[From Schenkius: Observationum Medicarum, Francofurti, 1609]

ANNALS OF MEDICAL HISTORY Third Ser ies , Volume IV Jul y , 1942 Numb er 4 RUDOLF VIRCHOW AND THE FRANCO-PRUSSIAN WAR

By H. G. SCHLUMBERGER

PHILADELPHIA

NCE again the na- at the University of , member of tions are at war and the Prussian Lower House, and founder the men of science, as well as leader of the Progressive physicians, and Party. In the first number of the cur- scholars are dis- rent volume of his Archiv published on mayed by what they September 23, Virchow wrote:1 see and even more A new war has begun and called the by what they hear. majority of our colleagues to the battle- But dismay is the precursor of impo- field and military hospital. The thoughts tence, and the proud tradition of medi- that I had planned to place at the begin- cine rejects it scornfully. A student of ning of this volume, and which were to man, the great physician is also a leader touch upon important aspects of interna- of men—all men. As such he recognizes tional cooperation, must be postponed no differences of class, nation, or creed, until the passion of the aroused peoples and though he deplores war itself, the has been quenched in bloody combat. I cannot find the calm necessary for the hatreds that it fosters are his greatest study of problems that presuppose a state concern. of peace; during hours in which the his- Such a physician was Rudolf Virchow tory of our nation is being decided on the —pathologist, anthropologist, idealist, field of battle. . . . We must be victorious and revolutionary. A glimpse of his so that at last we may be masters in our activities during the Franco-Prussian own house. War of 1870-71 may help us to formu- Indeed it is sad that at this moment we late our own course of action at a time are unable, as much as we should wish it, when the land we hold dear is striving to separate the government that forced this war upon us from the people which to retain its eminence. At the outbreak it has led to war. Well do we realize what of the war in July 1870, Virchow, then we owe this people, and Germany has cer- forty-nine years old, was at the height tainly been open in its appreciation. . . . of his powers as professor of German science and in par- ticular have enthusiastically followed the let us remember that the greater problem paths opened by the great French thinkers cannot be solved in war, rather, patient of the latter 18th and early 19th cen- and arduous work during peace time will turies. . . . be necessary to establish humane under- This gifted, cultured, and kindly French standing and intercourse as the basis for people—how it has been mistreated! Kept all public relations and the object of all in ignorance, yet seduced to boundless private endeavor. More especially in this conceit that it might be used for base ends. war we dare not forget that we are fighting Knowing nothing of our conditions, of that people which, after our own, has our government, of our customs, and of made the greatest sacrifices to free man- our history; unfamiliar with our present kind and with which, united in peace and strength and even ignorant of the geog- stimulated by competition, we could pro- raphy of our land, the French pamphlet- duce the finest of human works. . . . May eers and journalists dared to judge us and all science exert its influence when the our country. The French masses, unknow- peace is won to foster reconciliation and ing and blind, believed themselves priv- a comprehension of our community of ileged to guide our destiny. In truth, it interests. was a war of ignorance that was declared As in other times and other lands an against us. outburst of patriotic fervor followed the Turning from the international to declaration of war. The civilian popu- the medical problems arising out of the lation was anxious to share the added war Virchow stressed the humanitarian duties and many volunteer societies aspects of medicine. He emphasized were organized. In a Sunday news- the importance of the Red Cross which paper2 published only a few weeks after had been given official recognition only the outbreak of hostilities, Virchow con- four years before at the Geneva Confer- sidered the means whereby those not ence of 1866. Virchow continued: in the armed forces could render useful service: Medicine is called upon to prepare for the era of peace. In the midst of the terrors The chief concern in respect to mate- of war she and she alone is officially called rial accomplishments is the procurement upon to be present on the battlefield as of large sums of money. Even in time of the deputy of humanity, the representa- war most things can be bought and may tive of peace. Without distinction she even be purchased with a clearer regard takes friend and foe alike under her arm of the needs that prevail. Therefore, the to heal the bloody wounds, tend the in- chief activity of private organizations jured limbs, and cool the thirsty lips. In should be that of obtaining funds. The the powder smoke of battle she unfolds State needs its resources primarily for the the banner with the red cross which all prosecution of the war. . . . The human civilized nations have now recognized as sacrifices, both friend and foe, that are a sign of immunity. Thus she erects a made in war depend to a greater or less sanctuary for the wounded, protecting extent for their care upon the civilians. him from further attack and assuring him This then involves the founding and skilled assistance. Her frail tents and bar- maintenance of a hospital and the pro- racks arise wherever there is need, as shel- curement of all the articles, large and ters of human love and mercy. small, necessary for nursing. . . . The We must prove ourselves worthy of the secret of the great success of the volunteer distinction that those in power have given civilian nursing staff in the Crimean and us. We shall be the high priests of hu- American (Civil) Wars is to be found in manity at war, giving blessings to all. But the fact that those who were best pre- pared and most suited for the work en- water may be filtered through charcoal if tered the public service. the equipment is at hand. Otherwise it should be boiled, cooled, and drunk after In 1866 during the Seven Weeks the addition of small amounts of brandy, War with Austria, Virchow founded the tea, or coffee. Berlin Aid Society for the care of the 3. Quenching thirst with straight wounded and the provisioning of troops brandy, rum, or whiskey is a bad and in the Held. In its name he now wrote dangerous practice. These beverages incite an article3 on hygiene, the pamphlet to to repetition and then act as depressants be distributed among the soldiers then rather than as stimulants. A small quan- in France. It is addressed to the private, tity, however, added to lemonade, tea, or for Virchow had great confidence in the water is often beneficial for delicate stomachs. intelligence and self-reliance of the in- 4. Well fermented and aged beer in dividual. Because of their medical in- moderate amounts is recommended. But terest the '‘Rules" are given in full: here particularly the soldier should school The experience of all wars has taught himself in moderation, for only too often that the army suffers disproportionately he is offered new, poorly fermented, or more losses from sickness than from sour beer. These may upset the stomach wounds inflicted on the battlefield. A and bring about diarrhoea, dysentery, etc. large part of this illness may be prevented 5. The common dry country wine by the care and attention of the leaders which is so frequently adulterated, as well and physicians of the army. But no less as cider, are not advisable. For, particu- important is the care exercised by the larly in those not accustomed to them, individual soldier. Nothing is more dan- their enjoyment frequently leads to ab- gerous than the excessive self-confidence dominal distress. At least they should be and assurance with which the strong taken in very moderate quantities. young man considers himself equal to all 6. Worthy of use though unfamiliar to unfavorable conditions. A large number most of our soldiers is tea. On the march of troops are laid low by illness early in a weak concoction of cold tea is always the the campaign because of carelessness, ex- most dependable and wholesome means cesses, or uncleanliness. . . . May there- of quenching thirst. If many do not like fore, the following rules which deal with its taste this will prevent excessive drink- the chief causes of disease in the field, find ing. The concoction may be prepared the a sympathetic reader and be observed not night before while in quarters or bivouac only by the soldiers themselves, but re- and placed in casks or in the individual peatedly emphasized and enforced by the canteens. If it is very warm the tea may be acidulated by the addition of some lemon officers. juice or a few drops of vinegar. i. Clean cold water, though in itself an 7. Coffee is also a worthwhile beverage, excellent drink, should only be taken in but is less enjoyable when taken cold and large amounts when the soldier is at com- hence less satisfactory for quenching thirst. plete rest and quite cool. On the march, 8. Frequently the soldier is tempted to particularly on hot days, it is urgently ad- still hunger and thirst by eating unripe vised that only small quantities be drunk fruits such as apples and grapes. This can- at one time. On the contrary, it is well to not be too strongly condemned; even ripe rinse the mouth frequently with cold fruit should be eaten with care and in water. moderate amounts. 2. Particular care is necessary when no 9. If spoiled bread has been distributed spring or well water, but only river, brook, all mouldy spots, particularly within the or even swamp water is available. Such loaf, must be carefully cut out and dis- carded. Even cooking, which improves should be avoided. A belly-band is useful other forms of bad bread, does not render in combatting a tendency to diarrhoea and the mouldy parts harmless. stomach ache. 10. Freshly cooked vegetables, particu- 16. If the soldier is placed in quarters larly potatoes, may always be recom- after a hot march the windows in the house mended as excellent constituents of the are to be closed and all draft prevented. soldier’s diet. 17. While marching in great heat the 11. Fresh meat should be either broiled head should be kept lightly covered and or cooked for at least a short time. In the the neck protected by a thin over-hanging latter case the water must be hot before cloth such as a handkerchief. Covering the the meat is added, so that boiling will bps with a thin cloth will lessen thirst. begin almost at once. It may be necessary 18. In the event of real illness the physi- to soak salt pork or corned beef in water cian should be notified at once. False pride before boiling to remove some of the salt. or false modesty prevents many a sick sol- 12. Bodily cleanliness as well as clean dier from reporting soon enough. After- linen and clothing is essential for health. ward it is often too late for the doctor to However, urgent warning is given not to be of help. This is particularly true of bathe when the body is over heated nor constipation, diarrhoea, cough, and chest at that time to bathe the eyes and feet. pains. Many a case of dysentery, cholera, Moreover, these very useful and whole- and tuberculosis could be avoided and some functions should be carried out in much invalidism prevented if a physician the morning before breaking camp and in were promptly sought. the evening while at rest. It is unfortunate that Virchow wrote 13. Particular attention should be paid this booklet before he had visited the to the care of the feet. Above all, the shoes should be greased and kept soft. If they battlefields around Metz, which he did pinch the inside should be rubbed with a short time later. As a result many of soap or tallow. If the feet become painful, the suggestions strike even the casual socks should be changed frequently or at reader as quite impractical. What the least turned inside out. Better than socks, soldiers thought of them is indicated by which cannot be washed often enough, the following three letters4 which Vir- are insoles worn with the rough surface chow had the courage to print in the turned inward. The feet should be washed Archiv several weeks later. The first daily when at all possible. If any reddened letter reads: areas are present these should be rubbed with a little brandy to which some warm The Berlin Aid Society is requested to tallow has been added. send the necessities mentioned in this little 14. Abraded areas elsewhere on the pamphlet to the troops. For, if we were to body should be washed and then coated live in accordance with our instructions with tallow. we should have a very different fare. Here 15. Innumerable cases of sickness are one gets nothing but potatoes and a little brought about by colds. It should be noted meat with some rice and coffee. The latter that youth and bodily strength do not pro- of the kind wherein fifteen beans made six- tect against a cold. Sudden changes of teen cups. Bread is very scarce and the temperature are particularly dangerous. marches severe. Even before Paris we were Therefore shirts of cotton or flannel are drilled in brigades and then sent into superior to those of linen and people with battle. There is very little to smoke here, a weak chest should wear a flannel shirt or only our superiors enjoy that privilege. at least an undershirt of knitted or woven The undersigned are all grenadiers in the wool. Change of shirt while sweating active reserve. Another letter reads as follows: that he can eat, and then forbid the use of fruit or wine. From your wise “Health Rules” it is It is clear that during your you have readily seen that you have as yet never sat around the flesh pots of Egypt other- taken part in a campaign. It is quite un- wise you stupid fellows—for you are that derstandable that you, behind the stove in —wouldn't chatter so over your full glass Berlin, can readily obtain all these con- of old Bavarian beer. Here with us you veniences. But it is otherwise with the sol- can’t get anything for money, and if so dier in the field. Herewith I shall review the poor fellow who left an old father or your excellent rules of health serially in mother at home hasn’t got it. He’ll be the name of my comrades. happy when he can return, even though 1. Pure, clean, and cool water is more only half alive. If you loud-mouths and desired even by us than is swamp water and great intellects cotdd only be here on a we don't need someone from Berlin to tell day like the 16th or 18th of September! us about it. Moreover, it was often hardly You and your talk of rum, tallow, soap, possible to obtain even swamp water. shoe polish, sock changing, etc.! Just come 2. Honored sir, if we should follow your out here and try carrying a knapsack all wise teaching you would have to send the day—you'll fall over in the first hour. Any army a filtering machine, tea, coffee, or shepherd or swineherd can preach rules, rum. even I can do that, but under these condi- 3. If you have sent us so much rum and tions it won't work. Now that we are at the like, then we are indeed sorry for we the outposts at least send us some drawers have seen none of it. or a jacket, socks, and insoles. Send your 4. We’d all like to drink beer if we had Berlin washerwomen here to Gonnesse so any. If you would be so kind and send a that they can wash our shirts. Our cleaned few casks to the fusilier’s battalion they linen is more likely to attract vermin than would be accepted with the heartiest is a shirt we’ve had on for four weeks. Here thanks. you write of cotton or flannel shirts. Well, From the foregoing you will probably be then give them to us, or do you think we able to interpret the rest of your “Rules” alone. Best regards and many thanks for should strap the quartermaster’s depot and your advice. the Berlin arsenal on our backs? From the contents of these letters it Of the third and last letter Virchow is apparent that military censorship of said that it was so filthy that he could print only the first part of it: the soldiers’ mail was nonexistent or poorly enforced. After a half-hearted Your book of the Berlin Aid Society has defense Virchow admits that “. . . it been received today. I assure you that you may be seen from these letters that the and your whole Aid Society got up too ‘Health Rules’ reached the troops too late. Furthermore, you may well keep your hygiene to yourself and give the common late and hence failed. Whoever is in soldier, who has been enslaved and tor- need demands active assistance and not mented enough, the hope of getting some- good advice, even though the latter thing to eat and drink rather than your might still be useful. Hence it is my be- rules, which neither officers nor anyone lief that such pamphlets should in the else intend to follow. Give the private your future be distributed in time of peace salary or other income, else the matter of or at least before the campaign has coffee, tea, or rum cannot be carried out. Clean linen daily—do you think man is a begun. Then the soldier is still recep- pig? If you do then you’re the biggest. First tive and in a position to obtain all give the soldier bread or something else manner of things that are out of reach in enemy territory.” The latter part of contained space for thirty beds and was this quotation would indicate that Vir- well ventilated by means of windows chow had accepted the probability of and a large double door, the latter oc-

future wars, and that these would be cupying most of one of the end walls. fought not many years hence. Through this door abundant sunlight While the soldiers in the camps were could be admitted or the patients amusing themselves at his expense Vir- wheeled through it into the courtyard. chow entered a field of activity in which An interesting side-light is the fact that he was more successful. In 1866 one of the war department permitted no heat- the first tasks of the Berlin Aid So- ing installations on the mistaken as- ciety had been the conversion of an sumption that the war would certainly old Uhlan barracks into a hospital. On be over before winter! the whole the results had been satis- The barracks were in three V-shaped factory, and at the outbreak of the groups, with kitchens, morgue, laundry, war with France, Virchow was granted and administration buildings in the permission to construct a military hos- open spaces between the rows of pavil- pital on the famous Tempelhofer Field. ions (Fig. 2). A railway spur ran At that time he was well aware of the through the center of the group, facili- increasing importance of Berlin as a tating the admission of the wounded diplomatic and commercial center, and as well as the transport of supplies and anticipated its growth and need for equipment. Virchow pointed out that greater hospital facilities.5 The army it was the largest institution for the hospital gave him the opportunity to care of the wounded ever erected and build a temporary structure that would expressed the hope that it would serve serve as a proving ground for the latest as a pattern for later years. theories of hospital planning and man- During the Civil War our medical agement. corps had evolved this type of building The hospital consisted of a large as well as the group arrangement. number of barracks or pavilions made Virchow gratefully acknowledged this of wood and mounted on piles one to debt, stating that he had used the Lin- one and one-half feet high (Fig. 1). Each coln Hospital in Washington as his model. The chief reason for decentral- treatment of wounds. Rather I wanted ization was the belief that the spread of to show how many are the rules of cau- contagion could be more readily pre- tion that must surround any investiga-

vented. In fact so great was the dread tion in which general conclusions are of infectious diseases at that time that drawn from a limited series of cases.” the construction of even permanent The hospital was now ready but the city hospitals of wood was seriously en- transport of the wounded from the bat- tertained. It was suggested that in event tlefield to Berlin was extremely unsatis- of an epidemic such buildings could factory. Once again Virchow stepped readily be torn down and burned with- in, and he wrote:6 “Public interest has out great financial loss. Virchow op- been awakened by the unfortunate con- posed the idea primarily because it ditions prevailing in our ambulance presented such a grave fire hazard. trains. Even the gravely wounded lie Fear of harmful emanations from the stretched out upon the floor of ordi- ground prompted the placing of all the nary freight cars with only a few bun- pavilions on piles—all except one. This dles of straw to serve as bedding. There was built directly upon the ground on is no medical personnel and even order- the express wish of Virchow, and proved lies are usually absent. . . . The nurs- to be the most comfortable of all, par- ing care is left in the hands of voluntary ticularly in winter. Virchow objected committees posted at various way-sta- to the uncritical acceptance of a bac- tions.” terial etiology for every disease in which In speaking of these matters at the someone had discovered an organism in ministry, Virchow was told that three the tissues. After warning against such years before, in 1867, two hundred pas- unrestrained enthusiasm he con- senger coaches had been procured and tinued:3 “I did not advance these re- so arranged that all the partitions could marks in order to deny or weaken the easily be removed. The remaining posts view that pure air is essential for the were provided with hooks to carry the stretchers.7 Each of these coaches could rubber rings from the posts and walls of carry ten sick or wounded men (Figs. the car where they may serve as sick beds 3 and 4). Only a hundred had been sent for some time. Their elastic attachment

to the front; the rest were idle at the weakens the force of any shocks or vibra- time of Virchow’s visit. The minister tions. In America these hospital coaches informed him that a fair number could were so large that a single car could carry be placed at his disposal if the Berlin sixteen persons when grouped in two or three tiers and still have space left for a Aid Society would equip them and pro- small room in each corner. Two of these vide the needed personnel. That same rooms were used by the physician and evening the board of directors voted a nurses, the other two being the kitchen grant of 3,000 thalers for the purpose and pharmacy. Thus each car formed an of provisioning and furnishing ten hos- independent hospital unit. The Prussian pital coaches. In twelve days a train railway system, however, did not permit consisting of fourteen cars was ready for such a disposition. The coaches have only service in the transportation of the two axles and are so short that there is wounded. only space for ten persons arranged in two Virchow described the coaches as fol- tiers; and even then nearly all the room is lows:0 used up. Only a central aisle remains, lead- ing to the doors at the end of the coach. It should be mentioned that the prin- Here a platform overlaps a similar one of ciple on which the cars were furnished was the car coupled with it, forming a bridge first worked out in the American Civil between the two. Thus it is a simple mat- War. Stretchers that are suitable for use ter to pass from car to car throughout the on the battlefield can be suspended by whole length of the train at any time of the day or night. It was clear that centraliza- wounded. Indeed, not infrequently their tion could therefore be employed, hence illness follows a much longer and more the kitchen (Fig. 5), pharmacy, etc. each fatiguing service. But even a slightly

occupied a separate car. In this way, in- wounded soldier seems a much more stead of the American hospital coach, an worthy subject for public care than one entire train formed the hospital unit. . . . who is suffering from disease. Even a per- The hasty preparation of our train pro- son who has been kicked by a horse or run vided us with many difficulties. At one over is more esteemed; in fact, 1 remember time we were in danger of having to aban- one who had been butted by an ox and don our kitchen car because the axles be- enjoyed the most loving care because his came over-heated. Fortunately we were head wound was believed to have been the able to open the clogged oil ducts by means result of enemy action. of hue surgical sounds, else we would have Nevertheless, he would have pre- been unable to move an important part of ferred wounded soldiers because the our “hospital.” hospital in Berlin had been arranged Virchow detailed a number of minor and equipped for the care of the mishaps and official interference that wounded. The introduction of cases of greatly delayed the journey to the bat- infectious disease would complicate tlefields. No one knew where other matters. When the hospital train finally ambulance cars might be, and when arrived at Noveant in the vicinity of found they were usually connected to Metz, Virchow left it and went for an freight trains. Even the number and all day trip visiting the various field location of the wounded was unclear. hospitals in search of wounded. Of this For a time it looked as if Virchow journey he wrote: would have to fill his train with the vic- tims of typhoid and dysentery rather Our carriage was a simple peasant wagon of three boards and had been requisitioned than with wounded soldiers. In respect by the artillery in Germany. It was loaded to this he said staunchly: with boxes of gifts for the soldiers, these I am far from agreeing with those volun- boxes serving as seats for some of us. The teers who will care only for the wounded. coachman was a Hessian who had been Those sick from dysentery, typhoid, rheu- brought here six weeks before, somewhat matism, and pulmonary infections have against his will, and still wore nothing but sacrificed their health in the service of the his short blue linen jacket. He whipped his Fatherland quite as much as have the lean nag, we unfurled the ambulance flag, and were off. ... In Ars-aux-Moselle we the way we met a solitary rider buried in inspected the hospital barracks as well as his raincoat, apparently an officer of higher a chateau, dance hall, and school in rank. After the first casual greeting he which the injured were quartered and turned about, called me by name and in- chose several for removal to our train. . . . troduced himself. Through him I first We resumed our journey to Gravelotte, learned of Bazaine’s sortie made the day passing along a steep defile in a wooded before and of which no one (in this vicin- valley. The sky had been grey and over- ity) had any knowledge. We were at once cast and as we neared the plateau of able to arrange for the removal of the Gravelotte it began to rain. At the same wounded. When we arrived at Verneville time malodorous vapors arose from the for- the ambulances had just returned. . . . est gorge and the rain increased. When Night was setting in as we distributed the we reached the battlefield itself, where the second half of our gifts, partly directly to graves of the fallen with their low wooden the men of the 24th regiment, partly to crosses appeared in ever closer rows, we the quartermaster of the corps. We hur- could learn from personal experience the riedly began our return journey; the rain character acquired by this ground after driving horizontally against us so that the even a short downpour. The wind which drops stung our faces like grains of sand. gradually veered from north to east At times the horses failed. It was late at reached the intensity of a storm and rain night when we reached Noveant and our pelted us from all directions. However, this hospital train, but the first half of our task may have been well, for our guide assured had been accomplished—we knew where us that usually the most foul odors are ap- the wounded were. parent over the whole battlefield. In Gravelotte itself, where the houses on The next day Virchow was anxious the whole seemed to have suffered little, to be off to Ars, there to pick up the our gifts were greatly appreciated. The wounded he had seen the previous day. hospital, which was almost devoid of bet- While the train was in Ars the wounded ter wines and liquors, received half our from the hospitals in the vicinity would supply—and certainly they were badly be brought to Noveant and picked up needed. The six large tents for the there on the return trip. However, the wounded were fastened directly to the train was delayed because headquarters bare earth and were surrounded by fresh graves. The storm that came howling had forbidden all traffic about the sta- through the canvas poured rain in at every tion of Ars. The reason for this was opening. The poor inmates, consisting simple—a French battery located on largely of seriously wounded many of the heights of St. Quentin had the habit whom were Frenchmen, were feverish and of shelling the yard whenever a train hence very sensitive. They had crowded pulled in. But permission was finally their beds into the few dry places that they granted, the hospital train left Noveant, might be somewhat protected. The chief and shortly thereafter entered Ars. staff physician rewarded me for my gifts Hardly had it come to a halt when the with a warm dinner which we ate in a cold bring from St. Quentin began. This dreary room in front of a large empty fire- time, however, none of the shells were place. It consisted of hot soup with meat extract, stewed fruit, and coffee. The lat- directed on the station and Virchow ter was served in small tureens and eaten attributed this to the observance by the with large tin spoons. French of the red cross flag that had We then continued our journey in the been hoisted over the train. He con- pouring rain and driving wind. . . . On tinued: The stretchers were taken down, fully wounds, stood about the coach, from the prepared, and then sent to the various gangway of which I directed the loading. barracks so that the wounded could be I counted the remaining vacancies—there brought directly to their places in the were ten. But fourteen men waited hope- coach without further transfer. Everything fully for the moment when their entry into went along rapidly until a heavy rain the train would guarantee their return to began to fall, necessitating a temporary the homeland. I told them that only ten halt in the proceedings. ... In the mean- could come along and asked them to de- time the ambulances arrived carrying the cide among themselves who should remain wounded from the battlefield of Feves. behind. It was useless—each tried to seize These were all taken aboard immediately. a part of the coach. As victims of a ship- Eate at night our train returned to wreck grasp the life boat, so they clutched Noveant and we could at once begin the at the steps from which they sought to duties of caring for the sick. enter. Nothing remained but to admit The following morning, to our painful them all. Mattresses were laid on the floor surprise, we found ourselves on a siding in the narrow aisle between the stretchers the open end of which was blocked by an and the poor fellows gratefully lay down endless train loaded with compressed hay. upon them. And yet, when we changed All efforts to get out of this dilemma were the bandages, it turned out that nearly of no avail. There was no locomotive in all had suffered severe wounds. Head in- Noveant that cotdd be requisitioned, man- juries, one of which had penetrated the power was insufficient, and the good will , shots in the shoulder, arm, and hand of the station master was not enough to with fragmentation of the bones were get us free. Unfortunately the railway found anions; them. telegraph was out of order and each trip The trip back to Berlin took place to the station from the train took fifteen without mishap and in spite of a stop- minutes. Finally the military telegraph came to our aid and a locomotive was sent over in Nancy, required only (sic) from Pont-a-Mousson. After much shut- seventy-two hours. However, once when tling back and forth we were finally the train had reached the speed of an brought up immediately in front of the express Virchow was awakened in the barracks. In the meantime the morning middle of the night and told that in had passed. . . . one of the coaches the wounded could The task of removing the stretchers and not stand the shocks. And in truth, on transporting the wounded was carried out inspection he found that the injured with the greatest precision and dispatch. limbs had “nearly been shaken out of It was really moving to see how one after their bandages.” This was the case, another of the many onlookers came for- however, in only one coach, an old ward to lend a hand. Higher officers who had brought their relatives, the physicians model with very short springs. Else- of the barracks, railroad employees, vol- where the patients were all quite com- unteer nurses, hospital orderlies, and even fortable. Virchow concluded his ac- one of my friends who happened to arrive count of the journey with the statement from Saarbriicken—all took part. A per- that “for the first time the severely fect picture of human kindness! It needed wounded were taken directly from the scarcely three hours to fill five coaches, battlefield (Feves) and without being even though the greatest care was exer- transferred to a field hospital were car- cised. As we finally reached the last car a ried uninjured and well nursed over peculiar difficulty arose. A group of sol- hundreds of miles until they reached diers, apparently suffering from minor home. They spent the long journey on the same stretchers on which they were water in the transmission of the disease lifted into the coaches at Ars and is clearly shown in the following ac- Noveant; on them they were brought count8 of his experience while evacuat- by the train to the very doors of the ing the wounded from Metz: hospital, and finally were carried to Unfortunately we do not know enough their bed in the pavilion without a of the etiology of typhoid to enable us to single transfer.” analyse the source of the infection in the While the siege of Paris and of Metz individual case. As long as this is impos- dragged on into the winter months the sible we must remain uncertain in prophy- incidence of typhoid and dysentery laxis. In this respect I can point to the among the troops increased at an alarm- very unfavorable experience of our hos- ing rate. Virchow emphasized8 that the pital train. On October 7th we reached short duration of the wars with Den- Noveant, just above Metz; and began the return journey on the 10th. Our patients mark and Austria in 1864 and 1866, were almost all wounded, only a few con- respectively, had prevented the devel- valescent typhoid cases were on board. opment of the usual wartime epidemics. However, not a few of the wounded suf- Not only was the medical department fered from dysentery. It had been notice- poorly equipped to cope with the situ- ably cold when we left Berlin on October ation, but the physicians had only a 2nd and even during the somewhat long hazy notion of the of the dis- and frequently delayed trip diarrhoea eases with which they were dealing. was often noted among the orderlies and Virchow pointed out that “though in attendants. The majority of these could France, and especially in England and be traced to cold feet. In order to be quite Ireland, repeated sad experience had certain that our staff would be protected fortified the knowledge that there exist from harm we carried not only our own kitchen and stores of provisions, but also two forms of typhus—spotted or typhus a large water cask. I allowed the latter to fever and abdominal or typhoid fever be filled only after having personally con- —in Germany it became the custom to sulted a post surgeon to ascertain a source refer to both simply as typhus. Finally of pure water. In Noveant the drinking the conviction has become widespread water was obtained from a well which lay that the existence of a second form of at the other end of the village but which typhus is wholly fanciful.'’ He then de- the physicians had pronounced safe. In tailed the differential findings in the spite of these precautions four of the vol- two diseases at and stated that unteer attendants became seriously ill unlike other wars, typhoid rather than after the arrival in Berlin. Of five young typhus was epidemic among the troops. men between 17 and 19 years of age, three were bed ridden in the course of the next He took the opportunity, while citing two weeks. Two were my sons and one the statistics of our Civil War which son of Dr. Korte. Of nine orderlies one, showed a similar incidence of typhoid, the strongest of the lot, became ill. In to utter words of praise for the Ameri- young Korte and my eldest son the diag- can medical corps. nosis of typhoid fever was clear. Both Virchow sought the etiology of ty- entered upon a slow convalescence, the phoid in a general debilitated condi- former only after his life had been en- tion of the soldiers due to excessive dangered by severe intestinal bleeding. weariness, poorly cooked food, and In the case of the orderly the disease fol- sleeping on the damp earth. FI is recog- lowed an extremely mild course, so that nition of the importance of drinking for quite a while it appeared to be an intermittent fever with constipation, until months that have elapsed since the con- a sudden intestinal haemorrhage revealed clusion of peace. Even though the terrible its true nature. In my second son the in- ravages of the civil war may have done termittent character persisted to the end much to reveal the true nature of things —no exanthem, no cerebral symptoms, to a large number of the French, we real- slight splenic enlargement, frequent con- ize that years will be necessary before even stipation, clean tongue, moderate fever, the most unprejudiced opinion will fail were observed. to arouse anew the injured national pride. It is with profound sadness that we see, Finally, in the spring of 1871 the war even in learned circles, the complete sub- ended. emerged the victorious stitution of passion for reason. Ever more leader of a new and German men of science are replying to France was reduced to temporary im- the French attacks with unbounded potence in the affairs of Europe. The vehemence. These attacks, though in gen- volume of the Archiv issued at that eral wholly unjustified, are rendered ex- time contains a leading article9 by cusable by the circumstances in which Virchow in which he revealed the they arise. We should not forget that we grandeur of his social concepts: are the victors, and that as victors it is our duty to pave and hold open the way for Last September when the war was reconciliation, even though for a long raging in all its fury we expressed the time that way be spurned by the van- hope that all educated people would quished. exert their influence to bring about a reconciliation and to foster the realization In January, 1871, Pasteur returned of our community of interests. We repeat the diploma of honorary doctor of med- this wish most urgently, now that peace icine awarded to him in 1868 by the seems assured and the combatants are re- University of Bonn. He was inspired to turning home to take up their interrupted this action by the shelling of the Mu- duties. seum of Natural History during the But well do we know that the passions of the people can be more easily aroused bombardment of Paris. This same in- than calmed and that the torrent of public cident also led the anthropologist opinion finally drags everyone with it, Quatrefages to write an article intended the scholar as well as the laborer. During to prove that Prussians were descend- an emotional catastrophe such as that ants of a Mongol tribe. Pasteur con- which is now gripping the French people cluded his passionate denunciation with all have lost their capacity for cool and the statement:10 “This letter will not objective judgement. Everyone is too have much weight with a people whose greatly depressed by the sad plight of the State, by the suffering of so many indi- principles differ so totally from those viduals, and by his own losses. He cannot that inspire us, but it will at least echo quickly reconcile himself to the altered the indignation of French scientists.” circumstances, recognize the inevitable, Of this letter Virchow merely said,9 and quiet his outraged feelings. Nothing “I will not speak of the much discussed can be more ill founded than the demand letter of M. Pasteur with which he re- frequently expressed in Germany that the turned an honorary diploma given him French should accept their defeat and the at Bonn. And I do this because I de- peace that was forced upon them; that as friendly neighbors they should reestab- plore the way in which this highly lish regular and normal relationships. For meritorious man was answered and this more time is necessary than the few thereby irritated even more.” Nevertheless, when himself the ob- share and understand. A man of mixed ject of unjust attack Virchow was quick emotions like the rest of us, Virchow to reply. The following was printed in should not be judged too severely when a Lyons newspaper9 in April, 1871: he occasionally fails to follow the pre- cepts he teaches. As physicians inter- M. Chauvin has told us that the famous Berlin professor, the pride of German ested in the history of our profession, science—Rudolf Virchow—had been a let us harken to these words of caution student of Professor Kiiss at Strasbourg. and advice:8 Further, he says that Professor Kiiss had The history of medicine, or as I have published a small pamphlet in 1847 on the previously called it, the history of human of bone. In this can be suffering, will have to add the sum of the found the entire doctrine of cellular inestimable sacrifices of this war to the pathology for which great discovery and havoc of previous wars. May the students biological revolution M. Rudolf Virchow thereof be more attentive than in the past has been credited. Certainly it is true that and may they be energetic champions of the Prussian Rudolf Virchow did not cite the teaching that peace is essential if peo- his master, M. Kiiss, who is a scientist as ples shall prosper! Yet, it may be looked modest as he is profound. Rather, he upon as a great advance that in recent robbed and pillaged him—in the Prus- years men of peace have sought their ar- sian manner—and lacked the spirit to guments in the history of medicine—have share the credit. Had he done so he woidd begun to open this carefully preserved have lost prestige, and that is not the Prussian usage, be it in science or in war. treasury of all mankind. But is it not the bitterest irony that precisely the history Virchow replied with a vigor that has of the epidemics of Metz, based on pub- lost some of the scholarly objectivity he lications of the local medical society, so strongly recommended to others. should be the first example of this trend! “To this I could simply answer that the Just two years ago the International Peace whole thing is a pack of lies. Anyone Association in Paris brought out this in- who makes the effort to investigate the teresting booklet. But what did it help? sources would at once be convinced Even early in the conflict our own na- that there isn’t a grain of truth in it. tional Hotspurs demanded a war to the But that would be asking too much of finish in order, as they said, “to bring the ordinary run of French professors. about conditions that will better insure What need has a Frenchman to consult the peacefulness of our neighbor.” And yet, even then the conclusions of the foreign literature?’’ After this out- the historical researches at Metz could be burst he goes on for three printed pages read with gloomy foreboding: “Victorious to prove his point—he never was a stu- or vanquished, the armies in their pas- dent of M. Kiiss, he never studied in sage leave a long trail of suffering and Strasbourg, and first visited that city in death, the memory of which is perpetu- 1861. Further, Virchow says that Kiiss ated for many generations. Here is per- never wrote the article referred to and haps the mysterious cause of those instinc- that the one which he did publish—on tive hatreds that exist between certain vascularity in inflammation—had been nations, hatreds that can only be effaced cited several times in the Archiv. by long standing commercial and indus- This display of anger and indigna- trial relations.” tion serves to liven the picture we have Nothing is more difficult than the ap- of him, for these are feelings we can plication of the lessons of history to the problems of today. The masses are ig- tuted for the purposes of war in all norant of them and the statesmen forget times and by all nations. They must at them. last find expression in the world at But though the statesmen may for- peace if they are to be more than empty get, we the physicians of mankind must phrases. We dare not again betray the remember! The nobility of man is at- idealism of youth! That is being done tested by the unrestrained enthusiasm in the Germany of Nazi supermen with which young men of today are where the writings of Virchow are not sacrificing themselves for liberty and condemned only because they have be- freedom; ideals that have been prosti- come unintelligible.

Ref ere nces 1. Virch ow , R. Der Krieg mid die Wissen- 5. Virc ho w , R. Ucber Lazarette mid Ba- schaft. Arch. f. path. anat. u Physiol., racken. Berl. klin. Wchnschrft., 8:109, 51:1, 1870. 1871. 2. Virch ow , R. Die freiwillige Hiilfe im 6. Virc how , R. Der erste Sanitatszug des Kriege. Sonntags-Blatt fur Jedermann Berliner Hiilfs-Vereins fiir die deut- aus dem Volke, 32:255, 1870. (Re- schen Armeen im Felde. Berlin, Hirsch- printed in Gesammelte Abhandlungen wald, 1870. aus dem Gebiete der Oeffentlichen 7. Sanitats-Bericht ucber dir deutschen Heere im Kriege gegen Frankreich, medicin u. d. Seuchenlehre, Berlin, 1870-71. Berlin, 1884. Hirschwald, 1879.) 8. Virc how , R. Kriegtyphus mid Ruhr. 3. Virch ow , R. Gesundheitsregeln fiir die Virch. Arch., 52:1, 1871. Soldaten im Felde. Arch. f. path. Anat. 9. Virc how , R. Nach dem Kriege. Virch. u. Physiol. (Virch. Arch.) 51:127, 1870. Arch., 53:1, 1871. 4. Virc how , R. Feldpostbriefe fiber die 10. Vall ery -Rad ot , R. The Life of Pasteur. “Gesundheitsregeln.” Virch. Arch., 51: New York, Doubleday, Page and Co., 436, 1870. 1923, p. 190.