Douglas C. (Douglas Crawford) McMurtrie.

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peutic treatment could also be transferred to these hospitals, if the
institutions treating them had not the necessary specialists or appli-
ances. In accordance with this decree, the first orthopedic hospital
for crippled soldiers was opened in Vienna, in January, 1915. 3

About the same time, the Austrian ministry of the interior also
started an organization for assistance to disabled soldiers. In view
of the great variety of linguistic and economic conditions in the
empire, it was deemed advisable to intrust the care for invalids to the
several crownlands. In the capital of each crownland a Landes-
kommission was created, for the purpose, among other things, of
providing medical care and vocational reeducation for the war in-
valids of the crownland, and of creating the necessary institutions.

The ministry of public works also took up the matter of reeduca-
tion through the institutes for advancement of industry (Gewerbe-
forderungsinstitute) , which exist in every crownland. These insti-
tutes, as well as all the public trade schools, were instructed to help
in the reeducation work.*

A decree of the minister of war, of June 8, 1915, made vocational
reeducation of invalids obligatory. At the same time, the functions
of the military and of the civil authorities were delimited as follows : °

1. The military authorities provide the wounded with the first
medical assistance; they bear the cost of manufacturing and repair-
ing the artificial limbs as long as the patient stays in military service ;

1 Material lor this chapter prepared by Alexander Gourvitch.

•Dr. Hans Spitzy. OrthopSdisches Spital und Invalidenschulen. Monatsblatter liir
Invaliden- under Kriippelhilfe, Leipzig, 1915, No. 3.

8 Neues Wiener Tageblatt, Jan. 15, 1915.

« Die Versorgung der Kriegsbeschadigten, Wien, 1917, pp. 10-11.

5 Robert Weiss. Zur Arbeitsvermittlung fur Kriegsinvalide. Zeitschrift fur Kriippel-
fiirsorgc, Leipzig, 1916, ix, p. 321.



they bear the cost of the maintenance of soldiers in nonmilitary in-
stitutions; they keep the wounded under their control until he has
recuperated his capacity to work, or until he is discharged as an

2. The military authorities, in cooperation with the civil authori-
ties, provide the final treatment and the vocational re-education.

3. The civil authorities organize the employment service.

The wounded is not to be discharged from military service until
he is able to return to a civilian occupation.


The largest institution for the care of invalids is the Vienna
orthopedic hospital with its schools for invalids. It opened on Janu-
ary 20, 1915, with 1,000 beds. Four weeks later it was filled to
capacity; it has since been extended several times. By the end of
1915 the hospital, with its branches and annexes, had 2,000 beds, and
preparations were under way to add 1,000 more.

The institution consists of two services, the medical and the edu-

Medical Care.

The medical section receives from other hospitals wounded soldiers
whose wounds have been completely healed. They are given here
the necessary treatment by mechanotherapy, electrotheraphy, mas-
sage, use of orthopedic appliances, etc.

At the same time, those who require prosthetic appliances are
trained in using them. 6 The patients are supplied with prostheses
almost immediately upon being brought to the institution, usually
on the second day. The use of crutches is forbidden. 7 The man at
first receives a provisional plaster prosthesis. After a few days the
change in the form of the stump necessitates changes in the pro-
visional prosthesis. In some instances the prosthesis has to be modi-
fied several times. As the next step the patient is provided with an
" immediate " prosthesis, made of leather, which is lighter than the
first and is also of better appearance and resembling more closely
the future artificial limb. The latter, in its final form, is supplied
only after a month or more.

The prostheses and artificial limbs were at first produced in a small
shop at the hospital. Later, however, it became necessary to estab-
lish a factory in a separate building, under the supervision of Dr.
Spitzy, commander of the hospital.

"By the middle of 1915 there were already over 1,000 amputated among the patients
and their number was constantly increasing.

7 Spitzy, address to convention of German Orthopaedic Society, February, 1916. Zeit
schrift fiir Kruppelfiirsorge, Leipzig, 1916, ix, p. 137.


In connection with the hospital there has been created a central
organization of all orthopedic surgeons of Vienna, for the purpose
of supplying specialists to the several hospitals of the city. 8


The purpose of the educational action is the vocational reeducation
of invalids. The first object in view is always reeducation in the
former occupation of the patient, or in a connected occupation in the
same trade, and, according to the commander of the hospital, this
result is attained in all but 5 per cent of cases.

Each patient, after having completed the preliminary orthopedic
treatment, is assigned to a workshop. The workshops were at first
established in a public school. But later a garden city was created,
consisting of 42 barracks, with 100 men in each. The shops are
now distributed among those barracks.

Altogether there are about 30 trades taught, mostly small handi-
crafts, such as can be carried on in small rural localities. 9 The
most important trades and occupations are the following : 10

Woodwork (cabinetmakers, turners,

Metal work (locksmiths, blacksmiths,

braziers, electricians).
Basket making.




Leather work (harness-makers, purse-
makers, leather workers on artificial
limbs, and appliances).

There is a tailoring shop run by electric power and a similar shoe-
making shop for those former tailors and shoemakers who are unable
to resume completely their former occupation, but still can be trained
to work as machine operators and thus to apply their general experi-
ence in the trade.

In addition to manual trades there are courses in bookkeeping,
typewriting, arithmetic, and drawing.

With the assistance of several agricultural schools there has been
assembled in one hall a collection of agricultural machines and im-
plements. 11 The men wearing prosthetic appliances are trained in
handling them, and the necessary modifications are made in the

■ For the purpose of putting the production of bandages, prostheses, and artificial
limbs on a higher technical plane, Dr. Wilhelm Exner has created an organization where
all the branches of the work are centralized. The shops of this organization are estab-
lished in one of the Vienna hospitals. A limited number of rooms are reserved for
patients needing bandages or prostheses. The costs of production are covered out of a
fund made up by subscription. See Dr. von Aberle, at convention of German Federation
for Care of Cripples, Zeitschrlft fur Krflppelfursorge, Leipzig, 1915, viii, p. 190.

» The major proportion of the patients, about four-fifths, are peasants or small crafts-
men. See Spitzy, at convention of German Federation for Care of Cripples, February,
1915, Zeltschrift fiir Kruppelfiirsorge, viil, p. 188.

i° Spitzy. Die Invalidenschnlen, Wiener Fremdenblatt, January 22, 1915.

" Spitzy, at convention of German Federation for Care of Cripples, February, 1915,
Zeitechrift f(ir Kruppelfiirsorge, Leipzig, 1915, viii, p. 188.


implements so as to adapt them to the prostheses. An estate has
been put at the disposition of the hospital by a private person, on
which practical training in agriculture is carried on under the direc-
tion of a physician and of a one-armed teacher. 12

The men are assigned to workshops before they have received the
artificial limb in its final form, working with their temporary pros-
thesis, on which the necessary modifications, as indicated by experi-
ence, are made. As part of the reeducation, special attention is given
to teaching all the men wearing prostheses to repair and improve
them ; they are all given instruction in the required leather work and

A special school has been created for one-armed men, which is
directed by the one-armed architect, Karl Grosselfinger. There are
two courses given. One, the general course, consists of training the
crippled in performing the movements required for the satisfaction
of personal needs : washing, dressing, eating, lighting a match, writ-
ing with one hand, etc. The second course consists of training the
men in special occupations. 13 Manual workers usually can not be
restored to their former occupation, but are trained in other occupa-
tions of the same trade which require less manual effort; thus, a
mason becomes a draftsman, a waiter a hotel clerk, and so on.

The Vienna schools for invalids do not see their object in preparing
thoroughly trained skilled workers. The reeducation which they give
is complete only in the case of invalids who can be completely re-
stored to their former occupation, or of those who have to be adapted
to some easier work in their former trade. But with regard to those
whom it is desired to raise to a higher position in their trade, to one
requiring either considerable theoretic knowledge or special tech-
nical training, as well as with regard to those who have to be taught
a new trade, especially those young men who have never before had
any training in skilled work — the school is considered as purely pre-
paratory. Its primary purpose is to find the most suitable occupation
for the invalid, and to train him in the use of prostheses. In addi-
tion it gives him the first elements of a theoretic and practical trade
education. But the work of the school is considered rather from the
medical point of view, as a continuation of the medical treatment
and the completion of functional reeducation. The work in the shops
is often designated as Arbeitstherapie. 14

The specialization in skilled trades. is left to other institutions,
namely, to the regular vocational schools, which, through the co-

u Agricultural education is also given to war cripples at a number of agricultural
schools in the crownland of Lower Austria ; at Ober-Siebenbrunn, Pyhra by St. PBlten
Tulln, Krems, Mistelbach, Retz, Edelhof, etc. See Zeitschrtft fur Kriippelfiirsorge, Leip-
zig, 1915, viii, p. 292.

" Dr. H. W., Zeitschrift fur Kruppelfiirsorge, Leipzig, 1915, viii, p. 57.

" Spitzy, Monatsblatter fflr Invaliden, und Kriippelhilfe, Leipzig, 1915, No. 3 ; Zeit-
schrift fur Kruppelfiirsorge, Leipzig, 1915, viii, p. 189 ; Die Versorgung der Krlegsbe-
achadigten, Vienna, 1917, p. 11-12.


operation of the ministry of public works and of the trade associa-
tions, accept for final training the men sent by the schools for in-
valids. 15 Thus, in September, 1915, the ministry of public works
instituted courses in graphic arts for former workers of the graphic
trades (photographers, lithographers, printers, compositors, etc.), 16
In March, 1916, the same ministry started at the Imperial Technologi-
cal Trade Museum at Vienna a special course for training war in-
valids, in the first place former metal workers, residents of Vienna
and Lower Austria, in the supervision and management of electro-
technical works, and also as moving-picture operators. 17


The school is under military control, but its administration is
mixed. Besides the " medical director," who seems to be a military
official, there is a " technical director," supplied by the Vienna office
for the advancement of industry, of the ministry of public works. 18
These two officials advise the patients in the choice of an occupation
and direct all the reeducation work. In addition, there is an " econo-
mic director," who supervises the finances of the institution, the pur-
chase of material, etc., and a " social director," who keeps the records
of the patients, inquires as to their general needs, corresponds with
their former employers, etc.

The patient leaves the institution only when he is able either to
return to the army, or to his former occupation in civil life. In the
latter case, he is not discharged before the hospital finds employment
for him. In procuring employment, the hospital cooperates with
the public board for vocational advice of Vienna, to which it
assigns its own physicians, and with a representative of the ministry
of public works. In the case of independent landowners or crafts-
men, the hospital, before discharging them, makes an inquiry to as-
certain whether the revenues that can be expected would be sufficient
for the support of the invalid. The discharged men are in all cases
kept on the records of the hospital and observed as to the conditions
of work and earnings.


The general tendency in Austria has been to create institutions
of a large size, on the Vienna model, and to concentrate them in
large cities, of which there are relatively few in Austria. They are

15 Zeitschrlft ftlr Kriippelfursorge, Leipzig, 1915, viii, p. 180.
"Der Abend, Apr. 17, 1916.

" Osterrelchische Wochenschrift fur den Offentlichen Baudienst, 1916, No. 8.
18 Spitzy, at convention of German Federation for Care of Cripples, Zeitschrift fiir
Kriippelfiirsorge, Leipzig, 1915, yili, p. 188.


created mostly in the capitals of the different crownlands and by
the initiative of the local Landeskommissionen. By the end of 1915,
institutions for crippled soldiers existed in Prague, Reichenberg,
Troppau, Teschen, Graz, Cracow, Linz, Mehr-Ostran, and in several
of the largest industrial cities.

The railway administration has an organization of its own for
the care of its employees disabled in the war. It has created a home
for convalescents at the cost of 600,000 crowns. The interchangeable
parts of prosthetic appliances are manufactured in the railroad
shops. 19


The placement of war invalids became a feature of public policy
when the minister of the interior, by a decree of June 28, 1915, pre-
scribed the creation of an employment service in every kingdom
and crownland. 20 As organs of this service, an official bureau was
to be created at the capital of every crownland. The Vienna Bureau,
for the crownland of lower Austria, was created by the State and
has served as a model for those of other crownlands.

The bureau of Vienna consists of an employment department, a
record department, and a welfare department. It is assisted by a
military advisory board, presided over by a general, and by a voca-
tional advisory council, under the presidency of an orthopedic sur-
geon. Employment is procured for officers as well as for privates.
A certificate of invalidity from the military authorities is required
from every applicant. Only residents of Vienna and of the crown-
land of lower Austria are taken care of. Others are directed to the
capitals of their respective crownlands and provided with traveling

Applicants are required to fill out a questionnaire and are card-
indexed by their name, record number and occupational group.
On the other hand, the minister of the interior addressed an appeal
to all employers of labor for a statement as to positions available for
invalids. Appeals are being made through the press and by means
of posters and moving pictures. In addition, personal inquiries are
addressed by mail or by telephone to individual employers. Earlier
in the war, the cooperation of the employers' associations
(Berufsgenossenschaften) has been obtained; they had declared their
readiness to give preference to invalids in filling positions. 81 All
positions offered are card-indexed and classified by occupations.

a Die Versorgung der Kriegsbeschadigten, Vienna, 1917, pp. 45-46.

"Robert Weiss. Zur Arbeitsvermittlung fur Kriegsinvalide. Zeitschrift fur Kriippel-
fttrsorge, Leipzig, 1916, ix, pp. 320-324.

21 Spltzy, at convention of German Federation for Care of Cripples, February, 1915,
Zeitschrift fur KrUppelfiirsorge, Leipzig, 1915, viii, p. 189.


The bureau always endeavors first to find employment with the
former employer of the invalid, or if this is possible, in his former oc-
cupation, or in one related to it. Those invalids who are unable to
return to their former occupation are examined by the vocational
council and given the necessary advice. If necessary, they are
referred to the schools for invalids. Efforts are always made to
place the man at his old home.

All invalids for whom employment has been procured by the
bureau are kept on record for at least 6 months and are controlled
through inquiries addressed to their employers, to the local authori-
ties, etc. If the man is dismissed, the cause of the dismissal is as-
certained and, when possible, an attempt is made to have it repealed.
All invalids who are fit and willing to work are supported until em-
ployment is obtained for them. They receive board, lodging and
clothes at one of the barracks of the Vienna orthopedic hospital, and
exceptionally a small subsidy in cash. Those who are entirely dis-
abled for work are assigned to special homes.

In agreement with the provincial administration of the crownland
of lower Austria, 70 district employment bureaus for war invalids
were created at the beginning of 1916, to work in contact with the
councils of the 70 poor districts. 22

A joint conference of the central organization of Austrian manu-
facturers and of the central commission of Austrian trade unions in
the fall of 1917 worked out a number of general principles with regard
to employment of war invalids, which were accepted by the official
bureau of Vienna. The most important of these principles are as
follows :

Employment is to be obtained, wherever possible, with the former
employer, and preferably in the former trade. The employers are
asked to give the invalids — even those with diminished capacity — a
suitable employment at a fair remuneration. Invalids whose capacity
has not been diminished are to receive the same wages as other work-
men in the same group ; they are to be covered by all collective wage
agreements wherever such are in force. The remuneration of invalids
with diminished capacity is to be fixed by agreement between the
employers and the employees, or, wherever the employer as a rule
deals with the labor organization with regard to conditions of employ-
ment, between the employer and the organization. Wherever work
is paid by the piece the invalids are to receive the prevailing rates.
The pension paid by the military authorities shall in no case be taken
into account in fixing the wages. The working class is appealed to
to help the returning invalids to develop their full capacity to work.

« Zeitschrlft fttr Kriippelffirsorge, Leipzig, 1916, ix, p. 46.


The ministry of the interior has submitted this agreement to the
official bureaus of all other crown lands, with a recommendation to
bring about similar agreements in their provinces. 23

From the creation of the bureau of Vienna, in the middle of June,
to December 31, 1915, it received 2,342 offers of positions; 1,306 appli-
cants for employment appeared before it, of whom 581 were placed.
From January 1 to April 30, 1916, the number of positions offered was
4,164, and that of applicants 1,604, of whom 912 were placed.


Following a decree of the Hungarian premier, a census was taken,
at the end of 1914 and the beginning of 1915, of all war invalids in
Hungary. On February 1, 1915, a national conference on the prob-
lem of war cripples took place. An executive commission was elected
with the secretary of state as chairman. The commission at first
confined itself to the organization of medical care and of the reedu-
cation of cripples. The employment functions were not considered
as a state affair and were left to a commission of the Red Cross.
In September, 1915, however, several decrees put all the matter of
care for war cripples on a highly centralized basis. Both commis-
sions were dissolved and replaced by a Royal Hungarian Office for

These decrees provided that orthopedic appliances should be sup-
plied gratuitously. The, reeducation of disabled soldiers in their
former or in a new occupation was made obligatory. The treatment
and reeducation were not to last more than one year. Final treat-
ment and reeducation could be given in state institutions which were
to be created by the Office for Invalids or in the institutions under
military control, or in those of the Hungarian Red Cross ; in Croatia
and Slavonia, in institutions of the Croatin crownland commission
for the treatment and education of war invalids.

Special reexamination commissions were established at Budapest,
Pressburg, Kolozsvar, and Zagreb; the chairman and members are
appointed by the premier from medical and industrial circles. In-
valids refusing to use prostheses, to submit to the treatment, or to
follow the reeducation, have to appear before these commissions.
Those who persist in their refusal, in spite of the findings of the
commission, forfeit all or part of their claim to a pension, except
those who have been in active military service for 10 years or more.

The Office for Invalids, in collaboration with the war ministry, keeps
record of all soldiers incapacitated from military service and needing

M Neue Freie Presse, Sept. 7, 1917.

M Dr. Emerich I erenczi. Staatliche Invalidenfiirsorge In TFngarn, Zeitschrift fiir
Kriippelfflrsorge, Leipzig, 1916, ii. p. 145-153.


medical care. 25 It controls all sanitary institutions for the treatment
of crippled and disabled soldiers, all schools for invalids, all shops
manufacturing prostheses and artificial limbs, and all agricultural
and industrial training institutions. It has to support and supervise
all private institutions caring for invalids. It also manages the
placement of invalids.

The institutions under the control of the Office for Invalids are
officially divided in three classes: (1) Institutions for medical care;
(2) shops for the manufacture of prostheses; (3) schools for invalids.

The men are assigned to the different medical institutions by the
military authorities. They are received and discharged by the
director, upon report by a commission of officials of the institution.

All the medical institutions were created anew. These creations
started, in Budapest with four hospitals for 4,500 patients ; by the
middle of 1916 there were over 10,000 places at the Budapest hospitals
for invalids. Besides Budapest, similar institutions exist at Press-
burg, Kolozsvar, Kassa, and several other cities.

With regard to the production of artificial limbs, private industry
soon proved inadequate. The Office for Invalids established shops
for the manufacture of prostheses at the metal-trade schools of Buda-
pest and Perrony. The Budapest shop started with three workers in
March, 1915 ; the number increased to 125 by the beginning of 1916.
The work is done either by invalids or by soldiers assigned by the
military authorities. In the spring of 1916 there was created a per-
manent State factory for the free repair of prosthese and artificial

Of the schools for invalids, the largest is that of Budapest (700
pupils at the beginning of 1916). Up to 90 per cent of the pupils are
peasants. The object of the reeducation is to form small independent
craftsmen. The shops having the largest number of pupils are those
for shoemakers, tailors, harness makers, cartwrights, locksmiths,

Similar schools are found in Pressburg, Kassa, and Kolozsvar.
Alongside with vocational training, instruction in reading and writ-
ing is given to illiterates. Those who have interrupted the elementary
or high school education are given an opportunity to continue it. In
some of the schools instruction is also given in typewriting, stenog-
raphy, and bookkeeping.

At the Institute for the Blind at Budapest (140 patients) blind
soldiers are taught carpet making, brush making, massage, etc.

"According to a statement by Premier Tisza in the chamber of deputies, on Feb. 15,
1V16, there were In the Kingdom on Sept. 30, 1915, 28,932 soldiers incapacitated through

Online LibraryDouglas C. (Douglas Crawford) McMurtrieThe evolution of national systems of vocational reeducation for disabled soldiers and sailors → online text (page 22 of 38)