Amputation in the sixteenth and seventeenth centuries was a process of creation, not just agonizing limb removal. This surprising contention is a central argument of Heide Hausse’s outstanding first book, The Malleable Body: Surgeons, Artisans, and Amputees in Early Modern Germany. Hausse argues that surgeons in the Holy Roman Empire viewed the human body as a malleable entity, able to be shaped and changed by an adept artisan. She uses amputation and the fabrication of mechanical hands as a central focus for her discussion about this malleability. Surgeons who performed amputations focused as much on “how and what to create” as they did on the removal of a diseased appendage (93), while artisans who crafted protheses and authors who published about amputation and prosthetic limbs helped shape a new vision of the body for amputees. There has been remarkably little historical scholarship on amputation in the early modern period, and Hausse makes a clear case for why the topic is well worthy of study. Her innovative use of both textual and material sources adds a fresh perspective to the rich body of scholarship on artisans and the artisanal body in early modern Europe.

The Malleable Body strikes the fine balance of providing information on amputation and prosthetic limbs while also helping the reader to new ways of thinking about the juxtaposition of medicine and craftmanship in early modern Europe. The first chapter of the book gives a helpful overview of surgical training in the Holy Roman Empire, highlighting surgery’s complicated status as both an artisanal craft and a field of medical study. Hausse demonstrates the enormous variety of surgeons in the German-speaking regions, from village barbers trained only by experience to highly educated surgeons working for town councils or princely courts. She shows that any given surgeon could go through multiple careers in his lifetime, as he acquired additional skills and knowledge. Many surgeons also wrote and published books, and Hausse adroitly outlines the techniques surgeon author-practitioners used to establish authority with different audiences.

That background sets up Hausse’s main focus of the study: amputation and amputees. Here she is breaking new ground on a topic that has been woefully understudied given the rising number of amputations in the early modern period. In particular, the rise of gunpowder warfare on land and sea resulted in an increased number of amputees—but Hausse is careful to caution her reader against assuming that all amputations resulted from warfare, or that all amputees were male. Her book traces ideas about the way limbs putrefied and died, and, in response, the collective role played by medical and local communities in deciding for or against amputation; debates about the best techniques to use for amputation; the life of amputees post-amputation, including a very interesting discussion of phantom limb syndrome; and, finally, two chapters on mechanical hands, which delve into the material culture of protheses.

These are difficult topics, and Hausse handles them with sensitivity and intelligence. Throughout the book she encourages her readers to understand surgeons of the past rather than view their practices as barbaric. She explains how early modern people thought about the tissue death now known as gangrene—beginning with a “hot fire” that suffused a dying (but sometimes still salvageable) limb and progressing to a “cold fire” that indicated dead tissue and bone. Hausse notes that although the hot fire and the cold fire were consistent concepts in the literature, surgeons dealt with the problem in diverse ways. Her chapter on limb amputations spells out, in grisly detail, the variety of approaches and vibrant discussions on how and where to amputate. She explains the reasoning behind the common “five-fingers below the knee” guideline for lower leg amputations, which often removed a great deal of healthy tissue but left a stump that was easier to fit into a prosthetic limb. At the same time, she is careful to show that these methods were subject to fervent debate, as prominent critics proposed amputation methods that preserved as much healthy tissue as possible. Hausse argues that improvements to prosthetic limb technologies in the seventeenth century made longer stumps more workable, a sign that surgeons were not mindlessly following old practices but considering what methods would work best for the patient.

If Hausse’s first four chapters show outstanding historical skills in relaying an understudied topic, her fifth chapter breaks truly new ground. This chapter surveys surviving mechanical hands from 1500 to 1700 and is an exemplary illustration of how to use material culture fruitfully in historical analysis. From the start, Hausse makes a major intervention by calling the objects “mechanical” rather than “prosthetic” hands—a distinction that emphases the complex technologies that went into crafting these protheses, which all had movable digits. She takes the reader through the craftsmanship of various surviving hands and situates them in the artisanal workshops of clockmakers and gunsmiths. The ratchet systems in the more complicated hands required astounding technological ingenuity, and Hausse explains the specific functionality in a clear and engaging manner—but this chapter is not just a study of technological advancements. Hausse also discusses the role of the (mostly unknown) patron-amputees who commissioned the hands and speculates on how they would have used these objects. With this background, she then uses her sixth chapter to revisit a famous early modern prototype of a mechanical hand, published by French surgeon Ambroise Paré and translated into multiple languages. By starting with the objects and moving to the more well-known printed work, she is able to show aspects of the printed hand that are missing or unexplained. Taken together, these chapters introduce new methodologies for how to do material history. It is exciting to see objects so thoroughly at the center of historical arguments.

The Malleable Body is a highly sophisticated piece of historical writing—meticulously researched, beautifully written, and full of fascinating details and insights. It makes an exciting scholarly intervention in a number of fields, including the history of medicine, the history of technology, the history of warfare, and the history of the body. Hausse shows convincingly that amputations occurred with regularity and often with success in this time period; that early modern surgeons, families, and communities thought carefully about when and how to amputate; that prosthetic limbs were common and sometimes technologically sophisticated. All of these factors combined gave amputation an important role in ideas about the body and its malleability.