René Laennec
Encyclopedia
René-Théophile-Hyacinthe Laennec (17 February 1781 – 13 August 1826) was a French physician
. He invented the stethoscope
in 1816, while working at the Hôpital Necker and pioneered its use in diagnosing various chest conditions.
He became a lecturer at the Collège de France
in 1822 and professor of medicine in 1823. His final appointments were that of Head of the Medical Clinic at the Hôpital de la Charité
and Professor
at the Collège de France. He died of tuberculosis in 1826.
). His mother died of tuberculosis when he was five or six, and he went to live with his grand-uncle the Abbé
Laennec (a priest). At the age of twelve he proceeded to Nantes
where his uncle, Guillaime-François Laennec, worked in the faculty of medicine at the university. Laennec was a gifted student, he learned English and German, and began his medical studies under his uncle's direction.
His father (a lawyer) later discouraged him from continuing as a doctor and René then had a period of time where he took long walks in the country, danced, studied Greek and wrote poetry. However, in 1799 he returned to study. Laennec studied medicine in Paris under several famous physicians, including Dupuytren and Nicolas Corvisart des Marest. There he was trained to use sound as a diagnostic aid. Corvisart advocated the re-introduction of erc during the French Revolution
. Laennec was a devout Catholic. He was noted as a very kind man and his charity to the poor became proverbial.
Laennec had discovered that the new stethoscope
was superior to the normally used method of placing the ear over the chest, particularly if the patient was overweight. A stethoscope also avoided the embarrassment of placing the ear against the chest of a woman.
Laennec is said to have seen schoolchildren playing with long, hollow sticks in the days leading up to his innovation.
The children held their ear to one end of the stick while the opposite end was scratched with a pin, the stick transmitted and amplified the scratch. His skill as a flautist may also have inspired him. He built his first instrument as a 25 cm by 2.5 cm hollow wooden cylinder, which he later refined to comprise three detachable parts.
His clinical work allowed him to follow chest patients from bedside to the autopsy table. He was therefore able to correlate sounds captured by his new instruments with specific pathological changes in the chest, in effect pioneering a new non-invase diagnostic tool. Laennec was the first to classify and discuss the terms rales
, rhonchi
, crepitance, and egophony
– terms that doctors now use on a daily basis during physical exams and diagnoses. In February 1818, he presented his findings in a talk at the Academie de Medecin, later publishing his findings in 1819.
Laennec coined the phrase mediate auscultation
, (indirect listening) as opposed to the popular practice at the time of directly placing the ear on the chest (immediate auscultation
). He named his instrument the stethoscope
, from stethos (chest), and skopos (examination).
Not all doctors readily embraced the new stethoscope. Although the New England Journal of Medicine reported the invention of the stethoscope two years later, in 1821, as late as 1885 a professor of medicine stated, "He that hath ears to hear, let him use his ears and not a stethoscope." Even the founder of the American Heart Association
, L. A. Connor 1866–1950) carried a silk handkerchief with him to place on the wall of the chest for ear auscultation.
Laennec often referred to the stethoscope as "the cylinder," and as he neared death only a few years later, he bequeathed his own stethoscope to his nephew, referring to it as "the greatest legacy of my life."
The modern binaural stethoscope with two ear pieces, was invented in 1851 by Arthur Leared. George Cammann perfected the design of the instrument for commercial production in 1852, which has become the standard ever since.
He developed the understanding of peritonitis
and cirrhosis
. Although the disease of cirrhosis was known, Laennec gave cirrhosis its name, using the Greek word (kirrhos, tawny) that referred to the tawny, yellow nodules characteristic of the disease.
He originated the term melanoma
and described metastases of melanoma to the lungs. In 1804, while still a medical student, he was the first person to lecture on melanoma. This lecture was subsequently published in 1805. Laennec actually used the term 'melanose,' which he derived from the Greek (mela, melan) for "black." Over the years, there were bitter exchanges between Laennec and Dupuytren, the latter objecting that there was no mention of his work in this area and his role in its discovery.
He also studied tuberculosis
. Ironically, his nephew Mériadec Laennec, is said to have diagnosed tuberculosis in Laennec using Laennec’s stethoscope .
Laennec advocated objective scientific observation. Professor Benjamin Ward Richardson stated in Disciples of Aesculapius that "the true student of medicine reads Laennec's treatise on mediate auscultation and the use of the stethoscope once in two years at least as long as he is in practice. It ranks with the original work of Vesalius
, Harvey
and Hippocrates
."
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
. He invented the stethoscope
Stethoscope
The stethoscope is an acoustic medical device for auscultation, or listening to the internal sounds of an animal body. It is often used to listen to lung and heart sounds. It is also used to listen to intestines and blood flow in arteries and veins...
in 1816, while working at the Hôpital Necker and pioneered its use in diagnosing various chest conditions.
He became a lecturer at the Collège de France
Collège de France
The Collège de France is a higher education and research establishment located in Paris, France, in the 5th arrondissement, or Latin Quarter, across the street from the historical campus of La Sorbonne at the intersection of Rue Saint-Jacques and Rue des Écoles...
in 1822 and professor of medicine in 1823. His final appointments were that of Head of the Medical Clinic at the Hôpital de la Charité
Hôpital de la Charité
Hôpital de la Charité was a hospital in Paris founded in the 17th century and closed in 1935.-History:In 1606, Marie de Médicis invited the Brothers Hospitallers of St. John of God to come to France. The Abbot of Saint-Germain-des-Prés granted them the use of its former Saint-Père chapel, which...
and Professor
Professor
A professor is a scholarly teacher; the precise meaning of the term varies by country. Literally, professor derives from Latin as a "person who professes" being usually an expert in arts or sciences; a teacher of high rank...
at the Collège de France. He died of tuberculosis in 1826.
Early life and personality
Laennec was born in Quimper (BrittanyBrittany
Brittany is a cultural and administrative region in the north-west of France. Previously a kingdom and then a duchy, Brittany was united to the Kingdom of France in 1532 as a province. Brittany has also been referred to as Less, Lesser or Little Britain...
). His mother died of tuberculosis when he was five or six, and he went to live with his grand-uncle the Abbé
Abbé
Abbé is the French word for abbot. It is the title for lower-ranking Catholic clergymen in France....
Laennec (a priest). At the age of twelve he proceeded to Nantes
Nantes
Nantes is a city in western France, located on the Loire River, from the Atlantic coast. The city is the 6th largest in France, while its metropolitan area ranks 8th with over 800,000 inhabitants....
where his uncle, Guillaime-François Laennec, worked in the faculty of medicine at the university. Laennec was a gifted student, he learned English and German, and began his medical studies under his uncle's direction.
His father (a lawyer) later discouraged him from continuing as a doctor and René then had a period of time where he took long walks in the country, danced, studied Greek and wrote poetry. However, in 1799 he returned to study. Laennec studied medicine in Paris under several famous physicians, including Dupuytren and Nicolas Corvisart des Marest. There he was trained to use sound as a diagnostic aid. Corvisart advocated the re-introduction of erc during the French Revolution
French Revolution
The French Revolution , sometimes distinguished as the 'Great French Revolution' , was a period of radical social and political upheaval in France and Europe. The absolute monarchy that had ruled France for centuries collapsed in three years...
. Laennec was a devout Catholic. He was noted as a very kind man and his charity to the poor became proverbial.
The invention of the stethoscope
Laennec wrote the classic treatise De l'Auscultation Médiate, published in August 1819. The preface reads:In 1816, I was consulted by a young woman laboring under general symptoms of diseased heart, and in whose case percussion and the application of the hand were of little avail on account of the great degree of fatness. The other method just mentioned [direct auscultation] being rendered inadmissible by the age and sex of the patient, I happened to recollect a simple and well-known fact in acoustics, . . . 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 this suggestion, 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, and 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 the immediate application of my ear.
Laennec had discovered that the new stethoscope
Stethoscope
The stethoscope is an acoustic medical device for auscultation, or listening to the internal sounds of an animal body. It is often used to listen to lung and heart sounds. It is also used to listen to intestines and blood flow in arteries and veins...
was superior to the normally used method of placing the ear over the chest, particularly if the patient was overweight. A stethoscope also avoided the embarrassment of placing the ear against the chest of a woman.
The children held their ear to one end of the stick while the opposite end was scratched with a pin, the stick transmitted and amplified the scratch. His skill as a flautist may also have inspired him. He built his first instrument as a 25 cm by 2.5 cm hollow wooden cylinder, which he later refined to comprise three detachable parts.
His clinical work allowed him to follow chest patients from bedside to the autopsy table. He was therefore able to correlate sounds captured by his new instruments with specific pathological changes in the chest, in effect pioneering a new non-invase diagnostic tool. Laennec was the first to classify and discuss the terms rales
Rales
Crackles, crepitations, or rales are the clicking, rattling, or crackling noises that may be made by one or both lungs of a human with a respiratory disease during inhalation. They are often heard only with a stethoscope...
, rhonchi
Rhonchi
Rhonchi is the coarse rattling sound somewhat like snoring, usually caused by secretion in bronchial airways. Rhonchi is the plural form of the singular word rhonchus.-Description:...
, crepitance, and egophony
Egophony
Egophony is an increased resonance of voice sounds heard when auscultating the lungs, often caused by lung consolidation and fibrosis. It is due to enhanced transmission of high-frequency noise across fluid, such as in abnormal lung tissue, with lower frequencies filtered out...
– terms that doctors now use on a daily basis during physical exams and diagnoses. In February 1818, he presented his findings in a talk at the Academie de Medecin, later publishing his findings in 1819.
Laennec coined the phrase mediate auscultation
Mediate auscultation
Mediate auscultation is an antiquated medical term for listening to the internal sounds of the body using an instrument , usually a stethoscope. It is opposed to immediate auscultation, directly placing the ear on the body....
, (indirect listening) as opposed to the popular practice at the time of directly placing the ear on the chest (immediate auscultation
Immediate auscultation
Immediate auscultation is an antiquated medical term for listening to the internal sounds of the body, directly placing the ear on the body. It is opposed to mediate auscultation, using an instrument , usually a stethoscope....
). He named his instrument the stethoscope
Stethoscope
The stethoscope is an acoustic medical device for auscultation, or listening to the internal sounds of an animal body. It is often used to listen to lung and heart sounds. It is also used to listen to intestines and blood flow in arteries and veins...
, from stethos (chest), and skopos (examination).
Not all doctors readily embraced the new stethoscope. Although the New England Journal of Medicine reported the invention of the stethoscope two years later, in 1821, as late as 1885 a professor of medicine stated, "He that hath ears to hear, let him use his ears and not a stethoscope." Even the founder of the American Heart Association
American Heart Association
The American Heart Association is a non-profit organization in the United States that fosters appropriate cardiac care in an effort to reduce disability and deaths caused by cardiovascular disease and stroke. It is headquartered in Dallas, Texas...
, L. A. Connor 1866–1950) carried a silk handkerchief with him to place on the wall of the chest for ear auscultation.
Laennec often referred to the stethoscope as "the cylinder," and as he neared death only a few years later, he bequeathed his own stethoscope to his nephew, referring to it as "the greatest legacy of my life."
The modern binaural stethoscope with two ear pieces, was invented in 1851 by Arthur Leared. George Cammann perfected the design of the instrument for commercial production in 1852, which has become the standard ever since.
Other medical contributions
Peritonitis
Peritonitis is an inflammation of the peritoneum, the serous membrane that lines part of the abdominal cavity and viscera. Peritonitis may be localised or generalised, and may result from infection or from a non-infectious process.-Abdominal pain and tenderness:The main manifestations of...
and cirrhosis
Cirrhosis
Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules , leading to loss of liver function...
. Although the disease of cirrhosis was known, Laennec gave cirrhosis its name, using the Greek word (kirrhos, tawny) that referred to the tawny, yellow nodules characteristic of the disease.
He originated the term melanoma
Melanoma
Melanoma is a malignant tumor of melanocytes. Melanocytes are cells that produce the dark pigment, melanin, which is responsible for the color of skin. They predominantly occur in skin, but are also found in other parts of the body, including the bowel and the eye...
and described metastases of melanoma to the lungs. In 1804, while still a medical student, he was the first person to lecture on melanoma. This lecture was subsequently published in 1805. Laennec actually used the term 'melanose,' which he derived from the Greek (mela, melan) for "black." Over the years, there were bitter exchanges between Laennec and Dupuytren, the latter objecting that there was no mention of his work in this area and his role in its discovery.
He also studied tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
. Ironically, his nephew Mériadec Laennec, is said to have diagnosed tuberculosis in Laennec using Laennec’s stethoscope .
Laennec advocated objective scientific observation. Professor Benjamin Ward Richardson stated in Disciples of Aesculapius that "the true student of medicine reads Laennec's treatise on mediate auscultation and the use of the stethoscope once in two years at least as long as he is in practice. It ranks with the original work of Vesalius
Vesalius
Andreas Vesalius was a Flemish anatomist, physician, and author of one of the most influential books on human anatomy, De humani corporis fabrica . Vesalius is often referred to as the founder of modern human anatomy. Vesalius is the Latinized form of Andries van Wesel...
, Harvey
William Harvey
William Harvey was an English physician who was the first person to describe completely and in detail the systemic circulation and properties of blood being pumped to the body by the heart...
and Hippocrates
Hippocrates
Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...
."
Legacy
- Laennec's cirrhosisLaennec's cirrhosisLaennec's cirrhosis is named after René Laennec, a French physician and the inventor of the stethoscope. It is a disease of the liver in which the normal lobular architecture is lost, with fibrosis and later nodular regeneration. Laennec's cirrhosis can be associated with inflammatory...
refers to the appearance of regenerated liver, comprising small lobules separated by a fine, fibrous tissue; Laennec's thrombus is an antenatal thrombus in the heart
- Laennec's pearls refer to sputum produced by asthmatics.
- Hamman's murmur, also known as Laënnec-Hamman symptom, Laënnec-Müller-von Bergmann-Hamman symptom, or Hamman's crunch is a crunching sound heard over the precordium due to spontaneous mediastinal emphysema.
- At the Université Claude Bernard Lyon 1 one of the four medical schools is named after Laennec.