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Rudolf Virchow

He was the first to precisely describe and give names of diseases such as leukemia, chordoma, ochronosis, embolism, and thrombosis. He coined scientific terms, chromatin, agenesis, parenchyma, osteoid, amyloid degeneration, and spina bifida. His description of the transmission cycle of a roundworm Trichinella spiralis established the importance of meat inspection, which was started in Berlin. A number of medical terms are named after him, including Virchow's node, Virchow–Robin spaces, Virchow–Seckel syndrome, and Virchow's triad. He was the first to use hair analysis in criminal investigation, and recognised its limitations. His laborious analyses of the hair, skin, and eye colour of school children made him criticise the Aryan race concept as a myth.

Virchow's triad

Hypercoagulability

Hemodynamic changes (stasis, turbulence)

Endothelial injury/dysfunction

Virchow elucidated the etiology of pulmonary embolism, whereby thrombi occurring within the veins, particularly those of the extremities, become dislodged and migrate to the pulmonary vasculature. He published his description in 1856. In detailing the pathophysiology surrounding pulmonary embolism, he alluded to many of the factors known to contribute to venous thrombosis. While these factors had already been previously established in the medical literature by others, for unclear reasons they ultimately became known as Virchow's triad. This eponym emerge in the literature around 50 years after Virchow's death. Although the concept of the triad is usually attributed to Virchow, he did not include endothelial injury in his description. This has been attributed to a dispute Virchow had with Jean Cruveilhier, who considered local trauma of primary importance in the development of pulmonary artery thrombosis.

The Kaiser's case

Virchow was one of the leading physicians to Kaiser Frederick III, who suffered from cancer of larynx. While other physicians such as Ernst von Bergmann suggested surgical removal of the entire larynx, Virchow was opposed. The British surgeon, Morell Mackenzie, performed a biopsy in 1887 and sent it to Virchow, who identified them as "pachydermia verrucosa laryngis". Virchow affirmed that the tissues were not cancerous, even after several biopsy tests. The Kaiser died on 15 June 1888. The next day a post-mortem examination was performed by Virchow and his assistant. They found that the larynx was extensively damaged due to ulcer, and microscopic examination confirmed epidermal carcinoma. The Medical Report of Kaiser Frederick III was published on 11 July under the lead authorship of Bergmann. Virchow and Mackenzie were particularly criticised for all their works. The arguments between them turned into a century-long controversy, resulting in Virchow being accused of misdiagnosis and malpractice. But reassessment of the diagnostic history revealed that Virchow was right in his findings and decisions. It is now believed that the Kaiser had very rare form of hybrid verrucous carcinoma, and that Virchow had no way of correctly identifying it. The cancer type was correctly identified only in 1948 by Lauren Ackerman.

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