René-Théophile-Hyacinthe Laennec (French: [laɛnɛk]; born February 17, 1781; died August 13, 1826) was a French doctor and musician. He used his skill in making wooden flutes to create the stethoscope in 1816 while working at Hôpital Necker. He was the first to use the stethoscope to diagnose different chest illnesses. In 1822, he became a lecturer at the Collège de France. In 1823, he was named a professor of medicine. His last positions were as head of the medical clinic at Hôpital de la Charité and professor at the Collège de France. He fell into a coma and later died from tuberculosis on August 13, 1826, at the age of 45.

Early life

René Laennec was born in Quimper, Brittany. His mother died from tuberculosis when he was five years old, and he moved to live with his great-uncle, the Abbé Laennec, who was a priest. As a child, Laennec often had fevers and was very tired. He was also believed to have asthma. At the age of twelve, he went to Nantes, where his uncle, Guillaume-François Laennec, worked in the medical school at the university. Laennec was a talented student.

His father, a lawyer, did not want him to become a doctor. For a time, he walked in the countryside, danced, studied Greek, and wrote poetry. In 1799, he returned to study medicine at the University of Paris under Dupuytren and Jean-Nicolas Corvisart-Desmarets. There, he learned to use sound as a tool to help diagnose illnesses. Corvisart supported the use of percussion, a technique to examine the body, during the French Revolution.

Invention of the stethoscope

René Laennec wrote in the classic book De l'Auscultation Médiate.

Laennec discovered that the new stethoscope was better than the usual method of placing the ear directly on a patient’s chest, especially if the patient was overweight. A stethoscope also helped avoid the embarrassment of putting an ear against the chest of a woman.

Laennec is said to have watched children playing with a long piece of solid wood before inventing the stethoscope. The children placed their ears on one end of the stick while someone scratched the other end with a pin, and the stick carried and made the sound louder. His skill as a flautist may have also influenced his design. He first built the instrument as a hollow wooden cylinder that was 25 cm long and 2.5 cm wide. Later, he improved the design to include three separate parts. The improved version had a funnel-shaped part to help make sounds louder, which could be removed from the main body of the stethoscope.

Laennec’s work allowed him to follow patients with chest problems from their beds to autopsies. This helped him match the sounds he heard with specific health issues in the chest, creating a new way to diagnose illnesses without touching the body. For example, he could better identify tuberculosis by listening for certain chest sounds. Laennec was the first to describe and explain terms like rales, rhonchi, crepitance, and egophony, which doctors still use today during exams and diagnoses. He shared his findings with the French Academy of Sciences and published his major work, On Mediate Auscultation, in 1819.

Laennec introduced the term mediate auscultation, meaning listening to the body indirectly, compared to the older method of listening directly on the chest (immediate auscultation). He named his instrument the stethoscope, combining the Greek words for chest (stethos) and examination (skopos).

The stethoscope became popular after De l'Auscultation Médiate was translated and shared in France, England, Italy, and Germany in the early 1820s. However, not all doctors accepted the new tool at first. Even though the New England Journal of Medicine reported the invention in 1821, some doctors still preferred using their ears directly. For example, in 1885, a professor of medicine said, “He that hath ears to hear, let him use his ears and not a stethoscope.” Even L.A. Connor, the founder of the American Heart Association, carried a silk handkerchief to place on a patient’s chest when listening.

Laennec often called the stethoscope “the cylinder.” Near the end of his life, he gave his own stethoscope to his nephew, calling it “the greatest legacy of my life.”

The modern stethoscope, with two earpieces, was invented in 1851 by A. Leared. In 1852, G.P. Cammann improved the design for mass production, creating the version still used today.

Other medical contributions

He studied and explained the medical conditions known as peritonitis and cirrhosis. Although cirrhosis was already recognized as a disease, Laennec gave it its name. He used the Greek word kirrhos, meaning "tawny" or "yellow," to describe the yellow nodules that appear in the disease.

He created the term melanoma and described how melanoma can spread to the lungs. In 1804, while still a medical student, he gave the first lecture about melanoma. This lecture was published in 1805. Laennec originally used the term melanose, which came from the Greek word melan, meaning "black." Over time, Laennec and Dupuytren had disagreements. Dupuytren argued that Laennec did not credit him for his earlier work on the topic.

He also studied a disease called phthisis pulmonalis, which is another name for tuberculosis. It is said that his nephew, Mériadec Laennec, diagnosed tuberculosis in Laennec using Laennec’s own stethoscope. Laennec wrote a book titled A Treatise on the Disease of the Chest. In it, he discussed chest diseases like tuberculosis and diagnostic methods such as pectoriloquy. He described the symptoms of phthisis pulmonalis and the parts of the body it affects. The book was written in an academic style to help others learn.

Laennec promoted the use of objective scientific observation. Professor Benjamin Ward Richardson wrote in Disciples of Aesculapius that "the true student of medicine reads Laennec’s treatise on mediate auscultation and the use of the stethoscope at least once every two years while in practice. It is considered as important as the original works of Vesalius, Harvey, and Hippocrates."

Religious views

Laennec was very religious and remained a deeply religious Catholic throughout his life. He was known for being kind and for helping poor people, which became well-known. Austin Flint, who was president of the American Medical Association in 1884, stated that "Laennec's life shows that studying science does not harm religious faith."

In J. Forbes' annotated translation of Laennec's work, Forbes noted:

— J. Forbes (1838 [1835])

Legacy and tribute

Honors: Medical terms named after Laennec:

• Laennec's cirrhosis describes the appearance of liver tissue that has grown back, forming small sections called lobules separated by thin, fibrous tissue;
• Laennec's thrombus is a blood clot in the heart that forms before birth;
• Laennec's pearls refer to sputum, or mucus, coughed up by people with asthma;
• Hamman's murmur, also called Laënnec–Hamman symptom, Laënnec–Müller–von Bergmann–Hamman symptom, or Hamman's crunch, is a crunching sound caused by air trapped in the chest area, heard near the heart;
• At the Université Claude Bernard Lyon 1, one of the four medical schools is named after Laennec;
• On 17 February 2016, Google marked his 235th birthday with a Google Doodle.

Laennec in fiction

In Rudyard Kipling's book Rewards and Fairies, the second of two stories about children named Dan and Una, the characters meet people who lived in England long ago. In the short story "Marlake Witches," which takes place during the Napoleonic Wars, Una meets a young woman who is sick with tuberculosis. The woman mentions being treated by a French doctor named Rene Laennec, who was a prisoner allowed to stay in England under certain conditions. Laennec talks with a local herbalist about using "wooden trumpets" to listen to patients' chests, which causes the local doctor to feel unsure. Kipling clearly knew about Laennec's work and created a connection between him and England.

A 1949 French film titled Doctor Laennec features an actor named Pierre Blanchar playing the role of Rene Laennec.

Laennec's landmarks in Paris

On the outside wall of the "Hôpital Necker – Enfants Malades," where Laennec wrote about mediate auscultation, near the hospital's entrance at 149, Rue de Sèvres, there is a marble tablet with a carved picture of Laennec and this message: "In this hospital, Laennec discovered auscultation. 1781–1826."

• The entrance on Rue de Sèvres
• Laennec's memorial tablet
• One of the older buildings of the hospital
• De l'auscultation médiate… Paris: J.-A. Brosson et J.-S. Chaude, 1819.
• De l'auscultation médiate… Drawings of the stethoscope and lungs.
• De l'auscultation médiate… Most of the illustrations in his book show diseased lungs, as do these four images, which match lungs affected by tuberculosis.