Improvements in Hernia Trusses.
Year: 1892

page_text: Date of Application, 10th May, 1892
Complete Specification Left, 10th Feb., 1893-Accepted, 18th Mar., 1893
PROVISIONAL SPECIFICATION.
Improvements in Hernia Trusses.
:
I, ALEXANDER DALLAS of 65, West 35th Street, in the City, County, and
State of New York, United States of America, Physician, do hereby declare the
nature of this invention to be as follows:-
My improved truss is based on the following principles. In the straining of the
body in muscular effort such as physical work, the muscles forming the abdominal
walls are contracted and in response thereto the bowels are forced backward
against the bony walls of the pelvis and seeking the point of least resistance they
follow the concave walls of the ilium and finally recoil from the iliac fossa, striking
the weak internal ring of the inguinal canal, the shock resulting in distending such
ring and producing rupture by permitting entrance of the bowels to the canal and
causing a protrusion from or beyond the external ring. In the ordinary truss, the
whole pressure is applied on or below the external ring with a view of preventing
this protrusion. In my truss, however, I provide for the closure of the internal
ring and thereby prevent entrance of the bowels to the canal, thereby resisting
the rupture at its inception. And further, I relieve the shock on the internal ring
by causing the truss band to oppose and resist the recoil of the bowels in the
direction of the said ring. By thus lessening the shock on the internal ring, the
pressive force of the pad need not be great and in practice it is so gentle as to
cause no pain while perfectly effective for its purpose. Incidentally I provide for
supporting the truss in such a manner as to avoid pressure on the gluteal muscles
and thereby avoid all interference with natural locomotion.
The spring is so fashioned as to form an upward bend at each side to conform
to and rest on the crest of the ilium and at the back its ends are provided with
back pads and united by a connecting strap. At the front, the spring band is in
general inclined downward and inwardly from the side bends and at its lower front
portion is formed into a transverse central arched portion, the pads being secured
in the manner hereinafter described. The side portions of the band do not reach,
as is common in trusses, to the external ring, but terminate at such a point that
the pads exert their pressive force on the internal ring as above mentioned. Each
side portion, in addition to ranging in general along the portion of the lateral walls
of the abdomeu, in the direction of the internal ring, is so curved that the pads
are pressed against the person in a downward direction instead of upward as in
other trusses, the pad of course also being pressed inwardly at the same time.
Further, each portion is so curved as to itself normally tend to press inward and
rearward against the person in the direction of the pelvic bones, whereby it
opposes the recoil of the bowels from the anterior wall in the direction of the
internal ring and relieves such ring of much of the shock that it would otherwise
receive and the ring being effectively closed by the pad the lessened shock does
not result in the bowels gaining an entrance to the canal. To those skilled in
this class of surgery the difference will be readily apparent between my truss pads
pressing on the internal ring instead of the external ring and the difference be-
tween a downward and inward pressure as distinguished from an upward and inward
pressure and the office of the arms as an auxiliary to the pads in the manner
specified will be readily understood.
The construction of the pads is as follows:-A screw passes through the spring
band and into a stem which passes through the back plate of the pad and carries
a plate which is located within a chamber in the pad and said plate bearing against
one leaf or member of each of two elliptical springs, the opposite sides or mem-
bers of said springs fitting in recesses in the opposite wall of the chamber. The

page_text: ends of the springs bear against cups on the ends of spiral springs whose opposite
ends abut against the inner walls of the pads, these springs being designed for
properly maintaining the pads in yielding contact with the person.
An important feature of the invention also is the form of the bearing faces of
the pads. Each pad is formed with grooves or recesses starting from about the
centre and gradually deepening toward the lower edge, which grooves are designed
to receive the spermatic cords, vessels, and nerves, and in this manner pressure on
these important organs is further guarded against. This feature in the truss pad
is of great moment, since by it the injury resulting from the use of ordinary pads
is entirely obviated even when used in the position generally assumed by such
ordinary pads.
It will be seen from the above description that the truss pads and band are not
only structurally new, but perform their functions in a manner never before
practiced or capable of practice with prior trusses.
Dated this 10th day of May 1892.
By A. M. Wm. Clarke,
53, Chancery Lane, London, Chartered Patent Agents.
COMPLETE SPECIFICATION.
Improvements in Hernia Trusses.
'I ALEXANDER DALLAS of 65 West 35th Street, in the City, County, and
State of New York, United States of America, Physician do hereby declare the
nature of this invention and in what manner the same is to be performed, to
be particularly described and ascertained in and by the following statement :-
In order that the principles underlying my invention may be fully understood,
I will preface the description of the structural embodiment thereof by the following
explanation.
The trusses heretofore generally employed are so constructed that the pads
bear on the body at such a point as to exert their pressive force against the
external ring or opening of the inguinal canal, to prevent the bowels from pro-
truding therefrom. As there is practically but a thin integument over the external
ring, it follows that the pressure of the pad is exerted to a painful degree on the
external ring and the cords passing therethrough, the pressure being necessarily
pronounced to prevent protrusion of the bowels that have gained entrance to the
canal through the internal ring. This pronounced pressure being received by the
spermatic cords, &c., produces serious injury to these important organs.
I have discovered that a truss may be so constructed as to effectively perform
its functions, with little discomfort and without the possibility of injury to the
wearer.
My improved truss is based on the following principles. In the straining of the
body in muscular effort, such as physical work, the muscles forming the abdominal
walls are contracted, and in response thereto the bowels are forced backward against
the bony walls of the pelvis, and, seeking the point of least resistance, they follow
the concave walls of the ilium and finally recoil from the iliac fossa, striking the
weak internal ring of the inguinal canal, the shock resulting in distending such
ring and producing rupture by permitting entrance of the bowels to the canal and
causing a protrusion from or beyond the external ring; in the ordinary truss, the
whole pressure is applied on or below the external ring with a view of preventing
this protrusion. In my truss, however, I provide for the closure of the internal
ring, and thereby prevent entrance of the bowels to the canal, thereby resisting the
rupture at its inception. And, further, I relieve the shock on the internal ring by
causing the truss band to oppose and resist the recoil of the bowels in the direction
of the said ring. By thus lessening the shock on the internal ring, the pressive

page_text: Incidentally, I provide for supporting the truss in such a manner as to avoid
pressure on the gluteal muscles and thereby avoid all interference with natural
focomotion.
Reference is to be had to the accompanying drawings forming a part of this
Specification in which similar letters of reference indicate corresponding parts in
all the figures.
Figure 1 is a perspective view of the truss constructed in accordance with my
invention;
Figure 2 is a front view illustrating the truss applied;
Figure 3 is a back view illustrating it applied;
Figure 4 is a cross section through one of the pads, on line 4-4 Figure 6;
Figure 5 is a cross section through the pad on line 5-5 of Figure 6; and
Figure 6 is a view from the back or outer face of the pad with the back plate
removed.
In constructing a truss in accordance with my invention, the band A which
supports the pads, is formed of strong spring metal, preferably surrounded by
leather, and is so fashioned as to form an essentially upward bend a at each side to
conform to and rest on the crest of the ilium, and at the back it is divided and
its ends provided with the back pads B of suitable form.
The divided ends are united by a separate connecting strap C, formed with a
series of eyes or openings c, near each end for engaging the studs & of the back
pads when the truss is applied.
At the front, the spring band A is in general, inclined downward and inwardly,
from the bends a and at its lower front portion is formed into a transverse central
arched portion A¹, the truss pads D being secured in the manner hereinafter
described to such lower portion.
The side portions a¹ of the band, do not reach as is common in trusses, to the
external ring, but terminate at such a point that the pads D exert their pressive
force on the internal ring as above mentioned.
Each side portion in addition to ranging in general along the portion of the
lateral walls of the abdomen, in the direction of the internal ring, is so curved that
the pads are pressed against the person in a downward direction instead of upward
as in other trusses, the pad of course also being pressed inwardly at the same time.
Further, each portion a¹ is so curved, as to itself normally tend to press inward
and rearward against the person, in the direction of the pelvic bones, whereby it
opposes the recoil of the bowls from the anterior wall in the direction of the internal
ring, and relieves such ring of much of the shock that it would otherwise receive,
and the ring being effectively closed by the pad, the lessened shock does not result
in the bowels gaining an entrance to the canal.
To those skilled in this class of surgery, the difference will be readily apparent
between my truss pads pressing on the internal ring instead of the external ring,
and the difference between a downward and inward pressure as distinguished from
an upward and inward pressure, and the office of the arms as an auxiliary to the
pads in the manner specified will be readily understood.
passes
In detail, my improved pads are constructed as follows: A screw E
through the band A, and into the end of the stem or spindle F, which passes
through the back plate G of the pad D, and each stem F carries a plate H, which
is located within a recess d in the pad, and bears against one leaf or member of
each of two elliptical springs I, the opposite sides or members of said springs
fitting in recesses in the opposite wall d of recess d. The ends of the springs I
bear against cups k on the ends of spiral springs K, whose opposite ends abut
against the inner walls of recesses in the pads, the springs I, K, being designed
for properly maintaining the pads in yielding contact with the person.
An important feature of the invention also is the form of the bearing faces of
the pads D. As seen in Figure 1 each pad is formed with grooves or recesses D¹

page_text: starting from about the centre and gradually deepening toward the lower edge, which
grooves are designed to receive the spermatic cords, vessels and nerves, and in this
manner pressure on these important organs is further guarded against. This feature
in the truss pad is of great moment since by it the injury resulting from the use of
ordinary pads is entirely obviated, even when used in the position generally
assumed by such ordinary pads.
It will be seen from the above description that the truss pads and band are not
only structurally new, but perform their functions in a manner never before practiced
or capable of practice with prior trusses.
Having now particularly described and ascertained the nature of the said inven-
tion and in what manner the same is to be performed, I declare that what I
claim―
1. As a new article of manufacture, a truss having the spring band thereof
curved upward at each side to rest on the crest of the ilium, said band at the front
ranging downward in a direction to bear along the lateral walls of the abdomen
and carrying pads to bear on the internal ring of the inguinal canal, the said band
further being curved to exert a pressure on the pads in an inward and downward
.direction, and further formed at the sides with inward and rearward bands for
exerting an inward and backward pressure in a direction towards the pelvic walls
for relieving the initial shock of the recoil of the bowels, substantially as
described.
2. As a new article of manufacture a truss having pads for bearing each on the
internal ring of the inguinal canal, and having its spring band forming an
auxiliary truss at the sides and curved to exert a pressure inwardly and rearwardly
in direction of the pelvic walls, substantially as described.
3. In an abdominal truss, the pad made hollow and fitted for inward and outward
movement relatively to the truss band, combined with an expanding or pressure
device in the pad, consisting of one or more intermediate bowed or plate springs
and spiral springs expanding at the ends of said bowed or plate springs, sub-
stantially as described.
4. In an abdominal truss, the pad made with an interior recess and a stem on
which the pad slides, said stem having a plate or crossbar within the pad recess,
and an interior expanding or pressure device consisting of two elliptical springs
sustained by the stem crossbar and the front walls of the pad, and spiral springs
expanding at each end of each elliptical spring, substantially as described.
5. A truss having a pad adapted to exert its pressive force on the internal ring
of the inguinal canal of the human body, substantially as set forth.
6. A truss having a pad adapted to exert its pressive force against the internal
ring of the inguinal canal, and the band of which truss forms an auxiliary to
such pad, as specified.
7. A truss pad formed with a groove in its bearing face so fashioned as to
receive the spermatic cords and vessels and thus prevent injurious pressure of the
pad on such organs, substantially as described.
Dated this 10th day of February 1893.
By A. M. & Wm. Clark,
53, Chancery Lane, London, Chartered Patent Agents.