This book revolutionized the study of diseases of the chest. Auscultation in the instrumental sense dates from Laennec’s invention of the stethoscope (at first merely a roll of stiff paper) with a view to amplifying the sound of the heart’s action. The work illustrates Laennec's wooden stethoscope, which could be purchased from the publishers, and which was advertised for sale on the original printed wrappers of the first edition. Laennec's first wooden stethoscope was in two parts; later he invented a three-part stethoscope.

Laennec was considered the greatest teacher of his time on tuberculosis. Indeed, it was in elaboration of his investigation of the disease that he invented the stethoscope. He established that all phthisis is tuberculous, described pneumothorax and distinguished pneumonia from the various kinds of bronchitis and from pleuritis. He described “Laennec’s cirrhosis” – chronic interstitial hepatitis – on p. 368 of Vol. 1.  Laennec died of tuberculosis at the early age of 45. English translation of the first edition by J. Forbes, London, 1821. 

Second edition, hugely revised, expanded, and improved. The pagination of the first edition (1819) was 456 pp. in vol. 1 and 472 pp. in vol. 2. The second edition was expanded to 728pp. in vol. 1 and 790 pp. in vol. 2.

Laennec’s invention of the stethoscope, announced in the first edition of De l’Auscultation médiate (No. 2673) provided the first adequate method for diagnosing diseases of the thorax, and represented the greatest advance in physical diagnosis between Auenbrugger’s percussion and Röntgen’s discovery of x-rays. The second edition, 1826, is even more important, since it gives not only the various physical signs elicited in the chest, but adds the pathological anatomy, diagnosis, and treatment of each disease encountered.

“In the first edition [of De l’Auscultation médiate] (1819), Laennec pursues the analytic method, giving the different signs elicited by percussion and auscultation, with the corresponding anatomic lesions . . . In the second edition (1826), the process is turned about and the method is synthetic, each disease being described in detail in respect of diagnosis, pathology, and (most intelligent) treatment, so that this edition is, in effect, the most important treatise on diseases of the thoracic organs ever written” (Garrison, History of Medicine, p. 412; emphasis ours). Some copies of the second edition were sold with colored plates at a higher price.

Digital facsimile from BnF Gallica at this link.

Documents manuscripts by Laennec preserved in the Archives de l'Académie des Sciences, and Musée Laennec de la Bibliothèque Universitaire de Nantes, Section médecine-pharmacie.

"....relies on a vastly expanded foundation of primary source material, including thousands of pages of handwritten patient records, lecture notes, unpublished essays, and letters....

"Laennec’s famous Treatise on Mediate Auscultation was his only published book, but two lesser known works were left in manuscript: an early treatise on pathological anatomy and a later set of lectures on disease. The three parts of Duffin’s biography correspond to these books. First, she examines Laennec’s student research on the emerging science of pathological anatomy, the background for his major achievement. Second, she uses his clinical records to trace the discovery and development of “mediate auscultation” (listening through an instrument, or mediator, to sounds within the human body). The stethoscope allowed clinicians to “see” the organic alterations inside their living patients’ bodies. Finally, she explores the impact of auscultation on diagnostic practice and on concepts of disease. Analyzed here for the first time in their entirety, Laennec’s Collége de France lectures reveal his criticism of over-enthusiastic extrapolations of his own method at the expense of the patient’s story" (publisher).