The Honest Truth: It listens to what your body says, so let’s hear it for the stethoscope

A vital device for healthcare professionals, one instrument has come to be a recognised as a symbol of medicine itself.

Here, Professors Tom Rice and Anna Harris, authors of a new book on the history of the stethoscope, tell Laura Smith why it has become an icon.

What interested you in the stethoscope’s history?

The stethoscope is such a taken-for-granted object in medicine, both as an icon and also as a technology. And yet it is mysterious, too. What is a doctor listening to? How did it come to look like it does? What will be its relevance as more digital technologies enter the clinic?

When was the stethoscope first invented?

The accepted story is that the inventor was Rene Laennec, a French physician. He claimed that one day in 1816 he was walking near his hospital when he saw some children playing with a log, tapping out messages to each other. He was inspired to listen to his patients and initially used a rolled-up stack of paper, so the first stethoscope was essentially a paper tube.

Has the design and purpose changed over time?

Most significantly, from being a single tube to the two tubes that we are now mostly familiar with. There have also been alterations in regards to digitisation, materials of which it is made, and how it is connected to other technologies. The purpose of the stethoscope has also stayed the same in some respects – as a way to listen to patients’ bodily sounds – but it has also changed from becoming a controversial new and exciting technology in the 19th Century, to something that is now considered part of a more traditional approach to medicine, which involves listening, touching and spending time with patients.

Has it transformed diagnosis?

It transformed the way doctors thought about bodies, opening up the interior of living, breathing patients. It also took listening to patients in a new direction. Before, doctors listened to patients’ stories mostly for clues to diagnosis. Now they could also listen with their stethoscopes, to what they often considered more “objective” signs of disease.

What do you think makes the instrument so iconic?

Many professions have a tool of their trade that marks them out from others. For a long time for doctors this was the stethoscope. That has changed. And others, like mechanics and vets, use the stethoscope too, however the imagery has lingered.

Has it held any other uses outside medicine?

It has been used in wartime to listen for the sounds of enemy tunnelling, or by burglers to break into safes. Poets and novelists have seized on the instrument too as a metaphor for close and careful attention to the heart as a seat of feeling and emotion. Mechanics used the stethoscope to diagnose problems with cars.

You say the stethoscope “represents a human and humane type of medicine, that some perceive to be under threat” – can you explain what you mean?

There is an image in the book of Canadian physician William Osler at a bedside, carefully listening with his stethoscope, spending time with his patient. This is a way of practising medicine that many see being threatened by machines, in the sense that doctors now spend so much time looking at screens and not with patients. It is also threatened by hospitals and clinics on the brink, due to cuts in healthcare spending and work overload.

Could it become obsolete?

The stethoscope is unlikely to disappear from medicine as it has become part of the clinical toolkit and patients expect to see it used as part of their care.

The fact it is a simple and low-cost diagnostic device that is easy to make and easy to use (at least for basic tasks) could also ensure its ongoing relevance.

Any interesting facts?

In the 19th Century, a type of small stethoscope was designed so it could be clipped to the inside of a top hat, and in 1879 an Edinburgh medical student was accused of possessing a dangerous weapon when his stethoscope fell from his top hat during a snowball fight.

It is now also possible to 3D-print a stethoscope, and this can be done for $5.

That means stethoscopes can be distributed to places where medical resources are very limited.

Stethoscope, Reaktion Books, £20