The lack of qualified surgeons coupled with the unprecedented scale of casualties in the revolution motivated medical education reform. Medical students routinely assisted their teachers in the hospital to address understaffing, a marked departure from the historically hands-off style of medical teaching. Guidelines set forth by the revolutionary government, defined by Joseph-Ignace Guillotin and Félix Vicq-d'Azyr, formally asserted the importance of hospitals in medical education; by 1794, hospitals were regarded as the principle institution of medical training. Role of the patient in hospital medicine Patient-doctor relations took a new form in and after the French Revolution, as a product of the changing hospital environment. The revolutionary movement acknowledged a cause-and-effect relationship between poverty and disease. A key claim in the revolutionary platform was all citizens' right to health. A range of new ideas arose from the need to provide large-scale systematized treatments: foster parenting, wet nursing, and the soup kitchen were all innovations originating from Parisian hospitals. The hospitals were divided into specialized wards for various diseases and patient demographics, notably neonatology, pediatrics and geriatrics. Within these wards, patients became the subjects of medical study and observation; their presence in the hospital supported the process of medical research and training. However, these changes came at the cost of patient autonomy, and increased bureaucracy within the hospitals. Personalized treatment was compromised in favor of research-oriented practice. Diagnosis and the categorization of disease Means of diagnosis became increasingly evidence-based and impersonal. The factors considered in diagnosis shifted away from patient narrative in favor of physicians' observations. Doctors of the period, including François Victor Mérat de Vaumartoise (who studied under Jean-Nicolas Corvisart), noted the likelihood of patients exaggerating in their description of symptoms and pain, as well as an inability of the uneducated poor to accurately describe their experiences. Patient-doctor communication to aid in diagnosis was therefore limited to straightforward, non-technical questions. More important, however, were systematic and empirical observations of the patient. Beyond basic inspection, physicians used palpitation, percussion and auscultation to identify abnormalities. Pathological anatomy, examination, and empirical knowledge supplanted the role of the patient's account in the process of diagnosis. In the Necker-Enfants Malades Hospital, René Laennec invented the first stethoscope design to aid in diagnosis via auscultation. Laennec also devised a methodical procedure for diagnosis using the stethoscope, meticulously categorizing the patient data he collected. Precise diagnosis was also seen as evidence of scientific legitimacy, and within the medical