The Fathers of Percussion

D i m e / / s i o n s The Fathers of Percussion

Contributed by sion. His approach was to predict In 1778, Jean Corvisart, the res­ organ abnormality of chest diseases, cuer of percussion, left for Paris to Harry Bloch, MD then either confirm or refute his di­ study medicine. He received a degree agnosis by autopsy findings. A devo­ in 1782 and began a lifetime service Centuries before percussion and the tion to music played a role; not only at La Charite Hospital. Corvisart was stethoscope, the Hippocratic School did Auenbrugger play an instrument unsurpassed as a teacher of clinical of Cos and the School of Cnidus and write a libretto for an opera, but medicine at the bedside and pathol­ taught students to observe, to pal­ he was a master of pitch, resonance, ogy at the autopsy table. He became pate, and, with the ear on the chest, and tonal quality. chief of medicine in 1795 and intro­ to auscultate. These skills were In 1761, Auenbrugger’s Inven- duced the custom of one patient to a taught not for diagnosis but rather tum Novum was published, a medical bed, with beds widely separated and for prognosis. The Galenic-Hip- classic of 95 pages on the sounds separate male and female wards. pocratic doctrines, unchanging and produced by tapping on the walls of In 1808, 47 years after Auen­ rarely opposed, governed medicine the chest. It was written in Latin, and brugger’s publication, Corvisart and medical education for 1500 composed of 14 observations and 47 wrote a French translation of Inven­ years. sections. Percussion was described as tum Novum. He added 440 pages of Feudalism in France collapsed “a slow tapping with the fingers, commentary and, in effect, rescued with the Revolution of 1789. Con- brought close together and extended, percussion from oblivion. Percussion currendy, there was remarkable on the fingers of the other hand laid was adopted by clinicians world­ progress in medicine and medical ed­ on the chest.” The preface was re­ wide. ucation, attributable in great part to vealing: “I present the reader with a Corvisart was richly rewarded the creators of physical diagnosis. new sign . . . for detecting diseases for his work on chest diseases. He The development of physical diagno­ of the chest. This consists of percus­ became Napoleon’s doctor, an officer sis made France the center of world sion of the human thorax. . . of the Legion of Honor, and a Baron medicine and medical education in whereby an opinion is formed of the of the Empire. the first half of the 19th century. internal state of the cavity . . . the It is interesting to speculate Leopold Auenbrugger was the fruit of seven years observation. . . . which inventum novum we ridicule or inventor of percussion, a method of I have not been unconscious of the ignore today and whom we will re­ producing sounds by striking on the dangers . . . envy, malice, hatred, de­ ward for its rediscovery. walls of the thorax. He was born in traction and calumny.” Austria and studied medicine at the The book and the technique of University of Vienna. He received a percussion were ignored and even degree in 1752, and was appointed a Bibliography ridiculed with only a few exceptions: full-time physician at the Spanish Auenbrugger L. Inventum novum. Vienna: during a short period as professor of Military Hospital. Encountering the Trettner, 1761. medicine at Vienna, Maximillian Carnac CNB. Epoch-making contributions to usual difficulties in visualizing and Stoll taught percussion; a few Ger­ medicine. In: Surgery and the allied sci- assaying organ pathology in chest man schools did likewise; Albrecht ences. Philadelphia: WB Saunders, 1909. diseases, Auenbrugger recalled that Jarcho S. Morgagni and Auenbrugger in the V. Haller wrote a favorable review his father, an innkeeper, tapped on retrospect of 200 years. Bull Hist Med (1762) with little effect; a surgeon in 1961; 55:489-96. the sides of a wine barrel with his Paris and one in Copenhagen found Le Fanu WR. Notable medical books. India­ fingertips to produce sounds that in­ napolis, Ind: Lilly, 1976. percussion useful in the diagnosis of dicated the level of its contents. With Major RH. Classic descriptions of disease. empyema; and Oliver Goldsmith Springfield, 111: Charles C Thomas, 1948. this vision in mind, Auenbrugger wrote a review of Inventum Novum A review of “Inventum Novum attributed to concentrated on research in percus- Oliver Goldsmith.” Bull Hist Med 1959; for the London Ledger (1762), which 33:470-6. apparently no English doctor read. Robinson V. Pathfinders in medicine. New This neglect did not deter Auenbrug­ York: Medical Life Press, 1929. Front the Department o f Pediatrics, Downstate Medical Sigerist HE. The great doctors. New York: School, State University of New York, Kings County ger from the pleasures of practice, WW Norton, 1933. Hospital Medical Center, and Brookdale Hospital M ed­ family, music, opera, and frequent Walsh JJ. Makers of modern medicine. Free­ ical Center, Brooklyn, New York. Requests far reprints attendance at receptions at the court port, NY: Book for Libraries Press, 1970. should be sent to Harry Bloch, M D , 49 Crest Drive, Warner JH. Remembering Paris. Bull Hist South Orange, N J 07079. of Maria Theresa. Med 1991; 65:301-25. © 1993 Appleton & Lange ISSN 0094-3509 232 The Journal of Family Practice, Vol. 36, No. 2, 1993