In this appendix
War creates an industry
For an industry to develop there must be a demand for its product: war creates such a need when thousands upon thousands lose legs and arms. Provision of artificial limbs restores independence and dignity. The American Civil War ended in 1965 leaving many in this situation. At the Battle of Bull Run, Colonel J.E. Hanger, fighting for the South, lost a leg; the wooden appliance he made for himself was so successful that many other soldiers (and the Confederate Army itself) demanded limbs.
When injured men returned to England during the First World War, apart from a few small firms, there was no industry that could cope with the thousands of appliances needed. Not only was there no trained workforce, there was vitually no workforce at all: so many men had enlisted. The authorities turned to America and many thousands of wooden artificial limbs were imported, with technicians to make and fit them in England; but demand was huge, and manufacturing needed to be based here.
Limb makers from all over the world were invited to Roehampton House to attend the International Exposition of Artificial Limbs in 1915; 39 firms attended. J.F. Rowley & Co had sent their Kansas City branch manager, Billy Isle: he was a good organiser and a born leader, he also had an artificial foot after his own was crushed by a train and amputated. With characteristic enthusiasm, he would truthfully say to an amputee: “I know it is hard but it’s not what you’ve lost that counts, it’s what you have left.” He greatly impressed the judges, all members of the Royal College of Surgeons, by running the length of the exhibit hall and performing many other agile feats; they awarded him a gold medal and the first prize for lower extremity prostheses.
A contract was quickly offered to the J.F. Rowley Company with Billy Isle as general manager. Other companies who exhibited in 1915 and set up workshops at Roehampton were: J.E. Hanger Inc (who in 1926 took over J.F. Rowley, making them the largest manufacturer of legs in Great Britain); Carnes Artificial Arms Ltd; joining them later were W.R. Grossmith, Charles Salmon & Sons, Horace V. Duncan, C.A. Blatchford, Anderson & Whitelaw Ltd and Masters & Son. Cabinetmakers came to help from all parts of London, joined by other skilled woodworkers from the provinces. Experienced prosthetists came from the United States. All worked at a feverish pace. King George V and Queen Mary showed great interest in fabrication and fitting of the limbs, and Billy Isle is reported as saying that they were well informed and gracious to the amputee patients, and the staff.
Shortly after 1915, the firm of Desoutter Brothers Ltd came to Roehampton. One of the Desoutter family had lost a leg above the knee in a flying accident and the company, then operating a small aircraft factory at Hendon, designed a metal leg: it was made of Duralumin, extensively used in the construction of aeroplanes. J.E. Hanger had also produced a light metal leg at that time.
Hangers, Blatchfords and Vessa
Later during the First World War, in order to deal with the numbers involved and reduce the inconvenience of travelling, limb fitting centres were set up in some of the larger cities: each centre was staffed by a Roehampton trained surgeon with an administrataive staff with a branch workshop and fitting accommodation provided by contractors. Roehampton remained the parent centre where the limbs were made and repairs carried out.
At the beginning of 1934 Hangers were the main suppliers of metal and wooden legs at Roehampton, being the recognised contractors to the Ministry of Pensions for the whole of the country, having 16 branches attached to Ministry of Pensions Artifical Limb and Appliance Centres. Hangers had a large number of private civilian patients in addition and also exported limbs all over the world (even America). The company manufactured new legs at Roehampton and fitted them at the various centres for the following bodies: the Ministry of Labour, to rehabilitate industrial accident cases; the Board of Education, for school children; railway companies, for staff injured on the railways; charitable and hospital organisations. The orders for these categories of legs were channelled through the Trustees of Queen Mary’s Hospital who used the existing machinery of the Ministry of Pensions. The administrative work and many of the costs for patients were borne by the Trustees.
During the Second World War the work of Hangers was greatly expanded and whilst dealing with thousands of private cases, they remained the sole contractors to the Ministry of Pensions. On the passing of the National Health Service Act, 1948, Hangers soon lost their private work, most patients naturally preferring to be dealt with as NHS patients, in fact many taking the opportunity of acquiring new limbs.
At this time, the Desoutter business was sold to Vessa Ltd, so that the main contractors to the Ministry of Health were Hangers, Blatchfords and Vessa for legs and Steepers for arms.
Service expansion, research and development
During the first 12 years of the NHS a great expansion in the limb fitting service took place, many more Artificial Limb and Appliance Centres were established throughout the country, and several of the older centres were rebuilt. The new centres had more workshop space so that more extensive repairs and refitting could be performed locally and even a contribution made to the manufacture of new legs.
The Roehampton factories were set up in 1915 and it could be said that from then efforts were made by all concerned to improve standards. Indeed, there is evidence that the founders, notably Mrs Gwynne Holford, took a particular interest in this. It was not, however, until 1917 that a research department as such was set up in the Hospital and amongst its developments was Certalmid, a laminated plastic material. This material was principally used for arms but was also incorporated in leg manufacture and continued in use until after the Second World War and the emergence of plastics. This research department was the first of its kind. Regretably the department was closed some years after the end of the First World War and was not re-opened until 1945, under the leadership of A.W. Craft, in a small part of a new building erected during the Second World War. This research unit continued until it was incorporated in the BRADU (Biomechanical Research and Development Unit) in January 1967.