Our experience has been gained in connection with the Fédération des Mutilés, where hundreds of disabled men have been examined and fitted, and where we have always tried to give to each that appliance which is best suited to his work.
For this indeed is the vital principle, and great disappointments will result if, for æsthetic reasons, every patient is given the same appliance, whether it be the leg known as the American leg or an elaborate artificial arm. More often than might be believed accurate imitation of the external form of the natural limb is incompatible with good functional use. This is particularly so in the upper limb.
Perhaps the readers of these pages will gain a clear understanding of these principles; and we shall have attained our object if by enabling them to understand certain typical appliances we make it possible for them to devise others which are at the same time strong, shapely and practical.
Throughout the volume it will be found that we express a preference for the construction of artificial limbs for the lower limb out of wood, the method adopted by the Americans. This procedure, because strength and durability are so necessary, seems to us to constitute a very real advance; these considerations are, however, of much less importance in the case of the upper limb. It is a matter for regret that the French official instructions have not compelled our manufacturers to adopt this technique, too often the latter are inclined to keep to their old routine, but they can be induced to alter it, as we have proved by our success at the Fédération des Mutilés.
There is nothing revolutionary in such a suggestion. It has been adopted by the Belgian Government in the fitting centres which they have established; this is also the case with the English authorities, who, we understand, have even attracted from America special fitters for this work. We should have thought that we, in France, might have developed our national supply of artificial limbs in the same direction.
INTRODUCTION TO THE ENGLISH EDITION
The details of the manufacture of artificial limbs naturally differ greatly in different countries. So much so that at first sight it might appear useless to introduce into England and America the account given in this work of the methods adopted in France. But, as the authors state in their preface, the principles remain the same whatever the details of the methods used. In the lower limb the essentials to be studied are the points upon which weight can be taken, the "Bearing Points," the proper method of fitting the stump, the principles of securing stability and the mechanism of the knee and ankle joints. These remain unalterable whatever be the material used and whatever be the details of manufacture.
In England it has for a long time been understood that every sailor or soldier who has lost a limb has the right to expect that he will be supplied with a good artificial substitute. And, further, it has been taken for granted that this will, in the case of the lower limb, be a full artificial leg and not a peg leg. Therefore the standard pattern has in England been a full limb, and the peg has only been supplied as a temporary appliance, and as an alternative appliance to be used when the other limb requires alteration or repair. For this reason the possibilities of the peg leg, except in its simplest form, have perhaps been neglected in this country, and a study of the French methods of making these peg legs, particularly the convertible peg leg, is well worth while.