René Laënnec
FRENCH PHYSICIAN
René Laënnec, in full René-Théophile-Hyacinthe Laënnec, (born February 17, 1781, Quimper, Brittany, France—died August 13, 1826, Kerlouanec), French physician who invented the stethoscopeand perfected the art of auditory examination of the chest cavity.
When Laënnec was five years old, his mother, Michelle Félicité Guesdon, died from tuberculosis, leaving Laënnec and his brother, Michaud, in the incompetent care of their father, Théophile-Marie Laënnec, who worked as a civil servant and had a reputation for reckless spending. In 1793, during the French Revolution, Laënnec went to live with his uncle, Guillaume-François Laënnec, in the port city of Nantes, located in the Pays de la Loire region of western France. Laënnec’s uncle was the dean of medicine at the University of Nantes. Although the region was in the midst of counterrevolutionary revolts, the young Laënnec settled into his academic training and, under his uncle’s direction, began his medical studies. His first experience working in a hospital setting was at the Hôtel-Dieu of Nantes, where he learned to apply surgical dressings and to care for patients. In 1800 Laënnec went to Paris and entered the École Pratique, studying anatomy and dissection in the laboratory of surgeon and pathologist Guillaume Dupuytren. Dupuytren was a bright and ambitious academic who became known for his many surgical accomplishments and for his work in alleviating permanent tissuecontracture in the palm, a condition later named Dupuytren contracture. While Dupuytren undoubtedly influenced Laënnec’s studies, Laënnec also received instruction from other well-known French anatomists and physicians, including Gaspard Laurent Bayle, who studied tuberculosis and cancer; Marie-François-Xavier Bichat, who helped establish histology, the study of tissues; and Jean-Nicolas Corvisart des Marets, who used chest percussion to assess heart function and who served as personal physician to Napoleon I.
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Laënnec’s original stethoscope design consisted of a hollow tube of wood that was 3.5 cm (1.4 inches) in diameter and 25 cm (10 inches) long and was monoaural, transmitting sound to one ear. It could be easily disassembled and reassembled, and it used a special plug to facilitate the transmission of sounds from the patient’s heart and lungs. His instrument replaced the practice of immediate auscultation, in which the physician laid his ear on the chest of the patient to listen to chest sounds. The awkwardness that this method created in the case of women patients compelled Laënnec to find a better way to listen to the chest. His wooden monoaural stethoscope was replaced by models using rubber tubing at the end of the 19th century. Other advancements include the development of binaural stethoscopes, capable of transmitting sounds to both ears of the physician.
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In 1819 Laënnec published De l’auscultation médiate (“On Mediate Auscultation”), the first discourse on a variety of heart and lung sounds heard through the stethoscope. The first English translation of De l’auscultation médiate was published in London in 1821. Laënnec’s treatise aroused intense interest, and physicians from throughout Europe came to Paris to learn about Laënnec’s diagnostic tool. He became an internationally renowned lecturer.
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