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CHAPTER XXXIV - Cheap Artificial Limbs
From the International Journal of Surgery

CHEAPLY MADE LIMBS NOT SAFE. - From time to time the newspapers chronicle severe accidents happening to the wearers of artificial limbs as the result of faulty construction. Here is an instance taken from the Cincinnati Enquirer of December 19, 1901:

"Fred Rentz was severely injured last evening, about five o’clock, by falling on the street at Central Avenue and Liberty Street. His fall was due to a cork leg breaking. The unfortunate man was taken to a hospital by Patrol No. 5."

INVITING DISASTER. - There is a material in this brief item of profound thought on the part of every many who has occasion to require an artificial leg. There is material, too for a sermon on the iniquity of dealers who sell artificial limbs of inferior or defective workmanship. That there are many persons who commit the folly of risking their bodies, and possibly their lives, upon poorly made limbs for the sake of the few dollars saved thereby, and that there are dealers who are willing to encourage them in this folly, may be proved to the satisfaction of anyone who will read the daily papers carefully. Every few days cases are reported similar to the above, and in almost every case the disaster may be traced to the same cause-poor material or inefficient workmanship.

Mr. Rentz undoubtedly wore a cheap leg-cheap in construction, but very costly in the price he ultimately paid for it in money, suffering, and lost time. Some weakness in the wood or leather or steel (there is no cork in any artificial limb) was revealed by an accidental slip which brought an unusual strain upon it, and caused it to give way just when he had most need to rely upon it. The saying that "no chain is stronger that its weakest link" applies with the fullest possible force to an artificial leg. Every part may be perfect except one, and yet that one is certain to precipitate a fall of serious if not fatal results.

The adage that "the best is the cheapest" applies to almost everything that one may require. It applies without exception to the purchase of artificial limbs. The steeplejack will not make use of a cable unless he knows that it has been tested and proved to be capable of sustaining the weight that he will bring to bear upon it. The caisson worker will not descend below the bed of a river unless he is assured that the air-pumps are in perfect working order. No more should the wearer of an artificial limb trust himself upon it unless proved material, skill, and honesty have entered into its construction.

CONFIDENCE NECESSARY TO SUCCESS. - The essence of success in walking with an artificial leg is confidence. To learn to manipulate the limb is a very simple matter, but unless the wearer knows that he can rely upon it as thoroughly as he would upon his natural legs he will never be able to walk well or to move about with a sense of perfect freedom. There are thousands of persons walking about to-day with Marks’ artificial legs whose intimate friends are not aware that they have lost any of their natural members. They do not limp or hobble, and they do not find the slightest difficulty in moving about as freely as their most active neighbors - all because they have confidence; they know that every bit of material that enters into the leg is carefully tested and proved before it is used, and that, therefore, it cannot possibly give way under ordinary use or at some critical moment when they most need its support.

A vast amount of care and trained ability enters into the construction of a thoroughly reliable artificial leg, foot, or arm. It will not be sufficient to use ordinary material, or even the best material that can be bought through the ordinary channels of trade.

SELECTION OF MATERIAL. - As the first step in the manufacture of the artificial leg, an expert visits the woods and selects the tree from which the material is to be cut. To do this is no easy matter, and requires long experience. The tree must be neither too young nor too old. It must be free from knots and must have a firm, even grain that it will be equally strong in every part.

When the tree has been felled it must be cut into lengths and carefully split into sections, use being made only of the main body of the tree trunk in which the grain is firm and even. Only a small portion of the ordinary tree is available for this purpose.

When the wood has been thus carefully selected, it is by no means ready for use. It must then be kiln-dried, so as to be thoroughly shrunk before it can be utilized. About four years is required in this process before the stick of timber can be manufactured into an artificial leg.

It is not the wood alone that is selected with such careful attention to its strength and wearing qualities. The steel which goes to form the braces and joints of the leg is first carefully tested to detect the existence of any flaws or defects and to prove that it is capable of carrying a larger weight than it will be called upon to support.

The leather for the jacket which forms the upper part of the leg is selected with equal care. Only the strongest and most valuable parts can be used; the rest must be thrown away or used for some other purpose. The buckskin lacings are also a matter of solicitude, and are subjected to thorough tests to determine the weight they will sustain.

Even a more delicate matter is the proper vulcanizing of the rubber foot which plays an important part in every successful artificial leg. The elasticity of the foot depends upon the exact degree of heat applied to the rubber. Thus, at every step in the selection of material, the greatest care and judgment must be exercised.

The need of practical experience and expert judgment does not end with the selection of materials. Equal skill is needed to assemble them properly. An artificial leg, to be a source of comfort and usefulness to its wearer, must fit perfectly, and no two persons can be fitted by exactly similar legs. The highest skill of the artisan is required to meet and make allowances for all the little peculiarities of each individual wearer. It is ridiculous to assume that it is possible to fit all comers with artificial legs simply by carrying a few sizes in stock.

The worst mistake that the prospective purchaser of an artificial limb can make is to patronize one of the cheap establishments which are continually being started by disgruntled apprentices or discharged workmen. It seems incredible that a man who will not permit his horse to be shod by an incapable blacksmith, or his beard to be trimmed by a man of no experience as a barber, will nevertheless trust the delicate and vital task of supplying an artificial limb for himself or a member of his family to a crude bungler or a cheap mechanic. Yet such cases come to notice frequently. Too late, when permanent injury has been done to some delicate blood vessel or tender nerve center, or when a bad fall and broken bones have taught the lesson that better counsel might have imparted in the beginning, he turns to the firm that has a long-established reputation for efficiency, reliability, and honest dealing.

How much better-yes, how much cheaper-it would be to intrust one’s self in the beginning to a firm the members of which have gained a thorough knowledge of the subject through a business experience of years, which spares no expense to secure the most perfect materials for its artificial limbs, which employs the most carefully trained and thorough workmen, which owns the most important and successful patents for artificial limb appliances, and the name of which is a guarantee of good faith, good workmanship, and satisfaction to its customers!

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