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researchers. Tumors are as diverse as the sixty bodily organs in which they can arise. Some grow slowly, while others spread with stunning rapidity, often by hitching a ride in the bloodstream to other parts of the body, the process known as metastasis. Some are hardened masses that distend the skin, while others are buried deep in the body cavity. A few types of cancer, including leukemias, rarely form tumors at all unless they have metastasized to other organs. Most frustrating of all, various cancers respond very differently to treatments. Despite Hippocrates’ attempt at a unifying taxonomy, it turns out that cancer is not one disease but many—more than 150, by most definitions. Their only common characteristic is supercharged cell division, growth run amok.
    The first person to grasp the essential nature of cancer was another irascible, opinionated man of science: Rudolf Ludwig Karl Virchow. A diminutive, humorless, and hyperkinetic German born in 1821, Virchow was a physician who also made important contributions in an astonishing number of other fields, including anthropology, paleontology, and the biology of parasitic worms. In his spare time, he designed the Berlin sewer system and helped to excavate ancient Troy. 5 His chief fault was Paracelsian self-confidence, which made him reluctant to accept ideas he did not originate, including the two most important of his lifetime: Louis Pasteur’s germ theory and Charles Darwin’s theory of universal common descent via natural selection. A fiery liberal who manned the Berlin barricades during thefailed revolution of 1848 and was later a leading reformer in the German parliament, Virchow believed that social progress came through vigorous observation and testing, not abstract theory. “Medicine is a social science,” he declared in
Die Medizinische Reform
(The Medical Reformation), a radical newspaper he published during the tumult of 1848, “and politics is nothing else but medicine on a large scale.” 6
    A prodigy who could read Latin and Greek by age twelve, Virchow became fascinated with microscopes soon after choosing medicine for a career. While still in medical school, he began conducting microscopic examinations of diseased tissue, something almost no one else was doing at the time. His medical approach was as radical as his politics because, even as late as the mid-nineteenth century, the humoral theories of Hippocrates still held sway and illnesses were regarded as mere indicators of the same underlying problem: a bodily imbalance of blood, yellow bile, black bile, and phlegm. That is not what Virchow saw in his microscope. He saw groupings of diseased cells in bodies that were otherwise healthy. Diseases, he reasoned, were not signs of an organism out of balance. Instead, they were distinct, specific processes that could be monitored through close observation of aberrant cells under the microscope. Thus was born the science of microscopic pathology, the essential discipline of modern medicine, which Virchow championed for the rest of his long and extraordinarily productive life.
    Others had previously suggested that the cell was the basic unit of life, but Virchow was the first to propose that it was also the basic unit of disease. 7 An epigram he popularized but did not originate,
omnis cellula e cellula
(all cells arise from cells), therefore meant that cell division must be the means by which illnesses spread inside the body. Pathological processes begin, he reasoned, when a healthy cell malfunctions under the influence of some outside force. Virchow erred in rejecting Pasteur’s idea that the outside disruptor could be a living microorganism, a germ. Actually, both men were partly correct: Some diseases were microbial in origin and others were not, but almost all involved the disruption of cells in specific parts of an otherwise healthy body. With their separate insights, Virchow and his rival Pasteur drove a stake through the heart of classical