Leopold Auenbrugger
Encyclopedia
Josef Leopold Auenbrugger or Leopold von Auenbrugg (b. November 19, 1722, Graz
Graz
The more recent population figures do not give the whole picture as only people with principal residence status are counted and people with secondary residence status are not. Most of the people with secondary residence status in Graz are students...

, Austria
Austria
Austria , officially the Republic of Austria , is a landlocked country of roughly 8.4 million people in Central Europe. It is bordered by the Czech Republic and Germany to the north, Slovakia and Hungary to the east, Slovenia and Italy to the south, and Switzerland and Liechtenstein to the...

; died May 17, 1809), Austrian physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

 who invented percussion
Percussion (medicine)
Percussion is a method of tapping on a surface to determine the underlying structure, and is used in clinical examinations to assess the condition of the thorax or abdomen. It is one of the four methods of clinical examination, together with inspection, palpation and auscultation...

 as a diagnostic
Medical diagnosis
Medical diagnosis refers both to the process of attempting to determine or identify a possible disease or disorder , and to the opinion reached by this process...

 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
The more recent population figures do not give the whole picture as only people with principal residence status are counted and people with secondary residence status are not. Most of the people with secondary residence status in Graz are students...

 in Styria, an Austrian province. His father, a hotel
Hotel
A hotel is an establishment that provides paid lodging on a short-term basis. The provision of basic accommodation, in times past, consisting only of a room with a bed, a cupboard, a small table and a washstand has largely been replaced by rooms with modern facilities, including en-suite bathrooms...

 keeper, gave his son every opportunity for an excellent preliminary education in his native town and then sent him to Vienna
Vienna
Vienna is the capital and largest city of the Republic of Austria and one of the nine states of Austria. Vienna is Austria's primary city, with a population of about 1.723 million , and is by far the largest city in Austria, as well as its cultural, economic, and political centre...

 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
Chest
The chest is a part of the anatomy of humans and various other animals. It is sometimes referred to as the thorax or the bosom.-Chest anatomy - Humans and other hominids:...

, one could assess the texture 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. With this method, he was able to plot outlines of the heart
Heart
The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...

.
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 specimen
Specimen
A specimen is a portion/quantity of material for use in testing, examination, or study.BiologyA laboratory specimen is an individual animal, part of an animal, a plant, part of a plant, or a microorganism, used as a representative to study the properties of the whole population of that species or...

s, and besides made a number of experimental researches on dead bodies. He injected fluid into the pleural cavity
Pleural cavity
In human anatomy, the pleural cavity is the potential space between the two pleura of the lungs. The pleura is a serous membrane which folds back onto itself to form a two-layered, membrane structure. The thin space between the two pleural layers is known as the pleural cavity; it normally...

, 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
Auenbrugger's sign is a bulging of the epigastrium seen in cases of severe pericardial effusion. It is named after Joseph Leopold Auenbrugger....

, a bulging of the epigastric region in the thorax, in cases of large effusion
Effusion
In physics, effusion is the process in which individual molecules flow through a hole without collisions between molecules. This occurs if the diameter of the hole is considerably smaller than the mean free path of the molecules...

s of the pericardium
Pericardium
The pericardium is a double-walled sac that contains the heart and the roots of the great vessels.-Layers:...

, the membrane which envelops the heart
Human heart
The human heart is a muscular organ that provides a continuous blood circulation through the cardiac cycle and is one of the most vital organs in the human body...

.

His later studies were devoted to tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

. He pointed out how to detect cavities of the lung
Lung
The lung is the essential respiration organ in many air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located near the backbone on either side of the heart...

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
Oscillation
Oscillation is the repetitive variation, typically in time, of some measure about a central value or between two or more different states. Familiar examples include a swinging pendulum and AC power. The term vibration is sometimes used more narrowly to mean a mechanical oscillation but sometimes...

, or fremitus
Fremitus
Fremitus is a palpable vibration on the human body. In common medical usage, it usually refers to vocal fremitus, although there are several other types.-Pleural fremitus:...

, produced by the voice
Human voice
The human voice consists of sound made by a human being using the vocal folds for talking, singing, laughing, crying, screaming, etc. Its frequency ranges from about 60 to 7000 Hz. The human voice is specifically that part of human sound production in which the vocal folds are the primary...

 and breath. 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 Laennec
René-Théophile-Hyacinthe Laennec was a French physician. He invented the stethoscope in 1816, while working at the Hôpital Necker and pioneered its use in diagnosing various chest conditions....

, who, following up the ideas suggested by it, discovered auscultation
Auscultation
Auscultation is the term for listening to the internal sounds of the body, usually using a stethoscope...

.
The value of percussion in physical examination was later recognized by Jean-Nicolas Corvisart
Jean-Nicolas Corvisart
Jean-Nicolas Corvisart was an important figure in the history of French medicine. Born in the French village of Dricourt, Ardennes in 1755, Corvisart gained early notoriety for his translation of Leopold von Auenbrugg's Inventum Novum from Latin into French...

, who popularized it teaching it to his students in France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...

, and by Josef Skoda
Josef Škoda
Joseph Škoda 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:...

 in Vienna
Vienna
Vienna is the capital and largest city of the Republic of Austria and one of the nine states of Austria. Vienna is Austria's primary city, with a population of about 1.723 million , and is by far the largest city in Austria, as well as its cultural, economic, and political centre...

. He also translated and illustrated Auenbrugger's book in 1808, which helped to make Auenbrugger's work on percussion better known.

Auenbrugger lived to a happy old age. He was especially noted for his cordial relations with the younger members of his profession and for his kindness to the poor and to these suffering from tuberculosis. He is sometimes said to have died in the typhus
Typhus
Epidemic typhus is a form of typhus so named because the disease often causes epidemics following wars and natural disasters...

 epidemic
Epidemic
In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...

 of 1798, but he actually died over a decade later.

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