The History of Prosthetics
The use of prosthetics dates back to the fifth Egyptian Dynasty (2750-2625 B.C.). Archaeologists have excavated the oldest splint from this period.
The earliest written reference to an artificial limb was either made between 3500 and 1800 B.C. written in Sanskrit in the Rig-Veda, an ancient poem. It recounts the story of a warrior, Queen Vishpla, who lost her leg in battle, was fitted with an iron prosthesis and returned to battle around 500 B.C.. Herodotus wrote about a prisoner who escaped from his chains by cutting off his foot, which he replaced with a wooden substitute.
A Roman prosthesis from the Samite Wars, dating back to 300 B.C., was unearthed at Capri in in 1858. It was constructed of a wooden core, bronze shin and leather straps.
Pliny the Elder (23-79 A.D.) wrote in “Natural History” about Marcus Sergius who led his legion against Carthage (now Tunis ). During the second Punic War (218 to 210BC) and the invasion of the Carthaginians, it is believed that an iron hand was made for the Roman general Marcus Sergius to enable him to fight in the war. His prosthetic hand had limited use, only allowing him to hold his shield.
16th Century
In 1508 the German knight, Gotz Von Berlichingen, lost his right arm in the battle of Landshut when cannon fire struck his sword, which then severed his arm. He was fitted with replacement hands which were capable of moving at the joint.
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. He is credited for employing an artificial joint in the construction of a prosthesis. Ambroise Pare created Le Petit Lorrain hand made of iron that operated by springs and catches. Pare also discovered that using boiling oil to treat wounds had a negative effect and recommended ligation instead of cauterization in amputations.
In 1816 the Anglesea or clapped leg was developed for the First Marquess of Anglesea after he lost a limb during the battle of Waterloo the previous year. The latter name was given to the leg because of the noise it made on full extension.
1861 – 1865, The American Civil War was influencial in the developing field of prosthetics with an estimated 30,000 amputees resulting from battle injuries.
In 1862 the US Government committed to supplying prostheses to veterans.
In 1863 the rubber hand was invented. The hands were cast on a mould made from a model of the natural hand. It was attached to the artificial forearm by the means of a spindle. The fingers were flexible and would yield under pressure.
In 1863 Dubois L Parmelee of New York City improved artificial limbs by attachting a body socket to the limb with atmospheric pressure.
In 1898 Dr Vanghetti invented a limb which could move through muscle contraction.
It was not until the 20th Century that the most significant contributions to prosthetics were made.
The Artificial Limb Service was first set up by the War Office during the First World War. Artificial limb ‘Shops’ had been established at Roehampton and the Charterhouse Hospital (near Smithfield ). Some 25, 000 amputees had been treated at the 900 bed hospital for the war wounded. Many other Limb Fitting Centres such as those at Cardiff and Manchester were also started in the country during the 1914-1918 war.
After World War 2, with the resultant huge increase in young amputees, the need for better limb services became more apparent. This led to technology being concentrated on the development of a new knee that would stabilise during weight bearing but swing freely during walking.
In 1932 the Limb Fitting Service came under the Ministry of Pensions. In 1948, with the advent of the National Health Service, amputees other then the war wounded were accepted as patients at the centres.
In 1946, a major advancement was made in the attachment of lower limbs. A suction sock for the above-knee prosthesis was created at the University of California (UC) at Berkeley.
In 1960 the Russians produced a functional moving hand.
The 1970s then saw the development of ‘Modular Assembly Prosthesis’ which allowed the assembly of a prosthesis to be manufactured from a series of stock components. Then, in the 1980s, with the development of materials in the aircraft industry, the world’s first carbon fibre prosthetic system was made. This technology promoted high strength and light weight system. Then with the development of CAD CAM, plastic moulded limbs were introduced, fitting comfortably over the residual limb. Cosmetic skin were also being introduced around this time thanks to the development in silicone technology.
In 1975, Ysidro M. Martinez, an amputee himself, invented a below-knee prosthesis with a high centre of mass but also lightweight enough to facilitate acceleration and deceleration and reduce friction.
Then in the 1990s, development into the first commercially available microprocessor controlled prosthetic knee was carried out. Called the intelligent prosthesis (IP), the unit is programmed to each individual user during walking to achieve the smoothest, most energy-saving pattern. It reacts to speed changes but its intelligence does not extend to understanding environmental considerations such as stairs, ramps or uneven terrain.
References:
The Scottish Home and Health department. The future of the artificial limb service. Report of a working party set up by the Secretary of State. (Chair Denny M) 1970.
McColl 1. Review of Artificial Limb and Applicance Services Department of Health & Social Security. HMSO, 1986.
Prosthetic Advisory Group to Minister for the Disabled. A Report of the Working Party (Chair Carter-Jones, L). College of Occupational Therapists; 1994.
Mechatronics Case Study: Prosthetic hand. Matthew Cook, Julian Duncan, Mike Gibbons,Ben Harvey and Graham Nicholson; 2001
The History of Prosthetics, Mary Bellis
