Vickipedia

ARTIFI’CIAL LIMBS. With the exception of the celebrated’ artificial hand of the German knight, G�tz von Berlichingen* [* The iron hand of this knight, who has been immortalized by Goethe, it preserved at Jaxthausen, near Heilbronn, and a duplicate of it is in the Schloss Erbach, in the Odenwald. It is stated in Scott’s Harder Antiquities, vol. ii,p. 206, that the family of Clephane of Carslogie ‘have been in possession from time immemorial of a hand made in the exact representation of that of a man, curiously formed of steel,’ which was conferred by one of the kings of Scotland on a laird of Carslogie, who had lost his hand in the service of his country.�See Notes and Queries for July 17, 1867, p. 35.] �who flourished in the early part of the 16th c. (1513), and who was named The Iron-handed � which weighed 3 pounds, was so constructed as to grasp a sword or lance, and was invented by a mechanic of Nuremberg, our knowledge of artificial limbs dates from the time of Ambrose Pare whose (�nures de Chirurgie were published in 1575. The twelfth chapter of that volume, as translated by Thomas Johnson in 1605, shows ‘ by what means arms, legs, and hands may be made by art, and placed instead of the natural arms, legs, and hands that are cut off or lost.

The accompanying figures are copies of his drawing of ‘ an I made artificially of iron (fig. 1),’ and of ‘ the form of an arm made of iron verie artificially (fig. 2).’ He also gives a drawing of ‘a wooden leg made for a poor man’ (fig. 3), which is simply the common wooden leg with bucket receptacle still in use. No improvements worthy of record were made from the time of Abrose Pare to the beginning of the present century, when Baillif of Berlin constructed a hand which did not exceed a pound in weight, and in which the fingers, without the aid of the natural hand, not only exercised the movements of flexion and extension, but could be closed upon and retain light objects, such as a hat and even a pen. ‘Artificial hands,’ says Mr. Heather Bigg, ‘ are now constructed, by means of which a pin may be picked up from the ground, a glass raised to the lips, food carried to the mouth, and a sword drawn from its scabbard, and held with considerable firmness; while a combined arm and hand is fabricated, which is equal to the ordinary requirements of histrionic declamation.’�Orthopraxy, 1865, p. 157. The utility of an artificial arm depends much on the nature of the stump. A stump above the elbow is best suited for an arm when it gradually tapers to its lowest end, and terminates in a rounded surface. When an arm is removed at the shoulder-joint, and there is no stump, an artificial arm can still be fixed in its proper place by means of a corset. In amputation below the elbow joint, the best stump is one which includes about two-thirds of the fore-arm; while a stump formed by amputation at the wrist is very unsatisfactory. The simplest form of artificial arm intended to be attached to a stump terminating above the elbow, ‘ consists of a leathern sheath accurately fitted to the upper part of the stump. The lower end of the sheath is furnished with a wooden block and metal screw-plate, to which can be attached a fork for holding meat, a knife for cutting food, or a hook for carrying a weight.’�Op. cit. .p. 160. The arm should he so carried as to represent the position of the natural arm when at rest. It is retained in its position by shoulder and breast straps, and forms a light, useful, and inexpensive substitute for the lost member. More complicated, and therefore more expensive pieces of apparatus are made, in which motion is given to the fingers, a lateral action of the thumb is obtained, and the wrist-movements are partially imitated; and a degree of natural softness is given to the hand by a covering of gutta-percha and India-rubber. Such a hand, says Mr. Bigg, is often more symmetrical in aspect than the natural hand, but it possesses no efficient grasping power. Hence provision has to be made for attaching various instruments to its palm, such as special hooks, which can be removed at pleasure, for driving, shooting, &c.; apparatus for using the knife and the fork, for grasping the pen, &c.: indeed, the number and variety of instruments capable of being applied to an artificial hand are extremely great. Nothing has tended so much to the very highest development of artificial arms and hands, as an accident which happened more than a quarter of a century ago to the celebrated French tenor, M. Roger, who lost his right arm above the elbow.

It was necessary, for his future appearance on the stage, that he should have an artificial limb, which would serve the purposes of histrionic action, and permit him to grab a sword and draw it from its scabbard. Such a contrivance was invented in 1845 by Van Petersen, a Prussian mechanician, and the French Academy of Sciences commissioned MM. Gambey, Rayer, Valpeau, and Magendie to report upon it. For a history of the nature of the limb, the reader is referred to the report which appeared in the Comptes Rendus for that date, or to Mr. Bigg’s Orthopraxy, pp. 176�181. The apparatus, which weighs less than 18 ounces, was tested upon a soldier who had lost both arms. By its aid he was enabled to pick up a pen, take hold of a leaf of paper, &c.; and the old man’s joy during the experiment was so great, that the Academy presented him with a pair of these arms. Van Petersen’s conceptions have been extended and improved by Messr. Charriere, the celebrated surgical mechanics of Paris, aided by M. Huguier, the well-known surgeon. A very marvelous arm has also been almost simultaneously constructed by M. Bechard, which,’ by means of a single point of traction, placed in pronation, executes first the movement of supination, next in succession the extension of the fingers and abduction of the thumb: the hand is then wide open.’ -Bigg, op. cit. p. 190.

Artificial legs having fewer requirements to perform than artificial arms, are comparatively simple in structure. We borrow the description of our figure of the ordinary bucket leg in common use amongst the poorer classes from Mr. Bigg’s Orthopraxy. ‘ It consists of a hollow sheath or bucket, A. accurately conformed to the shape of the stump, and having�in lieu of the more symmetric proportions of the artificial leg�a ‘ pin,’ B, placed at its lower end to insure connection between it and the ground. This form of leg is strongly to be recommended when expense is an object, as it really fulfils all the conditions excepting external similitude embraced by a better piece of mechanism. It is likewise occasionally employed with benefit by those patients who, from lack of confidence, prefer learning the use of an artificial leg, by first practicing with the commonest substitute.’ As, when the body rests on a single leg, the center of gravity passes through the tuberosity of the ischium, it is essential that the bucket should be so made as to have its sole point of bearing against this part of the pelvis.

Of the more complicated forms of artificial leg three are especially popular. The first of these is of English origin, and owing to its having been adopted by the late Marquis of Anglesea, is known as the Anglesea leg. For a description of it, the reader is referred to Gray’s work on Artificial Limbs, one of the firm of Grays having been the constructor of the legs used by the marquis. This was for a long time the fashionable artificial leg. The second leg worthy of notice is that invented by an American named Palmer, and called the Palmer leg. From its lightness and the greater ease of walking with it, it has long superseded the Anglesea-leg in America. In the third of these legs, also invented in America, and known as Dr. Bly’s leg, the principal faults of the two other legs have been completely overcome. The advantages of this leg are thus summed up by Mr. Bigg, who has fully described and figured its mechanism: (1.) Adaptation to all amputations either above or below the knee. (2.) Rotation and lateral action of the ankle-joint. (3.) Power on the part of the patient to walk with ease on any surface, however irregular, as, owing to the motion of the ankle-joint, the sole of the foot readily accommodates itself to the unevenness of the ground, which is an advantage never before possessed by any artificial limb. (4.) The ankle-joint is rendered perfectly indestructible by ordinary wear, owing to its center being composed of a glass ball resting in a cup of vulcanite; thus it never gets out of repair, as the Anglesea leg but too frequently does, and the original cost is almost the only one the patient incurs. (5.) The action of the ankle-joint is created by five tendons, arranged in accordance with the position assigned to them in a natural leg. These tendons are capable of being rendered tight or loose in a few instants, so that the wearer of the leg has the power of adjusting with precision the exact degree of tension from which he finds the greatest comfort in walking, and also of giving the foot any position most pleasing to the eye. (6.) There is a self-acting spring in the knee-joint, urging the leg forward in walking, and imparting automatic motion, thus avoiding the least trouble to the patient, who finds the leg literally and not metaphorically walk by itself. (7.) The whole is covered by a beautiful flesh-colored enamel, thus avoiding the clumsy appearance of the wood, as is always found in an Anglesea leg, admitting of its being washed with soap and water like the human skin. (8). At the knee-joint there is a mechanical arrangement representing the crucial ligaments, and affording natural action to that articulation by which all shock to the stump in walking is avoided. This leg is patented, and as might be expected, is somewhat expensive.

In cases of arrested development of the lower limbs, short-legged persons may be made of the ordinary height by the use of two artificial feet placed twelve or more inches below the true feet, and attached to the legs by means of metallic rods, jointed at the knee and ankle.

Other parts not entitled to be called limbs, can also be replaced by mechanical art�such as the nose, lips, ears, palate, cheek, and eye. In the present advanced state of plastic surgery, deficiencies of the nose, lips, and palate can usually be remedied by an operation; cases, however, may occur where an artificial organ is required. Artificial ears are molded of silver, painted the natural color, and fixed in their place by a spring over the vertex of the head. Loss of an eye causes sad disfigurement; but the artificial eyes of Boissonneau (see his Renseigements G�n�raux sur les Yeux Artiftciels, leur Adoption et leur Usage), which have been shown in all the recent public exhibitions, completely throw all others in the shade, and cannot be detected without the closest inspection. For further details on all these subjects we must refer to Mr. Bigg’s volume, which is a complete encyclop�dia on these and allied topics.