ARTIFICIAL LIMBS AMD AMPUTATIONS. 
Translated from Le Bulletin General de Therapeutique Medicate et Chirurgicale, 
Paris, January 15, 1860. 
The old Surgeons in their art, always knew the end which 
they were pursuing, and also did not hesitate to introduce, in 
its development, everything which could conduce to that end. 
Accordingly, the investigation of remedies for mutilations 
figures in their works equally with those operations which 
have caused the loss of members, and that too at a time when 
mechanical knowledge could only furnish the crudest attempts 
for this branch of surgical therapeutics. Let us take, for ex- 
ample, the designs furnished us by Ambrose Pare, the most 
complete of all authors, in this respect. Now that the progress 
of the mechanic arts has furnished unquestionable aid, and can 
produce something better, all these notions have disappeared 
from our medical literature. Let a surgeon be consulted in 
regard to the means of concealing the simplest amputation, 
and he knows not what to advise, for he is ignorant both of 
the trials which have been made, and the state of art in what 
especially concerns this point. The surgeon is forced to send 
his patients for advice to the makers of artificial limbs, and to give 
them up to their attempts. 
Still there is a gap which must be filled. Our readers will 
do us the justice to acknowledge that there is no journal which 
seizes, with more avidity, upon the opportunities of setting 
forth the real result of investigation, than the Bulletin Genera). 
Since the late World’s Exhibition, we have not failed to make 
mention of the most important objects which were exhibited 
by inventors. Besides, whenever a useful appliance has been 
produced, a description, accompanied with designs, has ap- 
peared in our pages, to serve as a history of the invention. 
1 2 
Investigation of the Value of Artificial Limbs. 
LETTER FRl)M M. DEBOUT, SECRETARY OF THE SOCIETE DE 
CHIRURGIE, OF PARIS, TO M. MICHAUX, PROFESSOR OF SUR- 
GICAL CLINIQUE AT THE UNIVERSITY OF LOUVAIN. LEGS 
TAKING THE POINT OF SUPPORT AT THE PERINvEUM. 
Translated from Le Bulletin General de Therapeutique, Paris, May 30, 1860. 
An important question, whose solution has been long sought, 
is that of the services which automatic appliances can render 
to those who have lost the inferior part of the limb. Despite 
the special works published on this point of practical surgery, 
the truth is far from having been determined in all respects. I 
find a new proof in the lecture which you recently delivered to 
the Academy of Medicine in Belgium. In that learned pro- 
duction on the different amputations of the limb, after having 
demonstrated that the greatest efforts should be made to make 
the amputated use their stumps in walking, you end by re- 
jecting almost entirely amputation above the ankle. Is it not a re- 
jection of this operation that you come to in the following con- 
clusion ? “ Amputation above the ankle is only proper for 
persons aged or feeble, or those who, by their condition or 
social position, can easily procure a good artificial limb, and 
who are anxious to preserve, notwithstanding amputation, 
almost the normal form of the limb.” Thus, notwithstanding 
the greater danger to the invalid from amputation at the place of 
election, you do not hesitate to prefer it to amputation at the 
inferior third, in the case of the young and the poor. 
This is the judgment formed by Velpeau, in 1839, in his 
Treatise on Surgery, and which he repeated, in 1841, in his re- 
port to the Academy of Medicine upon the memoire of Messrs. 
Arnal and Ferd. Martin. I thought that the numerous exam- 
ples of the service rendered since that period, had led surgeons 
to no longer make any distinction between rich patients and 3 
those not possessed of a fortune. I see, with regret, that it is 
not so; and that, as in the time of Ambrose Pare, the prin- 
ciples of surgery are sacrificed to the facility of making the 
patient walk on the peg. This advance, taken by automatic 
mechanism in the question of amputations of the leg, has led 
me, for a series of years, not to let any occasion escape which 
might convince me of the utility of the artificial members, for, 
on the solution of this point depends the return of surgeons to the 
principles essentially conservative of their art. I have thought, 
then, that you might receive with interest the results of my in- 
vestigation in regard to such of the mutilated as have to pro- 
vide the necessities of life by daily labor. 
Before explaining to you the different considerations which, 
at least in my eyes, no longer permit us to sacrifice the most 
sacred interests of humanity to a question of mechanical con- 
venience, I must make mention of the different models of ar- 
tificial limbs which have been given us by our manufacturers. 
In 1696 a learned Dutch surgeon, Verduin, gave to the art 
the model of an artificial limb. This limb (Figs. 1 and 2) was 
Fig. 1. 
Fig. 2. 
Fig. 3. 
composed of a wooden foot, A, on which were fastened two 
pieces of steel, going up to a level with the articulation of the 
knee. A copper boot, B, encased the stump, and was fastened 4 
by rivets to the side-pieces, D. A thigh-socket, F, the anterior 
part of which encased the small of the thigh, was articulated 
by a hinge-joint with the side pieces, II. A chamois stocking 
(Fig. 3), which enveloped the stump, and went up as far as the 
superior part of the thigh, was held by the thigh-socket, and 
kept the stump suspended. Finally, to better protect the cica- 
trice, a soft cushion was placed at the bottom of the metallic 
boot, 
Verduin’s apparatus depended, as is easily seen, upon the 
excellent principle that we must seek a point of support upon 
the segment of the member superior to that which has under- 
gone amputation, instead of taking it at the condyles of the 
tibia and about the knee, as his fellow-countryman, Yon Sol- 
lingen, had done. Unfortunately, Verduin occupied himself, 
especially in his memoire, with a question of operative surgery 
—the flap—and, thinking he could furnish an argument more 
appropriate to the method he created than to his apparatus, he 
said: “ The advantage of having a large flap of flesh is, that 
the amputated can support himself upon the stump, and even walk 
firmly with the aid of an artificial limb, which cannot be done 
without pain when the amputation has taken place according 
to the old method.” As too frequently happens, Verduin, in 
exaggerating the advantages of his appliances, furnished matter 
for our argument which proves too powerful, since it increases 
the exaggeration at the cost of repelling better conclusions. 
Louis, in his report to the Academy of Surgery, misunder- 
standing the tendency of the conclusions drawn by Verduin, 
rejected both the method and the apparatus. After having re- 
ported the passage we have just cited, the celebrated surgeon 
added: “ Such an exaggeration does not give consequence to. 
an author whose weakness is to insist upon the merit of his 
own invention.” Thus, recalling the disposition of the con- 
dyles of the tibia, he adds : u The volume of the superior part 
of the tibia permits of the adjustment of this machine in such 
a way that it gives, under the tuberosity of this bone, a circular 
point of support, upon which the weight of the body can be 
sustained.” 
We know the power which the principle of authority had at 
that period. The decision made by Louis caused the abandon- 
ment of Verduin’s appliance, and a return to Von Sollingen’s. 5 
All the surgeons of the eighteenth century, those of Italy and 
England, as well as France, with the exception of Ravaton, 
endeavored to make their patients walk with appliances taking 
their point of support around the knee. None of these, de- 
spite their varied forms, were found to answer, and even more 
than a century was passed in fruitless attempts. 
In 1826, Professor Serre, of Montpellier, returning to Ver- 
duin’s principle, proposed a new artificial limb, taking its point 
of support at the small of the thigh. But, as too often happens 
when it is desired to make an idea popular, lie found it neces- 
sary to exaggerate the value of the principle, in order that it 
might the better be understood, preferred, and admitted. 
It is known how our learned brother, Mr. Goyrand, was led 
to open a new era in the construction of artificial limbs, in 
changing the point of support to the perinceum. This improve- 
ment henceforth entered into automatic appliances in current 
practice, especially for those amputated at the inferior third of 
the limb. 
In 1831, Mr. Goyrand (of Aix) had occasion to practise am- 
putation above the ankle upon an individual affected with tuber- 
cles, whose condition was ameliorated under the influence of 
the operation. Shortly afterwards, three new analogous cases 
were presented to his observation, and the rapidity of the cure, 
as well as the amelioration of the accompanying injury to the 
foot, called the attention of that learned surgeon to the ques- 
tion of mechanism. His patients cured, it remained to make 
them walk as advantageously as possible. Mr. Goyrand re- 
jected all the models of sockets since Ravaton. He understood 
that the pressure to which the stump had to submit in this sort 
of apparatus, could not but contort or tear open the cicatrice. 
Having witnessed the good result furnished by an artificial 
limb, worn by a young lady of Brignolles, amputated at the 
place of election, and whose apparatus had its principal point 
of support at the tuberosity of the ischium, Mr. Goyrand re- 
solved to apply a similar one to his patients. The ingenious 
orthopedist, Mille, inventor of that artificial limb, had it quickly 
modified to serve for amputation above the ankle. In fact, he 
merely had to dispose the side-joint in such a way as to encase 
and hold the long stump of those so amputated. The success 
which crowned these attempts was so perfect that Mr. Goy- 6 
rand’s patient could, with his artificial leg, walk (so says the 
author) as though he had his natural ones. 
* Mr. Goyrand, not willing that the result of this perfect con- 
quest should he lost, published, in 1835, a memoire, wherein he 
sought to give to amputation above the ankle the place it never 
should have lost in surgical practice. Then, knowing all the 
importance of the mechanical question, he describes and repre- 
sents the form and mechanism of Mille’s leg. 
Mr. Goyrand did still more. Fearing that the work which 
he had published was not sufficient to draw the profession out 
of its routine, he went to Paris to awaken the interest of its 
masters. As the principles which he defended were in con- 
formity with those of science, they were well received, and 
submitted to without delay. Mr. Velpeau—whose name is 
always found at the head of those who have first accepted real 
progress—Mr. Velpeau immediately put in practice amputation 
above the ankle; and then Roux, Gerdy, Blandin, Jobert, De 
Lamballe, and Lenoir were not slow inffollowing him. Finally, 
the facts became so numerous, that the results became appre- 
ciable in statistics. Messrs. Arnal and Ferd. Martin, in a 
memoire on amputations above the ankle, collected ninety-seven 
cases, and of this number eighty-seven were successes. These 
statistics, which furnish only a mortality of ten per cent, by 
operation at the inferior third of the limb, appeared exaggerated 
to Mr. Velpeau, and that learned reporter increased the mor- 
tality of this kind of amputation to about fifteen per cent. 
Admitting even this reduction, the principle of the place of 
election as placed by Ambrose Par6 was no more acceptable, 
since statistics have proved that amputation at the superior 
part of the limb caused the loss of half of those who submit- 
ted to it; therefore, all the surgeons of the civil hospital of 
Paris adopted Mr. Goyrand’s principle. 
The different hygienic condition of the great number of 
provincial hospitals causes mortality, in severe operations, to 
be much less there than in Paris. Though some of the sur- 
geons in charge of those establishments were not willing to 
take any notice of this principle, one of them, answering, a 
month since, my request for his observation on his own at- 
tempts in case of amputations, has not hesitated to deny the 
value of progress realized, and has given me proof of the impossi- 7 
bility which he found of making a soldier walk who had under- 
gone two amputations above the ankle, as well as the hard necessity 
of yielding to the pressing demands of the mutilated man to prac- 
tise two new operations at the place of election. 
Some analogous facts have led me to take up the statistical 
task of Mr. Arnal, and to follow his work, for the operation 
takes place daily in the current practice of Mr. Velpeau. This 
celebrated surgeon, who, in 1841, was credited with only seven 
operations in Mr. Arnal’s table, has now reached the figure of 
thirty amputations, among which he counts four deaths. One 
of the latter should be erased from the table, for the patient 
was phthisical, and yielded to his tuberculous aifection, and 
not in consequence of his operation. Mr. ISTelaton cites twelve 
cases, all successful but one ; Mr. Denonvilliers, ten cases and 
no deaths; Mr. Lenoir, forty-two cases, six deaths; Mr. Eobert, 
thirteen cases, two deaths; Mr. Michon, twenty-four cases, 
three deaths; finally, you, yourself, who in 1841 furnished only 
one single success, can now offer eight in eight operations. This 
result proves, then, that you intend only to call in question 
the services rendered by automatic appliances. 
If I here recall the figures which bear witness to the great 
safety of this operation, it is because a certain number of our 
provincial brethren do not believe the difference to be so marked 
between the dangers of amputation at the place of election, and the 
inferior third, for want of counting up the results. One of our 
colleagues of the Societe de Chirurgie, who has for a long time 
been in charge of the surgical department of a hospital in an 
important city of the South, wrote me as follows: 
“During my whole surgical experience I have practised 
exclusively amputation at the place of election. This was the 
rule—the reverse the exception. You know that, in our pro- 
vinces, it is a sort of law which we all recognize; besides, the 
social condition of our patients, the high price of automatic 
appliances, their insufficiency for workmen who have to labor 
hard, have prevented me from amputating above the ankle. 
My successors have done better than I. They have practised 
in turn the two operations, according to the indications of the 
case. In amputation at the place of election they had some 
reverses, but in fifteen amputations at the inferior third, they 
had fifteen successes. In presence of these results and those 8 
reported at Paris, the choice of the method cannot remain 
uncertain with the increasing perfection of automatic appli- 
ances. I do not doubt that you will finally bring us all to 
your way of seeing it. 
“ Doctor Vial, 
“ Physician of the Hospital of St. Ettmose.” 
Another confrere, Mr. Busquet, surgeon of the Laval Hospi- 
tal, answered my inquiry as follows: “I have undertaken nine- 
teen amputations at the place of election, in which number 
there were eight deaths, my patients being all poor workmen, 
whose resources would not allow them to obtain high-priced 
limbs. I have had only two cases of amputation at the infe- 
rior third, both of which were successful.” 
Thus, always the same results. How let us return to our 
automatic appliances, since, in this question of amputation of 
the limb, the accessory remains the principal. 
“Truths are wedges, to be driven to the head,” said Fonte- 
nelle. The great safety of amputation above the ankle, 
demonstrated daily by numerous facts announced officially at 
our academy, has not been sufficient to popularize this operation. 
It is not the proper moment to discuss whether it is absolutely 
necessary for the new appliances to take their principal point 
of support at the perinseum. This innovation of Mr. Goyrand 
has been fortunate in this,—it has drawn attention to Mille’s 
apparatus, obtained the confidence of surgeons, and thereby 
provoked new attempts, which have resulted in improving the 
model invented by the modest orthopedist of Aix. This appeal 
to the competition of other makers, has become indispensable 
by the death of Mille, which happened before he could be 
benefited by the results which a longer series of experiments 
might have furnished him. 
The new artificial leg was not to disappear. Mille, on leaving 
Paris, had charged one of our most intelligent makers, Mr. 
Charriere, with the construction of his model. And, on the 
other side, one of our most distinguished surgeon-orthopedists, 
Mr. Ferd. Martin, yielding to the solicitations of Blandin, en- 
gaged to furnish him with an apparatus which should allow 
those amputated at the inferior third to walk without a peg. 
The first attempts of Mr. Ferd. Martin were not successful, 9 
and would have compromised the future of the question, had 
not the moment arrived when mistakes could indeed retard, 
but could not prevent progress. Desirous of preventing injury 
to the extremity of the foot in walking, Mr. Martin had the ex- 
tremity of his new apparatus raised; he did not perceive that 
by this modification he had transformed his artificial leg into a 
peg, and changed the statical condition of the body. His pa- 
tients could not then walk with a flexible knee, and the limb 
had to be Jcept stiff by the aid of a stop-joint. 
The modification necessary to give flexibility to the knee 
was so simple that I am astonished that so great a mechanician 
as Mr. Martin remained so long without finding it out. It was 
merely needful to carry behind the axis the articulation of the 
shin and thigh-pieces. The principle stated, the means are 
found. Do not the springs which hold open the “capote ” of 
our cabs, present eccentric articulations, enough to offer the 
greatest resistance ? Fig. 6 (see cut) represents the model of 
Mr. Martin’s ; it is his first attempt, that is to say, the extre- 
mity of the foot raised, and the eccentric articulation of the shin 
and thigh-pieces. There is a second, without foot, designed 
for poor patients. It is like the others in the other points. 
In the artificial leg of Mr. Charriere, as in that of Mille, 
(Fig. 7), the foot is preserved, and the movements of flexion 
and extension of the extremity of the member produced by 
elastic springs. In the model presented in 1856 to the Societe 
de Chirurgie, (Fig. 8), the extension of the foot is maintained 
by the action of an artificial muscle, C, which, from the heel, A, 
is inserted in the posterior and inferior part of the thigh- 
socket, D. 
These models are not the only ones which have been tried. 
However, not to complicate my essay, you will permit me first 
to give account of those trials which have been made with ap- 
pliances taking their point of support at the perinseum ; they 
are the most numerous. We shall afterwards attend to the 
results furnished by the use of limbs taking their point of sup- 
port at the thigh. (See Plate of cuts.) 10 
Inquiry on Artificial Limbs. Value of the Point 
of Support. 
LETTER OF M. DEBOUT, SECRETARY OF THE SOCIETE DE CHI- 
RURGIE, OF PARIS, TO M. MICHAUX, PROF. SURGICAL CLINIC, 
UNIVERSITY OF LOUVAIN. 
Translated from, Le Bulletin General de Therapeutique, January 15, 1861. 
If the sole purpose of my letter were to prove the reality of 
the service which artificial limbs can render to those who have 
undergone amputation above the ankle, I should not give you 
a full account of the end of my inquiry, for the facts which I 
have placed before you ought to have convinced you on that 
point. It then remains for me to take up an important part 
of the question, viz., the discussions of the point of support of 
the artificial limbs. 
I commenced my study by the examination of such of the 
mutilated as had to provide their living by business, and it 
was found that all whom I saw made use of instruments tak- 
ing their point of support at the perinceum. If the choice of 
that mode had been the result of a comparative study of the 
value of different points of support, viz., the knee, thigh, and 
perinseum, I should have nothing to add. But it is not so. 
The reason that our surgeons have such a predilection for the 
model of Mille (of Aix) is entirely theoretic. Let us hasten to 
add, however, that this is based upon the physiological con- 
struction of the part supplied. The lower limb is principally 
a sustaining member ; so Mr. Goyrand has thought, reasonably, 
that there could not be given a too great extent to the point of 
support of the artificial limb, and, at the same time, a too solid 
base afforded the projection of the ischium. But Baglivi has 
said, there are two chief points in medicine,—theory and prac- 
tice. We know the principal ideas in the constitution of Mille’s 11 
model, as that was used more than two centuries ago by Ver- 
duin for the point of support at the thigh. How let us consult 
experience. 
When a truth has been repulsed by the very persons who 
ought to have comprehended its importance, it must be a long 
time before it is seen again to enter the domain of science. 
That this return does take place, must be because numerous 
and patent facts increase the evidence. 
It is now more than a century since Louis rejected the point 
of support at the thigh, and no one has yet returned to it. 
Hardly was an attempt made by Prof. Serre, of Montpellier, 
in 1826. During all that time the truth had a chance to make 
way for itself, and the value of the point of support at the 
thigh was studied by those of the mutilated who could not, or 
found it painful to have the point of support at the perinseum. 
Before speaking of facts, let us look for a moment at the 
different models which are in the Surgical Arsenal. I merely 
recite to you the first attempt of Verduin, the'design of which 
I have given you ; then come the models of Messrs. Palmer, 
Bechard, and Mathieu. They differ little from each other, 
with the exception of that of Mr. Palmer, in which the me- 
chanism which moves the limb is most simple and ingenious. 
Those of Messrs. Bechard and Mathieu have, as base, two 
pieces of steel encased in leather, the foot being held raised by 
springs, as in the apparatus of Mr. Ferd. Martin. These arti- 
ficial limbs possess only the principle of pegs. In the Palmer 
Limb, the action of the flexor spring is counterbalanced by an 
extensor-tendon, so that the foot aids in walking. Following 
are some trials, of which, for the greater part, I was a witness. 
I. Palmer Limb.—The first person whom I saw walking with 
this artificial limb was Mr. Palmer, the inventor of the Ame- 
rican Limb. The talented Philadelphian had had his leg am- 
putated at an age when the loss of the member is less to be 
regretted than the ulterior consequences. Desirous of conceal- 
ing his loss, he set himself to work at the construction of an 
artificial limb. Hot content with the different models given 
him, and endowed with great mechanical genius, he began to 
look for the means of constructing an appliance which would 
not only conceal his loss, but enable him to walk easily. Suc- 
cess has crowned his efforts, for it is difficult, even when one 12 
sees Mr. Palmer walking, to recognize that lie uses an artificial 
limb. In 1851, on returning from the World’s Exhibition, in 
London, I introduced the inventor to the Society de Chirurgie, 
and a good number of our colleagues could not tell which limb 
had been amputated. I have given you the plan of this limb. 
Charged with the duty of making a report on the magnificent 
appliance, you will permit me to reserve for that work the ex- 
planation of the exceedingly simple mechanism which causes 
the American artificial limb to move. 
Here is a second example of the fine action of the artificial 
limb. It is furnished us by the lady of one of our brother 
physicians and friends of London. This case is of the greatest 
importance, from the fact that this lady had made use, succes- 
sively, of appliances having their point of support at the peri- 
ngeum, and thigh, and she does not hesitate to accord the pre- 
ference to the latter, the plan of Palmer. 
II. A lady aged 47—Amputation at the middle of the limb— 
Use of artificial limbs since 1836—Successive trials of different 
models—Ferd. Martin, Mille, Palmer.—Madame X , from 
an accident caused by falling from a horse, was compelled to 
undergo amputation of the right limb. The operation was 
performed only a few inches below the place of election, al- 
though the injury was near the tibio-tarsal articulation. It was 
in June, 1836; the lady was then twenty-three years of age. 
As soon as she was able to leave her bed, an artificial leg was 
supplied her, made of ordinary wood, beautifully finished, but 
not the less the wooden leg, with all its inconveniences. (This 
appliance is fastened at the top by a band around the peringeum. 
When the mutilated sit down, the external piece causes a move- 
ment of torsion to the band, which painfully compresses the 
tissues. In a sitting posture the leg remains extended, and 
betrays the fact of amputation.) After using this appliance six 
months, the lady, knowing the experience which the physicians 
in our hospitals had, came to Paris, and procured an artificial 
leg from Mr. Ferd. Martin. She used it four years, walking 
with tolerable facility, the leg stiff. About this period the lady 
was married to one of our friends, a distinguished London phy- 
sician, who, not wishing her to lose the movement of the knee, 
had a leg made for her, after the model of Mille, by Weiss, the 
Charriere of London, i. e., one which flexes in walking. Ma- 13 
dame X used it until 1851; still there was something want- 
ing. Therefore, when I spoke to my friend of Mr. Palmer’s 
invention, after my first visit to the World’s Exhibition, his wife 
immediately became desirous of possessing an American limb. 
Here is the acknowledgment which has been transmitted to 
me (April, 1860): “At my very first trial of Mr. Palmer’s 
limb, I was convinced that I had found what I needed so bad-, 
ly. Since 18511 have used no other appliance. I walk easily 
three or four miles without fatigue ; I go about my house all day ; 
finally, I have again taken up horseback exercise, and ride 
nearly every day. The point of support is above and below the 
knee, and I give this the preference over that of the appliances 
of Weiss, and Ferd. Martin. I have found beauty and utility 
united in the Palmer limb ; many of my new acquaintances do 
not know that I have undergone amputation.” 
The Palmer Leg being of willow, it remains to be asked 
whether it can be grooved deeply enough to allow of a lodge- 
ment of the long stumps furnished by amputations above the 
ankle, and what modification the mechanism has to undergo, 
when placed in the lower part of the leg. As the inventor 
resides in the United States, I am forced to address myself to 
those who are near me to decide this question. The result of 
this first attempt has been most remarkable. 
III. Amputation at the inferior third of the limb—Successive 
employment of limbs having their point of support at the perinceum 
and thigh.—Mr. M., employed at the Bureau de Depots et Con- 
signations, was admitted, in 1843, to the St. Louis Hospital, to 
be treated for a white swelling at the tibio-tarsal articulation. 
As the disease could not be overcome by ordinary means, Mr. 
Jobert decided to perform amputation. The limb was taken 
off above the ankle. _ The wound having healed, the patient, 
then fifteen years old, made use of an artificial leg furnished by 
Charriere. This appliance lasted four years; and as this young 
man had suffered somewhat from having the point of support 
at the perinaeum, he addressed himself to another maker, Mr. 
The latter, believing that the excoriation of the 
tissues resulted merely from a fault in the disposition of the 
upper padding, constructed the new leg upon the same model. 
This appliance lasted the same time, and, despite the care 
taken for its prevention, it cut the skin of the patient. 14 
My investigation having led me to Mr. Bechard, I engaged 
tliat maker to construct, for the patient, an artificial leg on the 
Palmer model. Mr. Bechard understood immediately the 
interest attaching to this attempt, and took the greatest care 
to reproduce the mechanism of the American limb. The 
lower socket of the limb could be hollowed out sufficiently to 
prevent the stump being exposed to any friction; only, Mr. 
Bechard made use of different mechanism to move the foot, 
without respecting the property of his American confrere. 
One of the points of my investigation, the possibility of 
making those amputated at the lower part of the leg walk by 
Palmer’s invention, was answered. It remained to be seen 
how the patient liked the change of the point of support; for 
the American limb, as I have said, is fastened to the thigh. 
Mr. M. liked the modification so well, that he has since ordered 
a new limb to be constructed, in which he desires the same 
point of support to be preserved. Thus, in sixteen years, he 
has made use of two models; he has tried each the same length 
of time, and, like the English lady, he does not hesitate to give 
that the preference which has the point of support at the 
thigh. (Palmer’s.) 
Translated from Le Bulletin G£n6ral de TMrapeutique, Paris, March 15th, 1862. 
AN EMINENT FRENCH JUDGE RESTORED TO THE BENCH BY THE 
AMERICAN LEG. AMPUTATION OF BOTH LIMBS. USE OF AR- 
TIFICIAL LIMBS. SUCCESSIVE TRIAL OF TWO POINTS OF SUP- 
PORT. PREFERENCE GIVEN TO THE PALMER LEG. 
On the 4th of March, 1856, Mr. Choiselat, juge supleant at 
St. Menehould, thirty-two years of age, was accidentally 
thrown upon the rails of the Eastern Railroad, in the interior 
of the gaze de Meaux; a train in motion passed over both legs, 
which were literally ground to powder. The injured man was 
carried home, and, being examined, it was agreed that a double 
amputation was necessary; the operation took place next day 
by Mr. Ilouzelot. Fifty days after the accident, the wounds 
on the stump were healed. 15 
Mr. Choiselat at first made use of two pegs ; but, with such 
appliances, his public career was at an end; the dignity of the er- 
mine fitted ill the mien of two wooden legs. Mr. Houzelot re- 
membered that the Society de Chirurgie has charged him with 
the duty of making a report on Artificial Limbs, came to me 
to discuss the value of the different models manufactured by our 
makers. Our colleagues, like all French surgeons, had a pre- 
ference for appliances taking their point of support at the peri- 
neum ; but, after listening to the facts which I had previously 
reported, and acquainting himself wfith my personal expe- 
rience, Mr. Houzelot sided with me, and it was agreed that wTe 
should try upon our patient, the American Limb. The 
inventor being in America, I sent to Mr. Osborne, Mr. 
Palmer’s representative in London, the casts of the two stumps, 
requesting him, when the limbs should be finished, to be kind 
enough to come and attend personally to their application; he 
did so. Below are the acknowledgments which Mr. Houzelot 
has transmitted to me. 
July 16th, 1856. Mr. Choiselat made use of the Palmer 
limbs for the first time; notwithstanding the use of pegs for 
two months and a half, he soon learned the use of the new 
apparatus, rapidly and easily; on the third day, Mr. Choiselat 
went down to the garden and back again to his room, leaning 
on an attendant’s arm. 
The next (fourth day), he went in a carriage to the railroad 
depot, took the train to Chalons-sur-Marne, and made ten 
leagues by post to St. Menehould. There alone, and supported 
by a cane, he visited some of his friends, who were astonished 
at the result. 
September. Mr. Choiselat is passing the vacation in the 
country. Assisted by a cane, he walks for an hour and a half, 
without much fatigue 
March, 1857. With the aid of a cane, he has walked three 
and a half miles in one hour and forty minutes. 
During the whole time, the progress has been daily con- 
tinued and sensible; to-day, November, 1858, he walks easily. 
He wears his limbs fifteen hours successively; in his own apart- 
ments he walks without a cane, stoops, and readily picks up 
objects from the floor; he sits down and rises without aid; he 
walks very easily. Mr. Choiselat asserts that he has not been 16 
arrested in the performance of his ordinary vocation. Finally, 
after such an accident, the reparation is as perfect as possible. 
This judgment applies exclusively to the American Limb, 
which Mr. Qhoiselat prefers to all others, in every respect. 
“In order to gain abetter understanding of the value of the 
point of support, Mr. Choiselat had made for him one of Mille’s 
limbs, modified by Zavier, an old workman of Charriere’s. This 
artificial limb is made, like the Palmer leg, of willow, but the 
thigh-socket goes up to the perinseum, and offers a point of 
support at the ischium. The following is the result of the 
comparative examination of the two appliances. The Zavier 
leg, although of equal weight with Palmer’s, fatigues more in 
walking, cramps while in a sitting position, and permits of 
arising less easily, as well as of entering and descending from 
a carriage. 
“ The Palmer leg is light, is easily extended by the move- 
ments of the short levers (one of the stumps is three inches 
from the knee-pan, the other four inches). According to 
Judge Choiselat, the thigh-socket, which takes its point of 
support above the small part of the superior segment of the 
limb, offers a sustaining base, equal to that of Zavier’s appa- 
ratus, which goes up to the perinseum. 
“ Finally, an important matter,—the Palmer limb is the one 
which has been used longest without being repaired.” 
I have carefully noticed Judge Choiselat’s attempts every 
year. I have seen him frequently, and I even watched the 
preparation of the two new appliances. However, I have pre- 
ferred to give Mr. Ilouzelot’s account, because, living in the 
same city with Mr. Choiselat, he meets him daily, and his tes- 
timony has the greater value from the fact that, before witness- 
ing this experiment, our colleague had a great predilection for 
French appliances. 
Such are the facts of which I have been witness. 
Hebout. 
Note.—The report is continued, at great length, in the Bulletin General, from 
which further translations are in progress. To have received such a report from 
the most distinguished Society of Surgeons in Paris, is an honor of which the 
inventor is justly proud. 
B. F. P. 
Philadelphia, Jan. 17th, 1865.