IMPROVEMENTS IN APPARATUS FOR THE PREVENTION AND TREATMENT OF DIE- TORTIONS OF THE SPINE AND CHEST; ALSO FOR TREATMENT OF DISEASES OF THE SPINE AND OTHER. DISORDERS WHERE A RECUMBENT POSITION OF THE PATIENT IS REQUIRED
Year: 1846

page_text: TO ALL TO WHOM THESE PRESENTS SHALL COME, I, JAMES COLES,
of Harley Street, Cavendish Square, in the County of Middlesex, Surgeon,
send greeting.
WHEREAS Her present most Excellent Majesty Queen Victoria, by Her Royal
Letters Patent under the Great Seal of the United Kingdom of Great Britain
and Ireland, bearing date at Westminster, the Third day of September, One
thousand eight hundred and forty-six, in the tenth year of Her reign, did,
for Herself, Her heirs and successors, give and grant unto me, the said James
Coles, my executors, administrators, and assigns, Her especial licence, full
power, sole privilege and authority, that I, the said James Coles, my executors,
administrators, and assigns, or such others as I, the said James Coles, my
executors, administrators, 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 APPARATUS FOR THE PREVENTION AND TREATMENT OF DIE-
TORTIONS OF THE SPINE AND CHEST; ALSO FOR TREATMENT OF DISEASES OF THE
SPINE AND OTHER. DISORDERS WHERE A RECUMBENT POSITION OF THE PATIENT IS
REQUIRED;" in which said Letters Patent is contained a proviso, that I, the said
James Coles, shall cause a particular description of the nature of my said

page_text: Invention, and in what manner the same is to be performed, by an instrument
in writing under my hand and seal, to be inrolled in Her 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.
NOW KNOW YE, that in compliance with the said proviso, I, the said
James Coles, do hereby declare that the nature of my said Invention, and
the manner in which the same is to be performed, are fully described and
ascertained in and by the following statement thereof, reference being had to
the Drawings hereunto annexed, and to the figures and letters marked thereon
that is to say:-
The apparatus in which I claim the Invention of certain improvements
consisted of a machine known as the Prone Couch, employed for the purpose
of maintaining the recumbent position on the stomach and ch either by
day or by night, and of various machinery for the accomplishment of ce in
exercises for strengthening and otherwise benefitting the muscles of the back,
chest, and extremities of the human body. The prone couch. is represented in.
the Diagram Figure 1 of the accompanying Drawing. It consists of a hori-
zontal frame (a) supporting a flap (b), which is hinged at (a) to a sloping
board (a), in which is a moveable foot-board (f). It is supported on the end
of this sloping board and upon. two legs (d), which are united by a connecting
bar (e). In reclining upon this' couch the body of the patient rests upon the
horizontal flap from the point of the shoulder as far as the bend of the hips,
from whence the lower extremities hang downwards upon the sloping board
towards the foot-board. It is important to the perfect adaptation of this
couch to the case requiring its use that tho horizontal flap should be of an
exact length corresponding to that of the patient, measured from the bend of
the hips to the point of the shoulder; and my improvements for facilitating
this object consists in the substitution of a sliding framework in place of the
simple board which forms the old flap, by means of which I am able to make
that portion of the prone couch longer or shorter, as circumstances may
require. I thus render the same couch available for patients of different
sizes, or to the increasing size of the patient using it. This sliding frame
work is constructed in two parts (see Figure 2, a and b), and the following
will be found a convenient size. Upon two pieces of half-inch board, a and b,
Figure 8, prepared the width of the sloping board of the prone couch, and
seven inches in length (being half the length of the frame) when put together,
are screwed or glued lengthways a number of rails of the same thickness, and
fourteen inches long, c, c, Figure 2; their width must be proportioned to the

page_text: number employed, so that the projecting ends of the rails on one board
(d, Figure 2,) shall slide into the spaces between the rails of the other (e)
when the two parts are put together, as in Figure 3. Two similar pieces of
half-inch board are then fixed in the same manner on the top of the rails, and
the two parts of the frame thus constructed are put together by inserting the pro-
jecting ends of the rails of the one part d into the spaces thus formed between
the rails of the other e, and the two parts being closed the rails are entirely
concealed, and a level surface presented on both sides (a, Figure 6). This
frame is adjusted by means of a screw which is represented in Figure 8, or it
may be drawn out and in by the hand. When this framework is drawn out,
its upper surface presents a depression across its surface half an inch deep,
and the width to which the parts are separated (see Figure 8), which would
allow the mattress that lies upon the couch to sink into it and destroy the
equality of the surface, if not remdied. This is done by means of a thin brass
plate the width of the frame, and a sufficient length, which being screwed
upon the surface of one division of the frame lies flat upon that of the
other, and allows the latter to slide under it (when the frame is drawn out),
and thus covering the depression underneath it. Upon the prone couch a
thin mattress is used. To fix the foot-board at any height on the sloping
portion of the couch, and in such a manner so that the mattress might lie
under it, I construct it as follows:-Two brass or iron brackets are
attached to the sides of the foot-board (b, Figure 5), and project below it to
the thickness of the mattress, generally about two inches; they then expand
and form a foot, and at the same time turn inwards and under the mattress.
From the under surface of this part of the foot two button-headed pins project
downwards. Attached to the sloping board of the couch, close to and parallel
with its outer edges, are two plates of brass or iron, extending from the bottom
to as high as it is necessary to raise the foot-board (b, Figure 6). In these
plates keyholes are made at regular intervals, into which the two button-
headed pins on the foot of the brackets slide, and the foot-board is thus secured
in its place.
Figure 5 shews the foot-board thus constructed. The only parts of the
prone couch, as a separate apparatus, which I claim are, the expanding
frame and the foot-board as above constructed, and I disclaim any other
part.
Figure 7 is a Drawing of the Orthopaedic Sofa, which is a combination of
the prone couch, and of the means of performing various exercises in one
machine, which, when not employed as a remedial agent, represents a common

page_text: sofa. It is not necessary that it should be so arranged, and when economy is
an object all those parts which are only appliances of an ordinary sofa, as well
as all ornamental work about it, may be omitted without affecting its remedial
arrangements. A strong horizontal frame of wood is constructed in the
ordinary manner of a sofa frame, Figure 4 (a). Its dimensions are not
abitary, but a convenient size is about seven feet long by twenty-two inches
wide, the wood three inches deep by two wide. The upper surface of the side
pieces are grooved on their inner edges half an inch deep and an inch wide
(Figure 4, 6). This frame rests upon four legs, either permanently fixed or
. attached by common bed screws for the convenience of carriage; the legs
must not project on their inner sides beyond the plane of the sofa frame.
Within this frame, and forming its bed, lie those parts of the prone
couch which compose its horizontal expanding flap and its sloping board a,
Figure 6. The latter is divided into two parts, and the three parts are
hinged together. They are not attached to the sofa frame, but the
middle flap is hinged to a square frame of wood (c, Figure 4), which
traverses in a groove on each side of the frame the latter being at this part
prevented from spreading and allowing the sliding frame to fall out of the
grooves by an iron cross stay e, Figures 4 and 6. These three flaps when
lying horizontally within the sofa frame, are supported in the middle by the
sliding frame in front by brackets to be described, and the bottom flap being
hinged to the middle portion is retained in its place at the other extremity by
two bolts, which are received into the grooves in the frame of the sofa (f,
Figure 4), which allows them to traverse when the sliding frame is moved
backwards and forwards. This movement is effected by means of a screw,
which is attached to the under suface of the sliding frame, and works in a nut
fixed to the cross stay, which binds the sofa frame.
Figure 6 shows the couch and its sliding frame removed from the sofa and
elevated upon its brackets for use. This is done by drawing the bolts in the
bottom flap, which is allowed to drop to the floor; the middle flap is then
raised to complete the slope, and this and the horizontal flap is supported in
their 'places by the brackets. These brackets are represented in Figure 8;
they are also shewn at (9), Figures 4 and 6, the first shewing one when
unemployed and packed away under the expanding flaps of the couch, which
it then supports as part of the sofa bed, and the other representing its posi-.
tion and mode of action when supporting the flaps in forming the prone couch.
They are best constructed of iron or brass. The standard (a, Figure 8,) must
be of a length proportioned to the height to which the horizontal portion of

page_text: the prone couch is to be raised; it is jointed to a flat foot (6), which is bolted
to the under surface of the front cross bar of the sliding frame (i, Fig. 6).
This joint allows the bracket to lie horizontally close to the inner side of the
sofa frame, or to be raised perpendicularly and at right angles with its foot.
The head of the standard (c) expands, and its upper surface is formed into a
deep groove (d), to the posterior extremity of which a tongue is hinged (e),
which is of a length proportioned to the horizontal flap of the prone couch,
and which, when the bracket is unemployed, lies in a straight line with the
standard on the inside of the sofa frame, where it is supported by a pin g,
Figure 4. When the standard is raised perpendicularly the tongue drops into
the groove in its head, which it exactly fills, and thus forms a horizontal rest
for the horizontal flap of the prone couch. The angle thus formed comes in
immediate contact with the joint of the prone couch, and a loop which projects
from the tongue of the bracket backwards (f), and to which it is jointed,
passes over the head of a thumb screw attached to the sloping board of the
couch, and is secured there by turn of the screw, which firmly fixes the couch
and bracket in their places. A strong screw passes upwards through the head
of the standard into the bottom of the groove and under the tongue of the
bracket when lying in it. By turning this screw the tongue is raised more or
less in the grove, and thus the horizontal flap of the couch is more or less
sloped and the angle of the couch altered. Upon the couch lies a thin mattress
similar to that in use on the ordinary prone couch, and a foot-board is also
attached to and used in the same manner as previously described. To the
foot of the sofa a hollow cushion is attached (b, Figure 7); it is composed of a
framing with two ornamental side pieces, which framing is stuffed and covered
externally so as to form a scroll to the sofa, and lined with baize or otherwise
inside. It is strongly hinged to the cross rail of the sofa, so as to turn back
level with the sofa frame (Figure 11). This foot scroll contains an apparatus
represented in Figure 13, and which is exposed to view when the scroll is
turned back, as in Figure 11. It is used as represented by the Figure in the
sawing and stretching exercises, and consists of a strong spiral spring coiled
round a spindle, and covered by a cylinder of brass, tin, or other suitable
material a, Figure 13. The spindle 6 revolves when required, and is fixed
at other times by means of a rack and lever (c). Upon this spindle at cach
extremity of the cylinder is fixed a sheave of metal or wood (d), which has
wound upon it a strap of web or leather about five feet long, with a spring
loop at the end of it. Upon the outside of the left-hand sheave is fixed the
rack which works in a box (e), to which the lever is attached (f), the tooth

page_text: of the latter taking the notch of the rack and the other end projecting
externally; the spindle on this side then terminates in a brass (6) bearing
fixed in the ornamental side piece. From the sheave on the right hand the
spindle passes through the ornamental side pieco of the foot scroll where it is
squared for the reception of a window (9). The spindle is covered when not
in use by a moveable pattre or onament (c, Figure 7). Round the middle
of the cylinder a strap is coiled, about six feet long, which terminates in a
wooden handle (h). This handle, when not in use, is supported on two. hooks
fixed on the inner side of the cross bar of the scroll, and when in this position
it prevents the cylinder from moving whilst the spindle is in action in the
stretching exercise, as the rack secures the spindle when it is required to use
the cylinder in the sawing exercise. At the head of the sofa is a scroll,
similarly constructed and covered to that at the foot, but which surmounts a
square box to which it is hinged (d, Figure 7). In this situation it furnishes
a convenient pillow for the patient whilst reclining on the couch. It is not.
open at its under part like the foot scroll, but is closed by a flat board corrę-
sponding with the top of the box upon which it lies. When this scroll is
turned back at the joint it forms a table at a convenient height in front of the
couch. See a Drawing of the couch with a patient upon it (Figure 15). It
is to alter the distance between this table or the pillow and the couch that the s
frame upon which the latter rests is made to traverse. An iron spindle passes
through this head scroll, its squared extremities projecting through the orna-
mental sides, and being covered by their moveable pattries (c). To these
the winders, (Figure 9), two of which accompany-each-sofa, can-be-attached,
and the grinding exercise with one or both hands performed by the patient
whilst reclining upon the couch. The square box upon which the head scroll
rests when closed is hinged to the cross rail of the sofa frame like the foot
scroll, and the box and scroll thus turn back and out of the way when required
to form a level surface with the sofa frame d, Figure 11. The box when thus
turned back exposes a hand rail projecting out of it, which is grasped by the s
patient whilst stretching (see Figure 18). During that process it is necessary to
fix the box in its open position; this is done by means of a brass loop, which
is attached to the box and passes under the cross rail of the sofa frame, there
being fixed, by means of a thumb screw, to the rail; a similar loop is attached
for the same purpose to the foot scroll. On various parts of the sofa, as shewn s
in the Drawings, small ornamental pattries or medallions are attached; five
of them are removeable, the others permanently fixed. The situation of three
of these moveable pattries have been already described as covering the ends of

page_text: the spindles; the remaining two will be found one on each side of the sofa
frame nearest the head; they also cover spindles, which however, do not
revolve but pass through the rails of the sofa, and are rivetted into iron plates
(h, Figure 4,) screwed upon their inner sides. These fixed spindles are for the
purpose of attaching the winders one on each side of the sofa frame, to be
used in the sawing exercise. The heads of all the spindles and screw pins of
the apparatus are made of the same size, which the sockets of either of the
winders will accurately fit, so as to remove all difficulty in attaching them; and
the moveable pattries are retained in their places by means of a collar which fits
into the space left round the spindle for the reception of the socket of the winders.
To perform the swimming exercise a traversing cushion is also required
(Figure 10), which works in the grooves on the upper face of the sofa frame.
It is constructed upon a frame of wood the width of the sofa, and about
square. It is French stuffed, and rests upon two longitudinal bars, which are
attached to the under surface of its frame a in such a manner as to fit into the
grooves upon the upper surface of the side rails of the sofa frame. Into these
bars are inserted four friction rollers (c), which enables the cushion to traverse
easily the whole length of the sofa frame backwards and forwards. Two
cushions similarly constructed, but without the rollers, and of a size to fill the
remaining space between the head and foot scrolls of the sofa, assist to form a
complete sofa squab, which covers the whole of the apparatus underneath.
These two cushions, with the larger roller and pillow e, e, Figure 7, are the
only parts not applicable to the remedial purposes of the sofa, and may be put
by when the apparatus is required for use.
The only remaining part of the apparatus to be described are the spring and
levers by which the rowing exercise is performed. This is represented in
Figure 12, and consists of a strong plate of steel (a) wound as a spring round
an iron spindle (6), to which it is rivetted. The other extremity of the spring
is screwed to the under surface of the cross bar of the moveable frame to
which the couch is attached (c). The spring being thus fixed, the spindle is
made to revolve, by which the spring is acted upon. This spindle at each
extremity passes through a brass bearing (e), and then gives off a lever (f) at
right angles with it. These levers are about two feet long, and terminate in
handles (g). They are bent after passing from under the bar to which the
spring is attached so as to rise to a level with the inner edge of the grooves in
the sofa frame (m, Figure 4), along which they lie close and out of the way
when not in use. When the rowing exercise (17) is performed the end flap
of the couch is lowered to the ground, and the patient, seated upon-a-cushion

page_text: with her feet against the foot-board, grasps the handles of the levers, and,
bending herself backwards, draws them with her until her head touches the
sofa behind her; she then rises herself, and bending forwards to the extent of
her reach, repeats the-stroke backwards as in rowing. The sawing exercise
is performed as represented in the Drawing 14. In the swimming excr-
cise (16) the winders being fixed on the spindles in the sides of the sofa frame,
the patient lies at length upon the traversing cushion (10), and grasping the
winders, draws herself backwards and forwards to the extent of her arms.
In the stretching exercise (18) a leather belt is fixed round the waist; from
which a strap descends on each side, terminating with a-ring; the patient,
lying upon the traversing cushion, as in the last exercise, grasps the hand rail
in front of her; a winder is then applied to the spindle of the cylinder in the
foot scroll and held in the right hand whilst the lever of the rack is depressed
with the left; the two straps upon the sheaves will be thus unwound. to the
length required to attach them to the rings of the belt round the waist.
Removing the finger from the lever of the rack will arrest this motion, and
enable the operator to quit the winders and attach the straps; then, by
reversing the action of the winder, the straps will be tightened to the required
degree of tension which the rack will maintain; the patient then, pulling at
the hand rail, can stretch the body to the extent required.
I claim all those parts of the apparatus herein described as the Orthopedic
Sofa which are necessary to the accomplishment of the various objects enu-
merated, both as regards position and exercise, in combination; and I disclaim
all those parts of the sofa which are not necessary for these purposes. I
claim the prone couch as herein described as part of the Orthopaedic Sofa,
both separate and in combination. I claim the brackets which support the
couch also, both separate and in combination.. I claim the apparatus for
performing the rowing exercise, and numbered 12 in the Drawings, both
separate and in combination.. I.claim the apparatus by which the sawing and
stretching exercises are performed, numbered 19 in the Drawings, both
separate and in combination.. I. disclaim the invention of any of the
exercises herein described except as used in combination upon the Orthopaedic
Sofa.
In witness whereof, I; the said James Coles, have hereunto set my hand
~nd cool' thin Third day of March One thousand eight hundred and
JAMES (L.8.) COLES.

page_text: AND BE IT REMEMBERED, that on the Third day of March, in the
Tenth year of the reign of Her Majesty Queen Victoria, the said James Coles
came before our said Lady the Queen in Her Chancery, and acknowledged
the Instrument aforesaid, and all and every thing therein contained and
specified, in form above written. And also the Instrument aforesaid was
stamped according to the tenor of the Statute made in the fifty-fifth year of
the reign of His late Majesty King George the Third.
Inrolled the Third day of March, One thousand eight hundred and
forty-seven.