Contraception or Bust: Marketing Around the Comstock Laws

Blog by Diana Suciu, student at Case Western Reserve University
Essay winner, USNA 287Q Gothic Science, SAGES 2015
Instructor: Dr. Brandy Schillace

Comic depicting Comstock: woman gave birth to a naked infant!

From the late 1800’s until the 1960’s, the distribution and acquisition of contraceptives was banned in many American States. It was a popular belief, upheld by the enactment of the Comstock Law, that contraception would lead to promiscuous behavior. Passed in 1873, the Comstock Law enforced a heavy ban on all paraphernalia or literature associated with the topics of pornography, erotica, and contraception (Sex in the City, 1840’s, Dittrick Museum). The law was named after Anthony Comstock, a man who crusaded against the ‘obscene’ and ‘immoral behaviors’ that were rampant in the streets of large American cities (People & Events: Anthony Comstock’s “Chastity). Comstock embraced Victorian ideals, believing that contraception would cause men and women to act indecently and would erode the standards of morality that prevailed during the turn of the 19th century (Sex in the City, 1840’s). He was instrumental in enforcing a law in which men and women were denied legal access to contraceptives. The United States of America became the only western nation in this time period to convict citizens for the advertisement, distribution, or use of birth control (People & Events: Anthony Comstock’s “Chastity” Laws).

In 1875 a woman named Lydia Pinkham made it possible to obtain abortive agents despite the ever-present contraceptives ban. Under very careful advertising, she marketed a vegetable compound for ‘the worst female complaints’ (Lydia Pinkham Vegetable Compound). Her home brewed herbal elixir was a nationwide success; women bought her product to prevent ‘uterine tumors’ or the ‘changes of life’ from causing pain to their spine or abdomen.’ Lydia Pinkham put her picture on every bottle of her product; her motherly face became a household emblem for women all across the country. She became a marketing pioneer who was widely successful in established her product, and made her name as recognizable as Coke or Heinz (Schulman, 24). Many women came to think of Lydia as a confidant who would answer their letters and would provide personal and sexual advice. Even after her death, staff members from her company would answer letters from her faithful customers (Lydia E. Pinkham: Life and Legacy).

Lydia Pinkham's Tablets
Lydia Pinkham’s Tablets

Her advertisements claimed “it will dissolve and expel tumors from the uterus in an early stage of development. The tendency to cancerous humors there is checked very speedily by its use. It removes faintness, flatulency, destroys all cravings for stimulants, and relieves weakness of the stomach” (Ad from 1881 for Lydia Pinkham’s Compound at the Museum of Menstruation and Women’s Health.). To a modern casual observer this type of advertisement seems to be directed towards women whom experienced menstrual discomforts and similar ailments. To the Victorian reader the advertisement reads differently: the vegetable compound would cure nausea, strange cravings, and flatulence plausibly caused by unwanted growths in the uterus, and it worked particularly well if the ‘growths’ were in the early stages of development (Ad from 1881 for Lydia Pinkham’s Compound at the Museum of Menstruation and Women’s Health.”). It was an open, but cryptic advertisement for contraceptives aimed directly at the user and was prescribed to be taken daily as a drink or a pill to give strength to a ‘woman’s system’.

Pinkham’s over the counter contraceptive made it possible for women to receive abortive agents without getting prosecuted by the Comstock Law. This made the vegetable compound a common item to be found on many women’s nightstand. Ambiguous advertising of contraceptive products became common place throughout the enforcement of the Comstock Law (Chesler, 70). Because she was hailed as a public icon, no product sold as well as Lydia Pinkham’s Vegetable Compound. The company still exists under a different ownership, still branded under “Lydia Pinkham” and the compound’s main ingredients have not been altered from the traditional formula. Currently, the vegetable compound is marketed towards post-menopausal women, and “Lydia Pinkham” does not acknowledge the historical usages of the herbal elixir (Dietary Supplements and Pharmaceutical Products for Birth Control, PMS and Menopause). The company advertises that Lydia Pinkham’s Vegetable Compound was formerly used for treatment of PMS and other hormone imbalances, which could be probable, considering the vague wording of the early advertisements, yet given the true historical comprehension of the advertisement, unlikely (Dietary Supplements and Pharmaceutical Products for Birth Control, PMS and Menopause). Looking at the historical usages of the herbs versus their modern medical uses, we understand why the formula is now being used for post-menopausal symptoms and not for treating PMS. There are five main ingredients of the vegetable compound that are still the active ingredients in the current formula: Pleurisy root, Life root, fenugreek, unicorn root, and black cohosh (Dietary Supplements and Pharmaceutical Products for Birth Control, PMS and Menopause).

Another of the ‘female pills’ on display at Dittrick Museum–Dr. Bronson, for “obstruction”

Pleurisy root, also known as common milkweed, was historically used in the Americas as an oral contraceptive, as well as an anti-inflammatory agent. Modern medicine regards the herb as a mild anti-inflammatory, a reliever of coughs and mucus build up, and an estrogenic (Pleurisy Root – Herbal Encyclopedia). This root should not be consumed by pregnant women as it is dangerous for the health of a developing fetus and taken in high enough and repeated dosages can induce miscarriage. Still, the estrogenic and anti-inflammatory properties of the root make it appropriate for women going through the stresses of menopause (Pleurisy Root – Herbal Encyclopedia). Here we notice that while the compound’s main ingredients have been preserved, “Lydia Pinkham” is targeting a different market segment effectively avoiding direct competition with the latest contraceptive products. Life root, commonly known as yellow ragweed, has many medical uses. The roots have been used as an anti-inflammatory as well as a blood stimulant to help regulate the menstruation cycle and decrease menstrual pain in women. Life root root is known as an emmenagogues, a plant that stimulates blood flow to the uterus, which can stimulate menstruation or prevent pregnancy (Ragwort – Herbal Encyclopedia). Fenugreek, Unicorn Root, and Black cohosh are all forms of emmenagogues that are currently not recommended to be consumed by pregnant women, and have historically been used as abortive agents. Emmenagogues also have strong estrogenic properties and can be used as an alternative for women who cannot take hormone replacement therapy for menopause (Black Cohosh). Just like Coke & Heinz, Pinkham’s Vegetable Compound survived the passage of time and successfully redefined itself to a new consumer group without exposing its weakness by competing head-to-head with a modernly engineered contraceptive drug. The compound was the right medicine for the time when the Comstock Law blocked legal access to contraceptives.

Pinkham’s Vegetable Compound was sold by all druggists and apothecaries throughout the late 19th and early 20th centuries (Ad from 1881 for Lydia Pinkham’s Compound at the Museum of Menstruation and Women’s Health.”). Her product sold millions of bottles, and Mrs. Pinkham became a strong public figure. She was able to give advice to women on sexuality and personal care. Also, she drew attention to serious female medical issues that were being ignored by standard medical practice. Without the Comstock Law men would have had access to condoms and women to diaphragms, and her medicine may have not been so successful. In an ironic manor, what should have stopped her, created a need in the market. As much as a progressive woman like Lydia Pinkham had to despair at the Comstock Law, it also created new possibilities for women to find social progress despite political oppression.

Works Cited

“Ad from 1881 for Lydia Pinkham’s Compound at the Museum of Menstruation and Women’s Health.” Ad from 1881 for Lydia Pinkham’s Compound at the Museum of Menstruation and Women’s Health. Web. 4 Feb. 2015. <;.

“Black Cohosh.” University of Maryland Medical Center. Web. 7 Feb. 2015. <;.

Chesler, Ellen. Woman of Valor: Margaret Sanger and the Birth Control Movement in America. New York: Simon & Schuster, 1992. 70-75. Print.

“Dietary Supplements and Pharmaceutical Products for Birth Control, PMS and Menopause.” Web. 3 Feb. 2015. <;.

Dittrick Museum. “Lydia Pinkham Vegetable Compound”. Case Western Reserve university: Dittrick Museum,2015. Placard

Dittrick Museum. “Sex in the City, 1840’s”. Case Western Reserve university: Dittrick Museum,2015. Placard

“Lydia E. Pinkham: Life and Legacy.” Museum of Health Care Blog. 19 June 2014. Web. 2 Feb. 2015. <;.

“People & Events: Anthony Comstock’s “Chastity” Laws.” PBS. PBS. Web. 1 Feb. 2015. <;.

“Pleurisy Root – Herbal Encyclopedia.” Herbal Encyclopedia. 28 Dec. 2010. Web. 1 Feb. 2015. <;.

“Ragwort – Herbal Encyclopedia.” Herbal Encyclopedia. 28 Dec. 2010. Web. 1 Feb. 2015. <;.

Schulman, Bruce J. Making the American Century: Essays on the Political Culture of Twentieth Century America. Oxford: Oxford UP, USA, 2014.20-24 Print.

Rediscovering the Birthing Chair: Delivering Life While Sitting Up

Blog by Anneliese Braunegg, student at Case Western Reserve University
Essay winner, USNA 287Q Gothic Science, SAGES 2015
Instructor: Dr. Brandy Schillace

Birth Chair, Dittrick Museum
Birth Chair, Dittrick Museum

Envision two women. Each is in labor, each is in pain, and each is accompanied by a professional caretaker who is assisting her in giving birth. Here the similarities end. The first woman lies on a hospital bed with her hair strewn across the pillows; she is accompanied by a doctor, and she is simultaneously pushing her baby into the world as he pulls on it with forceps. The second woman sits on a birthing chair that was brought to and assembled in her bedroom; her hair is strewn across the chair back, she is accompanied by a midwife, and she is pushing her baby into the world as the midwife guides her through the process (“Midwifery Chair, c. 1850”).

The first woman is giving birth in 2015. The second woman is giving birth in 1850 (“Midwifery Chair, c. 1850”). In the generations between the second woman’s labor and the labor of her great-great granddaughter in this hospital room in 2015, now the present day, many changes will take place in the medical world. In an “‘unexplained revolution,’” typical birthing practice will “shift from female to male midwifery practice,” and “the female midwife… castigated as a rustic or vilified as a witch,” will come to “serve,” at most, “at the pleasure of the [male] surgeon” (Schillace). Pregnancy and labor will come to be “treated [not] as a natural process [but as] a medical condition” requiring a doctor’s intervention. (“Birth Chairs, Midwives, and Medicine”).

Birth chair, Dittrick Museum
Birth chair, Dittrick Museum, circa 1920

The primary birthing method shifted from use of the birthing chair to use of the birthing bed, “not necessarily because [lying on the birthing bed] is the best position for birth but… [because] it is the most convenient position for [the] doctor,” as it allows him to view the baby more easily and use a device that midwives have not used, the forceps (“Effective Birthing Positions”). Thus modern birthing culture will be born, and while women would, over time, become doctors, and pregnancy would come, once again, to be viewed as a natural state, the main method of delivery remained the birthing bed–the birthing chair largely forgotten. This is the way the world is today; however, hospitals of the present should not dismiss the method of the birthing chair too quickly. Giving birth on a bed, though it is the modern norm, is neither the only viable birthing option nor always the best one, and the expansion of birthing options would benefit the large number of modern women who go to hospitals to give birth to their babies.

Today, when most people picture a woman giving birth, they picture the woman lying on the hospital bed; less often do people picture the woman sitting on the birthing chair. The birthing chair birthing method is still used, but is much less common. This imbalance seems to imply that giving birth on a bed is somehow safer or more efficient than giving birth on a chair; however, studies evaluating the effectiveness of birthing chairs have shown that the birthing chair is a satisfactory birthing method for most patients who use it (Liddell, H. S., and P. R. Fisher) and that the use of a birthing chair does not increase the health risk to either the mother or the baby and is therefore a safe alternative to the use of a birthing bed (Kafka, M., et al.). Additionally, studies contrasting the birthing chair and the birthing bed have found there to be “less transient cord compression in upright positions” (Cottrell, B. H., and M. K. Shannahan) such as that taken while seated in a birthing chair and have found that “patients who delivered in the [birthing] chair [have] significantly lower rates of episiotomy [surgical cutting below the vagina performed to aid delivery] and manual separation of the placenta” in comparison to patients who delivered in a birthing bed (Scholz, H. S., et al.).

Birth chair, Dittrick Museum
Birth chair, Dittrick Museum,

While the birthing chair presents “minor disadvantages such as increased soiling of the chair” and, depending on the chair’s structure, “impedes operative deliveries from the perineal floor,” the advantages were determined to outweigh the minor disadvantages, and the suggested solution to the operative delivery impediment was not the use of a bed instead of a chair but instead a combination of the two into a birthing bed that can be shifted to accommodate all positions from sitting to recumbent (Schurz, A. R., H. Concin, and M. Kobermann). The results of these five studies indicate that while the birthing chair can safely be used as an effective alternative birthing method the birthing bed. In addition, because the less conventional birthing chair birthing method has been found to be a viable, potentially advantageous alternative to the birthing bed method, it would be beneficial to explore further the advantages of other less conventional birthing methods that exist.

The most effective of these other less conventional birthing methods include the birthing bar that attaches to a bed, the birthing stool, the upright sitting position, the kneeling position, and the curled side position, and each of these methods and positions presents certain advantages for the woman in labor (“Effective Birthing Positions”). These advantages include expanding the size of the woman’s pelvis (birthing bar and birthing stool), taking advantage of gravity to help push the baby (bar, stool, and upright sitting position), providing physical support for relaxation between contractions (bar, upright sitting position, kneeling position, and curled side position), and protection from back pain and vaginal tearing (kneeling position for the former and curled side position for the latter) (“Effective Birthing Positions”). Evidently, a variety of valid birthing methods exist. However, even though these methods present certain advantages to a woman in labor and even though, in the case of the birthing chair, research was performed as many twenty years ago indicating that the method is a positive one, the bed birthing method remains the primary birthing method made available to and used by laboring women. It is time that these studies’ suggestions be effected and that hospitals make information about and access to birthing chairs available to pregnant women, and it is time that other alternative birthing methods be scientifically examined and, if also found to be valid, also be publicized and made available.

Examination chair, circa 1875, Dittrick Museum

Some birthing centers do, in fact, offer some of these alternative birthing methods, and it is noteworthy that these methods are available not only at birthing centers specifically designated as alternative but also at some mainstream hospitals. A well-regarded example of such a hospital is MIT Medical, of the Massachusetts Institute of Technology in Cambridge, Massachusetts. In addition to offering the traditional option of giving birth on a bed, the hospital states on its website that it “alternative birth experiences are also available, including birthing chairs, birthing balls, hypnobirthing, doulas, and water births” (Patient Services: Obstetrics and Gynecology”). The fact that MIT Medical presents these options on its website is important; in order for effective birthing methods currently considered alternative to become accepted as mainstream, it is vital that established, well-respected hospitals embrace these methods and clearly state their availability. In doing so, hospitals make the labors of more women safer and easier, as they become better able to accommodate the needs of all the women who come to the hospital to deliver a child.

No two births are exactly alike. The uniqueness of each birth makes it vital that hospitals pay attention to the fact that giving birth in a bed, while the most common method of birthing, is not the only viable option and not always the best one. Hospitals like MIT Medical have taken a positive step toward addressing non-bed birthing methods, but even at MIT Medical, such methods are still presented as “alternative,” misleadingly implying that they may be less reliable than the bed birthing method (“Patient Services: Obstetrics and Gynecology”). Doctors and midwives should therefore continue to expand their knowledge and provision of different birthing practices and, just as importantly, make available to pregnant women and their partners information about the variety of safe, effective birthing options that exist. In doing so, they will ensure that both the woman in the bed and the woman in the chair will be in those places because they have chosen to give birth there and that they have chosen those places because they made the informed choice that those birthing methods are the best birthing methods for them.

Works Cited

“Birth Chairs, Midwives, and Medicine.” University Press of Mississippi. UP of Mississippi, n.d. Web. 6 Feb. 2015. <;.

Cottrell, B. H., and M. K. Shannahan. A Comparison of Fetal Outcome in Birth Chair and Delivery Table Births. N.p.: n.p., 1987. PubMed. Web. 6 Feb. 2015. <;.

“Effective Birthing Positions.” Taking Charge of Your Health & Wellbeing. U of Minnesota, Aug. 2009. Web. 6 Feb. 2015. <;.

Kafka, M., et al. The Birthing Stool–An Obstetrical Risk? N.p.: n.p., 1994. PubMed. Web. 6 Feb. 2015. <;.

Liddell, H. S., and P. R. Fisher. The Birthing Chair in the Second Stage of Labour. N.p.: n.p., 1985. PubMed. Web. 6 Feb. 2015. <;.

“Midwifery Chair, c. 1850.” Dittrick Medical History Center and Museum. Allen Memorial Medical Library. 11000 Euclid Ave, Cleveland, OH 44106-1714. 27 January 2015.

“Patient Services: Obstetrics and Gynecology.” MIT Medical. Massachusetts Institute of Technology, n.d. Web. 6 Feb. 2015. <;.

Schillace, Brandy. “On the Trail of the Machine: William Smellie’s ‘Celebrated Apparatus.'” Dittrick Museum Blog. Case Western Reserve University, 4 Apr. 2013. Web. 6 Feb. 2015. <;.

Scholz, H. S., et al. Spontaneous Vaginal Delivery in the Birth-Chair versus in the Conventional Dorsal Position: A Matched Controlled Comparison. N.p.: n.p., 2001. PubMed. Web. 6 Feb. 2015. <;.

Schurz, A. R., H. Concin, and M. Kobermann. Experience with EK-Birthing Chair (Author’s Transl). N.p.: n.p., 1981. PubMed. Web. 6 Feb. 2015. <;.


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

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.