We are favoured by Dr. Arnott, the author of ‘The Elements of Physics,’
with an unpublished extract from the fifth edition of his work, now in
the press. The invention here described promises to be such a real
blessing to humanity, that we feel great pleasure in assisting to make
known an improvement of such importance in the healing art; particularly
as its value is not a matter of speculation, and as its benevolent
author freely allows its use wherever the wants of his fellow-creatures
require its application:--
In many of the diseases which afflict humanity, more than half of the
suffering and danger is not really a part of the disease, but the effect
or consequence of the confinement to which the patient is subjected.
Thus a fracture of the bone of the arm is as serious a local injury as a
fracture of one of the bones of the leg; but the former leaves the
patient free to go about and amuse himself, or attend to business as he
wills, and to eat and drink as usual--in fact, hardly renders him an
invalid; while the latter imprisons the patient closely upon his bed,
and brings upon him, first, the irksomeness of the unvaried position,
and then the pains of the unequal pressures borne by the parts on which
the body rests. These, in many cases of confinement, disturb the sleep
and the appetite, and excite fever, or such constitutional irritation as
much to retard the cure of the original disease, and not unfrequently to
produce new and more serious disease. That complete inaction should
prove hurtful to the animal system, may by all be at once conceived; the
operation of the continued local pressures will be understood from the
following statements. The health, and even life, of every part of the
animal body depends on the sufficient circulation through it of fresh
blood, driven in by the force of the heart. Now when a man is sitting or
lying, the parts of his flesh compressed by the weight of the body do
not receive the blood so readily as at other times; and if from any
cause the action of his heart has become weak, the interruption will
both follow more quickly and be more complete. A peculiar uneasiness
soon arises where the circulation is thus obstructed, impelling the
person to change of position; and a healthy person changes as regularly,
and with as little reflection, as he winks to wipe and moisten his
eye-balls. A person weakened by disease, however, while he generally
feels the uneasiness sooner, as explained above, and therefore becomes
what is called restless, makes the changes with much fatigue; and should
the sensations after a time become indistinct, as in the delirium of
fever, in palsy, &c., or should the patient have become too weak to obey
the sensation, the compressed parts are kept so long without their
natural supply of blood that they lose their vitality, and become what
are called sloughs or mortified parts. These have afterwards to be
thrown off, if the patient survive, by the process of ulceration, and
they leave deep holes, requiring to be filled up by new flesh during a
tedious convalescence. Many a fever, after a favourable crisis, has
terminated fatally from this occurrence of sloughing on the back or
sacrum; and the same termination is common in lingering consumptions,
palsies, spine diseases, &c., and generally in diseases which confine
the patients long to bed.
It was to mitigate all, and entirely to prevent some, of the evils
attendant on the necessity of remaining in a reclining posture, that the
hydrostatic bed was contrived. It was first used under the following
circumstances.
A lady after her confinement, which occurred prematurely, and when her
child had been for some time dead, passed through a combination and
succession of low fever, jaundice, and slight phlegmasia dolens of one
leg. In her state of extreme depression of strength and of sensibility,
she rested too long in one posture, and the parts of the body on which
she had rested all suffered: a slough formed on the sacrum, another on
the heel; and in the left hip, on which she had lain much, inflammation
began, which terminated in abscess. These evils occurred while she was
using preparations of bark, and other means, to invigorate the
circulation, and while her ease and comfort were watched over by the
affectionate assiduity of her mother, with numerous attendants. After
the occurrence, she was placed upon the bed contrived for invalids by
Mr. Earle, furnished for this case with pillows of down and of air of
various sizes, and out of its mattress portions were cut opposite to the
sloughing parts; and Mr. Earle himself soon afforded his valuable aid.
Such, however, was the reduction of the powers of life, that in spite of
all endeavours, the mischief advanced, and about a week later, during
one night, the chief slough on the back was much enlarged, another had
formed near it, and a new abscess was produced in the right hip. An
air-pillow had pressed where the sloughs appeared. The patient was at
that time so weak that she generally fainted when her wounds were
dressed; she was passing days and nights of uninterrupted suffering, and
as all known means seemed insufficient to relieve her, her life was in
imminent danger.
Under these circumstances, the idea of the hydrostatic bed occurred to
me. Even the pressure of an air-pillow had killed her flesh, and it was
evident that persons in such a condition could not be saved unless they
could be supported without sensible inequality of pressure. I then
reflected, that the support of water to a floating body is so uniformly
diffused, that every thousandth of an inch of the inferior surface has
as it were its own separate liquid pillar, and no one part bears the
load of its neighbour--that a person resting in a bath is nearly thus
supported--that this patient might be laid upon the surface of a bath
over which a large sheet of the water-proof India-rubber cloth were
previously thrown, she being rendered sufficiently buoyant by a soft
mattress placed beneath her--thus would she repose on the face of the
water, like a swan on its plumage, without sensible pressure anywhere,
and almost as if the weight of her body were annihilated. The pressure
of the atmosphere on our bodies is of fifteen pounds per square inch of
its surface, but, because uniformly diffused, is not felt. The pressure
of a water-bath of depth to cover the body, is less than half a pound
per inch, and is similarly unperceived. A bed such as then planned was
immediately made. A trough of convenient length and breadth and a foot
deep was lined with metal to make it water-tight; it was about half
filled with water, and over it was thrown a sheet of the India-rubber
cloth as large as would be a complete lining to it if empty. Of this
sheet the edges, touched with varnish to prevent the water creeping
round by capillary attraction, were afterwards secured in a water-tight
manner all round to the upper border or top of the trough, shutting in
the water as closely as if it had been in bottles, the only entrance
left being through an opening at one corner, which could be perfectly
closed. Upon this expanded dry sheet a suitable mattress was laid, and
constituted a bed ready to receive its pillow and bed-clothes, and not
distinguishable from a common bed but by its most surpassing softness or
yielding. The bed was carried to the patient’s house, and she was laid
upon it; she was instantly relieved in a remarkable degree: sweet sleep
came to her; she awoke refreshed; she passed the next night much better
than usual; and on the following day, Mr. Earle found that all the sores
had assumed a healthy appearance: the healing from that time went on
rapidly, and no new sloughs were formed. When the patient was first laid
upon the bed, her mother asked her where the down pillows, which she
before had used, were to be placed; to which she answered, that she knew
not, for that she felt no pain to direct: in fact, she needed them no
more.
It may be here recalled to mind, that the human body is nearly of the
specific gravity of water, or of the weight of its bulk of water, and
therefore, as is known to swimmers, is just suspended or upheld in water
without exertion, when the swimmer rests tranquilly on his back with his
face upwards. He then displaces water equal to his own body in weight as
well as in bulk, and is supported as the displaced water would have
been. If his body be two and a half cubical feet in bulk (a common
size), he will just displace two and a half cubic feet of water, equal
in weight to his body. If, however, instead of displacing the water with
his mere body, he choose to have something around or under him which is
bulky with little weight, as the mattress of the bed above
described,--when his weight has forced two cubical feet of that under
the level of the water around, he will float with four-fifths of his
body above the level, and will sink much less into his floating mattress
than a person sinks in an ordinary feather-bed. It thus appears that by
choosing the thickness of the mattress, and if unusual positions are
required, by having different thickness in different parts, or by
placing a bulk of folded blanket or of pillow over or under the mattress
in certain situations, any desired position of the body may be easily
obtained.
This bed is a warm bed, owing to water being nearly an absolute
non-conductor of heat from above downwards, and owing to its allowing no
passage of cold air from below. From this last fact, however, less of
the perspiration, whether sensible or insensible, will be carried off by
the air than in a common bed, and unless the patient can leave the bed
daily to let it be aired, it is necessary to lay an oiled silk or other
water-proof cloth over the mattress, to prevent the perspiration from
descending to be condensed on the cloth below; or to place a blanket
below to be changed occasionally; or, finally, to lay under the mattress
a layer of cork, cut into small pieces, and so connected as to leave
passages between, for any desired degree of ventilation. This bed is in
itself as dry as a bed can be, for the India-rubber cloth (of which
bottles can be made) is quite impermeable to water, and the maker is now
preparing cloth expressly for this purpose. Then, as Sir Humphry Davy
recommended that his safety lamp should be double, some persons may
prefer a double sheet, to obviate the possibility of accident. Unlike
any other bed that ever was contrived, it allows the patient, when
capable of only feeble efforts, to change his position, almost like a
person swimming, and so to take a degree of exercise, affording the kind
of relief which in constrained positions is obtained by occasional
stretching, or which an invalid seeks by driving out in a soft-springed
carriage. It exceedingly facilitates turning for the purpose of dressing
wounds, for by raising one side of the mattress or depressing the other,
or merely by the patient’s extending a limb to one side, he is gently
rolled over, nearly as if he were simply suspended in water; and it is
possible even to dress wounds, apply poultices, or place vessels under
any part of the body, without moving the body at all; for there are some
inches of yielding water under the body, and the elastic mattress may at
any part be pushed down, leaving vacant space there, without the support
being lessened for the other parts. Then, with all the advantages which
other invalid beds possess, and with those which are entirely its own,
it may yet be made so cheaply, that even in hospitals, where economy
must prevail, it may at once be adopted for many of the bed-ridden. Mr.
Earle, within a few days of seeing the first one, had others made for
patients in St. Bartholomew’s Hospital, and has been as much pleased
with the results of them as of the first. The bed has since been
introduced into St. George’s Hospital by Mr. Keate, and elsewhere.--The
author has now seen enough of the effects of this bed to make him feel
it a duty at once to publish a notice of it. With it, evidently, the
fatal termination called sloughing, now so common, of fevers, and other
diseases, need never occur again. And not only will it prevent that
termination, but by alleviating the distress through the earlier stages,
it may prevent many cases from even reaching the degree of danger. Then
it is peculiarly applicable to cases of fractured bones, and other
surgical injuries; to palsies, diseases of the hip joint, and spine; and
universally where persons are obliged to pass much time in bed. And in
all classes of curvature of the spine, either actually existing or
threatened, it affords a means of laying a patient in any desired
position, and with any degree of pressure incessantly urging any part of
the spine back to its place. If used without the mattress, it becomes a
warm or a cold bath, not allowing the body however to be touched by the
water; and in India, it might be made a cool bed for persons sick or
sound, during the heats which there prevent sleep and endanger health.
There are numerous other professional adaptations and modifications of
it, which will readily occur to practitioners sufficiently versed in the
department of natural philosophy (hydrostatics) to which it belongs.
Before reflection a person might suppose a resemblance between it and an
air-bed or pillow, calling this a water-bed or pillow; but the
principles of the two are perfectly distinct or opposite. An air-pillow
supports by the _tension of the surface_ which encloses the air, and is
therefore like a hammock or the tight sacking under the straw mattress
of a common bed, and really is a hard pillow; but in the hydrostatic bed
there is no tense surface or web at all: the patient is floating upon
the water, on which a loose sheet is lying, merely to keep the mattress
dry, and every point of his body is supported by the water immediately
beneath it. To recall the difference here described, and which is of
great importance, the bed is better described by the appellation of
_hydrostatic bed_ than of _water-bed_.
The author has given no exclusive right or privilege to any person to
make this bed. He has hitherto employed the carpenter nearest to him,
Mr. Smith, 253, Tottenham-court Road, at the back of Bedford Square, and
the manufacturers of the water-proof cloth, Mackintosh and Co., 58,
Charing-Cross; but any carpenter or upholsterer may learn to supply
them, and he gives free permission to all.
The preceding paragraphs are intended as much to direct in the choice
and use of common beds for the sick, as to announce and describe the
hydrostatic bed for the cases where it may be required. At present the
medical attendant often leaves whatever regards the bed to the judgment
of friends or nurses; but evidently he who perceives clearly how much
the course and events of a malady may depend on the patient’s being
supported, so that no pain shall arise from local pressure, and as
little weariness as possible from the constrained position, will be
better able to use any bed to its greatest advantage, and where a choice
of beds is allowed, to choose the best. There is a bed formed of spiral
springs which diffuses the support more than any bed except the
hydrostatic bed; and had professional men generally known it, it would
have been more extensively used than it is, and would have received
modifications of which it is susceptible for medical purposes. It has
been long known, but chiefly as a mechanical curiosity or as an object
of luxury,--but so little known, that a few years ago an English
manufacturer took out a patent for it, believing it a novelty. It is now
made by upholsterers generally, and the same principle is applied in the
construction of sofas, chairs, and carriage cushions.
It is one of the many striking facts illustrative of the benefits
attending the commercial intercourse of mankind, that India-rubber, or
caoutchouc, for many years used only to rub out pencil-marks, has become
an important article in the manufacture of cloth; and it is pleasing to
think that probably one of its most extensive applications will be in
the mitigation of human suffering.
[Illustration: Trees producing Caoutchouc.]
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[ADVERTISEMENT.]
We deviate, for once, from our plan of excluding Advertisements, to give
extended circulation to the following Notice, which we believe will
interest many of the readers of THE PENNY MAGAZINE.
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_Under the Superintendence of the Society for the Diffusion of Useful
Knowledge._
EXTRACT from the REPORT to the GENERAL MEETING, dated 30th June, 1832:
“The success of the PENNY MAGAZINE has induced the Committee to
undertake the publication of a