The New York herald., 1922-07-30


Louis. May. 1852. Reprinted from the
1t should in infantle paralysis. In in
fantie paralysis massage. electricity.
manpulations. hydrotherapy and alT
other measures Of physiotherapy are OF
secondary and minor Importance as
compared with splinting i'm correct po-
sition. My attitude with regard to the
Carrel-Dskin or any other forms of
wound treatment (except drainage) In
compound injuries is exactly the same,
that is. they are secondary to correct
splnting.
This argument also brings up the old
question as to ssplinting and stiff joints.
whether Of the joint itself or of the ad-
jacent soft parts. is due not to immobil-
ization but to pathologic changes. Such
changes are always due to irritation. in
fiammation. tissue destruction and scar
formation. All of these are kept at min
imunl. not by movement but by rest.
The minor stiffness that is inevitable to
the minor injury can be broken up af-
ter healing occurs. The more serious
stiffness that results from more serious
injury cannot be broken up either at
the time by poor splinting or by force
later on.
Another important war experience,
and one which attracted much attention
at the time. had to do with the so-called
Willems method of the treatment Of in
fected joints by keeping them in mo-
tion. Accurate and careful adherence
to the exact technic promulgated by
Willems surely gave. and will give. good
results in some acute septic joints.
Careful splinting and sound healing
will give the same results or better.)
On the other hand, experience taught
us the great danger Of keeping infected
joints moving under any except ideal
conditions. l saw during the war. and
have seen since. many cases Of serious
disability and severe deformity In which
attempts were made to maintain motion
in joint case which should have been
protected and allowed to become stiff in
better position.
Even from one OF the most brilliant
procedures that came out of the sur
gerry Of the Observation-Disclosures
are negative as we'll as positive lessons
to be learned. Certainly we saw that
and complete removal Of badly dam
aged and infected tissues. That such
procedures should be done only by
skilled surgeons, how ever. Is attested by
the frequency with which principal
peripheral nerves were sacrificed and
serious disabilities resulted owing to
bony and soft part defects.
One of the greatest lessons of the
war is one in regard to which we. as
profession, still have much to learn.
This is the lesson Of the occupation Of
the sick and disabled. Both in the
army and out of 1t we are still pursu-
ing. with regard to our disabled. pol
icy which in many cases Is bad for
them and bad for us.
This is the policy Of compensation
without directed or supervised employ
ment 1t is true that we have a fairly
elaborate machine set up for the voca-
tional guidance and for the employment
of our crippled discharged soldiers. For
our industrial cripples there is almost
no provision whatever. The fault now
agencies as 1t is with the general public
and with the profession. The employ
ment of the idle presents a problem for
the solution of which the intelligent CO.
operation of the entire community Is
necessary AS long as ideness is per-
mitted. and especially as long as 1t is
encouraged. we shall have the problem
Of the unemployed. either lame or well.
Certainly, however. in institutions IN
which supervision is at hand every in
mate should be engaged, If possible. In
some sort of useful occupation. These
occupations can be made educational
and instructive as well as remunerative
and curative. Then the individual Will
be on the way to real rehabilitation.
socially as well as physically.
We have passed. have we not. that
period in human history In which power
and possession were yielded, to that one
who was physically the strongest? We
are supposed to have now government
which guarantees to US all equal rights
for the enjoyment of life, liberty and
the pursuit of happiness. Are we not
perhaps ready for the next step forward
into an era in which, by common con-
sent. we may give special opportunities.
special privileges and special facilities
for self-help (irstead OF merely char
ity) to those who Fundamentally or
physically--keep up under the strain of
competition with those who are. mt!