George Phillip Cammann (1804-1863): A physician's contribution to the modern stethoscope and auscultatory percussion

In the middle third of the 19th century, George Phillip Cammann became known for the stethoscope improvement that came to bear his name and for the development of the then-popular diagnostic technique of auscultatory percussion. During his postgraduate training at the Paris hospitals in 1828-1830, he acquired a special interest in auscultation while attending lectures given by a friend and colleague of Laennec's, French physician Pierre-Charles-Alexandre Louis (1787-1872). In his New York City practice, caring primarily for the working poor, he recognized the need for a better stethoscope and developed a modification that came to bear his name. He conducted research aimed at increasing the accuracy of physical diagnosis by improving and reporting on the technique of auscultatory percussion. An examination of the medical literature, both textbooks and journals, reveals the extent of influence that Cammann had on clinical practice resulting from his contributions to the improvement of the stethoscope and auscultatory percussion.

The Stethoscope in 19th-Century American Practice: Ideas, Rhetoric, and Eventual Adoption

The stethoscope was invented in 1816 by the French physician R.T.H. Laennec, who, after three years of clinical observations, published his treatise Mediate Auscultation in 1819. In his treatise, Laennec included details of his new method of using the stethoscope to provide physiological and pathological evaluation of patients. American physicians attended lectures and clinics at Paris hospitals and carried this information back to their respective medical schools and practices. This was accomplished by a relatively limited number of elite American physicians who were able to take advantage of travel abroad and whose practices were academically affiliated. However, it is a well-substantiated historical claim that the adoption of the stethoscope by most American physicians was slow. There are many reasons for slow adoption of the stethoscope in America, among which are lack of formal education, including bedside training in the stethoscope, complexity of interpretation of auscultatory information, hesitancy of the patient and physician to have an instrument placed between them, and lack of opportunities for continuing education for physicians after leaving medical school. As the nineteenth century progressed, scientific ideas and rhetoric related to auscultation and the stethoscope became more widespread, reflecting gradual acceptance and adoption of the stethoscope by American practitioners. In this article, I examine the ideas and rhetoric in medical journal articles, advertisements, and medical school textbooks to learn what was thought by physicians to be important in their practice. Advertisement of medical school curricula with mention of specific course work or lectures related to auscultation or the stethoscope is noted, reflecting increased interest in the stethoscope as an adjunct to physical examination. This information introduces evidence to test and bolster the existing historical claims of slow adoption of the stethoscope by addressing in more detail when and why adoption by American physicians became widespread.

200th Anniversary of the Beginning of Clinical Application of the Laennec's Stethoscope in 1819

Although stethoscope was invented by French physician René-Théophile-Hyacinthe Laennec (1781-1826) in 1816, its wider clinical application started only after the publication of his book entitled De l'Auscultation Médiate ou Traité, du Diagnostic des Maladies des Poumons et du Coeur in 1819. Its invention coincided with the development of the 'hospital medicine' in the post-revolutionary Paris during the first quarter of the 19th century. It has enabled then contemporary physicians to explain the correlation between the patient symptoms and the clinical findings and thus has helped the shift from the humoral pathology towards the solitary pathology.

Akarnan: The Stethoscope and Making of Modern Ayurveda, Bengal, c. 1894-1952

The histories of modern medical technologies have largely been studied exclusively within the biomedical context. Yet historians of medicine have increasingly demonstrated that a number of non-biomedical therapeutic traditions-Ayurvedic and Chinese medicine to name only two-have attained their own distinctive modernity. How has the incorporation of various medical technologies affected these neo-traditional medicines? What is the relationship between technologies and the body knowledge in non-biomedical therapeutics? Do shared technologies such as the stethoscope reveal the same bodily facts in biomedical and Ayurvedic contexts? These are some of the questions explored in this article by focusing on the uptake of the stethoscope in modern Ayurvedic medicine in Bengal. In the process the article also describes the emergence of a new sonic body in modern Ayurveda.

The stethoscope - A 200th anniversary

René T.H. Laënnec was the man who designed the first monaural instrument for mediate auscultation. The invention became a medical breakthrough. An instrument capable of enhancing the subtle sounds created by the human heart and lungs. This evolutionary instrument also had the benefit of decreasing the oftentim s too direct bodily contact between the doctor and the patient. Laënnec carefully described the different sounds created by the human organs and attempted to link them to the post mortem findings. Even though many doctors were enthusiastic regarding this new medical breakthrough, the stethoscope also had its opponents, but John Forbes' English translation of Laënnec's De l'auscultation midiate as well as William Stokes' treatise on the use of the stethoscope spread the news to the medical world. In Denmark the stethoscope was introduced by Oluf Lundt Bang, S.M. Trier and E. Hornemann. The next step forward was the develop- ment of the binaural stethoscope by G.P. Camman in New York. The Littmann Electronic Stethoscope (3M Health Care) created by David Littmann is considered the leading product globally in this medical field. Digitization, ultrasound and Doppler effect, as well as 2D and 3D printing, are evidence of an on-going evolution within this field of medical equipment as we get ready to celebrate the stethoscopes 200th anniversary.

[Disputes and history of fetal heart monitoring]

The concept of fetal heart monitoring to determine the fetal wellbeing state has been employed for almost 300 years, but in the last 50 years it has observed drastic changes due to the incorporation of the electronic devices that has started controversy since the moment of its description and point of start. The purpose of this article is to mention the key points and controversial moments in the history of the cardiotocography

A historical vignette (21). A tribute to noise

A tribute to noise. Noise is not only the harmful waste of the world of sounds. Some noises have contributed, or continue to contribute, an added value in three fields at least: Internal Medicine, Audiology and Music. Moreover, they are perceived naturally by the ear (Figure 1).

[Development of the stethoscope from Laennec to Cammann]

A history of Stethoscope from Laennec to Camman through Piorry, Nauche, Louis, Landouzy (father), Commins, Williams, Stokes, Billing and Depaul.

The tale of an old stethoscope: from Mr Bampton (1816-65) to the British Thoracic Society

The stethoscope has long been a powerful symbol of the physician. This article describes a stethoscope that was presented as a prize to an outstanding student, Mr Bampton, by his eminent teacher Dr James Hope (1801-41) in 1837. The extraordinary journey of this prize stethoscope that eventually found its way to North Wales and into the hands of the Liverpool physician, Robert Coope (1892-1972), is outlined. Its subsequent importance and symbolism to the Thoracic Society and the British Thoracic Society is emphasized.

[Prenatal medicine: from the obstetric stethoscope to the computerized telecardiotocography]

The aim of this article is to illustrate the history of fetal auscultation from the 19(th) century, when the fetus was considered as an object and the obstetrician as a ''mechanic of the birth'', to the present age, when the fetus is a subject and the obstetricians have at their disposal all the means they need to confirm his well-being and to early diagnose his pathologies, even using prenatal telemedicine.

[The concise history of atrial fibrillation]

The author reviews the history of atrial fibrillation, the most common sustained cardiac arrhythmia. The chaotic irregularity of arterial pulse was clearly acknowledged by most of physicians of the ancient China, Egypt and Greece. William Harvey (1578-1657), who first described the circulatory system appropriately, was probably the first to describe fibrillation of the auricles in animals in 1628. The French "clinical pathologist", Jean Baptist de Sénac (1693-1770) was the first who assumed a correlation between "rebellious palpitation" and stenosis of the mitral valve. Robert Adams (1791-1875) also reported in 1827 the association of irregular pulses and mitral stenosis. The discovery of digitalis leaf in 1785 by William Withering (1741-1799) brought relief to patients with atrial fibrillation and congestive heart failure by reducing the ventricular rate. From an analysis of simultaneously recorded arterial and venous pressure curves, the Scottish Sir James Mackenzie (1853-11925) demonstrated that a presystolic wave cannot be seen during "pulsus irregularis perpetuus", a term very first used by Heinrich Ewald Hering (1866-1948). Arthur Cushny (1866-1926) noted the similarity between pulse curves in clinical "delirium cordis" and those in dogs with atrial fibrillation. The first human ECG depicting atrial fibrillation was published by Willem Einthoven (1860-1927) in 1906. The proof of a direct connection between absolute arrhythmia and atrial fibrillation was established by two Viennese physicians, Carl Julius Rothberger and Heinrich Winterberg in 1909. Sir Thomas Lewis (1881-1945), the father of modem electrocardiography, studied electrophysiological characteristics of atrial fibrillation and has shown that its basic perpetuating mechanism is circus movement of electrical impulse (re-entry). After him, the major discoveries relating to the pathophysiology and clinical features of atrial fibrillation in the 20th century stemmed from Karel Frederick Wenckebach (1864-1940), Gordon Moe (1915-1989), Bernhard Lown (*1921) and Maurits Allessie. Over the past ten years, awareness has increased of transcatheter radiofrequency and cryoablation of non-valvular atrial fibrillation and the battle against formation of intraatrial thrombi for preventing cerebral thromboembolism.

How Laënnec invented the stethoscope

Although it is well known that Laënnec invented the stethoscope, the story of how he invented it is less well known. This article discusses the many theories behind the story as well as the impact of Laënnec's discovery on the practice of cardiology in the 21st century.

Rene Theophile Hyacinthe Laënnec (1781-1826): the man behind the stethoscope

Rene Theophile Hyacinthe Laënnec (1781-1826) was a French physician who, in 1816, invented the stethoscope. Using this new instrument, he investigated the sounds made by the heart and lungs and determined that his diagnoses were supported by the observations made during autopsies. Laënnec later published the first seminal work on the use of listening to body sounds, De L'auscultation Mediate (On Mediate Auscultation). Laënnec is considered the father of clinical auscultation and wrote the first descriptions of bronchiectasis and cirrhosis and also classified pulmonary conditions such as pneumonia, bronchiectasis, pleurisy, emphysema, pneumothorax, phthisis and other lung diseases from the sounds he heard with his invention. Laënnec perfected the art of physical examination of the chest and introduced many clinical terms still used today.

[The anatomical-clinical conceptualisation of pulmonary tuberculosis in the work of Laennec]

The present study discusses the description of the tubercules of the lung which appeared in the 1826 edition of the treatise De l'auscultation mediate (1819) by Laennec, the author with Bayle of the first anatomo-clinical conceptualisation of pulmonary tuberculosis. Employing the analytical framework developed by Othmar Keel, the study investigates the interrelationships between two contemporaneous modes of interpreting the pathological evidence--the localist vision and the anatomo-pathological conception--in order to understand the influences of the surgical model upon the progress of anatomical, physiopathological, and tissue investigations by researchers such as Hunter and Bichat.

Cross your heart: Some historical comments about fibrinous pericarditis

This article briefly describes the origin of one of the more common (food-related) pathologic terms--"bread and butter pericarditis." The eminent French physician, Laennec, the inventor of the stethoscope amongst several other important medical contributions, can be credited for having coined the term that is still in common usage amongst pathologists.

The stethoscope: some preliminary investigations

Textbooks, clinicians, and medical teachers differ as to whether the stethoscope bell or diaphragm should be used for auscultating respiratory sounds at the chest wall. Logic and our results suggest that stethoscope diaphragms are more appropriate.

The prelude to stethoscopy: some French, British and Irish contributions in the early nineteenth century. 2002

In 1819, René Laënnec published his classical work on the newly invented stethoscope; this was translated into English by John Forbes in 1821. This article describes some of the early contributions by various authors in their attempts to link the new auscultatory signs to the underlying pathology in the thorax.