Josef Leopold Auenbrugger or Avenbrugger (19 November 1722 – 17 May 1809),
also known as Leopold von Auenbrugger,
was an Austrian
physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
who invented
percussion
A percussion instrument is a musical instrument that is sounded by being struck or scraped by a beater including attached or enclosed beaters or rattles struck, scraped or rubbed by hand or struck against another similar instrument. Exc ...
as a
diagnostic
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engine ...
technique. On the strength of this discovery, he is considered one of the founders of modern medicine.
Biography
Auenbrugger was a native of
Graz
Graz (; sl, Gradec) is the capital city of the Austrian state of Styria and second-largest city in Austria after Vienna. As of 1 January 2021, it had a population of 331,562 (294,236 of whom had principal-residence status). In 2018, the popul ...
in
Styria
Styria (german: Steiermark ; Serbo-Croatian and sl, ; hu, Stájerország) is a state (''Bundesland'') in the southeast of Austria. With an area of , Styria is the second largest state of Austria, after Lower Austria. Styria is bordered to ...
, an Austrian province. His father, owner of the
inn
Inns are generally establishments or buildings where travelers can seek lodging, and usually, food and drink. Inns are typically located in the country or along a highway; before the advent of motorized transportation they also provided accommo ...
''Zum Schwarzen Mohren'', gave his son every opportunity for an excellent preliminary education in his native town and then sent him to
Vienna
en, Viennese
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, postal_code =
, timezone = CET
, utc_offset = +1
, timezone_DST ...
to complete his studies at the university. Auenbrugger was graduated as a physician at the age of 22 and then entered the
Spanish Military Hospital of Vienna, where he spent 10 years.
He found out that, by applying his ear to the patient and tapping lightly on the
chest
The thorax or chest is a part of the anatomy of humans, mammals, and other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main divisions of the crea ...
, one could assess the density of underlying tissues and organs. This technique of percussive diagnosis had its origins in testing the level of wine casks in the cellar of his father's hotel.
[Doctors:The History of Medicine through Biography ]Sherwin B. Nuland
Sherwin Bernard Nuland (born Shepsel Ber Nudelman; December 8, 1930 – March 3, 2014) was an American surgeon and writer who taught bioethics, history of medicine, and medicine at the Yale School of Medicine, and occasionally bioethics and hist ...
With this method, he was able to plot outlines of the
heart
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
.
It was the first time that a physician could relatively accurately and objectively determine an important sign of diseases. He published his findings in a booklet, but nobody paid much attention to it.
During his ten years of patient study, Auenbrugger confirmed his observations on the diagnostic value of percussion by comparison with
post-mortem
An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any dis ...
specimen
Specimen may refer to:
Science and technology
* Sample (material), a limited quantity of something which is intended to be similar to and represent a larger amount
* Biological specimen or biospecimen, an organic specimen held by a biorepository ...
s, and besides made a number of
experimental research
An experiment is a procedure carried out to support or refute a hypothesis, or determine the efficacy or likelihood of something previously untried. Experiments provide insight into cause-and-effect by demonstrating what outcome occurs when a ...
es on dead bodies. He injected fluid into the
pleural cavity
The pleural cavity, pleural space, or interpleural space is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication bet ...
, and showed that it was perfectly possible by percussion to tell exactly the limits of the fluid present, and thus to decide when and where efforts should be made for its removal.
His name is also associated with
Auenbrugger's sign
Auenbrugger's sign is a bulging of the epigastrium seen in cases of severe pericardial effusion. It is often not spotted because pericardial effusion can be caught on echocardiography
An echocardiography, echocardiogram, cardiac echo or simply ...
, a bulging of the
epigastric region
In anatomy, the epigastrium (or epigastric region) is the upper central region of the abdomen. It is located between the costal margins and the subcostal plane. Pain may be referred to the epigastrium from damage to structures derived from the fo ...
, in cases of large
effusion
In physics and chemistry, effusion is the process in which a gas escapes from a container through a hole of diameter considerably smaller than the mean free path of the molecules. Such a hole is often described as a ''pinhole'' and the escape ...
s of the
pericardium
The pericardium, also called pericardial sac, is a double-walled sac containing the heart and the roots of the great vessels. It has two layers, an outer layer made of strong connective tissue (fibrous pericardium), and an inner layer made of ...
, the membrane which envelops the
heart
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
.
His later studies were devoted to
tuberculosis
Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in ...
. He pointed out how to detect cavities of the
lung
The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of t ...
s, and how their location and size might be determined by percussion. He also recognized that information with regard to the contents of cavities in the lungs and conditions of lung tissue might be obtained by placing the hand on the chest and noting the
vibration
Vibration is a mechanical phenomenon whereby oscillations occur about an equilibrium point. The word comes from Latin ''vibrationem'' ("shaking, brandishing"). The oscillations may be periodic function, periodic, such as the motion of a pendulum ...
, or ''
fremitus
Fremitus is a vibration transmitted through the body. In common medical usage, it usually refers to assessment of the lungs by either the vibration intensity felt on the chest wall (''tactile fremitus'') and/or heard by a stethoscope on the chest ...
'', produced by the
voice
The human voice consists of sound made by a human being using the vocal tract, including talking, singing, laughing, crying, screaming, shouting, humming or yelling. The human voice frequency is specifically a part of human sound production in ...
and
breath
Breathing (or ventilation) is the process of moving air into and from the lungs to facilitate gas exchange with the internal environment, mostly to flush out carbon dioxide and bring in oxygen.
All aerobic creatures need oxygen for cellular ...
. These observations were published in a little book called ''Inventum Novum ex Percussione Thoracis Humani Interni Pectoris Morbos Detegendi'', the full English title being "A New Discovery that Enables the Physician from the Percussion of the Human Thorax to Detect the Diseases Hidden Within the Chest". It is considered a book that marks an epoch in the modern history of medicine.
Like most medical discoveries, Auenbrugger's method of diagnosis at first met with indifference. Before his death, however, it had aroused the attention of French physician
René Laennec
René-Théophile-Hyacinthe Laennec (; 17 February 1781 – 13 August 1826) was a French physician and musician. His skill at carving his own wooden flutes led him to invent the stethoscope in 1816, while working at the Hôpital Necker ...
, who, following up the ideas suggested by it, discovered
auscultation
Auscultation (based on the Latin verb ''auscultare'' "to listen") is listening to the internal sounds of the body, usually using a stethoscope. Auscultation is performed for the purposes of examining the circulatory and respiratory systems (hea ...
.
The value of percussion in physical examination was later recognized by
Jean-Nicolas Corvisart
Jean-Nicolas Corvisart-Desmarets (15 February 1755 – 18 September 1821) was a French physician.
Born in the village of Dricourt (now in Ardennes), Corvisart studied from 1777 at the Ecole de Médecine in Paris, later qualifying as ''docte ...
, who popularized it teaching it to his students in
France
France (), officially the French Republic ( ), is a country primarily located in Western Europe. It also comprises of Overseas France, overseas regions and territories in the Americas and the Atlantic Ocean, Atlantic, Pacific Ocean, Pac ...
, and by
Joseph Škoda
Joseph Škoda (10 December 1805 – 13 June 1881) was a Czech physician, medical professor and dermatologist. Together with Carl Freiherr von Rokitansky, he was the founder of the Modern Medical School of Vienna.
Life
Škoda was born in Pils ...
in
Vienna
en, Viennese
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, postal_code_type = Postal code
, postal_code =
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. He also translated and illustrated Auenbrugger's book in 1808, which helped to make Auenbrugger's work on percussion better known.
Auenbrugger lived to the age of 86. He was especially noted for his cordial relations with the younger members of his profession and for his kindness to the poor and to those suffering from tuberculosis. He is sometimes said to have died in the
typhus
Typhus, also known as typhus fever, is a group of infectious diseases that include epidemic typhus, scrub typhus, and murine typhus. Common symptoms include fever, headache, and a rash. Typically these begin one to two weeks after exposure.
...
epidemic
An epidemic (from Ancient Greek, Greek ἐπί ''epi'' "upon or above" and δῆμος ''demos'' "people") is the rapid spread of disease to a large number of patients among a given population within an area in a short period of time.
Epidemics ...
of 1798, but he actually died over a decade later.
Auenbrugger's daughter,
Marianna, was a composer and pupil of
Antonio Salieri
Antonio Salieri (18 August 17507 May 1825) was an Italian classical composer, conductor, and teacher. He was born in Legnago, south of Verona, in the Republic of Venice, and spent his adult life and career as a subject of the Habsburg monarchy ...
.
Further reading
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Notes
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References
External links
Josef Leopold Auenbrugger WhoNamedIt.
{{DEFAULTSORT:Auenbrugger, Leopold
1722 births
1809 deaths
18th-century Austrian physicians
Austrian Roman Catholics
Austrian untitled nobility