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When a' is of the same height as d'', the weight is divided according to the weight of the parts.
A''',b,d'' represents the whole weight of the body thrown upon the back,--a theoretical, but not a practical position, the feet being elevated. Both body and legs are here reversed 90° from the position a, b, d.
Here, then, support and motion are combined so as to throw at will the body weight on the back or thigh, or to divide it equally between both, the division being in any proportion desired. This arrangement is advantageous, because it distributes the pressure evenly, and yet allows of change. Still, it involves immobility of the great joints. By referring to the diagram it will be seen that it is easy to get more motions by using the joints in the support a, b, c, d. In Fig. 1, bend down c,d to a vertical position, and a, b, c, d, will represent a common chair position. Rotate this backward 45° upon the supposed frame and the W position is attained when the thighs and legs are flexed, and yet perfect support attained.
This forms the “triple inclined plane" of Dr. Lewis A. Sayre, of New York city, with this exception, that the joints in the described device are movable and adjustable. It is an excellent, theoretical, and practical position for persons suffering from fracture of the thigh. The weight of the body gives the extension, the position of the legs, the counter-extension. Being fitted to the sound thigh, of course the broken thigh is constantly drawn into place. The joints are, or can be, kept moving while the extension is continued. As motion is the natural condition of a joint, of course any device which allows of proper extension with absolute and relative motion (change) is a desideratum.
a, back; b, thigh; c, leg. Fig. II. represents a change in the position first given, so that the head approaches the floor,-a position which is useful in case of fainting from any cause.
With this device a, b, c, d, hung at b, on a frame, any position of the human body, sitting or reclining on the back, may be imitated. More than bed or lounge, or any previously offered device, it offers the opportunity of depressing the head and trunk almost to the floor.
With these preliminary observations, the writer desires to call attention to the contribution he offers, in solution of the mechanical problems proposed.
Fig. III. Mechanical drawing of author's chair.
The frame is made of cast iron, heavy enough for durability and safety. The back is curved to fit the body and varies in length from 24 to 36 inches. The sides are formed by circles, in order to get the strength of the double arch. Notches are cut on the posterior and upper quarters of the circles, in which play pawls attached to and regulating the back portion. Teeth are cut on the inside of the lower and posterior quarter, in which play cogs that are turned by an endless screw on a shaft attached to the side of the frame-work. This screw ensures control of the apparatus and regulates its motion. It may be
turned by the patient. The circles, also, afford support for · the arms of the chair. An iron cross-bar traverses the hori.
zontal diameter of the circles. This affords strength, and extending forward, forms an attachment for the seat portion and the bracket for the leg portion. It is fenestrated so that the seat portion can be lengthened. The leg portion consists of a U attached by a joint to the end of the seat portion. Half way down on each side are long pawls with teeth cut on the convex side which engage in the brackets of the seat portion. Suitable horns project in front from these pawls to permit their being lifted when it is desired to flex the legs. To extend the leg portion it is only necessary to draw it out upwards.
Foot Rest. This was attached to the earlier chairs, but has been abandoned as, unless fitted accurately to every leg, it prevented the accurate resting of both thigh and leg upon their support. Besides, the device is intended to relieve the feet from pressure. When a chair is intended for the use of only one person a foot rest may be applied. The thigh portion measures 17–22 inches.
The leg 17 inches. The width of the chair: varies from 18 to 25 inches.
Three inch castors are placed under each corner of the frame. The size of the frame was determined by actual test, and the length of side was governed by the stability under ordinary circumstances. Invalidism must have a chair that will not easily tip over. Remove the castors and the chair becomes almost a fixture.
Bed position of the chair.
FEATURES OF THIS CHAIR. (a). Center of support, the center of motion.
(6). Motions, those of the hip and knee joints, in vertical planes.
(C). Absolute motion without relative motion of body, thigh
(d). The reverse of the last.
(e). Accommodation to abnormal conditions, fractures and anchylosis. (f). Person can change the part rested upon.
In bedridden cases, this is of service in preventing bed-sores.
(g). A person can be raised from a supine to a sitting posture (or the reverse) gradually, and stop at thirty-four points
on the way.
(h). Adjustments to different lengths of thighs.
(3). Patient may be removed from bed to chair without lowering:
(j). Absolute motion made by endless screw and pawls of the simplest forms.
1. For orthopnça, as in asthma, heart disease, rheumatism, and where persons are obliged to sit up all night and cannot lie in bed.
2. For Fracture Bed. See sequel.
3. For Operating Chair, this was the original design of the chair to be used in modified thyrotomy as published by J. Campbell & Son, Boston, 1867.
Fig. V. Device for holding a child in the operation upon the thyroid cartilage.
For surgical operations of other kinds, it permits close contact of the operator •and fixation of patient. Faintness from hemorrhage is controlled; vomiting is readily managed by elevating to a vertical position.
As a gynecological and office chair, I have found it useful. See sequel.
(4.) In convalescence and invalidism it is a useful means of getting a patient out of bed so as to use an ordinary chair. See sequel.
(5.) In health, it may be used as a reclining and resting chajr. Women generally find it very restful in backache.
They are sold from $35 to $45; are durable, and will last for a generation with ordinary care. The upholstering varies with the tastes of the patient.
Chair with Fracture apparatus, which may be detached by removing one screw.
The device of the author represented in the cut, is for extension in fractures of the thighs or legs. It is held securely in place by one screw. Extension may be made by a weight attached to a cord that passes over a pulley, or by an india-rubber tube fastened to the slot in which the pulley plays. By this arrangement the joints are kept in motion without disarranging the extension. The patients may sit up for the sake of eating, reading or writing. For defecation, &c., a bed pan is provided, made somewhat like a common dusting pan. The patient may be moved about the apartment, up to the window or even into another room. In this manner the tedium of confinement is very much alleviated. This relief is by no means an unimportant element in securing a successful and satisfactory progress of the case. The elevation of the head and the motion of the great joints ensure a shorter convalescence.
The shocks, also, of motion and jars of the apartment,