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In 1816, a very obese young woman suffering from general symptoms of heart disease consulted Rene-Theophile-Hyacinthe Laennec for treatment. Laennec was perplexed about how to perform a clinical examination on her. Although he often used the technique of percussion, he rejected it in this case, as her extreme fatness would render it ineffective. Given her age and sex, direct auscultation of her heart with his ear placed against her chest was in his opinion inappropriate. While Laennec happened to be watching some children playing, he noticed that they were holding a piece of wood to their ears and scratching on the other end with a pin. This observation inspired him to roll up a cylinder of paper that he tied with a string and to use it to examine her. He placed one end of the cylinder over her heart and the other end to his ear. The results were excellent; he could clearly hear the sounds made by her heart.

Pleased with the excellent results, Laennec proceeded to construct a more durable instrument. He used a hollow wooden cylinder that measured 25 by 2.5 centimeters. Later, he improved upon his instrument by adding detachable parts and using brass rings. He created a detachable chest-piece and modified the stethoscope so that the earpiece could be unscrewed.

Wooden stethoscopes remained in use in the middle of the nineteenth century. The development of rubber tubing permitted the construction of different kinds of stethoscopes. In 1850, the modern binaural stethoscope with rubber tubes leading to both ears was developed. Types of stethoscopes include acoustic, electronic, and differential stethoscopes.

Laennec's greatest contribution to diagnosis of chest illness was his invention of the stethoscope, which made accurate diagnosis possible in cases that otherwise remained unclear. In 1818, he appeared before the Academy of Science in Paris with his findings and research on the stethoscope. In 1819, he published his two-volume work on the stethoscope and chest disease, De l'auscultation mediate (On Mediate Auscultation, 1821). Laennec's treatise brought a large number of physicians to Paris to see the stethoscope and to consult with him about its use. A revised version of the book, which correlated the sounds heard with the stethoscope with the lesion found at autopsy, was published in 1826.

Laennec gave the liver disease known as cirrhosis its name. He also made important discoveries about melanoma and distinguished its lesions from those of tuberculosis. He advanced the diagnosis of heart problems through his research. Using his stethoscope, he discovered and described two distinct heart sounds. As a result of his research and active practice as a physician, Laennec advanced both the knowledge and the methods of diagnosis available to physicians. He perfected the art of clinical diagnosis, which became one of the most valuable tools for the physician in the treatment of diseases, especially those of the chest. His invention of the stethoscope enabled physicians to distinguish and diagnose various chest diseases.   

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