With this issue, The Journal commences publication of selected case discussions from medical grand rounds at The Johns Hopkins Hospital, Baltimore, Md.1 Case discussions as a form of teaching began with William Osier and have continued at Hopkins.2 Osler performed rounds in the clinic on patients he had never seen before; he took a history and did a physical examination on the spot, and he said whatever he wished about them, drawing on his immense personal experience and his encyclopedic knowledge of the literature in three languages. Usually what Osier had to say was remarkably shrewd. Of course, he was in a somewhat privileged position: if Osler said the diagnosis was typhoid, no intern was going to quibble about the negative Widal's reaction.
With time, people who could discuss anything at a moment's notice became scarce, and rounds changed. The venue was moved from the clinic to an
Stobo JD, Murphy PA. Medical Grand Rounds at Hopkins. JAMA. 1989;261(21):3164. doi:10.1001/jama.1989.03420210112027
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