Observations on M. Laennec's method of forming a diagnosis of the diseases of the chest by means of the stethoscope, and of percussion; and upon some points of the French — Reading Notes

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METHOD OF FORMING A DIAGNOSIS

DISEASES OF THE CHEST

AND UPON SOME POINTS OF

THE FRENCH PRACTICE OF MEDICINE.

CHARLES SCUDAMORE, M.D. F.R.S.

Member of the College of Physicians in London; Honorary Member of Trinity College, Dublin; of the Medico-Chirurgical Society of Edinburgh; and of the Medical Society of Paris; Member of the Medico-Chirurgical Society of London; Physician in Ordinary to His Royal Highness the Prince Leopold of Saxe Coburg, &c. &c.

London: PRINTED FOR THE AUTHOR, By Joseph Mallett, 59, Wardour Street, Soho;

AND PUBLISHED BY LONGMAN, REES, ORME, BROWN, AND GREEN, PATERNOSTER ROW.

TO Sir HENRY HALFORD, Bart. K.H. F.R.S. PRESIDENT OF THE COLLEGE OF PHYSICIANS, PHYSICIAN TO THE KING, &c. &c. &c.

In requesting the honour of dedicating to you the following pages, I am actuated by the feelings of respect and personal regard, which I entertain equally for your public and for your private character.

It is also with more than ordinary interest that I address my observations to you, as the President of the College; an office which, it may with truth be said, you fill with no less dignity to yourself, than with benefit to the whole profession.

In becoming an advocate for the employment of the stethoscope, I disclaim adopting principles in the practice of physic, which might with any justice be called mechanical.

It cannot however be denied, that with all the improvements which the art of medicine has received, it still must, on many occasions, depend greatly on conjecture.

Some of the diseases of the chest are attended with such obscurity, that the detection of their precise nature bids defiance to the most acute penetration. What prudent physician, then, will disdain to avail himself of the means which this simple but philosophical instrument affords, of obtaining a more faithful diagnosis?

It is not intended that its use should supersede those established principles of our art, which early and regular education, as well as experience, have pointed out to us; but that it should serve as an auxiliary in the investigation of obscure disease.

For my own part, I have no apprehension that the judicious employment of the stethoscope can, in any degree, tend to make us negligent in observing the symptoms of diseases, or indifferent to the study of the usual means of diagnosis.

In the hope, that the general opinions which I have offered in this volume, may receive the high sanction of your approval,

I have the honour to remain, DEAR SIR, Your most obliged, faithful, And obedient Servant,

Wimpole Street, April 14th, 1826.

Having expressed my opinion generally on the merits of the stethoscope, in the course of the following Essay, I have little to say in the form of a preface.

Although the credit of the invention is due to the ingenuity of M. Laennec alone, and the volume which he has presented to us abounds with valuable pathology, it is of no small importance that the sentiments and the experience of others should also be collected and recorded.

Before any new method in the practice of medicine can be firmly established, or even deserve to be regarded in the light of fixed authority, it is incumbent upon us to examine all the collateral evidence which can be produced in its favour; and he who, with this view, contributes to the general stock of information, may claim the merit of usefulness, although he be not entitled to the more brilliant distinction awarded to genius.

It appears to me, that whoever adopts the use of the stethoscope, must study it for himself, and consider, that all which is offered to his attention by the industry and observations of others, is calculated to serve his purpose only as an introductory lesson.

The skilful employment of this instrument must be the result of practice. Every case which occurs, presents new and distinct matter for investigation. It is peculiarly necessary to be accurate in marking with nicety the nature of the impressions which are made upon the ear, and to reflect upon the phenomena with all the skill and care of the physiologist, the anatomist, and the physician. Nothing must be left to the imagination; for, if this creative faculty be exercised, the judgment may be misled, rather than informed and assisted.

I have purposely confined myself to a limited sketch of the general subjects which I have embraced; so that if the following pages should not appear to possess the merit of great novelty, they will, I hope, at least escape the imputation of being tedious and devoid of interest.