John Forbes? René Laënnec? The Times of London? Anonymous? Apocryphal?
Dear Quote Investigator: Sometimes the value and importance of an invention is misunderstood. Consider the following quotation about a newly introduced medical device in the 1800s:
That it will ever come into general use, notwithstanding its value, is extremely doubtful; because its beneficial application requires much time and gives a good bit of trouble both to the patient and the practitioner; because its hue and character are foreign and opposed to all our habits and associations.
This dismissive passage was about the stethoscope, a device which powerfully advanced diagnostic knowledge and capabilities in medicine. I am told that these words were printed in The Times newspaper of London in 1834. Could you research this quote to determine its larger context and to find out who precisely wrote it?
Quote Investigator: The basic form of the stethoscope was invented by the French physician René-Théophile-Hyacinthe Laënnec who published a description of the instrument in 1819. The early stethoscope consisted of a rigid hollow tube, and the physician listened to the sounds in the chest with one ear. Laënnec published a long treatise on the subject in French after introducing the device.
In 1821 Laënnec’s book was translated into English and published as “A Treatise on the Diseases of the Chest, in which they are described according to their Anatomical Characters, and their Diagnosis established on a new Principle by means of Acoustick Instruments”. The translator was John Forbes M.D., Physician to the Penzance Dispensary and Secretary of the Royal Geological Society of Cornwall.
The quotation given above was written by Forbes, and it appeared in the “Translator’s Preface” to the first English edition of Laënnec’s work. In the second edition and later editions the preface was modified and the quotation was removed.
It is tempting with hindsight to describe the opinion offered by Forbes as wrongheaded and foolish. But the quote above is incomplete. Forbes also suggested that the stethoscope was “one of the greatest discoveries in medicine”. Here is a longer excerpt [RLJF] [RLJW] [LMJF]:
… I have no doubt whatever, from my own experience of its value, that it will be acknowledged to be one of the greatest discoveries in medicine by all those who are of a temper, and in circumstances, that will enable them to give it a fair trial. That it will ever come into general use, notwithstanding its value, I am extremely doubtful; because its beneficial application requires much time, and gives a good deal of trouble both to the patient and the practitioner; and because its whole hue and character is foreign, and opposed to all our habits and associations. It must be confessed that there is something even ludicrous in the picture of a grave physician formally listening through a long tube applied to the patient’s thorax, as if the disease within were a living being that could communicate its condition to the sense without.
Forbes thought the stethoscope was an extraordinarily valuable instrument and that is why he expended considerable time and effort in translating Laënnec’s treatise. But he also thought it was difficult to use. Design innovations improved the instrument over time. A rigid tube was replaced by a flexible tube, and a binaural scheme was introduced to allow both ears to be used for listening.
Here are additional selected citations in chronological order.
In 1822 a review of the 1821 treatise was published in “The London Medical and Physical Journal” [LMJF]. The reviewer reprinted generous excerpts from the book. Indeed, all the sentences quoted above were included in the book review and much more. The evaluation of the stethoscope and of Forbes’ translation was generally quite favorable.
The flawed prediction about the stethoscope is still invoked in modern times. In 2007 a Committee of the Parliament of the United Kingdom held a hearing about the provision of health care. The following words were spoken by Richard Granger, Director General of IT for the National Health Service [RGNH]:
In 1834 The Times said, regarding a significant piece of medical technology, that, “it will never come into general use notwithstanding its value. It is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble to both the patient and the practitioner; and because its hue and character are foreign and opposed to all our habits and associations. It is just not going to get used”. That was The Times writing about an invention from 1816 which I do not think we generally consider to be adverse to medical practice now. They were writing about the stethoscope.
In conclusion the quote provided by the questioner was written by John Forbes. He was an advocate of the stethoscope, but he did not think that it would achieve ubiquitous use. He was wrong, but QI thinks he should not be harshly criticized by those who are able to see 190 years into the future.
(Thanks to MaryBeth Kren whose inquiry led to the construction of this question by QI and the initiation of this trace.)
[RLJF] 1821, A Treatise on the Diseases of the Chest by R.T.H. Laennec [René-Théophile-Hyacinthe Laënnec], Translated from French to English by John Forbes, Translator’s Preface by John Forbes, Start Page i, Quote Page xviii-xix, Printed for T. and C. Underwood, London. [Facsimile of the London 1821 Edition Published in 1962 by Hafner Publishing, New York] (HathiTrust) link link
[RLJW] 1823, A Treatise on the Diseases of the Chest by R.T.H. Laennec [René-Théophile-Hyacinthe Laënnec], Translated from French to English by John Forbes, Translator’s Preface by John Forbes, Start Page 1, Quote Page 13-14, [First American Edition], James Webster, Philadelphia, Pennsylvania. (Internet Archive) link link
[LMJF] 1822 February, The London Medical and Physical Journal, Volume 47, Critical Analysis of Foreign Literature Relative to the Various Branches of Medical Science, [Book Review of: A Treatise on the Diseases of the Chest], Section Start Page 129, Book Review Start Page 140, Quote Page 142, Published by J. Souter, London. (Google Books full view) link
[RGNH] 2007 April 26, Parliament of the United Kingdom, Commons Select Committee on Health – Minutes of Evidence, Examination of Witnesses (Questions 1-19), Question 2, [Words spoken by Richard Granger, Director General of IT (Information technology) for the NHS (National Health Service)] United Kingdom Parliament, Westminster, London. (Accessed at www.parliament.the-stationery-office.co.uk on June 15, 2012) link