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This apparatus is designed to permit persons of either sex who have lost their hands or the use of them to write legibly with their knees after a little practice. A piece of sole leather 15 inches long and 6 inches wide at one end and 4 at the other has a semicircular piece cut out on each side, 5 inches from the narrow end. This piece of leather is bent where the scallops come to fit over the bent knee, and the whole piece is bent from side to side. By two clips, such as are used in holding a pencil to the pocket, a pencil is fastened to the leather so as to project forward 4 inches in front of the knee.
This apparatus is held firmly to the knee by three strong brass springs attached by rivets. These are ¾ inch wide and are made of strips
Arthur T. Blachly. APPARATUS FOR WRITING WITH THE KNEE. JAMA. 1917;LXVIII(23):1696. doi:10.1001/jama.1917.04270060104012