Our new female physicians assistant (PA) intrigued me by telling me she was “auscultating this guys scrotum” i.e., listening to it with her stethoscope.

This caught my attention. Partly because, I told her, we’re going to get a reputation as having a deviant PA on staff (I was of course ribbing her - and one of her charms is that she has a great sense of humor). But also because I seem to have got onto a history of medicine kick, and was just reading about the invention of the stethoscope.

The invention of the stethoscope is attributed to the French physician Rene Laennec in 1816. He had watched children playing a game with a hollow stick where they put their ear to one end, and scratched the other with a pin (don’t ask me why). It was noted that the stick conducted or even amplified the sound.

Later, he was consulted “by a young woman, laboring under general symptoms of diseased heart”. Sometimes you can get an idea of what’s wrong with somebodies heart by palpation and percussion - ie feeling the heart beat and tapping on the chest wall. But”percussion and application of the hand were of little avail on account of the great degree of fatness.”

To listen to someone’s heart in those days you had to apply your ear to the patient’s chest wall. But Laennec was obviously a modest fellow, and noted that use of this conventional method was  “rendered inadmissible by the age and sex of the patient.”

Inventive to the last, he “rolled a quire of paper into a kind of cylinder” (don’t ask me what a “quire” of paper is) and applied it to the lady’s heart. He 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.”

Viola, he had invented the stethoscope.

Our new PA was quite justified in auscletating this guys scrotum, she told me, because he had an inguinal hernia that was pushing down into his nether regions and she was listening for bowel sounds.

It may be that it was a good Laennec did invent the stethascope, and allow us to keep a modest distance from our patient.

Our new assistant applying her ear to suspect scrotums might be even greater grounds for claims of deviance.                                 

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