The vascular surgeon Korotokoff, in Russia in 1900, recognizing that a constricted artery makes no sound, used a stethoscope to observe the sounds made by the blood flowing through the artery in the arm constricted by an arm band; he heard sounds as the band was released. The first sounds were taken as the systolic blood pressure and the sounds are called Korotkoff sounds; the technique is used to this day without change. Korotokoff ’s innovative discovery required only his thought of sound; he was not a researcher. Surgeons do not normally use stethoscopes but vascular surgeons do so, because they listen over expanded arteries, aneurysms that emit a loud bruit, a sound made as the blood strikes the expanded wall of the artery.
Many of the technologic advances in medicine have been provided for us by the collaboration of engineers, physicists, biologists, and medical doctors. Einthoven would not have produced the electrocardiogram in 1901 if Adler had not provided the wireless telegraph; also, the string galvanometer, a nonmedical device, was then available to Einthoven.
The advent of ultrasonography was an innovation prompted by the Titanic disaster and in 1939 the under¬water search for submarines. At the end of the war physicists and medical doctors collaborated to provide the ultrasound for neurologic investigations. Echocardiography stemmed from an engineer who worked in collaboration with a medical student and a physician. In 1964 Dr. Harvey Feigenbaum saw the unsophisticated machine at the American college of cardiology scientific session. He went back to his lab and borrowed an ultrasound machine from the neurosurgical division and used this to show that pericardial effusions around the heart could be observed by ultrasonic technique and presented his hallmark paper. His research work was not overwhelming and did not require much scientific thought or expertise. He was not a major research scientist. Many of the advances in echo-cardiography during 1965 or to 1990 can be attributed to his work and to sophistication by engineers.

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