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It is opposed to mediate auscultation, using an instrument (mediate), usually a stethoscope.
Originally, there was a distinction between immediate auscultation (unaided) and mediate auscultation (using an instrument).
Mediate auscultation is an antiquated medical term for listening (auscultation) to the internal sounds of the body using an instrument (mediate), usually a stethoscope.
Laennec coined the phrase 'mediate auscultation', (indirect listening) as opposed to the popular practice at the time of directly placing the ear on the chest (immediate auscultation).
He is credited with introducing the stethoscope into the United States and was an early advocate for the practice of mediate auscultation - listening to the body through a stethoscope - using the techniques that he had learned during his studies in Paris with Laënnec.
Professor Benjamin Ward Richardson stated in Disciples of Aesculapius that "the true student of medicine reads Laennec's treatise on mediate auscultation and the use of the stethoscope once in two years at least as long as he is in practice.