn and Berends. Only on the 22nd of July 1819 did he pass the Rigorosum (final examination). But here too money was too scarce to pay the Doctoral fees, and whilst his wealthier fellow students already had posts as young doctors, he first had to look for a new occupation 9

which could provide him the means to pay the “second instalment”. The opportunity for this came in the best and at the same time, decisive way for his entire future. In November 1817 (sic), he became an Assistent under Elias von Siebold, at the newly-built obstetric institute at the University. There began a completely new part of his life, and it is worth lingering for a moment at this point. Relatively early, midwifery in Berlin had taken on a scientific character. In the rest of Germany, completely chaotic conditions prevailed concerning both the knowledge and the Art of this subject. However, already in the seventeenth century, the Royal Midwifee5 – the celebrated Justine Siegmundin – had laid the foundations for a School which, with great experience and effort, was to pursue a really scientific basis for midwifery. A century later, in 1751, a teaching institute for midwifery had been established under Johan Friedrich Meckel; the first of its kind in Germany after the one at Göttingen. Skilled practitioners were educated there, of whom especially Ribcke, still echoes down to our time. But they no longer quite met the increased demands of the rapidly progressing epoch, and the young universitye6 – although well-equipped – was still lacking its own institute. Only the summons of Elias Siebold from Würzburg brought the desired progress. This already widely respected gynaecologist brought with him the name of a whole familye7 which had been not merely the foundation for the reputation of the Würzburg School, but had also given a hitherto unprecedented stimulus to both surgery and midwifery in Germany. Proceeding from such a solid foundation in anatomy, and – like almost all anatomically-educated doctors, equipped with a sober, unprejudiced attitude dedicated to discovery of mechanical processes – the men of the Siebold family had been able to gather around themselves a school of the best practitioners. Yes indeed, the hereditary influence was sufficiently e5 e6

i.e. to the family of the Elector of Brandenburg. The University of Berlin was founded in 1810.

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Memorial address for Carl Mayer (1795–1868) e7 Siebold family included Karl Kaspar von Siebold (1736–1807) surgeon and obstetrician at the Julius Hospital in Würzburg; his younger son Elias Siebold (1775–1828), was Professor of Obstetrics at Berlin, 1816–1828. Elias’ son Karl Theodor Ernst von Siebold (1804–1885) was a famous physiologist and zoologist. Another family member, Philipp Franz von Siebold (1796–1866) was the first European physician to teach Western medicine in Japan.

great for two daughters of the family to acquire – in Germany – the unusual honour of the Doctorate. Elias von Siebold insisted on having an independent University Institute in a separate building. It was granted to him. In the summer of 1817, the house at 29 Oranienburgerstrasse, now the Domstifte8 was bought, and a substantial part of the difficult task of arranging the fitting-out of the building fell to the newlyappointed Assistent Carl Mayer. He always attached a particular significance to this event. As, during this task he had learned by urgent necessity, he had learned to take on all those little worries – about laundry and bedding, about household instruments and implements, about provisions and medicaments of every kind – which in his later practice, so greatly simplified his intervention in the details of the labour ward, of patient – and examination rooms. On the 12th of November, the first pregnancy was taken on; on the 26th, the first birth took place, and on the 1st of May 1818 the ceremony of dedication took place with a speech from the chairman. An ambulatory clinic for women’s diseases had been opened at the same time. Carl Mayer remained in this post until 1821, when he had finally saved enough money to register for elevation to the (faculty) Doctorate. On the 13th of February of that year, he received the Doctorate from Rudolphi, who was Dean at the time. His dissertation De Polypis Uteri shows what experience he had gained meanwhile, and how accurately he had absorbed the teachings of his wise master and friend. Indeed, a close relationship developed between them, which became most warmly developed with the sons of the house. Eduard (Rudolphi), subsequently Professor of midwifery in Göttingen, remained in most frequent contact with him right up to his death, both by letter and word. And Carl – the celebrated comparative anatomist – never ceased to warmly recognize his qualities. Thus the father (Rudolphi senior) insisted on arranging the doctoral banquet in his house, and the young doctor was celebrated with lively speeches and with good Würzburg wine, which Mayer always highly appreciated. e8

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“cathedral foundation building”

His inaugural dissertation shows in what direction the new practitioner’s mind had begun to turn. What he dealt with was actually a gynaecological topic, and not – in the narrower sense – one on midwifery. In a most extensive exposition, which is carefully supported with references to the literature, he describes the polyps of the uterus in comparison with the numerous other lesions with which

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they could be confused. Then he goes in detail through the various forms of treatment, in order finally to defend the method of extirpation by means of scissors which had been introduced by Siebold, against the great and almost dominant authority of Levret. Although he was properly fair in respect of tying off the polyps and illustrates the instrument invented and improved by Ribcke, he nonetheless gives preference to the scissors, based on his own experience. One had only to see him operating in old age with this instrument – and thus to have known the true virtuosity with which he manipulated the otherwise awkward instrument – in order to understand the great advantages which he gained with it: – advantages which were so obvious that even that great mastery of art of operating – Dieffenbach – did not hesitate later on, in such cases, to turn to the proven skill of his friend. Seldom indeed has a university sent out into practical life a young doctor better prepared than him. The members of the faculty were indeed proud of this pupil, and Siebold especially maintained most fatherly feeling for him. He certainly had good reason for this. For in his long years of practice – and one so rich in experience, and which he used to great effect – Mayer not only never deviated from the principles of the Siebold school, but rather, he developed them to a still greater level of rigor. Careful observation of the natural course of physiological and pathological processes; ceaseless effort to adapt the doctor’s treatments according to this 12

natural course which he recognized from his experience; the almost pedantic exactness not only in the examination of the patient, but also according to the firm established rules of medical examination; the decisiveness and resolution of intervention when medical intervention was seen as unavoidable – those were the characteristics of the Siebold school, but no one developed them so logically, so sharply and so confidently as did Mayer. His position as an Assistent – which is usually an aide – became with him vis à vis the students one which approached that of a teacher. This led him rapidly to greater familiarity and accomplishment with the prevailing rules (of medical practice). The manly definitiveness of his character and the almost military precision of his medical orders, contributed all the more to his complete education. Thus prepared, Mayer began his own practice – not as just a simple doctor and midwife – but as a recognized “expert” in obstetrics and gynaecology. That at once became his scientific and professional title, which allowed people to distinguish his name, which was otherwise so easily confused – and in fact not infrequently misused – from all similar titles. Certainly his young practice demanded a variety of medical activity, and Mayer met the in part external demands with such care that he soon became the doctor for numerous families. These he not only supported as a doctor in illness and bodily needs of the most various kinds; but often he was also an esteemed friend and adviser in many other aspects of life. But naturally the public early on identified his outstanding

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abilities in obstetrics, and the trust of his colleagues in him brought to him more and more consultations in midwifery and gynaecological cases. Thus he gradually became the fully-formed specialist whom the younger generation has learned to know and honour. But at no time did he lose interest in medicine as a whole; and at no time did he refuse, to a lesser degree to fulfill all the duties of the practical doctor in all their aspects. On the 27th of June 1821, Mayer had been registered as a practicing doctor and midwife, and on the 1st of July he left the Institute which, by his activity, had achieved such a significant reputation within a short time. The death of an old midwife Doctor Wolter, for whom he had often deputized, quickly brought him an extensive practice which claimed his time day and night. Outstanding personal qualities rapidly assured him the personal trust which his scientific education inevitably evoked to such a great degree. Those who had only come to know him in later times will understand that Mayer had the reputation of being one of the finest men of his time. His cheerfulness and liveliness were expressed in his wellformed face and shone forth from his clear blue eyes. His movements had at the same time, the measured and free qualities which accompany moving in good society. But even more, one was taken by the fine naturalness and harmony which existed between his qualities, thoughts and speech. It is probable that few doctors have at their disposal such a degree of natural eloquence in both social and medical conversation. The flow of his speech was so fresh, his gestures so genuine, his enthusiasm so natural that it was almost impossible to escape the magic of this effect. Certainly Mayer was at pains to appear charming and to make an impression. Nothing was more hateful to him than that neglectful – one is inclined to say lazy – quality, which is only too common in Germany – and which in Berlin, in some circles, has been developed into a system – a system in which lasting attention is given neither to speech nor to attitude nor to movement – and where instead a partly natural, partly affected indifference towards others is shown – whereby people tend to find pleasure in wounding others rather than pleasing them. With Mayer, everything was carefully – one could say

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industriously – carried out. His bearing – which perhaps came from his war experience – had something erect about it; head, hair and beard, all very handsome, were maintained in faultless order. The toilette of his skin – not only of his hands and nails, which are so important to an obstetrician, but also of his whole body – took up considerable time every day. But it gave in return an impression of freshness and cleanliness to his appearance such as could not be given by any artificial means. What he spoke was not merely well-considered but said in such a way that the listener gained the conviction that the speaker had real interest in the subject. His words were clearly spoken, his sentences clearly formulated and completely finished. One felt his efforts not merely to speak and also to speak well. And it was the same with his movements.

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Some people could come to the conclusion that everything was constructed, artificial or mere form. I wish to note that some Germans have similar reproaches for the Frenchmen, particularly the Parisians. It occurs whenever they see how this charming and cultured people – in all their dealings; in their every syllable – demonstrate a certain striving for perfection of form. Indeed, anyone who sees in this always charming manner a particular agreeability as applying specifically to themselves – anyone who sees in this general politeness and desire to please as friendship and love (applying to them) – will frequently feel disappointed. But whose fault is that? Mayer never simulated friendship. Many a closer relationship was later loosened and finally dissolved. But it was not his fault if new developments in public and also private life gradually cast shadows over some shining places in his relationships with others. On the other hand, no one else will easily have maintained such numerous friendships for so long as did Mayer. Ever and again, old relationships came to the fore, even if – because of physical distance, through professional obstacles and those of daily life – lengthy interruptions occured. Up to his death 15

he was always a loyal friend who looked forwards keenly to seeing his friends. But the whole tenor of his daily activity, of his domestic life, and his health directed him in his last years to expect the obligingness and visits of his friends. He was ever less frequently in a position to return such visits and one knows unfortunately how, in such circumstances, a feeling of offence, mistrust and a cooling of attitude develops amongst such apparently neglected friends. Mayer felt it deeply and painfully that many an old friend gradually withdrew from him, indeed he himself finally complained frequently about being deserted and rejected. And again, one must concede to him that a man whose house is open to many friends cannot repay all of them equally by return visits. Scarcely had Mayer established his own household than the liveliest social life began there. His sister Caroline ran the small household and she told us often enough how, quite unexpectedly, guests often came with him to lunch or breakfast, when the kitchen and the pantry, and sometimes even the housekeeping money was insufficient. But a way out was always found, and the shortcomings were cheerfully ignored. Very soon, the household was enlarged. In 1824 Mayer married the daughter of the bank Assesser Martins, a widely respected and cultivated civil servant whose large family circle extended in many directions. It was one of those families which made for the celebrity and pride of old Berlin.1 Here Mayer’s social skills found both opportunity to expand further, and at the same time, grateful reception. After his toil in his practice, he met here cheerful and pleasant people – whose contact refreshed him and stimulated him to further activity. Not however, to every kind of social activity. However susceptible to stimulation was his nature – however gladly he participated in every pure enjoyment – he nonetheless, determinedly chose those types of recreation in which he had some skill. Neither the evening read-

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ings in the Martins family, nor theatrical performances were his hobby; he preferred things which he had thought out for himself or created. He was always receptive to music, and liked to participate in jolly songs, but there have certainly been few native Berliners who so completely shunned music education, concerts and theatre. Thus in his parents-in-laws’ house too, it was chess which gripped him and in fact, gripped him so much that he soon began to play it as a real Art, and was later able to take part in the great International Chess Tournaments. But more than any game, however, he was fascinated by human beings. Indeed one will seldom encounter such a rich circle of charming people who simultaneously were closely related and intimate with each other. In addition to the numerous daughters, there were the fine sons-in-law: the two brothers Illaire – lawyers; Sunderlin – later professor of Materia Medica in our faculty; and finally the two painters Däge and Steinbrück. Three sons – all of them of younger age – only later contributed to the family circle; and then only when Death had begun its sad harvest and had torn gaps in this garland. At that time, however, everything was still fresh and unspoiled, and full of merriment, hope, friendship and love. Mayer’s own household complemented it in the finest fashion. In addition to his old playmates and war-time comrades, new medical friends appeared, and the circle grew wider and wider. Amongst these I mention above all, the subsequently so famous surgeons Dieffenbach – who from the beginning of his time in Berlin, associated himself most closely with Mayer – and Baum in Göttingen. Amongst the older practitioners, were primarily Hein, Formey and Horn with whom there were good relationships. The younger generation, however, stuck together more and more. What it achieved on the more social and collegial side is evidenced in the still-extant “Heimia Society”e9 in whose poetry anthology – originating with

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e9

A society named in honour of Ernst Ludwig Heim (1704–1785). See website http://www.retrobibliothek.de/retrobib/seite.html?id=107833

the late Gedicke – we can also find indications of the history of this society. From it I mention only that in 1833, the new Society was formed from the union of two earlier societies, the Stolliana and the Van Swietenia, and that the poet (Gedicke) names ten of the founders: Zimmermann, Ohrtmann, Haseloff, Arnim, Berends, Pätsch, Thär, Eckard, Gedicke and Mayer. A fading memory! Let us here once again gratefully summon up the memory of this brave group of fine practitioners. Doctors die quickly and are rapidly forgotten. Therefore we are at least fulfilling a duty in retaining a grateful memory of them in the narrower circle of the medical family. That is, for as long as the modern view of the State – that medicine is a trade – has placed all medical interest on a merely materialistic foundation! With Mayer, those material concerns never determined his actions in any way at all. He conceived his art as a free one in the best sense of the word; his

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cheerful nature never allowed (him to be affected) by material worries nor by philosophical considerations on the value of money and work being worthy of reward.e10 This is not the place to discuss the difficult question of ‘medical fees’ and certainly not the place to answer it. I will only repeat what Mayer used to say: “I have never demanded an honorarium, and I have never – excepting only perhaps in occasional cases – been disadvantaged by this procedure”. His standpoint was that the rich must support the poor, and in such a way that the doctor carries over to the poor what he receives from the rich, but not in such a way that he presents higher bills to the rich man in order later to be able to carry out the transfer to the poor. Mayer himself did not deny that in order to proceed in this way, one must first have the wherewithall to live. He was fortunate enough to always find these means and he was therefore e10

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probable allusion to “the labourer being worthy of his hire” in the Lutheran Bible.

able to remain true to his custom. But he did not fail to recognize that one’s own livelihood is the first condition for this form of dealing with the public. And he never condemned anyone who did things differently. It was just that disinclination for medical bills was so deep that he never overcame it. This accounts for the fact that early on, he began to concern himself with the poor in a special way. Scarcely had his financial situation improved to an extent that he knew his growing family to be safe from worries about food, than he turned to the City Administration with an application to treat sick women free who through poverty were otherwise without care. This was in 1832. The Administration for the Poor gladly accepted this offer: doctors for the poor were directed to send sick women to Mayer, and the expenses for medicaments, bandages and instruments were assumed by the City Treasury. These however, were scarcely worth mentioning, because Mayer donated most of it without charge. As a rule, the annual budget of the City amounted to 100–150 thaler. For this, 200–300 invalid women were treated – many for a long period – because a large proportion of them had chronic diseases, prolapse, metritis chronica in its various forms and so on. This was a model for the organization of this treatment for the poor. Sick people came to Mayer’s house and were regularly examined with the greatest care, treated and documented. The observations thus gathered could claim to having a high degree of reliability, especially since Mayer had begun to attract younger doctors to assist him. They had to make records, visit the invalids in their homes, and help with and check the examination. This occurred approximately from the 1840s when at first, Siegfried Reimer, then Benno Reinhardt (1847), Rockwitz and Kauffmann occupied the position of Assistent.2 Other younger doctors too – specifically his later son-in-law Ludwig Ruge and numerous people not previously known to him – participated in these examinations. It was Mayer’s greatest pleasure to teach his method

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of examination precisely and to have the newcomers examine (patients) themselves, then to discuss the clinical aspects of these cases and finally to present his own experiences. There was a time when this kind of instruction – for which there were always willing students – was Mayer’s favourite activity. Indeed, he did it mostly because he was promulgating a hitherto almost virtually unknown science directly among practicing doctors. How many people from all parts of the world learned here for the first time to examine gynaecologically exactly, and to even think gynaecologically! At this time, his dearest wish was to make his experiences available to students and simultaneously to complement – in a regular hospital situation – (the clinical work) which was not accessible to him in the merely ambulatory clinic for the poor. This wish was not only unfulfilled, but was quite specifically refused. His efforts to achieve a Department in the Charité Hospital remained wholly unsuccessful. However painful it was for him, and however much it was generally regretted – (that such an appropriate, and for science so progressive, undertaking as a gynaecological division in Mayer’s hands would have been did not come about) – he did not allow himself to be intimidated. Quite to the contrary, he continued to work on sturdily in his own way. Certainly for a long time, little of this was perceptible to the outside world. Only in 1834 did he decide – apparently at Dieffenbach’s suggestion – to publish two of his operation cases. This occurred in two papers in the third year of the Medical Journal (Nos 3 and 13), of which the first concerned the successful extirpation of a fungating lesion of the vagina. Later Mayer attached very great importance to this case – which was carried through with scissors – because he thought he could assign this case to the so-called cauliflower growths.e11 The other article concerned the extirpation of polyps with scissors; and in particular, the

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e11

This could mean a verrucous carcinoma or “Buschke-Lowenstein tumour”, and not a fibroepithelial polyp or ulcerating carcinoma.

successful removal of a 4 pound, 4 lothe12 growth of this kind. However suited this data was for attracting the attention of the medical public, it would still not be sufficient to make clear to people further afield just how important was Mayer’s position at that time. He himself was not much concerned with this. In a completely happy marriage, five daughters and two sons had been born who were growing up with great promise. His tendency to withdraw into the inner circle of his family was reinforced by this. To this was added the love of microscopy which awoke in him quite suddenly. One of his brothers-in-law – the subsequently famous inventor of telescopes had approached Pistor, who together with Schiek had just produced in Berlin the first good microscopes.e13 With this, Mayer acquired an instrument, and because at that time it was not customary to occupy oneself with histology, he attached himself to Ehrenberg, heard his lecture, and had himself initiated by him into the “Art of Infusoria”. Now a new life began. On walks in the countryside around Berlin, bottles and glasses were filled

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from ditches and puddles and brought home.Then for hours – often deep into the night – he sat at the microscope and observed. Ehrenberg’s example also had the consequence that he went to work with slate pencil and fine brush in order to make drawings of the little creatures. This was strictly speaking, his first attempt to draw and reproduce in colour scientific objects. For the moment, these works were wholly a personal interest: – they gave him a pleasing occupation for his leisure hours, which not merely relaxed him, but also stimulated him. His zeal was so great that when quite special events occurred in his microscopical world during the night, he made his wife get out of bed in order to show her the miracles in the miniature world. But no real discoveries resulted. Certainly however, the patience of the observer; the endurance in e12 e13

a unit of weight, approximately 10g. achromatic type. See Otis (2007) pp 56–9.

21

pursuing even the smallest event; the absorption in the object; and finally the ability to draw and colour – (these were) qualities which later bore rich fruit at the patients’ bedsides. His instrument was not quite good enough for more sophisticated histological investigations – the only case where it was directly practically useful was in the investigation of the milk of wet-nurses which he carried through very carefully. For it had long been customary in his practice that no family took on a wet-nurse before he had given his approval. He had suitable people brought to him by reliable women, and only after the most exact testing was permission given for their employment. In the midst of this splendid and rewarding activity – which was almost never interrupted for more than a few days – his health was profoundly shaken by a serious illness. In 1836, he had begun, together with his colleagues von Arnim and Behrend, to engage two new skills which, until then, had remained almost foreign to him: riding and swimming. Just as with everything he began was undertaken and continued with a certain vigor until he had reached his goal, so it was here too. Every day there were extensive morning rides, and more than once, Mayer got into dangerous situations because of the boldness with which he tried to overcome the greatest obstacles. Nonetheless, he escaped each time with a moderate injury. It was different with swimming. It was his custom when riding to stop at the Lutze salt works at Unterbaum to have a swim, with which some instruction was associated. One day Mayer, who had still not made much progress in safe continuous swimming, wanted to undertake the socalled Spree stretch. After a while the swimming instructor who – for reasons of safety had tied a rope to him – thought that Mayer’s strength was failing; he began to pull him back whilst Mayer was still trying to go forward. In this struggle – which was carried out with great excitement – his strength became

22

exhausted. Almost unconscious, he was pulled to land. Convulsions occurred, and when he was brought home, there was a severe attack of fever, which a

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short while later, was followed by a second attack (of fever) no less violent. During the night, nine of his most experienced colleagues came together at his bedside; where opinions differed widely. The most proven practioners such as Horn and Barrez abandoned all hope; the others were in doubt as to whether it were an attack of the currently-prevalent malignant intermittent fevere14 – in which it was assumed that the third attack was usually fatal – or whether it was a case of an inflammatory, a rheumatic or a nervous fever. Arnim accepted the responsibility for a blood-letting, and the patient recovered – certainly very slowly but apparently completely. (Only four years later did severe disturbances of cardiac activity appear. These were attributed to an inflammation of the heart). After Mayer had hovered in danger of his life for several days recovery began, but subsequently, there was a certain irregularity in the heart beat which may not have been wholly unconnected with the circumstance of his last illness. This illness became the cause of his first prolonged interruption of his work. He went on a journey to Vienna, where just at that time, the new pathologicalanatomical school was winning its laurels.e15 It was the first time that he was able to observe in another place, a midwifery school with his own eyes, and in fact, a school which was working with a superfluity of cases of which up till then he had had no idea.e16 Full of new inspirations he returned home, where a particular honour was waiting for him. King Fredrick William IV – soon after his ascent to the throne – had created the title of Health Councillor (Sanitätsrath) and Carl Mayer was the first to receive it. It was desired to acknowledge his many years of selfless labour as Doctor for the Poor in this way. In 1846, promotion to Privy Health Councillor (Geheimer Sanitätsrath) occurred and at various times later followed the conferring of the Fourth and then of the Third class of the Order of the Red Eagle. e14

malaria Rokitansky’s school e16 this was the department in which Semmelweis made his observations on puerperal fever, see chapter 1. e15

However little Mayer was interested in mere external honours, he was at the same time not insensitive to the advantages which they had for his practice. Indeed, this latter grew constantly so that he found it necessary to limit his midwifery activities whilst preferring more and more his gynaecological work. This was connected with his thorough study of spase17 elsewhere, in which he was not satisfied by knowing them only superficially. On the contrary, he made contact with specific doctors, sent sick women to them with such exact medical histories that the latter could qualify as true models of this type of work, and for each case, he gave the most exact directions for the treatment program. During the period of treatment too, he had details sent to him, and reserved his right to give new orders. If at all possible, he visited the spas himself, gave instructions for the improvements in the installations which he thought necessary, and thus

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had a decisive effect far beyond the circle of his own practice. Thus, in 1841, he visited Franzensbad; in 1854 Krankenheil; in 1856 Wiesbaden; in 1858 Teplitz; in 1862 Dürkheim – not to mention numerous other spas. And at all of those places, he worked with the best of his powers towards the general well being. Meanwhile, circumstances in Prussia had changed in a glorious way. In 1840, the change of king had released the Liberal spirit, and it was clearly understandable that Mayer’s household was not among the last to be affected by this. As the older daughters grew up, various new factors entered the hitherto rather closed family circle. Younger men, who had grown up in a different intellectual atmosphere than that of the Wars of Liberatione18 brought political discussion along with them.e19 Together with the subsequent sons-in-law – Ruge and Seydel – a circle of friends came together which was most frequently composed of the brothers Schomburgk, Brüggemann, Müller-Strübing, Dieffenbach (Darmstadt); while Berthold Auerbach, Georg Fein, Franz Löher, Anold Ruge and other wellknown liberals joined in whenever they were in Berlin. e17

refers to the spa health movement in Europe from the eighteenth century onwards. Napoleonic Wars after 1812 – partly referring to the liberation of Prussian territories lost in the Treaty of Tilsit, but mythologised to an extent since then. e19 probably refers to the fact that political discussion was discouraged under the previous king. e18

24

Towards the year 1848, opinions grew sharper in these circles too, concerning what was necessary for the Fatherland. There were marked differences of opinion with the various older friends and family members; seemingly firm relationships within his old circle of friends were broken. It was only Eckard, Pätsch, and above all the loveable and always constant Schütz4, who continued with the more intimate connection. In spite of this, Mayer remained true to his basic liberal view right up to his death. Externally this damaged him enough, for in certain levels of society, he became absolutely unacceptable. But this was richly compensated by the growing recognition which came to him from elsewhere.And he was consoled by the awareness that he never gave any voice to his disappointment other than in private. Let people here and there see him as a Red Republican in the Great European Conspiracy; his actual political activity never went further than voting in favour of the liberal candidate in the Elected Assembly. These new relationships had visible results in two other directions. First of all in respect of the arrangements in his household. This was not only that in many cases, the personalities were different ones, but also the entire furnishings and decor were altered. Robert Schomburgke20 had brought from Guyana numerous objects of a still-barbaric art – weapons and household implements and all kinds of remarkable natural products – which he presented to Mayer. The latter now began on that so admirable redecoration of his rooms – admirable because of the taste and care in the choice of objets – which evoked the astonishment of all visitors and immediately occasioned ever new presents of a similar kind. Earlier on, he had limited himself to decorating his walls with the

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portraits of celebrated doctors – in particular obstetricians – and his interest in rare plants developed more and more; especially because he had been introduced to a large family of gardeners by his sister and brother3 with whom almost every new growth was immediately e20

Sir Robert Hermann Schomburgk (1804–1865) born in Saxony but British citizen, explorer, made two journeys to Guyana. Why he would have given Mayer these objects is unclear. However, both Robert’s brother’s (Otto 1810–1857; Moritz Richard 1811–1891) were apparently resident in Germany in the early lives, and Mayer may have attended a member of one of their families. Moritz accompanied Robert on the latter’s second journey to Guyana and collected specimens there for the University of Berlin (Encyclopaedia Britannica, 1911).

cultivated. Now evermore living and dead birds were added to a rich collection of magnificent indoor plants. There were aquariums with fish and amphibians, all imaginable rare and precious preserved specimens of strange sea animals, tasteful furniture and works of art, nick-nacks of such diverse kinds that his home was like a museum. And indeed, like the best managed and exhibited museum. Because here there was no disorder, no uncleanliness; nothing disturbing. Everything was in its place, and made an impression in the total artistic effect. These may seem to be external things, which should be kept in the background in a picture of the man himself, but they were part of it in the most intimate and pronounced way. For, as the house took on this “re-equipage”, the activities of the owner also became more domestically-oriented. The more livable the rooms became, the more he preferred to stay there, and the more he found it necessary to pass his time there, the more zeal he applied to making them comfortable. The biggest factor in this was a fracture of his ankle which he sustained in 1850 while he was alighting from a coach. Initially neglected, his leg soon proved to be so painful that for a long time he was housebound. It now became necessary to conduct a large part of his practice at home. Facilities hitherto existing only for his service to the poor, were extended and improved; the sick people became accustomed to this absolutely caring form of treatment; indeed it became the basis of a reputation such as had been enjoyed before him by no German gynaecologist. This was a reputation which soon brought patients to him from all corners of the world. Thus from this original modus operandi – which had been planned as only a temporary phase – there developed a custom which was subsequently never abandoned. The actual obstetric practice was continued only infrequently and in the most exceptional cases; his family practice was completely given up; the equipage was got rid of, and when he had finally set himself up in his own house (No 11 Auf dem Carlsbade), he had no medical practice at all outside its walls.

25

That was one side of the innovations. Thus however important it was for his house and for his clinical practice, it was of little significance compared to the other side which lay in the public arena, and particularly in the public scientific

26

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arena. This was the foundation of the Obstetric Society; an act which can be regarded as the greatest triumph of his life, and at the same time, as the most powerful impulse for his own scientific achievements. Earlier, Mayer had belonged to various scientific societies, but none had satisfied him. He needed a focus on the area of his actual work. Hitherto, there were many colleagues in the younger generation who, specifically in midwifery, needed the support of older and experienced practitioners, and who needed mutual counselling and discussion. Busch, who occupied the chair in the Faculty after Siebold, did not meet these needs. Joseph Hermann Schmidt, who had taken over the corresponding department in the Charité was even less familiar with that sober observation which the more mechanistic direction of the newer Medicine seemed to demand. Thus Mayer became the natural focus for all progressive efforts which were made predominantly by earlier pupils of Krukenberg, in particular Wegscheider, Ruge and Reimer. The foundation of the Society was the simple result of the awareness of these circumstances. On the 13th of February 1844, on the anniversary of his doctorate, his colleagues assembled for the inaugural session. Official permission was soon granted, and they succeeded in uniting all the parties when Busch was accepted as Honorary member and Schmidt as vice-president in the society.5 As far as I know, this was the first Obstetric Society to be established anywhere. It could scarcely have arisen without the new awakening of the spirits of freedom and of freedom of association which the new political atmosphere brought with it. The statutes were also totally dictated by this new Spirit. It was not the lecture, but in contrast, the discussion which was 27

the main thing; in the place of shy secrecy, there was immediately a publicising of the records of the proceedings, which was attractive and surprising because of their rich content. Not merely midwifery and gynaecology as Art and Science, but the whole situation of the obstetrician, collegial behaviour, relations with midwives and swaddling nurses (Wickelfrau), the care of newborn infants and women after labour – and so on. In these proceedings, the entire multifaceted matter of the care of woman and child from the medical standpoint moved into the foreground of discussion. Indeed in 1848, it was here that the first stimulus was given to those reforming efforts of doctors which have exerted such a lasting influence. In the session of the 2nd of April of that year, it was decided to send an invitation to all other medical societies for the election of deputies, who should organize the formation of a general assembly, initially of Berlin doctors. On the 30th of June, the general assembly, which had thus come into existence – and whose first chairman was Mayer – promulgated its appeal to Prussian doctors to prepare everywhere the foundations for the formulation of a new medical constitution.6 But however zealous these efforts were, and however warmly Mayer took part in them, they remained for the moment unsuccessful, and soon after he withdrew back to his own (obstetric) society.

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It would demand an account of its own to describe the history of this Society during a period of almost 25 years; its achievements and the particular influence of its continuing president. I pass over this – all the more because such an account would have to touch on various points which will only permit an objective treatment at a later date. But this must be noted – that the spirit in which the proceedings were conducted were initially determined by the Chairman. He always presented new factual material and he kept himself up to date with the most important German and foreign literature. His practice amongst the poor provided him and his Assistenten with ever new points of view for debate.The long sequence of Annual Proceedings of the Society bears witness to his literary productivity which was always based on personal observations. Thus the Society became more productive than any other medical society in Berlin has ever been; it had an enhancing influence on the status of our obstetricians, it led to imitation in other places where gradually obstetric societies arose in the same way. What distinguished Mayer as an actual obstetrician, and what made him so valuable for science as a whole, was above all, his defence of the patient treatment method of following the courses of nature and only intervening gently – as opposed to the somewhat aggressive and hasty action such as is practiced in some modern clinics. In this respect, within the Society, the various attitudes often disagreed strongly with each other – the first debate on perforation (“breaking of the waters”) exposed the division quite clearly. Mayer emphasized that he – just as little as his teacher Siebold – had never had reason for a perforation. It was known that few students at present in the course of a semester had no opportunity to see a perforation. Mayer acknowledged that there could be cases where perforation was appropriate, but certainly he had reason to believe that their number should be greatly reduced. His viewpoint was similar in other questions too, and I think it always will be important in midwifery to consult the judgment of a most accurate and reliable observer who has made his observation in complete calm and in the full sense of responsibility of a practicing doctor.7 But there was something else which distinguished Mayer from contemporary gynaecologists. I refer to his strict scientific orientation, and the associated tendency towards exact anatomical knowledge of the pathological changes, all of which had already been awakened

28

in him by Siebold, and which had been increased by his journey to Vienna. Thus it occurred that at the beginning of 1846, Reinhardt and I were invited to the sessions of the Society, and that the results of recent research were rapidly presented to the debating circle. The notably keen interest which Mayer personally demonstrated in our investigations soon had a determining influence on their further course. Thus if a substantial part of my work at that time were concern-

29

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ed with the physiological and pathological conditions of pregnancy and of the puerperium – as also of the newborn infant: – it is to be explained by the sympathetic atmosphere and stimulus of the Obstetric Society. My departure to Würzburg (1849) changed nothing in this respect. The close relationship as a relative which I had with the Mayer family; the presence of the two sons who studied in Würzburg; the close relationship which I achieved with Kiwisch, greatly strengthened our interactions. It was especially two important questions which held Mayer’s attention at this time – the history of the cauliflower growthe21, which he was the first in Germany to teach us to recognize more precisely, and the nature and treatment of the flexions in which he was in accord with Kiwisch – two questions which right up to the end formed the object of his most ardent research, and in the search for the original causes of which he never grew tired in spite of all failures. Repeated journeys to Würzburg were the start of many further excursions which extended more and more the horizons of this careful observer, and which finally took him beyond the borders of his home country to Switzerland, Italy, France and England. Everywhere he encountered grateful female patients who were eager to make his stay pleasant and recompense him for what he had shown to them – beneficial actions with most caring kindness. Mayer’s activities in the Society – which were initially the determining, indeed the controlling influence on its direction – were understandably reduced later on, as his strength declined. Great misfortune in his most immediate family circle tore loved ones away before their e21

30

see e11 document page 19.

time. Repeated illnesses of the most severe kind made him himself an invalid for months – one may almost say for years – at a time. At Easter 1856, because of a contusion to the ankle, he developed a limb inflammation which was lifethreatening and which gave cause to serious consideration as to whether an amputation should be done. After the most severe suffering, in which Mr von Langenbeck supported him with inexhaustible care, and after long absence from Berlin, Mayer was able finally to take up his practice again in the summer of 1857. But his foot was never quite healthy again and when in 1864, because of a sudden fall, he suffered broken ribs and new wounding to his foot, there began a series of disturbances spreading out more and more which were unmistakable signs of the decline of his body. A haemorrhage into his retina followed by repeated attacks of apparent uremia exhausted him more and more, and prepared his friends for his demise. Nonetheless, they had the joy of seeing him during the intervals of his illness return again and again to active scientific work. His most accomplished and most sought-after work – the first booklet of clinical data in the area of gynaecology – appeared in 1861, evoked by the lively applause which his lecture at the Natural

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Scientists Conference at Königsberg had aroused. From this, the world learned for the first time of those splendid illustrations of the pathological changes in the vagina which he – as an amateur in colour drawing – had executed with great mastery, and which the Society has been able to see, not in their dozens, but in their hundreds. Earlier, he had promised to produce a second booklet. That was the thought which, two days before his death, was still seriously concerning him, and which claimed his entire attention. Once again, he sat as before with his great books in front of him – the treasury of his experience – and placed in order the cases which he intended to use for the new edition. But it was destined to turn out differently. A renewed attack, which happened in the middle of the night, ended this so accomplished life in the course of the following morning. But he died with the same thought with which he had lived. He was always striving forward in the effort for progress, in the zealousness for science, in the surety of the actual observer. Of his two sons whom he had educated for his science, the younger – the optimistic and modest August – had succumbed to phthisis in 1861, at 30 years, far from his family home. He had still been able to give his father the satisfaction of showing that like him, he was a friend of science8 and of the poor. Mayer’s heirs in his profession are now only his surviving son, and the society which in a sense, was christened in his name. May it be granted to them to take that work right out into the world far and wide, that work to which his heart was attached just as much as it was to his family, the work of maintaining and educating a collegial company of cultivated, experienced and reliable obstetricians!

31

Notes

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1

The brother of the bank-assessor Martins was the Mining Chief (Berghauptmann) Martins, whose great achievements for the state are still remembered (Der Berggeist, Zeitung f. Berg-, Hüttenwesen und Industrie.1868 No 31).

2

Siegfried Reimer died on the 25th of July 1860 (Deutsche Klinik, 1860, no 32). Benno Reinhardt died on the 11th of March 1852 (Archiv. f. path. Anat u. Physiol. vol IV, p 541). In his inaugural dissertation and in the proceedings of the Obstetric Society (1852, V p 82) Rockwitz presented Mayer’s observations on flexions of the uterus. Kaufmann was for many years secretary of the Society, and gave several papers to it.

3

The sister Caroline, was married to the Court Gardener Fintelmann in Charlottenburg, whose name will remain in horticulture because of the breeding of dahlias (Georginas). The brother Louis was for a long time Court Gardener in Monbijou; subsequently in the New Garden at Potsdam.

4

In 1857, Krieger published a warmly expressed biographical sketch on Wilhelm Schütz commissioned by the Society for Scientific Medicine.

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Memorial address for Carl Mayer (1795–1868) 5

A short account of developments during the early stages of the Society is to be found in the Introduction to the first volume of the published proceedings.

6

More precise details may be found in the Medizinische Reform Nos 1 and 2, ff. An impression of the spirit which was alive at that time in the Obstetric Society is given in the foreword to the 3rd booklet (Heft) of its proceedings.

7

An account of Mayer’s general significance for practical medicine overall, written with great understanding of the real situation, is to be found in a review of the extant memorial address which appeared in the first Supplement to the National-Zeitung of the 5th of July 1868.

8

In addition to his excellent dissertation – “The Pelvis of Rachitic Individual and a Description of Two Diseased Bones Taken from Two Sisters” Berlin, 1855 – August Mayer (born on the 18th of September 1830) published valuable data in the proceedings of the Society (VIII, p 179) and in the Monatsschrift für Geburtskunde (1858, XII, 1, p 1). After a long absence from the family home, he died in Meran.

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Chapter 5 Morgagni and the anatomical concept by Rudolph Virchow An address presented on 30th of March, 1894 to the XI International Medical Congress at Rome, Italy. Printed as a booklet by August Hirschwald, Berlin and also printed in Berlin. klin. Wochenschr. 31: 345–350 (1894). Editors’ comments Giovanni Battista Morgagni (1682–1771) (Fig 5.1) had been a remarkable anatomist and clinician. He was born in Forlì and educated in Bologna (Fig 5.2), later becoming Professor of Anatomy in Padua. Early in his career Morgagni published world-renowned volumes on the internal genitalia, and was involved in the reform of Italian medical societies. For these he was made Fellow of the Royal Society in London (in 1722, see Royal Society Biographical data on Fellows, website). In his middle years, he wrote little, but continued to practice medicine and became physician to the Papacy. He prepared his book “The Seats and Causes of Disease” (1761) (Figs 5.3, 5.4) in retirement – and was said to have done so only at the urging of a pupil (Cameron, 1953b). A statue of Morgagni was erected in his native Forlì (Fig 5.5) in 1875. Virchow’s account here of the history of medicine and Morgagni’s contributions should be viewed in the context of an address to an international congress of physicians in Rome. Virchow was by this time an honoured ‘elder statesman’ of medical science (see chapter 1). It was politeness at an international meeting for the speaker to praise contributors in the host country to the topic of the lecture. (In 1898, Virchow similarly praised English contributors to medicine in his Huxley lecture in London). Thus the present lecture was not intended to be a balanced or thorough account of the history of Pathology. To supplement Virchow’s account a little, we may mention the extensive study of pathological anatomy which occurred outside Italy in the fifteenth and sixteenth centuries. In fact, in several countries, numerous compilations of case histories with autopsy findings were published in batches of a hundred (‘centuries’) or two hundred (‘bi-centuries’) (King and Meehan, 1973), and many other authors – for example, Théophile Bonet in Neuchâtel – published even more extensive compilations of cases up to Morgagni’s time. We may also mention the work of Jean Fernel (1485–1558) who was the outstanding physician of his time and introduced the word ‘Pathology’ into medicine (Sherrington, 1946). Whether or not Morgagni’s role in medicine is really as significant as is implied in this address has been questioned by Klemperer (1961) and the details can be read in that article, as well as in Cunningham (1996). Whatever view might be held on this question, Morgagni’s contribution to medicine was uncluttered by Ancient Greek teachings and inclinations to philosophy, so that he was a true ‘raw data’ scientist. In this way – as well as by being unaffected by contemporary metaphysical concepts such as Stahl’s version of Vitalism (See Driesch, 1914) – Morgagni certainly deserved to be included in Virchow’s pantheon of rational medical scientists among whom were also the other individuals eulogised in the various chapters of this book. In this address, Virchow also appears to be insisting on the importance of pathological anatomy in clinical medicine, and in particular underpinning Virchow’s own ‘philosophy’ of the

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Morgagni and the anatomical concept ‘Anatomical Concept’. This ‘philosophy’ is seen by many authors as a fault in Virchow (Rather, 1966). Thus Virchow’s statement on text page 22 in this article: “I maintain that no physician can think methodically about a disease process, when he cannot assign a locality for it in the body”, provides some basis for the criticism of Virchow that he refused to adapt to modern laboratory scientific discoveries, especially in microbiology (see Klemperer, 1961). On the other hand, Virchow does note the advances in these sciences (text pages 9, 23), and correctly states that they all involve the study of the physiological functions of cells, which he had in fact stressed early in his career (chapter 1 and Rather, 1990). Perhaps on this point of ‘excessive anatomicalism’, the text of this address should not be examined too rigorously. It is, after all, a polite, informative and elegant oration designed to please an international scientific audience on a single occasion, and not a minutely cross-checked statement concerning any fully-considered philosophical position or positions. Finally, we endorse the comment by earlier translators (Schleuter and Auer, 1938) of this piece that “It embodies no political significance for that period, and bears no relationship to later national or international happenings, none of which need have the least consideration in estimating its historical worth, because of its purely scientific comparisons”.

Editors’ summary of points Main text: P 5 general introduction; 6–7 Graeco-Roman medicine; 8–9 Arabic medicine; 10–12 Ancient medicine returns to Europe; 12 role of the Church; 13 beginnings of dissection of cadavers; 14 Paracelus; 15, Harvey and the circulation of the blood; 16 Morgagni and examination of diseased organs; 17 Germans who studied in Italy; 18–21 Morgagni’s contributions to pathology, Virchow denies “general diseases”; 22–23 the ‘anatomic concept’ in medicine and its importance, claims the anatomic concept extends beyond the pathologico-anatomical area, the Parisian School as deriving from Morgagni’s work, ‘localistic’ therapy. Notes: These are titled as follows: 24 ‘1. Mondino and the introduction of anatomical instruction into the curricula of Universities’; 26 ‘2. Morgagni and Forlì’.

The History of Medicine, though it always has a definite relationship with the history of human culture, still offers several noteworthy peculiarities. First of all, it has an uninterrupted development of about twenty-five centuries. From Hippocrates down to us, awareness of this connection has never been lost. While religions have changed and systems of jurisprudence have pushed each other aside, medical traditions have been preserved. Even today, we use the Ancient Greek terminology; even the barbarisms produced by the youthful innovators of today endeavour to retain at least a semblance of a Hellenistic origin. No other science had such firm foundations right from its beginning – none is in reality as old as medicine. Such longevity of the Doctrinee1 could hardly have been possible had there not been a unifying element in the nature of the object with which Medicine concerns itself – that is, an element which outlasts all changes in time and place, but which presents each new generation with the same problem for investigation. This problem is disease. To be sure, particular diseases vary according to time and place, but the question as to the nature of the disease in general always remains the same. And also the task of the physician – healing – does

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Figure 5.1. (left) Etching of Morgagni from his Adversia Anatomica, Bologna (1719). By courtesy of the Blocker History of Medicine Collections, Moody Medical Library, University of Texas.

Figure 5.2. (below left) Anatomical theatre Bologna restored to the state in which it was in Morgagni’s time. Figure 5.3. (below right) Title page of Morgagni’s “Seats and Causes of Diseases” (1769). By courtesy of Historical Collections & Services, Claude Moore Health Sciences Library, University of Virginia, VA.

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Morgagni and the anatomical concept

Figure 5.4. (left) Etching of Morgagni in “Seats and Causes of Disease”. By courtesy of Historical Collections & Services, Claude Moore Health Sciences Library, University of Virginia, VA.

Figure 5.5. (below) Statue of Morgagni in Forlì. By courtesy of the Forlì City Administration.

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not cease no matter whether the physician finds himself in Italy or in Russia, in Europe or America. e1

meaning Ancient Greek doctrines/traditions in medicine

In this respect, nothing is so indicative – even if at first glance so confusing – as the changes in medical schools according to time and place. Certainly, until towards the end of the Middle Ages, all these schools were associated with one or other of the Mediterranean countries. The Asklepiadse2 – and their fortunate heir, Hippocrates – derived the principles of their teachings from the polyclinics at the temple in Cos and other Near-Eastern places. From there the new doctrine spread over the whole Hellenic World, and did so particularly quickly after the establishment of the empire of Alexander the Great. But for a long time Asia Minor – including the parts further from the (Mediterranean) coast – remained the principal seat of the teachings from Cos. Not until Cicero’se3 time did the first Greek physicians appear in Rome, and not until later – in the Imperial Age – did Galen of Pergamone4 bring the formulated doctrine of Hippocratic pathology to the West. But in this there was no change in the actual theories. The humoral pathology of Galen did not claim to be anything more than a faithful interpretation of the teachings of Hippocrates. Though more than five hundred years separated the two men, their successors were in effect accustomed to looking at Hippocrates and Galen as contemporaries – even as the manifestations of a single personality. Throughout the centuries of its existence Imperial Rome did not produce any competitor to them. Celsuse5, the only classical author of the Latin race, produced so little which was original – and what is much more significant – so little of a general nature, that he has achieved some importance only for his interpretation of details. It was only in the Eastern Roman Empire that the School preserved a certain activity: – thus in Asia Minor, as well as in Byzantium, we encounter authors of quite independent significance, but who nevertheless owe their repute more to essentially specialized areas of study. Nonetheless, humoral pathology in the special form that Galen had given to it remained the

6

e2

followers of Askleopios, physician in Ancient Greek mythology, mentioned in Homer c900 BC (Bailey, 1996). e3 Roman statesman, orator, philosopher and political theorist (106–43 BC). e4 Greek physician and famous medical author (129–c200 AD). e5 Aulus Cornelius Celsus (25 BC–50 AD) Roman encyclopaedist; author of ‘On Medicine’.

accepted doctrine in the educated world in both the East and the West. The four cardinal humors – the Xvμoí of the Greeks, the humors of the Latins – were everywhere considered the basis for the physiological as well as for the pathological viewpoint of the structure of the human body and of the alterations in it during disease. Accordingly, each disease appeared as a dyscrasia, i.e., as an

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alteration in the mixture of the cardinal humorse6 in the separate parts or in the body as a whole. It remains an idle question as to how this conception was arrived at and where this doctrine originated. Egypt – the only other Mediterranean country that has bequeathed to us any comprehensive medical literature – has hitherto offered no adequate pointers to a possible explanation of this, even at the present day.e7 As far as more remote countries are concerned, only from India do we possess any coherent works in which, at most, there are links that can be recognised. But these also vary in detail from each other, and no internal consistency has been found. In any case, none of these countries has exerted a decisive influence on the progress of medical theory. The first perceptible new significant influence comes from an altogether different period and region; but this influence also grew up on the foundations of the Greek humoral pathology. After the fall of Alexander a series of independent states arose from the ruins of the eastern part of his empire, seeds of medical erudition were preserved within peoples which until then had seemed completely closed off from Western science. Smaller local centres were formed in Syria and Persia, and, in ever increasing numbers, physicians of repute sprang up there, who not only gained influence in their own regions but also became widely active as apostles of the science. This is the period when Jews and e6 e7

8

blood, phlegm, yellow bile and black bile. Virchow had been in Egypt in 1888, and was presumably quite conscious of this.

Arabs stepped forward to be among the most distinguished teachers of Medicine. Not until our own time were Hebrew manuscripts brought to light, which show with what zeal and learning Jewish doctors of the early Middle Ages were active in the preservation and promotion of Medicine. One may well say that the frequently inherited capability of the Jews – which has since accomplished so much for science – may be traced back to this period. Still greater was the importance of the Arabs who soon became the true bearers of medical doctrine and without whom perhaps even the writings of the Greek heroes would have fallen into oblivion. First in Mesopotamia and in neighbouring countries, and then in North Africa and predominantly in Spain, they founded schools that became nurseries of knowledge for the West. There the works of the Greek authors were read in Arabic translation and interpreted on the basis of increasing experience. But the Arabs also brought into consideration new factors that became of great influence, and which have an influence on the practice of medicine even today. One of these elements was the Spiritualistic one. If one disregards the incubatione8 – which was customary in the ancient Greek temple service – this factor was foreign to the objective intellect of the Hellenists, except for the symbol (Gleichnis) which we are about to mention. In Hippocrates, hardly a trace of it is to be found. But among the shepherd- and nomadic-tribes of the

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East, belief in supernatural forces – probably of prehistoric origin – has survived. These were different from the natural forces of the material world, because they would be seen to be effective in part outside the body as an independent essence and in part within the body; they would be active (in both cases) for a shorter or longer span of time. A prototype of these forces could be seen in the “living breath,” – which was also expressed in the Hellenic concept of Pneu?ma (pneumatic) – and which was rendered by Latin translators in its e8 refers to the ritual of sleeping in sacred places for medical therapeutic effects – a secular role of the temple in Ancient culture (Gray, 1943).

lesser manifestation as ‘halitus’ (gentle expiration), and in its stronger manifestation as ‘spiritus’ (blowing breath). Even in our times, echoes of this notion have attained great respectability in the ideas of animal magnetism and spiritism, and to some extent in hypnotism. Amongst the Arabians all this fell more into the sphere of speculative contemplation, such as might be made by any lonely brooding hermit.e9 A type of scientific background developed among the Arabs only out of a second – the chemical – way of looking at things, thanks to which the Arabians achieved such an important position in the history of the natural sciences. As is well known, they were the creators of the discipline of chemistry – which took its splendid position among the other natural sciences only at the end of the last (18th) century. The Arabians themselves never progressed beyond alchemy, but as they took the first steps on the path to analysis and synthesis – as they founded and practiced extraction, distillation, sublimation, precipitation in the production of pure metals and salts – the concept that finer components were hidden in the crude substances developed more and more. And the idea grew that these were carriers of energy and thereby were also the basis for the significant properties of raw materials. Thus the merely spiritualistic concept was associated more and more with the representation of true reality, in other words with a refined corporeality of the properties. And from this strange admixture, the dualistic conception reached the Western World where – likewise from prehistoric times – many precursors of these concepts were still alive. The contact with the East, arising from the Crusades, contributed much to giving validity to such ideas among the nations of the West. For science itself, this might possibly have been a minor influence, but at that time there was no Western science at all, – least of all any medical science. e9

9

here Virchow is expressing a view of the ‘Naturephilosophers’ (see chapter 1).

The Western world received its decisive influences in respect to Medicine directly from the learned Arabian schools – partly from Spain, and partly from North Africa. For the former the main point of contact was Southern France, for the latter it was Southern Italy. But whilst the importance of Montpellier

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developed only slowly and in barely visible form, the School of Salerno has remained for all of us as the real place where the ideas and experiences of the East broke in, imported first of all by Constantinus Africanus e10 toward the end of the 11th century. The Monastery of Monte Cassino soon joined in; the Benedictines took up these theories and thereafter included Medicine among the subjects taught in the Monastery schools. It is not surprising that the Medicine of the monks was once more the old humoral pathology. When it was recognized that Arabian pathology had been taken from the Greek authors, the Arabic translations of the Greek were turned into Latin. These translations – only much later revised by comparison with the original sources – became the foundation of study for many generations, not only in Italy but throughout the entire West where Latin had become the learned language, particularly from the time of Charlemagne. Hippocrates, and still more Galen, were recognized by the Church, and they attained by and by – if not through the expressed sanction of the Church – the actual position of Fathers of the Church. To doubt their reliability was deemed a sacrilege. Thus the teachings of Galenism – already venerable because of their age – became actual dogma. It might have been different, if that type of institution in which modern medicine found its real sources of knowledge had existed then – I mean hospitals. But the so-called hospitals of the Middle Ages, particularly the earlier ones, were in fact – as the name indicates – only hostels, e10

11

(1010–1087) medical translator and Benedictine monk, active in Salerno.

essentially for pilgrims. They provided a short rest for travellers, and the priests who conducted them only occasionally had the task of giving aid to the sick. However, many of these hostel–houses became actual hospitals later, mostly only after a long existence. It is appropriate here to mention the earliest known hospital, founded in the 7th century for Anglo-Saxon pilgrims here in Rome, by the Tiber Bridge. This Hospitale S. Spiritus in Sassiae11 later became the headquarters for the organization of Holy Ghost hospitals which was spread over the whole of the West by Pope Innocent III. It still stands on its original site (of course with many changes) as a great secular hospital. I have previously written the history of the Holy Ghost Hospitals, and demonstrated how little they accomplished in actual service to the sick and to medical science. Those among the hospitals that deserve mention in the history of medicine owe it almost without exception to the circumstance that they fell under secular administration – as a rule into the hands of the municipal authorities. Until the beginning of the last century, State governments almost everywhere did not take part in humanitarian tasks, and in the main, since then, they have done so pre–eminently because medical instruction of students at the Universities categorically requires the use of hospitals.

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For my exposition today, the hospitals have therefore only slight importance, because I merely desired to show this great gathering how the ancient and ultimately dogmatized medicine regained its freedom (from dogma), and developed into the new scientific medicine. This remarkable change was initiated by long struggles which were fought out in large measure on Italian soil, even if e11

Sassia is Latin for Saxon. However, hospitals/destitute asylums were established all over Europe. The one in Lübeck was founded in 1286, and is still intact (in 2008).

other nations also took part in the victorious conclusion. The prize (for success) in this contest, or more accurately the prizes, fell to Anatomy. It is hardly necessary to mention that throughout Antiquity only once, and in point of fact only for a short period, was the opportunity offered for anatomical research on the human being. It was at the time when, after the death of Alexander, rule over Egypt fell to the Ptolemiese12. Thereafter no similar possibility was ever given to a physician in ancient times. Therefore even Galen could not recommend anything other than to study (anatomical arrangements) of the monkey and hog – as animals nearest to man in their organization. From the very beginning, it can be understood that sacrifices during worship – which involved the ascertainment of the normal arrangements in sacrificial animals and their organs – also afforded many an opportunity for comparative observations of a pathological nature. Even ordinary slaughtered animals must have offered to a thinking observer enough material for reflection and observation that could be evaluated in studying human disease. There can be no doubt that Hippocrates already knew and used many a fact which was verified only centuries later in Man. But it is evident that both anatomy and pathology had to remain without certainty as long as studies on the human body had not provided strict proof of the particularity of (pathological) changes in individual parts (of the body). The real difficulty lay with the Church. The inherent disinclination of the public towards dissection of human cadavers was fortified by canonical interdiction. To this was added the fact that there was no need of dissection for any one who was convinced of Galen’s infallibility. Why dissect when the arrangement inside of the body is known? Thanks to this argumentation a curious dilemma e12

12

The Greek dynasty which ruled Egypt 305–30 BC.

arose that retarded the development of Anatomy for at least two centuries: – to ascertain if Galen was in error, one had to dissect – Science demanded it, but the Church declared that it was altogether certain that Galen had not erred; it was therefore unnecessary to undertake such a despicable deed. Given this dilemma, only the highest ecclesiastical authority could help and it did finally decide in favour of Science. In Rome there was never any dearth

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of physicians who considered it a duty to assist in the recognition of truth in Science, and quite a few personal physicians to the Popes have belonged to the active vanguard in that endeavour, right down to our time. This explains how at the beginning of the 14th century, Mondinoe13 in Bologna obtained permission to dissect and demonstrate several human corpses. Once the ground was broken, it gradually became passable for others. Thus the Italian universities achieved valuable expansion in medical instruction at a time when universities in most other countries were still deprived of it. Thus there were anatomists in Italy when such a profession was unknown elsewhere. Thus began the procession of medical students from northern nations to the Italian universities – primarily to Bologna and Padua; even graduates occasionally came to complete their education. Among these was the young scholar to whom it was granted – on the basis of his own planned investigations – to destroy forever the infallibility of Galen; and for the moment, at least in the domain of anatomy, to establish irrevocably and in an unassailable form, the pre–eminence of the autopsy. This was Andreas Vesalius, born in the area of present-day Belgium of a Low Germane14 family, educated in Francee15, but only achieving greatest distinction when Professor at Padua (1537–1544). This latter fact made it possible for him to become the true e13

1258–1326, Professor of Medicine; re-introduced dissection of human corpses in Europe. in Brussels, then a Flemish-speaking area, and hence part of ‘Lower Germany’ (which is northwest Europe from approximately Cologne to the North Sea and the Baltic). e15 in fact, he was a pupil of Fernel – see ‘Editors’ comments’ this chapter. e14

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reformer in the teaching of the foundations of medicine, and at the same time, establishing for all time the standing of anatomy as a fundamental science. Vesalius was one of those rare men of universal importance such as history can record only infrequently. Just as almost all cultured nations in Europe at that time – Italy, France, Germany, the Netherlands and even Spain – were able to recognize and honour him as a kinsman, so too the validity of his triumphs in anatomy was recognized and applied to all other branches of medicine alike. For all this, it is not altogether correct to call him the Reformer of Medicine. His anatomy, as such, was not in a position to eliminate humoral–pathology. Nothing could dissipate the conception that organs – accurately investigated for their location, attachments and arrangements – were composed of the four Humors. To bring about this change it was necessary to make a direct frontal attack on the centre of the battle-line of the dogmatists; on the doctrine of ‘dyscrasia’. This was achieved, with the violence of a conqueror, by a German who had a basic disdain for anatomy, and who used instead of it the Arabic tradition – of course in a very much altered form – as a means for achieving his purposes. This was Theophrastus Paracelsus, a contemporary of Vesalius. By proving the chemical untenability of the four humors and their inadmissibility as elementary substances, he was able – with the assistance of Arabistic addi-

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tions – to build up a sort of counter-doctrine that was half naturalistic and half spiritualistic. Alas, in the hands of his successors, it took on a preponderantly mystical character. It is difficult to say what would have developed for medicine out of this doctrine, a doctrine from which everything dogmatic had been cleared, but which on the other hand had been sacrificed to arbitrary subjectivism. But salvation was near. Already at the beginning of the 17th century, William Harvey established the theory of the circulation of the blood, and thereby laid the cornerstone of a new science – physiology – which soon rose to full glory as a companion to anatomy. He too came to Padua as a student to strengthen himself in anatomy. Under the guidance of Fabricius ab Acquapendente e16 he studied the arrangement of the blood-vessels and the heart and thus, at last, established blood as the ‘noblest humor’ – the proper ‘humor cardinalis’ – instead of designating it merely as one of the four cardinal humors. His theory of the circulation omitted only one notable, but also very significant, hole: he was unable to explain how the blood from the arteries reached the veins. To have furnished proof of this step by direct observation is again to the credit of an Italian investigator. It was the renowned teacher at the University of Bologna, Marcello Malpighi, who applied the newly invented microscope to the observation of processes in the living body, and discovered the capillary circulation. This discovery was in effect the coping-stone of the building, in whose construction Vesalius, Harvey and innumerable other learned men had expended their labours. This also established the transition of humoralpathology into haemato-pathology; thus a direction of research was founded, for the full development and transformation of which the next two centuries have laboured, and which has not even today been finally completed. Strangely, none of the scientists named here, reached the point of trying to apply the information from pure anatomy – and its development into experimental physiology – to pathology. For no one can busy himself continuously with anatomy without noticing the changes that diseases produce in the living body. In fact, we know that from Eustachius to Vesalius the pathologico-anatomical variations attracted the attention of anatomists. However, neither they nor their immediate successors recorded these deviations from the norm with the kind of care that could have produced

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e16 Hieronymus Fabricius (Girolamo Fabrici) 1537–1619, born in Acquapendente; Professor of Anatomy.

any foundation for a theory of pathology. On the contrary, the old idea that disease is something general became stronger as the conviction grew that a single fluid – circulating throughout the whole body – was simultaneously the carrier and the centre of all essential changes. Even the comprehensive studies of

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Hermann Boerhaave, that great teacher at Leyden, whose pupils soon occupied all professorial chairs in Central Europe, were unable to counter this view. They only succeeded in shifting the importance of local processes into the area of interest to doctors, but they finally achieved the idea that these local changes are due to local disturbances of the circulation. Thus the circulation always remained in the foreground of pathological speculation; Paracelsus’ idea of the vita propria of the organs was pushed aside as a spiritualistic false path. Morgagni’s development in youth was in this period. Fortune led him at first to an environment that was less favourable to pathological than to anatomical studies. Let us tarry here a moment! – When Giambattista Morgagni, hardly sixteen years of age, left the school of Forlì – the city of his birth – in 1698 and went to the University of Bologna, he found himself as it were, transposed into an anatomical atmosphere. Everybody still knew about the discoveries which had been made by Malpighi, Aranzi and Varoli. Soon he came into close contact with Valsalva, who involved him directly in his own anatomical studies and also introduced him both to pathology and to medical practice. In 1701 he received the laurea in medicine and philosophy, and a few years thereafter the presidency of the Academia Inquietorum, which later became the Istituto delle Scienze. His first substantial independent work, the Adversaria Anatomica Prima appeared in 1706. It was followed in succession by five additional small books. His fame grew so rapidly that in 17

1711 the Venetian Republic called him to the Faculty at Padua – the chair that had earlier been occupied by Vesalius. Here he developed such extensive teaching activity that the number of students became too large for the space in his lecture theatre. Despite the international character of this congress, I may be allowed to recall how much Germany was represented among those attending his lectures, and how our people (i.e. Germans) developed a special relationship with the great master. In 1715 Morgagni had already been elected Patronus Germanorum by his German students and with his assistance they furnished a library in a certain house that bore the inscription: Inclyta Natio Germanica Adjuvante Liberalissimo Protectore Cel. viro Io. Bapt. Morgagni M. P. L. P. has sibi emit sedes. However, seven years earlier (1708) he had received from Germany his first great foreign decoration: – the Academia Curiosorum Naturae (from which later the Academia Caesarea Car. Leopold Cur. Nat. developed) elected him to membership. In 1732 he was elected to the position of Adjunct. Morgagni himself repeatedly attested to how much he thought himself obligated by these honours, particularly when in 1761, at almost eighty years old, he published the first book of his great work De Sedibus et Causis Morborum. In the front is a dedication to Trew, the well-known member of the above-named academy. In the last book he expressed similar gratitude to the Berlin Academy of Sciences,

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which had elected him to membership in 1754, on a motion by Johann Friedrich Meckel, to whom the fifth book is dedicated. The method of research, as practiced in Italy by Valsalva and Morgagni, was in fact that which good physicians in Germany employed – among them, in first place, the members of the Academy of Natural Scientists, who since 1670 had published the first ScienceMedical journal – the Ephemerides Naturae Curiosum. If we leaf through the five books of Morgagni, we often encounter quotations from this journal; and how appreciatively the otherwise so cutting critic expresses himself in regard to these observers! Certainly, for a long time German doctors and natural scientists have shown a preference for attending, specifically, Padua and Bologna. And the Italians will not take it amiss if, when we cross the Brenner Pass and descend into Italy along the old imperial roade17 it is specifically in these towns that we renew our recollections of an old comradeship-in-arms on the field of science.e18 For Vesalius and Morgagni are the geniuses whose pictures constantly hover before us, whose glory has outlived all deeds of war in subsequent times and at whose summons, we renew the old alliances. For other nations there is nothing offensive in these alliances, because Morgagni does not belong to Italy alone, and still less to Germany. Even if he were not a citizen of several states (as had been Vesalius) he has become in full measure the representative of that science which is common to all peoples. To summon to memory his relationships with Germany seemed to me to be a duty of grateful recognition in recompense for all that we have received from him. But I gladly recognize that a still higher duty of thankfulness unites us all collectively assembled here; it is to bring the tribute of appreciation to his spirit for all that he accomplished in science. But how can what he has rendered to science be briefly expressed? When Giambattista Morgagni closed his eyes forever on the 6th of December 1771, aged 89 years, he left to the world a condensation of the work of a long life that had been dedicated to science from his early years onwards: the five books De sedibus et causis morborum. People did not call the e17 There is much of history in this. In Germany there is a long-held tradition of Italy as the ‘promised land’ for Germany – the ‘longing for the South’ (Requadt, 1962). Fredrick II (1194–1250) of the Hohenstaufen line of German kings was Holy Roman Emperor but also ‘King of Sicily’ (from 1198) and ‘King of the Romans’ (from 1212). Thus Italy was united with Germany in the Holy Roman Empire from 1212–1250. Fredrick II founded the medical school at Salerno (see main text of this document) and the University of Naples. At that time and afterwards, there was constant strife with the Papal States, and the Normans (French). The last Hohenstaufen leader (Conradin) was executed by Charles of Anjou after defeat in battle (1268). e18 In this sentence in the text, Virchow uses the words Auf dem Felde – the field of battle. The military image is emphasised in the next sentence of the text. The allusion may therefore relate to long history (see above).

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new discipline thus brought to life – and which soon afterwards was designated by the name pathological anatomy – but everybody already knew that these books contained the sum total of all factual knowledge about the material changes in disease that had been discovered up to that time. The new observations by Valsalva, and even the far more numerous ones of Morgagni himself were combined here with all the even more numerous observations that had been scattered through special publications of the academic and periodical writings in all western countries. Unlike the often uncritical and unreliable collections of autopsy findings from earlier times, every single observation here was checked according to its source, and then critically reviewed, not only to verify the anatomical facts but also to demonstrate and explain their relationships to clinical processes, and to give reasons for conclusions concerning diagnosis and prognosis. It was in no way a mere collection and reference work as his predecessors Schenck, von Grafenberg and Bonet had given us. Much more, it was a methodological handbook. And on the other hand its objective was not to promote anatomy as a pure science but to develop it as a fundamental science of practical medicine. Thus it is clear that only after Morgagni did the clinic attain its true importance. In London and in Paris, in Vienna and in Berlin, the full implications were explored of that which he had proposed. Therefore we can say that only through and by Morgagni was the dogmatism of the old schools completely shattered and that with him the new medicine begins. But I have still a further consideration to set before you. When I said the work De Sedibus et Causis Morborum is to be regarded in a methodological respect too as a model handbook,

20

the statement not only applies to the method of actual observation and the epicrisis of the individual case, but also to the method of its scientific utilisation of the doctrines of disease in general. In what way does this method of Morgagni differ most from that of his predecessors, and in what does his superior merit consist? It seems to me that neither the writers of medical history nor the representatives of individual specialties have done full justice to the genius of the great Forlian.e19 Up to Morgani’s time, for every consideration of disease, whether it was a general or highly particularised viewpoint of the disease or of the diseased – in the foreground was a weighing up of the nature of the disease – or as one would prefer to say – the essence of the disease. The processes were examined, the symptoms were established; one tried to ascertain the bodily changes, and then all of this was grouped together as a picture of the affliction; and the disease was given a name. If – as in the majority of the diseases – it was by no means obvious what was the nature or the behaviour of the disease, then the attempt was made to clarify all the information in a constructive way and to formulate the result. In this process, it was sometimes anatomical, sometimes clinical, and

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at other times the aetiological viewpoints which were decisive. And yet the nomenclature – chosen on the basis of these diverse viewpoints – was brought together in one coordinated denotation. If it was impossible to achieve much with the local manifestations, then one helped oneself out with a hypothesis, in which the most arbitrary presuppositions were considered admissible – yes, even as scientific. What manner of things were not perpetrated in cases of fever or with inflammation! Are there ‘essential fevers’? Is inflammation a unified concept? How various the answers given to these questions sound over time! Morgagni, who sought to study diseases as an anatomist, did not look upon the “essential nature” of disease as the first problem of the investigation. The title of his great work begins with the e19

i.e. the one from Forlì.

words: De sedibus morborum. In fact, this accords with the successive examinations which the physician generally – and the pathological anatomist in particular – must initiate in every individual case. I always impress this upon my students with the question: “Ubi est morbus?” Where is the disease? In this way the scientific path of investigation and the presupposition of a local process is foreshadowed. It is self-evident that such a question would be absurd if there actually were general diseases. To discuss the question of general diseases before such an enlightened assembly would seem to me to be an anachronism. Should anyone present still retain the recollection of universal diseases in a hidden fold of his braine20, he would soon find – with a little reflection – that in every patient an appreciable – indeed as a rule a preponderant – part of healthy life persists, and the diseased or even the dead parts are only a part of the body. This cannot be discussed in any scientific way with anyone who cannot grasp this. It is the task of pathological anatomy to demonstrate this conviction ad oculos: – “There is no sick body which is altered in all of its parts.” That is the meaning of the words sedes morbi which Morgagni has placed at the head, as the quintessence, of his experience. But pathological anatomy is unable to prove a sedes for every disease. In the great field of nervous diseases and even in that of poisonings, there are many instances where an anatomical investigation is insufficient. Not because there is no sedes morbi in them, but because the disease has produced no visible changes in the affected parts. Anatomy deals only with visible things. e20

21

for a contemporaneous English language view, see Phil Trans R. Soc Lond 17: 717–728, 1693.

Therefore the pathological–anatomical findings do not always accord with the concept of the seat of the disease. On the contrary, on the basis of our physiological and chemical knowledge we are now justified in speaking of the seat of disease even where we do not discover a visible change.

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It is this which I call the anatomic concept in medicine. I maintain that no physician can think methodically about a disease process, when he cannot assign to it a locality in the body. “Ubi est morbus” is the question with which the examination of the patient as much as the dead body must begin. But if this examination has not produced an actual result, the examination does not end there; it is much more the case that a new task begins. It is to ascertain from the entirety of the facts of the illness – and particularly the aetiological facts – the way to a consideration as to where the seat of the disease must be assumed to lie. Accordingly, the anatomic concept extends far beyond the pathologicoanatomical area. This concept is no longer restricted to the visible changes which the knife of the anatomist reveals for consideration. Much more, it joins onto the vital functions, and it embraces therefore a large part of what the present-day division-of-work assigns to the clinician. This division of work was not yet accomplished in Morgagni’s time, but although he was more an anatomist than a clinician, many a section of his great work deals preponderantly with the clinical field. This explains why such a large proportion of his successors belonged to the clinical schools and why he exercised such a decisive influence on the methods of physical examination. In this connection nothing is more characteristic than that the Parisian School of Bayle and Bichat, of Laennec and Dupuytren, has been specifically described as the School of Organicism. 23

Since then we have progressed far beyond the aims of this school. The search for the sedes morbi has advanced from the organs to the tissues and from the tissues to the cells. At the same time practical medicine has extended the principle of local treatment ever further to such an extent that it has been applied even to portions of the body that hitherto had been considered entirely inaccessible. Pharmacology as well as surgery has become more localistic from year to year. So much so that the old Morgagni, were he to be resurrected among us, would probably be horrified by this method – one which is so much in conflict with the ancient tradition; – thus present-day medicine actually has very little similarity to the Galenic. And yet we may perhaps be successful in gaining absolution from him, by convincing him that it is his own thought which now celebrates such triumphs – an idea which he himself did not develop fully and whose ultimate consequences he did not realise – but which emerged from his works for the first time in full strength: – the idea of the sedes morborum, or, as I have designated it, ‘the anatomic concept’. It is this thought that governs the physiology and pathology of today. Whether it leads one back to the cells, as it does me, or whether another formula is developed, it will surely remain the concept for the future. And this future will mark the beginning of its chronology in the days of Morgagni. Let him be honoured!

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Supplements 1. Mondino and the introduction of anatomical instruction into the curricula of Universities The description given on page 9 concerning the admission of demonstrated instruction in Anatomy to the School at Bologna, corresponds to what historians of medicine have recorded. It proceeds from the idea – although not specifically expressed – that human corpses were never dissected in Italy at all. This assumption is not quite correct. When, on my journey to Rome, I arrived in Bologna, the news reached me that the city librarian – commissioned by the Syndaco (Town Council) – had a work which had appeared several years ago to present to me. The Municipality, which has already published a sequence of large and learned treatises on the history of the University and of science in their city, always makes available such publications to me, since for more than twenty–three years I have been a Freeman of Bologna. It is a pleasant duty for me to set down here, as an addendum, some things from this publication, which bears the title “Historical Collection of the School of Anatomy of Bologna / Compendio storico della Scuola Anatomica di Bologna. Written by Michele Medici. Bologna, 1857”. The truly significant man who brought about the fundamental revolution in the comprehension of the human body had, according to this work, the name of Mondino, (not as he is usually called, “Mondini”) d’Luzzi. Mr Medici (l. c. p 17) explains that the name is an abbreviation of Remondino or Raimondo. His year of birth is unknown; it is known only that in 1290, in Bologna, he gained the Laurea Dottorale in Medicina and that he died there in 1326. Neither is anything precise known about the exact time at which he organised the first public dissection of a corpse. Mr Medici draws attention only to the adequately–known passage in Mondino’s Anatomy where, in the chapter Die Anatomia Matricis we are told that in both January 1315, and again in March of the same year, in each case a female corpse “was anatomised”, which possessed an enlarged uterus. In addition Mondino mentions the dissection of a pregnant sow undertaken in 1316. These passages are in “Clarification of the Anatomy of Mundinus” by J. Matthaeus Curtius from Pavia, (Pavia 1550) p 170. My edition is the same as that referred to by Mr Medici. The year 1315 must therefore be recognised as the year in which two anatomical dissections were undertaken by Mondino. However, as little is said as to whether they were public as is noted about whether they were the first. For the former, reasons may be proposed: thus Guido de Caulico (Guy von Chauliac), who studied at that time in Bologna, reports that Mondino frequently (multoties) carried out anatomic demonstrations (Medici, p 22). On the other hand, it cannot be doubted that dissections had been carried out earlier.

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As a fully valid example of this we can regard a forensic post–mortem report, established as having occurred in Bologna on the 15th of February 1302 (Medici, p 10). At the order of a judge, five doctors took part in the investigation, of whom two were Medici Physicians, and three were Medici Surgeons. Here physicians and surgeons already appear strictly separated, and at the same time (p 12) we are informed that after the middle of the thirteenth century a Universita degli Artisti (University of Practising Doctors) was instituted. But neither can it be doubted 26

that these physicians and surgeons, as well as Mondino himself, did not acquire their anatomical knowledge only at the last moment. They must have had not only such knowledge, but also a certain practical experience of anatomy. Thus Mondino’s activities too are set in a new light. Mr Medici has presented facts which indicate that even before Mondino the practice of human dissection was carried on in Italy. Devotees of these kinds of studies can be referred to the original work: but real certainty and a definite chronology will hardly be gained from there. 2. Morgagni and Forlì Data on Morgagni (p 12–13) have been taken in part from his own writings. For the chronological data I refer to the Historia vitae et operum J. B. Morgagni, by Tissot, which is printed at the front of the first volume of De Sedibus et Causis Morborum, Ebrodunie21 in Switzerland, 1779. Many valuable contributions were provided by the addresses given on the 27th of May 1875 at the unveiling of the statue in his home city Forlì (Forum Livii); see ‘Unveiling of the Monument for G. B. Morgagni’, Forlì, 1875). Already before this, closer relations between the old city and me had been established. In 1871 I was in Forlì for a short time at the Prehistory Congress. Soon afterwards, following a public invitation from a doctor there, a subscription was opened which accorded me a gold medal in the name of the Italian Doctors. I was not able to attend the unveiling of the monument in 1875, to which e21

27

now Yverdon.

I was invited. My letter of regret to the Sindaco is included in the report (Inaugurazioni, p 141). In spite of this, I received from the Municipality a bronze copy of the medal struck for the occasion. In the long period in between, the grateful Forlians have not forgotten these connections. When, on the occasion of the Congress in Rome, I was invited, in the first General Session on the 21st of May, to give the address (above) on Morgagni and medical thought, a colleague from Forlì, as delegate from the municipality there, came forward to present a number of large photographs of the monument, and to give to me a letter from the municipal authority, together with a magnificent copy of the medal in silver.

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The photograph bears the subscript: “At the XIth International Medical Congress, When Virchow Celebrates Morgagni Forlì rejoices 1894”. The text of the Address is as follows: “Forlì City Council 28th March 1894. On behalf of the Council of this city, which has the honour of being the birthplace of G. Battista Morgagni, I have the honour of presenting to you, Sir, this gift of a silver medal struck in memory of the unveiling in Forlì of the monument to its great citizen. To you, Sir, the celebrated founder of modern pathology, who, by investigating the disease in the fine structure of the cell, was the first to reveal its intimate nature, and who enriched science with a continuous series of discoveries; to you, Sir, who undertook lofty, ground-breaking studies in the anthropology and history of medical sciences, the homeland of the great anatomical pathologist, of whom you, Sir, are the most worthy successor, is privileged to show to you this sign of its highest regard on the solemn occasion in which you are undertaking to honour his memory and to illustrate his achievements. We beg you, Sir, to accept it as a testimonial of the profound, undying gratitude of this Council and of the citizens of Forlì, whose spokesman I have the honour of being. Please accept my most respectful and grateful thanks”.

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The Mayor and Council. To the Most Illustrious Gentleman, Professor Rudolf Virchow, in Rome. Amongst the many proofs of warm recognition which I have received in Italy, this address is particularly dear to me. I publish it here, in order once more to express publicly my deeply felt gratitude, and at the same time to lay before my compatriots a proof as to how intimate are the bands of friendship and the feeling of commonality which, for more than a hundred years, have bound our two nations together.

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Chapter 6 Other tributes 6a. Benno Ernst Heinrich Reinhardt (1819–1852) Pages in Remembrance Virchow’s Archive 4: 541–548 (1852) Editors’ comments Reinhardt was Virchow’s fellow-student and revolutionary comrade in Berlin. With Traube, they edited Beiträge zur experimentellen Pathologie, 1846–47, Berlin. (Only two issues were published). Virchow and Reinhardt then founded the Arch. f. path. Anat. u. Physiol u. f. klin. Med. – i.e. ‘Virchow’s Archive’. Reinhardt also became a pathologist, but died of tuberculosis at an early age. Reinhardt was particularly keen to subject therapy to ‘scientific examination’. Virchow seems to have maintained a close and even affectionate relationship with him. Additional works on Reinhardt are in the Biographisches Lexikon der hervorragenden Ärzte aller Zeiten und Völker and articles by Krietsch (1991, 1993).

Editors’ summary of points P 541, 542 some notes on the origin of Virchow’s Archive; 543 early colleagues in Berlin; 544 Reinhardt as a student; 545 early professional activities; 546 becomes Prosector at the Charité when Virchow is dismissed from that post, Reinhardt’s irregular lifestyle; 547 final illness; 548 scientific contribution.

Our readers will forgive us if we devote a few pages, which should perhaps be devoted to scientific investigation, to personal recollection and the history of the Archive itself. For the first time, an issue of this journal bears the name of only one editor – and we do not need to make special mention of the fact that it is death which has torn open this gap. It is exactly five years since this Archive first appeared. It was certainly daring on the part of two young, almost unknown men to wish to establish a journal intended to publish exclusively original articles, and for which there were scarcely any obvious contributors. Some courage was needed to risk one’s name in an enterprise which had to overcome so much competition and which did not conceal its intention of exerting influence on the course of the development of Science. It was a matter of initiating a struggle for principles and methods against established schools of thought

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and authorities – trusting merely to one’s own strength and confidence vis à vis a good cause. It was perhaps hubris, but certainly not ambition. Both of us would gladly have given our work to other journals, had they been available to us, but Traube’s Beiträge which published our first substantial essays was not continued, mainly for reasons relating to the publisher. The other 542

northern journals opposed us through of their lack of principle and their inner vacuity. The south German journals were remote from us, and in addition, I had had bitter experience of them. One of them had rejected my works on inflammation of the veins with ‘well-meaning advice’ – works whose content was in part later confirmed in its own columns. Another objected to all manner of things in my works, for example, that they were too chemical; it believed that, for the sake it its readers, it could only accept them in part. Over and above this, we felt ourselves to be full of enthusiasm for our task; my appointment as Prosector at the Charité had placed masses of material at our joint disposal. Some had already been processed; but there was much more to be dealt with. Many a journal originates from a business initiative of a bookseller; others through lack of occupation and income of the editor; yet others through the ambition to see oneself at the head of a journal, or through an interest in getting oneself to the heights and to power in the profession. Certainly in such cases,

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one does one’s own work, but it is preferable to let others do it for one. One can then concoct stop-gaps, miscellanies, and lighter articles, or one re-publishes dissertations etc and comfortably accepts money and fame. The heavy work, with little reward – or even none at all – one leaves to the collaborators. None of this applied to us. We had first to find a publisher for ourselves, and that we found such an accommodating and reliable one was attributable only to a combination of fortunate circumstances. We were not short of work and although we were not prepared to labour for nothing, we excluded in principle any payment for the editorial board, provided that the work of board members was not associated with any direct and considerable expense. What we wanted to achieve with the Archive was, indeed, influence but we were still at that happy time in life when one has few needs, a strong urge to creative activity, and therefore a great capacity for sacrifice – and when influence on science is esteemed incomparably more than any personal or professional effect. At that time Reinhardt was twenty-seven. We had begun our studies – without really getting to know each other – at almost the same time in 1839; even now, the winter semester of that year still provides the most pleasant memories for me. At that time, with many hard-working fellow-students, we sat on the same benches in Johannes Müller’s colloquia. Brücke’s refined pale face, the solid figure of Du Bois-Reymond, Riese’s powerful head – he who in 1848 led the Manual Worker’s Society – all these figures still live before my eyes. Later on, Reinhardt had gone to Halle and there – through the influence of the two Krukenbergs – he had received much encouragement towards working in the clinic and on microscopy. I made his acquaintance only in the autumn of 1844 – through his regional Prussian Kortüm – when he had returned to Berlin to undertake his doctorate. Even then he was occupied with investigations of pus and for his doctorate he proposed, among other things, the thesis: “The granulated species of cells does not depend on pure tiny granules (grains), sitting on their surface, as J. Vogel teaches, but rather from granules suspended in the cells’ fluid content, which are being moved by continual molecular motion”. It was specifically this thesis which first caused me to seek him out, and when now, at this moment, I consult his dissertation – to which, by the way, he did not attribute any special merit – I find, in addition, a Nürnberg woodcut which he stuck into the printed page of the dedication as a joke, together with the legend so soon to be confirmed: “Let us draw from the fountain of friendship, Which never dries up, Before, like the gentle wave, Life quickly ebbs away”.

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Our relations rapidly developed in a very friendly fashion, with our great agreement on all fundamental questions of science and life. With almost daily companionship a continuous 544

exchange of opinions and experiences soon brought us to the idea of a joint activity with the intention of founding and developing a science-based type of medicine.e1 In particular, it was the condition of academic medicine which, with our fresh memories of the State Examination, aroused our most lively opposition; the thought of establishing some new activity – in exotherice2 form and outside official circles – was the topic of frequent discussion. At such times the gentleness and calmness, which Reinhardt usually maintained on social occasions, sometimes disappeared completely and if – as often happened – we had walked up and down the room, conversing for half the night, his judgments gradually became harder and more relentless. In these circumstances, the thought of founding our own ‘exotheric journal’ became ever stronger and it was particularly Reinhardt who – while pressing further and further ahead with his work on pus – in real anger urged an independent step forward. This mood can be best characterized if I set down here a passage from a letter which he wrote to me from his home town Neu-Strelitz on the 12th of December 1845. I do not fear that it might be misinterpreted: “It is absolutely necessary that we join together and undertake an energetic campaign against the Esoterics and other people who now flood science with their absurd twaddle. If one reads all the junk which is now thrown together, one could go mad! In earlier times, such types of people made loud noises in therapy and Materia Medica, or in airy thoughts on the nature of disease – and they can have it. But it is not to be endured that such people dare to lay hands on pathological anatomy, microscopy, etc. At some time, though, one must really and seriously oppose this. If things continue in this way, general pathology and microscopic anatomy will become a junk room of fantasies and foolishness like Materia Medica. It is high time e1

he seems to mean not only science for the understanding of disease but also for treatments – a precursor of ‘evidence-based medicine’. e2 meaning “outside ‘the Establishment’” or “outside the Guild (Zunft)”. 545

that this rubbish be countered by exact, coherent investigation, and also by unsparing criticism through brutal directness (Grobheit). Schleiden’s “Fundamental Principles of Scientific Botany” could serve as a model for this”. Reinhardt concealed so much passion beneath such a mild, friendly exterior, and even his works seldom showed how much excitement he had to hold down when he struggled with men whose methods or principles he strongly despised. In this he lacked an audience which might, even if only moderately, have responded to his needs. The possibility of achieving such an audience seemed all the less likely, because of his marked indecisiveness when it came to

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action, his slowness in execution, and his tendency to take up some insignificant alternative activity. This often prevented him from taking advantage of opportunities when they were offered. Even when this Archive was founded, he was not satisfied just with the material accessible to hime3, because – from the beginning – he longed to develop clinical interests. Thus for a while in 1847, he took up an Assistantship with Carl Mayer, and supported him (Mayer) in his gynaeco-pathological practice, after he had completed his work on granular cells.e4 The latter work can probably be regarded as his most significant and farreaching achievement, and after he had, in a later treatise on the fissibility of nuclei, refuted Henle’se5 ill-considered objections to his work on pus. But the position with Mayer, too, did not give him the satisfaction of an activity which was completely his own. Therefore he tried to set up a solo practice whilst at the same time – in the winter – beginning investigations in the Charité of albuminuria. These investigations formed the basis of his later work on Bright’s disease. Only in 1848, during the cholera epidemic, was he successful in gaining for a while a more independent position at a metropolitan lazarete6, the results of which he recorded in this Archive. But, with the end of the epidemic, his previous desire for a relatively independent e3 This is understood to mean that pathological material was not enough for him on its own: – he wanted clinical material as well – so he could see diseases before death for clinico-pathological correlation according to the model of the work of Morgagni etc (chapter 2). e4 i.e. granular leukocytes. e5 Henle was not highly regarded by Virchow. e6 an emergency military-type hospital.

position recurred. Thus he decided in the following year to take up an Assistantship at the Ziegelstrasse Clinic, which was part of the Surgical Clinic. It was only after this that he obtained a relatively independent position as Prosector at the Charité. Already at Easter 1849, when my removal was decreed by Ladenberg’s Ministry, he had been offered my position, and on my advice he accepted it. When this decree was later rescinded – but on the other hand my negotiations with the University of Würzburg were advancing – he remained in his post of Assistent through to autumn. After my departure, he moved definitively into the Prosectorship. Our work for the Archive had already experienced disturbances. The political movement of 1848 had aroused Reinhardt no less than it did me, and in the same direction. Even if his activity was limited to narrower circles it was, all the same, striving for similar goals. Our separation from each other; the new duties; the foundation of the Charité Annals and of the Würzburg Proceedings; – all this seemed almost destined to bring about the demise of the Archive, although neither Reinhardt nor I had any intention of permitting this to happen. Yet the circumstances were more powerful than we were. On the one hand, I was slowly

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successful in finding time to undertake new work, and the participation of active colleagues also promised further development of the Archive. With Reinhardt, on the other hand, the difficulties brought about by his official position became greater and greater. This was to such an extent that an illness developed whose original cause was perhaps more hereditary, but whose immediate causes were probably grounded in the unfavourable factors in this epoch of his life discussed above. Whilst on the one hand he – with his inner intensity – gave himself over (hingeben) to microscopic studies, on the other hand, he led the most irregular life. He went out sociallye7 almost day and night; often for weeks at a time he ate irregularly; and for long periods he completely renounced the comforting influences of regular companionship and family life. e7

one senses that Virchow is being tactful: Verkehr may imply, here, ‘sowing of wild oats’, or a dissolute life style.

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No efforts to persuade him otherwise could bring him back, although he often found himself exhausted, sleepy and weakened. In the early part of 1846 the signs of his illness became apparent. When one evening, in rather cold weather, we were walking home from a session of the Society for Scientific Medicine, he felt a pleuritic pain which was confirmed at an immediately-arranged physical examination. Soon thereafter there was slight haemoptysis, and the auscultatory signs of an infiltration of the lung parenchyma developed. Careful nursing, repeated respites and stays at the seaside, improved and refreshed him extraordinarily. Even following a visit to Heligoland, which he had undertaken last year, he returned, apparently in good health. But then, at New Year, rheumatic pains appeared, followed very quickly by petechiae, and a great decline in strength, and finally an acute attack of tuberculosis to which he succumbed on the 11th of March. Right up to the last moment he had hoped that the illness would turn towards recovery. Of his old colleagues at the Archive, the cholera epidemic of 1848 tore away two of the most capable – Hein and Dümmler – who were at the height of their powers, and it will always remain one of my most painful memories to recall the terrible death throes which the much-tried Dümmler had to endure. Now, too, another of the founders of the Archive is no more, and I must almost call it a consolation that I did not witness the gradual decline of Reinhardt’s strength. What we strove for has been achieved to a greater extent than we could have hoped. The scientific method of research is now established in Medicine too; and even if only the foundations of exact empirical views have been laid, there can now no longer be any doubt that the present and coming generations will build further upon them. It is not our merit to have established this method. The new path would probably have

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been followed without us. But the fight against the still-existing jumble of arbitrary rationalism and crass empiricism – which we have fought in the Archive, and for which, by the introduction of comparative studies we had built a strong foundation – might, I believe, have contributed in no small measure to giving Pathology a new direction. Let us now continue in this honest and serious struggle, which our deceased friends have bequeathed to us as inheritance, and let us loyally preserve their memory, just as the science – which they served so well – will do.

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6b. Otto Carl Hermann Beckmann (1832–1860) Late professor in Göttingen Virchow’s Archive 19: 557–562 (1860).

Editor’s comments Beckmann was one of Virchow’s Assistenten during the latter’s time in Würzburg. He was greatly interested in various pathological conditions, but especially renal diseases. He died of tuberculosis at 27 years. Another obituary was published by Biermer (1860). Beckmann is mentioned in Haeckel’s Letters (pages 270, 288ff, 372, 400–1923).

Editors’ summary of points P 557 tragedy of tuberculosis among medical practitioners, biographical details of Beckmann; 558 student life and his teachers in Würzburg, move to Göttingen; return to Würzburg as lecturer; 559 work on renal tubular diseases; 560 fate of this; 561 return to Göttingen as Extraordinarius; 562 final illness and eloquent tribute.

The history of the sciences, indeed the history of the human spirit, records name upon name. If one leader falls away, the man behind takes his place, and continues the serious work of research, – which is never complete – and for which so many have to struggle. For it proceeds slowly enough – for individuals. The one struggles the longer, the other for the shorter time. With sorrowful heart, we see the ranks of old comrades become thinner with every passing year. We have only the consolation that the spirit of these friends stimulates a new generation to new labours. But the pain is the more bitter, the sorrow is the heavier, if it is the young generation which – having only just begun its striving – provides the sacrifice. When those whom we had become accustomed to regarding as our heirs and successors fall away before their time, we feel that the existence of the very things which we had hoped to secure for the whole great family of humanity, are threatened. We become doubtful as to whether we shall ever succeed in seeing the path of conquest followed further, which the deceased had so courageously opened up for us. For it is foolish to say that no-one is irreplaceable. Progress is always tied to individuals, and if the substitute is weak, if it is insufficient, then one soon comes to a standstill, if not to a regression. Such a young campaigner, well schooled and armed with the best weapons, was Otto Beckmann. In spite of his frail body he was courageous enough to take up specifically that science which destroys so many so early: pathological

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anatomy.e1 For though this science is still so young, how many severe losses must already be mourned! In one half century, what a number of dead! From Bichat and Laennec, onwards to Benno Reinhardt, Heinrich Meckel, and Otto Beckmann: – almost all died from consumption before they even achieved maturity. Is it the type of occupation which has such a consuming effect? Or is it the more fragile disposition of the body which leads them specifically to this occupation? Otto Carl Hermann Beckmann was born on the 9th September 1832 at Holzendorf in Mecklenburg-Schwerin.e2 He was the second son of his parents, both of whom guided his early education with all the greater care, because up to his twelfth year frequent serious illnesses – gastritis, neuritis, and inflammation of the chest – impeded his physical development. Of all nine children, this son was especially close to his mother’s heart. Constant hard work and an excellent memory soon propelled him forwards in spite of his sickliness. Early on he showed a preference for the natural sciences. In 1845 he entered the Gymnasium at Rostock where, thanks to his e1 Virchow clearly sees tuberculosis as an occupational hazard for pathological anatomists – but does not consider contagion as the cause. e2 Baltic city, between Lübeck and Rostock, was once a Duchy, and is now the capital of the state of Mecklenburg-Vorpommern.

careful education by his father (a clergyman), he was accepted immediately for the third class, and rapidly advanced to the first. At 18 he entered the University in Rostock, where he devoted himself to the study of the natural sciences and where his zeal for anatomy and zoology was awakened especially by Stannius. In the autumn of 1852 he came to Würzburg, which specifically at that time was beginning to flourish and attract the most talented young men from all areas of Germany. Very soon a circle of loyal and equally conscientious companions assembled around him, of whom I will mention here only Johannes Lachmann, Ernst Haeckel, August Mayer, Carl Gerhardt, and his regional compatriot Wilhelm Passow.e3 Within a short time he gained, in great measure, the regard and recognition of his teachers. But already at that time the particular misfortune showed itself – which later accompanied him so often – although initially in a manner which was more strange than otherwise. Late one evening, he and his friends were still together and were about to walk home peacefully. Suddenly, one of the well-known policemen of Würzburg arrested Beckmann, whom he maintained he had recognized from his light-coloured overcoat as the one who – a few hours previously – had disturbed the public peace by letting off a rocket in the street. All assertions to the contrary did not prevail; Beckmann had to spend the night under arrest. When the matter was finally judged, he was fined – him who most needed the support of others – a not inconsiderable amount. Part of the amount was collected by his teachers; but nonetheless I am inclined to think that this event influenced the fact that he left the

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University six months later. All of us much regretted his departure. For already then the inner change had begun which led him to Pathology. In his posthumous papers I recently received the very carefully-written notebook, which he had written up from my lectures in Würzburg on General Pathology and General Pathological Anatomy. It is doubly valuable to me now, because it provides me with sure evidence of my priority in many facts in my teaching, the originality of which others have tried to take away from me by much more recent claims. Beckmann then went to Göttingen, where he worked in the main under Baum and Wöhler. His first publication comes from this period: “Concerning a new urinary salt” (Annalen der Chemie und Physik, vol 91, p 367) – consisting of two parts ammonia, three parts urea one part of hydrochloric acid; and distinguished by its ability to form large leaf-like crystals. Soon he returned to Rostock, forced there by the conditions of his scholarship. However, in autumn 1854 he reappeared in Würzburg, where he attended clinics and medical lectures. Moreover, he began to work, with particular preference for microscopic studies, under Schenk, Kölliker and myself. I have found his very neat notebooks from 1855 covering my lectures on pathological anatomy and hereditary diseases, and also from my coursee4; and in addition a special little booklet with drawings of botanical, physiological and pathological microscopic images. From here onwards there is a wide range of individual notes, taken most painstakingly and carefully from all areas of natural scientific research, for which the so-liberally endowed e3 The text is ambiguous, but because ‘Passow’ is so characteristically North-East German, it is thought that Passow, like Beckmann, came from Mecklenburg. e4 perhaps a separate course on microscopy.

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reading room of the Würzburg Harmoniee5 and later on, an appointment at Canstatt’s Yearbooks, offered him the most favourable opportunity to study. How much work is set down in these loose pages, and how little was it able to bear the fruit which one might surely have expected from it! From the start, Kölliker took him up with the greatest friendliness and for years, thus protected, Beckmann pursued comparative anatomy and zoology with the idea of making them the main object of his studies. But who is master of his own preferences? Whilst Haeckel – his friend of many years – was an Assistent with me but turned ever more decisively to Zoology, Beckmann – in spite of being appointed in 1855 to the Prosectorship, in the Zoological Institute under Kölliker made vacant by Leydig’s departure – steadily and inevitably moved towards Pathological Anatomy. His first published work – to a certain extent standing on the border between these two areas of study – was the description of a double malformation which I had passed on to him (Dicephalus biatlanticus Gurlt) of the calf, which he presented at the Würzburg Physical-Medical Society meeting on the 9th of

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June 1855 (Verhandl. vol 6 p 145). Here one can already see the attributes which characterize all his later works : the conscientiousness and clarity in presentation, the precise weighing-up and fair evaluation of earlier works; care in the derivation of general conclusions; and finally – on this I may not remain silent – the most grateful, and at times almost embarrassing, devotion to his teachers. Around the same time – at my suggestion – he began investigations on the origins of renal cysts. These studies were the reason why thereafter, he undertook the most comprehensive studies of the kidneys – their functions and diseases – work which ceased only at his death, and which unfortunately cannot be reconstructed in any way at all from his posthumous papers. His first larger publication, illustrated by numerous clear drawings, appeared in this Archive (1856, vol 9 p 221) and was at the same time used by him as inaugural dissertation. It is probably sufficient here to point out that the thoroughness of work is not, perhaps, sufficiently valued even now. In fact, at no time has a greater number of reliable observations been made concerning changes in the urinary tubules. Very soon this was followed by another treatise “On the understanding of the kidneys” (this Archive 1857, vol 11 ps 50, 121). Anyone reading this treatise must be astonished not merely by the almost linguistically perfect and well-nigh exhaustive treatment of the literature, but also by the veritable treasure-house of work and the mass of special observations which are set down there in the most modest way. The entire presentation is very orderly and lucid. But perhaps the extensiveness of the individual observations and quotations may have intimidated even the official reviewers and may also have completely deterred the majority of other readers. This might be inferred from the general silence which greeted the work. For our times are like earlier ones: many people read, but few study. The most insignificant clinical lecture – which e5

a social club. See chapter 3 (Schönlein).

utterly bores the cognoscenti by yet again putting long-stale wares on the market – finds ever new circles of admirers. The single, individual observation must, however, be cast again and again in ever-more popular forms before it gains attention or respect. As far as I know, Beckmann never expressed himself on this point (the silence), but many facts indicate that he felt it. It must certainly have depressed him that the solicitude which he showed for his opponents – all the while from his standpoint of most meticulous observation and experience and in full knowledge of his opponents’ weaknesses – was misused by them, as they deliberately ignored the most important elements of his work. For Beckmann touches here on all essential questions of renal pathology; not superficially but – even if briefly – after most mature consideration and investigation. I know from my own observation how, day after day, with an ever mistrustful gaze, he built his proofs; how he, dissatisfied with anatomical investigation, moved to experimen-

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tation on the living animal, and how he then moved on to chemical analyses. Certainly, it is more comfortable and rewarding to write handbooks, and to serve the masses, but Beckmann remained true to his school in the fact that he did not write the handbook as the beginning, but regarded it as the end of literary activity. In the treatise which gives us the opportunity for this retrospective account, in the following order, he deals with the changes in the epithelium, in the glomeruli (Knäuel) and in the interstitial-tissue stroma. Here I will only emphasise that already at that time he derived not only certain sarcoma-like tumours and fibrous nodules (p 71), but also the origin of cystoid formations, from the stroma of the cortical substance. He extended his range – in part on experimental grounds – to albuminuria and the so-called cylinders (casts); and finally provided important contributions to the chemistry of kidney fluids, especially with respect to the occurrence of leucine and tyrosine in the same (p 127). He gave a short summary of these investigations to the Physical-Medical Society on the 4th of April 1857 (Verhandl. vol VIII, p 12). At this session, many reservations were expressed concerning his conclusions – for example, that mere increased pressure in the arterial system, such as is produced by ligating the origins of the large vessele6, does not cause albuminuria. These he later refuted (Verhandl. vol IX, p 142) by providing the data from his experiments. On the 31st of October 1857 he exhibited the atrophied kidney of a dog – a consequence of an artificial stricture of the ureter – whose left heart ventricle was found, 4 months after the operation, to be hypertrophic (Verhandl. vol VIII, p XXVI). Later he provided data on another case of cardiac hypertrophy in a dog after ligation of the aorta. He attempted to refute reservations brought forward against a hypertrophy of the ventricle by comparative measurements, and emphasized that one of the factors mentioned by Traube – namely the lessened flow of secretion from the blood – is less significant than the other; namely the increased tension in the aortic system (Verhandl. vol IX, p 145). On the 8th of May 1858 he described the finding in a dog which – after extensive necrosis of the upper thigh and its consequent conditione7 – had developed calcific deposits in the kidneys (Verhandl. vol IX, pp LIV and 147). e6 e7

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The experiment was probably tying off the aorta below the renal arteries. this necrosis probably followed the tying off of the aorta as in e1.

Whilst he thus showed the way forward for the most important experimental extensions to our pathological knowledge, at the same time he did not neglect anatomical study. Thus he gave an excellent description of a particularly characteristic case of capillary embolism (this Archive, 1857, vol XII, p 59); an essay on thrombosis of the renal vein in children (Würzb. Verhandl. 1858 vol XI, p 201); a lecture on the so-called simple nephritis in urinary retention and other bladder disorders – which he claimed were metastatic – (ibid p LXIII); a description of amyloid degeneration in which he was first to prove the occurrence

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of this material in the thyroid gland (this Archive vol XIII, p 94); the description of a beautiful (sic) case of embolism of the type mesenterica superior (ibid p 504). And all these observations are excellent not only because of the fidelity and care in presentation and examination, but even more through the fact that in each individual case the truths of existing theories were tested; moreover, far-reaching conclusions were drawn. Although not officially appointed Lecturer, early on he had begun to attract attention as a teacher too. His post as Prosector – although it did not stimulate him to actual zootomical works of lasting significance – gave him at least sufficient opportunity and material to give cases and guidelines to students for their own work. A series of excellent dissertations – prepared under his supervision – bears witness to this. I mention especially Kottmeier’s fine work: “On the understanding of the liver”, that of Aug. Marx: “On changes in the kidneys caused by venous hyperaemia”, as also that of Arnold Pagenstecher: “On amyloid degeneration”. On the other hand his official position was in no way satisfactory. Thus he therefore accepted with pleasure the invitation to become Extraordinarius (Adjunct Professor) in Pathological Anatomy in Göttingen. In autumn 1858 he moved there; in the shortest possible time he was fully appreciated by the teachers as well as the pupils. He was constantly active. Certainly, we have very little of his from this period. With the exception of two smaller communications – on petrified sperm (this Archive 1858, vol XV, p 540), and one concerning a case of Melanömia (ibid vol XVI, p 182)e8, nothing was published other than what his pupil Burckhardt contributed in his work on the epithelia of the efferent (ableitenden) urinary paths (Archiv vol XVII, p 94); and amongst his posthumous papers – which by his last will and testament, he entrusted to me, and which have been placed at my disposal by Geheimrat Hasse via his mother – there is only one, almost ready for publication, on haemorrhagic infarcts in the kidney. This should appear in the next volume of the Archive. But as is clear from an earlier communication (Würzb. Verhandl. vol IX, p 53), this too had been begun in Würzburg as is proved by the inserted case histories. His unbroken urge to work is also indicated by the written excerpts – which continue almost to his death – and by his short notes on the scant material available to him. Unfortunately, the situation was different with his actual working capacity. His long-delicate and highly-strung constitution e8 Melanömia refers to the diffuse blackening – due to deposition of a particular pigment, the ‘malarial pigment’ – of the lymph nodes, liver and spleen (i.e. reticulo-endothelial organs) in malaria. In the mid nineteenth century, it was confused to some extent, with melanin pigment of the skin.

had borne – unusually well and for a long period – the great exertions which he inflicted on himself. How often – when I encountered him in my room, pale and visibly affected and after he had been working for days at the microscope – did I have to warn him or even send him out into the fresh air! He always answer-

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ed, mildly and modestly, that he really had not done all that much. But in the winter of 1856–7 – after I had left Würzburg – he took ill with pleurisy from which, in spite of the most loving and careful nursing by Professor Friedreich, he recovered only slowly and with difficulty. When he came from Göttingen to visit me at Christmas 1858, I found him very much changed. His demeanour, formerly only modest, had become shy, and even withdrawn; he spoke softly as if uncertain; and then sometimes loudly and hastily. He felt himself under pressure; he attributed to external things, matters which were quite obviously due to his internal condition. Towards the early part of the next year, a serious relapse took place with the most profound disturbance of digestion, which made it necessary for him to take leave for a while. He went first of all to Poppelsdorf near Bonn, to his friend Lachmann, who was to follow him so soon in death; and later to Friedreich in Heidelberg. Apparently improved, he returned, but his worried friend had already recognized more serious illness. All attempts to persuade him to take further leave and to decide on a change of climate were in vain; he replied negatively to all letters written to him. Greatly worried, we saw winter approaching. It was to be his last. At Christmas 1859, following the communication from Mr Hasse, the disease of the lungs themselves could no longer be mistaken, and the appearance of continuous diarrhoea raised the fear that the digestive organs were seriously affected too. But in spite of this, he was not to be held back. Spiegelberg, who worked at the microscope with him every morning, saw himself forced to keep completely silent in order not to irritate him further. But the deterioration proceeded so quickly that finally, at the beginning of March 1860, he decided to seek the care of his parental home. Before that, however, he took a private room in hospital to wait for some return of strength for the journey. Too late! He did not leave hospital again alive. The loyal care of his mother, who hurried to him and spent the last four weeks at his bedside, could not save him. On 2nd of April, only twenty seven years old, softly and peacefully he breathed his last. Significant destruction in both lungs, almost continuous abscesses from the pylorus to the rectum; old accumulated caseous, mushy and calcified material of the lymph nodes of the neck, the chest and the lower part of the body – that was the sad result of the autopsy. Mr Hasse wrote of him quite correctly: “With Beckmann we have lost very much, because we can scarcely hope to find again such a reliable and precise observer, and such a friendly, modest colleague”. Who could feel that more than his teachere9, whom – as his grieving mother wrote – he (Beckmann) was still thinking of even in his last days of life! When I left Würzburg, it was Beckmann who – in the name and at the request of the students and in an audibly moved voice – made the memorial presentation to me. Now I have to be the one who helps to raise a memorial column in science to him. May his memory be hallowed! R. V. e9

i.e. Virchow.

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6c. Siegfried Reimer (1815–1860) A retrospective essay Deutsche Klinik, 305–309 (1860) Editors’ comments Virchow was six years younger than this medical man, but became a colleague during the early days of the Society for Scientific Medicine and of Virchow’s Archive. He died at 35, of septicaemia – a reminder of the tragedy of sudden fatal infective illnesses in those times.

Editors’ summary of points P 305 Introduction; 306 biographical sketch including medical experience, co-founder of the Society for Scientific Medicine; 307 early days of the Archive (Reimer was a brother of the publisher Georg Reimer), direct personality; 308 as Mayer’s Assistent, other appointments, small role in the revolution of 1848, as a Nationalist; marriage; 309 unexpected death from septicaemia – some details of autopsy findings provided.

“A worker in the field longs for the shade and a day-labourer longs for his work to be over (Job, 7:2)”. If he has worked for six days and the week is coming to an end, then he returns satisfied to his peaceful hut to prepare himself for the longed-for day of rest and the holiday. If then the sun goes down with a clear face, he may expect a fine day in the family circle. It was such an evening, before the Sunday, when, two weeks ago, we came together with many friends, outside the town for a solemn duty. After a dismal and cold week, a clear sky had again opened over us; the setting sun sent its last unbroken rays over the lush green of the trees. The air was full of peace, and the labourer was going home with the happy feeling of being about to enjoy well-earned leisure. Everything seemed to be full with the feeling of peace: it was as if a deep harmony had smoothed out the often so profound conflict between human beings and the rest of Nature. And yet, amongst all those present, there was no single one who could be happy with this feeling. Some probably thought of the preacher’s words “Everything is vanity, what is left to humankind of all the travail which he had under the sun: one generation passes, another arrives, but the Earth remains eternal”. For we had come to bury a friend, of whom everyone said: “There was none better”.e1 It was his last Saturday above the earth. As the sun sent its last welcoming rays across the meadowse2 many a glance of farewell fell across the open grave, and soon it was only the dull thud of falling sods of earthe3 which reminded us that nothing more remained of our friend than the memory.

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Certainly, he had been a powerful worker, and anyone seeking his services had known that he could trust him. With equal certainty he could have longed for the peace of Saturday, for in his own house the total bliss of a new marriage awaited him. Again, his holiday would have been happy, for he lacked nothing which could make his life satisfying, his heart merry, and his enjoyment secure. But he had, indeed, the right to hope for another kind of Saturday peace. He was not one of those tired workers who long for eternal peace: – he still approached his work with a fresh spirit, and the holiday was there only to recuperate and renew his strength for further activity. Life hung on to him with all the threads which can make existence worthwhile to the human being. No threatening sign had shaken him from the comfortable feeling of the happiness whose full enjoyment he had secured only a few months before. Without warning, he had departed forever from hearth and home. So suddenly had this heavy misfortune occurred that a feeling of desertion held all our hearts as if in rigor mortis. Lost, lost! – Let us recall our dismal memories. e1

a very emotive phrase, from a song of the Napoleonic Era, in relation to a fallen comrade. uses the elevated word Flur. e3 an image used by many nineteenth century poets, similar to the one of muffled hooves of horses in ceremonial burials. e2

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Siegfried Johannes Reimer was born in Berlin on the 21st of March, 1815. His father, the well-known publisher, friend of Arndt, Niebuhr, Jean Paul, Schlegel, Tieck, Schleiermacher, one of the boldest patriots who had himself taken part in the War of Liberation, chose the name Siegfried – almost certainly aware of its significance – by which the deceased was known and esteemed by so many people. The somewhat delicate boy grew up carefree in a large family of happy brothers and sisters, and cared for by his mother with particular preference. After he had had his early education at the Friedrich-Wilhelm Gymnasium, he went, as a fresh youth, to University. He remained for a year in Bonn, where he studied mainly philosophy and the sciences. Then he returned to Berlin, where he studied medicine itself, and took his doctorate on the 30th August, 1837. His dissertation was devoted to rickets. It is a work which, in comparison with the majority of inaugural treatises, is distinguished very positively by its thoroughly serious and careful presentation. As was customary at that time, when the young medical man did not so easily have the chance that he does now, to prove himself by his own research and thus advance Science – the dissertation gives a learned overview of contemporary experience. But it gives this in such detail and with such apposite critical treatment that one notes the independence of the author as being already completely formed. After the State Examination he went first to Halle in order, under the supervision of Krukenberg, to prepare himself for medical practice, and then to

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Vienna and Paris. Only in 1841 did he return to Berlin and settle there as a practising doctor. Soon afterwards he accepted the position of doctor at the newly-founded Elizabeth Hospital, which he later gave up in order to work as Municipal Doctor for the Poor. Meanwhile his health had deteriorated from year to year, and worrying symptoms of a creeping lung disease appeared. Thus, in the autumn of 1845 he decided to leave practice and to embark on a prolonged stay in the south. He spent the greater part of the winter in Rome. This stay resulted in a great improvement; when in the next year he returned from Italy he was able, although still somewhat weak and irritable, to be regarded, nonetheless, as cured. It was approximately at this time that I came to know him. The Society for Scientific Medicine, founded in 1844, was mainly initiated by comrades from his days in Halle, and united an initially small – but later rapidly-growing – circle of doctors, all striving for knowledge. For it was about then that, in the younger circles of the capital, fresher, independent movement began, which gained such lasting influence on the development of medicine overall. Reimer was amongst those who encouraged any young lecturer using new methods of examination or teaching, by participating in his courses, by cooperation, and by active help. Thus it was especially too, through his good offices that the Archive for Pathological and Physiological Anatomy found a publisher in his brother Georg Reimer, at a time when its editors were still completely unknown young people. It was in the Society for Scientific Medicine that all these efforts now found their focus. Just how specific Reimer’s help was here is shown by the fact that from this time onwards – when the journal, in accordance with its larger size, needed a more complete committee – Reimer was continuously a member of the committee. As treasurer he knew how to administer the finances of the Society so efficiently that he was able to assemble a relatively large sum of money. On the 20th of December, 1852, at the celebration of the founding of the Society, he gave the well-known lecture on the aim and limitations of therapy – the only printed work which, apart from his dissertation, he has left to us. This lecture (cf Deutsche Klinik, 1853, No 1–11) – from which extracts have passed into many other journals – is of a form and shape such as one will seldom find in a written lecture. It is not only that it makes the complete impression of being as if spoken, but it is also his mode of speech. It is the man in all his aspects whom we see before us. Here one really feels the truth of the saying: “The style is the man”e4. Let his friends ever and always refresh their memories here. This is where they will experience again that seemingly cool sense of calm which was yet only an externally-muted warmth. Here they will find again that his apparently biting sarcasm – which was never wounding – was, on the contrary, intended to suppress a markedly sharper, critical tendency. His presentation scorns the usual ballast of learnedness, which smaller spirits use to conceal the

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limited extent of their real knowledge. On the other hand it surprises us by asides which refer to quite different areas of Kultur. Indeed it is not quite free from the more piquant use of rare and unexpected quotations. We see the refined smile in the eye ranging over the attentively-listening gathering, whilst the whole face betrays that moderation and control which usually characterizes the north German graduate of the Gymnasium. But in all of this he never loses sight of his goal. Passing through all moods of the spirit, the listener is brought closer and closer to the conviction which the speaker wishes to evoke or to ensure, namely that medical practice is not powerless; science is not useless; but that unscientific method is perverse, even dangerous. He warms to his theme, and his voice rises as he describes what the well-educated doctor is able to achieve as house-doctor. But the sarcastic smile comes again; again there is a comparison between the Minister of Naturee5 and the Minister of State which verges on the bitter, and then with decided seriousness, with irreproachable conviction, comes to the conclusion, which is that “therapy, after stripping away the many illusions of which it was so proud, is to be regarded all the more as the vanguard of struggle for the goal to which all human efforts are directed – the improvement and education of the individual and of the human race”. That was his conviction. Accordingly he dealt with people as a doctor, as a citizen and as a human being. His official and social position made it possible for him to do that to a high degree. He showed this as Doctor for the Poor, and – this practice not taking up all his time – he took on the responsibility for a considerable period as Carl Mayer’s Assistent, where he assisted e4

from Buffon (1707–1788), “Discourse on Style” (1753). “servant of Nature”, as in: “Medicus in sanatione est minister naturae” = The doctor when healing is (only) a servant of Nature”. (Dr Menz). e5

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in the gynaecological treatment of the poor. He showed it as Doctor for the Debtors’ Prison, and finally as a doctor at the Bethesda Institution for the Sick. Along with this for years he was on the executive committee of the Men’s Gymnastic Associatione6 and for a year he was a teacher of anatomy and physiology at the Central Military Gymnastic Institute. But most of these positions did not keep his interest for long, because his independent spirit and his very directlyexpressed convictions encountered resistance which he could not overcome, and which, indeed, he did not want to avoid. The more freely he developed, the more definitely he struck out in that direction where, ultimately, the questions of freedom and independence are decided – that is to say, politics. In 1848–9, he still limited himself to private discussion about society, perhaps in part because none of the prevailing currents of the time were quite in accord with his ideas. But with every subsequent year he became ever more open and confident, and when finally in the last years (of his life), the National German movement grew ever more powerful, it found him amongst its open supporters. He did not hesitate to step forward with his name and his person and, as much as he could, by

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example and persuasion, to lead the hesitators to the movement. The example of his father who, in difficult times, had placed his possessions and life in the cause of winning back the Fatherlande7, lived on in him. It was to be noted that this inner liberation raised his spirits. It appeared in all his dealings, it expressed itself not only in the narrow circle of friends but in the medical societies for which he was sometimes a keynote speaker and administrator. Thus we see him especially in the official dinners for the Midwifery and the “Heimia”e8 societies. Only one thing was lacking from his happiness. And it seemed to be a thing which for a long time – bearing in mind his earlier precarious health – he would always be denied. But it was not to be withheld. On the 14th of December last year he took Elizabeth Jonas home as the wife whom he had married not long before; – a conscientious consoler, and loving protector who had just become a waif due to the death of the very best of all fathers. It must be sufficient to say that he was made wholly happy, and that it awoke in him the sweetest hopes for a long future happiness. In a large, evergrowing family circle, and the many relationships which resulted, he did not forget his friends, his science or his people. His zealous efforts were directed to helping to found a larger focal point for the scientific life of medicine in the capital. And it was especially to this aim that the Society for Scientific Medicine was amalgamated with the more recent Society of Berlin Doctors. And when finally this was concluded; when the Society for Scientific Medicine of which he was a co-founder held its last session on the 16th of July – when, both chairmen by chance absent, under his chairmanship, its dissolution was decreed – who would have suspected that this was the last time that Siegfried Reimer would address his colleagues? e6 Gymnastics had been popularized in Germany from 1806 onwards by the work of Friedrich Ludwig Jahn (1788–1852) the ‘Father of Gymnastics’ hence Turnvater Jahn. e7 i.e. the Napoleonic Wars. e8 See chapter 4, notee9.

“Quickly does death strike Man down”e9 – he did not notice that it was death. In the last days of the same week a small inflamed spot appeared on his right temple. Some called it a pustule, others a furuncle. Only on Sunday afternoon did he feel a tight pain in it. A superficial incision gave temporary relief; on Monday the local attacks increased somewhat, but without causing concern. Early on Tuesday he dealt with his patients at home. But already a rose-like swelling of the eyelid and of the forehead showed itself, with peculiar, wart-like eruptions being of the same size as the first lesion. His countenance collapsed, his breath became restricted and his pulse rapid. The consulting doctors, who held out no hope, were only able with difficulty to persuade him to go to bed. On Wednesday – while he was still fully conscious but his speech very restricted – the imminence of death could be predicted. By evening, the living man was a corpse. The autopsy revealed extensive diphtherial purulent periphlebitis of the

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temple and forehead area with moderate thrombosis, bilateral purulent pleuritis, with numerous fresh, and partly demarcated, relatively large metastases in the lungs. There were smaller, partly-formed pus-sites in the myocardium and in the wall of the pulmonary artery, as well as several embolic sites in the capsular region of the kidneys. In the apices of both lungs there were old, thin-walled, quite empty bronchiectatic cavities in addition to shrunken bronchial cavities filled with caseous material. Nowhere was there any evidence of tubercles. The whole illness naturally aroused suspicion of an ichoröse10 poisoning acquired through external causes. Careful examination on this point revealed no evidence of this. Thus he fell to a mighty, unsuspected enemy, who had secretly attacked his most noble organs. But he fell without complaint, unbowed, indeed one might say unconquered. He was torn from the midst of the most complete happiness, and she, who was left behind so unhappily, was yet bequeathed the consolation that right up to his final departure, the feeling of the happiness which he owed to her had been mighty in him, and that he passed on from her full of sweetest gratitude. The circle of friends, which has lost many a dear member, becomes smaller and smaller. May those left behind have the happiness of being able to grasp for the rest of their days – just as did the dear departed – the good fortune of personal moderation! May the departing sun find crowded around our graves such loyal companions as have stood together mourning here – for our sun too, sooner or later, will be extinguished. The earth must be left behind, and our home and the amiable wife; nor will any of those trees, which you cultivate follow you, except the hated cypress, its short-lived master.e11 Rud. Virchow. e9

From Schiller’s “William Tell”. was Virchow’s term for a pathological change of putrid decay, approximately equivalent to ‘wet’ gangrene. Reimer died of septicaemia, probably of cutaneous origin.The brain is not described. e11 Horace Odes II, 14.2 (6th stanza out of 7). In Roman custom, branches of cypress trees were placed near coffins at burial as an indication to the public (Nock, 1932). (Courtesy Dr Baltussen). e10 This

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6d. Carl Pagenstecher (1824–1865) Virchow’s Archive 35: 191–201 (1866). Editors’ comments This worthy man was three years younger than Virchow, and was a postgraduate student of the latter when both men were at the University of Berlin. He has two of the characteristics which Virchow admired: liberal-radical politics and a scientific approach to medicine. His death from some form of presumably infective disease is another example of how this now-uncommon circumstance was so common at the time. The family is mentioned by Sperber (1991).

Editors’ summary of points: P 191 introduction, biographical details; 192 youth and studies at Bonn and Göttingen; 193 studies in Berlin, Virchow as his teacher; 194 medical practice in Elberfeld, journey to Paris; 195 his father’s role in the 1848 revolution and effects on Carl; 196 marriage, domestic life, studies; 197 becomes an ophthalmologist; 198 role in foundation of clinics and a hospital; 199 publications on various surgical procedures; 200 teaching on croup, last works; 201 final illness.

In the following pages I recall a man whose loss, indeed, will be felt in the immediate future only within a narrower circle. I intend as far as it is possible for me, to keep his memory fresh and in addition to awaken for him the sympathy of our contemporaries to a greater extent. For there are men whom only external chance places in such a position that even their distinguished service withholds their name from that general awareness which they so deserve for a long time. These men would be worthy to stand in the eyes of the world as models for many people, but who were called away by death before they were in a position to have a beneficial influence beyond their more immediate environment. Such examples have for a long time not been lacking in the medical profession; may these lines contribute something to the fact that our profession will not be deficient in this awareness in the future. For modern times extend the doctor’s tasks more and more. These demands – which rapidly-growing science and the ever-greater needs of a more and more complex culture bring with them – increase rapidly; the danger has become much greater than before, that many of us – bowed down by the cares of practice and the struggles with the externalities of life – early lose the habit of looking up and ahead for new knowledge and humanistic culture. This danger has become incomparably greater. Thus it may be granted to a friend – who is not thinking merely of satisfying his own heart, but who also believes that he may be of service to his contemporaries – to give a brief sketch of the life of a doctor who, in the full sense of the word, was a man as a man should be. Carl Pagenstecher was born on 13th of January 1824 in the city of Nassau, where his father was a practicing doctor at the time. The latter – descendant of

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an old family whose members had acquired a reputation in the Laws, both as scholars and practitioners – was the son of a Professor 192

of Laws at the long-gone University of Herborn.e1 The father was a man of rare qualities of intellect and character, who had early left the limited circle of his home region, and settled in Elberfeld, where he was later one of the most sought-after doctors. Already when his son Carl was attending the Gymnasium, the father noted with delight Carl’s obvious inclination towards the study of nature. All sorts of collections were started and zealously enlarged, but neither philological, nor mathematical tasks, nor drawing nor music were neglected. In the autumn of 1841, at the age of seventeen, Carl was allowed to enrol at the University of Bonn, where he registered as a medical student. He remained there for a year, and heard lectures in the Sciences from Plücker, Bischoff, Goldfuss, Nöggerath and Treviranus; and in Anatomy from Mayer and Weber. At one blow, this academic atmosphere changed the boy – who until then had been reserved and introverted – into a free and open happy youth. Three months later, when he visited his family’s home at Christmas, his father found him almost as if transformed: a bubbling humour which from then on never deserted him, revealed itself united with serious scientific ambition. The considerably developed power of the local-regional student societies (landsmannschaftliche Verbindungen) – which at that time dominated the academic climate in the University – made it seem desirable to seek out a different university.e2 Thus in 1842 he went to Göttingen, where the elder Langenbecke3 soon won the greatest personal influence over him. He heard lectures in physiology from Rudolph Wagner, in comparative anatomy from Berthold; he dissected industriously with the prosector Pauli, and then studied general and special pathology and therapy, surgery and midwifery with Marx, Fuchs, Langenbeck, von Siebold, and Trefurt. Under the direction of the latter teachers he also attended the clinics and – as he was successful in developing closer relationships with them and was able to act independently at the sickbed and even to assist with operations – he gained, by active participation, a detailed knowledge of the care of individual patients and soon also achieved that confidence which is the greatest guarantee for the independent development of the man. At the same time an almost child-like respect e1

in the Westerwald (‘Western Forest’), a rather neglected part of Germany north of Frankfurt, while Elberfeld (now part of Wupperthal) is in the heart of the Ruhr industrial district. e2 The reasons for this could have been class and regional intolerances. Virchow does not elaborate. At this time, the University of Bonn was the only functioning university in the Rhineland. The others had been dissolved in the wake of the Napoleonic political consolidations from 1803. The University of Bonn had an aristocratic reputation (sometimes known as the ‘Princes University’) probably mainly because the City of Bonn had been (before the ecclesiastical state was abolished) the Residence of the Prince-Archbishop of Cologne. e3 Konrad Johann Martin Langenbeck (1776–1851), uncle of another surgeon, Bernard von Langenbeck (1810–1887).

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was induced in him for – above all others – the venerable Langenbeck. This preserved him from any feeling of that arrogance which can creep only too easily into the over-confident heart of the youth who feels in himself the certainty of his own merits. In autumn 1844 he went to Berlin where he gave himself wholly to clinical studies under Trüstedt, Troschel, Jüngken, Wolff, Schönlein, Busch, and Schöller. At the end of the summer semester of 1845 he was awarded his doctorate. His inaugural dissertation dealt with de morbis ab animalibus domesticis ad hominem transeuntibus / “Diseases of Animals which can Transfer to Humans”. This was followed by the State Examinations which occupied him right into the summer of 1846, and brought him the honorary title of Operateur. This period in Berlin was disheartening (niederschlagend) for him; and he resisted his father’s wish that he should embark on a career as an academic teacher – a resistance which was shared by many of his contemporaries in Berlin.e4 “I am coming to you,” he wrote, “to our free practicee5; then we can pursue our art and science with more certainty and more success”. It was at this time that I got to know him. He was one of those young doctors who, in the summer of 1846, attended my first course in Pathological Anatomy, which I gave as provisional prosector at the Charité. It was a select circle of youthful spirits; hardly one of them remained stuck in mediocrity. At that time we were all confident that a new scientific age was beginning, and that this science would become a general one; no longer confined by the boundaries between the separate academic disciplines. Various of our friends at that time – however confident they were – were called too early from the scene of human activity (i.e. died young), but those who survived have kept the bonds of sincere friendship and mutual respect, which alone make human hearts happy. On account of my course, Pagenstecher delayed his departure for Prague and Vienna until the 10th of August. He wrote to his father: “I am learning more here than I could learn there”, and (I can say this because he often repeated it), he openly declared that it was only here and for the e4 e5

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Hun (1883) indicated that there were many problems in the Faculty, without specifying what types. presumably meaning not as restricted as in Berlin.

first time, that he had been introduced to research in natural science. Soon afterwards I met him in Prague, where during the holidays he was zealously attending the Hospital. After a short stay in Vienna – which did not satisfy him much – he returned to the region of his birth via Munich. Then he entered the practice. At this time his father was at the height of his powers and authority – not only among the public but amongst his colleagues. For a number of years he had been president of the medical society for the governmental district of Düsseldorf. From all sides, people came forward to his eldest son in a friendly and trusting way. Everyone knew him. His open, free-spirited character, his

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healthy and acute understanding, his friendly dedication, his fine sense of tact, his secure knowledge and technical skill, all soon won for him general trust, respect and love. His father – who practiced all branches of the art of healing – was quickly able to introduce him into the entire area of medical activity, and soon passed on to him the surgical, midwifery and ophthalmic cases in the treatment of which he recognized that his son was his master. Indeed, his bold surgical operations – a disarticulation of the upper arm, the extirpation of an extensive ‘crop’e6, several cancers and the like, which were completed successfully – attracted great attention. An interesting case of cure of an ovarian colloide7 was published as his first work in the Rhenish Yearbooks, 1847. But Pagenstecher was not one of those types who is intoxicated by early success. Only too strongly he felt the necessity for further scientific development. His trusting relations with a father – who was as experienced as he was cultured, and a relationship which was and remained for both a source of most heartfelt affectionate satisfaction – still could not give him everything that he felt he was missing; and even the rich library of his family home did not satisfy his thirst for knowledge. At the beginning of August 1847 the second son Alexander, now Professor of Zoology at Heidelberg, returned from taking the State Examination in Berlin, and it was agreed that for the moment he should enter the practice, while Carl went to Paris. This journey took place in September. There the especially great amount of surgical material in the Parisian e6 e7

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swelling in the neck, can mean ‘wen’ or ‘goitre’. presumably mucinous cystadenoma.

hospitals was most energetically exploited. Shortly before the February Revolution broke out, he returned home in order to take part in the silver wedding celebration (on the 24th of February 1848) of his parents in the family circle. All six children were gathered together. But it was not to be the destiny of this family to harvest the fruits of common activity in patriarchal collaboration. The Revolution blew apart this beautiful circle. Only four weeks later the father, together with van der Heydt (later a Minister), were sent by the Elberfeld magistracy as delegates to the preliminary Parliamentary Assembly in Frankfurt. There they were elected to the Committee of Fifty, and in April they were unanimously elected – by those entitled to vote in the cities of Elberfeld and Barmen – to be their delegates to the Reichstag in Frankfurt for the preparation of the constitution.e8 Alexander (the second son) went to Salzbrunn as a ‘spa doctor’, from which position he was later driven out by political disfavour. Initially Carl was quite alone, but he knew how to assert himself. When his father returned in the winter – after an absence of eight months and the wreck of all his patriotic hopes – he found his old practice almost unaffected, and his son in possession of a considerable new one which he had won meanwhile. Thus, from then on, both were able to carry out their labours in separate spheres. In the summer of 1849, Carl entered into

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a happy but unfortunately only very brief marriage; for only a year later he lost his wife after she had presented him with a son. Meanwhile their medical activity grew enormously. In the autumn of 1849 the first cholera epidemic came to Elberfeld, raging there with great intensity for almost six months. Father and son were much in demand. The former has described the outbreak in a special booklet, but he felt his strength to be gradually declining, and his conviction that his son could replace him strengthened his decision to give up the practice completely. In the summer of 1852, after medical activity spanning 30 years, and at 53, the elder Pagenstecher moved to Heidelberg, not to retire but still fully serving his special area (medicine) in which he had toiled so loyally and for so long. Even at this time, this splendid old man was a pillar of the political movement in Badene9, which he helped to shape. His hospitable house served not only as a focus for surviving e8

Virchow uses Reichstag instead of Parlament. The former term fell into disuse in Napoleonic times, and was not formally revived until 1871. The preliminary Assembly was a gathering at Frankfurt of Liberals acting as self-appointed persons who decided that elections should be held. e9 Baden was in the extreme south-west of Germany, and the most liberal-minded state. Only there did the 1848 revolution leave any substantial mark.

members of his family to honour together the most admirable parental pair, but also served their friends as a place of refreshment and re-invigoration for manly endeavour. Meanwhile Carl (the son) had become the leading – one can almost say the sovereign – doctor in Elberfeld. His outstanding abilities and his inexhaustible activity – which were ready to serve the poor even more, almost, than the rich – ensured for him an advantage which soon extended over the entire area. His external situation developed not merely favourably, but brilliantly, and a new marriage in the summer of 1853 – to a close relative, Laura Jung – ensured for him domestic bliss such as cannot be more ideally imagined. But neither his practice nor his family ever let him forget that it is only science – eternally new science – which in the end secures long-lasting satisfaction for the doctor. It distressed him that, year after year, new treasures of knowledge and new methods of examination were acquired, and that he – being able only to read about these things – could not keep up with the all-conquering course of the researchers. Often he said to his Assistenten that he must start again from the beginning, otherwise he would be “consigned to the scrap heap”. “To become old and worn out” was an unbearable thought for him, because, as a practicing doctor, he was supposed to be “experienced in all saddles”, and hence he also wanted to be a student again in all schools. Thus he decided, whenever possible each year, to devote a period of time exclusively to study. I was not a little astonished when for the first time, in the summer semester of 1857, this experienced practitioner appeared again before me, and I saw him resuming the place in my courses which he had left ten years

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before. With all the zeal of a hard-working student – indeed with much greater enthusiasm – he attended lectures by von Langenbeck, von Graefe, Traube, and not satisfied by only doing this, he exerted a driving influence on all sides, especially on younger people. Again, he gathered all aspiring forces around him and, by his example and cautionary words, spurred them to greater activity. For three successive summers he returned to us, and it grieved him bitterly that the heavy burdens of the practice later on 197

prevented him from leaving that activity. And it grieved not only him. We, too, painfully missed this cheerful active man, this happy sociable being, this acute observer, this friendly adviser. He who combined the freshness and cheerfulness of youth with the seriousness and sense of security of the adult man; he who made our own youth live again for us and who at the same time checked our progress from year to year with a knowledgeable eye. – He will remain unforgettable for us. We developed the custom of having an informal party in semi-student fashion before his departure, at which he was the leader of every jolly activity. And many a doctor from outside who was permitted to take part, experienced for the first time – at these celebrations –of just how much human merriment the German heart is capable. The next fruit of these new studies was the foundation of his own surgicalophthalmologic polyclinic, which was soon so widely recognised that he – even with his Assistenten – was scarcely able to cope with the burden of work. The secure independence of his external position determined him all the more to ease the introduction into practice of younger colleagues in the most unselfish way, as also to treat and to tend patients without any regard to their rank in society. Not satisfied with this activity in Elberfeld and its sister city Barmen, he accepted calls for consultations far and wide. Recognition as an operating eye doctor and surgeon grew more and more, and he was not infrequently called to Westphalia, and to the left bank of the Rhine. Yes indeed, in addition to this, he carried out his civic and political duties – in the ever more difficult conditions in his fatherland – with manly openness and in an honourably liberal way. Thus it becomes understandable how powerfully and without exception this impression of heroic dedication to duty affected the entire population of Elberfeld – a population which was otherwise much and sharply divided by political and religious factors, and whose mercantile-industrial activity scarcely provided the basis for any enthusiasm for scientific effort.e10 But towards him, attitudes were different. The whole city looked up in admiration and love to their e10 Virchow may imply that the early industrialists were generally not sympathetic to scientific research for its own sake – perhaps a view gained through his efforts in public health; but it may be more likely that he meant that there was too little commercial activity to provide support for research.

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ever-ready helper in times of need and death.e11 The magistracy followed his advice and promoted, indeed drew his plans out of him. Thanks to this, Pagenstecher soon had the good fortune – in his double position as doctor and as a member of both the City Assembly and the Administration of the Poor – of being able to plan a great new hospital. Thus his favourite ambition was realized: – a haven for the physically and mentally ill, and at the same time the foundation of a clinic in the full sense of the word, and with the deepest significance for science.e12 Two veritable palaces for the sick (physical and mental) alongside each other rose under his direction at the entrance to the city. They were equipped with a munificence which city corporations with no capital assets of their own, have seldom created. On the 17th of December 1863, both houses were opened; 77 patients and 38 lunatics were admitted. By the middle of April 1864 there were 168 in-patients all told. Just as because of its facilities this institution could be called a model of technical care, so, too, it was destined to become a focus of scientific activity as well. Whilst he himself continued at his polyclinic, he took care at the same time to direct a group of doctors to work together so that the entire facilities for the care of the poor, the sick and invalid institutions and so on, were to be combined. He was punctilious in ensuring that everything was exactly recorded, and that all observations were registered, and that the painstaking care which he brought to sick people should also be applied to the recording of clinical experience in a scientific way. Earnestly, indeed with sometimes gruff severity, he demanded of everyone loyalty, dedication and reliable work. But human strength becomes exhausted. The enormous exertions which such great and visible successes brought to him undermined his powerful body which had been so well-prepared for hard tasks. Ever more frequently there were times when he felt exhausted. Retreat to a nearby family property, hunting, as well as journeys to Berlin and Heidelberg, – refreshed and strengthened him, as a rule, for long periods. But then he took up again the burden of affairs as if he were fully rejuvenated. Gradually he yielded too to the quite natural wish to add the e11 e12

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probable reference to cholera epidemics. Michel Foucault objected strongly to this thinking in his “Birth of the Clinic” (1963).

results of his experience to science in general. To start with quite infrequently, but later more often, he published especially his experiences in surgical operations. I draw attention to his interesting work on osteomalacia and caesarean (section), which is printed in the Verhandl. der Berlin. geburtshülflichen Ges. 1862, book XIV p 213, and which reports on ten cases of caesarean (section), amongst them three successful ones (cf Monatsschr. f. Geburts. 1858, Sept). In the Arch. f. klin. Chir. II p 312, he described noteworthy cases of surgical particulars, which at the same time show the boldness of his operative procedure. Amongst them are two cases of re-setting of the hip jointe13; one case of inci-

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sion of the abdomen with a presumed internal constriction and one case of abdominal incision and formation of an artificial anus in the soft tissues where sarcomatous obstruction of the intestine is present. In another place, he describes fourteen cases of incision for hernia. He demonstrated his ability in the surgical specialities in one treatise on drilling into the mastoid bone (Arch. f. klin. Chir. IV p 523) and in another on wounding of the lens capsule (Zehenders Monatsschrift f. Ophth. 1864). In all these works he not only demonstrated a sober, honest and acute power of observation, but also a technique which was as bold as it was caring, which seldom presents its results without giving directions for better methods in operative technique. Just as the hospital was simultaneously the climax and conclusion of his external activity, so, in even higher measure, was the first and only annual report on the hospital which he provided in 1865 in a volume of 167 pages (the climax) of his internal activity. For him it became both a report and a testament. In it Pagenstecher showed how he did it, and how his successors should do it. May they always at least come close to his example! This report – in addition to several mainly statistical works from his Assistenten Adolph Zander and Rauschenbusch, who right to the end stood loyally at his side – contains two longer treatises by Pagenstecher himself. One was on croup and croupous diseases of the soft palate in children, and the other on resections; both based on rich material exclusively from his own e13

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thought to be reduction of dislocation of the hip.

practice. They are significant not merely in a practical, but also in a scientific sense. His teaching on croup is treated in a manner which deviates completely from the contemporary views of many doctors. In particular diphtheria of the tonsil and jaw are separated from diphtheritic croup. Incidentally, in the statistical part (pp 19–22), his urano-plastic operations are listed. While working on this first annual report, his health had deteriorated substantially. It is difficult to determine how long this may have been going on. He himself says in his annual report (p 56) that he had wounded and infected himself during the tracheotomy of a croupous-diphtheritic child; that the wound, which had become diphtheritic, had become necrotic over a large area, and that in the fifth week, with attacks of shivering and repeated lymph vessel inflammations, he had developed diphtheritic angina and several furuncles. An autumn stay (1864) with his father in Heidelberg gave him some renewed strength, and he had departed with the promise to restrict himself from now on to the hospital and consultative practice. An unfortunate turn of events led him rapidly to forget this promise. External circumstances caused him once again to devote himself to the entire practice. Very soon the consequences became noticeable. The foreword and therewith the end of his annual report (sic) dates from January 1865. Soon afterwards he began to feel tired and apathetic; his stomach began to suffer; he withdrew from the practice and withdrew into himself. He

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continued only with operations, although a certain unsteadiness in his hand became noticeable. Before me lies his last letter to me of the 23rd of March 1865, in which he announced his annual report and at the same time, asks to have an Assistent recommended for his hospital. But his writing is so changed compared with earlier times, and so unsteady, that individual words can hardly be deciphered. Nevertheless, he entrusted himself to no doctor, and did nothing significant for himself. It almost seemed as if by then he had given up hope. He dragged himself around with great effort from day to day, and the opinion was felt that he had a severe stomach ailment. Only at the end of May, almost by chance, his father in Heidelberg heard of his condition, and for this reason became so alarmed that he immediately hastened to Elberfeld. A telegram informed me of his anxiety. Unfortunately we had to admit in respect of the patient – who greeted us with touching joy – that here we were confronted with a severe cerebral disorder. A severe attack of convulsions which commenced on one sidee14, and ended with unconsciousness, did indeed soon pass, and even brought a certain remission, but only for a short time. When, eight days later at Whitsun, I was again in Elberfeld, I found him weaker, and having renewed attacks of spasms and anxiety, which impressed more and more – even on the most optimistic of us – the danger to our dear invalid. Great irregularity and increasing weakness of cardiac and respiratory actions prepared the way for the approaching end. On the 15th of June, still fully conscious, he passed away quickly and gently. I do not know how better to conclude this than with the words of his sorelytested father: “He has led a life which was all too short but rich in deeds and full of recognition and love. He used his time in a way for which the average man would need a double measure. His memory remains a blessing for those left behind, but the loss is terribly hard”. Rudolph Virchow. e14 Jacksonian epilepsy, suggests a single cerebral cortical lesion. The disease was possibly a cerebral tumour or abscess.

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6e. Ludwig Traube (1818–1876) In Memory of L. Traube Berlin. klin. Wochenschr. No 16, 17th April: 209–10 (1876)

Editors’ comments This is a short piece giving details of Virchow’s involvement with Traube. There is little of a personal nature, nor of Traube’s work at the Charité. Traube had studied medicine in Breslau, Berlin and also in Vienna, where he had been influenced by Rokitansky and had learned clinical medicine of the lungs and heart in Vienna. Several clinical phenomena are associated with his name (Verghese et al, 1992). He became a leading chest physician at the Charité. In 1862, he became Ordinarius at the Friedrich-Wilhelms Institut, and in 1872 was appointed Professor at the University of Berlin. Other obituaries were published in German at the time (by Leyden, and by Freund). A statue of him in the grounds of the Charité was destroyed in the 1940s (Charité website). Additional data can be found in the Jewish Encyclopedia, and via Wikipedia.

Editor’s summary of points P 209 general comments, work in 1846; 210 begins work with Schönlein, general characteristics of Traube.

Exactly thirty years have passed since Traube’s name was first mentioned in the literature. For almost a whole generation, he augmented the fame of this name and reached a height of esteem on which he was visible even to those faraway. The world has long since formed its opinion of him; everyone believes that they can convey in a few words the merits of the man who has passed away. For one who experienced these thirty years at the same time, one who observed this man’s development from close at hand, it is less easy to find the words which might express the real merit and achievement of this powerful personality. Every newspaper scribe can say that Traube was a great doctor and that his impact on his so-called speciality – diseases of the chest – justifies us in setting him alongside Laennec and Skoda. But that is not his actual claim to fame, because at the time, there were even more famous doctors. And if, in the order of specialists in diseases of the chest, he really was third in line, he would still after all only be the third. Laennec died a few years after Traube was born, and the history of practical medicine will always have to regard Laennec’s book De L’ausculation Médiate as unique. No, Traube could lay claims of a different kind in order to assure for himself lasting posthumous fame. If one wishes to recall what he achieved, it is not sufficient to consider just his external position – which he had gained as reward for

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6e. Ludwig Traube (1818–1876) Figure 6e. Ludwig Traube.

long activity. One must also pursue the inner history of his development. One only understands the essence of such an intellectual nature if one grasps its actual creativity. And if today, when his body is returned to the earth, I take it on myself to give a short funeral address in this sense, so I dare to do it only because I am one of the few contemporaries who saw the beginning of his creative career, and who directly absorbed (from him and from the very beginnings), his efforts in accurate (clinical) interpretation. It was in 1846 when those two issues appeared which bore the title: Beiträge zur experimentellen Pathologie. Although short and not even concluded, they had a mighty effect, and will always have to be named in our literature as a visible sign of what Traube wanted to do. Of the few collaborators, only Rühle and I are still alive. Our friend Reinhardt departed the stage long since. Although Traube was only a few years older than the rest of us, in the early period, after our studies had been completed, the differences between us were large. He had already begun to give private courses on auscultation and percussion whilst we were only just beginning to apply our recently-acquired knowledge to teaching. Of all those involved, I was the only one who had a job – even if it was only a minor one. But I possessed (pathological and clinical) material for all of us, and as no one amongst us had any ambition other than to change the state of science by our own works – which seemed to us to be very low – so this awareness

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was sufficient for us to understand the correct method of research, in order to fill us with confidence in victory. Traube’s goal at that time was already quite clear. He expressed it himself in the following words, in the foreword to the Beiträge. “Having proceeded from thorough knowledge of facts already gained, Traube’s goals weree1 acutely-expressed questions as to perceived phenomena and equally definite answers, which are the result of a systematic sequence of exact experiments and, indeed, direct deductions from these experiments”. e1

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There is no verb in the original, and this phrase is inserted for sense.

What he was seeking was not facts, but explanations. Certainly, factual explanations proved by experiment and not merely speculative interpretations – but all the same, explanations. A very high goal, because it was a matter of clarifying the individual details of the mechanistic process in the confused interplay of life processes in the higher organisms, through which the final result is prepared and finally achieved. The model for this direction in research was Magendie – the great experimentalist of the Parisian School – whose method Johannes Müller had carried over in more complete fashion to the whole field of physiology. The man in our small circle who most closely associated himself with Magendie was Mendelssohn, long-disappeared – a victim of Lassalle’s heartless politics for which, in the notorious trial arising from the ‘casket theft’, he had to pay the price.e2 Perhaps he would have been chosen for greatest success specifically in the development of the experimental-pathological direction – and for the recognition of the mechanistic connection in the great organic process – because he would not recoil from any difficulty, and his skill in drawing together the mechanistic elements of experimentation was unexcelled. On the other hand: many are called but few are chosen. Traube was one of those few. Certainly, momentarily, it seemed that he would fall by the wayside. The completion, begun in the second issue (of the Beiträge), of his study “On the manifestations of choking in the respiratory apparatus”, encountered unexpected obstacles. Moreover, the business foundation of the Beiträge was at the outset over-estimated. There were difficulties with the book trade. After almost a year of waiting in vain, Reinhardt and I felt compelled to found the still-continuing Archiv f. path. Anat. u. Physiol. etc. in order to gain a certain place for our works. Meanwhile Traube continued to work on his own. At that time he attached little value to ‘facts’, if they had no interpretative value. After all, he had no access to medical practice, and in particular no material gained from hospital access. Only a revolution could open this up for him, the Jew. In 1848, in the Medicinische Reform numbers 4–6, edited by Leubuscher and me, Traube developed, in a longer article, his views on special clinics. Almost at the same time,

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thanks to a very active student movement, the Ministry was moved to give him a position of Assistent in the Charité. A civil Assistantship at the clinic, the first one of its kind, was established by Schönlein and given to him. Soon afterwards he became Dr habil. and Lecturer at the University. Therewith a new period of inner development and of work began. Now facts too became the object of his work. Indeed Traube – who up to that point had despised therapy on the basis of his Viennese studies, and especially of Skoda’s negative influence – now began, under Schönlein’s thoughtful direction, to apply himself to the study of the effects of medicaments. As a first result of these observations we should regard his work on digitalis – that favourite remedy of his chief (Schönlein) at the time. But here too he did not remain for very long with the facts. Again he put the question as to the ‘explanation’ and again began experiments as to the ‘mechanism’. And thus, via another route he came back to the same nerve, with investigation of which his ‘experiments’ had begun, namely, the vagus. It cannot be my task today to write the history of these studies nor of those which followed in a long sequence. For this, more peace and gathering of thoughts are required than these present days allow. What I wrote should only serve as first memories, in order to show the beginning of the path along which so many great things were achieved. But at the same time, it should remind us vis à vis the clinician, not to forget the physiologist; and vis à vis the practitioner, not to forget the researcher. Finally, it should say to the generation which has followed, that one must begin to train one’s own intellect early on, and one must long persist in the work if one wishes to equal such a man. It was a stern critic of himself, and a strong man of work, who has now concluded his long days of labour. Honour to his name! Berlin 13th April, 1876.

Rudolph Virchow.

e2

This may refer to the Mendelssohn who was involved in the actual theft, and was gaoled. See Wikipedia “Ferdinand Lassalle”.

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6f. In Memory of Nicholas Friedreich (1825–1882) Virchow’s Archive 90: 213–220 (1882). Editors’ comments One of Virchow’s Assistenten at Würzburg, Friedreich was later was called to Heidelberg, where he made great contributions to neurology and myology (e.g. ‘Friedreich’s ataxia’). Some biographical information can be found in Grimm (2001).

Editors’ summary of points P 213–4 Virchow’s contact with Friedreich; 215 family background; 216 early teaching in Würzburg; 217–218 later career; 219 final illness.

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When, a year ago, a wide circle of friends and pupils united with me in festivitiese1, only a few were missing from the by no means small number of those, who – over a teaching period of thirty years – had been closest to me as Assistenten and voluntary helpers. And at that time, only one of my former Assistenten, Karl Ernst Emil Hoffmann, Professor of Anatomy in Basel, had died, in fact several years previously. All the others were still alive – most of them still engaged in meaningful (professional) activity. Certainly a rare piece of good fortune! Even if it is per se in the natural order of things that the Assistent outlives the Professor – i.e. the successor his predecessor – a glance around us teaches us how many younger men pass away and how large, especially from medical ranks, is the proportion of those who are carried off before their time. However, in the single year which has passed since that celebration two men, who were able to greet me warmly there, have departed. Karl Hüter, who once upon a time had given up the post of Assistent at the Pathological Institute in order to become a practising surgeon – and Nicholas Friedreich who, following my departure from Würzburg, acted in my place there for a year until a highly complimentary summons to Heidelberg gave him the e1

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in 1881 – presumably refers to a celebration for Virchow’s sixtieth birthday.

influential position of an internist. Hüter was present at my celebration in person; indeed he felt himself to be so capable of action that, to our general surprise, he shortly afterwards moved into politics and joined me as a member of the Reichstag. Quickly and wholly unexpectedly a life which had still promised such rich fruit reached its end. For seldom had so much talent and so much industry been united with such energy and enterprise as came together in this man. On the other hand Friedreich had been able to send his greetings (as Dean and as a colleague) only in writing. Friedreich was, as we only became aware

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6f. In Memory of Nicholas Friedreich (1825–1882) Figure 6f. Nicholas Friedreich. Courtesy Fr. Helga Seifert, librarian, Institute of Pathology, University of Würzburg.

afterwards, already a broken man. But he bore his hard lot like a hero, concerned only that none of his family should be worried by knowing of his helplessness. It is a special duty for me to recall him here on this occasion. For twenty-six years one after another of his works appeared in this Archive. There was such a great number that simply to list them would take up a very large space. This issue will also publish his last posthumous treatise – the farewell from a loyal collaborator – a fresh memory from beyond the grave. When, in 1849, I assumed the Würzburg Professorship, Friedreich was just at the end of his academic studies. Following the shattering of the academic body – for political reasons, in 1832 – the teaching situation at the University was extremely demoralised. In recent years, however – at least in the Faculty of Medicine – it had improved again. Kölliker in particular, immediately after coming on the scene, had won decisive influence on the younger generation of students. Proof of this is a treatise on the skull of the Axolotl, which Kölliker published in the second report of the Royal Zootomical Institute at Würzburg (for the academic year 1847–8, appearing in 1849). It had been written by two ‘students of medicine’: Nicholas Friedreich and Karl Gegenbaur, after they had been allowed to develop work together most happily as colleagues at the same Hochschule.e2 Their friendship was to be broken only by death. e2

here in the sense of a tertiary educational institution, not a ‘high school’.

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Friedreich himself, with moving friendliness and right up to most recent times, remembered the effect which “my lectures and my direction” had exerted on him. He detailed this publicly, in particularly warm fashion, in the preface to his big monograph on progressive muscular atrophy and on true and false muscular hypertrophy (Berlin, 1873). It would be strange indeed, were I to refuse this recognition. I can say that, as a student, Friedreich was not a zealous attendee and worker only at my lectures and courses, but also afterwards when (in 1850) he had been awarded his doctorate and had taken up a post as Assistent in the medical clinic. In all cases, when something specially struck him, he turned to me and asked for my advice in his investigations. But I would like particularly to emphasise that he carried out his duties as Assistent as a matter of principle, with a zeal, perspicacity and an independence worthy of the highest praise. It was no exaggeration when Mr Otto Becker indicated this in the heartfelt speech which he gave on behalf of the Medical Faculty at the graveside of the departed. He told us that Friedreich had come from a family which, for two generations, had produced outstanding representatives of medical science in the Würzburg Faculty. His grandfather had been Director of the Medical Clinic. When Nicholas was born (in 1825) his father held the Chair of General Pathology. It was only with the shattering of the Medical Faculty (see above) that in 1833, the hard fate of exile fell on his father. One may interpret this inheritance more in the material, or more in the psychological sense. All the same, one can say that from the start Nicholas Friedreich proved himself as the true inheritor of the best practising medical qualities. And if, as he puts it, “the principles of cellular-pathological interpretation have been sure guiding stars for his clinical paths through the labyrinth of pathological processes”, the fact remains indubitable that his talent was pre-eminently that of the clinician and that, in essence, he developed it by his own efforts. For his chief at that time – Marcuse3 – had lost his sight before Friedreich took up the post as Assistent. And if, in spite of this, Marcus e3

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for details, see chapter 3 on Schönlein.

continued to conduct his clinic, no explanation is needed for the fact that he was not capable of teaching the methods and practices for examining sick people, by which ideal physicians were trained. Thus it was not because of him that Friedreich, Biermer, Gerhardt and Ziemssen became adornments of the German Clinic. As far as Friedreich in particular is concerned, he knew almost instinctively how to find his way by himself. In this respect nothing is more instructive than a glance at the works which he communicated in these years – mostly to the Physical-Medical Society. Certainly, his first contribution – at the session of the 1st of November 1851 (Verhandl. vol II, p 319) – dealt only with a single, even if really interesting, case of widening of the lymph vessels of the penis, but his next publication revealed his

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unique talent. This was his “Contributions to the theory of tumours in the cranial cavity” – the work which was the basis both for the award of his Dr. habil. and for his appointment as Lecturer in 1853. Here we encounter him in an area in which he later received general recognition; namely that of nerve pathology, which at that time, could still be described as almost barren territory. The careful unification of secure pathological-anatomical knowledge with unprejudiced clinical observation – which was his particular gift – appeared here fully for the first time. As the task had fallen to him over a long period to give instruction in the methods of physical examination of patients, there were very soon achievements in this direction too. These extended beyond the usual scope of the beginner. At the session of the Society on the 20th of January 1854 (Verhandl. vol V, p 185), in models of thoroughness of presentation, he reported two rare cases: one of traumatic pneumothorax with subsequent healing, the other a case of lung herniation in emphysema. His main work from this period, however, was a treatise on the diagnostic significance of objective signs of (pulmonary) cavitation. This he presented at the session on the 12th of April 1856 (Verhandl. VII, p 87). In it he presented the proof that “all objective signs of pathological cavities found within the lung parenchyma, sometimes occur on their own, but also, occasionally, in other disease circumstances”, especially in effusions in the pleural spaces. What distinguishes this treatise is not only the sharpness of perception and the accuracy in establishing the findings, but primarily the care with which – by extensive use of the literature – he criticises even literature of the most finely particularising kind, with seriousness and in the mildest way. But earlier, at the session on the 22nd of July 1854 (Verhandl. vol V, p 271), he had given a comprehensive report of 33 cases of abdominal typhus which he had observed during one of the infrequent typhus epidemics in Würzburg. As only a few fatal cases occurred in the course of this epidemic, his report is almost exclusively clinical: symptoms and treatment are dealt with extensively and discussed in a model way. One sees how every step leads him further along the path of a clinician. If, in spite of this path, the Faculty appointed Friedreich temporarily to the Chair of Pathological Anatomy and Physiology (in autumn 1856, when I had received my summons to Berlin), this temporary appointment will always stand as a glittering proof of how Friedreich, in the midst of his practical work, always knew the value of theoretical medicine. But we value just as much his decision to choose the Clinic, when, a year later, he received the invitation to take over a vacant (erledigte) Professorship at the Clinic of Internal Medicine at Heidelberg. Certainly, in his whole nature, he was an internist; he was only following his profession when he gave up his hometown and the situation which had become so dear to him at the Julius Hospital (at Würzburg) in order to take up

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the post to which, from then onwards, his powers were devoted right up to his death. And he never had cause to regret it. The number of his patients grew each year because the general conviction as to the sheer decency of his character and the sureness of his ability spread through ever wider circles. Patients from all regions (of Germany) and all classes sought his help, for his caring nature and his politeness were the same whether it was pauper or prince who called on his skills. How he conducted himself in the clinic and what his students have lost by his passing, has been eloquently described in the memorial words, which his wellproven Assistent, Mr Adolph Weil gave on the 10th of July in the clinic itself. 218

At this point, I can also refer to the above-mentioned address by Mr Otto Becker. To give an exhaustive presentation of Friedreich’s scientific works would amount to a long piece; I refrain from this all the more, because I know that a discussion of these works has been prepared elsewhere. The readers of this Archive may well not have lost the thread of his thinking, for, beginning at vols 9 and 10 – in which Friedreich reported the discovery of the corpora amylacea of the lungs, and new observations on Pneumomycosis aspergillia – there is a long sequence of his articles throughout the Archive right up to the present. All my readers will understand how painful is the loss of such a colleague. Because after all, he faithfully helped me where so many deserted me, in the huge enterprise of the “Handbook of Special Pathology and Therapy”e4, in which he dealt with cardiac diseases (vol V, section 2), as also diseases of the nose, of the soft palate, the trachea, thyroid and thymus gland (vol V, section 1, 3rd subsection, 1858). Following these works it has become easy to write new handbooks, but anyone wishing to evaluate the new ones will be able to convince himself, by comparison with the earlier literature, what a task it was to produce such refined work (as Virchow’s “Handbook”) out of rough material. In our times, when books are so detailed, gratitude has become a rare virtue. If ever again there is the leisure to look at the whole (medical literature), Friedreich’s share in providing the foundations of modern medicine will certainly not be overlooked. With Friedreich I have indeed lost more than a loyal co-worker. Since our paths went separate ways, I have had only infrequent opportunity to see him more than in passing or for a few days. My correspondence had become too extensive for me to be able to conduct it intensively with individuals, even with the dearest ones. Thus we could easily have become strangers to each other. But Friedreich was one of those friends of constancy. We were confident of each other, without everytime exchanging explanations; we understood each other without necessarily having to discuss every incident in detail. His life was so dedicated to science, to the sick and to the hospital e4 The

first volume (1854) of this Handbook was written by Virchow and Vogel. Virchow arranged for other authors to write five more volumes, but the work, perhaps, was originally meant to be longer.

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that it would not have been surprising had he misunderstood my public activities, as everyone else did. But there too, his sympathies were with me. He himself, as far as I recall, only entered the political arena once, at the time when the Catholic movemente5 was pressing into the foreground of practical concerns. There, however, his actions were thoroughly liberal and resolute. In other things, too, I always found him full of sympathy and understanding for general issues. Perhaps he had no time, and perhaps no compulsion either, to intrude practically into matters which were outside his immediate circle. In this a melancholy conviction played no small part, namely that his health was seriously under threat – an idea of which he became convinced at a time when his medical friends could still not perceive any symptom of a definite illness. In 1863, when he visited me in Glion, on Lake Geneva, he complained about his state of health. During our attempt to climb the Dent de Nayee6 he suffered such prolonged giddiness that the guide and I were able to bring him back down only with difficulty. After that he spoke continuously of a heart condition – particularly three years ago, when we spent several days together in Thun. All attempts failed to convince him that his cares were baseless – given the lack of objective evidence of heart disease; indeed, what particularly disturbed me at that time was that he insisted, with a certain anxiety, that I should visit him in Heidelberg in the same autumn. When I arrived and enjoyed his hospitality in his new house, he seemed relieved, merry and content. And yet, as later became clear, worry gnawed at him. He was right, because the aortic aneurysm which caused his agonising death, was obviously well developed. But he had learned to conceal the suffering that was consuming him from the world around him and from his friends – and most of all from his loyal life companion. No one was to be worried on his account. His colleague Becker says: “It was the sad tale of his suffering which gave us a glimpse into the real meaning of the expression ‘fortitude in adversity’. We encountered a picture of almost exalted resignation when e5 e6

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the revival of clericalism, see chapter 1. a mountain peak, above Lake Geneva on the French side.

we were permitted to visit him in his last months – him, our friend, in the rooms of the house which he had built for his old age and into which he had moved only to become ill and to die”. Thus let his memory remain with us as a model of loyalty, of constancy and of truthfulness! May the memory of this model remain forever unforgotten in German Medicine!

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6g. Theodor Schwann (1810–1882) An obituary by Rudolph Virchow Virchow’s Archive 87: 389–392 (1882). Editors’ comments This obituary is more about Virchow’s version of the history of the Cell Theory than about Schwann (see chapter 1). There are only a few details of his career, but both his scientific rectitude and his resistance to Church attempts to suggest that he supported miracles are noted. A biography (Stuedel, 1964) and a volume of Schwann’s letters (Florkin, 1961) have been published.

Editors’ summary of points P 389 Introduction, origins of the Cell Theory; 390 importance of Schleiden’s “Scientific Botany”, work in Müller’s laboratory, Schleiden’s error concerning the origin of cells; 391 cell formation seen as analogous to crystallization, cytoblastema theory, Schwann found that tissues come from cells, Virchow found that cells come from other cells – omnis cellula e cellula; 392 assertion of “independent life of the parts”, Schwann’s later career, affaire of Louise Lateau (1850–1883).

Sorrowful news seldom comes alone. On the 23rd of June last year, in Frankfurt am Main, Schleiden, the celebrated originator of the Cell Theory of Plants, died; on the evening of the 11th of January, in Cologne, Theodor Schwann, the stillmore celebrated originator of the Cell Theory of Animals, closed his eyes forever. Almost the same interval of time between the appearance of their first remarkable investigations separated the days of their respective deaths. Schwann himself has borne witness to the decisive influence which Schleiden’s works exerted on him. He entitled his classic book, which appeared in 1839: “Microscopic investigations on the coinciding of the structure and growth of animals and plants”. In the Foreword he extensively discussed the works of his predecessors, but amongst them he attributed to Schleiden the greatest and most decisive influence; for it was the latter who taught us to understand more exactly the developmental process of plant cells. The genetic approach – 390

which first of all Goethe established in ground-breaking fashion, and in the same way in plants – had now to be carried over to the animal organism. That was the task which the 28 year old Schwann, splendidly taught by Johannes Müller, set himself. He solved it in brilliant fashion, far beyond his own expectations. After him there has never been any serious dispute as to the fact that all tissues and organs of animal bodies are constructed from cells.

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6g. Theodor Schwann (1810–1882) Figure 6g. Theodor Schwann.

In our time of restless activity – when memory itself of a very recent past grows dim so rapidly – it may not be without value to renew the wreath of memory which representatives of all biological disciplines should lay on the grave of the brave, bold Schleiden.e1 Probably the animal cell theory would have been found without his efforts, but in fact he evoked it by his example. When my contemporaries and I began our researche2, this feeling was still so alive that we consulted Schleiden’s “Scientific Botany” almost as often as Schwann’s “Microscopic Investigations”. For us, too, the thought of the unity of organic nature revealed itself as so stimulating and fruitful that even the neophyte student felt full responsibility in himself to maintain his botanical comprehension in a certain parallel relationship with his anatomical and physiological knowledge. For me this memory is most uplifting. I began my studies in the year that Schwann – after he, having published his work while in Berlin (1839) – accepted the call to the Catholic University in Louvain. The scientific atmosphere in Berlin was still completely dominated by the new ideas. Johannes Müller himself, our honoured master, gave these ideas full expression in his teaching. Indeed, he was the first to introduce them in the broadest sense into Pathology; in that he applied the same method to the examination of tumours. No wonder, then, that we young men learned early on the “think cellular”! And yet how long it still took for the cellular idea to attain the necessary power to achieve complete victory! Schleiden, as soon became very clear, had

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committed a fundamental error in his observations. Right from the beginning he had built up the theory of ‘free cell formation’, which was for more than a decade, in the narrower sense, the term for “Cell Theory”. Schwann (in the preface) describes it as follows: “He (Schleiden) found that at the formation of plant cells in a grainy substance, small sharply defined granules arise at first; around these the cell nuclei (‘cytoblasts’) are formede3, which appear as if they were granular coagulations around those granules. The cytoblasts still grow for a time. Then a fine transparent bubble – the young cell – arises on them so that this latter initially sits on top of the cytoblast, like the reservoir of an hour-glass. It then spreads out further by growth.” That was the so-called hour-glass theory, which was willy-nilly called the Cell Theory. Schwann introduced this concept into animal developmental history. Concerning the free formation of cells, he immediately accepted the analogy with crystallizatione4; and therewith, further, the acceptance of a kind of mother-liquor, e1

Haeckel (1923) states that Schleiden had a chronically negative outlook and was unpopular as a person. e2 i.e. mid 1840s. e3 Note that in his “Cellular Pathology” (1858) Virchow drew cell nuclei as aggregates of regular small rounded structures (Figs 128, 133 and 142), but with little comment on the internal structure of nuclei. e4 i.e. as ordinary salts or organic compounds, such as urea, crystallize when the solvent in which they are dissolved, evaporates. 391

from which the “organic crystallization was presumed to proceed”. He called this mother-liquor, the ‘cytoblastema”. But therewith, unfortunately ab initio, the weeds had been sown amongst the corn, and the weeds grew luxuriantly.Anyone who spoke of the ‘Cell Theory’ automatically meant the generatio aequivoca of cells – their origin from one cytoblastema. From this the pathologists constructed the ‘plastic exudate’. All of us followed this wrong trail. The entire literature of microscopy of the 1840s remained stuck in it. The general pathology of the Viennese school was quite specifically shipwrecked on it. I myself, only very slowly and by means of wearying investigations, managed to return to the firm ground of facts, and was successful in finding a new and in principle different ‘Cell Theory’: – the theory of continuous formation, i.e. omnis cellula e cellula.e5 Today many people believe that Schwann’s Cell Theory is identical with our current Cell Theory. That is probably explained simply by the fact that even a book of the rank of Schwann’s “Microscopic Investigations” is only seldom read. After all, it never went into a second edition! One just passes on what one has heard, but no longer regards it as a duty to search through the original sources. Why should we still read Schleiden and Schwann, since the hour-glass theory – and with it the cytoblastemas, the exudates capable of organization, and the organo-plastic materials – have been buried? Yet one should read them, if only to put oneself in the position of being able to understand the

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strange fact that in spite of such great errors in their writings, the foundations were laid for the scientific progress of later times – ours; and certainly also too, for the coming age. Clearly, what was regarded as the main point – indeed one can say it was in the very foreground of Schwann’s thoughts – was a misunderstanding. He did not find the developmental history of the animal cell which he was looking for. But he demonstrated the development of the tissues – indeed the development of the whole body – from cells. Even today whether or not his data on this were correct in detail is disputed. Specifically on that point which has become of decisive significance for my own theory, i.e. the connective tissue and its relatives – I part company with him completely. Whilst he has the cells perishing therein, I have proved that cells persist there and thus gain a matrix for further cell formation. But these differences – however significant they might be for numerous individual questions of physiological and pathological development – are not important vis à vis Schwann’s general theory concerning the derivation of all tissues from cells. On the contrary, if one evaluates them appropriately, they really put his theory into a very clear light. This is because it is obvious that continuous cell formation is a more powerful proof for the correctness of this theory than a discontinuous one. It is also a fact that as long as the idea of ‘cytoblastemas’ still had currency, the attempt was made again and again to have fibres – or, expressed differently, ‘connective tissue’ – coming forth without intervention of cells from ‘plastic materials’.e6 Schwann’s immortal merit as a researcher was that he proved the consistent role of e5

This claim is believed by many authors to be unjustified, see chapter 1. for explanations of ‘fibres’, ‘globules’ and ‘cells’ see Rather (1972, 1978), Rather et al (1986), Harris (1999). e6

the cells – beginning with the egg cell and progressing right through to the tissues of the adult – in the creation of the whole body.e7 Perhaps Schwann may claim even greater merit as a thinker. Anyone wishing for more details on this should read Section III of Schwann’s work (p 197). Here he shows what he wants to be recognised as the ‘Theory of Cells’, namely “the development of the theorem that there is a general formational principle for all organic productions; and that cell formation is this forming principle, and things which follow on from this cell formation are also part of this theorem”. Later he argued this more closely but more pointedly (pp 220ff) – admittedly with extensive digressions into a very dubious area of physical explanations – the fact of the foundation of independent life in the elementary parts i.e. in the cells. “We must” he says, “in general attribute the ability to live independently to the cell, i.e. the combinations of molecules which are present in an individual cell are sufficient for the cells to develop the power to attract new molecules. The bases of nourishment and of growth do

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not lie in the organism as a whole but in the single elementary parts, i.e. in the cells (p 228)”.e8 Thus a thought was taken up again which for centuries had surfaced in science from time to time – but had been lost again and again – a thought that has lived in the people for millennia: – the idea of the independent life of the parts. And at the same time a form had been given to this idea which permitted its entry into more strict doctrine. Every year since then has brought new facts which strengthened this idea and made possible its application to all areas of biology. Now, moreover, it forms the sure basis of our views of life. This obituary does not intend to offer a description of all the individual achievements of the great researcher. I will not even speak of his investigations into fermentation and digestion, which would alone have been sufficient to surround his name with permanent glory. I should just like to add a word of recognition for the man himself. Schwann was called to Belgium, as a teacher in the Free Catholic Universitye9 because he was Catholic. I myself first got to know him in Louvain during a visit in 1846. When we were in personal contact for the second time, we were both engaged in the affair of Louise Lateau.e10 I had given my Breslau speech on miracles; he himself had been taken by senior Church officials to the miracle worker. This visit was used in the most contemptible way to imply that he had witnessed these miracles. His honourable and brave spirit allowed him to break through the trap which had been set for him, and he had no hesitation in honouring Truth and calling a lie a lie. May his memory be a hallowed one! e7

For Remak’s contribution to this, see Otis (2007). The concept of a “power” suggests Vitalism, which was a major belief of Müller (see Müller’s “Handbook of Physiology” written at the same time that Schwann was writing his own theory). e9 In its history of nearly six centuries the University of Leuven (Louvain) also knew some periods of misfortune. In 1797 the university was closed by the French government. In 1817 it re-opened as a state university, on instructions from the Dutch King. The University became a Catholic University again in 1835. The Faculty of Medicine remained successful in attracting valuable scientists such as Theodor Schwann, Professor of Anatomy and Embryology from 1839 to 1848, who had introduced the cellular theory (sic). In the twentieth century large areas of Leuven and many university buildings were destroyed in both World Wars. The University Library in particular was partly destroyed on both occasions. Adapted from Website http://www.kuleuven.be/english/about/history.htm e10 During her nineteenth year, Louise Lateau (1850–1883) developed wounds on the left chest, hands and feet, and later, on her head; all in association with visions of Christ’s passion. Ideas of Divine intervention were supported by some clerics, while notions of self harm and psychotic delusion were suggested by others. The case was famous for a long period. A recent summary with references has been provided by Lachapelle (2004). e8

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6h. Friedrich Heinrich Roloff (1830–1885) Address at the funeral of Geh. Med-Rath. Roloff, Director of the Royal Veterinary School. Given by Rudolph Virchow. Berlin. klin. Wochenschr. No 3, 18th of January: 47–8 (1886). Editors’ comments This address is a straightforward commemoration of a major figure in the history of veterinary medicine. Oddly, Virchow does not mention Roloff’s work on diseases of animals caused by factors in the diet (see Meyer, 1997). According to Meyer’s article, in German speaking countries Roloff was one of the first veterinarians to study the field of nutrition-related diseases such as osteomalacia, rickets and lupinosis. After careful epidemiologic studies Roloff developed hypotheses about the pathogenesis of the above mentioned diseases and tested them in experiments (with dogs or sheep). His work demonstrates that clinical observations may stimulate research in animal nutrition. Additional articles include Saunders (2000).

Editors’ summary of points P 42 introduction, early career, proponent of new concepts of pathology and disease in veterinary science, work on various pathological topics at University of Halle, work as district veterinarian for the Saale area, work on lung plague, Rinderpest, consumption in pigs, and anthrax; 43 work of the technical committee for veterinary practice in the 1870s, Roloff’s appointment to it in 1876, 1879 Director of the Veterinary School, sadness at his early death, choice of cremation rather than burial.

If I speak at this painful moment to sketch the greatness of our loss, and to enshrine in our memory the image of the departed – when family, friends, and the entire School, which has lost its beloved Chief, have gathered for a last time, before the coffin of the deceased in order in common sorrow to soften our grief – then I do so primarily at the wish of his relatives and his closest colleagues, and in the name of the technical deputation for the Veterinary profession, and finally out of the feeling of many years of personal friendship and heartfelt respect. I know that in this feeling I am at one with all who have ever come close to the deceased. Who has not experienced how mild he was to others, and how hard he was on himself! Always ready to help and to judge people in a humane fashion, he himself made the highest demands on himself. No sacrifice was too great for him if duty demanded it. And just what duty meant for him he proved most clearly during his long painful illness. He died still where the trust of his superiors had placed him; right to his last moment he was a true and loyal servant of the people. Roloff’s life came at a time of great development in the area to which he had devoted himself. In 1847, when he began his studies at this school, Veter-

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inary Science had sunk into a kind of retirement (Ruhestand). After splendid beginnings, a depressing decline had overcome the School. Medicine generally had realized only shortly before that – in the midst of immensely hectic progress in the sciences – it was up to medicine itself to take its place again. New methods of investigation had been developed, but the first campaign had brought more confusion and darkness than order and enlightenment. Years of painstaking work passed before new light came to the general area. A fortunate chance then led Roloff back to the School. In 1862, he was summoned to be a coach (Repetitor) on the teaching staff. Now he himself became a participant in the re-construction of Veterinary Science – or rather in a whole re-shaping of veterinary knowledge into a science. It was at this time that I got to know him, and when I was permitted to influence not only him, but also on his predecessor, who also died young. And it was then that I was able to help lay down the path for that fruitful mutual exchange between Medicine and Veterinary Science, which has been promoted so strongly by the deeds of Roloff and his predecessor. For the Berlin Veterinary School it will be an unforgettable glory that in this significant period it has had two directors, one after the other, who – fully conscious of the goals to be achieved and by their own example – directed every effort to keeping alive the imitative zeal of the younger generation. Roloff had the particular good fortune that, after he had absorbed the new methods and concepts, he was granted a position which allowed full opportunity and leisure for his own research. In 1865 he was appointed as Lecturer to the new Agricultural Institute in the University of Halle, and was soon thereafter promoted Extraordinarius. He occupied this position for twelve years – years of hard and demanding work. Now he showed how, via the new strict methods of investigation – whether it be by observation or by experiment – Nature can be compelled to give answers to intelligently-formulated questions. It was not without some feeling of satisfaction that I examined the series of treatises which he published in my Archive in the years 1866–69. The theories of osteomalacia and rickets, of fatty degeneration of the muscles in young domestic animals, of the caseation (käsigen) processes in the gut of pigs – were treated by him in completely independent, and in part, in decisive fashion. Indeed, even then he was close to discovering Actinomyces in pig meat. But the tasks presented to him were not limited to research and teaching. He was to be, and wanted to be, a practising veterinarian as well. Before his employment as Repetitor he had been District Veterinarian in Burgsteinfurt and in Liebenwerda. In Halle, in addition to his Professorship, the post of District Veterinarian for the Saale district was transferred to him. Here, in the centre of a province whose highly developed industry is in many cases based on the use of domestic animals, the great questions of animal hygiene confronted him. Many cases, especially of lung plague, were presented for his opinion, specifically at the time when the merits of protective inoculation were being

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most violently debated by friend and foe. His much-consulted book on inoculation for lung plague dates from 1868. It was followed, in 1871 by “Rinderpest”, in 1875 by “Consumption in Pigs” and in 1888 by “Anthrax”. I pass over other writings, important as they are, because they are not so much matters of public interest. For meanwhile, in the area of Veterinary Studies, great and fundamental changes had occurred. These were destined, in the public arena too, to open up quite new paths in the development and practice of the veterinarian. Through the wise initiative of his ministerial superiors, a technical committee for veterinary practice had been created. New syllabuses had been prescribed for the more completely-equipped veterinary schools. Finally, from 1875, far-reaching legislation was initiated concerning cattle plagues which strengthened and raised the whole position of the veterinarian. For a while Roloff was outside the decision-making circles, but in 1876, he became a full member of the Health Office of the (Second) Reich. In 1877 he was appointed Government Veterinarian for the District of Potsdam, became instructor at the Veterinary School there and was nominated as a member of the technical committee for Veterinary Affairs. In the next year, after the death of Gerlach, he was appointed Director of the Veterinary School which he led for seven years, and to which he gave all his strength. Many honours were accorded him, but almost every new one brought new work. For after all, the task in hand was to lead the entire body of Veterinary Science from its earlier repressed and withered state onto new paths to full recognition. These paths demanded the full dedication and devotion to duty and scientific education for all individual practitioners. Who was more fitted for this than the Director of the Veterinary School who – from the day he entered (the School) – was destined to awaken youthful zeal; later on with great rigour to make scientific and practical progress; and finally to observe the resulting achievements of veterinarians in official government posts? With what endurance, skill and care did he take on himself all these difficult tasks! How much work did this administrative burden cost him! We – who in the sessions of the Technical Committee had frequent opportunity to admire the clarity of his presentations, the persuasiveness of his methods, and the reliability of his experience – ask ourselves now, deeply grieving, who can possibly replace our great loss? And even if some substitute is given to us, our pain will be no less vis à vis the fact that such a man had to leave this world so early. Scarcely fifty-five years of age, he could – according to human reckoning – have still experienced many more years in order to see the fruits of his activity ripen. He leaves this School, indeed his Science, after it has passed through changes and achieved improvements such as he himself – not so very long ago – could scarcely have envisaged. He had been placed in a position in which, to a certain extent, he could be the very soul of further progress. Then he had to leave us! His strength was exhausted.

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But his spirit will remain in those institutions to whose creation he was summoned to contribute. He will – of that we are certain – remain influential and alive in the memory of those studying here, as a driving and elevating force! A wholly independent and modest spirit, and idealistic striving in Science, and moral rigor were the features of his life! Yes indeed, he was a whole man – as if poured from one single mould – in whom conviction and deed flowed harmoniously together from the same source. Thus he still appears to us in his last instruction. Deviating from the tradition of our time, he wished that his body should be consigned to the flames. His family and the grieving widow – all agree to the request of their loved one. They know indeed that religious belief can exist in every method of the disposal of the mortal body. Human opinions change. Only for the last thousand years have – on German soil – the dead been lowered into the earth. Certainly, for more than a thousand years before that, the bodies were cremated, although our ancestors hoped for Valhallae1. Our friend had his conviction as to the best method for disposing of mortal remains, and after his death, he still wanted to bear witness to this. True to himself, just as in life he was true to others! May he live on in the memory of us all! May his example strengthen us, and above all, his family, whenever they feel at all weak! May their spirits be raised by the thought that no hostile feeling remains after the departure of this man, and that everyone will honour him as a hero of work, and as a martyr to duty! Peace be with him. e1

Cremation was forbidden in usual Christian practice until the twentieth century, because burning of the body was regarded as inconsistent with resurrection of the individual body, and hence it was contrary to the Nicene Creed: “I believe … in the forgiveness of sins, the resurrection of the body and life everlasting. Amen”.

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6i. Richard von Volkmann (1830–1889) Memorial words delivered to the Berlin Medical Society on 4th December 1889 by Rudolph Virchow. Berlin. klin. Wochenschr. No 49, 9th of December: 1098 (1889) Editors’ comments This obituary is a short speech given by Virchow at a meeting of the Berlin Medical Society on receiving the news of the death of this great German surgeon. Working mainly in Halle, where he became Professor of Surgery (1867), Volkmann was an innovative operator (e.g. performing the first excision of a carcinoma of the rectum) as well as designing various pieces of equipment, and describing diseases related to surgical treatment, such as ‘Volkmann’s ischaemic contracture’. He adopted Lister’s methods of antisepsis, notably in 1872 when his hospital was about to be closed down because of the high incidence of sepsis in wounded soldiers from the Franco-Prussian War. He was ennobled ‘von’ in 1877. Literature concerning him is to be found at website http://www.whonamedit.com/doctor.cfm/1766.html, in Hach and Hach (2001) and in Willy et al (2008). Virchow seems to have had little professional or personal contact with him. An earlier translation of this piece was published in the Bulletin of the Johns Hopkins Hospital 1: 20 (1890).

Editors’ summary of points Introduction, travel from Jena to an international congress in Halle, other prominent surgeons who had died in recent years, contributions to the science, literature and teaching of Surgery.

Gentlemen, it is my painful duty at the beginning of our session today to summon back into your memory the great loss which German Medical Science has suffered in these recent days through the death of our colleague Richard von Volkmann. For a long time, he was one of the prime adornments of our Science, one of the most outstanding phenomena of practical surgery, and one of the greatest teachers of the subject in the field of theoretical sciences.We had become accustomed to see in him a kind of constant representative of German Surgery, and at the same time one of the few leaders still remaining from the great days of the warse1 when German Surgery emerged again in all its glory, armed with the new methods.e2 He has passed away just at the moment when we are preparing the great international Congress, and we can say that he has become the first sacrifice of this congress. Because, although seriously ill and needing help and rest, he travelled from Jena to Halle for a session of the organizing Committee of the Surgical Section. With great zeal he had participated in the discussions, and had even made proposals for arranging the proceedings. Then, during his return from Halle to Jena, he became ill with pneumonia, which rapidly tore him away

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Other tributes Figure 6i. Richard von Volkmann. Courtesy Fr. Helga Seifert, Librarian, Institute of Pathology, University of Würzburg.

from us. Anyone who like me, saw him just a few weeks ago must, however, have had the impression that the main strengths of this man had already been broken. On the other hand, no one gave up hope that it would still be possible for him – with the rich treasure of knowledge which he had gained in such hard work – to be present for the days of our conference, and to appear again as a major representative of our science. Perhaps I may briefly recall the many names which German Surgery has had to mourn in recent decades. If one looks back only at this short period, it is like a great battlefield. Our Langenbeck and Roser, at about the same age, have both passed on. Of the surgeons from the ware3, Wilms, Wagner and Busch have departed the scene. Hueter, Simon, Maass, not to forget the older Middeldorp, who nevertheless belonged to this school of young men; one after the other they have passed on. It is indeed, to some extent, in accord with the old experience with which every doctor, especially in earlier times, became accustomed on entering his profession. He knew he was dedicating himself to a profession which is not in the habit of letting its members grow old. Those few of us who reach a greater age: – we always look back, with a sense of having been deserted, at the many empty places which we see around us, at the many gaps

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6i. Richard von Volkmann (1830–1889)

in our memory, which the deaths of so many earlier collaborators have left behind. It is not my task to give a memorial address for Volkmann. You all know his most important services. I will just briefly recall that he was one of those surgeons who, following the example of our Bardeleben, early followed the path of aseptic treatment, shortly after Lister had introduced it. In this area he achieved his greatest and finest successes. In so many directions he advanced the various branches of Surgery: – in the actual operative techniques; in the treatment of wounds; in the treatment of surgical diseases, especially tumours – these he advanced by his own efforts. Finally, I may specifically emphasise that achievement through which he had such an influence on wide areas of medicine. This was his collection of clinical lectures, which was the first such work in the German medical literature, and which has given to many practicing doctors the opportunity to gain a complete picture of specific individual cases, such as could not be gained from the handbooks. To have introduced this type of popularization – and by the way, of recapitulation of recent progress of science for many practicing doctors – is a service which will stand out in the history of the literature of our time. Finally I may remind us of the fact that he, along with Langenbeck, not only founded the German Society for Surgery, but brought it to the high reputation which it enjoys to the present day, and which we all hope will not diminish in the future! I ask you gentlemen, to stand in memory of this excellent man. e1

Danish, 1864; Austrian 1866; French 1870–71 may be a reference, at least in part, to the adoption of Lister’s methods of antiseptic surgery at the end of the Franco-Prussian War (1870–71) e3 This probably means the Franco-Prussian War only. e2 This

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6j. Hermann von Helmholtz (1821–1894) Addresses and speeches given at the celebration which took place on the 2nd November 1891 in honour of Hermann von Helmholtz Together with a list of diplomas and honours, and also the congratulatory messages Hirschwald’s Bookshop, Berlin (1892) Editors’ comments Helmholtz was the pre-eminent physicist of the nineteenth century; his contributions ranged over optics, sound, heat, electricity and magnetism, with numerous discoveries. inventions and mathematical solutions to mark them. Like Virchow, he was a student at the military medical school (Friedrich Wilhelm Medical Institute, the ‘Pépinière’), and avoided some of his obligation to Army service by academic brilliance, and was an Assistent in Müller’s laboratory. However, his early academic posts were in Königsberg, Bonn and Heidelberg. Only in 1871 did he become Professor of Physics at the University of Berlin. Along with Brücke and Du Bois-Reymond, his philosophical outlook (in contrast to Müller’s), was strictly rational and mechanistic: no other forces have any effect in biology apart from those in physics and chemistry. Helmholtz was ennobled ‘von’ in 1882, and received numerous other awards. Several formal commemorative tributes comprise this ceremony. This one by Virchow marks their long association as colleagues. Virchow’s comments concern the period when they were young and how Helmholtz escaped from Müller’s influence concerning ‘vital forces’ (see chapter 2). There are numerous biographies and commentaries on Helmholtz, of which we note here Koenigsberger’s biography (1902) translated by Welby, and a recent edited volume of translations of essays by Helmholtz (Cahan, 1995).

Editors’ summary of points Introduction to the whole ceremony; 21 contributions have assisted Art, how medical men have established a ‘biological view’; 22 offers Diploma of Honorary membership of the Berlin Medical Society, Helmholtz mentions his own early work in medicine.

(Anonymous text on an unnumbered page at the beginning) On the 31st of August 1891, Hermann von Helmholtz completed his seventieth year. As the ‘jubilar’ spent the day in quiet seclusion in the mountains, a celebration was organized – with his permission – for the 2nd November, on which day forty-nine years previously, he had obtained the degree Doctor of Medicine. These festivities took place at his house in Charlottenburg. The various authorities, corporations, friends and pupils, personally presented their congratula-

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6j. Hermann von Helmholtz (1821–1894) Figure 6j. Hermann von Helmholtz. Photolithograph after a painting by Ludwig Knaus, 1881.

tions. In the evening of the same day, a celebratory banquet took place in the Hotel Kaiserhof in Berlin.

Representative of the Berlin Medical Society, Medical Geheimrat, Prof. Dr. Virchow. The Berlin Medical Society reminded itself early on of the fact that youe1 have never ceased to be a real physician in the modern sense. It is indeed a long time since you left the paths which we have seen as our duty to follow, and we have not always been able to see direct signs of your sympathy towards us. But nonetheless, there is one thing which has remained common to us – one thing in which, to my mind at least, the real greatness of your career is to be sought. That is: the modern development of the biological view itself, beyond the areas which, before that, had only been opened up in limited ways to consideration in terms of physics in the stricter sense. The gentlemen from the Academy of Art who have just spoken, reminded us of the intensity with which your investigations threw light on problems which concern them. We medical men feel above all that it was you who introduced us – through both the philosophical approach, as also through the approach

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of physics itself – to the determining of the location of the sense organs, and their relationships to perception. This was actually the first time since Descartes, that an attempt has been made to bring the localizatione2 of sensory perceptions in the actual sensory organs into direct connection with the stimuli which come from outside. During the period in which you completed these great achievements, we in medicine have also contributed a little to establishing the biological view, in the heightened form of modern science, as the basis of our activities. And specifically from this viewpoint we feel doubly how very useful it has been for us to see in you a biologist who at the same time, has assembled that great knowledge in mathematics and physics e1 e2

22

du is used – the personal form for close friends. in the actual organs – e.g. in the brain.

which will also gradually become the object of the earnest striving of our young men. The entire deepening of medicine which has been achieved in recent decades has comprised essentially the fuller exploration of those areas in which you were the first to move. And so I can say that we are indeed very proud that such a biological physicist has gone forth from medical circles. And, who it is hoped will, for a long time, have a decisive effect on philosophical opinion too. Today we allow ourselves to accord to you our highest honour, as we ask you to accept the Diploma of Honorary Member of the Medical Society and to look benevolently upon it. Personally I may not let this opportunity pass without expressing my heartfelt joy that it has been permitted to me, at such a late stage in life, to be able to reaffirm the friendship which has kept us together through so many years, and with which I hope, no external factor will ever interfere. Herr Helmholtz replied: My connection with Medicine has always been valuable and useful to me. Even now, I would still be completely qualified to appear as a practising doctor, although I have no intention of competing with you (the gathering). But the connection with medicine has given me one thing, namely a more complete knowledge of the biological aspect of natural phenomena than is usually given to a mathematician or physicist. And finally, I have found it of greatest value for an overview of all natural phenomena. My medical studies led me to a whole sequence of difficult problems which were at the same time, of more pressing concern because they were problems which demanded solution on account of their practical importance. In contrast, the physicist or mathematician has a theoretical interest in his work which if necessary he can postpone to a later time. To this extent, I have felt the problems which I encountered in medicine to be more pressing; even if, with my kind of intellectual endowment, I was not

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able to contribute much to their solution. I have only been able to approach what could be observed by the methods of physics. But, as I have already said, at the beginning of my career it was particularly the problems of the very nature of the Life Force (Lebenskraft) which concerned me, and which led me to investigate the preservation of the Force, and then further to investigate decay and fermentation, the development of heat in muscular action, the action of nerves etc. I ask you to pass on my warmest thanks to those who organized this gathering, and I hope that it will still be possible for me to be actively present at your sessions and profit from my new award.

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6k. Emil du Bois-Reymond (1818–1896) Address to Geheimrat du Bois-Reymond at the celebration for the golden jubilee of his doctorate on 12th February, 1893 by Rudolph Virchow Berlin. klin. Wochenschr. No 8, 20th of February: 198–199 (1893) Editors’ comments Of French extraction, du Bois-Reymond lived in Germany, and especially in Berlin. He graduated in Medicine from the University of Berlin, becoming an Assistent to Müller (1843–46), Lecturer in Physiology 1846–54; Extraordinarius 1855–8; and from 1858 to the end of his life, Professor of Physiology, all at the University of Berlin. His research interest was the role of electricity in physiological phenomena, especially muscle contraction. In later life, he published in wider areas including philosophy, popularising the word Ignorabimus. His theory of electricity as being due to ‘electricity molecules’ was only supplanted in the early twentieth century, when electrons were discovered. Du Bois-Reymond was a friend of Helmholtz, who held the Chair of Physics in the same period. The German-language literature on Bois-Reymond is extensive, including a eulogy by Rosenthal in 1912 and biographies by Borutau in 1922 and Ruff in 1981. Editions of Bois-Reymond’s correspondence, including with Alexander von Humboldt, and von Brücke have been published in German. His correspondence with Carl Ludwig has been published in English (du Bois-Reymond and Diepgen, 1982).

Editors’ summary of points P 108 Introduction, points in the history of biology at the beginning of du Bois-Reymond’s careeer, the mechanistic view in medicine, the ‘genetical’ (comparative) approach to biology; 109 the broad advances in research, later interest in philosophy.

Celebrations such as today’s are Janus-headede1. Directly before us we see the happy visage of the ‘jubilar’, and the great multitude of those offering congratulations. We are all part of this multitude, and how many good wishes for his future do we have in our hearts! This celebration in his later life sees our friend in good health. He has come to terms with the illness which plagued him for so long; his activities may be slightly limited and care required, but progress is not impeded. And his spirit is full of plans for scientific work which he has postponed only because he was weighed down by the burden of so many official positions. May it be granted to him still to bring many of these plans to fulfillment. In this hope too is his doctorate renewed – in a sense as a confident affirmation of a second era of distinguished activity to come. But, indeed, the Janus-head of this Golden Doctoral jubilee also looks back over a very much longer period of time than – in the usual run of human affairs –

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6k. Emil du Bois-Reymond (1818–1896) Figure 6k. Emil du Bois-Reymond.

may be presumed to lie in the future. It compels us automatically to look back right to his first doctorate. What happened before that can only be recounted by one or other of only a few of the rejoicing guests here, and by their speaking solely from their own memory. If it is granted to me to be one of these old comrades (from before his first doctorate) – if the unusual pleasure is accorded to me today as Rector of the University to speak to our rejuvenated Doctor – then I can only, for the moment, repeat what I have already said this morning: that the entire (academic) body is proud to count among its members such a man, living and still full of strength, who, in continuous and uninterrupted work, has studied and taught at this University for fifty years, and who is completely one of us. Here he rose through all the grades of the academic career: – from simple Doctor he ascended to Rector magnificus. His fame, which is world-wide, radiates back on his University in full splendour. Thus we can offer him, from the depths of our heart, our expression of gratitude for so much loyalty and constancy. It was a remarkable epoch – only comprehensible to those aware of its history – in which this honoured man began his first doctorate. In a certain sense, one may observe, that time was the end of one epoch – thousand years long, during which an endless sequence of old schools of thought replaced one another – but it was also the beginning of another: one of a reformation, not to say a revolution, from which a new Medicine came forth powerfully and victoriously. The new methods were already being developed which were destined to replace doctrine with close scrutiny of things, and to place observation and experiment where hitherto

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hypothesis had prevailed. (Albrecht von) Haller had established physiology as a special branch of science; Johann Friedrich Meckel – by introducing embryology – had given a secure foundation to the genetical mode of thoughte2. And finally, our great master Johannes Müllere3 had brought the most difficult problems of life – the actions of muscles and nerves – into the sphere of experimentation, whilst at the same time he completely re-worked all branches of anatomy, including comparative and pathological anatomy. But he (Müller) had not gone so far as completely to break the fetters of tradition which so firmly shackled the subject. In spite of every effort he had not succeeded in tracing even a single phenomenon of life back to a simple physical or chemical formula. Having grown up amidst the ‘natural historical’ and ‘natural philosophical’ schoolse4, he had almost aggressively cast off the habit of speculation, and had rejected the temptation of the traditional wisdom, which was to trace back the unity of life – through unending changes of the forms of life – to one simple Life Force. Who of us does not remember how – resigned to being unable to reduce the developmental history of the organs to actual connections – he had to be satisfied with proposing serried groups of forms which brought order to things lying alongside each other but no understanding of things which are widely separated. Johann Friedrich Meckele2 had already attempted to base the development – at least of mammals – on laws common to all of them, and he had made great strides along the same path which Darwin took much later with such great success. Müller, too, kept in his heart the hope of a final solution to the puzzle of the material connection between the life forms. And when, almost at the end of his life, he made the much-discussed discovery of the occurrence of a snail in a Holothuriae5 – and in fact, under circumstances which encouraged the idea that one type of animal had produced the other – he was overpowered by joyous excitement, indeed, greater than he had felt for a long time. But unfortunately, it was transformed into deepest melancholy when finally this apparently developmental phenomenon was found to be a parasite after all. Our young doctor (Du Bois-Reymond) found himself in the midst of this uncertainty when, half a century ago, he set about his own experiments. And behold, at the very first attempt, he was successful in clarifying the electrical processes in the living animal – notably in the nerves and muscles – by model experiments. He thus created a secure foundation for the theoretical approach to the relationship of life activity to ordinary physical and chemical processes of the outside world. Indeed, no science has derived greater use from this than medicine, especially since electrotherapy was developed on the basis of this science. Right up to the present day this therapy uses the simple apparatus, which our ‘jubilar’ constructed for his experiments, as an important method in the treatment of various disease processes. But the influence of the new knowledge has not remained limited to that, and even if the well-known upswing in electrical technology was not determined solely by it, this was certainly at least one

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point of departure for those astonishing innovations which we saw completed in the following years. Already when he took his doctorate in 1843 the sudden turnaround in intellectual attitudes was almost general. It was primarily directed against the last remnants of Naturphilosophie and ‘Vitalism’. – That modern trend had begun which in a few decades, led us right into the heart of the ‘Scientific Age’. In the course of these decades, much had been completely changed. Many amongst Müller’s pupilse6 still retained actually exaggerated hopes for the immediate, sole reign of physical explanations. It was at this time that Schwann described the organization of animal cells as a mere crystallization of formless substance, and also the time when my old friend Jordan thought that he could derive a valid model of physiological healing processes from the regeneration of damaged crystals. Confronted with so much pressure for an interpretation of these processes, biological observation moved into the background. The effect e1

Roman God with two heads, one looking forwards, the other backwards; origin of ‘January’. means ‘comparative’. Virchow must be referring to J. F. Meckel the Younger, but embryology was established long before that investigator; see chapter 1. e3 see chapter 2. Experimentation on nerves predated Müller. e4 see chapter 1, and also in chapter 3 (Schönlein) e5 see chapter 2. e6 i.e. even in the 1830s e2

was that it became, to some extent, difficult for us medical men to gain any hearing, even on the importance of anatomical knowledge. I always remember when the first good handbooks of histology appeared, one of our best physiologists found no other description for them than “picture books”. As so often, time has brought a softening of hostility between the parties, and therewith not only mutual tolerance but also full recognition. Nowhere is this tolerance more clearly expressed than in this magnificent Institut, which was founded in our University so much at the energetic urging of our honoured friend. In this Institut, here is a Physics Department, and there a Chemistry Department. But in the same Institut there are histologists, comparative anatomists and experimentalists. There, one thread of understanding joins onto the others. How well this shows up in the researches on muscular physiology, especially in its extension to the electrical organs of fish, the study of which our ‘jubilar’ began very early in his career. He carried this on from Alexander von Humboldt, and has continued right up to the present day. Detailed knowledge of progressive understanding of Nature has gradually become the common property of all well-educated people. The unusual popularity which our friend has won is not least explained by the fact that he has never spurned the idea of presenting progress in learning to large circles of people in an easily-understood manner. This is an aspect of this dear man’s activities which cannot be over-estimated. For it has contributed mightily to ensuring the general recognition which science has found widely among our

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people, and ultimately in all civilized peoples. Our honoured friend confessed to us this morning that he had learned the art of popularization through his public lectures at our university.e7 But he also added that whilst preparing these lectures, his thinking has been sharpened, and his attention has generally been directed towards the great phenomena of culture and of the intellect in general.e8 Thus he has won a mastery over the opinions of his contemporaries such as is granted to only a few. He has learned resignation too; and finally, from the fullness of his experience, he spoke that celebrated word – to proclaim which demands full manly courage: Ignorabimus. We, who have experienced all this with him, who have thought it all through with him, we feel in fullest gratitude the good fortune of being permitted to declare such a hero of the intellect as one of us. May he still remain long preserved for us in the joy of work and the happiness of doing things; a leader and adviser on the difficult paths of biology and a true friend as well as forbearing judge of our weaknesses! e7 Public lectures on Science were common in European society generally in the later nineteenth century. See, for example, the public lectures by T. H. Huxley and Ernst Haeckel. e8 i.e. sociology and philosophy.

The above address by Magnificenze9 the Rector of our University was given at the great celebratory banquet in his honour which, on the 12th of this month, brought together not only the prime representatives of Medical Science but also many notables from the wider fields of the Arts Faculty and many great names from Art and Literature. Already on the previous day the Minister in person, and representatives of numerous medical, scientific and chemical societies had presented their congratulations. J. Rosenthal had come as representative from Erlangen. On behalf of the Breslau faculty – whose physiologist R. Heidenhain as is well known was a pupil of Du Bois – Mr Waldeyer read an address sent from there. At the banquet itself, the guest-of-honour was celebrated in addresses by Messrs Anwers (for the Academy of Sciences), Jolly (as Dean of the Medical Faculty), Hirschfeld (as Dean of the Arts Faculty) and Exzellenze10 Helmholtz, who offered thanks to his old friend for much help along the way. Then follow excerpts from du Bois-Reymond’s reply, which succinctly describe the early development of his career. e9

traditional honorific for the Rector of a university. an honorific for high official rank. It did not imply the status of Ambassador.

e10

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6l. August Hirsch (1817–1894) By Rudolph Virchow Berlin. klin. Wochenschr. No 6, 5th of February: 129–130 (1894) Editors’ comments This is a sketch of a bookish man with considerable additional talents – administrator and ‘field epidemiologist’. His work is referred to in many books (see Beck, 1961), and considerable detail is given by Schneck (2005).

Editors’ summary of points P 129 Introduction, youth, Virchow’s first meeting with him; 130 his book on the historio-geography of medicine (epidemiology), he begins work on the continuation of the previous Canstatt’s Annual Reports, as the “Virchow-Hirsch Yearbooks”, Gurlt’s support, appointed Professor of History of Medicine and Pathology, foundation of the Society for Hygiene, he opposes claims of biochemists and microbiologists, reviews literature rather than original work, success as an administrator.

On the 28th of January, after long and hard suffering, August Hirsch was torn away from all the turbulence of life. With him there has departed from our midst a personality who – by his earnestness and endurance of effort, through his clarity and unprejudiced judgment, and in particular through the special nature of the study which he chose – raised himself far above the average level of his contemporaries. Honoured on all sides, almost without an enemy, he continued his activity through to the age of seventy-six. That this activity was applied to medicine, and in fact primarily to learned medicine, was his own work. Both the wish and tradition of his family had pointed him much more towards the commercial world, for which his home town Danzig offered such favourable opportunities. His decision brought this apprenticeship – which had already begun – to a rapid end: he returned to the Gelehrtenschulee1 and when he went on to the University he brought with him the urge to academic activity which he had already expressed. After he had passed the (State) examination he dedicated himself to practice, the demands of which he endeavoured to deal with positively and successfully. But very rapidly his library grew to an extent which far exceeded the needs of a practising doctor. He only became better known to a wider circle of colleagues on the occasion of his attendance at a Conference of Natural Scientists in Danzig. At that time he had already advanced a long way in writing a large work on the historical and geographical incidence of diseases, especially epi-

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Other tributes Figure 6l. August Hirsch. Courtesy Fr. Helga Seifert, librarian, Institute of Pathology, University of Würzburg.

demics. I still remember very clearly the shy manner with which he began his undertaking. Not long beforehand I had begun the publication of the multiauthored work “Handbook of Special Pathology and Therapy”.e2 At that time, he thought that his best course would be to put his work into this series. However, it was only at my urging that he published it independently, but with the same publishing house, in the same format and print style, and with similar presentation. This publication deservedly won great success; no better book on medical geography had for a long time, appeared anywhere at all in Germany. Hitherto, in the history of medicine, the history of epidemics had been treated only incidentally, along with other topics. Hirsch combined both elements skillfully, thus establishing broad foundations for his consideration of primary causes. His “Handbook of Historical-Geographical Medicine” has become a much sought-after aid in studies of hygiene. e1 e2

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an old term for Gymnasium. Edited by Virchow, 6 vols, 1854–1876, see also chapter 6f, Friedreich.

This book, the third section of which appeared in a second edition in 1866, aroused admiration as much for the learnedness of the author as for his stupendous industry in exhausting all literary sources. There is probably no recent book which has applied the journal material to such an extent in order to discuss the territorial relationships of diseases; and as far as possible from the orig-

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inal documents. Scarcely any of our Professors will have seen all the journals from which Hirsch had drawn these extracts. His practiced hand, which had become accustomed to this mode of work, facilitated the method which he applied to looking through the most recent journal articles. Who could equal him in this? Convinced of this, I resolved to request his participation in permanent form for the broad mass of doctors. The old Canstatt’s Annual Report – which had contributed so much to bringing German medical literature to such heights – never reached by either the French or the English, in 1867 was in danger, after existing for 25 years, of collapse. The publishers’ bookshop had given notice. The editorial process – up till then supposedly shared by Scherer, Eisenmann and me – was in reality carried out by Eisenmann almost alone. When Scherer and Eisenmann announced to me their wish to withdraw from the editorial committee, they gave me the right to decide on the future of the Annual Report. I did not believe that there was any better way of doing this than by chaining Hirsch to this important enterprise. He cooperated, and the volume for 1856 appeared under the subsequently so familiar title “Virchow-Hirsch” Yearbooks. Mr Gurlt supported Hirsch in the special editorial work. Thus the Annual Report was saved for Germany – I may say indeed, for the world. Because since then, it has proved impossible to establish rival undertakings – most certainly, in specialist areas – which were intended to make our Annual Report superfluous. On the contrary, from year to year, it has become richer in content and more reliable as a source. The young medical practitioner had meanwhile become Ordinarius in the Berlin Medical Faculty. Without any intermediary phase, with this step he reached the highest goal. That this had to be his goal lay in the nature of things. His studies were on too large a scale for him to be shut up in a doctor’s surgery. But perhaps, after all, he would not have reached this goal had not a strange misunderstanding helped him. The Minister of Education at that time – Heinrich von Mühler – was of the opinion that the Medical Faculty was pursuing a one-sided materialistic direction, He sought a counter balancing remedy. He thought that he had found this in the history of medicine. Thus he pushed for the nomination of Hirsch without suspecting that this man came from the same school from which stemmed the so-called Materialists, and that he would bring to the students neither speculative philosophy nor orthodoxy. In addition to this, the students did not want to know much about the history of medicine. Thus if Hirsch became a popular teacher he owed it not to his lectures on the history of medicine, but to his lectures on special pathology. It was not the students who profited more from the learning of the muchadmired Professor, but the practising doctors – especially those in government service. The time for public health care had arrived. The course of things brought with it the fact that in Berlin it was specifically Hirsch who had the reputation of being the ideal representative of the new science. As such he was placed at the head of the newly-founded Gesellschaft für Hygiene (‘Society for

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Hygiene’). He was commissioned by the (Second) Reich government to travel to the Volga when concern arose that the plague might pass from there to Europe. After all, earlier on (1864–5) in a more limited way, he had undertaken a mission to the middle Vistula, where a serious outbreak of cerebro-spinal meningitis was raging. He carried out his mission to the satisfaction of the authorities. Since then, he occasionally gave a seminar in Hygiene, and was a regular examiner in Public Health at the level of the State Examination. Anyone studing his activities during this time will appreciate that he was accustomed to think and to act in the sober, objective fashion of the wellschooled natural scientist. The cloudy nature of traditional aetiology was just as foreign to him as the exaggerated inductive thinking of the young chemists and microbiologists who – without sufficient knowledge derived from observations, without methodical preparation in the other branches of pathology, and also without sufficient practical experience – were accustomed to drawing the rashest conclusions solely from their momentary impressions. But Hirsch had a short-coming which he was never able to overcome. From the beginning he had so one-sidedly preferred studying the literature that the experimental and observational methods of modern medicine – although he was at pains always to keep up with their results – always remained remote from him. He used neither the microscope nor chemical reagents; he carried out neither vivisection nor autopsies – not because he did not heed them or because he undervalued them – but only because he was not trained in them. As a student he had left the University a few semesters too early for him to obtain practice in the new methods. In spirit, he agreed with the bearers of these teachings. Thus is explained the great respect accorded him from all sides: by the little-educated but also by the learned doctors.e3 He experienced the painful time when, with the foundation of a dedicated Chair in Hygiene, our Faculty no longer employed him as examiner or lecturer in this subject. The consequence was the loss of an activity which had become dear to him through long industrious participation. This meant no lessening in the esteem with which his colleagues held him; we knew that in everything he did he applied his best efforts; and these were great indeed. Thus in 1871 he had immediately taken on the post of organiser of a hospital train to France, when the military medical administration was unsure as to a suitable person. He carried out his task to the best of his ability. The Faculty chose him as Dean three times, and his administration was always regarded as successful. He was a reliable and constant personality. He never denied his liberal basic stance. Even when the dishonest machinations of anti-semitic Semites e4 pressed on him personally, conscientiousness and loyalty to duty protected him from any mistake. His friends always knew what they could expect from him; this needed neither discussion nor pre-negotiation. It is thus that they will cultivate and retain the memory of him. As far as the others are concerned, necessity will always lead them anew to the writings of our deceased friend. Historical-geographical pathology, the

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Yearbooks, and his latest work – the “History of German Medicine”, on which he worked at the request of the Munich Commission – will be indispensable aids in personal instruction for anyone wishing to acquire a total overview of the development of modern medicine. e3 This could be a reference to university-educated practitioners versus medical practitioners trained without university education. See Broman (1996). e4 Some Jews – almost all secularized (i.e. non-observers of the religion) and not necessarily baptized – in distancing themselves from their religious origins, adopted anti-Jewish attitudes.

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6m. In Memory of Felix Hoppe-Seyler (1825–1895) Virchow’s Archive 142: 386–388 (1895). Editors’ comments This is a summary of the career of the man himself, with emphasis on his position as one of many successful scientists to emerge from Virchow’s tutelage in Würzburg. There is very little personal detail. A short biography has been published in German (Thierfelder, 1926). Some details are given in Anon (1970) and a website: http://www.degruyter.de/journals/bc/detailEn.cfm?sel=fe

Editors’ summary of points P 389 biographical details, 1850 doctorate on chemistry of cartilage, difficulty finding a position in Germany, 1856 joins Virchow on the latter’s return to Berlin, 1861 called to the Chair at Tübingen, later in Strassburg, other individuals in the chemistry department of Virchow’s Institute in Berlin who went on to success, Hoppe-Seyler’s textbook on medical chemistry, how Virchow’s Archives supported the work.

In addition to the many great losses suffered this year by Science, one more has been added which quite closely affects this Archive and me personally. On the 10th of August Felix Hoppe-Seyler died suddenly at his home in Wasserburg on Lake Constance. It is not my task here to describe in full the importance and extent of the merits of this excellent man of science. I will restrict myself to recalling briefly his activities with respect to this Archive, and to the Berlin Pathological Institute. Felix Hoppe (at that time he had not yet added the name borrowed from his mother) was 387

born in Freiburg-am-Unstrut on the 26th of December 1825; after concluding his studies at the Universities of Halle, Leipzig and Berlin in 1850, he was awarded his doctorate here in Berlin. His dissertation, entitled “On the Structure of Cartilage and Something on Chondrin” / De Cartilagineum Structura et Chondrino Nonnulla, was for him the start of a great series of investigations on the interstitial substances of cartilages, bones and teeth. It appeared in this Archive in 1853 (vol V, p 170). In it he proved the possibility of isolating – by boiling under increased pressure – the substances of the tissues named. For me these wholly independently-conducted investigations were of particular value, because I had already shown at the session of the Würzburg Physical-Medical Society on the 6th of July 1850, the possibility of isolating bone cells (Körperchen) by salt acid (hydrochloric acid), and the development of cartilage cells into bone cells (Würzburg Verhandl. vol I, p 193). In a session on the 15th of March 1851 I had

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6m. In Memory of Felix Hoppe-Seyler (1825–1895) Figure 6m.1. Felix Hoppe Seyler. By courtesy of Dr. K. Möschel, Interfaculty Institute of Biochemistry, University of Tübingen.

Figure 6m.2. Plaque on the wall of the Tübingen Castle in which Hoppe-Seyler first worked in Tübingen. Photographed 2007.

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confirmed this fact by further observations, and also extended it by reporting the discovery of tissue cells through the entirety of the ‘connective substances’ (ibid II, p 150).e1 These works provided a direct reason for closer acquaintance with Hoppe. The latter meanwhile – because of his appointment as medical Assistent at the Berlin Work House (Arbeitshaus)e2 – had moved towards investigations of a more clinical kind. These too he published in this Archive. They concern the theoretical basis of percussion and auscultation (1854, vol VI, ps 143 and 331; 1855, vol VIII, p 250) as also of the serous transudates (1856 vol IX, p 245). Already in 1854, he had been appointed as Anatomical Prosector in Greifswald.e3 But this position satisfied him so little that in 1856 he wrote to me saying that – given the lack of prospects in the homeland – he was resolved to go to America. As negotiations on both my recall to Berlin and the new Pathological Institute were approaching their conclusion at precisely this time, I asked him to postpone his intention, because I hoped to be able to offer him an appropriate position in Germany. This hope was realized very soon, when Minister von Raumer agreed to both the appointment of an Assistent and the invitation to Hoppe. In the autumn of the same year he took up his appointment as Assistent, in which he was markedly successful. He received the summons to Tübingen in 1861. Previously, in 1860 and on my proposal, he had applied for and had been promoted to Extraordinarius. In those early years he was also occupied with dissections, which he shared with Grohe, who had followed me from Würzburg and assisted us as a volunteer. Meanwhile Hoppe preferred to apply himself to chemical investigations, and it was for me a particular pleasure to allow him space for these studies. Of the long sequence of these studies, I mention here primarily those on the effect of carbon monoxide on the blood (1857, vol XI, p 288 and 1858, vol XIII p 104), and on the influence of cane sugar on digestion and nutrition (1856, vol X, p 144), in e1

Virchow claims this discovery in histology, as is recorded by Ackerknecht (1953a). probably the Königliches Arbeitshaus (‘Royal Workhouse’), built 1756–58, near the street An der Contrescarpe to the south of the Paradeplatz (parade ground). http://www.stadtentwicklung.berlin.de/planen/staedtebau-projekte/alexanderplatz/en/geschichte/ chronologie/index.shtml e3 City with a long-standing University (founded 1456), now in the Federal state of MecklenburgVorpommern. e2

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particular the effect (of carbon monoxide) on circumpolarisation and the use of the Soleil-Ventzke apparatus (1857, vol XI, p 547; 1858 vol XIII, p 276; vol XV p 126); as also on the proof of bile acid in the urine in jaundice (ibid p 101). This list, which was destined to be greatly lengthened in the following years, is meant only to give an impression of the zeal and success which Hoppe brought to these chemical investigations. To make these successes completely

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clear, I should have to list the many pupils who worked under him in our chemistry laboratory. I will name only some of them. First of all there was von Recklinghausen, who so stimulated my interest by the carefulness of his work (1858, vol XIV, p 468) that when I was granted a second (anatomical Assistent), I offered him this post. Others were Lücke and W. Kühne, later his successor at the Pathological Institute, who carried out his first work on jaundice (1858, vol XIV, p 310) using Hoppe’s assay for bile acid. It was a great satisfaction to me too, when later on the University of Strassburg was being restructurede4, my advice was sought in the matter of appointments to Chairs in the Medical Faculty. I was able to propose von Roggenbach, Hoppe himself, von Recklinghausen and Lücke, not to mention other members of our circle. I cannot close this tribute without mentioning that in 1858 Hoppe published an excellent – and since then often re-published and much enlarged – “Introduction to Medical-Chemistry”, which has substantially contributed to popularizing the subject among students and graduates of medicine. To this opus were added further works: – some summaries, some individual works – until the number of collaborators made it necessary to create a journal specifically for physiological chemistry. Thus Hoppe became the founder of the new Physiological Chemistry. This Archive (i.e. Virchow’s) – which in the course of its long existence has offered asylum to almost every new, but still homeless, direction in scientific medicine – may claim the glory that for medical chemistry too, it has assured an open field and free access to our entire science. If it is granted to me to offer words of admiration for my old comrade and unfailingly loyal friend, the pain of his loss will be softened by the perception that his work has progressed so far that its continuation stands firmly as a sacred heritage for the programme of the future. Rud. Virchow. e4

after the return of Alsace-Lorraine to Germany following the Franco-Prussian War (1870–71).

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6n. A Memoir of Ernst Heinrich Reimer (1833–1897) Virchow’s Archive 150: 388–390 (1897) Editors’ comments In 1819 Georg Andreas Reimer (1776–1842) purchased a publishing house which had been previously associated with a Royal High School. His son Georg Ernst (1804–1885) continued the business; his son Ernst Heinrich Reimer is the subject of this obituary. Georg Ernst helped Virchow’s Archive from its inception. Reimer’s was a leading publishing house specializing in academic and high cultural works of all types. More information to be found in Reimer (1999) and at a website (http://de.wikipedia.org/wiki/Verlag_Georg_Reimer).

Editors’ summary of points P 388 Introduction, his father Georg Ernst Reimer; 389 history of Reimer’s business, biographical details, career before and after entering the family business, marriage and family; 390 publication of the booklets (Hefte) for the academic medical world.

A particular turn of fate means that at the end of each of a long series of volumes in this Archive I have to write a memorial to one of those men who through loyal labour have been responsible for the business side of our journal. In the leading article for the hundredth volume – at the beginning of 1885 – I had to lament the passing of Georg Reimer who, with two young and littleknown men, had had the courage to undertake the establishment of this Archive at a very difficult time. He had never wearied in bearing the expense of this, and expending intellectual effort in both areas to an unusual extent. At that time I also had to mourn the fact that he had not lived to see the day when the first hundred of these archive volumes could be sent out into the world complete. For me, personally, with him was lost not only a most reliable publisher and knowledgeable businessman, but a personal friend and brave comrade. Although we did not always agree with each other on political matters, we always pursued the same goals in matters of public interest; we brought about much good work for the prosperity of our city. Now it is his son Ernst whose death we have to mourn. He had continued the firm of Georg Reimer unchanged; many readers, perhaps, did not notice the change of man at the helm. Unfortunately it was not granted to him to dedicate his capacities to this fine and great work which he had inherited, for as long a period as his predecessors. A year ago he decided for reasons of ill-health to give up the publishers’ bookshop, which had been founded by his grandfather in 1819, and has achieved such an esteemed place in the history of german literature. Last January he transferred it – and thus the firm – by sale to Dr Walther de Gruyter,

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who promised to continue it with the same faithful and pious care for those attitudes to publishing which have always been predominant and at home here. The history of German publishing has now to record another family in which the same dedication was passed on from grandfather to grandson, but which, nonetheless, was forced from the arena without being able to keep the inheritance in the family. Ernst Heinrich Reimer was born in Berlin the 5th of July, 1833. At that time his father Georg Reimer was still living in the proud old palace in the Wilhelmstrasse, which was later owned by the Crown Commissariat and has since become the seat of the Housing Ministry. Its external appearance is still the same today. Early in life the son Ernst turned to the merchant navy. From 1850 to 1860 he was a mariner, and for a long time plied the East Asian coasts as captain of a merchantman. When his younger brother Max, who was the intended successor of his father in the bookshop, died in 1858, he renounced – not without some inner struggle – his mariner’s career and turned to the book trade. Then he spent an apprenticeship in Jena (with Frommann, 1860 – 1861), Bonn (with Marcus, 1861–1862) and Leipzig (with Felix, 1862–1863). Then he entered his father’s bookshop, first as assistant (1863), then as senior clerk (Procurist) (1865). In 1876 he became a partner and on the 1st of April 1884, sole proprietor. In 1863 he had married Marie Huschke. There were three children from this marriage. On the 31st of December 1896, he transferred the bookshop to his business successor. Just as his father earlier, he survived the leisure thus won for only nine months. On the 19th of October, after a brief painful illness, he passed away at the Villa Frankenhäuser in Jena. All of us who worked with him will keep him in loving and grateful memory. We knew that our Archive did not provide any financial profit for him, but he was prepared – for the honour and the glory of having such an journal in his publishing house – to guarantee its

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existence, to value it highly, and to bear burdens for it. Many a one who saw the familiar green softcover booklets (Hefte) appearing at ever shorter intervals and with ever better presentation, imagined that all this happened of its own accord, and that the publisher only had to collect the profits. But how often have I been convinced, by precise calculation, that the profit of some volumes was minimal or even negative! And how often did we ponder together how the ambitions of young research workers – of whom almost all wanted to have an illustration, if possible in colour, attached to his treatise – could be tempered without harshness and without injustice! Our appeals for the shortening of wide-ranging manuscripts, and for reduction in the number of plates seemed to many an author to be an interference with his rights and a disregard for wellearned claims! Now, when the target of so many unsatisfied demands has passed on, I will reveal that as a publisher he frequently went to the very limits

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of possibility, and that in the interests of the matter in hand he made sacrifices far exceeding his duty and responsibility. May German publishing never be lacking in such insightful and understanding representatives! Honour to his memory! Berlin, 30th October 1897,

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Rudolph Virchow.

6o. Obituary for Ernst Julius Gurlt (1825–1899) Virchow-Hirsch Yearbook (unnumbered page), 1899 Editors’s comments This is a straightforward tribute to a colleague in publishing. Gurlt’s father was almost certainly Ernst Friedrich Gurlt (1794–1882), Professor in the Veterinary School at the University of Berlin (Smollich, 1988). His work concerning the collection of data on the use of chloroform as an anaesthetic has been noted (Röse, 1995) and in addition, his book on fractures (not mentioned here) has been praised (Peltier, 1990).

Editors’ summary of points Gurlt agrees to co-edit Canstatt’s Yearbooks when Eisenmann dies, becomes a surgeon, interest in military surgery; his book on surgery.

When in 1867 the much-tried Eisenmann was dying, he transferred to me all rights and powers relating to the Annual Reports founded by Canstatt and later continued by Eisenmann himself. With full esteem for the great – and for German medicine so fruitful – effect which the Annual Reports had had, I took on this task which, difficult enough in itself, threatened specifically at that time to become a great burden for me. When I looked around for reliable helpers, my attention turned to two well-tested men of integrity: August Hirsch and Ernst Gurlt. Both men accepted my invitation. Thus we were successful not merely in maintaining the Annual Reports, but also in developing them to new heights. Specifically at this time – when we were trying hard to organise large new reports for the whole field of the exact sciences – reference may well be made to our Annual Reports as a model manual, not merely for Germany, but of value for the entire world of learning. Gurlt (born on the 13th of September 1825) was then in his forties. He had begun early to write scientific articles. In our youth we had both sought out the same topics – which occupied us for a long time – rickets. He soon turned to Surgery and never gave up this calling. As a surgeon he was also active in practice, but essentially he was attracted to the scientific aspect of this discipline. When the great wars camee1, and the experience of war-time surgery became dominant, Gurlt too gave it increased attention. His is the merit of having set the activities of the voluntary societies in the right lighte2, and of proving their significance for the conduct of the war. In the same way, as Minutes-Secretary of the German Surgical Society, he was the real historian of modern surgery in general, since the remarkable transformation of surgical methods wrought by Lister. In the interim he had retired from the editorial board of the Annual Reports (1872). Right up to his death he provided, alone and uninterruptedly, the Reports on amputations and resections; the Reports on war-time surgery dated

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Other tributes Fig 6o. Ernst Julius Gurlt.

only from 1870. After Hirsch’s death in 1894 he again took over the editorship along with Posner. Whilst he was preparing his great work on the history of Surgery – the fruit of his entire scientific life – he yet found time for the timeconsuming activities of our editorial committee. It was granted to him to complete his work; this will – as far we are able to see – remain for a long time the foundation of instruction within the learned circles of our science, and a model of true and lasting industry. Gurlt did not experience the beginning of the new century. But his work will still have value in the new century as a glorious witness for German industriousness and German loyalty (Treue).e3 When, after such long labours, we buried our suddenly-departed friend (on the 8th of January 1899), each of us felt that the gap, which was here torn open could be closed by no one else. But we consoled ourselves with the thought that his work will be a source of learning and a help to knowledge for the coming generations. e1

i.e. of 1864, 1866 and 1870–71. this is the literal translation. Probably means “in the right place” – “organised”. e3 Since the middle of the eighteenth century, Treue tended to suggest the oath of allegiance of the liegeman to his lord, and of the commissioned officers to the Head of State. In the nineteenth century, it was not necessarily a sign of excessive nationalistic tendencies, but still carried a specific connotation of personal loyalty. Cf Hagentreue in the 12th century poem Das Nibelungenlied – “The Song of the Nibelung”. e2

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Appendix 1. Virchow’s last year 1a. The celebration of Rudolph Virchow’s 80th Birthday A personal impression by Sir Felix Semon, Berlin, October 13th, 1901 With additional comments by other correspondents. The British Medical Journal ii, October 19th: 1180–1182 (1901) “COMMON admiration for great and good men draws nations together, and common pursuit of noble and scientific objects makes a brotherhood of intellectual interest.” These warm-hearted words from Dr. Pye-Smith’s contribution towards the international “Virchow Number” of the Berliner klinische Wochenschrift may fitly be taken as giving the keynote to the days through which we are living at the present moment. Unique as the man, in whose honour we are assembled here, are the celebrations on the occasion of his eightieth birthday, which a kind fate has permitted him to see in full and undimmed vigour of mind and body. From almost every European country, from America, from Japan, have representatives of all the manifold interests with which Virchow’s name has been and for ever will be connected, hurried to Berlin to “lay their wreaths at the great pathologist’s feet,” foremost amongst them, it need hardly be said, members of that profession which, without difference of nationality, looks upon him as its brightest, proudest ornament. It would be impossible for me, not having the official list of guests at my command, to enumerate all the distinguished guests and delegates who have flocked to Berlin. Suffice it to say that, besides representatives of all the German universities, societies, learned bodies, municipal corporations, Great Britain and Ireland are represented by Lord Lister (Royal Society and numerous other institutions), Sir Felix Semon (Royal College of Physicians), Mr. Howard Marsh (Royal College of Surgeons), Dr. Rose Bradford (Royal Medical and Chirurgical Society), Mr. Watson Cheyne (Pathological Society), Professor Muir (University of Glasgow), and Dr. Graham Brown (Royal College of Physicians of Edinburgh); France by Professor Cornil; Italy by His Excellency Professor Baccelli, Minister of Agriculture, and by Professor Maragliane; the Netherlands by Professor Stokvis; Austria by Professors Toldt, Weichselbaum, and various other delegates; Denmark by Professor Salomonsen; Norway by Professor Armauer Hansen; Switzerland by Professor Ruge; Russia by Professor von

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Raptschewski and several other men of science. In fact, there is hardly a single country which has not sent one or several representatives. The festivities were ushered in by a dinner on Friday evening, given by Professor Posner, one of the editors of the Berliner klinische Wochenschrift, which was of an absolutely international character. The hostess sat between Lord Lister and Professor Baccelli, next to whom in turn were placed Virchow himself and Professor von Leyden, whilst opposite were the Rector of Berlin University and Professor Gerhardt. Then followed, harmoniously mixed, a profusion of medical talent of all countries. The host, in a polyglot speech, drank to the health of all his guests, and Professor Baccelli most felicitously replied: “To the Queen of the Banquet, to the Emperor of Pathology, to the Senate of Science”. Lord Lister toasted host and hostess, and the Rector of Berlin University, Professor Hartnack, the absent Mrs. Virchow. This brought Virchow himself to his feet, and we enjoyed the somewhat unusual pleasure of his proposing the health of a dignity of the Church. (Professor Hartnack is a Professor of Theology.) It was late before the company separated, soon to assemble again at the Hotel Bristol, where at an informal meeting under Professor Waldeyer’s presidency all arrangements were made for the official celebration. The latter from beginning to end was so extraordinary of its kind, that as yet but three things stand out prominently from the kaleidoscopic impressions which overwhelmed us yesterday: the conviction that surely never before had a richer life been lived than Virchow’s, the joy and gladness that on the evening of such a life the achievements of this unique man are universally acknowledged without a single dissentient voice being heard, the thankfulness that such a man should have been spared to the world in such astonishing vigour of mind and body as this “Grand Old Man of Science”. For to begin with the last-named fact, surely it was astonishing that in the morning this octogenarian should have on the eve of his eightieth birthday treated the audience, which he had invited to his pathological museum, the pride and the joy of his old age, to a wonderful retrospect of the past, and a sketch of the future of pathology, made in a speech of one and a-half hour’s duration, a speech made without notes, should have sat through and have made at a two hours’ dinner in the evening one of the most felicitous and humorous dinner speeches ever heard, and should after this have listened and replied – standing almost the whole time – to speech-making, which lasted from 9.30 to 12.30 p.m. without any interruption, saying a kind word or two to almost everybody who had come to do him honour. But to remain in order and do my duty as faithful chronicler of events. At noon yesterday (Saturday) a most distinguished audience thronged, on the “Jubilar’s” own invitation, the amphitheatre of his museum. Secretaries of State, representatives of the German Army Medical Service, all his professorial colleagues, delegates from every civilised country, former assistants, now great men themselves, and pupils galore sat, as of old, at the master’s feet and listened spellbound to his broad-minded, philosophical statements concerning the mean-

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1a. The celebration of Rudolph Virchow’s 80th Birthday

ing of the word “pathology”, to his historical description of the development of his science, to his spirited defence of the views which he has unwaveringly held throughout his long life, to the sketch of the aims which he hopes will be steadfastly followed in his Institut, even when his strong hand – absit omen – should no longer guide it. It was a wonderful feat, and we all felt we had been privileged to be present at a historical occasion. At the end of Virchow’s oration, Surgeon – General Schäfer, the head of the Charité Hospital, with which the Pathological Institute is connected, expressed to him in warm, well-chosen words the thanks of the authorities of the hospital, and in conclusion our great teacher gave a demonstration of a series of beautiful photomicrographs of animal and vegetable parasites thrown upon a screen.After this the audience dispersed to admire the treasures of the museum, brought together and arranged with never – resting industry mainly by himself. But if the morning was most interesting it was surpassed by the evening. At 6 P.M. a company of 200, including Virchow’s family, sat down to dinner in the Festraum of the beautiful new abode of the Prussian House of Commons. From amongst the numerous speeches made I single out for special mention the heartfelt words of three hale and hearty contemporaries of Virchow’s, Drs. Körte, Langerhans, and Meyer, who told us of their recollections of “young” Virchow, who testified to the influence he had exercised upon their development, who praised him as a husband, a father, a lover of his domestic pets. And most interesting in the same connection was the speech made by Privy Councillore1 Althoff, who had unearthed from the archives of the Cultus–Ministerium, Virchow’s application for matriculation, dated Easter, 1839, the German essay he wrote on this occasion, entitled, “A Life Full of Work and Labour is no Burden but an Enjoyment”, and the report he received after examination. The latter, Dr. Althoff stated, was “somewhat monotonous”, there being no other terms in it than “excellent”, “very good”, “most satisfactory”. Even in “singing” he had satisfied his masters! It was a charming idea of the speaker’s to have had the two first-named documents reprinted, adorned by a portrait of the “Jubilar” at the age of 6 (!), which already foreshadows the massive forehead and the penetrating eyes of the future man (although the nose, he humorously observed, had since been improving), and to distribute the whole under the title “Little Virchow” amongst the company. After dinner we all adjourned to the imposing meeting room of the Prussian House of Commons, where meanwhile a large and distinguished company, including many ladies in brilliant toilettes, had assembled, and now the ceremony proper of the occasion began. It was a never-to-be-forgotten picture. The whole scientific world had assembled it seemed to do honour to one man. A neverending stream of bearers of the most illustrious names, decked with glittering stars and decorations, clad in the picturesque uniforms of many nations, bearing addresses, medals, pictures executed in Virchow’s honour, passed our dear old master, who for once in his life had donned his own high decorations, and

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who stood there erect, modestly listening to every word said in his praise, a tower of intellectual strength, and yet with a kind smile on his lips, a warm word, a firm shake of his hand for everybody who had come to congratulate him. It was a marvellous, an unforgettable sight! How much must this man, long though his life has been, have done, that the whole world should thus have united to do him honour! That thought, I believe, must have impressed itself with ever-increasing force, upon every witness of this imposing ceremony; that thought prevented it, in spite of its length, from ever becoming tedious; that thought filled us all with ever-growing respect and admiration for this unique man, as deputation after deputation passed and testified to what Virchow had been to them, what he had done for them. Never before had it become so clear to me what a giant we had come to do honour to. Politics, art, science, medicine, public health, municipal interests, hospital management, anthropology, geography, archaeology, palaeontology, natural sciences – all these various great interests, in each of which an ordinary mind would feel ample scope in employing all its time and talents, have been embraced by this master mind; on each of them has he impressed the stamp of his personality upon its development; in each of them his name is mentioned with respect and admiration. It was a pageant of a unique kind that passed before us last night. First a most gracious autograph letter from the German Emperor recording all that Virchow had done for Germany’s greatness and bestowing the Great Gold Medal for Science upon him – a spontaneous act of appreciation, which was most warmly welcomed by all. After this, deputations from the Prussian Ministry for Public Instruction, headed by the Secretary of State himself, from the Scientific Deputation for Medical Affairs, from the governing body of the Royal Museums, from the Prussian Ministry of War, from the Italian Government, from the Prussian Houses of Parliament, from the Berlin Academy of Sciences, from the University of Berlin, from the Medical Faculties of all German Universities, from the general practitioners of Germany, from the municipal authorities of Berlin, from his native town Schivelbein, from the village Virchow, from all the Berlin and many other German Medical Societies, from Anthropological and Natural Science Societies in all parts of Germany, from the German Society for Pisciculture – formed the first part of the procession. After a short interval the foreign deputations paid their reverence to the master. Need I say that nobody was more warmly acclaimed than our own revered leader, Lord Lister, who most warmly testified to the feelings of veneration, gratitude, and esteem in which Virchow is held in Great Britain and Ireland. Addresses from Virchow’s past and present assistants, and presentations of works specially written in honour of the occasion, brought this wonderful celebration at last to an end; but not before the last speaker, Professor B. Fraenkel, had drawn attention to the fact that it was no longer the eve of Virchow’s 80th birthday, but the 80th birthday itself which had dawned, for it was half an hour after midnight when the last speech had been made. A most enthusiastic “Hoch!”, in

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The order of the ceremonies

which the whole assembly joined upstanding – and the never-to-be-forgotten official celebration was at an end.Today Professor Waldeyer has invited a number of the foreign delegates to luncheon, and Virchow himself will unite his family and a few friends round him at dinner; but this is to be of a strictly private character, and the chronicler’s pleasing duty ends here with heartfelt wish that our “Jubilar” may long be spared in equal vigour of mind and body to his family, to his friends, to his country, and the whole world, which loves and admires him. e1

see ‘Translator’s Notes”, this volume.

Tributes from foreign countries The special number of the Berliner klinische Wochenschrift to which Sir Felix Semon refers is dated October 14th. It opens with an address in elegant Latin by Guido Baccelli, In Regio Romano Archiathenaeo Clinices Medicae Professor. Next comes a paper, the joint production of Professors Weichselbaum and Zuckerkandl of Vienna “On Virchow’s Influence on the Development of Pathological Anatomy, Public Health, and Anthropology in Austria”; then follows a short note, Souvenirs d’ Autrefois, by Professor Cornil of Paris, recalling the time which he spent working under Virchow in 1862; then the paper by Dr. PyeSmith on “The Influence of Virchow on Pathology in England”, from which Sir Felix Semon quotes; then a paper on Virchow and Medicine in the Netherlands, by Professor Stokvis of Amsterdam; next one on Rudolf Virchow and Russian Medicine, by Professor W. Schervinsky of Moscow; next on Rudolf Virchow and Swedish Pathology, by Professor Carl Sundberg of Stockholm; next on Rudolf Virchow and Danish Medicine, by Professor C. J. Salomonsen of Copenhagen; then a short note by Professor Georg Karamitzas of Athens, on Rudolf Virchow and Greek Medicine; then an article by Professor A. Jacoby of New York on Rudolf Virchow and American Medicine; and, finally, a description of the Pathological Museum of the University of Berlin by Professor O. Israel.

The order of the ceremonies (From our Special Correspondent in Berlin.) The great day of the Virchow celebration has come and gone, an “Indian summer” day of brilliant sunshine, the first after a long spell of rain and storms. To give an account of all the festive functions, which filled the day from forenoon to long past midnight, with only a short interval during the afternoon, would be impossible within the limits of a short letter. This may be said at once: Never yet has homage so wide, so general, and so deeply felt been paid to any private individual before. And this too: In that illustrious assemblage, the “fine flower” of

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medical science throughout the world, no personality was more interesting, more characteristic than the unbent, spare and wiry little figure of the octogenarian, with his keen but passionless face, his level voice and sober demeanour, as he stood for hours in his Pathological Museum, and again for hours at night in the Abgeordnetenhaus, without a trace of excitement or fatigue, up to the very last moment. The day itself had its prologue, a dinner in honour of Virchow and the foreign delegates, given by Professor Posner (who was secretary and chief moving spirit of the Berlin Virchow Committee), on Friday evening, October 11th. Virchow’s address On the October of 12th the official proceedings began at 11.30 in the Pathological Museum. Here Virchow received the Prussian Cultusminister, Dr. Studt; the Cabinet Ministers, Count Posadawsky, von Thielen, and Möller, with several of their heads of department and Geheimrath; von Leuthold, Army Surgeon in Chief, with the General Army Surgeons Schjerning, Stahl, and Schaper, Oberbürgermeister Kirschner, and other official personages. Dr. Studt made a speech, presenting a marble bust of Virchow, which is to remain in the museum. Then a move was made to the Lecture Hall, which meanwhile had entirely filled, all the foreign delegates and the whole medical world of Berlin being present. Needless to say, that a tremendous reception was accorded to Virchow as he stepped up to his laurel-wreathed lecturer’s desk. He began by words of thanks and welcome, and then led up to the subject of his address: The History of Pathology. For more than an hour he spoke, touching upon malformations, upon trichinosis, tuberculosis, etc., and upon the enlightenment to be gained on all these subjects by the collections of the Pathological Museum. After the address a large number of microscopic preparations were thrown on the screen, and finally Generalarzt Schaper rose to speak as the representative of the Charité Hospital, of which the Pathological Museum forms a part. For fifty-seven years, he said, the Charité had been the scene of Virchow’s incomparable labours. Might he live to see the completion of the entire Pathological Institute so admirably planned by him. A stand-up lunch and inspection of the treasures of the five-storeyed museum under Virchow’s leadership closed the morning’s proceedings at about half-past three. It may be interesting to note here that no fewer than 20,883 objects are arranged on view in the museum, while upwards of 2,000 more have still to be placed there. The banquet At half-past six a “small and intimate” banquet of 220 covers united the Virchow family with the foreign delegates, and chief personages of the Virchow celebration. Lord Lister and Baccelli, the Italian pathologist and Cabinet Minister, were perhaps the most remarked amongst the guests.

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Count Posadowsky gave the German Emperor’s health; Geheimrath Körte, Virchow’s oldest friend, gave the toast of the day; and other after-dinner speeches, affecting and jocular by turns, followed. Direktor Althoff, of the Cultusministerium, made an agreeable and unexpected diversion by presenting Virchow with a pamphlet, Der kleine Virchow, containing a portrait of the 7-year-old child and the school-boy’s matriculation essay on the motto: “A Life full of Work and Labour is no Burden, but a Boon”. Addresses of delegates Meantime the guests, who were to witness the great official function of the evening, had assembled in the Parliament Hall, the ladies in the galleries and boxes above. The banqueters from the dining hall slipped in groups and took their places, and at a quarter to nine (true to the Akademische Viertelstunde) a flourish to trumpets announced and welcomed the entrance of Virchow. And then began a series of addresses and presentations from all quarters of the globe, the mere enumeration of which would fill pages – in truth, a grand and universal homage to intellectual achievement! As the hours passed, medals, pictures, caskets, and rolls of addresses accumulated on the chairs and tables around Virchow, until at last he stood – for he stood through it all, the wonderful youth of 80! – fairly surrounded by them. Professor Waldeyer gave the opening address – a fine and spirited speech, at the close of which he presented a document setting forth the gift of 50,000 marks (£2,500), collected by colleagues near and far, as a contribution to the Virchow-Stiftung for the assistance of scientific research. The Cultusminister Studt read aloud a letter from the German Emperor, words of congratulation and grateful appreciation of Virchow’s great lifework, with the bestowal of the Great Gold Medal for Science. A congratulatory telegram from the Imperial Chancellor, Count von Bülow, was also read. Loud applause greeted Baccelli, who in the name of the Italian Government presented a picture (the heads of Morgagni and Virchow side by side, with the hexameter motto, Ut quos corda fovent praesentes lumina spectent), and read a beautiful and enthusiastic address written in Latin.Among the speeches that followed – their name is legion – a few stand out in one’s recollection. Harnack, rector of the Berlin University, was eloquent in claiming Virchow as the University’s “very own”; Oberbürgermeister Kirschner presented a contribution of 100,000 marks (£5,000) to the Virchow Stiftung, and asked Virchow to stand sponsor to the new municipal hospital. Dr Langerhans, President of the Town Council, read an address full of gratitude for Virchow’s labours for the weal of the City of Berlin; Professor von Bergmann – as delegate of the Berlin Medical Society – quoted from the minutes to prove that Virchow had read no fewer than 107 papers at its meetings, and had taken part in its discussions 587 times.

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Professor Cornil, the French delegate, was much applauded. Enthusiastic calls greeted Lord Lister, who said: “Revered master, I am here as a delegate of the Royal Society of London, of which you are an honoured member, and on behalf of which I have to present to you a loyal address. I have been also requested to hand you addresses from six other societies which greatly regret that it has been impossible for them to send special delegates. They are as follows: (1) The Anthropological Section of the British Association for the Advancement of Science; (2) the University of London; (3) the University of Edinburgh; (4) the Faculty of Physicians and Surgeons of Glasgow; (5) the Medico-Chirurgical Society of Edinburgh; (6) the Royal Academy of Medicine in Ireland.All these bodies join in recognition of your gigantic intellectual powers, in gratitude for the great benefits that you have conferred upon humanity, and in admiration of your personal character, your absolute uprightness, the courage which has enabled you always to advocate what you believed to be the cause of truth, liberty, and justice, and the genial nature which has won for you the love of all who know you. The astonishing vigour which you displayed in the address to which we listened to-day justifies the hope that, when many of us your juniors shall have been removed from this scene of labour, it may be granted to you to celebrate your 90th birthday not only in health and honour, but in continued activity in the service of mankind”. A graceful and modest speech was Sir Felix Semon’s, who said that he had been selected to convey the sincere congratulations of the Royal College of Physicians of London first because the College considered that it would be agreeable to Virchow to receive its good wishes from the mouth of an old and faithful pupil, and secondly because by selecting a native of Germany the College wished to emphasise the old scientific brotherhood which had so long united German and British science, and to express its sincere gratitude for the beneficial influence that Virchow had exercised no less upon English than upon German science. It was long past past midnight when Virchow’s former and present assistants, headed by Professors Liebreich (Berlin) and von Recklinghausen (Strassburg) came up at last to offer their homage and congratulations.

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Appendix 1b Pages in thanks for my friends By Rudolph Virchow Virchow’s Archive 167: 1–15 (1902) Editors’ comments This is an article of thanks to all those who expressed their best wishes to Virchow on the occasion of his eightieth birthday. There is a brief review of his achievements, without any general philosophical statement – in self-justification or otherwise. He may have begun to write this before his accident (on January 5th, 1902), but the article was published later in the same year. A summary of this article appeared in the Lancet: I pp 321–322 (1902).

Editors’ summary of points Pages 1–2 general points, how the birthday celebrations were arranged; 3 review of his major scientific activities, ‘hunger typhus’ – Dr Obermeyer and the causative spirillum; 4 events of 1848, sanitary improvements, Koch, importance of pathological anatomy; 5 achievements in sanitation in Berlin; 6 trichinosis, awards of Freedom of the cities of Berlin and Bologna; 7 other civic honours, specific gifts from southern Europe, Australia; 8 from Switzerland, and his contacts with that country; 9 gifts from England, Scotland and Ireland, Italy; 10 Scandinavia, Finland, France, Holland, Russia; 11 Japan; 12–13 Germany, including Royalty; 14 old friends from youth; 15 the Berlin Manual Worker’s Club, trust in people as an article of faith.

The 13th October of 1901 brought for me not merely a day of celebration of incomparable magnificence but a whole week of festivities with daily new joys, which was so rich that I was quite incapable of thanking all participants individually. Hence now – surveying it all – it becomes clear how many people were apparently or in fact, neglected; and thus I see no other way of getting closer to some extent to these many people, except through the Press. For my scientific friends – who, after all constituted the main contingent for this festival – this old archive, which for more than fifty years has been our common means of friendly communication with each other, may well fulfill this function once more. Its wide circulation – across the whole world – grants me the certainty that my words will not die away wholly unheard. When the thought emerged of celebrating my eightieth birthday, my closer friends reduced my disinclination to a public celebration with the assurance that any influence of mine on such a celebration was out of the question. Indeed, when the festive days approached, they

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treated me like a patient whose doctors have prescribed a regime of activity such that he must renounce making any arbitrary interference. Thus I was able to find out only piece-meal what they had in store for me. The committee – and particularly its chairman, so experienced in such tasks, and my dear friend and colleague Waldeyer, and his always ready and skillful executive Posner – was able to transform my inner excitement into such a state of calm that I abandoned all resistance. In this state, I entered the festival without being able to foresee all the consequences, and indeed – as I may assume – without the ring leaders themselves being able to have any picture as to what dimensions this festival would take on. Since then, the festival has taken place, and the Press has ensured that news of it has gone out everywhere. I restrain myself therefore, from giving yet another description of it here. A survey of the addresses and testimonials which reached me will perhaps be printed later: their number is so large that even listing the various categories at this point would be too cursory. The number of telegrams alone amounts to nearly eight hundred. Their content is so various that they have unrolled before me a mirror image of my entire, very restless, life and therefore to anyone else, they may well appear to be confusing. This comes from the fact that – in the course of time – I have taken very many different directions in research and activity, and that not merely the site of my professional work has changed, but also that I have undertaken long journeys through the whole of Europe, and have visited important parts of Asia and Africa. Personal relationships from each of these places have remained intact, and in point of fact, for the most part, the really close relationships are maintained by excellent people. Here, I would like to remember only Dürkheim in Rhine Palatinate. But also, almost all these places gave me the opportunity to open up new areas of knowledge for myself, and of devoting to them scientific works of my own. No little contribution to this has been made in no small measure by the fact that my frequent participation

3

in periodic scientific gatherings – whether national or international and particularly the German Society for Natural Scientists and Doctors, and the Society for German Anthropologists – compelled me directly into practical involvement. Thus the course of my researches has not only brought these various lands and their inhabitants into my ambit, but in each case – according to prevailing circumstances – I have made the objects of my studies Medicine and the Natural Sciences, also Anthropology and Archaeology, and occasionally too the literature, philosophy, politics and social conditions (of those regions). This mixture was not undertaken arbitrarily or indeed in any tendentious way. Decisive here was a mission with which I was entrusted at the beginning of 1848 by the then Prussian Minister of Health. It involved an investigation of the severe epidemic of so-called “hunger typhus” which had broken out in Upper Silesia. In discussing the causes of this epidemic, I reached the conviction that

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the worst reasons of it were to be found in the wretched social conditions, and that the fight against these miserable circumstances could only be carried out through by profound social reforms. My report aroused much displeasure, but I find consolation for this in the fact that the government very soon, took the path of reforms and that thereby, most beneficial results were achieved. Even more am I pleased by the feeling that my procedure has not only had significance for Upper Silesia, but that gradually, one region after the other has undertaken on a similar course of action (of improvement of social conditions). Subsequently our own region had repeated evil experiences of famine. Almost immediately after my move to Bavaria (i.e. Würzburg) in 1849, I was commissioned there to study the neediness in the Spessart district. In the following years, the hunger epidemic in Prussia too worsened considerably: I dealt with East Prussia in a specific essay, and as doctor in charge in the Charité, I twice saw my section completely filled with patients who were suffering from spotted fever (infectious typhus). From one of these epidemics, one of my Assistenten, Dr Obermeyer discovered the microscopic blood parasite Spirillum.e1 This opened the way to knowledge of the ever-growing number of dangerous blood parasites. I won’t speak of cholera, of smallpox, and other evil epidemics which increased movement (of humans) or the privations of war have brought to us. My only concern is to remind us once again of how unavoidable it is to place practical medicine in direct relationship to political legislation – something which I tried to do in the past in “Medical Reform” (1848–1849). Since public hygiene has become an integral (integrirender) component of general welfare, the reproach: “that a doctor is also a politician” has lost all meaning. Certainly, even now it is not easy to acknowledge the right of (the inclusion of) medical judgment in large questions of the lives of the people. Anyone who has continuously followed the discussions in recent years on acclimatization and colonisation will know how dangerous it is – when assessing the circumstances of the peoples’ lives – simply to ignore the scientific fundamentals or to judge them superficially. Sanitary conditions in the cities are relevant here. It was in Würzburg that I carried out my first experiments towards scientific statistics of local illnesses. Even before the question as to the spread of tuberculosis had become fashionable, I had carried out the first (and still perfectly valid) surveys of deaths due to phthisis in an entire metropolitan population. In following up these surveys, I attempted for years to investigate the nature of tubercle and of consumption, and I am of the opinion that my principle points – derived at that time – have not lost their significance, although I did not then know the tubercle bacillus. On the other hand, knowledge of this bacillus is not the “alpha and omega” of the tubercle theory, as has been very recently shown in the study of the bovine tuberculosis in cattle. This disease too, I first studied thoroughly when I was in Würzburg. My very accurate data did not prevent this being called tuberculosis,

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and even being denoted as the main source of human tuberculosis. Only the most recent data from a definitely unimpeachable witness, Mr Robert Koch, has stirred up the question again as to whether bovine e1

This was in 1873 (reference is on p 168 in Dhom, 2001). Relapsing (“recurrent”) fever is caused by strains of Borrelia recurrensis, spread by lice. Otto Obermeyer (now usually spelled “Obermeier”) was clinical Assistant in Virchow’s ward at the Charité (Köhler, 2005). The European type of the disease is called ‘Obermeyer’s relapsing fever’ (Lefebvre and Greenier, 1994).

5

tuberculosis is different from human tuberculosis. e2 But it is to be hoped that it will be a permanent warning, not to admit a mixing of the causes of disease with the nature of disease without thorough prior studies in pathological anatomy. I cannot leave this topic without reminding us of the great sanitary improvements associated with the construction of new human housing and settlements in recent times; whether they are carried out in towns or in villages. It was also the mixture of medicine and social politics which led me to that area in which – thanks to fortunate circumstances – I have been successful in fundamentally changing living conditions in Berlin. I owe the possibility of collaborating so decisively in such great changes, in the first instance to the circumstance that I had become a City Councillor in Berlin, and then (second) to the great and lasting trust my fellow citizens have had in me for almost fifty years. If later, they accorded me the Freedom of the City, I may also point to the fact that since my collaboration, the entire physiognomy of the German capital has been changed. Because the cleaning-up of the city demanded not only an all-encompassing water supply, a comprehensive drainage system and extensive sewerage farms, but also a corresponding straightening and leveling out of entire streets and building work in every house.That cost hundreds of millions, but my fellow citizens took on the enormous burden in the absolute trust that any sum of money is rewarded by its equivalent in health and longevity. Thus Berlin has become simultaneously one of the cleanest, most beautiful, but also healthiest of the large cities. If in spite of my accumulated – and at times really overburdening – responsibilities, I still retain supervision of the sanitation of the city and have even recently taken on again election as City Councillor, I may indeed presume that this will be attributed not to ambition but to a stern feeling for duty and persistence in following through great tasks. This semi-political activity is based overall on serious scientific prior study. In particular e2

6

See in Ackerknecht (1953).

the organization of city sanitation has almost wholly been achieved from communal initiative, and I am proud that I was able to collaborate in this and that now, the general legislation can advance based on our achievements. Perhaps a better “system” will still be found, but what has been achieved will certainly remain – in spite of everything – an ideal model. Here indeed, one may recall

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another very familiar example. I refer to meat inspection. A violent and continuing opposition was evoked by our proofs of Trichina in pig meat; and how long did it take before legislation supported the proposal to prescribe an increasingly effective meat inspection system! The City of Berlin very early introduced its laws for this, without any pressure from the State government. But even now, it has not been possible to bring international legislation into accord with the demands of science, and sometimes, because of this discordance, we were close to dangerous disputes with North America. The resolution ofe3 so-frequent conflict between practice and investigative (not merely theoretical) science, presupposes (voraussetzen) not only great cold bloodedness (Kaltblütigkeit) and care, but also great honesty and reliability, such as is scarcely ever been achieved for daily life without the controls of science. Worst of all here, are the half-informed, who in the arrogance of the common laymen, believe that they can ignore the stern demands of the learned researcher. Berlin is not the only city to have made me a Freeman, but the only one which did this on the basis of actual practical scientific work. There are other cities which have conferred the same honour on me. The first was Bologna (1867), the oldest university town in Italy, and the most enduring in its support of scientific work. With its city authorities – as the recent days have also shown – I have enjoyed continuous friendly relations. The greatest and most flourishing cities of my later home in beautiful Franconiae4 – Würzburg and Nürnberg – have in addition recently e3 e4

this sentence seems unintelligible without this. northern Bavaria.

named a street after me, as Berlin had already done earlier. Here I must note with great satisfaction that the Berlin city authorities have given my name to the largest hospital which has been built in our city. The communal authorities of the village of Virchow in Farther Pomerania (Hinterpommern), by means of an artistically-executed address, have even recalled the fact that they have not forgotten my visit years ago when I wanted to show the place to my sons. I mention these communal honours with particular joy. They are wholly without ulterior motive, have been accorded as a purely personal honour, and grant me great satisfaction. Along with this I gratefully acknowledge the many individual documents which have been sent to me principally in praise of my scientific works. Amongst them, in respect of the magnitude of the birthday gift and warmth of recognition takes pride of place the collective gift of the scientific and medical societies of Austria. In a large precious casket artistically made of onyx and bronze, there are eighty special – mostly decorated with splendid paintings – addresses, diplomas, etc, from the individual states (within Austria) and the learned bodies and societies constituted there, from the Vienna Academy right across to the Medical Societies of Siebenbürgen, Hungary and Bosnia, Abbazia and Zara. My much-

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honoured friend Toldt delivered it personally. It will remain for me a personally valued memory of him and of so many dear and esteemed colleagues. Closest to this jewel comes a collective address from the Australian doctors sent via Professor Wilson in Sydney. It is a substantial volume whose dedication page is decorated with rich miniature paintings, and which contains for every state (including Tasmania and New Zealand) the addresses of the individual donors on special cards. It is almost certainly the first time that an entire continent has unified its homage in one single document and has regarded the occasion as sufficiently important to bear witness of its participation in universal science. Consonant with its smaller area, and thus its much fewer numbers – but all the warmer in actual expression – are the representatives of Switzerland. But they brought a present which will 8

always remain dear to me; a splendid oil painting of the Walensee. I am telling the story about this because of its not-insignificant interest. It was in the days when – commissioned by the German Anthropological Society – I directed the large school survey on the colour of hair, eyes and skin, which was first carried out in all Germany, and then in Austria and Switzerland too. When studying the statistical sheets, I discovered a surprising relationship: in the district of Kerenzen, on the southern bank of the Walensee – in an area which we were accustomed to ascribing to Alemannic settlement – the brunette complexion was predominant in the school children. Since I assumed this to be a mistake, I informed Professor Kollmann in Basel, who had the Swiss data, and asked for enlightenment. I soon received the suggestion that it would be better for me to see for myself; so I stayed with my family in the charming Suggen valley at the foot of the Black Forest, and in close contact with my Freiburg friends, the Eckers and my dear godchild, subsequently Professor Paul Langerhans Jnr.There I received the invitation to go first of all to Basel for the birthday celebration for W. His. From there I went to the meeting of the Swiss Natural Scientists at Stachelberg in the Canton Glarus. Everything went splendidly. At the conference, I met one of my oldest pupils, Dr Schuler von Mollis – who has become factory medical officer for the entire Swiss Federation – and the parish priests of the Müllerhorn and the places on the Walensee. All agreed that the matter must be investigated on the spot. On the same evening, in spite of it being late at night, I set out with Kollmann, and we reached our next goal, the village of Obstalden, high above the lake. It may be said in advance, that the correctness of the school teachers’ data was proved, but we were simultaneously rewarded by the wonderful situation and view from Obstalden – which in the full light of the following morning – had such an enrapturing influence that I immediately concluded an agreement for a stay there with my family in the following Autumn. Thus there developed a relationship extending to the local people which since led my family and me there on repeated occasions. The wonderful atmosphere of Nature refreshed us, and later in difficult times, it has brought improvement and healing for my closest relatives. But within a few years,

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it has also made this lonely little village into such a sought-after rest-haven for many tourists that Obstalden has become a well-known place. This memory was destined to be kept fresh in my mind by the painting (presented to me), and I cannot merely praise this good result, but even more, (I must praise) the gracious feelings of the donors which this picture specifically attests. From the bottom of my heart, I thank the Swiss medical men who presented it to me, and I will not conceal the fact that the thought for it, as I later discovered, originated in a spirited woman. Mr Schuler strengthened the gift by collecting a whole sequence of photographs of the lake and the various places in the Glarner countryside. Every time I look at this painting – which now hangs in my house – I am overjoyed and moved by the heartfelt sentiments which fill the donors. This feeling also emerges in the address of greeting from the Zurich Nature Research Society and the Bern Medical Faculty, the Board of the Bern Historical Museum, and of Professors in Basel and Bern. I was moved with particular pleasure by a letter from the celebrated Egyptologist Nabille whom I had visited years ago while he was working in Bubastis. Gifts which I receive with the sense of greatest honour are from England, Scotland and Ireland. At the peak – from all these countries, the oldest and most celebrated societies, personally represented by my great friend Lord Lister – I name only the Royal Society of London, the Royal College of Surgeons and the Royal Medical and Surgical Society of England e5; similar institutes in Edinburgh, Glasgow and London; as well as the Universities of Birmingham and Aberdeen, the latter of which recently conferred on me in absentia the title of Doctor of Laws. From Italy, my much-proven benefactor, Minister Baccelli presented me personally – in the name of his government – with a double portrait of Morgagni and me, as also from my pupils there, a golden medal and a beautiful address. Also a similar one came from the Medical Faculty

9

e5 originally the “Medical and Chirurgical Society of London”, became the “Royal Medical and Chirurgical Society of London” in 1834, and after merging with other medical societies, became the “Royal Society of Medicine” in 1909.

in Rome, with the announcement of Honorary Doctorate. Scandinavia sent a Gold Medal of the Swedish Doctors Society with an Address. In addition, there were addresses from the Swedish Academy in Stockholm, the Medical Faculty of Upsala and Lund, the Norwegian Doctors of Christiana and Bergen, and the Medical Faculty in Copenhagen. From Helsingfors, I received a magnificent address distinguished by its original binding in birch tree bark, along with which may well be named, as rival pieces, gifts from the National Museum and the Medical Surgical Society of Rio de Janiero, and an address from Chile. From Paris, came a gold medal from the Anthropological Society with a headand-shoulders portrait of Broca, and a bronze statuette of Hippocrates by Paul

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Dubois, sent my Mr Languelonne, “Dedicated by French Friends and Scholars”. From Brussels, came a congratulatory address from the Belgian Royal Academy. From Holland, an address from the Amsterdam Doctors and Natural Scientists, with a large album of “Colleagues and Friends”, delivered in person by Professor Stokvis; from the Ethnographic Museum in Leyden the deluxe edition of “Wajang Proebwa” – (which is) the beginning of a deluxe work on Phillipine skulls – and a book “Modern Art in the Netherlands” by Mr Kleinmann in Haarlem. Finally there was an address from the Medical Faculty in Leiden. There were innumerable addresses from Russia, the country in which perhaps I have the greatest number of pupils in the medical profession. Right up to most recent days, new addresses arrived from the most distant citiese6 [Baku, Tiflis (Tibilsi), Kutais, Yalta, Odessa, Blagovestschensk, Charkow (Kharkov), Yaroslav, Yekaterinoslav (Ekaterinenburg), Lodz, Kazan, Kars, Kertsch, Kischinev, Kursk, Mohilew (Mogilev), Mitau, Omsk, Orel, Orenburg, Pensa, Polkowa, Nikolajew (Nikolaiev), Rjäsan, Riga, Rostov, Saratov, Simferopol, Stravropol, Tambov, Tomsk, Tula, Vilna (Wilnius), Warsaw, Vladikavkas, Voronezh, Zytomir (Zhitomir), Kostroma, Moscow, Vologda, Dorpat, Jurjew, Kiew (Kiev)], as also from medical, anthropological, geographical and historical societies. The Tsar had already conferred a high e6 the

11

alternative spellings in brackets are supplied by the editors.

Order on me, and permitted me to be nominated as honorary member of the medical council, and at the same time, initiated a collection of contributions for the Rudolph Virchow Foundation. Notices had arrived from various places to the effect that the collection of such contributions had begun. From Moscow, I count twentysix addresses, from Petersburg, twenty-six, from Odessa, twelve; from Kiev and Kazan, six each; eight from Kharkov; five from Riga; eight from Jurjew and so on. As far as the participation from abroad is concerned, I must limit myself to this, in itself, so glittering compilation. It will certainly be added to later. But I will just note one additional thing: the participation of that country whose friendship to such a great extent we have gained only in recent years – I mean Japan. How numerous are our medical graduates there; how loyally they retain the memory of their German education and what great help they already have given to us in research into difficult scientific problems! News of the celebrations in Tokyo only reached us here in recent days. The German Ambassador, Count Arco, had gathered his compatriots with Japanese friends in the embassy (in Tokyo), and I received their collective greetings. But individual scholars too, sent festive greetings; even from Kyoto – the newest Japanese University – there came a warm address (signed by Fujinami and Nakarai). At the top of the list of men in Tokoyo, there was our much honoured compatriot Professor Baelz who had only recently returned from his visit home. Under his leadership, we may well hope that the medical schools of Japan will in the future, fulfill their great cultural mission of propagating modern scientific methods in East Asia, and to

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make it firm for a long time, just as has happened in brilliant fashion, in America, thanks to others of our pupils! I see that I must keep things short, so as not to appear overly conceited. Holding back is doubly difficult for me, because now I have to talk about Germany. The task is the more difficult because my gratitude is aroused most strongly. Because here I should not only have to speak of the scholars and learned societies, of the most numerous benefactors and friends – in particular of the many friends in political, local governmental and commercial spheres – but also and especially, of the great and surprising recognition which has been accorded me in the most heartfelt form and unexpected degree. It is common knowledge that already before the celebration, his Majesty the Emperor and King, awarded me the highest “scientific” order of Prussia, and thereby gave the impetus to a general sympathy for me. An address of praise and the conferring of the great Golden Medal for science will keep this gracious recognition in permanent memory for me and my family. A dispatch from the Imperial Chancellor, at the Hubertusstocke7 of the 12th October, and an address from the State Secretary for the Ministry of the Interior confirmed my interpretation in the most friendly form. The Royal Prussian Ministry of Education presented a marble bust of me – executed by Hans Arnold – to the new Pathological Museum, the erection of which realized my earliest academic ambitions. This bust was unveiled by his Excellency the Minister of Education himself, with a laudatory address at the beginning of the celebrations. Through its secretary, the Academy of Sciences delivered its most flattering congratulations, accompanied by a bronze medallion, which the Academy had commissioned from B. Kruse. The Silesian Museum for the Applied Arts and Antiquities in Breslau presented a gold plaquette by E. Kempfer. The Imperial LeopoldCaroline German Academy of Natural Scientists presented an address together with their Gold Medal. The committee of the German Doctors’ Association brought a splendidly-executed illuminated homage. Everything of precious gifts in my honour, and artistically-presented addresses which have reached me, I passed on to Professor Lessing for public exhibition at his request. This took place in the beautiful Lichthof e8 of the Museum of Applied Arts. It aroused general admiration. I cannot close without expressing my particular gratitude to some eminent royal persons e7 e8

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a Hunting lodge of the Emperor, on Lake Werbellin, about 50 km north-east of Berlin. a naturally-lit courtyard; may refer to the building now part of the Technical University of Berlin.

who have been friendly to me for a long time; and who have indicated the continuation of their interest by their telegrams at this celebration too. These were Princess Theresa of Bavaria, Dukes Johann Albrecht and Georg of Mecklenburg, Prince Christian of Schleswig-Holstein, and the Duke of Ratibor.

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In the face of these really unusual honours accorded to me, I can do nothing more than repeat my warmest and most heartfelt thanks. The feeling of indebtedness is too great for me to express in writing, with any words which would do justice to my feelings. I am also too old to envisage new achievements worthy enough to be regarded as a gift in return. I shall not tire of working as long as my powers are sufficient. But I cannot promise any more than that I will try to bring a series of larger projects – which I began in earlier years – to a conclusion which is also useful for the world at large. For the rest, I can only ask that my future works should receive the same benevolent and considerate judgment, which I have hitherto enjoyed in rich measure and far beyond all expectation. The benevolent – I may perhaps say the loving – reception which I have encountered at these celebrations strengthens me in the wish to carry on working still for some time with the same dedication and independence. If it were correct that the world is ungrateful, then it would certainly be the greatest ingratitude if I were to apply this experience to myself too, and wished accordingly to regard it as a general characteristic of humanity. No one could expect to find, or certainly to claim, greater friendly support than that which I have encountered in all circles of our people and even amongst those belonging to foreign nations. I did not demand such devotion – it was voluntarily accorded me – neither did I expect it, but I thereby become all the more pleasantly surprised and deeply indebted. Whoever of the comrades of my youth, in some cases even of my childhood, who are still alive; and whatever of those things which have remained to me from the manifold 14

campaigns of earlier years; – all those people and things have come back to me again on this occasion, personally or by letter. Compatriots from Pomerania – the memory of whom I was able to renew only with some effort – announced themselves; in particular my old Schivelbein friends, have, as always, come confidently in order to bear witness to the permanence of their feelings. The faculty of the Gymnasium at Köslin where once upon a time I, as a pupil, enjoyed my pre-education, assured me anew of their loyal memory. Every city in which I once lived was busy in doing something special and particularly pleasant. But that does not merely apply to the past. If I look around then, alongside acquaintances from earlier times, I always see numerous friends from the present time, and it seems to me that specifically the sympathetic participation of presentday people, must signify for me a reliable indication of real loyalty and constancy. A small anecdote from the last few days has as I see, found wide and strikingly rapid circulation throughout the daily press. When I returned home from one of these celebrations late at night, I found to my greatest surprise that my little street, the Schellingstrasse, was brightly and completely illuminated. I had had no idea that my neighbours wished to receive me so kindly. But the street was also completely full of children, including quite small ones. I had to find my way to the door of my house through a real avenue of children, and the cries of

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jubilation from the little ones only ended when I had disappeared inside the house. But however often I now show myself in the street, the little ones come towards me with outstretched hands saying “Good morning Mr Virchow”! Thus from day to day, this feeling is passed on from child to child, and it should not surprise one if it stirs too, amongst the adults and even amongst the old people. The finest evening which I experienced at this time was a quite intimate celebration of our Manual Workers Society. Years ago, I myself had been a co-founder, and had followed its early stages with advice and deed. That was at a time when the then Crown Prince Friedrich still had leisure to concern himself with questions of the education of adults among the people at large. How often did he – and sometimes accompanied by his wife, the recentlydeceased Empress Friedrich – come to our Manual Workers Society in order to see its progress for himself. And when finally we had got so far as to complete a building of its own for the Club, how he, much to our joy, participated in it! Then came the time when our Manual Workers Society became the model for such organizations; when our young members went out into the world as apostles and founded Manual Workers’ Societies everywhere.There were such groups from Riga to Lisbon, and for our traveling members, it was everywhere as if a home had been prepared for them. The vitally encroaching wave of Socialism has in large part annihilated these creations. In spite of this, the Berlin Manual Workers Society has remained alive, and when I appeared recently at the celebration offered to me; when the old songs sounded forth; when I myself again gave a speech, then all hands reached out towards me like those of the children from Schellingstrasse. That is the gratitude of the people, and therefore I may say to every one; trust the people and work for them; then your reward will not be lacking, even if the demolition of numerous institutions, the disappearance of many people, the complete re-shaping of public life, brings the thought of our mortality very close to us. That is my confession of faith, and I hope to get by with this as long as I live. The City authorities of Berlin, the committees of all our hospitals, the learned societies and corporations throughout Germany have filled my family archives with wonderful addresses and diplomas of honour. Not a few of these societies have taken me up into the ranks of their members whilst conferring special titles of honour on me. If I do not go here into further detail, I must ask that this not be regarded as any undervaluation or disrespect vis à vis those not named, but only to consider that a complete survey could not be given in this expression of thanks. Berlin, 15th December 1901.

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Appendix 1c Some personal remiscences By Sir Felix Semon British Medical Journal ii, September 13th: 800–802 (1902)

Editors’ comments Felix Semon (1849–1921) was born and educated in Germany, but moved to Britain, where he became a very successful surgeon. He was a staunch admirer and friend of Virchow from the 1870s until the latter’s death. Semon’s autobiography was published in 1926.

Editors’ summary of points P 800, first meeting with Virchow; Virchow’s wide range of interests; his exactness tantamount to pedantry; feared by students as a teacher and examiner; 801, Semon’s own experience of this in a practical examination, Schiller quoted; nevertheless generally admired by students; genial at home, amiable at public gatherings, but caustic, ironic and sarcastic in argument; a friend of England; 802 English admirers; lack of recreations; unpunctuality; busy daily schedule; elements of his greatness.

Sir Felix Semon, C.V.O., who was a pupil and personal friend of Professor Virchow, has kindly contributed the following reminiscences of the great pathologist: – The Editor of the British Medical Journal has requested me to add to the tribute paid to the scientific life-work of Rudolf Virchow in these columns by contributing some personal reminiscences of my great master, and I willingly comply with his wish. It is now more than thirty years since I was presented to him, and I shall never forget the occasion of my introduction. Shortly after the end of the Franco-German war I was riding in the Thiergarten of Berlin, when I was hailed by a relative of mine, a member of the Berlin Town Council, returning from a meeting of that body in company with Professor Virchow, who then was, and indeed until a few years ago continued to be, one of the most energetic and influential members of the Berlin municipality. My relative presented me to the Professor, who directly pronounced the horse I rode a thoroughbred, and entered upon a disquisition on its qualities in a manner which fairly took my breath away. If he had authoritatively spoken about the latest phase of Prince Bismarck’s policy, about the canalization of Berlin, about some recent discoveries of lake-dwellers’ habitations, or of tumuli in Pomerania, or about a recent

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attack on his cellular pathology – one would have thought it perfectly natural in view of his well-known universality; but that the Leader of the Radicals in the German Reichstag and the Prussian Parliament, the Berlin Town Councillor, the President of the German Anthropological Society, the Professor of Pathological Anatomy in the University of Berlin, and the member of innumerable learned societies, should be able to discuss with equal authority the points of a thoroughbred – was, indeed, more than I had expected. At any rate it filled me at once with profound respect for the universality of his information, and this feeling deepened as years rolled by, and as I had the privilege of more and more frequently and intimately coming into contact with him. Whilst his knowledge of medical literature of all times and all nations was simply phenomenal, his acquaintance with all events of the day, with the progress of general science, with history, geography, general literature, art, was equally astounding. And what was most impressive was that his knowledge in all these various branches – the complete mastery of any one of which usually is looked upon as a very creditable achievement – was as thorough as it was general. Virchow, in fact, was nothing if not exact, and it was one of his most characteristic features that he demanded the same exactness in thought and expression which distinguished him from everybody with whom he came in contact. His critical faculties were, so to say, instinctive and ever on the alert. He rarely allowed an inexact or random statement inadvertently made in his presence to pass without correcting it, and when his own work came into question he was positively inexorable in his demands concerning the absolutely exact rendering of his meaning. I have had some experience of this in connexion with the translation of a few of his addresses into English. As a rule, when invited to give an address in this country, he sent his German manuscript for translation some time before he arrived, and it need not be said that only first-rate men were entrusted with this responsible task. As a matter of fact all his English addresses known to me were magnificently translated, and the author himself, when first glancing over the translation, was delighted. But he then usually withdrew into his room (ever since 1881 when coming to London he did me the honour of staying with me), and shortly afterwards there was a little knock at my door. So as soon as I heard that knock I knew what was coming and my misgivings were rarely falsified. He thought that such and such a phrase did not exactly enough render his meaning, and after he had once embarked upon that course there was no holding him. He grimly insisted on getting exactly what he wanted, and I remember at least two occasions when he was still actually correcting his manuscript whilst his audience was already assembling, and when I had the greatest difficulty in getting him on to the platform in proper time. Admirable as this was, it cannot be gainsaid, I am afraid, that his love of exactness occasionally amounted to a certain degree of pedantry. Thus, how often did he drive some unfortunate candidate whom he examined into sheer despair, because the youth did not exactly enough describe the colour of a specimen,

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and called it “pink”, whilst he ought to have said “violet!” How often did he suddenly interrupt himself in the midst of a most interesting pathological lecture, in the course of which he had sent round among the audience some illustrative specimens, and personally apostrophize an unsuspecting student in anything but complimentary terms, and at very considerable length, because he had noted that that unlucky individual held the glass containing the specimen somewhat obliquely, and because he feared that the spirit of wine in which it was preserved might touch and spoil the varnish by means of which the cover was sealed! In this connexion, I may say at once that my dear old master never was very gentle with his students, and that, particularly as an examiner, he was terribly feared. I have often wondered and never been able to understand why just on these occasions he should have so much departed from his usual quiet demeanour and have terrorized the innocents to such a degree that many of them actually forgot the little they knew. But whatever the explanation, the fact remains. The number of anecdotes known in connexion with this peculiarity of his is simply legion, and it may not be amiss in a memoir of this character if by way of illustration I related part of my own experiences with him when I passed my State examination. I ought to premise that on the last occasion on which I had seen him, namely, after passing my examination for the M.D. of Berlin, he had been kindness personified. Well, the day before I was up for the pathological “station” as it is called, of the State examination, I had to deliver a message from the clinic of the late Professor Traube, as one of whose clinical clerks I then acted, at the Pathological Institute. Virchow’s assistant was just engaged in making a necropsy, and, seeing me, asked whether he was mistaken in thinking that I was to be under examination next day. On my confirming his impression, he said, “Well, you had better look at this. It is a thing one does not see every day, namely, a melanotic sarcoma with numerous metastases. Who knows but that you may not be examined on that very subject.” I thanked my friend for 801

his kindness and asked for a little piece of the tumour. My request was willingly granted, and after my return home I examined the growth under the microscope and read up all I had put down on sarcoma in my memorandum book when listening to Virchow’s own lectures on the subject. Next morning the eight victims about to be immolated appeared at the appointed time – 8 a.m. punctually – in evening dress (such was, and possibly still may be, the ridiculous fashion) at the Pathological Institute. It was customary that two of the candidates should begin by making necropsies simultaneously, two should write the protocols of these examinations under their comrades’ dictation, two should prepare on the spot microscopic specimens, and the two remaining ones should be examined viva voce. After a while they all exchanged their occupations. In which order they were to begin was left entirely to the examiner’s decision, so that nobody knew beforehand what was first in store for him.

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Well, we waited and waited two mortal hours for the arbiter of our destinies. (I shall hereafter have something to say about Virchow’s general unpunctuality.) At last we espied him through the window, rushing up the little incline which led to the door of the old Pathological Institute. We grouped ourselves in a semicircle and received him with a deep bow. Without deigning to explain by a single word his late appearance, he immediately and not in the gentlest tone either, addressed me personally: “I suppose you are waiting for the permission of a magistrate (obrigkeitliche Erlaubniss) to open your microscope?” Seeing that I could not have the remotest idea that I should have first to use the microscope this was certainly a stunner. I, of course, did not reply, and made my microscope ready, whilst he ordered the other candidates about. “The two gentlemen who are to make a microscopic examination, to come here! There, sir (addressing me), is something for you.” Oh joy! It was the melanotic sarcoma! I turned round to look for a wooden tray on which to place the piece of tumour held out to me by the Professor, when I again heard his voice in its most caustic tones: “That is quite like your own dear self! Why look afar, when what you desire is near?” (In German he quoted Schiller: Warum in die Ferne schweifen? Sieh’ das Gute liegt so nah’!) “If you had only condescended to look in front of you, you would have seen a tray on the table before you.” This was true enough, but certainly not very encouraging. However, I received my piece of tumour and withdrew to the window, where I had placed my microscope. There I prepared as characteristic a slide of the growth as I could and waited for the dreaded moment of his coming to me. Meanwhile he raged about amongst my unfortunate comrades, like furious Ajax amongst the herds of the Achaeans. At last I heard his voice behind me: “What have you got there?” The accumulated experience of many generations had taught candidates, under no circumstances to begin by giving a diagnosis, and merely to describe appearances. This I did whilst he was attentively examining the preparation under the microscope. When I had finished he looked up, pushed his spectacles up, looked at me straight with his piercing eyes, and asked: “You see that?” Greatly surprised, I answered, “Yes, sir.” “I don’t,” was the reply; and next moment he was far away, scolding another candidate. I remained behind, much bewildered. Surely it was a sarcoma; surely I had given him a correct description? At last it dawned upon me that perhaps my preparation, although I had considered it a beauty, was not good enough for him. So I sat down again and laboriously fitted up another, which really was most characteristic. After about an hour, I heard his voice again behind me: “What have you got there?” “The same, sir, that I reported when first you asked me.” “What was that?” I repeated my description. He again looked up when I had finished, again pushed his spectacles up, looked at me again, and said: “You appear to possess an excellent memory, and to have learned by heart the pages of your

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memorandum book.” With this shrewd but enigmatic remark, he ran away again, leaving me this time absolutely nonplussed. I looked at the preparation under the microscope as he had left it. Surely there was all I had described. What to do now? After some deliberation I decided to do nothing, and simply to wait for the development of events. After another hour he came up again with the same question he had twice before addressed to me. I replied that I could only repeat what I had said before, “What do you think it is?” “A melanotic sarcoma, sir.” “You may go home.” And thus ended the first day of my examination in pathological anatomy, leaving me absolutely uncertain whether I had passed this part satisfactorily or whether I had been ploughed in it. After some very tempestuous occurrences on the second day I ultimately found that I had passed, and very satisfactorily, too, but I cannot honestly say that these two days were amongst the happiest of my life. Although experiences of that kind were for nearly half a century the rule, not the exception, amongst the candidates who presented themselves for examination at Berlin, Virchow, particularly during the last twenty years of his life, when the historical halo had begun to form which so happily surrounded his last phase of life, was very popular amongst his students. They had sense enough to see in him one of the greatest personalities of our times, they were happy and proud to be his pupils, and they came to look upon the examination as an unpleasant but unavoidable elementary necessity. The Festkommerse in his honour on the occasion of his 70th and 80th birthdays eloquently testified to his popularity amongst the youngest generations of students; whilst his older pupils came to be devoted to him with truly filial love. Nothing, for instance could be more touching than to hear the late Dr. Wilson Fox speak of Virchow. He looked up to him, fine man though he was himself, as to a superior being. Virchow himself was very fond and, as he well might be, very proud of his former assistants. To very few men it is given, as it was to him, to educate such a “school” of brilliant men, as he did; and whenever he spoke of them, it was with paternal pride and affection. And how could it be otherwise when such men as Cohnheim, von Recklinghausen, Waldeyer, Ponfick, and Grawitz – to mention but a few – were amongst them. Altogether, to see my dear old master in his most gentle and most genial mood, one had to see him in the circle of his family and friends. At great public gatherings, such as the International Medical Congresses, of which he was a regular visitor and at which he naturally formed the centre of attraction, he was amiable and kind enough, although occasionally, when people who had no earthly claim upon his time and attention bothered him overmuch, he disposed of them in very curt and peremptory fashion. In the course of political or medical discussions, when his ire had been roused, he was a truly formidable opponent, demolishing his antagonists whilst hardly ever raising his voice, by the force of inexorable logic, accurate information, and icy irony; whilst at other occasions, when he disdained to descend into the arena, the mere half amused, half sar-

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castic expression of his face was enough to confound his adversaries. But the most charming side of his character – his love for his family, his indulgence for his friends, his chivalrous kindliness towards women, were only revealed to a favourite few. His family simply adored him – his wife, his faithful companion for more than fifty years, had no other thought beside him, and those whom he honoured by his friendship vied with one another in making his path as smooth as they could. Of England he was ever a staunch friend. Various circumstances concurred to confirm this predilection. In the first place the liberal institutions of this country appealed to his own political instincts. He was reared at a time when the whole Continent of Europe suffered from that reaction which followed the Napoleonic wars, and when England alone was the bulwark of political freedom. He, himself the protagonist of the claims of the educated middle classes towards a very different position and appreciation in the body politic from what was accorded to them by the bureaucratic and feudal régime dominant in Prussia before 1848; himself a martyr to the convictions he fearlessly expressed after having witnessed the Silesian typhus epidemic of 1846, saw his own ideas of civil liberty realized in England, and admired it for this reason. Secondly, familiar as he was with medical literature of all countries and all times, he found much in the writings of various British medical worthies that was congenial to his own mode of thought. Thus I well remember how he always held up to his students John Goodsir as a model of keen and accurate observation; thus many of the readers of this will remember the eloquent tribute he paid in his Croonian lecture to the achievements of Glisson. Thirdly, he had many devoted English friends, whose feeling of personal attachment he warmly reciprocated. I have already mentioned Wilson Fox; I may further mention Professor Huxley, Sir James Paget, Lord Lister, Dr. Pye-Smith. He also had the highest opinion of poor Kanthack, whom we have lost much too early, and of Mr. Shattock, whose preparations at St. Thomas’s Hospital Museum he was in the habit of praising very enthusiastically. With Sir James Paget and his family an almost life-long friendship united him, and it was extremely touching when Sir James, who had long retired from all participation in social functions, drove up, shortly before his death to call on Virchow, and when the latter descended into the street to exchange a few kindly words with his old friend. Equally touching it was when, on the occasion of the small dinner given by Virchow on the occasion of his 80th birthday to his family and a few intimate friends, he did such eloquent homage to the greatness of Lord Lister’s work that the latter could hardly restrain his emotion. Nothing could have been more elevating, more stirring, than this tribute of genuine admiration paid by one great man to another. Finally, as explaining his particular liking of England, I can testify to the gratitude which Virchow felt, and more than once freely expressed to me, for the warmth of the receptions he always met with when visiting our shores. It will be in the recollection of many

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readers of this, that his two last visits to this country, namely, when he delivered the Croonian and the Huxley lectures, were a real sort of triumphal progress. He cherished the memory of the goodwill and enthusiasm then bestowed upon him amongst his most valued recollections. His recreations were few. He never indulged in any form of sport, and he worked hard even during his so-called holidays. Altogether the feeling of duty was uppermost in him; and even when he had attained the zenith of fame, he considered no form of work connected with his duties beneath him. A most characteristic fact in this connexion is that for more than fifty years he personally, and most attentively too, read the proofs of every single article published in his Archiv für pathologische Anatomie. How many editors, I wonder, can say thus much for themselves? I have incidentally mentioned his habitual unpunctuality. At the time when I was a student at Berlin this used to be made a subject of great complaint, particularly with regard to his professorial duties, and it cannot be denied that it was very aggravating, when the lecture to which one looked forward most eagerly in one’s day’s work was often unduly curtailed through the lecturer’s late appearance, or even omitted altogether. But how could it be otherwise with that unique man’s unique activity? His day was not an ordinary man’s day; he compressed into it the work of several industrious men! Let me sketch one such day. He would conduct an examination from 8 to 10, would superintend a microscopic class from 10 to 12, would lecture from 12 to 1, would be in the Reichstag from 2 to 5, in the Town Council from 5 to 6, in some committee meeting of the Prussian Parliament from 6 to 7, and preside at the meeting of the Berlin Medical Society or at the Anthropological Society, or deliver some popular address, or again do committee work from 7 to 9. Well may I be asked, But where did his meals come in? Where did all his enormous original and editorial literary work, his correspondence, his family life come in? Well, that is the wonder of all who had the privilege of coming near him. One of the explanations of his superhuman activity is that he required infinitely less sleep than most mortals. When I was a student at Berlin there was a sort of legend that he never slept more than five hours. When later on I had the great good fortune of being admitted into his family circle, I asked, whether there was any truth in that legend, and to my surprise learned that often it fell far behind the truth, and that more than once he had, when under – what was for him – exceptional pressure of work, not gone to bed at all, but worked through the whole night! Honour to a man who thus sacrifices himself for the public weal, and every allowance for his unavoidable unpunctuality! Strait-laced people may object that a man ought not to undertake more work than he could punctually fulfil, but whilst this in the case of ordinary mortals is true enough, the reply in Virchow’s case is that the world in many respects would have been much poorer had this wonderful man limited himself to the ordinary professor’s work and not shed the lustre of his personality, of his lofty mind, of his inexorable logic upon politics,

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municipal work, anthropology, ethnology, and a hundred other branches of human thought. If a few details of his routine work necessarily suffered from physical inability to be in several places at once, the whole human race benefited from the application of this master mind to so many different human interests. In the description which I gave last year in these columns of the celebration of his eightieth birthday particular attention was drawn to the fact that nothing had been more impressive in the homage done by representatives of all civilized nations to this “grand old man of science” than the universality of interests in which they agreed that humanity had been benefited by him. He was so fresh, so indefatigable on that occasion, that we all confidently hoped he would be spared to us for many years to come in all the wonderful freshness of his mind, in the no less wonderful elasticity of his body. The ease with which this octogenarian undertook, during what he was pleased to call his “holiday,” scientific journeys, which took him from Berlin to London and Edinburgh, from Edinburgh to Transsylvania, from Transsylvania to Breslau, from Breslau to Switzerland, was no less astounding than the fact that on the occasion of his 80th birthday he delivered, without any notes whatever, an address lasting nearly two hours, brimful of historical dates, in which he gave his views of the development of medicine and of his relationship to the last phases of this development. And now, so soon afterwards, he has been taken from us. We shall not see him any more in the flesh, as “Spy” has luckily preserved him for us in one of Vanity Fair’s most brilliant and characteristic cartoons: the little, slightly bent, lithe man with the parchment-like, somewhat yellowish, much wrinkled face and the slightly grizzled hair, which remained practically unchanged during the thirty years I have known him; with the small, piercing eyes covered by spectacles, which he always pushed up when reading or when about to make one of his caustic remarks; with his dry, sarcastic, somewhat monotonous voice; with his rapid gait, with his quiet, unostentatious demeanour – in every respect the best type of a German professor. To the world he was a genius and a model; to his science one of the greatest pathfinders; to his country a patriot who fearlessly did what he conceived to be his duty; to his family, his friends, and his pupils the kindest, most considerate, most beloved counsellor and friend. With the deepest sorrow we see him depart, but our consolation is that his work remains behind him, and that his fame, great as it is amongst his contemporaries, will increase as time goes on to legendary greatness, his name being ranked, as it deserves to be, with the greatest encyclopaedic minds the human race has produced. Requiescat in pace, magna anima!

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Figure A.1 (above) Virchow’s funeral cortege. Figure A.2 (below left) Virchow’s grave (photographed 2006 by Dr Peterson). Figure A.3 (below right) Grave plaque (photographed 2006 by Dr Peterson).

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Figure A.4 Virchow memorial at the Charité Hospital in Berlin (photographed 2006 by Dr Peterson).

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Appendix 1d Obituary Professor Rudolph Ludwig Karl Virchow The Lancet ii, September 13th: 762–765 (1902) GERMANY, and with her the entire scientific world, mourns the loss of Professor Rudolph Virchow who passed away on Friday last (Sept. 5th, 1902) in the eighty-first year of his age. As a man of science he was world-famous, and justly so, even if his reputation depended on his “Cellular Pathology” alone, for by this epoch-making work, indebted though he was, in part at least, to the researches of previous observers, such as Schwann and his former teacher, Müller, he rescued the science of treatment from the stigma of empiricism and established it firmly upon the basis of a scientific appreciation of ultimate causes. As a democratic politician he represented to his countrymen the very spirit of progress and social reform, and as such his name will remain a cherished memory. So strenuous was his advocacy of his principles and so uncompromising was his language in the opposition to what he considered retrograde measures as to provoke a challenge from Count von Bismarck on the occasion of the defeat of the Government on a navy vote – a challenge which he happily possessed the courage to decline. Although over 80 years of age Professor Virchow was in the habit of jumping on and off the tram-cars whilst they were in motion and on the occasion of the accident, which occurred to him on Jan. 5th, he slipped on getting down and fell heavily in the road. He lost consciousness for a certain time but on recovering was enabled to give his name and address to a policeman by whom he was removed to his house. Professor Körte of the Urban Hospital was called in and found that Professor Virchow had fractured the neck of his femur.There was a great amount of shock present and for the first few days after the accident a fatal issue was expected, but Professor Virchow’s constitution proved to be so excellent that he was soon in a fair way to recovery. Although advised to abstain from all mental work he was not a very tractable patient, and it is reported that he took so much interest in his own case that he declared that no osseous union would take place and that skiagrams which were taken proved the correctness of his opinion.After a time, however, he was able to get about on crutches and early in May he was removed to Teplitz with a view to try the effects of the hot springs which exist here. He improved so rapidly that after a few weeks’ stay he was able to go to Hartzburg. A very inclement summer, however, prevented him from taking due advantage of the mountain air. He was nearly always compelled to keep his

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rooms and by-and-by symptoms of bodily and mental debility supervened. He became more and more apathetic, slept for the greater part of the day, and was unable to leave his chair. About three weeks ago his friends decided to take him home and although the journey from Hartzburg to Berlin takes only four hours it had a very bad effect upon him. He became unconscious and never really recovered from the coma, but expired on the afternoon of the Sept. 5th. The news was received with the deepest sorrow by every class of the population of Berlin, and the Municipal Council, to which Professor Virchow had belonged since he went to live in Berlin, held an extraordinary meeting and decided that the funeral should be of a public character. Rudolph Ludwig Karl Virchow was born on Oct. 13th, 1821, at the small town of Schivelbein, near Stettin, in Farther Pomerania. Of his early years there is but scant record; he appears to have received his education in the gymnasium at Cöslin, where he distinguished himself by his linguistic abilities. In addition to his knowledge of Latin, Greek, English, and French he was a good Hebrew scholar and selected that language as an optional subject for his Abiturienten examination at the age of 18 years. He entered at the Friedrich-Wilhelm Institut, a training college for army surgeons now known as the Kaiser Wilhelm Academie, in 1839, where during the next five years he studied under, amongst others, Müller, Dieffenbach, and Caspar. In 1843 he proceeded to the degree of Unterarzt (Berlin University), presenting for his inaugural dissertation a thesis entitled, De Rheumate Praesertim Corneae.Although the students of the Friedrich-Wilhelm Institut received their education on the condition of serving in the army,Virchow, during his career there, showed so much skill and intelligence that by order of the General Staff Surgeon he was released from active service and was given the place of assistant at the Charité Hospital. Selecting the scientific rather than the practical side of his profession he obtained the following year the post of prosector of anatomy to the Charité Hospital, acting as assistant to Robert Froriep whom he eventually succeeded in 1846. Early in 1847 he became external lecturer in pathology at the University of Berlin, and shortly afterwards founded the well-known Archiv für pathologische Anatomie und Physiologie, und für klinische Medicin in collaboration with Benno Reinhardt. From the time of his colleague’s death in 1852 onward he continued to edit the journal alone and enjoyed the satisfaction of celebrating its jubilee, together with that of himself as a teacher, at a banquet held in the Kaiserhof in December, 1897. In 1848, an incident occurred which would have proved the undoing of a weaker man. Selected to accompany the medical officer entrusted with the investigation of a severe epidemic of relapsing fever (‘hunger-typhus’) in Silesia, the actual investigation and the preparation of the report thereon devolved upon Virchow, and these duties were carried out in the masterly style characteristic of the man. In his Mittheilungen über die in Oberschlesien herrschende Typhusepidemie he denounced the evils from which the disease resulted, demanded extensive reforms, and concluded by stating that nothing short of the extension

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of the benefits of civilisation to one and a half million living souls would successfully cope with the epidemic. Such reflections upon the ineptitude of the then administration, coupled with the fact that Virchow on his return had allied himself with the ultra-Radical party and had founded in association with Leubuscher a medico-political journal, Die Medicinischen Reformen (a paper that ceased to exist when Virchow was appointed to Würzburg), were amply sufficient to ensure his dismissal from all his professional posts in Berlin. His fame as a pathologist had, however, already spread beyond the confines of the capital and the University of Würzburg at once seized the opportunity and offered Virchow the professorship of pathology and the directorship of the newly-founded Pathological Institute.These posts were accepted and for the next seven years Virchow devoted himself almost completely to research work, contributing many valuable memoirs to the pages of his Archives and founding a school of workers and thinkers the results of whose observations cannot be too fully appreciated. In 1855 he commenced the publication of his best-known work, Die Cellularpathologie in ihrer Begründung auf Physiologische und Pathologische Gewebelehre, propounding therein, as the basis of his theories, the now familiar dictum, “Omnis cellula e cellula.” On the death of Professor Hemsbach the Faculty of the University of Berlin petitioned the Minister of Public Instruction to offer a chair of pathology to Virchow, and in spite of strong and bitter political opposition the appeal was successful and Virchow returned to Berlin. He accepted his appointment on the condition that a pathological institute should be founded, and the Government agreed to his wishes. Soon after his return to Berlin the first complete edition of his Die Cellular Pathologie appeared in 1858. His great work on new growths, unfortunately never completed, also dates from this period. Under his direction the pathological department, formerly the dissecting-room, of the Charité Hospital became a model for similar institutions. With indefatigable zeal he collected specimens of pathological conditions and arranged and classified them till he had got together a collection only to be equalled by the Hunterian Museum in London. One of his greatest satisfactions was when two years ago, on the occasion of the rebuilding of the Charité Hospital, he was able to open the Pathological Museum where his collection had finally found adequate room and was therefore made accessible to students and to the public. Besides this pathological museum he had made a large anthropological collection of his own, consisting mainly of crania of the different human races. Notwithstanding his manifold occupations he delivered his lectures regularly, and his assistants were only allowed to replace him for the practical work in microscopic anatomy and in making dissections. His lectures were attended not only by students but by medical men from every part of the world. He was not an orator in the usual sense of the word; his voice was weak and his speech was simple and without that power of carrying away an audience which is so common among French speakers, but when he was once upon the platform of the lecture-room everybody felt that the little man with

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the sharp grey eyes was one to be listened to with the utmost attention. After a few years spent in quiet work Virchow again entered public life as a member of the Berlin Municipal Council, with which body he was connected as an active member for a period of over 40 years. In this capacity his powers of organisation and his conception of the duties of the State with regard to the well-being of the people are evidenced by the establishment of the hospitals of Moabit and Friedrichshain and the lunatic asylums of Dalldorf and Lichtenberg. His greatest work, however, in practical hygiene was concerned with the introduction of drainage and in the erection of sewage-farms, hygienic improvements which he was enabled to carry out despite the opposition and the want of judgment displayed by a great part of the population and even by the authorities. Some doubts were expressed whether the soil of Berlin and its neighbourhood were fitted for a system of sewerage and a sewage farm. Experience, however, has shown that Virchow’s genius was right in insisting upon it, as since the establishment of the system Berlin has become one of the healthiest towns on the continent, enteric fever scarcely ever prevailing. Virchow’s hygienic work is closely connected with his political career. He was, as we have already stated, early elected a member of the Municipal Council and this position enabled him to carry out in a practical manner what he had found by theoretical and statistical studies to be the best for the health of the town. In 1862 he took his seat in the Prussian Diet and by sheer ability was soon recognised as the leader of the Radical party. This position he resigned, however, in 1878 and in 1880 he became a deputy of the Imperial Reichsrath. As leader of the Opposition he did yeoman service for his country, though his frequent conflicts with the Government prevented any of those decorations which are occasionally bestowed even upon scientific men falling to his lot. In 1866 his untiring energy found another outlet in the organisation of the ambulance service for the army, both in that campaign and in the succeeding one of 1870–7l. Pathology and politics, however, were insufficient to fill the life of this remarkable man. He was President of the German Geographical Society and the Society of Anthropology and Ethnology (of which he was one of the founders), and of many others. Archaeology and Egyptology also claimed place in his multitudinous interests, and it may truly be said that in whatever branch of science he worked he became an acknowledged authority. Honours of all kinds were showered upon him. In 1874 he became a member of the Royal Academy of Science in Berlin. On the occasion of the centenary of the Institut de France Virchow was made a Commander of the Legion of Honour and in the following year he became a Foreign Associate of the French Academy of Sciences. In 1893 Virchow visited England and delivered the Croonian Lecture of the Royal Society, a full report of which will be found in The Lancet of March 18th, 1893, p. 571; it was delivered in English, the subject being, “The Position of Pathology among the Biological Sciences.” The discourse, which shortly showed the steps by which Virchow had felt himself able to give utterance to his famous dictum, Omnis cellula e cellula, was a masterly exposition of the

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progress of pathology from the time of Harvey. Some six months previously the Royal Society had honoured both itself and Virchow by awarding him the Copley medal, a distinction of which he himself said, “Its significance far exceeds the distinctions which the changing favour of political powers is accustomed to bestow.” It was awarded for his investigations in Pathology, Pathological Anatomy, and Prehistoric Archaeology. He visited London again in 1898 and gave the Huxley Lecture at the Charing Cross Medical School on the “Recent Advances in Science and their bearing on Medicine and Surgery,” a lecture that impressed his hearers with the fact that advancing years had not blunted either his keen enthusiasm or his comprehensive grasp of detail. The lecture was delivered on Oct. 3rd and on the 5th Virchow was entertained at dinner at the Hôtel Métropole by the members of the medical profession of Great Britain and Ireland. Lord Lister presided, but Sir John Simon, Sir James Paget, and Sir Thomas Grainger Stewart were unavoidably absent. Of these three Sir John Simon alone remains to us, the other two having passed away. It was upon this occasion that Sir Samuel Wilks, the President of the Royal College of Physicians of London, said that he remembered the time somewhere about 40 years before when he was beginning to study the subjects which Professor Virchow had so advantageously taken up. He and his contemporaries were groping their way in the dark when a light came upon them suddenly from afar – a light which illuminated everything and penetrated into the interior and gave them a new insight into physiology and pathology. Virchow came to generalise like another Newton and gave them the Principia of medical science. With advancing years every occasion was taken of expressing to the Altmeister the affection and appreciation of contemporaries and pupils alike. Thus in 1891 his seventieth birthday was celebrated and a gold medal was presented to him by his Emperor in recognition of the immense services which he had rendered to science; in 1893, the fiftieth anniversary of his doctorate, and again in 1897, the jubilees of his first teaching appointment and of the foundation of the Archiv were made the subjects of sincere and hearty rejoicings; whilst on the occasion of his eightieth birthday – only last year – delegates from practically all the civilised countries of the world assembled in Berlin to do him honour. In the space at our disposal it is utterly impossible to attempt anything like a list of Virchow’s contributions to scientific literature or of the various honours of which he was the recipient. Suffice it to say that his active work ceased only with his death – the world’s appreciation of his worth remains. We hope next week to refer to the influence of Virchow as a pathologist upon that science which he has made his own, but we may say here that by his researches into the nature and causes of death he has let into the secret chambers of life a certain amount of light. It is to the patient work of men like Virchow and Pasteur among the dead, and of Lister, Ehrlich, and Van t’Hof among the living, that we may apply the words of Crookes: “In old Egyptian days a well-known inscription was carved over the portal of the temple of Isis: ‘I am whatever hath

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been, is, or ever will be; and my veil no man hath yet lifted’. Not thus do modern seekers after truth confront nature – the word that stands for the baffling mysteries of the universe. Steadily, unflinchingly, we strive to pierce the inmost heart of nature, from what she is to reconstruct what she has been and to prophesy what she yet shall be. Veil after veil we have, lifted and her face grows more beautiful, august, and wonderful with every barrier that is withdrawn.” On Tuesday, Sept. 9th, the body of Virchow was laid to rest in the cemetery of St. Matthew. The first portion of the burial service was said in the Rathhaus where the remains had lain overnight.The hall was draped in mourning and over the platform for the speakers hung a crucifix.The Prussian Ministers of Education and of Finance were present, together with Professor Mommsen, Professor Harnack, and Professor von Bergmann. Professor Waldeyer and others delivered orations and the procession, which was over a mile long, then started on its journey to the cemetery.

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Appendix 1e Obituary Rudolf Virchow The British Medical Journal, ii, September 13th: 803 (1902) RUDOLF VIRCHOW is dead. The hero who for the past twenty years has held undisputed pre-eminence in the realm of science is now translated to the Valhalla of his peers. His was the last great figure remaining to us of those who carried the torch of honest inquiry into the dark places of traditional dogma and mediaeval superstition. The universal reverence of mankind was his reward. This universality of recognition is the highest of all testimonies to the greatness of the man, for the ordinary layman is ignorant of the very meaning of the word pathology, one of the few branches of science which has not been made accessible to him by the facile effusions, so beloved in England, of the untrained amateur. It is hard indeed for a medical man, or even an expert pathologist of today, to realize to the full Virchow’s services to pathology. We owe to him not alone the direction which his study has taken during the last half century, but the very symbols in which its language is written. The first names which the student of the science of medicine has to learn were coined by Virchow to designate appearances which he either discovered or was the first to appreciate correctly. But this was only a small part of his work. He it was who recognized that the great laws of biology apply in disease as well as in health. Science is the knowledge of or the attempt to know the causes of things; it was Rudolf Virchow’s life-work to show that the causes of disease are, equally with the functions of the normal animal, accessible to rigid inquiry. What qualifications did this great man bring to his work? What qualities enabled him, alone and unaided, save by the pupils whom he had trained to carry the banner of pathology from the slough of academical speculation, of “free-cell formation” and the study of “humours” to the firm ground of Science and the base of the mountain of Truth? First of all absolute honesty. The very truth was the primary and the ultimate object of his search. Unprejudiced by the authority of his predecessors or the doubts of his contemporaries, free in himself from all cramping preconceptions, he set out resolutely to observe and frankly to record the biological phenomena of disease.The industry and singlemindedness by which he obtained his results was crowned by the definiteness, even the audacity, with which he announced them. Virchow was, like so many of the truly great, a simple-minded man, and the unadorned clearness of his literary style reflects his

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character. Add to all these endowments a mind which was to the highest degree both capacious and flexible, and a truly indomitable will, and the sources of his admitted supremacy will be evident. The appearance in 1847 of the first number of Virchow’s Archiv marked a new era in pathology, and for fifty-five years their editor and inspiring power “kept the crown of the causeway” in this branch of science. As he grew older he naturally became rather more cautious in the acceptance of new theories, but on the whole his brain continued to be marvellously elastic, and never led him into any of those lamentable displays of prejudice which are unfortunately only too familiar. The freshness of his Huxley lecture three years ago was not the least of its striking qualities. But it would ill beseem us to devote even this brief appreciation solely to his achievements in pure science. Virchow was above all one who loved his fellowmen. His political views, which, as is well known, were ardently democratic, do not concern us except that we are bound to record that they were the direct outcome of his experience among the famine and disease-stricken weavers of Silesia. But it is not too much to say that modern Berlin is a splendid monument of his zeal in the service of humanity. For three-and-forty years he was the consistent advocate of sanitary reform in that city, of the Municipal Council of which he was by far the most conspicuous figure. Water supply, disposal of sewage, hospitals and asylums, all were remodelled at his instigation and under this watchful eye, and an unhealthy metropolis standing upon an open sewer has, thanks to his consistent energy, become one of the most salubrious among the great cities of the world. In 1892 Virchow’s Berlin was able calmly and proudly to defy the challenge of cholera knocking at her very gates. These were his greatest works; but had he not undertaken any of them he had left behind him sufficient contributions to anthropology, to natural history, and to a score of other branches of knowledge to ensure an imperishable renown. We in England will ever remember with gratitude his affection for our island, his admiration for many of our institutions, and his generous recognition of our scientific workers. As the countrymen of Harvey, of Darwin, and of Francis Balfour, we are proud to share in the universal mourning, and to lay a wreath upon the bier of our departed master.

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Appendix 1f Virchow as Pathologist The Lancet, ii, September 20th: 819–20 (1902) In estimating the influence of VIRCHOW’S work on the evolution of contemporary pathology and in appraising the practical value of his labours in the interpretation of disease it would be unjust to his genius to enumerate merely the roll of his positive achievements. His victories lay rather in his fearless exposure of the many false premises and conceptions which obscured and paralysed the progress of medical knowledge, in redeeming from all suggestion of mysticism our understanding of the essential processes of disease, and in establishing for all time on the firm basis of truth the principles which should guide us in every biological inquiry. In organic evolution it is ever interesting to hazard a speculation as to what might have been the ultimate term of any particular series had any one of the factors in the chain of events which produced such a series been different in kind or in degree. What, for instance, would have eventuated in the evolution of the animal series had there been no glacial period? Or what would have been the ultimate effect on the development of man had some great upheaval of nature destroyed our first vertebrate ancestor without giving him an opportunity of stamping his individuality upon succeeding generations? And in like manner the speculation is not without interest to consider what would have been the trend of evolution in pathology had not VIRCHOW arisen with almost superhuman omniscience to knit together the tangled threads of divergent opinion into a homogeneous fabric of rational medicine? Would progress have advanced along the discordant lines of humoral pathology? Would the embittered strife of opposing schools still sap the energy of giants and direct the stream of genius into profitless and barren channels? Should we still be seeking for the essence of disease in the Archaeus of PARACELSUS? And would the grosser problems of pathology still remain unsolved, tarrying for the unfolding of the secrets of life? However, without indulging further in vain speculations as to the possible fate of presentday pathology had not the genius of VIRCHOW indicated the path which leads to the haven of truth, we will proceed at once to a consideration of the positive results of his investigations and arguments and of his influence in the determination of the universal theory of disease which today is accepted in every quarter of the civilised world. Concisely stated, this theory is that all disease presupposes life and that life is the property of the cell. The activities of the cell are the expression of this life, and they are evoked by stimuli of various kinds which reach the cell from without. The activities of cells individually or collectively are called physiological or

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normal as long as the general equilibrium of the organism is not disturbed. They become pathological when they overstep this limit. The conception of the identity in kind of these two vital processes – physiology and pathology – we owe largely to VIRCHOW. His discovery that all animal tissues which gave physiological or pathological evidences of life were composed of individual cells which responded to stimulation made it possible to apply this universal law of disease to every organ or structure in the body. He proved with the inadequate means at his disposal that bones and cartilage and connective tissue were anatomically constructed on the same cellular plan which applied in the case of muscles or secretory glands. He further showed that under the influence of appropriate stimuli each individual cell was capable of dividing and becoming two, and thus he not only explained growth, regeneration of tissue, and tumour formation, but, to use his own words, he was in a position to give utterance to the dictum, Omnis cellula e cellulâ, and to close the great gap which HARVEY’S Ovistic theory had left in the history of animal organisation. The far-reaching applications of this great truth were probably hardly realised by VIRCHOW at the time when he formulated his immortal aphorism, and it is possibly no hyperbole of speech to say that even today its significance to a considerable number of minds is little more than a denial of the possibility of spontaneous generation. The conception of disease as a process and not as an entity is founded on a recognition of the law that cells respond to stimuli by the manifestation and transformation of energy, and there is no branch of medicine or pathology which has not been profoundly affected by the application of this general principle. We can recognise in the protean symptoms of syphilis the consequences of cell excitation due to the circulation of some intangible poison which we cannot isolate and which we have never seen, but which by the particular application of VIRCHOW’S teaching we know must exist. We can recognise in tuberculosis the effects of constitutional poisoning and the formation of granulations and cells of distinct morphological structure due to the presence of living and organised stimuli which indirectly he has enabled us to isolate, recognise, and define. The insistence on the part of VIRCHOW that specific stimuli produced specific results, that the characters of the pathological lesions are dependent on the specificity of the stimuli – that is to say, on the qualitative rather than on the quantitative properties of the irritant – brought him into direct antagonism with HUEPPE and his school and exposed him to the satirical eloquence of that philosopher and bacteriologist. The study of the life-history of bacteria as occasional causative agents in the production of disease is a comparatively new, albeit a highly fruitful, line of research which in the light of VIRCHOW’S cellular pathology has been opened up and placed upon a rational basis. It is perhaps not too much to say that the development of our knowledge with regard to immunity to the formation of toxins and antitoxins is founded on principles which have been directly evolved from the fundamental conception that the cells in the animal body react mechanically and chemically to for-

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eign stimuli. On no other physiological basis could their significance be intelligible or the part which they play in the determination of disease be logically explained. In 1858, when VIRCHOW published his “Cellular Pathology,” the work, for which his memory will be for ever immortal, was in a sense complete, and it is a curious coincidence that another work, which won its author everlasting fame and was also in itself almost a complete system of biology – namely, DARWIN’S “Origin of Species” – was likewise published about the same time. VIRCHOW, like DARWIN, sprang into fame with startling suddenness; both of them commenced their illustrious careers by propounding a unitary theory of life which revolutionised their respective departments of biology, and both of them spent the rest of their lives in substantiating details which, though of individual value and interest, were almost entirely of secondary and subsidiary importance in comparison to the limitless possibilities of the great arguments which were outlined and unfolded in these monumental volumes. The record of VIRCHOW’S published writings has probably never been equalled by any other scientific investigator. The mere titles of his contributions to pathology, quite apart from other subjects, fill more than 20 pages of SCHWALBE’S closely written bibliography, a volume which was published to commemorate the veteran pathologist’s eightieth birthday and which was a complete record of all his published works. Among the more important results of these prolific labours must be included his early investigations into the conditions of vascular inflammation and the refutation of the then accepted theory of phlebitis, while our knowledge of embolism owes its origin and a large measure of its further development to his histological and experimental researches. In this connexion it is interesting to note that PAGET, to whom VIRCHOW undoubtedly owed certain inspirations for his “Cellular Pathology,” should have noticed the same morbid changes in various forms of embolism which VIRCHOW subsequently described and to which he attached a true pathological significance. He further indicated the difference between leukaemia and pyaemia and paved the way for the brilliant results which have more recently been achieved in the differential diagnosis of kindred conditions by the finer methods of haematology. We further enjoy the fruits of his labours in a better understanding of the puerperal condition, of animal pigments, of lardaceous disease, of trichiniasis, of syphilis, of leprosy, of cholera, of diphtheria, and of tuberculosis; in fact, there is no branch of pathology which has not benefited by his labours and by his research, and for the most part that favour series of volumes, VIRCHOW’S “Archive,” keeps the record. Like other great men, VIRCHOW made his mistakes, but as often as not it was his own hand that led to his own undoing. His view that the cells of connective tissue were able to take part in the pathological new growth of epithelial cells was based on erroneous observations and his explanation of the deformities and symptoms in cases of cretinism is founded on a pathology which is peculiarly narrow, while his opinion that the pathology of chlorosis could be explained on anatomical

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defects in the circulatory system and blood-forming organs is clearly at variance with ascertained facts. RUDOLF VIRCHOW is destined for ever to be remembered as the father of rational pathology and the first initiator of a philosophic system of medicine. Although his conception of disease has in no way elucidated the secrets of life or of protoplastic activities it has nailed the interpretation of the grosser phenomena of disease to the mast of cellular physiology.

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Appendix 2a Bibliographies of Virchow’s writings Andree C. (ed.) (1991) On Greece and Troy, Old and Young Scholars, Wives and Children. Letters of Rudolf Virchow and Heinrich Schliemann 1877–1885 / Über Griechenland und Troja, alte und junge Gelehrte, Ehefrauen und Kinder: Briefe von Rudolf Virchow und Heinrich Schliemann aus den Jahren 1877–1885 / With an Introduction by the editor. / herausgegeben und eingeleitet von Christian Andree. Böhlau, Cologne. (In German). Andree C. (ed.) (1992) Virchow R. Complete Works / Virchow R. Sämtliche Werke.: Peter Lang. 4. Abteilung I. Medizin. – Bern. (In German). Groeben C. and Wenig K. (eds) (1992) Anton Dohrn and Rudolf Virchow, Correspondence 1864–1902 / Anton Dohrn und Rudolf Virchow: Briefwechsel: 1864–1902. With a historical-scientific Introduction by the editors / mit einer wissenschaftshistorischen Einleitung von Christiane Groeben und Klaus Wenig. Akademie Verlag, Berlin. (In German). Hermann J. and Maass E. (1990) (eds), in collaboration with Andree C. and Hallof L. (1990) Correspondence between Heinrich Schliemann and Rudolf Virchow 1876–1890 / Korrespondenz zwischen Heinrich Schliemann und Rudolf Virchow: 1876–1890 / bearbeitet und herausgegeben von Joachim Herrmann und Evelin Maass; in Zusammenarbeit mit Christian Andree und Luise Hallof. Akademie-Verlag, Berlin. (In German). Jahns, C-M. (ed.) (1983). Rudolf Virchow, 1821–1902: Select Bibiography / Auswahlbibliographie. Humboldt Universität zu Berlin, Berlin. (In German). Morton L.T. (1993) Rudolf Ludwig Carl Virchow (1821–1902): Bibliography. J Med Biogr. 1: 46–7. Rabl M. (ed.) (1907) Virchow’s Letters to his Parents 1839–1864 / Rudolf Virchow Briefe an Seine Eltern, 1839 bis 1864. Wilhelm Engelmann, Leipzig. Translated by L.J. Rather and published in 1990; Science History Publications, Canton, MA. Rather L.J. (1990) A Commentary on the Medical Writings of Rudolph Virchow. Norman Publishing, San Francisco. Schwalbe J. (ed.) (1901) Virchow Bibliography / Virchow Bibliographie 1843–1901. Reimer, Berlin. (In German). Wenig K. (ed.) (1995) Rudolf Virchow and Emil du Bois-Reymond: Letters 1864–1894 / Rudolf Virchow und Emil du Bois-Reymond: Briefe, 1864–1894. Basilisken-Presse, Marburg/Lahn. (In German).

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Appendix 2b A bibliography of writings about Virchow This list includes items listed on the website of the Institute for Medical History, University of Würzburg, with additions, especially of English-language material, from various other sources. It also includes works which, although not primarily about Virchow, contain significant material referring to him. Translations of all non-English titles are supplied. A brief English language bibliography is to be found at the website “whonamedit.com”. The reference lists in Schipperges (1983),Andree (2002) and Goschler (2002), and the websiteorganised by Axel W. Bauer “http://www.uni-heidelberg.de/institute/fak5/igm/g47/bauerpa2.htm” provide additional bibliographies of writings about Virchow. However, no English translations of the German language titles are provided in any of these sources. In the following list, all items with a non-English title printed immediately after the English version of that title are written in that non-English language.

Ackerknecht E.H. (1953) Rudolf Virchow: Doctor, Statesman, Politician. Published in German by Enke, Stuttgart; in English by the University of Wisconsin Press, Madison, WI. Ackerknecht E.H. (1956/57) Virchow in Würzburg. Reports of the Physical-Medical Society of Würzburg / Virchow in Würzburg. Berichte der Physikalisch-Medizinischen Gesellschaft zu Würzburg. Neue Folge 68: 163–165. Altmann H.W. (1992) Virchow in Würzburg / Virchow in Würzburg. Verhandlungen der Deutschen Gesellschaft für Pathologie 76: XLV–LXVI. Andree C. (1988) Virchow and the Trias / Virchow und die Trias. Symposium Nürnberg. pp 10–11. Andree C. (2004) Rokitansky and Virchow: the giants of pathology in disputation. Wien med. Wochenschr. 154: 458–66. Anon. (1888) Otto von Bismarck and Rudolf Virchow / Otto von Bismarck und Rudolf Virchow. In: Kohut, Adolph: The book of famous duels / Das Buch berühmter Duelle. Repr. D. Originalausg. Berlin, 1888. pp. 127–134. Anon. (1891) Collected essays to mark Virchow’s 70th birthday were published in the Johns Hopkins University Circular No xi. Authors included Welch, Chew and Osler. Some essays were republished in the Boston Medical and Surgical Journal in the same year. Anon. (1893) Rudolf Virchow: impact on general pathology and pathological anatomy on the occasion of the 50th jubilee of his doctorate 1893. Rudolf Virchow: sein Wirken für allgemeine Pathologie und pathologische Anatomie; zu seinem 50 jährigen Doctorjubläum am 21. Oct. 1893 Enth.: Rindfleisch, E. von: Allgemeine Pathologie und pathologische Anatomie. Anon. (1901) Report on the celebration of Rudolf Virchow’s birthday on the 13th October 1901 / Bericht über die Feier von Rudolf Virchows 80. Geburtstag: am 13. Okt. 1901. Schumacher, Berlin. Anon. (1901) Honouring Rudolf Virchow on his 80th birthday / Ehrung Rudolf Virchows zu seinem 80. Geburtstage: am 13. Okt. 1901. Berlin.

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Appendix 2b: A bibliography of writings about Virchow Anon. (1902) Obituary: Rudolf Virchow, M.D. British Medical Journal 13. Sept. ii: 795–802. see Appendix 1e. Anon. (1902) “Ceremony in Memory of Rudolf Virchow / Gedächtniss-Feier f. Rudolf Virchow. Extraordinary sitting on the 13th October 1902. Verhandl. d. Berliner Ges. f. Anthropologie, Ethnologie und Urgeschichte. Verl. A. Asher, Berlin. Anon. (1903) Committee for the erection of a memorial for Rudolf Virchow: an invitation / Komitee zur Errichtung eines Denkmals für Rudolf Virchow: Aufruf. Berlin. Anon. (1921) Virchow for his 100th birthday: memorial supplement of the Vossichen Zeitung / Virchow zum 100. Geburtstag : Erinnerungsblatt der Vossischen Zeitung. Vossische Zeitung 482: 1. Anon. (1922) Virchow Rudolf: Professor of pathological anatomy. / Virchow Rudolf: Professor der pathologischen Anatomie 1821–1902. In “Biographies of Franconia” /. In: Lebensläufe aus Franken; 2. Kabitzsch und Mönnich, Würzburg. Anon. (1921) Berlin Medical Society, session on 26th October 1921, on the occasion of Rudolf Virchow’s Centenary / Berliner Medizinische Gesellschaft: Sitzung vom 26. Okt. 1921: z. 100. Geburtstag von Rudolf Virchow. Berlin. klin. Wochenschr. 58: 1364–1365. Anon. (1936) Rudolf Virchow. In: Pommeranian biographies / Rudolf Virchow. In: Pommersche Lebensbilder. Hrsg. von der Landesgeschichtlichen Forschungsstelle für Pommern. 2. Bd. Stettin, pp 198–236. Anon. (1956) 50 years: The Rudolf Virchow Hospital / 50 Jahre Rudolf-Vichow-Krankenhaus. Berlin. Anon. (1974) Virchow’s Egyptian journey 1888. Letters to his wife / Virchow R. Aegyptenreise 1888. Rudolf Virchows Briefe an seine Frau. Die Waage 13: 1–20. Anon. (1962) Troublesome doctor and politician. Rudolf Virchow, the great pathologist and hygienist died 60 years ago. Without source / Unbequemer Arzt und Politiker. Rudolf Virchow, der große Pathologe und Hygieniker, starb vor 60 Jahren. Ohne Quelle. (held by the Institute for Medical History, University of Würzburg). Anon. (1966) Rudolf Ludwig Karl Virchow (1821–1902) Omnis cellula e cellula. Minn. Med. 49: 359–60 contd. Anon. (2003) Billroth T. Pathology and therapeutics, in fifty lectures. 1871. Clin. Orthop. Rel. Res. 408: 4–11. Anon. (1986) Rudolf Virchow: precept and initiator for the DMW / Rudolf Virchow: Vorbild und Anreger für die DMW. In: Staehr, Christian, u.a.: “Looking for Traces” / Spurensuche. Thieme, Stuttgart pp 7–8. Anon. (1986) Sensitivity to Irritation (Rudolf Virchow and the paradigm shift) / Gereizte Empfindlichkeit (Rudolf Virchow und der Paradigmenwandel) in: Staehr, Christian: “Looking for Traces” / Spurensuche. Thieme, Stuttgart u.a. pp 30–33. Anon. (1986) DMW: For and against Virchow / DMW: Pro und contra Virchow. In: Staehr, Christian u.a. “Looking for Traces” / Spurensuche. Thieme, Stuttgart. pp. 13–15. Anon. (2002) Death day: medical man and politician in one person / Todestag: Mediziner und Politiker in einer Person. Ostpreußenblatt 7. Sept. Anon. (undated) Press reports on the death of Rudolf Virchow / Presseberichte zum Tode Rudolf Virchows. (Institute for Medical History, University of Würzburg). Anon. (undated) From the history of the Institute for pathology at the Charité and the history of the pathological museum, with pictorial material, e.g. cigar advertisement with Virchow’s picture / Aus der Geschichte des Instituts für Pathologie der Charité und des Pathologischen Museums. Incl. Bildmaterial, z.B. Zigarrenwerbung mit Konterfei Virchows. (Held by the Institute for Medical History, University of Würzburg). Anon. (undated) German Pathological Society on 13th October 1901; congratulations on his 80th birthday / Deutsche Pathologische Gesellschaft: Rudolf Virchow zum 13. Oktober 1901: Glückwunsch zum 80. Geburtstag. (Held by the Institute for Medical History, University of Würzburg). Aschoff L. (1921) Rudolf Virchow: a retrospect / Rudolf Virchow: ein Rückblick. Deut. Medizin. Wochensch. 47: 1185–1188.

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Appendix 2b: A bibliography of writings about Virchow Aschoff L. (1921) Virchow’s teaching of the degenerations (passive processes) and their further development / Virchows Lehre von den Degenerationen (passiven Vorgängen) und ihre Weiterentwicklung. Virchow’s Archiv 235: 152–185. Aschoff L. (1940) Rudolf Virchow. Science and Reputation throughout the World. Rudolf Virchow. Wissenschaft und Weltgeltung. Hoffmann und Campe Verl., Hamburg. Azar H.A. (1997) Rudolph Virchow: not just a pathologist. A re-examination of the report on the hunger-typhus in Upper Silesia. Ann. Diag. Pathol. 1: 65–71. Baccelli G. (1921) Rudolf Virchow, eighty years, anatomical principles celebrated throughout the world / Rudolpho Virchowio, octuagesimo anno nato, Anatomes Principi per Orbem celebratissimo. Berlin. klin. Wochenschr. 38: 1033–1034. In Italian. Bankl H. (2002) Revolution in the professorial chair / Revolutionär auf dem Lehrstuhl. Mainpost 31. 8. Bauer A. (1982) Virchow in Würzburg / Virchow in Würzburg. In: Bauer, Arnold: Rudolf Virchow. Stapp, Berlin, pp 41–51. Bauer A. (2000) “Politics are nothing more than medicine on a large scale”: Rudolf Virchow as pathologist, reformer and visionary / „Die Politik ist weiter nichts als Medicin im Grossen“: Rudolf Virchow als Pathologe, Reformer und Visionär. Immunologie Aktuell 1: 40–48. Becher W. (1891) “Rudolf Virchow: a biographical study” / Rudolf Virchow: eine biographische Studie. Karger, Berlin. Behr H. (1989) Then the fleas jumped at the Professor’s face / Da sprangen dem Professor die Flöhe ins Gesicht. Mainpost 2/3: 9. Beneke R. (1903) Rudolf Virchow: Memorial address / Rudolf Virchow: Gedächtnisrede. Naturwissenschaftliche Rundschau 18: 25–27; 35–39; 49–50. Beneke R. (1921) On Virchow’s importance for public health care and welfare / Von Virchows Bedeutung für die öffentliche Gesundheitspflege und Wohlfahrt. Deut. medizin. Wochenschr. 47: 1192–1195. Beneke R. (1940) Rudolf Virchow in the Robert Koch film / Rudolf Virchow im Robert-Koch-Film. Die Medizinische Welt 14: 584 ff. Beneke R. (1942) On ‘saving the honour’ of Rudolf Virchow and the German cell researchers: a notice about the work of Paul Diepgens and Erwin Rosner in Virchow’s Arch 307, 1941 / Zur „Ehrenrettung“ Rudolf Virchows und der deutschen Zellforscher: Anzeige der Arbeit Paul Diepgens u. Erwin Rosners in Virchows Archiv 307. 1941. Die medizin. Welt 16: 779 ff. Bignold, L.P., Coghlan B.L.D. and Jersmann H.P.A. (2007) David Paul Hansemann, Contributions to Oncology. Birkhäuser, Basel. Billroth T. (1924) Medical Sciences in the German Universities. (Translator not stated). Macmillan, New York. Boenheim F. (1957) Virchow: works and impact / Werk und Wirkung. Rütten & Loenig, Berlin. Braun G. (1926) Rudolf Virchow and the chair of pathological anatomy at the University of Zurich / Rudolf Virchow und der Lehrstuhl für pathologische Anatomie an der Universität Zürich. – 68 S. Züricher Medizingeschichtliche Abhandlungen 8. Breathnach C.S. (2002) Rudolf Virchow (1821–1902) and Die Cellularpathologie (1858). J. Ir. Coll. Physicians Surg. 31: 43–6. Brinkhous K.M. et al. (1968) Why Virchow became a physician. Arch. Pathol. 85: 331–334. Chiari H. (1902) Memorial address for Rudolf Virchow: Gedenkrede auf Rudolf Virchow. Prager medizin. Wochenschr. Jg. 27, Nr. 43. Cornil-Paris V. (1901) Memoirs of former times / Souvenirs d’autrefois. Berlin. klin. Wochenschr. 38: 1036. David, Heinz (1931) Rudolf Virchow and the Medicine of the Twentieth Century / Rudolf Virchow und die Medizin des 20. Jahrhunderts. Eds H. David, W. Selberg und H. Hamm, München: Quintessenz, 1993. Dettelbacher W. (1999) Transition from the barricades to the Professorial Chair / Von der Barrikade auf den Lehrstuhl gewechselt. Volksblatt 13. Jan.

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Appendix 2b: A bibliography of writings about Virchow Dhom G. (2001) “History of Histopathology” / Geschichte der Histopathologie. Chapters 7 and 8. Springer, Berlin. Dhom G. (2003) Traces of Rudolf Virchow’s contribution to medicine one hundred years on. Rudolf Virchows Spuren in der Medizin nach 100 Jahren. Pathologe 24: 1–8. Diepgen P. (1932) Virchow and Romanticism / Virchow und die Romantik. Deut. medizin. Wochenschr. 58: 1256–1258. Diepgen P. (1952) The Universality of Rudolf Virchow’s life work / Die Universalität von Rudolf Virchows Lebenswerk. Virchows Archiv 322: 221–232. Diepgen P. and Rosner E. (1941) On saving the honour of Rudolf Virchow and of the German cell researchers / Zur Ehrenrettung Rudolf Virchows und der deutschen Zellforscher. Virchows Archiv 307: 458–489. Dietrich A. (1921) The development of the theory of thrombosis and embolism since Virchow / Die Entwicklung der Lehre von der Thrombose und Embolie seit Virchow. Virchows Archiv 235: 212–224. Doerr W. (1978) Jean Cruveilhier, Carl v. Rokitansky, Rudolf Virchow. Virchows Archiv A 378: 1–16. Doerr W. (1958) Rudolf Virchow’s pathology and medicine of our time / Die Pathologie Rudolf Virchows und die Medizin unserer Zeit. Deut. medizin. Wochenschr. 83: 370–377. Doerr W., Altmann H.-W. and Götze H. (1971) On Rudolf Virchow’s 150th birthday / Zum 150. Geburtstag von Rudolf Virchow. Virchows Archiv Abt. B: Zellpathologie 8: I–VIII. Eckart W.U. (2002) I am limping badly and my courage has gone / Es hinkt sich schlecht und mein Mut ist klein geworden. Süddeutsche Zeitung Nr. 240. 17. October. Eppinger H. (1902) In memory of Rudolf Virchow: speech given at the session of the Styrian Doctors Society of 17th October 1902 / Erinnerung an Rudolf Virchow: Rede gehalten in der Sitzung des Vereins der Ärzte der Steiermark am 27. Oct. 1902. Mittheilungen des Vereins der Ärzte der Steiermark, Nr. 11. Ernst P. (1921) Virchow’s cellular pathology, in the past and in the present / Virchows Cellularpathologie einst und jetzt. Virchows Archiv 235: 52–151. Ewing J. (1921) Virchow’s influence on medical science in America / Der Einfluß Virchows auf die medizinische Wissenschaft in Amerika. Virchows Archiv 235: 444–452. Falk G. (1921) On the planned summons of Virchow to Giessen, 1849 / Über Virchows geplante Berufung nach Gießen 1849. Virchows Archiv 235: 31–44. Fischer B. (1922) What remains in Rudolf Virchow’s life work: on the hundredth anniversary of his birthday on the 13th October 1921 / Das Bleibende in Rudolf Virchows Lebenswerk: z. Jahrhundertfeier s. Geburtstages am 13. Okt. 1921. Frankfurter Zeitschrift für Pathologie 27: 1–20. Foa P. (1921) Virchow in Italy / Virchow in Italien. Virchows Archiv 235: 379–384. Froboese K. (1953) Rudolf Virchow, d. 5 9. 1902, a memorial and a word of warning to the present generation of doctors 50 years after his death / Rudolf Virchow d. 5. 9. 1902: e. Gedenk-und Mahnwort an die heutige Ärztegeneration 50 Jahre nach seinem Tod. Fischer, Stuttgart. Gortvay G. and Zoltan I. (1968) Semmelweiss, His Life and Work (chapter 6). Translated by Éva Róna, Akadémiai Kiadó, Budapest. Gruber G.B. (1939) Robert Koch and Rudolf Virchow / Robert Koch und Rudolf Virchow. Mitteilungen des Universitätsbundes Göttingen, vol. 20, Heft 1. Hauptmann S. and Schnalke, T. (2001) Rudolf Virchow’s view of malignant tumours / Rudolf Virchows Sicht der malignen Geschwülste. Pathologe 22: 291–295. Heidland A., Klassen, A., Rutkowski P. and Bahner U. (2006) The contribution of Rudolf Virchow to the concept of inflammation. J. Nephrol. 19 (Suppl 10): 102–109. Heim W. (1956) In the spirit of Virchow / Im Geiste Virchows. In: 50 Jahre Rudolf-Virchow-Krankenhaus 1906–1956. Berlin. pp 24–28. Heischkel E. (1947) Rudolf Virchow as publicist / Rudolf Virchow als Publizist. Medizinische Rundschau 1: 230–233. Hesse E. (1921) Rudolf Virchow and the public health / Rudolf Virchow und die öffentliche Gesundheitspflege. Virchows Archiv 325: 399–417. Hiltner G. (1970) Rudolf Virchow / Rudolf Virchow. Freies Geistesleben Verlag, Stuttgart.

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Appendix 2b: A bibliography of writings about Virchow Israel O. (1901) On Rudolf Virchow’s 80th birthday / Zu Rudolf Virchows 80. Geburtstage. Ärztliche Monatsschrift, Heft 10. Israel O. (1903) Rudolf Virchow. Annual Rpt of the Smithsonian Institute for the Year 1902. Government Printing Office, Washington D.C. Istel W. (2002) Revolutionary and ‘Medical Pope’: on the hundredth anniversary of his death / Revolutionär und Medizinpapst: zum 100.Todestag von Rudolf Virchow. Gesundheit im Beruf 3: 22–24. Ivanhoe F. (1970) Was Virchow right about Neandertal? Nature 227: 577–578. Jacob W. (1972) Rudolf Virchow’s contribution to a theory of medicine / Der Beitrag Rudolf Virchows zu einer Theorie der Medizin. Berichte der Physikalisch-Medizinischen Gesellschaft zu Würzburg. Neue Folge 80: 137–142. Jacob W. (1967) Virchow’s contribution to the “Handbook of Special Pathology and Therapy” / Virchows Beitrag zum Handbuch der speziellen Pathologie und Therapie. In: Jacob W. Medical Anthropology in the Nineteenth Century / Medizinische Anthropologie im 19. Jahrhundert. Enke, Stuttgart. pp 107–142. Jacoby A. (1901) Rudolf Virchow and American medicine / Rudolf Virchow und die amerikanische Medizin. Berlin. klin. Wochenschr. 38: 1046–1047. Jonecko A., Keil G. and Schmitt E. (1991) A little-known copy of the Berlin portrait of Rudolf Virchow / Eine wenig bekannte Kopie des Berliner Portraits von Rudolf Virchow. Medizinhistorisches Journal 26: 161–164. Jores L. (1921) The development of the theory of arteriosclerosis since Virchow / Die Entwicklung der Lehre von der Arteriosklerose seit Virchow. Virchows Archiv 235: 262–272. Kajita A. (1983) Rudolf Virchow and his successors / Rudolf Virchow und seine Nachfolger. Vortrag, gehalten bei der Herbsttagung der Deutschen Gesellschaft für Pathologie. Kaiserling C. (1921) Virchow’s importance for the theory of tumours / Virchows Bedeutung für die Lehre von den Geschwülsten. Deut. medizin. Wochenschr. 47: 1191–1192. Karamitzas G. (1901) Rudolf Virchow and Greek medicine / Rudolf Virchow und die griechische Medizin. Berlin. klin. Wochenschr. 38: 1046. Keil G. (2003) Rudolf Virchow. Würzburger medizinhistorische Mitteilungen 22: 524–525. Keil G. (1980) On the handing-on of the dissection records of Virchow when in Würzburg / Zur Überlieferung von Virchows Sektionsprotokollen. Sudhoff’s Archiv 64: 287–297. Klebs E. (1891) Rudolf Virchow: memorial pages for his 70th birthday, dedicated by an old pupil / Rudolf Virchow: Gedenkblätter zu seinem 70sten Geburtstage, gewidmet von einem alten Schüler. Deut. medicin. Wochenschr. 17: 1165–1168. Kleine H.O. (undated) Semmelweis and Virchow. A medical study, source unknown / Semmelweis und Virchow. Eine medizinhistorische Studie. Source unknown / Ohne Quelle (Held by the Institute of Medical History, University of Würzburg). Kölliker A. (1902) In memory of Rudolf Virchow / Zur Erinnerung an Rudolf Virchow. Anatomischer Anzeiger 22: 59–62. Kohl E. W. (1976) Virchow in Würzburg / Virchow in Würzburg. Wellm, Hannover. zugl.: Würzburg, Univ. Diss. (Held by the Institute of Medical History, University of Würzburg). Kraus Fr. (1921) R. Virchow and the present-day clinic / R. Virchow und die heutige Klinik. Virchows Archiv 235: 298–328. Krietsch P. (1991) The history of the prosector’s department of the Charité Berlin. 3. Rudolf Ludwig Carl Virchow, prosector of Charité, 1846 to 1849. Zentralbl. Pathol. 137: 531–41. Krietsch P. and Dietel M. (1996) Pathological-Anatomical Collection of the Virchow Museum in the Berlin Medical-Historical Museum at the Charité / Pathologisch-Anatomisches Cabinet. Vom Virchow-Museum zum Berliner Medizinhistorischen Museum in der Charité. Blackwell, Oxford, UK. Löhlein M. (1921) Rudolf Virchow and the development of aetiological research / Rudolf Virchow und die Entwicklung der ätiologischen Forschung. Virchows Archiv 235: 225–234. Lohse M. (2002) Rudolf Virchow: No duel with Otto von Bismarck (with a reader’s letter) / Rudolf Virchow: Kein Duell mit Otto von Bismarck (mit Leserbrief). Mainpost 18. January.

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Appendix 2b: A bibliography of writings about Virchow Lubarsch O. (1921) Biographical introduction / Biographische Einleitung. Virchows Archiv 235 (Gedenkband zum 100. Geburtstag Rud. Virchows): 1–30. Lubarsch O. (1921) Rudolf Virchow and his opus / Rudolf Virchow und sein Werk. Berlin. klin. Wochenschr. 58: 1345–1349. Lubarsch O. (1921) Virchow’s theory of inflammation and its subsequent development up to the present / Virchows Entzündungslehre und ihre Weiterentwicklung bis zur Gegenwart. Virchows Archiv 235: 186–211. Lubarsch O. (1921) Virchow’s theory of tumour and its subsequent development / Die Virchowsche Geschwülstlehre und ihre Weiterentwicklung. Virchows Archiv 235: 235–261. v. Luschan (no forenames given) (1921) Rudolf Virchow as anthropologist / Rudolf Virchow als Anthropologe. Virchows Archiv 325: 418–443. Mackenzie M. (1888) The illness of his Imperial Majesty, the Crown Prince / Die Krankheit Seiner Kaiserlichen Hoheit des deutschen Kronprinzen. Berlin. klin. Wochenschr. 25: 138. McManus J.F.A. (1958) Rudolf Virchow in 1858. Lab. Invest. 7: 549–553. McNeely I. F. (2002) “Medicine on a grand scale: Rudolf Virchow, liberalism, and the public health”. Wellcome Trust Centre for the History of Medicine at UCL, London. Malkin H.M. (1990) Rudolph Virchow and the durability of cellular pathology. Perspect. Biol. Med. 33: 431–443. Mamlock G. (1921) Virchow in the light of his contemporaries. Virchow im Lichte der Zeitgenossen. Deut. medizin. Wochenschr. 47: 1195. Mann G. (1991) Rudolf Virchow / Rudolf Virchow. In: Klassiker der Medizin II. Eds D. von Engelhardt and others. Beck, München, pp. 203–215. Marchand F. (1921) On the hundredth birthday of Rudolf Virchow / Zum hundertsten Geburtstag von Rudolf Virchow. Münchener medizin. Wochenschr. 68: 1271–1274. Marchand F (1902) Rudolf Virchow as pathologist: memorial address given on 21st October 1902 to the Medical Society in Leipzig / Rudolf Virchow als Pathologe: Gedächtnisrede gehalten am 21. Okt. 1902 in der Medizinischen Gesellschaft zu Leipzig. Lehmann, München. Merhof J. (2002) No day without (specimen) preparations: the Museum of the Charité remembers Rudolf Virchow. Kein Tag ohne Präparate. Museum der Charité erinnert an Rudolf Virchow. Berliner Morgenpost 29. Aug. Mettenleiter A. (1999) One hundred years ago, Rudolf Virchow came to Würzburg / Vor 150 Jahren kam Rudolf Virchow nach Würzburg. BLICK issue 2. Mettenleiter A. (2000) Rejection of Romantic Naturphilosophie: 150 years ago Virchow (1821–1902) came to Würzburg / Absage an romantische Naturphilosophie: vor 150 Jahren kam Virchow (1821–1902) nach Würzburg. Mainpost 11.February. Meyer E. (1956) Rudolf Virchow / Rudolf Virchow. Limes-Verl., Wiesbaden. Müller M. (1941) Rudolf Virchow as historian / Rudolf Virchow als Historiker. Sudhoff’s Archiv 34: 137–145. Orth J. (1893) Works in the Pathological Institute in Göttingen. Dedicated to Rudolf Virchow at the Golden Jubilee of his Doctorate. / Arbeiten aus dem pathologischen Institut in Göttingen. Herrn Rudolf Virchow zur Feier seines fünfzigjährigen Doctor-Jubiläums gewidmet. Verlag von August Hirschwald, Berlin. Orth J. (1902) Rudolf Virchow: memorial address given at the meeting of the Berlin Medical Society on the 29th October 1902 / Rudolf Virchow: Gedächtnisrede, gehalten in der Sitzung der Berliner Medicinischen Gesellschaft am 29. Oct. 1902. Berlin. klin. Wochenschr. 39: 1021–1027. Orth J. (1910) Virchow and bacteriology / Virchow und die Bakteriologie. Deut. medizin. Wochenschr. 36: 1937–1939. Orth J. (1921) R. Virchow half a century ago / R. Virchow vor einem halben Jahrhundert. Virchows Archiv 235: 31–44. Orth W. (1969) Rudolf Virchow, Practitioner and Politician / Rudolf Virchow, Arzt und Politiker. VVB Pharmazeutische Industrie, Inseldruck Rügen, Berlin.

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Appendix 2b: A bibliography of writings about Virchow Osler W. (1891) Virchow, the man and the student. Johns Hopkins Univ. Circ. xi, 17–19. See also: Boston M. & S. J., 1891, cxxv, 425–427. Otremba H. (2002) Thick skull and great anatomist. Dickschädel und großer Anatom. Volksblatt 2. September. Pagel W. (1931) Virchow and the foundations of nineteenth century medicine / Virchow und die Grundlagen der Medizin des XIX. Jahrhunderts. Jenaer medizin-historische Beiträge 14: 1–44. Panne K. (1967) “The Scientific Theory of Rudolf Virchow”. Die Wissenschaftstheorie von Rudolf Virchow. Unpublished doctoral dissertation, University of Düsseldorf. Pearse J.M.S. (2002) Rudolf Ludwig Karl Virchow (1821–1902). J. Neurol. 249: 492–493. Pye-Smith P.H. (1901) The Influence of Virchow on Pathology in England. Berlin. klin. Wochenschr. 38: 1036–1038. Rath G. (1957) The struggle between Cellular Pathology and Neural Pathology in the nineteenth century / Der Kampf zwischen Zellularpathologie und Neuralpathologie im neunzehnten Jahrhundert. Deut. medizin. Wochenschr. 82: 740–743. Rather L.J. (1962) Harvey, Virchow, Bernard, and the Methodology of Science. Introduction to “Disease, Life and Man: Translations of selected articles by R. Virchow”, Collier edition, New York, pp 13–38. Rather L.J. (1966) Rudolf Virchow’s views on pathology, pathological anatomy, and cellular pathology. Archives of Pathology 82: 197–204. Rather L.J. (1968) Virchow’s review of Rokitansky’s “Handbuch” in the Preussische MedizinalZeitung. Clio Medica 4: 127–140. Rather L.J. (1971) The place of Virchow’s “Cellular Pathology” in Medical Thought. (Introduction to Dover edition of Virchow’s “Cellular Pathology” – see Virchow, 1858) pp v–xxvii. Rather L.J. (1985) Collected essays on public health and epidemiology, translated, edited and with a foreword by L.J. Rather / Rudolf Virchow; Gesammelte Abhandlungen aus dem Gebiete der öffentlichen Medicin und der Seuchenlehre. Science History Publications, U.S.A, Canton, MA. Rathgeb E. (2002) Cell, shard and method (on the hundredth anniversary of the death of Rudolf Virchow) / Zelle, Scherbe und Methode (zum 100. Todestag von Rudolf Virchow). Frankfurter Allgemeine Zeitung Nr. 206. 5. September. Recklinghausen F. von (1903) Obituary for Rudolf Virchow / Nachruf auf Rudolf Virchow. Virchows Archiv 171: 2–7. Rieger C. (1901) On Virchow’s Jubilees: 1881, 1891, 1901 (manuscript) / Über Rudolf Virchows Jubiläen: 1881, 1891, 1901. (Handschrift). (Held by the Institute of Medical History, University of Würzburg). Ringert R. (1972) Virchow, doctor in social and scientific responsibility / Virchow, Arzt in sozialer und wissenschaftlicher Verantwortung. Berichte der Physikalisch-Medizinischen Gesellschaft zu Würzburg. Neue Folge 80: 121–136. Rössle R. (1934) Karl von Rokitansky and Rudolf Virchow / Karl von Rokitansky und Rudolf Virchow. Wiener medizin. Wochenschr. 47: 405–407. Rössle R. (1921) Rudolf Virchow and the pathology of the constitution / Rudolf Virchow und die Konstitutionspathologie. Münchener medizin. Wochenschr. 68: 1274–1277. Rössle R (1952) Rudolf Virchow’s lecture on general pathological anatomy and general pathology in the year 1852 / Rudolf Virchows Vorlesung über Allgemeine Pathologische Anatomie und Allgemeine Pathologie im Jahre 1852. Virchows Archiv 322: 233–239. Rössle R. (1937) Foreword to the 300th volume of Virchow’s Archive for Pathological Anatomy and Clinical Medicine / Vorwort zum 300. Bande von Virchows Archiv für Pathologische Anatomie und für klinische Medizin. Virchows Archiv 300: 1–3. Rössle R. (1937) Rudolf Virchow’s Würzburg lectures on pathology / Die Würzburger Vorlesungen Rudolf Virchows über Pathologie. Virchows Archiv 300: 4–30 Sacharoff G.P. (1921) Rudolf Virchow and Russian medicine / Rudolf Virchow und die russische Medizin. Virchows Archiv 235: 329–378.

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Appendix 2b: A bibliography of writings about Virchow Saherwala G., Schnalke T., Vanja K, Veigel H-J. (2002) Rudolf Virchow. Doctor, Collector, Politician / Rudolf Virchow. Mediziner, Sammler, Politiker. Berliner medizinhistorisches Museum der Charité, Berlin. Salomonsen C. J. (1901) Rudolf Virchow and Danish medicine / Rudolf Virchow und die dänische Medizin. Berlin. klin. Wochenschr. 38: 1045–1046. Schadewaldt H. (1972) Politics is nothing other than medicine on a large scale: the scientific theory of Rudolf Virchow / Die Politik ist nichts weiter als die Medizin im Großen : die Wissenschaftstheorie bei Rudolf Virchow. In: Gedenkfeier d. Dtsch. Ges. f. Pathol. aus Anlaß des 150. Geburtstages von Rudolf Virchow am 2. Okt. 1971 in Darmstadt. aus: Deutsches Ärzteblatt – Ärztliche Mitteilungen 69: 2251–2254; 2298–2303; 2364–2367; 2432–2436 (1972) Schattenfroh S. (2002) “Charité Guide Book”. Charité University Hospital, Berlin. Schervinsky W. (1901) Rudolf Virchow and Russian medicine / Rudolf Virchow und die russische Medizin. Berlin. klin. Wochenschr. 38: 1042–1044. Schipperges H. (1994) Rudolf Virchow. Rudolf Virchow. Rowohlt, Reinbek bei Hamburg. Schlüter H. (1938) Virchow as biologist / Virchow als Biologe. Hippokrates-Verl., Marquardt und Cie, Stuttgart and Leipzig. Schmidt M.B. (1903) Words in remembrance of Rudolf Virchow / Worte der Erinnerung an Rudolf Virchow. Archiv für Öffentliche Gesundheitspflege in Elsaß-Lothringen 22. Schmidt M.B. (1921) Virchow’s pathological-anatomical research on diseases of the osseous system / Virchows pathologisch-anatomische Forschungen über die Erkrankungen des Knochensystems. Virchows Archiv 235: 273–297. Schmidt M.B. (1922) Virchow, Rudolf, Professor of Pathological Anatomy 1821–1902 / Virchow, Rudolf, Professor der pathologischen Anatomie 1821–1902. In: Lebensläufe aus Franken. Hrsg. i.A. d. Ges. für Fränkische Geschichte von Anton Chroust. 2. Band. Kabitzsch und Mönnich, Würzburg, pp 465–475. Schrenk M. (1971) On Rudolf Virchow’s 150th birthday / Zu Rudolf Virchows 150. Geburtstag. (no further details). Institute for the History of Medicine, University of Würzburg. Schrenk M. (1972) Anthropological concepts in pathology since Rudolf Virchow / Anthropologische Konzepte in der Pathologie seit Rudolf Virchow. Berichte der Physikalisch-Medizinischen Gesellschaft zu Würzburg. Neue Folge 80: 143–147. Schröder H. (1921) Virchow: (on his 100th birthday 13th October 1920) / Virchow : (zu seinem 100. Geburtstag am 13. Oktober 1921). Münchener medizin. Wochenschr. 68: 1277–1278. Schweers H.F. (1974) Notes taken down from Virchow’s lectures during the Würzburg period / Nachschriften Virchowscher Vorlesungen aus der Würzburger Zeit. Mainz, Mainz Univ., Diss. Semon F. (1902a) Notes on the celebrations of Virchow’s eightieth birthday. Br. Med. J. Oct. 19: 1180–1182 (see Appendix 1 in this book). Semon F. (1902b) Rudolf Virchow - some personal reminiscences. Br. Med. J. Sept. 13: 800–802 (see Appendix 1 in this book). Sˇimon F. (1991) Rudolf Virchow as terminologist / Rudolf Virchow als Terminologe. Medizinhistorisches Journal 26: 329–336. Simon H. and Krietsch P. (1985) Rudolf Virchow and Berlin / Rudolf Virchow und Berlin: Patholog. Inst. d. Humboldt-Universität. Stäber P. (1987) Rudolf Virchow: from then on the lecture theatre became a political place / Rudolf Virchow: Die Aula wurde von da an ein politischer Ort. Urania 4: 68–69. Stein F. (1986) Rudolf Virchow and the striving for unity in scientific medicine / Rudolf Virchow und die Einheitsbestrebungen in der wissenschaftlichen Medizin. Bayerisches Ärzteblatt 40: 220–226. Stiefelhagen P. (2002) On the 100th anniversary of the death of Rudolf Virchow (1821–1902) / Zum 100. Todestag von Rudolf Virchow (1821–1902). Hamburger Ärzteblatt 10: 478–481. Stokvis B.J. (1901) Virchow and medicine in the Netherlands / Virchow und die niederländische Medizin. Berlin. klin. Wochenschr. 38: 1038–1042.

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Appendix 1. Virchow’s last year Sundberg C. (1901) Rudolf Virchow and Swedish pathology / Rudolf Virchow und die schwedische Pathologie. Berlin. klin. Wochenschr. 38: 1044–1045. Tappe D. and Frosch M. (2007) Rudolf Virchow and the recognition of alveolar echinococcosis in the 1850s. Emerging Infect. Dis. 13: 732–735. Thiel R. (1943) King Virchow. In: „Men against Death and the Devil“ / König Virchow. In: R. Thiel: Männer gegen Tod und Teufel. Berlin, pp 146–169. Unger H. (1953) The Würzburg years in Virchow’s life / Die Würzburger Jahre in Virchows Leben. In: U. Hellmuth (ed.): Virchow: A Life in Research / Virchow: ein Leben für die Forschung. Hoffmann und Campe, Hamburg. pp 167–195. Vasold M. (1988) Rudolf Virchow. Deutsche Verlag Anstalt, Stuttgart. Vasold M. (1990) Rudolf Virchow, a Great Doctor and Politician / Rudolf Virchow: der grosse Arzt und Politiker. Fischer Taschenbuch, Frankfurt am Main. Vogt K. (1901) Rudolf Virchow: on the 80th birthday of the great researcher / Rudolf Virchow: zum 80. Geburtstage des großen Forschers. 2. Beil. Zu Nr. 241 d. Anhaltischen Staats-Anzeigers. 13. Okt. Wagner R.P. (1999) Rudolph Virchow and the genetic basis of somatic ecology. Genetics 151: 917–920. Waldeyer W. (1903). Memorial Address for Rudolf Virchow / Gedächtnissrede auf Rudolf Virchow. Verhandl. der Königl. Akad. der Wiss., Berlin. Weichselbaum A. and Zuckerkandl, E. (1901) On Virchow’s influence on the development of pathological anatomy, on public health, and on anthropology in Austria / Über den Einfluss Virchows auf die Entwicklung der pathologischen Anatomie, der öffentlichen Gesundheitspflege und der Anthropologie in Österreich. Berliner klinische Wochenschrift 38: 1034–1036. Welch W.H. (1891) Rudolf Virchow, Pathologist. Johns Hopkins Univ. Circ. xi: 19–22 See also: Boston Medical & Surgical J. Oct 19, cxxv, 453–457. Winau R. (1997) Rudolf Virchow and the course of medicine in the nineteenth century / Rudolf Virchow und der Wandel der Medizin im 19. Jahrhundert. Verhandlungen der Deutschen Gesellschaft für Pathologie 81: 28–34. Winter K. (1976) “Rudolf Virchow”/ Rudolf Virchow. 2nd edn, Tuebner, Leipzig. Wirth I. (2005) Source Book for Dissection Activity at the Pathological Institute in the FriedrichWilhelm University of Berlin from 1856–1902: a Contribution to Virchow Research. / Quellenband zur Sektionstätigkeit im Pathologischen Institut der Friedrich-Wilhelms-Universität zu Berlin von 1856 bis 1902: ein Beitrag zur Virchow-Forschung. Logos Verlag, Berlin. Wittern-Sterzel, R. (2003) “Politics is nothing other than medicine on a large scale” – Rudolf Virchow and his importance for the development of social medicine / „Die Politik ist weiter nichts, als Medicin im Grossen“ – Rudolf Virchow und seine Bedeutung für die Entwicklung der Sozialmedizin. Verhandl. d. Deutschen Gesellschaft für Pathologie 87: 150–157. Yamagiwa K. (1921) Virchow’s influence on Japanese medicine / Virchows Einfluß auf die japanische Medizin. Virchow’s Archive 325: 385–398.

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Index

Academy of Art 229 Academy of Sciences 20, 168 Achorion Schönleinii 111 achromatic lens 16 Actinomyces 222 Administration for the Poor 146 Agassiz 29, 39 Agricultural Institute 222 albuminuria 188 alchemy 163 Alsace and Lorraine 13 Altenstein 35, 120, 132 Althoff 253 Amphibiae 35 amyloid 48, 189 anatomicalism 158, 172 Ancient Greek terminology 158 Andral 16 animal magnetism 29, 96, 163 animism 70 Anthrax 223 Anthropology 8 Anwers 236 aorta, ligation of 188 Arabs 162 Aranzi 168 Archiv für physiologische Heilkunde 122 Aristotle 19, 28, 31, 45, 49 Arndt 26 Arnim 149 Asklepiads 161 asthenie 70 Aufsee Seminary 125 Australian Doctors, collective address from 264 Autenrieth 78, 101, 104, 105, 130 autopsy 170 Axolotl 211 Baccelli 252 Bacon 28, 31 Baelz 266 Bamberg 67, 125, 133 Bamberg coins 127 Bamberg Library 69, 90, 100, 119, 128

Banks 30 Bardeleben 227 Barmen 202 Bartels 113 Basel 108 Bassi 111 Bauer 131 Baum 145, 186 Bay of Muggia 41 Bayle 172 Becker 212, 214 Beckmann 1 Beer 93 Behr 81, 82, 109 Bell 34 Bellermann 138 Berends 113, 140 Berlin 257, 263 Berlin City Council Vii, 8 Berlin Entomological Museum 103 Berlin Medical Society 225, 229, 257 Berlin School 67 Berlin Work House 244 Bernstorff 140 Bertele 71, 92, 94 Berthold 198 Bethesda Institution 194 Beyme 26 Bichat 16, 172 Biermer 212 biogenic law 19 biological view 229 Bischoff 27, 198 Bishop Julius 72 Bismarck Vii, 8, 267 Bismarck’s anti-Catholic Policies 8 blastema theory 40, 111 blood 34, 105 Blumenbach 29, 91 bodies, disposal of 224 Boerhaave 25, 28, 70, 168 Bologna 263 Bolongaro 108 Bonet 170 Bonn 30, 31

309

Index Boyen 26 Brandis 27 Brendel 81,109 Brentano 92 Bright’s disease 116, 181 Broussais 16 Brown 16, 28, 70, 102 Brownian System 92 Brownianism 70, 71, 91 Brücke 179 Brüggemann 150 Bruno 31 Bulls, Papal 121 Burckhardt 189 Burdach 98 Burschenschaft 26, 80, 81, 109 Busch 152, 199, 226 Buschke-Lowenstein tumour 147 caesarean (section) 203 calcific deposits 188 Calker 27 Canstatt’s Annual Reports Vii, 186, 239, 249 Capuchin preachers 122 carcinoma, verrucous 147 cardiac hypertrophy 188 Carlsbad Decrees 26 Carlsschule 22 caseation 222 casket theft 208 Caspar 281 casts, urinary 188 Catholic Church 10, 12, 13, 24, 106, 121, 164 Catholic Hospital 115 Catholic movement 215 Catholic University in Louvain 217 cattle plagues 223 cauliflower growth 147, 154 cell formation, hour-glass theory 218 cells, free formation of 218 cells, generatio aequivoca 218 cell theory 1, 9, 17, 218 “Cellular Pathology“ (1858) Vii, 1 Celsus 161 Charité Annals 181 Charité Hospital Vii, 1, 9, 48, 73, 113, 147, 152, 181, 199, 209, 253, 256, 261, 281 Charles of Anjou 169 Chauliac 173 chlorosis 290 cholera 8, 118, 181, 182, 201, 290,

310

chondrin 35 chorda dorsalis 38 Christianity 121 Cicero 161 citizens Corps 52 cleanliness 143 Clemens 92 Clement II 68 coarseness 119 Coblenz 22 comparative anatomy 40 “Comparative physiology of vision” 49 comparative physiology 33 Conference of Natural Scientists in Danzig 237 Congress of Vienna 12 connective tissue 219, 244 Conradi 123, 124 Constantinus Africanus 164 constitution of 1850 8 Cook, James 31 Cornil 255 cretinism 102, 290 Croonian Lecture 275 Cruveilhier 16 crystallization 218, 235 Cucumus 81 Cullen, William 28, 91 Cuvier 16, 22, 25, 35, 80 cypress trees 196 cytoblastema 218 cytoblasts 218 D’Alton 29, 76 D’Outrepont 76 Däge 145 Danzig 237 Darwin 234, 290 Darwinian Evolution 19 de Gruyter 246 De Sedibus et Causis Morborum 168, 170 Delbrück 27 Demme 102 Descartes 28, 230 Die Medicinischen Reformen 282 Dieffenbach 84, 113, 132, 142, 147, 150, 281 Diepenbrock 89 digitalis 116 diphtheria 290 diphtheritic angina 204 Doctor for the Debtor’s Prison 194

Index Doctor for the Poor 149, 193 dogmatics 121 Döllinger 29, 74, 76, 87, 91, 95, 96, 109, 115 Dömling 95 Dorn 69 Du Bois-Reymond 19, 179 duel 8 Dümmler 182 Dupuytren 75, 172 Dürkheim 260 Dutrochet 16 dyscrasia 166 Echinodermata 41 Eckard 150 Eckers 264 Ehrenberg 39, 147 Eisenmann 67, 68, 80, 81, 104, 105, 109, 239, 249 Ekbert 90 Elberfeld 202 “electors” 10 electrotherapy 234 Elementa Medicinae 70 elephantiasis 116 Elizabeth Hospital 193 Empress of Russia 114 enchondroma 39 England, Virchow friend of 275 epidemics 237, 238 epigenesis 14 Ermann 140 Escher 107 Esenbeck 27, 45 Etlinger 103, 104 Eustachius 97, 167 Faber 127 Fabricius 167 facial expression 49 Faust 49 Favus 51 Febronianism 12 Felix 247 Feuerbach 92 Finkelmann 138 Forlì 174 Formey 145 Forster 28, 31 Fortschrittspartei 13 fossil fishes 41

Fraenkel 254 Franco-Prussian War 225, 245 Frank 78, 79 Frankfurt Parliament 53 Franklin 28 Franks 93 Fredrick II 169 French Academy of Sciences 283 French Revolution 12, 16 Frerichs 118 Friedreich 1, 75, 190, 210 Friedrich III 57 Friedrich Wilhelm III 114, 132 Friedrich Wilhelm IV 89, 114 Friedrichshain 52 Friedrichs-Wilhelm-Institut 1, 281 Frommann 247 Froriep 1, 40, 117, 281 Fuchs 100, 103, 198 furuncles 204 Galen 28, 161 Galen’s infallibility 165 galvanism 28 Ganoidea 39 Gedicke 145 Gegenbaur 211 Geheimer Sanitätsrath 149 generational (alternating) change 41 genitalia 35 Gerhardt 185, 212, 252 Gerlach 107, 223 German Anthropological Society 264 German clinic 77, 113 German Confederation (Deutscher Bund) 26 German Empire 11, 13 German Geographical Society 283 German Romantic Movement 10 German Society for Natural Scientists and Doctors 260 German Society for Surgery 227, 249 Germaniabund 81 glands 35 Glion 215 Glisson 275 Gluge 40 Gmelin 116 Goethe 14, 24, 26, 29, 32, 34, 45, 47, 84, 87, 97, 105, 134, 216 Goethe’s father 42 Goethe’s mother 90

311

Index goitre 128 Goldfuss 27, 198 Göller 88, 99 Goodsir 275 Görres 23, 26, 86, 106, 121, 124, Görres Gymnasium 24 Göschen 119 Gotthard 69 Göttingen Seven 106 Graf 123 Griesinger 57, 82, 83, 110 Grohe 244 Grossbendtner 103 Grossi 109 Gruby 16 Guggenbühl 102 Gurlt, Ernst Friedrich 249 Güterbock 57, 85, 115 Guyana 150 Gymnasium of the Graues Kloster 138 Gymnastic Association 194 Haeckel 1, 185 haemato-pathology 167 halitus 163 Hall 34 Haller 28, 35, 37, 234 Hambach Festival 81 “Handbook of Historical-Geographical Medicine” 238 “Handbook of Physiology” 37 “Handbook of Special Pathology and Therapy” 214 Hansemann 9 Harless 27 “Harmonie” 128 Harnack 257, 285 Hartnack 252 Harvey 14, 167, 284 Harvey’s ovistic theory 289 Häser 103, 105 Hasse 189, 190 Hauser 92 Health Office 223 Hecker 52 Heffner 108, 118, 124 Hegel 10, 31 Heidenhain 236 “Heimia Society” 145, 195 Hein 145, 182 Heintz 117

312

Heller 98, 116 Helmholtz 236 hematoses 79 Hemsbach 282 Henle 39, 181 Henry III 68 Hensler 95 Herborn 198 Herczegy 119 Herder 10 Hernandez 127 Hernbstädt 140 Herwegh 84, 114 Herz 118 Hesselbach 98 Heusinger 95 Hewson 34 Hippocrates 161, 162 Hirschfeld 236 His 264 histological substitution 14 historical method 116 Historical-geographical pathology 240 Hoffmann 70, 81, 96, 210 Hohenlohe 108 Holothuria 41, 42, 92, 234 Holstein 53 Holy Roman Empire of the German Nation 10 Holy Roman Empire 169 Homeopathic Society 101 Hoppe-Seyler 8 Horace 196 Hormer 107 Horn 140, 145 Horsch 98 Hospitale S. spiritus in Sassia 164 hospitals of Moabit and Friedrichshain 283 hospitals of the Middle Ages 164 Hottinger 107 Hueppe 289 Hueter 226 Hufeland 71, 91, 92, 94, 132, 140 Humboldt 29, 32, 114, 235, Humer 88 humor cardinalis 167 humoral pathology 161 humoral theory 14 Hunter 73, 75 Huschke 247 Hüter 210 Huxley 275

Index Huxley Lecture 284 Hygiene 238 hypnotism 163 ichorös 196 idea of the organism 98 Ignorabimus 236 Illaire 145 imagination images 32, 48 impetigines 111 infusoria 147 Innerlichkeit 10 inoculation 223 Institut de France 283 “Introduction to Medical Chemistry” 245 irritability 71 Isis 27, 84 Israel 255 Istituto delle Scienze 168 Jäck 58, 101, 109, 111 Jacobs 89, 99 Jacoby 255 Jäger 110 Jahn 103, 195 Jesuit Order 12, 80 Jewish doctors 162 Jolly 236 Jordan 235 Julius Hospital 72, 75, 80, 92, 131, 213, Jung 201 Jüngken 199 Junker Administration 12 Kant 10, 28, 69, 87, 90, 96 Karamitzas 255 Kastner 27 Kauffmann 146 Kempfer 267 kidney fluids 188 Kielmeyer 44, 80, 105 Kieser 99 Kiewisch 154 Kilian 91 Kirschner 256, 257 Kiwisch 118 Klotzsch 125 Knape 140 Koch 262 Kölliker 186, 211 Kollmann 264

Königsberg, Natural Scientists Conference 155 Körte 253 Köslin 268 Kottmeier 189 Krukenberg 77, 152, 179, 192 Kühne 245 Kultur 194 Kulturkampf 8, 13 Lachmann 185, 190 ladder of nature 19, 48 Ladenberg’s Ministry 181 Laennec 16, 70, 71, 75, 77, 172, 206 Landtag (Prussian House of Assembly) 8, 12 Langenbeck 198, 202, 226, 253 Landshut 92 Lassalle 208 Latin clinic 85 Latin 84 Lauck 81 Lebert 57, 82, 110 Legallois 36 Lehrs 58, 123, 124 Leibnitz 28 Leopold-Caroline Academy 97 leprosy 290 Lessing 10, 267 leucin 118 leukaemia 290 Leutzinger 23 Levret 142 Leydig 186 Lichtenstein 140 Lichtenthaler 89 Liebreich 258 life force 15, 231, 234 Lindner 112 Link 140 Linnaeus 94 Linth 107 Lister 227, 249, 252, 254, 258, 265, 275, 284 Lister’s methods of antisepsis 225 Lohndorf 95 Louise Lateau 220 Löwig 116 Lücke 245 Ludwig, Crown Prince 106 Ludwig I of Bavaria 80 Ludwig’s Order 112 lunatic asylums of Dalldorf and Lichtenberg 283 lung plague 222

313

Index Maass 226 Magendie 36, 208 Magnus 104 malaria 149 Malpighi 35, 167 Malpighian bodies 48 Manual of Human Physiology 35 Manual Workers’ Society 179, 269 Marcus 69, 71, 81, 88, 91, 93, 99, 109, 130, 212, 247, Martins 144 Marx 189, 198 Mayer 26, 105, 132, 181, 185, 194, 198 Meckel 14, 19, 29, 35, 39, 47, 73, 140, 169, 234 medical fees 146 Medical Reform 1, 261 Medici 173 Medieval “Restoration” 106 Megner 130 Melanömia 189 Mendelssohn 208 Mesmerism 73 Mesopotamia 162 “Metamorphosis of Plants” 97 Meyer 57, 85, 253 Meyerbeer 115 microbiology 9 microscopy 16 Middeldorp 226 Miescher 40 Military Academy 39 Millenariarism 12 Mineralogical Museum 102 Minister naturae 83, 194 miracles 220 Mohr 100, 118 Möller 256 Mommsen 285 Mondino 166, 173 Monte Cassino 164 Montez 80 morbus maculosus Werlhofii et peliosis 117 Morgagni 17 Morgagni, method of 170 morphs 79 Most 58 Mühler 239 Müller 1, 14, 49, 71, 83, 94, 114, 118, 130, 179, 208, 216, 217, 220, 234, 281 Müller as no politician 43 Müller, oracular manner 49

314

Müller School 37 Müller, shipwreck 43 Müllerian duct 19 Müller-Strübing 150 Munich Academy 98 Musardines 111 Museum of Applied Arts 267 Myxinidae 38 Nabille 265 Napoleon 12 Nasse 26 Natural Historical School 14, 77, 78, 82, 103, 110, 122 Natural Historical Society 112 natural philosophical school 31, 57, 73, 77, 97, 99, 234, 235 Natural Scientists Conference at Königsberg 155 Nematode parasites 42 nephritis 188 nerve 105 Nesse 45 neuroses 79 Neuthor Tower 109 Nöggerath 27, 198 nosological systematist 110 Obermeyer 9, 261 Obstetric Society 152, 154 Oken 112 Oken 14, 19, 26, 29, 84, 99 omnis cellula e cellula 16, 218 “On Imagination Images” 33 “On the concordance of the theories of Hippocrates and Brown” 106 “On the Revolutionary Spirit in German Universities” 106 “ontogeny recapitulates phylogeny” 19 ontology 122 Order of the Red Eagle 149 Orelli 107, 112 Ossan 140 ossuary of Iphofen 102 osteomalacia 203, 222 Pagenstecher 8, 189 Paget 275, 290 Pallas 30 Pander 29, 76, 97 Papal Bull of 1302 13 Papal Bulls 121

Index Papal Infallibility 13 Paracelsus 28, 166, 288 Paré 93 Parisian School 16, 172 Parliamentary Assembly in Frankfurt 200 Passow 185 Pathological Museum 282 “Pathology and Therapy“ 104 Patronus Germanorum 168 Pätsch 150 Paul Langerhans Jnr. 264 Pauli 123 Pentacrinites 41 Pfeufer 75, 82, 98, 99, 100, 101, 118 Phasmids 45 phlebitis 290 phlogiston doctrine 91 physiology 32 Pickel 94, 115 pigs, consumption (TB) in 223 Pindar 14, 19 Pinel 58 Plagiostomata 39 plague 240 plastic exudate 218 plastic materials 219 Plücker 198 Pneumomycosis aspergillia 214 Poland 12 Polycystines 41 Pomerania 263, 268 Pope Innocent III 164 Pope Pius IX 13 Porrigo lupinosa 111 Porrio fungus 111 Posadawsky 256 Posner 119, 250, 252, 256, 260 Preformationism 14 Priestleyish 74 primum motum 74 primum movens 74 Prince of Prussia’s Palace 52 Prince Wittgenstein 108 Prochasca 96 Prochaska 34 psychology 33 Ptolemies 165 Purkinje 34, 39 Purkinje’s discoveries 40 pyaemia 290 Pye-Smith 255, 275

Rapp 129 Raptschewski 252 Raspail 16, 17, 18 Raumer 244 Rauschenbusch 204 Rauschenplatt 108 “Reaction“ 107 Recchus 127 Red Republican 150 reflex-actions 34 Reichert 19 Reichstag 210 Reil 39, 78, 79, 91, 113 Reimer, Siegfried 146, 152 Reimer, Georg 193, 246 Reimer Company 1 Reinhard 105, 146, 153, 281 relapsing (“recurrent”) fever 262 Remak 57, 58, 85, 111, 116, 117, Remak, “Diagnostic and Pathogenetic Investigations”, Berlin 1845 116 renal cysts 187 Retzius 51 Reuss 90 Revolution of 1848 Vii, 43 Rhenish Yearbooks 200 Ribcke 140, 142 Richter 124 rickets 249 Riese 179 Rindfleisch 102 Ringseis “A System of Medicine” 120 Ringseis 13, 57, 58, 80, 86, 92, 93, 95, 105, 109, 110, 118, 120, 121, 124, Ritter 29 Rockwitz 146 Rokitansky 99 Röschlaub 69, 71, 72, 79, 92, 94, 106, 120 Rosenberg, fortress 67 Rosenthal 236 Roser 110, 226 Rothlauf 89 Rothschild 108 Rotteck 107 Royal Academy of Science in Berlin 283 Royal Society of London 258 Royal Society of Medicine 265 Rp. Spiritus Sancti q.s. detur 119 Rudolph Virchow Foundation 266 Rudolphi 27, 30, 34-36, 39, 48, 140, 141, Rudolphi senior 141

315

Index Ruge 146, 152 Rühle 207 Rumph 88 Rust 114, 140 Rüttinger 112 Ruysch 35 Salerno 164 Salomonsen 255 sanitary improvements 261, 262 Sans Souci 132 Sars 41 Scarpa 96 Schäfer 253 Schaper 256 Scharlau 58, 123, 124 Schelling 15, 29, 71, 91, 92 Schenck 102, 170 Schenk 186 Scherer 239 Schervinsky 255 Schiek 147 Schiller 15 Schivelbein 1 Schjerning 256 Schlegel 27 Schleiden 40, 216 Schleiden’s “Fundamental Principles of Scientific Botany” 180, 217 Schlemm 36v Schleswig-Holstein 52 Schliemann 8 Schmidt 127, 152 Schöller 199 Schomburgk 150 Schönlein 1, 13, 77, 128, 199, 209 Schönlein as “Dalai Llama of medicine” 85 Schönlein as “medical Caesar” 121 Schönlein as medical Pope” 121 Schönlein, Frau 118 Schönlein, paleo-ontological collection 102 Schönlein, Philipp 124, 133 Schönlein, posthumous papers 130 Schönlein’s Assistenten 99 Schönlein’s “Clinical Lectures in the Charité Hospital in Berlin” 115 Schönlein’s donations 102 Schönlein’s father 68 Schönlein’s father-in-law 108 Schönlein’s favourite diseases 116 Schönlein’s way of life 126

316

School of Organicism 172 Schuler 265 Schultes 94 Schultze 23, 32, 36 Schulze 130, 132 Schütz 150, 156 Schwalbe 290 Schwann 1, 17, 18, 40, 235 Schwann’s “Microscopic Investigations” 217 Schwerin 52 sea cucumbers 41 sedes morbi 171 Seiler 92 seminal corpuscles 52 seminium morbi 52 Semon Vii, 258 Sensburg 102 sensory perceptions 230 Seufert 80, 81, 107–109, 132 Seydel 150 Shattock 275 Sickingen 22 Siebert 86, 100, 115, 119, 122, 123 Siebold 69, 91, 92, 94, 140, 141, 152, 153, 198 Siebold school 142 Siegmundin 140 Simon 40, 85, 116, 226 Skoda 206, 209 Skulls 102 “smooth-shark” of Aristotle 39 snails, in Holothuria 41, 42 Sniadetzky 47 Social Democrats 8 social relations to the organs 33 socialism 52, 269 Society for Anthropology, Ethnology and Prehistory 8 Society for German Anthropologists 260 Society for Hygiene 239 Society for Obstetrics 1 Society for Scientific Medicine 1, 182, 193, 195 Society of Anthropology and Ethnology 283 Society of Berlin Doctors 195 Sokoljskenny 104 Solbrig 121, 122, 124 Sömmering 29, 92 soul 49 spas 131, 149 Spessart 261 Spiegelberg 190 Spindler 96

Index Spinoza 28, 34 Spirillum 261 “Spy” 277 St Francis of Assisi 90 St Gangolf 58, 130 Stahl 70, 102, 157, 256, star-fish 41 Stark 99 Steenstrup 41 Steffens 91 Stein 27 Steinbrück 145 Steinbuch 34 Stenglein 58, 90 Sternberg 102 stethoscope 57, 85 sthenie 70 Stiebel 124 Stokvis 255 Stolliana 145 Stosch 113 student corps 52 student societies 198 Studt 256 Sundberg 255 Sunderlin 113, 145 supernatural forces 163 surgery 227 Swammerdam 17 Swiss data 264 syphilis 290 Textor 70, 76, 81, 91 The Science of Motion of Animals/De Phoronomia Animalium 27 thermometer 116 Thirty Years War 12 Thomann 92 Thuerheim 91 Transsylvania 277 transudates 244 Traube 57, 58, 85, 116, 132, 188, 202, 272, Traube’s Beiträge 178 Treaty of Lunéville 22 Trefurt 198 Treviranus 29, 39, 47, 198 trichinosis 256, 263, 290 Troschel 199 Troxler 107 Troy 8 Trüstedt 199

tubercle bacillus 261 tuberculosis 184, 290 tuberculosis, bovine 262 tuberculosis, human 262 tumours 39 typhus abdominalis 110 typhus crystals 83, 110 typhus 8, 52, 79, 213, 260, 281 typhuses 79, 104 tyrosin 118 Ubi est Morbus? Where is the disease? 171 ultramontanism 13, 68, 80, 85, 86, 106, 118, 120 Unger 111 University Library in Würzburg 128 University of Berlin 281 University of Bonn 27, 198 University of Halle 222 University of Würzburg 72, 96, 134 University of Zürich 81 Upper Silesia 260 Valentin 16 Valhalla 224 Valsalva 169 van der Heydt 200 van Helmont 28 Van Swietenia 145 “Vanity Fair” 277 Varoli 168 vertebral theory of the skull 97 Vesalius 28, 166 Veterinary School 222, 249 Veterinary Studies 223 Vierordt 110 views of nature 32 Villa Frankenhäuser 247 Virchow 57 Virchow and pedantry 271 Virchow and students 272 Virchow as examiner 272 Virchow’s Archive 177, 287 Virchow, gifts on 80th birthday 263 Virchow, Grand Old Man of Science 252 Virchow-Hirsch Yearbooks 239 Virchow on politeness 144, 214 Virchow-Stiftung 257 vita propria 168 vitalism 28, 157, 220, 235 vivisection 36 Vogel 179

317

Index Volkmann’s ischaemic contracture 225 Voltaism 73 von Aschhausen 90 von Baer 14, 19, 29, 45, 76, 97 von Bergmann 257, 285 von Bülow 257 von Dalberg 69 von Erthal 69, 90 von Graefe 202 von Grafenberg 170 von Haller 73 von Humboldt 26 von Langenbeck 154 von Leuthold 256 von Leyden 252 von Mollis 264 von Nadherny 118 von Oettingen-Wallerstein 108 von Recklinghausen 245, 258 von Rogenbach 245 von Savigny 92 von Siebold 73 von Thielen 256 von Walther 26, 71 Wagner 99, 100, 198, 226 Waldeyer 236, 252, 255, 257, 260, 285 Walther 29, 32, 72, 87, 91, 93, 94, 97, 106, 107, 123, 130 War of Liberation 139, 150, 192

318

Wartburg Festival 26 Weber 27, 198 Wegscheider 152 Weichselbaum 255 Welckers 26 “Whence and Whither?” (Schönlein’s favourite question) 116 Wiebel 132 Wilks 284 Wilms 226 Wilson 264 Wittgenstein 132 Wöhler 48, 186 Wolff 14, 19, 47, 73, 119, 199 Wunderlich 86, 101, 110, 116, 118, 122, 123 Würzburg 29 Würzburg clinic 100 Würzburg Physical-Medical Society 242 Würzburg Proceedings 181 Zander 204 Zell 131 Ziegelstrasse Clinic 181 Ziemssen 212 Zimmermann 111 zoogen 105 zoological material 103 Zuckerkandl 255 Zürich 57, 82, 107, 113 Zürich Hochschule 82