The beginnings of formal clinical teaching in Europe are regularly traced to Giovanni Battista da Monte, or Montanus, the Italian physician who taught medicine at Padua from approximately 1540 until his death in 1551. He famously took his students into hospital, but also to see his private patients.
Student notes of these sessions survive. Montanus advised students to observe those signs which were obvious to the naked eye. These could reveal the diseases that lay hidden within the body. While treating many private patients, Montanus could take greater time on his patients in the hospital. He carefully described their symptoms, including the visual characteristics of excrements, such as urine. Some mentioned the potential of doctors to taste the patient’s urine. Practitioners of humoral medicine had to be prepared to use all five of their senses when making a diagnosis.
By the end of the 1500s, Montanus’s reputation had begun to fade. Bedside observation and teaching were abandoned almost entirely. Hospital teaching had to be rediscovered in the 1700s and 1800s. Though Montanus was an early instructor in clinical medicine, records are less able to tell us if he was the first to lecture on hospital cases. This is unlikely since both Galen and Hippocrates emphasised observation of the patient. Nevertheless, interest in Montanus will continue. More information about his public and private teaching exists than for perhaps any other early doctor.