How it began
Leopold Auenbrugger, born in Graz in 1722, became a physician at the Spanish Hospital in Vienna. As the son of an innkeeper he is said to have tapped barrels in his father's cellar to hear how full they were, and he had a musician's trained ear. Over seven years he studied patients, observed autopsies and experimented on cadavers. In 1761 he published the method in Vienna in a Latin treatise known as the Inventum Novum.
Before it existed
Physicians of the time had no reliable way to judge the condition of the organs inside a living patient's chest, so treatment could not be directed. The head of the medical clinic in Vienna complained in print about how dark and difficult the diagnosis of fluid in the chest was. LITFL notes that the Italian physician Giovanni Maria Lancisi had earlier described percussion of the breastbone in consumption.
How it works
The examiner taps the chest and listens. Auenbrugger wrote that a healthy chest sounds like a drum covered with a thick woolen cloth, while a region that yields only the sound of a fleshy limb when struck is diseased. He checked his readings against findings after death and injected fluid into the chests of cadavers to show that percussion could mark the limits of the fluid.
How it spread
Acceptance came through France. Jean-Nicolas Corvisart, personal physician to Napoleon, taught percussion to his students and in 1808 published an annotated French translation, a year before Auenbrugger died. John Forbes published an English translation in London in 1824, and a German translation appeared in Vienna in 1843. Percussion of the chest is still practiced today with some modifications. Signs of large pericardial effusion still carry Auenbrugger's name.
Who pushed back
The method was not readily adopted. Auenbrugger's own teacher, Gerard van Swieten, did not mention it in his treatises of 1764 and 1772, and Anton de Haen, who led the Vienna medical clinic from 1754 to 1776, made no comment on it. Auenbrugger wrote that those who improve the arts and sciences are always beset by envy and detraction.
