Terms Explained: what is auscultation?

Photo by Kristine Wook on Unsplash

What do bats have to do with a 19th century French doctor who thought his patient was attractive? They both use AUSCULTATION.

To auscultate is to listen to someone’s organs as part of a medical exam.

This strategy goes way back. As early as the Egyptian physicians in the 17th century BC, physicians were performing “immediate auscultation” – the act of listening to organs by placing their ear as near the organ as possible. But things got a lot easier in the 1800s, due perhaps to some good-old-fashioned Catholic guilt.

French Catholic physician Rene Theophile Hyacinthe Laënnec was out walking one day when he saw two children playing together; one scratched a pin on one end of a long piece of wood while the other listened to it. Later, a woman came to Dr. Laënnec complaining of heart problems. Standard procedure at the time for doctors was to perform immediate auscultation – listen to the patient’s heart by putting their ear as close to the heart as possible. Because the woman was young, attractive, and large-busted, Dr. Laënnec was embarrassed to put his head to her chest to listen to her heart, and as an alternative – recalling the children playing –, he was struck with the idea for the stethoscope.

When he tried this form of “mediate auscultation”, he realized he could hear the patient’s heart better than he could with immediate auscultation. After years of research and refining his invention, he published the first widely recognized book on auscultation (for more, check out this fascinating article). Since then, stethoscopes have become ubiquitous in medical practice – “at the center of patient care” and “a symbol of the physician-patient relationship”. And they’ve gotten fancier, too, such that some now “include sound visualization, ambient noise reduction/cancellation, Bluetooth (Bluetooth SIG Inc, Kirkland, Wash) transmission, and computer algorithm diagnostic support”.

The other common tool to use for auscultation, particularly of fetal heartbeats, is a Doppler ultrasound. This tool uses sound waves to identify the movements of different blood vessels, very similar to how a bat identifies where bugs are flying by using echolocation. If you want to learn more about Doppler and other kinds of ultrasound, check out this fascinating Stuff You Should Know episode on the topic; keep in mind before playing this that the two hosts talk briefly about one’s experience with miscarriage.

If you want to hear what doctors hear when they perform auscultation, check out this website. And if you have questions about what a doctor is doing when they offer to perform an auscultation for you, remember you always have the right to ask for clarification and explanation.

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