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CHAPTER XVIII - Is It Profitable To Buy An Artificial Arm?
If I procure an artificial arm, will I make any practical use of it? If I do not, can it in any way contribute to my physical or mental comfort? Is the risk worth taking?

These are the questions that have to be answered. They weigh heavily upon the minds of those who find it necessary to exercise economy in their purchases.

Whether male or female, rich or poor, the feasibility of substituting a member that has been lost must be thoughtfully considered.

Let us first take up the questions of ornamentation.

ORNAMENTATION. - That a person will make a better appearance with an artificial arm properly dressed than with an empty sleeve, is obvious. To conceal any physical defect is a natural aim. There is nothing so distressing, especially to a sensitive person, as the exhibition of any imperfection in his anatomy.

The glass eye is worn for no other purpose than ornament. It fills a sightless socket and conveys the impression that the natural eye is there; it does not restore vision nor fulfill the optical functions, yet thousands of them are worn with a feeling that they are indispensable. They certainly look well, and are to be preferred to the cloth patch frequently seen. The man with a hunched back pays his tailor very dearly for the skillful adjustment of pads in his coat, so as to minimize the visibility of his deformity.

Any deficiency of the body that becomes conspicuous will attract attention and invite comment and sympathy. No person who maintains his self-respect, no matter what his disability may be, cares to be constantly reminded of it, and the commiseration of others, above all things, is the most abhorrent. To be frequently asked: "How did it happen?" "Did you lose your arm in the war?" "Were you in a railroad collision?" or to have such utterances as: "Poor, unfortunate man!" "How he must have suffered!"

"What a terrible loss!" whispered within your hearing, may, for awhile, be accepted in good part, but their repetition soon becomes annoying and odious.

An artificial arm will conceal the loss, restore a natural appearance to the person, avoid observation and comment, and after it has been worn a short time will become companionable and necessary to the wearerís mental comfort.

The Russian prince, Galitzin, obtained an artificial arm of us to cover a deformed and undeveloped member, the conspicuousness of which had given him much solicitude. He was elated over the results and pronounced the purchase a most satisfactory one, fully paying him for his long journey from Moscow to New York.

Miss Julia Shay Lindsay, of Polk County, Minn., struggled with this subject for some time, and finally ordered an artificial hand. The results that followed are clearly set forth in a letter recently addressed to us: "It is over five months since I received the artificial hand which my doctor ordered for me. I am very much pleased with it. No one can tell the artificial hand from the natural one. In this, it is a source of great comfort."

A. T. Basden, of Hamilton, Bermuda, who had both of his arms amputated between the elbows and wrists, wrote recently, as follows: "The artificial arms you sent me fit acceptably. They meet with my expectations. I find them helpful and especially valuable, as they hide my misfortune. Prior to the application of the arms, I suffered considerably with my stumps, but since wearing them the pain has entirely ceased.

HYGIENE. - This part of the subject, considering the importance it bears to the general health and welfare of the individual, has not been sufficiently emphasized. With much pleasure we quote from Dr. Schenck, of Cincinnati, Ohio: "Pain is the cry of a hungry nerve for food.

"When a part of the body becomes inactive, as is the case with the stump of an amputated arm, the inability to receive the necessary activity on account of the abbreviation of its length, permits the stump and muscles to fall into a quiescent condition; in consequence there occurs a stagnation in the venous system, which depends entirely upon muscular activity for the return of the venous blood to the lungs for aŽration, from whence it is again pumped by the heart to the different parts of the body, in order to carry nourishment and oxygen to the tissues so that the normal metabolism can occur, and thus produce the physiological tone required for a healthy individual.

"As such, an abbreviated member, unassisted, cannot contribute the necessary energy for its welfare; because of the above-explained pathological condition, it must suffer and lose its normal tone and indirectly, as in diseased organs of the body, affect the general economy in a more or less degree, depending upon the temperament of the individual.

"So that, from the hygienic view, an artificial arm will cause the defective part to functionate, causing activity of the remaining muscles, and thus stimulate its circulation, giving to the part the required nourishment and preventing the accumulation of effete material and dismissing a conspicuous deformity, which, no matter how indifferent the unfortunate assumes to be, has some influence upon his nervous system, all of which, being improved, is conducive to promote a healthy tone to the whole body."

It is not an infrequent occurrence for a person to complain of peculiar, dull aches, or nerve twitchings, or sharp, stinging darts of pain in his stump. Investigation will disclose the fact that these are nervous disturbances, due to muscular inactivity, and, as soon as stumps are forced to do something, the distress will almost invariably disappear.

Dr. Cook, United States Examining Surgeon, puts this phrase of the subject in an interesting and unique light:

"When a limb has been amputated, the stump, or remaining portion, takes on queer antics and assumes conditions that are in accordance with well-known physiological and psychological laws.

"For instance, it is no uncommon occurrence for a man who has lost a part of his leg by amputation to have a severe pain in the heel, foot, or toe of the lost member, or for those who have lost parts of their arms to have excruciating pains in the wrists, hands, or fingers of the amputated parts. To those unaccustomed to these nerve complications this may appear absurd, but they are facts well known to neurologists.

"It would seem that the stump, or part remaining after amputation, either resented the indignity that it had been subjected to, or else made its sorrow for its loss manifested by these means.

"The man who allows an amputated arm to hang indolently by his side makes a mistake. The muscles above the stump shrink and waste away for a lack of nourishment, and the nerves become irritable and neuralgic. An undisputed physiological law is that Ďaction increases strength,í and the reverse is just as true, that inaction produces weakness.

"Place an artificial arm on the idle stump and it at once begins to get a better circulation of the blood, the muscles begin to develop, and the nerves have something to think about besides their terminals."

Dr. L. G. Armstrong, of Boscobel, Wis., in emphasizing the importance to persons who have had legs or arms amputated, to procure artificial ones, presents in a forcible way the penalty that must be paid if a stump is permitted to become indolent:

"Artificial limbs have added much to afflicted humanity in the way of happiness and comfort.

"Physiology teaches plainly that the want of use of any part begets weakness. Atrophy of the muscles is sure to follow, which is the legitimate consequence of the neglect. To prevent this, begin using the stump as soon as it is thoroughly healed, when the adhesions are perfect, save atrophy, and put the muscles to their new use. Neuralgia of the stump is always sure to follow, or it may even antedate the withering away of the muscles for the want of proper use. Get a well-made, perfectly fitting limb, and you have at once removed the cause of nervous disturbances and the mental shock. You have added much to the personís ability to earn a livelihood. My experience is that artificial limbs are soon accepted, and soon used to advantage, and so much so that money would not induce the wearers to do without them. My advice is to get an artificial limb at the first practical moment, after the stump is perfectly healed."

Dr. T. P. Smith, of Tacoma, Wash., says: "During the last fourteen years you have fitted a great number of my patients with artificial limbs, and they have all given entire satisfaction. The proposition that a limb, whether a stump or whole, needs and is benefited by motion, is so self-evident as not to call for discussion; a stump becomes useless without it.

"I am in the habit of using motion in all cases of fracture, as well as in all cases of amputation, to prevent atrophy of the muscles, and stiffening of the joints, and as soon as a stump, after amputation, is healed, I insist on applying an artificial limb. Until the limb comes, I insist on the patient doing the best he can toward exercising and using his stump. After the limb is adjusted he will naturally use it, and that will prevent the stump from becoming flabby and fat.

"In conclusion, I will say that I know of no way to retain the use of a leg or arm, except it be early fitted with an artificial limb, and the sooner it is done the better. In spite of bandaging, and such motion and exercise as patients can give their stumps, they become large and flabby."

Dr. Geo. E. Powell, La Crosse, Wis., writes: "We have had your artificial limbs for twenty years and consider them the best made. We have never applied one that did not give satisfaction. Many arm stumps that were soft and doughy to the feel, became strikingly firm and vigorous with the use of artificial arms."

Dr. Chas. F. Noe, of Amana, Ia., states: "I wish to say that in my experience a well-fitting artificial arm exercises a beneficial influence on the stump, due to the stimulus given to circulation and nutrition, and thus preventing stagnation from disuse."

Dr. J. H. Sieling, of York, Pa., says: "The arm that you sent me recently has done more work than my fondest hopes expected; it has not only had a helping influence on my patientís stump, but adds greatly to his appearance. He is able to execute some very helpful acts with the elegant equipment; he eats, by its help, very artistically indeed. I am only too glad to add a word of commendation whenever opportunity offers."

Carl M. Person, of Webster County, Neb., states: "I will write to you and let you know that my arm is all right. I have worn it every day since I got it, and have never been chafed or experienced any inconvenience. The arm is useful as well as ornamental. I find that the exercise my stump receives from it prevents those dull pains that I suffered from for so long a time, and I value it for this reason far more than the money it cost."

William F. Starner, of Carroll County, Md., writes: "I have been wearing one of your artificial arms for about three years, and am well pleased with it. I can do most any kind of work. The arm exercises my stump, and keeps it in a more pleasant condition."

The utility to be deprived from an artificial arm depends very largely upon the length of the stump, the strength of the muscles, and the aptitude of the wearer. The stump must be long in order to provide a lever with which to control the hand and forearm in lifting such articles as may be placed in the hand. Although the artificial arm is very light, the power to elevate it must come from the muscles in the arm and shoulder, and when the stump is very short, and the muscles weak, the utility of an artificial arm is lessened. But, notwithstanding these conditions, the artificial arm should be worn on the shortest of stumps. There are persons who have more aptitude than others, and perform feats under adverse conditions that are marvelous; some with short stumps do more than others with long ones. It is safe to say, however, that any person, no matter how short a stump he may have, may, with patience and application, learn to operate an artificial arm, and derive a reasonable compensation from it. Ambition, application, and thoughtful effort will overcome many difficulties. If one person can learn to write quickly and legibly with an artificial hand, why should not another? If one person can handle a farming implement, such as a hoe, rake, ax, or wheelbarrow, or a carpenter can drive his plane, hold a nail or carry tools, there is no reason why others should fail.

Comment from follow-up survey
I am very happy with the new brace and it is lighter and much easier to handle. This is the first time in 6 years that I have been able to wear both shoes the same size.