200 years of the the stethoscope

Today the stethoscope is probably the most recognised medical instrument, and symbol of the medical profession, but did you know that it was invented 200 years ago? And that two Irish doctors were instrumental in its introduction and development?

 

 

The stethoscope was invented in 1816 by the French physician René Laënnec (1781-1826), as an aid to diagnosing chest conditions. It was also partly in response to the embarrassment of having to put his ear to the chest of female patients, and in some cases the problem caused by ‘the great degree of fatness’ of patients. Having experimented with a rolled up tube of card, the early Laënnec stethoscopes were simple long wooden tubes. In 1819 Laënnec published De l’Auscultation Médiate which included a description and image of his new invention.

 

 

In 1825, less than ten years after Laënnec pioneered the stethoscope, an Irish medical student in Edinburgh, William Stokes, published the first treatise on the use of the stethoscope in English. Returning to Ireland Stokes fought an uphill battle to introduce new methods of physical diagnosis. His son recalls his father telling him that when he “along with Robert Graves, [promoted] the methods of physical diagnosis advocated by Laënnec and Louis, he was ridiculed, satirized and even caricatured, by his contemporaries”.

 

 

Despite the slow start the stethoscope gained wide spread acceptance by the middle of the 19th century, and improvements were soon being made to the design. In 1851 Arthur Leared exhibited his design for a bi-aural stethoscope at the Great Exhibition, constructed using gutta-percha tubes. Leared was born in Wexford in 1822, and was educated at Trinity College, Dublin.  Leared practiced medicine in London, where he made many contributions to gastroenterology, and was physicians at the British Civil Hospital at Smyrna during the Crimean War. He travelled extensively and published several accounts of his experiences. He failed, however, to take steps to realise the commercial potential of his bi-aural stethoscope. In 1856 while the American doctors Marsh and Camman argued in print over who had invented the instrument first, Leared wrote to The Lancet to point out his prior claim.