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In 1816, when a young French physician Rene Theophile Hyacinthe Laennec fashioned a paper tube out of 24 sheets of paper and used it to hear voices from a patient's chest, a new era in medical diagnosis was inaugurated. For, Laennec's tube was actually the progenitor of the modern stethoscope, which physicians in coming years would use to probe into patient's organs and orifices and find out exact causes of diseases -- rather than react passively to a sufferer's complaints.
Laennec's tube was based on the simple principle that sound travels through solids. The principle had in the past inspired Chinese and Persians to use wooden tubes made from walnut trees to hear sounds from organs of the sick. In India, Ayurvedic healers sometimes used long glass tubes for the same purpose. Lannaec himself was inspired into making the device after watching urchins in Paris amplify sounds made by scratching a pin through a wooden beam. The doctor, along with his friend G L Bayle, was then serving at the Necker Hospital in Paris. A terrible tuberculosis epidemic had hit the city but physicians could do no more than conduct autopsies on the dead; the new tube would now help them identify the scourge by examining a diseased's chest.
Laennec further developed this simple device. He set up a small shop in his home, with a wood-turning lathe and created a stethoscope from a turned piece of wood, hollow in the centre. It was made of two pieces. One end had a hole to place against the ear, and the other was hollowed out into a cone. There was a third piece that fit into this cone which had a hollow brass cylinder placed inside it. This piece was placed in the stethoscope to listen to sounds from the heart, and removed when lungs had to be examined.
Interestingly, Laennec preferred to have his instrument simply called "Le Cylindre," as he thought naming such a fundamental instrument was unnecessary. In fact he quite resented the names given by his colleagues, and decided that if anything, it should be called the "stethoscope," which is derived from two words Greek words: 'I see,' and 'the chest.' The doctor continued his researches on the device till his death in 1826 -- quite ironically to tuberculosis.
In the nineteenth-century, many European and American physician-inventors improved on Lannaec's discovery. Many of them had vested interest s in promoting the use and enhancing the usefulness of the stethoscope: it accorded them professional recognition. Some were also motivated by the promise of profits if their version proved popular with practitioners. There were several compelling innovations, however. Some medical inventors used new materials such as India rubber, while others created more-elaborate paths to carry sound from the patient's chest to the ear. George Camman, a New York City physician, combined these approaches in 1855, when he developed the first practical binaural stethoscope that transmitted sound to both ears. In 1872, using Camman's modification, Louis Ferrai, a Paris-based physician wrote an account on different sounds that were characteristic of tuberculosis, asthma and other common ailments associated with soot cleaners and textile workers. In 1926, after several decades of mostly minor modifications, Boston cardiologist Howard Sprague reported an innovation that would define the "modern" stethoscope: he combined "bell" and "diaphragm" chest pieces into one unit that allowed the listener to selectively hear low-and high-pitched sounds. The invention was advertised in dailies and tabloids in London, New York and Amsterdam and the device became quite popular.
After enduring for over almost two hundred years, the stethoscope is now giving way to computerised machines that record and analyse the conditions of organs within minutes. Those who swear by these gadgets say they reduce errors. Others lament the decline of "stethoscopists" -- clinicians who were virtuosos of the instrument. Machines have taken over and will think for clinicians. But the humble stethoscope's contribution will never be forgotten.