strument still more elegant and slender we have the modern stethoscope in endless variety, as in Fig. 5. It is thus very evident how the modern instrument has been framed out of the original block of wood which was made the counterpart of Laennec's roll of paper.
I know not who invented the instruments with flexible tubes, but I have no doubt that a search into medical history could tell us. I remember, however, that the first flexible stethoscope which I ever saw was the one depicted in Fig. 6, and used by Dr. Golding Bird when he saw out-patients in the year 1843. Being much crippled with rheumatism, and therefore not wishing to rise from his chair, he found
|Fig. 6.||Fig. 7.||Fig. 8.|
this instrument very convenient; he also was enabled to pass the earpiece to gentlemen standing near him, while he held the cup on the part to be examined. I always thought it was his own invention. But, whether so or not, I do not think any great effort of genius was required to frame a flexible instrument, and then adapt it for the use of one or two ears. This being done, the next step would be to make two mouth-pieces to apply to the chest at different spots. Various modifications of these instruments have been made of late years, but the first notice of them I have any knowledge of in my reading is to be found in a letter to the "Lancet" of August 29, 1829, by Mr. Comins, of Edinburgh, headed "A Flexible Stethoscope." This was only twelve years after Laennec's invention. It is difficult from his description to picture the instrument, but it seems to have been composed of jointed tubes, and made for two ears as well as one. Mr. Comins expresses his surprise that the discoverer of mediate auscultation did not suggest a flexible instrument, as he says "it can be used in the highest ranks of society without offending fastidious delicacy." A very interesting fact was first pointed out to me by Dr. Andrew Clark, with respect to a peculiarity of the binaural in the objective appreciation of sounds; that if each ear-piece be separately used, and