Ambrose Parè, a noted French physician, born in 1500, and called the father of French surgery, describes an artificial hand made of iron, with more perfect mechanism than the one worn by Göetz; in this hand the thumb is immovable and all the fingers are opened and closed simultaneously under the influence of a single spring.
During Ambrose Parè’s time efforts were made to restore natural movements of the lost parts in order to enable the maimed to perform all ordinary labor. Leather, paper, and other metals were substituted for iron. Parè leaves a figure of a leather hand, but without details as to its mechanism; it is apparently made with immovable fingers and thumb, but with a sheath inserted between the thumb and index finger for receiving a pen, etc. He further describes an artificial forearm, which can, by the aid of the sound hand, be brought into any degree of flexion and maintained there by the use of a pawl caught into meshes of a cog wheel. The artificial arms described by Ambrose Parè, although extremely heavy, seem to have been in favor until the latter part of the eighteenth century; at this time a monk of the order of Carmelites designed a hand made of sheet tin, with movable fingers and thumb, to be articulated by movement of the stump, but we are informed that it was too complicated to be used with any degree of success except in cases of amputation near the wrist joint. We have a description of an arm made subsequently of leather and covered with sheepskin, colored in such a manner as to represent the appearance of the human skin, and to make it appear more natural the nails were made of white horn. The improvements in the hand were mostly in the appearance, without any important addition to its utility or usefulness.
In 1818 a Dr. Graefe suggested the construction of an arm susceptible of manipulation by means of cords attached to a corset surrounding the shoulders, the arm to be moved without the aid of the sound hand. This principle of attachment for the movement of the forearm and fingers is followed to the present time with various modifications.
The early history of artificial arms seems to refer mainly to their special construction and application for people of renown who had suffered the loss of their natural extremities. Until a comparatively recent period the impracticability, on account of complicated heavy mechanism, and the great expense of these appliances, precluded anything like a general demand for their use. As the inventive geniuses of modern times have devised and produced so many labor and time-saving instruments and machines, that are, however useful, nevertheless the cause of much horrible mutilation of humanity, so also have they in some measure made compensation to the maimed by the progress and improvement attained in the utility of the appliances for the substitution of lost members. Simplicity of mechanism, the application of extremely light material in such a manner as to preserve the necessary strength, are the prominent features of progress in artificial arm construction, and in combination with the prevailing moderate prices, bring them into popular favor with those who have use for them.
However light, strong and mechanically perfect an arm and hand may be made, its success or failure—provided the stump is sound and of sufficient length—depends much upon the continued patience and perseverance of the wearer in getting accustomed to its use. The preservation of the form and the general improvement in the appearance produced by a properly constructed and comfortably fitted arm, to say nothing of its usefulness and convenience, should be an incentive to persistent effort on the part of the wearer to habituate himself to it, and if this is practiced for a few weeks there need be no fear of the ultimate result.
Sockets for the Stumps
For amputation below the elbow the neatest and best fitting socket is made from specially prepared stiff leather moulded over a cast of the stump, supported with a framework of steel and lined with buckskin or kid. The advantages over a wooden socket are that it is less clumsy, adheres more closely to the stump, that there is no danger of splitting, and withal is equally as durable. We make them, however, of wood if desired. For amputation above the elbow the artificial elbow is made of wood, and it is sometimes desirable to extend the wood upward in one piece to form the socket.
Aluminum
Much has been anticipated and hoped for in artificial limb work from this new and extremely light metal, but it has proved objectionable for any parts in both arms and legs that come in near contact with the stumps, owing to the rapid oxidization that takes place from perspiration, and its practical use is confined to fingers, toes, and such other minor fixtures as are not likely to come in contact with any part of the body.