"The rise of the was vigorously debated in the Journal in the late 19th century. ... ... With germ theory, the scientific foundation for the use of vaccines, new and old, was at last demonstrated. was a constant topic of debate in the Journal from its earliest years, as it remains in contemporary societies, conveying ongoing tensions between social mandates and individual liberties, the good of the many and the risks to the few. The Journal would report many “firsts” in subsequent years, including the first major quantitative study linking smoking to (1928), the introduction of the (1970), and early clinical descriptions of AIDS (1981). And breakthroughs reported elsewhere quickly found their way to the Journal. , for example, first described in the ' in 1922, received extensive review and discussion in the Journal later that year, and many articles analyzing its optimal use in diabetes followed. Myriad new diagnostic technologies accompanied changes in the theory and treatment of disease. The Journal offers a window onto the rise of new medical technologies, from stethoscopes to improved tourniquets, from 's x-rays to and beyond. Technologies that probe and visualize the body represented a critical aspect of the development of modern medical practice and the conceptualization of pathologies. The focus on disease specificity and causal mechanism that emerged with the germ theory would ultimately drive research at the molecular and genetic level that continues to be reflected in the Journal."