- Auenbrugger, Corvisart, and the Perception of Disease
In 1761, the Austrian physician Leopold Auenbrugger published the Inventum novum, 1 in which he expounded on his discovery of percussion of the thorax. By tapping with his fingers on the chests of his patients and listening to the sounds produced therein, he could determine the healthy or diseased state of their thoracic cavity. A hollow sound indicated a healthy chest, whereas a dull, flat sound (which he compared to that produced when the flesh of the thigh is struck) was a sign of disease. He subsequently confirmed the connections between various sounds and pulmonary diseases by postmortem experiments on cadavers. His ingenious invention made lesions in some of the previously inaccessible inner recesses of the body suddenly perceptible and open to diagnosis and preventive cures. It gave rise later to Laënnec’s discovery of auscultation and the stethoscope, which would transform the practice of medicine and whose value is still proclaimed, and puts Auenbrugger today “at the head of modern physical diagnosis.” 2
But percussion was to remain in oblivion for all intents and purposes until 1808, the year Corvisart translated Auenbrugger’s work from Latin into French. 3 It was not the first translation, for Rozière de la Chassagne had already produced a French translation in 1770. 4 Yet it was Corvisart’s work, and not Rozière’s, that finally rescued Auenbrugger’s discovery and gave it the prominence it deserved. Why was such an important invention relegated, momentarily at least, to the dustbin of history? The [End Page 473] answer to this question reveals a rich nexus of medical, philosophical, religious, and personal influences at work in the culture of eighteenth-century Europe and, specifically, of France, my particular focus here. Others have attempted to answer this baffling question. 5 After briefly sketching some of the historical reasons for this neglect, I propose to build on the research of others and add my own independent observations, grouping them under the general category of prejudices arising from the eighteenth-century approach to the mind-body problem. In addition to elucidating why percussion was not recognized in the latter half of the eighteenth century, I also hope to show why it was recognized by Corvisart only in the early nineteenth century. My subsequent discussion of his translation of and commentary on Auenbrugger’s work attempts to demonstrate Corvisart’s thorough assimilation of the rhetoric of the French Enlightenment. That rhetoric incorporated to a large degree the philosophy of sensationism and its attendant notion of the sensory origin of ideas, which scholars have overlooked in their insistence on sensationism’s emphasis of observation, experience, and analysis. A study of the place of sensationism and the mind-body question in the period’s medical discourse both points to and helps clarify the taboo against touching the patient in eighteenth-century medical practice. Ultimately, early nineteenth-century medicine rejoins and reinforces the epistemological thinking of the century that preceded it.
Auenbrugger enjoyed the company of some of the most distinguished teachers and colleagues in Europe at the time. He studied medicine in Vienna with van Swieten, who himself had studied with the Dutch master teacher Boerhaave in Leyden. Auenbrugger composed his pithy work after seven years of careful observation of chest diseases at the Spanish military hospital of the Holy Trinity in Vienna. Had his short treatise benefited from a favorable review by his prestigious teacher, perhaps it would have quickly gained renown. But for some reason (jealousy and even contempt are sometimes adduced), 6 neither van Swieten nor his well-known fellow physician de Haen paid much attention to the new discovery. Other contemporaries like Vogel confused it with the ancient Hippocratic practice of succussion, in which the patient was held under the arms and vigorously shaken to determine the presence of fluid and air in the thorax from a splashing sound. Everyone underestimated the novelty of Auenbrugger’s discovery. Although percussion of other organs like the heart or abdomen had been practiced in ancient times, Auenbrugger had, as Coury points out, no forerunners in the percussion of the thorax. 7 A review of...