The stethoscope. It’s iconic. You’re playing Pictionary and you pull the “doctor” card? Easy – sketch a stethoscope. Need a last-minute Halloween costume? Easy – throw a stethoscope around your shoulders. Google image search “doctor” and you can count the number of stethoscope-less doctors on one hand. How did this instrument become so emblematic of the field of medicine? What can it tell us about our heart and lungs? And is its future under threat? That’s where this episode comes in. We explore the invention, evolution, and application of this tool, from the tragic life story of its inventor to the surprising amount of controversy over whether the stethoscope still holds a place in medicine today. Tune in for all this and so much more, including a doctor’s-ear perspective of the heart and lungs, complete with all the heart and lung sounds you could want!
| History | Biology |
| Bishop, P. J. “Evolution of the stethoscope.” Journal of the Royal Society of Medicine 73.6 (1980): 448-456. | https://www.med.umich.edu/lrc/psb_open/html/repo/primer_heartsound/primer_heartsound.html |
| Coues, William Pearce. “Laennec, the Man—1781–1826.” The Boston Medical and Surgical Journal 195.5 (1926): 208-211. | Lung sounds recordings: Rocha, B.M., Filos, D., Mendes, L., Vogiatzis, I., Perantoni, E., Kaimakamis, E., Natsiavas, P., Oliveira, A., Jácome, C., Marques, A. and Paiva, R.P., 2018. Α respiratory sound database for the development of automated classification. In Precision Medicine Powered by pHealth and Connected Health: ICBHI 2017, Thessaloniki, Greece, 18-21 November 2017 (pp. 33-37). Springer Singapore. Available at: https://bhichallenge.med.auth.gr/ |
| Lethbridge, Robert, and Mark L. Everard. “The stethoscope: Historical considerations.” Breath Sounds: From Basic Science to Clinical Practice (2018): 15-31. | Heart sounds recordings: Liu, C., Springer, D., Li, Q., Moody, B., Juan, R.A., Chorro, F.J., Castells, F., Roig, J.M., Silva, I., Johnson, A.E. and Syed, Z., 2016. An open access database for the evaluation of heart sound algorithms. Physiological measurement, 37(12), p.2181. Available at: https://archive.physionet.org/physiobank/database/challenge/2016/ as part of the project PhysioNet: Goldberger, A.L., Amaral, L.A., Glass, L., Hausdorff, J.M., Ivanov, P.C., Mark, R.G., Mietus, J.E., Moody, G.B., Peng, C.K. and Stanley, H.E., 2000. PhysioBank, PhysioToolkit, and PhysioNet: components of a new research resource for complex physiologic signals. circulation, 101(23), pp.e215-e220. |
| Longtin, Yves, et al. “Contamination of stethoscopes and physicians’ hands after a physical examination.” Mayo Clinic Proceedings. Vol. 89. No. 3. Elsevier, 2014. | Bohadana, A., Izbicki, G. and Kraman, S.S., 2014. Fundamentals of lung auscultation. New England Journal of Medicine, 370(8), pp.744-751. |
| Murphy, Raymond LH. “In defense of the stethoscope.” Respiratory care 53.3 (2008): 355-369. | Walker, H.K., Hall, W.D. and Hurst, J.W., 1990. Clinical methods: the history, physical, and laboratory examinations. |
| Reinhart, Richard A. “The stethoscope in 19th-century American practice: ideas, rhetoric, and eventual adoption.” Canadian Bulletin of Medical History 37.1 (2020): 50-87. | Swarup, S. and Makaryus, A.N., 2018. Digital stethoscope: technology update. Medical Devices: Evidence and Research, pp.29-36. |
| Reiser, Stanley Joel. “The medical influence of the stethoscope.” Scientific American 240.2 (1979): 148-157. | Reiser, S.J., 1979. The medical influence of the stethoscope. Scientific American, 240(2), pp.148-157. |
| Rosenthal, Robert L. “Throw the stethoscope away: a historical essay.” American Journal of Cardiology 111.12 (2013): 1823-1828. | Murphy, R.L., 2008. In defense of the stethoscope. Respiratory care, 53(3), pp.355-369. |
| Syers, H. W. “THE DECAY OF AUSCULTATION AND THE USE OF THE BINAURAL STETHOSCOPE.” The Lancet 159.4093 (1902): 369-370. | Yang, C., Zhang, W., Pang, Z., Zhang, J., Zou, D., Zhang, X., Guo, S., Wan, J., Wang, K. and Pang, W., 2021. A low-cost, ear-contactless electronic stethoscope powered by Raspberry Pi for auscultation of patients with COVID-19: prototype development and feasibility study. JMIR Medical Informatics, 9(1), p.e22753. |
| Vincent, Rony. “I look into the chest: History and evolution of stethoscope.” Journal of the Practice of Cardiovascular Sciences 8.3 (2022): 168-173. | Falter, M., Gruwez, H. and Young, J., 2021. The future is more than a digital stethoscope. European Heart Journal-Digital Health, 2(4), pp.557-558. |
| Weitz, Howard H., and Salvatore Mangione. “In defense of the stethoscope and the bedside.” The American journal of medicine 108.8 (2000): 669-671. | Obermeyer, Z. and Emanuel, E.J., 2016. Predicting the future—big data, machine learning, and clinical medicine. New England Journal of Medicine, 375(13), pp.1216-1219. |
| Solomon, S.D. and Saldana, F., 2014. Point-of-care ultrasound in medical education—stop listening and look. New England Journal of Medicine, 370(12), pp.1083-1085. |
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One thought on “Episode 151 Stethoscope: Lub dub”
Re: Episode 151 – my unsolicited opinion… as someone who has had asthma since I was 18 months old, so 48 years and a heart murmur, the only thing that bothers me is the number of times that a doctor has listened to my lungs (when I am having a problem) and said “Well, your lungs are clear!” Great I don’t have pneumonia, but that doesn’t account for the fact that I cannot breathe, that can feel the crackle in my lungs and that, at times, I can actual taste an “infection?” – foul taste when I cough up air out of my lungs. I have even had a Dr tell me that I don’t have an infection because he’s right 90% of the time. What? Anyway love your podcasts, they never fail to intrigue and make me think!