The legacy of Karl Rokitansky.

Abstract

Karl Rokitansky. Illustration by Venita Jay, MD, FRCPC. B the middle of the 19th century, Vienna flourished as a European center of excellence in medical teaching. This fame is attributable to the New Vienna School, one of the founders of which was the eminent pathologist, Karl Rokitansky. At the Institute of Pathological Anatomy, the coming of Rokitansky marked the beginning of a new era in the history of pathology. Karl Rokitansky (1804–1878) was born in Konigsgratz, Bohemia. He studied medicine in Prague and Vienna, graduating in 1828. Shortly thereafter, he became an assistant in Pathological Anatomy to Wagner at the Vienna School. As a student, Rokitansky was profoundly influenced by the French school of medicine and by the concepts of comparative anatomy and embryology put forth by Johann Friedrich Meckel. Rokitansky became professor of pathological anatomy at the Vienna School and remained there until 4 years prior to his death. Rokitansky was an astute observer who recorded all he saw with admirable clarity and thoroughness. Stressing what the naked eye could see helped him lay the foundations of pathological anatomy, following the initiatives of the preeminent anatomist, Giovanni Morgagni. It was not enough to simply get a good anatomical exposition; Rokitansky stressed the importance of correlating symptomatology and disease with anatomical appearances. At the completion of a postmortem examination, he worked backward to determine what could have led to the observed pathology. His writings were masterful and won him praise for their clarity and vitality. At the Pathology Institute of the Allgemeines Krankenhaus, a new hospital regulation had increased the availability of bodies for postmortem examination. It is believed that Rokitansky probably had access to between 1500 and 1800 cadavers annually. Great diagnosticians like Skoda performed their studies on living patients and later checked their observations with gross findings in Rokitansky’s postmortem room. By the time Rokitansky retired, after having spent an active career in Vienna, he had performed more than 30 000 postmortem examinations and had several thousands more available for his review. Rokitansky’s record of scientific publications was astounding. His Handbuch der pathologischen Anatomie, published