The Introduction lays out the theoretical and political stakes of the book. It shows how abolitionist white radicals saw enslavement as a diseased part of the national body that had to be lopped off. Through an exploration of political speeches, cartoons, song-sheets, sermons, fiction, and poetry, the author shows how the amputated bodies of Civil War veterans represented the possibility of a new kind of nation that had Black citizenship at its core.

Chapter 1 traces the antebellum faith in the non-finality of death and its antithesis in the irreparable change wrought by amputation. In sentimental theology, the dead are never wholly gone – they live on to inspire and save, awaiting reunion with those they leave behind. The dead child embodies the reality of unpredictability and at the same time operates within a narrative that soothes. The author contrasts antebellum postmortem photography and images of amputees and amputated limbs. Postmortem photography of children reinforces the sense that the family has not really been ruptured, that death isn’t really the end. Photographs of amputee Civil War soldiers do quite the opposite. Rather than operating as postmortem photography does, as a mediator between the living child, its dead body, and the family left behind, the portrait of the amputee is insistently in the present, even as the lost limb is consigned to an unrecuperable past. While nineteenth-century pictures of dead children often encouraged the fiction that the photograph’s subject was an ongoing member of the family, amputation photography – both medical and vernacular – insists on the permanence of bodily change.

Chapter 2 explores accounts by Civil War nurses and surgeons – first-person nonfiction, lightly fictionalized narrative, sensationalized memoir, and fiction. The central texts in this chapter are Walt Whitman’s Memoranda after the War, Louisa May Alcott’s Hospital Sketches, John Brinton’s Personal Memoirs, Susie King Taylor’s Reminiscences of My Life in Camp, and S. Weir Mitchell’s “The Case of George Dedlow.” These narrators represent amputation in different ways, especially the scene of amputation itself, the image of a basket or trough of dismembered limbs, and amputee reflections on the relationship between their remaining bodies and their absent limbs. However, for all the narrators in these texts, amputation is part of a meditation on the meanings of intact and amputated bodies, and their role in making sense of the Civil War. The chapter ends with a discussion of the Army Medical Museum, in which amputated limbs were catalogued, stored, and displayed as examples of the damage done by gunshots and shells. This dovetails with a reading of George Dedlow, in which the protagonist’s legs, stored in alcohol at the Museum, return to him briefly during a séance, absurdly marrying hopes for bodily resurrection with spiritualism’s belief in a humanized heaven.

Phantom limb pain (PLP) is a common source of distress and discomfort post-amputation. Up to 85% of amputees will experience PLP at some point and many cases become chronic pain conditions. While the pain has been well documented for decades, the exact pathophysiology is still unclear, and thus hindering a more accurate means of treatment. Patients with significant pain in the limb pre-amputation, lack of psychological counseling, and more proximal amputations in general seem to be more prone to pain; however, the presentation of PLP varies greatly from case to case. There are many noninvasive therapies, exercises, and medications that are recommended as first-line treatment, but the most effective and best-evidenced treatments involve electrical stimulation of peripheral nerves. Despite this lead on a promising treatment, the quality of evidence supporting or refuting any given modality is overall weak and requires much more homogenous study to truly be analyzed for efficacy.

This essay explores the relationship of literature and perversity in Roberto’s Bolaño’s short fictions “The Secret of Evil,” “The Insufferable Gaucho,” and Distant Star. While literature within the history of Latin American letters often provides a critique of or antidote to political and economic atrocities, in Bolaño’s texts literature is complicit in the very horrors it depicts. In Bolaño’s view, any effort to pit fiction and social actuality against each other in the interest of rescuing either represents a means to avoid the disturbance that, for Bolaño, defines contemporary existence.

This chapter surveys the evidence for extremity prostheses and assistive technology (walking sticks, canes, crutches, corrective footwear) in classical antiquity. It discusses the different ways in which an extremity such as an arm or leg might be lost (surgical intervention, military activity, judicial and extra-judicial punishment, self-mutilation or deliberate mutilation), and how individuals dealt with their resulting impairments and disabilities. Not everyone could utilise a prosthesis due to the nature of their impairment; they might need to, or indeed choose to, use another type of assistive technology, such as a crutch.

This chapter considers Romantic surgery from the patient’s perspective. It uses Astley Cooper’s rich archive of personal correspondence to explore the complex emotions associated with the experience of surgical illness and its treatment, as well as the ways in which emotional expression functioned as a form of agency within the private surgical relationship. In addition to considering private patients, this chapter also examines how emotions expressed and mediated agency within what, following Michel Foucault, we might consider the ‘disciplinary’ space of the hospital. The pre-anaesthetic surgical patient was a deeply unstable and ‘messy’ ontological entity whose pre-operative health and post-operative recovery were determined by a complex melding of constitutional, nervous, and emotional factors. Thus, as this chapter demonstrates, the patient’s own body could exert an unconscious material agency, often frustrating both surgical intervention and the patient’s own will, something that was most evident in the associations between irritability and obstreperousness that characterised contemporary discourses on amputation and its discontents.

When age-related physical impairments affect a person’s performance of functional tasks, rehabilitation may restore function and improve an elder’s independence and participation in society. Included is a review of how to perform a functional assessment, a description of the members of a rehabilitation team, and an introduction to the various settings where an elder can receive rehabilitation. The chapter describes geriatric assistive devices that improve self-care and mobility and reviews specific rehabilitation interventions for common debilitating conditions such as stroke, Parkinson’s disease, hip fracture, and lower-extremity amputation.

Clinical cases covering the spectrum of upper limb pathology are presented here. In the hand, these include congenital hand deficiencies, Dupuytren’s disease, rheumatoid disease, nerve lesions and tendon transfers. In the elbow, this includes osteoarthritis and in the shoulder, massive cuff tear, scapula winging and painful shoulder arthroplasty. Clinical examination findings for each of the cases are highlighted.