200 Years old…and still listening: The Stethoscope
There are not to many instruments that were invented 200 years ago and are still in use. One notable exception is the stethoscope. This year celebrating its 200th birthday, the stethoscope remains a permanent fixture around the necks of the majority of today’s clinicians.
The stethoscope was invented by in 1816 when a young French physician named René Theophile Hyacinthe Laennec was examining a young female patient. The invention grew out of the necessity of modesty as Laennec, so the story goes, was trying to listen to sounds emanating from a young women’s chest, but was reticent to use “direct auscultation”, so to preserve modesty. As such, he rolled up 24 sheets of paper forming a tube so as to conduct the sound.1
Laennec spent the next three years experimenting with using different materials to make various configurations of tubes, the predecessor to the modern day stethoscope.2The term stethoscope comes from the Greek word stethos, meaning chest and the Greek wordskopein, meaning to look at.3
There has been much debate as to whether the stethoscope still has a role in modern-day diagnostics. For example, Cardiologist Eric Topol recently tweeted “The stehoscope’s 200th birthday should also be its funeral”.4 Undoubtedly Topol was referring to the notion that modern-day diagnostics for heart and lung conditions come from imaging techniques, and not from what we can here through the stethoscope.
However, others disagree. In an article by Larry Husten in Medpage Today,5 reference is made to an editorial in the Journal of the American College of Cardiology, where esteemed cardiologist Valentin Fuster warned “against over-reliance on advanced technologies like ultrasound: “As clinicians, we need to continue to interact with our patients, listen to their histories, their lifestyles, and their bodies — the last of which is where auscultation continues to play a dynamic role in our daily practices.” Stethoscopes, he wrote, “allow us to physically listen to the sounds of the body.” He cited several clinical scenarios in which the stethoscope “remains essential.”
All that said, I continued to use my stethoscope throughout my entire clinical practice. Of course, my cardiologist friends would have said that listening to bowel sounds is more or less useless, and they would eagerly add, that a surgeon trying to listen to the heart, would be equally useless.
The debate notwithstanding, if you google image the word “doctor” you will find that 48 of the first 50 images that appear, show a doctor with a stethoscope around his or her neck.6 So the instrument endures, will enjoy its 200th birthday, and await the decision regarding its fate in its third century.
If you have any stories about your stethoscope, respond to the blog, or better yet…please drop by the Macklem House, my door is always open.