Rudolf Virchow's Report on the 1848 typhus epidemic is one of the neglected classics of "social medicine"--a term he did much to popularize. His analysis of the epidemic emphasized the economic, social, and cultural factors involved in its etiology, and clearly identified the contradictory social forces that prevented any simple solution. Instead of recommending medical changes (i.e., more doctors or hospitals), he outlined a revolutionary program of social reconstruction; including full employment, higher wages, the establishment of agricultural cooperatives, universal education, and the disestablishment of the Catholic Church. This article includes the first English translation of these long-term recommendations. It also locates Virchow's Report within the context of the Medical Reform Movement of 1848 and traces his influence on the subsequent development of social medicine. Parallels are drawn between Virchow's attempts to reform health care and current developments in the political economy of health.