Prosthetics, Medicine, and Disability in Modern America: The Case of the A. A. Marks Artificial Limb Company.

Through the case of the A. A. Marks Artificial Limb Company, this article explores how the technology and business of prosthetics grew in America up to the First World War. In 1853, Amasa A. Marks established the artificial limb company A. A. Marks in New York. By the time of the First World War, the company had become the largest supplier of artificial limbs in the United States and had gained international recognition, exporting its products all over the world. Focusing on the company's growth before the war, this paper analyzes how American artificial limb makers positioned themselves between art and medicine and between surgeons and disabled customers at a time when their occupation had yet to be established as a specialized profession. From the mid-nineteenth century when the artificial limb business burgeoned to the First World War, American society went through various social and cultural changes that influenced the prosthetics industry and the perception of disability. During the Civil War, numerous soldiers were injured but survived because advancements in amputation techniques enabled surgeons to save more lives despite limb loss. The growing number of maimed veterans required more mechanical and public support for their rehabilitation. As a reconstruction project of the nation and a way to address the sense of damaged masculinity felt by injured war veterans, both Union and Confederate states approved support for providing them with artificial limbs at public expense. In postbellum America, as well as deformity and amputation, industrialization created a need for artificial limbs as the brutality of advanced weapons and unfortunate accidents involving machines and railroads increased the number of amputees. Thus during the late nineteenth century and early twentieth century, recognition of maimed bodies in public places went through a legislative and cultural transformation. The growth of artificial limb manufacturer A. A. Marks was in tune with such technological, medical, and sociocultural changes. Along with technological innovations and patents to protect these innovations, Amasa Marks devised various marketing methods and strategies through which the company secured customers and finally expanded the prosthetics market. As its customers increased, the company accumulated quantitative and qualitative data from patients' responses and interviews, and its own observations. In the late nineteenth century, George E. Marks, Amasa Marks's son and a representative of the company, analyzed customers' experiences of disability, gathering information on patterns of disability and mortality rates. Based on the company's rich experience with a large number of patient cases, George Marks advanced criticisms of surgical methods and provided second opinions on amputation surgeries. In doing so, he attempted to promote the limb maker's position from mere artisan to specialist, redefining the relationship between medicine and prosthetics and between surgeon and prosthetist. He also conveyed patients' complaints and needs to the medical men in the process, and distributed the company's findings and knowledge to surgeons and the general public by publishing treatises, articles, and manuals. Consequently, the company influenced an important epistemological turn in which the prosthetic perspective was considered prior to amputation surgery, not just as an inevitable follow-up.