René Laennec

LAENNEC, René (René Théophile Hyacinthe Laennec, 1781–1826), a famous French physician who, in an era dominated by various speculative hypotheses, became the creator of a new anatomical-clinical method in medicine. The merits of Laennec are characterized by three points. Firstly, he is the creator of auscultation. With the help of an instrument he invented, the stethoscope ("chest explorer"), he discovered a whole series of new clinical signs of diseases of the thoracic cavity, to which he gave an exact description, providing them with the corresponding anatomical substrate. This anatomical-clinical semiotics remains unshakable to this day.

Secondly, Laennec was a major pathologist who linked anatomy with clinical practice and, for the first time, without a microscope, using only a magnifying glass, provided a fairly accurate morphological description of numerous pathological processes. Finally, Laennec was the first to give a clear description of tuberculosis, providing it with a definite anatomical concept, and without knowing its etiology, he established its specificity, uniting the diverse pictures of this complex process with the word "tuberculosis," which he used for the first time. Laennec was born in Quimper (Brittany) into a doctor's family. From the age of 14, he began to study medicine, working in the hospital of Nantes. From the very first months, he seriously engaged in anatomy and became very attached to dissection work. His success was so great that at 18 he already received a position as a military doctor. In 1801, Laennec moved to Paris, where his talent unfolded widely under the guidance of the famous Bichat and Corvisart. At 21, Laennec published his first remarkable work on peritonitis. In it, for the first time, various types of peritonitis were indicated, and its individual symptoms were described with striking accuracy, etc. Then Laennec published a number of works on worms, on the anatomy of the meninges, on cirrhosis of the liver, etc., and became a close collaborator of the famous surgeon Dupuytren. Soon, Laennec became the chairman of the Anatomical Society founded by Dupuytren. At 24, Laennec presented two dissertations on Hippocrates. In the first, he expressed the thought that Hippocrates is a collective name and his works are the product of the labor of a whole series of researchers. In the second, he subjected the very teaching of Hippocrates to analysis. Simultaneously with autopsies, Laennec carried out tireless observations of patients, using various methods known at that time: inspection, palpation, succussion, percussion (invented by Auenbrugger in 1765), and listening directly with the ear. But the latter did not give the tangible results that were obtained after Laennec's invention of the stethoscope (1816). For three years, Laennec worked continuously in hospitals, gathering facts and observations, and finally published his famous book "Traite d'auscultation mediate" (Paris, 1819). This book has not lost its significance to this day, especially in the field of phenomena and signs of respiratory diseases. Among the numerous masterful descriptions in this work, the chapter on tuberculosis draws particular attention. Laennec firmly stated that there is no other consumption except that which depends on the formation of tubercles in the organism; thus, many years before the discovery of the tuberculosis bacillus, he established the specificity of tuberculosis and the presence of a single pathological-anatomical substrate in it. Laennec was the first to point out the tubercular nature of serous pleurisy.

Laennec's view on hemoptysis is of unusual interest for that time; he was the first to definitely state that hemoptysis is a consequence, not a cause, of tuberculosis. Laennec was the first to point out the possibility of curing tuberculosis and cited in his book amazing anatomical and clinical examples of the scarring of cavities. Laennec's views on the treatment of pulmonary consumption are quite modern: he speaks of mental and physical rest, air, and proper nutrition. As often happens with remarkable discoveries, Laennec's book was met rather coldly; it was feared that "this new method of auscultation would come into fashion and force doctors to forget the holy Hippocratic traditions." However, soon Laennec's fame became worldwide. He was elected professor at the College de France and a member of the Medical Academy. Laennec died in Brittany from pulmonary tuberculosis in poverty and, a few weeks before his death, had vainly petitioned for a prize for his remarkable book.