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. 2006 April;2006(4)
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Josef Leopold Auenbrugger: the inventor of percussion

Who more appropriate to discover percussion in the human form than a Viennese-trained physician? Josef Leopold Auenbrugger invented the technique of percussing the patient’s chest in 1754, just two years before Wolfgang Amadeus Mozart’s birth in 1756.

The son of an innkeeper, Auenbrugger is said to have tapped wine barrels in his father’s cellar as a boy to find out how full they were. Little would one expect that this percussive background would lead to a medical breakthrough. Later in life he became a composer and wrote an opera for Austrian Empress Marie Theresa.

Auenbrugger described the lung as sounding like a drum with a heavy cloth over it. When the lung is full, stated Auenbrugger, such as in the case of pneumonia, the sound is similar to tapping the fleshy part of the thigh. Auenbrugger practiced these techniques on cadavers. He injected fluid into the pleural cavity and created a science around when and where efforts should be made for its removal.

These observations were published in a small book, now considered a medical classic. Called Inventum Novum , the full English title is A New Discovery that Enables the Physician from the Percussion of the Human Thorax to Detect the Diseases Hidden Within the Chest (and hence, the shorter, more common title).

To some the physical exam is defunct, supplanted by scans and lab. Two hundred and fifty years later, the technique of percussion is still a cornerstone of the art of the physical exam.

What is a great story—albeit true—without rejection and shame? His ideas rejected and forced to resign his commission in his current post, Auenbrugger showed understanding of human nature in the following statement: “I have not been unconscious of the dangers I must encounter, since it has always been the fate of those who have illustrated or improved the arts and sciences by their discovery, to be beset by envy, malice, hatred, detraction, and calumny.”

Auenbrugger’s work did eventually rise out of obscurity largely through the exposure of Jean Nicolas Corvisart, Napoleon’s favorite physician. Corvisart, who also influenced René-Théophile-Hyacinthe Laennec, inventor of the stethoscope, led a school of medicine that hoped to correlate the clinical exam to pathologic findings. Corvisart taught the method of percussion to his students and in 1808 translated and published the book with annotations—just a year before Auenbrugger’s death. Ironically, Auenbrugger may not have known about this translation that spread rapidly among the medical community.

To some the physical exam is defunct, supplanted by scans and lab. Two hundred and fifty years later, the technique of percussion is still a cornerstone of the art of the physical exam. Next time you percuss an ascitic abdomen or tap out the level of a pleural effusion, think back to Leopold Auenbrugger, his Inventum Novum, and the birth of the modern physical exam. TH

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Cerebral Palsy Who Is At Fault for Cerebral Palsy?

In many cases, the brain damage that leads to cerebral palsy (CP) can be traced to mistakes made by healthcare providers.

For example, a doctor may fail to diagnose a maternal infection that results in the baby’s brain developing improperly.

A healthcare provider may also make a mistake during labor , such as using the forceps too aggressively and causing bleeding of the brain. These and other types of medical negligence can be the direct cause of a child’s life being changed by cerebral palsy.

Determining how the CP happened and who was to blame is very important. The law allows injured victims and their families to take legal action against the responsible person or entity.

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Mistakes by Medical Providers

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These are just a few of the potential situations where healthcare professionals could be at fault for a child developing cerebral palsy. Nurses, doctors, midwives, interns, anesthesiologists and hospitals all have a duty to patients who are pregnant or giving birth and who seek care. Whenever these professionals fall short in fulfilling their obligations, they are to blame for the injury or damage that occurs.

Who is to Blame if My Child Develops Cerebral Palsy?

Doctors and other healthcare providers are held to a professional standard of care. This means they are expected to provide reasonable quality medical services to patients who come to them for prenatal care and for labor and delivery.

To determine if a doctor is negligent and responsible for causing a child to develop cerebral palsy, it is essential to consider the care provider’s behavior and evaluate whether it fell short of what a reasonable professional with the same background would have done in the same situation.

For example, the care provided by an anesthesiologist would be compared to what a reasonable anesthesiologist would have done, while a nurse’s actions would be evaluated in light of what a reasonable nurse would have done. If the care provider fell short of what is reasonable and this failure was a direct cause of the brain damage leading to cerebral palsy, that provider is at fault.

In some cases, there may be multiple individuals or entities who are to blame. For example, both a doctor and a hospital may be at fault for a child’s development of CP, or both a doctor and a nurse may be to blame.

Hospitals, doctors and others who employ staff can also be held legally responsible for the negligent actions of those who work for them. For example, if a hospital employs a doctor and the doctor makes a careless mistake, this could be viewed as the legal equivalent of the hospital itself being careless.

It can sometimes be tough to determine exactly who you should make a claim against as a result of a botched labor or delivery leading to cerebral palsy. An experienced attorney can help you to protect your rights and hold the appropriate people and entities accountable for the harm they have caused.

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Virginia Tech Percussion Ensemble (VTP), directed by Dr. Annie Stevens, is a university ensemble open to music majors and non-majors by auditionin the fall semester. VTP performs a wide body of repertoire from classical transcriptions and chamber works to traditional West African drumming music and large percussion orchestra pieces. The ensemble features several guest artists throughout the year and students have the opportunity to participate in masterclasses with visiting guests artists on several occasions.

Audition information: All non-majors must show fluency on both snare drum and mallets to be considered for the ensemble. The audition for non-majors consists of the audition etudes (see the link below), as well as sight reading on both snare drum and mallets. 4-mallet technique on mallets is not a requirement for acceptance into the ensemble. There is an expectation that ensemble members will meet at least once a week for rehearsal outside of designated class time. Non-majors interested in auditioning should email Dr. Annie Stevens atajs@vt.eduto set up an audition date. The audition will occur the week before fall semester classes, or during the first week of classes. There will be no auditions for acceptance into the ensemble for the spring semester.Auditions only occur in the fall.

Audition information:

Audition Etudes: Mitchell Peters: Intermediate Snare Drum Studies, #28 Morris Goldenberg: Modern School for Xylophone, Marimba, and Vibraphone, Etude V View the 2017-2018 Audition Packet here .

Audition Etudes:

Fall 2017 Percussion Ensemble Concert: Saturday, November 4 Lyric Theatre Blacksburg, VA Visit the Virginia Tech Percussion Facebook page :

View a recently released dynamic music video of the Virginia Tech Percussion Ensemble , directed by Annie Stevens, of Shared Space by Ivan Trevino. The video features the ensemble performing in prominent locales around Virginia Tech and Blacksburg including the War Memorial, Horticulture Garden, Henderson Lawn, VT Recording Studio, and Heritage Park. As a collaborative project between students and faculty, Annie Stevens is the director and producer of the audio recording, Ryan Vazquez (junior, music technology andApplied Economic Management: International Trade and Development) is the recording engineer, and Steven Arnold (sophomore music education and music performance) is the video editor. The performers include: Steven Arnold (sophomore, music education and music performance), JD Grizzle (senior, music education and music performance), Chris Hochella (junior, music performance), Jesse Hughes (sophomore, music education and music performance), Joshua Morrison (sophomore, music education and music technology), Laura Moniuszko (sophomore, music education and music performance), Denver Nuckolls (sophomore, music performance and music technology).

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Curl up in our Cozy Hoboken accommodations amid pleasing shades of taupe and cobalt. Sink into the signature W bed with pillow-top mattress, 350-thread-count sheets and goose down comforter and pillows and take in the charming Hoboken views. When business calls, answer atour work desk with a comfy office chair and High-Speed Internet Access. Unwind with a slate-finished bathroom full of luxurious Bliss® Spa bath amenities in the walk-in shower with cheeky peek-a-boo glass doors. Snuggle up in a plush W spa robe, explore the delightful Munchie Box, and take in our state-of-the-art entertainment system featuring a 50" LCD TV, Nude Studio Bluetooth speaker, iPod docking station, and an alarm clock with USB charging ports.

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Heighten your angle above New York in our Spectacular Hoboken accommodations.In a stylish setting of taupe and cobalt, fall asleep and wake up to treetop views of the spectacular Manhattan skyline across the sprawling Hudson River. Drift away in the signature W bed available in king or double configurations with pillow-top mattress, 350-thread-count sheets and goose down comforter and pillows.

Experience our state-of-the-art entertainment system featuring a 50" LCD TV, Nude Studio Bluetooth speaker, iPod docking station, and an alarm clock with USB charging ports. Kick back in a plush W spa robe and go for a spin in our swivel sofa chair (king rooms only) as you explore the delightful Munchie Box. When business calls, answer atour work desk with office chair, High-Speed Internet Access and dual-line cordless phones. Unwind in the slate-finished bathroom full of luxurious Bliss® Spa bath amenities.

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