Manual of Artificial Limbs Lays Blueprint for A.A. Marks Company


The A.A. Marks Company claimed it was the world’s largest manufacturer of artificial arms and legs. But the pioneering O&P firm is probably best remembered in the industry for a classic in trade literature, the Manual of Artificial Limbs.

Illustrated Handbook

Veteran orthotists and prosthetists know the illustrated handbook, which Ted Trower, the owner of A-S-C Orthotics & Prosthetics, described as “part textbook, part mail order catalog and a large part sales pitch.” Based in Jackson, Mich., A-S-C posted the manual on its Web site “with the consent and cooperation of Winkley Orthotics & Prosthetics who purchased the A.A. Marks Company in 1957.”

Located at 701 Broadway in New York City, A.A. Marks operated in a five-story building with a two-level basement.

“The capacity represents an output larger than the aggregate of any other ten artificial limb factories in the world,” Scientific American magazine reported.

Marks sold prostheses by mail order and fitted them in person.

“We have endeavored to emphasize the fact that personal fittings for simple amputations are, as a rule, unnecessary and that we do not advise anyone to go to the expense and annoyance incident to visiting the manufacturer without first making the attempt by measurements,” the manual advised.

The handbook said amputees uneasy about measuring themselves should get help from their “physician or druggist, or upon one whom we will designate.” Marks pledged to adjust mail order limbs at no extra charge.

The manual recommended personal fittings for amputees who had “stumps with abnormal conditions, incapable of being explained either descriptively, diagramatically or by casts.” The same was true for “all deformity cases.” The booklet promised that “those who come to us for personal attention will be welcomed and promptly attended to on their arrival.”

Convenient Hours, Location

Marks was open from 7 a.m. to 5 p.m. Mondays through Fridays and 7 a.m. to 3 p.m. on Saturdays. The manual included a map showing the company’s location, which was “central and accessible by electric, surface, elevated and subway cars.” A ride on an elevated train, including a transfer, cost a nickel, according to the manual.

Company staffers were available to pick up out-of-town customers at city piers, ferry landings or train stations.

“If the arrival occurs after business hours it will be well to go to some reputable hotel near by and remain over night,” the manual advised. “We suggest the Broadway Central Hotel, 671 Broadway, which is within three hundred feet of our establishment.”

The manual clued customers planning to come by carriage that one-horse hack drivers could only charge a dollar for carrying one or two passengers up to two miles. The fare was $1.50 for up to three miles.

  Besides testimonials, the manual and other Marks literature was filled with copious engravings and photos of amputees going about their business with Marks limbs. Other artificial arm and leg manufacturers similarly marketed their prostheses.

“As we are located within two miles of every railroad and steamboat terminal, it will be seen that one dollar or one dollar and a half is the most that legally can be charged,” the manual explained. But more than two persons riding in a two-horse carriage had to pay extra.

“It is always best to make a bargain with the driver before entering his vehicle,” the manual proposed. For the convenience of mass transit patrons, police were always available to provide “such directions and information as may be needed,” according to the manual.

Marks also made house calls to amputees needing prostheses “if expenses and extra time are paid for.” In addition, the company assured that women who wished “to be waited upon by one of their own sex will find women in our office for their accommodation.”

Largest Supplier of Limbs

A.A. Marks started his company in 1853 “for the purpose of relieving and helping the maimed and deformed,” according to Dr. James Law, who wrote an introduction to the Manual of Artificial Limbs in 1907. By then, Marks was the biggest company in the world “devoted to the manufacture of artificial legs or artificial arms,” Law said. “The business is … conducted in a large way by men thoroughly familiar with every detail of artificial limb manufacture; men who have brought to it the widest practical knowledge and years of the most attentive study and effort.”

Besides limbs, Marks also manufactured push-button, folding pocket knives — including an improved knife-fork combination model — crutches, crutch tips and wheelchairs. Marks cutlery was suitable for amputees minus a hand, according to the manual. Wheelchairs — “Invalid Rolling Chairs” — were for sale or rent.

Marks soon had a rival in J.E. Hanger, who began his pioneering orthotics and prosthetics firm in 1861. Ultimately, Hanger outlasted Marks; today his company is the Hanger Orthopedic Group. Winkley, headquartered in Golden Valley, Minn., liquidated A.A. Marks after buying the firm 45 years ago.

According to the manual, Marks was heaped with honors for his artificial limbs. Apparently, he first displayed his prostheses in 1858 at the Crystal Palace in New York City. Because the exhibition hall burned, no prizes were given. But in 1859, Marks won what was evidently his first award, a silver medal from the American Institute of New York City.

Two years later, the Civil War broke out, and in 1862 Congress passed a law granting one free limb to each honorably discharged Union veteran. Marks became a prime supplier of prostheses to blueclad soldiers and sailors who sacrificed arms and legs in America’s bloodiest conflict, wrote Katherine Ott in Artificial Parts, Practical Lives: Modern Histories of Prosthetics, a collection of essays published by New York University Press.

After the war, Marks and Hanger won several government contracts to furnish amputee vets with prostheses. Demand for Marks and Hanger prostheses also increased as America’s rapid postwar industrialization took a grim toll in worker limbs.

Top Honors

While Hanger sprouted branch offices in different cities, Marks stayed put in New York City. Taking a none-too-subtle swipe at the competition, the manual explained, “Our profession is like that of a surgeon. Our skill and judgment cannot be relegated to one in charge of a branch establishment. If we were to establish branches we would have to place them under the management of others and would, more or less, jeopardize the welfare of our patrons. As substitutes for branches, our system of fitting from measurements has been devised and has been found adequate.”

Marks’ specialty was artificial arms and legs fitted with rubber hands and feet, which the company invented and patented, Law wrote. “The spring mattress rubber foot and the rubber hand with ductile fingers are the most recent improvements.”

In the late 19th-century, Marks won more awards at a number of expositions, most of them hosted by the American Institute in New York City. The company won top honors, too, at the World’s Columbian Exposition in Chicago in 1893, according to Law. A famous world’s fair, the Columbian Exposition lasted six months and attracted millions of visitors.

Manufactured Prostheses

  Marks’ specialty was artificial arms and legs fitted with rubber hands and feet, which the company invented and patented.

Evidently many fairgoers marveled at Marks-manufactured prostheses.

“In an impressive bid to capture visitors’ attention, the firm had constructed four large display cases roofed by a gilded dome and a ‘colossal golden leg’ that towered over the surrounding exhibits,” Stephen Mihm wrote in Artificial Parts.

A company pamphlet explained that each case “contained artificial limbs for amputations in the hips, thighs, knees, ankles, feet, shoulders, arms, elbows, forearms, wrists, hands and fingers.” There were more than 50 limbs in all. “Though the Marks Company took the highest award on this occasion, it was not for lack of competition,” Mihm wrote. “In a testament to the demand for prostheses, no fewer than nine manufacturers of artificial limbs had assembled on this occasion to display their wares.”

Marks captured a medal and diploma for points of excellence earned by its rubber foot, knee joints and rubber hand. The exposition’s Board of Lady Managers also awarded Marks a pair of diplomas for superior design and invention, the manual said.

By 1907, according to Law, Marks had earned “46 first and highest awards” in competition with other limb makers. More important than prizes, he added, were “the freely proffered expressions of regard and satisfaction from its clients, from the men and women who have been helped and whose lives have been aided and bettered through the use of its apparatus.” Such was “the very highest measure of praise one can hope to receive,” the doctor said.

Prostheses for All

According to Law, Marx made artificial arms and legs suitable for the widest range of amputations, from the simplest to the most complicated. The firm “has developed special types of limbs for groups of special cases, many of which are of utmost complexity; it has fitted and helped persons with delicate and tender stumps, also many with stumps of awkward shape and difficult forms; it has applied artificial limbs and appliances to persons with one sound limb as well as to those who have been deprived of both, and the volume of testimony it has received from its clients, filled with gratitude, stimulates it to continued endeavors.”

The manual included about 800 testimonials from Marks customers. “… I had an artificial limb made by you and it fitted well,” Ida Albury reported from the Bahamas. “I have a family of six and I do all the work myself; I don’t know any woman in the town that can do harder work than I.”

Railroad brakeman Charles C. Anders of Northampton County, Pa., said he never took off his Marks leg except to sleep.

“I have walked as far as twelve miles in one day,” he added.

Engineer William J. Angier of Wake County, N.C., was grateful for his Marks artificial leg.

“I am running a locomotive every day, hauling passenger trains, and I am never inconvenienced in any way,” he claimed.

Farmer and clerk Harmon Daily of Essex County, N.Y., bought a pair of prostheses from Marks after an accident claimed both of his legs below the knees.

“I have to be on my feet 16 hours out of every 24,” he wrote. “I can follow a plow or hoe and can do almost anything that I did before I lost my legs. I can climb a ladder no matter how tall, and when I get to the top I feel as safe as I would be on the ground.”


Besides testimonials, the manual and other Marks literature was filled with copious engravings and photos of amputees going about their business with Marks limbs. Other artificial arm and leg manufacturers similarly marketed their prostheses.

In their catalogs, Marks and other limb makers commonly published images of working men using farm equipment and heavy machinery. “Such images demonstrated the viability of an artificial arm that in no way compromised either the worker’s masculinity or his ability to earn a living,” Ott wrote.

Likewise, Minh pointed out that “in their depiction of middle-class amputees, companies made a point of showing off how well the limb concealed their condition … Typically, they presented a ‘before and after’ series of images that showed the amputee seated on a chair, and then standing without evidence of the leg.”

Marks published trade cards that had the company logo on one side and, on the other, images of amputees with and without their limbs.

“Superimposed onto one frame, these photos offered dramatic evidence of the ability of these prostheses to make a man ‘whole’ again,” Mihm wrote.

Authority on Prostheses

  In Manual of Artificial Limbs, Marks made artificial arms and legs suitable for the widest range of amputations, from the simplest to the most complicated.

Marks didn’t shy from other forms of self-promotion in the book.

“The book is destined to be an authority on the important subject of prostheses, a book of interest and concern to the surgeon and physician as well as to the maimed,” Law predicted.

He pinned plaudits aplenty on the company that produced the manual. “That the house has grown from a small shop to a vast manufacturing establishment with a hundred thousand correspondents located in all parts of the world is due not only to the intelligent way in which its business has been conducted, but to the inherent merits of its products,” Law said.

In a rare flash of modesty, Law demurred that Marks “does not claim that every maimed and crippled person can be restored to the full use of his extremities by its apparatus.” But the physician also posited, “It is reasonable, however, to claim that its skill and facilities enable the firm to help the maimed better and more thoroughly than any other establishment in the world, and as the house has helped so many in the past there is abundant encouragement for the maimed of the future.”

Marks doubtless was heartened when it landed another lucrative government contract in 1904. The U.S. Panama Canal Commission chose Marks to supply prostheses to construction workers who lost limbs digging the canal between the Atlantic and Pacific oceans. The company responded with a solid ankle, rubber-soled foot that was ideal for the steamy jungle heat of Panama, said Fred Eschen of Eschen P&O Labs Inc. in New York City.

World War I

Demand for Marx limbs increased again after the United States entered World War I in 1917. The Army wanted a steady supply of prostheses for an anticipated flood of amputee veterans. To that end, the brass summoned Marks and other limb makers to Washington, D.C. The group became the Artificial Limb Manufacturers Association, ancestor of the American Orthotic and Prosthetic Association.

By the time World War II began, Marks was on the wane as a leader in the orthotics and prosthetics industry, Eschen said. All that is left of A.A. Marks are memories and its storied Manual of Artificial Limbs.

Textbook and Mail Order

A-S-C’s characterization of the booklet as “part textbook, part mail order catalog, and a large part sales pitch” is accurate. But A-S-C, Winkley, Hanger and every other modern producer of orthotics and prosthetics would doubtless agree with the sentiment of another observation from Dr. Law, one that doesn’t have the hollow ring of a sales pitch.

“Modern skill,” Dr. Law wrote, “has brought no more useful aid to humanity than the artificial limb which transforms a helpless member of society into a useful one.”

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