In the 19th century, the foundations for the modernization of healthcare were laid in Europe: Instead of private charity, state activities took center stage, and medicine was based on scientific principles. In the discourse on a modern healthcare system, academic physicians emerged as the leading voices. They achieved ascent to the social elite and became recognized, state and society-accepted sole experts in matters of health. With the professionalization of the medical profession came the displacement of traditional healing professions in the healthcare market. Among those displaced were the guild-organized surgical craftsmen who had practiced external cures and healing techniques for centuries.