Makers of Modern MedicineWalsh, James J. (James Joseph)
History
Makers of Modern Medicine
Walsh, James J. (James Joseph)
Medicine -- Biography
With regard to cavities in the lungs, Auenbrugger was able not only to
demonstrate their presence and to show by autopsy records that his
localization and determination of their approximate form and size were
correct, but he also understood the method of their formation and
explains the reasons for certain varieties of cavities that occur. He
speaks of two classes of cavity formations. From one kind there is an
ichorous discharge; from the other variety the evacuations are
purulent. Cavities with non-purulent secretions are situated only in
the lung. Abscesses of various kinds--that is, cavities with purulent
secretions--may occur in any part, or in any of the organs of the
thorax. The lung cavities are usually due to the breaking down of what
he calls crude tubercles. Both kinds of cavities may either be closed
or have an opening into the bronchi.
Auenbrugger showed very well how to distinguish, by percussion,
cavities of various kinds, and set it down as a principle, that before
the evacuation of the contents of the cavity percussion over it gave a
distinctly dull note, resembling that obtained when the thigh is
percussed, while after evacuation, as by copious expectoration, a
distinctly resonant note occurred. It is clear from his discussion of
the symptoms noted in cavities (at least in the opinion of Dr.
Merbach, who wrote a sketch of Auenbrugger's life for the
Jahresbericht der Gesellschaft für Natur und Heilkunde in Dresden,
{66} in 1861), that Auenbrugger was very near the discovery of
auscultation in his study of pulmonary cavities. Auenbrugger says that
when a cavity has been located by means of percussion, if the hand be
laid over the place beneath which it lies and the patient is asked to
cough, the fremitus produced by the pus in the cavity can be felt as
it moves under the coughing impulse. This is what we now know as
palpation. If instead of using his hand Auenbrugger had applied his
ear to the chest, auscultation would have been discovered nearly half
a century before Laennec began his work upon the subject. Perhaps
Merbach, who was himself a native of Styria and a professor at the
University of Gratz, was for patriotic motives more ready than others
might be to give Auenbrugger credit for practically discovering
auscultation.
Public-domain text, read in full here on John Shaqi.
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