This timeline of prosthetics in WWI will students through the evolution of medical technology during the war using primary sources and readings. Context is provided for developments before and after the war, and primary source images are included to illustrate the changes over time.
Introduction
Throughout centuries, people have innovated in times of challenge, particularly during war. Consider how WWI and medical pioneers changed the world of prosthetics with this timeline.
An Overview:
As early as 950 BCE, humans designed prosthetics. The earliest example was discovered on a mummy in ancient Egypt – a big toe made of wood and leather. From ancient civilizations through the Victorian era, prosthetics were used for both function and aesthetics. Evolutions in design and materials led to the first body-powered prosthetic hand in 1857.
By the 1900s, new treatments and technologies emerged in the field. Before, patients had two prosthetic options: a functional limb for manual labor or a cosmetic limb without function. The blending of form and function came with the new century.
On August 5th, 1914, the first land battle of World War I began in Liège, Belgium. Thus began a long war that would leave millions with permanent injuries, and millions more dead across the globe. While casualty counts from the first weeks are unclear, it is known that in the first four months of the war, the French lost 310,000 soldiers.
The new violent, chaotic and terrifying war technologies led to the First World War becoming the heart of prosthetic innovation. Over 100,000 soldiers, sailors and pilots experienced limb loss during the war, with over 4,400 Americans receiving treatment and prosthetics. These estimations do not account for non-uniformed support personnel, such as mechanics or nurses, or civilian casualties.
WWI led to the creation of the Walter Reed Army Medical Hospital’s prosthetic laboratory, occupational and physical therapy programs, and redesigned the Veterans Bureau, which later became the Department of Veterans Affairs. The first half of the century also introduced new medical materials, revolutionized prosthetic devices and encouraged movements for more complete and inclusive representation and legislation.
Timeline
Interactive timeline showing 15 events, one at a time. Use the previous and next buttons, or the left and right arrow keys, to move between events. The timeline navigation below lets you jump to any event.
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Pre-WWI: 1900-1914
1911
As the new century dawned, European doctors searched for more functional and elegant artificial limbs that could be manipulated to help with daily life and manual labor, rather than the single-purpose designs from history. In 1911, William T. Carnes of the Carnes Artificial Limb Company patented arm and hand prosthetics that could provide limited dexterity and cosmetic simulation for amputees.
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1911: Carnes Arm instruction sheet
This instruction sheet was provided to customers to teach them how to use their Carnes Arm.
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1911: Carnes Hand instruction sheet
This was the instruction sheet provided to customers to teach them how to put new cords into their prosthetic hand.
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1911: Carnes prosthetic limb
This prosthetic limb was designed by Carnes Artificial Limb Co. for Corporal Henry G. Botjer of the New York National Guard.
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WWI: 1914-1918
1915-1916
Germany’s Siemens-Schuckert-Werke began manufacturing their Siemens Universal Work Arm, a functional prosthetic with special inserts to individualize the arm for the wearer’s needs. These prosthetic devices were designed for industrial laborers and agricultural work but missed aesthetic qualities. Similar designs from other European manufacturers sought to provide war-wounded with prosthetic limbs that could survive the demands of factory or farm work. By 1916, Germany purchased their own licenses to build “Carnes Arms,” providing war casualties with a prosthetic for light office work. While not useful for manual labor, and often uncomfortable to wear, the arm set expectations for future prostheses.
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1915-1916: German man
A German man learns to work with a hammer and anvil while using two prosthetic arms.
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1915-1916: German soldier
A German soldier shaving a piece of wood using a prosthesis on his left arm.
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1915-1916: French soldier
A French soldier with both arms amputated during the WWI uses prosthetic arms to move soil with a pitchfork.
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1915: Form meets Function
During the same year, the “Openshaw” wooden carrying hand was designed by British surgeon, Thomas Openshaw, and later patented for production by Anderson & Whitelaw, Ltd, a manufacturer of medical devices and prosthetics during the war. Each hand was individually carved from wood and designed with a jointed thumb, index, and middle finger. The little finger and ring finger were fixed in position and reinforced with metal, so bags and other items could be easily carried. The hand was designed to be screwed into a prosthetic arm. The wooden hand had the aesthetic elements of a lifelike hand, but limited use as anything other than a hook. Its designer, Thomas Openshaw, was a senior surgeon at Queen Mary’s Hospital in Roehampton, England, which was established in 1915 to deal with the growing number of amputees created by the First World War and eventually treated just over half of the 41,000 servicemembers.
The “Openshaw” wooden carrying hand; note the metal piece keeping the right and little fingers held into position.
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1917: Rowley Artificial Limb Company
The Rowley Artificial Limb Company became a success in 1917, with manufacturing houses in Pittsburgh and Chicago and distributors across the country. A leg amputee himself, J.F. Rowley began his prosthetics business in the 1880s out of frustration with the prosthetic legs available at the time, inventing his own “Rowley Leg.” Like many other prosthetists in business at the time, Rowley used his own one-legged state to claim expertise on amputee support and prosthetic design.
This prosthetic “Rowley Leg” was used by Missourian Finis Edward Rayhill, a bugler wounded on Aug. 11, 1918. His leg was amputated in France, and then he returned to the United States for rehabilitative care and was fitted with this prosthetic leg.
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1918-1919: Mass production
At the start of the war, 94% of American prosthetic firms used wood to make individually sculpted artificial limbs for patients, which required craftsmen to continuously rework the limb until the fit was acceptable. Handcrafting a prosthetic from wood could take months or even years. Walter Reed Army Hospital’s Limb Lab sought to standardize and speed up the process by using new materials. New prosthetic designs, like the vulcanized fiber E-Z-Leg by the E-Z-Fit Artificial Limb Company, began catching the attention of U.S. Army medical leadership as options for amputees.
By late 1918, the Chicago-based Dorrance Artificial Limb Company introduced their version of a “utility arm.” Advertised as “The Arm that Arms You for Work or Play,” the design enabled the wearer to select and directly attach work tools to the limb itself. Walter Reed Army Hospital’s Limb Lab created a similar arm that could be modified based on the soldier’s line of work and even included a selection of sporting attachments.
Courtesy U.S. National Archives
A man being fitted for his E-Z Fit artificial limb.
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1918-1919: Publications
Internally produced magazines from the Veterans Bureau and the War Department – like “The Come-Back and Carry On!” – gave rehabilitating servicemembers a mix of encouragement and practical tips for returning to civilian life with their new prostheses. These publications served as a form of propaganda, pressing veterans to quickly overcome physical and emotional struggles with their prostheses and focus on returning to the working world.
Courtesy U.S. National Library of Medicine
This issue of the Carry On! magazine was published in 1918 as propaganda to push servicemembers to be ready to go back to work.
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Post-WWI
1921
On Aug. 9, 1921, Congress combined the efforts of the three different federal agencies under the new Bureau of Veterans Affairs. With this, they set up a new system of veterans’ benefits, including disability compensation, service member insurance and job rehabilitation for the disabled.
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1924: Norman T. Kirk
Renowned orthopedic surgeon Norman T. Kirk published his medical findings and personal experiences, “Amputations.” From his experiences at General Hospital No. 3 and Walter Reed Army Hospital, Kirk’s studies had an immediate impact on care for those with sustained limb loss from combat injuries. Kirk’s direct approach to surgical orthopedic care and recovery, which included continued medical support, formed the basis for today’s multidisciplinary approach to amputation care and prosthetic support.
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1943: Norman T. Kirk
Major General Kirk was appointed as the United States Army’s Surgeon General, becoming the first board certified orthopedic surgeon to hold the job. Bringing his experiences from WWI to the assignment, he immediately created clinical policies for battlefield casualties and traumatic limb loss happening in WWII. Combining staged surgical care, physical therapy and prosthetic fitting support for all amputees, Major General Kirk applied the same multidisciplinary team approach he had originally developed in WWI at Walter Reed.
"We are the Maimed"
In Flanders fields we do not lie
Where poppies grow and larks will fly,
Forever singing as they go
Above the bodies, row on row,
Of those whose duty was to die.
We are the maimed! Death did deny
It’s solace. Crippled, blind, we try
To find on earth the peace they know
In Flanders fields.
Forget us not! As years go by,
On your remembrance we rely
For love that sees the hearts below
Our broken Bodies. Else we grow
To crave our peace with those who lie
In Flanders Fields.
Conclusion
The experiences of WWI set the stage for future innovation, many of which found direct applications during WWI and continued to shape subsequent eras. The medical discoveries, theories, and ideas that formed from the ashes of the Great War have played a vital role in enhancing contemporary options, accessibility and quality of care for individuals choosing prosthetic assistance.
