Douglas C. (Douglas Crawford) McMurtrie.

The evolution of national systems of vocational reeducation for disabled soldiers and sailors online

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one-legged, standing high jump for the one-legged, putting the shot
by the one-armed, also ball throwing and handball for the latter, the
stump being used as well as the good arm. The third army district
(Nurnberg) has a similar program. The reserve hospital at Gorden,
Brandenburg, emphasizes long distance running and takes its men
for long hikes in the open in regular running costume. An exhibition
contest was recently held at this hospital for the purpose of convincing
doctors and social workers all over the country of the possibilities for
the cripple in outdoors sports. 16 Swimming is also being emphasized.
In Berlin cripples have been given free entrance tickets to the public
swimming pools. Their swimming is supervised and no one allpwed
to go into deep water until the instructor is sure of his ability. On
a day when 40 cripples, mostly with arm and leg injuries, made their
first attempt, all of them were able to swim without help. In a swim-
ming gymkhana organized later, two legless men competed among the
others. 17

There is a movement to arouse popular interest in this branch of
cripple welfare. The Deutsche Reichsausschutz fur Leibesiibungen
has supplied medals at hospital contests. 18 Local care committees en-
courage the formation in their districts of permanent athletic clubs
for cripples, which tend to keep up their physical condition. Such
clubs have been formed in Berlin, Leipzig, Hamburg, Essen, Mann-
heim, and Kiel. 19

Trade training, even when given in the hospital, is under civilian
auspices and will be discussed later. Many hospitals, however, even
when they do not attempt to train a man to a trade, have a workshop
or two attached for purposes of functional reeducation. In such a
case manual training is counted as part of the medical treatment and
is managed by the hospital under military authority, though occa-
sionally, as at Diisseldorf, the care committee of the district sends

15 Zeltschrift ffir Krflppelfiirsorge, Leipzig, 1915, viii, 19-22.

"Vom Krieg zur Friedensarbeit, Berlin, 1917, iii, 26-27.

« Vom Krieg zur Friedensarbeit, Berlin, 1917, iii, 28.

18 Korrespondenz fur Krlegswohlfahrtspflege, Berlin, 1917, iii, 27.

» Zeitschrift fiir Krflppelfiirsorge, Leipzig, 1917, x, 220-225.

57710—18 10


visiting teachers to help the men with some simple manual occupation
before they are able to be out of bed. There is great emphasis, in all
reports on the subject, on the fact that even this occupational therapy
should be really useful and should lead the patient direct to some
practical occupation. There is also some emphasis on the fact that a
man should be visited and his mind turned toward work at the earliest
possible moment before mental lethargy has any chance to set in.


All artificial limbs are furnished and kept in repair by the Govern-
ment, which also furnishes new ones when necessary.

In distinction from the practice of other countries, the Government
prescribes no standard pattern. It would appear that each orthope-
dist selects the limbs for his own patients. The war department has
prescribed certain maximum prices for prostheses of different types,
e. g., for amputation of lower arm, of upper arm, lower leg, and upper
leg. The department will not be responsible for prostheses costing
more than these standard prices. Otherwise, there is no official super-
vision exercised, and the matter is left to the doctors and engineers of
the country.

The result is an immense stimulation of activity. The magazines
are full of descriptions of new prostheses recommended by doctors
and manual training teachers from all parts of the country. At an
exhibition of artificial limbs, held at Charlottenburg, there were
shown 30 kinds of artificial arms and 50 legs in actual use. 20 The
Orthopadische Gesellschaft (Orthopedic Society) has devoted much
discussion to the matter and there has been wide education and pub-

The principle now thoroughly accepted is that the prosthesis
should reproduce not the lost limb, but the lost function. It should
not be an imitation arm or leg, but a tool. The standard of merit
is the number of activities it makes possible. The prostheses usually
supplied to cripples answer this definition. The legs are very like
the old-fashioned peg leg; the arms are some variation of jointed
rod with an arrangement by which different appliances may be
fastened to it. With the arm is supplied a wooden hand covered
with a glove which may be attached for street wear. The so-called
Sonntagsarm (Sunday arm) is never supplied except on request to
clerical workers.

The limbs are made by private firms, many of whom sell them
at cost price as a patriotic measure. Some of the hospitals have an
orthopedic workshop as part of their vocational training equipment,
and these make their own limbs or at least prostheses for temporary

_ _ » ■ i , . ...I ..I, ,, „„„

■•Die Versorgung der Kriegbeschadigten, Wien, 191 Y, p. 10.


wear. But there are certain well-known makes of limb which have
come into very general use.

Limbs Used.

The Jagenberg arm. — This is the invention of a factory owner
at Diisseldorf, where there is a very large school for the wounded.
It consists of two metal rods joined by a ball-and-socket joint which
can be turned in any direction, a grip of the well hand sufficing
to fix or loosen it. It is fastened to the stump by a tight-fitting
leather cuff. With the arm is furnished a set of 20 attachments
suitable for all the ordinary operations of life, such as eating, dress-
ing, etc., and a wooden hand for street wear. The number of at-
tachments can be added to at will to suit any trade. The arm is
easily made and its parts can be had at any factory. 21

Rota arm. — Made at the Rota Works, Aachen, after designs by
the engineer Felix Meyer. Very similar to the Jagenberg arm, it
differs in the manner of attaching tools. A set of attachments and
an artificial hand is also furnished with this arm. 22

Siemens-Schuchert arm. — Made by the Siemens-Schiickert Works,
Niirnberg, after designs by Dr. Silberstein, of the Royal Reserve
Hospital, Niirnberg. The firm manufactures the arms at cost. This
differs from the Jagenberg and Rota arms in having the weight of
the arm borne by a strap over the shoulder, while in the two former
the weight comes on the stump. The arm has been tried out par-
ticularly in the Niirnberg carpentry shops with great success. It
has a carefully worked-out set of attachments fitted especially for
carpentering. 28

Riedinger arm. — The invention of Prof. Riedinger, Wiirzburg.
It consists of a long leather upper arm and short metal lower arm,
with a tube into which attachments can be screwed. It is fastened
on by a complicated harness over the shoulder and is particularly
good for heavy lifting. 24

Brandt arm. — The invention of Wilhelm Brandt, Brunswick.
This is a celluloid arm with sliding joint, meant for lighter work.

Hanover arm. — Made by the firm of Nicolai, Hanover. Here the
ball joint is replaced by a hinge, fastened at any angle by wing
screws. This arm has also a set of attachments. It is light and
particularly suited to clerical workers. 26

21 Ulbrlch, Martin. Die evangelfsehe Klrehe und die Kriegsbeschadigten, Giitersloh.
1917, p. 16.

^Ulbrlth, Martin. Die evangelische Kirchc und die Kriegsbeschadigten, Giitersloh,
1917, p. 16.

" Ulbrlch, Martin. Die evangelische Kirche und die Kriegsbeschadigten, Giitersloh,
1917, p. 16.

M Ulbrlch, Martin. Die evangelische Kirche und die Kriegsbeschadigten, Giitersloh,
1917, p. 16.

» Ulbrlch, Martin. Die evangelische Klrcne und die Kriegsbeschadigten, Giitersloh,
1917, p. 17.


The two Schonheits or Sonntags arms (decorative arms) made
are the Schiisse arm, Leipzig, and Carnes arm, an American patent
purchased by a German firm. The Schiisse arm is a perfect imita-
tion of the human arm entirely useless and purchased only by
wealthy cripples as an extra prosthesis. The Carnes arm is also
an imitation, but with a very complicated mechanism, by which
most of the operations of daily life can be managed. . The Carnes
arm is too expensive and fragile for wide use.- A cheap imitation
of the Carnes arm has been invented by Prof. Bade, Hanover, but is
not durable. Even this has not met with wide approval, because
the arms made on the tool plan far surpass it in working usefulness.

Two hand prostheses are in wide use, both of them invented by .
cripples and both on the principle of the claw. The hand best suited
to factory workers is that invented by the locksmith, Matthias Natius.
It consists of an iron claw fastened with straps to the stump. It
grasps a tool like a hand and can then be clamped in that position. 28

The Keller claw was invented by a farmer, August Keller, and con-
sists of three wires the thickness of a lead pencil, wound together
claw shape and fastened to the stump by a strap. It grasps tools as
does the Natius hand, and its owner has found it entirely successful
for all farm operations. It has now been patented and is being
widely copied. 27

The makes of artificial legs have not been so standardized. The
general principle on which they are made is that of simple construc-
tion and swift repair. Orthopedists have given up the effort to get
much foot movement and the usual plan is an un jointed foot with a
convex sole. The most noteworthy improvement is that adopted
at Freiburg of reducing the weight by making the upper leg of a
thin metal rod. The shape of. the leg is retained by covering the
rod with a wire form covered with elastic. Dr. Alfred Jaks, of
Chemnitz, has invented a leg consisting of parallel levers which are
set in motion by raising and lowering the stump. 28

Investigation and Publicity.

All these prostheses are in use, each one being popular in its own
neighborhood or in some particular trade. In February, 1916, the
Verband Deutscher Ingenieure (Society of German Engineers) made
an attempt to standardize the various efforts. It offered three prizes
for the best artificial arm suited to mechanical workers and combin-
ing the qualities of lightness, cheapness, and working usefulness.

"TJlbrich, Martin. Die evangelische Kirche und die KriegBbeschSdigten, Glitersloh,
1917, p. 18.

T/lbrlch, Martin. Die evangelische Kirche und die KriegsbeschSdigten, Giitersloh,
1917, p. 17.

^TJlbrich, Martin. Die evangelische Kirche und die Kriegsbeschiidigten, Giitersloh,
1917, p. 18.


There were 82 entries for this contest, 60 of which fulfilled the en-
trance requirements. The ideal arm was not found and the first prize
remained unrewarded, but the second and third prizes went to the
Jagenberg and Rota arms described above, and small sums are
awarded to the various other entries. 29

The prize entries were on view for three months, with very good
educational results. The society then decided to establish a perma-
nent Priifungsstelle (test station) for artificial limbs, which was
opened at Charlottenburg in February, 1916. The station is a small
workshop where about 10 cripples who are skilled mechanics can be
employed at once and give a thorough working trial to any prosthesis.
Up to August, 1916, the station had tried out 16 arms, 3 hands, and 4
legs and had had under investigation 19 arms and 5 legs. • The
station has been empowered by the medical department of the Garde-
korps, the local military authority in the Berlin district, to advise all
cripples under its supervision as to prostheses. To August, 1916,
345 cripples had been so advised. 30 The Kaiser, from sums placed
at his disposal for war relief, has recently turned over 50,000 marks
to be used for the purchase and testing of artificial limbs. Twenty
thousand of this goes direct to the Priifungsstelle at Charlottenburg.


In the German system, the functions of vocational advice and re-
education are closely allied and can hardly be treated separately.
They constitute the first half of civilian duties toward war cripples
and are managed in combination or separately, according to the

Although vocational advice, in fact, precedes reeducation, it is more
convenient, in this study, to take it up second, since its discussion
necessitate a knowledge of the reeducational possibilities.

The chief thing to be noted about reeducation in Germany is that
it goes on at the same time as the medical treatment, the two processes
are simultaneous, not consecutive as is largely the case in England.
This has two causes : First, there is the strong conviction among all
cripple welfare workers that results can be obtained only by getting
hold of a patient at the earliest possible moment of convalescence,
and second, the fact that, since the Imperial Government does not
pay anything toward reeducation, it is more economical for the care
committees to attend to it while the men are in the hospitals and thus
save themselves the expense of maintenance. The usual plan of the
care committees, as has been said, is to give men their trade train-
ing while they are still in the military hospital, beginning it, in fact,

20 Zeitschrlft fUr Kriippelfiirsorge, Leipzig, 1916, ix, 100.
30 Zeitschrlft fur Kriippelfiirsorge, Leipzig, 19]", x, 41—12.


as soon as they are able to be out of bed. Given this plan for the
housing of the men, there are two possible arrangements for the
workshops. Either the care committee can maintain workshops in
the hospitals, or it can use a separate building to which the men are
transported every day.

Both these plans are in use, the one adopted depending on the
funds and the buildings available to the local care committee. We
may allude to them for convenience as the indoor plan, that where
the instruction is given in the hospital, and the outdoor plan, when
the men are taken out to school.

Indoor Plan.

There are a certain number of hospitals, like the larger cripple
schools, which are already equipped with shops or where it has been
possible to build them. In these, a very complete system of trade
training is carried out under the hospital roof by civilian instructors.
The plan must, of course, have the cooperation of the local Bezirks-
kommando (district commandant) and of the hospital director. In
view of the professions made by the war department, it is the under-
standing that this will always be forthcoming. Different hospitals
have complained of a certain amount of friction, but this is only in
details and in individual cases. As a rule, the military authorities
are exceedingly glad to turn over this part of the work, which they
are unable to carry.

Since the discipline of the hospital is military, the men can be as-
signed by the director to different shops to spend a certain number
of hours every day. The civilian instructor does not actually force
them to work, but the example of other pupils is usually enough for
an apathetic man. In a very few hospitals, such as the agricultural
school at Kortau, it has been possible to assign crippled officers as
instructors and the discipline is entirely military.


The Niirnberg hospital is the most complete example of this plan
to hand, though even this hospital, which was fortunate enough
to obtain space and equipment for workshops, does not manage the
reeducation problem exclusively within its own walls, but works in
close connection with the city schools.

The Niirnberg hospital has 900 beds. It occupies three new hospital
buildings, turned over to the military authorities by the city of Niirn-
berg and furnished with all the modern orthopedic equipment. The
school facilities include a large-sized piece of land and 12 work-
shops, the latter fitted up with machinery and tools, which are the gift


of private manufacturing firms The teaching is by professional
teachers, who have volunteered their services, and foremen from
manufacturing shops, whose services are donated by their employers.
The instruction at this hospital resolves itself into two divisions —
general and theoretic instruction in the schools of Niirnberg and
practical shop work in the hospital workshops. The curriculum is
as follows:

A. Theoretic work (special classes held by volunteer teachers in Niirnberg
schools, with occasional class at hospital).

1. Left-handed writing.

2. Improved writing with right


3. Typewriting.

4. Stenography.

5. Commercial course.

6. General course for industrial work-


7. Farm bookkeeping.

8. Theoretic course for the building

trades (carpenters, locksmiths,

9. Theoretic course for building trades

(masons, plasterers, etc.).

10. Decoration and design.

11. Theoretic course for machinists.

12. Left-handed drawing.

13. Office management.

B. Practical work (in workshops with volunteer foremen or teachers).

1. Tailoring.

2. Painting.

3. Bookbinding.

4. Printing.

5. Locksmithing.

6. Shoemaking.

7. Saddlery.

8. Weaving (by hand and machine).

9. Orthopedic mechanics.
M>. Machine tool work.

11. Carpentry.

12. Farming.

13. Paper hanging.

14. Toymaking.

15. Blacksmithing.

16. Brushmaking.

These courses all have regular hours and insist on the men turning
out work which is up to commercial standard. 31

As far as can be gathered, the indoor plan is the one least often
followed. A few of the larger cripple homes, with the big hospitals
at Niirnberg, Munich, Marfeld, and Gorden, are the chief examples.
The cripple homes, of course, already had their equipment, and
Niirnberg and Munich are in Bavaria where the State government
finances the cripple work and a larger outlay is possible. Gorden
may pos'sibly be an exception, but reports of its work are not at hand.
Other hospitals managed in this way are m remote places where there
are no educational advantages and the hospital is obliged to furnish
what it can.

Outdoor Plan.

The plan more often followed is the outdoor plan, where the in-
struction takes place in the local trade schools. There are excellent

31 KrlegsinTalidenfiirsorge. Darstellung der in Niirnberg getroffenen Massnahmen.
Wiirzgberg, 1015, p. 1-40.


facilities for this, since every town has at least one trade school.
Some representative of the education authorities generally serves
on the local care committee, and the schools are eager in any case to
offer free instruction. German magazines are full of advertisements
of free courses for war cripples, offered by schools of the most vary-
ing kind, public and private, from agricultural and commercial
schools to professional schools and universities.

The plan of any local care committee can, therefore, be elastic.
In a small town it may simply arrange that its cripples be given free
instruction at the local trade school, in the regular classes or a special
class. In a large town, like Diisseldorf. where there are 50 hospi-
tals, the committee has taken entire possession of a school building
equipped with shops and tools and gives 20 courses open to men
from all the hospitals. Other institutions of the outdoor type fall
between the two extremes, but some reciprocal arrangement between
school and hospital may be considered the typical German institution
The instruction in institutions of the outdoor type is not under
military discipline. The arrangement of the school with the hos-
pital authorities is a purely informal one. The hospital director
gives the men permission to be absent during certain hours to at-
tend school; the school reports to the director whether or not they
attend. Attendance is not compulsory and men can not be punished
for misbehavior, but the school reserves the right to refuse such
pupils as seem idle or subversive of order. This generally is disci-
pline enough.

The war department has the right to dismiss a man from the
hospital as soon as his physical treatment is over, without regard to
the status of his trade training. This matter has to be arranged by
informal cooperation between the civilian school directors and the
military hospital authorities. As a rule, the hospitals are willing
to keep a man until his trade training is complete, even though they
would otherwise dismiss him sooner. It is planned that none of the
school courses shall take more than six months, the maximum time
for hospital care. These short courses are intended for men of ex-
perience who need further practice in their old trade or in an allied
one. Six months is, of course, not long enough to give a man com-
plete training in a new trade, since some require an apprenticeship of
one or more years. If a man needs further training after the short
school course, he becomes the charge of the local care committee,
which supports him while he attends a technical school or pays the
premium for apprenticing him to a master workman.

The courses given in this way attain a high standard of efficiency,
both because of the good school facilities and because a large number
of the men dealt with are already trained workmen with a good


foundation to build on. It is the plan of the schools that, when a
man is dismissed, he shall be qualified to go back to work or to a
higher school. Arrangements are made with the handicraft guilds
that men in their line of work shall be able to take their master test
at the school and be graduated master workmen. It is also seen to
that every man has a fair common school education before he begins
on a special trade.


The Diisseldorf school, which has issued the fullest report obtain-
able, offers the following curriculum. 32

A. General education.

1. Preliminary course.

(o) Civics.

( 6 ) Germ an — -writing,
grammar, etc.

2. Manual training (as prepara-

tion for trade training).

3. Education of one-armed and

left-handed men.

B. Theoretic trade courses.

4. Building trades.

5. Metal-working trades.

(a) Course for machinists.

(b) Course for draftsmen.

6. Commercial course.

7. Course for railway and postal

employees and lower posi-
tions in civil service.
(a) Office work.
(6) Telegraphy.

Another form of the outdoor plan is to send the cripples out from
the hospital to shops in the neighborhood. Sometimes they are
regularly apprenticed to a master workman, the care committee pay-
ing the premium ; sometimes they are sent for shorter periods on pay-
ment of a small tuition fee. This system is followed for individuals
at Diisseldorf and much more at Cochum. Otherwise, it is an expe-
dient for the smaller places where the school facilities are not good
and the cripples are fewer.

It is not possible to find out how many schools there are in Ger-
many of the standard of Niirnberg and Diisseldorf. Others noted in
the appendix are referred to, but full reports of them are not avail-
able. The two described appear to maintain a very high standard of
efficiency. In both, the instruction is regular and thorough and with
one end — to fit the cripple to pass the only real test, that of actually
making his living in the world without help. The emphasis in all

8. Course for store clerks.

9. Agricultural course.

10. Course in handicraft as prep-

aration for journeyman's
and master tests.
C. Practical trade courses with shop

11. Electrical work.

12. Metal work.

13. Carpentry and cabinet work.

14. L-ocksmithing.

15. Stone masonry and carving.

16. Graphic trades (printing, lith-

ography, etc.)

17. Bookbinding, cardboard, and

leather work.

18. Painting and plastering.

19. Upholstery and decorating.

20. Dental laboratory work.

1 Uotter, Karl, and Herold. Diisseldorfpr Verwundetenschule, Diisseldorf, 1916, p. 7-8.


the German writing on the subject is to the same point. The necessity
for turning out really skilled workmen is thoroughly realized and it
is insisted that whatever work the cripple does, even during his
earliest attempts, should be calculated to give him a correct working

Schools for One- Armed.

It is recognized in Germany that the one-armed man has the great-
est handicap, and special arrangements are made for his training.
Besides exercises and instruction in the hospitals, there are schools

Online LibraryDouglas C. (Douglas Crawford) McMurtrieThe evolution of national systems of vocational reeducation for disabled soldiers and sailors → online text (page 17 of 38)