One and a Half Centuries of Forgetting and Rediscovering: Virchow’s Lasting Contributions to Social Medicine

Abstract

Since Rudolf Virchow's classic work on social medicine appeared in the mid-19th century, subsequent generations have generally forgotten its message and only later discovered the conditions of society that generate disease and mortality. Now, when pathogenic factors in the workplace and environment threaten the survival of humanity and other forms of life, it is not surprising that these problems attract attention. Current work on the social determinants of health states, however, rarely traces their early intellectual history. Instead, these works tend to be presented as new discoveries, as if previous generations had not made similar observations and reached the same conclusions about the social cause of illness and death. Virchow's contributions to social medicine, as well as his life as a political activist trying to change the social conditions that generate disease, remain vital as we face the increasingly serious problems generated by problems such as global warming, toxic waste, occupational and environmental carcinogenesis, and the commercialization of water reserves. His broad vision of the social origins of disease deserves more than the obscurity into which much of his work has fallen. In this brief preface to Virchow's report on the typhus epidemic in Silesia, which he published during the intense revolutionary upheavals in Europe in 1848, I try to place his report in the context of his life and the social conditions of his time. It also describes some of Virchow's later impacts on fields such as social medicine in Latin America.