“The hand is an extension of the human brain.” Immanuel Kant- German Philosopher In their quest to find a cure to nearly every ailment, humans have come up with ingenious methods to solve various medical problems, including the loss of limbs. The following is an outline of the development of prosthetic hands from crude wooden models to the high tech replacements of today. Early Civilizations Before the Greek, Roman and Egyptian civilizations emerged, prosthesis were made out of leather and wood. These early devices were developed for aesthetic purposes and weren’t functional. Reasons for amputations varied. Some amputations were part of ceremonial sacrifices offered to deities; others were punishment for stealing, and as a remedy for leprosy and gangrene. During this time science came into the arena of prosthetics. Leather, was abandoned and metal and wood became the prominent materials for replacement. During the Punic War (218 to 210BC) an iron hand was made for the Roman general Marcus Sergius, so that he may return to the war. His prosthetic hand was limited, for it only allowed him to hold his shield. The Dark Ages AD500 to 1500

Scientific development was stagnated. Those in need for prosthesis were limited to hook hands. Prosthesis that resembled the hand was constrained to the wealthy. Knights who lost their hands in the war had hands fashioned that would function during battle. These hands were heavy and cumbersome. Furthermore, the mortality rate for amputees was 80%. This was due to wound care practices, which included applying boiling oils to the wounds, searing with hot iron and guillotine amputations. The production of pus was believed to be an indication that healing was taking place. The surgeon had 30 seconds to remove the limb and 3 minutes to close it. Amputations and replacement were life threatening, as many patients bled to death. The Renaissance The development of improved surgical procedures was responsible for the major advances in the field of prosthetics. 1508- The German Knight Gotz Von Berlichingen, (known as Robin Hood) lost both hands, and had replacement iron hands, that were capable of moving at the joint. 1510- 1590 Ambroise Pare, the father of Prosthetics, was a surgeon-barber, credited for employing an artificial joint in the construction of prosthesis. Creator of Le Petit Lorrain hand made of iron that operated by springs and catches. Paré’s other contributions to the surgical field included the discovery that using boiling oil to treat gunshot wounds had a negative effect and recommended ligation instead of cauterization in amputations. He is believed to be the first person that learned to tie an artery.

1600-1800s The development of anesthesia, analeptics, blood clotting styptics and disease fighting drugs made replacement surgery a curative method. These new techniques allowed surgeons to create functional prosthesis. These devices were improvements of the earlier armor type replacement hands that gradually gained function but sacrificed aesthetics. Despite these refinements, however, the mortality rate was still high and it was said that it was “safer to have a limb amputated by gunfire than by a surgeon.” Antiseptic surgical techniques were developed in the late 1800s and weren’t widely employed. The Civil War 1861-1865 The Civil War was influential in the development of the field of prosthetics in The United States. With a minimum of 30,000 amputees, the need for scientific research and development for replacement limbs was evident. In 1862 the US government committed itself to supplying prostheses to veterans and providing funding that stimulated development. At this time many clinics open to treat amputees and many adds surface claiming to have successful prosthetics. The government fails to regulate and set standards for these new businesses, which often times exaggerated their success, or provided prosthesis for a limited population.

In 1863 the rubber hand is invented. It was a material of choice because of its resiliency in contrast to wood and steel. The hands were cast on a mold made from a model of the natural hand and it was attached to the end of the artificial forearm by means of a spindle. The fingers were flexible and would yield under pressure, having sufficient elasticity and adhesion to hold light articles. It presented a natural appearance and was pleasant to the touch. It was far more durable than the wooden hand. It might fall or strike a hard object and would not break. It could be slipped from the socket and a hook, knife, fork, brush, ring or other implement put in its place.

Rubber hands for specific task, such as sawing, were also produced.

WWI and WWII After WWI the U.S Army Surgeon General calls for a meeting with prosthetists to discuss prosthetic technology and it development. The American Orthotics and Prosthetics Association is established and is responsible for improving prosthetic care, organizing U.S prosthetist, and for research and development. In 1950, the Surgeon General calls for another meeting after it was evident that the US lagged behind in prosthesis development. Governmental funding is increased and standardized prosthetic training is introduced. Modern Era In the 1960s Russia produced a functional moving hand. Following this accomplishment the US developed a functional arm. Today electrical hands with strong silicone covers are in wide use. The field of prosthetics has increased significantly with new developments underway. Prosthesis controlled by sounds, nerves, and muscles are on the market or in research. Hands that have a more life like quality are also available and are improving in function everyday. The movement of fingers, and coordinated movements is now possible. The twentieth century has seen major advancements in an effort to perfect and mimic the range of motions of an actual hand.