Name/Title
HISTORY OF THE STETHOSCOPEEntry/Object ID
2020.19.56Description
The Amazing Evolution of the Stethoscope
by Matthew Huh
The Stethoscope is most likely the most recognizable and best instrument representing the physician. Over the years, the number and sheer variety have been astounding. Just in the US alone, there have been 318 patents related to the stethoscope during 1976-2000. Modifications for the stethoscope, like most medical instruments, relied on trial and error. However, it was the industrial revolution which provided the momentum for perfecting the instrument. For example, Charles Goodyear invented the process to make vulcanized rubber in 1839. John Dunlop, a veterinary surgeon, invented tubing and then tires for his son's tricycle in 1887. These paved the way for the manufacturing of specialized rubber tubing. The stethoscope transformed from a rigid one to a flexible one. In 1928, Dupont introduced nylon and plastics. All these milestones paved the way for further modifications to transform the stethoscope into the modern day stethoscope that physicians use today.
The relatively modern final product, whichever the shape and length, or material, evolved to have the following key components: ear piece, head piece and chest piece. The ear piece consisted of small tips which were placed in the ear canal. The head piece was the portion that connected the tubing to the ear piece with a rigid metal part. The chest piece was the end that was applied to the body.
Prior to the invention of the stethoscope, examination relied on immediate auscultation, which was essentially placing an ear right on the patient’s chest and listening directly to the heart and lungs. Another option was percussion, which consisted of tapping on the chest or back and listening to the resulting sound, a method developed by Joseph Leopold Auenbrugger, an Austrian physician. Interestingly, his father was an innkeeper who tapped on wine barrels to determine their fullness.
The story of the evolution of the stethoscope began with Hippocrates, the father of Medicine, in 350 BCE, where he attempts to hone his skills of auscultation by noting the "succussion splash." This hippocratic succussion consisted of shaking the patient and listening to the patient's thorax to "hear" the empyema, a collection of pus and fluid in the lung cavity. Fortunately for patients, medical diagnosis evolved to become much less traumatic. By the 20th century, the stethoscope became an indispensable tool. Despite all of the improvements and changes through the years, the stethoscope continues to serve the basic principle behind it, which is to provide clinicians a way to perform auscultation and identify specific sounds to aid in diagnosis.