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made of posters, cartoons, mottoes, and slogans. Spe-
cial postal cards w r ere devised with inspirational
illustrations and to minimize the effort of writing
home at least every two weeks, which was required,
and especially when informing home relatives
promptly of every change in address. A question-
naire was addressed to 15,000 men asking each to
specify grievances, disappointments, improvements,
etc., whether he looked to the future with confidence
or dread, and who, if anyone, or what had hindered
or helped his development as a good soldier. The re-
sults of this are not yet accessible. 1

The civilized world has more and more felt the
need of morale education, and many very diverse
schemes to that end have been devised. 2 But there
are still many who doubt with Socrates whether vir-
tue can really be taught. No one who has studied
the Greenleaf scheme can doubt that morale, which is
a somewhat different thing, can be inculcated. If all
the ideals of that camp were realized, as they might

1 In the above characterization I have been materially aided by
the informal report of this work made out for me by Mr. H. D.
Fryer, who supplied me with various typewritten but as yet un-
printed memoranda and circulars, including the Yerkes report of
July, 1918, and pamphlets, the special publications of the American
Social Hygiene Association, etc.

3 See a description of these many methods in my Educational
Problems, i, Chapter 5.

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MORALE

have been if the war had lasted longer and these
schemes had been more evolved, the world would have
had here an object lesson of the highest value. Had
this work been finished, it would have greatly reduced
the pathetic abatement of individual and army mo-
rale all the way from the soldier's induction into
service to his home-coming, discharge, and his ree'n-
listment in work. As it was, each of these stages, al-
though much was done to counteract this tendency,
marked a decline of morale. Here we could have
learned many lessons from England if we had chosen
to, but if another war ever comes we shall do vastly
better. All in all, the story of what was done at
Greenleaf for those who passed through its two weeks'
course, each day of which was minutely scheduled
even to the menus of each of its meals, has not only
its inspiration but its lessons for civilian industrial
and educational life. Every business concern should
have, along with its psychological testers and the
evaluation of its industrial efficiency, its morale spe-
cialists, and so should educational institutions; and
possibly sometime each political party, each trade,
each social organization, and perhaps each church to
develop its own esprit de corps and to keep it at the
top of its condition, as chivalry and the medieval
guilds did so well. We need to realize anew and
more and more clearly that the ultimate human value
of every occupation and institution is what it con-
tributes to develop and sustain personal and general
morale, and that the effectiveness with which they do

186



SPECIFIC MORALE FOE THE ARMY

this is the standpoint from which every other aim and
achievement and even production itself is a by-pro-
duct. Even the war was, on the whole, a good or bad
thing for the world as it advanced or lessened the
morale of the nations that had a part in it.



CHAPTER XII



MORALE AND REHABILITATION OF THE WOUNDED. 1

The state of mind of the maimed soldier and how it has been met
The marvelous work of the surgeon The persuader What is
done in the various countries to restore the soldier to efficiency
and settle him in a vocation Success here second to no other
triumph of morale.

If the average sound soldier felt the contrast be-
tween the enthusiasm with which he was sent off to
the war and the acclaim with which he was welcomed
home again on the one hand, and the cooler and more
discriminating spirit that he found on reentering in-

*The chief journals devoted to rehabilitation are (a) In England,
Recalled to Life: A Journal Devoted to the Care, Reeducation, and
Return to Civil Life of Disabled Soldiers and Sailors (first No., June,
1917) and Reveille, began in August, 1918. (b) In this country the
Surgeon-General's office in January, 1918, began publishing typewrit-
ten bulletins on recent literature on reconstruction and reeducation
which in the following June was continued in the journal, Carry On.
Our government has also issued a special series of bulletins (No. 30
appeared in April, 1919) on different aspects of this work. See, too,
E. T. Devine's Carnegie report on Disabled Soldiers and Sailors
Pensions and Training (N. Y., 1919). The Red Cross has published
two series of pamphlets on various aspects of the subject, (c) In
France we have Larousse Medical since 1917 (copiously illustrated),
(d) In Germany we have Kriegsinvalidenfiirsorge since 1916.

Besides this serial material there is a literature on the subject
far too voluminous to cite. See Dr. R. F. Fox's Physical Remedies
for Disabled Soldiers (London, 1917) ; A. Broca and Ducroquet's Ar-
tificial Limbs. Tr. by R. C. Elmslie (London, 1918) ; R. T. MacKen-
zie's Reclaiming the Maimed (N. Y., 1919) ; G. Harris' Redemption
of the Disabled (N. Y.. Appleton, 1919) ; D. C. McMurtrie's The Dis-
abled Soldier (N. Y., Macmillan, 1919) ; H. C. Marr's Psychoses of the
War (London, Bailliere, 1919) ; also The Physiology of Industrial
Organization, by J. Amar. (Paris, 1917). In this and subsequent pub-
lications the author was one of the first to try to analyze the move-
ments in occupations and their relations to physiological principles.
For a single sot of articles I find nothing better than that of Thomas
Gregory's in World's Work (Aug., 1918.)

188



EEHABILITATION OF THE WOUNDED

dustrial life on the other, this contrast was far
sharper for the wounded. True, employers in some
firms at first discriminated in favor of the wounded
soldier, but this spirit always and everywhere tends
to yield sooner or later to that of efficiency, which
can afford to pay a man for only the services he is
actually able to render. Some enthusiastic girls, also,
hospital and Ked Cross nurses, married the maimed
and even accepted "baskets" (a gruesome army slang
word for those who have lost all four limbs) as hus-
bands, but this pitch of fervor was rare and also tran-
sient, for pity and love cannot long be confounded.
Thus the returned soldier who is seriously mutilated
or invalided, of which the war has produced several
millions, is in fact in a pathetic condition. The
possibility of having to exhibit his mutilations on the
street and begging from passers-by is something the
self-respecting veteran, who has heard wounds suf-
fered in his country's service called glorious, feels to
be as bitter as death itself, and it is a shame for any
country to permit it, as many often have in the past,
sometimes even to those to whom it has given pen-
sions. Very careful examinations of the discharged
were wisely planned to prevent unjustifiable claims
for after-effects of the war, which are often such a
burden and were so especially after our Civil War,
when for many years the total pension budget in-
creased inversely as the number of survivors.

In the first place, the maimed man generally has
his physical vitality and vigor more or less reduced,

189



and perhaps his mental tone is lowered ; hence he has
less courage in facing life than before. Again, the
very members most essential in his occupation may
be gone or incapacitated so that he must start all
over again in a new line of work, and this is more
discouraging for the skilled craftsman than for the
unskilled laborer. Finally, many wounds so disfig-
ure the body and even the face that the victim shrinks
from being seen, and he may be a painful object even
to those nearest and dearest to him. Thus he tends
to feel himself useless and dependent, his pride is
galled, and he may despair, although he rarely com-
mits suicide. He more often grows suspicious that
his disfigurement has abated love of wife, children,
and friends, that their devotions are from a sense of
duty and perhaps performed with inner repugnance.
Sometimes instinct inclines him to compensate for
these feelings by arrogance and domineering au-
thority to compel what he fears love falters in doing.
Who save those who have suffered thus can conceive
the inner tortures of an athlete suddenly made a
cripple for life or of an attractive face made ugly and
repellent, suggesting in some cases a disposition the
very opposite of that which really exists.

Again,it is not surprising that the seriously wound-
ed soldier should thus gravitate more or less strongly,
according to circumstances and disposition, toward a
state of mind in which the typical case feels that he
has made unwonted sacrifices for his country, which
should henceforth care for him, and also perhaps that

190



REHABILITATION OP THE WOUNDED

his friends and family should very gladly serve him.
His exceptional sacrifices demand exceptional recog-
nition and reward. If it is glorious to die for one's
country, it is hardly less but more glorious to be mu-
tilated in its service. He is at least more heroic than
those who came through without scathe. He has
"done his bit and got his hit" and now the nation he
has helped to save owes him a comfortable living.
This obligation was almost implied in the sentiment
with which he was sent off to the front, and he feels
neglected and deems the world ungrateful. At the
institutions for convalescents ( e. g., the Walter Reed
and other such hospitals) the persuaders and en-
couragers found, this attitude not at all uncommon
and one of the very hardest to meet or modify. This
state of mind was, of course, more common among
those who enlisted under the allurements of our meth-
ods of recruiting volunteers but has been only less
frequent among those drafted. It may make men pes-
simistic but it rarely goes so far as to make them con-
scious parasites, though it may make them enemies
of even our industrial society.

Now it is just these two classes of cases which
illustrate the most utter debacle of morale. But it is
also upon some of these that morale has wrought its
most marvelous regenerations, for both the despair of
the first and the cynicism of the latter class have
been triumphantly overcome, although we must
frankly admit that there have been some of both who
resisted all cure.

191



MOKALE

First of all the agencies of rehabilitation comes
surgery with its now marvelous arsenal of ever new,
more refined and effective methods, which have made
it such a power for morale as well as for physical sal-
vage. The soldier is young, in good condition, rarely
suffers from operative phobia, and in general makes
a good patient. Many are at first reconciled to dis-
ablement because it means a furlough or perhaps
"blighty" for good, and are grateful to fate because
it is better at least than "going West," a spirit that
may, though happily rarely does, culminate in malin-
gering, magnifying symptoms, and possibly in self-
inflicted wounds; while a few heroic souls chafe under
everything that interferes with getting back into the
fray.

Men with faces shattered ("gargoyles" or Cali-
bans) are given, e. g., new noses made out of perhaps
their own rib-bone covered by a flap or two of skin
from a part of the face that can be later covered by a
false beard. An artificial jaw may be fitted by the
aid of a plaster cast with paraffin, or a new and care-
fully molded cheek is made to conform as nearly as
possible to the photograph of the patient before his
injury, and these and even ears are usually supported
in some way by glasses. When we read not only of
plastic surgery but of the grafting of glands and the
substitution of parts and organs in the living man
by those taken from animals and even cadavers, we
wonder whether, along the line of these methods, life
may. not sometime be rejuvenated, and we think of

192



iBEHABILITATION OF THE WOUNDED

bold and clever romances like "The Heart of Don
Vega," whose old heart was physically replaced by a
new one, with a change of disposition ; or of the clever
story by an anonymous author of the man who had a
new brain. Skull disfigurements are cleverly dis-
guised, and not only eyes and teeth but ears are re-
placed by artificial ones, and all these facial surger-
ies restore those who would otherwise be isolated
from the commerce of life. As to limbs, there is a far
less percentage of amputations than ever before, not
only of feet and legs, which are far more often wound-
ed and more often require this treatment than do
hands and arms, but even the latter can be replaced
by extremely ingenious devices so intricate that only
long practice gives skill enough to bring out all their
possibilities. Some of these artificial limbs are stand-
ardized but others have been evolved by individuals,
with fingers working by springs released by rolling
balls held in grooves, which with sufficient skill can
perform very many of the functions of the normal
hand. 2 With various sockets and inserts very many
different things can be done and tools, perhaps modi-
fied, can be used, and not a few patients have invented
ingenious devices to meet their own type of need.
Not only tools but sometimes industrial processes
have been modified, and this was done before the ar-
mistice in more than four-score occupations, which

a P. Martinier and G. Lemerle: Injuries of the Face and Jaw and
Their Repair, Lond., Bailli&re, 1917 ; and G. Seccombe Hett : Meth-
ods of Repair of Wounds of the TSlose and ~Nasal Accessory Sinuses
Proc. Royal Soc. of Med., XII, No. 8, July, 1919.

193



MORALE

have been thus fitted to the maimed as they have
been to these callings. Some cripples before as well
as those made by the war have become prodigies of
rehabilitation, like L. Simms (Outlook, September
11, 1918) who at six lost both hands by amputation
midway between the wrist and elbow, but went
through Oberlin College, became superintendent of
schools, and tells us that he can thread a needle and
sew, use the typewriter and piano, shave, shoot, write,
dress and undress, etc. We have also the noted case
of M. J. Dowling, who some thirty-six years ago had
hands and feet frozen off in a Minnesota blizzard, and
is now a bank president and director of various insti-
tutions. Such men are a splendid object lesson to
the maimed and are brought as examples of courage
and perseverance to hospitals for war cripples. Four-
teen of these "encouragers" have been brought to this
country from France.

But it is when surgery and mechanical devices
have done their best that the higher work of morale
for these cases really begins. There was often,
especially in England, a very persistent idea that if
the crippled learned to earn, his pension might be
diminished, and even effective legislation to prevent
this did not entirely obviate the need of personal per-
suasion and counter-assurance. When a new occupa-
tion must be chosen, it should be as near the old one
as possible, and thus choice requires much discrim-
ination and a wise adviser can here often be of great
help.

194



First of all, the subject must realize that, as
Gregory puts it, when a man loses his leg it affects
his thinking perhaps even more than it does his walk-
ing for he is liable to lose his nerve, at least for a
time. Rehabilitation is hardly more a question of
arms, legs, and eyesight than it is of point of view
of the cripple himself and also that of his friends
and of the public. He must not be cobbled up, pen-
sioned, and turned loose to become a tramp or ped-
dler of shoestrings or pencils, as was too often the
case after our Civil War, nor merely given an
official job by the government, as was the case in
Germany and France after the War of 1870. He is
handicapped but not done for. Our half million
cripples not only in the hospital but in the curative
workshop, one of which was attached to every army
corps, must develop new ambitions and aims. The
mind must be focused on the object as a product
and not on the process of making it. He must come
to think of himself not as marred but of what he can
do. He should be given occupations even in bed,
where he is liable to form habits of moping, drifting,
and being waited on. It is in work that brings re-
sults and awakens interest, so that stiff joints slow-
ly grow flexible and strength increases, that the
value lies, and when these increments are measured
by the protractor and dynamometer, even if the res-
toration is slow it gives buoyancy instead of depres-
sion. This result is, however, often best if disre-
garded and left one side as a by-product. A man

195



MOKALE

tired with working a foot- treadle, e. g., designed only
to restore the lost power of movement in the leg, if
put to fret-work on a jigsaw finds his rate of im-
provement in leg power augmented. The notion of
his helplessness must be stamped out.

Our government and others have made very in-
teresting collections of stories of men who have en-
countered such handicaps, and it has many movies
showing cripples engaged in not only many kinds
of occupations but in a great variety of games ; while
there is a long list of devices and inventions, some
petty and individual and some of great and general
significance, made by cripples not only to help them-
selves but for the benefit of their comrades in mis-
fortune. Besides this wonderful collection there is
in the Surgeon-General's office an illustrated book
made up of the life histories of cripples who have
succeeded, a copy of which is now accessible to every
disabled soldier or sailor. It was also designed to
help the "cheer-up" squad, for these "twice heroes"
show what grit and pluck can do.

The state of mind of the cripples, as Gregory so
well puts it, thus needs great attention. Patriotic
hysteria in the first year of the war so glorified the
wounded soldier that the police hesitated to arrest
him for almost any excess. In France many at first
became habitual drunkards, and here only four per
cent were willing to go back to their old jobs as
wage-earners. Coddling, overadulation, and hospital-
itis, which result from long being served and doing

196



REHABILITATION OF THE WOUNDED

nothing, well illustrate how mistaken treatment de-
nothing, well illsutrate how mistaken treatment de-
stroys morale. The nation's gratitude must not spoil
its heroes, and even their friends must expect them
to play men's parts and not lapse toward the plane
of pauperism. Then after this first flush of en-
thusiasm came the era of preferential employment.
Pennsylvania, e. g., alone provided industrial posi-
tions for 42,111 American disabled soldiers and sail-
ors, and in France there was the same process of
spoiling by unwise solicitude, followed by a new
regime. But this stage quickly passed. Employers are
patriotic but they cannot long be expected to engage
these men unless it is a sound business proposition.
Some ten per cent of the four thousand members of
our National Association of Manufacturers agreed to
employ disabled men, but there were ever more dis-
criminations. Thus the war cripple must eventually
succeed or fail according to the worth of the service he
can render.

Countries differ greatly in their programs all the
way from .where the surgeon leaves the soldier
through his complete reeducation and industrial re-
habilitation in society. The Gorgas conference in
January, 1918, drew up an excellent plan and bill
which Congressional politics killed. Of all countries
Canada has Ijy general consent done best. Some
would have the individual not discharged from the
army but kept under military control until he is
self-supporting or at least has reached his maximum
of efficiency. This plan, however, has nowhere been

197



MOKALE

adopted save in Belgium, and there for the most part
with only skilled laborers, because it is deemed an
unwarrantable interference with personal liberty,
and also because to realize the best that is in an in-
dividual his own interest must be a source of chief
appeal. In the Red Cross Institution in New York
City, under the patronage of the Millbank gift, vo-
cational teachers have been given courses on the in-
dustrial needs. In France the most remarkable in-
stitution is L'Ecole Joffre. It was founded at Char-
leroi by M. Anzer Besaque, and when the Germans
destroyed it, he drifted to Lyons, where he met the
famous mayor, Herriot, one of the most picturesque
figures in France. Here it was that the above-named
school developed. In France reeducation was main-
ly under military discipline, with a view to the sol-
dier's return to the army, and industrial training
there is voluntary. In Great Britain men are dis-
charged too soon and too much liberty is given to
break off training if it becomes irksome. In Queen
Mary's convalescent hospital are concentrated all the
artificial limbs, and here men go after amputation.
The Queen gave the workshop, where each patient is
given a leaflet describing the courses so that he may
choose wisely. Although only the beginnings are
taught here, the soldier's mind is taken off his in-
juries and he lives in an atmosphere of usefulness.
When he acquires his limb, he goes to Eoehampton,
where he is given more leaflets, listens to lectures, is
given advice, etc. Sir Arthur Pearson, himself blind,

198



REHABILITATION OF THE WOUNDED

has provided for blind soldiers. St. Dunstan's, given
by Otto Kahn of New York, has several annexes.
This institution to-day represents the very last and
best thing that civilization can yet do for the blind.
The Lord Roberts' Memorial Workshop, opened just
after the South African war, has set the fashion for
half a dozen others. Then, too, soldiers are en-
couraged to settle on land. There are innumerable
smaller efforts by philanthropic individuals and or-
ganizations. Since May, 1917, and the Interallied
Conference, the allied nations have united to make
this work more effective.

Physical, mental, and moral therapy go hand in
hand. Medical electrotherapy, X-rays, douches,
massage, hydrotherapy, light, artificial air-currents,
plays and games, occupations as treatment, scores of
appliances, some suggested by the Zander apparatus,
and testing and measuring every degree of improve-
ment, protractors, e. g., to test foot-drop, ab- and ad-
duction, pro- and supination, etc. all these show the
singular ingenuity which physical therapy 'has de-
veloped in meeting the emergencies of war and in
adapting everything to the vast variety of individual
cases. Now the same is true with the war psychas-
thenias. Horrible recurrent dreams, e. g., may be
banished by painting or by narrating them. 3 A pho-
bia can be abated by tracing it to its roots in an ex-
perience of childhood; mental vacuity and helpless-
fiess by successfully prospecting through the pa-

1 See H. C. Marr: The Psychoses of the War, 60 et seq., Lond.,
Frowde, 1919.

199



MOKALE

tieut's life and mind for something that profoundly
affects his personality. In some cases it is necessary
to go back to and repeat school-room topics and
methods, perhaps even in more simple form than in
the school itself, and thus to build up a new personal-
ity. Often the psychotherapist finds it very hard to
discover a point of interest vital enough to start
from. Each day in the process of analysis presents
new problems which must be met by new methods.
In the more purely morale cases the chief task is to
find or make a motive and a goal for rehabilitation
not only in making the patient feel that life and his
efforts are worth while but in giving him the most
indispensable preparedness for his new life, viz.,
hope and confidence. The example of those who
have best overcome most of the obstacles due to dis-
ablement is one of the most precious of all the moral
inspirations of the war and should be spread before
the young in all lands, beside the story of great men
who rose from obscurity and by dint of their own
efforts have impressed themselves upon history, and
also along with the record of the most heroic war
martyrs who have fallen in battle, in order that youth
may be heartened in fighting its way to success. A
man who has been shattered in body and mind and
nevertheless succeeds in making good, despite his in-
firmities and in face of the many subtle temptations
within and without to be a laggard, is a true hero
of morale, of whose life even a nation seeking reha-


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