HINTS  ON
RUPTURE  AND  TRUSSES,
               a x i»
REMARKS ON INS T II U M E N T S,
      Jfor tjic Relief of Jltfonratj,
BEING A GUIDE TO THOSE WHO REQUIRE THE AID OF
         THE SURGICAL MACHINIST,
                B Y
     ROBERT  ^RUCE,
Surgeons' Anatomical Instrument and Bandage Maker,
   3XTo. 145 XiOMBARD ST.?
         BALTIMORE:
PRINTED BY FREDERICK A. HANZSCHE
             1854. 
* 
         HINTS  ON


RUPTURE AND TRUSSES,

                AND

REMARKS  ON INSTRUMENTS,

      Jfor % Relief of ^tfflnmfg,  -

BEING A GUIDE  TO THOSE WHO REQUIRE THE AID OF
         THE  SURGICAL MACHINIST,

                 B Y

     ROBERT  BRUCE,

Surgeons' Anatomical Instrument and Bandage Maker,

    No. 1-4.S  IjOmBAIlD ST.,
                | SURGEON GENERAL'S OFFICE

              ~[     SEP, -3<H803_
         BALTIMORE: //"fitf'J
PRINTED BY FRFDERiGJL^«trA4JUUL0BJbp^^»"----
1854. 
WI
3?8lli 
PREFACE.
  The following short treatise is not meant to throw
light upon any particular branch of the Medical Sci-
ence, but is merely a few useful hints and remarks
for the information of those who may be afflicted
with Rupture, or  any other disease or deformity to
which  mechanical  means are applied.
  Such a little  work was suggested to the author,
first by several medical friends in Grlascow, Scotland,
and more recently by his many medical friends of
Virginia and Maryland.  They were of opinion that
such a guide would be of service to persons in want
of the  aid of the Surgical Machinist;  and that by
exposing the practices of those unqualified for such a
profession, prevent much uneasiness to the medical
attendant, and much danger and useless expense to
the patient.
 ' That such a  guide was wanted, none who have
paid any attention to the  subject will deny.  In
every town, truss and bandage makers are springing
up, devoid of principle, making false pretentions and
devices to allure the unsuspecting into their hands;
and the  person  so unsuspecting as to trust to such
empirics,  may be thankful if only money has been
uselessly thrown away.  The members of the medi-
cal profession are well aware of the injuries that have
been sustained by  patients from  maltreatment, by
the application of instruments wrongly constructed,
and  applied by  ignorant pretenders.  The  writer
was early trained to all the minutiae of the practical
part of the business^ in the establishment of his fa-
ther-in-law at Glascow, Scotland, carried  on under
the firm of Marrison iv- Edwards, who were the orig- 
IV.
PREFACE.
inal Truss and Bandage makers of that city, and from
whom  such a host have sprung, and well known to
the medical profession for forty years, and till this
date both in Europe and America.
  Being desirious of bringing the business to as much
perfection as possible, he  underwent  a course  of
studies, by which he became familiar with the anat-
omy and surgical relations of the different parts  of
the body, paying particular attention to the parts
connected with Hernia, and the different forms  of
deformity.  He was enabled to see that much ig-
norance was shown even  by the most popular ma-
chinists, and to  a deplorable extent by the general
mass of pretenders.  He has no wish to be thought
a medical man,  but simply one who being practi-
cally a  mechanic,  has  made himself familiar with
the* different forms of disease, and by such qualifi-
cations he hopes to be of service to suffering man-
kind, and raise this branch from the  depths  to
which it has been sunk by those who have no other
qualifications than having been bred hammermen,
saddlers or stay makers. 
HINTS ON RUPTURE  AND TRUSSES.
              Hernia or Rupture.
  Is the name applied to tumor formed by a descent
or profusion of intestine.   It  generally appears in
the  groin,  and  lower'parts  of the  abdomen.   It
may occasionally disappear for a short  time, and
generally does so, when in a reclining position.   It
is often attended with little or  no pain at first, and
varies in size and contents, in  different individuals.
The individual  often thinks  that it is merely a
small swelling, which will disappear in a day or two,
and neglects obtaining advice, until its bulk, or the
pain attendant, forces him to  consult his physician
or surgeon.   Others, from a feeling of delicacy, do
not  get advice, but hasten  to  some shop  where
trusses are sold,  buy one and  think they are quite
safe; which course  often, leads to painful results.
The only  wise and prudent  plan is to  consult a
medical man, and,  if ruptured, the party will  of
course be told to get a truss;  and if a proper truss
be applied, little inconvenience if any, will be felt
from the  rupture.   Too much caution cannot be
employed in the choice  of a truss-maker, as it  is
disgraceful but true,  that many who have no other
qualifications but a claim to the anvil and awl, pro-
fess truss-making.  So  general  has the  sale  of
trusses become,  that they  are found in  the  shops
and windows  of hardwaremen, tinmen, and toy-
dealers.  These  trusses are made in  factories by
men who like  their  employers, may  have heard of
such a  thing as rupture, but are entirely ignorant
       1* 
6         HINTS ON RUPTURE AND TRUSSES.

as to what it is, and that there are more kinds than
one.  Travellers are sent round about the country,
who sell them in conjunction with knives, scissors
&c.  The shop-keeper is induced by the representa-
tions of the traveler,  to take  a  few dozen on trial,
thinking they  will be a profitable article for sale.
He is  told that  the springs are warranted and
strong, this is  thought a proof of superior quality.
Every  medical  man is aware that strong springs in
some cases are  very injurious.   These trusses, with
the exception of size, are made all alike, and are,
from the very nature of their construction, unsuita-
ble for any description of rupture.   It is sad to think
of the results of such a traffic; cases are daily hap-
pening of trusses  being applied where no rupture
exists, causing  great pain and danger to the wearer.
   All  the information which the seller requires con-
cerning the rupture, is the size round the body;  he
does not know that a truss to suit one kind of rupture,
would be injurious to another.   His trusses are all
alike,  except in size; and he thinks he does quite.
right if he gives one the size.   As there are different
kinds of rupture, differing m position, size and course
of descent or protrusion, it must be obvious to every
one that  no particular kind  or  shape of truss  can
reasonably be applicable to all.   Truss-making has
been too much  abandoned to mechanics of the lowest
class, who from some disqualification do not succeed
at their original trade;  they manage to get employ-
ment from some person of standing and  soon after
set up for themselves.  A man to be a truss-maker
must be qualified  by  being a mechanic, and possess-
ing a  knowledge  of the anatomy of the parts con-
nected  with rupture; if such be the case,  he can
practise his profession with benefit to mankind  and
satisfaction to  himself.  If every truss maker and 
HINTS ON RUPTURE AND TRUSSES.
7
vender were so qualified, the medical man would be
saved much unnecessary trouble and uneasiness, and
the  ruptured community,  from  much  pain  and
danger.
  I will now endeavor to ma.ke the different kinds
of rupture as plain  and  intelligible as possible,
without going to that depth, which to any except
the medical  student,  must  be confusing instead of
beneficial.
  Oblique Inguinal Hernia is  the most frequent
kind,  and receives its name from its descending
obliquely through the inguinal canal, or the  pas-
sage through which the spermactic vessels pass out
of the abdomen  to the scrotum:  the same rupture
descending into  the scrotum,  is called Scrotal Her-
nia.  This kind of rupture  is  at  first  generally
easily reducible.   Some persons feel no pain from it,
and allow  it to go on increasing, until the scrotum is
swelled to such an extent that the weight and bulk
demand assistance. A truss to act properly for this
kind of rupture,  should net, as is generally  sup-
posed  by  truss-makers press on the bone of the
pube, but  higher up, so as if possible prevent the
rupture from lying in the canal.   Pressure on the
bone is dangerous as well as painful.'
   Direct  Inguinal Hernia is of more rare occur-
rence, and shows itself at the same part of the groin
as the other; it  protrudes directiy through, not
descending like the  other.  A  truss to suit this
kind, must act a little differently from the other.
   Femoral Hernia generally  shows itself suddenly
at the bend of the thigh.   It descends through the
passage formed  for the transmission of the vessels of
the thigh.   After descending, it moves up  a little,
and is worse to reduce than  the preceding.   It is
also attended with'more pain.   It is of more fre- 
8
HINTS ON RUPTURE AND TRUSSES.
quent occurrence in females than in males.  It must
be evident that a truss to suit this kind, must be of
a different construction from those for inguinal rup-
ture.   Notwithstanding  this trusses are daily  ap-
plied promiscuously to. all kinds.
.  Umbilieal Hernia shows itself at  the navel, and
is found oftener in women and children than in men.
It is  generally  easily reducible, and by a properly
fitting truss, can  be  easily kept from protruding.
A truss for this  kind is of course of  an entirely dif-
ferent construction.
  Congenital Inguinal Hernia occurs in infants, and
shows itself soon after birth; it requires great at-
tention on account of its connection with the testicle.
Improper treatment is often productive of very se-
rious injury.  In  all cases the  medical man ought
to decide whether a truss should be  applied or not;
and if the parts are in such a condition as to be bene-
fited  by  the application of  a truss,  it will require
great nicety to  make it fit properly, without any
chance of being  injurious.
  Rupture happens occasionally at other parts than
here enumerated,  but as this short  treatise is only
meant to. give a superficial  glance at the most com-
mon kinds,  I will not enter into a  detail of them.
  Rupture may be produced by sudden exertion,
such  as jumping,  lifting a  heavy weight, a violent
cough and sometimes in children by crying; it may
be produced by  a person returning to work after
having been confined by illness for  sometime,  and
exerting himself while still debilitated, und by many
other causes; it often comes  on so gradually that no
cause can be given for  it whatever, as the individual
may not be aware for sometime that he has a rupture.
  A radical  cure may be effected in children if care
be taken to have  a proper truss and to wear it regu- 
HINTS ON RUPTURE AND TRUSSES.
9
larly;  if not worn regularly, however suitable the
truss may  be,  a cure cannot be effected.   In this
respect parents cannot be too particular.  In wash-
ing the child,  the finger  can be placed over the
aperture so as to prevent the rupture from descending
and the truss applied immediately, after.  In young
children the truss  should  have two or three extra
calico covers, or to be covered with silk oil-cloth,  so
as to preserve the spring by keeping it dry.
   In adults, the cure is seldom attempted;  after a
truss is worn for sometime, the rupture may not
descend, but it is not safe to leave off the truss,  as
the rupture will likely appear again, though not
always  so.  Properly fitting trusses are \vorn with
ease, and it is little or no inconvenience to wear one.
Individuals ruptured,  who  are fond  of  bathing,
should  be  provided with a truss to be worn while
so occupied.  Bathing-trusses should be as  near  as
possible in color to the skin, so that they  may  be
scarcely observable.
   Rupture frequently happens on both  sides, but
the one may, as is  often the case, be of a different
description * from the other.  A tumor  may also
exist on the same side, and lying near to the rup-
ture.   The pad of  the truss for such a case must be
made with a cavity in it, for the reception of the
tumor, and of such a  shape as to keep the rupture
from escaping  without pressing on the other swell-
ing.   It is not  unfrequent to see  swellings,  not
ruptures, treated as ruptjires,  by  having a truss
applied by some unskflfultruss-maker.
   It is hoped that these few general ideas will be of
service to individuals afflicted  with  rupture,  by
making it evident, that as ruptures vary, so must
trusses, and kinds of trusses ; also that no particular
truss or patent can be equally answerable to every 
10       HINTS ON RUPTURES AND TRUSSES.

description of  rupture.  Any scientific truss-maker
will not confine himself to one kind of truss, but
will on seeing the case make such an instrument as
he thinks will suit in every respect.   A truss to suit
a lady,  would not  do equally* well for  a laborer,
with a  rupture to the  same extent; nor  would a
truss to suit a gentleman engaged in an office suit a
sailor or soldier equally as  well.  There can be no
precise plan of making trusses, but they should vary
according to  circumstances.  The  physician does
not in every case of similar disease prescribe exactly
the same quantity  of a particular  medicine,  but
uses his  discretion  as to  how much.   In truss-
making  the same discretion can be used, and to
great advantage.
  The truss-maker should see the case if convenient,
and if not, as good a description of the rupture as
possible should be sent, with size round the body.
The truss should be worn regularly, and only taken
off  while in bed,  and put on before getting out of
bed again.  Few ruptures descend while, in  bed;
but if so, a night or sleeping truss should be worn.
I will now conclude my remarks on  trusses, and it
is hoped that  they will be of service to  those who
have to  wear them-, if so the desired object will be
gained,  and the writer fully compensated.

            TRUSSES FOR  PILES.

  I would call attention to my invention of truss for
the distressing and  disagreeable disease of Piles,
as one granting instant relief to the patient as well
as affording him every ease in walking or riding. 
           SPINAL COMPLAINTS.
  Much has been said and written, against what is
termed Steel Stays.  I have read several treaties con-
demnatory of them, from which it appeared evident
that a wrong idea  of the plan of action of  a pro-
perly constructed machine had been formed.  All
screwing up  and bandaging of the body in them
was condemned.   This is quite in accordance with
reason.   But an  instrument,  or spine  stay, con-
structed on scientific principles, will not act, as is
often thought by twisting  and  screwing up the
body.  Such a plan is highly injurious, and  no en-
lightened man would either practice or countenance
it.   That there are many instruments  made,  styled
spine machines and .stays, which look like a saddle,
and  act more as a dragging weight than a support,
cannot be denied.  But as long as hammermen and
saddlers  of the lowest description,  who have  no
other qualification than having been  employed  in
some menial capacity in an establishment  where
spinal instruments are made, are employed by the
unwary^ such instruments will be found.
  It  is lamentable  to think what ignorance per-
vades the  majority of those  who profess to  make
such instruments.   I know several of them,  who,
by some means or other, fell  in with an old pair of
stays.  These were stripped of leather, and kept for
patterns for the  men to  make others  by.  I have
often seen stays  which  were aiding, the disease
rather than counteracting it,  and of  such a weight,
that the individual  has  actually been  unable  to
"carry  them  when  on for  any length of time."
That there are numerous individuals who have been 
12         HINTS ON SPINAL COMPLAINTS.

greatly  benefited by the support given them by a
proper instrument,  many medical men can affirm.
There are also many diseases of the spine, to which
mechanical aid would be of no use,  but on the con-
trary injurious.   The  great aim oMhe stay is, or
ought to be to give support—to raise the weight off
the part affected, and bring the body as near as pos-
sible to  the proper position.   This can be effected
without  compressing the chest or abdomen.  By
being light, and acting  properly and not hanging
on  the body, instead of them being  felt  as an in-
cumbrance, the reverse is the case, as relief and ease
are felt.  The lever principle is allowed by promi-
nent medical men to be the best, and that which
gives relief sooner than any other.   Of late it has
been recommended by  seve/al of the  most eminent
surgeons  of England, Scotland  and France, like-
wise by a great many distinguished professors  of
these United States.   The plan  of action is scien-
tific,  and the weight is much* less than the other
kinds.  Within  these  few. months  I  have made
several, and the  results  are highly satisfactory.  I
would recommend none to get any instruments for
the relief of spinal disease without the concfrVrence
of their medical adviser.
  Such a course is prudent and safe.  As" I/ have
before stated,  in some  cases the application of any
instrument might be and frequently is  injurious.
Medical men differ much in their opinion as to the
treatment of the  spine.  Many .of high character
have recourse to mechanical means, and others as
prominent have not.   In all cases the advice of an
eminent physician or surgeon ought to be obtained,
and acted upon.   I might communicate many cases
where benefit was obtained  by the  application' of
mechanical aid,  but the following will suffice. 
HINTS ON SPINAL COMPLAINTS."
13
  A gentleman called, and said he had a son,  who
was  afflicted with a severe curvature of the spine.
He  had been recommended  by a physician to get
me  to  make some  machine  to relieve him.  On
visiting and examining  the boy,. I found the spine
curved to the right, inclining  from  the middle of
the  neck to the centre of the back, or from the cen-
tre  of the cervical vertebrae to the centre of the
dorsal.  There was also a considerable projection
backwards.  The boy could  not walk, unless by
supporting himself by  placing his hands  on his
thighs.  To attempt  to cure this Avas out  of the
question.   An instrument was planned to give  sup-
port without compressing.  When nearly finished I
received orders not to proceed,  as another medical
man had said steel stays would be injurious.  The
child got weaker, and the parents went to reside  in
the country, to  try if a change of air .would be of
benefit.  The resident physician there saw him, and
thought spine supporters Avould be of the greatest
service to him, and recommended them to apply  to
me for them.  The child was brought to town, and
got the supports properly fitted.  At that time he
was pale and sickly,  and could scarcely stand.   In
a shorj time he joined  in the  amusements  of the
other children, and daily gained strength.  It  is
three years since he got  them, and he is now  con-
siderably taller, healthy looking, and has not been
confined a day on account of his health since.  The
curvature has not increased, and, as he has grown
considerable, is not so prominent.   All that was at-
tempted was done, viz : to take the weight off the
part affected, and to  raise the body as soon as pos-
sible to its proper position,  without screwing up  or
forcing.
  A similar case of  curvature occurred in a boy
       2 
14        'HINTS ON  SPINAL COMPLAINTS.

about the same age,  the son of a gentleman in the
country.  The boy was boarded with  a lady in
town.   In consequence of the deformity in his spine,
he wras very weak, and wTas confined to the house.
The family adviser, an eminent surgeon, ordered me
to make a support or stay that would lift the weight
off the part affected without compressing; this was
done, and like the preceding,  he has grown a good
deal,  and his general health  is as good as that of
any of his playmates.
   Another, was a boy about ten years of ago, witli
slight lateral curvature.  A spinal stay was made
and approved of.  He wore the stay for about two
years ;  by that time he had growrn, and the curva-
ture had disappeared.  This  happened before the
preceding.  He is now a well-formed and strong-
looking  young man,   and is captain  of a  mer-
chantman.
   Numerous instances  might  be quoted, as I am
repeatedly making such machines, and have been
engaged  longer,  and if not more extensively, at
least as much so as any in  the United States.  But
. it is considered useless, I have  many with liberty to
refer to, and the selection made is deemed sufficient.
   That  many cases  of curvature can be benefited
by the application of proper mechanical aid, is evi-
dent from the proofs of" the patients themselves, and
from the fact,  that such aid is had recourse to by
gentlemen of high standing in  the medical profes-
sion.   Encasements  of steel and tight bandaging
must be avoided.  No fixed  rule  should be  laid
down for the* particular shape,  but  modifications
made, as the case may require.
   If mechanical means are thought to be of benefit
by the physician who is consulted, great care should
be made in the choice of the macliinist, as it must 
            HINTS  ON DEFORMITIES, &C.           15

be plain, that all depend on the suitableness of the
construction for the case, and of its acting in such a
manner as  to  have a  tendency to  check  the  dis-
tortion.
  I will not extend these remarks as they are meant
to be strictly general, and not an attempt to throw
any additional light on this department  of medical
science.

      DISTORTION  OF THE  FEET, &c.
  Club feet of children, in most cases, can be effect-
ually cured, by an application of proper bandages.
  During the last sixteen  years in this city, I have
cured many children, who are now free from any
deformity. " Failures may, and often  do arise, by
the carelessness of after-treatment, also from instru-
ments not being  properly constructed or adjusted.
   The cure can be effected without injury to the foot
or leg, as proof can show.  Great care in the con-
struction of the instrument, and a knowledge of the
anatomy  of the foot and  leg, -is requisite to effect
this.
   Medical, men have  often recourse to the division
of tendons in  deformity of feet and legs.   Several
eminent in the profession in this country and Eu-
rope, have devoted much time to this subject, and
their efforts have often,  though not always, been
attended with success.  In older cases of club-foot,
the division"of tendon or tendons, as the case may
be,  is necessary.
   In young children, under three years of age, cures
by the use of bandages have often been made.  It
is pitiable  to  see many  attempt to make proper
bandages for the cure of club-feet, who are quite in-
competent for the task, and care little for the result,
so they get their money.   Many make bandages all 
 10         HINTS ON  DEFORMITIES, <fcC.

 alike, no matter what  may be the extent or kind of
 deformity.  The greater part are so made as to act
 in confirming the distortion.  The parents are put
 to expense, time is wasted,  and the foot is made no
 better.   Then it is frequently too late even for the
 operation to do good.  Parents if recommended by
 their physicians to get bandages  should be cautious
 to whom to  apply for them.  The foot should be
 dressed, and the bandage shifted every two or three
 weeks by the maker; on the proper application all
 depends, and the  parents or nurse should be made
 quite familiar with the plan of putting the bandage
 on, before doing it themselves.   Failures often hap-
 pen  from a want of attention in this respect.  No
 man of character should attempt to make bandages
 who is not familiar with the anatomy of-the parts
 deformed, and who is not competent to attend suffi-
 ciently to the after-adjustments.
   Surgeons after  the  operation,  apply  different
 kinds of bandages to  keep the limb in its proper
 position for sometime.   Several surgeons have a pe-
 culiar construction of their own.
   Knees,  drop-ancles, and many other deform-
 ities, can be  treated successfully at a  much later
 age  than club-foot.  All bandages should be  con-
 structed on as  light  a principle as possible,  and
 should not act by pinching the feet and legs, hurting
 the action  of the muscles,  &c, but ought to act as
 much as possible by lever.   It is astonishing to see
 persons advertising  amongst other  bandages,  leg
irons for sale.   Indeed these leg irons are oftener
more like  manacles than  any  thing else.  It is
absurd to keep them ready,  as every case requires a
special  construction.   If such is  not the case  the
individual  would be much better without them, as
no good can be done, but probably injury, 
          HINTS ON VARICOUS VEINS,  AC.        17

  It is not my intention to enter into a list of cases,
as it is well known that cures by "proper mechani-
cal aid" have been effected, and are being effected.
Parties should not without the  consent of their
medical adviser get any instrument,  as he must be
the best judge whether it will be of benefit or not.

   VARICOUS VEINS, WEAK LEGS, &c.
  It is now generally allowed by medical men that
the Elastic Lacing Bandages  are  in every respect
superior  to the common rolling bandage; as their
use is now generally well known, it is needless to
enter into a  detail of all the  complaints  in which
they  are of service.   As it is not imperative that
the individual should wait personally on the maker
for a plan of  measurements to be taken, .see plate.
  It  would extend these pages to a much greater
length than is thought requisite to enter into a detail
of all the numerous articles made for the relief and
sustainance of the human frame.   I will therefore
only add a list of a few:
  Accouchement  Belts are of the greatest  service
before and after confinement.   Several eminent phy-
sicians have given it as their opinion that no ladv
should be without one.   Personal attendance is not
necessary.
   Inclined Planes are of great service  in treatment
of spinal  complaints.
  Spring Crutches, much preferable to the common
crutch.
  Suspensory Bandages, of great service in  riding,
and disease of the scrotum, &c.
   Abdominal Supporters, are of the  greatest utility
for weakness or falling of womb,  giving to the pa-
tient not only support  in  this distressing  disease
       9* 
i8        HINTS ON  VARICOUS  VEINS, <S:C.

but at the same time affording great comfort and
ease.
  Steel "Supporters, (Triggups) arc especially re-
commended for Stiff, Weak, Inflamed or Contracted
Limbs, which will greatly facilitate the patient to
walk,  and with  great  ease,  without any support
from crutches or canes.'
  Daniel's Patent Obstetrical Supporter. Having
obtained the  right to manufacture and  sell in this
city,  Daniel's  Obstetrical Supporter, I  would  re-
spectfully beg leave to recommend it to the notice of
the medical faculty.
  Splints, Arm Slings,  Straight Jackets, &c. <Sa:.
  Artificial Legs,  Arms,  Hands, Hospital Tin
Legs, &c.

  In  conclusion permit  me to  refer  to the following
recommendatory letters respecting  the several artij
cles  made by me, for  the relief of those  affiictcd
with  the painful  and  distressing   diseases,  etc.,
treated upon  in this  small work. 
RECOMMENDATORY  LETTERS.
                  Baltimore, Nov. 21st, 1854.
  Dear Sir:—It gives me much  pleasure to  add
my testimony in  favor of your surgical manufac-
ture.
  In the many cases which I have used the various
articles mentioned in your catalogue,  I am glad to
say they have given  general satisfaction, and ad-
mirably  suited the purpose for which they were
designed.  Among  those recommended by me I
may mention trusses, spinal  supporters for the
treatment of curvature, abdominal supporters, laced
stockings, splints for  fractures, club-foot apparatus,
and artificial limbs;  and as a Baltimorean I feel
proud to say, that we need not go beyond the con-
fines of our own city to obtain a supply of any of
the various apparatus so essential to the  successful
management  of surgical cases.
  On one occasion it became necessary to apply to
you for an artificial leg for a friend from Tennessee,
who had been supplied with one,  at  an  enormous
expense,  from Philadelphia, which was worse than
useless, proving,  as  it  did, a constant source of
irritation and pain,  which prevented its  use  for
weeks at a time, whilst yours was worn afterwards
without the slightest inconvenience,
  There is a versatality of genius  indispensible in
the  proper  construction  of the various  appliances
which the peculiarity of the cases may suggest, and 
20
recommendatory letters.
without a desire to over-rate your abilities, I am
glad to say, that I have found you quick to perceive
and  prompt to execute.  Furthermore,  it will  be
my  pleasure,  at all times  when  an unfortunate
necessity demands it, to give you the preference in
the manufacture of s any  apparatus that I  may
require.
                 Very truly, your Friend,
          WM. H. BALTZELL,  A.M.,M.D.
To Mr. Robert Bruce, Lombard Street,  Bait.
             Baltimore,  1st Month, 27, 1854.
To Robert Bruce.
  Esteemed Friend:—It gives me pleasure to add
my testimony to that  of many others, to thy skill
and promptness in adapting various surgical appa-
ratus and instruments  to the object they are designed
to effect.
  Having frequently had occasion to profit by thy
assistance  and ability  in contriving and manufac-
turing ip the several branches of thy business, I re-
commend  thee  to others  as fully worthy of their
patronage and confidence.
                         Respectfully,
                RICHD.  H. THOMAS, M.D.,
        Professor Obstel.,  University of Maryland.
                  Baltimore, Nov. 21th,  1854.
  Dear Sir:—Having had frequent occasion  to
make use of the trusses and bandages made by yon,
and being satisfied with the results obtained, I can
with confidence recommend you to those who  may
require the articles manufactured by you.  I con-
sider you  as very proficient in your  art, and pos-
sessing the intelligence and mechanical skill neces-
sary to execute any apparatus that may be required 
recommendatory  letters.         21
by the surgeon in the treatment of the various dis-
eases to which the human frame is liable.
       Yours truly,   H.  CHATHARD, M.D.
To Mr. Robert Bruce, No. 145 Lombard Street.

             • Baltimore, November 8th, 1854.
Mr. Robert Bruce.
  Dear Sir:—Having, for a number of  years, ap-
plied  many surgical contrivances manufactured by
you, especially those adapted to meet the'different
varieties of hernia, spiral curvatures, and  other
deformities of the body,  I have invariably found
them   ingeniously constructed,  and admirably
adapted to meet  the wants of  the sufferers.
     Respectfully,  JOHN S. MONKUR, M.D.

             Baltimore,  November 10th, 1854.
Mr. Robert Bruce.
   Dear Sir:—It  gives me great pleasure to be able
to  state that the trusses and the  abdominal sup-
porters  of your manufacture, which I had frequent
occasion to employ in my practice,  have  invariably
given the greatest satisfaction,  and would therefore
recommend your  establishment to the patronage of
the suffering commmunity.
             Yours respectfully,
                ABRAM. B.  ARNOLD, M.D.
                  . Baltimore, Nov. 9th, 1854.
  Mr. Robert Bruce has made suspensory bandages
in so superior a manner for cases  under my care,
that I  have great pleasure in recommending  his
work to surgeons and others, who may need articles
manufactured by him.
                 JOHN FONERDEN, M.D.,
Medical Superintendent Md. Hospital for_the Insane. 
22
recommendatory letters.
                  Baltimore, Nov. 20th,  1854.
  Sir:—I have met with but few cases of hernia in
my practice but have uniformily succeeded in their
treatment, by the aid of your tact in adapting the
means indicated.
                       Respectfully,
                  DAVID STEWART, M.D.,
                            79 N. Eutaw Street.
                  Baltimore, lCUh Nov., 1854.
Mr.  Robert Bruce.
  Sir:—You inform me that you are about to issue
an advertisement  of your establishment and appa-
ratus, and request me to give you an expression of
the manner  in which  my orders for surgical appli-
ances have been filled.  I can say, briefly and cheer-
fully, that,  in my judgment, you have displayed
much aptness  in  adapting  means to the results to
be obtained, and have furnished  most  excellent in-
struments.  Several cases  of club feet and other
deformities have been cured, without any operation,
by apparatus which  was made at your establish-
ment.
                  Respectfully,
                             WM. M. KEMP.
    Prince George County, Md., Nov. 20, 1854.
  Dear Sir ;—Below I append  a  recommendatory
notice of your artificial leg.  You can make what
use of it you think proper.
                 Very respectfully yours,
                              J, H. BAYNE.
  Mr. Bruce :—It affords me pleasure to add my
testimony in  favor of your artificial leg.  I  have
examined its mechanism particularly,  and think it
exhibits great superiority for simplicity and dura-
 
RECOMMENDATORY letters.
23
bility.   Its imitation  of the natural leg is admira-
ble.  It has been used by  several-of my patients
with great satisfaction.
                   JOHN M. BAYNE, M.D.
             Baltimore,  November 23rd, 1854.
  Dear Sir:—It gives me great pleasure to recom-
mend you as a careful and efficient manufacturer of
instruments for the relief of natural imperfections,
distortions, or the result of injuries.
  The reputation which your  diligent exertions in
this branch has already given you is worthy of con-
tinued and increased patronage, and I am sure will
result in the satisfaction'and relief of those who  are
suffering.
                    Yours trulv, tvre.,
             W. CHEW VAN BIBBER, M.D.
Robert Bruce, Lombard Street.

                   Baltimore, Nov. 25/7/., 1854.
  I have often had occasion  to procure from Mr.
Bruce apparatus for deformed feet,  trusses, and
other mechanical means employed in surgery..  The
articles Avhich he  has furnished  have been ingen-
iously made and well adapted.  I cheerfully recom-
mend  his work to  surgeons  and  others who may
require it.
                        N. R. SMITH, M.D.,
          Professor of Surgery, University of Md.

               Baltimore., November  28th, 1854.
Mu. Robert Bruce,
   Dear Sir:—Allow me to state for the information
of  those that may be afflicted, that I  have used
your truss for more than twenty years past, with
very  general satisfaction.  Those that have  had 
24          recommendatory  letters.

occasion to use them have given them their decided
preference over others, and many have been radi-
cally cured.
              Respectfully yours,
                       JOHN WHITRIDGE.
                   Baltimore, Nov. 30th, 1854.
  I have had frequent occasions to recommend the
use of the surgical apparatus made  by Mr. Robert
Bruce, of this city, and it gives me much pleasure
to say, that I have invariably found it admirably
adapted for the  accomplishment  of  the objects de-
signed.   With extraordinary mechanical skill Mr.
Bruce unites an  amount •of useful  and  practical
knowledge rarely possessed by a man in his vocation.
                    ROBT. FULTON,  M.D.,
                                53 Sharp Street,  i
                  Baltimore, Nov. 30th,  1854.
  Mr. Bruce has long and favorably been known to
the medical profession of Baltimore as a skillful
manufacturer of artificial legs, trusses, mechanical
contrivances for curvature of the spine,  for the cure
of club feet and other physical deformities.
  It gives me much pleasure to add  my testimony
to his high qualifications as to ingenuity, skill and
judgment.
                   FELIX  JENKINS, M.D.,
    Late Resident Physician, Baltimore Infirmary.
                  Baltimore, Nov. 30th,  1854.
Mr. Robert Bruce.
  Sir:—For some years past I have had occasion to
apply to you myself and directing others who have
required trusses, bandages, «uspendors, and instru-
ments for deformities of the*feet, &c, also diseases 
recommendatory letters.          25
of the spine and hip, which have succeeded in afford-
ing the greatest possible relief, and entire satisfac-
tion to my patients,  I  shall with  pleasure continue
recommending those who consult me  in  cases of a
similar nature.    I am,  Sir, respectfully,
                      Your obdt. servant,
                   EDWARD BAKER, M.D.
                    Baltimore, Dec. 1st, 1854.
  I have employed on different occasions apparatus
prepared by Mr.  Bruce,  and have  always found
them well made and efficient, fulfilling the purpose
for which they were intended.
            G. W. MILTENBERGER, M.D.
                   Baltimore, Dec. 4th, 1854.
Mr. Robt. Bruce,
  Sir:—In  answer to your  request it  gives  me
pleasure to say, that you have, on many occasions,
worked  for me,  and that  I  have been uniformily
satisfied with what you have  done.  I ^ have no
hesitation in recommending you as  an  ingenious
and faithful artizan.            J. BUCKLER.

                   Baltimore, Dec. 5th, 1854.
  I have  seen several of Mr. Brace's appliances  •
for the relief of hernia, curved spine, jaricous veins,
club feet, and other affections requiring mechanical
aids, all of which he skillfully adapts to each indi-
vidual case.
  He ought to be more generally  known  and pat-
ronized, especially by  surgeons, who are often con-
sulted by  patients who might be relieved by well
adjusted mechanical means.
                     E. C. BALDWIN, M.D.,
                            41 N. Eutaw Street, 
26          RECOMMENDATORY letters, AC

                      Baltimore, Dec.  5ih, 1854.
  I have known Mr. Robert Bruce personally and
as a surgical support maker many years, and  have
often had occasion to avail myself of his great know-
ledge of this business and practical skill, much to
the benefit of those  who required  the aid  of  such
apparatus.   He was trained in one of the best insti-
tutions of the kind in Scotland,  and  he shows by
his work that he is well qualified  in every branch
of his business to do justice to those who  may apply
to him,  and relieve suffering humanity.               <
                          JOHN W. DUNBAR.



EXTRACT from the REPORT of the JUDGES, CLASS 38.
  dentistry, dental and surgical instruments.
  The ease deposited by Robert Bruce contains a number of articles
of great value to suffering humanity, and of inestimable service in the
practice of surgery, and we recommend  the skill displayed in the
workmanship and to the adaptation to the ends for which they were
formed, as worthy of peculiar commendation, and as such articles
have few devoted to their manufacture, and with such skill in their
production, we therefore place them as the first of their class, and as
such commend them to the attention of the Judges; but we deem it
just to a worthy and competent artificer to draw special attention to the
Artificial Leg contained in the case, as deserving of great commenda.
tion, and the  more worthy of encouragement as he is the only manu-
facturer of the article south of Philadelphia.

                        C A.  HARRIS, M. D.,
                        JOHN W. DUNBAR, M.D.,        I
                        II. \V. BAXLEY, M. D.,
                        W. CHEW VAN BIBBER,  M. D.,
                        'SAMUEL  JACKSON. 
LACE STOCiaNG.  *  ARTIFICIAL HAND.  ARTIFICIAL LEG.
LACE KNEE CAP
CLUB FOOT
BANDAGES.
  STEEL
SUPPORTER.
SPRING
CRUTCH. 
STEEL STAYS.

  (BACK.)
STEEL STAYS.

  (FRONT.)
nCEMORRnOID
   TRUSS.
UMBILICAL
  TRUSS.
SINGLE TRUSS.    DOUBLE TRUSS.
ABDOMINAL
  TRUSS.
 
 
SPINE   STAYS,          \
VF;
ROBERT   BRUCE,
    No. 145 M.HBARU STREET,
arjwa

i?e(/s tea re respectfully to return his sincere thanks
for the liberal patronage  ichich has been extended to ^
him.  From  the great increase in his business it is  ,'
evident that the principle upon ivhieh it is conducted  j
         meets with the approbation of the



and the public generally.  Every article emanating
from his establishment is made under his direct aus-
pices, constructed and applied to suit perfectly.  Per-
                   sons getting

        TRUSSES  OR  BANDAGES,
will be  attended far  One  Year,  so that  a proper
adjustment may with more certainty be always main-
tained.   This system  has  been approved  of by his y
numerous  customers, and is generally  followed up. -f
     f&~  ORDERS PROMPTLY ATTENDED  TO. -§^    U