René-Théophile-Hyacinthe Laënnec

1781-1826

French Physician and Inventor

In 1816 René Laënnec invented the stethoscope. His 1819 book about his use of this instrument inaugurated the modern era of diagnosing chest, heart, and lung diseases accurately and scientifically.

Laënnec was born in Quimper, a small town on the seacoast of West Brittany, France. He was baptized "Théophile-René-Marie-Hyacinthe Laënnec," but was known professionally as either "René-Théophile-Hyacinthe Laënnec," which appears on his tombstone, or simply "R.-T.-H. Laënnec."

Laënnec's mother died of tuberculosis when he was five. His father had little interest in his children and in 1788 sent him to live with his uncle Guillaume, a prominent physician in Nantes. Laënnec studied hard and aimed to become an engineer, but the French Revolution violently interrupted his education. Especially in 1793-94 Nantes was a bloodbath, as Jean-Baptiste Carrier suppressed the Vendée revolts. Several times Guillaume narrowly escaped execution.

By 1795 the worst was over. Laënnec, influenced by both his recent war experience and the pervasiveness of tuberculosis in his own family, now decided on a career in medicine. At the age of fourteen he was apprenticed to his uncle as a surgeon in several hospitals in Nantes. He wandered around northwestern France for a few years and served briefly in Napoleon's army before moving to Paris to begin serious medical study in 1801.

He learned dissection under Baron Guillaume Dupuytren (1777-1835) at the École Pratique but soon became the star pupil of Baron Jean Nicolas Corvisart des Marets (1755-1821) at the Hôpital de la Charité. He received his M.D. in 1803 with the top prize in medicine and the only prize in surgery. He soon became known as one of the best clinicians and medical scientists in France. Through the influence of Corvisart, he secured prestigious appointments in Paris, such as visiting physician at the Hôpital Necker. For the rest of his life he divided his time between working in Paris and vacationing for his health in Brittany. He had always been weak and sickly, suffering from asthma, tuberculosis, and migraine headaches.

Besides inventing the stethoscope, Laënnec's greatest contribution to medicine was helping to redefine the concept of disease itself. Before his time, scientists did not know clearly what a disease was. Some, such as William Cullen (1710-1790), thought that diseases were separate "things" that could be classified like animals or plants. Others, such as Benjamin Rush (1745-1813), thought that there was only one disease—fever—and that the various so-called diseases were just aspects of it.

But in France Laënnec and many of his teachers, colleagues, and students shifted the focus of medical research from the whole disease to the particular organs or parts of the body that were affected by it. They recognized that the respective anatomies of diseased and healthy persons differ in specific, measurable ways. Thus, they centered their attention on the "lesion," that is, on any change from a normal anatomical structure. They discovered that such changes are usually harmful. They performed autopsies to correlate their observations of diseases in living patients with their knowledge of anatomy.

Using autopsies and dissection to study disease was a relatively new idea in Laënnec's time. This branch of medical research became known as "pathological anatomy," and its understanding of individual lesions is now fundamental to the understanding of disease.

Several lesions are named after him, such as "Laënnec's thrombus," a blood clot in the heart, and "Laënnec's cirrhosis," a certain kind of progressive liver destruction.

Laënnec's pathological research contributed most to our knowledge of respiratory tract diseases, especially tuberculosis. Ironically, it was this disease that killed him in 1826.

ERIC V.D. LUFT