'It's All Done With Mirrors': V.S. Ramachandran and the Material Culture of Phantom Limb Research

This article examines the material culture of neuroscientist Vilayanur S. Ramachandran's research into phantom limbs. In the 1990s Ramachandran used a 'mirror box' to 'resurrect' phantom limbs and thus to treat the pain that often accompanied them. The experimental success of his mirror therapy led Ramachandran to see mirrors as a useful model of brain function, a tendency that explains his attraction to work on 'mirror neurons'. I argue that Ramachandran's fascination with and repeated appeal to the mirror can be explained by the way it allowed him to confront a perennial problem in the mind and brain sciences, that of the relationship between a supposedly immaterial mind and a material brain. By producing what Ramachandran called a 'virtual reality', relating in varied and complex ways to the material world, the mirror reproduced a form of psycho-physical parallelism and dualistic ontology, while conforming to the materialist norms of neuroscience today.

The Torments of Spring: Jake Barnes's Phantom Limb in The Sun Also Rises

While critics recently have found The Sun Also Rises a fruitful text for reexamining issues of gender and sexuality in Hemingway's work, a significant aspect of Jake Barnes's genital wounding has been overlooked. At least from the time of the American Civil War, a diverse body of medical literature has documented the psychosomatic reality of phantom genitalia in traumatically injured men. Revisiting the novel from this perspective-imagining that Jake Barnes is haunted by a penile ghost-allows us to see this character as something more than a victim of disability. Instead, we might think of Jake's material self as figuratively masculine but accidentally transgendered: a body that others can desire and that still can choose, or not, to reciprocate sexual feeling.

"Doomed to go in company with miserable pain": surgical recognition and treatment of amputation-related pain on the Western Front during World War 1

The principal feature of injuries from World War 1 was musculoskeletal trauma and injury to peripheral nerves as a result of damage to the upper and lower limbs caused by gunshot wounds and fragments of artillery munitions. Amputation was used as a treatment in field hospitals to save lives; limb conservation was a secondary consideration. A century later, the principal feature of injuries to soldiers in today's wars in Iraq and Afghanistan is also musculoskeletal trauma and injury to the peripheral nerves caused by improvised explosive devices. Common to both types of injury is postamputation pain. We searched The Lancet's archives in this Series paper to show the efforts of surgeons in World War 1 to understand and treat postamputation pain in its own right both during and immediately after the war. Despite unprecedented patient numbers and levels of civilian medical expertise, little progress was made in providing relief from this type of pain, a grave concern to the surgeons treating these soldiers. Today postamputation pain is understood beyond a surgical context but remains a complex and poorly understood condition with few effective treatments.

Phantoms in artists: the lost limbs of Blaise Cendrars,Arthur Rimbaud, and Paul Wittgenstein

There have been an increasing number of reports of postamputation pain and problems linked to phantom limbs over recent years, particularly in relation to war-related amputations. These problems, which are often poorly understood and considered rather mysterious, are still relevant because they are difficult to treat medically. Functional neuroimaging techniques now enable us to better understand their pathophysiology and to consider new rehabilitation techniques. Phantom limbs have often been a source of inspiration to writers, particularly in the period following the First World War, which was responsible for thousands of amputees. Some artists have suffered from postamputation complications themselves and have expressed them through their artistic works. Blaise Cendrars (1887-1961), one of the greatest authors of the twentieth century, suffered from stump pain and phantom limb phenomena for almost half a century following the amputation of his right arm during the First World War. He suffered from these phenomena until the end of his life and his literary work and personal correspondence are peppered with references to them. Arthur Rimbaud (1854-1891), one of the most famous poets in world literature, developed severe stump pain after his right leg was amputated due to a tumor. He survived for only six months after the procedure but left behind an account of the pain he experienced in correspondence to his family. The famous pianist Paul Wittgenstein (1887-1961), whose right arm was amputated during the First World War, became a famous left-handed concert pianist. The phantom movements of his right hand helped him to develop the dexterity of his left hand. The impact on the artistic life of these three men provides an original illustration of the various postamputation complications, specifically phantom limbs, stump pain, and moving phantom.

Mirror therapy for facial paralysis in traditional South Asian Islamic medicine

Mirror therapy has stimulated a dynamic clinical and research agenda for the treatment of poststroke hemiparesis and phantom pain. The origins of mirror therapy are thought to lie with the end of the twentieth century. This article translates key sections on the use of mirror therapy for facial paralysis from Muhammad Akbar Arzānī, an influential practitioner of South Asian Islamic medicine. Given that his text appeared over a quarter millennium before Western accounts of mirror therapy, this article calls for an amendment to the historical record so that Arzānī is recognized.

William Porterfield (ca. 1696-1771) and his phantom limb: an overlooked first self-report by a man of medicine

EARLY REPORTS OF phantom limbs by Ambroise Paré and René Descartes were based on second- or third-hand descriptions provided by amputees. William Porterfield (ca. 1696-1771) was a prominent Scottish physician and was possibly the first man of medicine to write about his experiences after having a leg amputated. Porterfield was an authority on vision; he devised the first optometer and examined accommodation after cataract operations. Rather than using the phenomenon of a phantom limb to question the veracity of the senses (as Descartes had done), Porterfield integrated his phantom limb experiences into his general account of sensory function.

Five early accounts of phantom limb in context: Paré, Descartes, Lemos, Bell, and Mitchell

PHANTOM LIMB WAS described long before American physician and surgeon Silas Weir Mitchell coined the term and drew attention to the disorder in the 1860s. The early descriptions of Ambroise Paré, René Descartes, Aaron Lemos, Charles Bell, and then Mitchell of this strange consequence of amputation are presented in historical and cultural context. These five men described phantom limbs for various reasons. They also differed when it came to explaining and dealing with these illusory sensations. The rich history of phantom limbs can begin to be appreciated by viewing the contributions of these individuals in perspective and by realizing that their writings represent only a fraction of what was published about phantom limbs more than 130 years ago.

[So-called initial description of phantom pain by Ambroise Paré. "Chose digne d'admiration et quasi incredible": the "douleur ès parties mortes et amputées"]

In his (1552 (1554?) "Harquebusses and other guns" tractate the French surgeon, Ambroise Paré (1510-1590) described the post-amputation syndrome-considered to be the first description of this syndrome--which, on hermaneutic analysis, proves surprisingly complete: Paré differentiated pre-amputation pain ("la douleur ès parties mortes") from post-operative symptoms; he differentiated stump pain from phantom-limb sensations ("faux sentiments"), and he succeeded in distinguishing pain-free exteroceptive sensations--the so-called phantom-limb sensation--from phantom-limb pain proper ("la douleur ès parties amputées"). He characterised the psychogenic pain syndrome ("se plaigner fort"), described protracted, intermittent and delayed courses, as also exogenous modulating factors which--e.g. the weather ("les causes froides")--exacerbate the situation, or--e.g. massage--can also ameliorate it. Furthermore, he made use of psychological factors to combat pain, and rejected the use of multiple peripheral surgery to treat pain. He proposed two neurological models to explain the etiology of phantom-limb pain, one postulating peripheral changes in stump nerves, the other, involving memory, suggesting a cerebral origin, and locating algogenesis in the brain.