A history of cardiac auscultation and some of its contributors

Before the 19th century, physicians could listen to the heart only by applying their ear directly to the chest. This “immediate auscultation” suffered from social and technical limitations, which resulted in its disfavor. With the invention of the stethoscope by Laennec in 1816, “mediate auscultation” became possible, introducing an exciting and practical new method of bedside examination. Over the past 2 centuries, many illustrious physicians have contributed to the understanding of cardiac auscultation by providing an explanation for the sounds and noises that are heard in the normal and diseased heart. This article traces the lives and achievements of those who have contributed importantly to cardiac auscultation. Auscultation remains a low cost, but still sophisticated procedure that intimately connects the physician to the patient and transfers that all-important clinical power known as “the laying on of the hands.” When used with skill, it may correctly determine whether more expensive testing should be ordered. In this way, the stethoscope deserves our continued respect and more attention as an indispensable aid for the evaluation of our patients.