Self-Machinery?: Steel Trusses and the Management of Ruptures in Eighteenth-Century Europe

On 13 March 1761, Monsieur de Bompré from Saint-Poursaint in Auvergne wrote to William Blakey, a surgeon and watchmaker. Blakey ran a fashionable toyware business with his wife Elisabeth Aumerle whose retail shop was located on the rue des Prouvaires close to the faubourg Saint-Honoré. Bompré was writing on behalf of a friend, who had suffered from violent diarrhea for two months caused by a bilious humor, and was eventually saved by "epiquagonera," the South American ipecacuanha. One night after his recovery, he slipped, causing light pain in the right-hand side of the navel. Not noticing it at first, he then ached each time he blew his nose or touched his belly. As the rupture grew, he called on both his physician and surgeon, who equipped him with a steel truss. He was sent a brayer (steel bandage) from Paris, which was dreadfully painful: the ball applied to the hernia was too big and the steel belt fitted so tightly that when he coughed, the left side of the navel nearly opened. As a consequence, he stopped wearing his steel truss. On his friend's behalf, Bompré inquired:

[H]ow are the trusses you make [constructed]? If they can be put on by oneself, if they do not incommode breeches as brayers do, and if they have a steel-belt. I am fairly sure that their belts could be made out of cotton, so that a person could attach it by oneself. Finally, please tell me how those you advertised are made, so that my friend can go to Paris, or order them if he thinks he can have use of them, put them on and take them off by himself.¹

Bompré, one of Blakey's fifty corresponding customers during the period 1761-71, was actively seeking information on new body technologies to contain his friend's rupture. Like other patients, he had looked in the press and requested advice from surgeons; aware of the latest drugs available on the market to cure digestive problems, he also imagined designs or materials that would help improve these instruments for the body. He was, above all, an active consumer, making innovation happen.

In the case of Blakey's steel trusses, innovation relied upon the use of new materials, especially in the different varieties of cemented steel that were manufactured in northeast England and in the Sheffield region. Cemented steel's flexibility was a result of sophisticated processes of faggoting, forge-welding, and recarburing, and was first used in watch springs. It found new applications in trusses, or bandages, for ruptures, and in pessaries for prolapsed uteri; their manufacture into first springs and later waistbands provided powerful and precise fitting to the body. As has been argued, by the eighteenth century, steel had become the material par excellence for handy, precise, and adjustable tools.² The use of steel instruments enhanced manipulation, hand dexterity, and skills; as such, they belonged to the numerous metallurgic devices that were ranged under the designation of toyware, which covered a large range of "curious commodities," from chains, buckles, buttons, pins, and spurs to toothpicks, hair irons, and tweezers. Bodily technologies, which penetrated the skin or were applied to its surface, used a wide range of materials, including leather, human hair, tortoise shell, and baleen.³ From ore to skin, from Sheffield to Marennes or Gand, steel trusses, processed along complex and intertwining chains, exemplify the intricacies of the Enlightenment worlds of manufacturing, trade, and consumption. Steel trusses were part of an economy of variety and adaptability that relied upon a combination of media and the fitness of materials to supply consumers' needs. They were emblematic of the praise for functionality, for "fitness of purpose" in Adam Smith's words.⁴ We shall see that the careful management of the qualities of steel was pivotal to the making of steel trusses.

Steel trusses indeed fit into the burgeoning consumer society in which health care and medicine played an important part. The early modern consumption of medicine...