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In the winter of 1848, an epidemic of typhus ravaged Upper Silesia, a largely Polish mining and agricultural enclave in the Prussian Empire. Months earlier, heavy floods had destroyed large swaths of cropland, leaving the peasants to subsist on a paltry diet of clover, grass, and rotten potatoes. Weakened by starvation, they readily succumbed to infection. The Prussian authorities tapped a precocious twenty-six-year-old junior physician named Rudolf Ludwig Karl Virchow, at Berlin’s Charité Hospital, to perform the routine task of surveying the outbreak. For three weeks, Virchow travelled from town to town, observing that families of six or more often shared single room dwellings, turning homes into hotbeds of contagion. He noted the stigmata of the typhus rash — angry red spots that mysteriously spared the face and soles of the hands and feet — documented the nature of fevers, coughs, and diarrhea, and performed a few autopsies.  Virchow’s report to the Prussian Minister for Religion, Education, and Medicine contained mortality statistics and clinical descriptions. He also dispensed predictable recommendations for flood control and drainage systems. But what exercised Virchow the most — and what his sponsors least wanted to confront — were the deeper causes of the epidemic. “The nouveaux riches” who extracted wealth in metals and minerals from the mines treated their Silesian workers “not as human beings but as machines,” he wrote. He blamed the Catholic Church for keeping “the people bigoted, stupid and dependent.” “If these conditions were removed,” the bold young doctor offered the minister, “I am sure that epidemic typhus would not recur.”  Even before he left for Upper Silesia, Virchow was primed to see the threads between social conditions and disease. In Friedrich Engels’ treatise on the working class in Manchester and the deathtrap factories in which they toiled, which appeared in 1845, he read about the cramped conditions and the poor ventilation, the gruesome machine accidents, the toxic fumes and the woolen fibers they inhaled with every breath. From Edwin Chadwick’s Report into the Sanitary Conditions of the Labouring Population of Great Britain, from 1842, Virchow learned that workers in the North rarely passed their thirtieth birthdays. He read of families crammed into half-lit quarters, choking on the stench of human and animal waste, grinding away their years under a sky so thick with soot that it blocked the sun and caused their children’s legs to bow from rickets. In a letter to his father, Virchow said that his immersion in the Silesian typhus epidemic had turned him from “half a man [to] a whole one, whose medical beliefs fuse with his political and social ones.” Ten days after Virchow returned to Berlin in mid-March, the spring riots erupted, one of many protests against monarchy spreading across Europe. He flung himself into the short-lived revolution, brandishing a pistol at the barricades — a feat of activism followed by months of local political involvement that led Charité to suspend him. Fortunately, the University of Würzburg was eager to attract the medical prodigy and offered Virchow a position on the condition that he not use it as “a playground for radical tendencies.” He accepted the demand for his depoliticization, and used his new position instead as a proving ground for wondrous advances in medical science. He perfected new microscopic techniques that helped him discover how tumors form, how tissues proliferate, and how blood clots. Virchow was among the first to correctly link the origin of cancers from otherwise normal cells, the first to describe leukemia, and the first to use hair analysis in a criminal investigation. He discovered the life  cycle of the parasite Trichinella spiralis, or “pork worm,” which established the importance of meat inspection in Germany. Yet the laboratory could not contain him. The experience in Upper Silesia had convinced him that doctors, knowing as they did the true conditions of humanity, made the best statesmen. Thus, after completing in 1858 his magisterial text Cellular Pathology as Based upon Physiological and Pathological Histology, a work that is regarded as the foundation of modern pathology, Virchow moved back into politics, this time as a professional. He became a member of the Berlin City Council beginning in 1859 and planned the city’s sewage system. He next entered the Prussian House of Representatives and in 1880, at the age of fifty-nine, the German Reichstag. Virchow’s well-justified faith that social reform was necessary to combat disease never left him. When he celebrated his eightieth birthday in 1901, he was hailed by physicians all over the world as the “father of social medicine,” or medecine sociale. The term was coined by Jules Guerin, a French physician — doing so, coincidentally yet auspiciously, one day after Virchow’s return from Upper Silesia — to indicate “the numerous relations which exist between medicine and public affairs.”  These “numerous relations between medicine and public affairs” formed the philosophical heart of public health in Europe. In America, however, the field organized itself around technical strategies aimed at the leading causes of death at the turn of the century, which were influenza, pneumonia, diphtheria, tuberculosis, and cholera. It was a time when physicians had little to offer in the way of medical treatment. Opium, laxatives, sleeping powders, bloodletting, and leeches were the mainstays of care. In a speech in 1860, Oliver Wendell Holmes Sr. famously told his colleagues in the Massachusetts Medical Society that “opium, which the Creator himself seems to prescribe, wine which is a food, and the vapors which produce the miracle of anesthesia… I firmly believe that if the whole material medica, as now used, could be sunk to the bottom of the sea, it would be all the better for mankind — and all the worse for the fishes.”  Public health experts and doctors worked together closely to contain epidemics, but as drug discoveries mounted — among them penicillin for a broad swath of infections in 1928 (though it was not used until 1942) and the sulfa drugs in the 1930s — the power and prestige of the medical profession