The Willed Hand

1916 · Kinetic Arm Prosthesis · Work 1044 of 1,871

The oak-panelled plenary hall of a parliament building in Berlin on a February morning, grey winter light through a glass ceiling, at the front a plain unmarked oak speaker's table, beside it an artificial forearm upright on a wooden stand, a carved hand of pale wood with jointed fingers, a glossy red-brown wooden shaft, a brown leather sleeve, at the table the man, a slim man of forty, moustache, pince-nez, receding dark hair, in a black frock coat and white wing collar, one hand raised toward the wooden fingers, physicians in dark frock coats on the benches seen from directly behind.

Who
Ferdinand Sauerbruch (1875–1951) was the best-known German surgeon of the first half of the 20th century. Born in Barmen, now part of Wuppertal, on 3 July 1875, he studied medicine at Marburg, Jena and Leipzig and in October 1903 joined Johannes von Mikulicz-Radecki at the university surgical clinic in Breslau. There, in 1904, a low-pressure chamber built for the purpose allowed him for the first time to carry out major operations on the open chest without the lung collapsing. By way of Greifswald and Marburg he moved to Zurich in 1910, to Munich in 1918 and in 1927 to the Charité in Berlin, whose surgical clinic he headed until 1949. He never joined the Nazi party, was no antisemite and helped his deputy Rudolf Nissen into exile. Yet in 1933 he publicly welcomed Hitler's seizure of power, in 1934 became a state councillor and in 1937 accepted the National Prize founded by Hitler. From 1937, as an assessor in the Reich Research Council, he also handled applications that referred to human experiments in concentration camps. He learned at conferences of experiments on Polish women at Ravensbrück and kept silent. He died in Berlin on 2 July 1951.
The moment
On Tuesday, 8 February 1916, the German Orthopaedic Society held an extraordinary meeting in the plenary chamber of the Reichstag building in Berlin. The morning, from 10 a.m. to 1 p.m., was given over to artificial limbs; the war had left an enormous number of amputees. Before Sauerbruch, other doctors spoke on artificial legs and arms; the Munich orthopaedist Lange called the American Carnes arm too heavy, too complicated and, at 1,000 marks, too expensive. Sauerbruch, then a professor in Zurich, spoke on "Kinetic arm prostheses". His idea was that the muscles of the stump itself should move the artificial hand. He presented soldiers in whom he had shaped the muscles into bulges with a skin-lined canal running through them; with an ivory rod inserted, they could lift 30 to 45 kilograms. He also showed a prosthesis whose fingers were moved by this force. The problem was solved surgically, he said, but the model of the hand did not yet meet his requirements. The picture shows him at the speaker's table, one hand raised toward the wooden fingers of the arm on its stand.
The other side
"Solved surgically" was only half the story: the men had been operated on, but the hand to go with it was still missing. The Zentralblatt reported that a hand mechanism for the muscle bulges had "not yet been found". In April 1916, in the preface to his book, Sauerbruch himself wrote that making a voluntarily movable artificial hand had "so far failed because of a number of technical difficulties". The idea, he wrote there, came from Professor Stodola; the first prosthesis was supplied by the firm of Windler. Later the arm spread widely under Sauerbruch's name. He made use of the war in other ways too: as a professor in neutral Switzerland he crossed the border at weekends to operate in German military hospitals, with instruments from Zurich, and caused a scandal.

What the sources leave open: What the plenary chamber looked like in 1916 and exactly which prosthesis Sauerbruch showed is not described in the reports consulted; hall, table and the wooden arm on its stand are typified. The two meeting reports differ in emphasis but do not contradict each other: the DMW mentions a prosthesis shown whose model did not yet satisfy Sauerbruch himself, the Zentralblatt a hand mechanism still lacking. The full text of the lecture was not consulted. The soldiers presented are left out of the picture on purpose.

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