Exhibition recalls history of amputees

Henry Paget, the second Earl of Uxbridge, had already survived wave after wave of French cavalry attack that saw eight – some thought nine – horses shot dead from right underneath him.

Now the cavalry commander was lying wounded in the filthy, stinking mud as the Battle of Waterloo blazed all around, the sudden, shocking realisation of his awful injury gradually dawning on him.

“The story goes that he turned to the Duke of Wellington, who was nearby, and said ‘By God, sir, I’ve lost my leg!’ And the Duke replied, ‘By God, sir, so you have!’”

The rusty grapeshot from a French cannon had, indeed, blasted away the earl’s leg. And, as Tacye Phillipson, curator of a new exhibition examining how technology down the centuries helped restore the lives of amputees like him recalls, the stiff repartee between the two was nothing if not understated and stoic.

“They did things differently in those days,” she agrees with a respectful nod. “His leg was amputated immediately. What’s interesting, though, is that the prosthetic limb which he went on to wear remained in production for a whole century afterwards, becoming slightly refined and more affordable, but more or less the same until the First World War.”

Of course the risk to life and, for many, limb, has been a prerequisite for any soldier going into battle since time began. From the age of King Tutankhamun’s Egyptian army to modern fighting forces in the maelstrom of Afghanistan, the loss of an arm or leg, a hand or a foot, may not result in headline news but still brings devastating, lifelong consequences.

It’s equally distressing for civilians who are caught up in the crossfire or become the innocent victims of landmines. For them, the impact of literally putting a foot wrong can leave broken bodies no longer fit to work, earn money and, ultimately, simply survive.

Now their plight and the efforts made down the years to help them regain vital mobility is to be explored in Reconstructing Lives, what promises to be a fascinating and at times moving exhibition at Edinburgh Castle’s National War Museum. The exhibition looks at the impact of losing a limb in battle – for soldier or civilian – and the ever-evolving technology which has helped rebuild lives.

Exhibits range from basic wooden “peg” legs – the kinds found described in Roman literature – through to hi-tech 21st-century carbon-fibre running blades, the source of debate over whether users have an unfair advantage over other competitors on the running track.

There are also prosthetic hands and arms, from the armour-like iron hands developed in the 16th century to the split hook hand designed by American amputee DW Dorrance in 1912 and still in use 100 years later. Perhaps among the most fascinating is a modern i-limb hand, created by Livingston-based NHS spin-off company Touch Bionics, the first to have five individually powered fingers.

Absorbing as the exhibits are, they are merely pieces of metal, leather, plastic and computer chips without the poignant and moving stories of amputees on show alongside them, bringing powerful reminders of how conflict even today is robbing soldiers and civilians of mobility.

Of course, in the days of English Cavalry Commander Henry Paget and the Battle of Waterloo, there were far fewer choices available to soldiers who found themselves horrendously wounded on the field of battle and were lucky enough to survive.

While his amputated limb went on macabre display at the village of Waterloo, he was fitted with what became known as an Anglesey leg. Cutting-edge in its day, it’s now primitive compared with another exhibit, a 2011 Orion knee, made by English firm Endolite and containing a micro-processor so clever it can deduce what the wearer is doing and adapt accordingly.

“The Anglesey leg was top class when the Marquess of Anglesey lost his leg,” explains Tacye, who has included a variety of prosthetic hands and arms designed in Edinburgh in the exhibition. “It has basically got tendons from knee to ankle so when you bend your knee, the ankle moves appropriately.

“There has been tremendous progress through the years,” she adds. “There are literary references to the Romans using prosthetic limbs such as ‘peg legs’. Then iron was used because it survived better than wood and leather was used to create sockets.

“By the 19th century there were quite a few varieties of wood leg, some with knee joints which would link to the ankles – such as the Anglesey Leg.”

Major conflicts such as the First World War unfolded alongside massive improvements in medical care and technological advances brought huge developments in the kinds of prosthetic limbs available, she adds.

“In this country there were around 41,000 amputees after the First World War, so there was this really strong social need to return these people home and do what could be done to pay back the country’s debt.

“During and after the war there was such a manpower shortage that there was also a financial desire to return as many people as possible to being productive members of society and give them ways to earn a living and support a family.

“A lot of working arms were produced. You could unscrew the hand and screw on a hammer or a chisel or a special tool for holding a spade and then on Sundays, you could put on a hand.”

The Second World War saw further advances in the kinds of prosthetic limbs available to wounded soldiers and civilians. But it was a medical scandal in the Sixties which led to a raft of advances in the kinds of false limbs available, many pioneered here in Edinburgh.

“The Thalidomide tragedy led to Edinburgh becoming one of the few centres throughout the country set up to pay society’s debt to these children born with terrible congenital malformations,” explains Tacye. “That, combined with the city’s background in medical research, meant Edinburgh became very successful at developing new kinds of artificial limbs.”

The result is a broad range of examples of prosthetics from the local NHS collection in the National War Museum exhibition. It also led to the creation of NHS arms-length firm Touch Bionics, whose life-changing “robotic” hands integrate with the nervous system to translate into precise finger movement.

But while the leap from wooden peg legs to computer chip technology is impressive, Tacye points out a key element to emerge from compiling the exhibition is how the highest spec prosthetic might not necessarily be the best for every amputee.

Indeed, the simple but effective Jaipur leg – fitted to tens of thousands of people each year in poorer parts of the world and just £30 compared with around £2000 for an average western prosthesis – is more effective for many amputees.

“In the display is a running leg, the iconic flexible ‘J’ shape which Chris Moon, a double amputee, wore to run the West Highland Way race, 135 miles continuous without a rest,” she explains. “He says this was the toughest ultimate distance race he’d ever done because the legs are sprung, they bounce you up and along.

“They work well on flat surfaces but the West Highland Way is anything but flat, so he was bounced about at random angles the whole way.

“So here is this wonderful piece of engineering, yet most people don’t run marathons. And for someone like a World War Two veteran, they need a stable walking leg, not a hi-tech running leg.

“Sometimes the more basic is actually the better.”

• Reconstructing Lives is at the National War Museum, Edinburgh Castle, from Friday, March 9, until February 2013. Entry free with admission to Edinburgh Castle.

PIONEERS IN ANCIENT EGYPT

The Egyptians were early pioneers of prosthesis, while Greek historian Herodotus told the tale of Hegesistratus, a Greek diviner who cut off his foot to escape his Spartan captors and replaced it with a wooden one.

As time progressed, metal prosthetic limbs and hands were introduced. Some included metal knee joints and articulated feet controlled using tendons made from catgut. Later, some were fitted with springs and metals such as lighter-weight aluminium were introduced.

Some famous military men eschewed the idea of a false limb – Lord Nelson preferred to tuck his sleeve into his jacket rather than use a prosthetic hand. Others became famous for their’s – Douglas Bader lost both legs in an aircraft crash in 1931, yet went on to become a Second World War ace pilot.

More than 130 British soldiers in Afghanistan lost at least one limb between 2009 and 2010.