The Modern Men of Parts

A man of many artificial parts was lawyer Frank Tull. His teeth had been fashioned for him and fitted to his jaws by a doctor of dental surgery ...He had a silver plate in his skull to guard a hole from which a brain tumor had been removed. One of his legs was made of metal and fiber; it took the place of the flesh-and-blood leg his mother had given him in her womb ...In his left arm, a platinum wire took the place of the humerus . . . One hundred years after he died they opened up his coffin. All they found were strings and wires.

In 1935, when Author Charles Finney created him as a character in the novel The Circus of Dr. Lao, Frank Tull was considered to be, at most, the product of a fertile imagination. Yet, less than 40 years later, the concept of semi-artificial man no longer seems as farfetched. Though modern medicine has yet to produce a real-life counterpart of television's Six Million Dollar Man* it has developed workable replacements for many important body parts, and is steadily moving toward the day when hospitals may well have to follow the lead of auto-repair shops and add spare parts departments to their facilities.

Man has been replacing damaged portions of his body with artificial parts for centuries. Peg legs have been used since 600 B.C., and metal hands since the 16th century. Boston Silversmith Paul Revere was well known for the quality of the false teeth he fashioned long before his midnight message to Massachusetts' minutemen. But today's many and various replacements, made of such space-age materials as Teflon, the nonstick plastic, and pyrolytic carbon, a diamond-hard substance, are far more sophisticated. Unlike earlier devices, which were worn outside the body and usually removed at night, they are true replacements, designed to be implanted permanently and to duplicate, if not actually improve upon nature. Some examples:

LIMBS. Artificial thigh bones made of titanium and other modern alloys are being developed, primarily by Japanese surgeons. Dr. Yasuto Itami, of Tokyo, recently designed and implanted a titanium and polyethylene thigh bone that can be precisely adjusted to fit the patient when it is installed. Other orthopedists are using cords of woven Dacron--which is chemically inert and thus will not trigger an immune response --to repair or replace damaged tendons. Dr. William Harrison Jr. of Tulsa, Okla., uses Dacron tubing to repair separated shoulders; the material forms a scaffolding or framework upon which new ligament can grow and is so effective that one 17-year-old patient went back to competitive wrestling eight weeks after treatment.

JOINTS. Medicine is having considerable success with artificial joints. A plastic and steel copy of the ball-and-socket hip joint perfected by Britain's Dr. John Charnley in 1962 is being in stalled at the rate of 25,000 a year, mostly in patients with severe crippling arthritis. The cost (including hospitalization and doctors' fees): $2,500. Nor is this all that is being done for victims of this disease. Knuckle joints made of metal alloys are being used to replace damaged ones in thumbs and fingers. Doctors have implanted a metal and plastic device in the knees of several thousand elderly patients with degenerative arthritis, enabling some to walk for the first time in years. Ankle joints, although still highly experimental, have been installed in many patients, and work is under way on an elbow joint. Doctors at Chicago's Michael Reese Medical Center have restored mobility to two women with severely damaged shoulder joints. They have replaced the joints with stainless-steel and plastic prostheses. These in corporate a built-in safety feature: like ski bindings that release under leg-fracturing pressures, the joints are designed to dislocate rather than break under too much stress.

CIRCULATORY SYSTEM.

Tubes of synthetic fibers have been widely used to replace arterial parts since Georgetown University's Dr. Charles Hufnagel first applied the technique to humans. He fitted an Orion graft in the femoral artery of a Korean War veteran in 1953 and then applied the technique to the aorta, the body's largest blood vessel. Knitted Dacron is now commonly used for this purpose. Houston's Dr. Michael E. DeBakey and his former colleague, now rival, Dr. Denton Cooley, have performed thou sands of such grafts in patients whose arteries have been damaged or closed by atherosclerosis. They have also done more valve jobs than most auto mechanics. Cooley has implanted some 4,300 heart valves in his patients, DeBakey at least 3,000. Their heart valves consist of a pyrolytic carbon ball or disc in a titanium wire cage and cost about $5,000 installed. Says DeBakey: "Because of the development of these parts, there are thousands of people leading normal lives today who would otherwise be dead or suffering. Many of these people are economically self-sufficient because of them."

VOICE AND SENSE ORGANS. Dr. Stanley Taub, at the New York Medical College, is developing a device which is designed to improve the speaking ability of selected patients who have undergone a laryngectomy (removal of the larynx and vocal cords). Some of these patients cannot learn esophageal, or "burp" speech, which is achieved by swallowing air--and few who do learn it can speak clearly. Dr. Taub's patients wear a device that is not technically an implant, but a highly intimate explant; it consists of a small case, worn on the upper chest and containing a valve system that regulates the air flow from one opening in the side of the neck into another in the windpipe. With the aid of the system, expired air activates tissues in the esophagus to produce near-normal, if somewhat husky, speech.

Even more sophisticated devices may enable the totally deaf to hear or the blind to see. Doctors at the Los Angeles Ear Research Institute have implanted an electronic stimulator in the ears of five patients, while researchers at the University of Utah's Institute for Biomedical Engineering are working on an artificial hearing system that would directly stimulate the brain's auditory area (TIME cover, Jan. 14). A Boston researcher is trying to adapt a night-vision device used by the Army for victims of retinitis pigmentosa, a genetic disease that causes progressive blindness.

Scientists at the Utah institute and in London, Ont., are experimenting with an artificial vision unit that would enable blind patients to see. Their system, which is far from ready for general use, would involve implanting a subminiature television camera in a glass eye, a tiny computer in a conventional eyeglass frame and electrodes in the brain to stimulate the visual cortex. Doctors are still not sure just how long the brain can safely be electronically stimulated, but they do have encouraging indications that their visual prosthesis will work. In tests using a regular television camera, two patients, one of them a 29-year-old ex-G.I. who lost his sight in Viet Nam seven years ago, "saw" and recognized patterns formed by dots of light. Dr. Willem Kolff, director of the Utah institute, predicts that when the device is perfected, it will enable the blind to see something "like a picture on the Scoreboard of the Houston Astrodome."

VITAL ORGANS. Kolff, who developed the first dialysis machine, or artificial kidney, used for treating patients, is also working on a miniaturized model that could be carried over the shoulder in a case no bigger than a large handbag. The almost complete lack of success with heart transplants--mostly because of the body's rejection of foreign tissue --has accelerated research on the artificial heart--or at least on replacements for parts of the heart. Doctors at the Texas Heart Institute are working on three types of assist pumps for damaged hearts--a pneumatic device for short-term relief and electric-and nuclear-powered machines for longer-term use. Dr. George Magovern of Allegheny General Hospital in Pittsburgh is trying to adapt nuclear power to replace a ventricle, one of the main pumping chambers, in a damaged heart. Late last year in Utah, Kolff s team implanted a complete artificial heart in a calf. The animal, named Crocker, survived the operation, regained its appetite, stood up and walked around for 28 days before a clot blocked the blood flow--buoying hopes that humans too may some day be sustained by artificial hearts.

*An ex-astronaut equiped, after a near-fatal crash, with atomic-powered legs and an arm, and a zoom-lens eye.

This file is automatically generated by a robot program, so viewer discretion is required.