The text and photograph on this page are excerpted from a four-volume series of books titled Oncology Tumors & Treatment: A Photographic History, by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photo below is from the volume titled “The Antiseptic Era: 1876–1900.” The photograph appears courtesy of Stanley B. Burns, MD, and The Burns Archive. To view additional photos from this series of books, visit burnsarchive.com.
The core of modern medical practice and diagnosis was the development of laboratory-based medicine. By making the positive identification of the disease process possible, the scientific and clinical laboratories pulled medicine out of its Dark Ages. The major diagnostic key to neoplastic disease was the accurate cellular differentiation of the tumor, which was critical for disease management. For centuries, patients were operated on for ‘cancers’ that were often nonmalignant or even infective processes.
Robert Koch, MD (1843–1910), firmly established the science of bacteriology and proved that laboratories were critical to diagnosis. In 1877, he was the first to show a specific microorganism could cause a specific disease when he demonstrated the life cycle of the anthrax bacillus. And, in 1882, Dr. Koch changed the practice of medicine forever with his elucidation of the germ theory of disease, together with his “Koch’s Postulates,” used for establishing the cause of a disease.
Laboratories soon became a necessary part of every hospital. Although the university’s laboratories remained important research centers, special institutes were established to conduct research. Over the next 30 years, these combined facilities discovered the cause of dozens of diseases.
Birth of Pathology Laboratories
While Dr. Koch dominated the field of infectious disease, Rudolf Virchow, MD (1821–1902), was the moving force in the field of neoplastic disease. In 1858, Dr. Virchow established new protocols in cellular pathology, laying the foundation for the necessity of the correct identification of the cell type in disease, especially tumors. Dr. Virchow, along with Carl Rokitansky, MD (1804–1878), Julius Cohnheim, MD (1839–1884), and others, clarified this need for accurate pathologic diagnosis. Their research proved that organs have specific cell types, each with the ability to create a malignancy, and, at times, the malignant cell type itself can have varied pathogenicity based on intracellular elements. The medical community gradually accepted these concepts, and, by the 1890s, pathology laboratories joined the bacteriologic and chemical analysis laboratories at hospitals and medical institutions.
This photograph of a pathology laboratory at the Medical School in Bordeaux, France, is from an album made to document its new facilities. These pathologists proudly pose with their instruments. ■