Listening to the Body Electric - continued...

Part 1: Sounding bodies

Today the use of auditory techniques in medical examinations is a common practice. The history of this method goes back to the 1750’s, when the Viennese physician, Joseph Leopold von Auenbrugger (1722 - 1809), presented the percussion of the chest as a diagnostic tool. In his treatise, Inveritum novum ex percussione thoracis huinani ut signo abstrusos iriterni pectoris morbos detegendi (1761), Auenbrugger showed that percussion sounds convey useful information about the physical condition of the patient. He writes, "I here present the Reader with a new sign I have discovered for detecting diseases of the chest. This consists in the Percussion of the human thorax, whereby, according to the character of the particular sounds thence elicited, an opinion is formed of the internal state of that cavity" (quoted after Forbes 1936, p. 7).

Some historians of medicine consider Auenbrugger to have "initiated modern scientific medicine" (Clendening 1960, p. 306). As convincing as his method of using percussion may seem today, it did not gain immediate recognition. Only when Jean-Nicolas Corvisart (1755 - 1821) published a French translation of Auenbrugger’s treatise in 1808, did this state of affairs start to change.

At the end of the 18th century medical knowledge underwent profound changes. Nosology, the old classification system of pathological signs, was about to be replaced by the emerging discourse of pathological anatomy and physiology. Both of them built heavily on the dissection of the body. The obvious disadvantage of autopsy was that it could only be performed on the dead. As a visual examination into the living body was impossible, other means of investigation were developed. As a result, the dialogue with the patient, i.e. the patient’s ‘case history,’ which formerly had been the basis for medical diagnosis, was considered less important. Gradually, it was replaced by the physical examination of the body (Foucault 1973).

Focusing on the "story" the body tells, Corvisart promoted what he called the "éducation médical des senses," i.e. the refining of the clinician’s senses in order to locate and identify diseases. Based on this concept, he strongly recommended techniques such as palpation, percussion, and direct auscultation which is listening to the body by placing one’s ear on the patient's thorax.