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1407 E. Michigan Ave., Jackson 517-784-1142 770 Riverside Ave., Suite 101, Adrian 517-263-3310
CHAPTER X - Both Leg Amputations
The triumphs of artificial limb-making are shown to advantage in the restoration to active life of those who have had both of their lower extremities removed. When such persons are enabled to get about freely, walk gracefully, and engage in such labors as their callings in life require, a great and beneficial work has been accomplished, and the strongest possible evidence is presented to show that the mind of the prothesist has not been passive during the past half century. The problems these cases present are profoundly difficult, thought and effort have never been given to more laudable purposes than to their solution. The amelioration of the conditions of these unfortunate persons commands the highest talent and the most humane impulses.

ANCIENT METHODS. - But a short time ago the loss of both legs was regarded as irreparable. The person who met with that misfortune was either consigned to a wheel chair, or obliged to hitch himself about on knees or haunches. Cut J 1 to J 4 show some of the various methods employed by those deprived of both their limbs. Formerly these methods were the only means for locomotion the subject could employ. But at the present time the methods are used preliminary to obtaining and wearing artificial legs. When these methods are contrasted with those that are shown later on, the progress and developments that have been made in the adaptation of artificial legs will be in plain view.

BOTH FEET PARTLY AMPUTATED. - Cut J 5 shows a case in which both feet were removed at the insteps; a pair of artificial legs constructed on the plan of Cut C 18, page 32, was applied.

LOWER INSTEP AND LEG AMPUTATIONS. - Cut J 6 shows an amputation of the left foot at the instep and of the right leg at the junction of the lower and middle third. Artificial legs C 18 and E 17 were applied.

BOTH FEET AMPUTATED AT THE ANKLES. - Cut J 7 shows a double ankle-joint amputation with the extremities incapable of bearing pressure. A pair of artificial legs, constructed on the plan of D 21 and described on page 43, was applied. Cut J 8 shows the same case with the legs applied and the wearer standing. In this particular instance the amputations resulted from frostbite, and the extremities of the stumps were very sensitive and with impaired circulation. It was therefore necessary to avoid interference with circulation and to secure the absolute freedom of the extremities from contact.

ANKLE JOINT AND KNEE AMPUTATIONS. - Cut J 9 shows an amputation of the left foot at the ankle after the Pirogoff method, and the right leg at the knee joint after the Gritti operation; artificial legs D 12 and G 17 were applied. Cut J 10 presents the wearer with artificial legs applied and attired as in daily life.

UPPER INSTEP AND LEG AMPUTATIONS. - Cut J 11 shows an amputation of left foot at the instep and the right leg at the middle third. Artificial legs C 18 and E 17 were applied. Cut J 12 shows the wearer with the legs applied, engaging in his occupation as oysterman. This person has been employed in that industry for many years, and finds himself unhampered in his work.

Cut J 13 shows an amputation of the right foot at the instep and of the left leg immediately below the knee. The right foot was poorly nourished, and sensitive at the extremity, so much so as to completely prohibit any pressure. Cut J 14 illustrates the same case with D 21 and E 17 legs applied.

BOTH LEG AMPUTATIONS. - Cuts J 15 to J 21 illustrate amputations of both legs at various points between the knees and ankles, covering many lengths, characteristics of flaps, and situations of cicatrices.

Artificial legs suitable for any of these amputations, as shown in Cut J 21, are constructed on the plan of E 17. Cut J 22 shows the legs applied. The freedom with which wearers of legs for double amputations can get about, the naturalness with which they can sit, lie down, stand, walk, ascend elevations, ladders, ride bicycles, skate, and engage in almost any occupation are shown in Cuts J 22 to J 32.

PRACTICAL RESULTS. - Persons wearing two artificial legs are so thoroughly in control of their means of locomotion that they go about much as other people. They readily resume their former occupations, no matter how arduous they may have been. Cut J 28 illustrates a case of double-leg amputations with artificial legs E 17 applied. A short time after obtaining the legs the wearer resumed his work of baggage master, lifting heavy trunks, carrying them about, and putting them on trains as one would do with natural legs. Cut J 29 portrays a railroad man with two artificial legs operating a switch. He dismounts, attends to the switch, frequently gets aboard while the train is in motion, and performs the work of a brakeman. He moves about quickly, steps over ties, and appears to be on as firm footing as if he had never been deprived of nature’s extremities. Cut J 30 shows a young man wearing two artificial legs, plan E 17; he is conductor on a railroad, performing duties in a thoroughly efficient manner. He walks through the train when it is running at its greatest speed, collects tickets, and punches them. The cars jolt, pitch, and sway, but he retains his balance with no perceptible effort or awkwardness.

At station he alights, watches passengers, gives signals, and boards his train. It never occurs to anyone that his lower extremities are not real, and his actions never betray that fact. With wooden articulating feet it would be extremely difficult for him to discharge such duties. He would feel unsafe, tottlish, and unsteady, but with rubber feet with spring mattress, rigidly attached, he has sound footing, and is capable of the most difficult feats of balancing.

BELOW-KNEE AND KNEE-JOINT AMPUTATIONS. - Cut J 31 represents a case with both legs amputated; the right disjointed at the knee, and the left amputated three inches below the knee; Nos. E 17 and G 7 legs were applied. This man when in street attire presents the appearance of a person with natural extremities. He walks naturally, and never consents to use a cane. He is a member of the Knights of Pythias, and takes pride in parading with his lodge. Cut J 32 shows him in his uniform.

BELOW-KNEE AND ABOVE-KNEE AMPUTATIONS. - Cut J 33 represents amputations of both legs, the right below the knee and the left above the knee. Cut J 34 represents the same case, with E 17 and H 15 applied.

Cut J 35 shows a similar case; the right stump only five and one-half inches from the body, and the left one and one-half inches below the knee. E 17 was applied to the left side and H 15 to the right. The subject was restored to not only a natural appearance, but to the ability of walking without the aid of canes or crutches, and so naturally that he has associated with persons for long periods without betraying the fact that his lower limbs were artificial. This young man has walked half a mile in eight minutes without great effort. He works at the bench during the day, and the evenings are frequently spent at the billiard table. Cut J 36 shows him as he appears on his artificial legs, and in street attire.

ENGAGING IN FORMER PURSUITS. - We have many patrons wearing E 17 and H 15 artificial legs for double amputations who exhibit remarkable skill in performing feats that require sound footing.

Cut J 37 shows a person with two artificial legs as above described in a rowboat, illustrating the manner in which he can brace himself while pulling a strong oar.

Cut J 38 shows another similarly equipped at the pool table, balancing himself on one foot while making a difficult shot.

Cut J 39 represents another with thigh and leg amputation, on a ladder, at a great distance from the ground; his footing is sound, his arms are free; he can hold a paint can in one hand, while he applies a brush with the other.

Cut J 40 represents another riding horseback, securely seated in the saddle, and feet in stirrups. The spring mattress rubber feet are used in all of these cases, and sound and reliable footing are due to the excellent feature obtained by that means.

BOTH LEGS AND BOTH ARMS AMPUTATED. - Cut J 41 represents a case in which both legs and both hands were amputated. A pair of artificial legs, and a pair of artificial arms were applied. The wearer became able to walk about in a very natural way; his artificial arms enabled him to feed himself at the table, write, and perform such work as does not depend upon delicate finger movements and the sense of touch.

BOTH LEGS AMPUTATED ABOVE THE KNEES. - No matter how extensively a person may be dismembered, prothetic science is capable of rescuing him from a life of helplessness. Only a brief period has elapsed since it was considered rash to apply a pair of artificial legs to a person who had both of his natural legs amputated above the knees. Attempts to substitute such a large portion of the body depending on short thigh stumps for support, resulted in failures, and until modern ideas were introduced and appropriate means for attachments were devised, failure followed every effort. In 1864 the first pair of artificial legs was applied to double thigh amputations; the subject was a soldier of the Civil War. Although he was able to sit, stand, and walk on his artificial legs, the effort was so great that the wearer soon tired of them and abandoned their use, and became the occupant of a wheel-chair, dependent on his family.

In 1879 Mr. Marks made his second attempt, and succeeded admirably. The subject was a young man with two thigh stumps that reached nearly to the knees. This man soon acquired the art of balancing, and became so adept that he could walk about the house without the aid of canes or crutches, but when in the street he found it necessary to use a pair of canes. He has worn the pair of legs made in 1879 up to the present time. He is engaged in active business pursuits, and has reared and supported a large family.

Since the above date we have applied upwards of a hundred pairs of artificial legs to double thigh amputations. The manner in which these limbs were constructed, the way in which they were applied and adjusted, and the methods employed to give better control of the movements have varied according to the conditions of each case. Each double thigh amputation presents problems of an individual character, and as there are seldom two alike, these problems must be solved by the manufacturer. The solution lies in the hanging of the legs, the method of suspension, limiting the motion of the knees, and the absolute rigidity of the ankles. We cite a few cases.

Cut J 42 represents double thigh stumps, produced by amputations made to remove deformed parts. A pair of artificial legs of suitable construction was applied. The great lengths of these stumps gave such control over the artificial limbs that it was not necessary to apply hip joints or knee locks. The subject was a musician. In a brief time he was able to walk naturally, resuming his profession, and now has a national reputation as a clarionetist. He walks on the stage, plays the instrument, acknowledges encores, and retires in the usual stage manner.

Cut J 43 represents a double knee joint amputation. A pair of suitable artificial legs are shown in the same cut. Cut J 44 shows the artificial legs applied, and the wearer in the act of walking.

Cut J 45 represents a child who had both legs amputated above the knees on account of a railroad accident. A pair of artificial legs with knee locks was applied to advantage. The child has, for a number of years, walked on the artificial legs very satisfactorily. He has been enabled to walk to school and indulge in childish pastimes. The manner in which the artificial legs were held in place is shown in Cut J 46, front view, and Cut J 47, rear view.

Cut J 48 represents a double thigh amputation, the result of a railroad accident. Cut J 49 shows the application of a pair of artificial legs with the wearer seated. Cut J 50 represents the same person standing, and in Cut J 51 he is attired as he appears when walking. This case is one of the most remarkable on record. The stumps only extended to about the middle of the thighs, but through the energy of the wearer and the efficiency of the artificial legs, he was able, in a brief time, to walk about in a very natural way, and go up and down stairs; he uses no canes about the house. The artificial legs H 15 were applied with hip joints and automatic knee locks, but after a brief time the wearer dispensed with the locks and found that he could control the artificial knee joints without danger of treacherous flexing. Under earlier systems this case would have been considered hopeless, and the thought of applying artificial limbs would never have been entertained.

Comment from follow-up survey
The office staff is great. My daughter walks in and Alice reads her books. Thank you for your great help in making her legs straight.