The stethoscope: celebration or cremation after 200 years?

The stethoscope is currently at the crossroads. For two centuries now, the stethoscope has been a central part of examining the thorax. Nevertheless, this omnipresent tool of the medical profession (‘conversation piece’) is at the heart of the debate over how diagnostic medicine should be practised. At the moment, there are many divergent views on the value of using the stethoscope as a primary diagnostic tool for clinical investigation [1–3]. “The stethoscope is dead and its time has gone”, according to Dr. Jagat Narula, cardiologist at the Icahn School of Medicine at Mount Sinai Hospital in New York (Washington Post, 2 January 2016). This view is opposed by Dr. W. Reid Thompson, paediatrician at Johns Hopkins University School of Medicine (Baltimore, USA), who clearly stated that listening to sounds of the body will remain valuable. Since its introduction in 1816, the stethoscope has been an indispensable bedside approach for listening to heart sounds. The French physician Dr. René Laennec, working at Necker-Enfants Malades Hospital in Paris, can be considered the ‘father’ of the stethoscope. At that time, Laennec introduced a cylindrical device, open at each end, to auscultate the thorax. He called his instrument a stethoscope, whose name is derived from the Greek words stethos, i. e. chest, and skopeo i. e. to look at (observe). Over the years, the cylindrical stethoscope was modified – after the introduction of rubber – by a device that had hearing pieces fitting into the physician’s ears. Other advancements were the introduction of the bell to recognise low-pitched sounds,