Avoiding the Dead of Winter

The Dittrick Museum of Medical History is located in Northeast Ohio — an area known for harsh, long winters. After last year’s “Polar Vortex,” we dug into our collections to discover how 19th century physicians would advise how to protect ourselves from the dangers of falling temperatures.

Frontispiece from Taking Cold, 1873

Frontispiece from Taking Cold, 1873

A little text entitled Taking Cold: The Cause of Half Our Diseases (1873) by Dr. John Hayward outlines ways to maintain warmth and health. To the author, “Taking Cold” referred to being exposed to cold air, while catching “A Cold” was one of the many diseases this exposure could cause. In fact, the following preventative methods were vitally important as Hayward determined the origin of half the known 19th century diseases was such an exposure. Additionally, cold-caused diseases accounted for half the cases of illness and death the author attended to as a physician. Granted, Hayward only recognized ninety different diseases at the time his book was published.

Preventing “Taking Cold”

Caricature by George Cruikshank (1800)

Caricature by George Cruikshank (1800)

Clothing: Hayward warned readers that wearing improper or insufficient clothing could result in ill-health or death. For example, wearing “muslin and low-bodied dresses by ladies and thinner neckties, vests, and boots by gentlemen for evening parties” could leave an individual at risk for various maladies, such as tuberculosis, bronchitis, headache, or neuralgia.

To be safe in cold environments, the author advised adults and children constantly wear winter flannels, particularly at night. He specifically cautioned against exposing a child’s bare skin to changes in temperature. Unfortunately, the doctor was sure most people did not heed his clothing advice as “many a lovely child has been sacrificed to its mother’s pride and her tyrant, Fashion.”

Food: To avoid the dangers of cold, Hayward advised all individuals consume “flesh” once or twice a day and to never be exposed to the cold when hungry as the system was then “less resistant to evil influences.”

Etching by Cruikshank depicting the types of baths used in the "Cold Water Cure."

Etching by Cruikshank depicting the types of baths used in the “The Cold Water Cure.”

Baths: Interestingly, Hayward recommended daily cold baths to prevent the damaging effects of exposure to cold air. Following the principles of Hydropathy, these invigorating baths steeled the system against the perils of temperature variations and provided a variety of other health benefits. In fact, Joel Shew, author of Hydropathy, Or, the Water Cure (1851) recommended cold baths for the treatment a huge number of ailments, including rickets, gout, cancer, tuberculosis, and ague.

Respirator based on Jeffreys' Design from an 1890 Down Bros. Catalog.

Respirator based on Jeffreys’ Design from an 1890 Down Bros. Catalog.

Respirators: The final means of avoiding “taking cold” was to use a respirator before going out into the winter air or even just before entering colder rooms. Hayward recommended using the Jeffreys’ respirator to “warm the fresh air as it is being drawn into the lungs” by the action of breathing through layers of fine metallic wire.

The Last Resort

Understanding that not all of his readers would be able to completely avoid the cold, Hayward also provided information about “the antidote of taking cold,” a substance known as aconitine, or monkshood. Although still marginally used as an anti-fever herbal remedy, the toxic properties of the plant make frequent use a dangerous gamble. Thus, Hayward’s recommendation that “no person ought to be be without a bottle of this invaluable preventative, nor neglect to take it on the slightest suspicion of cold” is probably not the most sound advice. Best to stick to wearing many layers, cold baths, frequent meat-eating, and using a respirator.

About the Author:

Catherine Osborn, BA, BS, is a graduate student in Medical Anthropology at Case Western Reserve University, the Editorial Associate at Culture, Medicine and Psychiatry, as well as a Research Assistant at the Dittrick Museum of Medical History. She enjoys pursuing historical tangents and proving she can find almost any source online.


Down Brothers. 1890. Catalog of Surgical Instruments and Appliances. London.

Hayward, John. 1873. Taking Cold; (The Cause of Half Our Diseases): It’s Nature, Causes, Prevention, and Cure. E. Gould & Son, London.

Shew, Joel. 1851. Hydropathy, or The Water Cure; it’s Principles, Processes, and Modes of Treatment. Fowlers and Wells Publishers, New York City, NY.

The Stomach and its Discontents: Digesting the Winter Holidays

photo 1“One of the most uncomfortable beings on earth is a Dyspeptic. To most other invalids there is some hope of a change […] It will neither kill the patient nor depart from him. Hitherto, it has been more hopeless than a sentence of imprisonment for life.” –J.C. Eno, A Treatise on the Stomach and its Trials 1865.

For a number of people, the winter holidays coincide with family meals of increased size and frequency, an unaccustomed embarrassment of riches. (I recall family dinners of my youth wherein an entire table had been commandeered only for desserts, for instance.) But as with all good things, too much is the cause of various complaints–mostly to digestion.

A look at our historical collections might suggest to the casual reader that ailments of the stomach occupied our forebears more than anything else. The variety of tracts, treatises, books, warnings, cures, and quackery are matched only by the strange moralistic tenor of their presentation. The stomach made the man (and woman), apparently, and to be plagued by bad digestion was a more devilish thing, if we take Eno’s suggestion, than dphoto 2eath itself. What was a dyspectic to do?

The suggestions for cure might surprise and alarm you. Eno remained convinced that the secret to good digestion was proper nutrition, and what could be more nutritious than “raw meat jelly”? Milk and eggs were also highly recommended (let’s hope none of the patients were lactose intolerant). [1] Of course, J.C. Eno might not be the very best or most unbiased account. He was, after all, a manufacturer of digestive aids!

Some other useful anecdotes from the collection:

1. Remember to chew! From DIGESTION AND ITS DISORDERS, 1867, F.W. Pavy:

“Defective mastication, arising from a habit of too hastily eating–or bolting the food, or from a faulty condition of the masticatory organs, forms a frequent source of imperfect digestion.”  [2]

2. Always be mindful of those hard to digest items…again, not for the lactose intolerant. Or for the vegetarian, apparently. From ON PAIN AFTER FOOD, 1854, Edward Ballard:

“These observations show that vegetable substances generally are digested less readily than animal, and that inviducal articles, veal and pork are digested most slowly; mutton, beef, and fowl with greater rapidity; turkey, lamb, and young pig and potato still more readily; fish, milk, pearl barley and tapioca more quickly than these; and that gastric digestion was completed in the shortest time in the instances of rice, eggs, salmon, tripe and venison.” [3]

3. Moderation in all things! From THE STOMACH AND ITS TRIALS, 1865, J.C. Eno:

A Judicious Rule–1st, Restrain your appetite, and get always up from table with a desire to eat more; 2d, Do not touch anything that does not agree with your stomach, be it mot agreeable to the palate. As Burton says, ‘Excess of meat breedeth sickness, and gluttony causeth choleric diseases; by surfeiting many perish, but he that dieteth himself prolongeth his life.” [1]

4. Let us not get carried away, though… INDIGESTIONS, 1867, Thomas King Chambers:

“A few years ago, during the prevalence of the attention excited by Mr. Banting’s case [miraculous weight loss], I did indeed hear reports of persons having injured themselves by adopting with over-strictness the system by which that famous man tells us he regained the sight of his toes, forgetting that no similar mountain to his had ever impeded their view… The possible rectification of their circumference is not worth such stoicism, and they stop in good time.” [4]

So Happy New Year to all! May we digest these winter months with as much or more grace as our forebears (all “meat jelly” aside).

By Brandy Schillace, Research Associate, Guest Curator, Dittrick Museum


[1] Eno, J.C. The Stomach and its Trials. London, 1865.

[2] Pavy, F.W. A Treatise on the Function of Digestion; its disorders, and their treatment. London, 1867.

[3] Ballard, Edward. On Pain After Food, London, 1854

[4] Chambers, Thomas King. Indigestions; or Diseases of the Digestive Organs, Functionally Treated., London, 1867.


Tis the Season for Sneezin! Historical “Cures” for the Common Cold

photoThe temperatures are dropping; snow begins to fly. Soon, our thoughts are turned to hearth and home, warm drinks, good company, and holiday cheer. But nothing dampens the spirit like that other winter arrival: the common cold.

It has plagued us for centuries, and we’ve devised a lot of rather strange “cures” and even strange alleviations for symptoms. Lisa Smith provides some of the more elaborate ones in a post for the Sloane Letters Blog, including bleeding, blisters, and purging (as well as drinking milk for lung ailments!) Cookbooks also carried home remedies; the blog Jane Austen’s World provides an excerpt from The Compleat Housewife or, Accomplish’d Gentlewoman’s Companion, a 1753 cookbook compiled by Eliza Smith:

Take pearls, crab’s-eyes, red coral, white amber, burnt hartshorn, and oriental bezoar, of each half an ounce; the black tips of crabs-claws three ounces; make all into a paste, with a jelly of vipers, and roll it into little balls, which dry and keep for use. (See more)

One interesting work on the common cold–and the dangers of ignoring it–comes from the Dittrick rare book collection: A serious address on the dangerous consequences of neglecting common coughs and colds : with ample directions for the prevention cure of consumptions / the fourth edition. To which are added observations on the hooping [sic] cough and asthma, by Thomas Hayes in 1786.

As Hayes is quick to point out, “great numbers of persons of both sexes are afflicted every Winter with most dreadful colds” (5). He blames the common cold for “an annual loss of twenty thousand persons in the island of Great Britain” and wonders, given it’s terrible consequences, why more attention isn’t paid to the matter. The whole purpose of his essay, in fact, is to “convince the public of the danger of depending too much upon that fatal expectation”–that of getting better on their own (11). Let’s take a moment to see how Hayes work stacks up to our modern conception of the common cold, shall we?

1. Causes of the Cold

Hayes: A cold arises from the effect of cold or moist air, applied to the surface of the body and lungs, from going too thinly clad, or exposing the body to cold air, after having been heated by exercise; or, when the pores are opened from drinking warm liquors. (13)

Today, we understand that the common cold may actually be caused by any number of over 100 viruses, the rhinovirus being most prevalent. It enters the body by mouth, eyes, or nose, usually by touching commonly shared objects or by inhaling air infected with the droplets of someone else’s cough or sneeze. The cold, we now realize, does not cause colds, but we do see more infections in the winter. Why? Because we are in closer proximity to other people, the primary culprits for spreading the virus.

2. Symptoms of a Cold

Hayes: A Cold, then, is a sense of chilliness on the skin, attended with lassitude or weariness, and slight shivers at times, with a degree of headache and flying pains in the small of the back and limbs, a stuffing of the nose, frequent sneezing, and a running of clear limpid water from the eyes and nose, with or without a dry tickling cough, or hoarsness. Sometimes the sneezing, stuffing of the nose, or cough, give the first intelligence of its approach.  (19)

The symptoms, it seems, have not really changed much in the past few hundred years! The Mayo Clinic gives a list, but most of us could supply the same from experience:

  • Runny or stuffy nose
  • Itchy or sore throat
  • Cough
  • Congestion
  • Slight body aches or a mild headache
  • Sneezing
  • Watery eyes
  • Low-grade fever
  • Mild fatigue

Hayes also points out that left unattended, the cold may attack the lungs and become far more serious; the modern clinic will instead suggest that a worsening of symptoms means that you do not have a cold at all, but something much more serious (like a respiratory infection or flu).

3. The “Cure” for the Common Cold

Hayes: In curing colds, three things are essentially necessary; to open the obstructed pores; to discharge any irritating matter out of the constitution and to observe such a kind of diet […] conducive to recovery. (32).

The obstructed pores may be opened with heat, and with a variety of powders and tinctures (most of which sound rather alarming). Bathing in warm water and inhaling steam are also recommended and seem a bit more reasonable to the modern reader. These are to be followed by bleeding or purging, however, to remove the “bad” and make way for the good. But perhaps most interesting is the diet Hayes is pleased to recommend to patients suffering from cold.

To begin, he suggests limiting intake of any kind. To eat and drink: water-gruel, small pudding, rice, beer, linseed-tea, toast and apple-water. To correct the blood, boiled turnips, roasted apples, cauliflower, broccoli, lettuce, alfalfa (35). For a troubling cough, a “syrup of white poppies” (no doubt effective). To “sheath passage to the lungs,” he recommends emulsions of the following sort:

Take of barley water, six measures; white sugar, and powder of gum arabic, of each three drams; gradually mix one ounce of fresh and sweet oils of almonds, linseed, and olives.

If this does not answer,

A dram or two of spermaceti (that is, the substance of the sperm whale cranial cavity) may be dissolved with double the quantity of mucilege of gum arabic, and a little sugar […] The spermaceti should be free of rancidity, and when the emulsion id made it should not be kept above twenty-four hours, as it is apt to ferment. (40-41).

These concoctions were meant to coat the throat; the recipes for “purging” the body are more elaborate still (and even less pleasant!)

And what of today’s cure for the cold? Alas, there isn’t one! Antibiotics are of no use, and most over the counter remedies only mask or lesson symptoms. The greatest advice generally consists in drinking plenty of fluids , getting plenty of rest, getting good nutrition and vitamins, and–despite Hayes grave warning–waiting for nature to take it’s course!


Brandy Schillace, PhD, is a medical humanities scholar and historian, research associate to the Dittrick Museum, and managing editor of Culture, Medicine, & Psychiatry. She splits her time between old books and new technology…and spends an awful lot of time in the basement.


The Colorful Chemistry of Show Globes

The Colorful (and Dangerous?) History of Show Globes

Many hypotheses swirl around the origins of the pharmacist’s show globe, (see this amazing online exhibit from the Waring Historical Library), but by the late 19th century, these spherical glass containers functioned more as traditional signage. Just as barber poles, the colorful globes alerted people walking by about the goods and services inside. According to American Druggist and Pharmaceutical Record, “bold, indeed, and reckless would be the druggist who should discard the colored show globe, and not one of you can name druggists who can tell why they have them except for the single reason that others do.” [1]

Whitall, Tatum, & Co, 1897

Whitall, Tatum, & Co, 1897

Continue reading


Welcome to the final installment of the Dittrick’s special series on student work. Today we feature a guest post from Jonah Raider-Roth on the writings of Charles Knowlton. Want to learn more? Visit the Dittrick Museum’s Skuy Gallery of historical contraception or the website’s early literature page, for more details.

1800-1900Sex and Sensibility: The Writings and Controversy of Charles Knowlton

Scientific understanding is usually hailed as progressive, driving humanity toward some higher knowledge and ability. However, different views of morality occasionally draw a great deal of criticism toward commonplace knowledge and discovery. Charles Knowlton, who found himself at the center of one such conflict, made a name for himself in 1832 publishing a book called Fruits of Philosophy, or the Private Companion of Young Married People, the first widely read book discussing contraception techniques (Langer 679). Although this book was the cause of a great deal of uproar in the American Christian community and ultimately resulted in its author and later publishers being taken to court, it made a huge stride in popularizing contraceptive and birth control practices.

Knowlton’s interest in the working of the human reproductive system probably started with his own reproductive illness. The gonorrhoea dormientium (seminal discharges occurring at night) that he suffered from as a teenager was at the time “regarded by authorities as a grave threat to health and sanity,” and after going to ten physicians for treatment for this disease he became depressed (Reed n.p.). This depression would ultimately be treated by electric shock therapy from mechanic Charles Stuart, one of whose daughters (named Tabitha) Knowlton married at the age of 21. Knowlton would go on to recommend early marriage “as a cure for many of the problems of youth.” (Marden n.p.)

Knowlton’s book presented a straightforward explanation of sex, sexual organs, and various methods of contraception, defending its moral position at length. “If population be not restrained by some great physical calamity,” he wrote, reflecting an idea first made popular by the philosopher Thomas Malthus, “the time will come when the earth cannot support its inhabitants.” (Knowlton n.p.) Defending his writing as scientific knowledge to which every person had a natural right, Knowlton described in great detail the anatomy of the penis and the vagina, as well as the current scientific understanding of menstruation, conception, and pregnancy. Although Knowlton and his contemporaries suspected that it was semen which caused pregnancy, Knowlton did not appear to understand the concept of eggs and fertilization.

Most controversial of all, however, was the section concerning and four different methods of contraception, including withdrawal, early condoms, vaginal sponge inserts, and the injection of spermicidal compounds to “destroy the fecundating property” of semen (Knowlton n.p.). None of these contraceptive practices were new or radical discoveries, but the publication of this list in mainstream media, accompanied by many pages of why these practices were moral and important to society, would soon bring Knowlton plenty of criticism and prosecution.

During its initial print run, Fruits of Philosophy did not sell particularly well. At first Knowlton did not publish it widely at all, giving copies of it only to those close to him, and when it was finally published in 1832, roughly 10,000 copies were sold during the first eight years (Marden n.p.). Knowlton, however, was tried and sentenced to three months in jail by a Massachusetts court for “distributing birth control literature.” (Langer 679)

Knowlton died in 1850, but the real controversy began almost 30 years later, when British publishers Charles Bradlaugh and Annie Besant republished the book in England. “We republish [this book], in order to text the right of publication,” Bradlaugh and Besant wrote. “We republish this pamphlet, honestly believing that on all questions affecting the happiness of the people… fullest right of free discussion ought to be maintained at all hazards.” (published in Knowlton n.p.) They were arrested in 1877 and convicted for publishing obscene material that would drive the Queen’s subjects to “‘indecent, lewd, filthy, bawdy, and immoral practices.’” (The High Court of Justice qtd. by Langer 685)

Although it took decades for its importance to be acknowledged, Knowlton’s book began a change in the way America thought about contraception. Even today, the debate rages on in the worlds of politics and religion, but Knowlton’s writing and that of others that followed began to show the nation that contraception was not a taboo but in fact normal. It was healthy and could even be helpful to society. Knowlton’s writing is now acknowledged by some scholars as “the most influential of all of the early writings on the subject.” (Langer 680)


Jonah Raider-Roth is an undergraduate student at Case Western Reserve University.


Works Cited

Knowlton, Charles. Fruits of Philosophy; Or, The Private Companion of Young Married People .. London: J. Watson, n.d. Project Gutenberg. Web. 16 Sept. 2014.

Langer, William L. “The Origins of the Birth Control Movement in England in the Early Nineteenth Century.” The Journal of Interdisciplinary History. Vol. 5, No. 4, The History of the Family, II (Spring, 1975) (pp. 669-686). PDF file. Accessed 16 September 2014.

Marden, Parker G. “A Man Ahead of His Time.” Dartmouth Alumni Magazine. January 1967. Web. Accessed 14 September 2014.

Reed, James. “Knowlton, Charles.” American National Biography Online. February 2000. Web. Accessed 16 September 2014.

Student Research at the Dittrick, part 2

Last week, we featured some of the work being done by undergraduates pertaining to the Dittrick collections. Today’s student guest post talks about an unusual artifact from the museum: the compression chamber of nobel-prize winner John James Rickard Macleod.

compression-chamberUnder Pressure: How a Metal Tube Saved Lives

Caisson disease was a mystery. It had no visible cause and no known treatment. The people who witnessed this were dumbfounded at how random it seemed. The symptoms were varied and sudden and even the healthiest of men could be stricken. How do you guard yourself against an invisible, undiscriminating affliction? Framed like this it sounds scary even know, but there is a more common name that is slightly less intimidating: the bends. Most people associate the bends with divers, but the term is synonymous with caisson disease. The term caisson disease actually originated with caisson workers in the late 1800s (Butler 446). A caisson is a hollow chamber that is lowered onto the seabed to dig up mud and install bridge bases and supports. The chamber is filled with high pressure gas to prevent water from entering (Butler 445). As the workers ascended, the pressure they experienced would drop to normal, atmospheric pressure. This sudden change in pressure is what causes caisson disease. There was little understanding of the effects of high pressure on humans at this time. They did not know that at high pressures, the blood is able to absorb more gases than usual. The oxygen could be used by the body and carbon dioxide could be exhaled, but nitrogen got stuck in the body. As the pressure rapidly dropped, the nitrogen formed gas bubbles in the blood, which impaired breathing and proper blood flow (Caisson illness and diver’s palsy: an experimental study 407). Even mild cases resulted in death due to a lack of treatment. People saw workers bending over in pain, throwing up and dying (often hours after they left the caisson) with no visible cause or way to treat it. John James Macleod’s work with the compression chamber helped shed light on the mysterious caisson disease and was ultimately adapted for use in medicine.

Macleod constructed the compression chamber for his research. It consisted of a bronze tube with thick, glass walls on both ends and valves to control the internal pressure (Dittrick Museum). He placed mice inside the chamber and subjected them to differing pressures and changes in pressure. He looked at the physiological changes experienced by the mice to hypothesize how the pressures would affect humans. Specifically, Macleod focused his attention on the caisson workers from the Eads and Brooklyn bridges (Compression Chamber, 1904)

The Eads and Brooklyn bridges were both constructed in the 1870s using a pressurized, metal chamber called a caisson (Butler 448-452). The workers would ascend from the caisson quickly, the pressure dropping just as rapidly. What made the situation worse was that the gas that was pumped into the caisson was not controlled. It was the same air that was in the surrounding area. If the workers had known the dangers of nitrogen gas, they could have limited illness by pumping in air with higher concentrations of oxygen. Andrew Smith studied the Brooklyn workers and devised a preventative plan to reduce caisson disease. He advocated for gradual introduction to high pressure for new works and staged decompression both entering and exiting the caisson (Butler 452-457). Alphonse Jaminet came up with very similar preventative measures during the construction of the Eads Bridge. Unfortunately, there was very little medical evidence and employers were hesitant to implement them for fear of losing productivity. Word of caisson disease was already out there, and the pool of potential employees had already shrunk. To implement these preventative measures would mean more shift rotations, more workers and possibly better compensation.

Macleod’s experiments were conducted after the bridge incidents, but he helped to shed light on the mystery of caisson disease and provided scientific evidence to back up the claims made by Smith and Jaminet. Macleod started at the source. He first looked at cases of illness in caisson workers to determine what kinds of symptoms were related to the disease (Caisson illness and diver’s palsy: an experimental study 404-406). He also observed autopsies to see what physical changes occurred inside the body. From this information, he tried to predict the length and intensity of pressure a person could be exposed to before suffering noticeable ill effects. Through his observational research, Macleod was able to formulate a plan for experimentation with high pressure without using human guinea pigs. What Macleod did do was use mice as the guinea pigs. His observation oh caisson workers had allowed him to guess that long exposure and high pressure were the causes of caisson disease (Caisson illness and a diver’s palsy: an experimental study 425). With the mice, he noticed that they suffered less ill effects if the pressure was increased incrementally (The influence of compressed air on the respiratory exchange 494-495). He determined that the best way to prevent caisson disease was to stage the decompression process so that the body would have time to adjust and expel gasses, eliminating the toxic buildup of nitrogen. Macleod’s discoveries helped ease the minds of everyone—they now knew the cause of caisson disease and how to prevent it. Furthermore, the evidence was enough for employers to start tentatively implementing the safer working conditions advocated for by Smith and Jaminet. Workers now knew that at higher pressures, they were to get more frequent breaks along with staged decompression. Research concerning compressed air and the human body continued on after Macleod and the compression chamber grew from an experimental tool to a medical one.

Macleod created the compression tube so he could study caisson disease without exposing people. Ironically, a larger version is now in use specifically for people, utilizing a process called hyperbolic oxygen therapy (HBOT). The high pressure in the chamber allows more oxygen to be absorbed by the body (National Institutes of Health). This absorption process aids in the healing of bones and burns as well as gas poisonings and embolisms. The addition of pure oxygen speeds up this process and limits exposure time to high pressures, and thanks to the work of Macleod, the patients are carefully and slowly returned to normal pressure. The compression chamber is also available to help people who have already succumbed to caisson disease (National Institutes of Health). It is mostly for divers since working conditions are now under stricter safety controls. The compression chamber helps to ease people back to standard pressure in a controlled setting.

The compression tube helped to shed light on the mysteries of caisson disease and has even led to some helpful medical uses. Though Macleod was just one of many scientists looking into caisson disease, he was one of the few to have a laboratory compression tube. His model compression experiments allowed him to discover symptoms and causes of caisson disease without having to expose humans to those conditions. His discoveries eventually led to safer working conditions being implemented for caisson workers and the compression tube was later adapted for medical use.


Masato Miyagi: Born in Okinawa, Masato moved to the U.S. at the age of three. He is a second year student at Case Western, studying psychology. He hopes to work as a sports psychiatrist in the future.


Works Cited

Butler, W.P. “Caisson disease during the construction of the Eads and Brooklyn Bridges: A review.” Undersea Hyperbaric Medical Journal. 31.4 (2004): 445-459. Web. 14 September 2014.

“Compression Chamber, 1904.” Dittrick Medical History Center. Case Western Reserve University, 2014. Web. 14 September 2014.

Dittrick Museum. “Compression Chamber.” Case Western Reserve University: Dittrick Museum, 2014. Placard.

Hill, Leonard; Macleod, J.J.R. “Caisson illness and diver’s palsy: an experimental study.” Journal of Hygiene 3 (1903): 401-445. Web. 14 September 2014.

Hill, Leonard; Macleod, J.J.R. “The influence of compressed air on the respiratory exchange.” Journal of Physiology 29 (1903): 492-510. Web. 14 September 2014.

National Institutes of Health. “Hyperbaric oxygen therapy.” Medline Plus. 30 August 2012. Web. 14 September 2014.

Student Research at the Dittrick

The Dittrick Medical History Center welcomes researchers from the community, the region, the nation, and abroad. We’ve been pleased to host a number of colleagues, including David Jones, Diana Day, Mike Sappol, and many others. But seasoned scholars and PhDs are not the only visitors to the collections here; Case Western Reserve University students frequently attend classes in the museum’s Zverina room. Today, we begin a three part series featuring some of their work. As always, we welcome all curious and intrepid explorers of our medical past!

Bowles Stethoscope Bowles Stethoscope from the Sharp & Sharp Catalog of Instruments, 1905.

Bowles Stethoscope from the Sharp & Sharp Catalog of Instruments, 1905.

There are few instruments more recognizable or emblematic of medicine than the stethoscope. Today’s post, from Cara Smith, will look at its history and development.

Sounds like Progress: The Stethoscope’s Impact on Medical Diagnosis and Knowledge

Medicine in the early 1800’s was a removed practice; doctors diagnosed and treated patients based on observations and conversations. During that era, physical contact and even physical observation was considered “unseemly” (Aronson 171). As a result, one can imagine the difficulties that this incurred in the field of medicine. In order to treat patients properly, doctors need direct and often physical observations, something patients of this time were not eager to provide to the prying gaze of a doctor. However, in 1816, Dr. Rene Laennec, in an imaginative improvisation, created a medical instrument that helped to break down this barrier between patient and doctor and initiate a shift in the mentality of medicine: the stethoscope (Aronson 171). At this point in time, auscultation, the art of listening to the human body to determine ailments, was already in existence.   However, this process was done in an extremely invasive and uncomfortable manner, especially for females. The doctor would place his ear directly upon the patient’s chest and try to discern the sounds coming from within, a method known as immediate auscultation (Sterne 120). Because of the social stigma surrounding direct patient care, this method was only undertaken in dire circumstances, such as the case Dr. Laennec was faced with. An already socially awkward situation was made even more so as Dr. Laennec realized that the weight of his female patient prevented him from hearing her heart (Aronson 171). Thus, to solve this issue, Dr. Laennec improvised and “rolled a quire of paper into a kind of cylinder and applied one end of it to the region of the heart and the other to my ear, and was not a little surprised… to find that I could thereby perceive the action of the heart in a manner much more clear” (Sterne 117). This seemingly simplistic adjustment was anything but simple; Dr. Laennec’s invention of the stethoscope, a device that allows doctors to obtain a direct audio of a patient’s insides from a socially acceptable distance, introduced an entire new mode of medical investigation and diagnosis that would eventually answer many questions of medicine -but would also create many unforeseen problems as well.

The invention of the stethoscope was so beneficial in answering questions of medicine because it began to melt away the social barrier placed between doctors and patients. The stethoscope was “designed to operate within the parameters of a set of social relationships, and it helped to cement and formalize those relations: the doctor-patient relationship, the structure of clinical research and pedagogy” (Sterne 116). Despite strict moral standards, the stethoscope allowed doctors to begin to transcend the stigmas of morality and privacy of the era. Patients became much more comfortable with physical examination, allowing doctors to not only diagnose and treat more effectively, but also to learn much more about the human body. Prior to the progress in the doctor-patient relationship initiated by the stethoscope, doctors had to resort to autopsy as their “primary site of knowledge” of the human anatomy (Sterne 125). While this source of data provided doctors with invaluable knowledge of the inner systems and structures of the body, the fact remained that these autopsies were performed on failed cases; patients who, unfortunately, were not provided with proper treatment either because they were not diagnosed properly or the treatment they sought simply did not exist. Armed with the stethoscope and patients’ trust, doctors were now able to begin delving into the mysteries of the living body without violating a patient’s comfort. Instead of observing human bodies in which the blood has stopped moving and the lungs have stopped breathing, doctors were able to shift the “primary site of knowledge in pathological anatomy back from the dead to the living” (Sterne 126). Thus, doctors could observe diseases and other medical problems inside of the body as they were occurring, granting them a new depth of insight. As a result, doctors were able to begin formulating a more detailed and accurate image of the human anatomy as well as the diseases that ravaged it, initiating a new era of medical investigation.

However, as with all major discoveries that initiate rapid progress, the stethoscope precipitated multiple concerns. For instance, the stethoscope created a concern of dealing with the accuracy of the information being obtained. First of all, because of the time period, many questioned the validity and accuracy of observations made with the stethoscope (Sterne 121). The philosophy of the time focused on the idea of the separation of mind and body. Descartes, a major philosopher of the time, claimed that any knowledge obtained through the human senses is inherently flawed. Because the body is separated from the “immaterial mind,” senses are easily deceived (Skirry). With this in mind, the question arises whether a diagnosis based solely on the sounds that doctors perceive to emanate from the body is valid enough to consider using as a basis for discovery, especially considering the difficulty to interpret sounds into symptoms (Sterne 132). In addition, another major problem was that many of the discoveries doctors were making in their living patients were those of diseases that had yet to be fully analyzed. Thus, the discoveries that doctors were making unfortunately caused patients great dread, as in many cases “diagnostic knowledge preceded any notion of a cure” (Sterne 129). While doctors were able to take these discoveries and eventually craft cures, the patients had to live with the dread of knowing they carried an incurable disease. Ethically, this relates to the idea of whether certain knowledge is worth the accompanying consequences. Do patients want to know if they have a disease that they will eventually die from? The patient has a right to know his or her ailment, but should the technology exist that can provide them this information if it is inherently unwanted?

In conclusion, despite the multiple drawbacks that the stethoscope inherently possesses, the stethoscope still persists today as one of the most widely recognized medical symbols. It has essentially inspired the modern medical attitude of “a diagnostically assertive domain” in which doctors depend on the “inner dynamics of the body’s organs… to infer the physical nature of the underlying pathological process” (Aronson 171). Once doctors realized the value of being able to interpret the inner workings of the human body, the idea of the stethoscope and auscultation expounded upon itself; doctors were eager to discover what other sounds they could interpret from different parts of the human body. New instruments and technologies from today reach even further inside of the body, revealing everything from broken bones to mutated DNA. As with the stethoscope, these new technologies such as X-Ray, MRI, and echocardiographs also risk moving at too fast of a pace, diagnosing patients with diseases that are currently beyond modern medicine’s healing capabilities. However, similar to the stethoscope, these developing technologies continue to play an integral role in identifying the causes of these incurable diseases, perpetuating the culture of discovery in medicine for years to come. Thus, the stethoscope can be considered one of the first steps toward the modern medical mentality; the mentality that understanding the inner workings of the body is the key to new knowledge.


Cara Smith, a native Clevelander, is currently a sophomore Biomedical Engineering major at Case Western Reserve University. Within this field, she hopes to eventually pursue further education in neural engineering as well as travel as much as possible. Apart from being a student, she is also a supplemental instructor for Principles of Chemistry for Engineers and a member of multiple wind ensembles on campus in which she plays the flute.


Works Cited

Aronson, Stanley M. “A Heart-Beat Is Amplified and Then Resonates In History.” Medicine & Health Rhode Island 95.6 (2012): 171. Academic Search Complete. Web. 13 Sept. 2014.

Skirry, Justin. “Rene Descartes (1596-1650).” Internet Encyclopedia of Philsophy. Nebraska-Wesleyan University. IEP. Web. 15 Sep 2014.

Sterne, Jonathan. “Mediate Auscultation, The Stethoscope, And The “Autopsy Of The Living”: Medicine’s Acoustic Culture.” Journal Of Medical Humanities 22.2 (2001): 115-136. Academic Search Complete. Web. 13 Sept. 2014.

[Various stethoscopes; Blaufox Hall of Diagnostic Instruments]. [c. late 1800s early 1900s]. Metal and wooden stethoscopes. Dittrick Museum of Medical History, Cleveland.