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Lucas Brosovich
UWRT 1103
Professor Jizi
9/12/15
To Arms, Prove Your Metal
In a time where information and knowledge comes with a few twitches of ones fingertips,
anyone can become a master of their interests. There is only one topic though that has captivated
me throughout my life, the thought of prosthetic limbs. More specifically, the prosthetic limb that
is featured in an anime called Fullmetal Alchemist. For those that are not familiar with this
show, the concept is that the prosthetic, referenced as automail, is a limb that the user has that
acts almost as if they had never lost the limb. The major difference between automail and a
regular prosthesis is that it seems like it is completely made of metal. Although the idea is purely
fictional and made majorly for entertainment purposes, the idea has somehow stayed with me
many years after I was done with the anime. Is it possible for someone today to have a fully
functioning automail prosthetic? For this to happen, some key features must be observed: The
automail is not limited to one type or one limb, a person can have multiple automail and of
different types. Next the limb must be able to move independently like a natural appendage, only
relying on the nearest muscles for any support. Lastly, it must be sensitive enough to not crush
whatever it is that it is holding, actual feeling or sense of however is not important to the user.
Where to begin though, as prosthetics have been around for a while, maybe the point has already
been passed.

The journey back in time to the first prosthetic begins in Egypt. It was here where many
pioneers in the field of prosthetics worked. It has been found that most of their works were for
the feeling of wholeness. A prosthetic toe found with an Egyptian mummy appeared to have been
for functional purposes as well as that feeling of wholeness (Norton). Although a journey of a
thousand miles must begin with the first step, it may be slightly more difficult if one is missing
their toe. There is little to mention of new prosthetics or revolutionary ideas in the field of
prosthetics until the Renaissance. However, the Dark ages did see a rise in peg legs and hook
hands. It is not until the mid-1500 where,
French Army barber/surgeon Ambroise Par is considered by many to be the father of
modern amputation surgery and prosthetic design. He introduced modern amputation
procedures (1529) to the medical community and made prostheses (1536) for upper- and
lower-extremity amputees. He also invented an above-knee device that was a kneeling
peg leg and foot prosthesis that had a fixed position, adjustable harness, knee lock control
and other engineering features that are used in today's devices. His work showed the first
true understanding of how a prosthesis should function. A colleague of Par's, Lorrain, a
French locksmith, offered one of the most important contributions to the field when he
used leather, paper and glue in place of heavy iron in making a prosthesis. (Norton)
It was from this momentous man that all of the groundwork for todays prosthetics. Without his
work it is most like that many people would have peg legs and hand hooks. From there on it was
one refinement after the other. Making the limbs lighter and more slightly was as important as
functionality. This continued up until present day where people have begun to incorporate
computers and electronics into prosthetics. So, with the vastly growing field, there come to be a
great many different types of prosthesis.

Peoples take on prostheses are as wide and varied as there are types of prosthesis. For
instance some people will prefer functionality of aesthetics. Others will be just the opposite,
requiring the most lifelike of artificial limbs that serve little to no functionality. Furthermore
there are others who say heck to it all and chose to not even bother with a prosthesis. There are
however a few categories that prosthetics can be put into to help make understanding them
easier: There are Activity-Specific Prostheses which are designed for a specific purpose, like
golfing or rowing a canoe and everything in between. Next are Body-Powered Prostheses which
uses a cable to operate a prosthetic elbow or the opening and closing of a grasping device. After
that are the Externally Powered Prostheses, which use motors and other electrical components
and have a wider range of uses than the Body-Powered Prostheses but can be slower to operate
and are controlled by either Noninvasive Sources of Signal or Invasive Sources of Signal (Lee).
The ones that are going to be focused on are the Externally Powered Prostheses of the Invasive
Sources which can be sorted into even more categories themselves. So many options and still
more to come. It is good to have options however as each of these sub categories coming up soon
each have their own distinctive characteristics themselves. The most prominent of these being
the ones concerning targeted muscle reinnervation, or TMR or short. What Brian Lee and his
associates tell concerning this is:
In TMR, the residual sensorimotor nerves that innervate the missing limb are surgically
connected to remaining muscle groups on the proximal residual limb or chest wall. After
several months, these nerves innervate the new host muscle and skin resulting in
functional contraction and sensation. This new muscle group acts as a bioamplifier for the
nerve, generating muscle contractions that can be sensed by skin EMG electrodes and
used as control signals to operate an externally powered prosthesisIn addition to motor

function, sensation such as touch, pressure, vibration, and temperature for the missing
limb is often restored to the skin overlying the newly reinnervated muscles Natural
attempted movements result in corresponding expected movement of the prosthesis
(Lee).
To most, this will sound like much and more that will simply fly right over their head. To put it
simply, after various surgeries in moving around nerve bundles to corresponding muscle groups,
sensors in the prosthetic will pick up on what the person is trying to do by reading which muscles
are contacting and which muscles are relaxed. Similar in how one will move their arm up or
down and feel a few muscles in their chest tighten even though it is the shoulder that is doing
most of the work. So, this puts one requirement down, but what if it is just a fluke. Are there
others like it? The answer to that is yes. An article of NBC News stated:
32-year-old Zac Vawter has been fitted with an artificial limb that uses neurosignals
from his upper leg muscles to control the prosthetic knee and ankle. The motorized limb
is the first thought-controlled bionic legUntil now, only thought-controlled bionic arms
have been available to amputees after multiple revisions to the legs software and two
major revisions to the legs mechanics, Vawter says he can walk up and down stairs the
way he did before the accident (Mantel).
This is a great piece as it helps prove two of the necessary requirements with one fell swoop. Not
only proves point two concerning that the limb can move independently while only relying on
the surrounding muscles but, also proves point one in that there are multiple types and forms of
similar pieces. Although it is a pretty penny to make, about 1one million dollars (Mantel), that
does not make it any less of a reality. That does not however mean that all good, there is still one
more requirement to meet before the fiction can become a reality.

The very last point that must be made it that of some sensory input. In the anime Fullmetal
Alchemist the various characters who used automail were able to handle many different
varieties of objects with deft and graceful maneuvers, even hold someones hand without
crushing it. This in itself is an amazing feat as there is no way that someone can actually feel
what is going on with their prosthetic, right? Guess again, MIT technology reviews had this to
say on the subject:
Researchers at the Cleveland Veterans Affairs Medical Center and Case Western Reserve
University have developed a new kind of interface that can convey a sense of touch from
20 spots on a prosthetic hand. It does this by directly stimulating nerve bundlesknown
as peripheral nervesin the arms of patients; two people have so far been fitted with the
interface. Whats more, the implants continue to work after 18 months, a noteworthy
milestone given that electrical interfaces to nerve tissue can gradually degrade in
performanceAt the heart of the technology is a custom version of an interface known
as a cuff electrode.Then a total of 20 electrodes on the three cuffs deliver electrical
signals to nerve fibers called axons from outside a protective sheath of living cells that
surround those nerve fibers. This approach differs from other experimental technologies,
which penetrate the sheath in order to directly touch the axons. These sheath-penetrating
interfaces are thought to offer higher resolution, at least initially, but with a potentially
higher risk of signal degradation or nerve damage over the long term. And so they have
not been tested for longer than a few weeks (Talbot).
So, it can be seen why there have been difficulties in this area. Connecting unnatural products to
our natural ones is more difficult than science fiction would have people believe. Also it houses
dangers of nerve degradation and potential loss of nerve input. Losing a hand is pretty be, but not

being able to feel the rest of ones arm would be terrifying indeed. There was however great
success in the sensory feedback experiment that they conducted. A 48-year-old Ohio man who
lost his right hand in an accident three years ago using his prosthetic hand to pick up and remove
stems from cherries without crushing them from excessive squeezing (Talbot). There are many
prosthetics that make use of this technology. As the earlier mentioned TMR prosthetics use a
form of this, it is not the same as the prosthetic used by the 48-year-old. Something similar to
what he would be using would be Modular Prosthetic Limb or MPL. This is a limb that
specializes in as much sensory feedback as it does functionality. Returning to Lee and friends he
says:
This limb aims to be the most sophisticated and advanced upper extremity prosthesis
with full biologic motion at the shoulder, elbow, wrist, and fingers. The MPL features 17
DOF (degree of freedom) with 26 articulating joints. Each finger is capable of
independent movementOne of the most exciting aspects of the MPL is the numerous
embedded sensors that provide sensory feedback from the robotic limb to the patient.
Sensors at the fingertips measure force, vibration, fine point contact, and temperature.
Additional data, such as joint angle, velocity, and torque, are also recorded from the arm
enabling improved control of the hand and arm. This sensory information eventually can
be delivered back to the patient in the form of artificial sensation either by vibrations on
the skin surface or by directly stimulating the primary somatosensory cortex 10 and 44.
Sensorization of the MPL is a crucial aspect of creating a prosthetic limb with realistic
sensory feedback to the patient (Lee).
What do they mean, what do all these lovely and fancy words mean? What it all equates to is this
limb has a much wider range of movement and flection than most others do. Also it prides itself

on is sensory collection which in time can be transferred back to the user. So being it the
difference between the prosthetic directly interfacing with the nerves or just providing some
input to a muscle or the surface of ones skin, there is an acceptable amount of sensory in these
prosthetics. That then proves to be a point towards the requirements met for automail to be a real
thing. Wait a minute, that is all three points met.
With so many advances in prosthetics, the question had been raised. Is it possible that
fiction such as those seen in amines like Fullmetal Alchemist become a reality in todays
world? Looking back we can see that the criteria has been met. There are prosthetics that can
move entirely dependent on only the surrounding muscles. There are multiple types and are
available for many a different limb. Lastly, they have enough sensory input for the user to be
aware of what they are doing and control their limb with finesse. Once all of these are put into
one place it gets a little difficult to see why this fiction isnt a reality. There are a few problems
that come up. Firstly, it is insanely expensive. When looking back it is can be seen that, The
U.S. Armys Telemedicine and Advanced Technology Research Center funded the Chicago study
with an $8 million grant to add neural information to the control systems of advanced robotic leg
prostheses(Mantel). Eight million dollars, that is just the tip of the iceberg though. Other groups
have poured even more money into trying to figure out the working of the nervous system and
how to better understand it. The other problem that arises is that there are other studies that keep
people occupied too. For instance,
Scientists say they've cracked the neural "code" in a mouse's retina to create a device
that restores near-normal sight in blind miceBut before blind people can be outfitted
with high-performing bionic eyes, the researchers' devicelikely will have to undergo
several clinical trials, especially to test safety of the gene therapy component (Gannon).

Making an eye that will enable the blind to see would make modern science seem like the
miracles of Jesus. That would begin to outshine a glorified prosthetic in a time when robotics and
electronics are anywhere and everywhere. There are those however, who will persist until they
achieve their desired dream. Creating and making the automail has been mine for a long time.
Although I am willing to surrender my torch to someone more qualified and better equipped to
make it happen, I will not let the flame die. Kick me down and cripple me, I will stand up and
make this dream a reality, one way or another.

Works Cited

Gannon, By Megan. "An Artificial Eye That Can See?" LiveScience. TechMedia Network, 14
Aug. 2012. Web. 21 Oct. 2015.
Lee, Brian, Frank J. Attenello, Charles Y. Liu, Micheal P. McLoughlin, and Michael L. J.
Apuzzo. "Recapitulating Flesh with Silicon and Steel: Advancements in Upper Extremity
Robotic Prosthetics." Science Dirrect. Elsevier, May-June 2014. Web. 11 Nov. 2015.
Mantel, Barbra. "First Mind-controlled Bionic Leg a 'groundbreaking' Advance - NBC News."
NBC News. N.p., 25 Sept. 2013. Web. 21 Oct. 2015.
Norton, Kim M. "A Brief History of Prosthetics." InMotion. Amputee Coalition, Nov.-Dec.
2007. Web. 11 Nov. 2015.
Talbot, David. "A Prosthetic Hand That Sends Feelings to Its Wearer | MIT Technology
Review." MIT Technology Review. N.p., 05 Dec. 2013. Web. 21 Oct. 2015.