James Edward Hanger was born at Mount Hope, his father's plantation near Churchville, Virginia. His parents were William Alexander Hanger and Eliza Hogshed Hanger. He attended local elementary schools and, in 1859, enrolled at Washington College in Lexington, Virginia to study engineering.
He was an 18-year-old sophomore when the Civil War began, and he decided to leave school and join the newly formed Churchville Cavalry, which was under the command of Captain Franklin Sterrett.
The first two shots were canister and directed at the Cavalry Camps, the third shot was a 6 pound solid shot aimed at a stable in which the Churchville Cavalry Company had slept. This shot struck the ground, richochetted, entering the stable and struck me. I remained in the stable til they came looking for plunder, about four hours after I was wounded. My limb was amputated by Dr. James D. Robinson, 16th Ohio Volunteers.Hanger's shattered leg was amputated about seven inches below the hip bone. This loss of limb was one of the first occurrences in a war that saw more than 50,000 additional amputations performed.
Hanger remained in Philippi for several weeks and then was sent as a prisoner to Camp Chase in Ohio. In August 1861, after a prisoner of war exchange, he returned to his family home in Virginia.
Dissatisfied with both the fit and the function of his above-knee prosthesis, Hanger designed a new prosthesis constructed of whittled barrel staves and metal. His design used rubber bumpers rather than standard catgut tendons, and featured hinges at both the knee and foot.