René-Théophile-Hyacinthe Laënnec

• Born: February 17, 1781
• Birthplace: Quimper, France
• Died: August 13, 1826
• Place of death: Kerlouanec, France

French physician

Laënnec revolutionized medicine through his research in pathological anatomy and his work in clinical diagnosis. His invention of the stethoscope made possible accurate diagnosis of chest and heart problems.

Primary field: Medicine and medical technology

Primary invention: Stethoscope

Early Life

René-Théophile-Hyacinthe Laënnec (ruh-NAY tay-aw-FEEL yah-SAHNT lay-NEHK) was born in Quimper, France, on February 17, 1781. When he was five years old, his mother died of tuberculosis. His father did not feel that he could take care of the boy properly, so René was sent to live with his great uncle the Abbé Laënnec. He was not a healthy child; he suffered from pyrexia and asthma and spent much of his time playing the flute and writing poetry. He also learned Greek and Latin and studied the classics.

The majority of the Laënnec family were lawyers, and many held positions in the parliament of Brittany. However, René’s uncle Dr. Guillaume François Laënnec was dean of the medical school at the University of Nantes. René’s interest was in medicine, not law, and when he was twelve years old he went to Nantes, where his uncle encouraged him to pursue a medical career. In 1795, when he was only fourteen years old, René was already working at the Hôtel-Dieu in Nantes, assisting with the care of patients, and there he began his medical education with his uncle. At the age of eighteen, René was serving as a third-class surgeon in the Military Hospital of Nantes. A short time later, he was at the Hospice de la Fraternité and then a surgeon at the Hôtel-Dieu. This was an excellent opportunity for the young man to observe a large variety of patient treatment and surgery.

In 1801, Laënnec went to Paris, where he studied medicine at the École Pratique and at the Hôpital de la Charité. He attended lectures given by the most talented physicians of the day: He learned dissection and was introduced to macroscopic pathology in the laboratories of Guillaume Dupuytren; studied heart and pulmonary conditions with Jean-Nicolas Corvisart, Napoleon Bonaparte’s doctor; listened to Philippe Pinel, the founder of modern psychiatry, explain his theories of mental illness as a disease; and was a student of anatomy and physiology with Marie François Xavier Bichat, the father of the science of anatomy. Laënnec was especially talented as a diagnostician and as a pathologist. Soon, he started to do research on his own and to publish his findings in medical reviews.

In 1802, at the age of twenty-two, he obtained first place in the Concours Général de Médecine et de Chirurgie (general medicine and surgery exam). That year, he published a number of papers on various medical subjects and served as editor of the Journal de Médecine. While preparing his thesis, he gave private classes on pathological anatomy. In June, 1804, he defended his thesis and graduated.

Life’s Work

Laënnec’s career in medicine combined the fields of research scientist, practicing physician, and medical journalist. After graduating, he became an associate of the Société de l’École de Médecine and published a considerable number of articles, many of which dealt with pathological anatomy. However, his article on melanoma published in 1806 resulted in a rupture with Dupuytren, who insisted that Laënnec had failed to give him adequate credit for his work in the field. This quarrel, coupled with family problems, his uncle’s death from tuberculosis, and financial difficulties, caused Laënnec a number of health problems, and he was forced to return to his native Brittany to recuperate.

Once his health was restored, Laënnec returned to Paris, became an editor-shareholder of the Journal de Médecine, and once again established a private practice. In 1808, he founded the Athénée Médical. He received an appointment as personal physician to Cardinal Joseph Fesch, Napoleon’s uncle, and also published a number of articles on pathological anatomy. In 1810, Georges Cuvier, the founder of pathological anatomy, praised Laënnec as one of the very best in that field.

During the war years of 1812 and 1813, Laënnec was at the Salpétrière Hospital taking charge of the wounded Breton soldiers. He also taught medical pathology at the Hôpital Necker. During this period after his return to Paris, Laënnec was disappointed that he had not been offered a senior position as a physician in a Paris hospital. The offer finally came in 1816 from the Hôpital Necker. Laënnec immediately accepted and enjoyed a vast celebrity as a doctor. It was while he was at Hôpital Necker that he would make his most significant medical contribution, the stethoscope. In 1819, an obese young woman with symptoms of heart disease became his patient. Due to the impossibility of using percussion and the impropriety of placing his ear to her chest, he searched for another method and invented the stethoscope.

Shortly thereafter, Laënnec received a number of honors. In July, 1822, he was appointed chair and professor of medicine at the Collège de France. In January, 1823, he was accepted as a full member of the French Academy of Medicine. He also received an appointment as a professor at the medical clinic at the Hôpital de la Charité. In 1824, he was awarded the Legion of Honor.

Throughout his life, Laënnec was a devout Catholic and a kind and generous individual. He counted among his patients many famous people such as the author François-René de Chateaubriand, but he also treated many poor patients. Laënnec did not marry until 1824, just shortly before his death from tuberculosis. In May, 1826, suffering from deteriorating health, he left Paris and returned to Brittany, hoping to restore himself to better health. He continued to deny that his illness was tuberculosis until he asked his nephew Mériadec to listen to his chest with a stethoscope and describe his findings. What Mériadec reported left no doubt in Laënnec’s mind that he was dying from tuberculosis. He willed all of his scientific papers, his watch, and his ring to this nephew. He also left him his stethoscope. Laënnec truly realized the importance and value of his invention and described it as the best item he was leaving to Mériadec. On August 13, 1826, he died in Kerlouanec, France.

Impact

Laënnec had a most significant impact on medicine both as a researcher and as a practicing physician. Influenced by the teachings of Corvisart, who had reintroduced the usefulness of chest percussion first used by Leopold Auenbrugger, Laënnec further explored this method and published the results of his work, which became the basis for diagnosing chest disease.

His greatest contribution to diagnosis of chest illness was his invention of the stethoscope, which made accurate diagnosis possible in cases that otherwise remained unclear. In 1818, he appeared before the Academy of Science in Paris with his findings and research on the stethoscope. In 1819, he published his two-volume work on the stethoscope and chest disease, De l’auscultation médiate (On Mediate Auscultation, 1821). Laënnec’s treatise brought a large number of physicians to Paris to see the stethoscope and to consult with him about its use. A revised version of the book, which correlated the sounds heard with the stethoscope with the lesion found at autopsy, was published in 1826.

Laënnec gave the liver disease known as cirrhosis its name. He also made important discoveries about melanoma and distinguished its lesions from those of tuberculosis. He advanced the diagnosis of heart problems through his research. Using his stethoscope, he discovered and described two distinct heart sounds. As a result of his research and active practice as a physician, Laënnec advanced both the knowledge and the methods of diagnosis available to physicians. He perfected the art of clinical diagnosis, which became one of the most valuable tools for the physician in the treatment of diseases, especially those of the chest. His invention of the stethoscope enabled physicians to distinguish and diagnose various chest diseases.

Bibliography

Blaufox, M. Donald. An Ear to the Chest: An Illustrated History of the Evolution of the Stethoscope. New York: Parthenon, 2002. Discusses various means of chest examination, types of stethoscopes, and the debate over the stethoscope versus immediate auscultation. Illustrated, photographs, index, suggested reading.

Hannaway, Caroline, and Ann La Berge, eds. Constructing Paris Medicine. Atlanta, Ga.: Rodopi, 1998. Chapters 5 and 6 discuss Corvisart and Laënnec and their professional relationship with François-Joseph-Victor Broussais. Treats clinical medicine. Bibliography and index.

La Berge, Ann, and Mordechai Feingold, eds. French Medical Culture in the Nineteenth Century. Atlanta, Ga.: Rodopi, 1994. Examines the role of medicine in academic, social, and military contexts. Chapter 3, “Private Practice and Public Research: The Patients of Laënnec,” discusses Laënnec as practicing physician and researcher. Index.

Maulitz, Russell Charles. Morbid Appearances: The Anatomy of Pathology in the Early Nineteenth Century. New York: Cambridge University Press, 2002. Discusses Laënnec’s work and his interaction with his colleagues and his importance in the development of the science of pathology. Also discusses pathology in England. Selected bibliography. Index.

Williams, Elizabeth A. Physical and the Moral: Anthropology, Physiology, and Philosophical Medicine in France, 1750-1850. New York: Cambridge University Press, 1994. Good general study of the intellectual and professional climate in which Laënnec studied and practiced.