Many surgeons have emphasized the importance of the psychiatric or psychologic components of the total problem of limb loss, stump construction and training in the productive use of prosthetic devices. As an example, MacDonald1 has stated that "the surgeon has a definite responsibility in stimulating confidence and in teaching the man to use his appliance. Overoptimism on the part of the patient at the beginning is sometimes followed by an equal degree of depression when he feels the weight of the appliance and he has his first difficulty with his overenthusiastic attempts at walking." In spite of this attitude the reported studies on the psychiatric reaction to amputation consist, for the most part, of studies of phantom sensations. The complication of "phantom limb" has received much attention from many authors.2 There is no general agreement as to the peripheral or central origin of these phenomena, but most writers
EWALT JR, BLAIR H. PSYCHIATRIC REACTION TO AMPUTATION: LIEUTENANT COLONEL GUY C. RANDALL MEDICAL CORPS, ARMY OF THE UNITED STATES. JAMA. 1945;128(9):645–652. doi:10.1001/jama.1945.02860260019007
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