Friday, March 27, 2009

René Laënnec

A Catholic physician invented the stethoscope? Yes - and also how it is useful in understanding diseases...
The important part of the discovery was supposed to consist in the use of the wooden cylinder which Laënnec came to employ instead of the roll of paper originally used. This wooden cylinder, now familiar to us under the excellent name invented for it by Laënnec himself is the modern single stethoscope. This instrument is of great service. The really important part of Laënnec's work, however, was not the invention of the stethoscope, but the exact observation of the changes of the breath sounds that could be noted with it in various forms of chest diseases. Laënnec succeeded in pointing out how each one of the various diseases of the heart and lungs might be recognized from every other. Before his time, most of the diseases of the lungs, if accompanied with any tendency to fever particularly, were called lung fever. He showed the difference between bronchitis and pneumonia, pneumonia and pleurisy, and the various forms of tuberculosis and even the rarer pathological conditions of the lung, such as cancer, or the more familiar conditions usually not associated with fever, emphysema, and some of the forms of retraction.

With regard to heart disease, it was before Laënnec's discovery almost a sealed chapter in practical medicine. It was known that people died from heart disease often and, not infrequently, without much warning. The possibility that heart conditions could be separated one from another, and that some of them could be proved to be comparatively harmless, some of them liable to cause lingering illness, while others were surely associated with the probability of sudden fatal termination, was scarcely dreamed of. It is to Laënnec's introduction of auscultation that modern medicine owes all its exacter knowledge of heart lesions and their significance. He himself did not solve all the mysteries of sound here as he did in the lungs; indeed, he made some mistakes that render him more sympathetic because they bring him down to the level of our humanity. He did make important discoveries with regard to heart disease, and his method of diagnosis during his own life was, in the hands of the Irish school of medicine, to prove the key to the problems of disease he failed to unlock.
Almost at once Laënnec's method of auscultation attracted widespread attention.
Dr. Addison, who is best known by the disease which since his original description has been called by his name, was no less enthusiastic in praise of Laënnec's work. He said:
"Were I to affirm that Laënnec contributed more toward the advancement of the medical art than any other single individual, either of ancient or of modern times, I should probably be advancing a proposition which, in the estimation of many, is neither extravagant nor unjust. His work, De l'Auscultation Mediate, will ever remain a monument of genius, industry, modesty and truth. It is a work in perusing which every succeeding page only tends to increase our admiration of the man, to captivate our attention, and to command our confidence. We are led insensibly to the bedside of his patients; we are startled by the originality of his system; we can hardly persuade ourselves that any means so simple can accomplish so much, can overcome and reduce to order the chaotic confusion of thoracic pathology; and hesitate not in the end to acknowledge our unqualified wonder at the triumphant confirmation of all he professed to accomplish."


Laënnec was known for his simple Bretagne faith, for his humble piety, and for uniformly consistent devotion to the Catholic Church, of which he was so faithful a member. His charity was well known, and while his purse was very ready to assist the needy, he did not hesitate to give to the poor what was so much more precious to him, and it may be said to the world also, than money - his time. After his death, and only then, the extent of his charity became known.

Dr. Austin Flint said of him: "Laënnec's life affords an instance among many others disproving the vulgar error that the pursuits of science are unfavorable to religious faith. He lived and died a firm believer in the truths of Christianity. He was a truly moral and a sincerely religious man."

Of his death, his contemporary, Bayle, who is one of his biographers, and who had been his friend from early youth, said:
His death was that of a true Christian, supported by the hope of a better life, prepared by the constant practice of virtue; he saw his end approach with composure and resignation. His religious principles, imbibed with his earliest knowledge, were strengthened by the conviction of his maturer reason. He took no pains to conceal his religious sentiments when they were disadvantageous to his worldly interests, and he made no display of them when their avowal might have contributed to favor and advancement.

Surely in these few lines is sketched a picture of ideal Christian manhood. There are those who think it wonderful to find it in a man of genius as great as Laënnec. It should not be surprising, however, for surely genius can bow in acknowledgment to its Creator.
Shortly after the death of Pasteur it was well said that two of the greatest medical scientists of the nineteenth century have given to the physicians of France a magnificent, encouraging and comforting example. It is almost needless to say these two were Laënnec and Pasteur, and their example is not for France alone, but for the whole medical world They were living nineteenth century answers to the advocates of free thought, who would say that religious belief and especially Catholic faith make men sterile in the realm of scientific thought.
[Dr. Walsh, Makers of Modern Medicine]
As you no doubt expected, Dr. Walsh has an entire chapter on Dr. Laënnec. Fr. Kneller's is short but also moving:
René Théodore Hyacinthe Laënnec was the first to employ auscultation and percussion in the diagnosis of pulmonary disease. His profoundly religious attitude of mind, maintained in an atmosphere of indifference and scepticism, was well known to his contemporaries. A story is told of him which illustrates this in a striking and slightly humorous fashion. He was travelling with his wife from Paris to Brest, when their carriage came into collision with another, and the occupants were thrown out on the road. There was naturally, a scene of great confusion, but in due time things were put in order again. Then Laënnec opened his lips for the first time. He said to his wife: "We left off our Rosary at such and such a place"; and they calmly resumed it as if nothing had happened).

"Like so many other masters of medicine, like Rivière, Baillou, Winslow, Bonnet, Baglivi, Morgagni, Boerhaave, Haller, he was led by his study of the hunted frame, the marvellous adaptation of its organs to one another and to the external world, to admire and love the Creator of such marvels. His mind was at one with that of his friend Bayle."

Laënnec describes his discovery with characteristic simplicity. Hitherto, he says, two methods of investigation have been employed in the investigation of pulmonary disease, the application of the hand and of the ear. There are many cases in which neither is successful. For himself he has chanced upon a third and better one.
In 1816 I was consulted by a young person who was labouring from the general symptoms of a diseased heart. In her case, percussion and the application of the hand (what modern doctors call 'palpation'), were of little service because of a considerable degree of stoutness. The other method, that namely of listening to the sounds within the chest by the direct application of the ear to the chest wall, being rendered inadmissible by the age and sex of the patient, I happened to recollect a simple and well-known fact in acoustics and fancied it might be turned to some use on the present occasion. The fact I allude to is the great distinctness with which we hear the scratch of a pin at one end of a piece of wood on applying our ear to the other.
Immediately on the occurrence of this idea I rolled a quire of paper into a kind of cylinder and applied one end of it to the region of the heart and the other to my ear. I was not a little surprised and pleased to find that I could thereby perceive the action of the heart in a manner much more clear and distinct than I had ever been able to do by immediate application of the ear.
From this moment I imagined that the circumstance might furnish means for enabling us to ascertain the character not only of the beating of the heart, but of every species of sound produced by the motion of all the thoracic viscera, and consequently for the exploration of the respiration, the voice, the death rattle, and perhaps even the movements of fluid effused in the pleura or pericardium. With this conviction I forthwith commenced at the Necker Hospital a series of observations from which I have been able to deduce a set of new signs of diseases of the chest. These are for the most part certain, easily perceptible, and calculated, perhaps, to render the diagnosis of the diseases of the lungs, heart and pleura as decided and circumstantial as the indications furnished to the surgeon by the finger or the probe, in the complaints wherein these are of use.

[Fr. Kneller, Christianity and the Leaders of Modern Science]

Outstanding. Another scientist who used the Rosary.

Also see here.


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