THE TRUE METHOD OF REDUCING RUPTURES, &c.
[]MY Truſs is only intended for the benefit of ſuch Ruptures in the Groin and Scrotum as there is a poſ⯑ſibility of returning again into the Abdomen; tho' I make others of a different conſtruction, according to the ſituation of the part from whence it proceeds, and other circumſtances that may attend it; and in particular a new in⯑vented Elaſtic Bandage for a Rupture in the Navel; for the invention of which I am in part obliged to Dr. ALLEN, of Dalwich College.
BEFORE I give any directions how to apply my Truſs, it may be proper to ſay ſomething [2]with regard to the ſafeſt and eaſieſt manner of reducing the Inteſtine, when fallen down; and the following is the method I have always practiſed with great ſucceſs.
I MUST too premiſe, that I have ſome hopes my Readers will not entertain a leſs favoura⯑ble Opinion of me, if I avoid the pompoſity of ſome perſons who have wrote on this ſub⯑ject; if I do not endeavour to raiſe my merit on the ſound of a word, and torture language for new-fangled and varying names, merely becauſe the ſymptoms of the diſorder are triflingly different.
IF the Rupture then be much enlarged, or painful, it will be of great ſervice to the Pa⯑tient, before the reduction is attempted, to take a gentle cooling purgative, ſuch as a de⯑coction of Tamarinds with Sena, or a ſolution of Salts and Manna; and if he is of a plethoric or full habit of body, to let a moderate quan⯑tity of blood will be proper; and at the ſame time the parts ſhould be fomented with a piece of flannel wrung out of a warm decoction of emollient herbs, ſuch as Chamomile Flowers, Mallows, &c.
[3]AFTER theſe preparations, you ſhould pro⯑ceed in the following manner: Lay the Pa⯑tient upon his back in ſuch a poſture that his Buttocks may be conſiderably higher than his Head, as by that means the Bowels that are within the Belly will fall more towards the Breaſt, and not only give way to what is to be returned, but be of ſome aſſiſtance to the reduction. Then you muſt examine care⯑fully as to the ſituation of the Teſticles; and if you find they are forced up towards the ſides of the Scrotum by the ſize of the Rup⯑ture, you muſt be very cautious not to ſqueeze them in your attempt. If you find them compreſſed at the bottom of the Scro⯑tum, you muſt with the fore-finger and thumb of one hand ſeparate them from the ruptured part, and with the ſame fingers of the other hand take hold of the upper part that is next the Ring of the Muſcles, or place from whence the Rupture comes out, and work it gently in, in the ſame manner as you obſerve Women do with a cow's teats when they milk her. By obſerving this me⯑thod you will never be apt to ſtrain the Rings of the Muſcles, nor hurt the Inteſtine, ſo as to occaſion an inflammation of any of theſe parts.
[4]As to the application of the Truſs, it will be more convenient to put it ſlack round the Patient's Body before he is laid down, as by his getting up after the reduction there might be ſome riſque of the Bowel falling down again. Take hold of each end of the ſpring, and open it wide enough to receive his Body ſide-ways; and after you have got the Bowel fairly reduced, apply the Cuſhion of the Tr [...]ſs upon the Rings or Orifice from whence the Bowel came out. It muſt have a gentle hold of the upper part of the Os Pubis or Sharebone; but take care it is not placed too high or too low: The Spring will be a direction, which ſhould come round the Os Ilium, and cloſe to the juncture of the Thigh-bones, and touch the Rump juſt [...]here the clift of the Buttocks begins; which parts are called by the Anatomiſts, the Great Trochanter of the Thigh-bones, and the middle of the Os Sacrum. The Truſs muſt be made ſo tight as to make it ſit cloſe, otherwiſe it will neither do its office, nor be eaſy to the wearer.
ALWAYS keep under the Cuſhion four fold of old coarſe linnen, which will keep the part cool and eaſy, and prevent the Cuſhion from being ſpoiled by the moiſture of the [5]Skin. It will be a great addition to the Truſs, if for ſix or ſeven weeks, or longer (that is to ſay, till the Patient has compleated his cure, which, if he has youth on his ſide, may poſſi⯑bly be in two months; of which, indeed, I have ſeen ſome inſtances, but then the Patient has been very obſervant of the rules preſcribed him) the parts are bathed with very cold wa⯑ter every night and morning, which may be done conveniently in the following manner: Take a piece of large linen cloth, fold it up pretty thick ſo as to be about ſix or ſeven in⯑ches ſquare, a few ſtitches may be put into it to keep the folds together; dip it into a baſon of cold water, (but, that you may not wet the Truſs, looſe it, and lay the Pad or Cuſhion that was in the Groin up to the Navel out of the way of the water) then ſqueeze and apply it to the Scrotum and Groin, and as it loſes its cold⯑neſs dip it in the water again and again, which ſhould be continued for half an hour at a time: It is moſt convenient this cold bathing ſhould be performed when the Patient is naked in bed. It is neceſſary that the Patient's breeches ſhould be very long in the Thighs, ſo as to al⯑low the waiſtband to come high up on the Pel⯑vices above the Truſs, for if it bear thereon it [6]will add ſo much to the preſſure, which will make it very uneaſy.
I MUST here adviſe my Reader, that in ex⯑amining any thing like a Rupture, he does not miſtake a Swelling of the Spermatic Chord, or in the Groin, for one; as by handling any thing of that kind roughly, he may not only give the Patient an exquiſite deal of pain, but do great miſchief. If it is really a Rupture, gentle means, without being in too great a hurry, will anſwer beſt. A very gentle preſ⯑ſure of the Fingers in an erect poſture will ſometimes cauſe it to diſappear: But if this ſhold fail, lay your Patient on his Back; then rub your Fingers upwards and downwards ob⯑liquely from the Os Ilium to the Os Pubis. This is to be continued for a conſiderable time; but if it ſhould not remove it, and it ſtill continues to the touch as at firſt, the Pa⯑tient muſt continue in the ſame ſituation, and have the part fomented, and the above opera⯑tion again performed: After which, ſhould it ſtill continue hard, it is certainly no Rupture*.
[7]I HAVE been frequently ſhocked at the cruelty with which I have ſeen Surgeons uſe their Patients, merely by miſtaking a Swel⯑ling for a Rupture.—On theſe occaſions I have remonſtrated;—but as I was not bred a Surgeon, my counſel was treated with con⯑tempt, altho' they quickly found their at⯑tempts in that way were in vain.
IT may not here be improper to obſerve, that my knowledge in theſe matters took its firſt riſe from being afflicted with a Rupture myſelf. I tried all the different kinds of Truſſes that have been uſed and recommended by Surgeons for many years back, but found the beſt of them ſubject to ſome inconveniency. However, as I was originally a Mechanic, I went to work with an intention to avoid the inconveniencies of thoſe I had uſed; and after trying ſeveral different new forms, I at laſt hit upon that which I now offer to the Public, and has given ſo much ſatisfaction to all who have uſed it. As to any farther knowledge [8]I have of Ruptures, I am obliged to ſome Gen⯑tlemen of the Faculty, particularly Dr. Hun⯑ter and Dr. Livingſton; alſo to Dr. Barry, for the books he recommended to my peruſal. When put you in mind how ridiculous the Surgeons of former times appear in this more enlightened age, in having rejected Frere Jaques's new method of Cutting for the Stone, for no other reaſon but becauſe he was not a regular bred Surgeon, I hope no Gen⯑tleman of the Faculty will condemn my Truſs, till he can prove its having any deficiency, and has compared it very narrowly with others that continue in uſe. The recommendation of thoſe who have experienced its benefit (which ſome thouſands in the dominions of Britain, France, Italy, Germany, Holland, and Por⯑tugal, have done) would perhaps be ſuffi⯑cient, but that many people who are ſubject to any diſorder of that kind are fond of con⯑cealing it, and conſequently will never mention any thing of my Truſs. However, in my be⯑ing conſtituted Truſs-Maker to his Majeſty's Royal Hoſpital at Greenwich; even when Mr. Alexander Reid, firſt Surgeon's Mate of Chel⯑ſea Hoſpital; Mr. William Blackey, of the College of Surgeons at Paris; and Mr. Ed⯑diſon, Bedſtead-Maker, of Hanover-Street, [9]Long-Acre, with a letter of recommenda⯑tion ſigned by a great number of regular-bred Surgeons, (amongſt whom I wiſh Mr. Haw⯑kins had not been one) ſome of them too the moſt eminent in the profeſſion in Truſſes in Lon⯑don; were candidates in oppoſition to me, can⯑not fail to give the Public a juſt idea ofits merit. Theſe gentlemen, it is well known, did ſtand a fair trial with me every day, almoſt for two months, before the Phyſicians and Surgeons of the Royal Hoſpital made their report of the candidates different merits; on which I was ap⯑pointed Elaſtic Truſs-maker by the Honorable Board of Directors of his Majeſty's Royal Hoſpital.
I THINK it would be here an unpardonable offence to poſterity, not to inform my Read⯑ers, that to this day a Surgeon of the greateſt eminence recommends a Shoemaker. to all his Ruptured Patients to make the Truſſes for them, though I am very certain he does not know iron from ſteel, when it is made out of the common ſizes of the bars thereof. This I have from jobbing-ſmiths, ſome of whom the ſeller has employed ever ſince he was con⯑verted from a Shoemaker into a Truſs-maker. It is this eminent Surgeon and this Shoemaker that Counſellor Brand, at May's Hill, Green⯑wich, [10]means in his letter therefrom to me, which is hereafter inſerted for the uſe of the public, amongſt others ſent me, together with Certificates of the Efficacy of my Truſſes above all others made uſe of.
SHORTLY after I had invented my Elaſtic Truſs, I had an opportunity of ſending ſome of them to Mr. Ranby, Principal Serjeant-Surgeon to his Majeſty; in conſequence of which I received the following letter.
To ROBERT BRAND, Cutler, in Aberdeen.
SOME time ago, I believe about the time you mention, a Soldier left two Truſſes at my houſe, and in a day or two afterwards took them away. I underſtood from my ſervant that he was the maker of them. They appeared to me to vary a little from the common ones: However, when you come up in June, bring ſome with you, which if upon trial anſwer better than thoſe uſed now, you will certainly meet with encouragement.
"THAT I bought one of theſe Truſſes from the bearer, Robert Brand, Cutler, and that it has done better with me than one I had from England, or one I had made in this place; is in juſtice and gratitude to his merit
"I SHALL only add (which is indeed truth) that this Truſs is ſo very convenient, that I can walk and do every thing elſe as freely with it as if I had no ailment at all.
"IN juſtice and gratitude to Robert Brand, Truſs-maker, in Aberdeen, I acknowledge that I have had a Rupture for theſe five years; that about that time I was an inva⯑lid, doing garriſon duty at the Iſland of Guernſey, I had a Truſs purchaſed at Lon⯑don for me by Mr. Roſe, the King's Re⯑ceiver [12]in the iſland; which I wore, but with great pain, for the ſpace of four years. I then got a Truſs which came from Chel⯑ſea Hoſpital, but with no better ſucceſs; until about a month ago, I purchaſed one from Mr. Brand, being a ſingle Truſs and fitted for the right ſide, which has anſwer⯑ed the intent, by giving me no pain in my walking, keeps up the Rupture, and with⯑out the incumbrance of a Thigh-ſtrap: Is atteſted to be truth by me, this 30th day of May, 1764.
"THE above declaration is atteſted by me, John Dye, of Tilligrieg, one of his Ma⯑jeſty's Juſtices of the Peace for the County of Aberdeen,
"I Doctor Thomas Livingſton, Phyſician to the Infirmary at Aberdeen, do hereby certify, that Robert Brand, Cutler, in this City, has beſtowed great pains and atten⯑tion [13]in contriving a new conſtruction of Rupture-truſſes, which, for eaſe as well as prevention of the diſeaſe, ſeems to anſwer better than the ordinary Truſſes formerly in uſe; and it conſiſts with my particular know⯑ledge, that many people have uſed them with great benefit and ſatisfaction.
IN January, 1765, the following Memorial was preſented to the Edinburgh Society for the Encouragement of Arts, &c. by Mr. Barclay, their Secretary.
I HUMBLY beg leave to repreſent to you, that Ruptures are unfortunately too com⯑mon: Perhaps the fourth part of mankind labour under them in old age; and as to women who have had children, if half of them eſcape accidents of this kind, it is a miracle.
[14]BEING originally* a Cutler and Surgeon's Inſtrument-maker, and having been for ma⯑ny years afflicted with a Rupture which great⯑ly incommoded me in the neceſſary functi⯑ons of life, I had recourſe to the various Truſſes and Bandages made uſe of for re⯑lieving that misfortune, both from London and Paris; but finding them very incom⯑modious as well as ineffectual, I applied myſelf with great attention to the improve⯑ment of thoſe neceſſary contrivances; and, after many years repeated trials and many years experience have at laſt happily ſucceed⯑ed, and ſo greatly improved the Steel Truſs, as to make it anſwer every deſireable purpoſe for the curing as well as palliating that trou⯑bleſome diſorder; which numbers as well as myſelf have experienced, both here and in London; to authenticate which aſſertion, letters, ſhould it be thought neceſſary, can be produced from Patients reſident at both places.
[15]THE great advantages which my Truſſes have, in conſequence of this Improvement, above others, are as follow:
FIRST, by an Elaſtic Spring, peculiar to themſelves, they are accommodated equally well to perſons of every Age and Size; ſo that two different Sizes is the only requiſite for making them fit every perſon of above two years of age; and the ſame circumſtance likewiſe makes them more proper for exportation than any hitherto invented.
SECONDLY, They do not require that troubleſome and incommodious appendage a Thigh-ſtrap, ſo commonly uſed in other Bandages.
THIRDLY, They by the Elaſticity above⯑mentioned maintain a conſtant, equal, and uniform preſſure on the part only affected, and imitate the kind preſſure of the Hand in all its degrees, in all the different atti⯑tudes of the Body; whereby the parts mak⯑ing the Rupture are ſo conſtantly kept from coming down, that an opportunity is given to the relaxed and ruptured parts through [16]which they deſcend to recover their former ſtate, and thereby prove to the Patient a radical Cure.
FOUR THLY, I can afford to ſell the above⯑mentioned Truſſes at as low a price as the other Truſs-makers in Britain ſell their Iron Truſſes, without any other property to them than dignifying them with the names of Steel and Spring Truſſes.
THESE, and other advantages, too te⯑dious to mention, convince me that this im⯑provement, when generally known, will prove a very great benefit to a very great part of mankind: And therefore I perſuade myſelf that ſhould it meet with your appro⯑bation, I ſhall not fail of ſharing that encou⯑ragement and generoſity which ſo highly dig⯑nifies your honourable Society.
IN conſequence of the preſentation of the foregoing memorial I received the following letter:
To ROBERT BRAND, Cutler, and Truſs-Ma⯑ker, in Aberdeen:
YOU here have the report Dr. Monro gives the Society of Arts, on the back of your me⯑morial, which I returned this day to Mr. Barclay, who ſaid it would make nothing as to premium. After his reſpectful compliments to the honourable Society, Dr. Monro ſays, "The Truſſes Mr. Brand preſents is no new invention, as there is of the ſame kind and ſame materials uſed by moſt Surgeons in Europe for many years paſt: The only eſ⯑ſential circumſtance is, the circular Steel Spring is more ſtrict than thoſe in common uſe, which makes them ſit eaſier on the Pati⯑ent, and better fit perſons of different ſizes." He adds, "that this laſt is ſcarce worth obſer⯑vation, as each perſon ought to have his [18]meaſure taken in the moſt accurate man⯑ner. March 6th, 1765."
‘"P. S. A few days after I delivered your memorial to Mr. Barclay he called at my houſe, and told me the Society had pitched on Dr. Monro to examine into the merits of your Truſſes; which the Doctor very readily aſ⯑ſented to, and that I muſt carry them to him directly; which I accordingly did. On opening the box, taking them out, and ſhew⯑ing them to the Doctor, he ſaid they were made in the ſame manner as Mr. Auchinlec here makes them. I ſaid there was a great difference. But ſtill the Doctor inſiſted there was none. On this, his ſon ſtept into another room, and brought one of Auchinlec's mak⯑ing out, and on comparing them together, he confeſſed there was a difference.—Had he ſuffered as much pain with Truſſes as I have done, he would ſooner have ſeen it.’
WHEN perſons of confined ideas, and who have not the advantages of education, fall into [19]an error, there is an excuſe ready for them: The groſs miſtakes of a man of letters are un⯑pardonable. Dr. Monro's miſapprehenſion in⯑deed ſeems WILFUL. Could any thing be more uncandid than his declaration that my Truſſes and Mr. Auchinlec's were alike?—Could any thing be more mean than the hard-ſtrain'd acknowledgement, that ‘"there was ſome dif⯑ference?"’ In his report he ſays, ‘"that my Truſs differs from others, only in the circular Steel Spring being more ſtrict than thoſe in common uſe; which makes them ſit eaſier, and better fit perſons of different ſizes;"’ but this eaſe and this convenience, it ſeems, are not worth thinking of, becauſe ‘"each perſon ought to have his meaſure taken in the moſt ac⯑curate manner."’—Here is philoſophy! —I frequently ſend Truſſes to the Eaſt and Weſt Indies—Were Dr. Monro living, I would aſk him, if I ſhould make a voyage every time I receive an order.—
HERE follow ſeveral teſtimonies to the merits of my Truſs, which, without further ceremony, the Reader will, I believe, accept.
[20]To Mr. BRAND, in Great Peter's Street, Weſtminſter.
"THE Machine you laſt left with me does its office very well, and ſits eaſy.
To Mr. BRAND, in Great Peter's Street, Weſtminſter.
"AFTER a variety of Truſſes I have made uſe of from different perſons recommended to me by a Surgeon of great character in Town, which did not do their office; yours that I have now on, and have worn conſtantly nine or ten weeks, not only fully anſwers its purpoſe of keeping the Gut up, but ſits very eaſy, and is attended with little or no trou⯑ble.
"ON the recommendation of Dr. Hunter, I made uſe of Mr. Brand's Elaſtic Truſs, to a youth about ſeven years of age, who had been afflicted with a Scrotal Rupture for two or three years. I had uſed in the courſe of that time ſeveral ineffectual means without ſucceſs: Yours he wore with great eaſe, and intirely prevented any return of the diſorder.
"THESE are to certify that I have ſeen Mr. Brand's Bandages for Ruptures, and that from the ſeveral opportunities I have had for them, find they anſwer better than any other I have had occaſion to uſe.
"THIS is to certify, that I have frequently recommended Mr. Robert Brand, Truſs-Maker, whoſe Bandages always gave great ſatisfaction to my Patients, and to me.
"THESE are to certify, that I have ſeen and carefully examined the Elaſtic Bandages for Ruptures, made by Mr. Robert Brand, of Peter-Street Weſtminſter, Truſs-Maker; and am of opinion, that they are neat and ſtrong in their conſtruction, very ingenious in their contrivance, and more peculiarly adapted to ſeveral purpoſes of a Truſs than any other Bandage I have ever ſeen.
"HAVING made uſe of the Truſſes made by Mr. Brand, on ſome Patients afflicted with Ruptures, I think it no more than a piece of juſtice due to his ingenuity, to ac⯑knowledge, that they have ſucceeded very [23]well in fulfilling the intention for which they were applied; nor have I ever ſeen any Truſſes which I ſhould prefer to them.
"THESE are humbly to certify the Go⯑vernors of the Royal Hoſpital at Green⯑wich, that I have ſeen ſeveral inſtances of Ruptures, where the Patients have unſuc⯑ceſsfully made uſe of ſeveral Operators Truſſes, which were painful and uneaſy to them; and afterwards being adviſed to uſe Mr. Brand's Elaſtic ones, they found ſpeedy eaſe, and no pain therefrom; and for that reaſon, in my opinion, his deſerves the preference of all other Truſſes.
"I HAVB ſeen ſome inſtances where Mr. [24]Brand's Elaſtic Truſſes have been ſucceſs⯑ful, where others have failed.
"I HAVE ſeen ſome inſtances where Mr. Brand's Elaſtic Truſſes have been ſucceſs⯑ful, where others have failed; therefore I think they deſerve peculiar notice.
"THESE are to certify that I recommended a Patient to Mr. Brand, who had been afflicted from his infancy with an inguinal Rupture, and had tried all means for a cure, with the different ſorts of Truſſes, without ſucceſs, giv⯑ing him great pain in wearing them, ſo that he was often obliged to leave them off, and his Rupture would as often come down; but after applying Mr. Brand's Truſs, he found to his great ſatisfaction that he could wear it with great eaſe, and declared himſelf much obliged to the ingenious Author [25]of ſuch a Truſs, from which he had found ſo much relief.
IN the caſe referred to by this Gentleman, on reducing the Rupture, if great care was not taken to divide the Teſticle from it, the latter would follow the former into the Belly.
"THIS is to certify that I have often ex⯑amined, and ſeen applied, Mr. Brand's Steel Truſſes, and I do imagine that they are bet⯑ter adapted for the cure of Ruptures than any I have ſeen.
"I Hereby certify, that after having recom⯑mended various ſorts of Truſſes to my Pa⯑tients, I can find none ſo eaſy to the wearers, or ſo well adapted to the relief of their diſ⯑orders, [26]as the Elaſtic Truſſes made by Mr. Brand, of Peter-Sreet, Weſtminſter.
To Mr. ROBERT BRAND, TRUSS-MAKER to his Majeſty's Royal Hoſpital at Greenwich: At his Houſe in St. Martin's-Lane, near Charing-Croſs, London.
"THE generoſity and humanity with which you treated me demand the moſt grateful acknowledgments, and nothing gives me more concern than to think that neceſſity ſhould oblige me to leave London without being able to pay you, as my friend was not in town, and the ſhip going away. There⯑fore I muſt intreat you to be patient for a ſhort time, and you ſhall have no cauſe to complain. In the interim I ſend you my Note for 2l. 10s. payable in ſix months af⯑ter date, tho' the ſum I owe you is only 2l. 2s. And as I ſhall make a remittance [27]by the return of the ſhip from South Caro⯑lina, to Mr. Edward Upton, in Paternoſter-Row, I ſhall deſire him at the ſame time to take up the Note. Permit me to aſſure you, Sir, that I ſhall ſpare no pains to recommend your Truſſes in South Carolina: And in the mean time pleaſe to pay my compliments to your good ſpouſe and ſon.
MR. Spencer was a gentleman of the clergy, and had a living in North America. Being afflicted with a very large Femoral Rupture, he applied to ſeveral for relief without any ſucceſs; among whom was the ingenious Mr. Blackey, of Paris, who ap⯑plied a Truſs that was adapted for a Groin Rupture on his Femoral Rupture; how⯑ever, I made a proper Truſs for him, and ap⯑plied it; which I had no ſooner done, and he finding that it would do its office, than he deſired me to take it off. I aſked him why? [28]He ſaid becauſe he had not money ſufficient about him to pay for it, and that his friend was not in town. I told him I had no doubt of the money, for I believed him a gentle⯑man. On which we parted; and I never faw, nor heard from him, till I received the letter inſerted.
HE faithfully remitted the money, and I received it.
To Mr. ROBERT BRAND.
"A SHORT time ſince, I deſired my brother to call on you for an Elaſtic Steel Truſs, for a Patient I have here. During the time he has uſed it, has found the greateſt be⯑nefit. Have reaſon to think he will get a per⯑fect cure, by perſevering in the uſe of it. This morning, as he was applying it as uſual, the part broke as you ſee, which beg you to get mended, and ſend to the bearer for conveyance to,