During and after the Civil War, the empty sleeve became a metaphor for veterans returning to a life they once lived easily, which was now a struggle. Few activities are as basic to daily life in Western cultures as eating with a knife and fork. Theuse of a traditional knife and fork pairing, though, requires the use of two hands in a fairly complicated series of maneuvers. Thus, one of the most necessary tools in the alternative toolkit of an upper-limb amputee is an eating utensil for one hand. After Admiral Horatio Nelson of the British Royal Navylost an arm in battle in 1797, he used custom eating utensils. These implements, known as Nelson knives, consisted of a forkknife combination on a single handle, the short knife blade holding the place of a fourth tine. Custom orders of this type were not within the means of most American Civil War veterans, and a more utilitarian utensil was devised by Dr. William L. Detmold. Detmold was a New York surgeon of some wealth and prestige, having developed an innovative surgery for club-clubfoot. Detmold helped to organize the U.S. Army MedicalCorps for service in the Civil War, and he served as professor of military surgery and hygiene at the College of Physicians and Surgeons, New York. Detmold wrote and lectured regularly on the injuries of war, especially gunshot wounds to various parts of the body. Detmold volunteered as a civilian surgeon at the First Battle of Bull Run. He became interested in amputation and prosthesis after his experience on the field, and this led him to invent the Detmold knife (Fig.1), an adaptive utensil that would help one-armed veterans rebuild the skills they needed to eat unassisted. The Detmold knife was manufactured by George Tiemann and Company (New York, New York) and was supplied by the U.S. Government to veterans of the Civil War after the loss of an upper limb. The Detmold knife was steel with a wooden handle and included a soft case for carrying when dining outside the home.
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