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Stethoscopes

French physician, Rene Theophile Hyacinthe Laennec invented the stethoscope in 1816. Before the stethoscope, doctors would place their ear directly onto the patient’s chest, a practice called “immediate auscultation”. Laennec’s masterpiece, “A Treatise on the Diseases of the Chest” describes the practice of “mediate auscultation” using his instrument to identify sounds made by the heart and correlate them with pathology. By the 1850s, the stethoscope had become one of the doctor’s vital tools. Today a stethoscope around the neck is one of the most recognisable images of the medical profession.

 

In 1829, Welsh physician Dr Charles Williams invented the first binaural stethoscope by attaching two pipes with lead earpieces—rubber had not been invented yet. The instrument, much like stethoscopes that are used today, could be twisted at various angles so the physician could stand comfortably and less pressure was applied to the patient’s chest. Irish physician Arthur Leared invented the version with rubber tubing in 1851.

 

In the 1890s, the Laennec hollow wooden tube was modified and soon replaced by various hand crafted wooden monaural designs.

 

Image References

The wooden stethoscope in the museum’s collection originally belonged to Sir Byron Bramwell, a Physician in the Royal Infirmary of Edinburgh until his retirement in 1912. He was elected President of the Royal College of Physicians of Edinburgh in 1911 and held office for two years. The stethoscope passed in sequence to: Sir Stanley Professor of Medicine, University of Edinburgh; Dr John McLeod, Physician at the Western General Hospital, Edinburgh; Professor Michael Oliver, President of the Royal College of Physicians of Edinburgh and Senior Cardiologists to the Royal Infirmary of Edinburgh. On his retirement in 1989 Professor Oliver donated the stethoscope to the Department of Cardiology in the Royal Infirmary.

 

Laennec’s masterpiece, “A Treatise on the Diseases of the Chest“, 1834.

 

The diaphragm chest piece was introduced in 1894 by Robert Bowles of Massachusetts. A growing acceptance of the need for both a bell and a diaphragm, led Howard Sprague to design the first combination chest piece in 1926.

 

In 1958, Dr Aubrey Leatham of St Georges Hospital, London recognised a large bell was required for acoustic efficiency, but a small bell was needed for children or thin bony chests. He designed a lever mechanism which incorporated a smaller bell inside a larger bell.

 

Electronic stethoscopes that amplify the sounds in the chest and produce graphs were first produced in the 1970s and continue to be refined.

 

Image References

The Bock differential stethoscope, 1918. The intensity of the first and second heart sounds were measured with the rotating dial and compared between the apex and base of the heart.

 

The Sprague Bowles stethoscope, 1926. A combined bell and diaphragm with a tap to switch from one to the other. Invented in the USA.

 

Binaural combined stethoscope. The bell and diaphragm end-pieces were exchanged manually. Used in Newcastle by Dr Hewan Dewar, in 1933.

 

Leatham stethoscope, 1958. Invented in Britain. The bell is in two sizes with a sliding mechanism.

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