“The doctors say it dates back to a film where I had these huge prosthetic breasts because my character was breast-feeding. The weight of them, and of the baby, did my back in."---Anna Friel (English actress). As the US Civil War dragged on, the number of amputations rose astronomically, forcing Americans to enter the field of prosthetics. James Hanger, one of the first amputees of the Civil War, developed what he later patented as the ‘Hanger Limb' from whittled barrel staves. People such as Hanger, Selpho, Palmer and A.A. Marks helped transform and advance the prosthetics field with their refinements in mechanisms and materials of the devices of the time. Around 1912 with the budding of aviation technology, an English aviator, Marcel Desoutter, who lost his leg in an airplane accident, made the first aluminum prosthesis with the aid of his brother, Charles, an aeronautical engineer. This was followed by a similar advancement by Hanger. Other inventions developed by Desoutter and Hanger, such as pelvic suspension rather than shoulder suspension, provided a more efficient and stable way of operating the prosthesis and direct knee control. This led to knee control systems such as the knee brake. There were a great many amputations (30,000 in the Union Army). In 1862, the government guaranteed prostheses for veterans who lost limbs in the war. A southern soldier, J.E. Hanger, who lost his leg in 1861, replaced the catgut tendons of the American leg with rubber bumpers to control dorsiflexion and plantarflexion, and he used the plug fit wood socket. He then opened a clinic in Richmond, Virginia. Later the rubber foot, the forerunner of the SACH foot, came into use and eliminated the complicated articulated ankle of the Bly leg. In 1885, Heather Bigg wrote a pioneering textbook on amputations and prostheses. In it he details instructions to place the knee joint of the prosthesis posterior to the anatomical knee centre and emphasises the need for correct alignment. During this time with government money a great many "clinics" opened. By 1917 there were about 200 clinics and 2000 skilled workmen. Many extraordinary claims were made at this time such as the Bly leg. Many of the manufacturers were amputees themselves and thought their inventions were a cure all. But in reality, they fit only themselves and a select patient group. Around 1912 with the budding of aviation technology, an English aviator, Marcel Desoutter, who lost his leg in an airplane accident, made the first aluminum prosthesis with the aid of his brother, Charles, an aeronautical engineer. This was followed by a similar advancement by Hanger. In the same year (1912), Gustav Hermann made the first aluminum leg prosthesis. In 1915, the first externally powered prosthetic limbs are built in Germany. Other inventions developed by Desoutter and Hanger, such as pelvic suspension rather than shoulder suspension, provided a more efficient and stable way of operating the prosthesis and direct knee control. This led to knee control systems such as the knee brake. Dear Egyptian Mail readers, Your comments and/or contributions are welcome. We promise to publish whatever is deemed publishable at the end of each series of articles. [email protected]