Prosthetic Toe of Painted Cartonnage

Prosthetic Toe of Painted Cartonnage



We are searching data for your request:

Forums and discussions:
Manuals and reference books:
Data from registers:
Wait the end of the search in all databases.
Upon completion, a link will appear to access the found materials.


Shahr-e Sukhteh, a Bronze Age settlement in southeastern Iran, yielded a lightweight, 2.5-centimeter (1 in) prosthetic eyeball made of bitumen paste over which was laid a thin layer of gold. Hemispherical, it bore a hole through each side, which enabled it to be secured to the eye orbit with gold wire.

The center of the eyeball was &ldquoengraved&rdquo with an iris and the golden rays of the Sun. The remains with which the prosthetic eye was found date from 2900 to 2800 BC. At a height of 1.8 meters (6 ft), the unusually tall woman was likely to have been of royal or noble blood.

In the fifth century BC, Egyptian priests also fashioned early prosthetic eyes known as ectblepharons. Constructed of painted clay or enameled metal that was attached to cloth, these prostheses were worn outside the socket.


Egyptian toe tests show they're likely to be the world's oldest prosthetics

The results of scientific tests using replicas of two ancient Egyptian artificial toes, including one that was found on the foot of a mummy, suggest that they're likely to be the world's first prosthetic body parts.

The University of Manchester researcher Dr Jacky Finch wanted to find out if a three part wood and leather toe dating from between 950 to 710 BC found on a female mummy buried near Luxor in Egypt, and the Greville Chester artificial toe from before 600 BC and made of cartonnage (a sort of papier maché mixture made using linen, glue and plaster), could be used as practical tools to help their owners to walk. Both display significant signs of wear and their design features also suggest they may have been more than cosmetic additions.

Dr Finch says: "Several experts have examined these objects and had suggested that they were the earliest prosthetic devices in existence. There are many instances of the ancient Egyptians creating false body parts for burial but the wear plus their design both suggest they were used by people to help them to walk. To try to prove this has been a complex and challenging process involving experts in not only Egyptian burial practices but also in prosthetic design and in computerized gait assessment."

Dr Finch, who is based in the Faculty of Life Sciences' KNH Centre for Biomedical Egyptology, recruited two volunteers who were both missing their right big toe. Design replicas of the ancient toes were made to fit each volunteer along with replica leather ancient Egyptian style sandals.

The tests were carried out at the Gait Laboratory at Salford University's Centre for Rehabilitation and Human Performance Research. Each volunteer was asked to walk on a 10 metre walkway bare foot, in their own shoes and wearing the replicas with and without the sandals. Their movement was tracked using 10 special cameras and the pressure of their footsteps was measured using a special mat. The 10 best walking trials were recorded for each foot, using their normal left foot as the control.

It was surprising how well both volunteers were able to walk using these devices although one volunteer performed much better than the other. The camera footage revealed that when wearing the sandals with the cartonnage replica, one of the volunteers achieved 87% of the flexion achieved by their normal left toe. The three part wood and leather design producing nearly 78%. Interestingly the ability to push off using the prosthetic toe was not as good when this volunteer wasn't wearing the sandals. The second volunteer was still able to produce between 60-63% flexion wearing the replicas with or without the sandals.

When wearing the replicas the pressure measurements showed that for both volunteers there were no overly high pressure points. This indicated that the false toes were not causing any undue discomfort or possible tissue damage. However, when the volunteers wore just the replica sandals without the false toes the pressure being applied under the foot rose sharply.

Dr Finch says: "The pressure data tells us that it would have been very difficult for an ancient Egyptian missing a big toe to walk normally wearing traditional sandals. They could of course remained bare foot or perhaps have worn some sort of sock or boot over the false toe, but our research suggests that wearing these false toes made walking in a sandal more comfortable."

Alongside the test data Dr Finch also asked her volunteers to fill in a questionnaire about how they felt when doing the trials in the gait laboratory. Despite it having performed well the comfort scores for the cartonnage replica were disappointing although it was felt to be an excellent cosmetic replacement. Describing the performance of the three part wooden and leather toe both volunteers found this one to be extremely comfortable, scoring it highly, one volunteer commenting that with time he could get used to walking in it.

Assessing the volunteers' experience Dr Finch said: "It was very encouraging that both volunteers were able to walk wearing the replicas. Now that we have the gait analysis data and volunteer feedback alongside the obvious signs of wear we can provide a more convincing argument that the original artefacts had some intended prosthetic function.

The findings from this study, which have been published in the Journal of Prosthetics and Orthotics, means the earliest known prosthetic is now more likely to come from ancient Egypt. The three part example pre-dates by some 400 years what is currently thought to be the oldest, although untested, prosthetic device. This is a bronze and wooden leg that was found in a Roman burial in Capua, Southern Italy. That has been dated to 300 BC although only a replica now remains as the original was destroyed in a bombing raid over London during the war.


These Toes Were Made for Walking

Battle past the hoards of school children in the British Museum ogling at the dried up body of a 5417 year old ginger man from Upper Egypt and you might just make it to a small nondescript case standing on the north-facing side of room 63. Here is where, in my humble opinion, the real treasures are to be found.

This fascinating object, nearly 12cm in length and 7cm in width, is made from a material known as Cartonnage, made by layering linen impregnated with animal glue and gesso, a plaster-like binding material: a sort of Ancient papier-mâché. The top layer shows feint cracks and the edges display signs of wear or ageing.

You are looking at the Grenville Chester Great Toe. But the name is misleading in two respects: first, Reverend Greville John Chester did not own the toe, nor was it made for him, he merely delivered it to the British Museum around 1881 after ‘wintering in Egypt’ and second, that ‘Great’ refers – sadly – only to the hallux or ‘big toe’, rather than the object’s well-deserved prestige. The Great Toe is a prosthesis, an artificial body part, understood to replace a missing one, as its derivation from the Greek ‘pros tithenai’, to place in addition, makes clear.

The shape resembles the big toe of a human right foot, and at one point would have been completed by an artificial toenail. In this photo of the reverse side you can just make out a number of holes around the edges through which the prosthesis could have been attached to something else, such as a sandal strap or a sock. The cartonnage has been covered with a layer of crushed dolomitic limestone and ochre colourant, creating the tan-coloured layer you can see in the picture, most likely to allow the prosthesis to blend in with the skin-colour of its wearer.

The Great Toe is not the only one of its kind. In 1998, 17 years after Reverend Grenville brought the Cartonnage toe to the British Museum, a team of German archaeologists excavating a site on the West Bank of the Nile, opposite Luxor, came across a badly damaged mummy from the 21st or 22nd Dynasty (1025-740 BC). Attached to the fragmented body of a middle-aged female was another prosthetic toe. The prosthesis, as you can see below, is very different from that in the British Museum. It’s made from three separate pieces of wood which are held together by seven leather laces. It appears that a piece of material would have stretched over the wooden plates to secure the ensemble together.

‘Valley of Nobles’ prosthetic toe, Cairo Museum

The most important question to ask in relation to these objects, in order that we might think about their interaction with the human body, is whether they were actually used. The answer is not as obvious as you might initially think, for reasons – I hope – that will shortly become clear.

The first place to look is for signs of wear, indications that an object has been used or fitted for an individual. The second thing to consider is the usability of these objects: how well they withstand the pressure of walking and sufficiently support the body. For the big toe, which supports 40% of the body’s weight whilst walking, this is especially important.

An X-ray of the mummy found near Luxor showed an intact layer of soft tissue and skin covering the site of amputation by the toe, suggesting it was amputated during the woman’s life. This would make it the oldest known intravital (during the life) limb prosthesis! But that doesn’t help us much when we come to the use of the object itself. On close examination, the wood shows signs of wear and recent research suggests that it was even refitted several times, with two distinct phases identified. The prosthesis displays a remarkable sophistication, with a hinge and three wooden plates, increasing movement and allowing it to mimic the flexing of the joint when walking. The carving is also particularly impressive, displaying convincing anatomy and representation of the human toe. Considering all these aspects together, we can confidently conclude that the prosthesis was used during the individual’s lifetime and, most likely, made to measure to her specific amputation site. The mummy has been identified as Tabaketenaut, the daughter of the wealthy priest for whom the tomb was made. Further guesses have been had as to what might have caused her to lose a toe, among them gangrene resulting from arteriosclerosis, but it’s impossible to know for sure.

Dr Jacqueline Finch, a researcher at the University of Manchester, took this investigation one step further and decided to test the two prosthetics. Replicas were made of both the cartonnage and wooden toes, in keeping with the materials, and two individuals with similar amputation sites tried out the two models. Both volunteers found the wooden prosthesis more comfortable, but both the prosthetic toes performed remarkably well.

The third toe in this series is the Albany Toe, named after the Albany Institute of History and Art in the United States. The Institute holds the mummy of Ankhefenmut, a priest from the temple of Mut at Karnak in Thebes during the 21st Dynasty (1085-945 BC, so similar dates to the mummy found near Luxor) who was reported to have died in 966 BC. He was probably between 55 and 65 years old when he died. After X-rays and CT scans, it was revealed that the mummy had an artificial toe on the right-foot. Based on density shown in the scan, it appears to be made of a ceramic-like material. Because the mummy remains wrapped, it is impossible to carry out investigations on the artificial toe and so it remains unclear whether it was worn in real life. The prosthesis, shown in the scan below, comprises of two distinct parts, highlighted by their different densities. The part which makes contact with the foot appears to be ceramic, but the part representing the toe appears to be made of wood coated with a layer of resin.

CT Scan of the foot reveals an artificial toe. The ceramic material is shown by the whiter part, with the feint outline of the wooden toe showing the second part. Albany Institute

Ceramic is hard, brittle and fragile, perhaps not the most obvious choice of material for a prosthesis required to assist walking, or holding body weight. In addition to this consideration, no attachment sites have been located on the prosthesis, suggesting that it was never used, nor was it intended to be used. Then why was it there?

Mummification was a process of embalming and wrapping the body in order to preserve it for the next world, fitting in with Ancient Egyptian ideas of resurrection. It was not just the soul which would be resurrected, but the body itself, and so the body’s preservation was crucial. The embalmers also appeared to have had a certain degree of creative license – bodies were shortened or lengthened, moulded in plaster and packed with anything from mud to sand. Sawdust was sometimes stuffed between the skin and muscles to define contours, plaits and curls were woven into the natural hair and false eyes, noses and even genitals were added. Spells on the inner sides of tombs speak of ‘reassembling’ and the ‘reuniting of the body’. This ideology of the completed body can also be seen in ’embalmer’s restorations’, where limbs were replaced by dummies – often made of linen and resin. The image below depicts the false arm of a mummy in the Gulbenkian Museum in Durham, UK. Whilst the shape of the object might seem like a convincing prosthesis, the structure is made entirely of cloth, with rolls of material inserted to represent fingers and thumb. The object has then been soaked in resin. This was not a useable prosthesis, but a dummy, intended to complete and preserve the body for the next resurrected world.

Although we are not able to see the Albany Toe, its is most likely that it fits in this category, created by embalmers to serve Ankhefenmut in the next life. Some toes were made for walking, but not this one. Sadly, we are unable to date the Grenville Chester Great Toe, as little information remains about its excavation. Jacqueline Finch has suggested it predates 600 BC based on the characteristics of the linen, but no further context is known. The prosthesis found near Luxor, however, is thought to be one of the oldest known prosthetic body parts, displaying a high level of sophistication around 1000 BC.

Brier, B., Vinh, P., Schuster, M., Mayforth, H. and Johnson Chapin, E. (2015), A Radiologic Study of an Ancient Egyptian Mummy with a Prosthetic Toe, The Anatomical Record 298: 1047–1058

Gray, P.H.K, (1966), Embalmer’s Restorations, Journal of Egyptian Archaeology 138-140

Finch, J. (2011) The art of medicine: the ancient origins of prosthetic medicine, The Lancet 377: 548–9


How Prosthetic Limbs Work

Ancient literature contains references to prosthetic limbs in stories and poems, but some of the earliest historical accounts of prosthetic limb use were recorded in Greek and Roman times. For instance, there's the historical account of of Marcus Sergius, a Roman general who lost his right hand while battling in the second Punic War. Famously, he had a replacement hand fashioned out of iron for the purpose of holding his shield and was able to return to battle and continue fighting.

In the year 2000, researchers in Cairo, Egypt, unearthed what they believe to be the oldest documented artificial body part -- a prosthetic toe made of wood and leather. The device, found attached to the nearly 3,000-year-old mumified remains of an Egyptian noblewoman, is a good representation of how little prosthetic limbs have changed throughout history. With the exception of very recent times, prosthetic devices have been constructed of basic materials, such as wood and metal, and held to the body with leather attachments.

To show how little prosthetic limbs have advanced through most of history, consider the artificial hands and legs of the Dark Ages -- nearly 2,000 years later. Armored knights of this era often relied on iron prosthetic limbs, usually crafted by the same metalworker who made their armor. These bulky limbs were admittedly not very functional and were actually used more for the purpose of hiding the lost limb, which was considered at the time to be an embarrassing deformity.

Most famously attributed to seafaring pirates, peglegs with wooden cores and metal hands shaped into hooks have actually been the prosthetic standard throughout much of history. While Hollywood has exaggerated their use of hooks and peglegs, pirates did sometimes rely on these types of prostheses. The required materials for these devices could be scavenged from a common pirate ship however, a trained doctor would have been rare. Instead, the ship's cook typically performed amputation surgeries, albeit with poor success rates.

In the early part of the 16th century, French military doctor Ambroise Paré, also famous for his work with amputation techniques, contributed some of the first major advances in prosthetics seen for many years. Paré invented a hinged mechanical hand as well as prosthetic legs that featured advances such as locking knees and specialized attachment harnesses. Around 1690, a Dutch surgeon, Pieter Verduyn, later developed a lower leg prosthesis with specialized hinges and a leather cuff for improved attachment to the body. Amazingly, many of the advances contributed by these two doctors are still common features of modern day prosthetic devices.

With the advent of gaseous anesthesia in the 1840s, doctors could perform longer, more meticulous amputation surgeries, allowing them to operate on the limb stump in such a way as to prepare it for interfacing with a prosthesis. Advances in sterile, germ free surgeries also improved the success rate of amputation procedures, increasing the need for prosthetic limbs.

As artificial limbs became more common, advances in areas such as joint technology and suction-based attachment methods continued to advance the field of prosthetics. Notably, in 1812, a prosthetic arm was developed that could be controlled by the opposite shoulder with connecting straps -- somewhat similar to how brakes are controlled on a bike.

The National Academy of Sciences, an American governmental agency, established the Artificial Limb Program in 1945. The program was created in response to the influx of World War II veteran amputees and for the purpose of advancing scientific progress in artificial limb development. Since this time, advances in areas such as materials, computer design methods and surgical techniques have helped prosthetic limbs to become increasingly lifelike and functional.

A common cultural belief -- one held during various periods throughout history -- is that a person who loses a limb during his or her time on Earth will remain limbless in the afterlife. To avoid this fate, amputated limbs were commonly saved for later burial along with the rest of the body.


3000 Years old Egyptian Prosthetic Toe discovered

World’s oldest available prosthetic limbs are artificial toes found with a female egyptian mummy.
This Egyptian prosthetic toe dates back to 950 BC and volunteers without a big toe showed the prosthetics would have made walking around in ancient Egyptian sandals much easier, suggesting they were not just used in burial or in some other non-practical way.
Ofcourse, the oldest recorded history of Prosthesis and artificial limbs were mentioned in Rig Veda

Researchers have found two such prosthetic toes, one is the Greville Chester toe, now in the British Museum, which dates back before 600 BC. and is made of cartonnage, an ancient type of papier maché made with a mixture of linen, animal glue and tinted plaster.
The other is the wood and leather Cairo toe at the Egyptian Museum in Cairo, which was found on a female mummy near Luxor and is thought to date back to between 950 and 710 B.C.

These two are older than the bronze and wooden Roman Capua leg, which dates back to 300 BC.
For the voltuneers, false toes did not cause any high-pressure points, suggesting the prosthetics were relatively comfortable.

The Greville Chester toe, named after the reverend who discovered it in Thebes near present-day Luxor in Egypt, is made of cartonnage, which is a type of papier maché made by soaking linen in animal glue and painting it with tinted plaster. It is shaped like a right big toe and at one time held a false toenail. The artificial toe shows considerable signs of wear, the researchers said, including signs of rubbing.
Unlike the ownerless Greville Chester, the Cairo toe was found fastened onto the right toe of a female mummy identified as Tabaketenmut who lived some time during the period from 950-710 B.C. “Tabaketenmut may have had diabetes, which could have caused ischemic gangrene in the toe. The stump subsequently healed without the need for stitches,” the researchers wrote.

The toe had certain features, such as a simple hinge, that might have served to mimic the toe joint, including a chamfered, or beveled, front edge, and a flattened underside for stability. Both toes sported eight lacing holes on the inner edge and four on the outer, likely to attach the toe onto the foot or fasten it onto a sock or sandal, the researchers added.

“The wear on the Greville Chester toe and the important design features on the Cairo toe led me to speculate that these toes were perhaps worn by their owners in life and not simply attached to the foot during mummification for religious or ritualistic reasons,” they quoted.


This 3,000-Year-Old Wooden Toe Shows Early Artistry of Prosthetics

Almost two decades ago, archeologists working in a burial chamber in the Sheikh ´Abd el-Qurna necropolis west of Luxor, Egypt, found something unexpected: An exquisitely crafted prosthetic big toe fitted to the remains of a woman believed to be the daughter of a high status ancient Egyptian priest. 

As George Dvorsky at Gizmodo reports, the faux-toe, known as the Cairo Toe or the Greville Chester Great Toe is roughly 3,000 years old, and is likely the earliest practical prosthesis ever discovered. Now, a detailed study of the digit has unlocked new secrets about the Cairo Toe.

Researchers took a closer look at the toe using modern microscopy, X-ray technology, and computer tomography. Their 3D scans of the toe, which are not yet published, identified the materials the prosthesis was made from and how it was crafted. The most interesting finding, however, was that the toe was refitted several times to exactly match the woman’s foot.

“The [toe] testifies to the skills of an artisan who was very familiar with the human physiognomy,” according to a press release from the University of Basel in Switzerland. “The technical know-how can be seen particularly well in the mobility of the prosthetic extension and the robust structure of the belt strap. The fact that the prosthesis was made in such a laborious and meticulous manner indicates that the owner valued a natural look, aesthetics and wearing comfort and that she was able to count on highly qualified specialists to provide this.”

The analysis was part of a reexamination of the Sheikh ´Abd el-Qurna tombs and its related artifacts. Experts from the University of Basel and other institutions are creating 3D archaeological and geological maps of the tombs. The necropolis, a warren of rock-cut tombs, was active in the 15th century B.C. and was remodeled several times over the centuries. The tombs were eventually used as dwellings for early Christian hermits and were occupied by other people into the 20th century.

The Toe's Tomb is one of many burial chambers in the area believed to be reserved for high-status Egyptians associated with the pharoah, like the priest and his daughter. As the BBC reports, she likely died between the ages of 50 and 60 and suffered a toe amputation sometime in her past that had time to completely heal before her death.

The big question is whether the life-like toe was worn mainly for looks or if it actually improved the balance and functioning of its wearer. There has always been a tension between aesthetics and functionality since people first crafted artifical limbs, explains Katherine Ott, a curator of the division of medicine and science at The National Museum of American History.

“It’s always been an issue and there’s never a single answer. Every era and culture has different definition of what they consider body integrity what makes you whole," she tells Smithsonian.com. Though many of these early prostheses were likely challenging and uncomfortable to wear, "they prevent people from staring and make the user feel more integrated [into society],” she says.

The Cairo Toe, however, is unlike many other prosthetics from ancient times, Ott explains. Though it beautifully imitates a natural toe, it may have also helped the wearer with balance. Its stitching and mixed leather and wooden construction likely made it much more comfortable than other ancient prosthetics.

For example, the Egyptian cartonnage toe is an older prosthesis made of a type of linen Papier-mâché and was uncovered with a mummy in the 1880s. But this toe doesn't bend at any joint, and modern tests suggests that if it was worn in real life, it was likely too uncomfortable to sport long term. Similarly, the Ancient Roman Capua leg—another early prosthesis from 300 B.C.—was cast in bronze. This heavy and non-jointed structure was likely impractical to wear.

"Generally prosthetics that mimic body parts don’t work as well. They are usually clumsy and fatiguing," says Ott. But perhaps that wasn't so with the Cairo Toe. Hopefully this ancient prosthetic was as functional as it was beautiful, making the wearer feel both emotionally and physically more whole.

About Jason Daley

Jason Daley is a Madison, Wisconsin-based writer specializing in natural history, science, travel, and the environment. His work has appeared in Discover, Popular Science, Outside, Men’s Journal, and other magazines.


Prostheses in the Ancient World and the Middle Ages

The oldest known prosthetic device existing in our world is also one of the smallest. Scientists have dated a wooden prosthetic toe found in mummified remains in Cairo to somewhere around the year 950 BC. The “Cairo Toe,” as it came to be known, was a prosthetic used to replace the wearer’s big toe. It is intriguingly lifelike, being shaped, carved and stained to imitate the natural look of an ancient Egyptian’s big toe, and much of that natural aesthetic is still evident when looking at pictures of the primitive device. The toe consisted of two wooden pieces which were lashed together by leather thread through holes bored into the wood the toe also had a leather strap which secured the toe to the foot through more leather threads.

This attention to the aesthetic appeal of prostheses is fairly common among ancient devices and may even have been more important than helping to improve function. Another prosthetic device from the ancient world known as the “Cartonnage Toe,” which dates to about 600 BC, may have been made strictly for cosmetic purposes.

The medical practice of amputation goes back as far as the 4th century, when Hippocrates described the procedure in his medical text “On Joints.” Amputations in the ancient world and through the Middle Ages occurred for many reasons which are, thankfully, not common practice today. The taking of a limb could have resulted from a ritual sacrifice or a punishment for stealing just as well as a battlefield wound, and in fact many centuries would pass before battlefield medicine reached the point where it could save those who needed amputation. Through the Middle Ages, the medical procedures involved such brutal practices which, coupled with no practical knowledge of germ theory and patient care, resulted in an 80 percent mortality rate.

Other early prosthetic devices either exist or are known. Although it was destroyed during an air raid in World War II, the “Capua Leg” is the world’s oldest prosthetic leg, dating back to 300 BC and found in Capua, Italy. A replica of the leg exists and it has been shown at the London Science Museum. Records from the Roman scholar Pliny the Elder, writing in the 1st century AD, describes a right arm prosthetic designed to hold a shield used by a general in the Second Punic Wars (218 BC – 200 BC). Medical development during the Middle Ages was very limited, however, and there was little work to be done in this field until the next major period of cultural development would occur in Europe.


Egyptian toes likely to be the world’s oldest prosthetics

The results of scientific tests using replicas of two ancient Egyptian artificial toes, including one that was found on the foot of a mummy, suggest that they&rsquore likely to be the world&rsquos first prosthetic body parts.

The University of Manchester researcher Dr Jacky Finch wanted to find out if a three-part wood and leather toe dating from between 950 to 710 BC found on a female mummy buried near Luxor in Egypt, and the Greville Chester artificial toe from before 600 BC and made of cartonnage (a sort of papier maché mixture made using linen, glue and plaster), could be used as practical tools to help their owners to walk. Both display significant signs of wear and their design features also suggest they may have been more than cosmetic additions.

Dr Finch says: &ldquoSeveral experts have examined these objects and had suggested that they were the earliest prosthetic devices in existence. There are many instances of the ancient Egyptians creating false body parts for burial but the wear plus their design both suggest they were used by people to help them to walk. To try to prove this has been a complex and challenging process involving experts in not only Egyptian burial practices but also in prosthetic design and in computerized gait assessment.&rdquo

Dr Finch, who is based in the Faculty of Life Sciences&rsquo KNH Centre for Biomedical Egyptology, recruited two volunteers who were both missing their right big toe. Design replicas of the ancient toes were made to fit each volunteer along with replica leather ancient Egyptian style sandals.

The tests were carried out at the Gait Laboratory at Salford University&rsquos Centre for Rehabilitation and Human Performance Research. Each volunteer was asked to walk on a 10 metre walkway bare foot, in their own shoes and wearing the replicas with and without the sandals. Their movement was tracked using 10 special cameras and the pressure of their footsteps was measured using a special mat. The 10 best walking trials were recorded for each foot, using their normal left foot as the control.

It was surprising how well both volunteers were able to walk using these devices although one volunteer performed much better than the other. The camera footage revealed that when wearing the sandals with the cartonnage replica, one of the volunteers achieved 87% of the flexion achieved by their normal left toe. The three part wood and leather design producing nearly 78%. Interestingly the ability to push off using the prosthetic toe was not as good when this volunteer wasn&rsquot wearing the sandals. The second volunteer was still able to produce between 60-63% flexion wearing the replicas with or without the sandals.

When wearing the replicas the pressure measurements showed that for both volunteers there were no overly high pressure points. This indicated that the false toes were not causing any undue discomfort or possible tissue damage. However, when the volunteers wore just the replica sandals without the false toes the pressure being applied under the foot rose sharply.

Dr Finch says: &ldquoThe pressure data tells us that it would have been very difficult for an ancient Egyptian missing a big toe to walk normally wearing traditional sandals. They could of course remained bare foot or perhaps have worn some sort of sock or boot over the false toe, but our research suggests that wearing these false toes made walking in a sandal more comfortable.&rdquo

Alongside the test data Dr Finch also asked her volunteers to fill in a questionnaire about how they felt when doing the trials in the gait laboratory. Despite it having performed well the comfort scores for the cartonnage replica were disappointing although it was felt to be an excellent cosmetic replacement. Describing the performance of the three part wooden and leather toe both volunteers found this one to be extremely comfortable, scoring it highly, one volunteer commenting that with time he could get used to walking in it.

Assessing the volunteers&rsquo experience Dr Finch said: &ldquoIt was very encouraging that both volunteers were able to walk wearing the replicas. Now that we have the gait analysis data and volunteer feedback alongside the obvious signs of wear we can provide a more convincing argument that the original artefacts had some intended prosthetic function.

The findings from this study, which have been published in full in the Journal of Prosthetics and Orthotics, means the earliest known prosthetic is now more likely to come from ancient Egypt. The three part example pre-dates by some 400 years what is currently thought to be the oldest, although untested, prosthetic device. This is a bronze and wooden leg that was found in a Roman burial in Capua, Southern Italy. That has been dated to 300 BC although only a replica now remains as the original was destroyed in a bombing raid over London during the war.


Then and now

Surviving examples like these indicate that extremity prostheses were designed, commissioned, and manufactured to an individual’s specific preferences. The same artisans that produced personalised armour and weapons likely produced personalised prostheses for wounded veterans.

Considering the ancient association of disabled people with crafts such as metalwork – epitomised by the Greek god Hephaistos and his Roman counterpart Vulcan – artisans may even have drawn on their own experiences of impairment to inspire their creations. Soldiers like Silus would duly have been able to defy their societies’ expectations and continue to play significant roles at moments of historical significance.

Hephaistos/Vulcan, engraved 1716 by E. Jeaurat. Wikimedia

We historians do have to speculate here to some extent: we don’t know how soldiers acquired their prostheses, since medical treatises do not mention these procedures. Yet it seems probable that the technology improved due to the horrors of war – just as today’s advances are partly a response to the unprecedented levels of multiple traumatic injuries that soldiers suffered in Afghanistan and Iraq. And then as now, prostheses were collaborative efforts between medics, technologists and artists.

After the ancient era, prostheses barely improved until the 16th century. That was when Ambroise Paré, the royal surgeon to four successive French kings, invented mechanical versions including knees and fingers capable of bending somewhat like the real thing.

So when we see the latest prostheses giving veterans an incomparable quality of life or helping athletes to achieve amazing things at the Paralympics, it is worth reflecting on the distance travelled. We have been trying to make amends for humanity’s worst tendencies for 25 centuries. Long may such advances continue to be a vital consolation.

Top image: False toe on mummy found near Luxor. Egyptian Museum

The article ‘ Severed Limbs and Wooden Feet: How the Ancients Invented Prosthetics’ by Jane Draycott was originally published on The Conversation and has been republished under a Creative Commons license.


Watch the video: Partial Foot Prosthetic