“Will my dad take us back now that he married a new mom? » The Nantes doctor, Guillaume Laennec looks, without responding, at his nephews Théophile – fourteen years old and finishing his schooling at the Oratorian college – as well as his younger brother, Michel, known as Michaud. When becoming a widower, his brother entrusted his two sons to him, it was only for a few weeks. Since then, the years have passed and the widower, too busy wasting his wife's dowry, has not found a moment to take care of his children. Fortunately, Uncle Guillaume Laennec has affection for them. In the year 1795, what worries him is the announcement of the arrival of the army of Charrette and the Chouans in their city (1). The royal army is pushed back (2) and Republican Nantes can breathe. For a short time.
The political antagonisms in Paris, brought to a head by the war and the invasion of foreign armies, divided France into so many partisans and provoked civil war. The guillotine, installed in large cities, is used to settle the final debates. Nantes, accused of federalism, the assembly reacted as it had towards Lyon (3) and sent one of its representatives on a mission, Carrier, to impose “terror” and crush anarchy. The city panics. Carrier is accompanied by his secretary, Prigent-Keraudren, a friend of Uncle Guillaume Laennec. This more than likely saved his life because Carrier, judging the guillotine too slow, inaugurated, to purge the region of reactionary elements, the “drownings of Nantes” (4). Théophile and Michaud Laennec come face to face with these terrible adventures. It was at this time that their father chose to remarry in February 1795, to Geneviève Urvoy de Saint Bedan. Will he want his children back? “No, they might as well be at their uncle’s. Let them stay there! »
At the end of the year, Théophile begins his medical studies to become a 3rd class surgeon. When he finishes them, the insurrection is general: the government sends a troop of 60,000 soldiers. He is part of it, as a health officer. Order was restored, the army was demobilized, and Théophile's post was abolished on August 13, 1800. He wanted to go to Paris to pursue his career.
Uncle Guillaume then wrote to his brother to send the money needed for the trip. The father is very annoyed: “Don’t let us bother him anymore. Ah, ccs children! So we will never get rid of it. »
The great Parisian doctors
Théophile went there on foot and found his brother, Michaud, on April 4, 1801, in an attic on rue Roger Collard, near the Luxembourg Gardens. He wrote to his uncle: “I have little ambition. As long as I can live and make myself useful. » His teacher is Corvisart and specifies: “I only know Mr. Corvisart who does not want to see sick people because it bothers him. Besides, although I work every day for him, he barely knows me. »
He also meets Dupuytren. The professors of medicine at this time were as young as the generals, with an average age of twenty years. Laennec has twenty-one. In September 1801, he published an article in the Journal of Medicine on peritonitis. Clinicians, until now, have confused peritonitis and enteritis. His descriptions are still used today, such as “facies flu”. Dupuytren associates this promising colleague with his work. The two brothers succeeded in their canning careers. Michaud won a prize in the general competition for beautiful letters which got him hired by the prefect of Beauvais for a career as a senior civil servant, while Théophile published an article in August 1803 on the subdeltoid synovial bursa which he had just discovered and passed his exams successfully.
He dedicates his thesis (5) to Uncle Guillaume.
Doctor Laennec is twenty-two years old. This is the moment his father chooses to remember him. Since he has arrived, let him get a job – which he says is not very tiring but well paid! Having fathered a famous son, he has every right to it.
A Christian doctor
In Paris, Doctor Laennec found asthma and faith. He suffers from terrible attacks that suffocate him and has become a devout practitioner. At the same time, a religious revival occurred: the Concordat was signed, and Châteaubriand published The Genius of Christianity.
On May 27, 1803, Laennec became a member of the Jesuit congregation. His religious commitment earned him ridicule from his colleagues, who were mostly atheists and fiercely secular. However, his professional qualities were such that he won the great dissection competition of year 11, opened a public anatomy course, and published articles (6).
He also entered the medicine and surgery competitions, obtaining the first two prizes. Laennec writes to his father to ask him to send him money so that he can wear a proper costume during the awards ceremony. The latter promises him a money order but manages to make an anomaly that prevents the recipient from touching him – these cruel jokes, which he is accustomed to, delight him. It is therefore in his threadbare suit that Laennec is received at the Ministry of the Interior by Chaptal, to whom the father does not fail to write, recommending himself to his son, to request a position.
When Pope Pius VII came to Paris to crown Napoleon, Laennec was presented on December 18, 1804, by representatives of his congregation. His father immediately wrote to the Emperor, always recommending himself to his son, to demand a place in the administration. Laennec, as soon as he learns it, is dismayed, which aggravates his asthma.
Urban pollution
He only dreams of the countryside, but how to get there? It's suffocating in Paris. One day, he decides to leave the city and walks twelve hours straight to return cured! Then collapses on his bed and sleeps for another twelve hours. Before we suspect the existence of urban pollution, he suffers from it.
Another problem bothered him: Dupuytren kept his collaboration a secret. Laennec, wanting to maintain the authorship of his inventions, prepared an anatomy course in 1805. Once again, it is a triumph: Laennec also reveals himself to be a master of words. Unable to go far away, he traveled thanks to books, learned Low Breton, and thought about Sanskrit. Then, a miracle of notoriety, two cousins (7), near Soissons, invited him to come and spend three weeks with them, during the holidays. He later recalls these moments as the most pleasant of his life (8): “We made music, played proverbs, wrote verses, filled in rhyming bits, played a few games of chess. »
Then return to Paris. The purse is always empty, its patients bring in little: barely 400 F per year. The following year, his poor health forced him to abandon his anatomy classes. But little by little, customers flocked in: he had a good reputation and the congregation referred practicing Christians to him. Fortunately, he only got a volunteer position in a dispensary. He knows he can't count on anyone's help, starting with his father who continues to lead a happy life in Quimper where he runs an open table.
An unworthy father
He has long since eaten up his second wife's dowry, having obtained guardianship of the estate of his mother-in-law who herself also spent it all. But the time has come for accountability. He then remembers his second son, Michaud, thanks to whom he managed to get a position: advisor to the prefecture of Quimper.
Having learned that he is a little unwell (9), he invites him to rest at his place. Stunned by this generosity, Michaud goes there, not suspecting that his father only needs his services. Arriving home, rather than taking him to a room to rest, his father leads him to an office overflowing with documents. " Go to work! »
Having ordered him to file his accounts, the father leaves to join his friends. While carefully sorting the papers, Michaud noted with dismay the thefts being carried out! He also discovers that he is preparing a scam against Guillaume Laennec, to accuse him of having robbed him and his two children. Furious, Michaud immediately left for Nantes, despite his poor health, to warn Uncle Guillaume of the maneuver.
It's winter, it's cold, the roads are potholed, and Michaud's health, already delicate, is getting worse. Then, despite his fever, he takes a closer look at the situation of his mother's inheritance. It's simple: the father has spent everything and is in debt throughout Brittany. On the sly, he sold farms, and placed mortgages, while taking the precaution of putting his first wife's property in usufruct until her death, thus preventing the slightest alienation of his property. His two sons will inherit nothing!
So that his second wife is not accused of complicity, Father Laennec has just obtained in court a separation of property between the spouses. Warned of his second son's dissatisfaction, he immediately filed a complaint for threats against him. And without telling him why, on October 12, 1809, he begged his eldest son to lend him money. Laennec can only send him 500 F which he uses to pay the lawyer against his son.
Michaud, exhausted and furious, took to his bed, only to die in Quimper on January 10, 1810. Immediately, old Laennec changed his suit and attacked his son's will, claiming to be his only legitimate heir. Rejected but not discouraged, he obtained from the court that his surviving son, Doctor Laennec, be responsible for his debts and pay for Michaud's burial alone.
Physician to the Emperor’s uncle
Back in the capital, Laennec learned that thanks to his friends in the congregation, he was appointed physician to Cardinal Fesch, uncle of the Emperor (10). This sinecure lasted two years until in 1812 he left for Lyon, where Laennec refused to follow him.
In the waiting room of his office, a large crucifix announces the piety of the doctor, his colleagues mockingly having nicknamed him “the oratory”. His Parisian clientele is not only religious but wealthy (11), with Chateaubriand among his patients. He regularly and free of charge treats the poor, who make up half of his patients.
He would have liked to live in his mother's birthplace in Quimper and set up there as a doctor. The climate there is beneficial and, when he goes there, his asthma disappears. He is thinking of getting married. He is presented with a dowry of 12,000 pounds annuity – a sum necessary to support a doctor – but the bride is eighteen years old. “Much too young, not serious enough” he decides without even meeting her.
Rather than marry, exhausted by his asthma, he makes his will. Nothing to his father, everything to his uncle Guillaume's two sons.
To finish repaying his father's debts, he sells the house in Quimper. Farewell dream of settling there. He will have to stay in Paris. All that remains of his once brilliant maternal inheritance is a small manor, Kerlouarnec, and a few poor farms near Pont-l'abbé. He is thirty-three years old. He finds the capital in turmoil. The war is lost. Laennec does not like Napoleon but is worried about the fall of the Empire, which caused the invasion of enemy troops.
Will the terrible era of the Revolution that he experienced as a child in Nantes return? Hospitals are overflowing with wounded, typhus appears in Paris, and eleven student doctors die. At Salpetrière, Laennec takes particular care of wounded Bretons who only speak their language and do not understand French.
After the abdication of Napoleon and the return of the Bourbons to the throne, Laennec returned to Kerlouarnec. The old mansion is in ruins. He had it restored.
Return of the father
It is then that his father, whom he had forgotten for a moment, enters his life again. We have just discovered in the archives a letter that he sent to the Convention to congratulate it on the death of Louis XVI. When the Bourbons, with Louis XVIII (12), returned to the throne, the risk was great. He was immediately dismissed from his position as advisor to the Quimper prefecture, which he obtained thanks to Michaud. It was his only recognized resource, so he now finds himself hooking the only son he has left.
The desire to settle in Brittany fades and Laennec must return to Paris, his customers, and his asthma.
On June 5, 1816, while going to see a patient, he met one of his friends, the director of Public Assistance, who offered him a position in Necker. He decides to research pulmonary emphysema, chest conditions interest him all the more since he suffers from it and his brother died from it. He wants to study the lesions observed during his autopsies on the living. However, the rib cage is not suitable for palpation. Doctors should place their ears against the ribs. What could they conclude from these strange noises?
For a doctor, examining a female breast is not socially correct (13). One morning in September 1816, passing through the ticket offices of the Louvre, he watched children playing. What game? Very excited, they are assembled at the two ends of a beam. One of them scratches the wood with a pin; at the other end, the group, with their ears to the wood, hears the tiny scratching and shows their enthusiasm by screaming with pleasure.
The stethoscope
Laennec looks at them smiling: the transmission of sound has always been known. The Gauls, with their ears to the ground – just like the North American Indians – were capable of distinguishing the number of their enemies from a great distance.
Suddenly, he stops, frozen by the idea that has just struck him. He goes to see a patient suffering from a heart condition that is difficult to diagnose because she is very overweight. As soon as he arrives at her house, he asks for a sheet of paper and rolls it up to apply one end to the patient's back and her ear to the other. He closes his eyes in bliss, slowly moving his cylinder following the changing noises.
“What is the sun of Austerlitz worth, compared to this discovery? » For two thousand years, we have tried to listen to the sounds of a thorax: he, for the first time, has just done so. What Hippocrates and other doctors sought in vain, thanks to Laennec a student will be able to learn in a few weeks.
From 1817, he worked to classify the different noises heard in the thorax and built an effective and practical instrument. The progress of his work was interrupted by illness. Between asthma, gout, migraines, and syncope, Laennec practices auscultation among his clients. On August 4, 1818, he wrote: “My work on the stethoscope is almost completed. The extracts that I delivered to the medical academy were well received. It's a find. Too bad it was made by someone incapable of making money from it. I'll only get a little smoke out of it. » In twenty-two months, he discovered and defined pulmonary semiology and wrote a booklet on the subject (14).
In the amphitheater of Necker, where he autopsies deceased patients, invariably, the anatomical lesions in the diagnosis made by Laennec before their death.
His colleagues gave the invention of the stethoscope a polite welcome. It only owes its excellent reputation for not being ridiculed. The publisher Bresson and Chardé published his work Medical auscultation in 1819. If the reception from French doctors bordered on total indifference, on the contrary, the English and German doctors were enthusiastic and translated Laennec's treatise. They continue to come to Necker to receive his teaching. His colleagues, jealous, tried to ban his classes. They call him a “pushy Jesuit”, a retrograde and ridiculous “lounge jerk”. Too late, the success is international.
On July 31, 1822, Laennec was appointed professor at the Collège de France, but he could no longer bear fatigue and his health was failing him. Very ill, overwhelmed by gout and asthma, Laennec, who called his body "his rag", no longer felt the strength to teach. He leaves his apartment and resigns from his post in Necker, wanting to retire to Kerlouarnec, to die there.
His father, furious, convinced that this is a maneuver to take away his pension, by organizing his insolvency, refuses to give way and threatens him with a lawsuit.
Laennec, meeting his family friends, then married Madame Argou, forty-three years old, on December 16, 1824, at the town hall of the 6th arrondissement, before a religious ceremony in Saint-Sulpice. Knowing his father, he signs an inter vivos donation in the marriage contract. Shortly after, he was diagnosed with phthisis, the same illness from which his brother died. He carefully wrote his will, bequeathing the usufruct of his property to his wife and then, upon his death, all to his cousins, sons of his uncle Guillaume. He studies with the notary all the means so that his father cannot have it broken. To protect himself, he made a codicil, granting an annuity of 600 F to his father on the condition that he leave his widow in peace after her death. He died on Sunday, August 13, 1826, resting since then in his beloved Brittany.
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