(11) E. Boinet:  Les doctrines medicules, leur evolution, Paris,
     1907, pp. 85-86.

It was a pupil of Corvisart, Rene Theophile Laennec, who laid the foundation of modern clinical medicine.  The story of his life is well known.  A Breton by birth, he had a hard, up-hill struggle as a young man—­a struggle of which we have only recently been made aware by the publication of a charming book by Professor Rouxeau of Nantes—­“Laennec avant 1806.”  Influenced by Corvisart, he began to combine the accurate study of cases in the wards with anatomical investigations in the dead-house.  Before Laennec, the examination of a patient had been largely by sense of sight, supplemented by that of touch, as in estimating the degree of fever, or the character of the pulse.  Auenbrugger’s “Inventum novum” of percussion, recognized by Corvisart, extended the field; but the discovery of auscultation by Laennec, and the publication of his work—­“De l’Auscultation Mediate,” 1819,—­marked an era in the study of medicine.  The clinical recognition of individual diseases had made really very little progress; with the stethoscope begins the day of physical diagnosis.  The clinical pathology of the heart, lungs and abdomen was revolutionized.  Laennec’s book is in the category of the eight or ten greatest contributions to the science of medicine.(*) His description of tuberculosis is perhaps the most masterly chapter in clinical medicine.  This revolution was effected by a simple extension of the Hippocratic method from the bed to the dead-house, and by correlating the signs and symptoms of a disease with its anatomical appearances.

     (*) John Forbes’s translation of Auenbrugger and part of his
     translation of Lacnnec are reprinted in Camac’s Epoch-making
     Contributions, etc., 1909.—­Ed.

The pupils and successors of Corvisart—­Bayle, Andral, Bouillaud, Chomel, Piorry, Bretonneau, Rayer, Cruveilhier and Trousseau—­brought a new spirit into the profession.  Everywhere the investigation of disease by clinical-pathological methods widened enormously the diagnostic powers of the physician.  By this method Richard Bright, in 1836, opened a new chapter on the relation of disease of the kidney to dropsy, and to albuminous urine.  It had already been shown by Blackwell and by Wells, the celebrated Charleston (S.C.) physician, in 1811, that the urine contained albumin in many cases of dropsy, but it was not until Bright began a careful investigation of the bodies of patients who had presented these symptoms, that he discovered the association of various forms of disease of the kidney with anasarca and albuminous urine.  In no direction was the harvest of this combined study more abundant than in the complicated and confused subject of fever.  The work of Louis and of his pupils, W.W.  Gerhard and others, revealed the distinction between typhus and typhoid fever, and so cleared up one of the most obscure problems