instruction an essential part of the physician's education, but the difficulties which were encountered proved so much greater than was anticipated that it was soon found necessary to abandon the plan; and then for many years no further effort was made, either at Padua or at any of the other Italian medical schools, to introduce clinical teaching. After the lapse of nearly a century, Johannes Heurnius (1543-1601), Professor of Medicine at the University of Leyden, made an effort to introduce the plan of teaching medicine at the bedside; and a few years later (1630) two other professors of the same university—viz., Otho Heurnius, son of Johannes, and E. Schrevelius—formally introduced clinical instruction at the city hospital. The plan which they adopted was the following: The students in turn were permitted first to question the patient about his ailment and then afterward to make whatever physical examination appeared to be necessary; next, each one of them stated briefly what he believed to be the nature of the malady, and also gave his views as to the prognosis, symptoms and treatment; after which the professor commented on these different reports, pointing out both the correct and the incorrect features in each case. After a short trial of the plan it became clear that it would have to be abandoned, for the students did not like to have attention called in such a public manner to their mistakes. Then, a few years later, Sylvius, who at that time was the Professor of Medicine, introduced a system of clinical teaching which is thus briefly described by his colleague, Lucas Schacht:—
When, followed by his pupils, he approached the bedside of a
patient, he assumed the air of one who is entirely ignorant of
the nature of that person's malady, of the accompanying symptoms,
and of the treatment which was being carried out. Then he began
to ask first one and then another of the students a great variety
of questions respecting the case that was under consideration,—questions
which at first seemed to have been propounded in a
haphazard fashion, but which in reality were so cleverly formulated
as to elicit from the class all the information needed for the
making of a correct diagnosis, while leaving on the minds of the
