Editing Rudolf Virchow (section)

===Theory of cancer origin===

Virchow was the first to correctly link the origin of cancers from otherwise normal cells.<ref>{{cite journal|last1=Wagner|first1=RP|title=Anecdotal, historical and critical commentaries on genetics. Rudolph Virchow and the genetic basis of somatic ecology|journal=Genetics|year=1999|volume=151|issue=3|pages=917–920|doi=10.1093/genetics/151.3.917|pmid=10049910|url=http://www.genetics.org/content/151/3/917.full|pmc=1460541|access-date=22 December 2014|archive-date=27 September 2021|archive-url=https://web.archive.org/web/20210927050758/https://www.genetics.org/content/151/3/917.full|url-status=live}}</ref> (His teacher Müller had proposed that cancers originated from cells, but from special cells, which he called blastema.) In 1855, he suggested that cancers arise from the activation of dormant cells (perhaps similar to cells now known as [[stem cell]]s) present in mature tissue.<ref>{{cite web|last1=Goldthwaite|first1=Charles A.|title=Are Stem Cells Involved in Cancer?|url=http://stemcells.nih.gov/info/Regenerative_Medicine/pages/2006chapter9.aspx|publisher=National Institutes of Health|access-date=22 December 2014|date=20 November 2011|archive-date=22 December 2014|archive-url=https://web.archive.org/web/20141222123016/http://stemcells.nih.gov/info/Regenerative_Medicine/pages/2006chapter9.aspx|url-status=dead}}</ref> Virchow believed that cancer is caused by severe irritation in the tissues, and his theory came to be known as chronic irritation theory. He thought, rather wrongly, that the irritation spread in the form of liquid so that cancer rapidly increases.<ref>{{cite web|title=The History of Cancer|url=http://www.cancer.org/cancer/cancerbasics/thehistoryofcancer/the-history-of-cancer-cancer-causes-theories-throughout-history|publisher=American Cancer Society, Inc.|access-date=22 December 2014|archive-date=22 December 2014|archive-url=https://web.archive.org/web/20141222130553/http://www.cancer.org/cancer/cancerbasics/thehistoryofcancer/the-history-of-cancer-cancer-causes-theories-throughout-history|url-status=live}}</ref> His theory was largely ignored, as he was proved wrong that it was not by liquid, but by [[metastasis]] of the already cancerous cells that cancers spread. (Metastasis was first described by [[Karl Thiersch]] in the 1860s.)<ref>{{cite web|last1=Mandal|first1=Aranya|title=Cancer History|url=http://www.news-medical.net/health/Cancer-History.aspx|website=News-Medical.net|access-date=22 December 2014|date=2 December 2009|archive-date=22 December 2014|archive-url=https://web.archive.org/web/20141222122854/http://www.news-medical.net/health/Cancer-History.aspx|url-status=live}}</ref>

He made a crucial observation that certain cancers ([[carcinoma]] in the modern sense) were inherently associated with white blood cells (which are now called [[macrophages]]) that produced irritation ([[inflammation]]). It was only towards the end of the 20th century that Virchow's theory was taken seriously.<ref>{{cite journal|last1=Balkwill|first1=Fran|author-link=Fran Balkwill|last2=Mantovani|first2=Alberto|year=2001|title=Inflammation and cancer: back to Virchow?|journal=The Lancet|volume=357|issue=9255|pages=539–545|doi=10.1016/S0140-6736(00)04046-0|pmid=11229684|s2cid=1730949}}</ref> It was realised that specific cancers (including those of [[mesothelioma]], lung, prostate, bladder, pancreatic, cervical, esophageal, [[melanoma]], and head and neck) are indeed strongly associated with long-term inflammation.<ref>{{cite journal|last1=Coussens|first1=LM|last2=Werb|first2=Z|title=Inflammation and cancer|journal=Nature|year=2002|volume=420|issue=6917|pages=860–867|doi=10.1038/nature01322|pmid=12490959|pmc=2803035|bibcode=2002Natur.420..860C}}</ref><ref>{{cite journal|last1=Ostrand-Rosenberg|first1=S.|last2=Sinha|first2=P.|title=Myeloid-derived suppressor cells: linking inflammation and cancer|journal=The Journal of Immunology|year=2009|volume=182|issue=8|pages=4499–4506|doi=10.4049/jimmunol.0802740|pmid=19342621|pmc=2810498}}</ref> In addition it became clear that prolonged use of anti-inflammatory drugs, such as [[aspirin]], reduced cancer risk.<ref>{{cite journal|last1=Baron|first1=John A.|last2=Sandler|first2=Robert S.|title=Nonsteroidal anti-inflammatory drugs and cancer prevention|journal=Annual Review of Medicine|year=2000|volume=51|issue=1|pages=511–523|doi=10.1146/annurev.med.51.1.511|pmid=10774479}}</ref> Experiments also show that drugs that block inflammation simultaneously inhibit tumour formation and development.<ref>{{cite journal|last1=Mantovani|first1=Alberto|last2=Allavena|first2=Paola|last3=Sica|first3=Antonio|last4=Balkwill|first4=Frances|title=Cancer-related inflammation|journal=Nature|year=2008|volume=454|issue=7203|pages=436–444|doi=10.1038/nature07205|pmid=18650914|bibcode=2008Natur.454..436M|url=https://air.unimi.it/bitstream/2434/145688/2/Cancer-related%20inflammation_Nature.pdf|hdl=2434/145688|s2cid=4429118|access-date=20 April 2018|archive-date=30 October 2022|archive-url=https://web.archive.org/web/20221030195610/https://air.unimi.it/bitstream/2434/145688/2/Cancer-related%20inflammation_Nature.pdf|url-status=live}}</ref>

====The Kaiser's case====

Virchow was one of the leading physicians to [[Kaiser]] [[Frederick III, German Emperor|Frederick III]], who suffered from [[Laryngeal cancer|cancer of the larynx]]. While other physicians such as [[Ernst von Bergmann]] suggested surgical removal of the entire larynx, Virchow was opposed to it because no successful operation of this kind had ever been done. The British surgeon [[Morell Mackenzie]] performed a [[biopsy]] of the Kaiser in 1887 and sent it to Virchow, who identified it as "pachydermia verrucosa laryngis". Virchow affirmed that the tissues were not cancerous, even after several biopsy tests.<ref name="Cardesa-2011" /><ref name="Ober-1970" />

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 by ulceration, and microscopic examination confirmed [[carcinoma|epidermal carcinoma]]. ''Die Krankheit Kaiser Friedrich des Dritten (The Medical Report of Kaiser Frederick III)'' was published on 11 July under the lead authorship of Bergmann. But Virchow and Mackenzie were omitted, and they were particularly criticised for all their works.<ref>{{cite web|last1=Lucas|first1=Charles T|title=Virchow's mistake|url=http://innominatesociety.com/Articles/Virchows%20Mistake.htm|publisher=The Innominate Society of Louisville|access-date=27 November 2014|archive-date=14 February 2015|archive-url=https://web.archive.org/web/20150214094305/http://www.innominatesociety.com/Articles/Virchows%20Mistake.htm|url-status=live}}</ref> 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 hybrid verrucous carcinoma, a very rare form of [[verrucous carcinoma]], and that Virchow had no way of correctly identifying it.<ref name="Cardesa-2011">{{cite journal|last1=Cardesa|first1=Antonio|last2=Zidar|first2=Nina|last3=Alos|first3=Llucia|last4=Nadal|first4=Alfons|last5=Gale|first5=Nina|last6=Klöppel|first6=Günter|title=The Kaiser's cancer revisited: was Virchow totally wrong?|journal=Virchows Archiv|year=2011|volume=458|issue=6|pages=649–657|doi=10.1007/s00428-011-1075-0|pmid=21494762|s2cid=23301771}}</ref><ref name="Ober-1970">{{cite journal|last1=Ober|first1=WB|title=The case of the Kaiser's cancer|journal=Pathology Annual|year=1970|volume=5|pages=207–216|pmid=4939999}}</ref><ref>{{cite book|last1=Wagener|first1=D.J.Th.|title=The History of Oncology|year=2009|publisher=Springer|location=Houten|isbn=978-9-0313-6143-4|pages=104–105|url=https://books.google.com/books?id=53fmwacXu44C}}</ref> (The cancer type was correctly identified only in 1948 by [[Lauren Ackerman]].)<ref>{{cite journal|last1=Oliva|first1=H|last2=Aguilera|first2=B|title=The harmful biopsies of Kaiser Frederick III|journal=Revista Clinica Espanola|year=1986|volume=178|issue=8|pages=409–411|pmid=3526428|language=es}}</ref><ref>{{cite journal|last1=Depprich|first1=Rita A.|last2=Handschel|first2=Jörg G.|last3=Fritzemeier|first3=Claus U.|last4=Engers|first4=Rainer|last5=Kübler|first5=Norbert R.|title=Hybrid verrucous carcinoma of the oral cavity: A challenge for the clinician and the pathologist|journal=Oral Oncology Extra|year=2006|volume=42|issue=2|pages=85–90|doi=10.1016/j.ooe.2005.09.006}}</ref>