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Severed Limbs and Wooden Feet: How the Ancients Invented Prosthetics

Severed Limbs and Wooden Feet: How the Ancients Invented Prosthetics



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We are living through an incredibly exciting period for prosthetics. A pioneering brain computer interface that will allow veterans to control artificial body parts with their minds was recently announced by researchers in Virginia in the US. Meanwhile, Newcastle University in the UK is developing limbs which “see” objects in front of them and react at speeds more comparable with the real thing.

Projects like these are steadily helping people with prostheses to move more naturally and easily than ever before. But what few people appreciate is just how far back this field actually goes.

If you were thinking a couple of hundred years, or maybe since the medieval era, you wouldn’t even be close. Amputations and prostheses date back to ancient times, and saw advances that were heralded as no less life-changing then as they are today. It’s a fascinating story of gods, gladiators and the limits of human endurance that adds a whole other dimension to understanding this discipline.

Prosthetics begins

Warfare was not kind to the bodies of soldiers in Ancient Greece and Rome. It has been estimated that in Ancient Greece, about 80% of seriously wounded soldiers died on the day of battle. Of the remaining 20%, a third died of their injuries after returning home. It is not easy to make direct comparisons with modern times, but these figures are certainly likely to be much higher.

Whether survivors in the ancient era were injured in battle by a blade, spear or missile, or in camp by frostbite or trench foot, their arms, legs and extremities were incredibly vulnerable. In Ancient Greece, they benefited from simple surgical amputations as far back as the late fifth or early fourth century BC. The Hippocratic treatise On Joints attests to rudimentary amputations of fingers, toes, hands and feet, but cautions against amputating an entire arm or leg.

Around the same time, orthopaedic surgery had refined to the point that prostheses were starting to become available as alternatives to staffs, sticks and crutches. We see this in the account of the Graeco-Persian War (499-449BC) by the historian Herodotus, for instance. Herodotus recounts how the Persian diviner Hegesistratus, when imprisoned by the Spartans, amputated part of his own foot to escape his shackles, then procured a wooden replacement.

Egypt was using similar technology around the same period. Prosthetic toes made from wood or layers of fibre known as cartonnage have been recovered from burial sites, such as the one from a mummy near Luxor pictured below. They show signs of wear and tear, indicating that they were functional rather than purely cosmetic.

Prosthetic hand from ancient Egypt

Surgical techniques advanced considerably during the Hellenistic period (323-31BC), the last era before Greek dominance gave way to Rome. These advances were thanks to medical practitioners at the Museion and Library in Alexandria making in-depth anatomy studies by dissecting and even vivisecting criminals sentenced to death.

This improved their understanding of the circulatory system and led them to discover that blood vessels could be tied off to prevent bleeding, which meant that amputations could be done slowly and carefully. There was less risk that the patient would die of blood loss, and stumps were now more amenable to prosthesis use.

It is unlikely to be a coincidence that prostheses advanced at the same time. An artificial leg recovered from a tomb in Capua in southern Italy, dated to the late fourth or early third century BC, had a wooden core covered in bronze sheeting. This was held in place by a leather and bronze belt, which would have made movement easier.

Another example is the Roman general Marcus Sergius Silus. He lost his right hand during the Second Punic War (218-201BC), which was fought between the Romans and Hannibal of Carthage in latterday Tunisia. But rather than retire, Silus procured an iron hand which he subsequently used to bear his shield, transferring his sword to his left hand instead.

Battle of Zama in Second Punic War, Giulio Romano 1521.

Then and now

Surviving examples like these indicate that extremity prostheses were designed, commissioned, and manufactured to an individual’s specific preferences. The same artisans that produced personalised armour and weapons likely produced personalised prostheses for wounded veterans.

Considering the ancient association of disabled people with crafts such as metalwork – epitomised by the Greek god Hephaistos and his Roman counterpart Vulcan – artisans may even have drawn on their own experiences of impairment to inspire their creations. Soldiers like Silus would duly have been able to defy their societies’ expectations and continue to play significant roles at moments of historical significance.

Hephaistos/Vulcan, engraved 1716 by E. Jeaurat. Wikimedia

We historians do have to speculate here to some extent: we don’t know how soldiers acquired their prostheses, since medical treatises do not mention these procedures. Yet it seems probable that the technology improved due to the horrors of war – just as today’s advances are partly a response to the unprecedented levels of multiple traumatic injuries that soldiers suffered in Afghanistan and Iraq. And then as now, prostheses were collaborative efforts between medics, technologists and artists.

After the ancient era, prostheses barely improved until the 16th century. That was when Ambroise Paré, the royal surgeon to four successive French kings, invented mechanical versions including knees and fingers capable of bending somewhat like the real thing.

So when we see the latest prostheses giving veterans an incomparable quality of life or helping athletes to achieve amazing things at the Paralympics, it is worth reflecting on the distance travelled. We have been trying to make amends for humanity’s worst tendencies for 25 centuries. Long may such advances continue to be a vital consolation.

Top image: False toe on mummy found near Luxor. Egyptian Museum

The article ‘ Severed Limbs and Wooden Feet: How the Ancients Invented Prosthetics’ by Jane Draycott was originally published on The Conversation and has been republished under a Creative Commons license.


10 Facts About The History Of Prosthetic Limbs

Unlike the gecko and the octopus, humans, unfortunately, can&rsquot regrow lost limbs after they&rsquove been severed. That&rsquos why prostheses, artificial limbs, have such a long history in engineering and medicine. From the horrors of war to the devastation of disease, history has provided ample opportunity for innovation.

Today, thanks to the imaginations of inventors, amputees have more options than ever before for rehabilitation after such tragic injuries. Here is a list of the most interesting facts in the history of prosthetic technology, from ancient times to the speculations of a distant future.


A short history of prosthetics

Prosthetics have both a practical purpose and an emotional one, with some people feeling that they help to make them whole. In ancient Egypt, there is evidence of a woman with a prosthetic toe that is made from wood and leather and some people say wouldn’t have affected her ability to walk. Those people hypothesise that because they were a sandal wearing culture, she had felt it important to her identity to have the prosthetic. Others believe that it will have contributed to her ability to walk. Either way, I think it’s pretty amazing that we have evidence of prosthetics that old, especially given the materials they were generally made with. In Egypt they were made from fibre and wood and echoed the importance they placed on wholeness.

Another early example is an artificial leg that dates back to about 300 BC. It was found in Italy and was made of bronze and iron with a wooden core. It’s thought this was held in place by a leather belt.

Whilst we tend to think of a prosthesis as replacing a limb, they are used to replace other body parts including eyes, breasts and teeth. And when it comes to teeth we find a lot more literature. Did you know, for example, that at one time hippo ivory was used to make false teeth as it was stronger than alternative ivory and didn’t yellow so quickly.

Etruscan false teeth from between 8 th and 3 rd century BCE have been discovered as have sets of false teeth which were made from animal teeth or even human teeth and were connected to intact teeth with a metal band. Anyway, I don’t like the dentist and all this talk about teeth is too much for me….

Hook hands, peg legs and iron hands were used from roman times to the end of the middle ages with little advancement in technology. In the 16 th century, a hinged arm and a locking leg were invented. The heavy iron was replaced by a mix of leather, paper and glue tanks for a French locksmith of all people. We also have to thank watchmakers for contributing to the development of prosthetics as gears and springs were used and needed a careful approach for the intricate parts.

The history of prosthetics is about the history of the prosthetics of the wealthy, or lucky, as is often the case today. Knights may have been fitted with them because of their status but possibly also because the history of prosthetics has always been intertwined with the history of wars and the soldiers that fight in them. We know of a roman general that lost his hand and couldn’t fight, but with the aid of an iron prosthetic that could hold his shield, he was able to retain his identity as a general and presumably return to war…

Around 1800, a breakthrough was made in the mechanics of prosthetic limbs by James Potts. His ‘Anglesey’ leg had articulated parts and used cat-gut tendons to hinge the knee and ankle, creating a walking motion when the toe was lifted. This design was further developed by adding a heel spring.

The American Civil War saw many many limbs amputated and the US government supplied these soldiers with prosthetics, allowing them to return to work…. So kind! This vastly increased demand and presumably there were tweaks to design at the same time. Midway through the war, a new way of attaching the prosthesis was developed that used suction rather than straps. Another prosthetic that came from the war was a rubber hand which had fingers and was able to connect to an array of attachments.

World War One also saw an increased demand for prosthetics but poor designs and poor fitting led to many going unused. Common complaints included pain related to friction between prosthesis and the amputated limb and the weight of the prosthetic.

Throughout most of history, prosthetic limbs were wood or metal although I read about one that was made from plaster and animal glue and another that was iron with a wooden core. More recently, lighter options have become available. Lightweight aluminium combined with the suction attachment made for more practical and more affordable options and more recently plastics and electronics have followed. Another big change is around the look of them. Historically, prosthetic limbs have been designed to replicate the limb and to make other people feel comfortable but in recent decades, there has been a noticeable move towards function over appearance.

In the 1960s, children affected by thalidomide were born with malformed limbs and technological solutions to medical issues were sought. These came in the form of personalised prosthetics which sped up the advancement of this area. Gas powered prosthetics were invented to help children and whilst they may have sounded great, and certainly I’m sure some kids found them helpful, others found them difficult and cumbersome. They required a lot of time away from home to fit them and teach the children how to use them and this obviously had to be repeated as the child grew. Further, as the child grew up, they wanted to be able to do more with their prosthesis such as feed themselves, write and go to the toilet by themselves. To be able to do these tasks would make mainstream school accessible.

Gas had been chosen as a power source because batteries at that point were impractical. As time went on, other ideas were considered and someone thought that a more modular system might work and by this point technology had shrunk making batteries more practical.

In the 1990s, knees that used computer chips were introduced. The chip controlled the speed and swing of the knee joint and sensors provided feedback. In 1998 the first electric arm was fitted. The i-limb was the first prosthetic to have individually powered fingers and gave the user more control and more feedback. As well as limbs that allow for walking, we have seen limbs that are designed for running and other sports.

Today we are seeing a more personalised approach to prosthetics including the alternative limb project which seeks to go beyond the replacement of a limb and creates imaginative and personalised options.


How Prosthetic Limbs Work

Ancient literature contains references to prosthetic limbs in stories and poems, but some of the earliest historical accounts of prosthetic limb use were recorded in Greek and Roman times. For instance, there's the historical account of of Marcus Sergius, a Roman general who lost his right hand while battling in the second Punic War. Famously, he had a replacement hand fashioned out of iron for the purpose of holding his shield and was able to return to battle and continue fighting.

In the year 2000, researchers in Cairo, Egypt, unearthed what they believe to be the oldest documented artificial body part -- a prosthetic toe made of wood and leather. The device, found attached to the nearly 3,000-year-old mumified remains of an Egyptian noblewoman, is a good representation of how little prosthetic limbs have changed throughout history. With the exception of very recent times, prosthetic devices have been constructed of basic materials, such as wood and metal, and held to the body with leather attachments.

To show how little prosthetic limbs have advanced through most of history, consider the artificial hands and legs of the Dark Ages -- nearly 2,000 years later. Armored knights of this era often relied on iron prosthetic limbs, usually crafted by the same metalworker who made their armor. These bulky limbs were admittedly not very functional and were actually used more for the purpose of hiding the lost limb, which was considered at the time to be an embarrassing deformity.

Most famously attributed to seafaring pirates, peglegs with wooden cores and metal hands shaped into hooks have actually been the prosthetic standard throughout much of history. While Hollywood has exaggerated their use of hooks and peglegs, pirates did sometimes rely on these types of prostheses. The required materials for these devices could be scavenged from a common pirate ship however, a trained doctor would have been rare. Instead, the ship's cook typically performed amputation surgeries, albeit with poor success rates.

In the early part of the 16th century, French military doctor Ambroise Paré, also famous for his work with amputation techniques, contributed some of the first major advances in prosthetics seen for many years. Paré invented a hinged mechanical hand as well as prosthetic legs that featured advances such as locking knees and specialized attachment harnesses. Around 1690, a Dutch surgeon, Pieter Verduyn, later developed a lower leg prosthesis with specialized hinges and a leather cuff for improved attachment to the body. Amazingly, many of the advances contributed by these two doctors are still common features of modern day prosthetic devices.

With the advent of gaseous anesthesia in the 1840s, doctors could perform longer, more meticulous amputation surgeries, allowing them to operate on the limb stump in such a way as to prepare it for interfacing with a prosthesis. Advances in sterile, germ free surgeries also improved the success rate of amputation procedures, increasing the need for prosthetic limbs.

As artificial limbs became more common, advances in areas such as joint technology and suction-based attachment methods continued to advance the field of prosthetics. Notably, in 1812, a prosthetic arm was developed that could be controlled by the opposite shoulder with connecting straps -- somewhat similar to how brakes are controlled on a bike.

The National Academy of Sciences, an American governmental agency, established the Artificial Limb Program in 1945. The program was created in response to the influx of World War II veteran amputees and for the purpose of advancing scientific progress in artificial limb development. Since this time, advances in areas such as materials, computer design methods and surgical techniques have helped prosthetic limbs to become increasingly lifelike and functional.

A common cultural belief -- one held during various periods throughout history -- is that a person who loses a limb during his or her time on Earth will remain limbless in the afterlife. To avoid this fate, amputated limbs were commonly saved for later burial along with the rest of the body.


Your third limb

The evolution of prosthetics has come a long way to what it is today. The first prosthetic limbs have changed continuously over the course of time, and through numerous improvements and fine-tuning, transformed the first peg legs and hand hooks into the modern products we see today. Despite all of these changes, the role of prosthetic limbs has never changed, and it is still serves as a replacement for people who have lost their limbs.

Prosthetics have always been around throughout history of mankind. There are differing opinions as to who was the first to develop and use prosthetic limbs. One of the earliest known references of prosthetic limbs is the story of a Persian soldier, Hegistratus, who escaped his captives by cutting off his foot and replaced it later with a wooden on. The Ancient Egyptians and Romans were both known to use wooden and iron arms and feet to replace their lost limbs from war. Knights who lost their arms during the Middle Ages were fitted with basic prosthetics so that they were still able to hold up a shield. These prosthetics had minimal function and were only able to perform very limited tasks.

However, what historians generally agree on is the earliest case of an advanced prosthetic arm which belonged of Gotz Von Berlichingen, a German Knight. He lost his right arm in battle, and fitted himself with a prosthetic arm with catches and springs. Such a design was way ahead of its time in the 16 th century and enabled him to hold objects ranging from a sword to a feather pen.

Over on the other side of the globe around the same period, an Italian surgeon traveling in Asia recorded observations of a double arm amputee who was able to remove his hat, open his purse, and sign his name.

Based on such earlier works, the French surgeon Ambroise Paré further improved prosthetic limbs as well as inventing an above-knee prosthetic in 1536. This device had a kneeling peg leg and foot prosthesis that formed the basic engineering features that are used in today's devices. His work showed the first true understanding of how a prosthesis should function.

In the 19 th century with the progress of warfare technology, amputees were becoming increasingly common, leading to technological advancements in prosthetic technology.

In 1800, James Potts, designed a new prosthetic leg that would be controlled by tendons from the knee to the ankle that had a steel knee join and an articulated foot. It would be known as the “Anglesey Leg” after Marquess of Anglesey, who wore it after losing his leg in the Battle of Waterloo.

In 1846, Benjamin Palmer further improved the aesthetic designs of the “Anglesey Leg” with his aim of concealing the unsightly gaps between various components. Through adding an anterior spring, and concealed tendons, he was able to simulate more natural-looking movement for the amputee.

Over the years, the design of prosthetic limbs began to change tremendously. Dubois L Parmelee developed an advanced socket for prosthetic limbs in 1863 that relied on atmospheric pressure to secure the socket. 25 years later, Giuliano Vanghetti successfully invented a way for amputees to use their remaining muscle contractions to move the prosthetic limbs in 1898. The materials used for prosthetics also changed from wood to more longer lasting materials like aluminium.

Following World War II, war veterans with missing limbs were dissatisfied with the level of technology in their prosthetics and demanded improvement. This led to the U.S. government securing a deal with military companies to prioritise developing prosthetic function over that of weapons. This agreement further paved the way for further development and production of modern prosthetics.

Another milestone for prosthetic limbs was the revolutionary development of socket technology. In the 1980s, John Sabolich revolutionised prosthetic limb technology with his new designs, allowing specialised containment for muscular tissue and distributing weight more evenly. Fast fo rward to today, technology for prosthetics has advanced even further by leaps and bounds.

For example, today’s prosthetics are made of stronger and lighter materials like carbon fiber and include the use of electronics to control limbs using muscle movements by converting them to electrical signals. Today’s prosthetic technology has the aim of returning amputees to their pre-amputation lifestyle, rather than merely restoring basic functions and for aesthetic reasons. DARPA’s continuous research over the past decade led to a breakthrough in the earlier half of 2013, when it developed a mind controlled prosthetic limb. For an amputee having a restored sense of touch, as well as being able to move the limb without consciously looking at it, this new technological advancement brings a greater degree of control back to the subject, and opens up even more possibilities as to what the future can bring to such an amazing technology.


Taking Technological Leaps

The carnage of the Civil War led to a dramatic increase in the number of amputees, and the field of prosthetics needed to rise to the demand. James Hanger, a confederate soldier, became the first amputee in the war and went on to invent the ‘Hanger Limb’ a prosthetic leg made from barrel staves and metal, that featured hinged joints at the knee and ankle. The Hanger Limb was the most advanced limb in the history of prosthetics, and the company he founded continues to be a leader in the industry today.

In spite of the tremendous loss of life and limb in the World Wars, there wasn’t a corresponding leap in prosthetic technology like the one seen in the Civil War – at least not until 1946, when researchers at UC Berkeley developed a suction sock for lower-limb amputees. Similar attachment technology is still in use today.

In the 1970’s, the inventor Ysidro M. Martinez made a huge impact on the history of prosthetics when he developed a lower-limb prosthesis that, instead of trying to replicate the motion of a natural limb, focused on improving gait and reducing friction. By relieving pressure and making walking more comfortable, Martinez (an amputee himself) improved the lives of many future patients.


My Diary

Biblical Goliath may not have been a giant

David slays Goliath in this illustration by Gustave Dore from the Dore Bible, 1866. (Image: © Universal History Archive/Universal Images Group via Getty Images)

Goliath, the giant who was felled by King David in the Hebrew Bible, is described as having a jaw-dropping height.

But that number may not have been a true physical measurement but rather a metaphor, drawn from the width of his hometown’s city wall, new research suggests. That doesn’t reveal whether other aspects of the story are true — for instance whether Goliath was a giant or whether his mismatched battle with David took place.

“We’re not trying to make a statement on the veracity of the story,” said Jeffrey Chadwick, Jerusalem Center Professor of Archaeology and Near Eastern Studies at Brigham Young University, in a paper he presented at the American Schools of Oriental Research (ASOR) virtual annual meeting on Nov 19. “The issue is the metric,” he said, “where does it come from, where might it have been obtained?”


Amputation Leads to Prosthetic Advancement

In 1529, French surgeon Ambroise Pare (1510-1590) introduced amputation as a lifesaving measure in medicine. Soon after, Pare started developing prosthetic limbs in a scientific manner. And in 1863, Dubois L. Parmelee of New York City made a significant improvement to the attachment of artificial limbs by fastening a body socket to the limb with atmospheric pressure. While he was not the first person to do so, he was the first to make it practical enough to be used in medical practices. In 1898, a doctor named Vanghetti came up with an artificial limb that could move through muscle contraction.

It wasn’t until the middle of the 20 th century that major advancements were made in the attachment of lower limbs. In 1945, the National Academy of Sciences established the Artificial Limb Program as a way to improve the quality of life of World War II veterans who suffered the loss of limbs in combat. A year later, researchers at the University of California at Berkeley developed a suction sock for the above-knee prosthesis.


SoylentNews

Projects like these are steadily helping people with prostheses to move more naturally and easily than ever before. But what few people appreciate is just how far back this field actually goes. [phys.org]

If you were thinking a couple of hundred years, or maybe since the medieval era, you wouldn't even be close. Amputations and prostheses date back to ancient times, and saw advances that were heralded as no less life-changing then as they are today. It's a fascinating story of gods, gladiators and the limits of human endurance that adds a whole other dimension to understanding this discipline.

.

Whether survivors in the ancient era were injured in battle by a blade, spear or missile, or in camp by frostbite or trench foot, their arms, legs and extremities were incredibly vulnerable. In Ancient Greece, they benefited from simple surgical amputations as far back as the late fifth or early fourth century BC. The Hippocratic treatise On Joints [virginia.edu] attests to rudimentary amputations of fingers, toes, hands and feet, but cautions against amputating an entire arm or leg.

Around the same time, orthopaedic surgery had refined to the point that prostheses were starting to become available as alternatives to staffs, sticks and crutches. We see this in the account [usu.edu] of the Graeco-Persian War (499-449BC) by the historian Herodotus, for instance. Herodotus recounts how the Persian diviner Hegesistratus, when imprisoned by the Spartans, amputated part of his own foot to escape his shackles, then procured a wooden replacement.

Egypt was using similar technology around the same period. Prosthetic toes made from wood or layers of fibre known as cartonnage [ucl.ac.uk] have been recovered [thelancet.com] from burial sites, such as the one from a mummy near Luxor pictured below. They show signs of wear and tear, indicating that they were functional rather than purely cosmetic.

Technological, scientific, and medical progress are not as linear as we suppose.


Watch the video: Amputee Makes History with APLs Modular Prosthetic Limb (August 2022).