Sunday, 16 February 2014

From Wood to Cyber: The American Civil War and the Advancement of Prosthetics

This week I read an article in the MIT Review (December 2013) on how a new prosthetic hand can now send signals to its wearer. The Cleveland Veterans Affairs Medical Center and Case Western Reserve University (big enough name!) has developed a hand that can sense touch and not squeeze things to mush by stimulating nerve bundles—which died or were lopped off—in the prostetic hand. 

A video shows a man who lost his right hand in an accident three years ago using the hand to pick up and remove stems from cherries. How it does it is the force detectors on the fingers of the hand convey touch information directly to three pea-sized nerve interfaces surgically implanted in his lower right arm. The wearer controls the hand through a technology called a myoelectric interface, which uses signals from the muscles in his lower arm.

Wow. Big departure from wearing a peg leg! How did we get here? Thank the Americans and their Civil War. (1861-1865) Before that...

Egyptian Fake Toe - and the foot still attached. Ummmm….

Prosthetic limbs have existed ever since people needed a helping hand or foot. Romans use to make limbs out of iron for soldiers who lost bits in battles. Further developments in movement, wearability and realism continued, but the biggest jump was during and after the Civil War. New advancements of technology in weapons, especially riffles which could now be loaded quicker and now used round balls that exploded on impact, which led to a huge level of shrapnel and disfiguring, not killing, wounds. Diseases as well such as gangrene also rotted away bodies but did not always kill. Estimates from records are that over 60,000 amputations were done.

Four years of death and dismemberment resulted in many men needing artificial limbs to go back to some normalcy. This created a rise in manufacturing of limbs. Hello capitalism!

About 150 patents were issued for artificial limb designs between 1861 and 1873. To be able to afford a new appendage, the Federal government allocated in 1862 Union veterans $75 to buy an artificial leg and $50 for an arm, and by 1864 the Confederacy was also providing financial assistance for such purchases. The payments usually covered the cost of the device and travel to a showroom for it to be fitted. Others refused to wear them however as a sign of their sacrifice and a reminder. The idea , however, that false limbs could be functional and look natural was born of this period.

nullBefore wood and steel were the materials, but the discovery and commercial use of rubber with its resiliency, flexibility, and more natural appearance was more appealing to veterans. With fingers that could move under pressure, some had lifelike action to hold small objects like a fork or pencil. The odder adaptations were making the limb into a Swiss Army knife, where you could detach it and add hooks, brushes, sawing attachments, or other accessories. In this picture the mass manufacturing of limbs, which gives a new meaning to arms factory. (You know I was going to go there eventually)

Left, one of James Hanger’s early patents from 1891 shows his novel hinged mechanism. Image courtesy Right, Samuel Decker was another veteran who developed his own mechanical arms, and later went on to become an official Doorkeeper at the U.S. House of Representatives.

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