November 28, 2012 [“DISCOVERIES” IN THE ENLIGHTENMENT]
Changes in scientific knowledge: average literate people are becoming more interested in
science and technology.
o Royal Society of London (1662)
o Academia Royale des Science, Paris (1666)
o Akademie der Wissenchaften, Berlin (1700)
+ regional and provincial areas.
Each had their own publications and membership was very exclusive.
18 Century Coffeehouses
Ideal venue for scientific discussions. It was cheap, and as a result, became less exclusive.
People could sit in, listen to, and participate in debates between doctors.
Greek for “craft” and “tools.” Medical tools examples include: hearing horns, walking sticks, etc.
Different types become available and perception of illness by patients and doctors changed.
Discoveries always have a long pre-history (social, political, economic, cultural, philosophical
context). Pre-history of the 18 Century included: art, the widespread use of the printing press,
the Enlightenment, religious wars, end of absolute monarchies, and revolutions.
Stethoscope “discovered” by René T.H. Laennec (1781-1826) involved the surrounding contexts.
Since the Middle Ages, hospitals have been places of refuge, and don’t become places of
research and discovery until much later.
1789 – French medical faculties were abolished, and didn’t re-open until 1794 under the name
of The School of Health. No graduates for 5 years because those studying medicine were
almost all members of the overthrown (French) elite.
Sought to combine medicine and surgery…in hospital. Therefore opportunities for discussion
became available and popular.
A disease would have been diagnosed using described symptoms, and was therefore subjective
and unreliable. This process is known as sensualism (synonymous with empiricism). There was
no way for the doctor to determine what was taking place inside the patient. When the Paris
school was revived, they opposed the connection of bedside medicine with anatomy, reverting
back to Hippocrates.
Jean-Nicolas Corvisart des Marets, 1755 – 1821
Religious skeptic and supporter of the Revolution.
Taught internal medicine – non-surgical treatments.
1780’s: Learned about percussion (tapping fingers against the chest). Deep & full sounds =
“resonance” = health; Dull = unhealthy and likely fluid-filled.
Learned about percussion through Leopold Auenbrugger (1722-1809), Austrian physician
interested in music. Applied the musical technique to the human thorax.
Translates Auenbrugger’s book.
Popular instructor, veered from sensualism.
1801 – Laennec becomes one of his students. Grew up in the Revolution and enlisted as a
surgical aid in the army, moved to Paris after, and doctor by 1804. November 28, 2012 [“DISCOVERIES” IN THE ENLIGHTENMENT]
o Cultivated the classics, and supported the monarchy and religion. As a result, it was
very difficult for him to find work. st
o 1816 – Rewarded with a position at Necker Hospital (1 pediatric hospital). Made the
observation of listening to the heart without invading. This was simply rediscovery,
leading to the invention of the stethoscope (originally a rolled up paper notebook put
against the patient’s heart and doctor’s ear, sealed with gum and a piece of string).
o “Mediate auscultation” = active listener. Physical findings of patients were recorded.
o Autopsies would reveal whether his theories were applicable.
o After a few years, he had full knowledge of the reasoning behind different breath
o The stethoscope became immediately internationally popular even by his enemies.
Pierre de Beaubien, 1796-1881
Brought the stethoscope back from Paris to Montreal.
The stethoscope ushers anatomy into the practise of medicine! It also helped detect abnormal
lesions (in the lungs).
Organicism = all diseases can be related to internal organic changes, detectable by the
stethoscope. The idea dominates by the 19 Century. Patient’s subjective symptoms become
less relevant. Thus, the stethoscope was very much a turning point.
Controversial establishment invoking various gassings of humans.