<P> On losing the 1883 rivalry in Alexandria, Pasteur switched research direction, and introduced his third vaccine--rabies vaccine--the first vaccine for humans since Jenner's for smallpox . From across the globe, donations poured in, funding the founding of Pasteur Institute, the globe's first biomedical institute, which opened in 1888 . Along with Koch's bacteriologists, Pasteur's group--which preferred the term microbiology--led medicine into the new era of "scientific medicine" upon bacteriology and germ theory . Accepted from Jakob Henle, Koch's steps to confirm a species' pathogenicity became famed as "Koch's postulates". Although his proposed tuberculosis treatment, tuberculin, seemingly failed, it soon was used to test for infection with the involved species . In 1905, Koch was awarded the Nobel Prize in Physiology or Medicine, and remains renowned as the founder of medical microbiology . </P> <P> Women had always served in ancillary roles, and as midwives and healers . The professionalization of medicine forced them increasingly to the sidelines . As hospitals multiplied they relied in Europe on orders of Roman Catholic nun - nurses, and German Protestant and Anglican deaconesses in the early 19th century . They were trained in traditional methods of physical care that involved little knowledge of medicine . The breakthrough to professionalization based on knowledge of advanced medicine was led by Florence Nightingale in England . She resolved to provide more advanced training than she saw on the Continent . At Kaiserswerth, where the first German nursing schools were founded in 1836 by Theodor Fliedner, she said, "The nursing was nil and the hygiene horrible .") Britain's male doctors preferred the old system, but Nightingale won out and her Nightingale Training School opened in 1860 and became a model . The Nightingale solution depended on the patronage of upper class women, and they proved eager to serve . Royalty became involved . In 1902 the wife of the British king took control of the nursing unit of the British army, became its president, and renamed it after herself as the Queen Alexandra's Royal Army Nursing Corps; when she died the next queen became president . Today its Colonel In Chief is the daughter - in - law of Queen Elizabeth . In the United States, upper middle class women who already supported hospitals promoted nursing . The new profession proved highly attractive to women of all backgrounds, and schools of nursing opened in the late 19th century . They soon a function of large hospitals, where they provided a steady stream of low - paid idealistic workers . The International Red Cross began operations in numerous countries in the late 19th century, promoting nursing as an ideal profession for middle class women . </P> <P> The Nightingale model was widely copied . Linda Richards (1841--1930) studied in London and became the first professionally trained American nurse . She established nursing training programs in the United States and Japan, and created the first system for keeping individual medical records for hospitalized patients . The Russian Orthodox Church sponsored seven orders of nursing sisters in the late 19th century . They ran hospitals, clinics, almshouses, pharmacies, and shelters as well as training schools for nurses . In the Soviet era (1917--1991), with the aristocratic sponsors gone, nursing became a low - prestige occupation based in poorly maintained hospitals . </P> <P> It was very difficult for women to become doctors in any field before the 1970s . Elizabeth Blackwell (1821--1910) became the first woman to formally study and practice medicine in the United States . She was a leader in women's medical education . While Blackwell viewed medicine as a means for social and moral reform, her student Mary Putnam Jacobi (1842--1906) focused on curing disease . At a deeper level of disagreement, Blackwell felt that women would succeed in medicine because of their humane female values, but Jacobi believed that women should participate as the equals of men in all medical specialties using identical methods, values and insights . In the Soviet Union although the majority of medical doctors were women, they were paid less than the mostly male factory workers . </P>

When were the first documented medical records created