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 Creey Ferguson was an Irish physician educated at Trinity College 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! Dr. Ferguson spent one year in Paris studying with Laennec and Kergaradec to learn the use of the stethoscope, most especially for fetal auscultation. In 1830, Dr. Ferguson published two papers on auscultation using then 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 eventually becamethe First Professor of Medicine at Queens University, although he recieved little rcognition at home or abroad. 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. Mr. Ferguson demonstrated the use of a unique "teaching" monaural stethoscope at the International Exhibition of 1862 in London. Indeed, on this very website there is an Alison differential binaural stethoscope marked "Ferguson." However, instrument makers often marked their instruments with their name even though they did not invent them. Note on the cover picture of the earpiece of a Ferguson stethoscope is the mark "Coxeter & Sons" the instrument maker. There is no evidence of their designing a 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. (Caroline Louise Avery, Importing the Stethoscope: The Uptake of Mediate Auscultation by British Practitioners, 1816-1850, Appendix 2, page 308-15, Thesis for Doctor of Philosophy, The University of Leeds, School of Philosophy, Religion, and History of Science, December 2020)