How did doctors in the 19th century come to be the indispensible experts that they were before the advent of bacteriology and 'modern medicine'? And what role did paperwork have to play in this? The Bieler doctor and politician Cäsar Bloesch (1804-1863) left a legacy of 55 medical practice records. Consultations, testimonies, assessments and vaccination charts, but also weather observations and the populace's state of health were all put to paper. Taking these written records, Lina Gafner shows how medical book-keeping fits into the context of political conflicts, professional policy, scientific controversies and bourgeois-male self-conception. For the first time, it becomes clear how medical thought and practice in the 19th century were influenced by the demands of a modern administrative state, and how doctors attained a central place in government and society through their paperwork.