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Nothing identifies a doctor so readily as the stethoscope. It is the unmistakable tool of his trade, without which he would not seem fully or even partially equipped. But in fact the use of an instrument for listening to sounds in the chest (stethos) did not emerge until the beginning of the nineteenth century. Up until then, physicians had followed the example of the ancient Greek, Hippocrates, and listened to the sounds of the heart and lungs by placing an ear close to the chest - 'immediate auscultation', as it is called.

Then in 1816 Rene Laennec invented an instrument for mediate auscultation -listening with an intervening device -which revolutionized the whole procedure of diagnosing heart disorders. Initially he used a rolled tube of paper, later a hollow wooden cylinder. Although different in outward form from the modern instrument, with its flexible tubing and double earpiece, Laennec's device was basically the same as is used today. Indeed, the original, straight stethoscope is still used for certain tasks such as listening to the heart of the unborn baby.

However, the stethoscope in itself is not enough. To use it properly for diagnostic purposes requires clinical skill and knowledge.



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