On the differential stethoscope and its value in the diagnosis of diseases of the lungs and heart / by George L. Carrick.

  • Carrick, George L., 1840-1908.
Date:
[1873]
Catalogue details

Licence: Public Domain Mark

Credit: On the differential stethoscope and its value in the diagnosis of diseases of the lungs and heart / by George L. Carrick. Source: Wellcome Collection.

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    Dr Hughes Bennett1 of Edinburgh, and Dr Fuller2 of St George’s Hospital, London, have recently borne evidence to the great assistance in the diagnosis of pulmonary disease they have derived from the use of the differential stethoscope; while Dr Gairdner of Glasgow, so long ago as 1862, drew attention to the value of the instrument in detecting the seat of cardiac murmurs.3 Having enumerated the slight but real, and noticed the great but imaginary, disadvantages which the differential stethoscope presents when compared to the uniaural instrument, I shall bring this paper to a close. Before doing so, however, I have only to remark, that the opinions I have passed in regard to the differential stethoscope have been drawn solely from experience; and that when I first used the instrument, I endeavoured to test its value fairly and dispassionately. Thus, of the 550 cases of phthisis and other chest diseases that entered those wards of the Brompton Consumption Hospital, to which I was attached for six months as resident clinical assistant, I examined every case first with the uni¬ aural stethoscope only, and noted down the physical signs. The next day, I auscultated the patient with the differential stethoscope, and then compared notes, and often made out with the differential what I had missed with the ordinary instrument. Moreover, I enjoyed the privilege of having my diagnosis either corrected or confirmed by the physicians to the hospital, and by its resident medical officer. Since then I have used the differential stethoscope almost daily for the last eight years in several thousand cases of chest affection, and extended acquaintance with the instrument has only confirmed the favourable opinion I had formed of it after the first few trials. Indeed, I have such faith in it, that I feel I can never conscientiously pronounce an opinion on the condition of a patient’s lungs without having carefully examined them with the differential stethoscope. If I omit doing so, I know that I have not availed myself of a most important aid to diagnosis. Of course, it requires a little patience and time to master the instru¬ ment thoroughly, but then there is no instrument to which the same objection does not apply. Like all other stethoscopes, the differential one must be regarded as simply an aid to diagnosis, 1 A System of Medicine, vol. iii., article “ Phtliisis Pulmonalis,” by J. H. Bennett, M.D.; London, 1871, p. 565. 2 On Diseases of the Lungs and Air-passages, by H. W. Fuller, M.D. London, p. 75. ’ 3 In a work on diseases of the heart, by Professor Flint of New York, so recently published as 1870, and to which I have already had occasion to refer, no mention whatsoever is made of the differential stethoscope. There is little excuse for the author if, in 1870, he was not aware of the existence of Alison’s stethoscope; still less excuse if, being acquainted with the instrument, and having employed it, he withholds his opinion regarding its properties from his readers. For the same reason it is difficult to understand why Sir Thomas Watson, in the latest(fif th) edition of his “ Principles and Practice of Physic,” omits any reference to the differential stethoscope,—the more so, as his book professes to convey to his readers the newest methods of research up to the date of publication.