Letting Fall Grains of Sand or Pins into a Glass: Finding the Poetry of René Laennec at the Historical Medical Library

-by Wood Institute travel grantee Ligia Bouton*

I arrived in Philadelphia on a beautiful clear afternoon in October. After Hurricane Joaquin grazed the city a few days before, the buildings looked freshly washed and the light remained watery. I was in Philadelphia with the help of a Wood Institute Travel Grant from the College of Physicians to facilitate research toward my current creative project, “The Cage Went in Search of a Bird.” This project explores how tuberculosis captured America’s collective cultural imagination during the 19th century, creating an image of an illness that affected both the body and the spirit. I hoped to find texts in the Historical Medical Library focused on the treatment of the disease in the 19th century and then explore any breathing devices or other medical apparatus developed to treat tuberculosis that was housed in the Mütter Museum’s collections.

I hadn’t been to the College of Physicians since 2003 when I was a graduate student in the Masters of Fine Arts program at the Mason Gross School at Rutgers. At that time, I had been drawn to the Mütter Museum to study Chevalier Jackson’s collection of swallowed objects. However, during my first visit, I became side-tracked by a temporary exhibition on historical cases of conjoined twins. As I visited the Museum regularly over the next few months, I eventually developed “Join,” a project in which I created fabric structures that attached my body to the bodies of other women who played major roles in my life.

“Join” 2003, still from digital video
“Join” 2003, still from digital video


As with my first visits to the College of Physicians in 2003, my time this past October in the Historical Medical Library and later in the collections of the Mütter Museum led me in unexpected directions. During my first days at the Historical Medical Library, I requested text after text that seemed to reflect the same limited ideas about tuberculosis. It became evident that doctors were at a complete loss on how to even attempt to treat this deadly pandemic. The documentation of medical devices used in the treatment of tuberculosis and consumption in the 19th century were very limited and many of the descriptions of popular “cures” were vague. Even as Robert Koch isolated the Microbacterium tuberculosis in 1882, doctors could do little more than recommend rest, exercise, good hygiene, and the fresh, dry air of a sanatorium.

Ultimately, however, all of these frustrating false starts led me in to a small book by Merie’dec Laennec called A Manual of Percussion and Auscultation (translated from the French by James Birch Sharpe in the Historical Medical Library’s 1832 edition). This book condenses the ideas and language passed on to Merie’dec Laennec by his uncle René Laennec as he invented and developed the stethoscope in 1816. René Laennec developed this simple but revolutionary piece of equipment expressly to better understand the effect of tuberculosis on the lungs. In a tragic twist of fate, Merie’dec later diagnosed his uncle with tuberculosis using the stethoscope he had designed for this purpose.

What struck me immediately about this small volume was its deeply poetic language. Here we see René, and ultimately Merie’dec, struggling to articulate the very real experience of hearing sounds contained within the body for the first time through the new stethoscope. I became fascinated by the metaphors used to describe the sounds of breath moving in and out of the lungs, especially when the organs were affected by the cavities of tuberculosis. As I compiled all these descriptions together, they formed a kind of found poem, lyrics sung by our body without sounds ever leaving our mouths:


a grave sound

sometimes resembles snoring

sometimes the sound of a bass string rubbed by the finger

the cooing of the turtle dove.


a little, grave or sharp, dull or sonorous, whistling

the cry of little birds

the clicking of a small valve

the inflation of a dry bladder


gently striking with a pin a piece of metal, glass, or china

letting fall grains of sand or pins into a glass


Each of these lines is at the same time deeply familiar and completely foreign. The “cooing of the turtle dove” transforms dramatically as we imagine the sound originating from within our own body.

Prior to my trip to Philadelphia, my research for “A Cage Went in Search of a Bird” focused primarily on tuberculosis as a cultural phenomenon in the 19th century and the resulting identity ascribed to a victim of the disease. Since a person who was consumptive could have been terminally ill with a deeply debilitating bacterial infection, or alternatively could be someone who was solitary and artistic, I was hoping to find evidence in the collections of the Historical Medical Library of medical apparatus that displayed an imaginative resonance far beyond the confines of the diagnosis. If the spirit was perceived to be in peril at the same time that the body ailed, then surely the treatment must embody the link between the mortal soul and the body’s contamination. This connection was absent in all the inhalers, vaporizers, and electro-magnetic instruments I researched. But here, in Laennec’s description of the body, and the body in distress, I found the resonance I was looking for. As Laennec struggled to come to terms with the new technology he had created, he also found the need to generate language that would be evocative enough to communicate the new landscape the stethoscope had uncovered. In the end, I was reminded that the body itself produces a much broader and deeper wonder than any cultural ideas we can place upon it.

Leaving the Library to spend a few days exploring the collections of the Mütter, I found I was armed with a new understanding of my project and new directions to pursue. Laennec’s language helped me to interrogate the internal landscape of the body itself, rather than focusing on the instruments we create to probe and possibly fix the body.

Since returning home to New Mexico, this language has continued to haunt me as I wrestle with “The Cage Went in Search of A Bird” in my studio. Is it possible to create an image that can evoke the sound of “letting fall grains of sand or pins into a glass”? René Laennec certainly envisioned a word within the body where such sounds were vivid and meaningful, and now I hope to translate that vision into a new series of photographs.


A photograph of the space inside a tubercular cavity from a microscope slide created in 1886. From the collections of the Mütter Museum, 2015.
A photograph of the space inside a tubercular cavity from a microscope slide created in 1886. From the collections of the Mütter Museum, 2015.


*Ligia Bouton is the Associate Professor of Interdisciplinary Foundations at the University of New Mexico.  She received an F.C. Wood Institute Travel Grant from the College of Physicians of Philadelphia in 2015.