IN 1856, WHEN MANY VICTORIAN PHYSICIANS WERE STRUGGLING TO DEFINE A MODEL OF CLINICAL MEDICINE, the reviewer of one collection of case histories voiced his dismay at the physician-author's preference for “dreadful incidents” and “cases exceptional and strange” (“Works” 473). Indeed, although physicians of the clinical era did not disguise their efforts to achieve a new kind of discourse, productive of a “realist” vision, few acknowledge how often the “clinical” case history of the nineteenth century also shares the romantic discourse of the Gothic, especially its interest in the supernatural and the unexplainable and its narrative aim of arousing suspense, horror, and astonishment in the reader. Literary critics have also focused primarily on the association of medical narrative with a realist literary discourse. Nineteenth-century physicians did campaign for the formal, objective, and professional clinical discourse that serves as their contribution to a realist aesthetic, in the process explicitly rejecting eighteenth-century medicine's fascination with “the curious” and its subterranean affiliation with the unknown, the unexplainable, and the subjective. But, as I show in this article, a discourse of “the curious,” allied with a Gothic literary aesthetic, stubbornly remained a critical element of many case histories, though it often presented under the mask of the more acceptable term, “interesting.” The discourse of Gothic romance in the case history provides a narrative frame that, unlike the essentially realist clinical discourse, could make sense of the physician's curious gaze, which had become nearly unrecognizable as a specifically medical vision. Indeed, a “curious” medical discourse haunts even case histories of the high clinical era, late in the century; and it energizes the nineteenth-century Gothic novel. Samuel Warren's novel Passages from the Diary of a Late Physician–deplored in the quotation above–illuminates this tradition of “Gothic medicine” as it plays out in the nineteenth-century novel. This tradition, I argue, provides the novel with a powerful model of cultural contamination and conflict in its yoking of disparate discourses. Gothic medicine demonstrates the importance of clinical medicine to literary romance, and it cannot help but reveal the ghost of “the curious” in the clinic.