ARTES
SCIENTIA
LIBRARY
VERITAS
OF THE
UNIVERSITY OF MICHIGAN
SALUT
TCEBOR
41-QUERIS-PENINSULAM AMENAM
CIRCUMSPICE
The
George E. Wantz
(UM Medicine 1946)
Collection



A PRACTICAL & FAMILIAR
TREATISE ON RUPTURES,
CONTAINING
versally
AN ENTIRELY NEW AND APPROVED METHOD of luring
and arresting OF TREATING THESE he progress of those
DISTRESSING AFFLICTIONS,
THROUGHOUT THEIR VARIOUS STAGES.
Illustrated by Eight distinct Drawings of
TRUSSES AND BANDAGES,
Differing, both in their Principle and Effect,
FROM ANY PREVIOUS INVENTION;
WITH DIRECTIONS FOR THE APPLICATION OF EACH
TRUSS, OR BANDAGE,
TO SUCH CASES AS THEY ARE RESPECTIVELY ADAPTED.
It also contains
CERTIFICATES FROM MANY EMINENT SURGEONS, AND
THE GENERAL OPINION ENTERTAINED BY THE
LEADING MEN OF THE FACULTY.
"The President of the Mechanics' Institution has declared the above to be
the only real Improvement, in the form of a Truss, that
had ever come under his inspection."
TO WHICHS ADDED,
THE TESTIMONY OF PRIVATE GENTLEMEN, AFFIDAVITS SWORN
AT THE MANSION HOUSE AND EXTRACTS IN REFERENCE TO
THE ABOVE, FROM ALL THE LEADING JOURNALS
OF SCIENCE AND MEDICINE.
DEDICATED TO THE ROYAL COLLEGE OF SURGEONS,
By WILLIAM COLES. of Churing Groß
Tras ellaße to his merestert forces the th
2nd Edition London:
PUBLISHED BY THE AUTHOR AND PATENTEE, LONDON BRIDGE;
And Sold by SIMPKIN & MARSHALL, Stationers' Court; ANDERSON,
Smithfield; Cox, St. Thomas's Street; G. VIRTUE, Ivy Lane,
Paternoster Row, and Temple Street, Bristol; T. MORGAN,
16, High Street, Bristol; RATTLE & BRINE, Brock Street, Bath;
W. FREEMAN & SON, Exeter; and all Booksellers.
PRICE 28

MUTTUS
AGENTS.
CONTENT 6970ES
TASHT
Bristol-Mr. T. MORGAN, Rookseller, 16, High St.
Bath-Messrs. STEAD & Co. Chemists, 33, Milsom St.
Exeter-Mr. PENN Surgeon, &c. Fore Street.
Devonport-M WILLIAMS, Bookseller, Fore Street.
A MOST
Entered at Stationers' Hall.
HOW &
OT: 192313
2347 2007
ATOR SET OF G
lla bus ante. I od 25 26
HARVEY, Printer, 22, Great Surrey Street, Blackfriars Road.

TO THE
ROYAL COLLEGE OF SURGEONS.
GENTLEMEN,
18600601
PERMIT me to lay before you the following
pages, the object of which is to relieve, if not the
one of
most important, the most afflicting disease with which
any human being can be visited, viz. Ruptures.
ten
shall not presume, Gentlemen, in this place, to
offer many remarks, but allow me to observe, that if my
own sufferings during a period of several years, and
the experience which they have taught me, can afford
any alleviation, in so distressing a case as Hernia, to
such as are doomed to labour under its influence,
those sufferings will be soothed in the gratifying re-
flection, that a probability now exists, of its being
some day, not only of national, but of worldly impor-
tance to mankind
The only observation, Gentleman, I would here
make relative to myself is, that my affliction was con-
siderably aggravated by wearing a patent Truss,
which possessed no other flexibility than those which
have been employed for centuries past, and which,
experience has since taught me, arose from a defi-
ciency of an internal action in the pad.
As I possessed a tolerable share of mechanical

vi.
B
genius, I was led to the discovery of a new principle
which completely obviated that inconvenience under
which I had suffered the severest tortures, and which,
I am happy to add, is found useful in hundreds of
different objects, for which it had never before been
employed; particularly such Instruments as are uni-
versally employed to relieve the above complaints.
I have taken the liberty to publish the opinions
given by many eminent gentlemen of the faculty in
favor of my improved Trusses and Bandages, many
of which I have been favored with, without solicita-
tion, as well as from private individuals who have
experienced relief from them alone, after every other
which is proved by hundreds of
means had failed, tetter, from Ruptured person,
my possession.
Having thus far attained so proud a pre-eminence,
the fruits of many laborious days and nights, attended
with considerable expence, I now humbly venture
to solicit a share of your patronage in proportion to
the merits which my Trusses may, in your estimation,
possess, as a reward for my exertion and perse-
verance in the cause of humanity.
now
en Years active
I am, GENTLEMEN,
with sentiments of the highest consideration & respect,
your most obedient and very humble Servant,
WILLIAM COLES
No. 1, London Bridge, Upper Thames Street.

PREFACE.
DEEPLY impressed with a sense of the important
subject to which I have before alluded, and the in-
numerable difficulties which have hitherto arrested
my progress since commencing this Business, fully
justifies me in the resolution I have taken to furnish
this little volume of transactions, which perhaps, in
any other country but Great Britain, would have
been hailed as the happiest omen of good to mankind,
It is not, as might well be supposed, to display
my
abilities as an Author, a task for which, I candidly
confess, I am, from the nature of my pursuits, (inde-
pendent of my education,) utterly incompetent. My
principle object, therefore, is to render
Book as
intelligible, and my services as useful, as possible,
to all who may have the misfortune to require my ad-
vice or assistance.
my
Possessing a competent knowledge of the Anato-
mical Structure, and a general idea where each par

viii.
ticular case is seated, by having been afflicted with
one of its worst species, I was compelled to direct
my most strenuous attention towards effecting a more
perfect and convenient security than any thing which
human skill could then furnish, or permit myself
to become a prey to one of the most degrading of all
human maladies.
So various and complicated are the different spe-
cies of Rupture, and so subject is the human frame,
from a variety of causes, to visitations of this afflicting
nature, that notwithstanding the wide field which is
open for the display of mechanical genius to fur-
nish relief in such cases, nothing had previously
been suggested which was at all calculated to afford
relief to a Ruptured Patient, with that degree of se-
curity which could lay claim to public patronage.
Where people have models to work from, it is
no difficult task to imitate them; this, however,
was not my case: I had no pattern to imitate, nor
any person to instruct me: my own imagination,
instigated by my personal sufferings, aided me in
accomplishing what a less efficacious stimulus could
not have suggested..
In studying, therefore, to relieve myself, I am
providentially blessed with the means of affording
relief in cases infinitely worse than my own.
What will a certain Truss-maker say, who advised

ix.
one of my Patients* that he would not be safe to ride
home, even in his carriage, with a Bandage such as will
hereafter be described, and therefore lent him a
German Truss as a better security, until he could
furnish him with a new one, when he peruses this
little manuel, and finds, that many of the most dis-
tinguished and ablest judges in the kingdom, (with
whom he has been upon terms of intimacy,) have
declared mine to be the greatest improvement that
has ever been made in the construction of a Truss,
and some have said, that it is the only real improve-
ment that has ever been submitted to their inspec-
tion.-See Dr. BIRKBECK'S Opinion, as recorded in
vol. 1, Mechanic's Magazine.
The principal object I have in view, is to remove
the prejudice which a Patient, suffering under this
affliction, naturally inculcates, when he finds every
apparatus, which he had made use of, fail to se-
cure his Rupture; nor has the Surgeon, who recom-
mends these instruments, less reason to be preju-
diced: for it sometimes gives them an infinite deal
* As the Patient here alluded to had a good wheel-barrow full of
Trusses in his possession, not one of which was of the least service
to him, I had the curiosity to enquire, about twelve months after,
whether he was in a fair prospect of cure, when I learned, he was
so benumbed with pressure, that he had fallen down stairs and
killed himself.

X.
of trouble. A senior Surgeon of one of our Hospitals,
on being told that I had an improved Truss to shew
him, swore he would be ddif he ever would look
at another Truss so long as he lived. There are,
however, men who stand high in the profession, who
were equally as prematurely prejudiced, who have
been kind enough to retract their opinion in my
favor, whose respectability is equally as indisputable
as the competence of their judgment. Under the im-
pression that my improvements will meet the sanction
and patronage of my readers, I beg to refer them to
the substance of the following pages.

CONTENTS.
Dedication
Preface
Ruptures, Symptoms of
Ruptures, Appearance of, and Means of Cure
page
5
T
13
15
17
and Sir A. COOPER......
Strangulated Hernia, how Produced
Trusses, their Important Office considered
Neglected Hernia, Remarks on, by Professor LAWRENCE,
Ventral and Umbilical Hernia, Explanation of
18
19
20
Hospital Patients, how Treated after Operation .......... ibid.
National Loss, how to be Repaired
Inguinal Hernia, Explanation of ........
Serotal Hernia, Explanation of
Scrotal Hernia, how Treated
...
Strangulation, how Treated
Author's Case
.....ibid.
21
22
ibid.
23
25
Extract from Dolby's Edition of Buchan's Domestic Medicine 27
Cushions of Trusses, how adjusted...
Trusses and Bandages, Drawings of
Drawings, Explanation of ...
Irreducible Scrotal Hernia, how Treated
30
31 to 33
35
39
Extract from No. 28, Journal of Science, Literature, and
the Arts
....ibid.
40
41
Extract from No XI. Medico Chirurgical Review .........
Extract from 118, London Medical Repository
288, London Medical and Physical Journal.. 42
VI
Extract froux su Astley Coopers
peative on Hernia Part 1 Plate 32

xii.
Extract from No. IV. Family Oracle .....
Certificate from Henry Earle, Esq. F. R. S.
Mr. Martin
Pounds pressure of a Truss, how Ascertained
Certificate from Mr. James Daniel, Sen. ........
42
ibid.
44
ibid.
45
Wm. Compson, Esq. Surgeon ............ ibid.
4504
On instruments for relieving the Curvature of the Spine ibid.
Tiff between a Patient and Surgeon of a Rupture Society 46
Certificate from Mr. Churchill, Surgeon, &c. ......... ....ibid.
Affidavit of Robert Hubbard.....
Certificate from W. C. Hunt & Son, Surgeons
-
Mr. Hillman, Surgeon
47
48
49
ibid.
Mr. William Andrews
Caryer Vickery, Esq. Surgeon, R. N. .... 50
Mr. Mason, Surgeon
Affidavit of John Hulbert
Patients of Rupture Societies, how Treated
Prejudice, how to Cure it
Remarks, Private gentlemens'
Sentiments Expressed by Eminent Surgeons
... ibid.
...
51
52
61
62
63
68
Irreducible Hernias, how treated .........
Scrotal Bandage, not to be employed in Strictures of the Ure-
thra, &c.
Serotal Bandage, how to be applied....
Sir A. Cooper's advice to elderly people
Scrotal Hernia, critical Remarks on .....
69
ibid.
... 71
72
73
76 to 78
......
Plate, exhibiting the Internal State of the Bowels ........
Anecdotes on Hospital and Private practice
A hint to the Patient, when he consults his Medical Friend 82
Instruction to Patients previous to sending their order for a
Truss
Echract
ibid.

TREATISE ON RUPTURES.
9102 91
(lato) one padi
SYMPTOMS OF RUPTURE.
Ser out of
RUPTURE, or Hernia, is well known, in every
part of the habitable Globe, to be one of the most
distressing maladies that human beings have to en-
counter; and it cannot be a matter of surprise, that its
sufferings should excite the most ignorant and un-
learned to employ their skill in inventing means to
relieve themselves; and, when they have so done, to
convey a knowledge thereof for the benefit of those
who may be labouring under its influence. ool and
Since, then, this is a disease to which even the
strongest and most healthy are equally liable with
those of the most delicate constitutions, and that it
is to be found among all ranks of Society, from a
prince to the humblest peasant, and frequently dis-
organizes the whole frame, before it makes any ex-
ternal appearance.
B

14
Costiveness, and weakness, accompanied with
severe paines when coughing or sneezing, are its
usual symptoms; and although the Patients feel
the necessity of a constant pressure upon the part,
they are totally ignorant of the means generally em-
ployed, and where to obtain them. They feel their
constitutions impaired; and being entire strangers
to the real cause of their disorder, generally employ
some internal remedy, which tends to weaken the
diseased parts, and confirm their rupture, while the
still more necessary precaution of pressing* upon
the part, is wholly neglected.
Others, either from motives of delicacy, or from
total neglect, treat this disease with perfect indiffer-
ence; and permits it to advance beyond the possibi-
lity of its being again returned into the body, before
they can prevail upon themselves to divulge a secret
with which every person who sees them is already
but too well acquainted.
*A large pincushion, with a girth attached to it, and tied round
the body, might be employed; or the common Truss may be worn
for a few days, until a proper one can be procured; but ought
never to be relied on.

15
d
APPEARANCES OF RUPTURE,
AND MEANS OF CURING ITuborg of as
Rupture, or Hernia, is a swelling produced by a
protrusion of the bowels, which ought naturally to
be contained within the cavity of the belly.
21
Its appearances are generally in the stomach,
navel, belly, groin, scrotum, or purse; and in fe-
males, the fore part of the thigh; and are therefore
denominated Ventral, Umbilical, Inguinal, Scrotal,
or Femoral Ruptures.
To use the language of the late PERCIVAL POTT,
Esq. of St. Bartholomew's Hospital, in his valuable
Treatise on Ruptures, "There is no radical cure,
except for
young persons;-that to replace the pro-
lapsed bowels within the cavity of the belly, and
prevent its falling out again, by means of a proper
bandage-is all that the art of Surgery is capable
of doing in this disease."
Sir A. COOPER, in his valuable Treatise on Hernia,
chap. v. page 15, observes, that he has known a
Hernia cured in nine months; but he, nevertheless,
advises a Truss to be worn two years at least, even
B 2

16
by young persons; in whom alone the complaint
is curable by this method.
Every Truss, therefore, should be so constructed
as to produce pressure wthout irritating the parts.
Infants are seldom known to cry, except when in
pain. It therefore behoves Parents, who have any
regard for their offspring, to take the earliest oppor-
tunity of ascertaining the most probable means of
curing them. Nothing can retard the progress of
cure more than crying.
It is likewise the duty of every nurse, who has
the care of Ruptured infants, to keep this Book in
their possession. Ladies cannot make a more valuable
present to their nurses. Thousands of infants have
died of this disease before the mother or nurse had
any idea of their being Ruptured.
Professor LAWRENCE, in his valuable Treatise on
Ruptures, page 98, observes, "that the improve-
ments which have lately been made in the construc-
tion of Trusses, have greatly diminished the incon-
venience attending their use." The Reader will find
more substantial evidence of this fact towards the
end of this Work,
SHWONK
novo dasol in a720

17
The Important Office required of
Trusses.
No Truss can be said to have performed its office
which has not kept the Hernia firm within the ring,
and entirely prevented its approach into the lower
bus
extremities.
Those Patients who have had recourse to the best
means of obtaining relief, and find their Ruptures
still getting worse, is an evident proof that the Truss
they wore was defective, and that they might have
suffered much less had they never wore them.
All those Patients who have placed themselves
under my care, having a bad Rupture, have attributed
it to the following cause, viz. the common Truss,
which is either manufactured or sold in every Town;
or Village in the Kingdom, and is therefore almost
universally recommended to newly-ruptured Pa-
tients; its defects are never pointed out to the
Patient by those who supply them with that article.
The common Truss having no internal action in the
pad, and its position naturally inclining inwards,
presses much harder at the end than in the centre of
the pad, where the Rupture lies: it is always goad-
B 3

18
ing the Patient; and seldom, if ever, produces an
equalized pressure upon the ring, or opening, where
the Rupture protrudes; and thereby permits the
Rupture imperceptibly to advance lower and lower
until it is completely out of the reach of the Truss,
and the Patient feels considerably more punished
with it than he would have been without it. At
length, he is under the necessity of dispensing with
Trusses; and the Rupture sometimes increases al-
most down to the knees; in which state I have known
some persons continue a miserable spectacle for
nearly twenty years. "The vast size to which neg-
lected Hernia sometimes increases, not only prohibits
all active exertion, but by involving in the male the
integuments of the penis, incapacitates the subject
from the act of copulation. These considerations
should render every person, afflicted with a Rupture,
anxious to have the parts replaced, and to have a
proper Truss."-Professor LAWRENCE's Treatise on
Ruptures, page 67.
e See also Sir A. COOPER's Treatise on Hernia, in
which is mentioned a Case of a Black, who was seen
by Sir R. WILSON, in Egypt, having an Umbilical
Rupture which reached from his navel to his ancles,
-Chap. iv. page 12.
bang ayowla
88

19
EXPLANATION OF VENTRAL AND
UMBILICAL HERNIA.
VENTRAL HERNIA is occasioned from the perito-
næum, or their membrane, which lines the stomach
and bowels, giving way, and thereby admits a por-
tion of air, which produces a tumour or swelling in
different parts of the stomach, or belly; and although
it is not liable to strangulate, it frequently produces
spasms in the stomach; and is besides of considerable
uneasiness to the Patient; and, like other Ruptures,
is constantly increasing in bulk, unless it is com-
pressed within the body.
UMBILICAL HERNIA is a portion of intestines
which make their appearance in the navel; the open-
ing through which they pass is called the ring, whence
a small portion of gut, either in the situation of the
navel or groin, not larger than a walnut, frequently
produces strangulation; and when it cannot be re-
turned within the body, an incision must be made in
the belly, or groin, to enable the Surgeon to reduce
it; which, in surgery, is termed an operation.

20
The following is copied from Professor LAWRENCE'S
Treatise on Ruptures:-
"As soon as the cicatrix (wound) has acquired
sufficient firmness, and before the patient leaves
his bed, a Truss should be applied, and must be con-
stantly worn. The operation only removes the imme-
diate danger, leaving the patient still subject to a
future protrusion of the bowels, which, indeed, often
takes place to a greater extent than before."
Hence arises the necessity of a different kind of
Truss than the patient had previously worn, or he
can benefit but little by the operation.
A certain nobleman lost his life, after undergoing
the operation, in consequence of the incapacity of his
Truss to secure the Rupture.
Every feeling heart must deplore the sufferings
and death of the late illustrious Duke of Bedford.
His death was a national loss, and can only be nation-
ally repaired, by exciting an investigation into the
best mode of effectually securing Ruptures."-W.
HALL TIMBREL'S Practical Observations on the
Management of Ruptures, page 69.

21
Explanation of Inguinal Hernia.
INGUINAL HERNIA is by far the most general; its
appearance is in the lower part of the abdomen, or
groin, occasioned by a portion of intestines forcing
a passage through the canal, or internal opening.
This species of Rupture, and that of the navel, is as
capable of being cured in young patients, as a wound
in any other part of the body, and the dangers of
strangulation avoided by the timely application of a
Truss, which must be so constructed as to enable the
patient to endure a constant pressure; for if a Truss
is only worn a few days, and from its galling qua-
lities the patient is induced to leave it off, if the
Rupture lies in the groin, he may soon expect to have
the whole contents into the scrotum or purse.
INGUINAL HERNIA, as it regards the female, is very
similar to the Inguinal Hernia in males. The round
ligament of the uterus supplies the place of the sper-
⚫matic cords, except that the opening in the external
oblique is considerably smaller; and unless the intes-
tines, omentum, &c. are secured by pressure, patients
ought never to consider themselves out of danger.
atowath to iego en saco doum as diw yeh zo

22
Explanation of the Femoral and
Scrotal Hernia.
bde
The FEMORAL RUPTURE, which most frequently
occurs to the female, and often happens to the male,
is easily distinguished from Inguinal or Congenital
Hernia, from its appearing in the hollow of the groin,
close to the thigh. "The latter description of Her-
Senia is when two Ruptures unite in the same focus."
SCROTAL HERNIA, is so called from the position
of the intestines, caul, or omentum, and sometimes
air, which has forced a passage into the scrotum, or
purse, which is very frequently the case in defiance
of every instrument that has yet been invented to
confine it, the Scrotal Bandage excepted. See Fig. 4.
And even this bandage, when the bowels are in a very
relaxed state, will allow a portion of the omentum to
protrude in very large Ruptures, but not so as to
cause pain or danger, as it so effectually closes the
opening as to prevent the intestines from passing
down; it is also the most comfortable instrument
that has yet been constructed, and may be worn night
or day, with as much ease as a pair of drawers.

23
Treatment of Strangulated Hernia.
olled od odai
ad you Jucilag
STRANGULATED HERNIA is generally produced by
some violent exertion, when the Rupture is not effec-
tually secured, whereby the patient is suddenly seized
with sickness, and sometimes vomiting. Whatever
may be the object of his pursuit, let him retire to
bed, and place himself in a recumbent posture, and
procure surgical aid, if possible. and elasin
If the bowels are in a confined state, a dose of salts,
or jallap, or other opening medicine, may be taken,
and a clyster of warm mutton broth, or gruel, may
be thrown up, the medicine being frequently thrown
off the stomach without producing the desired effect.
Let the patient keep perfectly quiet, and avoid
talking, and lay on his back with the knee rather
raised up on the side of the complaint; and let him,
if he cannot get surgical assistance, press upon his
Rupture for several hours together with both hands,
which will produce a warmth, or perspiration; and
when the parts become relaxed, he should endeavour
to return it himself. If the Rupture is in the scrotum,
he should first divide it from the testicles with one
hand, and press it gently upwards, and with the fin-
of the other hand, endeavour to conduct it by
small quantities through the channel whence it de-
gers

24
scended, from thence it should be pressed side-ways
into the hollow of the groin. However ignorant the
patient may be of the direct point to which the Rup-
ture recedes, he might probably effect its return,
which by a few hours delay might be rendered inef-
fectual by the most skilful surgeon. Had the noble-
man, whose misfortune I have before alluded to,
done this, his life, in all probability, would have
been saved.
Patients thus circumstanced, should act with firm-
ness and composure. Some persons have been known
to ride and drive many miles to get into a hospital,
in the hope of being furnished with a Truss. Take it
for granted that it is not the practice of hospitals to
furnish patients with Trusses, unless they first under-
go the operation.
Should the above method fail, ices applied for-a
considerable time to the part affected, or the warm
bath must be employed to produce relaxation. When
this fails, an operation is unavoidable.
bus noiterigen to a horq lliw daidw
ovasbas bluoda od bozulon omosod ang ad nodw
to dial onquil bamid si autor of
sno diw zoloitzot od moil i abivil at bluoda od
-nodi di bus bisqu yung ti zavq bas baad
yd ti tonhaos of wovesbas busd
-abi soneda logrado en quoit
do it to arg
estilineup fema

25
THE AUTHOR'S CASE.
02
Aimell
ABOUT four years since, I had the misfortune to
bring on a Rupture, in consequence of a stoppage in
the bowels, which continued eight or nine days. I
sent for a medical friend, who examined me, but
could perceive no external appearance of Rupture.
I. He advised me, as a matter of precaution, to wear
a Truss, which might prevent its getting worse. I
then sent a note, with proper directions of size of the
body, to a very ingenious Patent Truss Maker, (the
principle of which had been explained to me some
years before,) requesting him to make me a Truss;
the spring, although stronger than I could well bear,
failed, during the most trifling exertion, to secure
the Rupture; the pad being of an oval form, was ca-
pable of being adjusted, but became, when screwed,
perfectly stubborn in effect, like the common Truss,
which irritated and inflamed the part, and produced
la continual soreness upon the body, and frequently
permitted the Rupture to escape, when it acted pow-
erfully in forcing the intestines down. I was under
the necessity of retiring to my chamber frequently in
the day time; and placing my body low, and my feet
ove) ai ai gaidton yea ano I jadi lotio

26
against the wall or bedpost, to allow it to descend,
as generally towards the latter part of the day, the
Hernia became so painful that I could not bear to
touch it with my fingers. I had scarcely worn my
Truss six months, when I was under the necessity of
dispensing with it entirely, and I bound myself with
an oath, that I never would attempt to wear it again.
I then made my case known to a very celebrated
Surgeons' Instrument-maker, with whom I had been
formerly acquainted, who knew much better than I
did what the properties of Trusses were, and proba-
bly of that which I had worn myself; and he declared
that he did not know a better.
It would not be prudent to give a relation of what
passed between us on that occasion. If I were, I am
persuaded it would open the eyes of my fellow-
sufferers more than any thing which has ever been
said or written upon the subject; suffice it to say,
that he advised me not to throw away my money any
where. He observed, that I had brains in my head;
(a very common phrase among mechanics,) and if I
chose to set them to work, he had no doubt but I
could contrive something which would answer my
purpose, at least. esitati od gostol
Whether I have accomplished that desirable ob-
ject, time will shew. y gatosfy has omistab ods
It is certain, that I can say nothing in its favor

27
which has not already been said by the inventors of
every newly-constructed Truss. To offer any com-
ment would be useless. I shall, therefore, content
myself with copying a few remarks which have fallen
from the pens of several well-informed writers, and
add the testimony of a few disinterested persons, and
leave my readers to judge for themselves.
tied
Extract from Dolby's New Edition of Buchan's
Domestic Medicine.
liv noz bus
"Surgery, in all ages, has been considered the
most important of all science, because it conduces
most towards removing the impediments to the hap-
piness and comfort of mankind.ed salo blu adr
"There is also a Science connected with it, which
(although a mechanical one) is but little inferior to it,
viz. the Instruments with which they perform those
operations. We cannot remain silent observers of
the progress which has lately been made in one of
its most important branches,
THAT OF TRUSSES.Jaosto
"Among the various diseases incident to mankind,
there are none more painful, nor more dreadful in its.
consequences, than Ruptures; nearly one-eighth of the
population of this kingdom, (and in warm climates a

28
still larger portion) are under the necessity of wearing,
during a great portion of their lives, some mechani-
cal apparatus, either to arrest its baneful progress,
or to alleviate the sufferings of its victim. We shall
devote a small portion of our pages to illustrate and
render this subject more familiar to the Patients.
"The only remedy for this disease, is a Truss, or
Bandage. Whatever its principle or construction may
be, it is in appearance but a simple and insignificant
machine; it is, nevertheless, one of the most important
instruments in Surgery; deprive a man of his Truss,
and you will soon deprive him of existence; it is not
the instrument of a day, a week, nor a year, but gene-
rally for the term of life; therefore every person who
-has, or may hereafter have the misfortune to require
the aid of such an instrument, should endeavour to
bear in mind, that however strong or healthy they
may be, they are equally liable to this disease with
those of the most delicate constitutions, and that it
regards neither rank, age, nor sex. Its symptoms are
severe pains when coughing or sneezing; its appear-
ances are in various parts of the abdomen, but most
commonly in the groin, where a tumour or swelling
is produced by a protrusion of the intestines, called,
ain Surgery, Inguinal Hernia; and if the Patient does
not confine the intestines by a pressure upon the ring,
s or opening, where the tumour appears, the parts be-

29
come inflamed, and mortification frequently ensues ;*
if the intestines are suffered to proceed, the male pa-
tient will soon have the contents of the bowels into
the purse, or scrotum, whence it is called Scrotal Her-
nia, and that of the female into the fore part of the
thigh, whence it is called the Femoral Hernia. Femo-
ral Hernia sometimes occurs to the male, and is even
worse than the Scrotal Hernia. if neglected
"If we may be allowed to judge from what appears
in the 28th number of the Quarterly Journal of
Science, Literature, and Art; Nos. XI, XIII, and
XVI, Quarterly Medico Chirurgical Review; Nos.
288 and 294, London Medical and Physical Journal;
No. 118, London Medical Repository; Volume 1,
or No. 27, Mechanics Magazine; and numberless
other Journals, all of which have given an opinion
without fee or reward, we should not hesitate to say,
that Mr. COLES has made a better improvement in the
construction of Trusses within three or four years
past, than has been made before in as many centuries.
"It may be proper to observe, that lusty people can
endure much greater pressure than lean persons; and
it would be advisable, when the Patient is punished
by the pad of a Truss, to put an old silk rag or hand-
kerchief, three or four times double, under the pad
*A recent case is more liable to the above cause than one of
long standing.
y but never finds to way into the

30
of his Truss; and in case the Patient should have a
sore place under any part of a Truss, he should al-
ways apply a piece of fine white rag, and never let the
leather of his Truss come in contact with it, as the
leather will assuredly draw it to a wound, and the
moisture arising therefrom will rot and injure the
Truss, as will also filth or dirt of any description; the
parts affected should be washed at least once a week
in cold water.
Sonali
"In case the cushion in the back of the 3-quarter
Truss, fig. 1, should not press in the centre of the
back, take out the two screws, and reverse it, taking
care that the longest screws are fixed into the holes
wherein you can thrust a pin through the cushions.
In case of Femoral Hernia, the cushion should press
beyond the centre of the back, so that the Truss shall
have an equal bearing, back and front. Figures, 2, 3,
5, and 7, should press also in the centre of the back,
which will only require the use of a screw-driver
to enable the Patient to shift the cushion.
"In cases of Scrotal Hernia, the fore part of the shirt
should rather be confined under the waistband of the
small cloths, than between the legs, in which case,
the parts will keep airy and cold: nothing can be
more injurious to a Ruptured Patient than keeping
the parts in a state of perspiration.
9 grods sil

31
2
3
4
1
on
Exhact pom Fr Astley Coopers Treatise on hernia port 1-Nate 6
A Bandage has been recently invented by lotes which is well.
adapted to seepport scrotal rupture it consist of a Circular
bandage
shap with the pad acting by means of a spiral spring the lover
part of the pad is lengthened downwards so as to pass between
the thigh and the scrotum and thus make pussure upon the whole
length of the Sac. a shap is continued from the lower part of the lad
to the back part of Circular Bandage. he has also constructed a Fussin
resembling in some respects the Common Seuss but the pad instead of
being fixed works with a spiral spring which allows it to peld in the
various motions of the body and at the same time to make more.
uniform pressure than the Ball and sockit pad (Salmon's) can effect.


33
со
7
9
ས་་་
5

Drawings of
This Truess
who
are
Five
crnia in persons
Extract from Sir Astley Coopers. Treative in tornia
Part 1. Plate 6. wherein appears.
of Salmons Ball & Sockett Truss
Fruß is well adapted for hernia
not under the neoffsite of carning their
bread by the sweat of their Crowd; and I therefore
of
recommend it to the opulent and the higher orders
of society, but when Hernice requires strong pressure
under great bodily exertion I prefer a traps which is
less Liable to obey its situation. There it this objection
to Salmons trust that it cannot be worn
not be worn during,
the night se as to make pressure
the
cere
of
the disease demands a
and regular pressure
the rupture, and
ds a constant, equal

35
EXPLANATION OF THE DRAWINGS.
g
FIG. 1, is an opposite-sided Truss, having a re-
turned end to the outer spring, with two holes to
admit two screws, by which it is screwed to the spi-
ral spring in the front pad; there are also several holes
in the spring to enable the Patient to shift the back-
cushion directly opposite to the pad upon the Rup-
ture. This Truss does not merely possess a self-adjust-
ing movement, but that which is of infinitely greater
importance-a yielding resistance to the descent of
the Rupture. The strap is brought round the body, and
looped to the screw-head of the front pad, which gives
it a degree of firmness necessary to the security of
the Patient, without drawing the pad from the Rup-
ture, which is always the case with other self-adjust-
ing Trusses.
FIG 2, is a half Truss; the front pad resembles
the common Truss in its form; it possesses the same
yielding quality as the former; it is to be applied on
the Ruptured side; a cushion is screwed in the centre
of the back, which, by means of a spring, yields in all
directions; a strap forms the other half of this Truss,
which is looped on to the front pad.
ts A
This is the Truss to which Mr. EARLE particularly
alludes in his certificate. Maste
Hama to ame

36
FIG. 3, is a double Truss, upon the same princi-
ple as the latter: the springs have several holes in the
back, and are screwed to a cushion, which presses on
the centre of the back, and which is capable of being
increased or diminished in size.
FIGURES, 1, 2, and 3, are proper to be employed in
cases of Inguinal or Femoral Hernia; neither case
requires any under-strap.
FIG. 4, is a Bandage for a left-side Scrotal Hernia,
having only one spiral spring in the centre of the pad,
the girdle has a piece of steel-plate stitched into one
end, which is screwed to the pad: the pad, being placed
upon the opening into the purse, is drawn across
the neck of the bladder to the hip-bone, opposite to
the Ruptured side, one end of which forms a loop,
and the girdle passes through it, and is looped to the
screw in the pad, by which its pressure is that of a
lever acting upon the spiral spring.
The pad is made to fit the os pubis, and is not in-
tended to press upon the Rupture as other Trusses
do, but merely to close the opening into the purse,
through which the majority of old Ruptures will
escape, in defiance of every other Truss which has
yet been employed to confine it.tes annitoorib
A strap, or ribband, may be looped to the girdle
behind, and worn next the body, and buttoned to
the drawers, or small clothes, in front. In case the

37
4
Patient has not a good hip to keep it up, this brace
over the shoulder will be found a great acquisition
in walking, or riding. If the Patient wears a flan-
nel waistcoat, a loop should be sewn upon the shoul-
der to keep it in its place.
Fig. 5, is a balf Truss for Umbilical Hernia. The
spring is bent down square in front, and has two holes;
the front pad has two spiral springs, to which the
outer spring is screwed, which effects a gentle resist-
ance to the rude pressure of the outer spring, and
prevents the possibility of the pad giving way at bot-
tom; the cushion should press in the center of the
back, which is capable of being bent to fit the back,
The strap forms the other half of this Truss, and its
pressure may be increased at pleasure by looping the
strap tighter.
Fig. 6, is a bandage for Umbilical or Ventral
Hernia, having from one to three spiral springs placed
near the center of the pad, capable of resisting from
seven to twenty pounds pressure, over which is a
piece of steel, or tin plate, stitched into the girdle or
band, and screwed to the spiral springs, whereby
its pressure is that of a lever acting upon the spiral
springs. In slight cases, however, the band need not
be more than one inch and a half wide, with a few holes
at the end to loop it on to the front pad, to which
C

38
should be added, a slight neck strap, or ribband, to
prevent its sliding down, which will be found to
answer every expectation. But in bad cases, the
band or girdle must be wider, and two straps are
sewn to the end of the girdle, having several holes,
which are to be looped on to the screws of the front
pad, whereby its pressure is equal to a spring Truss,
and might be worn day or night, without the slight-
est inconvenience.
Figures 5 and 6, are referred to in Mr. MARTIN'S
certificate, which will be found the most effectual
and comfortable instruments that have ever been em-
ployed in cases of Umbilical Rupture, or Corpulence.
Those Ladies or Gentlemen who have been accus-
tomed to wear Mr. GORDON'S Elastic Steel Belt,
the springs of which are riveted or screwed to the
back cushion, will find the spiral spring admirably
adapted to that instrument, which will render the
springs less liable to break, and afford them a greater
portion of elasticity than can otherwise be obtained.
Fig. 7, is a double spring Truss, adapted to
secure an Inguinal Hernia on the left side, and a
Scrotal or Omental Hernia on the right; the latter
pad is formed like the Scrotal bandage, and is made
to fit the os pubis: it has two spiral springs, to which
the outer spring is screwed. This Truss has been
found to answer every expectation, in cases of the

39
above description, where an objection has been
raised to a continuation of the strap between the legs.
Mr. MASON's certificate refers to figures 4, 6, & 7.
Mr. HILLMAN's, and Dr. VICKERY's, to fig. 3.
Fig. 8, is a bandage for a double Scrotal Hernia,
having a steel plate stitched into the girdle immedi-
ately over each pad; one plate has several holes to
enable the Patient to shift the pad, if required;
strap is sewn to the long pad, which is intended to
loop on to the short pad, to confine it down. I can
confidently state, that I do not meet with one Rup-
ture in twenty, of the above description, which is
capable of being returned into the body; but this
bandage will effectually resist its descent.
I have had great experience in cases of irreducible
Hernia; and have invented an instrument which
will effectually prevent the Rupture increasing,
and render the Patient secure and comfortable.-
See Hubbard's Affidavit, page 47.
None of the above Trusses are proper to be
employed in cases of irreducible Hernia,
Extract from No. 28, Journal of Science, Lite-
rature, and the Arts, Royal Institution.
"WE understand that Mr. COLES has effected a
c 2

40
considerable improvement in the construction of
Trusses, by which the pressure upon the ring is not
merely equalized, but which adjusts itself, without
inconvenience to the wearer, to the different attitudes
in which the body may be placed."
No. 11, of the Medical Chirurgical Review, gives
a drawing and description of the Trusses, with di-
rections how to apply them to such cases as they
are best suited.
This Journal anticipates, that, at no distant pe-
riod, one of the first Rupture Societies in the
world will be Established upon this Principle.-
A Subscriber to the City Truss Society, who resides
in Shoe Lane, at a very old establishment, informed
me, that he had paid nine guineas to that charity;
and he had never been applied to but once for a
Truss during nine years, which he furnished; and
soon after it was returned to him as being of no use
to the Patient.
On the other hand, a poor hard-working man, re-
siding in Crown Street, Soho, having a wife and
four children, informed me, about two years since,
that the truss he had worn for two years became
broke; and his Friend, a Subscriber to the City
Truss Society, who had furnished him with it, having
gone abroad, he represented his case to the Surgeon,

41
and likewise to their Truss-maker, who refused to
furnish him with a new one, or a clue to a Subscriber.
I saw that man last winter, who told me that his
Rupture was much worse; and he declared that he
had the same piece of a Truss on his person then
which he had worn four years.
Extract from No. 118, London Medical Repository.
"An ingeniously contrived Truss has been submit-
ted to our inspection, which appears well calculated
to answer every expectation of such an apparatus.
The chief difference between this and the common
Truss, consists in two spiral springs being introduced
between the Truss and the pad; which, whilst it
admits of a self-adjusting movement, furnishes a
sufficient degree of yielding pressure. We are ac-
quainted with several cases in which these Trusses
are now made use of; and the principle appears to us
sufficiently novel and ingenious, to induce us to draw
the attention of Surgeons to its merits.'
99
The following certificate of its practical utility
justifiesus in our desire, that ingenious and useful in-
ventions, connected with our profession, should at
least obtain that reward which publicity is calculated
to obtain for them:-
c 3

42
Certificate from HENRY EARLE, Esq. F. R. S. As-
sistant Surgeon to St. Bartholomew's Hospital,
and Surgeon to the Foundling.
I hereby certify, that Mr. COLES has perfectly
succeeded in keeping up a very difficult and com-
plicated Rupture, on which I operated some years
since, in which case many of the best Truss-makers
in London had failed to afford any relief.
When I placed this Patient under his care, I pro-
mised, should he succeed, to give him a certificate
of
my approbation; and in conformity with that,
I now state my firm conviction, that his Truss will
be found more efficacious than any at present em-
ployed in similar cases. I have since tried his Trusses
in other cases, and have been much pleased with
the ingenuity he has displayed in adapting his means
to the circumstances of each ease.
HENRY EARLE,
28, George Street, Hanover Square.
JULY 23, 1824.
Extract from No. 288, London Medical and
Physical Journal.
"A Truss of a very ingenious construction has
lately been submitted to our inspection, backed by
a strong recommendation from a Medical Friend

43
case.
who has proved its efficacy in his own particular
It is the Invention of a Mr. COLES, residing
at London Bridge. Although it is not very easy to
convey an accurate idea of any instrument by mere
words, we may, perhaps, be enabled to afford some
explanation of the difference which exists between
this and the common Truss, by remarking, that two
spiral springs are introduced between the Truss and
the pad, which, whilst it admits of a self-adjusting
movement, permits a certain degree of yielding
pressure. We are acquainted with several cases in
which those Trusses are now made use of; and the
principle appears to us sufficiently novel and inge-
nious to induce us to draw the attention of the Medi-
cal Profession to investigate its merits.'"
99
Mr. HENRY EARLE'S certificate appears in a sub-
sequent number of this Journal, with further re-
marks from the Editor.
Extract from No. 4, of the Family Oracle,
"Those who want Trusses, may try Mr. COLES's,
of London Bridge. Our friend, Mr. HENRY EARLE,
informs us, that they are superior to all others; and
we cannot suspect him of abetting a puff. We in-
tend, bye-and-bye, to examine Mr. COLES's improve-
ments more minutely."-See also Nos. 7 and 8 of
the Family Oracle.

44
No. XIV. Medico Chirurgical Review has likewise
inserted Mr. EARLE'S certificate.
Extract from No.XVI, Medico Chirurgical Review.
"I hereby certify, that I have twice suffered the
dangers of Strangulated Hernia, which had almost
proved fatal. I placed myself under the care of an
eminent Surgeon in this neighbourhood, from whom
I learned that Mr. COLES had given proofs of extra-
ordinary talent in his profession. A Truss was pro-
cured, (see fig. 5.) which effected a pressure of at
least sixteen pounds upon the Hernia, which was
not removed from the part for fourteen days and
nights. He has since applied a bandage, (see fig. 6.)
which I have worn for a much longer period without
removing it. It is with great satisfaction that I can
inform those who may be similarly circumstanced,
that I have never suffered a shadow of pain since I
have been under his care.
"JOHN MARTIN,
Licenced Victualler,
"Dover Castle Inn, Deptford."
Nov. 21, 1823.
If a patient wishes to ascertain the pressure of his
Truss, let him find the diameter of his body, which,
in a man of Mr. MARTIN'S stature, is about twenty

45
inches; hold the Truss in your hand, and suspend
as many pounds weight to the front pad as will open
it twenty inches, will give you the exact pressure.
I hereby certify, that I have had the misfortune
to be afflicted with a very distressing Rupture up-
wards of ten years. I consulted a very eminent
Surgeon, who recommended me to his Surgical In-
strument-maker for a Truss of the common sort;
which Truss having failed to secure the Rupture on
the right side, another Rupture took place on the
left. The Truss injured and inflamed the parts to
that degree which sometimes prevented my wearing
it for several weeks together. The cause of my suf-
ferings became known to several friends, who ad-
vised me to try Mr. COLES's Patent Bandage: and I
feel great pleasure in testifying to the world, that he
has rendered me that ease and comfort which, at my
advanced age, I never again expected to enjoy.
26th APRIL, 1824.
JAMES DANIEL, Sen.
156, Tooley Street, Southwark.
I hereby certify, that I have employed Mr. COLES
to construct instruments for supporting the body in
cases of distortions of the spine; and I find that his
instruments will adapt themselves much better to

46
the different attitudes of the body, and afford the
patient much greater comfort, than any others with
which I am acquainted.
WILLIAM COMPSON,
Surgeon to the GENERAL DISPENSARY,
Aldersgate Street.
3, Frederick's Place, Old Jewry, FEB, 10, 1824.
Several of Mr. COMPSON'S Patients have likewise
worn my Trusses; one of whom, a gentleman of
great respectability, informed me, that he had for-
merly applied to a Surgeon of a Rupture Society,
whom he supposed to be the best judge of such com-
plaints. He paid a guinea to the Surgeon for his
fee, and one, guinea and half for a single Truss.
After having it altered twice, he told the Surgeon
that it would not answer in his case; (the Surgeon
very unfeelingly replied, that he must do the best
he could with it.)
I feel great pleasure in giving my testimony to the
efficiency of Mr. COLES's Truss, which I invariably
recommend to my Patients. It is worn with comfort,
and supports the protruding parts more effectually
than any others with which I am acquainted.
JAMES MORSS CHURCHILL,
13, Princes Street, Leicester Square.
17th MAY, 1824.

47
Extract from No. XVI, Medico Chirurgical Review.
London ROBERT HUBBARD, of the parish
TO WIT. S of St. Sepulchre, London, maketh
oath, and saith, that he hath laboured under a very
severe Rupture upwards of thirty years, which has
increased to an enormous size, and disabled him
for many years past from following his avocation as a
Smith; this deponent likewise worked as Journeyman
for several eminent Truss-makers in London, but he
never saw a Truss in his life which was calculated
to secure his Rupture in its present state, until Mr.
COLES applied one of his invention, whereby he, the
said deponent, hath been rendered perfectly secure,
and free from pain during eighteen months past; and
that he is thereby enabled to work at his business,
or walk four miles in one hour with ease.
(Signed.)
ROBERT HUBBARD,
Sworn at the Mansion House, before me,
W. HEYGATE, Mayor.
AUG. 20, 1823.
SW 90:
Another affidavit was drawn up in equally strong
terms, and the Patient attended at the Mansion House
during the Mayoralty of Mr. Alderman Bridges, who
was then at Carlton Palace. He was a journeyman

48
founder, in the employ of Messrs. DEVEY, Shoe lane,
who having intimated a desire to go again the fol-
lowing day, was prevented by the foreman, probably
from an idea, that it might induce persons to call him
from his work. The affidavit stated, that his sufferings,
which at times prevented his working for a week to-
gether, originated from the incapacity of the Trusses
which had been furnished to him by the City Truss
Society, to secure his Rupture; he has worn a band-
age ever since,
To Mr. W. COLES,
SIR,-A lady of this town having consulted us
for her son, who has been Ruptured on one side since
last October, and having in vain tried three different
elastic steel Trusses, besides others without springs,
to keep his Rupture from descending, found the one
you sent us most satisfactorily, and most comfortably
to succeed, the Rupture not having come down once
since we first applied it in March last. One of the
greatest advantages in your Trusses, is, that people
can conveniently sleep in them, by which means they
obtain a cure, though of many years standing.
I recollect, in Sir A. COOPER's Lectures on Hernia,
he said, that if constant pressure could be made on

49
Hernias by night and by day, he had no doubt but
very old Hernias might be radically cured by it.
Your most obedient Servants,
July 17, 1824.
W. C. HUNT & SON,
Dartmouth.ett
Mr. HILLMAN feels pleasure in recommending Mr.
COLES's self-adjusting Truss as being, in his opi-
nion, the best instrument in use at this time, from its
affording an uniform pressure under all the positions
of the body.
Argyll Street, 8th July, 1824.
To Mr. W.COLES,
SIR,-If you had told me that you could stop the
Thames from flowing, I should as readily believe
it as I could believe you capable of constructing an
instrument which would effectually secure my Her-
nia. Since you have performed so wonderful an
operation, and rendered me as comfortable as any
living creature can be, I should indeed be guilty
of the basest ingratitude if I concealed so great a
blessing from my fellow-sufferers, and render my-
self unworthy the favor that has been conferred on

50
me, not only from you, but also the Honorable
Commissioners of his Majesty's Customs, who kindly
placed me under your care.
I shall, therefore, most willingly yield to occular
demonstration when any of your Medical or Private
friends require it.
I am, SIR,
with sentiments of gratitude and respect,
your very humble and obedient Servant,
sigo elil si gels as
ali
W. ANDREWS.
SEPT. 15, 1824.
Camberwell.
I hereby certify, that I have worn the Trusses of
Mr. COLES's invention, for sixteen months past, and
have found them more easy, and more efficacious,
than any others which I had worn for fourteen years
previously.
SEPT 20, 1824.
CARYER VICKERY, Surgeon, R. N.
London.
I hereby certify, that in various cases of Hernia, I
have tried Mr. COLES's Trusses, and I find them very
superior to any I ever used.
ling
Bluede M. L. MASON,
Member of the Royal College of Surgeons,
bus
AUGUST 30, 1824.
Newington.

51
London JOHN HULBERT maketh oath and
TO WIT. S saith, that he has laboured for sixteen
years under a very painful Rupture, and that his em-
ployers, Messrs. HEATH and Company, of Queen Street,
Cheapside, has procured for him, through the medium
of a friend, a single Truss, and also a double one, from
the City of London Truss Society, neither of which
ever afforded him any relief, although he believes
that he has been to the Society's Depò ten different
times, in the hope that their defects may be found out
and remedied. This deponent further saith, that his
Rupture is ten times as large as it was when he first
applied to the Society, in consequence of its having
no other support than a canvas bag for the last four
years, whereby the Rupture has continued to increase
in bulk; and he has been labouring for several years
past in continual misery, and frequently being com-
pelled to leave off work during his working hours,
and retire to bed.
This deponent further maketh oath, that the Rup-
ture is effectually secured by the application of an
exceedingly simple single bandage, the invention of
Mr. COLES, of London Bridge, and he is thereby ena-
bled to follow his occupation, which is very laborious,
as well as he could at any former period, and that he
finds his health and strength perfectly recovered;
and he hopes that by giving publicity to his case,

52
others who are labouring under this dreadful af-
fliction, will avail themselves of the inestimable be-
nefit which such an invention is calculated to afford.
JOHN HULBERT,
(Signed)
Sworn at the Mansion House, 14th July, 1824,
before me,
R. WAITHMAN, Mayor.
Another Patient who has been upwards of thirty
years in the employ of Messrs.. STRINGER and Com-
pany, in Monument Yard, who are subscribers to the
aforesaid society, whence he had been furnished with
Trusses, informed me, that when their Truss-maker
found he could not make him a Truss which was
capable of affording him any relief, that he sent him
to the Surgeon to be re-examined: as he believed the
complaint to be something more than a Rupture, the
surgeon ordered him back again, and directed that
they should make him Trusses until they did make
one to answer his purpose.
No words can describe the sufferings which this
man has endured; the Rupture came down to the size
of a large bladder when blown, the vacuum in the
body became filled with air; and when he attempted
to reduce the Rupture, the air was forced into a

53
wrong channel, which produced the spasms, and fre-
quently threatened his dissolution; and rendered him
utterly unfit for any employment. He then placed
himself under my care. I secured his Rupture effec-
tually with a single bandage, and I permitted him to
wear it for a week; and I told him that if it did not
answer his expectation, he might return it without
being at one farthing expense; he never returned it,
or complained of its not performing its wonted office.
There is likewise a Servant in the employ of the
Lord Mayor elect, who is likewise a subscriber to
the aforesaid society, whose Rupture got much worse
while wearing their Truss, which he declared had
almost killed him, and he never would go near the
Society again; he likewise wears a single Bandage of
the same description as the former Patient.
The Fishmongers' Company furnished a Patient
with one of my bandages, whose case had baffled all
the Rupture Societies.
Another Patient in precisely the same situation, as
five of the foregoing patients, informed me that he
made his case known to a worthy Alderman, not with
a view of having a Truss given to him, but in the hope
that his recommendation would ensure him a sove-
reign remedy for his affliction, of which the Alder-
man told him he need not doubt; off he posted to
Hatton Garden, and delivered the Alderman's mes-

54
sage, or note; and when he exhibited his case, "Oh,"
says the surgeon, "you want a double Truss."-
"Double Truss, Sir," says the Patient," I have only
a single Rupture." At which the surgeon appeared
offended, and he replied, if you know better than me,
you had better go somewhere else. The Patient, per-
ceiving that he had gone a step 100 far, at length
yielded to the learned Surgeon's superior judgment;
a memorandum was then put into his hand, con-
taining instructions to their Truss-maker, who,
when he had taken the measure, asked the Patient
if he was aware of the expence he was about to
incur; being answered in the negative, he resumed,
it will be two guineas and half. The Patient said
he had not so much money in his pocket, but if
he would get it made in a few days, he would call
and pay for it. The Truss was made, and the Pa-
tient, anxious to get relieved, cheerfully drew his
leathers, when, to his astonishment, the Surgeon
had interfered, and he was only to pay one guinea
and half instead of two guineas and half. Probably
the Surgeon had made an enquiry respecting the
charge thereof, and thinking it rather unconscion-
able, he might have raised an objection to it in
consideration of his being a working man, who had
a very large family to support; he had, besides, an
aukward Rupture; and he might probably foresee

55
the consequence, if they charged that enormous sum
of money, and failed to secure the Rupture; and
that it might lead to an exposure, which might pos-
sibly reach the ears of the person who recommended
him; and he might have added, you know our
worthy President has been a kind friend to us;
and he has always done us a good turn whenever he
had the opportunity.
Under such circumstances, he may probably advise
a reduction in the price, especially if he had received
his fee, which I forgot to make inquiry about, To
prove a Truss you must wear it, (but not until you
have paid for it,) and when you have ascertained its
defects, you may have it altered and re-altered until
your patience is exhausted, which was the case here,
and the patient declares, that he never wore it more
than two days. He has worn for one year a single
bandage of the same description as the former Pa-
tients.
Another Patient informed me, that he had a letter
from a Friend to procure a Truss from the above So-
ciety, which never secured his Rupture two hours.
He also had it altered, and re-altered, and paid a
sovereign fee to the surgeon out of his own pocket.
Another Patient took a child in arms from Peckham
to get a Truss, and forgot to take the old one; he was
obliged to lose a second days labour, and to bring the

56
child, and likewise the old Truss before he could ob-
tain a new one, this act of charity has induced
both the father and son to wear my Trusses.
Subscribers little think that an old Truss may be
converted into a new one at half the original expence!
I was once so charitably disposed, as to send half
a dozen of my Patent Trusses a present to this Socie-
ty, and offered, at the same time, to supply them with
my patent Truss at fifteen per cent. less than the sub-
scribers now pay for the common Truss, for which I
never received so much as I thunk you, I was told
that my price might do for private Patients, but not
for the poor.
Lord have mercy on the poor! I suppose those
are likewise considered poor, who can only afford to
pay two guineas and half for a Truss. There are
four Rupture Societies in this metropolis; one of
which supplies near four thousand Trusses annually,
each of them adopts the common Truss, which they
say will see out my invention, as it has done all others.
Neither of these Societies has ever sent me a single
Patient, (except Sir JOHN PINHORN, Treasurer to the
Borough Truss Society, who sent me two patients
only,) although I have frequently forwarded letters to
their committees. The last letter which I addressed to
the City Truss Society, was dated 9th January, 1822,
which was laid before their Committee, wherein I

57
observed, that if their Surgeon coincided in the general:
opinion which the medical profession entertained of
my Patent Truss, and he had a wish to continue their
present Truss-maker, I would allow them the right
to exercise my Patent, if they would pay me sixpence
for a single Truss, and one shilling for a double one;
and in addition to that, I would subscribe £10 an-
nually towards the Institution; this offer, like all the
former, was rejected. It has long been the custom of
several of the Rupture Societies, by way of advertise-
ment, to furnish each Patient with a plan of the Ins-
titution. I shall confine myself particularly to that
which is furnished at the expence of the subscribers
of the City Truss Society, in which all the advantages
which the Subscribers and the Public have derived
since its commencement, are set forth in very glow-
ing terms.
The Governors, (meaning the Subscribers,) are de-
sired to be very circumspect as to whom they recom-
mend, the charity having been imposed upon by im-
proper persons obtaining relief.
Improper persons implies male or female decently
attired, or such persons as can afford to buy a Truss;
for none, says the Pamphlet, but those who are
really indigent, can be admitted to receive any
benefit from this charity! And even those indigent
persons are not permitted to keep an old Truss in

58
reserve; they might have a new one as often as they
pleased, provided they return their old one, and go
with a letter from any other subscriber.
The Pamphlet runs thus, " To all affluent persons,
regularly, or occasionally, employing workmen
or labourers, who in their service are daily liable
to accidents of the kind, relieved by this Society,
who, it is not doubted, will feel the propriety, and
also the pleasure, of becoming Governors; the
public are moreover assured, that the City Truss So-
ciety is conducted upon a system of discreet eco-
nomy, the Governors of the City Dispensary having
permitted the use of their premises, and the officers
of this charity receiving no other reward for their ser-
vices, than that of partaking with the Subscribers at
large in the "rich luxury of doing good." This is the
most complete hypocritical cant I ever read. If
I am rightly informed, the Apothecaries' Company
only pays half the price for the common Truss to
sell to therich, which the Subscribers now pay for their
Trusses to give to the poor. I pledge my honor,
that I can get my living by making better Trusses
for five shillings, than that which JonN HULBERT
obtained from the Society, which cost Mr. ALDER-
MAN MAGNEY fourteen, which together with the sin-
gle Truss which he had before, cost one guinea, which
sum would have procured two effectual Bandages,
such as HULBERT now wears.

59
"Oh! prejudice, how blind thou art!"
I will venture to assert without the fear of contra-
diction, that millions of such articles have been
manufactured and sold in this metropolis, which have
never been soiled by the wearer. Stos
If these good and charitable people cannot enter
into my feelings for their poor applicants, I trust they
will in future feel for their pockets, for I will maintain
that a pocket has been lessened of seven shillings as
often as a single Ruptured Patient obtains a double
Truss, and the Patient doubly punished by wearing
them. In perusing the aforesaid plan of the Institution,
printed in 1819, I was struck with astonishment to
find that out of 17,578 Patients who had Inguinal and
Femoral Ruptures, 7,510 wore double Trusses. On
examining my books for the last three years I find,
that although a great number of my Patients have worn
double Trusses, there is not one in five who wears a
double one at this time; and I am clearly of opinion,
that not one in ten would ever require a double
Truss, if an effectual single Truss was employed on
their first being Ruptured.
Patient,-if you don't secure one Rupture,
You will soon have two,
If you neglect them,
They will soon secure you.

60
If either of those Patients to whom I have alluded,
whose very existence depends upon the Truss they
wear, had complained to the Subscribers that the
Trusses they had bestowed were of no service what-
ever, they would have been considered ungrateful
beings, utterly unworthy the kindness they had be-
stowed upon them; but let a friend, a brother, or child
of their own, be placed before them in the same si-
tuation, and let them behold with their own eyes the
wretchedness which they must inevitably endure,
until welcome death puts a period to their misery,
they would probably see the necessity of interfering
personally in an affair of so much importance.
I often think, that during the few years which I
have devoted to this business, if one-third part of the
charitable people was pulling with me, who are now
pulling against me, that I might have been instru-
mental in saving the lives of hundreds who have died
prematurely of this disease, and rendered thousands
perfectly comfortable, who are now in misery.*
*W. HALL TIMBREL observes, in his Practical Observations on
the management of Ruptures, that no disease ever gave rise to so
many new inventions as Ruptures.
If the learned doctor had said, that it arose from the imperfec-
tions of the common Truss, in defiance of his newly-invented
calico pad, and double-tongued buckle, which his friend BLAIR
so much admired, and for which he received a Gold Medal from
the Society of Arts, he would have been correct.

61
A nobleman, whose name I am not authorised
to mention, gave me five pounds for a single Truss.
An eminent Solicitor, who resides in Westminster,
gave me five guineas for two Trusses, as described
in fig. 3, the principle of which he declares to be ex-
cellent; he has tried almost every new invention, and
has authorized me to refer any gentleman to him
for information. Several other gentlemen, who, from
motives of delicacy, are desirous only to conceal their
affliction from their acquaintance, would at any
time submit to Surgical examination, if any good
was likely to result from it; they have employed all
kinds of Trusses which have been invented for the
last twenty or thirty years. Notwithstanding the nu-
merous and well-authenticated cases which I have
stated, party prejudices still remain unshaken.
A certain Surgeon of a Rupture Society very re-
cently declared, in the presence of several persons,
that if all the Surgeons in London were to say that
the bandage which I adopt in my own case was a
good one, he would not believe them. If the said Sur-
geon, or any other Surgeon of a Rupture Society,
will undertake to wear a common Truss upon their
own person, of sufficient strength to secure my Rup-
ture, I will undertake to cure them of their preju-
dice. I will run them three miles, or walk ten times
nada com botearathidh bp old

62
that distance, for twenty sovereigns. The Bandage
I wear is precisely of the same construction as five
out of six of those bad cases which I have alluded
to; and such is the ease and comfort which I enjoy,
that I protest I feel no more inconvenience nor pain,
either from the effects of my Rupture, or from the
galling of my Truss, than I should do from the bite
of a flea; and I am capable of enduring that exer-
tion and fatigue which I could not do four years ago,
if I might have had the whole world for doing it.-
Such was the debilitated state of my body at that
time, (although I wore my Truss,) that I was under
continual apprehension, every time I sneezed or
coughed, that I should be Ruptured in some other
part of the body.
A gentleman, who resides at Woolwich, has had
several bandages of the same kind; and a Medical
gentleman of that place requested him to put on one
of a more recent patent, which was sent there for
him to make a Report on. The Patient threw
it off immediately, and ordered me to bring him
down a new one; and when he paid for it, he de-
clared, that he would rather give ten guineas for my
Bandage, than he would wear out one of the Trusses
which then lay before him, if he might have a thou-
sand guineas for wearing it. It is to be hoped, that
reports from honorable and disinterested men, when

63
addressed to the higher authorities, will have its due
weight. The Surgeon being present, was desired
to include the above in his report,
I called at the Old Jewry, upon W. NORRIS, Esq.
Surgeon of the Charter House, and now President.
of the Royal College of Surgeons, about three years
ago, and requested permission to shew him my
improvement in the construction of Trusses. He
replied, he did not think it possible to make an im-
provement in the construction of Trusses. I asked
him if he was an advocate for any particular sort;
he replied, that he considered SALMON and ODY'S
the best in use: having one of their Trusses at
hand, I requested him to compare them together;
he did so, and he examined the principle of each
Truss very minutely, and he paid me the highest com-
pliment that a man could bestow: "Yours," he
said "is a very great improvement, indeed, a very
great improvement."
He hoped that my terms were not exorbitant; and
requested me to send him a card, and he would give
them a trial. He has done so.
Sir WILLIAM BLIZARD, senior Surgeon of the Lon-
don Hospital, when officiating as President of the
Royal College of Surgeons, expressed his appro-
bation of my invention in the most unequivocal terms
D 2

64
and requested me to meet him the next day at the
London Hospital, when he would immediately in-
troduce them; agreeable to his request I waited
upon him, when he sent me word, that he had not
a case immediately under his care; but he would
send for me the first case which came into the
hospital.
Mr. LEESE, and likewise Mr. SPRY, Surgeons to
the Honorable East India Company, have declared
this to be the best Truss that has ever been submit-
ted to their inspection.
Sir ASTLEY COOPER likewise bestowed the high-
est eulogium on my plan, the principle of which he
acknowledged to be new: he desired me to leave my
Trusses at Guy's Hospital, and he would adopt them.
I also shewed my improvement to the Secretary
of the Royal College of Surgeons, who appeared
much pleased with it: he said, "that man who can
produce any new invention, which is calculated to
alleviate so large a portion of human suffering, will
ever be considered by me to be a great public
character."
JOHN HEAVISIDE, Esquire, of George Street, Han-
over Square, was much pleased with the principle of
my Trusses; he examined the one I wore very mi-
nutely; he told me that he had once a foreign Am-
bassador apply to him, whose Rupture was similar to

65
my own, and every time he endeavoured to mount
his horse, the Rupture came down, and he took him
to every Truss-maker in London, and got a new
Truss for him.*
The late GEORGE CHANDLER, Esquire, senior Sur-
geon of St. Thomas's Hospital, proved the effect of
this patent upon his own person; his affliction was
such as required two double Trusses at the same time,
being Ruptured in four different places, and he ac-
knowledged them to be the best that he had ever seen;
and he declared, if he had sufficient influence in St.
Thomas's Hospital, he would not permit a Truss of
any other description to be employed there, unless
any person could produce a better Truss.†
BENJAMIN TRAVERS, Esq. Surgeon of St. Thomas's
Hospital, acknowledged that no man entertained a
higher opinion of my Truss than he did, and that
it deserved to be encouraged.+
* It is no new thing for any Gentleman, having a bad Rupture,
to know what every Truss-maker in London can do for him, (W.
COLES excepted.)
+ My Trusses were left at St. Thomas's Hospital three years ago
by Mr. CHANDLER's request; but I have not heard that they have
ever been shewn to Patient, or Pupil.
+ It would afford me infinite pleasure, if I could say that any
one of the aforesaid Gentlemen had put a Patient under my
care.
D3

66
ASTON KEY, Esq. Surgeon of Guy's Hospital, a
near relation to Sir ASTLEY COOPER, said he would
freely give his opinion on the merit of this Truss,
which he did in the following words-" it is the best
that has ever been got up."
The Surgeon of his Majesty's Customs has em-
ployed five different kinds out of eight, which are
here exhibited as being adapted to the different spe-
cies of Hernia, which he has placed under my care.
Messrs. BROOKS, BELL, CARPUE, CARLISLE,
GRAINGER, and MAYO, Lecturers on Anatomy, have
all spoken of this invention in the most favourable
terms; and I am proud to add, that one of the latter
gentlemen once purchased my Bandage for one of
his Patients. The reader will not, under such cir-
cumstances, be surprised at being told, that there are
thousands of persons in this metropolis alone who are
utterly incapacitated from following any laborious
employment, who, like myself, are capable of being
brought into action with all the vigour of youth, did
they but know where to obtain a remedy, or whom to
apply to for advice. Scarcely can we cross a street in
this metropolis but we behold men whose Ruptures
excite the pity or disgust of all who behold them; they
are dead to all earthly enjoyments, and by degrees
are shut out from all Society; and frequently the very
air they breath is tainted with their loathsome disease;

67
ask them the cause, and they will tell you that it
originated from the incapacity of their Trusses to
secure it. Perhaps I have not yet painted this disease
in its proper colours; I shall therefore draw the at-
tention of the Reader to the case of ROBERT HUB-
BARD, alluded to in page 47, although I have met
with many worse cases than his.
This poor man, although of a middling age,
being unable any longer to struggle with hard la-
bour, was obligated to take shelter in a workhouse.
One of the parishoners who had noticed his being
employed in drawing the machine for watering the
streets, who possesses more humanity than is com-
monly felt in behalf of such poor wretches, sent him
to me to provide him a Truss; and if the Parish
would not discharge the debt, he would discharge
it himself. I found, on examining the Hernia,
the penis had entirely disappeared. I enquired how
he contrived to make water; he replied, that the
water ran over the Rupture as water would run
out of a bladder when a hole is cut in its side, which
he usually wiped off with his shirt. Persons in
better circumstances make use of a tin pipe to
conduct the water from them. The great weight
of the bowels often strips the skin from the bone;
and the heat thereof causes a running or wound be-
tween the Rupture and the thighs, the smell of

68
which is extremely offensive, and can never be
healed while the Rupture is down.
I have kept up this man's Rupture three years,
for the trifling sum of ten shillings and sixpence;
and he is secure and comfortable to the present day.
I have no doubt but there are hundreds of
persons
now in London ruptured, lingering out their youth-
ful days in workhouses, who would be able, with
the assistance of a proper Truss, to provide a com-
fortable support for themselves and families.
Having endeavoured to render this subject as fa-
miliar as possible to the Patient, by the former
drawings, and the mode of applying each Truss,
there yet remains one phenomenon of Rupture to
be explained, viz. Irreducible Hernia.--Whether it
is Umbilical, Inguinal, or Femoral, it will be
scarcely necessary to add, that such cases generally
arise from negligence or improper treatment. It
is enough, however, for the Patient to know he
has a Rupture, which cannot, (without hazarding
his life,) be returned within the cavity of the
belly, and that it assumes a globular appearance.
The pad of the Truss, therefore, should be larger in
circumference; and instead of being convex, as the
former drawings represent, the pad must be made
* Fuller's earth, mixed with water, should be applied to keep
the parts cold.

69
concave; whereby the Patient derives the same sup-
port and comfort which the hollow of the hand is
calculated to afford in such cases.
As many Surgeons have expressed an opinion that
the Scrotal bandage, by pressing on the pubis, may
injure the spermatic cords, I can only say, that I
have never known any patient complain of it; nor
have I felt it myself, although I have frequently
worn it for a week together without having occasion
to adjust it, or take it off.
It should not, however, be employed in cases of
obstruction in the urinary passages, nor in cases of
irreducible Scrotal Hernia, as a pressure upon the
intestines may produce strangulation. Patients hav-
ing a Scrotal Hernia, should take care to put up
every particle of the Rupture, and likewise the
omentum, which is very soft and slippery, and place
the pad as near the penis and testicles as possible;
and in cases where the opening into the purse is very
large, the pad must also be large; and it must oc-
cupy nearly the entire space between the legs, which
drives the penis and testicles upon the opposite thigh.
The thigh strap cannot well be too short to effect a
firm pressure at the bottom part of the pubis, or
bone between the thighs; if the thigh-strap is, too
long, the pad will rise up towards the belly and
the Rupture will escape.

70
If the Rupture should by accident descend, while
the patient wears this Bandage, he should not allow
it to remain down any length of time, as the Rupture
will get hard, and press the hair or stuffing of the
Truss out of its proper place; they must press the
pad up with their hand, flush on the edge nearest the
penis, and with a little care and attention, they will
get completely master of their Rupture. This Band-
age has been worn, in cases of Femoral Hernia, by
male and female;* the understrap is in that case drawn
the reverse side, in the same manner as the thigh-strap
is worn to the common Truss, and the girdle passes
through it, in which case the thigh-strap will re-
quire letting out about two inches longer.
The above Bandage has also a string sewed to the
girdle near the hip bone, and another to the end of
the thigh strap, to confine the strap in its proper
place, which will prevent its sliding towards the
fundament, when it would also allow the Rupture
to escape. The omentum will sometimes protrude
in large Scrotal Hernias, which the Patient should
always put up when he goes to bed. If he suffers it
to remain down any length of time, an adhesion
might take place, which might prevent the possibility
of its being again returned into the body.delf
*Ladies might communicate with Mrs. COLES either personally
or by letter, post paid,

71
Sir ASTLEY COOPER recommends, that all elderly
people should sleep in their Truss, lest any unex-
pected occasion should call the Patient from bed,
unprepared for the sudden change of posture.*
He likewise observes, that a small Hernia is more lia-
ble to be strangulated than a large one, the pressure
upon the contents being more violent. Sir A.
COOPER'S Treatise on Hernia, c. 7, p. 22.
eds
In justice to the Patient, and to myself, it is but
right to observe, that I never recommend the use of
this Bandage to infants, when there is a prospect of
effecting a cure; and I never have yet met with a
single case which required palliative means. Every
Patient, who allows a Surgeon or agent to apply
this Bandage, should examine himself in a glass
very minutely, before he takes it off. Numbers of
people have entirely forgot how to apply it the next
day. Scrotal Hernia is more difficult to manage
than any other description, on account of the opening
into the Scrotum, and the great weight of the abdo-
minal parts being suspended over it; and it has oc-
cupied much more of my attention on account of its
having been but little regarded by Anatomists, who
generally pass over it in silence, or with perfect in-
difference. If it had been possible to secure Scrotal
* Valetudinarians will find the above Bandage admirably
adapted to their cases.

72
Hernia by pressure upon the loose intestines, (or
what high-learned Authors call abdominal parieties,)
agreeable to the usual mode laid down by Anatomists,
we should not perceive one Scrotal Hernia where we
now find a hundred. Each of the before-mentioned
Patients, as well as myself, have probably employed
a Truss from the commencement of their affliction :
the evil has frequently been pointed out, but no man
has ever yet furnished a remedy equal to that which
I now submit to the world. svisado
alt of
In perusing the plan of the Institution, to which I
have before alluded, which particularly denominates
the different species of Rupture which the Truss
Society had relieved in twelve years, amounting to
nearly 23,000 cases, 1 do not find Scrotal Hernia
once mentioned. tipi od odled
This appears the more remarkable, as the Surgeon,
under whose superintendance the Institution had
gained a pre-eminence over its competitors, was him-
self a Lecturer on Anatomy. basmuloto
The following drawing exhibits the state of the
bowels when divested of its internal support, viz. the
peritonæum, or caul, which confines the bowels in
the lower belly; and common sense will tell you
that it can only be secured, or kept in the body, by
a pressure such as no human being is capable of
enduring.
evoda ads In Ha
I shall endeavour to illustrate this subject by sup-

73
fig. 9.


75
posing a lake or river, coming from the north,
branching off in three different directions, east, south,
and west; would any human being attempt to arrest
the progress of either by pressure? no, you must fol
low my example, and raise a bank against it. Ano-
ther example may be adduced, the truth of which
thousands of Patients who are now living can testify,
who have made a constant practice of reducing their
Ruptures at least once in 24 hours, when they retire
to rest, with their bodies in a perfectly horizontal
posture; the bowels nevertheless will find their level,
unless they are retained by external pressure, because
they are higher than the os pubis; and a portion will
always protrude into the scrotum or purse, which
might very reasonably be compared with the watery
element; but were it possible to raise the two bodies
in a perpendicular attitude, what would be the re-
sult? the water, like a Rupture, would rush out, ne-
ver to return. This is an every-day occurrence, and
millions of our fellow-creatures have thus ended their
earthly career.
Having quoted a few observations which have es
caped the lips of several eminent Surgeons, all of
whom have spoken in favourable terms, I shall now
state, without the least reserve, all that has ever been
said against it to my knowledge; and add a few
anecdotes which I trust will enable the reader to
reconcile what otherwise might appear inconsistent

76
Anecdotes on Hospital and Private
Practice.
dinge
A Surgeon, who presided over one of the largest
establishments in England, informed me, that upon
the average he put on a Truss per day throughout the
year; and as his patronage was very great, it was
much sought after; he had the opportunity of inspect-
ing every new improvement that had lately been
made in the form of a Truss, but he was sorry to say,
that he considered mine to be the worst improvement
he had ever seen; and he advised me to put my
Trusses into my bag, and sink them into the Thames,
and go and follow some other employment: this pro-
duced a smile on the countenances of the medical
students who surrounded us, and, I might add, for a
moment cast a cloud over my sanguine hopes; but
I soon recovered, when I addressed him in the fol-
blow off Silne
lowing words:-
SIR,-You told me just now, that you had a great
many Ruptured Patients in this Hospital; if you will
produce one of them who is similarly afflicted to my-
self, who is capable of performing that laborious ex-
ercise which I will perform in this Hospital, in your
presence, I will give that man five guineas. He re-
plied, he had men in that Hosptal who could put me
into their pockets. Some time after, I received a letter
from the aforesaid gentleman, couched in nearly the

77
same language, wherein he advised me to keep away
from Greenwich Hospital, which I did, until another
Surgeon was appointed to succeed him in that office,
to whom I also exhibited my improved Trusses. He
not only approved of the principle, but immediately
introduced me into the Surgery, to see what stock he
had on hand. He declared his determination to
adopt them as soon as he could clear the place of
what he was pleased to term, A HEAP OF RUBBISH.
Having shewn my improved Truss to one of the
Surgeons of St. George's Hospital, at his own house,
who highly complimented me for my ingenuity, and
desired me to meet him the next morning at St.
George's Hospital, when he would introduce me to
Sir EVERARD HOME, and the other Surgeons, imagin-
ing, perhaps, that it need only be shewn to the afore-
said gentleman to insure its introduction into that
Hospital; but Sir EVERARD, having more penetra-
tion than any other Surgeon who has inspected them,
instantly discovered something in my plan which
he observed was not new, and therefore it contained
no charms for him.
Some time after, I was mentioning this circum-
stance to Mr. WHITEHEAD, one of the Governors of
that Hospital, who had the curiosity to satisfy is own
mind, why my Truss could not be employed in their
Hospital if it was better than any other. He address

78
ed a letter to the Committee, and desired me to for-
ward it to the Hospital, and wait his arrival. The
letter was laid before the Committee, and I believe
acted upon previous to the Governor making his ap-
pearance; and the same Surgeon who had, upon the
previous occasion, introduced me to his professional
brethren, gave me a nod, and, whispering into my
ear, told me, he feared that I should not succeed there.
I very naturally asked him, why? because Mr. EGG
has such a fast hold here, he replied. It is the first
time that I ever knew an Egg have claws; I shall
leave the reader to judge what metal his claws are
made of. Mr. WHITEHEAD attended, and was evi-
dently disappointed at my not being permitted to
leave one of my Trusses for trial; he desired me,
however, not to be cast down about it, as he would
certainly bring it forward at some future period.
I was once exhibiting my Truss to a Surgeon in
the City, and had scarcely been five minutes in the
house, when a Patient came into the room, crouching
like an ass under a heavy burden, and he proceeded
instanter to divest himself of his load, viz, an opposite-
sided self-adjusting patent Truss; and turning his
small clothes down to his knees, exhibited his Truss,
as drawn on fig. 9; the spring of which, instead of
being placed on the opposite side, when it would
have encompassed two thirds of the body, (see Truss,

79
fig. 1,) was placed on the Ruptured side, with the
spring hanging down about the middle of the thigh.
He laid it upon the table, saying, he would not wear
it another day if they wonld give him the world,
for it had almost killed him. I applied it to the
reverse side, at which the surgeon appeared a little
chagrined; and the Patient cut a caper or two about
the room, and observed, he could wear it that
way; but as it had punished him so severely, he
never would wear it again. He then applied one
of my Trusses, and observed, although it was
much too large for him, he was in heaven, com-
paratively speaking. He desired I would permit him
to wear it until I could furnish him with a new one;
and, on being informed that he might have one
the next day, departed, when the following con-
versation took place :-The Surgeon asked what I
charged for a single Truss, and what allowance I
made. I told him my price, and that I allowed my
agents one-third part; and I would allow him the
same. He said, that would not do. I asked him
what would do. He said I must allow him half. I
observed, that there was a great deal more mechani-
cal labour in my Truss than in any other kind, and I
could not furnish them upon such terms; he replied,
if he wanted any more Trusses he should not apply
to me for them. I resolved, however, that if the Pa-

80
tient liked my Truss, he should know where to apply
for a new one; and I printed my name, and place of
residence in very legible letters, on the leather case
of the spring; but in the sequel it will appear I was
outwitted.
The Patient leaving town in great haste, took the
new Truss, which was left for him at the aforesaid
Surgeons, and wore the old one away; he returned
to town again in the course of a week.
en I forgot to mention one circumstance that oc-
curred previous to the Patient coming into the room.
The aforesaid Surgeon took up a common Truss, or
what some persons call a GERMAN TRUSS, which had
been given to me by one of my Patients, who had
formerly been under Mr. EGG's care, which, he ob-
served, was a single Truss.
I told him that the Patient bought it for a double
one, and that he had paid three guineas for it. Oh,
yes, he added, it is a double Truss. To talk about sin-
gle or double Trusses, or the mode of applying them,
is one thing; and to know how to purchase them, is
another; and to shew that they had learnt the most
important branch of the business, a book was present-
ed to me by a partner in the concern, which, I believe,
contained Mr. MAW's list of prices for Surgeon's
Instruments, &c. and my attention was immediately
directed to the common, or German Truss, which, in

81
the way of business, would realize a profit of 400 per
cent, whereas my Truss, even if I could have com-
plied with their terms, would only realize one hun-
dred per cent profit; and therefore an insurmountable
obstacle presented itself to my doing any good in
the world.
A fortnight having elapsed, I waited upon the Sur-
geon for my old Truss, and the money for the new
one, when I found both of my Trusses carefully
packed up in a parcel, and I might take them, and
go about
my business. I asked the Surgeon what
Truss he had employed. He answered, the common
Truss. I observed, the least he could have done was
to point out the defect of my Truss, and give me the
opportunity to correct it, observing, that the best Truss
in the world may be rendered useless, unless it fitted
the Patient, or was properly applied.
Having a previous knowledge of the Patient, I
waited upon him, and instead of receiving civility,
or common politeness, for the hire of my old Truss,
and the pains I had taken to furnish him with a
new one, he said, that he did not order the Truss;
but if I made his Surgeon pay for it, he would take
care that they should not be a looser by it. Six months
passed away before I could make up my mind to call
upon the Surgeon for the aforesaid Trusses: on ex-
amining them, I found that the new one had not been

82
in the least soiled, except the leather case, to which
something like vitriol had been employed to erase my
name from it. I resolved to probe this filthy lucre
system to the bottom; and if I could find no exception
to the above rule, I had no alternative but that of ad-
vancing my price one-half. I therefore waited upon
Mr. HENRY EARLE, who had placed more Patients
under my care than all the Hospital Surgeons in the
kingdom, and I made up my mind to give him a hand-
some fee. "Stop, stop!" says Mr. EARLE," I never
yet soiled my hands with the earnings of a Truss-ma-
ker, and I hope I never shall." I am happy to say
I have found other exceptions to the above rule;
nevertheless I advise every Patient, when he con-
sults his medical friend, never to ask whose Truss he
recommends rather ask whose Truss is best, and let
it be optional to yourselves whether you adopt them
or not.
Whether a Surgeon sends an order, or the Patient
himself, they ought always to describe how a Patient
is formed, whether round and corpulent, or thin
made. If the Rupture be close to the thigh, it is a
Femoral Rupture. The Truss must be shorter in
the front part than would be required for an Ingui-
nal Rupture; if the case be a Scrotal Rupture, the
pad of the Truss must go as far beyond that of the
Inguinal Rupture.

83
That I might be properly understood, that only
can be considered Inguinal which will remain in the
body without the aid of an instrument to confine it,
and that which has forced a passage into the scrotum
or purse, is Scrotal, whether the contents be large
or small; the man who will suffer it to remain
there, can have but little regard for himself,
much less for his wife and family, if he should be
so unfortunate as to have either, for life will soon
become a burden to him.
If the Patient has tried various kinds of Trusses,
and none will keep up his Rupture, or if the accident
has recently happened, and he never wore a Truss
before, he should so express it, and he may rely
upon every attention being paid to meet the
circumstances of the case: send likewise the number
of inches round the body; and be particular in de-
scribing right or left, single or double, and which
side is worst.
Every Patient, who will peruse this Book care-
fully, may acquire a perfect knowledge of the nature
of their disease, and be enabled to form some idea
which Truss is best adapted to their case.
As many thousand persons are officiating as
Agents for other Truss-makers in various parts of
the kingdom, and none of them have, upon any one
occasion, ever applied to me for a Truss, I consider

84
them to be no advocates for any improvement in the
construction of a Truss; and therefore I do not in-
vite such persons to act for me as Agents.
vbed
Respectable Tradesmen, residing in large manu-
facturing districts, who may be desirous of acting
for me as agents, will please signify the same by
letter post-paid, and, when duly authorised, their
names shall appear in the second edition of this Work
Preference will be given to those who are afflicted.
Should any infirm Lady, or Gentleman, residing
at a distance, require my personal attendance, my
Terms will not exceed One Guinea per day, exclusive
of travelling expences.
Every information relative to the Patient, should
be forwarded, to furnish an idea what means is best
to be employed in every case.
N. B. Riding Suspenders, Clavicle Bandages,
and other Instruments for bodily deformity, upon
very superior principles.
Hiw odw
b
2071 doidu
THE END.
A
T. HARVEY, Printer, 22, Great Surrey Street, Blackfriars.