A stethoscope is described in which stereophonic auscultation is achieved by attaching a sound-conducting tube and chest piece to a 2-way stopcock close to the main binaural. In the monophonic mode, a second binaural and conducting tube can be attached via a Y-connector close to the chest piece, permitting 2 observers to listen simultaneously.

The story of the stethoscope.

Stereophonic stethoscope with teaching attachment.

concern itself with types of hearing impairment, but also encompasses areas of particular auditory sensitivity. One very ‘visible’ realm of auditory sensitivity is found close to the home of audiology in Western medicine. Audiologists are used to medicalizing the appearance of particular auditory conditions, but this particular phenomenon is born out of medicine rather than being categorized and defined by it. Doctors are required to carefully hone their ears, acquiring a distinct auditory focus, as they begin to auscultate. They must master the skill of careful listening in order to detect subtle clues, to decode meaningful sound from the noise of the body. Of course, auscultation is an auditory acuity which is created thorough the strategic use of a particular hearing aid – namely the stethoscope. Without their stethoscopes, doctors are deaf, and many important diagnostic signs disappear into the realm of ‘the unheard’. In possession of the stethoscope, however, and in command of stethoscopic listening, doctors wield an interesting sensory reach, they hold a definite auditory power. ‘Hearing, it seems, has nothing active in it: it is mere supine susceptibility’ remarks phenomenologist Jonathan Ree (1999: 53). This statement assigns hearing the status of total passivity. It is a ‘non-act’, a state of being rather than a process in which people are able to assume any kind of agency. The hearer is simply a receptacle, carrying his or her ears around, but having no control over the sounds which drip into them. Conceptualized in this way, hearing a sound is an act devoid of consciousness, intention or purpose. But Ree points out that, listening can be an active means of inquiry, an intentioned engagement with the world. The example he uses is that of the doctor, ‘investigating a patient’s internal organs by means of the ear, perhaps assisted by a stethoscope’ (ibid). Here we see a very different side of the ear’s personality. The doctor uses it to seek out information, to find clues as to the patient’s state of health. The nature of the ear, then, its metaphorical shape, is reversed. Instead of a receptive organ, passively receiving those sounds which happen to fall into it, the ear is transformed into an active, penetrating, proboscis of knowledge. In H. G. Well’s famous storyThe Country of the Blind, the main character, Nunez, stumbles upon a village inhabited entirely by blind people. Nunez is awed to find that the members of this blind community have a sense of hearing so acute that they are able to ‘hear the very beating of his heart’ ([1914] 1997: 15). Nunez finds this extraordinary acuity both mysterious and disturbing. But with their stethoscopes, doctors, too, acquire this same ability to hear with uncanny penetration. In his piece on ‘The Sound’ as a science of diagnosis, Reiser suggests that the stethoscope has unnerved patients by the seemingly magical powers which the instrument lends to the physician (1997: 831). We see the emergence of what Murray Schafer describes as ‘claireaudience’ (2003: 25). Claireaudience refers to a capacity to hear ‘through’, or ‘beyond’ the sensory horizons which normally present themselves. In auscultation, not only is the doctor able to hear through the layers of tissue into a realm which is usually inaudible, but he or she is also able to infer what certain sounds imply, what significance they might hold for a patient’s well-being. The auscultator is able to deduce the relevance of sounds which are incomprehensible, even undetectable to those not trained in medicine. The term ‘claireaudience’ resonates closely with that of ‘clairvoyance’. While clairvoyance also refers to an extraordinary sensory capacity, namely, an ability to see beyond the boundaries of normal experience, it also implies an ability to see into the future, to pre-empt events intuitively. The pre-emptive element is important to a consideration of auscultation. The auscultator’s ear is one which is able to ‘hear into’ the health of a patient, and predict, or describe the outlook for a particular individual. He or she is also able to explain in some detail and with considerable precision, the kind of treatment which will be required. A juxtaposition of the concepts of ‘claireaudience’ and ‘clairvoyance’, then, creates an interesting notion of ‘auditory vision’, and intuitive and ‘forwardlooking’ auditory scope, which is clearly evident in the day-to-day practice of the doctor. Audiologists ‘hear’ a great deal about the social implications of hearing impairment. But what of the social implications of a superior capacity to hear, or of an ability to hear exceptionally well into certain areas? In his ethnography of the Suya of Mato Grosso, Brazil, Seeger (1975) describes the high significance attached to the faculty of hearing. Seeger writes that ‘a person possessed of extraordinary powers of hearing is a paragon of virtue’ (ibid: 251). The significance accorded to hearing in Suya society is highlighted (for men) by an expansion of the earlobes, effected over time through the insertion of a wooden disk into the flesh. The word ku-umba in the Suya language translates not only as ‘to hear’ but also as ‘to

The story of the stethoscope.

Citations

Stereophonic stethoscope with teaching attachment.

An Anthropological Insound into Medical Listening

References

Stereophonic stethoscope with teaching attachment.

An Anthropological Insound into Medical Listening