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By the late nineteenth century, an enlarged and sophisticated CSH medical staff personified the transformation of orthodox medicine from a theoretical art to a laboratory-based science. Several important medical developments spurred this transformation and, in turn, initiated changes in both medical treatment at CSH and the makeup of its medical staff.
The most important development, the introduction of the germ theory, transformed the way physicians approached disease. Rather than viewing the body holistically and attributing diseases to social and moral forces, physicians began to imagine disease as microscopic germs invading certain organs or groups of organs. This new disease paradigm, coupled with the movement for professionalization in medicine, encouraged the development of medical specialization, laboratory research, and institutionalized clinical training.