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Cholera Epidemics in the 19th Century

The Great Plague of London, 1665

The Boston Smallpox Epidemic, 1721

“Pestilence” and the Printed Books of the Late 15th Century

Spanish Influenza in North America, 1918–1919

Syphilis, 1494–1923

Tropical Diseases and the Construction of the Panama Canal, 1904–1914

Tuberculosis in Europe and North America, 1800–1922

The Yellow Fever Epidemic in Philadelphia, 1793

General Materials

Notable People

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Rudolf Virchow, 1821–1902

Rudolf Virchow, a prolific and influential 19th–century German physician, pathologist, and anthropologist, is one of the founders of “social medicine.” Social medicine unites medical and political thought, and, as Virchow stated, “Medicine is a social science, and politics is nothing more than medicine on a grand scale.” In his view, medicine and public health practices, applied politically, could transform society; politics and social systems could have profoundly positive or negative effects on public health; and both the politician and the physician had a moral obligation to heal society.

Virchow believed that all epidemics were social in origin. In his famous report on the 1847–48 typhus epidemic in Upper Silesia—a Prussian province, now within the borders of Poland—Virchow stated that the proper response to the epidemic was political, not medical. The improvement of social conditions, he wrote, would achieve the desired result “far more rapidly and more successfully.”

Virchow, like Florence Nightingale, was skeptical of the germ theory because of its potential to deemphasize the social factors that caused disease and to encourage a superficial approach to prevention and cure. He believed that any simple or mechanical explanation of disease was wrong, disagreeing with both Pettenkofer’s “three factors” approach and Koch’s reductionism. Poverty caused disease as much as germs.

Virchow was not alone in his convictions. He shared them with numerous friends and colleagues who were also part of the mid–19th–century social medicine and medical reform movements in France and England, as well as Germany.

Cellular Pathology and Berlin’s Sewer System

An influential social thinker, Virchow was also the author of the canonical text Cellular Pathology, published in 1858. In Cellular Pathology, Virchow continued to connect the biological with the political, describing the human body as a “cellular democracy” and a “republic of cells” with equal viability, and disease as the result of a disturbance in cellular organization. “Learn to see microscopically,” he wrote. His approach had a profound impact on German biomedical research. Virchow also completed important work on leukemia, trichinosis, and tumor development.

Virchow was a liberal during a period of competing political ideologies, including socialism, conservatism, and radical nationalism. He co–founded the Progressive Party in Germany and was elected in 1860 to the Prussian House of Representatives. His approach typically combined a sweeping progressive ideology with many practical, even mundane, public health reforms.

While serving as a city councilman in Berlin, Virchow combined his scientific training and his political convictions. He was a central figure in the construction of Berlin’s sewer system. According to the English sanitary reformer Edwin Chadwick, Berlin was the smelliest capital city in Europe. Sewage was dumped into dung pits to be carted away at night, or left in open troughs at the sides of the street to be swept away by the rain. People wore boots in the street even in the summer. Between 1873 and the 1890s, when the sewer project was completed, Virchow served as a bridge between politicians and scientists, and embodied the role of physician–reformer.


Virchow trained or influenced many students who went on to important scientific careers, many of whom passed through the Berlin Pathological Institute, which Virchow founded.

His most powerful legacy, however, is probably in the field of social medicine. Virchow believed that the physician must serve as “attorney for the poor,” and social medicine remains an important component of medical and public health thought and practice addressing epidemic and contagious disease.


Selected Contagion Resources

This is a partial list of digitized materials available in Contagion: Historical Views of Diseases and Epidemics. Additional materials may be found by browsing the topic “Rudolf Virchow, 1821–1902” and by searching the collection’s Catalog and Full Text databases.

Web Pages

Concepts of Contagion and Epidemics
Florence Nightingale, 1820–1910
Germ Theory
Public Health, 1800–1922
Robert Koch, 1843–1920
Max von Pettenkofer, 1818–1901


Virchow, Rudolf Ludwig Karl. Freiheit der Wissenschaft im Modernen Staat. English The Freedom of Science in the Modern State: A Discourse Delivered at the Third General Meeting of the Fiftieth Conference of the German Association of Naturalists and Physicians at Munich, on the 22nd of September, 1877; with a new preface by the author; translated from the German, with the author’s sanction. London: John Murray, 1878.
Virchow, Rudolf Ludwig Karl. Fortschritte der Kriegsheilkunde. English Infection-Diseases in the Army: Chiefly, Wound Fever, Typhoid, Dysentery and Diphtheria, translated from the German by John James. London: H.K. Lewis, 1879.

Cellular Pathology and Berlin’s Sewer System

Chadwick, Edwin. Great Britain. Poor Law Commissioners. Report to Her Majesty’s Principal Secretary of State for the Home Department, from the Poor Law Commissioners on an Inquiry into the Sanitary Condition of the Labouring Population of Great Britain: With Appendices. London: Printed by W. Clowes and Sons, for H.M.S.O., 1842.
Virchow, Rudolf Ludwig Karl. Cellularpathologie in Ihrer Begründung Auf Physiologische und Pathologische Gewebelehre. English. Cellular Pathology as Based upon Physiological and Pathological Histology: Twenty Lectures Delivered in the Pathological Institute of Berlin during the Months of February, March, and April, 1858. London: John Churchill, 1860.
Virchow, Rudolf Ludwig Karl. Reinigung und Entwässerung Berlins: General–Bericht über die Arbeiten der Städtischen Gemischten Deputation für die Untersuchung der auf die Kanalisation und Abfuhr Bezüglichen Fragen. Berlin: A. Hirschwald, 1873.


The following sources were used in writing this page.

Ackerknecht, Erwin H. Rudolf Virchow: Doctor, Statesman, Anthropologist. University of Wisconsin Press, 1953.
Evans, Richard. Death in Hamburg: Society and Politics in the Cholera Years, 1830–1910. Oxford: Clarendon Press, 1987.
McNeely, Ian F. “Medicine on a Grand Scale”: Rudolf Virchow, Liberalism, and the Public Health. Wellcome Trust Centre for the History of Medicine at University College London, 2002.
Porter, Roy. The Greatest Benefit to Mankind: A Medical History of Humanity. New York: W.W. Norton & Company, 1997.


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