The development of weapons of war and the development of treatments for those damaged by them often go hand in hand. William Birnie looks at some curious appliances designed to improve the lives of those who lost limbs in the First World War.
It is easier to destroy than to repair, with the resources for destruction provided by society often greater, yet the years during and following the First War World saw significant and exceptional attempts to help those who had returned home permanently injured by destruction on an industrial scale.
Horrific wounds from new technological advances such as machine guns, shell fragments and poison gas meant that over 41,000 men lost at least one limb as a result of their injuries gained during the war (and this was in the British Armed Forces alone). The modern mechanised nature of warfare led one man to write home and comment on the carnage: ‘this is not war; it is the ending of the world’.
The conditions on the front line meant a lower standard of medical care, unhygienic equipment, lack of water, inadequate lighting and poor supplies of operating instruments, including ligatures, needles and supports. When this is considered against the remarkable fact that it took, on average, between eight and twelve hours to evacuate a wounded soldier from the front to a Casualty Clearing Station (CCS), it is not surprising that so many men returned home without a limb. The even starker situation at Gallipoli, where a soldier had to face a voyage of two to three days, led Major Stanley Argyle to despair at the number of limbs that were amputated and lives lost that would otherwise have been saved.
Motorised transport made it possible to establish the clearing stations on the Western Front, which were staffed by surgeons, nurses and anaesthetists, yet these were far from satisfactory themselves and the sheer length of the front often meant they were six to nine miles behind. Trying to operate on filthy war wounds instead of clean unbroken flesh meant the neat techniques in which an ‘aesthetic result’ was paramount had to be abandoned in favour of ‘crude unfinished ways’, much to the chagrin of surgeons working amidst the bloodshed.
Servicemen were entitled to free artificial limbs (until 1948 artificial limbs were provided free of charge only to those who had lost limbs as a result of war service), but by 1915 the existing system could not keep pace. Throughout the war, limb provision remained a problem, combined with a lack of hospital space for men awaiting limbs.
Two American firms, Rowley and Hanger, were invited by the government to set up subsidiaries in Roehampton, London, in the grounds of a former mansion commandeered by the Imperial War Office. This site became Queen Mary’s Hospital and opened its doors to its first 25 patients in 1915. During the war it became known as one of the world’s leading limb fitting and amputee rehabilitation centres, providing treatment and training opportunities so that patients could later find employment. Demand was high and often men left hospital with artificial arms without the proper training in their use. Artificial limbs were made on-site, yet, despite this, limb provision remained a struggle and it was only after the armistice that the situation was brought under control. New mechanisms were patented and lucrative government contracts enabled new research and developments to take place.
The appliances shown above, part of our ‘Treating Yourself’ section in our Medicine Man gallery, fitted to a mechanical substitute for the arms made for an amputee who had lost both arms at the shoulders (a rare injury even during the First World War). They are components of a much larger prototype developed by an Edinburgh gas fitter, George Thompson. The tools clipped onto the mechanical arm, which was then fastened onto a table. The tools and arm would be operated using foot pedals situated under the table and driven by a series of levers.
The idea of this amateur invention was to enable amputees, with practice, to eventually be able to accomplish everyday tasks independently. There is a conventional set of a knife, a fork and a spoon that has been slightly modified, along with weighted scissors, a round metal object designed to carry a cup, a ‘rubber thumb’ to turn the pages of a book, a cigarette lighter, and a fountain pen, the nib of which has been specially angled in order to fit into the ceramic ink bottle.
Moreover, there was a need to provide help not only for the physical, visible injuries connected with the loss of a limb, but also the invisible, mental ones, and a story of consummate resourcefulness can be found in the years after the war in Germany. Physically disabled from birth, Carl Hermann Unthan (1848–1929), helped the physically disabled soldiers when they returned home to Germany by publishing Ohne Arme durchs leben (Surviving Life Without Arms, 1916), an illustrated handbook for disabled veterans. He worked quickly, writing seventy-eight pages of it in twenty days. It was a step-by-step guide how to master life’s challenges and adapt. It seems incredible to believe but Unthan had trained himself to fasten a necktie, use a knife and fork, even play the violin, using only his feet. He travelled around Germany hoping to be a motivator and lead by example.
It is an interesting idea to think that medical treatment is constantly refined to keep pace with the improvements in weapon technology and the damage it inflicts, with doctors and surgeons forced to rethink their interventions in order to give patients the best possible chances of survival. The First World War was the last war where amputations, on otherwise healthy young men, were at such a high level, and consequently provisions had to be made at home for those returning injured.
William Birnie is a Visitor Services Assistant at Wellcome Collection. You can contact him at firstname.lastname@example.org.