IMPROVEMENTS IN INVALID COUCHES
Year: 1871

page_text: LETTERS PATENT to James Gillingham, of Chard, in the County.
of Somerset, Surgical Instrument Maker, for the Invention of
"IMPROVEMENTS IN INVALID COUCHES."
Scaled the 8th March 1872, and dated the 15th September 1871.
PROVISIONAL SPECIFICATION left by the said James Gillingham
at the Office of the Commissioners of Patents, with his Petition, on
the 15th September 1871.
I, JAMES GILLINGHAM, of Chard, in the County of Somerset,.
Surgical Instrument Maker, do hereby declare the nature of the said
Invention for "IMPROVEMENTS IN INVALID COUCHES," to be as follows:
This couch is composed essentially of two frames, an upper frame
resting on a lower frame. The upper frame is hinged to the under
frame at the foot, and is lengthways jointed in say three parts or frames
fitted with movable framed cushions. Preferably the back or head
frame is comparatively short, the seat or middle frame is about the same
length as the head frame, and the foot or bottom frame is the longest!

page_text: It is by placing the frames aforesaid at various angles in relation to each
other and to the under frame, that I am enabled to adapt the couch for
various uses, as will be hereafter described. There are lateral straps
onc on each side secured to the back or head and the seat or middle
frame by studs or knobs and by stretchers, one being a sliding or
telescopic stretcher. There is a rack or racks on the under frame, on or
in which the ends of the stretchers rest according to the position the
couch may be required to assume. The sliding stretcher is attached to
the back or head frame. The next stretcher is attached to the middle
or seat frame. The two next stretchers are arranged on the foot or
bottom frame at or near its joint with the seat frame. The fifth
stretcher supports the cushion on the foot frame. Stretchers of various
lengths may be applied, thereby enabling a person to work say thirty or
more changes, producing say thirty or more different articles or pieces
of furniture, and with the appendages belonging to the couch it can
be used for nearly forty different purposes. It will also make
upwards of 400 graduations of the human body.
It may be made of any suitable material, but by preference wood;
the cushions may be fitted with springs or stuffed as required, or instead
of cushions plain movable boards may be used for surgical operations.
The foot cushions when required may be made in two halves, so that
with one half raised it will serve as a leg rest for fractures, while the
other leg remains in its natural position. The jointed top frame is
perforated with holes vertically and horizontally, so that the appendages
used with it having corresponding dowels may be easily attached and
removed. The appendages are:-A moveable foot board which can be
shifted according to the length of the patient, a pair of movable arms,
a movable table with book rest, movable side boards or flaps for a long
cot, and a movable head board with open double flaps. These flaps
are kept open in certain positions by a stretcher, and hinged to a
back bar so as to produce a head rest, a back rest, a shoulder rest, or
a book rest.
The couch is lifted to its various positions by means of dowels
secured in handles, and placed in the holes of the frames horizontally.
The same handles placed vertically in the frame serve as hand lifters for
the patient to draw himself up in position. The holes in the sides of
the frame are also intended for holdfasts to extend the limbs or to brace
the patient down to the couch.

page_text: Other appendages may be added if desired, but the before-named are
found sufficient for most practical purposes.
1
The uses of this couch are various:-It will make an ottoman at the
side of a room, or for persons to sit back to back in the centre of a
room. With holdfasts in the side holes it will make a plane for
extending the limbs or for bracing down the body. With its side
boards it will make a long cot for children to sleep feet to feet, or be
used to prevent a patient from falling out of bed. With the head
board turned into a back rest it makes a lounge. With the foot board
it makes a bed. With the head or, back frame of the couch raised it
makes a bed-chair, and in this position the table may be used for any
desired purpose, such as to support food glasses and other articles, and
as a reading desk. When required the seat flap may in this position
be supplied with a movable cushion with aperture for chamber utensil,
to be used without getting out of bed. Stripped of the bedclothes it
makes a plain couch. By lifting the short foot stretcher it makes a
prone chair. It also makes two prone couches for spinal cases, for
lying on the face and back, the head board forming a book rest. It
makes a kneeling chair for the patient to kneel to read and write.
It forms a plain couch for a child and an inclined plane for grown
up persons. It forms a couch raised in the middle for extending the
stomach. It makes an arm chair, a prone couch for a child, a raised
vertical chair, a raised incline chair, a raised incline couch chair, a
couch for rupture cases for the head to lie lower than the body, a couch
for raising the feet level with the head in a sitting position, and a
surgical operation table. It may however be put to many other
positions and uses than those here enumerated. Where it may be
necessary to lift the couch with a patient on it on to a bed or
elsewhere without taking the patient off the couch, I provide a third
frame to which the legs of the couch are secured, and the rack portion
formed on an intermediate frame so that the latter, viz., the
intermediate frame and the couch proper, may be lifted away with
the patient on it on to a floor, bed, railway carriage, or other place, or
can be placed on wheels and thus conveyed to any desired place, or
instead of having an additional frame, by unscrewing the legs from
the rack frame a similar result may be accomplished to that just
described.

page_text: It will be understood then that my improved couch differs from
other couches in that it is capable of producing. with one and the
same couch those many positions required in hospitals and other
places which to obtain heretofore it has been necessary to employ
separate or at any rate several apparatus.
SPECIFICATION in pursuance of the conditions of the Letters Patent,
filed by the said James Gillingham in the Great Seal Patent
Office on the 13th March 1872.
TO ALL TO WHOM THESE PRESENTS SHALL COME, I, JAMES
GILLINGHAM, of Chard, in the County of Somerset, Surgical Instru-
ment Maker, send greeting.
WHEREAS Her most Excellent Majesty Queen Victoria, by Her
Letters Patent, bearing date the Fifteenth day of September, in the
year of our Lord One thousand eight hundred and seventy-one, in the
thirty-fifth year of Her reign, did, for Herself, Her heirs and
successors, give and grant unto me, the said James Gillingham, Her
special licence that I, the said James Gillingham, my executors,
administrators, and assigns, or such others as I, the said James
Gillingham, my executors, administrators, and assigns, should at any time
agree with, and no others, from time to time and at all times
thereafter during the term therein expressed, should and lawfully
might make use, exercise, and vend, within the United Kingdom of
Great Britain and Ireland, the Channel Islands, and Isle of Man, an
Invention for "IMPROVEMENTS IN INVALID COUCHES," upon the condition
(amongst others) that I, the said James Gillingham, my executors,
or administrators, by an instrument in writing under my, or their
.or one of their hands and seals, should particularly describe and
ascertain the nature of the said Invention, and in what manner the
same was to be performed, and cause the same to be filed in the
Great Seal Patent Office within six calendar months next and
immediately after the date of the said Letters Patent.
NOW KNOW YE, that I, the said James Gillingham, do hereby
declare the nature of my said Invention, and in what manner the same

page_text: is to be performed, to be particularly described and ascertained in and
by the following statement, reference being had to the accompanying
Drawings and to the letters of reference marked thereon, that is
to say :-
-
This couch is composed essentially of two frames, an upper frame
resting on a lower frame.
The upper frame is hinged to the under
frame at the foot and is lengthways jointed in say three parts or
frames fitted with movable framed cushions; the back or head
frame is comparatively short, the seat or middle frame is about the
same.length as the head frame, and the foot or bottom frame is the
longest. It is by placing the frames aforesaid at various angles in
relation to each other and to the under frame that I am enabled to
adapt the couch for various uses, as will be hereafter described. There
are lateral straps one on each side secured to the back or head and
the seat or middle frame by studs or knobs, and there are stretchers,
one being a sliding or telescopic stretcher.. There is a rack or racks on
the under frame on or in which the ends of the stretchers rest according
to the position the couch may be required to assume. The sliding
stretcher or pair of stretchers is attached to the back or head frame.
The next stretcher or pair of stretchers is attached to the middle or seat
frame. The two next stretchers are arranged one on each side of the
foot or bottom frame at or near its joint with the scat frame. The
fifth stretcher serves to support the cushion on the font frame when
required. Stretchers of various lengths may be applied, thereby
enabling a person to work say thirty or more changes, producing
say thirty or more different articles or pieces of furniture, and with the
appendages belonging to the couch it can be used for nearly forty
different purposes. It will also make upwards of 400 graduations of the
human body.
.
It may be made of any suitable material, but by preference wood; the
cushions may be fitted with springs or stuffed as required, or instead of
cushions one long flexible mattress or plain movable boards may be
used for surgical operations. The foot cushions (when required) may
be made in two halves, so that with one arm raised one half cushion will
serve as a leg rest for fractures while the other leg remains in its
natural position on the other half. The jointed top frame is perforated
with holes vertically and horizontally, so that the appendages used with
it having corresponding dowels may be, easily attached and removed.

page_text: The appendages arc-A movable foot board which can be shifted
according to the length of the patient, a pair of movable arms, a
movable table with book rest, movable side boards or flaps for a long cot,
and a movable head board with open double flaps. These latter double
flaps are kept open in certain positions by a stretcher and hinged to a
back bar so as to produce a head rest, a back rest, a shoulder rest, or a
book rest.
The couch is lifted to its various positions by means of dowels secured
in handles and placed in the holes of the frames horizontally, and
retained in position by means of the aforesaid stretchers and rack. Or
the couch may be lifted into its various positions by means of a screw
or a worm wheel or other well known mechanical appliance. The
aforesaid handles placed vertically in the frame serve, as hand lifters for
the patient to draw himself up in position. The holes in the sides of
the frame are also intended for holdfasts to extend the limbs or to brace
the patient down to the couch.
Other appendages may be added if desired, but the before-named are
found sufficient for most practical purposes.
The uses of this couch are various :-It will make an ottoman at the
side of a room or for persons to sit back to back in the centre of a room.
With holdfasts in the side holes it will make a plane for extending the
limbs or for bracing down the body. With its side boards it will make
a long cot for children to sleep feet to feet or be used to prevent a
patient from falling out of bed. With the head board turned into a
back rest it makes a lounge. With the foot board it makes a bed.
With the head or back frame of the couch raised it makes a bed chair,
and in this position the table may be used for any desired purpose, such
as to support food, glasses, and other articles, or as a reading desk.
When required the seat flap may in this position be supplied with a
movable cushion with aperture for chamber utensil to be used without
getting out of bed. Stripped of the bed clothes it makes a plain couch.
By lifting the short foot stretcher it makes a prone chair. It also
makes two prone couches for spinal cases for lying on the face and back,
the head board forming a book rest. It makes a kneeling chair for the
patient to knccl to read and write. It forms a plain couch for a child
and an inclined plane for a grown-up person. It forms a couch raised in
the middle for extending the stomach. It makes an arm chair, a prone
couch for a child, a raised vertical chair, a raised incline chair,

page_text: a raised incline couch chair, a couch for rupture cases for the head
to lie lower than the body, a couch for raising the feet level with
the head in a sitting position, and a surgical operation table.. It
may however be put in many other positions and be applied to other
uses than those here enumerated. Where it may be necessary to lift
the couch with a patient on it onto a bed or elsewhere without taking
the patient off the couch, I provide a third frame or stand so that the
intermediate frame containing the rack and the couch proper may be
lifted away with the patient on it onto a floor, bed, railway carriage, or
other place, or it can be placed on wheels and thus conveyed to any
desired place, or instead of having an additional frame or stand, the legs
can be screwed to the rack frame, and by unscrewing the legs from the
rack frame a similar result may be accomplished to that just described.
It will be understood then that my improved couch differs from other
couches in that it is capable of producing with one and the same couch
those many positions required in hospitals and other places which
to obtain heretofore it has been necessary to employ separate or at
any rate several apparatus. The couch can be constructed in wood
or metal, and its principle of construction may be applied to ordinary

page_text: in order to shew that such apparatus can be applied thereto when
required; e is a foot board which can be removed when required;
ff, are knobs or pins whereby straps are attached when required; g. 9,
are holes to receive additional fittings. The cushions G and H in the
frames D and E are loose, and the cushion on flap F moves with it.
Sheet 2 shews my Invention applied to a couch in a great many:
different positions and with the various appendages applied thereto.
Figure 1 shews the couch in its compact form, in which it can be used
as an ottoman. All the cushions are shifting; the centre one may if
required be replaced by a plain cushion for ordinary use. Fig. 2 shows
the couch as applied to the extension of the limbs in any position
or bracing the body down. The lateral holes in the top frame serve:
to secure the studs and straps. The vertical holes are for fixing the
various appendages. Fig. 3 shews the couch lifted out with the
patient on it from the stand for the purpose of being placed on the floor,
or on a bed, for being conveyed to a railway or other carriage or
on board ship, or for being used as a stretcher, table, or chair. The
couch must be secured after it has been lifted from the stand-by:
the dowels. Fig. 4 shews the couch as adapted for hip diseases,
the head and shoulders being raised a little, without bending the
hip joint. It may be fitted if required with removable drawers
underneath as shewn. Fig. 5 shows the couch arranged as al
bedstead fitted with a shifting foot board. By securing the sheet
to the holdfast on one side of the couch and pulling up the opposite
side the patient may be turned on one side without touching him.
Handles, as shewn on Fig. 11, may be fixed for the patient to draw
himself up in bed by. Fig. 6 represents the couch transformed
into a cot with movable side boards to prevent the patient from
rolling out of bed. These side boards can be used in any of the
raised positions of the couch. Fig. 7 shews the couch with movable
back and head scroll. When raised into the position shewn
Fig. 20 it forms the same couch with inclined legs; if too high it
can be lifted from the stand on to the ground. Fig. 8 represents
a couch with a long back taking in head and spine; the head of
the couch is here reversed so as to form the foot, and the ordinary
foot cushion. is lifted from the stand so as to form a back; comparé
with Fig. 13. Fig. 9 shews the couch adapted for rupture cases
for raising the pelvis or lower part of the trunk so that the intestines
may fall back into their normal position: ~ This couch is shown without
•
on

page_text: a separate stand, the legs being screwed on to the under frame of
the couch itself, as shewn, if required. Fig. 10 represents a couch
for rupture cases, the whole lower extremities of the patient being
raised. Fig. 11 represents a couch for similar cases, but differently
set. The limbs of the body may if required be expanded by being
secured to the lateral holdfasts of the frame as on Fig. 2. The
handles are for the patient to draw himself up by. Fig. 12 shews
the couch arranged as a bed chair for raising the patient without
being propped up by pillows. In this position the cushions for
receptacle can be used if required. Fig. 13 shows a couch arranged
somewhat similarly to that shewn at Fig. 12, but with a movable table
and head rest and without bed clothes or foot board. The table or
other appendages can be used in any of the positions of the couch.
Fig. 14 represents the couch, in the shape of a prone chair or double
inclined plane; the head rest is shewn folded up, forming a rest for
head and shoulders, but is also suitable for a book rest, a back rest, or a
seat in the various positions of the couch. It supports a pillow here.
Fig. 15 shews a pronc chair somewhat similar to the preceding but with
the bottom cushion raised, a position of comfort for many cases. The
couch in any of its chair forms has two movable arms which can be
used if required. Fig. 16 represents the couch arranged for a raised
head and legs and lowered spine. In this or any other position it can
be supplied with jointed arms for book or candle rest. Fig. 17 shows
the couch arranged as a kneeling chair with reading or writing table.
From the second joint it forms a couch for a child. Fig. 18 shews a
knecling chair, the patient resting on the chest with his feet raised.
Fig. 19, a spine couch for the patient to lie on his back; the foot board
is movable and can be shifted to suit the length of the patient. Fig. 20;
a spine couch for the patient to lie face downwards; if too high for the
patient the couch may be lifted bodily off its stand on to the floor.
Fig. 21, an inclined plane couch for a position between lying and
standing, in order to relieve the spine of pressure. Fig. 22, an inclined
plane couch placed in a somewhat different position to the preceding.
Fig. 23, an inclined plane couch similar to the last-described, but for the
head to lie lower. Fig. 24, a raised angled but inclined couch; all 'the
cushions are made to slide in their frames as the couch is shifted into its
various positions. Fig. 25, a raised plane couch supplied with boards,
it serves for an operating table in the camp or hospital; if too high it
may be lifted off the stand, and the latter being supplied with boards

page_text: forms a second plane or bedstead. Fig. 26 shews another position of the
couch suitable for hip diseases, the patient's head and shoulders being
raised without flexing the hip; if too high the couch may be lifted off
the stand. Fig. 27, the couch arranged for a patient suffering from
prolapsus ani or for operations of the rectum; when the position is
reversed, the back resting on the top and the legs lowered it answers for
operation of the urethra. Fig. 28, a prone spine couch for a child, face
or back, and a prone chair combined; a strip is here placed across the
rack of the couch as a rest for the seat which in other positions forms
the head rest. Fig. 29, a raised chair, the legs of the patient being in
an inclined position. Fig. 30, a raised chair somewhat similar to the
preceding; it is fitted with a writing table and enables the patient to
look out from the window into the street; if too high it may be lifted
off the stand and forms an excellent chair. Fig. 31, a raised chair with
split foot cushion, one-half of the cushion being raised for dressing and
resting a fractured leg; the straps are fastened to the studs of the seat
flap and bottom frame. Fig. 32, a raised chair with the back drawn up
perfectly straight and the back stretcher sloping towards the back, so
that the chair cannot tip over backwards. Fig. 33, the couch is here
lifted off the stand with the patient on it and placed on a three or four-
wheeled carriage. Fig. 34, the couch is here lifted off the stand with
the patient on it and placed on the ground.
Although I have described and shewn five stretchers or pairs of
stretchers for carrying out the objects of my Invention, I do not limit
myself to that number exclusively; I may for instance do away with the
telescopic stretcher at the head cushion and the short stretchers b at the
joint of the foot cushion. This is in both cases done by means of a pair
of ordinary stretchers such as 6', and by fitting such pairs of stretchers
(6' being one of them) with a horizontal cross bar at the desired height
and extending beyond the stretchers. Such stretchers may be made to
rest on pins instead of in the racks in the raised position and the ends of
the cross bar rests on the frame when in the lowered position.
And having now described the nature of this my Invention, and in
what manner the same is to be performed, it must be understood that I
do not simply claim the construction of invalid couches with three hinged
flaps; but I do claim as of my improvements in invalid.couches,―
Firstly. The construction of invalid couches with an upper and a
lower frame, the former consisting of three hinged flaps of or about the

page_text: JAMES GILLINGHAM. (L.S.)