Conduct disorder

@eqko Ron~evi]
Will stethoscope survive?
René Théophile Hyacinthe Laennec (1781-1826) invented the stethoscope in 1816
and he personally gave the name to the instrument. The word comes from Greek
words stethos, meaning chest, and skopein, meaning to explore. He didn´t like
immediate auscultation (placing the doctor´s ear on the patient´s chest) and he was
happy that he can start with mediate auscultation using his new instrument. It
seems that he was a shy person and he was too emarrassed to place his ears directly
on a lady’s chest (1). Laennec described the invention (translated from French by
John Forbes, 1834): „ I recalled a well known acoustic phenomenon: if you place
your ear against one end of a wood beam the scratch of a pin at the other end is
distinctly audible. It occurred to me that this physical property might serve a useful
purpose in the case I was dealing with. I then tightly rolled a sheet of paper, one end
of which I placed over the precordium (chest) and my ear to the other. I was
surprised and elated to be able to hear the beating of her heart with far greater
clearness than I ever had with direct application of my ear. I immediately saw that
this might become an indispensable method for studying, not only the beating of the
heart, but all movements able of producing sound in the chest cavity “(2). After 3
years of testing various materials to create tube he decided to use a hollow tube of
wood, 25 cm long and 3,5 cm in diameter. He published his book De l´auscutlation
Médiate in 1819 without a big medical attention. It is interesting that this book was
sold at the price of 13 francs with stethoscope for an extra price of 3 francs (3). The
beginning of the stethoscope was not spectacular but year after year it becomes the
only one instrument common to all doctors and become a symbol of the profession.
Laennec stethoscope (or cylinder how he used to call the instrument) was
monoaural. Dr. George Philip Camman from New York in 1855 introduced the first
binaural stethoscope. Camman´s stethoscope was similar to modern acoustic
stethoscopes by having two tubes from the ear pieces extend to join a single bellshaped
chest piece (1).
Howard Sprague designed the first combination of bell and diaphragm chest piece in
1926. Later in 1940΄s, together with an engineer Maurice Rappaport, he improved
this kind of stethoscope which is in use even today. Dr. Aubrey Leatham, an English
cardiologist, designed in 1958 a combination diaphragm and bell stethoscope, with
incorporated a second much smaller bell inside the first. The smaller bell was
extended by a lever mechanism enabling auscultation of infants and children. Dr.
David Littmann, a cardiologist at West Roxbury Hospital in Massachusetts, designed
in 1961 a lightweight stethoscope, with a single tube binaural (4). Littmann
stethoscope becomes the most popular and even now it is probably most used
stethoscope among health professionals around the world.
Страна 28