Stethoscopes and Breasts

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Pioneer. Doctor. Inventor. Terrified of boobs.

Our society is utterly fascinated by breasts. The reasons for which are beyond me, but these strange fleshy and bulbous protuberances quite possess our public conscience and hind-brains like no other bodily formation. Women of means practically bisect themselves with incapacitating corsets to push and squeeze them this way and that, while men will almost walk into traffic to catch a quick glimpse of the peculiar lumps of tissue. Even evolutionary speaking they serve no purpose (breasts that is, not men – although this is debatable), as most animal species lactate quite adequately despite not having mammary glands of any significant size.

However, it turns out that they have provided some use to our species and human medicine after all, and were it not for a rather sizable set belonging to a young lady suffering from an unspecified heart condition, we might not have had at our disposal the most valuable and revolutionary diagnostic tool of modern times – the stethoscope.

L0012064 Monaural stethoscope; Laennec type.
Early stethoscope – or a telescope. Or kaleidoscope. One of these. Or all three!

René-Théophile-Hyacinthe Laennec (pronounced ‘leh-neck‘) was a devout, diminutive, but brilliant doctor, born in Brittany in 1781. Tubercular his entire life, and perhaps consequently fearing an early demise, he nevertheless managed to accomplish a prodigious catalog of achievements, among them the discovery of peritonitis, disease of the abdomen, and cirrhosis, the common ailment of the liver and bane of chronic alcoholics everywhere.

It’s important to note that medical diagnoses as it related to the organs themselves was still a very new concept. Prior to pioneers like Laennec, Corvisart and the like, the previous several thousand years had seen ill-health attributed to anything from an annoyed deity to malignant air, with everything else blamed on the ubiquitous humors. Even Laennec’s own ailment, tuberculosis, was known as ‘consumption’, named for the symptoms rather than the cause. Things began to change at the end of the 18th century and trained doctors of medicine were encouraged to carefully examine a patient, and once the poor victim inevitably snuffed it, follow the corpse to the dissection slab to find the root cause – this was the birth of what is now known as pathological anatomy.

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“Hey, that weird doctor is coming round again. Breathe heavy, it totally ruins his concentration…”

But what about the breasts! I was told there would be breasts, I hear you cry. Calm down. I’m getting to it.

Before the stethoscope was invented, early diagnoses of lung issues were done via percussion – heavy tapping of the fingers against the sternum (more on this another time) and for heart issues, one would listen by placing the ear against the chest.

One day in 1816, recently appointed head of surgery René Laennec was conducting one of his Grand Tours, the colloquial term ascribed to the new method of training and assessment, where students would follow qualified doctors from bedside to bedside to examine the sick and determine the symptoms and possible treatment (emphasis on the word possible). With his entourage in tow, Laennec approached one such patient, a beautiful and extremely buxom young woman with an as yet un-diagnosed malady of the heart.

Laennec’s middle name was ‘Hyacinth’ and his delicate demeanor more than met this title. Utterly unwilling to put his ear anywhere near her heaving bosom, despite the failing cardiac muscle beneath, he became flustered and embarrassed, and moved swiftly on to the next patient. The poor man was about as inexperienced with the fairer sex as you can get, yet later on in the day, clearly still concerned for the patient, he struck upon an idea.

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Thanks to one man’s aversion to these only when the owner was alive, we have the stethoscope….

Rushing back to the subject, he rolled up a paper tube, placing one end against her chest and the other end to his ear. He found to his delight and relief, that not only could he hear her heart, but the palpitations and rhythm were more audible than would be allowed with the ear alone. He was saved from immodesty and had invented the stethoscope at the same time. Laennec himself writes in his 1819 publication:

“The other method just mentioned [direct auscultation] being rendered inadmissible by the age and sex of the patient, I happened to recollect a simple and well-known fact in acoustics, […] and was not a little surprised and pleased to find that I could thereby perceive the action of the heart in a manner much more clear and distinct than I had ever been able to do by the immediate application of my ear.”

Laennec engineered and created a wooden multi-part stethoscope tube and sold many of them, making them on his own wood-lathe, the design of which became the staple for over a century until modifications involving rubber tubing were introduced – to the dismay of many doctors I presume, no longer able to places their faces as near to vulnerable patients as before.

And so it appears that we have much to thank this specific external anatomical feature of the fairer sex – not to mention Laennec’s embarrassment towards it  – for not only raising the blood pressures of mankind, but helping diagnose the ailments of the faulty blood-pump itself.

Sources available on request.

This article was first published on May 15th 2015 in The Pandora Society

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