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A Great War Led to Great Prosthetic Strides

World War I was one of the largest battles in history. Mostly fought in Europe between 1914 and 1918, it claimed more than 17 million lives. Another 20 million were wounded, many losing arms and legs.

A ‘crop of bionic men’

“World War I slaughtered and mutilated soldiers on a scale the world had never seen,” Thomas Schlich, professor in History of Medicine at the Department of Social Studies of Medicine at McGill University, wrote in a 2014 CNN article titled, “The ‘bionic men’ of World War I.” “It is little wonder that its vast numbers of returning crippled veterans led to major gains in the technology of prosthetic limbs.”

According to Schlich, almost every modern prosthesis is rooted “in the technological advances that emerged from World War I.” That might seem hard for prosthetic manufacturers, prosthetists and physical therapists to believe. Prostheses in World War I were still being made of wood, steel and leather. The plastics age had yet to dawn. Titanium, carbon fiber and myoelectric technology were decades in the future. Nonetheless, Schlich wrote that World War I “produced its own crop of bionic men.”

Requirements for use

The war was a year old when the German Association of Engineers devised guidelines that established the basic requirements for an artificial arm suitable for artisans, skilled workers and other laborers, according to Heather Perry in Recycling the Disabled: Army Medicine and Modernity in World War I.

The prosthesis was to be for work, not for show. The device also had to be simple enough for the amputee to put it on and take it off, clean it and keep it in good working order, all by himself, Perry wrote.

The source for movement had to be an uninjured part of the body, ideally the shoulder. “The arm stump should not serve to carry the tool holder or be cramped by the prosthetic sleeve,” according to Perry, adding “the stump’s potential for movement should be maximized.”

Statue, located in Messines, Belgium, depicts German and British soldiers shaking hands during Christmas truce of 1914.
Statue, located in Messines, Belgium, depicts German and British soldiers shaking hands during Christmas truce of 1914.

Image: Craig B, O&P News.

In addition, to keep costs down, the same arm should be suitable for right- and left-handed wearers employed in all lines of work, as well as “resilient and reliable enough for all necessary uses.”

The ‘Work-Arm’

An example of a universal prosthesis was the “Work-Arm,” for war-injured craftsmen, workers and farmers, invented in 1916 at the Siemens-Schuckert factor in Nuremberg, Germany. “The device was a tool holder with interchangeable working implements” Perry said.

The arm featured a leather harness, which was strapped around the amputee’s body, and a metal shoulder ring, which fit around the residual limb. A pair of metal rods extended down from the shoulder ring to form the upper arm of the prosthesis. At the end of the arm was a metal joint in which any number of specially designed working hands could be inserted and fastened. The interchangeable tools included hammers, clamps, forks and hooks and could be bought through mail order catalogs. The arm also could accommodate most tools made by other companies.

It was hailed as “the first artificial arm which has been constructed exclusively as a work-tool. The uncompromising implementation of this idea – to create a machine and not an ‘arm’ – led logically to considerable divergence from all previous systems,” Perry wrote.

While it was inexpensive to produce, it was not cheap to buy. Nonetheless, orthopedists endorsed the Work-Arm, which was considered revolutionary for its time.

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Merging man and machine

According to Schlich, prostheses like this “literally merged man and machine, leaving the disabled man firmly attached to his workstation. An amputee veteran would arrive at his workplace in the factory, hook up the remaining part of his limb to the prosthesis, which in turn would be linked to one of the industrial machines in the factory. He would work for hours like this as a link in a functional kinetic chain.”

He added, “The image of men tied to their work resonates unsettlingly with Karl Marx’s prediction that the urban proletariat would one day become a mere ‘appendage of the machine.’” It is an example of how military and industrial conceptions of the body were extended to dehumanize the body itself.”

Likewise, in Finding Common Ground: New Directions in World War I Studies, Jennifer Keene and Michael Neiberg wrote, “in trying to maximize … labor potential, many arms physically transformed its wearers into interchangeable workers who could be appended to any one of a number of industrial machines within their own factory.”

Thus, engineers who designed such worker limbs “were part of a rationalization or industrialization of the disabled body which stemmed from new ideas about physical rehabilitation so that through the advent of modern technology, some of these men became living appendages to the war machine itself — rationalized, industrialized, optimized workers.”

On the other hand, “some visionaries, of course, embraced prosthetics as a means for human transformation, as if the body were a malleable object that could be dignified and enhanced by technology,” Schlich wrote. “And some thinkers go even further and interpret technological enhancement as the next step in human evolution.”

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