Page:Stewart 1879 On the teaching of medicine in Edinburgh University.djvu/12

10 condensation which is necessary, and very specially because of the difficulty at the present time of laying down principles capable of wide application. But if you compare the descriptions given in the class-room with the cases you observe in the wards, noting their points of correspondence and of difference, you will find that with wonderfully little effort your knowledge grows up towards completeness.

The course of clinical medicine consists of (a) lectures on cases under treatment, and (b') studies at the bedside. I have shown you how these clinical lectures took origin more than 130 years ago, and have told you of the favourable impression which they at first produced. Nowadays it is necessary rather to vindicate the usefulness of the clinical lectures, because the other method of teaching—the bedside instruction—is (and I think justly) more highly appreciated. Consider their advantages. Not unfrequently it is possible for us to bring patients into the lecture-room, and there demonstrate the features of their maladies, and even when this cannot be done, I know of no method more profitable than clinical lecturing, for the comparison of an individual case with the type, or of a group of cases with the type and with one another. The clinical lecture also affords opportunity which cannot be obtained in the systematic course, or in any other way, for a detailed exposition of some special and remarkable feature of disease, a discussion of an important symptom, as it has shown itself in different cases, or of the uses of and modes of using a particular remedy. But I could not speak so favourably of the clinical lectures if they were mere systematic disquisitions tacked on to a brief description of a case. An old friend once told me that he met a hospital physician who had been working hard in town all autumn, and who, in answer to an inquiry what the work bad been, innocently replied that he had been writing his clinical lectures for next winter. I do not know whether the clinical lectures proved useful or not, but I believe that the Edinburgh students of the present day would not relish such productions. Good clinical lectures must be the fruits of accurate and thoughtful study of the individual cases to which they relate.

The clinical lectures are delivered by the four ordinary Clinical Professors in rotation, and the Professor of Obstetrics