WHO DESIGNED THE FERGUSON STETHOSCOPE?

The Fergusson model of the monaural stethoscope was designed in England and became the most popular model used in the latter half of 19th century medical practice. It was made of straight grained, less dense woods with a small-bore central hole such that sounds were readily transmitted. It measured approximately 7 inches in length with a slender stem that had a rounded chest-end bell about 1 inch in diameter that rested comfortably on the patient. The ear plate was approximately 2.5 inches in diameter and fit snuggly over the ear to prevent dispersion of the transmitted sounds. The Fergusson stethoscopes often had a maker's mark, physician's name or initials, or other identifying characteristic engraved on the ear plate.

Who designed this stethoscope? There were two British doctors with similar names during the later part of the 19th century who might have been involved in the design of this model of the stethoscope. Sir William Fergusson was a leading Scottish surgeon, educated at the University of Edinburgh and surgeon at the Royal Infirmary of Edinburgh where the stethoscope was in use at that time. He was appointed Professor of Surgery at Kings College Hospital in London when he was just 32 years old and eventually was appointed surgeon to both Queen Victoria and Prince Albert. Dr Fergusson was widely recognized for his operative skills, conservative approach to surgery and invention of many useful surgical instruments. His text on "System of Practical Surgery" first published in 1842 was highly regarded but only mentions the use of the stethoscope for auscultation. Although he was also noted to be a be an excellent carpenter, rivaling skilled artisans, there is no record of his designing a stethoscope.

Dr. John Creery Ferguson was an Irish physician educated at Trinity College, Dublin University and The Royal Infirmary of Edinburgh. His close friend in Dublin was Dr. William Stokes, who was an expert on auscultation and wrote a text on stethoscopy while just a medical student! Ferguson went to at Edinburgh in 1824 for wider study, and also in 1827 spent one year in Paris studying with Laennec and Kergaradec to learn the use of the stethoscope, most especially for fetal auscultation. Ferguson became the first person in the British Isles to utilize the Laennec stethoscope at the Dublin General Dispensary in November 1827. In 1829, Dr. Ferguson published two papers on auscultation using the stethoscope in the Dublin Medical Transactions (the only issue of this journal ever published): "Auscultation The Only Unequivical Evidence Of Preganancy" and "Pulmonary Apoplexy, Illustrative Of The Value Of Mediate Auscultation." Dr. Ferguson was noted for his advocacy of using the stethoscope for both thoracic and fetal auscultation. He was appointed King’s Professor of Physic at Dublin University in 1846. In Ulster, he was the first Professor of Medicine at the new Queen’s College, from 1849, as well as the first president of the Ulster Medical Society. While attending physician to the Belfast General Hospital, he published a significant paper entitled “Consumption: what is and what it is not.” There also is no record of his designing a stethoscope.

In addition, during the same period, there was a prominent instrument maker named Daniel Ferguson of Ferguson and Son who was the instrument maker to the St. Bartholomew's Hospital in London. They produced both monaural and binaural stethoscopes, see the 'Ferguson' mark on the cover photo of a monaural stethoscope for this article and Alison's binaural stethoscope in the Stethoscope Gallery. However, instrument makers often marked their instruments with their name even though they did not invent them. The 1851 Great Exhibition and 1862 International Exhibition in London list surgical instruments manufactured by Fergusion and Son, but no mention of a stethoscope. There is no evidence of Ferguson and Son designing the Ferguson stethoscope.

The listing of the Ferguson or Fergusson model of the stethoscope was spelled with either one “s” or two "s" in English instrument-maker catalogues of the day such as Down Brothers, Arnold and Sons, Allen & Hansbury and Maw. It should be noted that in the classic American Armamentarium Chirurgicum by George Tiemann & Co. the name for this model of stethoscope was spelled Ferguson. Because of the prominence of Sir William Fergusson in England, most assume that he either designed this stethoscope or the stethoscope was named after him. However, only John Creery Ferguson always used and advocated for the use of the stethoscope for auscultation. So, it seems most appropriate to surmise the Ferguson stethoscope was designed by him. Nevertheless, the origin of the most popular model of the 19th century monaural stethoscope that was used well into the early part of the 20th century remains unclear.

Reference: Avery, Caroline Louise (2020). Importing the Stethoscope: The Uptake of Mediate Auscultation by British Practitioners, 1816-1850. PhD thesis, University of Leeds.