IMPROVEMENTS IN APPARATUS FOR THE RELIEF OR CORRECTION OF STIFFNESS, WEAKNESS, OR DISTORTION IN THE HUMAN BODY
Year: 1845

page_text: TO ALL TO WHOM THESE PRESENTS SHALL COME, I, JOSEPH
AMESBURY, of 12, Devonshire Street, Portland Place, in the Parish of Saint
Mary-le-Bone, and County of Middlesex, Surgeon, send greeting.
WHEREAS Her present most Excellent Majesty Queen Victoria, by Her
Royal Letters Patent under the Great Seal of Great Britain, bearing date at
Westminster, the Sixth day of May, in the eighth year of Her reign, did,
for Herself, Her heirs and successors, give and grant unto me, the said
Joseph Amesbury, Her especial licence, full power, sole privilege and
authority, that I, the said Joseph Amesbury, my exors, adñors, and assigns,
or such others as I, the said Joseph Amesbury, 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 APPARATUS FOR THE
RELIEF OR CORRECTION OF STIFFNESS, WEAKNESS, OR DISTORTION IN THE HUMAN
BODY;" in which said Letters Patent is contained a proviso that I, the said
Joseph Amesbury, shall cause a particular description of the nature of
my Invention, and in what manner the same is to be performed, to be
enrolled 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

page_text: 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
Joseph Amesbury, do hereby declare the nature of my 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 group of Figures, from one to thirty-eight inclusive, shew the apparatus
which I have invented to be used in certain distortions and weaknesses as
they occur in the lower extremities. Figure I., a compound bar of steel.
Figure II., an edge view of the same. Figure III. shews the compound
bar in the bent position, with an additional plate hereafter to be described.
A, Figures I., III., and IV., a curved lever received into a notch, seen in
Figure II. at a, and rivetted at b, Figures I., III, and IV., so as to allow it a
limited movement in a direction perpendicular to the bar. This curved lever
has a loop formed at each end c, c, Figures I., III., and IV. It is curved,
Figure IV., to suit the side of the hips of the person and to prevent injury to
the soft parts. In some cases only one limb of this bar is used, as seen at
Figure III. The part B, Figures I., III., IV., has formed in it at d long
loops rounded at the edges, and several screw holes e, Figures I. and III., and
is turned so as to form a loop at the lower end f. Through this loop the
part C passes, and it is fastened to the part B by a screw received into one
of the screwed holes in the part B, as seen at 9, Figures I., II., and III.
The lower end of the piece C is strengthened by a piece of steel placed on one
side of it h. This piece and the part C are wider at the lower ends and
extended and cut so as to form the cheeks between which the upper end of
the part D, Figure V., is received. These parts are rivetted together by a
screwed rivet i so as to form a knuckle joint. In the part C is placed a pin
or stud k, and this part is hollowed out at the side so as to receive the
jecting part of the catch, Figure VI., which is rivetted to the pieces h and
part C at m. The part C and the strengthened part h together are so made
as to allow the spring n in the catch, Figures I., III., VI., to move upon
them. This spring is rivetted to the catch at o. A groove is formed in these
parts so as to admit the part p of the catch, Figure VI., as seen in Figure I.
The lower end g of the catch is enlarged, and made in the form of an irregular
square, the projecting part of which is received into a notch s, formed in the
sides of the pieces C and h and in the side of the upper end of the part D,
Figure V, as seen at s, Figure I. When the catch is forced into the notch
pro-

page_text: by the action of the spring n, the parts C and D are immoveably fixed
together; but when the head r of the catch is removed from the notch s the
parts C and D may be bent on each other, so as to form a right angle, or to
any degree between a straight line and a right angle, as in Figure III., but
only in one direction, the shoulders in the parts C, D, at t, t, preventing them
from being bent in the opposite direction. Figure VI. is an edge view of the
catch with the spring attached. Figure VII. is a front view of the same.
The part D, Figures I., II., III., V., VIII., has a stud fixed in it at u; screw
holes are made below v, and a loop is formed at the lower end, through which
the part E, Figures I., II., III. passes. The part E has a hole, through which
a headed screw w is passed into one of the screw holes in the part D to fasten
the parts E, D, together, in the same manner as the parts B and C at f. The
part E is narrowed and turned so as to form a right angle, the lower portion of
which is formed into a screw x, Figure II. The part D has rivetted to it
occasionally a thin steel plate y in Figure III. and V., to spread its influence
over a larger surface of the limb when in use. Figure IX. represents a
steel plate, having raised upon it a screwed hole, seen in section in Figure X.
The holes in the plate 1, 1, are to admit the rivets. The screwed hole z is
made to receive the screw x, Figure II., as seen in Figure IX. When the
compound bar, Figure I., and its foot piece, Figure IX., are used for the
distortion called in-knee, Figure XI., it is fitted up with padded bands or
straps formed of leather or other appropriate materials. Figure XII., a com-
pound padded strap. The part 2 is formed to pass through the long loops
or mortices d, Figures I., II., III.; the part 3, to be buckled over the bar.
Figure XIII. shews a knee strap to be passed round the limb over the
compound bar at the knee. This may have when necessary two other straps
to pass round the limb, as in Figures XVII. Figure XIV., one of the
straps made to pass through the loops c, c. Figure I. Figure XV., a pad
placed on the part B, as in Figure XVI. Figure XVI. shows the apparatus
placed together ready for use. Figure XVII. shews the apparatus Figure
XVI. as in use for the case Figure XI. The apparatus is made of a strength
suitable to the age and size of the person requiring it, and by the shifting
joints formed by the parts B, C, D, E, the compound bar may be altered in
length at the pleasure of the operator. By tightening the strap, Figure XIV.,
as seen in application in Figure XVII., the front of the feet are turned inward
by tightening the strap passed through the corresponding loops behind the
body; the front of the feet may be turned outward by keeping the straps
properly balancing each other according to the circumstances of the case.
The feet are kept in their right position by lengthening the bar, Figure I., and

page_text: tightening the strap 2, Figure XII., as seen in use in Figure XVII. The
weight of the body is taken from the limb where the bar is locked, as shewn in
this Figure, and by tightening the knee strap, Figure XIII., when applied as
in Figure XVII., the knee is drawn toward the bar at the knee, while the ankle
(supported by a strap carried round it, over the bar and buckle, as seen in this
Figure, or when necessary) is prevented from being drawn outward too much
by the introduction of a small pad between the bar and leg at the ankle, as
seen in Figure XVI., or by other apparatus which I will now describe.
In many cases the simple arrangement of the parts of my apparatus
above described is sufficient to effect a cure, the same being regulated from
time to time to suit the varying circumstances of each case, care being taken
also of the general health of the patients, but in others, in which the ankle
is strongly thrown outward, additional parts are required. In these cases
I use the parts shewn in Figure XVIII. and Figure XIX. Figure XVIII.
is a front view of these parts, and Figure XIX. an edge view. F is a thin
steel plate, curved and attached to the steel part G by a knuckle joint, at
4. The part G is made with or without a shifting joint, and has the lower
end narrowed and bent to a right angle, and formed into a screw 5, Figure
XIX. In extreme cases of in-knee a knuckle joint is formed in this part,
at 6, Figure XX. When the parts Figure XVIII. or Figure XX. are
used in connection with the parts Figure XVI. the foot part has two screwed
holes formed in it, as seen in Figure XXI. and in section in Figure XXII.,
one for the reception of the screw, Figure XIX., XX., and the other for the
screw, Figure II., as seen in Figure XXIII. The part F, Figure XVIII.,
is padded and furnished with a leather strap, bellied, which is fixed upon the
plate, as shewn in Figure XXIV. These parts are seen in use with the parts
Figure XVI. in Figure XXV. In many cases the knee bends outward, and the
ankle inward, as in Figure XXVI. For the cure of these I use the parts shewn
in Figure XVI., with the addition of a pad placed on the inner side of the
joint i of the bar, Figure 11., as seen in Figure VIII., at 7, of such a degree
of thickness as the case may require. When the leg bones are bent outwards
also, as in Figure XXVI. A, or independent of out-knee, I apply the plate
Y, Figures III. and V., so as to cause the knee and also the leg bones to
be operated on at the same time, on the leg bones only when the knee joint
is not involved in the complaint. Figures XXVII., XXVII., one shewing
a front and the other a lateral view, exhibit the parts of the apparatus thus
arranged in full operation. In a very bad case, Figure XXVI. A, of this
kind, in which the parts are now restored to their natural line by the steady
operation of the apparatus, the apparatus being regulated for that purpose

page_text: by tightening the straps and altering the shifting joints from time to time,
according to the judgment of the operator. When only one limb is affected,
the strap, Figure XIV., is passed through one of the loops c in the part A,
and is then carried round the pelvis or hips, and passed through the corre-
sponding loop, and then returned upon itself and buckled. If only one limb
of the part A is used, the strap Figure XIV. is carried through the loop and
buckled round the hips. If the object be to turn the front of the foot outward
the limb or part which projects backward when the apparatus is placed on
the limb of the patient is used, and when the object is to turn the front of
the foot inward the front part or limb of the lever is used. Another case is
where there is such a degree of weakness in the muscles of the limb, or some
of them, that the limb is rendered almost, sometimes quite, useless, without
adequate support. When the front muscles of the leg have becomes paralysed,
or nearly so, with more or less weakness of the muscles of the limb above the
knee, the apparatus requires to be more complicated, in order to meet the
circumstances, so as to increase the utility of the limbs, add to the comforts
and diminish the clandication of the patient. I employ in such cases the
parts shewn in Figure XXVIII. in connection with those shewn in Figure
XVI. 8, Figure XXVIII., is a thin plate of steel, long enough to pass
round the inner and back part of the leg, and curved so as to suit those parts.
This plate is rivetted at 10 to the part 9, which is a bar of steel. At 11 a
joint is formed with the part 12, which allows the parts 9 and 12 to turn
upon each other. The movement is limited however by a strong pin or stud
placed below the rivet 13 and 14, against which the projecting part 15 strikes
when the parts 9 and 12 are brought to a given line (commonly straight)
with each other. The part 12 is bent at a right angle at 16, and spread out
to form a plate, as seen in Figure XXIX. 17 is a section of the part 12.
This plate, when in use, is placed between the inner and outer soles of the.
boot, and has holes in it, 18, 18, to allow of its being rivetted to the leather.
This plate may have formed in it or soldered on it a screwed hole, to admit
the screw a, Figure II. When the screwed hole is formed with or in this
plate the plate Figure IX. is not used in such cases, being superseded by
the plate XXIX., having a screwed hole on its surface, of the form shewn at z,
Figures IX. and X. When the muscles of the back of the limb have lost their
power, or when the power has become so much diminished in comparison with
that of those which bend the foot, that the use of apparatus is expedient to
diminish the inconvenience experienced in walking, in such cases I employ
the parts shewn in Figure XXX. These parts differ somewhat in arrange-
ment from the arrangement necessary in the last case. The differences are

page_text: these, videlicit:-The plate 8 is elongated anterior to the part 9, and curved
so as to suit the front of the leg, and the catch 15 formed at the lower
end of this part is placed before instead of behind the joint 11. In cases of
extreme weakness of the muscles two straps are required, and are used as
shewn in Figure XXXII. The parts seen in Figure XVI. in connection
with those represented in Figures XXVIII. and those in Figure XXX. are
shown as far as necessary for illustration in Figures XXXI. and XXXII.,
and when the muscles of the back and also of the front of the leg have lost
their power, it is proper to carry the part 8 partly round the back as well
as partly round the front of the leg. In such cases two catches at the
joint 1.1 are necessary. The part 8 is padded and furnished with straps and
buckles to fasten it to the limb. When the leg bones are bent forwards, as
in Figure XXXIII., I use the parts shewn in Figures XXXIV., XXXV.,
and XXXVI., in connection with the parts shewn in Figure XVI. The steel-
work in Figure XXXIV. is the same as in Figure XVIII. and Figure XIX.,
but padded and fitted up with straps and buckles, as seen in Figure XXXIV.
Figure XXXV. is a pad composed of soft material, and fitted up with four
straps and buckles, as seen in this Figure. Figure XXXVI. also is a pad
of soft material, fitted up with straps and buckles, as here shewn. The
buckles, as is seen, have two tongues, and the straps are strong web. Figure
XXXVII. is a back view of the parts XXXIV., XXXV., and XXXVI.,
as seen in use in the case XXXIII., and Figure XXXVIII. is a front
view. The manner of the application of the apparatus being shewn in these
Figures, as for the case XXXIII., the action of the different parts is manifest.
The effects must be modified according to the judgment of the operator.
The apparatus shewn in the group of Figures from I, to XXXVIII. inclusive,
is that which I use in the above cases of deformity and local weakness, which
are very common; varieties of such cases occur and require to be treated with
corresponding modifications in the apparatus and their application, and these
must be determined by the professional attendant upon the same principles,
according to the number and extent of the parts involved in the complaint,
and the accompanying circumstances observed in the particular case.
Distortions and deformities in the spine and chest, arising from disease or
muscular weakness, or otherwise, are numerous and very various, and the
apparatus employed in their correction or relief must also be numerous, and
also varied to suit the circumstances of the cases as they occur.
There are
very few of these cases even when accompanied with structural disease that
require to be treated by confinement in the inclined or horizontal posture, but
a system of apparatus is necessary which might be modified and, rendered

page_text: suitable to the states or conditions of the several parts distorted or deformed,
and such as can be made to produce such actions on and afford such defence
to the bony structure as tend to bring the distorted parts into their natural
positions, and to restore the deformed parts to their natural figure, while the
general frame requires to be so effectually supported and sustained as to
prevent the super-incumbent weight or the movements of the body from acting
injuriously upon them. To provide for the difficulties met with in these cases,
and to enable the patient to take exercise in the open air, I make use of the
following portable apparatus, which I call my spine supports, and which com-
pletely answers these purposes, and also places the bones of the trunk very.
much under the command of the surgeon, and thereby enables him to carry on
the curative measures in whatever posture the body may be placed, and
whether the person be exercising on my exercising plane or other apparatus in
the open air, or otherwise. This portable curative apparatus consists of two
plates or standards of hardened and tempered steel, inflexible sideways, but
capable of yielding back and front to the motions of the body of the patient.
These plates or standards may be also composed of two or more pieces
variously bent and connected to suit the circumstances of the various cases for
which they are designed. One of these, as made of one piece of steel, is
shown separately in Figure XXXIX. These plates may be made of steel
thicker or thinner, agreeably to the state of the case, the age of the patient, or
other circumstances. These plates are curved or bent so as to suit the par-
ticular form of the back or front of the body of the wearer, Figure XL. being
an edge view of that intended for the back, and XLI. an edge view of that
intended for the front of the body. This plate XXXIX. is first to be enclothed
or encased within soft leather all over it. There is likewise prepared a clothing
for the trunk or body of the wearer, and likewise to include or enclose these
springs XXXIX. in the following manner :-The main portion of this clothing
is composed of two thicknesses of woven cloth of cotton or other material,
which may be strengthened when needful by introducing a layer of the stout
hempen or linen cloth, commonly known by the name of brown holland. In
general I prefer to use the cotton fabric known by the name of jean. Those
pieces are stitched together in the manner commonly practised in stay-making,
with gores if required, and a parallel groove or case is made to receive the
spring in a situation so as to be placed in the centre of the front of the body
of the patient. Previous, however, to their being stitched together, the parts
beneath the spring, which are to be lodged or brought into contact with the
body of the wearer, must have interposed between them and the body two,
three, or more layers of soft woollen cloth or flann l, and be additionally

page_text: strengthened with two layers or slips of stout brown holland cloth; the whole
must then be stitched together so as to leave a space fit to receive the spring
covered with leather for the front of the body, as before-mentioned. This
spring is secured in the clothing by its being stitched or sewn together at top
and bottom. The situation of the front spring XLI. is shewn at 19, 19, in
Figure XLII. and in Figure XLIII. The clothing so described is not, how-
ever, made in one entire piece, but is formed in two or more, agreeably to the
nature of the case. In Figure XLII. it is shewn as separable about the
middle, the upper portion of it 20, 20, overlapping the lower part 21, 21,
about one inch and a half, and is furnished with loops 22, which can be
attached to buttons, affixed upon the parts 21 to receive them. These loops
are formed partly of slips of india rubber, elastic cloth, or webbing, partly of
leather, in which the loops are made. The leather is sewed or otherwise
These portions of india-rubber web
attached to the webbing or elastic cloth.
are lodged within cavities formed within the thicknesses of the clothing, so as
to allow them a degree of motion sideways, in order to accommodate them to
the required and varying circumstances. These particulars are shewn by
dotted lines in Figure XLII. To the upper part of the spring XXXIX. one
or two metal buckles 23 are placed on each side. These are held in their
places by a layer of brown holland and of jean, placed across the spring over
the brown holland covering it, and previous to the different thicknesses of the
clothing being all stitched together, the buckles resting on pads or cushions placed
beneath them. There are also provided two shoulder parts 24, 24, shewn in
Figure XLII., and one of which is shewn separately in Figure XLIV., but
which, however, is adapted to the female clothing, and is connected with the
upper part of the spring 19, 19, by the straps and buckles shewn in Figure
XLIII. at 23. The shoulder parts 24, 24, have one or two stout cotton
webbing straps attached to the front parts of them, as shewn in Figure XLIV.
at 25, and in Figures XLII. and XLIII. I commonly use one for the
female and two for the male.
The fore part of this clothing having been thus described, I shall now pro-
ceed to show how the back or hinder part of the apparatus is formed. Another
steel spring plate or standard Figure XL, which is also enclosed, is provided.
This is seen as padded and furnished with ten metal buckles and loops on each
side in Figure XLV., and underneath the buckles there are placed two pads
or cushions, which are in fact extensions of the coverings which form the pad
and other parts lining the inner part of the steel spring. These are shewn in
section on a larger scale, and as ready to be stitched together, in Figure XLVI..
and as combined together by stitching in Figure XLVII. This back portion

page_text: of the apparatus is united with one side of the fore part of it in the manner
shewn in Figure XLII., the right side of which shews the fore part of the
clothing buckled to the back part or standard, while the other straps in that
Figure are shewn as ready to be so buckled. These straps are laid between
the thicknesses constituting the part 20, 21, and are fixed by double rows of
stitching. The parts 24, 24, which are shewn separately, as for the female
figure in Figure XLIV., are to be covered where they come in contact-with
the armpits when in use, in the manner shewn in Figure XLII. at 26, 26, or
by a section on a larger scale in Figure XLVIII., where is seen a piece of
thick soft leather 25, stitched along the outer side, and then turned over the
stitching and brought down to the part 24, Figure XLIV., and again secured
by stitching, and thus leaving a pipe or tube through which is to be passed
one of the rounded parts of two leather straps 26, 26, Figure XLII., one of
which is shewn separately in Figure XLIX., and both are shewn as being in
the parts in Figure XLII., these rounded parts enclosing within them short
pieces of cord or twine for the purpose of giving substance and roundness
to those parts. The ends of both these straps 27 are joined to the front
standard 19, incased by metal buckles, shewn in Figure XLII. and XLIII.
The shoulder part, Figure XLIV., is often used without the piped strap,
Figure XLIX., in slight cases. Two other straps 29, 29, Figure XLII., aro
shewn as attached to the front clothing by buttons, and are brought round
each thigh in the manner of the straps applied to trusses, and are then fastened
or secured by the buckles 30, 30, as shewn in Figure L. In order to prevent
excoriation they are covered with soft leather, as shewn in Figure XLII.
There is likewise provided a cloth flap 31, which is affixed at the lower end of
the spring 28 at the back, and is furnished with tapes or springs by which it
can be secured by a button-hole made to receive the button affixed just above
the buckles. Each side and the upper parts of this flat 31 are also stiffened
by means of slips of whalebone introduced within pipings or tubes, or places
provided to receive or retain them. Figure LI. shows a neck spring seen in
its widest part. 32, holes for sewing the soft material to the top of the springs.
38, cogs. Figure LII. and LIII. edge views of this spring. The spring
Figure LI. is received into a box formed in the following manner :-A thin
plate of steel is taken, Figure LIV., and on it is laid a slip of steel, Figure LV.,
as seen in dotted lines at 34, Figure LIV. On the opposite side, at the top, is
placed another small portion of steel of the same thickness, Figure LVI., also
indicated by dotted lines at 35. On the lower corner 36 of the plate, Figure
LIV., is placed a spring, Figure LVII. There is then introduced a catch,
LVIII. at 37, and on these parts is laid the plate Figure LIX., which is fixed

page_text: to the other parts by rivetting, as exhibited with a neck spring, introduced in
Figure LX. Figure LXI. shows the form usually made for the front standard
Figure XLI., and Figure LX. is the usual form placed on the back standard
Figure XL. Figure LXII. shows the plate as reversed, the catch Figure
LVIII. and the spring Figure LVII. being also reversed when this form is
used. The parts being thus arranged, pressure of the thumb on the catch at
38 will cause the catch to turn on its axis, and the tooth or head of it 39 to
be drawn from the cog 33, Figure LI., and then the neck spring may be
shifted or withdrawn; and as soon as the pressure of the thumb is removed,
the spring Figure LVII. acts on the part of the catch 38, and forces it back
again into the box, where it prevents the neck spring from shifting. Figure
LXIII. shows the end of the box. Figure LXIV. exhibits the side of the
box opposite to that in which the catch is placed. Here the box is seen on
two small portions of steel, which are sometimes used in order to allow the
neck spring to pass into it over a nut and screw, presently to be described.
These portions, Figures LXV., LXV., are made of a thickness to answer the
purpose intended. When the box is completed it is laid on the covering of
the standard Fig. XLI. at 40, in Figure L., and riveted through this part
of the covering to the standard. The inner part of the covering is then
replaced over the part of the standard intended to lie nearest the back, and
stretched so as to cover up the spring or standard completely, the padding
described being so placed as to cover the inner surface to defend the body from
being fretted by the hard material of which the standard is composed. The
parts, Figure LXV., are only used when room is wanted to allow the neck
spring, Figure LI., to pass freely into the box. They are always necessary,
however, when the screwed nut, presently to be described, is used on the top
of the front standard. Figure LXVI. the same as Figure LX., but showing
a form of neck strap, the ends of which are received by metal buckles
placed at the top of the neck springs, one of which is seen buckled in this
Figure. This strap is composed in the following manner, namely, a portion
of steel, from one inch and a half to two inches and a half long, and
slightly curved, is placed on a piece of strap webbing, on this is laid a
piece of strong cardboard, and on this two or three layers of flannel or
woollen cloth, and over this a piece of soft leather; the outer surface may
then be covered with black silk or other material, and the whole stitched
together to form the neck strap here represented. The parts shown in
Figure LI. to LXVI. inclusive, constitute the neck parts of my apparatus,
which I commonly use in such cases as do not require the neck apparatus
to be more complicated, but in some cases, presently to be mentioned, other

page_text: parts are necessary, as will be hereafter shown. In the use of my spine
support, as above described, the lateral antagonizing actions, by which the
lateral curves of the spine are connected, exert more or less influence on the
front of the chest, so that it would be necessary to use it with very great
caution, in order to prevent the chest from being contracted in the anterio-
posterior direction. This effect of the apparatus renders it necessary to limit
its lateral bearings much more than is desirable in many cases, and in some
its influence could only be permitted to be very inadequate for the reduction
of the curvature. In order to get over this inconvenience, and to protect the
chest from pressure in its anterio-posterior direction, I invented what I call
a chest guard, by which the evil here mentioned is entirely prevented. The
chest guard is a curved spring, shown in Figure LXVII. 41, 41, are studs
screwed into the springs. Figure LXVIII. is a section of the chest guard
on a full size scale, and Figure LXIX., a portion of one end of it. 42 are
holes in the chest guard for attaching the soft material or covering to it by
sewing. When the guard is in use the studs 41, 41, are received into the
holes 43, 43, in the plates of the boxes, Figures LX., LXI., one stud being
placed in a hole in the front plate and the other in a hole in the back plate
or cover of the boxes respectively. In certain stages of lateral curvature of
the spine accompanied with torsion, which causes one side of the chest to
project backward and the other forward, it is important that every action
which is calculated to resist the return of the spinal bones to their natural
relative position, and also the sides of the chest, should be removed, so that as
the surgeon reduces the lateral curvatures by the operation of the means
employed, the tortion, which is a consequence of the lateral curves, may be at
the same time also removed. In my apparatus, as above described, the parts
of the chest which had become flattened from the effects of the curvature
receive part of the pressure employed to aid in the reduction of the lateral
curves; for instance, when the right side of the chest projects backward, the
latero-anterior part of the same side is commonly more or less flattened, and on
the left side the anterior part projects forward, while the latero-posterior part is
more or less hollow and flattened. In such cases, though the soft parts of
the support in action operates more upon the latero-posterior and latero-
anterior projections than upon the opposite hollowed and flattened parts, yet
the hollowed and flattened parts on the convex sides of the spinal curves
especially are not free from the pressure. and, consequently, the favorable
influences of the supports made to reduce the lateral curves and to remove the
consequent torsion of the spine and chest would be hindered in effecting the
latter object by the pressure exerted by the support on the hollowed and
.

page_text: 44 are
flattened parts on the convex sides of the curves as well as on the projecting
parts, though, as I have said, in a less degree on the former than on the latter.
To remove this impediment to restoration, I invented additional springs or
levers, to be used with the support in such a manner as to protect the
hollowed and flattened parts from pressure, and at the same time to aid in the
removal of the anterior and posterior projections of the chest through the
medium of the soft material, by producing an action upon them more
calculated to draw the ribs into their natural relative positions, and thereby to
remove also the torsion of the spine. Figure LXX. shows the broadside of a
cross back spring, and Figure LXXI. an edge view of the same.
holes for the attachment of a strap, as seen in Figure LXXII. When this
spring is in use, the curved end 45 is received into the mortice 46, Figure LX.,
and applied as will presently be shown. Figure LXXIII. is a back lateral
spring. Figure LXXIV. is an edge view of the same, bent. Figure LXXV.,
the same, covered or enclosed in cotton jean or other soft material, and fitted
up with strong webbing straps. Figure LXXVI., a variety of the same
widened in one part to adapt it to the condition of the parts. Figure
LXXVII. is a shoulder spring represented in its broadest view; the spring
is hollowed out a little at 47 to cause it to lie easily on the front of the
shoulder when padded. 48 are square holes to receive the shoulder screw
shown in in Figure LXXVIII. 49 are round holes to receive the projecting
holed screw 50 formed in or on the front standard, Figure XLI., of the
support. Figure LXXX., edge view of the shoulder spring. Figure
LXXXI., a front lateral spring. 51 is a holo to receive the screw Figure
LXXXVIII., which passes through the spring Figure LXXVII. at 48, and
the spring, Figure LXXXI., at 51, and is received by a screwed nut, which
works on a washer and binds the springs together, as seen in Figure LXXXII.
Figure LXXXIII. and Figure LXXXIV. are edge views of the springs,
Figure LXXXI. Figure LXXXIII. is a form for the male, and Figure
LXXXIV. for the female. Figure LXXXV. is the spring, Figure LXXXI.,
widened at one part; this is done by a very thin plate of steel, which is
rivetted to the spring. The front lateral spring, Figure LXXXI., and also the
back lateral spring, Figure LXXIII., are made of various curves, and twists,
and widths, and strengths, to suit the condition and size of the parts, according
to the judgement of the surgeon or operator. Figure LXXXII. shows a front
lateral spring fastened to the shoulder part Figure LXXVII., and fitted up
with straps, both springs being encased or covered with cotton jean or other
soft material. 52 is a web strap stitched to the shoulder part, and received
by a buckle fastened to the support at 53, Figure LXXXVI. 54, 54, 54,

page_text: in Figure LXXXII., are straps stitched on the side spring, and received
into the buckles stitched to the support, as seen in Figure LXXXVI.,
at 55, 55, 55. The end of the spring LXXVII. is seen in Figure LXXXVI.
fastened to the holed screw, shown at 50 in Figure XLI., by means of a
broad notched beaded screw, seen in Figure LXXXVII. The parts
elucidated and shown in Figures from XXXIX. to LXXXVII., inclusive,
are seen in operation in Figure LXXXVI. and LXXXVIII. In Figure
LXXXVI. is seen the front neck spring, the chest guard at 57, the shoulder
piece 58, and front side spring 59, in use with the other parts of my spine
support already mentioned. At 60 the neck spring, Figure LI., is seen
passing over the screw Figure LXXXVII., which is shown in place by a
dotted line. The front lateral spring is seen passing under the upper and
middle pieces of the soft material of the support, and its situation is marked
by a dotted line. In Figure LXXXVIII. is seen the situation of the cross
back spring, Figure LXX., 61, with one end passed into the mortice 46
of the plate, Figure LIX., and the other end passing under the shoulder piece
of the soft material 62, its situation being marked by dotted lines. Here the
upper end of the back side spring Figure LXXIII. rests upon it. The back
side spring in this case is passed under the shoulder piece as well as the
middle piece of the soft material, as marked by dotted lines at 63, and over
the back part of the chest guard, and its upper end is seen at 64. The
situation of the back side spring under the soft material is seen by the dotted
lines. The manner of connecting the cross back piece and the back side spring
together is seen in Figure XC., where the strap, seen in Figure LXXII.,
of the cross back spring is shown passing round the back side spring and
brought out ready to be received into a buckle attached to the soft material
of the support under the arm at 65 in Figure LXXXVIII. The position
of the back side spring under the soft material can be regulated by means of
the straps attached to it, as in Figure XC. One of the ends of the upper
strap is received by the buckle under the arm, and the other by one of the
buckles fastened to the back standard of the support, to which the box
Figure LX. is attached. One of the ends of the lower strap 66, Figure
LXXV., is received by a buckle stitched to the support 67, in Figure
LXXXVIII., and the other by one of the buckles connected to the back
standard of the support. The cross spring Figure LXX. is commonly made
straight to the crooked end; but when the arrangement of the parts which
have been shown is required, it may be bent if necessary, the object being in
certain cases to prevent the back side spring from pressing upon the shoulder.
When the widened back side spring Figure LXXVI. is deemed necessary for

page_text: the better protection of the parts, it can be fastened to the cross bar spring by
a headed screw and a nut, as seen in Figure XCI. This prevents the
additional cross parts 68 from being thrown too close to the chest by the
action of the soft material pressing on it. By the arrangement of the back and
front side springs with the shoulder spring and cross back spring, as shown in
Figure LXXXVI. and Figure LXXXVIII., the hollow and flattened parts
of the chest arising from lateral curvature are effectually preserved from
pressure, while the side springs or levers operate so as to aid, through the
medium of the soft material, in the reduction of the corresponding projections
of the back and front of the chest. Two other advantages are derivable from
the arrangement and form of the front side spring and shoulder piece, namely,
the breast in the female is defended from pressure, which is of great impor-
tance, and the shoulder, which is thrown unnaturally forward by the deformity
of the back of the chest, is pressed gradually back to its natural situation by
the operation of the shoulder spring upon it, the shoulder spring itself being
acted upon more or less powerfully by the front side spring, so as to produce
this effect. The chest guard is made of sufficient span, strength, and temper
to preserve the front of the chest from all pressure, or to any extent that may
be consistent with the curative intentions of the operator. There are many
cases of lateral curvature of the spine, however, which cannot be cured.
even by the improved apparatus above described, as when the deforming
process has proceeded to a great extent and the spine and ribs have become
strongly fixed in their distorted positions, and the particular bones altered
in form, producing lateral, anterior, and posterior projections, with core-
sponding concavities and other irregularities in the contigmation of the
parts involved in the complaint. In such cases it is necessary to produce a
combined series of action of sufficient power to meet and overcome the
increased difficulties which present themselves, and, which cannot be done as
far as the condition of the parts will allow by any combination of the apparatus
hitherto described. The actions must be positive on all the unnatural pro-
jections in directions tending to reduce the projecting parts to their natural posi-
tion in the body, while, in order that the positive influence of the apparatus may
not be impeded, all the unnaturally hollowed and flattened parts are preserved
perfectly free from pressure. Figure XCII. is a shoulder piece, the same as
shown in Figure LXXVII., but with an addition of a thin plate of steel rivetted
to it at 69. This part 69 is bent, as is seen in section in Figure XCIII., or more
or less to suit the figure of the part of the chest near which it lies when in use.
This shoulder spring is encased in soft material before it is applied, and has
formed at the top of the steel part 69, or in the soft material, a long loop.

page_text: Figure XCIV. represents a back side spring longer than that represented
at Figure LXXXIII., and having holes at the end 70 to admit the threads
used in stitching a web strap 71, Figure XCV. to it at this part. The
spring is shown encased in soft material, and the straps seen crossing the
spring in this Figure are the same as those seen in Figure LXXV. Figure
XCVI. is an edge view of this spring. Figure XCVII. exhibits the long
back side spring, Figure XCV., in use in connection with that shown in
use in Figure LXXXVIII. and other parts. Its situation under the soft
material of the middle and shoulder piece of the support is marked by dotted
lines. The spring being placed as is seen in the Figure XCVII., the webbing
strap 71 is carried across the shoulder, and is then passed through the loop
formed in or on the part 69, Figure XCII., as seen in Figure XCVIII. at
73. This strap 71, is then returned upon itself, and carried over the top of
the spring under a loop or stay formed in the soft material, and as seen at 74,
Figure XCVII. It is then carried down and is received by a metal buckle
stitched to the support at 75. The cross straps 76, 76, are buckled in the
following manner :-One end of the upper strap is passed under the back
standard of the support, as marked by dotted lines at 77, and is then received
by one of the metal buckles of that standard at 78. The other end is received
by a buckle stitched to the part of the shoulder piece of soft material, which
is under the arm, and is indicated at 79. One of the ends of the lower cross
strap is received by a buckle stitched to the lower piece of the support at 80,
and the other by one of the buckles 81 stitched to the material covering the
back standard, in the same manner as the spring, Figure LXXV. in Figures
LXXXVIII. and as also seen in this Figure XCVII. It is to be observed
that padding composed of woollen fabric or other soft material is introduced
under the bearing parts of the lateral and other springs, of sufficient thickness
to prevent the skin from being injured by their pressure under judicious
management. The thickness and situation of the pads must be regulated
according to the condition of the parts and the object of the operator, no one
thickness or position being applicable to every case. In Figures LXXXVI.
and LXXXVIII., the back lateral spring Figure LXXV., and the front
lateral spring Figure LXXXI., as attached to the metal shoulder piece
or spring, are represented as in use to defend the hollowed and flattened parts
of the chest from pressure, but the back lateral spring Figure XCV. is
seen in use in Figure XCVII., in such a manner as to enable the surgeon or
operator to produce any degree of pressure on the part or parts of the chest
of the same side projecting backward, with a view to press. the ribs forward
to their natural relative positions, that may be consistent with the condition

page_text: of the parts and safety of the patient. The front side spring being confined
at the lower end, as seen in Figure LXXXVI., or in any other manner, and
the lower end of the long back spring Figure XCV., as shown in Figure
XCVII., or otherwise, the tightening of the strap 71, passed over the
shoulder as above mentioned, causes the spring Figure XCV. to exert a
direct influence on the projection of the side of the chest, tending to force
the ribs forwards into their natural relative position, in any degree that may
be consistent with the safety of the patient, the hollowed and flattened parts
of the front of the ribs arising from their alteration in form, and from their
incroaching unnaturally upon the cavity of the chest, being protected froin
pressure by the front side spring, as indicated in Figure LXXXVI. There
is no impediment offered by the support to the reduction of the ribs to their
natural form and position under the action of the long side spring, as seen
in use in Figure XCVII. If the front side spring were suffered to operate
on the latero-anterior part of the chest, at the same time that its opposite
back spring is operating on the latero posterior, a force may be used
sufficient to crush the side of the chest, provided the straps and levers
were made strong enough; but as the front. spring is defending the front>
of the chest from pressure, while the long back spring is operating on the
posterior projection, the effect tends to undo the torsion of the spine by
the action of the spring on the ribs, and to restore the natural figure of
the chest. The application of my apparatus as last described enables the
surgeon to employ a degree of power sufficient to overcome the difficulties
which present themselves in many cases, but there are others in which it is.
not enough to operate on the latero-posterior projections of the chest, leaving
the front of the corresponding side and the other side of the back of the
chest free from pressure, as shown in Figure XCVII, and XCVIII., but an
action corresponding in kind with that exerted on the latero-posterior projection
must be made to operate on the other side of the latero-anterior part of the
chest, where the ribs project forwards, and in such a manner that the flattened
parts of the corresponding sides of the back and front of the chest may
left free from pressure. In order to accomplish this I introduce another
lever or spring, similar in kind to that shewn in Figure XCIV. This is bent,
and formed to suit the configuration of the latero-anterior region of the
chest at the part on which it is to operate, and then encased in soft material,
as is described and shewn in Figure XCV., but with this exception, namely,
it has a loop formed in the steel, or in the soft material at the top, as shewn
in Figure XCIX. The back spring or lever Figure LXXIII., as seen in
use at Figure XCVII., is also made longer, and formed at the top 70 like
be

page_text: Figure XCIV., and has a web strap attached to it, as shewn at 71, Figure
XCV. Theso parts being provided as here described, and bent, twisted,
widened, and padded, so as to suit the state of the parts and size of the
patient, they are to be used in the following manner, videlicit:-The encased
spring furnished with straps, Figure XCIX., is to be introduced under the
middle and shoulder pieces of soft material, as indicated by dotted lines in
Figure C, and fastened at the lower end 82 by buckles, as seen in that
Figure or otherwise. One of the ends of the top strap 83, Figure XCIX.
is carried under or below the front standard of the support, as indicated
by dotted lines, and is received by a metal buckle at 84, and the other end
is carried under the arm, where it is received by a buckle stitched on the
soft material forming the shoulder part, Figure XLIV., at 24 of the support.
The spring being thus placed it can be fixed in the exact position required
by means of the cross straps and their corresponding buckles. The back
lateral spring, fitted up as shown in Figure XCV., having been introduced
under the soft material forming the middle and upper parts of the support,
and over the cross back spring Figure LXX., as indicated in Figure CI.,
the web strap affixed to the upper end of it, as described, is carried across
the shoulder, passed through the loop 85, Figure XCIX., as shown at 86,
Figure C. The strap is then returned upon itself, passed through a loop
affixed to the top of the back lateral spring, as exhibited at 87, Figure CI.,
and is carried down to the side of the support, where it is received and fixed
by a buckle at any degree of tightness that the circumstances of the case may
indicate. The straps fixed across this spring are received by buckles, and
by these means this spring is fixed in the desired line on the latero-posterior
part of the chest, in the same manner as has been described in speaking of
the spring or lever Figure XCV., and indicated also in Figure CI., one of
the ends of the top cross strap being received by a buckle under the arm, and
the other carried between the body and back standard, to be received by a
buckle on the side of that standard at 88. The lower end is confined, as is
shown in this Figure CI., or in any other convenient manner, the object
being to fix the lower end in a proper line, and to prevent it from rising, so
as to destroy or diminish the influence of the spring when its upper end is
acted upon by the strap attached to it, and as shown in use in this Figure.
By the arrangement of the levers or springs, as seen in Figure C. and CI.,
the posterior part of the right side of the chest may be pressed forward, and
the anterior part of the left side pressed sumultaneously backwards, in such a
manner as to remove the torsion of the spine, and to restore the ribs to their
natural relative position; the anterior part of the right side and the posterior

page_text: part of the left side being at the same time defended from pressure. It
sometimes happens however that the spine turns upon itself in different
directions, so as to carry backward one part of the side of the chest, and
forward another part of the same side, and in this way in some cases there is
found on one side of the back of the chest one projection, and on the other
two, while the front of the chest partakes of the same kind of irregularity.
To meet these circumstances of these cases a modification in the application
of the latero-posterio and laterio-anterior levers is required. In these cases
the cross back spring Figure LXXII., seen in use in Figure LXXXVIII.,
is omitted, and the latero-posteror springs are so bent and padded that when
they are fixed in their proper places they can be made to operate on all
the unnatural projections on the back of the chest on both sides at the-same
time. This is done by tightening the straps which connect these levers with
the latero-anterior levers across the shoulders. These springs being fixed
along the latero-posterior regions of the body, one made to perform the double
office of operating on the posterior projections, and of defending the depressed
and flattened parts of the back of the chest from pressure, the clothing or
soft material of the support connected to the back standard being so arranged
as to cause the levers thus to operate. The pads used must as above stated
be placed under the bearing parts of the levers, or, in other words, on the
projections. The regulation of the actions must be left to the judgment of
the surgeon. The manner of introducing the springs, and their situation, is
indicated in Figure CII., but this is varied as the circumstances of the case
may require, the principle of operation being the same in all. In some cases
of the description last mentioned, instead of carrying up the latero-anterior
spring to the base of the neck, it is expedient to introduce another cross
shoulder spring or lever, with a view to protect the other part of the side of
the front of the chest from the influence of the latero-anterior lever at this
part, while it is made to operate on the lower part on the same side. This
is done by placing the upper end on a cross shoulder lever, as is shewn in
Figure CIII., and as is seen in Figure CV. without the head and neck
apparatus. Again, in some cases, the opposite side of the top of the front of
the chest requires to be acted on, while the lower part is required to be
protected from pressure. This latter object may be obtained by the intro-
duction of a pad under the lever, where it joins the shoulder spring
or lever, of sufficient thickness to produce this effect, while the lower
end may be kept from the body by a cross lever connected to the lower
part of the front standard, as seen in Figure CIII. at 89, where one
end of a lever similar to that shewn in Figure LXXII. is received by

page_text: :
a long loop formed in the edge of a steel plate rivetted to the front standard.
The lever rests on the front spring or standard, and is extended towards
the side, so that the lower end of the latero-anterior lever may rest on it and
be confined in its proper situation by straps and buckles, as exhibited in this
Figure, where is shewn one of the cross levers, as seen in Figure CIII. at 89.
Should it be required, the transverse shoulder levers may at any time be.
removed and the latero-anterior lever be carried up to the base of the neck, in
the same manner as indicated in Figure C, the lower end being fastened by
straps and buckles or placed on a transverse lever, as shewn in Figure CIII.,
as may be most expedient according to the circumstances of the case. In
some cases there is much special deformity of the chest in connection with
deformity of the spine. This is produced by other causes than spinal deviation
and often exists without it. Sometimes the chest projects strongly forward at
the centre of the upper part, while the sides and lower parts are much con-
tracted and flattened or depressed. In such cases the apparatus is so
arranged as to meet the circumstances which present themselves. The chest,
where it is contracted and depressed, must be defended from pressure, while
the upper projecting part must be gently borne upon by the apparatus. To
answer these indications in connection with those which must be met for the
restoration of the spine and the deformity of the chest occasioned by it, I
apply the latero-posterior levers so as to aid in removing any posterior
projections of the chest which the lateral curvature may have occasioned;
sometimes the arrangement of these levers as is seen in Figure CI., some-
times as shewn in Figure CII., the principle in all these cases being to use
them in such a manner as to cause them to bear upon the unnatural
projections, and at the same time to defend the depressed or flattened parts
from pressure. The latero-anterior levers above described are made to rest on
two shoulder levers in such cases as seen in Figure CIV. By this arrange-
inent it will be seen the upper projecting part of the chest may be acted upon
with any degree of force that may be consistent with the safety of the patient,
with the latero-anterior and lower parts of the chest are kept entirely free from
pressure. The degree of pressure is regulated by the straps which connect
the upper ends of the latero-posterior levers with the shoulder levers or springs,
& as seen exhibited in this Figure CIV. Under their lower ends cross levers
may be placed as indicated in Figure CIII. at 89, or hard leather if required.
The object of placing the lower ends of the levers on cross levers when in use,
or introducing a piece of hard leather under them, is the more effectually to
lefend the abdomen from undue pressure or to defend the lower anterior
parts of the sides of the chest from pressure more effectually. In most cases

page_text: the arrangement of the lower ends, as seen in Figure 3, is all that is necessary.
In other respects the apparatus is used as in cases of spinal curvature uncon-
nected with special deformity of the chest. In some cases where there is
special deformity of the chest in connection with deformity of the spine, I use
my chest corrector, Figure CVI. This is a thin plate of steel bent to the
form of the chest, and narrowed and extended at the angles so as to form the
four arms 90, 90, 90, 90. At the extremity of each of the upper arms is
formed a long loop in the steel 91, 91, or loops may be formed in the soft
material with which the chest corrector is covered. The lower arms and the
centre of the lower end are pierced with small holes for the purpose of
receiving the thread used in stitching the webbing straps 92, 92, 92, to them.
The chest corrector may be used for the removal of projections in one or more
parts of the chest at the same time, whether they exist in the front or the
. latero-anterior region. Before using the chest corrector I pad the parts of it
which are destined to bear on the unnatural projections, and then apply it
under the front standard, and wholly or in part also under other parts of the
support. Its situation is shewn by dotted lines in a front view in Figure CVII.
By using the latero-anterior levers in connection with two shoulder levers, as
seen in this Figure, and the chest guard, the front of the support may be
prevented altogether, if desirable, from pressing on the chest corrector. One
or both the latero-anterior levers may be also used to aid in determining the
action of the chest corrector, especially on a given part; for instance, if the
object be to apply pressure across a large portion of the upper part of the front
of the chest, the lower arms of the chest corrector would be placed so as to
lie on the latero-anterior springs or levers, as indicated in Figure CVII. If
the object be to apply pressure to a given part of the side of the chest near
the breast bone, one of the lower limbs may be made to lie on one of the
latero-anterior levers, while the other is placed between the latero-anterior lever
on the other side and the chest. When the chest corrector is properly
arranged in connection with the spine support, one of the web straps 92 is
carried down behind the front standard of the support, and turned upon itsell
over the lower end of that standard, and then passed through a loop to be
received by a buckle, as shewn in Figure CVII. The other two web straps
92, 92, are passed round to the back of the chest, over the latero-posterio
levers, to which they may be connected by a turn of each strap over the leve
of the corresponding side, and then fastened together by buckling, as shewn in
Figure CVIII., where the latero-posterior levers are seen in action. The
web straps affixed to the upper ends of the latero-posterio levers are passer
across the shoulders at the base of the neck, passed through the loops formed

page_text: in the upper arms of the chest corrector at 91, 91, Figure CVII., and
returned on themselves, and buckled as indicated in Figure CVIII. When
the apparatus is thus arranged the chest corrector may be made to exert its
influence according to the intention of the operator, by tightening the straps
attached to the arms of it. If the whole of the metal part of the chest
corrector is placed under the front of the spine support, with the latero-
anterior levers attached with shoulder levers or springs, as above described, the
tightening the straps passed through the loops of the upper arms, and those
attached to the lower arms equally, the whole of the front of the chest may be
borne upon, or such unnatural projections at this part as it is the object of the
operator to reduce. If the straps attached to the lower arms be loosened, and
the straps passing through the loops of the upper arm be tightened, the upper
part of the chest will be the principal seat of action. If the straps connected
with one side of the chest corrector be tightened, and those connected with the
other side be loosened, one side of the chest will be principally acted upon.
The chest corrector having been described, and several modes of using it
pointed out, the condition of the parts in special cases will indicate any variety
in its application in connection with my spine support that may be necessary,
and these must be determined by the judgment of the operator. In many
cases there is more or less projection of the spine backward accompanying
lateral curvature. In these cases the shoulders and upper part of the trunk
are inclined forward. In order to aid in the removal of this defect in the
figure, I employ braces in connection with other parts of my apparatus.
These consist of pieces of cotton, jean, or other soft material, narrowed and
padded at one end to prevent it from injuring the skin of the arm-pit. To
this part is attached a strap, or a strap furnished with a buckle. Figures CIX.
shew the form of braces which I employ. The broad ends 93, 93, are affixed
to the covering and pad of the back standard by stitching or otherwise. At
94, 94, thin slips of whalebone are introduced to keep the soft material
spread out at this part. At 95, 95, Figure CIX., they are rounded and
padded. Figures CX. exhibit the braces in use in connection with other
parts of my spinal apparatus. They are shewn buckled together on the back
of the support at 96. By tightening the braces the shoulders are drawn back-
wards, and the upper part of the trunk made to approach the back standard of
the support without interfering with the curative influence of other parts of
the apparatus.
In some cases the spinal curative extends to the neck
in such a manner as to form a lateral curve in the neck, throwing the head
forward or to one side, so that the apparatus described are not sufficient to
sustain the neck and head in their erect position, or to aid materially in

page_text: removing the deformity at this part. In these cases it is necessary to extend
the support to the head. This I do in the following manner, videlicet:-The
chest guard Figure LXVII. is formed as represented in Figure CXI., and
has a thin plate of steel moulded to the side of the head and fastened upon it
so as to admit of a limited rotatory movement, and as shewn in this Figure
CXI. The plate which I call the head plate is padded with woollen material,
so that it may be made to bear against the side of the head without producing
distress to the patient. The chest guard thus formed and furnished is used as
seen in Figure CXII. The ends being placed in the holes of the neck spring
boxes the plate is brought to the side of the head and made to exert a lifting
action, by a strap and buckle stitched to each neck spring. When this form
of guard is used each neck spring has affixed to it two buckles and one web
strap. The strap is carried round the limb of the chest guard, and then
returned upon itself and buckled to its proper buckle. This having been done
before and behind, the guard may be drawn against the side of the head with
the desired degree of force to influence the upper end of the curve, while the
convex side of it is operated upon by the neck strap which confines the two
neck springs together, in the manner indicated in this Figure and shewn in
Figure CIII. When the head is thrown forward, in consequence of a
posterior curve, I use the head apparatus Figures CXIII., CXIV., CXV.
The toothed part Figure CXVIII. is formed to be received into the box
formed as for the neck spring, and as above described, but rather deeper, to
admit this part of the head apparatus, which is made thicker and stronger than
the ordinary neck springs. The end 97 is bent and formed into a pivot, on
which is placed the part Figure CXIV., and which has a hole in it at 98 to
receive it. The standards 99, 99, are formed on the part Figure CXIV. so
that they may be shifted at the pleasure of the operator, and fixed by means
of screws 100 passing through them and pressing against the part on which
they are placed. The parts Figures CXIV. are furnished with straps suited
to the back of the head and chin, and are shewn as in use with the part
CXIII. in Figure CXVI. This arrangement for supporting the head may
be exchanged at any time for the parts Figure CXV. The toothed end 101
is in like manner received into the box rivetted to the back standard, and the
bowed part is placed so as to be over the head. The part 102 hangs on this,
its position being fixed by a screw which passes through the part 103, and is
screwed down between the notches 104 in the part on which it is placed.
A swivel is formed at 105 on which the
direction with the movement of the head.
with straps is seen in use, Figure CXVII.
part 102 moves freely in
rotary
This arrangement being fitted up
When there is a particular projec

page_text: tion of the spine backward, as from disease or weakness, and where there is
great tenderness, as in some cases of spinal irritation, I use two levers
to form the back standard of the support, of half the width of that standard
when made of one lever. When two levers are employed they are encased
and padded as when one is used, with this exception, however, viz. :-They
are separated from each other by stitching, and when the box Figure LX is
required to be used with them, they are joined by two cross portions of metal
at the upper ends which are rivetted to them; on these cross pieces the box is
rivetted, and the rivets are afterwards covered by the common pad of the back
standard, the soft material being stitched round the incased metal parts as
indicated or described. Figure CXVII. shews a support in use, with two
levers in the back standard, and with head apparatus applied. The compound
jointed standard composed of a series of levers, Figure CXVIII., is applicable
in some
cases. This is composed of narrow thin plates of steel jointed
together, so that each of the two upper and lower pieces may turn freely on
axes, leaving the outer ends free, and all the other pieces are connected
together, as shewn in the Drawings). When this compound standard is
used one is employed for the back of the trunk and one for the front of it.
The lower pieces one clongated, as shewn in this Figure, and the two upper
may terminate where they cross each other at 106, or where they join the next
levers. One or both of the top levers may be bent and carried to the neck, or to
the head, and used as the circumstances of the case may indicate. The com-
pound jointed standards thus formed are furnished with stiff leather padded
and fixed to it in the manner following, videlicet:-Figure CXIX., a piece of
hard leather broader at the lower end, where it has a hole formed in it 107.
Above this hole is a long hole 108; near the top is another long hole 109,
which is made longer than the last. The hole 108 is required to be about an
inch and a half in length, and the whole 109 about three inches long. The
edges of the holes are strengthened on the sides by thin narrow plates of metal
let into the leather, and fixed by rivetting or otherwise; the side presented to
view in the Drawing is that intended to be placed nearest the body. The com-
pound jointed standard Figure CXVIII. is fixed to this leather in the following
manner, videlicet:-Three square pins, each of which has an enlarged head on
one end, the other end of each pin being formed with a screw to receive
nut 112, Fig. 121, between which and the enlarged head the edges of the holes
in the leather are enclosed, while the pins being square are thereby prevented
turning in those holes. The square pins are formed with a female screw to
receive a screw pin 114, by which they are screwed to the standard, as is
shewn on a larger scale in Figure 121. The square pins are made to fit the

page_text: width of the holes in the hard leather, Figure CXIX., so, however, that the
two intended for the holes 108, 109, may slide easily along these holes. These
several parts having been prepared, the square pins are introduced as above
described with respect to Figure 121. The leather is then padded with woollen
cloth or other material, and fastened to it by stitching. The compound jointed
standard properly fitted up, as will be shewn, is to be then laid on the leather,
and the screws 114, made to fit the female screws in the square pin, are then
passed through the centre joints 100, 100, 100, into those female screws placed
ready to receive them, and the whole are fastened together so as to allow the
square pins in the holes 108, 109, to traverse the length of those holes when
the compound standard is elongated or shortened. Figure CXX. shews the
compound standard thus fixed on the leather, having buckles attached to the
ends of the levers at the lateral angles, and to the two lower levers to the two
upper ends, and of the two upper levers as for the back parts. Figure CXXI.
is a section of the leather as padded for use on a larger scale. The padding
of woollen cloth or soft material is so placed as to leave the head 111 of the
square pins free, as seen in this Figure 113, a line shewing the situation of the
compound jointed standard between the nut and screw pin 114. The man-
ner of fixing the buckles to the lateral angles is shewn on a larger scale in
Figure CXXII., where the buckle is seen fastened to the end of the levers,
forming the lateral angles, by soft thin strong leather. One end of the leather
attached to the buckle is divided into three parts, which are passed round the
ends of the levers at the angles doubled upon themselves, and are then stitched
to the leather situated between the ends of the levers, and the metal buckle by
two rows of stitching; stitches are also passed through the leather and the
holes seen in the ends of the levers to prevent the buckles from slipping from
the ends of the levers to which they are attached. Figure CXXIII. shews
the manner of fixing the soft material or clothing for the body to the front
compound jointed standard. Layers of cotton, jean, or other cloth is used for
the clothing, two of which are toothed where they are to embrace the ends of
the short levers, and through the whole length of the front and back parts, and
as will be presently shewn. Two of the ends of the cloth so cut are made to
embrace the ends of the levers, as seen in this Figure, and are there stitched
to each other by a small row of stitching, between which are placed a portion
of whalebone 115. When necessary the attachment of the cloth may be
further strengthened by narrow tape passed over the ends of the levers, and
stitched in by the stitching which confines the two layers of cloth together.
Stitches are passed through the cloth and the holes near the ends of the levers
to keep the cloth from shifting from its proper places. The outer layer of the

page_text: cloth is not directly attached to the ends of the levers, but is strengthened at
the edges in the line of the centre joints of the standard in the manner in
which stays are usually strengthened at the same parts
casing and thin flat
springs or whalebone. Figure CXXIV. shews the two under layers toothed
and affixed to the ends of the short levers of the compound standard intended
for the front of the body, and which is shewn as secured to the stiff padded
leather, as has been described, the upper portion of the clothing being confined
to the upper ends of the short levers by buckles and straps, as seen in this
Figure, or they can be confined, when required, to the two upper lateral angles
by the same means. In this Figure two buckles and two straps are seen as
fixing the upper or shoulder portion of the clothing to the levers which form
the upper lateral angle on the right side 116, and on the left side the clothing
is not attached to the corresponding angle 117. The arrangement at this part
shews the attachment of the clothing for the male on the right side, and for
the female on the left. The clothing is attached to the lower ends of the
lower levers by buckles and straps; a strap 118, with a buckle, is passed
through the two lower loops of the lower levers to draw them toward each
other, and so to elongate the standard, as may be required. The whole
standard is supported at its proper degree of elongation by the action of
this strap 118, and by the straps 119, 119, affixed to the lower ends of the
lower levers, and the buckles stitched to the support at 120, 120, as seen in
Figure CXXVII. The two layers of the cloth being properly affixed to the
front standard by stitching, and with buckles and straps, the third or outer
layer on each side is brought over the standard, and the two sides are then
laced together, as seen in Figure CXXVI. and CXXVII. The two layers of
the cloth, which are toothed or notched in front, are also toothed or notched
behind, but instead of the teeth being fixed by stitching to the back standard,
webbing straps are introduced through the whole length between the layers
forming each tooth, and firmly secured by two rows of stitching, between
which a thin spring, or a thin portion of whalebone, is encased between the
two layers of cloth, in order to keep the cloth properly spread out at these
parts. There are also formed cases by stitching in the parts of the clothing
intended to cover the back and front of the body, as seen in Figures CXXVI.,
CXXIX., and others at 122, &c., in which thin springs are placed and
5 secured by stitching to keep the clothing properly spread out as it lies on the
body. These two portions of the outer layer of the cloth are formed at the
edges like the corresponding front layer, and are also closed over the back
standard by lacing. The manner of attaching the upper and middle, and the
middle and lower pieces together, is by elastic web and buttons and button-

page_text: holes, and as has been described and shewn, & as also indicated in Figures
CXXVI. and CXXIX. and others. When the apparatus is not required to
operate directly on the head or neck, the back and front standards terminate
on the hard leather at 128, Figure CXVIII. and CXX., the elongations of
the levers intended for the head and neck being omitted. In this arrangement
the top buckles are fastened to the ends of the levers 128, 123, the ends of
the levers being pierced with holes to allow of their being fixed by stitching.
When the levers thus terminate, the back and front parts of the support being
closed, present on the body the appearance shewn in Figures CXXVI. and
CXXVIII. The straps and buckles which appear at 120, 120, in these and
other Figures, are those which are fastened to the lower ends of the lower
levers to keep them properly separated from each other. The upper levers of
the back and front standard may be carried to the neck and head, and bent
and formed so as to support these parts. Figure CXXIX. shews one as
carried to the head, and the other to the neck; this being carried up at the
front as well as at the back. The two shorter that go to the neck are con-
nected together by a strap such as has been described, and buckles in the
manner indicated in this Figure. In Figure CXXX. the two levers, one from
the back and the other from the front standard, are seen as carried to the head,
turned and placed on a portion of thin steel plate, padded; on the steel plate is
placed another portion of metal to form a tube in which the ends lie when the
support with this arrangement for the head is in action. The plate is seen
separately on a large scale in Figure CXXXI. where it is shewn as padded,
and in section in Figure CXXXII., and having the ends of the head levers
resting in the the tube. The ends of the levers may be inserted into or
removed from the tube at pleasure, but are prevented from thrusting one
another out or going too far by a shoulder formed in each, as seen in
Figure CXXXI., and they may be kept in their places when necessary by
ribbon or tape stitched to the pad, and tied over them, as shown in this
Figure. The plate is padded with woollen cloth or other soft material where
it comes in contact with the head. Figure CXXVII. shows both the anterior
top levers of the front standard as carried to the head, for the purpose of
preventing the head from dropping forward; the chin rests in a strap formed
to fit it, and which is connected to studs or buckles affixed to the outer sides
near the ends of the levers. The back levers can be carried up and connected
with the front, and made to rest upon a plate, as described, and the lateral
plates on which they rest can be connected behind to support the back of the
head while the lateral parts of the neck and the back of the neck may be
supported by straps and buckles connecting the lateral levers together, and also

page_text: the back levers, as indicated in Figure CXXXIII. and CXXVII. or as it
may be required. When the chest guard, Figure LXVII. above described, is
used in connection with compound jointed standard steel plates, with holes to
receive the studs 41, 41, may be rivitted on the upper part of the hard leather
Figure CXX. at 124. This form of plate here shewn allows the chest guard
to be placed around either shoulder, or both, if required. I can use other
parts of my apparatus above described in connection with the compound
jointed standard, as the latero-anterior levers extending to the base of
the neck as before shewn, and which may be fixed in their places by
buckles and straps; but in cases which require their use I prefer the
several arrangements before described, and shewn in the Figures, as being
more simple and easily managed by the surgeon.
When the compound-
jointed standards are used, and the support properly closed round the hips to
prevent it from slipping, they are made to produce a powerful lifting action
at the same time that they are made to operate on all the lateral unnatural
projections through the medium of the soft material by which they are con-
nected, in such a manner as tends to reduce the curves of the spine, and
restore the deformed parts to their natural relative positions. The parts of
the clothing are to be buckled so as to bear on the unnatural projections,
while those portions which cover the hollow or flattened parts of the body
are left comparatively loose, that no impediment may be offered by the support
to the return of the spine to its natural line or the pelvis. The Diagram
Figure CXXXVI. is illustrative of such actions. The straps and buckles
120, 120, and that represented at 125, enable the operator to regulate the
action of the levers when in use, as the circumstances of the case may
require. This form of lever is more applicable to recent cases than to those
in which the deforming process have made much advancment. In some cases
the chest is deformed anteriorly independant of and unconnected with spinal
curvature. In such cases I have recourse to my chest corrector, Figure CVI.,
with my Patent stays, in which the back parts are closed by buckles and
straps. I insert in the latero-posterior portions of the stays levers with buckles
and straps similar to those described and illustrated in Figures XCV., but with-
out the cross strap 76. These levers are encased between the layers of the
stays by stitching, as indicated in Figure CXXXIV., where their situation
and width is indicated by the stitching. When the stays are thus furnished,
the chest corrector is placed and annanged between the stays and the body,
and the stays are then closed upon it. The webbing straps affixed to the
tops of the latero-posterior levers are then passed through the loops formed
in or on the upper arms of the chest corrector returned upon themselves, and

page_text: buckled, as seen in this Figure, and the arrangement of the front parts is
seen in Figure CXXXV., where the situation of the chest corrector as marked
by dotted lines. The strap attached to the middle of the lower edge of the
chest corrector is then brought up over the lower end of the busk of the
stays, and buckled, as seen in Figure CXXXV. The straps affixed to the
lower arms of the chest corrector are carried through holes or long loops
previously. made in the stays turned round the latero-posterior levers 126
and buckled at the back, as shewn in Figure CXXXIV. The chest corrector
being thus arranged, the operator can produce an influence on such projections
in the anterior parts of the chest as require to be reduced. The straps must
be so regulated that the bearing of the corrector on the unnatural projections of
the chest may be very gentle, and so as only in a slight degree to impede the
movement of the chest in inspiration. The action must be regulated from
time to time as the state of the parts may require.
The operation of my apparatus for distortions, deformities, and local mus-
cular weakness in the lower extremities, is shewn in Figures XVII., XXV.,
XXVII., XXVII., XXXI., XXXII., XXXVII., and XXXVIII. In
Figures XVII. and XXV., the action is seen to be in the direction of the
length of the limb, in which direction a gentle traction is produced when
necessary between the foot and the hip, in order to facilitate the return
of the distorted bones to their natural relative position, which is effected
principally by the lateral actions of the apparatus. The same principles are
carried out as shown in Figure XVII., XXVII., with the addition of a
rotatory action, which is effected by the cross lever A, shown in Figure I.,
with its appropriated straps, which have been described. In Figures XVII.
and XXV., the reduction of the distortion is effected by traction in the long
axis of the limb, the support being made of sufficient length by shifting tho
joints to produce this effect when the boot is firmly laced, and the upper straps
and buckles, Figure XII., are properly fastened, and the apparatus fixed in the
straight position. The lateral effect is produced by drawing the projecting parts
towards the bar or bars of the apparatus. In these cases part of the super-
incumbent weight is thrown upon the compound bar Figure I., of the apparatus.
In Figure XXVII. the reduction of the distortion is effected by traction or
extension, and counter-extension, more or less in the long axis of the limb, as
in the last case, and by drawing the limb towards the bar, Figure I., at the
lower part, and the bar toward the limb at the upper, so as to cause it to
press upon the outer side of the limb at the knee and foot, and so compel the
parts by a gradual process to assume the line which is natural to the limb.
In the deformity, Figure XXXIII., the apparatus is seen in Figure XXXVII.

page_text: and XXXVIII. producing antagonizing actions upon the deformed bones, the
upper parts of the bones being drawn forwards by the action of the apparatus,
while the middle is drawn backwards. In these cases nearly the whole of the
superincumbent weight of the body in walking or standing is thrown upon
the bar Figure I. with a view to favor the restorative action of other parts
of the apparatus. In Figure XXXI. and XXXII. a large portion of the
superincumbent weight, sometimes nearly the whole of it, is thrown upon
the bar, Figure I., which in these cases, as in those just mentioned, is
carried to the hip and secured, as has been described and shown, while
the bars at the lower part, aided by the straps, antagonize the actions of the
stronger muscles, and sustain the foot at a proper angle upon the legs; or,
when the muscles and front of the leg are weak, the foot is kept at. a proper
angle by the antagonizing action of the levers or bars assisted by the straps
employed. In all these cases the bar, Figure I., is kept locked or fixed
in the straight position by the catch when the person is walking or stand-
ing. If a combination of these several cases occur in the same limb, such
parts of the apparatus as may be necessary must be employed together and
modified so as to meet the circumstances of the case, and which the
knowledge of the actions of the several parts will readily suggest to the
operator.
The action of other parts of my apparatus upon the head and trunk may be
gathered from what has been said, but they may be further illustrated by
referring to the Diagram Figure CXXXVII., where the direction of the straps
indicates the transverse and oblique lateral actions, the oblique actions upwards
or downwards producing effects also at the same time more or less transverse.
The several parts of the soft material having been buckled close over the pro-
jections of each side of the body are made to antagonize each other through the
medium of the back and front standards, as indicated in this Figure. A lifting
action is seen in Figure CXVI., a protecting action in all the Figures where
the chest guard is employed, and in all those Figures where the lateral levers
are employed for this purpose anterior and posterior actions are shewn when
the chest corrector is employed as in Figure CVII., and where the braces
are used, as in Figure CX., rotatory actions are shewn, as in Figure C;
when my apparatus is used as many of the mechanical powers as are
herein mentioned must be taken and combined so as to produce such
actions, such protection, and such support as the condition of the parts in
any given case may require, whether the affections be in the spine, chest, or
limbs, or any or all of them, and whether the complaint be complicated with

page_text: disease or otherwise. The apparatus employed should not be removed from
the limbs or trunk, except for the purposes of ablution and changing the
under clothing, except in some cases of paralysis. Their effect should be
modified from time to time as the condition of the parts may require.
From what has been said it will be seen that my apparatus is applicable in
various combinations of its parts to local deformities or weaknesses, as they
occur in one limb only or one part of a limb, or in both limbs, and in
different parts and varieties at the same time, and as I have shown or
indicated, or appropriate combinations may be used for the relief or correction
of deformities and weakness as they occur in the spine, chest, and limbs at
the same time and as has been described. The apparatus must be made of
a size and strength, and in such combinations of parts, as will be found
adequate for the purposes intended. No more nor any less should be
employed than is sufficient to meet the circumstances of the case for which
they are constructed. With respect to the metal employed in the construction
of my leg apparatus, it is proper to state that I use or cause to be used steel
of spring temper, the bars varying in width from half an inch to one inch,
and in thickness from one eighth to one quarter of an inch, the bars being
somewhat curved where they are not required to touch each other; the full
thickness named is made in their middle through their whole length. The
degree of thickness and width varies with the size of the person for whom
they are made and the purpose which they are intended to answer. The
steel used in the formation of the standards, and the lateral levers used in
my spine supports, varies in width from three quarters of an inch to an inch,
and a half an inch being the common width employed for adult patients.
The same width is used for the neck springs at their broadest part, and also
for the narrowest parts of the shoulder springs, but the cross back and front
levers or springs are not required to be more than half an inch wide, and
the thickness in all these springs or levers is commonly about of an inch,
or more or less as may be necessary; when the back standard is composed of
two springs or levers, they are made half the width of one but of the same
thickness as one. When the compound jointed standard is used the width
of the several bars or levers may be made to vary also in width and thickness,
according to the strength required; from one quarter of an inch to three
eighths in width is convenient, except the levers intended to lie on the
lower parts of the body, where they must be rather wider to give additional
strength to these parts, and also to allow room for the formation of the
long holes which are made in them. The thickness is a full eighth of an

page_text: inch, and the length from two inches to two inches and a half, except the
two upper or two lower levers or limbs, which require to be more varied in
length according to the object of the surgeon or operator.
Having given a description of my apparatus, and shewn, with the assistance
of the Drawings hereunto annexed, the manner in which the same are
made, and pointed out several descriptions of cases in which the same or
parts of the same are applicable, also the manner of using them in such
cases. I think it right to mention that I do not intend it to be understood
that the said apparatus above described or shown are of themselves commonly
sufficient for the restoration of the several distorted or weakened parts of the
body which have been named, but I hereby distinctly state, that the several
apparatus or parts of apparatus are used with safety and success by competent
persons duly qualified as medical men, able to regulate their actions, being
properly conversant with the effects of such apparatus on the human body,
when employed with due regard to its structure and to the functions of life,
and to the several parts in a state of health or deformity or disease for the
restoration of which the use of apparatus is required. It is also to be under-
stood that due attention is to be given to the diet of the patient, and to the
use of melicine, manipulations, and exercises, which should be specially
directed for the particular purposes, as the same may arise, on the broad
principles of medical, surgical, and mechanical scienco. I do not intend
to convey that my apparatus will be found in all cases for which they are
employed to supersede the necessity of surgical operations when employed
for the relief or corrector of deformities in the limbs or in the trunk, though
with few exceptions, especially in cases of deformity of the spine and chest,
they will be found to do so under judicious management. But where the
knife is required, the apparatus which I have invented comes in as a most
important and safe auxiliary in the restoration of the affected parts, and
will be found indeed the grand means to enable the surgeon to restore the
parts which have become weakened, distorted, or deformed, to their natural
strength, form, and situation in the body; means which with the several
aids derivable from medical and surgical science, as the same may be neces-
sary in particular cases, will not disappoint the fair expectations of the
properly instructed and judicious professional attendant, or the fond hopes
of those committed to his care: The great principle to be observed in the
treatment of deformities is to restore the distorted parts to their natural
situations and to keep them there, and also to restore the particular bones
which have become deformed to their natural figure, without injury to the
health or to parts of the body not involved in the complaint. The first:

page_text: of these principles may be answered in some recent cases by the hand, or
simply by position; but as the hand cannot be kept in continual operation
the distortion will return when the hand is removed, and as long continued
confinement to the horizontal or inclined position is often found to be injurious
to the health, it should rarely be advised. The surgeon must not depend on
the unaided powers of the body alone for the restoration of deformity, except
it may be in some very recent and slight cases, for if the powers of the body
have become too weak to sustain the bones and joints in their proper relation
to each other, it is not in general to be expected that they will be sufficiently
strengthened to restore them when they have become distorted or deformed.
This fact is proved by every day's experience; were it otherwise such cases
would be rarely met with in adults, whereas experience proves them to be very
common. Distortions and deformities can rarely be removed even in the
early stages, by medicine, by diet, by friction, by change of air, by exercises, or
by the combined operation of all these; otherwise, why is it so constantly
found that where such means are resorted to, these cases get worse and worse,
distressing the mind, disturbing the health, destroying the prospects, and often
prematurely the bodies of the sufferers. While the surgeon does not despise
or reject any of the means I have named, but avails himself of them as
circumstances may require, he must consider, if he would treat deformities and
weaknesses with satisfaction to himself and to those submitted to his care, that
his principal agents must be mechanical, and that they must be regulated
diligently by the laws of mechanics, as the same are applicable to apparatus
applied to the human body. If we want to prop a bulging wall, which is a
mechanical structure, we have recourse to mechanism for that purpose, full
well knowing from experience that nothing else will answer the purpose.
The human body is a most complicated machine, and if its framework gets
out of place, or bulges here or there, mechanical appliances must be had
recourse to to reduce the projections, and to aid in restoring the functions of
the parts to their full operations. A bulging wall may be propped, and the
forces employed may be even sufficiently powerful to restore it to its perpen-
dicular again, but though such restoration might be effected, it never becomes
firm from propping; take the props away and it will soon return to its
former inclinations and ultimately tumble to the ground. Not so, however,
with the human body, the framework of which may give way during periods
of weakness or disease, and become incapable of reduction without adequate
mechanical assistance; but when such assistance is furnished, and properly
applied, and regulated with due regard to the functions and structure of every
part, the distortions or deformities are gradually reduced, the bones are

page_text: brought into their natural relative positions, and their forms are altered to their
natural figure, and, except in cases of parylisis, they gradually acquire, under
judicious management, their natural tone and firmness, and become capable,
in a very large majority of cases, of sustaining the superincumbent weight of
the body without yielding unnaturally when all adventitious aids are removed.
In some cases, however, the natural figure cannot be restored, as where there
has been a great loss of substance from long continued disease, or very great
deformity of the particular bones from many years continuance of the deform-
ing process, and in cases which have arisen from paralytic affections, but even
in almost all these, which are to be considered incurable, great relief and
comfort are derivable from a right application and management of properly
constructed apparatus. It is not to be inferred that I consider my apparatus
herein described as superseding all other apparatus used in the treatment of
distortions, deformities, and weaknesses, but I regard them as superseding in
utility and safety all others hitherto invented for the treatment of the several
varieties of deformities, distortions, and weaknesses herein named or described.
The apparatus may be varied in manner of construction to a very great
extent; it must, therefore, be considered that my main object is to develope
the principles upon which apparatus constructed for the treatment of dis-
tortions, deformities, or muscular weaknesses, as they occur in the spine,
chest, and limbs, should be made, and to show modes of carrying out those
principles in the formation of apparatus by which the desired effects may
produced. These principles I shall now proceed to shew and determine:-
The great principle to be observed in the construction of all apparatus to be
applied to the human body for the correction or relief of distortions, or local
muscular weakness, as they, or either, or any, or all of them occur in the
spine, chest, and limbs, or in either or any of these parts, is that which
operates by antagonising forces, so that the unnatural protuberances to be
reduced, or the parts to be supported, can be simultaneously acted upon in
such directions as tend to restore the projecting or distorted parts to their
natural positions, without the necessity of confining the person affected to the
inclined or horizontal posture, and without interfering injuriously with the
functions of life, while all external mechanical impediments calculated to
hinder such restoration can be by such apparatus at the same time prevented or
removed. Upon this principle the unnatural external projections arising from
distortions or deformities are simultaneously made the fulcra of all the levers
or other mechanical powers employed in their reduction and in the restoration
of the affected parts to their natural relative position and figure. The
antagonism as a whole is the apparatus employed employed versus the unna-
be

page_text: tural projections and inclinations, and in its parts versus particular unnatural
projections and inclinations, and whether such distortions, deformities, or
inclinations exist in the spine, chest, or limbs, or in any or all of these parts.
The principle of antagonism, embracing also the principle of protection, as
above described, I carry out by a series of supports and other apparatus
adapted to the cases for which they are employed, as I have shown. The
several apparatus, or parts of apparatus, consist of a series of levers in various
numbers and in various forms, arranged in various lines and connected in
various manners by metal or otherwise, as by screws, racks, rivets, pivots,
springs, catches, buckles and straps, buttons and button holes, so as to form
such manner of apparatus as may be required, some being made to protect
certain parts from pressure, while others act upon other parts with any degree
of force which in the judgment of the operator may be safe and proper, and
in any direction in which the spine, chest, or limbs, or any or all of them, may
be made the centre or centres of such actions. The operation of the mechanical
powers employed can respectively be made more or less local, and more or
less powerful, by the use of screws, wedges, racks, pads, springs, straps, and
other auxiliaries variously placed, as the state of the parts may indicate. The
forces employed by me are entirely under the power of the operator for
protection and for action, as the circumstances of the case may require,
tending continually, when judiciously managed, to restore the parts individually
and collectively, and in no way hindering their restoration. It is manifest that
no one combination of apparatus is suited to all the forms of distortion,
deformity, or local muscular weakness that occur in the spine, chest, and
limbs, or either of them. The apparatus must be suited to the case, but the
principle of action and protection by antagonizing forces should be the same in
all, when used for correction or relief of distortion, deformity, or local muscular
weakness, as the same occur in the spine, chest, and limbs, or in any of their
parts.
In the treatment of distortion of the spine and chest, and also dis-
tortions of other parts of the bony structure, whether arising from disease or
otherwise, my apparatus worn upon the body are so constructed as to produce,
at the pleasure of the operator, a simultaneous action at once partially and
generally on all the unnatural projections requiring to be reduced, the unnatural
projections being themselves the yielding fulcra on which the antagonizing
forms employed are made simultaneously to operate directly or indirectly, and
with various degrees of force, as may be necessary for their mutual reduction.
The concave external surfaces arising from the unnatural projections or promi-
nences are at the same time protected from external pressure, so as to leave

page_text: room at those parts for the restoration of the body to its natural form under
the influence of the means used, without the necessity of confinement to the
inclined or horizontal posture, and without interfering injuriously with the
natural functions of the body. The antagonism as above stated is effected by
my apparatus in directions longitudinally, laterally, anteriorily, and posteriorly,
transversely, obliquely, and rotatorily, or in all these directions at the same
time, or in any number of them, and consecutively or simultaneously, as
may be required, the great object of such actions being restoration of the
natural figure, and the restoration and maintenance of the equilibrium of the
body in the natural line.
I now proceed to declare,―
Firstly, that I disclaim the right to the exclusive use of any part or parts
of the said apparatus separately, and which part or parts were previously.
known and in use for stiffness, weakness, or distortion in the human body.
Secondly, I disclaim the exclusive right to the use of any of the various
parts of the said apparatus, however variously constructed, and which are
herein described, and which were previously known and in use, except when I
use the said part or parts in new and useful combination or combinations.
Thirdly, I disclaim the exclusive right to the use of any of the material or
materials of which the various parts of the said apparatus are composed,
excepting so far as the said material or materials are used by me in the com-
bination of such part or parts of the said apparatus as are new in principle, or
in new and useful combination or combinations.
Fourthly, I claim the various apparatus or parts of apparatus herein
described, in new and useful combinations together, or in various new and
useful combinations with other parts of the said apparatus; the mechanical
powers employed being constructed and variously combined according to my
principle or principles, which I have observed in the construction and combina-
tions of my portable apparatus herein described, that is to say, upon the
principle or principles of antagonizing actions, and of protection, so as to
produce directly or indirectly the variously combined and modified influences
or effects herein named, described, or indicated at once, on all the projections
arising from distortion; and affording also at the same time protection from
such external or other mechanical pressure to the several parts of the body as
would hinder the restoration of the figure, and as the same combination or
combinations may be suitable to the circumstance of each particular case, the
apparatus being so constructed or combined upon the said principle or prin-
ciples, are my apparatus. And such of the said apparatus or parts of appa-
ratus as I am entitled to claim to use separately, I claim to use separately and

page_text: exclusively, as well as in new and useful combination or combinations with
other parts of the same apparatus.
Fifthly, I claim the exclusive right to the use of the old or known part or
parts of the said apparatus, and of all appropriate materials, so far as the same
are or may be used in constructing my apparatus in new and useful combination.
with the said newly-formed parts thereof herein described.
Sixthly, I do hereby declare that the apparatus, as the same are herein
indicated, described, made, used, combined, and constructed, do, together,
make up my improvements in apparatus for the relief or connection of
stiffness, weakness, or distortion of the human body.
Having thus described the construction of the various apparatus, and the
manner of their application in use, I now proceed to distinguish those parts
which I claim as believing the same to be new; and with the exception of
those parts which I do so claim, I expressly disclaim the other portions of the
said apparatus, except when I use the same in new and useful combination, as
before mentioned.
In the group of Figures from 1 to 88 inclusive, I claim the connection of
the part A in Figures 1, 3, 4, with the part B shown in Figures 1, 3, 4, and
other Figures; and this part A so connected in combination with other parts
of the compound bar, Figures 1, 2, 3, 5, 6, 7, 8, and the parts shewn in
Figures 9, 10. I claim also the strap, Figure 14, or other connecting medium
for the same purpose, in combination with the part A, Figures 1, 3, 4, and in
combination with other parts of the apparatus, shown in Figures 1, 2, 3, 5, 6,
7, 8, 9, 10, 12, 18, 15, and also as partly shown in connection in Figure 16,
and as in use as herein described in Figures 17, 25, 27, 27, and indicated
and herein described as used in Figures 31, 32, 37, 38. The use of the part A
is to enable the surgeon to operate on the limb in cases of in-knee, Figure 11,
so as to keep the feet in their right position in respect to other parts of the
limb and body, which is done by the action of the strap, Figure 14, used as has
been shown. The joint l, as described, by which the parts A and B are con-
nected, facilitates the movements of the trunk upon the limbs, and the limbs
upon the trunk, when the apparatus shewn in Figure 16 is used, as seen in
Figure 17, and shown or indicated also in other Figures. When the part A is
used with the straps, Figure 14, in the cases shewn in Figure 26, they aid
also in drawing the compound bar Figure 1 close to the upper part of the
limb, as may be required. When only one limb of the person is effected, this
is done by the operation of the strap, Figure 14, on the hips, but when both
limbs are so deformed, and the compound bar is fitted up and used, as has
been described, the parts A antagonize each other, but they are made to

page_text: approximate by the straps operating on the parts A, and through them the
upper end of the bar on each side is drawn toward the upper parts of the
limb. In this case the feet and ankles being kept in their right position
by the apparatus, the fulcra are placed at the foot, ankle, and knee, and in the
case Figure 26 A, also at the legs, the compound bar being made to operate
on all these parts by the other portions of the apparatus employed, as shewn
in Figures 27, 27. I am aware that apparatus with shifting and hinge joints
have been used before for the removal of distortions of the knee and ankle,
and that the same are often carried up to the hips, and by a portion of steel
placed transversely to the top of the leg and thigh parts, the same are confined
to the hips, but in these leg apparatus in use there are no special stops in the
hinge joints intended to be placed nearest to the hip and knee and ankle, and
therefore nothing to prevent the lateral movement of the parts above and
below the joints, and consequently no provision to enable the surgeon to cause
part of the weight of the body above the limb to be borne or suspended by
the apparatus when the wearer is standing or walking; nor is there any pro-
vision in them to enable the surgeon to produce gentle traction on the limb,
by which the restoration of the bones to their right position and form is often
greatly facilitated.
I disclaim all such apparatus. The compound bar,
Figure 1, was invented by me, as shown in Figure 2, and has been long used
by me in my practice, but without the part A and the strap Figure 14. In
this bar there is commonly no hinge joint formed at the ankle, the movement
of the screw, in the screwed hole Figure 9, superseding the utility of such
joint, and at the knee part the hinge joint is furnished with a moveable stop,
by which the parts of the bar above and below this joint are made to have
at pleasure the effect of an inflexible lever without joints, on which any part,
or the whole of the weight of the body may be thrown when the bar is fitted
up and used, as has been herein described. I do not claim, therefore, under
this Patent, the said bar, as so made and formerly used by myself, but I do
claim this compound bar as formerly made in combination with the additional
part A jointed to it, as described, and the soft material in the form of straps or
otherwise, by which it is connected with its corresponding parts, or affixed to
the apparatus on the opposite side, or by which it is connected to the hips, as
herein indicated and described in the Drawings. The principles carried out
by this bar, and the appendages herein described, as formerly used with it, in
combination with my improvements or additions, that is to say, the part A, and
its appropriate connections, are, first, gentle traction in the long axis of the
bar, rotation of the limb, and especially of the foot, and lateral antagonism
between itself and the hips of the patient, or between itself and the corre-

page_text: sponding parts placed on the opposite side, and between itself and the unnatural
projections of the limb, and suspension by which part of the weight above may
be thrown upon it, and so taken off from the limb, which is not in a condition
to bear it without yielding or binding the restorative process. It is manifest
that the same effects may be produced by an inflexible bar without shifting or
hinge joints or both. And I claim such a bar in connection with my improve-
ments, as above mentioned, but the shifting joints are for the purpose of
facilitating the adaptation of the apparatus to suit the condition and alteration
of the parts, and the hinge joints with stops are to facilitate the movements of
the patient, as the same may be allowed by the surgeon. I prefer therefore,
the compound bar Figure 1, and as above shewn in other Figures, believing
the same to be more manageable, more comfortable in use, and equally efficient
with one in which any or all the joints are omitted. The parts which I have
above clained singly, or in combination, I also claim in combination, as the
same may be required with the parts herein described, and also shown or
indicated in Figures 18, 19, 20, 21, 22, 23, 24, 28, 29, 30, 34, 35, 36, and
indicated as applied, as herein described, in Figures 25, 31, 32, 37, 38. The
use of the apparatus Figure 1, fitted up with soft material in the form of straps
having buckles affixed to them, or other means of connection, in combination
with other parts of the apparatus, as indicated in Figure 25, are the same as
have been mentioned, but with the addition of the jointed lever, Figure 20,
fitted up with the plate, Figure 21, as in Figure 24, the lateral protrusion of
the ankle, seen in Figure 25, may be corrected, these being formed between
the projecting parts and the lever placed on the inner side of the limb, as
shewn in Figure 25, antagonizing actions through the medium of the material
or materials placed on the outer side of the ankle joint, and connected over
the lever, so as to enable the operator to cause the ankle joint to approximate
to it as the circumstances of the parts will allow; such approximation of the
ankle joint toward the lever can be facilitated by the other parts of the
apparatus. The apparatus, Figure 16, with the parts, Figures 28, 29, 30, fitted
up with appropriate soft material, and having a screwed hole made on the part
Figure 29, form a combination to be used in certain cases complicated with
muscular weakness, from which the several advantages derivable from the
combinations already claimed may be obtained, so far as the same are required
for relief or correction of the distortions shewn, as indicated in Figures 11,
26, 26 A, with the additional antagonizing actions between different parts of
the apparatus and other parts, and between the apparatus and the limb,
whereby the weak parts may be aided, supported, and protected, and the dis-
torted parts reduced to their proper relative positions, the surgeon taking care

page_text: to fit up the apparatus in its different parts, and, as a whole, regulate the same
as the circumstances and condition of the limb or limbs may require. If
necessary, two stops, allowing a limited motion, can be formed at the hinge
joint, Figures 28, 30, the part 8 being elongated, as may be necessary. This
arrangement I also claim, in combination with the part Figure 16, as fitted
up as may be required. If the distortion be still further complicated with
deformity or distortion of parts of particular bones, the parts Figures 35, 36,
are used with either of the levers Figures 18, 20, 30, fitted up as described,
and also as shewn and indicated in Figure 34, as may be required. When
the parts Figures 35, 36, are employed, as for the complication exhibited in
Figure 33, as indicated in Figures 37, 38, antagonizing actions are produced
by different parts of the apparatus upon the limb, and as between the limb
and the apparatus, as indicated or illustrated by Figures 37, 38, and other
Figures. If either of the levers, Figures 18, 20, 30, be carried up along the
inside of the thigh to aid in the correction of bent thigh bone, an arrangement
similar to that shewn in application in Figures 37, 38, will also operate on the
thigh bone in connection with other parts of the apparatus in a manner the
same as the arrangement shown in these Figures operates on the bones of the
leg. Besides the principles of extention and counter-extention, suspension,
support, protection, and lateral actions produced by the apparatus already
described, singly or in combination, there is also superadded in this case
anterio posterior and posterio anterior antagonizing actions, by the use of the
parts, Figures 35, 86, employed as have been described and indicated. The
several combinations of apparatus, by which these principles are carried out
under the various and varying circumstances of distortion and muscular and
other weaknesses, as they occur in the lower extremities, are my apparatus.
In the correction of distortions of the spine and chest arising from disease or
weakness, various combinations of apparatus are required to suit the various
conditions of the parts as they are found to exist in these cases. The actions
of the several parts of the apparatus must be under the control of the
surgeon, so as to enable him to answer the several indications which are
observed, so far as the same can be answered by any apparatus. worn upon the
body. In the management of these cases, I claim the exclusive right to the
application and use of anterior lateral levers, and posterior lateral levers, and
either used for protection and for action, or for action only, as may be required.
I also claim the exclusive right to the use of those herein described, and shewn
in Figures 94, 95, 96, 99, with the privilege to modify their form, width, and
thickness, in combination with any or all the other parts of the apparatus
herein described, and also shewn in the Drawings, as the said levers are or can

page_text: be employed to aid in the correction or relief of spinal distortion, or weakness,
or distortion of the chest, or both or all of them.
I also claim the several combinations of the said anterior and posterior
lateral levers, with other parts of the apparatus herein described or indicated,
and as exhibited, as the same can be severally used in the groups of Figures
from 97 to 185 inclusive.
'
I also claim the part 69, Figure 92, in combination with the part 77, and
as used with my anterior and posterior lateral levers, or either of them, as
herein shown, and as seen as employed in Figure 104 and others herein
described, and whether the same be made by an elongation of the lateral
levers extending above the part Figure 77, whereby the same effect in some
cases can be produced or as herein described.
I also claim the materials by which the anterior and posterior levers are
made to act on each other, or by which the posterior lateral lever or levers
are made to act on the parts made to bear on the front standard, and on the
fore part of the shoulder or shoulders, as shown in the Figures, where, these
parts are shown as in use; also all the connecting materials by which the
said anterior and posterior lateral levers or springs are connected with other
parts of the apparatus herein described, or by which they can be connected
to other apparatus.
I also claim the chest corrector, Figure 106, and whether made out of one
or several pieces of appropriate material, and as the same can be applied in
combination for distortions of the chest; also in combination with any part
or parts of the apparatus herein described, and also indicated in Figures
107, 108, and with stays and posterior lateral levers, as indicated in Figures
184, 135.
I also claim the manner of connecting the parts, Figures 85, 70, so as
to keep the part 85 from turning on its axis, when in use under the action of
other parts of the support, and as shown in Figure 91.
I also claim the chest guard, Figure 111, used as a head support and chest
guard with two levers in the back standard, as described herein, and indicated
in Figure 112..
I also claim the chest guard in combination with head apparatus, as indi-
cated in Figure 116, as the same may be required, and with the head
apparatus, Figure 115, when employed instead of that shown in application
in Figure 116, and as indicated in Figure 117.
I also claim the compound jointed standard, Figure 118, in its various
modifications, so far as the same are applicable as means of relief or correction
of spinal distortion or muscular weakness; also the several combinations of

page_text: apparatus with the said compound jointed standard herein indicated, described.
or shewn or indicated in the group of Figures from 118 to 188.
I am aware that various forms of apparatus are in use for the correction.
or relief of spinal distortions and weaknesses of the parts connected with
the spinal bones, and in some of them the apparatus is extended to the
head. The principle intended to be carried out by such apparatus is to
make the hips the basis of the support intended to bo given to the spine,
and therefore the various forms of apparatus in use are constructed so as to
receive a part of the weight above, and convey it to the hips. Such spinal
supports are constructed with metallic springs, made to embrace the hips, and
metallic crutches are introduced into the lateral parts, extending from the
framework round the hips to the armpits. Lateral plates of steel are sometimes
connected with the lateral crutches with a view to prevent the increase of
the lateral projections of the chest arising from the distortion of the spine.
These several parts are more or less encased in soft material, and when.com-
bined together are confined to the body by lacing, and are called spine
supports, spine correctors, &c.
In one form of spine support there is, in addition to the parts named as
in common use, a standard connected to the framework adapted to the hips,
and carried up to receive part of the weight of the head through the
medium of connecting apparatus, and convey the same to the hips. In
another description of spinal apparatus the hips are made the fulcrum of a
lever connected with the parts, firmly enclosing them. This lever is extended
up the back, and made to operate on the convex side of the principal lateral
projection of the chest arising from distortion of the spine. In another
kind of spinal apparatus, in addition to the lateral crutches before named,
there is introduced in a direction transversely to the body springs intended
to prevent the increase of the principal lateral projection of the chest, and
to protect the flattened parts behind. The metallic parts of this apparatus
are enclosed in leather, cotton, or linen material, and applied to the body by
lacing. I disclaim all such combinations, the principle of which is to make
the hips the basis or fulcrum of the support which they are intended to afford
to the spine and other parts above the hips.
Another form of spinal support is that which I have invented and have
long used for the relief or correction of spinal distortion and muscular
weakness, the principal parts of which are shown as applied in Figures
49, 50, and which is fully described in my Specification appertaining to my
Patent, bearing date at Westminster, the Fourth day of April, 1837.
The principle of this combination is not to take the weight of the body

page_text: above the hips from the particular spinal bones, and carry it to the hips by
the apparatus, but to bring the spinal bones into their natural lines with each
other, and cause them to bear individually their natural portion of the weight
in proportion as they approach the natural line. In accomplishing this purpose
the apparatus is made to perform antagonizing actions between different parts
of itself and different parts of the body in a manner agreeable to the object
to be accomplished. It is made to operate upon all the lateral projec-
tions arising from spinal curvature, whether the projections be in the spine
only or also in the chest and hips. The actions are principally lateral, though
in different directions, so as to produce in some parts oblique depressing
actions, and in others oblique suspending actions, antagonizing each other,
transverse actions in the same parts of the opposite sides, and in different
parts of the opposite side of the body. All the actions of this combination
are towards the anterior and posterior standards. The direction of the
actions is regulated by the extent and character of the lateral projections of
the body on which they are made to operate, and their intensity according to
the resistance which they have to overcome. The operation of the apparatus
as a whole is on all the unnatural protruberances projecting laterally, the same
being the. fulcra, the extent of which the apparatus by its determined
influence under proper regulation tends continually to reduce. The lines of
influence from the sides to the centre of the body are as various as the
form and extent of the lateral protruberances which the apparatus is intended
to correct. This, however, is not the apparatus or spine support which I
now specify; but I claim the several combinations formed by this apparatus
with my newly invented parts.
In these improved combinations or Inventions all the lateral actions of my
former Invention are preserved, the unnaturally hollowed and flattened parts
are protected from pressure, all hurtful influence on the organization, and on
the vital functions of the body, are removed. The anterior and posterior
projections of the sides of the chest, which could not be sufficiently controuled
by any apparatus in use, whether they arise from tortion of the spine or
otherwise, are by the new combinations herein described brought under the
action of new and additional mechanical forces which are made to operate
directly and powerfully upon them in various combinations, and in such
directions and with degrees of intensity equal to the requirements of the
particular case, or as far as the parts operated on will bear without injury.
By the several new combinations herein described or indicated, forming
together my spine supports now specified, every variety of action which I
have herein named can be effected upon the external surface of the distorted

page_text: parts in such directions, in such manner, and with such force as in the
judgment of the surgeon may be safely induced for the reduction of the
unnatural projections, and the restoration of the natural figure, while the
actions can be varied so as to afford support simply to the parts in particular,
or to the whole of the trunk and head, as may be necessary when all
distortion is removed. Nearly if not all the action of the ordinary spine
supports centre in the hips; in my Invention they centre also in various parts
of the body above the hips. In the common supports there is but one
common centre of action; in my Inventions there are many centres of action.
By the common supports all cases of distortion of the spine are treated upon
one principle, namely, making the hips the fulcrum or basis of all the levers
employed. In mine the fulcra of the several mechanical powers employed are
the unnatural projections of the body, and consequently the fulcra of the
support upon the body are co-extensive with the projections to be reduced.
By the common apparatus the action is much the same, and very similar in all
cases, allowing of little variation or modification. By my Inventions they can
be easily varied to suit the particular and varying condition of the parts as a
whole, or in various relations, and their influence can always be so regulated
as to be positive and determined. The results observed under the use of the
ordinary supports are uncertain and commonly unfavorable; by mine the
actions are demonstrably sure in mechanical effect, and the results are most
satisfactory.
My principle or combination of principles is to make the unnatural pro-
jections arising from distortion of the spine, chest, and other parts the fulcra of
the several mechanical combinations employed for their reduction, so that
every bone of the spine and other parts involved in the distortions herein
named can be made gradually to bear, as may be required, its proper share of
the weight above, so far as the same may be expedient, while all external
mechanical impediments to the restoration of the natural figure are removed
by the apparatus.
•
I claim also the several combinations so acting and so protecting as herein
named as my apparatus.
I claim the application and exclusive use of my spinal apparatus, in combi-
nation with my apparatus for distortions and weaknesses of the limbs, as
herein mentioned and described.
In witness whereof, I, the said Joseph Amesbury, have hereunto set my
hand and seal, this Sixth day of November, in the year of our
Lord One thousand eight hundred and forty-five.
JOSEPH (L.S.) AMESBURY.

page_text: AND BE IT REMEMBERED, that on the Sixth day of November, in
the year of our Lord 1845, the aforesaid Joseph Amesbury came before our
said Lady the Queen in Her Chancery, and acknowledged the Specification
aforesaid, and all and every thing therein contained and specified, in form
above written. And also the Specification aforesaid was stamped according to
the tenor of the Statute made for that purpose.
Enrolled the Sixth day of November, in the year of our Lord One
thousand eight hundred and forty-five.