The history of the method of auscultation
Diagnostic research method of sounds that occur in the body. Description of the method of auscultation the french scientist R. Laennec. The invention of the stethoscope and modern microstethophone. Advantages and disadvantages of flexible stethoscope.
| Рубрика | Медицина |
| Вид | доклад |
| Язык | английский |
| Дата добавления | 10.03.2013 |
| Размер файла | 2,3 M |
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MEDICAL UNIVERSITY ASTANA
REPORT
Theme: The history of the method of auscultation
Done by: Artykbayeva A.
346 GM
ASTANA - 2012
Auscultation (auscultare - hear, hear) - a method of investigation by the perception of sounds that arise naturally in the body, which are perceived by directly or indirectly - with the help of a solid body - contact our ear to the surface of the body. Hearing voices, coughing, sneezing, noisy breathing, wheezing, rumbling in the gut and other sounds, audible at a distance, not a method of auscultation.
Listening to the sounds that occur within our body, used for diagnostic purposes in the past. Thus, in the writings of Hippocrates, there are references to the noise pleural friction, noise splashing in the pleural cavity, rales in the lungs. At the beginning of our era, of course, be able to listen to the noise and the heart. But then one and a half thousand years listening played no role in the study patients.
Diagnostic method is only through listening french scientist Rene Laennec (1781-1826), who was a gifted clinician, pathologist and professor at the medical school in Paris. In 1819 he published a work entitled "The mediocre auscultation or recognition of disease of the lungs and heart, which is based mainly on this new method of research," in which he laid the foundation of modern auscultation and so it worked out that the basic principles are the same.
But enough words. Nothing so helps to understand the past, does not help to breathe its air, as viewing household sketches of the time.
Let's take a closer look at the picture
sound body auscultation stethoscope
Here an unknown artist depicted a scene auscultation seriously ill in hospital. Please note: the doctor in boots, no coat, though the surrounding staff dressed in white robes. There is evidence that Dr. depicts the Laennec.
Now, with the words of Laennec, it was so. It is already quite well-known Paris physician invited to visit a young lady high society: a malaise. He came, as usual, probably just like the doctor in the first image, started the survey, would lean his ear to her chest to hold auscultation, but prim and proper lady pushed him and said it would not allow any man, even a doctor, to touch her chest. Laennec confused, blushed. We had to somehow come out of a delicate situation, "save face." That's when he thought of the notebook, which for the record carried. He rolled up the book tube, one end leaning against the chest, while the other leaned against the ear. To his surprise, he clearly heard and breath and wheezing, as never before. He realized that by chance, made a discovery. Laennec temporarily abandoned the practice and the time devoted to the study of auscultation. Invented the stethoscope. A few years later (1816) he will bring to the court colleagues huge tome: "Auscultation". In it he describes in detail the methodology and successfully auscultation auscultatory phenomena and all that in the future for almost 2 centuries little has been added. Here we can mention only Gey, who said the physical essence of auscultatory symptoms, and Czech Skoda researcher who created modern microstethophone.
In this photo shows a collection of stethoscopes collected physician-collector in the 19th century. Apparently, stethoscopes are not on the date of their creation, as the oldest stethoscope - a tube without socket is placed in the center. It also placed microstethophone Skoda.
Consultation of doctors while listening patient with a special device. See how easy it is witty and designed.
The name was given by Laennec stethoscope. His stethoscope initially resembled paper parcel. It was a hollow wooden tube length of 33 cm of the same diameter throughout, which parses the middle. Modification of the original form going in different directions: the thinning of the tube, shortening it more convenient device ear the end, the use of different materials for the tube.
The stethoscope is a cylindrical tube. The wide part is most of the funnel-shaped form and is applied to the ear, and a narrower, so called bell stethoscope - the body of a patient. Stethoscopes are made of different materials: wood, metal, ivory, plastic. Subsequently, instead of solid stethoscopes were offered a flexible, first recommended Filatov. Thus from the usual bell stethoscope are two rubber tubes, the ends of which are inserted into the ears of the researcher. Finally, the last modification stethoscope on his breast the end, put it in the accession arrangements for resonance to enhance the sound effects. So there were various forms of stethoscope. First simple, when the end of the stethoscope chest was fitted with a rubber membrane and are more complex when the final part of the stethoscope is a metal cavity, covered with a membrane. Sound phenomena occurring in a particular organ, transferred to a membrane, which comes in the swing. The cavity, covered with the membrane, and the theory of resonance amplifies the sound. Sometimes the classroom use multifonendoskop.
In principle, the term stethoscope, this Laennec, did not accurately reflect the purpose of this device, as it comes from two words - stethos - chest and scopeo - look. Dignity flexible stethoscope two things: ease of research for the doctor and for the patient and greater amplification. They almost do not change the character of natural sounds and give a little side noise. The disadvantage is a significant change in the natural character of sounds and a lot of background noise can easily arise. They are inconvenient for the physician and the patient and their use tiring.
Finally, here are two photos that reflect modern technology auscultation.
First picture: the initial period of training of students at Yale University (USA).
Second image: a consultation at the bedside at Columbia University (USA).
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