It is not intended that its use should supersede those established principles of our art, which early and regular education, as well as experience, have pointed out to us; but that it should serve as an auxiliary in the investigation of obscure disease. For my own part, I have no apprehension that the judicious employment of the stethoscope can, in any degree, tend to make us negligent in observing the symptoms of diseases, or indifferent to the study of the usual means of diagnosis. In the hope, that the general opinions which I have offered in this volume, may receive the high sanction of your approval, I have the honour to remain, DEAR SIR, Your most obliged, faithful, And obedient Servant, CHARLES SCUDAMORE. Wimpole Street, April 14th, 1826. PREFACE. Having expressed my opinion generally on the merits of the stethoscope, in the course of the following Essay, I have little to say in the form of a preface. Although the credit of the invention is due to the ingenuity of M. Laennec alone, and the volume which he has presented to us abounds with valuable pathology, it is of no small importance that the sentiments and the experience of others should also be collected and recorded. Before any new method in the practice of medicine can be firmly established, or even deserve to be regarded in the light of fixed authority, it is incumbent upon us to examine all the collateral evidence which can be produced in its favour; and he who, with this view, contributes to the general stock of information, may claim the merit of usefulness, although he be not entitled to the more brilliant distinction awarded to genius. It appears to me, that whoever adopts the use of the stethoscope, must study it for himself, and consider, that all which is offered to his attention by the industry and observations of others, is calculated to serve his purpose only as an introductory lesson. The skilful employment of this instrument must be the result of practice. Every case which occurs, presents new and distinct matter for investigation. It is peculiarly necessary to be accurate in marking with nicety the nature of the impressions which are made upon the ear, and to reflect upon the phenomena with all the skill and care of the physiologist, the anatomist, and the physician. Nothing must be left to the imagination; for, if this creative faculty be exercised, the judgment may be misled, rather than informed and assisted. I have purposely confined myself to a limited sketch of the general subjects which I have embraced; so that if the following pages should not appear to possess the merit of great novelty, they will, I hope, at least escape the imputation of being tedious and devoid of interest. OBSERVATIONS, _&c. &c._