Frédéric Le Blay René Théophile Hyacinthe Laennec entreprit la traduction des Traités des maladies aiguës et des maladies chroniques du médecin romain Caelius Aurelianus. À partir de l’édition des manuscrits établie en 2009, je propose une analyse interprétative de la démarche du clinicien. Au-delà de la curiosité érudite d’un amoureux des classiques, je cherche à montrer que l’exercice de lecture et de traduction des textes constitutifs d’une histoire de la clinique s’intègre dans la méthode de Laennec et contribue à fonder (...) son épistémologie médicale, à une époque où les pratiques sont soumises à des redéfinitions majeures. Une telle entreprise, qui fait du texte, constituant d’une littérature, une donnée d’expérience en vue du diagnostic, n’est pas sans présenter quelque analogie avec certaines orientations contemporaines. (shrink)

The practice of mediate auscultation—listening to the body through a stethoscope—was at the center of new articulations of medical thought and practice in the 19th century. During that period, the stethoscope became the hallmark of medical modernity. This article offers a detailed examination of the work of RTH Laennec and other important writings on the stethoscope in order to argue for the centrality of a distinctive orientation toward listening in modern medicine. The development of mediate auscultation applied medical and scientific (...) reason to listening, just as a particular practice of hearing the body became integral to everyday functioning of medicine. Mediate auscultation was thus an artifact of a new approach to reason and the senses, one based in a scientific mindset and a logic of mediation. (shrink)

With the introduction of the technique of auscultation in nineteenth-century medicine, the auditory became a most important means of producing diagnostic knowledge. The correct classification and interpretation of the sounds revealed by auscultation, however, remained an issue of negotiation and often controversy throughout the mid-nineteenth century. This article examines the codification of lung sounds within two cultural and geographic contexts: first, the original approach as it was developed by Laennec and his followers in Paris that came to be dominant in (...) French medicine, and second, the alternative approach that grew out of Joseph Skoda’s reception of Laennec’s method in Vienna and became widely adopted in the German-speaking world. On one hand, it will be argued that lung sound classifications attempted a standardization of the perception and the interpretation of auscultation sounds. On the other hand, it will be shown that the development of auscultation sounds was shaped by the local context in which it took place. This article seeks to shed light on the way in which auditory experiences were instrumentalized for epistemic purposes in medicine. Furthermore, it discusses the role of standardization both as a mechanism for the universalization of knowledge and as a contextually bounded practice. (shrink)

What does the word clinic mean? The clinic is first a place to diagnose and treat sick persons. The clinic is also a way of thinking and speaking; it is a discursive practice that links health with knowledge. For Michel Foucault the clinic is a mode of perception and enunciation that allows us to see and name disease and to place statements about illness among statements about birth and death. Within the clinic resides understanding of disease visible on the surface, (...) yet hidden within the tissual depths, of an ailing patient. Foucault shows that by the dawn of the nineteenth-century medicine is no longer a two-dimensional reading of symptoms, but a three-dimensional probing from symptomatic surface into disease interior. The anatomical site of disorder hidden within tissual depths is visible to the scrutiny of pathologist, endoscopist or radiologist. The clinic, a discourse that enables us to think about disease when we make statements about health and death, operates not only in its familiar textual domain, the medical journal, but in pictures of the scene at the sickbed, and poetry about disease. The truth of disease and placement of that truth in a general plan of the world in Renaissance woodcuts and John Donne's poetry is different from the regime of truth after the birth of the clinic in Bichat'sTreatise on Membranes, the paintings of Laennec, Agnew and Gross, the modern lithographs and the verse of Walt Whitman and L. E. Sissman. Foucault's clinic is where knowledge and sickness some together in the modern period. (shrink)

The clinical relation is the singular encounter between a patient who complains and a doctor who listens, in order to relieve and cure. But it is going through a period of crisis. One even announces his impending death! Strangely, technological advances are now coming to its rescue, prompting it to bounce back. Two hundred years after the stethoscope, the mediated vision by portable ultrasound becomes reality and enters the stage to probe the sick body “at his bedside”. This virtual visible (...) from the clinical examination becomes thus visible to the clinician, doctors and patients in general, because the images can be shared. That means for the clinician to take possession of space that was impermeable until there: the vision penetrates beyond old barriers, but it will only assert its full power if it is permeated by a clinical relation restored to its true beauty. (shrink)