Getting a Leg Up: A Brief History of Prosthetics through the lens of our collection

Though Ernest was a farmer, and—according to family—was not a particularly wealthy individual, he was lucky enough to acquire two full, well-made, advanced prosthetic legs.

The history of an individual prosthetic limb can be difficult to trace, as good documentation is often lacking. The Museum of Health Care at Kingston has six prosthetic limbs in its collection, and two more waiting to be accessioned from the 1910s/20s—all of them legs. Our six artificial legs originate from a range of time periods; our oldest from the 1840s, one estimated from around World War One, two from the 1930s, one from the 1950s, and one from the 1960s. However, we know very little about the history of most of these prosthetic limbs because for many years there was little advancement in the field of prosthetics, and because the aforementioned lack of documentation makes any individual limb’s history difficult to trace.

Ernest Hannah and his family
Ernest Elmer Hanna (Second from the right) and his Family (Photo courtesy of Heritage Place Museum, Lyn, ON)

That name is Ernest Elmer Hanna. Born in 1896 in the village of Lyn, Ontario, Ernest Hanna was a farmer, as his father was before him, and as his son Raymond was after him.[1] In 1920, he married Pearl Green, and they had two children who survived into adulthood; Raymond and Leona.[2] Around the year 1931, when he was about thirty-five years old, he lost his left leg above the knee in an accident. There are multiple accounts of the accident, but they all agree that Ernest was driving a horse and carriage (in one version it is a sleigh, and in another he is helping fill in a swamp in front of a nearby farm[3]) when his horse bolted and caused the accident in which Ernest broke his leg. Ernest allegedly sustained a compound fracture of his femur; an injury which entails part of the broken bone coming through the skin. This causes greater risk of infection, and, because the femurs are the most irrigated bones in the body, there is also a risk of a fatal haemorrhage if the bone is not set in time. Unfortunately for Ernest Hanna, his limb became infected. Gangrene set in, and his leg had to be amputated.[4]

2560px-Dry_gangrene_of_the_foot_and_ankle_Wellcome_L0061216
Watercolour by thomas Godart of dry Gangrene of the foot and ankle (Photo Courtesy of the Wellcome Collection and St. Batholomew’s Hospital Archives & museum

Compound fractures and gangrene were not uncommon causes for amputation in the past; in 1899, they were listed among the most common and necessary of all. In addition, other medical issues demanding amputation included lacerated and contused wounds, diseases of the bones and joints, and malignant tumours.[5] From the 1930s to the 1960s, this began to change, and the most common causes of amputation we find today became more prevalent, these being vascular disease, diabetes, and cancer, as well as trauma.[6] Most of the common causes of amputation at the turn of the last century had their roots in either trauma (injury) or infection, and in many cases, a combination of the two, as in the case of Ernest Hanna.

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Tools from a 1860s Amputation and surgery Kit in the Museum of Health Care collection.

Though Ernest was a farmer, and—according to family—was not a particularly wealthy individual, he was lucky enough to acquire two full, well-made, advanced prosthetic legs. Both were made of strong wood, leather, and metal, had strong knee joints, and were painted to match Ernest’s skin tone. They apparently lasted his entire life. One, slightly heavier than the other and with a larger strap, was his “working leg”, while the other was his “Sunday leg”.[7]

Ernest Hanagh Sunday Leg
Ernest Hanna’s Sunday Leg 
Working Leg
Ernest Hanna’s Working Leg

In the 1930s, as now, prosthetic limbs were an expensive commodity, and it is unknown how Ernest managed to pay for them, nor from where he got them. It is possible that they were made for him by someone he knew, or by a maker in a nearby city. The Government of Canada sometimes also produced prosthetic limbs, such as the leg in our collection from the 1960s, but these would have most likely been made for war veterans as opposed to civilians like Ernest Hanna. Ernest could conceivably have ordered his prosthetic legs from a catalogue, as some surgical instrument makers made prosthetic limbs. One such business was the A. S. Aloe Company of St. Louis, Missouri, U.S.A. In their catalogue for 1895, a section was devoted to prosthetics of all kinds, which included specific instructions for ordering. To order a limb from the catalogue, the patient had to send in all of the pertinent measurements, and sometimes even a plaster cast of the residual limb. The Aloe Company advised and preferred that the patient travel to St. Louis to be fitted for a limb in person to ensure accuracy, but they could prepare a limb based solely on measurements if need be.[8]

The Aloe Catalogue not only provides insight into the process of obtaining an artificial limb, but also into the cost to patients. In 1895, the most advanced leg listed in the catalogue was McCullough’s Improved Artificial Leg, which closely mimicked the human form and had well-fitting joints. It cost one hundred dollars for a full leg prosthetic. A simple peg leg, by contrast, only cost fifteen dollars.[9] For this reason, a peg leg was sometimes nicknamed the “poor man’s peg”. It was recommended that an amputee have two prosthetic legs, in case one needed repairs or there was an emergency. Broca and Ducroquet’s book Artificial Limbs, part of a series called Military Medical Manuals produced in France in 1918, recommended that the spare limb be a peg leg, as it could be purchased by poor patients who could not afford two full legs.[10]

Prosthetic Legs improved.jpeg
A. S. Aloe Company, Inc., Aloe’s Illustrated and Priced Catalogue of Superior Surgical Instruments, Physician’s Supplies, and Hospital Furnishings, 6th ed. (St. Louis: A. S. Aloe Company, 1895)

Along with the advantage of being much cheaper than more complex legs, the peg leg was light, and gave good support for walking. However, Ernest’s full leg, though heavier and more expensive, would have been much better than a peg leg for sitting down, as well as walking on rough terrain.[11] A peg leg could also be substantially more painful than an improved one. Patients who had amputations below the knee and wore a peg leg in which their knee remained bent often found themselves in so much pain that they would plead with the doctor to amputate further.[12] Furthermore, a peg leg would not serve to hide the amputation; it did not look like a real leg. This often meant a great deal to people, and in Ernest Hanna’s case, he went so far as to thumbtack a sock to his artificial leg to increase the appearance of normalcy and make it match his remaining leg as closely as possible. Ernest walked with a cane or crutch and may have had a swinging gait, but he was able to spend the remainder of his life working on his farm despite his amputation.[13]

peg leg
1840s Peg Leg from the Museum of Health Care Collection

Ernest Hanna passed away on February 18th, 1969. His family assumed that he had been buried with his prosthetic legs, but they were later found in the possession of Ernest’s son Raymond, who had kept many of his family’s things in trunks after they died.[14] While Ernest had kept the same two legs over the course of his life, advancements were being made in the field of prosthetics. Until the 1960s with the introduction of hydraulics, not much innovation had occurred over Ernest’s lifetime, besides a general shift away from wood, leather, and metal in favour of plastics, such as the kind used in the limb in our collection for 1961.[15] Today, myoelectric limbs and 3D printing are at the forefront of prosthetic technology.

3D-Printed-Prosthetics-Where-We-Are-Today-IMG-04
Industrial Design Student, William Root, has 3D printed an Exo Prosthetic Leg, printed using Titanium. (Photo Courtesy of the Amputee Coalition)

Myoelectric prosthetics, though mostly used for hands, are a break from the traditional “body-powered” prosthetics of the past. Body powered prosthetics use the movements of the amputee in other parts of the body; for instance, a prosthetic arm might be controlled by movements of the chest, shoulder, and remaining arm. Instead of using body movements to cause a prosthetic arm to move and flex, myoelectric arms use the natural electrical signals from the amputee’s muscles in the residual limb to function.[16] 3D printed prosthetics provide a lighter, cheaper alternative to myoelectric limbs for those who find them too heavy or cannot afford them.[17]

According to certified Prosthetist Martin Robertson of V2innovations Orthotics and Prosthetics, if Ernest had lost his leg today, “a very basic trans-femoral prosthesis would cost ~ $7500.00 in Ontario.”[18] It can be difficult for amputees to find limbs to suit their needs within their budget. Perhaps the most difficult is the case of child amputees, who need to have their limbs replaced more often than adults as they grow, adding to the cost. Luckily, much of the cost can be covered through Ontario’s Assistive Devices Program, and non-profits like the War Amps are also helpful resources for amputees. As well, the rise of the disability rights movement has helped gain attention and support for amputees looking to acquire artificial limbs. Furthermore, these limbs no longer need to look so much like their natural counterparts to hide the amputation; an artificial limb can even become a source of pride and beauty for its wearer.

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V2Innovations Mobility for Life Prosthetic leg (Photo Courtesy of V2Innovations and Össur Life without Limitations)

Having Ernest Hanna’s prosthetic legs in our collection gives us insight into the history of prosthetics as a whole, and allows us to delve deeper into the history of the other limbs in our collection. With time and research, we may yet be able to tell their stories, and the stories of those to whom they belonged.


Special Thanks

Special thanks to John Mack of the Heritage Place Museum in Lyn, Ontario for helping me with research on Ernest Hanna and putting the question out to his community. Thanks to the residents of the Village of Lyn!

Thanks as well to Kim Reid of the Peterborough Museum and Archives for helping put me back on the right track when I found a completely different Ernest and Pearl Hanna who had lived in Peterborough.

Thanks to Martin Robertson of V2innovations Orthotics and Prosthetics for answering my questions about modern prosthetics!


About the Author: Shaelyn Ryan

Shaelyn

Shaelyn Ryan is an undergraduate student in the department of History at Queen’s University, starting her third year in the fall. She is a summer student at the Museum of Healthcare at Kingston this summer and has been working at the museum for the past year. This summer, she is helping to catalogue and research the museum’s collection of artefacts as a Collections Technician


Citations

[1] Affidavit of Marriage, Ernest Elmer Hanna to Pearl Olive Green, 11th of June, 1920, Leeds County, Ontario, Ancestry.ca records.; Tanya Garofalo, interview by Museum of Healthcare at Kingston, March 6, 2012.

[2] Affidavit of Marriage, 1920.; Leona Aytheryne Foley obituary, Kingston, Ontario, The Kingston Whig Standard, 22 October 2005, https://www.genealogiequebec.com/necro/ontario/kingston/the-kingston-whig-standard-on/60540/HANNA-Leona-Aytheryne/obituary.

[3] Garofalo, interview.; Carole Bourret, July 18th, 2018, 5:00 p.m., comment on Heritage Place Museum, Lyn, “Ernest Lloyd Hanna”, Facebook, https://www.facebook.com/heritageplacemuseum/posts/1777006975752414.

[4] Ibid.; Ibid.

[5] William W. Keen, J. William White, et al., eds., An American Text-book of Surgery, For Practitioners and Students, 3rd ed. (Philadelphia: W. B. Saunders, 1899), 1151-1152.

[6] Ralf Lindholm, “Features of Amputation Surgery Among Civilians During the Period 1930-1960,” Acta Orthopaedica Scandinavica 35 (1964): 85, DOI: 10.3109/17453676508989341.; “Limb Loss Statistics,” Amputee Coalition, 2018, https://www.amputee-coalition.org/resources/limb-loss-statistics/.

[7] Garofalo, interview.

[8] A. S. Aloe Company, Inc., Aloe’s Illustrated and Priced Catalogue of Superior Surgical Instruments, Physician’s Supplies, and Hospital Furnishings, 6th ed. (St. Louis: A. S. Aloe Company, 1895), 887.

[9] Ibid.

[10] A. Broca and Ducroquet, Artificial Limbs, Military Medical Manuals, trans. ed. R. C. Elmslie (London: University of London Press, Ltd., 1918), 28, 29.

[11] B. A. Watson, A Treatise on Amputations of the Extremities and their Complications (Philadelphia: P. Blakiston, Son, & Co., 1885), 450, 451.

[12] Ibid., 423.

[13] Garofalo, interview.

[14] Ibid.

[15] “1961: Members Test the Hydra-Cadence Leg,” The War Amps, 2018, https://www.waramps.ca/about-us/history/#section-1960s.

[16] “Myoelectric Prosthetics Hands,” Ottoblock, n.d., https://www.ottobock.co.uk/prosthetics/info_for_new_amputees/prosthetic-technology-explained/function___action/.

[17] “Myoelectric Prosthetics,” myoelectricprosthetics.com, n.d.

[18] Martin Robertson, email to author, August 8, 2018.

 

 


3 thoughts on “Getting a Leg Up: A Brief History of Prosthetics through the lens of our collection

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