Mending Broken Soldiers: The Union and Confederate Programs to Supply Artificial Limbs by Guy Hasegawa (review)

This slim volume by Guy Hasegawa, pharmacist, senior editor for the American Journal of Health-System Pharmacy, and coeditor of Years of Change and Suffering: Modern Perspectives on Civil War Medicine (2009), focuses on attempts to address the sudden need for thousands of artificial limbs brought on by the Civil War. To detail Confederate wartime efforts to provide artificial limbs, Hasegawa examines the Association for the Relief of Maimed Soldiers (ARMS) records. For the parallel Union story, he mines letters and documents from the United States Army surgeon general, adjutant general, United States Army Command, and other government sources, as well as advertisements from artificial limb manufacturers. The book has a useful appendix on those manufacturers, a striking photo section, and a companion website with lists of all those who received limbs in the wartime programs. The narrative that emerges from these various sources highlights the importance of “dedicated individuals establishing programs from scratch,” albeit within the context of vastly different regional manufacturing capacities (xi).

Hasegawa notes that 75 percent of the sixty thousand soldiers who underwent amputation survived it. Many of these survivors would have benefitted from an artificial limb for appearance’s sake and to replace at least some functionality. At the start of the war, artificial limb manufacturing was largely limited to a competitive northern market. Initially, amputees had to pay for their own limbs, which typically cost much more than they made. The Union first appropriated money in July 1862 for artificial limbs under a program administered by the Union army surgeon general. Hasegawa highlights the Union’s use of boards of expert surgeons from 1862 to 1865 to evaluate the various offerings from the northern manufacturers, thus increasing those products’ reliability. Before long, there was such diversity of options that Union amputees could also pay for upgraded versions or accessories. (Hasegawa notes, however, that this led to charges of price gouging by various manufacturers.) Ultimately, Hasegawa praises the Union program for spinning up from virtually nothing to a “remarkable logistical accomplishment,” which by 1867 provided a significant percentage of eligible amputees with artificial limbs (by his estimates, 64 percent of leg amputees and 45 percent of arm amputees) (45).

In contrast to the Union government’s offerings, Confederate amputees were on their own until the 1864 formation of ARMS, a private benevolent society loosely affiliated with the Confederate government. Hasegawa thoroughly mines the ARMS records to depict the difficulties this organization and its secretary, William Carrington, faced in raising money, in finding reliable manufacturers in the war-torn South, in figuring out how to get amputees to places where they could be fitted, and in wartime inflation. Add to that the difficulty of finding skilled laborers, increasing material shortages, and interruptions from nearby fighting, and it is easy to see why ARMS only provided 430 actual limbs by March 1865, when its last activity was recorded. Still, Hasegawa praises the organization and Carrington for their accomplishments despite those obstacles.

Hasegawa briefly discusses the postwar period, with northern and southern limb manufacturers vying for a market fueled by need and by both Federal funds for Union amputees and scattered southern state programs for former Confederates. It is unfair for a reviewer to criticize a book for not doing more than its author intended, but there does seem to have been a missed opportunity here for a study that would more solidly position this story within the larger context of artificial limbs and amputees in the antebellum and postbellum years (although the second and final chapters at least start to address these issues).

Hasegawa’s narrow focus may also be a problem for readers looking for a larger historiographical context. Recent works by Brian Jordan, Brian Craig Miller, Megan Kate Nelson, and James Marten on the physical impact of the war on soldiers’ bodies (and the practical and psychological aspects of artificial limbs) aren...