Lewis, chair of medicine at the University of Oregon Medical School from 1947 to 1972, was a legendary diagnostician who expected his students to not only perform but to master techniques such as jumping percussion. A 1950s-era pamphlet from the Pacific Northwest Archives, On becoming a ward clerk, provides evidence that Lewis' techniques were practiced almost exclusively in the Medical School hospitals and clinics:
"The conduct and report of the history and physical examination should conform to the manner and standards outlined in the manual, "THE HISTORY AND PHYSICAL EXAMINATION", and should be comprehensive. It is strongly recommended that the manual be used at the bedside until its contents become so familiar that this practice is unnecessary."Familiarity with the contents and ability to perform the techniques outlined therein were not necessarily the same thing, however. In that gap lies the art of medicine.