Auenbrugger, Joseph Leopold
Auenbrugger, Joseph Leopold
(b. Graz, Austria, 19 November 1722; d. Vienna, Austria, 18 May 1809)
The son of a wealthy innkeeper, Auenbrugger received his medical education at the University of Vienna, where Gerard van Swieten had, through a series of reforms, made the Faculty of Medicine the leading one in Europe. Soon Auenbrugger came under van Swieten’s influence; the extent of this influence is shown by his dedication to van Swieten of a work suggesting camphor as a treatment for a special form of mania (Experimentum nascens de remedio specifico sub signo specifico in mania virorum, 1776). He graduated on 18 November 1752.
From 1751 to 1758 Auenbrugger worked as assistant physician at the Spanish Hospital, but did not receive a salary until 1755. Because of his work in the hospital, Empress Maria Theresa in 1757 ordered the Faculty of Medicine to admit him as a member without charging him any fees. From 1758 to 1762 he was chief physician at the Spanish Hospital, obtaining experience in the diagnosis of chest diseases. After leaving the Spanish Hospital, Auenbrugger was a prominent practitioner in Vienna. For his medical achievements he was ennobled in 1784 by Emperor Joseph II.
Auenbrugger is considered the founder of chest percussion. He was undoubtedly aided in developing this diagnostic technique by his musical knowledge (he wrote the libretto for a comic opera by Antonio Salieri), which enabled him to perceive differences in tone when the chest was tapped. For seven years he had observed the changes in tone caused by diseases of the lungs or the heart in patients at the Spanish Hospital, checking and controlling his findings by dissections of corpses and by experiments. In the Inventum novum (1761) he presented his findings. If one taps with the fingertips on a healthy chest wall, one will perceive a sound like that of a drum. Diseases in the chest cavity change the normal tone of the tapping to a sonus altior (high or tympanitic sound), a sonus obscurior (indistinct sound), or a sonus carnis percussae (dull sound). Auenbrugger’s method permitted the determination of disease-caused changes in the lungs and heart of a live patient and thus gave a new, dependable foundation to the diagnosis of chest diseases. Even with the development of X rays, this method still has diagnostic value.
In the first few years after its publication the Inventum novum was reviewed in several journals, the first mention probably being that of Oliver Goldsmith in the London Public Ledger (27 August 1761). In 1762 Albrecht von Haller drew attention to “this important work” in his lengthy review in the Göttingische Anzeigen von gelehrten Sachen. More influential than these positive references, however, was the opinion of Rudolf August Vogel, who could not find anything new in the Inventum novum; rather, he claimed to recognize in it only the succussio Hippocratis. Van Swieten and Anton de Haen, the chief of the Vienna Clinic, never mentioned Auenbrugger’s percussion, not even when discussing diseases of the chest, but Maximilian Stoll, de Haen’s successor, described it in his publications and systematically taught it at the bedside. The spread of Auenbrugger’s technique was interrupted by Stoll’s premature death; his successors Jacob Reinlein and Johann Peter Frank did nothing to carry on his work.
Nevertheless, chest percussion was used as a diagnostic tool before 1800. Heinrich Callisen, a surgeon in Copenhagen, reported several observations obtained by percussion in his System der Wundarzneikunst (1788); and the Parisian surgeon Raphael Bienvenu Sabatier used it to advantage for the diagnosis of empyema. Percussion was practiced and taught at several German universities, including Halle, Wittenberg, Wūrzburg, and Rostock. About 1797 Jean-Nicolas Corvisart learned of chest percussion by reading Stoll. He investigated the method for several years and soon taught it to his students. In his classic book on heart diseases, Essai sur les maladies et les lésions organiques du coeur (1806), he based numerous diagnoses on percussion. Since there was only Rozière de la Chassagne’s inadequate translation of the Inventum novum (1770), Corvisart published a new one in 1808, enriching it with a large number of his own observations and thus ending any question of the applicability of the new method.
I. Original Works. Auenbrugger’s major work was Inventum novum ex percussione thoracis humani ut signo abstrusos interni pectoris morbos detegendi (Vienna, 1761, 1763, 1775). French translations were made by Rozière de la Chassagne, in Manuel des pulmoniques (Paris, 1770), and by Jean-Nicolas Corvisart (Paris, 1808). An English translation by John Forbes, in Original Cases With Dissections and Observations... Selected from Auenbrugger, Corvisart, Laennec and Others (London, 1824), was reprinted in F. A. Willius and T. E. Keys, Cardiac Classics (St. Louis, Mo., 1941), pp. 193–213, and in C. N. B. Camac, Classics of Medicine and Surgery (New York, 1959), pp. 120–147; it also appears, with an introduction by Henry E. Sigerist, in Bulletin of the Institute of the History of Medicine, 4 (1936), 373–403. A facsimile of the Latin text, together with the French, English, and German translations and a biographical sketch, has been published by Max Neuburger (Vienna-Leipzig, 1922). Auenbrugger also wrote Von der stillen Wuth oder dem Triebe zum Selbstmorde als einer wirklichen Krankheit, mit Original-Beobachtungen und Anmerkungen (Dessau, 1783) and the libretto for Salieri’s Der Rauchfangkehrer (Vienna, 1781).
II. Secondary Literature. Writings on Auenbrugger or his work are P. James Bishop, “A List of Papers, etc., on Leopold Auenbrugger (1722–1809) and the History of Percussion,” in Medical History, 5 (1961), 192–196, a bibliography listing all important works pertinent to the subject with short critical remarks that facilitate orientation; H. L. Blumgart, “Leopold Auenbrugger. His “Inventum novum’-1761,” in Circulation, 24 (1961), 1–4; C. Costa, “Sobre la vicisitud creadora—Auenbrugger y Morgagni frente a frente,” in Anales chilenos de historia de la medicina, 5 (1963), 63–223; Charles Coury, “Auenbrugger, Corvisart et les origines de la percussion,” in J. N. Corvisart, Nouvelle méthode pour reconnaître les maladies internes de la poitrine par la percussion de cette cavité par Auenbrugger (Paris, 1968), pp. 109–160; M. Jantsch, “200 Jahre “Inventum novum,’” in Wiener medizinische Wochenschrift, 111 (1961), 199–202; R. G. Rate, “Leopold Auenbrugger and the “Inventum novum,’” in Journal of the Kansas Medical Society, 67 (1966), 30–33; and J. J. Smith, “The ’Inventum novum’ of Joseph Leopold Auenbrugger,” in Bulletin of the New York Academy of Medicine, 38 (1962), 691–701.