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Listening the unseen
Two exciting developments took place in early 19th century. Around 1750s Leopold Auenbrugger invented percussion, and in 1816 Laennec invented stethoscope, and thus auscultation. Leopold also discovered ‘fremitus‘ to feel sound on the chest wall, as it travels through the lungs. Before this physicians spoke with their patients, and could see visible physical signs and could feel pulsations and large organs. Now they could also listen sounds from the invisible. It must have been magic to know if lungs had drowned in water, or how blood is flowing through heart.
Leopold’s invention would have gone unnoticed, but for French physician Jean-Nicolas Corvisart. He was fond of percussion and popularised it among his students – Laennec, Dupuytren, and Bretonneau. These students would go on to identify clinical signs. Laennec in addition to inventing stethoscope coined the terms cirrhosis and melanoma. Dupuytren identified a hand-contracture named after him, and Bretonneau identified typhoid fever and named diphtheria. Corvisart was a personnel physician to Napoleon Bonaparte till he was exiled in 1815. He died of stroke in 1821.
Naming clinical signs and diseases
Wilhelm Griesinger was a German and Jean Charcot a French neurologist, both were born within eight years of each other in 1817 and 1825 respectively. Griesinger a professor of medicine wrote texts describing medical and tropical illnesses, and devoted much of his later life in care of intellectually impaired. Griesinger’s sign (swollen mastoid in sigmoid sinus thrombophlebitis) is named after him.
Charcot was a pioneer neurologist and developed the sequence of clinical examination, like we see today. He was also a pioneer in psychiatry and hypnosis. At least 15 different signs and diseases are named after him (Charcot’s foot, Charcot-marie-tooth disease, Charcot’s disease (now motor neurone disease), Charcot’s triad in cholangitis etc). Various famous physicians and psychiatrists studied with him and include Sigmund Freud, Joseph Babinski, Charles-Joseph Bouchard and Georges Gilles de la Tourette.
In the doorsteps of 20th century
Jean Antoine Villemin was another contemporary of Charcot. In 1865 he proved that tuberculosis is transmissible. Meanwhile in late 19th century Mayo brothers (William and Charles) established Mayo’s clinic. This beginning would lead to a chain of hospitals, that would transform medical care in United States in the 20th century.
Many other physicians who have been honoured with postage stamps. Gheorghe Marinescu was a Romanian neurologist, who pioneered neurology teaching. Egas Moniz was a Portuguese physician who pioneered prefrontal lobectomy and performed first cerebral angiography. MP Konchalovsky was a Russian physician who established internal medicine training in Moscow. These and many other 19th century physicians established traditions that would reap benefits of discoveries made in early 20th century.