1053

THE LANCET.

LONDON: SATURDAY, OCTOBER 19, 1901.

Hoch! Professor Virchow.

HOOH I PROFESSOR VIRCHOW.

ON Saturday last an anniversary was celebrated in Berlin 1

- which has impressed the whole civilised world, and, in

particular, has caused all those sections of thinking persons Ewho take an interest in science to reflect on the possi-bilities for good that lie in the brain of an individual

worker. For the proceedings in Berlin, as will be seen ’’

from our report of them, testify in a remarkable manner

to the admiration ’ which the whole scientific world 1

tas for the vast and far-reaching character of Professor

VIRCHOW’S pathological and anthropological work. Scien-

tific men benefit their’ generation in different ways, just asmen with powers of artistic achievement may do ; but thereis’one rougli difference very ’generally existent between thetwo classes.’ ’The artist has’all life for his theme ; the

scientific man is, as a rule, a specialist in some departmentof’life, which may be large or which may be small, butwhich is none the less a department. He does his

work: probably this work overlaps the work of brother

men of science who are applying themselves to the study ofa second department of exact knowledge, and who in theirturn overlap with their labours the labours being carried onin a third department. The world is especially fortunate if

the outcome of such special endeavours can be made to fallunder one great scheme ; and of all the benefactors of

civilisation the most practical is he who can not only detectthe factors that are common to the separate results of

individual endeavour, but who can systematise these resultsand interpret their true significance by the formulation of a

general law. Such a man was DARWIN, such a man is LISTER,and such a man is VIRCHOW ; and comparison can rightly beclaimed for each of them with the poet or the painter. Pro-

fessor VIRCHOW is one of the rare figures in the world’s historyof men who have been able to combine in their work the results

of specialised endeavour with a poetically immense imagina-tion. Just as great works of imagination-the really greatpicture, oratorio, or poem-deal with the elementary passionsand appeal to us by senses that are common in greater orless degree to the whole world, so Professor VIRCHOW’S

pathological work has been large and simple. Extraordinaryapplication and insight may have gone to its accomplishment,but its meaning is clear and its value undoubted. Fifty yearsago he laid the foundations of modern pathology by beginninga series of investigations which terminated in the enunciationof the doctrine of omnis cellula e cellulâ. Before his work at

Wiirzburg University there was no working theory that wouldreally account for the commonest pathological processes. It

was imagined that a formative but structureless blastema

was thrown out between injured and separated surfaces, andthat, for some reason or other, this blastema was obligingenough to become tendinous where the injury was of

tendon, muscular where it was of muscle, and so on.

VIRCHOW perceived that the whole process had factors in

common whatever the injury and whatever the tissue con-cerned ; while his understanding refused to admit as

satisfactory the theory of free-cell formation which

amounted, in his opinion, to the doctrine of spontaneousgeneration. After much patient endeavour he demonstratedthe fact that all living tissues were composed of cells andthat the transforming and reparative processes which wenton in those tissues were the results of changes in those cells. -He has himself put on record the circumstances in which

his studies took the directions that have led to such greatevents, but those circumstances may well be repeated,; especially as they bear out the view that only a man gifted. with great powers of imagination could possibly have seen

so far ahead, and so have been supported during his in-

vestigations by the expectation of important issues. It

was towards the end of his academical stadies, more

1 than 50 years ago, that young VIRCHOW had to take up the

work of assistant in the ophthalmic clinic of the Oharité x

- Hospital at Berlin.

s" We had "

(these are his words in the HuxleyLecture 1 delivered at Charing Cross Hospital in October,1898) " severe cases of keratitis, but I saw in them

e no exudation. Numerous cataract operations were per- formed ; the wounds were closed, but not by plastic

exudation ; this was absent from all corneal scars.

Could this be explained by the circumstance that theLt cornea, apart from its circumference, is a non-vascular

tissue I then turned my attention to the non-vasculartissues ; first to the articular cartilage, and behold,

- r here also I found the greatest changes without the

,f presence of exudation, or at any rate of plastic exu-

. dation. My experimental studies then extended tothe walls of the larger arteries and then also in part

n to the veins, and they showed equally that they can

undergo great changes without even a trace of exudation.Later investigations on endocarditis led to the same result,11 provided that parietal thrombi are not regarded as exuda-

)f tion. In all these cases and in every place we found,t changes in the tissue cells-active, such as multiplicationof nuclei, or passive, such as fatty degeneration. Most>f of these processes were of the nature of proliferations."

It will be seen that VIRCHOW at once grasped the signifi-acance of his observations : he saw by the power of his

1, imagination whither they would carry him. The actual

phenomena lay before the eyes of all, yet this young house-)- surgeon was the first to whom their true meaning was7 revealed. He saw that the theory of a plastic exudation wasts arbitrary and erroneous. He saw, to use his words again,

’’ that there is no such thing as plastic exudationwhich is ever simply amorphous ; the cells which have

. been found in it have not arisen there. It is proved

1s in numberless places. The doctrine of the discontinuousor origin of pathological new formations is set aside. Every

such new formation presupposes tissue from which its cellsarise, that is, its matrix. Pathology has been late in

ry arriving at a knowledge of this correspondence, but I thinkit has acquired special value for biology in general.

,rs Proliferation is an active property of special cells but itcannot be performed by all cells alike. That in no way

19 alters the fact that it can only be performed by cells.It is just as little a function of the entire organism, forthis would then have to be unicellular. In this propertyat lies the explanation of origin from a single egg, the

Id wonderful process which comes to pass but once in the

It life of the animal. Once the tissues have arisen each cellof the tissue may, in respect of proliferation, be compared

na to an ovum ; it brings forth a new progeny from which newtissue grows, this tissue bearing, as a rule, the stamp of itsmatrix ; it is built on the maternal type."

1 THE LANCET, Oct. 8th, 1898, p. 909.

1054 THE REORGANISATION OF THE ROYAL ARMY MEDICAL CORPS.

As a result of Professor YiRCnow’s demonstration of

these pathological views it follows that the pathologist of

to-day can no more conceive of organised structures exhibit-

ing vital phenomena, whether the simplest or the most

complex, without reference to the cell as a unit than

we can conceive of the sun apart from light and heat.

The biologist, the pathologist, and the chemist, their

labours all combined, cannot solve the whole problem of

existence, but thanks to Professor VIRCHOW’S labours-

to his splendid imagination grafted upon his painstakingsearch for truth and his exact verification of detail-

we can congratulate ourselves upon some progress. We

can repeat with confidence another of his sayings, "thatthe future of medicine will be secured if the connexion

between clinical practice and the facts of pathologicalanatomy and experimental pathology is maintained nn-

broken. "

Professor VIRCHOw’S career as a politician would have

made him a notable citizen of the great German empireapart from all the work by which he has rendered his name

internationally famous ; but it is not our place to make

more than a passing comment upon this phase of his

full life. He has been called an ardent reformer, but

his views were what might have been expected from

a sound and enlightened man of science. He desired to

see his country developed for the better, he worked for the

gradual replacing of what was ill, for the regular elimi-

nation of faults, and for the no less regular introductionof improvements. He displayed in imperial and municipalpolitics the qualities of foresight and accuracy that had

rendered him famous in science, and won golden opinions asan economist and a practical sanitarian. No true medical

man can ever be a party politician-the label under whichhe votes can never more than partly describe his creed; andProfessor VIRCHOW, while he was a Radical in conservative

opinion, was ousted from his seat in the Reichstag for aBerlin constituency by the Social Democrats. As a true

medical man he knew that complicated ills can harclly everbe dealt with by one drastic operation : they require all-round treatment. At the same time lie knew that to tinker

in this direction or in that, in the desire to deal with

symptoms, and to neglect an exhaustive search for a commoncause of the symptoms is almost certainly to condemn the

patient to death. Hence his political life has been no bed ofroses. Probably he could not go fast enough or far enoughto please some, while his zeal for reform was too hot to

suit others. He has lived to see the development of the

German Empire from a congeries of isolated kingdoms,unable to see that their common good demanded a common

policy and a common head, into a strongly welded union. He

had stormy passages with the great architect of that Empire,Prince BISMARCK, and on all occasions he stuck to his guns.He was as a politician the true man of science, believingthat all proceedings on a false theory must lead to disaster.Political quackery was abhorrent to him, and where he

thought a system wrong; whatever the eminence of its

supporters, he was bold to speak his mind. It is not to

be wondered at that the career of such a man has inspiredhis scientific brethren with the desire to do him honour uponhis eightieth birthday. We share that desire. Hoch !

Professor VIRCHOw.

The Reorganisation of the RoyalArmy Medical Corps.

THE report of the Committee on the Reorganisation ofthe Army Medical Services has, on the whole, met

with a fierce fire of adverse criticism. It seems to be-

forgotten that that document is after all only a report

embodying the recommendations of a committee, and it

may be asked whether it is not somewhat premature-to pronounce absolutely condemnatory judgment on a

still immature scheme, about which there is yet so much

to be learned’? Might it not be well before entering upona course threatening to arrest the growth and development.of further efforts in this direction to wait until somethingmore is known about the scheme and the intentions of the

Government in regard to it ?There are two ways of dealing with the scheme at,

this stage of its career. One is to disregard anyhonest and well-intentioned attempt on the part of its,

framers to deal with a confessedly very difficult and com-

plicated subject and to hail its advent by mercilesslysetting about to find out all its flaws, actual or potential,thus threatening its existence ab initio. The other and

more conciliatory method is to regard the aim and spirit,of the scheme, as outlined, in a general, broad, and com-

prehensive manner, to credit its framers with honesty ofendeavour and purpose if such be apparent on the face.

of it, and to defer the task of searching for all the blots.

and defects that might be discoverable in their proposals,until their exact effect and bearing are better known.

By showing a disposition to consider frankly and favour-ably any bonâ-fide scheme’ of reorganisation a fair claim

is set up that regard must be given to subsequent criti-cisms and objections. In the case of the long controversythat has been going on between the medical services andnumerous Governments we have considered that it was iii

the interest of the medical profession as a whole and of

the medical services in particular to take the latter course.It cannot be denied that the report of the Committee on.

the Reorganisation of the Army Medical Services, in addi-

tion to an increase in the pay of medical officers, contains.

some other good proposals and suggestions. If it contained-

nothing else than a suggestion as to the possible transla-

tion of the medical school from Netley to London and the

provision of a military hospital in the metropolis, where

medical officers would have unrivalled opportunities for

seeing hospital work and for obtaining clinical instruction

of the best and most varied kind, it would be a greatstep in the right direction and, as we believe, of

great value to the medical service. We need not,

say that, having already advocated this measure, we

quite concur in all that Sir WILLIAM MACCORMAC has

recently said on the subject. As he pointed out, someinstitution is required similar to that of the Kaiser

Wilhelm Institute of Berlin. It would have been easy

enough to find a number of points in the report which lentthemselves to criticism or about which misgivings would

naturally arise, for some of them lie on the surface, butwe thought that such criticism would follow naturallyand smoothly upon detailed consideration of the scheme.

As we have stated, the effect and working, of some of