In medicine, a prosthesis, is an artificial device that replaces a missing body part lost through trauma, disease, or congenital conditions.
Prosthetic devices have existed for centuries. Originally prosthetics were simply replacements for missing limbs, but now they help people have extremely active lives.
Such improvements have been made possible because of new surgical techniques, the advancement of components for making prosthetics, and creative engineering ideas.
Rig-Veda (estimated to be composed around 23720 BCE), is the first recorded document about a prosthesis.
The anatomy, physiology, embryology etc. are discussed very clearly in Vedas.
The surgery is the most amazing science found in Rig Veda over thousands of years ago.
It mentions the concept of Artificial Limbs in history of prosthesis.
“Sodao janghamaysing vishapalaoi dhana hite sterba pratyadhattyam” Rig-Veda- 1:116:15
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The foot of Vispala, the wife of Khela, was cut off, like the wing of a bird, in an engagement by night.
Immediately you gave her a metallic leg, so that she might walk.
Khela was a king; Agastya was his purohita. Through his prayers the Aswins gave Vispala a metallic leg.
In vedic times, surgery was practiced including major operations like amputation, laparotomy and trephining of the skull.
Other Historic References of Prothesis
Aristophanes included a character with a prosthetic leg in his play “Birds.”
Its reference also dates back to the fifth Egyptian Dynasty (2750-2625 B.C.). Archaeologists have excavated the oldest splint from this period.
Around 500 BC, Herodotus wrote about a prisoner who escaped from his chains by cutting off his foot, which he replaced with a wooden substitute.
A Roman prosthesis from the Samite Wars, dating back to 300 BC, was unearthed at Capri in in 1858. It was constructed of a wooden core, bronze shin and leather straps.
In 16th century, we can find multiple references to prosthetic devices used like :
- In 1508 the German knight, Gotz Von Berlichingen, lost his right arm in the battle of Landshut when cannon fire struck his sword, which then severed his arm. He was fitted with replacement hands which were capable of moving at the joint.
- In 1529, French surgeon, Ambroise Pare (1510-1590), introduced amputation as a lifesaving measure in medicine. Soon after, Pare started developing prosthetic limbs in a scientific manner. He is credited for employing an artificial joint in the construction of a prosthesis. Ambroise Pare created Le Petit Lorrain hand made of iron that operated by springs and catches. Pare also discovered that using boiling oil to treat wounds had a negative effect and recommended ligation instead of cauterization in amputations.
- In 1816 the Anglesea or clapped leg was developed for the First Marquess of Anglesea after he lost a limb during the battle of Waterloo the previous year. The latter name was given to the leg because of the noise it made on full extension.
- 1861 – 1865, The American Civil War was influencial in the developing field of prosthetics with an estimated 30,000 amputees resulting from battle injuries.
- In 1862 the US Government committed to supplying prostheses to veterans.
- In 1863 the rubber hand was invented. The hands were cast on a mould made from a model of the natural hand. It was attached to the artificial forearm by the means of a spindle. The fingers were flexible and would yield under pressure.
- In 1863 Dubois L Parmelee of New York City improved artificial limbs by attachting a body socket to the limb with atmospheric pressure.
- In 1898 Dr Vanghetti invented a limb which could move through muscle contraction.
In 20th century, more progress was made including microprocessor controlled devices.
- The Artificial Limb Service was first set up by the War Office during the First World War. Artificial limb ‘Shops’ had been established at Roehampton and the Charterhouse Hospital (near Smithfield ). Some 25, 000 amputees had been treated at the 900 bed hospital for the war wounded. Many other Limb Fitting Centres such as those at Cardiff and Manchester were also started in the country during the 1914-1918 war.
- After World War 2, with the resultant huge increase in young amputees, the need for better limb services became more apparent. This led to technology being concentrated on the development of a new knee that would stabilise during weight bearing but swing freely during walking.
- In 1932 the Limb Fitting Service came under the Ministry of Pensions. In 1948, with the advent of the National Health Service, amputees other then the war wounded were accepted as patients at the centres.
- In 1946, a major advancement was made in the attachment of lower limbs. A suction sock for the above-knee prosthesis was created at the University of California (UC) at Berkeley.
- In 1960 the Russians produced a functional moving hand.
- The 1970s then saw the development of ‘Modular Assembly Prosthesis’ which allowed the assembly of a prosthesis to be manufactured from a series of stock components. Then, in the 1980s, with the development of materials in the aircraft industry, the world’s first carbon fibre prosthetic system was made. This technology promoted high strength and light weight system. Then with the development of CAD CAM, plastic moulded limbs were introduced, fitting comfortably over the residual limb. Cosmetic skin were also being introduced around this time thanks to the development in silicone technology.
- In 1975, Ysidro M. Martinez, an amputee himself, invented a below-knee prosthesis with a high centre of mass but also lightweight enough to facilitate acceleration and deceleration and reduce friction.
- Then in the 1990s, development into the first commercially available microprocessor controlled prosthetic knee was carried out. Called the intelligent prosthesis (IP), the unit is programmed to each individual user during walking to achieve the smoothest, most energy-saving pattern. It reacts to speed changes but its intelligence does not extend to understanding environmental considerations such as stairs, ramps or uneven terrain.
Unfortunately, we only have references of prosthetic device in rig veda, but no literature or method describing how it can be applied and achieved today.
