The Locksmith, the Surgeon, and the Mechanical Hand: Communicating Technical Knowledge in Early Modern Europe.

This article uses a locksmith's design for a mechanical hand in the surgeon Ambroise Paré's widely influential Oeuvres (1575) to examine the transmission of technical knowledge in early modern Europe. The article interprets Paré's chapter on artificial limbs through the lens of material culture, and then uses its findings to explore the movement of craft knowledge through print. A comparison between Paré's woodcut image of the prosthesis and an extant sixteenth-century mechanical hand from Kassel, Germany grounds Paré's woodcut in ongoing practices of making prosthetic technology. Analyzing the transmission of Paré's Oeuvres in light of the creative environment of artificial limb design and construction transforms our understanding of the potential utility of the printed image for different viewers. The dissemination of this woodcut design reveals a form of technical knowledge transfer that was endlessly adaptable to the experiences of artisans from different craft groups.

Survival to amputation in pre-antibiotic era: a case study from a Longobard necropolis (6th-8th centuries AD).

The Longobard necropolis of Povegliano Veronese dates from the 6th to the 8th centuries AD. Among the 164 tombs excavated, the skeleton of an older male shows a well-healed amputated right forearm. The orientation of the forearm fracture suggests an angled cut by a single blow. Reasons why a forearm might be amputated include combat, medical intervention, and judicial punishment. As with other amputation cases reported in literature, this one exhibits both healing and osteoblastic response. We argue that the forelimb stump morphology suggests the use of a prosthesis. Moreover, dental modification of RI2 shows considerable wear and smoothing of the occlusal surface, which points to dental use in attaching the prosthesis to the limb. Other indications of how this individual adjusted to his amputated condition includes a slight change in the orientation of the right glenoid fossa surface, and thinning of right humeral cortical bone. This is a remarkable example in which an older male survived the loss of a forelimb in pre-antibiotic era. We link archaeological remains found in the tomb (buckle and knife) with the biological evidence to show how a combined bioarchaeological approach can provide a clearer interpretation of the life history of an individual.

Giuliano Vanghetti and the innovation of "cineplastic operations".

OBJECTIVE: Developing functional artificial limbs for amputees has been a centuries-old challenge in medicine. We review the mechanical and neurologic principles of "cineplastic operations" and "plastic motors" used to restore movements in prostheses, with special attention to the work of Giuliano Vanghetti. METHODS: We evaluated original publications describing cineplastic operations, biographic information, writings, drawings, and unpublished letters from the Vanghetti library, preserved in Empoli, Italy, and performed a bibliographic search and comparison for similar procedures in the literature. RESULTS: Vanghetti's method for cineplastic operations differs from similar previous methods, being the first aimed at exploiting natural movements of the remnant muscles to activate the mechanical prosthesis, and the first to do so by directly connecting the prosthesis to the residual muscles and tendons. This represented a frame-changing innovation for that time and paved the way for current neuroprosthetic approaches. The first description of the method was published in 1898 and human studies started in 1900. The results of these studies were presented in 1905 and published in 1906 in Plastic and Kinematic Prosthesis. A German surgeon, Ferdinand Sauerbruch, often acknowledged as the inventor of the method, published his first results in 1915. CONCLUSIONS: Vanghetti was the first to accurately perform and describe cineplastic operations for patients following an upper arm amputation. He considered the neurologic implications of the problem and, perhaps in an effort to provide more appropriate proprioceptive feedback, he intuitively applied the prostheses so that they were functionally activated by the muscles of the proximal stump.

The \"Jaipur Foot\": India?s Most Popular Prosthetic for Amputees Is Not the Latest in Technology, but It's Still the Most Suitable Option for Many Patients Almost 50 Years after Its Development.

It is 8 a.m. on a December morning in Jaipur, Rajasthan, India. The day has just begun at Bhagawan Mahavir Vikalanga Sahayata Samithi (BMVSS), a nonprofit organization dedicated to fitting the disabled with artificial limbs (Figure 1). Slowly, patients from across India and neighboring countries gather in the center?s front yard. By the end of the day, more than 35 people will make a long journey back to their homes and communities outfitted with a new prosthetic leg or arm that will promise them a more active and functional future. The entire treatment is free.

Prosthetic Manhood in the Soviet Union at the End of World War II.

Millions of Soviet soldiers were disabled as a direct consequence of their service in the Second World War. Yet despite its expressions of gratitude for their sacrifices, the state evinced a great deal of discomfort regarding their damaged bodies. The countless armless and legless veterans were a constant reminder of the destruction suffered by the country as a whole, an association increasingly incompatible with the postwar agenda of wholesale reconstruction. This article focuses on a key strategy for erasing the scars of war, one with ostensibly unambiguous benefit for the disabled themselves: the development of prostheses. In addition to fostering independence from others and ultimately from the state, artificial limbs would facilitate the veterans' return to the kinds of socially useful labor by which the country defined itself. In so doing, this strategy engendered the establishment of a new model of masculinity: a prosthetic manhood.

Crutch art painting in the Middle Ages as orthopaedic heritage (part II: the peg leg, the bent-knee peg and the beggar).

Little of historical value about crutches can be ascertained before the Middle Ages. In contrast, the Middle Ages offer many examples for the study of crutches. Even if no medical report can be found, the immense patronage of the Church, encouraging artists to portray the saints and their miracles, has left great masterpieces that drew people with crutches. Pictures and the history of medieval conceptions of disability appear to provide an interesting chronicle of surgery of the peg leg and the bent-knee peg among the representations of cripples and beggars.

[[Medico-historical findings of (neuro-) prosthetics: an online survey]. / Medizinhistorische Fundstücke aus der (Neuro-)Prothetik: eine Online-Analyse.

This article presents an online survey on medico-historical (neuro-)prostheses. Important findings of the past 3000 years are outlined: toe prostheses from ancient Egypt, the Capua leg prosthesis, Götz von Berlichingen's artificial hands and Sauerbruch's prosthetic arm. These historical examples are compared with modern neuroprosthetics. It is also shown that historical prostheses were in no way primitive and, even more, that ancient people already used first intelligent medical engineering approaches.

[Amputation and equipment of the lower limb during the Revolution and the Empire]. / Amputation et appareillage du membre inférieur pendant la Révolution et l'Empire.

During the French Revolution and Napoleon's campaigns, above-knee or below-knee amputations were performed either immediately or with a delay, which favoured septic problems. A rapidly operated amputation by a well-trained surgeon was the best way to save the life of a soldier who suffered from an open comminuted fracture of a limb. The conditions on military campaigns were indeed hard ones: doctors and surgeons had practically no resources and the transportation of severely injured persons was difficult. Such conditions favoured the pain and the danger caused by an injury, and it was rather impossible for the medical corps to lavish repeated treatments on the wounds. The amputated soldiers were then given prostheses: either a traditional peg-leg, with a flexed knee joint for trans-tibial amputations, or an "imitative" prosthesis, which tended to look like a real leg with eventually an articulated knee or foot. The author mentions famous or unrecognized amputated men, describing significant events.

Limb amputations from the ancient times to the present.

Amputations, or the removal of limbs at different levels, have been performed since the ancient times. The first reports of amputations originate from the ancient ruins in Egypt, where primitive prosthetic toes were found in the tombs of the Pharaohs. In Europe, during the period of ancient Greece and Rome, various examples of amputations were described on amphoras and mosaics. During the middle ages, the body was marginalized and replaced by the worship of human spirituality. As a result reports of amputations from that time period are scarce. True development of amputation and prosthetic techniques took place during the Renaissance and centuries that followed. Present-day indications for amputation are similar to those utilized in the ancient times. The greatest development of limb amputation techniques and prosthetic methods began in the 20th century and continues to this day. Despite the development of new techniques in prosthetics, many solutions have their roots in designs originating in the ancient times and differ only in their structural design.

Ambroise Paré IV: The early history of artificial limbs (from robotic to prostheses).

One of the earliest written references to prosthetics is found in a book published in France in 1579. That year, French surgeon Ambroise Paré (1510-1590) published his complete works, part of which described some of the artificial limbs he fitted on his amputees. As a military surgeon, Paré had removed many a soldier's shattered arm or leg, and he eventually began designing and building artificial limbs to help the men who had been maimed.