This was Howard's only book. Osler, in his anonymous obituary of his mentor R. Palmer Howard (1823-1889), wrote, "As a teacher of medicine for thirty-three years, Dr. Howard enjoyed a unique reputation in his own country. To him was due, in great part, the development of that admirable and systematic plan of clinical instruction which has prevailed for so long in the Montreal General Hospital." (Osler, "Robert Palmer Howard," Med. News. 1889, 54, 419). (Quoted by W. Bruce Fye).