Go back to article: Prosthetic limbs on display: from maker to user
Prosthetics in Edinburgh
The Royal College of Surgeons of England’s connections with prosthetic users were for the most part via the clinicians involved, on a national scale. At National Museums Scotland – largely based in Edinburgh – the links were more local, and via designers. To understand the deployment of prosthetics in our projects at National Museums Scotland, it will be helpful to outline this background.
Edinburgh's reputation for prosthetic design emerged in the 1960s through work with children affected by thalidomide. Between 1958 and 1961 the drug was taken by thousands of expectant mothers suffering from morning sickness. It had a side effect that resulted in children born with missing or partial limbs. David Simpson, a medical physicist who developed the first foetal heart monitor in the 1950s, became director of the Powered Prosthesis Unit in Edinburgh at the Princess Margaret Rose Hospital in 1963 and was tasked with designing and building prosthetics (especially upper limbs) which could be used by children affected by thalidomide. By the end of that year the unit was serving sixty children from across Scotland and Northern Ireland (Dolan and Gow, 2013). Designing prosthetics for children was complex: they needed to be especially robust and intuitive. The team’s first outputs, the Simpson Series 1 arms, were powered by carbon dioxide, and they allowed the user to rotate their wrist and to grasp. The arms were self-levelling, which, crucially, allowed users to feed themselves. The work was unpatented and thus free for any hospital in the world to use.
The limbs Simpson and his colleagues developed had to keep up with the growth of the child as well as incorporating new technologies. ‘The children are getting older and communicating better’, he reported, ‘and our work, therefore, is improving. The children have three terribly fundamental needs to carry out on their own. To eat. To write. To go to the lavatory’ (Anon, 1964). In the late 1960s, Simpson Series 2 arms had shoulder elevation, elbow bending, grasping hand and rotations of the wrist and upper arm.
As the needs of patients changed, the Powered Prosthesis Unit at the Princess Margaret Rose Hospital went on to become the Rehabilitation Engineering Service, and still later the Southeast Mobility and Rehabilitation Technology (SMART) Centre. Engineer David Gow, director from 1993, wanted to create a modular prosthetic arm system which could be used for both arms and at different ages. At the time, many commercial components were incompatible with one another and he hoped the modular system would address the need for powered partial hands for both children and adults. Gow recognised that the pneumatic design was ‘inconvenient and cumbersome [...] with limitations in functionality’ (Gow, 1999). He wanted to create a prosthetic which was lighter and more-user friendly while maintaining a modular design. In 1998, the Edinburgh Modular Arm System (EMAS), known as ‘the world’s first bionic arm’, was fitted to hotelier Campbell Aird, who had lost his arm to cancer. It weighed 1.8 kg, less than an organic arm, was battery powered and controlled by electronic micro sensors.
Although EMAS was never available commercially, the design team became Scotland’s first NHS spin-out company, Touch EMAS, later Touch Bionics, based in Livingston (outside Edinburgh). Under Gow’s leadership Touch Bionics designed their artificial hand, the i-limb. Launched in 2007, it was the first commercial prosthetic to have five individually powered fingers.
The i-limb was a flagship object for the National Museum of Scotland capital redevelopment 2012–16. The Museum’s curators had been following the progress of the Powered Prosthesis Unit and its successors. In 2008, we borrowed a first generation i-LIMB (as it was then branded) for the permanent gallery Scotland: A Changing Nation to feature in a display showing the strength and range of current scientific and technological innovation in Scotland. At the time, Touch Bionics were not ready to donate one of their few demonstration hands to the Museum, but they later transferred it to the national collection, and remain keen to provide one of their latest model for display, rather than have us include the older model.
The main strength of the National Museum’s prosthetics collection arrived in a coordinated acquisition from two sources. Some prototypes of Simpson’s work had remained with his family, and were donated to us by his son Allen D C Simpson, a former curator in the Museum; he also facilitated the acquisition of a collection held by the NHS. In all, 146 hands, arms or significant parts thereof were collected. As these had formed the makers’ research and heritage collection they had been pre-selected for survival on the basis of their design interest. Accompanying information included Gow’s recollections of what each of the items were. While patient stories were included, they were largely apocryphal and were subsumed within an overall narrative of technical innovation. For instance, we learned that maintenance of older technology endured because the prosthetists did not want to have to tell users they needed to learn to use a different limb from the one they were used to. But for the most part, like many science and technology acquisitions of this kind, we acquired the collection as evidence of technological development.
Component DOI: http://dx.doi.org/10.15180/170806/003