Mystery Object number 3 revealed: an early stethoscope in the North Carolina Department of Cultural Resources

My clever reader Nevin got it right again – this is an early example of a stethoscope, from the collections of the North Carolina Department of Cultural Resources (http://collections.ncdcr.gov)

 

Monaural stethoscope
Ca. 1850
Pine
Collections of the North Carolina Department of Cultural Resources
http://collections.ncdcr.gov

Although the idea that the sounds produced by organs in the human body can help a physician diagnose a patient’s ailments dates as far back as the writings of Hippocrates in 350 BC, it was not until the late eighteenth century that Western doctors began to examine their patients’ bodies so closely.[1] Then one day in 1816, a young French doctor named René Laennec, who had read, with some skepticism, theories about the acoustical phenomena of illness in the body, was confronted with a severely overweight patient with a heart condition. He decided to listen to her heart, but since she was quite a young lady he felt bashful at the prospect of applying his ear directly to her ample bosom. Instead he rolled some sheets of paper into a tube, and pressed one end against her chest wall, and the other to his ear. To his delight he discovered that despite her obesity he could hear her heart distinctly. The stethoscope (from the Greek words for “I see” and “chest”) was born.[2]

Laennec became an instant convert to the acoustical theory of disease. Three years later he published a influential (and often erroneous) treatise on different internally produced body sounds, and how to distinguish healthy sounds from symptoms of illness, using a stethoscope. He devoted a large section of his treatise to the sounds made by the lungs, and became a specialist in tuberculosis.[3]

Laennec’s stethoscope was simple hollow wooden tube. The stethoscope seen here is based on a later version, invented by another French doctor, Pierre Piorry, in 1828. Piorry’s stethoscope had, as this one does, a wide bell-shaped opening at the chest end, to better capture sound, and a larger earpiece as well.[4]

The invention of the stethoscope gave rise to several controversies, some of which haunt the medical profession to this day. To begin with, Laennec heaped scorn on older methods of diagnosing illnesses – particularly relying on a patient’s testimony regarding his or her symptoms. Patients, he felt, were often unreliable witnesses who failed to understand their bodies, or simply exaggerated symptoms to get attention. An instrument, such as a stethoscope, provided a doctor with purely objective evidence, which he could then interpret correctly.

Many doctors objected to the idea of using any sort of diagnostic device at all. Social values were different than they are now, and surgeons, who used their hands like menials, ranked  much lower on the social scale than book-learned doctors. Some doctors felt that carrying around even such a simple instrument as the stethoscope made them look like surgeons. And then there was the problem of where to put the thing when venturing out on a house call. In one’s hat, perhaps?[5]

Nonetheless, the stethoscope caught on. By the second quarter of the nineteenth century it was in common usage in Great Britain and America, and several new versions emerged, including a short broad stethoscope meant to stand firmly on the distended belly of a pregnant woman, and a stethoscope with a long flexible tube between the sound bell and the earpiece, which allowed the physician to stand upright and move the instrument over his patient’s body, instead of stooping down close and asking the patient to twist this way and that. In 1851 Dr. Arthur Leared designed a stethoscope with two tubes and two earpieces, instead of one, and this is essentially the stethoscope as we know it today.[6]

 

1884 version of the binaural stethoscope
Engraving
Popular Science Monthly, volume 25 June 1884
http://commons.wikipedia.org

Problems persisted. Oliver Wendell Holmes, professor of anatomy at Harvard, advocated the use of the stethoscope, but also he recognized that the medical community had come to exaggerate its revelatory powers.[7] In 1848 Holmes wrote a satiric poem about a young doctor anxious to demonstrate his diagnostic skills with his new stethoscope. Unfortunately, he failed to notice that some flies had taken up residence inside it. “The first was a bottle-fly, big and blue/The second was smaller, and thin and long;/ Soon there was a concert between the two/Like an octave flute and a tavern gong.” Hearing the buzzing in his stethoscope, the foolish young doctor made a number of serious misdiagnoses. “This poor young man was all aghast/The price of stethoscopes came down./ And so he was reduced at last/To practice in a country town.” Holmes’ conclusion: use a stethoscope by all means, but use your common sense as well.[8]

 


[1] Stanley Joel Reiser, Medicine and the Reign of Technology (Cambridge: Cambridge University Press, 1978), 23.

[2] Ibid., 25.

[3] Id., 25- 36.

[4] “The Monaural Stethoscope,” Surgical Antiques Online, www.antiquemed.com/monaural_stethoscope.htm

[5] Reiser,37.

[6] Ibid., 41.

[7] Edwin Palmer Hoyt, The Improper Bostonian: Dr. Oliver Wendell Holmes (New York: Morrow, 1979), 81-82

[8] Reiser, 34-35

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3 Responses to Mystery Object number 3 revealed: an early stethoscope in the North Carolina Department of Cultural Resources RSS Comments (RSS)

  1. Dave Irwin says:

    It’s interesting to see the societal changes and general acceptance associated with the use of any medical instrument, not just stethoscopes. If I’m not mistaken, even eyeglasses were looked on with disdain and suspicion and for a long time before they became generally accepted. Now, they are a fashion statement. It’s a similar situation with stethoscopes: doctors, nurses, etc. all have their favorites, and there are so many different designs and colors available. Not only have they become a must-have device, even for students, but they are fashionable. Very interesting!

  2. It’s interesting to see how the humankind has evolved across centuries, especially when it comes to medical devices. The fact that you could diagnose a patient by listening with a stethoscope might have seemed like black magic at that time, but it’s a well established practice this day. Great walk down the history lane with this article, thanks.

  3. Rich says:

    It’s really cool looking back to see how acceptance of things like this change in time. Great satiric poem by Holmes! Side note … I love woodworking and I think I’m gonna build my own wooden Monaural stethoscope

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