IMPROVEMENTS IN INSTRUMENTS FOR SUPPORTING THE PROLAPSED UTERUS
Year: 1836

page_text: TO ALL TO WHOM THESE PRESENTS SHALL COME, I, AMOS
GERALD HULL, of Cockspur Street, Charing Cross, in the County of Middle-
sex, send greeting.
WHEREAS His present most Excellent Majesty King William the Fourth,
by His Letters Patent under the Great Seal of Great Britain, bearing date at
Westminster, the Ninth day of June, in the sixth year of His reign, did, for
Himself, His heirs and successors, give and grant unto me, the said Amos
Gerald Hull, His especial license, full power, sole privilege and authority,
that I, the said Amos Gerald Hull, my exors, adñññors, and assigns, and such
others as I, the said Amos Gerald Hull, my exors, admors, or assigns, should
at any time agree with, and no others, from time to time and at all times
during the term of years therein expressed, should and lawfully might make,
use, exercise, and vend, within England, Wales, and the Town of Berwick-
upon-Tweed, my Invention of "IMPROVEMENTS IN INSTRUMENTS FOR SUPPORTING
THE PROLAPSED UTERUS," communicated to me by a certain foreigner residing
abroad; in which said Letters Patent is contained a proviso, that I, the said
Amos Gerald Hull, shall cause a particular description of the nature of my
Invention, and in what manner the same is to be performed, to be inrolled in
His said Majesty's High Court of Chancery within six calendar months next
and immediately after the date of the said in part recited Letters Patent, as in
and by the same, reference being thereunto had, will more fully and at large
appear.

page_text: NOW KNOW YE, that in compliance with the said proviso, I, the said
Amos Gerald Hull, do hereby declare that the nature of the said Invention,
and the manner in which the same is to be performed, aro particularly
described and ascertained in and by the following statement thereof, refer-
ence being had to the Drawing hereunto annexed, and to the figures and
letters marked thereon, that is to say :-
My Invention of improvements in instruments for supporting the prolapsed
uterus, consists of instruments to relieve and cure displacement of the womb,
and on a new principle, and different from the accepted usages of the present
surgical practice. The principle is that of external pressure in contra-
distinction to all the intervaginal means heretofore adopted. This pressure is
to be effected either singly upon the hypogastric region, or conjointly upon
hypogastric and perineal regions. Experience has proved that properly
directed pressure upon or against the lower part of the abdomen, and upon
the perineal region always relieves, and frequently removes the displacement
of the womb, and many maladies consequent thereon. The apparatus for the
purpose of obtaining the proper pressure, and for which the Patent has becu
obtained, consists of the following parts:-A spring; two pads, one for the
belly, the other for the back of the patient; a wedge of cork or other suitable
material to slide between the belly pad and the spring; and a perineal strap.
The spring is an elastic hoop of steel clearly shewn in the Drawing. The
back pad is formed by a simple plate of metal attached to the posterior end of
the spring cushioned, and only intended to allow this extremity of the spring
to rest comfortably upon the back of the patient, and to serve for the attach-
ment of straps to be described.
The Lower Belly or Hypogastric Pad.-This pad must be so formed
as to be applied below the naval to that part known as the hypogastric
region. This pad has the form of a double inclined plane, the inner
or hollow aspect of which is applied to the belly, and called the inner
surface, the outer surface is the converse of the inner, and is called the back
of the pad. It is necesary that the planes of the inuer surface of this pad
should be moveable, so that the pad can always be made to correspond exactly
to the various and changing convexities of the abdomen. To effect this im-
portant object, the pad consists of two wings of thin metal or other suitable
material, joined together near the centre of the pad by a hinge fixture. These
wings, joined as aforesaid, form a pad plate, which is covered with soft leather
or cloth, and wadded or stuffed on its inner surface, so as to make a soft
cushion for the belly of the patient. The belly pad is attached to the spring
by any convenient fixture by its back or outer surface at the centre by means

page_text: of the cork wedge above-named, which is slid along the under surface of the
spring (upon which it is looped) till it lies upon the smaller wing of the pad,
the lesser wing is depressed, and by retracting it along the spring, away from
the pad, the lesser wing elevates itself to contract with the spring, wherefore
it is to be seen that the wedge of cork or other suitable material, acting upon
a hinge pad, accomplishes the proposed object so necessary in the case, that is,
it lessens or increases the capacity or angle of the double planed inner surface
of the pad, so as to make the front or padded surface of it correspond with
perfect exactness to the variable convexity of the surface of the belly, and
besides, as the spring is hooped shaped, and made to pass through the fixture
upon the centre of the back of the pad, and terminates upon the back of the
larger wing of the pad, and therefore presses harder upon that wing than it
does upon the lesser wing, the wedge being placed between the lesser wing,
and the spring imparts any quantity of the force of the spring to that wing
that may be required to render the pressure of the spring equal upon the two
wings of the pad, by which means both sides of the hypogastric regions of the
belly are equally pressed by the apparatus, a result which is very important to
the cure of the difficulties to which this 'apparatus is intended to be applied.
The apparatus is to be applied by placing the back pad upon the spine just
'above its junction with the hip bones, and the hypogastric pad upon the entire
lower part of the front surface of the belly, the spring embracing the body
closely from one pad to the other. Furthermore, the spring is to be increased
by a cushion strap extending from the front to the back pad, and inclosing
the plate of the back pad so as to form a cushioned pad of it, and still con-
tinued around the opposite side of the body, embraced by the spring so as to
fasten upon the front pad, and regulate its position there with greater certainty.
The Perineum Strap.-This consists of a strap of convenient size and material,
clastic is preferable, which extends from the back pad under the bottom of
the belly between the thighs, in order to its being attached to the front pad
by holes upon corresponding knobs, so that it can be shortened or lengthened
by being buttoned higher or lower upon the knobs of the front pad. This
strap contains upon its inner surface a prismatic triangular shaped wedge
(called an external pessary) also elastic, its apex looking upward and made to
correspond to the part known as the perineum, against which it is to be firmly
pressed. This apparatus completed by the addition of the perineal strap, is
to be applied when there are displacements of the womb with relaxation of the
vagina, and protusive or pouching of the perineum. If the vagina and peri-
neum are not affected, the apparatus without the perineum strap may be applied.
From the foregoing description, and an examination of the Drawing, a

page_text: workman acquainted with the making of ordinary trusses, will readily be
able to carry this Invention into effect, so far as the making of the instrument,
and a medical man will be able to direct its application to the patient.
Having thus described the nature of the Invention, and the best means I
am acquainted with for combining the necessary parts of the apparatus, I
do declare, that I lay no claim to the separate parts thereof, other than is
hereafter claimed, nor do I confine myself to the precise arrangement, as
variations may be made, but what I do claim, is, the application of such
combination, or the essential parts thereof, consisting of the front bypogastric
pad a, and the perineal wedge or cushion b, to obtain external pressure to the
parts above-mentioned, for the supporting of the prolapsed uterus as above
described.
In witness whereof, I, the said Amos Gerald Hull, have hereunto set my
hand and seal this Fifth day of December in the year of our Lord