Making Sense of Sound: Auscultation and Lung Sound Codification in Nineteenth-Century French and German Medicine

Abstract

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.

Laennec Contributions to the Field of Medicine

“…His classification of pulmonary conditions is still used today. 4,5 Throughout Laennec's medical work and research, his diagnoses were supported with observations and findings from autopsies. 1 Rene Laennec started publishing important scientific papers on various topics in 1802.…”

Turning Aggression into an Object of Intervention: Tinkering in a Crime Control Pilot Study

“…For instance, Mody (2005) shows how sounds are part of the organization of laboratory work. Lachmund (1999) examines how lung sound codification systems are variably constituted in different countries. 4 The Dutch DPA contended that no privacy regulations were violated.…”

Training the Auscultative Ear

“…Specific mention of the other main pioneering figure, Viennese physician Joseph Skoda, is missing from English and French chapters on auscultation; his scientific contributions, however, appear to have been integrated. See Lachmund (1999). 3.…”

“…They include physical examination textbooks, specialized lung auscultation guides, select audio and audiovisual study aids, and medical-technological research. Much historical work already exists that examines the social, technological, and scientific conditions in which the practice of auscultation -its technique and its codification -could and did develop (see Reiser 1978;Duffin 1998;Lachmund 1999;Sterne 2003b). Tom Rice's ethnographic work on learning the basics of heart auscultation in the clinical rotation setting has established important conceptual and empirical groundwork for understanding the nature, function, and status of these specialized listening skills in the medical profession (Rice 2008(Rice , 2010(Rice , 2012.…”