Laennec, Théophile-René-Hyacinthe

(b. Quimper, France, 12 February 1781; d. Kerbouarnec, Brittany, France, 13 August 1826)

medicine.

Laennec’s mother died in her early thirties, probably from tuberculosis. His father, a lieutent at the admiralty in Quimper, being unable to care for his children, Théopile was sent to his uncle, a physician at Nantes; there he was introduced to medical work. The French Revolution struck Nantes fiercely, and Laennec worked in the city’s hospitals. In 1795 he was commissioned a third surgeon at the Hôpital de la Paix and shortly afterward at the Hospice de la Fraternité. It was at the latter that Laennec became acquainted with clinical work, surgical dressings, and treatment of patients. His health was not good, for he suffered from lassitude and occasional periods of pyrexia. He found consolation in music and spent his spare time playing the flute and writing poetry.

His father wished him to abandon the study of medicine, and during a period of indecision Laennec wasted time at Quimper, dancing, taking country rambles, and playing the flute, with occasional study of Greek. In June 1799 he returned to his medical studies and was appointed surgeon at the Hôtel-Dieu in Nantes. From there he entered the École Pratique in Paris and studied dissection in Dupuytren’s laboratory. The following year, in June 1802, he published his first paper in Journal de médecine, “Observations sur une maladie de coeur”; it was followed in August, in the same journal, by “Histoire des inflammations du péritoine.” His collegues at this time were Gaspard Bayle, Xavier Bichat, Le Roux, and Corvisart. Bayle’s early death from tuberculosis caused Laennec much sorrow; and this, couple with his dislike for Dupuytren, nearly resulted in his leaving Paris. Bichat persuaded him not to go and together they published a number of papers on anatomy in Journal de médecine in 1802 and 1803.

In 1803 Laennec was awarded the prize for surgery and shared the prize for medicine awarded by the Grandes Écoles of Paris. His reputation increased, and he began to give private instruction in morbid anatomy to supplement his meager income. Although suffering from asthma, he worked hard and announced his classification of anatomical lesions into encephaloid and scirrhous types. He also found that the tubercle lesion could be present in all organs of the body and was identical with the lungs; he did not, however, realize that the condition was infectious. His thesis, “Propositions sur la doctrine d’Hippocrate relativement à la médecine-pratique,” was presented and accepted in July 1804; he therreby became an associate of the Société de l’École de Médecine.

Family troubles, the death of his uncle from tuberculosis, and financial difficulties, coupled with his break with Dupuytren, disturnbed the continuity of Laennec’s work and caused his health to fail. He recovered by going to Brittany, and on his return to Paris he became an editor-shareholder of the Journal de médecine. Private practice increased; but he was disappointed in not being appointed assistant physician at the Hôtel-Dieu in Paris, physician to the emperor’s pages, or head of the department of anatomical studies. Taking the initiative himself, in 1808 he founded the Athénée Médical, which merged with the Société Académique de Médecine de Paris. Shortly afterward he was appointed personal physician to Cardinal Fesch, the uncle of Napolean I, but the cardinal was exiled after the fall of Napolean. After failing to be elected to the chair of Hippocratic medicine and rare cases, Laennec began preparing articles on pathological anatomy and ascarids for the Dictionnaire des sciences médicales. At this time (1812–1813) France was at war, and Laennec took charge of the wards in the Salêtriére reserved for wounded Breton soldiers.

On the restoration of the monarchy, Laennec settled down to routine work but failed to obtain the chair of forensic medicine; reluctantly he accepted the post of physician to the Necker Hospital. It was here that he became interested in emphysema, tuberculosis, and physical signs of the chest. Although auscultation had been known since the days of Hippocrates, it was always done by the “direct” method, which often was very inconvenient. Laennec introduced what he called the “mediate” method, using a hollow tube for listening to the lungs and a solid wooden rod for heart sounds; by February 1818 he was able to present a paper on the subject to the Académie de Médecine. His poor health obliged him to live in Brittany as a gentleman farmer for some months; but by the end of 1818 he returned to Paris and soon was able to classify the physical signs of egophony, rales, rhonchi, and crepitations, which he described in detail in his book De l’auscultation médiate. The work was published in August 1819 and was acknowledged to be a great advance in the knowledge of chest diseases.

Again increasing asthma, headaches, and dyspepsia forced Laennec to return in October 1819 to his estates at Kerbouarnec, Brittany where he assumed the role of a country squire; however the possiblity of election to the chair of medicine in Paris led him back to his clinic at the Necker Hospital. Owing to personal animosities, it was not until July 1822 that he was appointed to the chair and a lectureship at the Collége de France. After this honors came rapidly to Laennec. In January 1823 he became a full member of the Académie de Médecine, and in August 1824 he was made a chevalier of the Legion of Honor. His private practice increased and included many distinguished persons. As a lecturer he became internationally famous; at times as many as fifty doctors awaited his arrival at the Chaité Hospital, to which he had transferred his clinical work from the Necker.

Laennec’s health at this time was fairly good. Feeling the need of help in his domestic affairs, he engaged as housekeeper a Mme. Argon, whom he married in December 1824. The happy union helped him to publish a new edition of his book and enter the competition for the Montyon Prize in physiology, but the extra work caused a return of his chest symptoms and forced him to leave Paris in May 1826, never to return. The climate of Brittany brought a temporary improvement in his health, but he died on 13 August of that year.

BIBLIOGRAPHY

I. Original Works. Laennec’s writings are “Note sur l’arachnoÏde intérieure, ou sur la portion de cette membrane qui tapisse les ventricules du cerveau,” in Journal de médecine, 5 (1803), 254–263; “Note sur une capsule synoviale située entre l’apophyse acromion et l’humerus,” ibid., 422–426; “Lettre sur des tuniques qui envelppent certains viscéres et fournissent des gaines membraneuses à leurs vaisseaux,” ibid., 539–575, 6 (1903), 73–90; Propositions sur la doctrine d’Hippocrate (Paris, 1804), his thesis presented on 11 June 1804 at the École de Médecine (repr., Paris, 1923); “Mémoire sur les vers vasiculaires et prinicipalement sur ceux qui se trouvent dans le corps humain,” in Mémoires de la Société de la Faculaté de médecine (1804), 176; and “Mémoire sur le distomus intersectus, nouveau genre de vers intestins,” ibid., (1809), 1–281.

De l’auscultation médiate, 2 vols. (Paris, 1819), appeared in many subsequent editions and translations; there is an English trans. of selected passages from the 1st ed., with biography by William Hale-White (New York, 1923).

II. Secondary Literature. Perhaps the most intimate biography is R. Kervran, Laënnec: His Life and Times (New York—Oxford, 1960), translated from the French by D. C. Abrahams-Curiel, which contains a comprehensive bibliography of the literature on Laennec.

Frederick Heaf