by Dr. Lindsey Fitzharris.
Since its invention in 1816, the stethoscope has become one of the most iconic symbols of the medical profession. Yet there was a time when doctors had to assess the inner sounds of the human body unaided. In 350 B.C., Hippocrates—the ‘Father of Medicine’—suggested gently shaking the patient by the shoulders, while applying one’s ear directly to the chest in order to determine the presence of thoracic empyema, or pus in the lungs. For over a thousand years, medical practitioners would follow in Hippocrates’s footsteps, relying on only their ears to diagnose chest infections in patients.
All this changed in the 19th century, when the French physician, René Laennec (below), was presented with a young, female patient who was ‘labouring under general symptoms of a diseased heart’. Laennec tapped on her torso with his fingers—a technique called percussion—to determine whether fluid was present around her heart. Unfortunately, this didn’t work ‘on account of the great degree of fatness’ in the patient. He considered pressing his ear to her chest, as Hippocrates advised, but rejected this idea due to her tender age. Desperate to find a solution, Laennec changed tactics.
I rolled a quire of paper into a sort of cylinder and applied one end of it to the region of the heart and the other to my ear, and was not a little surprised and pleased, to find that I could thereby perceive the action of the heart in a manner much more clear and distinct than I had even been able to do by the immediate application of the ear.
Laennec’s original model (right) looked nothing like its modern successor. It was a hollow, wooden tube, which he called ‘Le Cylindre’, with only one earpiece. By the 1890s; however, the instrument had taken on its more familiar shape, consisting of two earpieces and a bell-shaped end.
Eventually, Laennec would call this instrument a ‘stethoscope’, from the Greek words meaning ‘I see’ and ‘the chest’. Within a decade, Laennec’s invention could be found proudly displayed in the windows of medical shops around Paris. The instrument’s ready availability—along with translations of Laennec’s medical texts into German, English and Italian—helped to spread its use within the medical community. Before long, the stethoscope came to symbolise the progressive forces of medicine. Even George Elliot would write of a doctor who irked his conservative colleagues by advocating the value of the ‘French instrument’ in her 1832 novel, Middlemarch.
What the microscope did for scientists, the stethoscope did for doctors. For the first time in history, physicians were able to listen, with startling clarity, to the internal workings of the body. Laennec dedicated the next ten years of his life to studying chest diseases, and was the first to write comprehensive medical descriptions of bronchiectasis, emphysema, pleuritis, and pneumonia.
Then, in 1826, the good doctor fell ill while conducting studies on tuberculosis, the contagious processes of which were not yet understood. He asked his nephew to listen to his chest using his stethoscope. The findings were disturbingly familiar to the man who had heard just such sounds a thousand times in dying patients. A few months later, Laennec succumbed to the disease he had worked so hard to explain and describe. Ironically, it was with his own invention that the French physician became aware of his inescapable fate.
On August 13th, René Laennec—the man who had invented the stethoscope and changed medicine forever—died at the tragically young age of 45.