Leopold Auenbrugger

Josef Leopold Auenbrugger von Auenbrugg

Josef Leopold Auenbrugger von Auenbrugg (1722 – 1809) was an Austrian Physician

Credited with describing the effectiveness of chest percussion in the diagnosis of cardiac and respiratory disease.

Eponyms: Auenbrugger Sign I and II in cases of extensive pericardial effusion and Auenbrugger Osteophony/Bone Sign (more commonly Heuter sign)

Auenbrugger described camphor-induced seizures as a remedy for manic psychosis and suicidal thought.


Biography
  • Born in Graz, Austria on 19th November 1722
  • 1752 – Physician at the Spanish Military Hospital, Vienna
  • 1754 – Defined and described ‘percussion‘ of the chest to define pleural effusions.
  • 1779 – Wrote the libretto to Antonio Salieri’s three-act opera, The Chimney Sweep (‘Der Rauchfangkehrer’), first performed in the Burgtheater in Vienna in April 1781
  • 1780 – Haydn composed the six Auenbrugger keyboard Sonatas for the Auenbrugger’s talented musical daughters (Marianna and Caterina) in 1780
  • 1783 – Knighted for services to medicine by Emporer Joseph II
  • 1790 – Physician to Wolfgang Amadeus Mozart, Vienna
  • Died in Vienna on 18th May 1809

Eponyms

Auenbrugger Sign (1761)

Dullness to percussion in Traube’s space associated with large pericardial effusion and descent of the left lobe of the liver

I have observed the following specific signs of the dropsy of the pericardium: The sound in the cardiac region, which I have already stated (III. 2. 3.) to be naturally more obscure than in the other parts of the chest, is now as completely deadened as if the percussion were applied to a fleshy limb.

Auenbrugger XLVI. Signs of Hydropericardium. 1761
Auenbrugger sign II (1761)

The bulging of the epigastrium (epigastric region) in patients with large pericardial effusion.

A swelling is perceived in the precordia, which can readily be distinguished, by its superior resistance, from the stomach distended by flatus.

Auenbrugger XLVI. Signs of Hydropericardium. 1761
Auenbrugger Bone Sign (Heuter sign)

Used to define the presence of upper limb fracture or dislocation via osteophony. Each olecranon is tapped whilst listening over the manubrium with the bell of the stethoscope. Intact bone gives a bright, crisp tapping sound to percussion with equal sound transmission to each side. If osteophony reveals a muffled or distant quality to the sound, this suggests a humeral fracture or glenohumeral dislocation.

Hueter-sign-Auenbrugger-Bone-Sign

Key Medical Attributions

Chest percussion

Described chest percussion to diagnose chest conditions. The son of an innkeeper, Auenbrugger is said to have tapped wine barrels in his father’s cellar as a boy to find out how full they were.

Auenbrugger validated his clinical observations on the use of diagnostic percussion by comparing clinical assessments with post-mortem findings and injecting fluid into the pleural cavity of cadavers to demonstrate that percussion could accurately define the physical limits of any fluid present.

I have not been unconscious of the dangers I must encounter, since it has always been the fate of those who have illustrated or improved the arts and sciences by their discovery, to be beset by envy, malice, hatred, detraction, and calumny.

Auenbrugger 1807

Unfortunately his work was largely unheralded at the time. His teacher (Van Swieten) in 1764 and 1772 major treatises on ‘pulmonary chills and chest water’ failed to mention Auenbrugger. Similarly De Haen, who was the head of the medical clinic in Vienna from 1754-1776 makes no comment on percussion in “Ratio Medendi In Nosocomio Practico Vol I to VIII” ironically complaining “how dark and difficult is the diagnosis of the thoracic water, the pleuritic and pericardian exudates.”

It was not until a French republication by Jean-Nicolas Corvisart des Marest (1755-1821), personal physician to Napoleon, appeared in 1808 that the diagnostic method gained worldwide acceptance. Corvisart taught the method of percussion to his students and in 1808 translated and published the book with annotations a year before Auenbrugger’s death


Controversies

Italian physician Giovanni Maria Lances (1654-1720), first described percussion of the chest bone in the diagnosis of consumption (tuberculosis)


Major Publications


References


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eponym

the person behind the name

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

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