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Cardiovascular Diseases

Since its invention by René Laënnec in 1816, the stethoscope has become a near-universal symbol for the medical profession.1 Yet many aspects of the cardiovascular system remained mysterious in the time of Laënnec; the second heart sound (i.e. the 'dub' in the characteristic 'lub-dub') was not correctly identified as a ventricular contraction until experiments conducted in the 1860s by Etienne-Jules Marey and Auguste Chaveau, during which they were able to measure the changing pressure in every chamber of a beating heart simultaneously.2 Other new technology for cardiovascular examination and diagnosis included the sphygmograph and a primitive cardiograph designed in the mid-1850s by Marey, the first instruments capable of continuously graphing the pulse in wave-form, a precursor to both the modern EKG and the polygraph machine.3

Blood transfusion, however, was possibly the most impactful and hard-won achievement in the history of the scientific study of the vascular system. Doctors in the 19th century knew that human-to-human blood transfusion was possible; they did not, however, know why transfusion worked in some cases while causing terrible rejections reactions in others. Blood transfusion experiments had been criminalized in France in 1670 after one especially public debacle; however, scientific interest rekindled following a few successful experiments in the late 18th century.4 This great medical mystery of the 19th century was solved in the first year of the 20th, when Karl Landsteiner identified the ABO blood groups. The discovery made blood transfusion and donation safe and feasible; coupled with the technology to refrigerate, transport, and store blood in 'blood banks' at medical facilities, it dramatically extended the amount of time a patient could spend in surgery.5 Later in the 20th century University of Paris alumnus André Frédéric Cournand (with Werner Forssmann and Dickinson Richards) received the 1956 Nobel Prize for Medicine for the first successful cardiac catheterization.6

Notes

  1. Roguin, "René Théophile-Hyacinthe Laënnec," 230-1.
  2. Silverman, 339-340; Espinosa, Vlietstra, and Mann, "J.B.A. Chaveau, E.J. Marey, and Their Resolution of the Apex Beat Controversy," 197-202.
  3. Reichert, "A History of the Development of Cardiology," 8.
  4. McCann, History of Haematology. For the fascinating story behind the aforementioned debacle, see Holly Tucker, Blood Work.
  5. Lin, "Karl Landsteiner," 126; McCann, A History of Haematology.
  6. Boulanger, "Cardiovascular Research in France," 657.

Bibliography & Further Reading

    • Boulanger, Chantal M, Jean-Sébastien Silvestre, and Alain Tedgui. "Cardiovascular Research in France." Circulation Research 122 (2018): 657-660. DOI: 10.1161/CIRCRESAHA.117.310841.
    • Espinosa, R.E., R.E. Vlietstra, and R.J. Mann. "J.B.A. Chauveau, E.J. Marey, and their resolution of the apex beat controversy through intracardiac pressure recordings." Mayo Clinic Proceedings 58.3 (1983): 197-202.
    • Lin, Jain I. Karl Landsteiner: Founder of Immunohematology." Laboratory Medicine 15.2 (1984: 126-129. DOI: 10.1093/labmed/15.2.126.
    • McCann, Shaun R. A History of Haematology: From Herodotus to HIV. Oxford University Press, 2016. DOI: 10.1093/med/9780198717607.001.0001.
    • Reichert, Philip. "A History of the Development of Cardiology as a Medical Specialty." Clinical Cardiology 1.1 (1978): 5-15. DOI: 10.1002/clc.4960010102.
    • Roguin, Ariel. "René Théophile-Hyacinthe Laënnec (1781-1826): The Man Behind the Stethoscope." Clinical Medicine & Research 4.3 (2006): 230-235.
    • Silverman, Mark E. "Etienne-Jules Marey: 19th-Century Cardiovascular Physiologist and Inventor of Cinematography." Clinical Cardiology 19 (1996): 339-341.
    • Tucker, Holly. Blood Work: A Tale of Medicine and Murder in the Scientific Revolution. New York: W.W. Norton & Co., 2011.