7 René Laënnec 7Napoleon’s empire fell. While Laënnec’s embrace of
Catholic doctrine was viewed favourably by royalists,
many in the medical profession criticized his conservatism,
which contradicted the views of many academicians.
Nonetheless, Laënnec’s restored faith inspired him to find
better ways to care for people, especially the poor. From
1812 to 1813, during the Napoleonic Wars, Laënnec took
charge of the wards in the Salpêtrière Hospital in Paris,
which was reserved for wounded soldiers. After the return
of the monarchy, in 1816 Laënnec was appointed as physi-
cian at the Necker Hospital in Paris, where he developed
the stethoscope.
Laënnec’s original stethoscope design consisted of a
hollow tube of wood that was 3.5 cm (1.4 inches) in diam-
eter and 25 cm (10 inches) long and was monoaural,
transmitting sound to one ear. It could be easily disas-
sembled and reassembled, and it used a special plug to
facilitate the transmission of sounds from the patient’s
heart and lungs. His instrument replaced the practice of
immediate auscultation, in which the physician laid his
ear on the chest of the patient to listen to chest sounds.
The awkwardness that this method created in the case of
women patients compelled Laënnec to find a better way
to listen to the chest. His wooden monoaural stethoscope
was replaced by models using rubber tubing at the end
of the 19th century. Other advancements include the
development of binaural stethoscopes, capable of trans-
mitting sounds to both ears of the physician.
In 1819 Laënnec published De l’auscultation médiate
(“On Mediate Auscultation”), the first discourse on a variety
of heart and lung sounds heard through the stethoscope.
The first English translation of De l’auscultation médiate
was published in London in 1821. Laënnec’s treatise
aroused intense interest, and physicians from throughout