ABSTRACT
The modern approach to medicine was ushered in slowly by a paradigm shift in the conceptualisation of disease. The Leopold Auenbrugger, an innkeeper's son with an ear for music, 'opened up the world of the ear as a clinical instrument’. He became a physician and while working in Vienna discovered that he could use percussion to differentiate between a healthy and diseased organ. He differentiated four notes — normal, tympanic, dull, and flat — and went on to describe the sounds he elicited for different lung diseases as well as those in dropsy and aneurysm: 'If a sonorous region of the chest appears, on percussion, entirely destitute of the natural sounds — that is, if it yields only a sound like that of a fleshy limb when struck — disease exists in that region.’.
