You're using an outdated browser and can not see this website's design. We've allowed you to access all the content however, so you're not missing anything other than the pretty wrapper. Please download any browser that supports standards to view the full site.
1407 E. Michigan Ave., Jackson 517-784-1142 770 Riverside Ave., Suite 101, Adrian 517-263-3310
CHAPTER XIV - Artificial Legs For Infants And Children
THE PROBLEM CONSIDERED. - It is a serious problem that confronts the parents of a child who has had one or both legs amputated. The parent, in happy possession of all his limbs, realizes more keenly than the child the misfortune that has happened. An artificial leg is, no doubt, the immediate and only remedy that can be suggested, but even this presents thoughts of expense for remodeling, and the question is often asked if the benefits will justify the costs incurred, and whether it may not be better to wait until the child has obtained his growth, before equipping him with the needed limbs.

A child, however young, is as greatly disabled by the loss of a leg as an adult. If one leg is lost he becomes dependent on crutches; if both legs are lost, he has to be carried in the arms or pushed about in a rolling chair, or is obliged to hitch himself about on his haunches as best he may. Such methods are at once unnatural and objectionable; they have a hurtful effect on the physique of a growing child, as well as harming the limbs, stumps, and joints. Walking on a pair of crutches for any length of time pushes the shoulders forward, settles the neck in the chest, and the spine fails to develop the sustaining strength demanded in later life.

Walking on one crutch, as most children do, cants the body sidewise, elevates one shoulder above the other, tilts the pelvis, and produces an over-development of one side of the body at the expense of the other. If the use of crutches is continued throughout the growing period, the disproportions resulting from unequal development will bring troubles that will last through life and imperil health. The stump, being pendent from the body and performing no functions, will become poorly adapted to the use of an artificial leg. The muscles will become atrophied, the joints enervated, and the range of motion lessened. It will be troublesome to wear an artificial leg under these conditions, and the task of disciplining the stump will be more difficult. It is doubtful if the harm thus done can ever be righted.

We can cite many cases where the neglect to apply an artificial leg to a growing child has been the cause of physical weaknesses that have been impossible to correct. Contracted hips and knees, weakened spines, deflected and rotated stumps, are a few of the many ills that have been traced to this neglect.

Failure to apply artificial legs in double amputations is attended with more serious consequences. The stumps are held in flexed positions and subjected to such unnatural influences that the wearing of a pair of artificial legs, when undertaken later on, is greatly hampered. The art of balancing is forgotten and has to be learned again. The hip joints, having been in flexed positions during the greater part of the development period, have become more or less set, and extension is difficult and painful when the erect position is attempted.

SUPPORT FROM THE PELVIS MORE NATURAL. - An artificial leg applied to a child, no matter how young, supplies a support to the amputated side that is the nearest approach to nature. It gives freedom to the arms, the joints and muscles are kept in activity. Being propped from the pelvis instead of from the shoulders, the spine, chest, and shoulders are not distorted, but are as free to perform their functions as if the child had never lost a limb. All the parts of the body maintain their proper relations and develop symmetrically.

The child invariably becomes expert in the use of one or a pair of artificial limbs, if applied soon after amputation; he mingles with other children, and engages in the same sports and exercises, the variety, which makes him strong mentally and physically, keeps him healthy, and prepares the foundation for the vigorous manhood and active life before him.

ALTERATIONS FOR GROWTH. - A child will outgrow his artificial leg, but this does not entail a serious loss; the leg can be altered in length and size to accommodate his growth and development. The expense attending such changes is not large, no greater than that of changing or renewing crutches, or repairing rolling chairs.

The only growth of the child that affects the length of the artificial leg is that which takes place in the sound leg from the knee to the floor. A child may, in the course of two years, grow four inches in his entire height, but the growth in the sound leg, from the knee to the floor, will be less than an inch. It is, therefore, evident that a child growing four inches in height will not require his artificial leg to be lengthened over an inch.

FREQUENCY OF ALTERATIONS. - The frequency with which an artificial leg worn by a child is lengthened, is about once in two years, oftener if the growth is more than usually rapid, and the expense attending each lengthening is not over $5.00. In families where economy has to be exercised to an extreme degree, the lengthening of the leg can be deferred, if necessary, by increasing the thickness of the sole and the heel on the shoe worn on the artificial foot as soon as growth requires. The size of the leg can be increased, and the foot can be enlarged, and in this way the leg can be made to last from five to ten years. It will thus be seen that in extreme cases a child can be supplied with an artificial leg, and the leg can be kept in proper length, at an expense of about $2.50 a year. We can hardly conceive of a parent who is so poor that he cannot meet this expense, or who is so heartless that he would see his offspring hobbling about on crutches during his youth merely to save so small an expenditure.

THE PARENTSí MORAL OBLIGATION. - Duty is the most important matter to be considered. All parents are bound by the laws of nature, as well as by those of the State, to perform those services that will protect the health and comfort of their offspring, to care for them in sickness, to lessen their afflictions, and alleviate their sufferings. It seems a flagrant violation of these laws for a parent to require his child to go on crutches, subjecting him or her to the dangers of impaired health and arrested development, when an artificial leg can be easily obtained and cheaply maintained, a leg that will perform such important work in ameliorating the childís condition. An artificial leg should be regarded an indispensable, more important than fine clothing, and next to the food that is required to sustain life. No conscientious parent, in viewing all the facts connected with this important subject, can hesitate in deciding on what course to pursue. If financial resources are limited, there should be no disgrace felt in calling upon friends for assistance; the urgency is too great to be neglected through scruples. The child must be rescued from a life of torture and embarrassment, and the parents must act to save themselves the censure and rebuke that neglect of this kind will bring in later years.

DEFORMITIES FROM THE USE OF CRUTCHES. - Look at the child who is required to go about on a pair of crutches (Cut M 1). See how the shoulders are pushed upward, how the head leans forward, the chest is sunken, and how generally disfigured he appears. Look at the child who hobbles about on one crutch (Cut M 2), see how one shoulder is raised higher than the other; how the body is thrown to one side, the sound leg deflected, the neck crooked. Now, look at the child who has been cared for humanely (Cut M 3), who has been given an artificial leg and propped in a natural way on the amputated side.

He is the picture of symmetry, his health is robust. No one would suspect that anything unusual had occurred to him, his artificial leg performs the functions of the lost one. He has forgotten his loss, and never admits his disability. He does everything his companions do; he is in the ball game with them, he rides the bicycle, skates, dances, and is not denied a single privilege belonging to those in possession of their natural extremities. "To clinch the nail of theory with a few blows from the hammer of experience" we cite a few cases that have come under our observation.

PRACTICAL ILLUSTRATIONS. - Cuts M 4 and M 5 portray Mabel T., who, when less than nine months old, had her left leg amputated very close to the knee. After recovering from the operation, it was discovered that the tendons of the knee were contracting and the stump being drawn into a flexed position. The mother became alarmed and consulted her physician. It was feared that if the child was permitted to continue as she was, she would, in a short time, lose the use of the knee joint. She had not begun to creep. It was evident that if an artificial leg were applied, the stump would be forced into such activity that the knee mobility would be preserved, and one was obtained. The socket was made to fit the stump snugly, the joints were placed on the sides to harmonize with the natural knee joint; a thigh piece incased the thigh. The leg would swing when the child was carried, and forced the stump to move at the knee.

In a few months the child began to creep. The mother was surprised one morning to find her standing by the chair, putting some of her weight on the leg. It was not long before she began to walk, then to run and play. The leg was lengthened quite frequently, and enlarged several times. During her childhood she ran and romped about as other children, went to school, and was as happy as any of her companions; she is now a young lady of twenty-two. Although her parents were in moderate circumstances, they always felt that their daughterís health and perfect development were important, and they denied themselves many things, but considered themselves amply compensated for the care they had given to the needs of their daughter.

Carrie K., when seven years of age, was run over by a carriage and lost her left leg. An artificial one was applied as soon as the stump had healed. The distinguished Dr. James Knight, the founder of the Childrenís Hospital in New York City, took the case in hand, and realizing the importance of putting the child on a leg instead of keeping her on crutches, interceded in her behalf. A leg was applied and she grew up with it; she developed gracefully and now is a woman of forty-three years. Cut M 6 represents her as she appeared when brought to us in 1869. Cut M 7 represents her with artificial leg applied, and Cut M 8 gives her as she appears to-day, a thankful wife and a happy mother.

Thomas Kehr, when eight years of age, was run over by the cars, both of his legs were crushed, the right was amputated four inches below the body, and the left two inches below the knee. As soon as the child recovered from the operation Dr. Samual J. Brady, of Brooklyn, advised that he be provided with a pair of artificial legs with rubber feet. They were obtained and applied, and the manner in which the young man got along is clearly stated in Dr. Bradyís letter of 1876, from which we make the following extract: "I have thoroughly examined the case of the boy Thomas Kehr, who has been wearing a pair of artificial legs for six months. About a year and a half ago he was run over and both of his lower limbs were so crushed that I amputated them, the one well above the knee, the other an inch and a half below. At the time of the operation many expressed the wish that death would occur, as the lad being very poor, it was thought that his future would not only be a burden to himself, but that his support, should he reach manís estate, would depend upon the charity of the public, as it was considered an impossibility for him to serviceably use artificial limbs.

"I am thankful that I can say that Marksí artificial legs have made his future worth the living.

"I saw him two weeks after he had put the legs on for the first time, and it astonished me greatly to see the remarkable use he had so soon acquired; since then I have seen him many times, and quite recently I saw him walking without the use of canes. He has, much to my astonishment, been fully and absolutely restored.

"I attribute the wonderful success in this boyís case mainly to the superior results achieved by your inventions, and to the fact that the legs were put on so soon after the amputations that the stumps had not had a chance to forget their functions."

Mr. Kehr is now a man of forty years. He is an active, capable, energetic workman, in perfect health, earning his livelihood and maintaining a family. If this man had been neglected in his childhood, he would be to-day a helpless object of pity, instead of a self-supporting member of the community.

Annie L. Beckwith lost her leg below the knee in 1887, when she was seven years of age. An artificial leg was immediately applied. It has been lengthened several times since. She is now a woman of good proportions, strong and healthy. Cuts M 9 and M 10 represent her as she appears without and with her artificial leg.

Manuel Parraga, of San Salvador, Central America, had his leg amputated above the knee in 1876, when eleven years of age. An artificial leg was applied immediately. His weight at the time was seventy-five pounds. The lad has developed into a full-grown man, weighing two hundred pounds. He is strong, healthy, and has a model stump, and walks about in the most natural way. In a letter recently addressed to us he says: "For a long time I have been desirous of writing to you and expressing my continued satisfaction in the work that you have done for me. Since I have returned to Central America I find it necessary to make long journeys on horseback. The artificial leg assists me very much. I pride myself on my easy and graceful movements, and the facility with which I mount and dismount. The India-rubber foot on the artificial leg is a most excellent invention; without it I question my ability to walk with safety in this country; where the streets are so rough and stony."

John Jerome Booth, son of Dr. J. P. Booth, had his leg amputated when seven years of age; railroad accident. An artificial leg was applied when he was eight years old. He then weighed fifty-seven pounds. The young man has grown and developed symmetrically and is now twenty-four years of age. He refers to the early application of his artificial leg as an exhibition of good judgment on the part of his father, for which he feels greatly indebted. He says that if he had been neglected when he was young, he would not be in possession of his present strength and proportion.

George G. Griswold had the left leg amputated below the knee when twelve years of age. An artificial leg was applied within a year after amputation. We quote from a letter written by his father. "The leg was applied to my son when he was less than thirteen years old, fitted from measurements without requiring his presence, has been in constant use. I hardly know of anything that he cannot do that other boys of his age can with sound limbs. He walks, skates, plays ball (Cut M 11), and climbs trees. When he was sixteen years of age we moved to another town, and for about a year scarcely a single schoolmate or neighbor ever suspected that he wore an artificial leg. I do not think it is possible to find an artificial leg equal to that which you construct for young and growing children. I have never regretted having applied an artificial leg to my son on account of his tender age."

William T. Wilson, when fifteen years of age, was run over by a railroad car and had his leg mangled so greatly that amputation was necessary. A few months after an artificial leg was applied. He weighed one hundred and ten pounds, and was at the period of life when growth and development promised to be rapid. The artificial leg was lengthened twice in four years.

James Good, at the age of thirteen, was run over by the cars and the left leg amputated below the knee. Seven months after amputation an artificial leg was applied; age fourteen, weight eighty pounds. The boy has grown to a man of large proportions, and at this writing is a locomotive engineer.

George W. Sheridan, son of General George A. Sheridan, was thrown from a carriage by a runaway horse, when he was ten years old. One leg was crushed and had to be amputated below the knee. Nine months later his mother, becoming solicitous about the childís development, insisted on an artificial leg being obtained, this in opposition to the advice of her husband and family medical adviser. The mother gained her point, and a leg was applied, and the child used it immediately, and the effect upon his health was surprising. We quote from the Generalís letter: "My son is now fifteen years of age. He has worn a leg of your make for the last five years, always with comfort and satisfaction. When visiting him at his school a while since, I found he was out for a dayís fishing. When he returned and stated where he had been, the teacher remarked that he had walked at least ten miles. George skates on steel or roller skates, rides a bicycle, and in short enjoys to the full the usual sports of boys of his own age. I now realize that it would have been a mistake, almost a crime, to have made the boy wait until he had stopped growing before supplying him with your artificial leg."

Hattie L. Moore had her leg amputated at the age of thirteen. Six months after the operation an artificial foot was applied. She wore it five years without lengthening. The growth of the natural foot, from the ankle down, was not great enough to require any alteration in the artificial foot. We quote from her letter: "My foot was amputated when but a child of thirteen, and as soon as the stump had healed, I had one of your admirable rubber feet supplied, made and fitted from measurements. It fitted me as if I had gone to New York and had had the foot fitted by your own hand. I have used the foot four years now, to the untold satisfaction of myself, and the utmost gratification of my friends, who often tell me that they would never notice anything peculiar about my walk. I have lived with people nine months without their discovering that I was lame.

"I am at present doing a daughterís part of housework, standing on my feet the greater part of the time."

William E. Shaw, leg amputated for injury to the knee. An artificial one was applied when nine years of age. To quote from his fatherís letter: "My boy has had great success with the artificial leg that you made for him. He can walk and get about excellently. He would not be without it for anything. It is unquestionably the best thing for a child, when he has lost one of his legs, to get an artificial one without delay."

John Kershaw, leg amputated above the knee, railroad accident. Artificial leg applied when ten years of age, immediately after the healing of his stump.

Dr. A. C. Dedrick writes: "I passed John Kershaw in the street three months ago. From the success in his case I certainly advise the application of an artificial leg to a young and growing lad as soon as the stump has healed. John Kershaw has been able, thanks to the artificial leg, to enjoy his early life equally with others not so unfortunate. He plays football, baseball, and all other sports. I think he would have lost all power of stump if the leg had not been employed. The stump is only about six inches long, and would in all probability have become flexed if he had grown older without a leg to keep the hip joint in condition."

Flossie Lee, leg amputated below the knee. Artificial leg applied when four years of age. Dr. G. A. Harris, of Chepachet, R. I., writes, "Flossie Lee has worn an artificial leg, which you fitted her five years ago, continuously since that time, except when sent to you for lengthening. It is needless to say that her health, in both mind and body, is different from what it would have been had she been confined to the house all these years. She has been to school, and runs about like other children, which means everything to a growing child. No change has been made in the leg all these years, except the increase in length."

Thomas McAleer, leg amputated above the knee on account of accident. Artificial leg applied when seven years of age. Dr. D. K. Dickinson writes: "McAleer, whom you so nicely fitted with an artificial limb for amputation above the knee joint, has received great satisfaction. I recommend the application of a limb by all means in similar cases."

Ettie Stangl, leg amputated below the knee in 1889. David Jones, of Richardson County, Neb., writes in regard to the case: "Ettie Stangl, to whom you applied an artificial leg when she was very young, has worn it continually. She does not appear like a cripple, she moves about so naturally. I can say that the artificial leg was a source of comfort to her, and I think providing her with the limb when she was so young was the best thing that could be done for her health and comfort."

Mary Wiley, both feet amputated in 1891; cause, railroad accident. Artificial feet were applied several months later. She was then eight years of age. This little girl is a forcible example of the wisdom of applying artificial limbs to children, especially when both are amputated.

Clarence Wintersgill, both legs amputated: right, six inches below, and left, three inches above the knee; cause, railroad accident. Artificial legs applied within a few months. Age, seven. Dr. R. F. Wintersgill writes as follows: "In regard to my sonís case, the application of a pair of artificial limbs has been a wonderful success. He was but seven years of age when you made his limbs, but learned rapidly how to use them. He now skates, rides a horse, goes to school, and walks several miles without resting. I was advised not to get Clarence any limbs until he had ceased growing and had almost made up my mind to wait, but to look at my little child sitting out in the yard helplessly, and to think that he must do so until he had finished growing, made me almost frantic. In the meantime, one of my neighbors provided me with one of your books, and I studied it day and night until I came to the conclusion to try a pair of your legs, with the results mentioned above.

"You will remember, Clarenceís left leg is off above the knee and the right below the knee. He was wearing his artificial limbs one year after amputation, and if I had to do it over again he would wear them in one month."

John E. Palmer, leg amputated below the knee. Artificial leg applied within six months; age, nine years. His father, Bradford Palmer, writes: "I am glad to let you know what success my boy has had in using his artificial leg. He was only nine years old when he commenced wearing it. I can say that it has afforded him the greatest satisfaction, and he could in no way be induced to do without it. He is growing fast and has the best of health."

Anton Gaub, leg amputated in 1884. Artificial leg applied within a few months after amputation; age, four. Gaub is now (1905) twenty-five years of age, full grown and well developed. He has always used the leg and never cared for crutches. He is strong, in good health, and walks great distances without becoming fatigued. He is actively engaged in business. His parents refer with pride to their decision in putting him on an artificial leg when he was so young.

Roscoe E. Bosworth, leg amputated below the knee in 1890; age, nine years. His father, Levi Bosworth, of Worcester County, Mass., writes: "I consider that it was a very wise thing on my part to have supplied my boy with an artificial leg when he was so young. He now has full use of his knee and hip joints, which I think would have become greatly impaired if he had not used the leg. He is now in good health, well developed. Crutches, which he used for a short time, always made him sick.

"Roscoe has skated, ridden a bicycle, and done almost everything other boys do. If I had a child only two years of age and he needed an artificial leg I would put one on immediately."

Roy V. Bryant, leg amputated above the knee when seven years of age; artificial leg applied immediately. His father writes as follows: "My son has worn his artificial leg constantly, with the exception of times when it has been at your factory, for lengthening. He is now twenty years of age. He has grown straight, strong, muscular, well developed. I am thoroughly convinced, from the experience in my own sonís case, that an artificial leg cannot be applied when a child is too young."

Carl T. W. Banks, leg amputated above the knee; railroad accident; artificial leg applied within six months after amputation. His mother writes: "The question of applying an artificial leg to a young child was one of great thought to me. Many of my friends thought it unwise to do so, but I could not bear to see my son Carl going on crutches, so I got a leg and had it put on when he was only seven years old. He has been wearing it since, and he is now well developed, strong and healthy. During his childhood days he played with other boys, in all kinds of weather and at all kinds of games."

Emma Zern, leg amputated above the knee. Dr. J. William Trabert, of Annville, Pa., writes: "Emma Zernís leg was amputated in the lower third of the thigh in 1890, when nine years of age. She received an artificial leg from you within six months. She has been wearing the same constantly. In the following spring she grew 2 Ĺ inches. The leg had to be lengthened, but it did not cost very much to do it.

"At first I was doubtful that a child of her age should have an artificial limb, but am now convinced that a child cannot be too young, as this case has shown."

Nellie Cartwright, at the age of eleven, met with an injury to the leg that necessitated an amputation below the knee. Six months after an artificial limb was applied. Her father writes: "I purchased an artificial leg from you for my daughter in 1893. She was then eleven years old. She has used the leg constantly. I am delighted with the results and prepared to say that I recommend the use of artificial limbs to children of any age, and the sooner the child has a leg applied after losing a natural one the better it will be for that child. There are two reasons that should induce a parent to act promptly: First, an artificial leg enables a child to walk naturally, promoting good health and symmetrical growth. Second, a child becomes accustomed to the use of the limb while young and active and will ever afterwards use it with better results than it could if the use was delayed until maturity."

Clara Giere, leg amputated below the knee; age, eight. An artificial leg was applied immediately. Dr. E. Alonzo Giere, of Hayfield, Minn., writes: "The artificial leg which I obtained for Clara has given good satisfaction. The child has grown and the leg has had to be lengthened. She is still using it with comfort."

Dr. A. R. Eaton, of Elizabeth, N. J., under date of March 31, 1904, writes: "The facts of my case are as follows: In March, 1891, I had my left leg so badly crushed as to require a supracondylar thigh amputation (Gritti-Stokes type). In May of the same year I applied one of your artificial legs and wore it for a considerable length of time. Since I have attained my growth I have had another one made. The leg was a blessing to me from the start. As a matter of fact, I would have been lost without it at any time. I walk easily long distances, sometimes ride a bicycle, other times ride a horse; I play tennis, golf, etc. In fact, do with ease and facility almost all ordinary things.

"My observation leads me to believe that this excellence of locomotion is only possible with the Marks leg, for I see cases similar to my own using ankle-joint legs who are able to enjoy only ordinary usefulness.

"In regard to the application of artificial legs to young and growing children, I can say that my own case is an example. The artificial leg was applied when I was thirteen years old. I am now fully grown and am a physician engaged in active practice. My professional knowledge tells me that it is a most advisable procedure, for the use of a leg strengthens the stump, prevents atrophy of joint structures and soft parts, and trains a child in the use of a leg, and when he reaches adult life he will have perfect control over it, and he will become strong and healthy."

Charlie Moore, at the age of eight, had his leg crushed by a wagon. Amputation was above the knee. His mother writes: "My little son, Charlie Moore, when eight years of age, met with an accident that resulted in the amputation of his right leg. He went on crutches two years. He was pale and sickly and grew but little. The doctor said he was sure that the constant use of crutches would induce spinal disease or lung trouble. I therefore resolved to get an artificial leg for him. I did so, and as a result he now has good health, is well grown and thoroughly developed. I advise buying your make of artificial limbs for young and growing children. They are light and strong in construction and easily lengthened."

Comment from follow-up survey
I would very much recommend any one to you.