Two features of the progress in medicine in the Nineteenth Century, negative as they may seem to have been, were undoubtedly potent in the promotion of advance.  They were the recognition of the fact that many dangerous diseases are self-limited, and the experiment of the so-called “expectant treatment.”  The result of the first of them was to teach men to desist from futile attempts to cure the self-limited diseases, in the sense of cutting them short in their course, and the “expectant treatment” followed as a natural consequence.  It was a method of managing disease rather than attempting to cure it.  There was no interference save to promote the patient’s comfort, to nourish him as thoroughly as might be without unduly taxing his powers, and to meet complications as they arose.  It was stooping to conquer, perhaps, but it was a policy that conduced greatly to the well-being of the sick, improved their chances of recovery, and enabled physicians to study disease more accurately by reason of its course not being rendered irregular by meddlesome medication.  It has never been dropped, and it never will be, save as such directly curative agents as the antitoxines are made available.

In the early part of the century, except for gross anatomy and operative surgery, medicine was taught almost wholly, so far as the schools were concerned, by means of didactic lectures.  The “drawing” capacity of a professor was proportionate rather to his rhetorical powers and to the persuasiveness with which he inculcated the views peculiar to himself than to the amount of real information that he conveyed to the students.  Although the apprentice system—­for that was what the practice of students’ attaching themselves to individual practitioners, whom they called their preceptors, virtually amounted to—­in many instances made up more or less completely for the lack of systematic clinical teaching, yet in the great majority of cases it amounted to little more than the preceptor’s allowing the student the use of his library and occasionally examining into the latter’s diligence and intelligence, in return for which he, the preceptor, required an annual fee and exacted from the student such minor services as his proficiency enabled him to render.  It is true the students “walked” the hospitals, drinking in some great man’s utterances, but they did it in droves, not a moiety of them being able to get a good look at a patient, unless it was such a passing glance as might tell them that the patient was jaundiced.  By clinical teaching we understand teaching, not in glittering generalities, but in the concrete, either at the bedside, as the word clinical originally implied, or at least with the patient actually present to illustrate in his person the professor’s descriptions and the success or failure of the treatment employed.  The clinic is now firmly established, and has been for years, but it was long before this grand result was attained.