THE SUPPORT AND CURE OF HERNIA BY M NOW AND IMPROVED FORM OR TRUSS 1.
Year: 1868

page_text: LETTERS PATENT to Walter Arthur, of 14, Upper Kennington Green,
Surrey, and William Arthur, of 72, Albany Street, Regent's Park,
Middlesex, for the Invention of "THE SUPPORT AND CURE OF HERNIA BY
M
NOW AND IMPROVED FORM OR TRUSS
1.39
PROVISIONAL SPECIFICATION left by the said Walter Arthur and
William Arthur at the Office of the Commissioners of Patents, with
their Petition, on the 16th March 1868.
We, WALTER ARTHUR, of 14, Upper Kennington Green, Surrey, and
WILLIAM ARTHUR, of 72, Albany Street, Regent's Park, Middlesex, do
hereby declare the nature of the said Invention for "THE SUPPORT AND
CURE OF HERNIA BY MEANS OF A NEW AND IMPROVED FORM OP TRUSS," to be as
follows:-
Our Invention (see Plate 1) consists of a plate of metal or other hard
material covered with leather or other suitable substance; with its
convexity towards the abdomen, and covering the herniary apertures;
Its long axis is from above downwards, and in the treatment of inguinal,
scrotal, and femoral hernia its outer edge runs parallel to the line of

page_text: the groin at a short distance inside it. We fix a bar of metal or other
suitable material obliquely across the plate near its centre, and projecting
like arms at either side beyond it, so that when the plate shall lie parallel
to the line of the groin the bar shall lie straight across the abdomen,
or at right angles to the mesial line, the whole apparatus having
nearly the appearance of the letter X, or in certain cases also of a cross.
A strap round the pelvis above the hips is buckled to either end of
the bar, and fixes the plate in its position over the hernia. By this
arrangement of the bar with its projecting arms across the centre of
the plate a complete balance of the instrument is effected, and which
is one of its most prominent features. The ends of the bar are raised
in front of the plate for the purpose of receiving more direct pressure
from the straps. Efficiency may also be obtained in other positions
of the instrument, the plate may lie straight up and down the abdomen,
or its upper end inclined inwards, and the arms or levers may be in
the form of extensions of the plate or projections from it, and attached
to the plate in other.positions and directions than those described. A
plate or pad of the requisite length, and balanced by reason of having
the pelvic strap attached to its centre would also be contained in our
principle. We find it necessary in many cases to apply elastics or
springs to the ends of the cross bar for the purpose of compensation
in various positions of the body, such elastics or springs being furnished
with buckles or other contrivances for the attachment of the ends of
the strap. We also effect compensation and leverage thus. The ends
of the strap are buckled or otherwise attached to moveable levers or
slides (see Fig. 2) connected to the plate, or to projections from it,
such sliding levers having what may be called telescopic action, by
reason of elastics or springs attached to their posterior ends. In many
cases of hernia, especially such as have become bad by neglect or
imperfect appliances, we fix the lower end of the plate by a curved
bar or lever (see Fig. 3) which runs from above downwards through
eyes attached to the plate near its outer edge; a strap is attached to
'the lower end of this lever, which it follows in every direction by
reason of its principle of rotation; the strap is carried behind the
scrotum and attached to the pelvic strap, near where it passes over
the hip of the opposite side. This lever with its strap continuation
may also in some cases be carried round the inner side of the thigh,
and attached to the pelvic strap a short distance behind the hip of its
own side. This lever may also be a fixture on the plate, having received

page_text: the requisite curve for attachment to either side. When this curved
lever is used the plate may be convex in one or both directions, and
less in length by about one-fourth, such reduction of length to be from
its upper end. In umbilical hernia the plate is of an oblong shape
from above downwards, and is retained in its position over the hernia
by two cross bars fixed across the plate at either end; two straps are
required, one round the hips, the other round the waist, for attachment
to the upper and lower levers or cross bars. The straps are made of.
strap leather, with the smooth or cuticular side to the wearer's skin,
and beveled off to nothing on the other side. The transverse section
of the strap would be represented by Fig. 4.
We call our Invention the X-shaped balanced or crucial truss, con-
sisting of a plate which covers the hernia, together with arms extending
at either side for the attachment of a strap which passes round the pelvis
and above the hips, called the pelvic strap.
J
We claim a plate of any shape with arms or levers fixed or sliding
extending from any part of it, which shall cause it to be balanced over
the hernia by the application of a pelvic strap:
'
We claim any plate or pad which shall have the pelvic strap attached
to its centre, that is to say, one half above, the other half below the
strap attachment, and which shall thereby be balanced over the hernia. "
We claim the application of a curved bar or lever with rotary action,
for fixing with increased power in certain cases the lower end of the
plate, together also with its mode of attachment to the pelvic strap'at
the opposite side of the body.
We claim the application of sliding levers with elastics or springs
attached posteriorly for the purpose of compensation.
We claim the application of elastics or springs to the anterior ends
of the levers for the purpose of compensation.
We claim straps beveled off to nothing on the rough side, and with
the cuticular side applied to the skin for the purpose of sustaining
the plate. The plate (see Fig. 5) will in many cases require a larger
superficies above than below the cross bar, because of having more firm
support for the lower portion.
:

page_text: SPECIFICATION in pursuance of the conditions of the Letters Patent,
filed by the said Walter Arthur and William Arthur in the Great
Seal Patent Office on the 15th September 1868.
TO ALL TO WHOM THESE PRESENTS SHALL COME, we, WALTER
ARTHUR, of 14, Upper Kennington Green, in the County of Surrey, and
WILLIAM ARTHUR, of 72, Albany Street, Regent's Park, in the County
of Middlesex, send greeting..
WHEREAS Her most Excellent Majesty Queen Victoria, by Her
Letters Patent, bearing date the Sixteenth day of March, in the year of
our Lord One thousand eight hundred and sixty-eight, in the thirty-
first year of Her reign, did, for Herself, Her heirs and successors, give
and grant unto us, the said Walter Arthur and William Arthur, Her
special licence that we, the said Walter Arthur and William Arthur,
our executors, administrators, and assigns, or such others as we, the said
Walter Arthur and William Arthur, our executors, administrators, and
assigns, should at any time agree with, and no others, from time to time
and at all times thereafter during the term therein expressed, should
and lawfully might make, use, exercise, and vend, within the United
Kingdom of Great Britain and Ireland, the Channel Islands, and Isle of
Man, an Invention for "THE SUPPORT AND CURE OF HERNIA BY MEANS OF A
NEW AND IMPROVED FORM OF TRUSS," upon the condition (amongst others)
that we, the said Walter Arthur and William Arthur, our executors or
administrators, by an instrument in writing under our hands and seals,
should particularly describe and ascertain the nature of the said Inven-
tion, and in what manner the same was to be performed, and cause the
same to be filed in the Great Seal Patent Office within six calendar
months next and immediately after the date of the said Letters
Patent.
NOW KNOW YE, that we, the said Walter Arthur and William
Arthur, do hereby declare the nature of our said Invention, and in
what manner the same is to be performed, to be particularly described
and ascertained in and by the following statement :-
Our Invention for the support and cure of hernia by means of a new
and improved form of truss may be described as a balanced truss, which
is retained in its position by the lateral attachment of a strap round
the pelvis, and which requires no perineal or crutch strap, with an
exception to be presently stated.

page_text: It consists of a plate of hard material, by preference of thin metal,
covered with leather or other suitable substance, its outline is somewhat
kidney-shaped, and in its application to inguinal, scrotal, and femoral
hernia its major axis is from above downwards and inwards, and it lies
parallel or nearly so to the line of the groin; it is slightly convex
towards the abdomen, and its upper and inner angle has an extra
amount of convexity or forward curve for the purpose of apposition.
We use a pad on its posterior surface composed of some elastic material,
and prefer vulcanized sheet india-rubber of, say, about from an eighth
of an inch to a quarter of an inch thick, and covered also with soft
leather; this pad extends beyond the plate in different degrees, videlicet,
less at the sides, more at the bottom, and most at the top, as shewn in
Fig. 1; this pad is not only a soft elastic cushion, but it obviates in
a great degree the extension of the plate in the direction and degrees
above stated; this pad need not necessarily be attached, but then an
increased extent of plate would be required. In Fig. 6, which is for
femoral hernia, the pad has a further extension on its outer and lower
edge. We fix a bar of metal or other suitable material by rivets, screws,
or other means obliquely across the plate a little below its centre, and
projecting like arms at either side; a strap round the pelvis above the
hip joints, which may be called the pelvic strap, is attached by buckle
or by buttons to either arm, and fixes the truss in its position over the
hernia, so that when the truss is fixed in the line of the groin the arms
shall lie straight across one side of the abdomen, or at right angles to
the mesial line; these arms are raised in front of the plate for the
purpose of receiving more direct pressure from the strap, and the outer
arm is raised more than the inner one (see Fig. 2) to compensate for
the lower level of the outer edge of the. truss as it lies in its position;
these arms may also be formed in one piece with the plate instead of
being affixed to it, or they may be separate projections affixed to the
plate. The plate has a greater surface above than below the arms, and
the pad also has more surface above than below, so as to compensate
for the different degrees of resistance in both these portions of the
abdomen, the support being of a more yielding character above than
below, and by this mode of adjusting the extent of the surfaces of the
truss above and below the arms to the resistance opposed to them a
well-balanced instrument is obtained. The pressure from this truss
being from an extensive surface and nearly flat where it covers the
hernia is not liable to produce pain or uneasiness by arresting the

page_text: circulation in the spermatic cord or femoral vessels. The arms need
not necessarily always extend beyond the edges of the truss, as for
instance, in double hernia, where any great extension of the arms would
be obviously inconvenient. In a second mode of its application to
femoral hernia the truss would have a course from above downwards
and outwards over the pubic end of Poubart's ligament; in this mode of
its application the lower end of the plate would be curved forward
for apposition to the groin and thigh, in which case it has the appearance
shewn in Fig. 7. In some cases also the inner arm may be entirely
dispensed with, and the strap attached directly to the plate by means
of a buckle or button, retaining the outer arm as before. A pad of
any suitable material, such as wood, cork, &c., without the arms,. but
possessing instead sufficient thickness for efficient strap pressure, and
with the pelvic strap attached to the body of such pad and in such part
of its surface as to cause it to be balanced over the hernia is another
mode by which it may be constructed. In double hernia the inner arms
of both trusses are attached by a strap and button, and one pelvic strap
is used to connect the outer arms (as shewn in Fig. 5.) We use straps
by preference of leather with the smooth or cuticular side to the skin
of the wearer, and the edges of the outer rough side bevilled off to a
thin edge, by which greater smoothness and softness are obtained.
Made or padded straps, such as those in general use, will however be
necessary for many persons. Elastics or springs are sometimes also
attached to the arms and in connection with the strap to allow play for
various positions, or the arms may have sliding action by reason of
elastics or springs attached, to their posterior ends, as shewn in Fig. 8,
or the arms themselves may be made of spring materials for the purpose
before stated. In the exceptional cases before referred to, such as old,
bad, and neglected hernia; we fix the lower end of the plate by a curved
bar or lever, as shewn in Fig. 9, which runs from above downwards
through eyes attached to the plate near its outer edge; by this arrange-
ment it rotates sufficiently in the eyes to be adjusted to any direction;
it is also suspended superiorly by elastic to allow adjustment perpen-
dicularly; a strap is attached to the lower end of this lever, and is
carried behind the scrotum and attached to the pelvic strap near where
it passes over the hip of the opposite side, or it may also be carried
round the inner side of the thigh of its own side, and thence to the
pelvic strap near the hip of its own side, or it may be a fixture on the
plate having received the requisite curve and direction for attachment

page_text: to either side. This bar in addition to its leverage has also this great
advantage over ordinary crutch straps of passing over very sensitive
parts without pressing on them. The terms balanced truss, and balanced
over the hernia, mean the adjustment of its surface above and below the
arms to the resistance opposed to them, as before stated, and the plate.
with its pad may for this purpose be considered as one, so that the arms
if they were attached at or even above the centre of the plate would
still not disarrange the balance if at the same time the pad of extra
strength and extent superiorly were substituted.
In order however that our Invention may be fully understood and
readily carried into effect, we proceed to describe it more particularly
by reference to the accompanying Drawings, in which are represented
our new and improved truss, with different modes of applying the

page_text: Fig. 8 is a full-sized front view of a right inguinal truss, in which
the arms c, c, have a sliding action through the eyes m, m, m, m, in which
Figs. n, n, are the springs composed of elastic bands.
Fig. 9 is a full-sized front view of an inguinal truss shewing the
arrangement of the curved bar or lever o revolving in eyes m, m, and
suspended superiorly by the elastic band n.
Fig. 10 shews the application of the truss last described.
We claim as our Invention a truss balanced as described and retained
in its position as described by the lateral attachment of a strap round
the pelvis alone.
We claim the arms of the same, both fixed and sliding, as before
described.
We claim the curved lever with its mode of adjustment, as before
described for carrying an improved 'crutch strap.
We claim the combination of the various parts herein-before described
or illustrated in the Drawings, together with their modifications.
In witness whereof, we, the said Walter Arthur and William
Arthur, have hereunto set our hands and seals, this Fourteenth
day of September, in the year of our Lord One thousand eight
hundred and sixty-eight.
Witness,
THOMAS MOY,
1, Clifford's Inn.
(L.S.)
WALTER ARTHUR.
WILLIAM ARTHUR. (L.S.)