PLAIN REMARKS ON THE NATURE AND CURE OF RUPTURE; A DESCRIPTION OF The on\y wett adapted and pevfeet\y 4 effectual Instrument. BY A. G-. HULL, M. D. ISVENTOR AND PATENTEE, PERMANENT MEMBER OF THE STATE MEDICAL SOCIETY, AND LATE PRESIDENT OF THE ONEIDA MEDICAL SOCIETY, 109 Fulton-Street, New-York. NEW-YORK: II. SPEAR, PRINTER, 119 FLY-MARKET. 1826. r/(s i'O ' •..-■ t A TO !w ;k 82746912�� PRACTICAL ELUCIDATION THE NATURE OF HERNIA., TOGETHER WITH SOME RZMARK8 ON THE HITHERTO USED FOR ITS CONFINEMENT, WITH AN EXPLANATION OF The experience,utility and effectual cure9, OF THE INSTRUMENT NOW RECOMMENDED BY A. G HULL, 1VL D. INVENTOR AND PATENTEE, PERMANENT SIEMBER OF THE STATE MKDIGAL SOCIETY, AB» LATE RESIDENT OF THE ONEIDA MEDICAL SOCIETY. THIRD EDITION WITH ADDITIONAL MATTER AND TESTIMONIALS. He maketh sore and he bindeth up; he woundtth, and kis hands maketh whole.— Job. NEW-YORK: a. SPEAR, PRINTER, 119 FLY-MARKET* 1826. ft 1 s y- PREFACE. The author of these few practical observations, during twen- ty-five years' practice in surgery, having witnessed the dreadful consequences incident to ruptures, the indescribable agony at- tending them, and the loss of many valuable lives, of both sex- es, almost uniformly the result of bad and ineffectual Trusses, or neglecting to use any—was prompted by feelings of humanity, professional duty and pride, to devote a share of his time and attention (during the last seven years) to the disease of hernia, and the construction of an instrument for the different species of that disease, and without arrogating to himself superior powers, or intelligence, he is now satisfied that he has brought into suc- cessful operation an improved Truss, happily adapted to all cases of ruptures, of both sexes. By his own experience, and that of many others, he does not hesitate to announce to the world the efficient powers combined in his contrivance. The benefits already derived to thousands by the use of this instru- ment, has given the inventor gratification better felt than can be expressed: The use of this instrument is no longer a subject of doubt or experiment; for the excehYncy of any useful innovation is always known by its effects. The author feels satisfied in having given to the world an important alleviator, as well as a probable cure, of a disability or disease, which hitherto the pride of professional science has unwittingly too much ne- glected : and he feeb a conscious pleasure that he has not de- rogated from scientific surgery by making use of mechanical skill. Hereafter surgeons may do more in various other dis eases or casualties : with regard to rupture, it is believed, that now all is done that can be even desirable j that which has never been contemplated—a complete care. IV PREPARE. Every benevolent heart will sympathize and rejoice with the author and inventor for a surgical improvement now known and acknowledged as an efficient remedy on the plan of prevention and the only cure of a dangerous and distressing disease, one so common and so little attended to by scientific men that misery instead of comfort has been the result, from want of skill and in- genuity in adapting an instrument. One is now offered and fearlessly declared to be the desideratum of ages and the proved cure of hundreds. Whatever effect ignorance or prejudice may have upon the minds of individuals, the enlightened part of the profession will acknowledge, as an important acquisition to the healing art, an improvement which has already received the sanction and pa- tronage of many of our rcost distinguished citizens : and what- ever should hereafter be the fate of the improvement, it will ever be to the author a source of conscious pleasure, that it has already relieved much of the distress of his fellow-men, and ne doubt preserved to their friends and the community many valu- able lives. TRUSSES Among the various causes of human misery, few are produc- tive of so much distress as the disease of Hernia. So long baf- fled in their attempts to cure the complaint, surgeons appear to have abandoned it to mechanics, and to have confined their re- search to the best mode of reduction and operation, without thinking it possible to obviate, almost entirely, the necessity of so difficult, dangerous and painful a resource. For the purpose of confining the viscera within the parietes of the abdomen, many differently constructed instruments have been invented, but all without any reference to the anatomy, or physiology of the parts concerned ; and it has been a subject of serious regret that they have hitherto provr J : rest which the mus- cles obtained while the patient is in a recumbent posture. In this position there is little chance for the descent of the bowel, and even if such an occurrence take place, there is no more foundation for the assertion of Mr. Cooper, 'that all hope of a radical cure is destroyed in a moment," than there was for- merly for the opinion, that the least motion of a fractured limb would destroy the whole progress it had made in uniting. The qualities we have united in the Truss, are equally appli- cable to every species «>f Hernia, and we can say, without the fear of contradiction, that the proportion of cures it has effected is altogether unparalleled. It may, perhaps, be an interesting inquiry to some, how this instrument produces its effects; and we think, after considering its construction, this question can be answered to the satisfaction of every rational mind. It wiU be observed, that this Truss presents a concave surface to the rupture opening. The concavity of the plate is occupied by an elastic cushion, the resistance of which is sufficient to reduce the protruding intestine while it is prevented escaping to any considerable distance by the pressure of the metallic plate. Which pressure bein r greatest at the circumference and dimin- ishing toward the centre tends constantly to approximate the hernial parieties and afford them rest and mechanical support. It is therefore obvious that nothing is suffered to intervene be- tween the lips of the opening, as is the case when the intestine protrudes, or a convex pad is applied, but a fair opportunity is presented for the fibres to recover their tone, or to heal ; when any laceration has been produced by violence done to the parts. * For the safety and convenience of those who may fancy it necessary to wear any thing in the night, the author has invented a Noctnrna" Truss, so modified as to maintain the same principle. 10 It is a law of the animal economy, particularly noticed by Dor sey, that all hollow parts of the body, have a tendency to adapt themselves to their contents. For the cure of Hernia then, it is only necessary to remove every obstacle which counteracts this tendency. This indica- tion is certainly very far from being answered by the convex pad, and we think it can only be fulfilled by one which shall reduce the bowel without dilating the ring ; with this view, we Slave applied the concave pad, which has more than answered our expectations, in preventing a decent of the gut, and in res- toring the fibres, which it undoubtedly greatly facilitates by its constant, uniform and approximating mode of pressure. But without investigating the modus operandi, it is sufficient for the patient, and for all practical purposes, for the physician to know,, that with this instrument Hernia may always be secured. If ap- plied in cases of umbilical, or congenital Hernia in children, it will in every instance, remove the necessity of an operation. In cases of congenital Hernia, it should be applied before adhesion takes place but not until the testicle has made its decent. If this particular, period should be more carefully observed by surgeons, and the application of the Truss, (instead of being abandoned to mechanics) receive agreatershare ot lleir rttmiieu, thty might be instrumental in obviating much of the distress which has been entailed upon the world. It is a fact well known to the profession in the County of Oneida, and has been a subject of congratulation in their Medi- cal Society, where the Truss was invented and first brought into use, that from the year 1800 to 1819 from three to five persons were annually the subjects of operations from strangu- lated Hernia : and that from the year 1819 to 1822, not a sin- gle case had occurred within the knowledge of any individual member of the society. This surprising alteration was attribu- ted, solely, to the general use of the instrument now under con- sideration. With all these facts before the public, we are sorry to ob- serve, that many of the faculty are still determined to be scep- tical, and to persevere in giving the preference to the convex pad. It is a knowledge of this fact, and we trust, a just sense of the duty we owe to the public, which has induced us to make so many observations in recommending our own improvements. We are not unconscious that the malicious may attribute it to a less worty motive ; but as we have thus far, (in introducing what we consider a valuable instrument,) had the mortification to encounter the sneers of our brethren, and the independence ro disregard them, we shall not probably at this late period, shrink from the task assigned us. " through fear to cope mali- "i'rmks, for an affection of his head. On taking leave he observed that he thought it a duty which he owed to the inte- rests of humanity to make known to us the great advantages he had experienced from the use of '• the New-York truss." He had been afflicted with an inguinal hernia several years, for which he had consulted many surgeons in this country and in Europe, and applied every kind of truss that could be obtained without being able to prevent the disease from returning on the slightest exertion. A few months before he came under our notice, he had consulted Dr. Hull, in New-York, who applied the new hinge truss with such perfect success that no descent of the hernia had ever afterwards occurred. The most inter- esting circumstance in the case, however, was, that no inconve- nience had been experienced from the use of the instrument, which the gentleman recommended to us as by far the most excellent one that had ever been applied on his person. The warm and urgent recommendation of our patient induced us to procure a number of the instruments thus alluded to, for the purpose of giving them a fair trial under our own immediate 3 lei -jLtservation. We have since that time applied them upon eight different patients, two of which were afflicted with double scro- tal hernia. The results of our experience have been so satis- factory that we cannot avoid offering our testimony in favour of the new truss, which we consider as altogether the best which, we have as yet been made acquainted with. The New-York Medical and Physical Quarterly Journal, No. 15 for Sept. 1825, edited by John B. Beck, M D. Fellow of the College of Physicians and Surgeons of Nczv-York, and corres- ponding member of the Medical Society of London, <$,-c. <$-c. Daniel L. M. Peixotto, M. D. and John Btll, M. D. Professor of Anatomy and Physiology in the University of Vermont, and Surgeon to the New-York Eye Inlrmary. We take some share of reproach to ourselves for not having before this notice.I the very great improvements made by Dr. Hull in the construction of trusses. The truth is, it is only recently that our attention was particularly directed to the sub- ject ; and we were surprised to find how vastly superior the invention of Dr. Hull was to any instrument of the kind which had heretofore couic wii'uia our knowledge. The principle on which it is constructed, appears to us to be equally just and original, and the very gratifying success which has attended its application, abundantly confirms the soundness of the theoreti- cal principles by which it was suggested. AmosG. Hull, M. D Dear Sir—Since our interview at my house, I have the satis- faction to inform you that I have been cured of a rupture of 15 years continuance, by the use of your Truss. I found on the first trial that it was more effectual in retaining the bowel than any in- strument I have ever used. I soon found that a favorabl e change had taken place and I supposed myself cured. About this time I was reduced very low with Typhus fever, as I began to recover 1 again found appearance of the rupture. I applied the Truss again and in a few weeks found myself cured. I continued the instru- ment about ope year when I left it off and for the last three years have been quite free from the complaint. 1 am respectfully your Friend and Sevt. „, , , SAMUEL B WOODWARD, M. D. Wethersfield, (Conn.) June 1, 1824. Dr. A. G. Hull, Dear Sir—My partner, Dr. Nash, has been ruptured from his infancy up, and found no effectual means of relief till he applied your Truss and says it has been one of the greatest comforts of fn« life, and to all appearance has effected a cure. DAVID HULL, Fairfield, Con 19 The patentee is gratified, as well on his own account, as for the credit of medical science and the utility of the public, to be . able to add to former certificates, the following depositions ; which, together with oral testimony of many surgeons, ob- tained for him a verdict, under Judge Thompson,* of the United States Court, on an action brought by the patentee against Lee and Hopkins, of Hartford, Con. of whom he re- commended damages, for selling Fair's Trusses, so called, made in imitation of his truss, much to the expressed satisfac- tion of judge, jury and auditors. The result of this trial it is hoped, will be a warning to all invaders, and a caution to me- dical men and medical societies against giving countenance to imposition and fraud, by encouraging with their recommend- ations, mechanics and pr^tendeis, much to the discredit of the profession,'in the sale of mutilated instruments, made in imita- tion of the patentee's Truss, as in the late instance of the pi rated instrument of Bela Farr. I Valentine Mott, of the city of New-York, Doctor of Me- dicine, do affirm, that 1 have, for several years past, paid much attention to the construction and use of Trusses ; and it gives me pleasure to state, that the Truss, invented by Dr. Amos G. Hull, possesses in my opinion both in structure and principle, qualities and advantages, which are entirely original, and which render its application, in all cases, an efficacious remedy to pre- vent a descent of the bowel, and that in most cases it may be applied with a reasonable prospect of cure. These advantages and qualities consist in the concave form of the rupture pad to- wards the diseased part; in the limited mobility of the hinge and shoulder joint ; in the new mode of regulating and adjusting the rupture pad on the spring by means of a mortice or eye, with its accompanying screw, without perforating the spring, and in the great advantages of the double truss in applying Dr. Hull's principle to a rupture in both groins, and regulating the position and pressure of the additional pad, by means of its moveable graduating spring and cork wedge. I can confidently say, and do confidently say, that I consider the above enumerated qualities and advantages original and peculiar to Dr. Hull's Truss, never having seen or read of them, or either of them Before the invention and introduction of that instrument. The great and signal benefits which are produced by this * Judge Thompson in his charge to the Jury, expressed a strong opin- ion upon the facts in favour of the novelty and importance of the invent ion, and remarked that there were meny patents obtained for trifling pur- poses, but that this was highly important and meritorious, anji deserved ♦be proiection of the community, and that in his opinion, the inven'Io» vrs well described in the specification '20' Truss result from its strict subservience to and accordance wilt. scientific and surgical principles. Its mechanical adaptation to the parts, the simplicity of its construction, the limited motion nicely graduated by experiment to the different attitudes of the body, and to the action of the muscle- ; the permanency and se- curity of its location on the body, and its pressure in the circum- ference of the abdominal ring, are qualities, the tendency of which is to strengthen and restore the weakene parts, to con- tract the aperture, and ultimately to accomplish a cure of the disease. The operation and effect of this Truss is therefore directly the reverse of all trusses formerly in use, which being convex, tended to enlarge the dimensions of the rupture opening. Until I was acquainted with Dr. Hull's instrument, I was in the practice of u^ing Salmon Ody k Co's Truss ; but the unli- mited ball and socket motion, as well as the convex form,of the rupture pad, render that truss in many cases ineffectual to se- cure the hernial protrusion, in consequence of which, its use is always injurious, or at least unsafe. These defects are well overcome by the principle embraced in Dr. Hull's invention, and experience has confirmed me in the great and superior uti- lity of his instrument, which I have recommended to general use, and adopted in my own practice to the exclusion of all others. I am of opinion that the union of physical design and mecha- nical structure in this instrument render it what has long been the desideratum of pracical surgeons in Europe and America. And that the structure of this instrument, and the principle em- braced in its mechanism, are new in their application to the dis- ease of Hernia, and originated with Dr. Hull. And further saith not. VALENTINE MOTT, M. D. Samuel L Mitchill, deposeth and saith as follows, viz. Having been requested to give an opinion concerning the Truss invented by Dr. Amos G. Hull, I state it as my belief, that he hath succeeded in making a valuable and important improvement in the construction of that piv ce of remedial apparatus. On ex- amining the same, and considering the language of his letters patent, under the authority of the United States, it seems to me that it possesses qualities different from any other instrument or thing called by the same name, or employed for a similar pur- pose. Among its excellencies and peculiarities, 1 mention the con- Cavity of the rupture pad. the manner in which it is connected with the spring, the mode of adaptation to the diseased part, the ease and flexibility of ita various motions, and the two-fold or M double form of it wherever the patient's case requires the em ployment of a rupture-pad to each groin. It appears to me, that in these several points or particulars, there is something so dif- ferent from the other trusses I am acquainted with, that the pa- tentee may really be considered as having discovered what was not known before, and therefore entitled to the benefit of an invention as secured to him under the act of congress, granting exclusive privileges for a term of years, pursuant to the provi- sion of the constitution of the United Mates. Upon full consideration of the matter, I view this invention, discovery and improvement, under the modification and con- struction of the said patentee as fairly and fully his, as any thing of the kind can be made, under the patent law and his specification. And lurther saith not. SAMUEL L. MITCHILL, M. D. Physician in the City of New-York, and a Professor in the University. I, Joseph Evans, of the City of New-York, being forty-five years old, do affirm and say, that about seven years since I be- came ruptured, and 1 applied to a celebrated physician, Dr. Philip Sing Physick, at Philadelphia, who informed me I could never be cured, but that I could get a truss, which would keep up my bowels ; accordingly procured one, which I discovered to be Dr. Hull's patent Truss, altered by the seller of it for an im- provement but which 1 found after wearing it, quite insufficient even to make me comfortable ; with no prospect of any cure, I then applied to Dr. Hull in person, who furnished me with one of his late patent hinge Trusses, and after wearing about three months, I found myself entirely cured, so much so, that 1 can walk about with safety, without wearing the truss : in fact, after wearing the truss as mentioned six months, 1 considered myself cured complete, and in my opinion, it is one of the greatest bles- sings and improvements to mankind that is known ; and 1 am much pleased to >/\ve this certificate in favour of the worthy in-' ventor o* said truss in question, and 1 do most confidently believe that Dr. Amos G. Hull is the sole inventor of the truss in ques- tion. JOSEPH EVANS, 35 Ferry-street. I, Samuel Akerly, M. D., practising Physician of the city of New-York, and Member of the County Medical Society of the same place do depose and say, that I have examined the trusses made and invented by Dr. Amos G. Hull, late of Utica, but now of the city of New-York, and consider them an improvement on all former trusses, and admirably well adapted to the different forms of Hernia or rupture. I further depose that I approve 22 of the report made to the Medical Society, in May, 1824, by a committee, consisting of Drs. Pascalis, Mott, Manley, Cheese- man and Rogers, in which report the said committee gave the preference to Dr. Hull's Trusses over all others which they had seen or examined ; and 1 believe that the opinion of phy- sicians in this place is generally in favour of the same. The deponent further saitb, that in August, 1824, he made drawings of the several forms of Dr. Hull's Trasses, and the several parts thereof, to accompany a specification for a patent to embrace a former patent and atl his subsequent improvements, whereby the deponent became acquainted with the mi utioe and detail of the invention of Dr. Hull and the improvements which he claimed as his own. Among these are, firts, the pressure of th pad upon the rupture, by means of a hinge motion, and not that of a pivot as in other trusses ; second, the shape of the pad-plate and the pad itself, both of which are concave. This concavity of the pad of Dr. Hull's Trusses is a new and important prin- ciple, and appears to be peculiar to him and to belong ,o his in- vention. By the concavity of the pad, the pressure made by the spring of the truss is applied to the sides of the hole or opening through which the intestines descend, thereby tending to cure the Hernia, by closing the opening ; whereas by the pads of all other trusses being convex, they press into the opening and en- large it or prevent its closing. Third, the pressure of Dr. Hull's Trusses is regulated by a moveable spring and a sliding wedge attached thereto, and this may be applied to the single or double Hernia or rupture, but is particularly well adapted o a rupture on both sides. There are other improvements by means of the application of screws, &c , especially for umbilical Hernia, which Dr. Hull claims as his own, but those above mentioned are the principal a;id most important, and the deponent verily believes them to be the invention of the said Dr. Amos G. Hull, and further he saith not. SAMUEL AKERLY, M. D. I Fflix Pascalis, of the city of New York, M D. a member of the county Medical Society of New-York and a censor of the State Medical Society, depose and say, that in the month of * May, 1824,1 was by a resolution of said Society appointed with Valentine Mott, M. D. James R. Manley, M. D. John C. Cheesman, M. D. and J. Kearney Rogers, M. D as a commit- tee, and directed to examine into the merits of a certain mechan- ical Truss invented by Amos G- Hull, M. D. of thi3 state, and to report to the aforesaid Society thereupon. That having as Chairman of the said committee convened the same and several times examined various specimens of the said truss, and having heard many persons who bpd been relieved by the use of tbr. 23 same, state the operation and benefits of the same, it was resoi ved and unanimously agreed to submit to the said society the following testimonials as to the advantages and merits of the truss invented by Dr. Hull, and which had not been seen, or heard of before by the said committee, in any kind of t russ, known to them. 1st. Th-t it possesses a hinge motion in place of the pivot motion, which obtains in approved trusses before in use. 2d. That the shape of the pad itself being concave, and not convex, causes a pressure on the ring, and not on the hernial Tumor, the peculiar advantage 01 which is, that it promotes the closing of the rupture, and which before, had never been provided for. 3d. That the truss of Dr. Hull for double Hernia, requires double pads, has the fixture of a wedge spring, in order to graduate or equalize the pressure of the one to that of the other, which is a real desideratum that had never been attended to before, in the construction of Trusses. Which report was accepted and approved of by the said Medical Society, and ordered to be inserted in the minutes of the day for the use of Dr. Hull. The deponent also says that on further examination of Dr. Hulls '1 russ, he finds it to be so ingeniously constructed, that by a fixture on the pad, it can not only be adjusted on the main spring, at minutely variable points, but that it can be made by anothei fixture, controlable by certain movements of the trunk or the pelvis. And he further saith that he has known and wit- nessed the successive improvements by which Dr Hull the inventor, has brought his Truss to its present state of perfection, since he first presented and submitted the same to the said Soci- ety, at Albany in the year 1818, and believes him to be the sole inventor of the whole. And further saith not. FELIX PASCALIS, M. D. 1 William Whitely, of Utica, in the county of Oneida, and State of New-York, being of lawful age, do depose and say, that I have been employed by Dr. Hull, (the plaintiff) to manu- facture the hinge and pivot Truss claimed by and patented to him, since its first introduction to public use. And that I have been acquainted with all the improvements and alterations in the construction and mechanism of the said Truss heretofore made by the said Amos G. Hull. And 1 do further depose that I am well acquainted with the said Truss as described in Dr. Hull's Patent, bearing date the 19th day of August, 1824, which pat- ent I have read, and compared with a model of the said Truss; And further that it is my opinion from my knowledge of the instrument and its use, that the said Truss as described in that M patent is a perfect instrument being so arranged and constructed as entirely to answer the purposes of its invention. And I do further depose that since the invention of the said Truss, Dr. Hull has paid out large sums of money and been at great expense and devot d much time in improving the said Truss and bring- ing the instrument to its present state of perfection, which could only be accomplished by long use and experiment. And I do further depose that from my acquaintance with the said Truss', and its invention, and the successive improvements in its constructing Dr. Amos G. Hull is to my knowledge and be- lief, the inventor of the said Truss, as described in the said pat- ent." And further saith not WILLIAM WHITELY. I Charles Carpenter, of Harrison Town County of West- Chester, and State of New-York, of lawful age, do affirm and say that for a number of years I was -severely afflicted with a rupture or pushing out of the bowel in each groin, and finding no means of relief, and my complaint daily increasing, I went to the city of New-York, and obtained a Truss called the Ball and Socket Truss of Salmon Ody &. Co. London, made specially for me, and for which 1 paid ten dollars, which I applied, and from its fitttng me well, I hoped to find relief. This was in March 1823. I continued to wear this Truss eighty or ninety days, and after giving it a fair trial and using every effort to make it answer my purpose, I found it to fail in keeping the bowel se- cure, and that it occasioned great pain by the pads rolling on their edges and the bowel slipping out through the aperture. I found also that the pad, from its convex shape, and its unlimited motion, passed into the rupture as it would open by the motion of the body, and also, that it would turn round on the ball, roll on its edge, and catch the gut between the pad, and the sides of the rupture, and the consequence would be great pain and tor- ment, and I was often obliged in the course of a day, to stop and adjust it. At the end of about three months, having heard of the improved Truss of Dr. Amos G. Hull, the plaintiff, I applied to him for one, and on its application, 1 was immediately gratified and surprised to find the difference between the effect of the convex and concave pad, the latter being used by him, and which I immediately found kept up the bowel with ease and quietness, and in less than a year from the commencement of using it, I found myself nearly well. I found that the Truss of Dr. Hull was perfectly regulated by its simple mechanical ar- rangement, and that it kept in its place and performed its office of keeping up the bowel in all or any of the positions in which the body is usually thrown in a laborious employment, that of a farmer, and in which I suffered scarcely any inconvenience, and no sensible pain whatever. CHARLES CARPENTER. 2,'i I John Coxko v, oi the city and State of New-Y ork, Machinist, being of lawful age, do depose that for about four years past I have been occasionally employed by Dr. Amos G. Hull as a mechanic in constructing the models of the various plans and improvements projected by him from time to time in the forma- tion of his Truss. And I do further depose that he invented the concave rupture pad, with its combined fixtures together with the metallic plate and cork wedge attached to the double inguinal Truss, agreeable to the specification contained in the letters patent granted by the United States to the said Hull on the 19th day of August, 1824, which letters patent I have read. And I do further depose that Dr. Hull has at intervals during the above mentioned period been employed in the city of New- York, in improving the mechanical structure of the Truss for the relief and cure of rupture, and that from time to time he this deponent has been employed by the Doctor to make the impro- ved alterations, until it was brought by him to its present state, which he the deponent thinks very complete,and does not think it could be made better. And that his having been employed by the Doctor from time to time as aforesaid, is the reason of his belief that the plaintiff is the inventor of the said improve- ments, and of the instrument for which he has received a pat- ent as above mentioned. The deponent further saith that he has often seen patients at the office of Dr. Hull in the city of New-York who had applied for relief under the disease of Rup- ture or Hernia, and has in a great many instances heard them while under the Doctor's hands express their satisfaction at the relief they felt from the application of this Truss. The depo- nent further saith that for the relief of the above mentioned disease, there are many trusses of different constructions which have been invented and brought into use by other persons, and that none of these correspond in mechanical structure and prin- ciple with the Truss, as inserted and used by the plaintiff, and described in his patent as above mentioned. And the deponent further saith that from his acquaintance with the subject matter of the present deposition he fully believes that the plaintiff is the original inventor of the Instrument described in his afore said patent. And further saith not. JOHN CONROY. City and county of New-York, ss. Thomas W. Hunter, of the said city physician and surgeon, being duly sworn doth de- pose and say that he is a member of the faculty of physicians and surgeons of Glasgow, and also of the Medical Society of the city and county of New-York, in which latter place he has resided and practised during the last eight years, previous to 2o which he had resided and practised in the aforesaid capacities, about seven years, in Port Glasgow. That his experience in the use of Trusses during many years practice in Glasgow aforesaid, and also in New-York, has made him acquainted with the superior advantages of Dr. Hull, the above plaintiff's patent Truss, over those of all others, which he has seen or heard of. He has long witnessed the application of the Racket Truss ap- proved by Dr. Lawrenre an operator in surgery of great emi- nence, and by many others, which fails in preventing the descent of the bowel in most cases, especially where much exercise of the body is necessary He is also well acquainted with the Ball and Socket Truss of Salmon Ody & Co. of London, and has frequently witnessed its inefficacy to secure the bowel, and has frequently witnessed the complaints of patients under the pain they have suffered on this account. Two very interesting cases of" scrotal Rupture, (which is of the w rst and most difficult kind) to which this deponent was called about five years ago, one in this city, and the other in Brooklyn, gave him a particu- lar opportunity to ascertain the merits of the plaintiff's Truss, after the total inadequacy of Salmon Ody &. Go's. Truss was apparent, and had in fact proved injurious ; and in both these cases the plaintiff's Truss w;.s worn with perfect comfort, and effected a complete cure in less than twelve months. He fur- ther saith, that the mechanism of the plaintiff's Truss is novel in principle and construction, and combines the advantages leading to comfort and cure, which are so extremely desirable, and have never before, to the knowledge or belief of this deponent, been adopted. The deponent further saith, that the Truss in- vented by the plaintiff is approved of by the most eminent phy- sicians and surgeons in Europe and in the United States, partic- ularly by the celebrated Dr Astley Cooper of London. The deponent further saith, that from his reading, and also from his experience and observation, he is satisfied that the Truss of the plaintiff is in its structure, a new and original invention., and highly useful. The deponent further saith, that Dr. Hull's mode of constructing the double Truss, by means of the second spring, to which the second pad is attached, and the cork wedge, used to graduate its pressure more exactly, with the slide and screw, is, in the opinion of this deponent, entirely new and original, and renders the Truss highly useful. The deponent further saith, that he has seen the pamphlet attached to the dep- osition of Dr. Samuel Osborne taken in this cause, and that the invention of Dr. Hull is very well described in the 16th, 17th und 18th pages of the said pamphlet. And further saith not. WILLIAM HUNTER. 27 i Cyrus Perkins, 01 the city, county and State of New-York cjoctor in medicine, depose and say that I have been a practition- er of physic and surgery for twenty three years last past, and that I have been long conversant with the disease called hernia ; which is a tumor occasioned by the partial escape of a bowel or some other portion of the contents of the belly, through a rup- ture or breach of its side. And with a view to afford the relief best suited to the nature of the disease, I have for many years been in the habit of examining and applying at different times a variety of instruments called trusses, with a view after returning into the belly the protruded part, to oppose a force, at the breach, sufficient to prevent the re-escape of the bowel. In all the instruments for this purpose which I have used, seen or read of, till the one for which Dr. Amos G. Hull has obtained a patent, the pressure was made by applying to the rupture part the convex surlace of a pad—which pad was either firmly fixed to the part by a spring and strap—or else it had a free ball and socket motion as in the instrument sold in the shops under the name of Salmon & Ody's Truss. The Trusses with fixed pads were, for the most part, extremely uncomfortable to the wearer and often quite insupportable. Salmon & Ody's Truss on the other hand, owing to a too free motion of the pad would occa- sionally allow a protrusion of the bowel and thereby greatly en- danger the safety of the patient. The tendency of all convex pads is to inerease the disease by forcing their way, like a wedge, into the opening, and thereby increasing the size of the breach. Whereas the Truss invented by Dr. Hull, and des- cribed in his pamphlet, entitled " Observations on Hernia and Trusses," act« on an entire different, principle. It has a plane pad, fixed on a concave plate, so that instead of the strong pres- sure being made by the centre of the pad (as is the case in all Trusses) this of Dr. Hull's makes the strong pressure by its circular margin, and a diminished pressure by its centre. It thereby not only prevents the escape of the bowel, but approx- imates and often seucres in contact the ruptured part, so as eventually, in many cases, to effect a radical and permanent cure. This appears to me to be the great excellence of Dr. Hull's Truss and is sufficient in my opinion tb give it a decided prefe- rence over all others with which I am acquainted. There are several other peculiar points of excellence in this Truss ; the most important of which is the introduction of the combined motion of the pivot and hinge, between the pad and spring; so as to graduate the quantity of motion in the most desirable manner. And indeed the combination of mechanical principles adopted in the construction of this Truss is so different fw>m that used in the formation of an}1, other that it may be fairly considered a new instrument. 1 furthermore believe that Dr. Amos G. Hull is entitled to all the privileges and immunities of the author of a useful invention, as the inventor of this instrument. CYRUS PERKINS. I Daniel D". Walters, of the city of New-York Physician and Surgeon, do depose and say that I have been in the practice of my profession for more than twenty five years last past, and for many years have been concerned in a druggist store, and in the sale of Trusses, and am well acquainted with them. That I am acquainted with the Truss claimed by the plaintiff, Dr. Amos G. Hull, as his invention, that I consider it constructed upon principles different from any hitherto in use, and the only Truss with which I am acquainted, that, in my opinion is calcu- lated to effect a cure of rupture, and the same, as far as my knowledge extends is an original invention of the said plaintiff*. That it embraces advantages not to be met with in any other- Truss, and is well described by Dr. Beck in bis deposition in this case, which I have seen, in the following language to wit: " 1st. The peculiar shape of the pad, which in theTruss of Dr. Hull is concave, instead of convex, as it is in other Trusses. 2d. The peculiar connection between the spring and pad, being n combination of the hinge and pivot joint. 3d. The peculiar application of the pad and parts connected with it, and the spring by means of the slide motion, and the facility with which the pad maybe fixed to any part of the spring. 4th. The pecu- liar construction of the double inguinal Truss, being simply the addition of another pad, attached to a short elastic, metallic plate. This plate with its pad move on the main spring by the same power of adjustment and fixture as the. first pad, the press- ure of the pads being graduated at pleasure by an intervening cork wedge." And I further say that I have seen the plaintiff's Truss in use, in many instances, during the last three or four years, and am satisfied from my own observation, that it affords more protec- tion to the patient, by preventing with greater certainty the des- cent of the contents of the abdomen, than any other Truss hith- erto in.use, and is the only Truss in my opinion, calculated, from its principles and construction, to effect a cure of rupture. And the said Truss is applied and worn with more ease and safety than any other Truss1. And further saith not. DANIEL D. WALTERS, M. D. I, John B. Beck, of the city and county of New-York, of law- lul age, depose and say, that I am a Doctor of Medicine, and a practitioner of Physic and Surgerv in the citv of New-York : that 1 am acquainted with the Truss claimed by Dr. Amos G. Hull, as his invention ; that I consider it as constructed upon principles different from any truss hitherto in use, and as far as my knowledge extends, perfectly original ; that it embraces ad- vantages not to be met with in any other truss, being, 1st. The peculiar shape of the pad, which in the Truss of Dr. Hull, is concave, instead of convex, as it is in other trusses. Second, The peculiar connection between the spring and pad, being a combination of the hinge and pivot joint. Third, The peculiar application of the pad and its accompaniments to the spring, by means of the slide motion, and the facility with which the pad may be fixed to any part of the spring Fourth, The peculiar construction of the Double Inguinal Truss, being simply the ad- dition of another pad attached to a short elastic, metallic plate ; this plate, with its pad, move on the main spring by the same power of adjustment and fixture as the first pad, the pressure of the pads being graduated at pleasure by an intervening cork wedge. For a more particular description of these advantages, see pages 16 and 17 of thisp amphlet. And further, 1 depose that from facts which have come to my knowledge, I am convinced that Dr. Hull's Truss has proved successful in accomplishing cures of Hernia, in several cases where the ordinary trusses as well as the truss of Salmon, Ody &. Co. had been faithfully used without effect. For the greater certainty of description, this deponent refers to the various mo- dels of trusses appended to the deposition of Dr. Samuel Osborn, in this cause. JOHN B. BECK, M D. I, John F. Gray, practising Physician and Surgeon of the city and county of New-York, do depose and say, that 1 have been acquainted with the application and use of Dr Amos G. Hull's Trus« for three years and more. I have been acquainted with the mechanism, use, and results ol various trusses employed previous to the indention of Dr. Hull's, pariicularly the truss of Salmon, Ody & Co. The defects of Salmon, Ody & Cos. truss, with others previously used, are as follows .—a convex rupture pad ; the effect of which is, to distend the rupture opening, and either an unlimited motion of this pad between the spring or belt, and the abdomen ; or an immoveable fixture of the pad to the spring or belt; the evils of either of which modes are to render the position of the pad in the rupture opening insecure and un- controulable ; thereby frequently allowing the intestine, to escape and endangering the delicate parts adjacent. All which defects and evils are obviated by the Truss of Dr. Hull, in the r'dl.owing manner :—1. The rupture pad of Dr. Hull's T^iss is 30 Koaca-ce, pressing around the circumference of the Hernial pa- rieles, and urging them to a closure of the rupture opening, which is covered by the cushion in the concavity of the rupture pad-plate ; the resistance of this cushion being just sufficient to reduce the protruding gut or bowel. 2. The motion of the rupture pad between the spring and abdomen, is regulated by a joint, with a mortice and tenon, which tenon has a shoulder, so graduated, as to allow of motion in all directions with the body, yet limited to such an extent as will effectually secure the po- sition of the pad on the rupture opening, thereby preventing the escape of the gut or bowel, or injury of the adjacent parts with certainty, under all circumstances. 3. The position of this pad and joint, with its said tenon and shoulder, or any given point of the spring, is secured by means of a vertical screw, perforating the button-like head of the tenon, but not perforating the spring. The peculiar advantage of which mechanism consists in adjusting the position of the pad on the rupture opening, with perfect ac- curac}r, on persons of various sizes, but quite nearly alike : a point is hereby attained, which is all-important to the security of the gut or bowel, in very many instances, where all other modes of fixture necessarily fail of the desired effect. Furthermore, another advantage of Dr. Hull's invention, con- sists in securing a rupture in each groin, or double inguinal rup- ture, with the same facility and certainty as a single rupture. This is effected by means of bis compound or double inguinal Truss, which consists in attaching another rupture pad to the circular spring, by means of a short elastic metallic plate; or smaller spring slightly curved ; this pad, with its accompanying plate on spring, moves on the main spring, in the same manner as the rupture pad, in the single truss above described, and its position on the second rupture opening is regulated by the same power of adjustment .-tnd fixture : the degree of pressure of the second pad is increased or lessened at pleasure, by means of a moveable cork wedge, placed between the lesser and greater, deriving the ultimate and efficient pressure of both pads from the greater or main spring entirely. Furthermore, I have witnessed numerous instances, in which other trusses have been laid aside after proving hurtful and inef- ficient, and exchanged for the Truss of Dr. Hull, whieh has in all these cases effectually and comfortably secured the rupture, not unfrequently effecting a perfect cure of the disease. This superior efficiency depends, in my opinion, upon the surgical principle embraced by the invention of Dr. Hull, as an associate, whole and unembraced by any other truss. This combination of mechanism, 1 believe to be original with Dr. Hull. JOHN F. GRAY. •J I I, i^amuel Osborne, of the city and county of New-York, oi lawful age, Physician and Surgeon, do depose and say, I have been in the practice of physc and surgery, thirty years, and do still practise the same. During thirty years, I have had much experience in the disease called Hernia or Rupture, and fre- quently had occasion to lament the inadequacy of trusses to con- fine the intestine, and also frequently to witness the injurious effects resulting from their improper structure. A few \ears sinee, (four or five,) having become acquainted with the Truss invented by Dr. Hull, it was with astonishment I found that what was hitherto a de-ideratum in surgery, was ab- solutely obtained by his truss, viz.—A certain and easy confine- ment of the intestine in all cases, with a reasonable prospect of cure in most. In the construction of all trusses previous to Dr. Hull's, the object of the surgeon had been limited to the confine- \ ment of the intestine, and this, in many cases inadequately, in all with great inconvenience to the wearer, in many with injurious and even dangerous consequences. The inadequacy, injurious and dangerous tendency of all hitherto known trusses, resulted from their mechanical structure upon false surgical principles ; they were so constructed as to press into the opening, thereby enlarging it, and rendering callous its edges ; whereas the prin- ciple upon which the Truss of Dr. Hull is made to act, is a well known surgical principle, but never before called into successful operation in this disease, viz—pressure disposing to contraction, approximation and cohesion; the consequence of which is, in this disease, frequent cure by Dr. Hull's Truss, as known to the deponent. Dr. Hull's Truss is so constructed, that the concave surface (of the rupture pad,) next to the body, giving the greatest pressure to the circumference, tends to approximate the parts through which the intestine has protruded, and affords support and ease The hinge and pivot connecting the spring r.nd pad, is ^ so constructed with a tenon and mortice as to preserve a double hinge limited joint, securing a uniform, easy and effectual pres- sure of the spring on the pad, and the pad on the opening and surrounding parts. The power of graduating the spring and fixing the pad to any minuteness, is a hitherto unknown conve- nience, enabling the surgeon, or even the patient, without the presence of a mechanic, to adapt a large truss to a small body, The great mobility of other trusses—their painful pressure on the edge of the ring as well as the integuments, often occasions inflamation, and where suffered to have such play as to be any way easy to the wearer, the gut is very liable to protrude, and in that state from the improper construction of the truss, the gut become strangulated and inflamed. Well acquainted with all the trusses hitherto used, 1 more particularly refer to the Truss of Salmon, Ody & Co., as tha*: i-amst which less objection lies than to any preceding, and thai which has of late years been more generally recommended by the profession. Dr. Hull's Tru-s answers all the good inten- tions of any hitherto known truss, and obviates all the objections which obtained against them. The Truss of Salmon, Ody & Co., or what is called the Ball and Socket Truss, marked Brevet Salmon, 33—82 ; annexed to this deposition, exhibits truly Salmon & Ody's Truss. This truss, and the objections to its use, are truly and correctly set forth and described by Dr. Hull, in his pamphlet, hereunto annexed, pages 6, 7 and 8. The Truss invented by Dr. Hull, and described in bis patent, dated 19th of August, 1824, is that desideratum we have been so long wanting, and which in subjecting mechanical ingenuity to surgical design, is entirely new, and belonging exclusively to Dr. Hull. Some parts of Dr. Hull's instrument are, in appearance, simi Jar to some others ; but as a whole in mechanical structure, surgical design, certainty of aim, convenience, economy and cu- rative properties, hitherto unknown. In Dr. Hull's Truss, the concavity of the pad towards the body, the combined hinge and pivot joint limiting the motion of the pad-plate, and securing its own proper position according to the varied motions of the body, together with the mode of varying the position of the pad in re- lation to the spring, by means of a screw to press on the spring without a hole, are points peculiar to his truss. In relation to the double truss, there are these points appertaining to Dr. Hull's Truss, and not to any preceding truss. Dr. Hull's Truss obviates the necessity of straps, by possessing the same power of fixture as the single truss, to which a second pad is added, at- tached to a short metal spring, and the pressure of the pads gra- duated at pleasure by means of an intervening cork wedge, I have known Dr. Hull's Truss worn with perfect comfort - where other trusses were very tormenting, or totally unbear- able ; and 1 have known several cures effected by Dr Hull's Truss, where it would have been impossible to attain the same result from any other known truss. While in the army of the United States, I procured the dis- charge of several soldiers, because I was unable, with any known truss, to effectually secure the rupture ; with Dr. Hull's Truss, I am satisfied I could have rendered them useful to the govern- ment, comfortable to themselves, and in many cases effected per- fect cures. SAMUEL OSBORN