THE 
CONDUCTOR, 
AND 
Containing Splints: 
Or a Description off 
Two New Invented Instruments^ 
For the more fafe Conveyance 
AS WELL AS 
The more Easy and Perfect CURE 
O F 
FRACTURES of the LEG, 
Whether Simple or Compound. 
TO WHICH ARE ADDED, 
'I hree Copper-Plates, fliewing the Conftrudion 
and Application of the CONDUCTOR. 
By Jonathan Wathen, Surgeon. 
Author of a Tranflation of Boerhaave’s Lectures on the Lues 
Venerea. Pra&^calObfervations on the Cure of the Venereal 
Difeafe by Mercurials.' 'And an Aidwer to the Letter of J. 
Keyfer, Surgeon at Paris. 
LONDON: 
Printed for, and fold by J. and F. Rivincton in St. 
Paul’s Church-Yard. 1767. PART I. 
THE 
CONDUCTOR. 
FRACTURES of the larger Bones 
in the human Body, are frequently 
attended with fevere, and fometimes 
fatal Confequences. 
But as the Leg of all other Members is 
moft commonly expofed to, and differs the 
greateft Injuries from Accidents of this 
Kind ; fo many and various are the Ma- 
chines and Contrivances which at different 
Times have been invented and applied in 
fuch Cafes, with confiderablc Succefs. 
Thofe of the ingenious Mr. Petit, and of 
our Countryman Mr. Gooch of Norwich) are, 
I believe, the beft and mofc ufeful of any yet 
known ; They are however greatly deficient 
in fome neccflafy and capital Points of Uti- 
lity. My prefent Intention is to fupply the De- 
ficiencies of thefe, and indeed of. all others 
hitherto recommended, or received into 
Practice. 
This Defign may be reduced into two 
Heads. The eaiy and fafe Conveyance of 
the Patient from the Place wherever the Ac- 
cident may happen, to his being placed in 
Bed for the necefiary Time of his Cure. 
And next the Prefer vation of the fractured 
Bones in their natural Pofition, until that 
Cure be perfectly accomplifhed. 
In both which I would be underfiood to 
mean, not only all fimple, but alfo com- 
pound Fradlures to a certain Degree. 
The firft Intention may be accompliihed 
by the Conductor, fo called from its Ufe 
and fafe Purpofe of Conveyancef the fecond 
by Splints or Side Pieces : In which 
the fradured Limb may be compleatly re- 
ceived, and lodged till the Cure is performed. 
Itfhould be obferved, that very few Writers 
have confidered the Neceffity ©f fuch an 
Afliftant Inftmment as the Conductor ; at 
lead; they have not produced any one com- 
pleatly qualified for the needful and fafe 
Conveyance of the Patient, in that critical 
Time of Danger. 
The Machines which have beft fucceeded, 
are defined merely to Setting and Retention, 
and can be applied only after the Patient is 
placed in Bed ; fo that, however judicioully conftrudted in thofe Refpedts, they cannot 
prevent many of the Evils attendant on 
Fradtures of the Leg which were already 
produced, antecedent to their Application 
And farther, the Patient is very often un- 
happily deprived for a confiderable Time, of 
receiving any Service from them -j-, as will 
evidently appear by attending to the follow- 
ing Circumftances. 
¥/hen a Fradture happens to the Leg, fo 
that both Bones are broken, the inferior 
Part becomes pendulous and liable to Flexi- 
ons every Way. Neverthelefs the Patient 
muft be removed from the Place where the 
Accident happened to his own Habitation; 
generally up one or more Stories; or, if 
deftitute and indigent, to the next adjoining 
Hofpital. It is therefore impoffible (from 
any Means yet known) but that in fuch a 
Conveyance the Limb will be frequently and 
variously contorted, and bent; by which 
the Parts furrouoding the Bones are bruifed, 
pricked, and lacerated by the Extremities of 
the fradfured Pieces; whence Pain, Swelling, 
Inflammation-f*, Convulfions, Mortifications, 
arife; and often Death itfelf, if not pre- 
vented by a fpeedy Amputation of the Limb. 
Three melancholy Inftances of this Kind 
(which were lately under my Care) ftrongly 
induced me to wi(h that fbmething could 
t + See Note, Page 4. be invented, which might effectually pre- 
vent the Injuries fuffained by fuch a Patient 
in his Removal from the Place where the 
Accident was received, to that where he muff 
remain till cured. 
The Importance of fuch a Contrivance 
will appear moft evidently, if we reflect on 
the State of the Patient when the Hurt is 
fir(t received; perhaps the Fradlure was then 
merely fimple, if fo, the Injury is (compa- 
ratively fpeaking) but inconsiderable. Ne- 
verthelefs, by the ufual Methods of convey- 
ing him Plome, however prudently conduct- 
ed, Contufion and Swelling* may be pro- 
duced, if not a compound Fradhire. 
This lafl: Misfortune frequently fucceeds 
what was at firft a fimple Fradure only, 
when, fhould the Leg be preferved, the 
Cure will, notwithfianding the greatefl: 
Care and Affiduity, be uncertain, imperfed, 
unfatisfadory to the Patient, and often dif- 
honourable to the blamelefs Surgeon. 
Though thde Effects do not always attend 
every broken Leg, it is owing more to 
Chance than Defign. 
If the Fradure be oblique, complicated, 
or the Bones forced through the Skin, &c. 
the aforefaid Injuries are proporlionably aug- 
* When thvfc Symptoms proceed to any eonfiderableDe- 
gree, every Surgeon defers the Application of tfrait Ban- 
dage, Splints, &c. or what is called fetting of the Limb, till 
they are removed. merited, and almoft inevitably determine the 
immediate Lofs of the Limb to prevent that 
of Life * 
Such are the Confequences of Motion to 
a Patient with a broken Leg. Influenced 
by thefe Confiderations, which arofe from 
repeated Proofs of what is above advanced, 
I have contrived a very Ample Machine, 
which may be moil eafily and expeditioufly 
applied as foon as poflible after, or on the 
Spot where the Accident is received; by 
which the Limb may be immediately ftrait- 
ened, and the Bones reduced and retained in 
their proper Place, foftrongly andflrmly, as to 
seAfl; any Probability of being difplaced by 
any Conveyance whatever. 
Nor has this Aflertion of its Utility a 
Foundation in Theory and Speculation only, 
but it is fupported by the repeated Practice 
and Experience of feveral Surgeons of re- 
putation, and greatly approved of by others 
* If the FraCture be very oblique, and the fubreqaent: 
Splints f found incapable of fufficiently counteracting the 
contractile Force of the Mufcles, and preventing the over- 
lopping of the Bones, the Conductor may flill be kept on 
the Limb, by which its due Length will be preferved, with 
very little Inconvenience to the Patient, if the following 
Cautions beobferved. Cut the Stocking off above the Mal- 
leoli, leaving the Remainder on the Foot, over which muft 
be wore an eafy high quartered Shoe buckled ; which will 
be found fufficient to fecure the Heel from that Heat or 
Sorenefs, which would otherwife arife from a long conti- 
nued Preffure of the inferior Part of the Conductor. 
•f- See Part 11. ef the hr ft Eminence ; amongft whom I 
have the Honour and Permiffion to mention 
MefTrs. Hawkins and Gataker, Surgeons to 
St. George’s Hofpital; Mr. Baker, Senior 
Surgeon to St. Thomas’s, and Mr. Warner, 
Surgeon to Guys, &c. By the Order of the 
iirit of thefe Gentlemen, this Inffrument has 
been ufed in St, George’s for many Months, 
with entire Satisfaction. To thefe Tefti- 
moniais I have the Pleafure to add that of 
Dr. Hunter, who frequently viiits the Hof- 
pital firft mentioned, and who allures me he 
is thoroughly convinced of its great Im- 
portance. 
Mr. Gervais, Koufe Surgeon to St. George’s, 
greatly efteemed for his Induftry and Abili- 
ties in his Profeffion, was the Perfon ap- 
pointed to make Trial of this Inftrument; 
who fays, the Patients felt fo much Eafe the 
Moment it was put on, that they ufually 
expreffed it by defiring to walk, declar- 
ing they were .perfectly free from Pain; 
in which State, notwithstanding all fubfe- 
quent Motions, they continued till the Inftru- 
rnefct was taken off, which was after the Pa- 
tient was placed in his Bed, Bleeding, Glif- 
ter, &c. adminiftcred, and the proper Appa- 
ratus got ready for treating the FraCture 
agreeable to its various Circumftances ; when 
another important Advantage of this Initru- 
ment difcovered itfeif, for as it reftored the Bones to their proper and natural Pofition 
at its firft Application, fo all further Ex- 
tenfion was thereby rendered unnecefifary. 
We muft therefore take it off from the 
fractured Limb with the greateft CautL 
on, fo as not to difturb or mifplace the 
Pieces, which are to be retained as exactly as 
poflible in the fame State till the Cure is ac- 
compli died by other Applications; concern- 
ing which I (hall juft obferve, that the Ap- 
paratus hitherto made Ufe of for the Treat- 
ment of either ftmple or compound Fractures 
of the Leg, is not fo complete as could be 
wiftied : So that in Fa ft, a perfect and 
ftightly Cure is rather to be imputed to the 
Skill and Care of the Surgeon, and the fa- 
vourable Circumftancesof the Fracture, than 
to any Perfection in the I ftiali 
only add one Obfervation more in Proof of 
the Utility of the Inftrument here mention- 
ed, derived from the ill Succefs of Amputa- 
tion after FraClures of the Leg, viz. That 
we fhall find upon fair Enquiry, that not 
above one Patient in three furvive that 
Operation. I have now ftiewn, that the 
Caufe by which Amputation is rendered 
fo frequently necefifary, is the Want of an 
Inftrument capable of preventing tbs Ac- 
cidents before-mentioned, and what great 
t See Part 11. Advantages may be derived from this which 
I now offer to the Public, viz. The Pre- 
fervation of the Limb, frequently of Life, 
and an Exemption from a Variety of other 
Evils to the Patient,  
IPlale /. 
9 & 
/r(>m -fa (j?m/ /^.Vz. PART 11. 
THE 
Containing Splints. 
Of a New Construction. J?late 2 EXP L A N A t I O N 
OF THE 
PLATES. 
-hewing the Skeleton of the Conductor fe- 
parated into two Portions. 
PLATE I. 
Figure I. 
The Knee Band a made of Tin a little bent, 
divided by four Joints b, that it may fit 
any Limb great or fmall. Holes c for fix- 
ing the Buckle and Strap. Others d 
round each Margin for fewing on the 
Padding. Two Tin Canulas e grooved on 
the Outfide, and furnifhed on the Infide 
with Brafs Springs f and Catches g; fmall 
Holes hy through which the Catches pafs 
to meet the Serrse of the upright Portions 
when they are within the Canulae. 
The Figure in the Middle reprefents the In- 
fide of the Tube with the Groove. 
Figure 11. 
The Ancle Band a lefs, but contracted as 
the former , Shoulders b, to fupport and 
render the ferrated Portions parallel to the 
grooved Canulas, bothofßrafs. 
3y comprefling the Springs, the Catches are 
raifed, and admit the whole Length of the 
upright ferrated Portions within the Ca- EXPLANATION, 
nulae, reducing the Inftrument to net, 
half its Length ; from whence by lh'4 
Dilpolition of the Catches and Serrs, the r 
are retraced without any Difficulty j br 
cannot be returned the fame Way, unle 
the Catches are elevated by compreffinj 
the Springs; fo that when the Condudtc 
is applied to the Leg, whatever Extenfi 
on be given, is by that Means fecured to 
it with the greateft Certainty, though al- 
terable with the greateft Eafe. 
The fame Inftrument covered with Leatk 
that it may lit eafy on the Limb. 
PLATE 11. 
PLATE 111. 
The Conductor applied to a compound frac- 
tured Leg, by which the Limb is fitted 
for Conveyance. 
This Inftrument is well conftru&ed at a reafona- 
ble Price, by Mr. Mafemore, jun. Tinman, in 
Old Bethlem. TU/r 3 . PART 11. 
THE 
CONTAINING SPLINTS. 
HAVING taken the Liberty of men- 
tioning fome Defeats in the prefent 
Apparatus for Fractures of the Leg, 
I would now point out, and endeavour to re- 
*pedy thofe Deficiencies, by a new and dif- 
eient Kind of Machinery, which I have not 
only fucceeded happily with myfelf, but fe- 
v*Jra Very eminent Surgeons, who have 
2 °^e(- .em *nto Practice, confirm 
my by their own Experience, and 
tK With the Truth to affirm, 
mat they are fuperior in Efficacy to ail others 
115 r cur*n£ Ffaftures of the Leg. 
n f pLINTs generally ufed for this Pur- 
ehher of Pafteboard, Banbox 
; ' ,r° ’ /Ji* lined with Leather, or 
?SL oljf/re m covered on both Sides in the 
lame Manner. 
i tW°T ate rendered ufe- 
£an£ tnd of Humidity, they are for 
tLat Reafon’ m flmpL, but Ml more in 
compound Fradlures, almoft wholly dif- 
carded. ■' Thofe of Deal (which are naofl in Ef- 
teem) keep their StifFnefs in Length, and 
are formed to embrace very completely fuch 
Parts as are not only long, but at the fame 
Time perfectly round; but fince the Shape 
of the Bones and Mufcles of the Leg, ren- 
der that Limb of a very different Form ;fb 
thefe cannot perfectly fupport and retain the 
fradured Pieces with fufficient Stability, un- 
lefs the unequal Parts be mod: accurately 
filled up with Bolflers, &c. and thereby 
brought to a cylindrical Figure ; much Art 
is therefore neceflary to their due Applica- 
tion; and as thefe Appendages are very apt 
to change and flip from their proper Situa- 
tion, a frequent Renewal of them is required; 
and not only fo, but the Side Edges <<f the 
Splints, prefs more on the Limb than any 
Part of them, caufing a Hollownefs through 
their whole Length; whence a partial, un- 
equal, and often hurtful Compreflion. On 
which Account I have for fome Years pre- 
ferred thofe of Tin, as prefling more ade- 
quately, though they have the fame Incon- 
veniencies and Difadvantages as the former, 
with Refped to the true Shape of the Limb* 
This will, I doubt not, be admitted as a 
true Reprefentation of the prefent Machi- 
nery for Fradures of the Leg, fo far as it 
relates to the Strudure and Ufe of Splints; 
whofe Deficiencies are too apparent to cfcape 
Obfervation, and too eafily account for pro- tuberant Callufes, and midiaped Legs, which 
fometimes take place even after Fradures 
not of the word Kind. 
I fhall now, agreeable to my Promife, at- 
tempt to mend the Faults I have obferved 
by a new Species of Splints, made of 
ftrong thick Leather, formed in fuch a Man- 
ner as to fit the true Shape of the Leg, re- 
ceiving it on each Side as in a Mould. 
That for the bifida is longer and broader 
than the other, with an End Piece to fuftain 
the Foot; longer, becaufe it is needful that 
the whole Length of the Limb fhould be 
furnifhed with fuch a Stay and Support as 
may defend it from thofe accidental or other 
Motions of the Mufcles, Ancle, &c. which 
might otherwife happen, and more or lefs 
difturb and affed the Fradure; a Circum- 
ftance unprovided for in the former Appara- 
tus ; nor does the moft accurate Bandage 
afford fufficient Security againft this Evil. 
It is broader, as the mufcular Outline is 
larger than on the Infide of the Leg, and 
made concave, fo as to receive and adapt itftif 
to the Shape of thofe Mufcles from their 
Origin, almoft to their Infertiom 
That for the Infide is fhorter and narrow- 
er ; its anterior Portion plain, adapting it- 
felf to the Tibia j its pofterior Concave to 
receive the Bellies of the Mufcles behind 
that Bone ; diminifhing in Breadth as it de- 
fcends, it fhapes itfelf to the Infide of the Small of the Leg, and at lafi: ends in a Con- 
cavity to receive the Malleolus Internus, 
with a Margin to prefs againfi: the Infide of 
the Foot; Straps with Holes at their Extre- 
mities, one below the Knee, the other above 
the Ancle; a third to the Margin of the 
Foot-piece. Betwixt the two former, the 
whole Space is filled with Loops, to pals in 
Straps (furnilhed with Buckles) higher or 
lower at Pleafure. 
The fmaller or infide Splint has two 
Pins, at correfpondent Places and Balances, 
fo as to anfwer the two firft mentioned 
fixed Straps of the greater or outer; and to 
which they, (viz.) the Straps are faftened, 
when the firapped Pieces or Splints are 
applied, excepting only that the Foot-firap 
or Stirrup is buttoned to the lowermofi: of 
the Pins already fpecified : The whole Space 
betwixt the Pins is filled with Loops as the 
former, and for the fame Reafon ; it ought 
to be obferved, that the Straps, whether 
fixed or moveable, be made of oiled or Bridle 
Leather, as no other will endure Wet or 
Moifture of any Kind, without fpoiling. 
Thcfe Splints are (as before-mentioned) 
confirudted of thick and ftrong Leather, 
worked into the Shape above dd'cribed, by 
hammering and jacking it upon Blocks, fo 
moulded, as to give them that proper and 
neceifary Form. 
Three or four Sizes are required to fit dif- 
ferent Legs, The Blocks may be had at the Carvers, and the Splints may be eaiily 
made by any Saddler, Jack Boot-maker, Gfc. 
But as they are already executed with the 
greateft Perfection and Elegance, and at a 
very reafonable Expence, by Mr. Mellor, 
Sadler in DevonJhire-Jtreet, it is needlefs to 
fet others on the fame Experiment. 
By the Operation of Jacking ; they are as 
Caps, Boots, &c. rendered impenetrable to 
almoft any kind of Humidity, efpecially if their 
Infides be japanned or painted ; a Quality of the 
greateft Confequence in compound FraCtures 
of the Leg : On which they maybe applied 
fooner, and in a more early State than any 
others, even fo as to preferve in a great Mea- 
sure, the true Shape of the Limb, when 
Hackly put on over emmoilient or other To- 
pics, where needful. 
I would here note another ufeful and im- 
portant Advantage, afforded by thefe Splints 
in fuch Cafes ; where if only one be taken 
off at a Time in dreffing the Wound, and 
the other carefully held on; the latter will 
be found an effectual Support to the Limb, 
and preferve the fradured Pieces fteady dur- 
ing the neceffary Movements: Nay, in ma- 
ny Cafes where the Wound (as frequently 
happens) is on the anterior Part of the Leg, 
they need only be dipped a little on one Side 
for that Purpofc. 
I have lately feen fome Splints made, as I 
imagine, of Glue and brown Paper, covered with Canvas, of the fame Shape with the 
above defcribed; they are perfectly ftiff and 
rigid when cold; foften a little by the 
Warmth of the Limb, but grow flabby and 
ufelefs, where the Perforation is confidera- 
ble, or when moiftened by any common 
Embrocation; it is therefore apparent enough 
they cannot be depended on in Ample, but 
Rill lefs in compound Fradhircs of the Leg. 
Others are made of thin Plate Iron painted, 
with a Foot-piece to move and fix at Plea- 
fure: Thofe I faw were very indifferently 
fhaped; but were they executed on the very 
fame Plan as thofe I now recommend. Lea- 
ther mud: certainly be not only more elegant, 
but more ufeful in this Cafe, ban it is pof- 
fible Iron Aiould be, for Reafons too obvious 
to mention. 
Thefe Splints are found capable of pre- 
ferving the Limb in its true natural Shape, 
with as much Eafe to the Patient, and as 
little Trouble to the Surgeon, as can reafona- 
bly be expected; for though they have fuf- 
ficient Strength and Stiffnefs, they are not 
fo rigid as to imprefs the tender Parts pain- 
fully : There is a Kind of Elafticity in Lea- 
ther thus prepared, capable of yielding, ac- 
commodating itfelf a little to the Parts, and 
reftoring itfelf again when the Refiftance is 
removed. 
They give fuch a Firmnefs to the broken 
Farts, that the Limb maybe removed, andfuf- fered to lie inflected on either Side, or in fach 
aManner as is moft convenient an eafy to the 
Patient; who is thereby exempted from the 
great Misfortune of being always confined to 
one particular Pofture; a moft defirable and 
happy Releafe, which the old Apparatus 
would not admit of with any Degree of Safety. 
The Patient may alfo be removed with 
great Security, much fooner from one Bed 
or Houfe to another, than formerly. 
It may perhaps be imagined, that thefe 
Splints might alfo ferve the fame Pur- 
pores as the Conductor; be applied as eafily, 
and with as good Effedf, as that Inftrument, 
to convey the Patient from the Place of the 
Accident, as from one Houfe to another af- 
terwards. To obviate fuch a Suppofition, 
it need only be confidered, that a Patient’s 
Cloaths, efpecially Shoes and Stockings, 
are then on the fractured Member, and muft 
of Necefiity be taken off, before the Splints 
can be well applied after which, not only 
a Surgeon, but proper Afliftance is required, 
rightly to reduce the Fradture, and hold 
it in that State till thefe new-conflradled 
Side Pieces are accurately fixed upon the 
Eimb. It is plain, here are too many 
Things to be done, too many proper At- 
neceflary to do them, and too 
much Time required for their due Appli- 
cation, to an Accident, perhaps in the 
Street, amidfi: a Concourfe of People ; or in the Country, where little or no Afiifiance 
is to be had; whereas the Condudor is ea- 
fily and inftantly applied, without taking off 
the Cloaths, Shoes, Stockings, &c. by al- 
moft any one that ever faw it, pulling the 
Limb ftrait, and fixing it at the fame Time 
fo ffeady, as to fit it for Conveyance in the 
ihortefi; Time imaginable to his Abode, 
where it fhould be taken off, with the Cau- 
tion already obferved, and the Splints ap- 
plied with the greatefl Care and Accuracy, 
The Offices then of thefe two Appara- 
tufes are very properly difiind; yet at 
the fame Time are both of the utmoil Im- 
portance in Fradures of the Leo;. 
Although I have confined myfelf to a 
fradured Leg in this fmall Trad, I can- 
not omit the prefent Occafion of recom- 
mending Splints of the fame Kind and 
Strudure, in Fradures of fome other Parts, 
efpecially where the Patient is mufcular, as 
in the Arm and Fore-arm, c'Sc. for the fame 
Reafon as in the Leg. But no Bone re- 
quires them more than the Clavicle, whofe 
crooked Shape renders the Cure of it, when 
fradured, generality ,very impeded and ine- 
legant for Want of fuch a Contrivance. 
FINIS,