In the last decades of the nineteenth century, European medicine became far more powerful by allying itself with emerging scientific techniques and technologies. Germ theory, bacteriology and chemical analysis joined new diagnostic instruments and drug therapies in changing clinical practice. At the same time, doctors and surgeons fought to establish themselves as professional groups, distancing themselves from traditional and imported medical systems.
For the patient, medical experiences changed dramatically. More accurate information about what was wrong, powerful new drugs and less painful procedures all improved patient care. However the proliferation of new instruments and diagnostic tests also meant that the individual’s own perceptions of their condition carried less weight with doctors, who favoured more objective measures of illness and disease.
Clinical medicine adopted the ideas and practices being developed away from hospitals in specialist laboratories. New ideas in science provided powerful new tools for doctors and surgeons, but they could also challenge practitioners' authority. Some of them felt that the practice of medicine was, and should remain, an ‘art’. They argued against an over-reliance on machines and instruments and instead put their trust in the perceptions of the practitioner. The question of whether accurate diagnosis is a purely scientific process or relies on the skill of the individual practitioner has continued to this day.