Auenbrugger and Laënnec Figure 1: Two pioneers who have Leopold Auenbrugger demarcated the development a musical ear and this undoubtedly of Western thoracic medicine helped him unravel the dullness and resonances which he elicited through Roger Ellul-Micallef MD(Malta), PhD(Edin), FRCP(Edin), FRCP(Lond) the percussion of the chest and correlate them to underlying Department of Clinical Pharmacology & Therapeutics pathological processes. He published University of Malta, Msida, Malta his findings in 1761,5 as a modest Email:
[email protected] little volume of 75 pages, ‘Inventum novum in percussione thoracis ut signo With the publications in 1761 of Giovan Battista Morgagni’s abstrusos interim pectoris morbis detegendi thoracis’. (Figure 2) (1682-1771) ‘De sedibus et causis morborum’ (On the Sites Auenbrugger established that by and Causes of Diseases),1,2 pathological anatomy became a percussing the chest wall a careful science in its own right. Morgagni’s aim was to try and clinician could obtain almost as much correlate the symptoms of a disease as it developed with information about underlying pathology 3 findings at post mortem. Although this found immediate as if he were looking through the chest. application in surgical disorders, where lesions were often It was thus possible to diagnose visible and palpable, it was not thought to be equally useful in abscesses, areas of collapse, cases of internal ailments as long as physicians were unable to consolidation of the lung, air in the explore what was happening to internal organs during life.4 pleural cavity, pleural effusion and This was made possible with the clinical diagnostic procedures different kinds of enlargements of the pioneered by Leopold Auenbrugger (1722-1809) and by René heart.6,7 Théophile Hyacinthe Laënnec (1781-1826).