False toe on mummy found near Luxor.

Severed Limbs and Wooden Feet: How the Ancients Invented Prosthetics

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We are living through an incredibly exciting period for prosthetics. A pioneering brain computer interface that will allow veterans to control artificial body parts with their minds was recently announced by researchers in Virginia in the US. Meanwhile, Newcastle University in the UK is developing limbs which “see” objects in front of them and react at speeds more comparable with the real thing.

Projects like these are steadily helping people with prostheses to move more naturally and easily than ever before. But what few people appreciate is just how far back this field actually goes.

If you were thinking a couple of hundred years, or maybe since the medieval era, you wouldn’t even be close. Amputations and prostheses date back to ancient times, and saw advances that were heralded as no less life-changing then as they are today. It’s a fascinating story of gods, gladiators and the limits of human endurance that adds a whole other dimension to understanding this discipline.

Prosthetics begins

Warfare was not kind to the bodies of soldiers in Ancient Greece and Rome. It has been  estimated that  in Ancient Greece, about 80% of seriously wounded soldiers died on the day of battle. Of the remaining 20%, a third died of their injuries after returning home. It is not easy to make direct comparisons with modern times, but these figures are certainly likely to be much higher.

Whether survivors in the ancient era were injured in battle by a blade, spear or missile, or in camp by frostbite or trench foot, their arms, legs and extremities were incredibly vulnerable. In Ancient Greece, they benefited from simple surgical amputations as far back as the late fifth or early fourth century BC. The Hippocratic treatise  On Joints  attests to rudimentary amputations of fingers, toes, hands and feet, but cautions against amputating an entire arm or leg.

Around the same time, orthopaedic surgery had refined to the point that prostheses were starting to become available as alternatives to staffs, sticks and crutches. We see this  in the account  of the Graeco-Persian War (499-449BC) by the historian Herodotus, for instance. Herodotus recounts how the Persian diviner Hegesistratus, when imprisoned by the Spartans, amputated part of his own foot to escape his shackles, then procured a wooden replacement.

Egypt was using similar technology around the same period. Prosthetic toes made from wood or layers of fibre known as  cartonnage have been recovered  from burial sites, such as the one from a mummy near Luxor pictured below. They show signs of wear and tear, indicating that they were functional rather than purely cosmetic.

Prosthetic hand from ancient Egypt

Prosthetic hand from ancient Egypt

Surgical techniques advanced considerably during the  Hellenistic period  (323-31BC), the last era before Greek dominance gave way to Rome. These advances were  thanks to  medical practitioners at the Museion and Library in Alexandria making in-depth anatomy studies by dissecting and even vivisecting criminals sentenced to death.

This improved their understanding of the circulatory system and led them to discover that blood vessels could be tied off to prevent bleeding, which meant that amputations could be done slowly and carefully. There was less risk that the patient would die of blood loss, and stumps were now more amenable to prosthesis use.

It is unlikely to be a coincidence that prostheses advanced at the same time. An artificial leg recovered from a tomb in Capua in southern Italy, dated to the late fourth or early third century BC, had a wooden core covered in bronze sheeting. This was held in place by a leather and bronze belt, which would have made movement easier.

Another example is the Roman general Marcus Sergius Silus. He lost his right hand during the  Second Punic War  (218-201BC), which was fought between the Romans and  Hannibal of Carthage  in latterday Tunisia. But rather than retire, Silus procured an iron hand which he subsequently used to bear his shield, transferring his sword to his left hand instead.

Battle of Zama in Second Punic War, Giulio Romano 1521.

Battle of Zama in Second Punic War, Giulio Romano 1521.

Then and now

Surviving examples like these indicate that extremity prostheses were designed, commissioned, and manufactured to an individual’s specific preferences. The same artisans that produced personalised armour and weapons likely produced personalised prostheses for wounded veterans.

Considering the ancient association of disabled people with crafts such as metalwork – epitomised by the Greek god  Hephaistos and his Roman counterpart Vulcan  – artisans may even have drawn on their own experiences of impairment to inspire their creations. Soldiers like Silus would duly have been able to defy their societies’ expectations and continue to play significant roles at moments of historical significance.

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Roman glass (not the legendary flexible glass). Landesmuseum Württemberg, Stuttgart.
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