A few of Skoda's more eminent colleagues deserve brief mention: Oppolzer (1808-1871) was singularly gifted in diagnosis, popular, a teacher of wide influence, and manifested in superlative degree the characteristics that constitute a great physician; he wrote little, but was for a long time Professor of Medicine at Prague. Von Hebra, the elder (1816-1880), worked a complete revolution in dermatology, and developed a classification based upon the pathological anatomy of the skin. He instituted a new and independent line of therapeutics as applied to this branch of our art, for which the medical world will ever hold him in grateful remembrance. Sigmund and Zeissel during the same period did much to clear up the problems of syphilis. To Czermak (1828-1873) and TUrck (1807-1868) we are indebted (practically) for the making a specialty of diseases of the nose and larynx; of like service to ophthalmology were Jàger, Jaxtthal, Arlt, Stellwag von Carion, Hasner, Mauthner, Fuchs, and von Reuss, while Gruber and Politzer did as much for diseases of the ear.
An indirect offshoot of the new Vienna school is the so-called "Physiological Medicine," founded by Eoser (1817-1888), of Stuttgart (late Professor of Surgery in Marburg), seconded by Griesinger and Wunderlich. Their views were directed against the symptomatologists and idealists, and particularly against the School of Natural History, the claim being that physiology must include vital phenomena, while from the morbid portions of these phenomena the special science should be formed as an artificial, yet practical, division of knowledge. 'Wunderlich's book of therapeutics was for a long time the best guide in this direction, inasmuch as it left to individual thought and judgment—the Hippocratic method of investigation—the determination of value and demand. Another offshoot, that differs but little from this save in definition, is the "School of Rational Medicine," originated by Pfeufer (1806-1869) and Henle (1809-1855), and which, since 1841, has been represented by a special journal. While Wunderlich claimed pathology to be the physiology of the sick, Henle considered this questionable and made no distinction at all between the physiology of the healthy and that of the ill. The language of the followers of this school contrasted strongly with that emanating from other schools, and for a time was confident and ingeniously triumphant; nevertheless, it did not forget philosophical speculation, and Hegel may now be regarded as indirectly the godfather of rational medicine.
The vagaries of Paracelsus led indirectly, though positively, to the foundation of Homoeopathy, and likewise originated the doctrine that bears the name of Rademacher (1772-1849). It is curious that this pseudoparacelsic system should spring up alongside of the Vienna school, its teachings being the classification of diseases by their therapy, Rademacher's followers possessed three universal remedies,—"cubic niter (nitrate of sodium), copper, and iron,"—and also three primary diseases that must take their titles from the three universal medicaments. In spite of the admission that these diseases were unknown, it was boldly asserted they were with certainty to be cured by the three chief remedies. The three primary diseases, "sodic nitrate, copper, and iron diseases," do not necessarily remain as such, as they may throw some organ "into a condition of sympathy, and thus it results that iron disease may express itself in the form of consumption, delirium tremens, etc., while a copper disease may appear as worms, paralysis, jaundice, etc." Besides universal diseases and universal remedies there were diseases of organs, to be diagnosed by the efficacy of organ remedies; thus, abdominal diseases must be relieved by corresponding "abdominal remedies," head diseases with "head remedies," chest diseases with "chest remedies," etc. Also for each particular viscus there must be a special remedy. What is the most surprising about this absurd doctrine is that it found followers, some even quite capable in their way.
Now, too, reappeared the Hydrotherapeutic System—the great apostle of which was Priessnitz (1799-1852)—based upon gross views of humoral pathology, according to which a disease entity was to be expelled in the form of sweat, eruption, etc. Poultices, cold packs, and cold baths were the principal therapeutic measures. Winternitz has made hydrotherapy popular and, in a measure, effective in the management of certain maladies.
Rudolph Virchow in 1858 instituted the doctrine or theory known as "Modern Vitalism," which, in fact, was borrowed from natural scientific medicine, and distinguished from the vitalism of the previous century in that it breaks up the old vital force, which was supposed to be either distributed throughout the entire body or located in a few organs, into an indefinite number of associate vital forces working harmoniously, and assigns to them all the final elementary principles without microscopic seat. "Every animal principle has a sum of vital unities, each of which bears all the characteristics of life. The characteristics and unity of life cannot be found in any determinate point of a higher organism,—e.g., in the brain,—but only in the definite, ever-recurring arrangement of each element present; hence it results that the composition of a large body amounts to a kind of social arrangement, in which each one of the movements of individual existence is dependent upon the others, but in such a way that each element has a special activity of its own, and that each, although it receives the impulse to its own activity from other parts, still itself performs its own functions." This is nothing but another way of expressing the cell-doctrine, to which many medical men are now committed, which means that all bodies are built up of cells and that each cell has a unity and a purpose of its own.
In 1677 Sir Robert Hooke discovered plant-cells; later Schwann discovered animal cells and Robert Brown cell-nuclei; but it remained for Virchow to supply the gap which had risen between anatomical knowledge and medical theory; that is, to supply a "cellular pathology," since which time the cell has assumed the rôle which the fibre occupied in the theories of the seventeenth and eighteenth centuries. Time alone can decide as to the ultimate validity of this theory, which has in certain circles been most enthusiastically received. One of its weakest aspects is, perhaps, that the so-called intercellular substance plays an uncertain and unsatisfactory part. An important feature in which the cellular pathology differs from other systems, and particularly from the old humoral pathology, is in the doctrine that the blood itself is not the proper and original cause of dyscrasiæ, and probably not the cause of continuous alteration of the tissues; that these dyscrasiæ arise because the blood is not an independent structure, but dependent upon the condition of the patient in consequence of its continuous conveyance of the noxious material from all parts of the body,—the blood is, therefore, merely the medium for the production of the dyscrasia. This theory has made several peculiar, new, and symptomatic or morphological forms of disease, such as leukæmia, leucocytosis, etc. Virchow also cleared up the old and obscure ideas regarding pyæmia, and proved that an absorption of pus into the blood, which the name implies, is quite impossible; likewise, that pyæmia is inseparable from thrombotic processes.
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Virchow was born in Pomerania in 1821, and in 1849, he distinguished himself by attaining the highest grade in the career of the learned,—a professorship, which he first held in Würzburg. During earlier years his residence and labors were largely the result of necessities arising from political views, for on account of these he was long denied a residence in Berlin. A personal friend, now old, once an interne in the great Julius Spital, in Würzburg, at the time when Virchow taught there, tells me a light was burning every night in Virchow's room until 3 a.m., and yet the professor was always out at work by 7. It was by such intense application that he arrived at his present position at the very top of the professional ladder; but very few men have the physique and constitution to stand such arduous study. In 1856 he assumed the chair of Pathological Anatomy in Berlin, and introduced microscopical anatomy, to which Rokitansky had not given sufficient attention. Virchow was a former pupil of Johannes Muller, famous as a physiologist and pathologist, and his views to-day are often tinged by the doctrines acquired from this great teacher. He is also a great admirer of Harvey, whose picture, at least for a long time, was the only one permitted to hang in his study. His first edition of Cellular Pathology appeared in 1858; the colossal work on Tumors in 1866, in which he carried out the division of morbid growths originally adopted by Johannes Müller in 1838, classifying them according to their microscopical elements. He is also scarcely more celebrated for his teachings and labors than for the number of famous pupils brought up under his influence, among whom may be mentioned Leyden, Recklinghausen, Cohnheim, Waldeyer, Kuhne, and Rindfieisch. As a result of his labors has arisen in Germany what has been called the "Medical School of Natural Sciences," that seeks, by means of pathological anatomy and microscopy, experimental physiology and pathology, and the other applied methods, to make of medicine an exact science; and to it belong such men as Zienissen, Gerhardt, Notlniagel, Liebermeis-ter, Senator, Erb, Vogel, and others. An offshoot from this is the so-called "Munich Clinical School," to which belong von Buhl, Pettonkofer, Seitz, and Oertel.