Student discoveries in the pulmonary and cardiovascular systems.

C ontributions to science by medical undergraduates are legion. In the pulmonary and cardiovascular fields there were more than a dozen outstanding contributors, and this paper will discuss them briefly. Naturally, one thinks first of Laennec in the pulmonary field. His first published paper was on mitral valvular disease. Contrary to popular belief he was a pathologist at heart, and in fact before graduating he was made editor of the Journal of Medicine, Surgery and Pharmacy. Among the preoccupations of this penniless but brilliant student were the membranes which lined the heart, the brain, the joints, and the abdominal cavity. His student paper on peritonitis has been described as a fine piece of original work. The membranous coverings of viscera were also investigated by the youthful student at La Charit#{233} where lie studied under Corvisart, who was translating the classic work of Auenbrugger on percussion. Clearly Laennec was the right man in the right place when, in 1817, lie invented the stethoscope to verify, through the chest wall in the living, what he had studied for years in the dead. Two years later he produced his book De l’auscultation M#{233}dkzte which he regarded as describing a “means of enabling us to ascertain the character, not only of the action of the heart, but of every species of sound produced by motion of all the thoracic viscera. “ His second edition seven years later added the clinicopathologic correlation of his findings in tuberculosis, pneumnothorax, emphysema, bronchiectasis, cancer of the lung, and pleurisy. Sir William Osler never tired of urging his students to read the Forbes translation, for instance, as it related to Laennec’s account of pneumonia: “Besides the sound of crepitation, a sensation of humidity . . . is clearly conveyed . . . it is the pathognomonic sign of the first stage of peripneumonv, disappearing on the supervention of hepatization and reappearing with the resolution of the inflammation.” Laennec’s classic work on the stethoscope was