Getting a Hearing at TJU: Early Stethoscope Collection
A search under keyword "auscultation" Jefferson’s online library catalog will offer up a recent (© 2000) item, Heart & lung sounds workshop [sound recording], created and presented by Salvatore Mangione, MD. Dr. Mangione is a JMC graduate and faculty member in a clinical tradition linking him back to the inventor of the stethoscope himself.
Since ancient times, health care givers have listened to patients’ body sounds, by "immediate" auscultation -- that is, the doctor’s ear to the patient’s torso. The limits of this technique were augmented in the mid-18th century by percussion, a clinical method devised by Joseph Leopold Auenbrugger (1722-1809), who built on the knowledge of his innkeeper father’s practice of rapping on kegs and barrels and listening to the sounds of different liquid levels.
Credited with the invention of the monaural stethoscope, René Théophile Hyacinthe Laënnec (1781-1826) recorded that in 1816, dissatisfied with the results of percussion and ’immediate’ auscultation, he used a rolled-up newspaper and then a tube of sturdy papier-mâché to assist in his diagnoses.
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| Austin Flint, Jr. (1836-1915), famous physiologist and graduate of JMC 1857. |
This French physician published his clinical findings in 1819, De L’Auscultation Mediate. Included in this landmark work (a rare first edition is held in TJU’s Archives and Special Collections) are illustrations on "how-to" make your own improved wooden "tube" ("le cylinder").
One of Laënnec’s followers, James Jackson (1777-1868), trained Austin Flint, Sr., a Harvard physician, in the use of this new technology. Flint joined the JMC faculty for one year, 1843-1844, as Professor of Medicine. Flint made several important contributions to the knowledge of diseases of the heart and the respiratory system and coined the term "bronchio-vascular breathing." Flint popularized the binaural stethoscope in the U.S. in his Treatise on the Principles and Practice of Medicine (1866) and made so profound an impact on medicine he is known as "the American Laënnec."
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| Selection of monaural stethoscopes from Archives & Special Collections, Scott Memorial Library. A Laënnec instrument, donated by Dr. P. Brooke Bland (JMC 1901), is displayed horizontally. |
Although his stay at JMC was short, Flint’s son, Austin, Jr. (1836-1915), attended JMC and graduated in 1857 (his thesis was titled "Phenomena of the Capillary Circulation").
The younger Austin was a prolific writer and one of his many textbooks, A Manual of Auscultation and Percussion (5th ed., 1890), was edited by fellow a Jeffersonian, J.C. Wilson.
The many developmental advances of the modern binaural stethoscope focused on a flexible tube adaptation. The Archives and Special Collections hold several valuable monaural stethoscopes, dating from the early 19th century to the late 20th century. The fact that monaural instruments are still currently being used worldwide demonstrates the longevity of the invention.
For further reading:
WB 26 B645E 2002
An ear to the chest : an illustrated history of the evolution of the stethoscope.
Blaufox, M. Donald.