Percussion of the chest: Leopold Auenbrugger

Percussion for examination of the chest was first described in 1754 in a little book written in Latin as ” a new discovery that enables the physician from the percussion of the human thorax to detect the diseases hidden within the chest”. At publication the book was ignored and percussion received little attention until popularized decades later by Laennec and Corvisart in France and Joseph Skoda in Vienna. These great physicians confirmed that “dullness on percussion”, perceived like striking the fleshy part of the thigh, indicated  fluid or solidification (as in pneumonia) within the chest. Credit for this observation is generally given to the Austrian physician Leopold Auenbrugger.

Born in 1722, Auenbrugger graduated from medical school at age twenty-two. He was greatly influenced by  the Dutch physician Gerhard van Swieten, who at the instigation of Empress Maria Theresa had reorganized medicine in what became known as the First Vienna School. After working for ten years at the Spanish Military Hospital in Vienna, Auenbrugger established a successful practice; carried out studies on tuberculosis; also conducted experiments regarding his new technique by filling the lungs of dead bodies with fluids and study the effects produced by percussion. He was knighted in 1783 by Emperor Joseph II and died in 1809, perhaps from typhus fever.

 

Tradition has it that Auenbrugger, an innkeeper’s son, learned about percussion by watching his father tap on the wine barrels in his cellar to determine how full they were.  He may also have been aided by an excellent musical ear, developed by growing up in one of the great musical capitals of Europe. He wrote the libretto for a three act opera by Antonio Salieri, “The Chimney Sweep”, performed in the Burgtheater in Vienna in 1781; had two daughters who were good pianists; was a great lover of music and frequently held afternoon musical gatherings at his home and had once invited Mozart as his guest.

 

In the history of science many inventions are based in part on earlier observations. It is known that Auenbrugger’s teacher van Swieten had regularly percussed the abdomen to distinguish ascites from gaseous distension. But it was Auenbrugger who first used percussion to diagnose diseases of the chest and brought his technique to the attention of the medical community.

 


 

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