RESEARCH IN MEDICINE 211 



ment of pathological laboratories epitomized the history of organization 

 in medical effort as follows : 



As in the seventeenth century anatomical theaters, in the eighteenth, clinics, 

 in the first part of the nineteenth, physiological institutes, so now the time has 

 come to call into existence pathological institutes and to make them as accessible 

 as possible to all. 



Since then, the laboratory idea has spread rapidly ; not alone labora- 

 tories of pathology have been founded, but also laboratories of bac- 

 teriology, hygiene, physiological chemistry, pharmacology and every 

 branch of endeavor promising advance in the science of medicine. Not 

 only have such laboratories come into existence in university schools of 

 medicine ajid in hospitals, but many independent laboratories for 

 research alone have been founded in the large medical centers, as the 

 Pasteur Institute in Paris (1888), the Imperial Institute for Experi- 

 mental Medicine in St. Petersburg (1890), the Institute for Infectious 

 Diseases in Berlin (1891), the Lister Institute for Preventive Medicine 

 in London (1891), the Institute for Experimental Therapeutics in 

 Frankfort (1896), the Rockefeller Institute for Medical Eesearch in 

 New York (1901), the Memorial Institute for Infectious Diseases in 

 Chicago (1902), the Henry Phipps Institute for the Study, Treatment 

 and Prevention of Tuberculosis in Philadelphia (1903). Likewise, 

 municipal, state, provincial and national laboratories, devoted to work 

 concerned with the public health, have been established. Some, follow- 

 ing the example of the first laboratory of hygiene, that of Pettenkoffer,, 

 founded by the Bavarian government in 1872, have been most active in 

 investigation; others are devoted mainly to the routine work necessary 

 for the conservation of the public health. How essential laboratories 

 of the latter type are is shown by the fact that several states, New York 

 among the first, have established county or district laboratories to care 

 for the problems of communities distant from the state laboratory and 

 the laboratories of the larger cities. 



So also laboratories as an integral part of hospitals, the so-called 

 clinical laboratories — the first of which was established by Ziemssen in 

 Munich about 1886 — have become a necessary part of every hospital 

 which makes any pretense of accurate diagnosis and adequate therapy. 

 The list might be extended to include also laboratories devoted to special 

 diseases, as cancer and tuberculosis, diseases peculiar to the tropics, and 

 diseases of animals, or to special branches as surgical pathology, neuro- 

 pathology and psychopathy. This wonderful extension of the labora- 

 tory idea in medicine dates only from the simple beginnings of Purkinje 

 and Liebig in 1824^25. At the present day, Germany alone is said to 

 have over two hundred such medical institutes, and to this policy of 

 establishing laboratories must be ascribed her leadership in the medical 

 sciences since the third decade of the past century. 



