I'm coming to the realization as I post these that many are untitled or merely bear the assignment's title. This paper's no different. At least in that regard: few other of my papers were so horribly "philosophical" as this, moreover this, as far as I know, is the only one that used a source that was actually quoted snippets taken from one single web page of a transcript of a speech inspired by real quotes. The class was a bunch of hooey anyways.

Biomedicine and Politics
[presumably in the words of Rudolf Virchow]

copyright 5 December 2000 by Mike Lietz

“Medicine is a social science, and politics is nothing else but medicine on a large scale. Medicine, as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution: the politician, the practical anthropologist, must find the means for their actual solution.” -- Rudolf Virchow

Prominent in the mid-nineteenth century, German physiologist Rudolf Carl Virchow was very much the quotable visionary. Reductionist by creed, the charismatic Virchow nevertheless liked to make grandiose claims about his chosen field and the world at large. Carried away by his neat solution to the typhus problems of Upper Silesia, Virchow wrote, “Medicine is social science, and politics is nothing else but medicine on a large scale.” While a compelling sentiment, his claim does not hold up to scientific scrutiny or the historical record. Simple biological knowledge as well as the eugenics movement and the general failure of universal health care all present evidence against Virchow’s argument.

Virchow was an idealist. His ideas, while seductive and grand, just do not apply to reality. In the beginning of the famous quote, “Medicine is social science,” Virchow implies that politics work on the body on a small scale. Virchow later remarks, “The body is a free state of equal individuals, a federation of cells, a democratic cell state,” and this simply is not true. It is a nice, idealistic simplification but ultimately a flawed one. Politics is the leadership and governance of the many by a few individuals, based on equal rights and participation. Common policies, rules and benefits abound in the political landscape. Medicine, on the other hand, is significantly less generalized in scope and practice; instead it is the treatment of the individual and unique with varied methods and approaches. There exist few universal cures or treatments for bodily ailments. For example, toothaches are not treated with foot powders and lobotomies do not alleviate tendonitis. Treatments in medicine are specific to particular ailments and areas of the body. In contrast, programs in politics are more sweeping in scope, and are meant to apply to large groups, if not a majority, of a populace. Virchow however, stated that “Disease is not something personal and special, but only a manifestation of life under modified conditions, operating according to the same laws as apply to the living body at all times, from the first moment until death,” but this is no longer prevailing opinion — diseases are individual and unique, and don’t necessarily have such long lifetimes. As such, diseases as a whole cannot be treated merely as interchangeable members of a democratic political body.

Furthermore, in a true democracy, all members are equal in right, privilege and importance, and as such enjoy equal status. Virchow obviously does not consider the fact that some parts of the body are less important than others: some cells and organs are more equal than others. For example, neurons in the auditory cortex of the brain respond to sounds twenty-four hours per day, regardless of consciousness of the individual, while neurons responding to taste fire only while an individual is eating. Those possessing a high-school level knowledge of anatomy know many examples that reflect this inside the human body.

The body contains several structures of questionable usefulness. Two parts that the majority of people have removed — painlessly, usually — are their tonsils and their third molars: wisdom teeth. Both can be removed without losing any of the body’s functionality or harming the person. Removing any part of an truly equal, democratically political body would have a similar detrimental effect to that body, as is the case with the human heart, digestive tract or head, but this does not hold true for tonsils and wisdom teeth. A body with an arm removed is functionally very different than one with one less tooth. Fracturing the spinal column can permanently paralyze a person; fracturing the same person’s pinky finger causes a temporary annoyance at worst. This disparity of usefulness taken to its extreme leads to one part of the body that can be harmful, even deadly, if not removed: the appendix. With its main function still unknown to science, the appendix remains a largely superfluous organ. Democracies are not known for their overabundance of useless members, and rightly so. Such evidence does not support Virchow’s “free state of individuals with equal rights, though not equal abilities, which persists because the individuals depend on each other.” On the contrary, it describes a chaotic, interlocking system not easily likened to a political philosophy.

The argument could be made that Virchow may have been speaking on a smaller scale. He thought, after all, to have “a complete knowledge of the human body, this most miraculous masterpiece of nature unknown to so many!” Many cells composing different parts of the body are in fact very similar. For instance, gametes, — sperm and ova — the human cells for reproduction, do not contain vital cell automata like mitochondria, and lack even a full set of DNA. Furthermore, brain cells consume nearly four times as much blood and nutrients as those in any other part the body. Also in the brain, sensations from tactile nerves are given higher precedence than those of olfactory and visual cell nerves. The human body is able to respond a surprising four times more quickly to a stimulus on the skin such as heat, than to one from the eyes, ears, nose or taste buds. Furthermore, the cerebral cortex contains more neurons that respond to sensations from the tongue, lips, fingers, and genitals than all the rest of the body combined. Clearly the human body does not allocate equal priority to all of its components, and thus is no “free state of individuals with equal rights”.

The core of Virchow’s argument was the converse, though, regarding not the political body but the body politic. Virchow was no stranger to politics himself. He served in the German Parliament after 1848 as a progressive, and would likely have liked to rule the Silesians he studied, having written, “The government has done nothing for Upper Silesia”. Virchow’s fully placed the health and welfare of the citizens of that province in the hands of the government in Berlin. He placed the culpability for the disease in the hands of the unaffected politician, not the peasant who, as he reported, “in general does not wash himself at all, but leaves it to celestial providence to free his body, occasionally by a heavy shower of rain, from the crusts of dirt accumulated on it.” This expectation that public health is the responsibility of politicians leaves no course for correction of mistakes and public grievances, and no possibility for personal responsibly or autonomy.

The intermingling of medicine and politics has not produced an abundance of positive results. While a few rare initiatives have purely been beneficial to society as a whole, such as public health initiatives including vaccination, history gives us many examples of inequality and injustice in medicine as politics and politics as medicine. Political implementation of biased biological concepts into policies leads to the downfall of objectivity in the law. As seen in the eugenics movement of the 20th century, racist and idealist views mixed to create a newfound subordinate class and a mockery of political democracy.

Eugenics gives the clearest examples for the separation of politics and scientific theory. An offshoot of biological determinism, eugenics contends that since unfavorable traits and circumstances are inborn to an individual, eliminating that individual removes the continuance of the unwanted characteristics. The word “eugenics” itself means “good reproduction”, and put into practice, means one group controlling the reproduction of others for the betterment of the population at large. As such, eugenics is a pervasive but incredibly dangerous philosophy. Taken to its grisliest extreme it can and did result in mass killings, and even in lesser implementation it produces oppression and injustice for large groups of people.

Germany before World War II was a hotbed of political turmoil, with Christian leaders blaming Jewish Germans with the country’s problems. It was this tension that led to the atrocities enacted by the Nazis once they were solidly in power. Adolf Hitler had the ideas of Eugenics in mind when he ordered the mass extermination of the Jews, his scapegoat for the problems of the fatherland. He blamed them not only for the shortcomings of the nation but for the downfall of society at large, and so biased, wanted to eliminate them. Hitler’s vision of the future included only the supposedly genetically superior Aryans, and to that end he consolidated Germany’s Jewish population into work and prison camps. Eventually he ordered many of them to their death in various manners, and he allowed his scientists and doctors to experiment on other Jews. His treatment of them was not of equal human beings, but of lesser animals; so convinced was he of their genetic inferiority.

Germany wasn’t the only country where eugenic policies were implemented. Prior to the Führer’s rise in Europe, similar (though not ultimately genocidal) initiatives had already been implemented across the Atlantic. In the early 20th century, the United States enacted many eugenics-related policies, from state laws regarding forced sterilization to marriage restrictions. By 1915, over 30 states had laws on the books restricting marriages, allowing them to be voided by such claims as sexual promiscuity and feeblemindedness. At the same time, seven states had laws allowing forced sterilization of individuals, resulting eventually in around 60,000 sterilizations by 1960. Both of these legal maneuvers were intended to keep only the appropriate, worthy citizens married and capable of reproduction. In 1924 the United States House of Representatives passed the Immigration Act, largely on the testimony of Harry Laughlin, a prominent authority on immigration. Laughlin, based on flawed intelligence tests and personal biases, persuaded the government to limit immigrants to a restrictive and unjust quota system. In this system, those entering the United States from different countries were admitted or turned away based on the percentage their nationality represented in polls taken under President Coolidge in 1890. Southeastern Europeans were among of the many groups specifically targeted by this initiative. The rationale behind this plan was to keep the those supposedly less intelligent, and potentially less beneficent to society out of the country and thus keep them from reproducing into or tainting the American population, since, as Laughlin demonstrated, such citizens were disproportionately represented in the nation’s jails and asylums. In these cases, the biological theory became justification for racial injustice. When Virchow spoke of politics, he had the ideas of equality and justice in mind, not of domination and inequality. Eugenics represented everything Virchow opposed in government.

Eugenics is not the only failing of Virchow’s argument. The universalization of health care, clearly a political concern, has not always met with universal success. While largely implemented and adequate in Europe, health care for all Americans is still unsupported at any political level. The current political landscape places insurance companies and private organizations between health care and the people who would benefit from it, insulating the politicians doubly from the populace. In 1996, 35 million Americans had no health care at all, and millions more had minimal coverage at best. Initiatives begun by the Clintons in that year failed in the initial stages. Studies have shown that what health care has been implemented has not benefited the poor, those who would need it most. Truly politicized, democratic medicine would allow for equal coverage and benefits for the entire population, and in the United States this is clearly not the case. Bureaucratic politics and commercial interests have stalled any sort of universal health care initiative, and created an insulating buffer zone between the politicians and their constituents. Reality in this case provides a stark contrast to Virchow’s ideal relationship of politics and medicine, and he himself admitted, “I oppose the centralization of life in the hands of a supreme state with all my might.”

One problem in the mating of biological sciences and politics, then, is consensus. While initiatives benefiting the population as a whole, such as widespread vaccination and public sanitation, met with universal acceptance (eventually), those benefiting only some, like eugenics and state-run health care systems have both supporters and detractors. These programs not popular with everyone have faced corresponding resistance and eventual failure. This disagreement is a crowning characteristic of the political system, and also its downfall at times. Unfair and unjust policies are doomed to fail (as many of the American eugenics laws were found unconstitutional) but have the potential to harm before being removed.

Taken literally, Rudolf Virchow’s quote does not hold up to scientific evidence. Medicine is not purely “social science”, nor politics “medicine on a large scale”. Many scientific and historic contrasts separate the two, ranging from inequalities in the body to biologically deterministic legislative actions. While Virchow was speaking idealistically, his exaggeration prompted by his political passion carries with it a dangerous sentiment. This argument, implemented into actions and laws, leads to a breakdown in credibility of the biological sciences and the downfall of politics’ ideals of equality and justice. Virchow argues, “If medicine is to fulfill her great task, then she must enter the political and social life,” but the relationship between the biomedical sciences and politics is a complex and tenuous one, clearly not the simple one that Rudolf Virchow described.


NOTE:
All of the Rudolf Virchow quotes I have used appear in the transcript of a speech given by Dr. Ed Friedlander, which can be found on the Internet at pathguy.com

All other non-idiosyncratic material comes from [Professor Gaggio's] class lectures.


I'd all but forgotten about this paper, but now I can remember more. The question this paper was supposed to answer regarded much less of the quote I have provided, but I didn't like the assignment. No matter how hard I thought, I just didn't "get" what I was supposed to expound so many pages about.. I procrastinated for many days, philosophically trying to answer the original, much too vague question and somehow stumbled across that web page. With a whole new arsenal of alleged Virchow quotes, I decided to answer a question nobody'd really asked, with more information than anyone could've expected. Did it work? I haven't uncovered the graded version, so we may never know.


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