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 laboratories of pathology have been founded, but also laboratories of bacteriology, 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 and 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 Experimental 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 Research 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, following 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, neuropathology and psychopathy. This wonderful extension of the laboratory idea in medicine dates only from the simple beginnings of Purkinjé 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.
