During and after the Civil War, the empty sleeve became a metaphor for veterans returning to a life they once lived easily, which was now a struggle. Few activities are as basic to daily life in Western cultures as eating with a knife and fork. The use of a traditional knife and fork pairing, though, requires the use of two hands in a fairly complicated series of maneuvers. Thus, one of the most necessary tools in the alternative toolkit of an upper-limb amputee is an eating utensil for one hand. After Admiral Horatio Nelson of the British Royal Navy lost an arm in battle in 1797, he used custom eating utensils. These implements, known as Nelson knives, consisted of a fork–knife combination on a single handle, the short knife blade holding the place of a fourth tine. Custom orders of this type were not within the means of most American Civil War veterans, and a more utilitarian utensil was devised by Dr. William L. Detmold. Detmold was a New York surgeon of some wealth and prestige, having developed an innovative surgery for clubfoot. Detmold helped to organize the U.S. Army Medical Corps for service in the Civil War, and he served as professor of military surgery and hygiene at the College of Physicians and Surgeons, New York. Detmold wrote and lectured regularly on the injuries of war, especially gunshot wounds to various parts of the body. Detmold volunteered as a civilian surgeon at the First Battle of Bull Run. He became interested in amputation and prosthesis after his experience on the field, and this led him to invent the Detmold knife (Fig.1), an adaptive utensil that would help one-armed veterans rebuild the skills they needed to eat unassisted. The Detmold knife was manufactured by George Tiemann and Company (New York, New York) and was supplied by the U.S. Government to veterans of the Civil War after the loss of an upper limb. The Detmold knife was steel with a wooden handle and included a soft case for carrying when dining outside the home. Detmold’s design differs somewhat from the Nelson utensil, in that the fork portion consists of short tines carved out of the knife blade. Over time, a knife-and-fork utensil was developed in the United Kingdom that, although called a Nelson knife, resembled a Detmold knife. Utensils of this type are still available for purchase in the United Kingdom and Australia. The Detmold knife was acquired by the Army Medical Museum (now the National Museum of Health and Medicine) MoGer International in support of the National Museum of Health and Medicine, Defense Health Agency, 2500 Linden Lane, Silver Spring, MD 20910. Ms. Bradford, an employee of MoGer International, serves as Museum Specialist at the National Museum of Health and Medicine. The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick, MD 21701-5014 is the administering acquisition office. Award number W81XWH-13-C-0016. The National Museum of Health and Medicine (NMHM), a Department of Defense museum founded as the Army Medical Museum in 1862, is committed to documenting the nation’s military medical heritage while sustaining a repository of contemporary medical technology to advance military medicine. This series of articles illuminates objects and collections of interest to AMSUS readers. For more about the NMHM, visit www .medicalmuseum.mil. The contributor hereby certifies the contribution to be a work of the U.S. Government, which has been prepared by an officer or employee of the U.S. Government as part of his or her official duties, and therefore precluded from copyright protection under 17 USC §105. The contribution is in the public domain by operation of laws of the United States. The opinions and assertions contained herein are those of the author and do not necessarily represent the views of the NMHM or the Department of Defense (DoD), any of the military services or other DoD components or any other government agencies, and does not constitute an endorsement by the DoD of any of the opinions expressed, or any information, products or services contained therein. doi: 10.7205/MILMED-D-15-00550 FIGURE 1. 150812-A-MP902-015. Civil War amputees used this adaptive knife and fork designed by W.L. Detmold and produced by George Tiemann and Company. The knife is currently on display at the National Museum of Health and Medicine in Silver Spring, MD. (M-129.00018) (Disclosure: This image has been manipulated using dodging and burning techniques. It has been cropped to emphasize the subject.) (National Museum of Health and Medicine photo illustration by Matthew Breitbart/Released).