“All that prosthetic makeup drains you. By the time it's lunch, you're done.” – Mickey Rourke (American actor, screenwriter and retired boxer). The Roman scholar Pliny the Elder (23-79 AD) wrote of a Roman general in the Second Punic War (218-210 BC) who had a right arm amputated. He had an iron hand fashioned to hold his shield and was able to return to battle. The Dark Ages (476 to 1000) were, as their name implies, a time in which there was little scientific illumination. The feudal system effectively divided all regions of Europe into many tiny isolated kingdoms. This hampered the scientific process because no central forum for government or learning existed. Thus, as in every aspect of human endeavour, the Dark Ages saw little advancement in prosthetics other than the hand hook and peg leg. Most prostheses of the time were made to hide deformities or injuries sustained in battle. A knight would be fitted with a prosthesis that was designed only to hold a shield or for a leg to appear in the stirrups, with little attention to functionality. Outside of battle, only the wealthy were lucky enough to be fitted with a peg leg or hand hook for daily function. Many of the surgical techniques developed by the Greeks and Romans fell into disuse as there were fewer educated people from each region to read, use, test, and record their findings. At this time primitive techniques such as crushing the limb, dipping in hot oil, or searing with hot irons were used. The guillotine technique was used and the limb surface was allowed to granulate. It was common for tradesmen, including armorers, to design and create artificial limbs. People of all trades often contributed to making the devices; watchmakers were particularly instrumental in adding intricate internal functions with springs and gears. Speed was of the essence. Most people died of blood loss, and those who did not usually succumbed to infection from the dirty surgical techniques. Pus was not only expected but thought of as an indication of normal healing. These techniques did not die out until the mid to late 1800s.
