E. F. Shaw Wilgis - The Wonder of the Human Hand: Care and Repair of the Bodys Most Marvelous Instrument

THE WONDER of the HUMAN HAND

A JOHNS HOPKINS PRESS HEALTH BOOK

Care and Repair of the Bodys
Most Marvelous Instrument

EDITED BY E. F. SHAW WILGIS, M.D.
With Fourteen Experts from the
Renowned Curtis National Hand Center

Note to the reader: This book is not intended to provide medical or legal advice. The services of a competent professional should be obtained whenever medical, legal, or other specific advice is needed.

Drug dosage: The author and publisher have made reasonable efforts to determine that the selection of drugs discussed in this text conform to the practices of the general medical community. The medications described do not necessarily have specific approval by the U.S. Food and Drug Administration for use in the diseases and dosages for which they are recommended. In view of ongoing research, changes in governmental regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert of each drug for any change in indications and dosage and for warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently used drug.

2014 Johns Hopkins University Press

All rights reserved. Published 2014

Printed in the United States of America on acid-free paper

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Library of Congress Cataloging-in-Publication Data

The wonder of the human hand : care and repair of the bodys most marvelous instrument / edited by E. F. Shaw Wilgis, M.D.

pages cm (A Johns Hopkins Press health book)

With fourteen experts from the renowned Curtis National Hand Center

Includes index.

ISBN 978-1-4214-1547-5 (hardcover : alk. paper) ISBN 1-4214-1547-X (hardcover : alk. paper) ISBN 978-1-4214-1548-2 (pbk. : alk. paper) ISBN 1-4214-1548-8 (pbk. : alk. paper) ISBN 978-1-4214-1549-9 (electronic) ISBN 1-4214-1549-6 (electronic) 1. HandPhysiologyPopular works. 2. HandAnatomyPopular works. 3. HandMovementsPopular works. I. Wilgis, E. F. Shaw, editor.

QP334.W52 2014

611'.737dc23 2014006750

A catalog record for this book is available from the British Library.

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Johns Hopkins University Press uses environmentally friendly book materials, including recycled text paper that is composed of at least 30 percent post-consumer waste, whenever possible.

E. F. SHAW WILGIS, M.D.

E. F. SHAW WILGIS, M.D.

RYAN D. KATZ, M.D.

MICHAEL A. McCLINTON, M.D.

W. HUGH BAUGHER, M.D., AND THOMAS J. GRAHAM, M.D.

PHILIP CLAPHAM, B.S., AND KEVIN C. CHUNG, M.D.

RAYMOND A. WITTSTADT, M.D.

REBECCA J. SAUNDERS, P.T., C.H.T.

KEITH A. SEGALMAN, M.D.

KENNETH R. MEANS JR., M.D.

RYAN M. ZIMMERMAN, M.D., AND NEAL B. ZIMMERMAN, M.D.

CHRISTOPHER L. FORTHMAN, M.D.

JAMES P. HIGGINS, M.D.

The Marvel of the Human Hand

E. F. Shaw Wilgis, M.D.

We have hands; we can stand on them if we want to. Thats our privilege. Thats the joy of a mortal body. And thats why God needs us. Because God loves to feel things through our hands.

Elizabeth Gilbert

As a person who has spent his professional life immersed in the study and practice of medical science, I would like to cite the hand as the anatomy of human progress.

Our hands interact with the environment in ways that are more sophisticated, more varied, and literally more productive than any other part of the body. As the instrument that manifests so much of what the brain is capable of imagining, the hand has been on the front line of history as we have reached, grasped, pinched, and pulled our way to a kinder, safer, more enlightened world. Since the beginning of the species, our progress has been inextricably tied to the marvelous capabilities of our hands.

It is with our hands that we first recorded our immediate environmentoffering insight for thousands of later generationsby painting sprawling scenes of humans and animals and daily life on the walls of caves. Our hands did the work when we pushed rocks into place at Stonehenge and thousands of other sites to help us follow what must have been our earliest inkling of the recurring annual seasons. When we carved the Sanskrit of Persia or the hieroglyphics of Egypt, our hands began the written record of our lives. Pens, ink, paperitems conceived by our mindscould not have been fabricated without our hands, nor employed to continually advance human society.

Our hands have played a starring role in helping us meet our most basic needsfood, shelter, clothing. Think about it: the ingenuity of teasing and spinning strands of thread from balls of raw cotton plucked from prickly bolls is a testament to the mind, no doubt. But it is the fine dexterity of the hand that turned a vision into a fiber, and then a woven cloth. And when circumstance allowed a respite from the activities of survival, the hand hammered gold into pieces of adornment, polished carved hunks of marble into works of art, and built musical instruments. From rote, mundane activities to our most sublime achievements as humans, the hand has helped us progress toward a better world and a deeper understanding of our place in it.

Across all cultures and down the millennia of history, our recognition of the significance of the hand is consistently expressed in two universal and exclusively human endeavors: religion and art. In Buddhism, for example, 10 specific hand gestures represent the religions core moral principles. Called mudras, they are instantly recognizable to followers of the faith, and are regularly depicted in Buddhist art (sculptures, paintings) and written chronicles. The mudras, as translated from Sanskrit, are:

fearlessness (formed by an open right palm facing outward at chest level or slightly higher)

meditation (the hands are placed together loosely in the lap with one hand cupping the other, tips of the thumbs touching)

greeting and adoration (palms and fingers of both hands are pressed together flat, held at heart or forehead level)

truthfulness (the left hand is held on the lap, palm up, and the right hand points down to the earth)

compassion and sincerity (usually the left hand, held palm up, fingers and thumb in a relaxed, natural position)

expelling evil (right hand, held palm out at shoulder level, with middle and third fingers bent toward palm while index and small fingers are raised, thumb touching tip of middle finger)

confidence / connection with divine energy (hands are placed flat with palms pressed against middle of chest, crossed, right over left)