ú ñThe invention of the stethoscope, the development of anaesthetics, and the use of antiseptics all helped in the fight against disease.ñ
Diagnosis of disease became more reliable with the invention of the stethoscope in 1816 by the French physician Rene Laennec (1781-1826). Laennec came up with the idea after watching two children amusing themselves by tapping lightly on a stick then listening to the transmitted sound. He immediately realized the possibilities of the technique for his work on chest diseases such as tuberculosis and emphysema. Laennec's stethoscope, or ºcylindreº as he called it, was a simple boxwood tube, which he placed on a patient's chest and through which he listened to the sounds made by the heart and lungs. He wrote a treatise ºDe l'Auscultation Mediateº ("On Indirect Auscultation") in 1819, describing the many strange sounds that the stethoscope revealed. "Direct" auscultation - in which the doctor placed an ear directly on the patient's chest - had been in use for centuries, but the indirect method had far greater potential.
Dissection techniques were also developed in the 19th century, especially for autopsies. Pierre Francois Percy and Dominique Larrey, field surgeons in Napoleon's Army, developed better operating techniques during the Russian campaign of 1812. Amputations were carried out to prevent gangrene in wounded limbs. There were no anaesthetics at the time: patients were sedated with opium or made drunk with alcohol, and then tied down while surgery was performed. During the 1840s, surgeons discovered the anaesthetic properties of chloroform and ether, which spared patients much suffering and made possible longer and more complex operations.
The greatest advance at this time came from the work of the French chemist and biologist Louis Pasteur (1822-95). He demonstrated that germs (bacteria) caused certain diseases, and were responsible for the infection of surgical wounds. The British surgeon Joseph Lister (1827-1912) took up Pasteur's ideas and, around 1865, introduced the idea of antiseptic surgery. He began cleaning wounds with a carbolic-acid solution and used a carbolic-acid spray in the operating room, to prevent bacterial infection. Subsequently, when it was realized that bacteria were not only airborne but could also be transmitted by hands and instruments, surgeons adopted the aseptic technique - sterilizing equipment and linen, and wearing gloves - which is still used today. ª w 4
