The percussing physician

 The percussing physician

All medical students remember being taught the basic clinical methods of inspection, palpation, percussion and auscultation when they step into hospital wards and this forms a part of their training. I remember trying to use my middle finger which was suddenly called the pleximeter and trying make out the differences in resonance and diagnosing fluid, cavities etc. In the chest and abdomen.

This technique of medical percussion was invented by Leopold Auenbrugger in 1761 while seeing his father use it on wine barrels in his tavern. Percussion involves listening with ears, fingers and skin. This is like a musician who detects tone while playing percussion instruments. Though he was inspired in this invention by his father, he was accused of plagiarising Hippocrates, who had already discovered somewhat similar techniques. As a reward for his invention of the technique, Auenbrugger was dismissed from military hospital service though his private practice thrived.

His technique was rediscovered and popularized by Corvisart, who was Napoleon’s physician and remains popular to this day.

Auenbrugger was also a composer and wrote an opera for an Austrian empress.This composition was called “The chimney Sweep” and was a libretto for a comic opera. Here is a part of the music that he composed.

https://www.youtube.com/watch?v=bTVLJJd0-OQ

Flute and stethoscope

 I spent the last few days racking my brains trying to find an association between the flute and the stethoscope. I will elaborate further in the following paragraphs.

The flute is a woodwind instrument that produces sound according to Bernoulli principle.

The stethoscope is the instrument used to listen to sounds from within the chest and is the most popular gadget commonly identified with doctors.

The stethoscope was invented by Rene Laennec in 1816. Laennec studied medicine at Paris. He was a surgeon/physician and trained under prominent physicians of that time. Laennec's mother had died of tuberculosis and with frequent interruptions because of his own ill-health, he studied and worked on chest disorders like Tuberculosis and emphysema.   

Laennec used to play the flute and being an excellent carpenter, used to carve his own flutes. The method used to listen to chest sounds was crude at the time and involved direct application of ear to the chest wall. Laennec once noticed some children playing with hollow sticks and using them to listen to pin scratches. This gave him an idea and coupled with his knowledge of acoustics led him to make a wooden cylinder about 25 cms long which revolutionized the method of auscultation of the chest and survives to this day.

Laennec ironically died due to tuberculosis and it is said that when he listened to his own chest sounds with his stethoscope, he was horrified. When we proudly flaunt our stethoscopes, we realize and appreciate  the work and genius of many persons who helped us reach here.

Keys and cuts; Brahms and Billroth

 

I was going through literature about surgeons who were musicians and came across this interesting information. In this write-up, I am going to discuss the association between Billroth, a surgeon and Brahms, a composer.

Billroth is known to surgeons as the pioneer and founding father of abdominal surgery. I know him from his association with gastrectomy. I did not know that he was also a proficient musician. He wanted to study music but was persuaded to take up medicine by his family. He played both the piano and violin. He never considered science and music to be in conflict with each other. He attempted to apply scientific principles to musicality and wrote research articles on this subject. He organized small concerts at his home.

Johannes Brahms was a noted composer in Vienna. Along with Bach and Beethoven , he was considered musical royalty (3’B’ s).Practically all of his compositions were played first in Billroth’s home.

Billroth and Brahms developed a close friendship. They met in Zurich and their association continued lifelong.  

Billroth believed that the study of music aided his surgical abilities. Although he was pessimistic regarding the future of music, thankfully he has been proved wrong.

There are several associations between physicians and artists. In Greek mythology, Phoebus- Apollo is considered to be the God of both medicine and music. Here is a piece of Billroth's music.

Foleys, Foleys and follies!

 I came across this term while browsing through an audio software and thought that I knew it from somewhere. That word, foley, turned out to be familiar terrotory.  

A Foley artist creates sounds for media to improve the quality of audio. Everyday sounds like footsteps, creaking doors etc are such examples. This was started by a person named Jack Foley and it became a specialty all by itself which survives to this day.

The more popular Foley (in my world) is the Foley catheter named after Dr Frederic Foley, an American urologist and this self retaining catheter has been and will be used by most healthcare personnel.     

Etymologically, the word foley is derived from Irish language and means plunderer!