ARTIFICIAL LIMBS, substitutes for human arms and legs and parts thereof, toes, feet, hands and fingers, appliances for exci sions, fractures and other disabilities of lower and upper extremities, the manufacture of which has received the attention of surgeons and mechanics from a very early date. In the great work on surgery by Ambrose Pare, in 1579, he refers to and gives detailed illustra tions of an artificial arm and leg, and although the construction was of a rude character they showed a very good attempt to conceal the mutilation. In 1696 an artificial leg was in vented by Verduin, a Dutch surgeon. It was composed of a wooden foot, to which was fastened two strips of steel extending up to the knee. To these strips was riveted a copper socket to receive the stump; a leather for lacing around the thigh was connected to the socket by two steel side-joints, thus dividing the points of support between the thigh and stump. The construction of this leg was improved later by Professor Serre of Montpelier. Im provements and new limbs were more recently introduced into England and France by Fred. Martin, M. Charriere, MM. Mathieu and Bechard, but these were mostly unprotected by patents. Thomas Mann secured patents for artificial limbs 20 Jan. 1790, and 1810. James Potts of England patented a new leg 15 Nov. 1800. This soon became celebrated as the •Anglesea leg,° because it was so tong worn by the Marquis of Anglesea. An improvement on this leg was patented by William Selpho, who was the first manufacturer of note in New York, where he established himself in 1839. Other inventors and manufacturers soon took a great interest in the business — so many, in fact, that the American patent office shows a record of about 150 patents on artificial legs, or more than double that of all European pat ents on limbs. The Civil War, which caused the mutilation of so many soldiers and sailors, and the liberality of the government in supply ing their losses with artificial limbs, naturally stimulated the efforts of inventors in producing such substitutes as would be accepted. These soldiers and sailors were supplied once in every five years, and to this demand is added that of those who have lost limbs from disease or acci dent, making in all about 100,000 in the United States who have to he supplied with new limbs on an average of about once in every five to eight years. The perfection to which limbs have been brought is wonderful and very inter esting. A person with two artificial legs can walk so perfectly as to avoid detection, and a person with a single amputation can almost defy detection. Notable improvements in artificial limbs, and more particularly in legs, were made by C. A. Frees, by J. Condell and by A. A. Marks of New York. One of these improve ments, and one of the most important, consists in the movements of the knee and ankle joints, by which the whole limb is strengthened and made more durable. An important feature of
this piece of mechanism consists in the intro duction of a universal motion at the ankle-joint, imitating the astragalus movement with an ad ditional joint, and thus producing a most per fect artificial substitute. Another of his im provements, of equal importance, is in the knee joint of the leg for thigh amputation, which is so arranged that when in a sitting position the cord and spring are relaxed, re lieving all strain and pressure; and when rising to an upright position the cord and spring are again brought into proper position without strain or unnatural movement, no extra attach ments being required. Artificial arms and ex tension apparatus for short legs are also won derful examples of American ingenuity.
The great European War gave a great im petus to the manufacture 'of artificial limbs, and organized effort was made especially by the French authorities to place the entire tech nique of artificial limb supply upon a standard ized scientific basis. A laboratory of military prosthesis was established in Paris where care ful determinations were made of the muscular and nervous conditions in and around the damaged limb. In accordance with these ob servations, individual prescriptions were made and carried out with a degree of skill which could not by any possibility be approached in times of peace, with the negligible number of cases which then arise. A German firm per fected a system attached rigidly to the shoulder, whereby movements based upon the humerus, collar-bone or shoulder-blade are transmitted to the stump of the forearm. The hook ter minating this artificial arm can be subjected to heavy loads without in the least straining the enfeebled muscles of the wounded man.
An artificial arm for those whose amputa tion had preserved the elbow-joint was con structed by an American firm which made possible a large variety of movements. Flexions of the wrist, • opening and rotating of the whand,° placing the °fingers° in certain positions and holding them firmly there, are all accom plished with no intervention of the other hand aside from the engaging and disengaging of a catch.
The average price for an arm fitted to an amputation above elbow, with full finger and universal wrist movement is from $100 to $125 and $150; below the elbow from $75 to $100; for a leg above or below the knee the prices are about similar. Consult Condell, J., 'Life-like Artificial Legs and Arms' (New York 1886) Marks, A. A., 'Manual of Artificial Limbs' (New York 1914) ; Palmer, B. F., 'Will the American Government Present an Artificial Arm (Not a "Clutch") to the Mutilated Amer ican Soldier ?' (Philadelphia 1863).