Thursday, March 10, 2005

Believe it, or not ...


Photos by Patricia McAllister

Prosthetic limbs were manufactured for amputees during and after the Civil War. This circa 1864 prosthetic leg, resembling a piece of armor from a medieval knight's ensemble, featured a moveable knee and toes. The oldest artificial leg on display at the museum is a model patented in 1850.


Two American inmates in a Japanese prisoner of war camp in Burma made this leg in 1942 for a fellow POW whose leg was amputated after developing a tropical ulcer due to the unsanitary conditions in the camp. The leg, made from the remains of a leather belt and metal folding chair, was whittled using only a pocketknife. The leg was constructed in secret so the Japanese guards would not confiscate their tools and equipment before completion.

In January 1945, Dewey Force, an X-ray technician with a medical support battalion, destroyed his foot after he stepped on a landmine in France. After his leg was amputated below the knee, he was fitted with this artificial leg at the Battle Creek Rehabilitation Hospital in Michigan.

Museum exhibit photos by Patricia McAllister
Just a brief jaunt from almost any building on the Walter Reed post, is a jewel in the crown of the Armed Forces Institute of Pathology. The National Museum of Health and Medicine was founded in 1862 as the Army Medical Museum. Its original purpose was to study and improve medical conditions during the Civil War, specifically war wounds. By the war's end, the museum had collected about 2,000 bones, such as amputated arms and legs.

While many of the exhibits still reflect this connection, such as "Battlefield Surgery 101: From the Civil War to Vietnam," there are also others that appeal to the macabre-buff in us all. The weirder treats include everything from a giant (human) hairball that puts any housecat to shame, to spines twisted by scoliosis. All the exhibits serve to educate and inform visitors about the evolution of medicine, while also serving to entertain the mind.

The history of the museum is equally interesting. It was previously located in such places as Ford's Theater, from 1866 to 1887, and on the Mall until the late 1960s. "We were the most visited museum on the Mall when we were there," said Steven Solomon, public affairs officer for the museum. "We were also the most visited museum off the Mall until 9/11 and the spy museum opened." The heightened security after 9/11 naturally resulted in a drop in visitation, but Solomon said the museum still draws 50,000 to 60,000 visitors annually.

The museum's historical connection to Ford's Theater remains, in a permanent display about President Abraham Lincoln. Skull fragments and hair from the president can be viewed close-up. So can other remnants from Lincoln's demise, such as the blood-stained cuffs from the museum surgeon who attended his autopsy.

Five major collections are found at the museum - anatomical, historical, archival, neuroanatomical and human developmental anatomy. These comprise nearly 25 million specimens and artifacts. Medical researchers from around the globe come here to study them.

More than 14,000 objects are included in the historical collection alone. The earliest item is a handcrafted leather and gold-tooled Robert Hooke microscope dating from the 1660s, part of the Billings Microscope Collection, containing more than 600 microscopes - the world's largest. The "Evolution of the Microscope" exhibit traces the history of this instrument by displaying examples of beautifully crafted antiques.

But an item need not be ancient to have value to the museum. Historical collections manager Alan Hawk said the most recent items are related to the Global War on Terrorism, documenting current medical activities. Hawk is always interested in acquiring more items to enrich the museum's historical collection.

"If there's anything readers have - something they might have of interest to us, please let us know," Hawk said. "Things documenting the history of military medicine is our primary focus."

An example of this is the evolution of surgery. "We can pretty much document a century of plastic surgery, from the Civil War to the Vietnam War era," Hawk said, in reference to a collection of "life masks," plaster casts of living Soldiers' faces taken during various stages of facial surgical repairs. These admittedly haunting items make one appreciate modern medicine even more.

One of the more famous surgical tools in the museum's care is a Heine Osteotome, a surgical Swiss Army-type "all in one" tool that operates in a similar fashion to a modern chainsaw. The spectacular gold-plated model in the museum dates from 1876 and was created as a showpiece for the Philadelphia Exposition. The actual invention dates back to the 1830s. It was primarily used to speed up sawing through bone.

"We're a storehouse of technology, of ideas people use and develop - some fall out of favor, some continue to be used, and some things may come back in different forms for different uses," Hawk said. "Part of our mission is to preserve these things so that people in the future can look at what people did at this time, or any time period."

Surgical collections are not limited to American military medicine, but include examples from other countries such as Japan, Germany, and Vietnam. The Viet Cong were particularly adept at turning scrap aluminum into surgical instruments during the Vietnam War, and the museum has handmade examples so well-crafted that they appear on first glance to be mass-produced.

Lenore Barbian is the museum's assistant curator for anatomical collections. Her expertise is in skeletal biology, human anatomy and physiology. She said the Civil War collection is probably the most accessed at the museum.

"Since we know all the names of all the Soldiers that these specimens came from, we get people doing family histories, or people doing regimental histories, or people interested in specific battles," Barbian explained. She said historians and medical students also regularly utilize the extensive collection.

Some collections the museum acquired were inherited from other facilities. One of the more recent interesting and famous of these came from the New York medical examiner's office, and includes anatomical specimens dating back to the 1930s. Barbian displayed one skull with a broad metal beam thrust right through it - in this case at least, the cause of death is rather evident.

Presidential body parts in storage range from Garfield's spine to Eisenhower's gallstones, as well as remnants of presidential assassins. There are even some famous non-humans residing here. The museum has the skeletons of the first two monkeys and chimpanzee to survive space travel - named Able, Baker and Ham, respectively.

The world-famous Carnegie Collection of human embryos is also located at the museum. Imaging specialist Elizabeth Lockett serves as co-curator of the museum's permanent exhibit "From a Single Cell: Human Reproduction, Growth, and Development." Real specimens demonstrate the development of humans from the embryonic stage to age five.

For those with an artistic bent, "The Human Body Revealed" and "The Visible Skeleton Series" by artist Laura Ferguson provide a fascinating glimpse inside the human body. And for those whose tastes run to more sedate pursuits, chief archivist Michael Rhode of the Otis Historical Archives is able and willing to assist those searching for particular documents or records relating to medical history.

Whatever aspect of medicine appeals to a visitor, there is something here to fascinate and entertain. After all, it's not every day you can see the bullet that killed Abraham Lincoln in one case, and live leeches in another.

The National Museum of Health and Medicine is open daily from 10 a.m. to 5:30 p.m. Admission and parking are free. Visits are self-guided and take about two hours. Free guided tours are available for groups of 10 or more with advance reservations by calling 782-2200.

For more information, visit the museum's Web site at www.nmhm.washingtondc.museum.

History of prostheses

The earliest description of a limb prosthesis is found in Herodotus' "The Histories" written in 484 B.C. Herodotus tells of a Persian soldier, Hegesistratus, who was imprisoned by the enemy. In order to escape from the stocks, Hegesistratus cut off part of his own foot. He later wore a wooden replacement.

The oldest known prosthesis, discovered in a tomb in Capua, Italy was an artificial leg made out of copper and wood dating back to 300 B.C. Unfortunately the leg was destroyed by bombing during World War II. In the 15th and 16th centuries many prostheses were made from iron. They were created for soldiers by the same craftsmen who made their suits of armor. In 1529, French army surgeon Ambroise Pare introduced amputation as a lifesaving measure in medicine. Pare also contributed to the design of limb prostheses.

Many innovations were made in the 19th century. Lighter-weight prostheses made from wood instead of metal gained popularity. In 1800, James Potts designed his famous wooden "Anglesey leg" which lifted the toe when bending the knee through the use of artificial tendons. In 1812 an arm prosthesis was developed which produced movement in the arm and hand using straps connected to the opposite shoulder.

Interest in artificial limbs increased late in the century due to the large number of amputations during the Civil War. That prosthesis technology advanced during this time was primarily due to two factors - the availability of government funding of prostheses for war veterans, and the discovery of anesthetics such as chloroform and ether, allowing longer surgeries during which more functional amputation stumps could be shaped. These more carefully designed stumps enabled prosthetists to improve the fit of their devices.

This 1945 prosthesis was commonly issued to amputees during World War II. Although it looked like a hand when covered by a glove, the wearer had difficulty using it to pick up and handle things.

- from "History of Prostheses"- courtesy University of Iowa