THE HISTORY OF INTERNAL MEDICINE 231 



the various diseases much advance was made after the first quarter of 

 the last century. The British physicians made especially valuable and 

 numerous contributions in this field, displaying a practical and clini- 

 cal bent contrasting with the dominant anatomical tone of the contem- 

 porary French school. In the last decade of the eighteenth century 

 Edward Jenner (1749-1823) had introduced vaccination against small- 

 pox. The second quarter of the nineteenth century was one of active 

 development and many important contributions were made by the 

 British clinicians, typically and brilliantly begun by Eichard Bright 

 (1789-1858), of London, who in 1827 elucidated the subject of renal 

 diseases (" Bright' s disease"). Among others eminent in this period 

 were William Stokes (1804-1878) and Eobert James Graves (1797- 

 1853), of Dublin; and John Hughes Bennett (1812-1875), of Edin- 

 burgh, who was influential in bringing about the disuse of bleeding. 

 The conceptions of continued fevers, which had previously always been 

 vague and confused, were immensely clarified about this time by the 

 differentiation of typhus and typhoid fevers as distinct diseases; this 

 result was largely brought about by a contribution in 1837 by an Ameri- 

 can, W. W. Gerhard (1809-1872), of Philadelphia. Anesthesia with 

 nitrous oxide was introduced in 1844 by Horace "Wells, a dentist of 

 Hartford, Conn. ; with ether in 1846 by another dentist, W. T. G. Mor- 

 ton of Boston; and with chloroform in 1847 by Sir James Young 

 Simpson, of Edinburgh. 



About the middle of the last century the medical doctrines of the 

 French school were introduced into Vienna by Eokitansky (1804- 

 1878), who with Joseph Skoda (1805-1881) and others were pioneers 

 in that development of scientific medicine in Austria and Germany 

 which has attained such eminence. The identification of the cells of 

 plants and animals by Schleiden and Schwann about 1838 opened the 

 way to new conceptions of vital processes, and in 1858 Eudolph Vir- 

 chow (1821-1902) presented his epochal doctrine of cellular pathology. 



The discovery of the pathogenic role of bacteria and the develop- 

 ment of bacteriologic science has been one of the most illuminating 

 developments in the whole history of medicine, elucidating, as it has, 

 the pathology of the large and important group of infectious diseases 

 and vastly increasing the efficiency of medical and surgical treatment. 

 Following earlier scattered discoveries, the great foundations of bac- 

 teriology were established by Louis Pasteur (1822-1895), of France, 

 beginning during the fifties of the last century. The introduction of 

 improved methods of research by Eobert Koch (1843-1910), of Ger- 

 many, about 1882, gave the science a vast impetus. The principal ap- 

 plication of bacteriologic science has yielded incalculable benefits to 

 humanity, as in the introduction of antisepsis by Sir Joseph Lister 

 (1827- ) during the sixties of the nineteenth century, of the spe- 



