Rokitansky

NAME: Rokitansky, Karl, Freiherr von (baron of)

ACHIEVEMENT(S): Pathological anatomy.

NICKNAME/ALIAS: None

DATE/PLACE OF BIRTH: 19 February 1804, at Konigsgratz, Bohemia

DATE/PLACE/AGE AT DEATH: 23 July 1878, in Vienna, Austria.  Aged 74

DISCIPLINE: Pathologist

FIELD: Anatomy

LANGUAGE: Czech and German

PARENTS: ?

SIBLINGS: ?

SPOUSE: ?

CHILDREN: Four sons

EDUCATION: University of Prague; University of Vienna

MAJOR WORK: 'Textbook of Pathological Anatomy,”  3 vol., 1842-46

LIFE AND TIMES: Rokitansky first studied philosophy at the University of Prague, and

then in 1824 enrolled at the University of Vienna to study medicine. In Vienna, he came under the influence of the French school of medicine and the course of comparative anatomy and embryology being taught by Johann Friedrich Meckel.  

Rokitansky graduated in 1828, and shortly afterwards became an assistant in pathological anatomy to Rudolph Wagner at the Vienna Medical School, where he studied, amongst

others, the important new works on pathological anatomy by the French physician <studied work of> Andral*.

In 1839 he produced  the first description of  spondylolisthesis and spondylitic deformity of the spine (the forward displacement of one vertebra over another), and in 1843 his classic description of acute yellow atrophy of the liver (now known as Rokitansky's disease).  Between 1842 and 1846 he published the three volumes of his 'Handbook of Pathological Anatomy' an authoritative work based on the results of several hundred post mortems.

In 1844 Rokitansky was appointed professor of pathological anatomy at the Vienna General Hospital, a position he held for the next thirty years. It was here in 1846 that he inspired the Bohemian student Ignaz Semmelweis to take up the study of medicine, and afterward supported him in his struggle to eliminate childbed fever in Europe's maternity wards.

Meanwhile, at the Institute of Pathological Anatomy at the Vienna General Hospital, a new hospital regulation had increased the availability of bodies for post-mortem examination, and Rokitansky suddenly got between 1500 and 1800 cadavers a year. In his post mortems he generally worked backwards to determine what could have led to the observed pathology, constantly stressing the importance of correlating symptomatology and disease with the body’s appearance.

During Rokitansky's career in Vienna he performed more than 30,000 post mortem examinations, and had several thousands more available for his review. The result included papers on his studies on goitre, perforating gastric ulcers, spondylolisthetic deformity of the pelvis, lardaceous disease of the spleen, liver and kidney, cysts in various viscera, and various neoplasms.

Rokitanksy also created the basis for a differentiation of lobar pneumonia (originating in the lower lobe of the lung) and lobular pneumonia, or bronchopneumonia (originating in the finer subdivisions of the branched bronchial tree), and established the micro-pathology of pulmonary emphysema (a condition of the lung characterized by enlarged air spaces separated from the terminals of the bronchial tree).

In 1849 Rokitansky became dean of the medical faculty, and the following year was appointed rector of the University of Vienna. In 1852 he published his study of congenital heart disease: 'On Some of the Most Important Diseases of the Arteries', in which his study of embryology helped him to predict what might evolve when embryo development went astray.

This work was followed by one of his greatest studies, 'The Defects in the Septum of the Heart' (1875), the result of 14 years of observation, which featured his transposition theory of the deviation of the aortic septum, and described a large number of developmental anomalies and cardiac malformations. He was also the first to detect bacteria in lesions of malignant endocarditis, an often rapidly fatal inflammation of the membrane lining the inner walls of the heart.

During the 1850s Rokitansky was one of the first to examine multiple sclerosis (MS) lesions microscopically, in 1857 making a key discovery when he noticed "fatty corpuscles" in the MS lesions, which <work related to> Charcot* later described as "the wreck and detritus resulting from the disintegration of the nerve-tubes". This discovery enhanced the pathological understanding of MS, and brought neurologists closer to establishing a major feature of the disease, nerve demyelination.

His theory that there was a chemical susceptibility to disease was attacked by <ideas superseded by> Virchow*, the founder of modern cellular pathology, and he was eventually forced to accept Virchow's view, and to rewrite the first edition of his textbook, eliminating all traces of his old theory (1875).

ASSESSMENT:  His work helped establish the study of pathological anatomy a

cornerstone of modern medical practice and established the New Vienna School as a world medical centre during the latter half of the 19th century.

EXTRA CONNECTIONS:  He taught <taught> Vierordt*

ONELINER:  Karl Rokitansky, early pioneer of pathological anatomy

BIBLIOGRAPHY:

EB

Jay, Venita, “The Legacy of Karl Rokitansky", in Archives of Pathology  and Laboratory Medicine, (March 2000), 124, 345-6