A treatise on the diseases of the chest and on mediate auscultation / by R.T.H Laennec ... ; translated from the latest French edition, with notes and a sketch of the author's life, by John Forbes ... ; with plates ; from the third revised London edition, with additional notes.

  • Laennec, R. T. H. (René Théophile Hyacinthe), 1781-1826.
Date:
1830
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases of the chest and on mediate auscultation / by R.T.H Laennec ... ; translated from the latest French edition, with notes and a sketch of the author's life, by John Forbes ... ; with plates ; from the third revised London edition, with additional notes. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    had prosecuted this line of inquiry further, there is no doubt that he would have discovered many valuable truths, and might per- haps have arrived at mediate auscultation itself. But he seems to have proceeded no further than to announce the incorrect observation above quoted, and which his successors appear to have totally disregarded. This seems at first sight wonderful; and yet nothing is of more common occurrence: it is not given to any man to comprehend all the relations and all the conse- quences of the most simple fact; and we know that nature's se- crets are more frequently betrayed by fortuitous circumstances than obtained by the force of our scientific efforts. Since the publication of my researches, some physicians have attempted to repeat them by immediate auscultation; and there is one or two of these who seem to give this method the prefer- ence. Their chief reasons are—that it saves the trouble of car- rying an instrument; that it enables us to perceive more sounds at once, and therefore more intelligibly; and that it is more easy to apply the ear than to keep the stethoscope in exact contact with the side. These reasons are more specious than well founded. It is true that the ear applied to- the chest enables us to hear more sounds than we do by the stethoscope, particularly if the use of this in- strument is not familiar to us. But this arises chiefly from this circumstance, that all the parts of the observer's head which bear upon the chest, namely, the cheek-bone, the temples and the angle of the jaw, become, severally, conductors of sound, and may thus convey the sound of respiration to the ear, although none exists immediately beneath it. This circumstance may lead to serious mistakes in cases where the pulmonary obstruction is partial and of small extent. To a person who has never tried either of the methods, it is no doubt an easier matter to apply the ear to the chest than to make use of the stethoscope; although the habit of using this instrument may be acquired in a very few days. But there exist innumerable reasons which will always render mediate auscultation a much surer guide and of much more extensive employment. I will here notice some of the principal of these:— 1. We cannot apply the ear to many points of the chest where important signs most frequently are found, such as the axilla, the