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Provision for War Cripples in Germany

I. INTRODUCTION

- There are two outstanding features about the German system of care for war cripples. In the first place, it is not a system in the sense in which Italy, Canada, France, and England have sys- tems. In all these countries, the work is more or less unified under one authority; they make, in varying degrees, an attempt at even distribu- tion of schools and hospitals. In Germany, there is no real central authority, the schools are of varying types and most unevenly distributed. 'The second feature is the volunteer character of the work. The matter of re-education is wholly in private hands and is not even super- vised by the Imperial Government. In this respect, the German Government takes less part in the work than the government of any other nation. These two features, lack of system and lack of government control, have been the subject of wholesale condemnation from writers of other nations. As far as can be seen, however, the volume of work done and the efficiency of indi- vidual institutions rank extremely high.

As a matter of fact, the lack of centralization in the German system need not indicate essential insufficiency. There are two obvious causes for it. In the first place, Germany was the country which, of all others, had, when the war broke out, the most foundation for caring for cripples. Some of the other countries which had no such arrangements, had to create their systems from the bottom up, notably Italy and Canada, which are now the most uniform. It is the work which has grown by experiment from stage to stage which usually shows the least consistent plan on paper, and the German re-education system appears to fall under this head, ^.'-'^hen the war broke out, Germany had, under different auspices, all the elements with which to begin immediate work. There were fifty-eight

cripple homes under private auspices ; there were sanitaria and re-education workshops for indus- trial cripples under the employers' accident insurance companies; there were orthopedic hospitals under the municipalities, and there were trade schools and employment bureaus under various government auspices. It was diffi- cult to knock these elements together under one management and yet each was efficient of its kind and ready to be turned over at full working strength to the purpose of war. Under such cir- cumstances, the natural development was that each should remain more or less autonomous, simply co-operating with the others on whatever system appeared practical in each locality.

Further than this, the work is thoroughly planned. It is not what is done for the cripples which is unsystematized, but the way in which it is done. Germany has a complete definite scheme as to what constitutes the reconstruction of war cripples. It is accepted by all the insti- tutions working to this end, it is put in practice, and the statement is that in ninety per cent, of the cases the desired results are obtained. The scheme, as expressed by Dr. Biesalski, Germany's leading orthopedic surgeon, is as follows:

1. No charity, but work for the war cripple.

2. Cripples must be returned to their homes and

their old conditions; as far as possible, to their old work.

3. Cripples must be distributed among the mass of

the people as though nothing had happened.

4. There is no such thing as being crippled, while

there exists the iron will to overcome the handicap.

5. There must be the fullest publicity on this sub-

ject, first of all among the cripples themselves.''

These words express not only an ideal, but an outline of the work as actually put through.

^ Zeitschrift fiir KruppelfUrsorge, Leipzig, 1915, viii, 15.

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There appears to be no discussion in Germany as to the results obtainable. The principle that no one need be a cripple unless he himself wishes it, and that 'the wounded man must sink back into the mass of the people as though nothing had happened', is accepted as a creed. As far as this goes, there is entire uniformity and sys- tem, with less discussion of possibilities and results than is to be found in any other nation. The volunteer character of the work is also explainable on historical grounds. Volunteer work in Germany does not mean unskilled work. Germany was used to relying on private organ- izations for efficient work in the field of social welfare and to granting them a semi-official status. Her whole system of social insurance, for instance, was managed in this way. More- over, her volunteer social workers were often men who held government positions and who did this work in their unofficial capacity or who were closely allied with the governing class. To speak of volunteer work in Germany does not, there- fore, mean irresponsible or untrained work, but work in the spirit and of the quality of govern- ment work done under different auspices. To illustrate the German attitude, there may be quoted the speech of the president of the Imperial Committee for the Care of War Cripples, made at a conference called by the committee at Cologne, August 22 to 25, 1916:

To me the most inspiring thing about this organiza- tion of ours for the care of war cripples, which embraces all Germany, has always been its voluntary character. We needed no laws and no decrees, no impulse from our rulers. Spontaneously, in one day, the great edifice sprang from the earth created by the mighty force of brotherly, cherishing love.*

The enthusiasm of this speech is typical, but the man who makes it cannot be counted merely an inspired private citizen; he is the Captain General of the Prussian Province of Brandenburg and, though speaking in a private capacity, must be presumed to work in full accord with the government and in the government spirit.

It is gathered that the work for cripples, being managed usually by people of this stamp, is

2 Verhandlungsbericht uber die Tagung fur Kriegsbeschadig- ten-fiirsorge in Koln. Berlin, 191 7, p. 27. (Reichsausschuss der Kriegsbeschadigtenfiirsorge. Sonderschriften, Heft i.)

largely a matter of class. There have been re- quests in the Reichstag, mostly from the socialist side, that the government take over the whole work. The government's obvious reason for not doing so is, of course, a matter of money coupled with the fact that to leave such a matter to private initiative is not such a shiftless act in Germany as it would be in a country with a less developed system of private charity. A list of contributions made by some of the principal German cities to June, 1916, may show the extent to which thework is dependent on private charity:

		Marks per 1,000
City	Marks	inhabitants
Cologne	707,000	1,367
Beriin	570,000	275
Dusseldorf	430,000	1,170
Wiesbaden	142,000	1,299
Leipzig	140,000	237
Potsdam	66,000	1,064

ACTUAL PROGRAM OF WORK

There have been various estimates made of the number of German cripples. The latest available is that up to August, 1916, published by the Kolnische Volkszeitung, which gives ' the arm amputation cases as 6,000 and leg amputations as 10,000.

For these men there are four necessary stages of treatment: (i) medical treatment, (2) provi- sion of artificial limbs and functional re-educa- tion, (3) vocational re-education and vocational advice, (4) placement. These activities are cut sharply in half, the first two being the function of the Imperial Government and the last two of private and state agencies.

The general course of a wounded German sol- dier from the battlefield to civil life is as follows : He receives his first treatment at the field dress- ing station and goes from there by ambulance to the field hospital, where surgical treatment takes place. He is then removed by train to the rear, possibly to a hospital along the lines of communi- cation, possibly to a reserve hospital in the in- terior or even to the orthopedic hospital, where he is to have final intensive treatment. This is decided by military convenience and by his need for more or jess immediate treatment.

• Zeiischrift fUr Kriippelfiirsorge, Leipzig, 1916, ix, 382.

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He is kept at the reserve or the orthopedic hospital under military discipline until his physi- cal condition is brought back to normal, during which time there are various arrangements for his re-education. These will be taken up later. On discharge from the hospital, he goes back to his reserve battalion, the unit at the rear which supplies new reserves for the corresponding bat- talion at the front, to await his pension and dis- missal. As a rule, there is an effort to send men for treatment to the home town where their re- serve battalion is quartered, so that this will not mean another change of place. While he is with the reserve battalion, his pension is decided on by the local military board and he is finally dis- missed as dienstunfdhig, or unfit for service.

Most of the civilian activities, both in re-edu- cation and in placement, take place while the man is under the authority of hospital or reserve battalion. This makes necessary the closest co-operation between military and civilian authorities. The effect is that of two interlock- ing systems functioning side by side, occasionally overlapping, occasionally failing to make perfect connections, but, as a rule because they are not really different in spirit, managing very effect- ively.

II. ORGANIZATION

The organization of the volunteer work for the care of war cripples began a few days after the declaration of war, through the activity of the Deutsche Vereinigung fiir Krilppelfursorge (Ger- man Federation for the Care of Cripples). This society, as has been mentioned, is an institution of long standing, having as members fifty-eight cripple homes, some of them founded almost a century ago. The chief mover in the organiza- tion was Dr. Konrad Biesalski, director of the Oscar-Helene Heim fiir Heilung und Erziehung Gehrechlicher Kinder (Oscar Helen Home for Treatment and Education of Crippled Children) in Berlin-Zehlendorf. Immediately after the outbreak of the war, the Kaiserin, at Dr. Beisal- ski's suggestion, sent a telegram to the Vereini- gung fiir Krtippelfilrsorge, asking that the Ger- man cripple homes throw open their doors to war cripples. To this, all the homes immediately consented. Further than this. Dr. Biesalski

undertook a tour of Germany under the auspices of the Red Cross, in which he visited all the prin- cipal cities, urging the formation of voluntary committees for the care of war cripples. The gospel he preached was one which had been the creed of leading German orthopedists for many years, namely, that almost any cripple could be made fit to work again and that education for work should be the regular treatment. The im- mediate result was the .formation of volunteer committees in many cities and of larger ones in some states and provinces and the starting of work in all parts of the empire under various auspices and with various plans. By February, 1915, this local organization had proceeded so far that the Vereinigung fiir Krilppelfursorge, under the auspices of the Kaiserin, called a special meet- ing in Berlin to compare notes and lay down the guiding principles.

At this meeting, there were present officials of the various states and provinces, representatives of the medical profession, the teachers, the em- ployers, the workmen, the military authorities and, of the large social welfare organizations, the Red Cross, the sick benefit societies, the state accident insurance associations, etc. The general principle was laid down as above, that the Imperial Government, through the War Department, should be responsible for the wounded soldier in so far as he required physical care, but that all responsibility for re-education and return to industrial life should belong to private charity or to the different states of the empire, if they cared to take it up. Dr. Schwien- ing, staff surgeon of the Gardekorps, in laying down the position of the military authorities, said: "The aim of the military authorities is to restore to the wounded man, as fully as possible, the use of his injured or weakened limbs. . . Our purpose is not only that men should have the requisite practice in the use of their prostheses and should then be discharged. The military authorities are prepared to keep them even longer under care and give them opportunities in spe- cial hospitals for further practice and in prepara- tion for a trade. . . Naturally, for various reasons, it is not possible to keep all wounded and crippled men in hospitals until they have fully learned a new trade or are able to resume

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their old one. But to give them the preliminary practice for this, and thus to smoothe the transi- tion into civil life, to this the military authorities consider themselves indubitably bound." '

This left the division of labor clear. Dr. Schwiening's allusions to 'opportunities for fur- ther practice' turned out to mean nothing more than cordial intentions and a little manual train- ing in the way of functional re-education. The private agencies represented at the meeting, therefore, prepared to leave to the War Depart- ment all questions of physical care and to con- centrate on vocational advice, re-education, and placement. The question of financial responsi- bility was touched on, but not settled. There was no authority from the Imperial Government for assuming that any expenses would be de- frayed, except those for physical care. The private societies and the individual states were left to finance their part of the work with any support they could get. There was obvious, even at this early meeting, the split of opinion as to this division of responsibility. Several speakers stated definitely that the Imperial Gov- ernment ought to control and plan the work or, at least, to finance it. No government repre- sentative, however, had been authorized to make any promises on this subject and the aloof atti- tude then assumed has continued, under growing criticism. The general understanding, however, was a thoroughly cordial one. The military authorities expressed themselves as deeply grateful for the volunteer work and in full co- operation with it. They promised to consult with the private agencies as to the assignment of men to different hospitals and not to remove or discharge men suddenly without regard to the interests of their training. They also promised that private agencies should have facilities for visiting the hospitals for teaching and vocational advice and that army doctors should be in- structed to cooperate with them in every way.

As a matter of fact, the actual working out of this cooperation depends on the Bezirkscom- mando (the local military authority) in any given place. For military purposes, Germany is divided into thirty-two districts, all the hospitals in any district being under the authority of the

' Zeitschrift fiir Kriippelfiirsorge, Leipzig, 1915, viii, 146.

commander of the local army corps. It is in this man's power to facilitate private work or to make it difficult, and, since most of the younger and more progressive men are at the front, the army commander is sometimes a man with little appreciation of the cripples' wider needs.

There has, at times, been friction between in- dividual military commanders and the volunteer agencies in their districts. The War Department is fully awake to the harmful effects of this state of affairs and, on December 27, 1916, issued the following decree ^ looking to more complete co- operation :

The problems of vocational advice, re-education and placement can be solved by the military authorities only by constant and systematic cooperation with the civilian agencies for the care of war cripples. It should, therefore, not be left to the discretion of the local mili- tary hospital authorities, whether vocational advisers should be permitted in the hospitals or not; there should be a regular understanding on this point with the central care committee. . . The military author- ity must accord every possible support to the upbuild- ing and the intensive growth of the civilian cripple work because, after demobilization, the further social care of our war cripples will fall entirely on these civilian agencies. In preparation for that time, these agencies must be placed in a position to discharge their heavy task with the greatest possible success.

The organization of the volunteer work, as reported at the Berlin meeting, varied greatly with the different parts of the empire. Germany is divided into twenty-six states, the largest of which, Prussia, has twelve provinces, each larger than many of the other states. Roughly, it may be said that the eastern part of the empire is the more sparsely settled agricultural section and the western the populous industrial section. The degree of development of schools, hospitals and institutions for social welfare differs according to the character of the individual states and according to their location.

Though the Imperial Government had taken no part whatever in the organization of re-edu- cation work, the governments of the various Ger- man states and of the Prussian provinces had

' Leilsalze uber Berufsberatung und Berufsausbildung. Berlin, 1917, p. 20. (Reichsausschuss der Kriegsbeschadigten- (ilrsorge. Sonderschriften, Heft 2.)

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sometimes assumed responsibility. The work thus organized falls under three classifications:

1. Work financed and directed entirely by the state government.

Bavaria stands alone under this head. The whole work is financed and managed by the state under the Ministry of the Interior, assisted by an advisory committee of representative citi- zens. The various government officers through- out the state are the officers of the cripple welfare work and each one has an advisory committee of local people to help with the actual case work.

2. Work initiated and directed by the govern- ment but with private cooperation and support.

Under this head fall all but one of the Prussian provinces, including more than half of Germany. The head of a Prussian province is called the Landeshauptmann. In almost every case, the Landeshauptmann formed a special care commit- tee with himself at the head, and the local com- mittees all over the province were subordinated to this central authority. The plan was to use, to the full, all existing provincial institutions, such as schools, almshouses, and hospitals. The funds were furnished by the province, but with the understanding that the State of Prussia and, ultimately, the Imperial Government, must take over the burden.' The City of Berlin assumed the responsibility for its own cripples on the same understanding.^ In August, 1917, there was formed a central organization for all Prussia.

3. Work initiated and financed by private agen- cies but with government cooperation.

This is the plan in Saxony, Baden, Wiirtem- berg, the Thuringian states, Hesse, Waldeck, and the Prussian province of Hesse Nassau which has joined forces with the last two.^ In Wiirtem- berg, the Minister of State issued the call for organization but left the actual work to private societies; in Hesse, Hesse Nassau, and Waldeck, the whole organization was volunteer, the state governments taking only the most passive cog- nizance of it.

In all these divisions of the empire, no matter what the chief authority was, there were local

' Korrespondenzfiir Kriegswohlfahrlspflege, Berlin, 191S, i. 69.

* Zeitsckrift filr Kriippelfiirsorge, Leipzig, 1915, viii, 290.

' Zeitschrift fiir Kriippelfiirsorge, Leipzig, 1915, viii, 67; 1916, ix, 24. Korrespondenz fiir Kriegswohlfahrlspflege, Berlin, 191S, i, 69.

organizations in almost every town. In these local committees, whether they were the real directors of the work as in Hesse, or only advisory bodies as in Bavaria, the agencies represented were usually the same. They comprised repre- sentatives of the municipality, the local Bezirks- commando (military district command), the acci- dent insurance associations, the Red Cross, the women's clubs, the employers, and, with varying frequency, the Chamber of Commerce, the Chamber of Trades, the Chamber of Handwork, and the unions. The arrangement was a Haupt- fiirsorge organization (general committee) com- posed in this way and representing the whole state or province, and under it Filrsorgestellen (local offices) in the various towns. In the very small places, individual men would represent the cripple work. By August, 1916, it could be reported that Germany was thoroughly covered with a network of such organizations.' They were, of course, not all of equal efficiency, since the social conditions and the facilities differed greatly in the different states. In Westphalia and the Rhine, which are thickly settled indus- trial provinces, the arrangements are excellent; in Mecklenburg, which is agricultural and con- servative, reports showed very scant progress. The efficiency of the whole organization depends on the enthusiasm and ability of the different individuals concerned in the work. There have been complaints in the papers that the Fiirsorge- stelle in some localities exists only in name or that the local representative is an uneducated person unable to discharge his responsibilities.

PRESENT ORGANIZATION

The unsystematized character of the whole work soon began to present difficulties. The Prussian provinces, having organized their work with a good deal of formality, felt the need of common standards for the whole country and, as early as September, 1915, called a meeting of representatives of the cripple work to discuss a common organization. At this meeting, the Reichsausschuss (National Committee) was formed. The committee consists of one repre-

• Verhandlungsbericht iiber die Tagung fiir Kriegsbeschddig- tenfiirsorge in Koln, Berlin, 1917, p. i, 20. (Reichsausschuss der Kriegsbeschadigtenfursorge. Sonderschriften, Heft i.)

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sentative each from all the states of the empire. The twelve Prussian provinces have only one representative, but they meet beforehand to select him and to agree on their policy. Coop- eration of the Reichsausschuss with the Imperial Government is secured by the presence of a commissioner appointed by the Ministry of the Interior. . . The Ministers of the Interior of each of the separate states may also send repre- sentatives if they are not otherwise in touch with the work. This makes the Reichsausschuss an extremely large body. Its actual work, however, is done by an executive committee consisting of thirteen representatives chosen equally from the north, the middle, and the southern states, and from the City of Berlin. Its president is Dr. von Winterfeldt, Landeshauptmann of Branden- burg.

The duty of the Reichsausschuss is to co-ordi- nate the work of the various organizations and to make investigations and plans for future work. It has published sets of guiding principles for vocational advice, re-education and land settle- ment and for the general work of the local com- mittees. All doubtful matters and questions of policy are referred to it. It has sub-committees to investigate and report plans in the following fields : Legal action, cooperation of local commit- tees, finance, publicity, statistics, medical treat- ment, vocational advice and re-education, place- ment, land settlement and housing, families of war cripples.' It also is the medium through which any funds contributed by the Imperial Government are distributed. So far, these have consisted only in one grant of five million marks which is almost negligible compared with what the private organizations are spending.*

III. MEDICAL TREATMENT

The responsibility for medical treatment, as stated above, is exclusively the province of the Imperial Government, as represented by the War Department. All hospitals where wounded soldiers are treated, whether for first surgical care or later convalescent care, are under mili-

' Verhandlungsbericht iiber die Tagung fur Kriegsbeschddig- tenfiirsorge in Koln, Berlin, 1917, p. 21-26. (Reichsausschuss der KriegsbeschadigtenfUrsorge. Sonderschriften, Heft !.)■

' Zeitschrift fiir Kriippelfiirsorge, Leipzig, 1916, ix, 139.

tary authority and discipline. These hospitals fall into two divisions, not according to function, but according to management.

The first type is that called Reservelazarett, Festungslazarett or Garnisonlazarett (reserve hos- pital). In these the staff are all regular army men or civilians recently elevated to army rank, and the hospital is financed by the war office and devoted entirely to the care of wounded soldiers.' The second is called Vereinslazarett (affiliated hospital). These are private hospitals which have put at the disposal of the War Department sometimes their whole plant and sometimes merely a certain number of beds. In such cases, the hospital continues to manage its own finances and is under the direction of its regular staff, but the War Department puts in a representa- tive who is responsible for the discipline of the soldiers received. The Department may also assign army men to act as teachers at their regular army pay, and a good many crippled officers and non-commissioned officers are em- ployed in this way.

There is an informal understanding between the military authorities and the Vereinslazaretten, which are often specialized orthopedic hospitals and cripple homes, that the department will try to send men to hospitals which are in their home district or which specialize in the treatment of their particular injuries. If the disposition can- not be made at first, the department arranges to transfer men ultimately, so that they will get the benefit of specialized care. The department pays the Vereinslazaretten 3.50 marks a day for each wounded soldier received.

There are no reports of the total number of orthopedic hospitals in Germany. Dr. Schwien- ing, chief medical officer of the Gardekorps, Berlin, in February, 1915, made the following statement: "On the tenth day of mobilization, there were about 100,000 beds in the Reserve and Vereinslazaretten at the disposal of the mili- tary authorities and this number doubled in a short time. . . In countless hospitals, we had, at our disposal, medico-mechanic and other apparatus for physical and hydrotherapeutic cure. We had also military convalescent hos- pitals and sanitaria for mechano- and hydro-

' Zeitschrift fiir Kriippelfiirsorge, Leipzig, 191 5. viii, 53.

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therapy. . . The greatest specialists, if they were not already at the front, were appointed consulting experts at the military hospitals." He gave the following figures as to the number of medico-mechanical institutions at the disposal of the War Department, according to military districts. Each district is designated not geo- graphically, but by the number of the army corps under whose authority it falls.

Gardekorps

Army Corps No. II

Army Corps No. X

Army Corps No. VI

Army Corps No. XI Army Corps No. VII

Army Corps No. XIV

Berlin

Rhein Westfalen

24

7 15

21 plus 7 hydro- therapeutic

8 80

134

There are places in 107 sanitaria reserved for soldiers.^ These figures would seem to apply both to Reserve and Vereinslazaretten but are obviously not complete, since there are thirty- two army corps districts in the empire.

These Vereinslazaretten, temporarily united under government service, are of the most vari- ous kinds. Germany had paid a great deal of attention to the care of cripples, even before the war. There had been developed, during fifty years' experience, fifty-four cripple homes, rang- ing in size from six beds to three hundred. Some of them were already taking adults as well as children; they had among them 221 workshops, teaching fifty-one trades. Dr. Biesalski, secre- tary of the Vereinigung Jtir Kruppelftirsorge gives a list of 138 establishments belonging to the Vereinigung and caring for war cripples. Some of these, however, are only out-patient clinics.

Another agency which had promoted the study of the care and training of cripples was the Ger- man system of social insurance. Under the in- surance laws, there are two agencies responsible for the care of industrial cripples. The Kranken- kassen (sick-benefit societies) to which employers contribute one-third and employees two-thirds, take charge of a workman for the first twenty- six weeks of illness. After that, the Berufsgenos-

' Zeitschrift fur Kruppelftirsorge, Leipzig, 191S, viii, 142.

senschaften (employers' accident insurance asso- ciations) support him for the rest of the time, or in case of permanent invalidity. This support means both medical care and sick payments. The medical care may be given either in the patient's home or in a hospital, and the injured man is obliged to accept the kind of treatment offered or forego his privileges.

As a consequence, both Krankenkassen and Berufsgenossenschaften have excellent hospitals. Particularly the Berufsgenossenschaften, which have charge of the men for longer periods and are more concerned with cripples than with mere cases of sickness, have made a special study of the physical and mental training of industrial cripples. Preparing a man to resume his trade was to their advantage, since it relieved them of the necessity of paying him a permanent pension.

At the outbreak of the war, cripple homes, Krankenkassen, and Berufsgenossenschaften all offered their hospitals to the War Department, as Vereinslazaretten and the municipalities offered their hospitals and almshouses. Beside this, the Red Cross established some orthopedic hospitals in localities where there seemed a lack, and pri- vate individuals and charitable institutions did the same. The result was a fairly complete net- work of orthopedic homes distributed all over the empire, to which men could be sent for final intensive treatment. Dr. Leo Mayer, recently of the Orthopedic Hospital Am Urban, Berlin, states that there must be at present about 200 such institutions and that it may confidently be said that Germany's facilities for giving ortho- pedic treatment to crippled soldiers are quite adequate.

PROCESS OF TREATMENT

The principle upon which the orthopedic treat- ment proceeds is that practically every cripple can be made fit to work again. This attitude is assumed by all the German writers, in contrast to the French, who make much more conserva- tive estimates. It appears to be a definite public policy to assume as an article of faith that rehabilitation is an absolute success and that dis- cussion is superfluous. Dr. Biesalski states that from ninety per cent, to ninety-five per cent, of all war cripples treated are returned to industrial

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life. Dr. Leo Mayer says that of 400 treated at the hospital Am Urban, only two were unable to go back to work.

The time of treatment for a man in the ortho- pedic hospital is from two to six months. Men are kept here until they are ready to go back to the army or are pronounced definitely dienst- unfdhig, unfit for service. Even if they are so unfit, the War Department does not discharge them until they are pronounced by the physician physically fit to go back to civil life. It some- times happens that a man has a relapse after discharge or that a further, expensive treatment might improve his condition. In this case, the military authorities take no responsibility and private charity must attend to him as a civilian.

FACILITIES

There is great enthusiasm in Germany over the advances made in orthopedic treatment, and it is certain that the best hospitals are excel- lently equipped. The arrangements at Niirn- berg, for instance, include an operating room, a room for making plaster casts, an X-ray machine, hot and cold baths, massage, electric and medico- mechanical treatments of all sorts. To what ex- tent all the hospitals are supplied with modern orthopedic devices cannot be ascertained. There has been some complaint in the papers that the remoter hospitals have very incomplete arrange- ments and that the great demand for orthope- dists leaves some places unsupplied. New short courses for orthopedists have been put in at some of the medical schools and there is an enthusi- astic effort to meet the lack; also there is wide publicity on the subject which tends to bring the poorer hospitals up to the standard.

More and more emphasis is being placed on physical exercise as a means of strengthening the stump and also the remaining limbs and of bringing the physical condition back to the standard. The plan is that a man shall begin very simple but systematic physical exercises even before he is out of bed. These are gradually increased until finally he has two or three hours a day under a regular gymnasium instructor. In many places, physical directors from the public schools and universities have volunteered their services and act as part of the regular hos-

pital staff. Turnvereine, or athletic clubs for adults, are very common in German towns and these often have a gymnasium or an athletic field which they turn over to the cripples. Most of the larger towns have public parks and swim- ming pools which they place at the disposal of the hospitals. Games and outdoor sports are found to have an immense therapeutic value, both psychological and physical as compared with medico-mechanical treatment.

At Munich, at the Konigliche Universitats- Poliklinik and the Medico-mechanische Ambu- latorium, 2,000 wounded men receive regular physical training. The Oscar-Helene Heim, Ber- lin-Zehlendorf, reports as part of its regular training for one-armed and one-legged men, ball playing, spear throwing, bowling, shooting, and quoits.' The sports at Ettlingen include work on parallel bars for one-armed men, and hand ball and jumping for one-legged men, besides regular calisthenic exercises pursued in the open. At the one-armed school at Heidelberg, Dr. Risson reports club swinging for one-legged men, a con- test with the horse between the one-armed and one-legged, standing high jump for the one- legged, putting the shot by the one-armed, also ball throwing and hand ball for the latter, the stump being used as well as the good arm. The third army district (Niirnberg) 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 outdoor sports.* Swimming is also being empha- sized. In Berlin, cripples have been given free entrance tickets to the public swimming pools. Their swimming is supervised and no one allowed to go into deep water until the instructor is sure of his ability. On a day when forty cripples, mostly with arm and leg injuries, made their first attempt, all of them were able to swim without help. In a swimming gymkhana organized later, two legless men competed among the others.*

' Zeitschrift far Kriippelfiirsorge, Leipzig, 1915, viii, 19-22. * Vom Krieg zur Friedensarbeit, Berlin. 191 7, iii, 26-27. ' Vom Krieg zur Friedensarbeit, Berlin, 1917, iii, 28.

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There is a movement to arouse popular inter- est in this branch of cripple welfare. The Deutsche Reichsausschuss fur Leibesubungen has supplied medals at hospital contests.* Local care committees encourage 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, Mannheim, and Kiel.'

Trade training, even when given in the hos- pital, is under civilian auspices and will be dis- cussed later. Many hospitals, however, even when they do not attempt to train a man to a trade, have a workshop or two attached for pur- poses of functional re-education. In such a case, manual training is counted as part of the medical treatment and is managed by the hospital under military authority, though occasionally, as at Diisseldorf, the care committee of the district sends 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 em- phasis 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.

IV. ARTIFICIAL LIMBS

All artificial limbs are furnished and kept in repair by the government, 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 orthopedist selects the limbs for his own patients. The War Department has prescribed certain maxi- mum 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 ofificial supervision exercised, and the matter is left to the doctors and engineers of the country.

• Vom Krieg zur Friedensarbeit, Berlin, 1917, iii, 27.

^ Zeilschrift fiir Kriippelfursorge, Leipzig, 1917, x, 220-225.

The result is an immense stimulation of ac- tivity. 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 thirty kinds of artificial arms and fifty legs in actual use.^ The Orthopddische Gesellschaft (Ortho- pedic Society) has devoted much discussion to the matter and there has been wide education and publicity.

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 pos- sible. The prostheses usually supplied to crip- ples answer this definition. The legs are very like the old-fashioned peg leg; the arms are some variation of jointed rod with an arrange- ment 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 ortho- pedic workshop as part of their vocational train- ing equipment, and these make their own limbs or at least prostheses for temporary 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 twenty attachments suitable for all the ordinary operations of life, such as eating, dressing, etc., and a wooden hand for street wear. The number of attachments can be added to at will to suit

' Die Versorgung der Kriegsbeschadigten. Wien, 1917, p. 10.

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any trade. The arm is easily made and its parts can be had at any factory.^

Rota Arm. Made at the Rota Works, Aachen, after designs by the engineer FeHx 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.'

Siemens- Schuckert Arm. Made by the Sie- mens-Schuckert Works, Niirnberg, after designs by Dr. Silberstein, of the Royal Reserve Hos- pital, 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 particularly in the Niirnberg carpentry shops with great success. It has a carefully worked-out set of attachments fitted especially for carpentering.*

Riedinger Arm. The invention of Professor 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.*

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.'

The two Schonheits or Sonntags arms (decora- tive arms) made are the Schiisse arm, Leipzig, and Carnes arm, an American patent purchased by a German firm. The Schiisse arm is a perfect imitation of the human arm, entirely useless and purchased only by wealthy cripples as an extra

2 Ulbrich, Martin. Die evangelische Kirche und die Kriegsbeschadigten. Giltersloh, 1917, p. 16.

' Ulbrich, Martin. Die evangelische Kirche und die Kriegsbeschadigten. Giitersloh, 1917, p. 16.

* Ulbrich, Martin. Die evangelische Kirche und die Kriegsbeschadigten. Giitersloh, 1917, p. 16.

' Ulbrich, Martin. Die evangelische Kirche und die Kriegsbeschadigten. Giitersloh, 1917, p. 16.

' Ulbrich, Martin. Die evangelische Kirche und die Kriegsbeschadigten. Giitersloh, 1917, p. 17.

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 Professor 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 lock- smith 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.

The Keller claw was invented by a farmer, August Keller, and consists 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.*

The makes of artificial leg have not been so standardized. The general principle on which they are made is that of simple construction and swift repair. Orthopedists have given up the effort to get much foot movement and the usual plan is an unjointed 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.'

INVESTIGATION AND PUBLICITY

All these prostheses are in use, each one being popular in its own neighborhood or in some

' Ulbrich, Martin. Die evangelische Kirche und die Kriegsbeschadigten. Giitersloh, 1917, p. 18.

» Ulbrich, Martin. Die evangelische Kirche und die Kriegsbeschadigten. Giitersloh, 1917, p. I7-

• Ulbrich, Martin. Die evangelische Kirche und die Kriegsbeschadigten. Giitersloh, 1917, p. 18.

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particular trade. In February, 1916, the Ver- band 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 combining the qualities of lightness, cheap- ness, and working usefulness. There were eighty- two entries for this contest, sixty of which ful- filled the entrance requirements. The ideal arm was not found and the first prize remained unre- warded, but the second and third prizes went to the Jagenberg and Rota arms described above and small sums were awarded to the various other entries.^"

The prize entries were on view for three months with very good educational results. The Society then decided to establish a permanent Priifungs- stelle (test station) for artificial limbs, which was opened at Charlottenburg in February, 1916. The station is a small workshop where about ten cripples who are skilled mechanics can be em- ployed at once and give a thorough working trial to any prosthesis. Up to August, 1916, the station had tried out sixteen arms, three hands and four legs and had had under investiga- tion nineteen arms and five legs. The station has been empowered by the medical department of the Gardekorps, the local military authority in the Berlin district, to advise all cripples under its supervision as to prostheses. To August, 1916, 345 cripples Jiad been so advised." 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.

V. RE-EDUCATION

In the German system, the functions of voca- tional 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 locality.

Although vocational advice in fact precedes re-education, it is more convenient, in this study, to take it up second, since its discussion necessi-

'" Zeilschrift fur Kruppelfilrsorge, Leipzig, 1916, ix, 190. " Zeitschrift fiir Kruppelfiirsorge, Leipzig, 1917, x, 41-42.

tates a knowledge of the re-educational possi- bilities.

The chief thing to be noted about re-education 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 J 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 possi- ble moment of convalescence, and second, the fact that, since the Imperial Government does not pay anything toward re-education, 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 main- tenance. 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, 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, where 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 possi- ble 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 Bezirkskommando (district commandant) and of the hospital director. In view of the pro- fessions made by the War Department, it is the understanding that this will always be forthcom- ing. Different hospitals have complained of a certain amount of friction, but this is only in details and in individual cases. As a rule, the

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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 rrien can be assigned by the director to dif- ferent 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 agri- cultural school at Kortau, it has been possible to assign crippled officers as instructors and the discipline is entirely military.

NURNBERG

The Nurnberg 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 re-education problem exclusively within its own walls, but works in close connec- tion with the city schools.

The Nurnberg hospital has 900 beds. It occupies three new hospital buildings, turned over to the military authorities by the City of Nurnberg and furnished with all the modern orthopedic equipment. The school facilities include a large-sized piece of land and twelve workshops, the latter fitted up with machinery and tools, which are the gift of private manu- facturing 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 instruc- tion in the schools of Nurnberg, and practical shop work in the hospital workshops. The cur- riculum is as follows:

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

1. Left-handed writing.

2. Improved writing with right hand.

3. Typewriting.

4. Stenography.

5. Commercial course.

6. General course for industrial workers.

7. Farm bookkeeping.

8. Theoretic course for the building trades (car-

penters, locksmiths, etc.).

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 fore- men 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.

10. 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.'

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 Nurn- berg, Munich, Marfeld, and Gorden, are the chief examples. The cripple homes, of course, already had their equipment, and Nurnberg and Munich are in Bavaria where the state govern- ment finances the cripple work and a larger outlay is possible. Gorden may possibly be an exception but reports of its work are not at hand. Other hospitals managed in this way are in 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 instruction takes place in the local trade schools. There are excellent facili- ties for this, since every town has at least one

» Kriegsinvalidenfursorge. Darstellung der in Nurnberg getroffenen Massnahmen. Wurzburg, IQIS. P- 1-45-

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trade school. Some representative of the educa- tion 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 varying kind, public and private, from agricultural and commercial schools to profes- sional 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 Dusseldorf, where there are fifty hos- pitals, the committee has taken entire possession of a school building equipped with shops and tools and gives twenty 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 Ger- man institution.

The instruction in institutions of the outdoor type is not under military discipline; the ar- rangement of the school with the hospital authori- ties is a purely informal one. The hospital director gives the men permission to be absent during certain hours to attend school; the school reports to the director whether or not they attend. Attendance is not compulsory and men cannot be punished for misbehavior, but the school reserves the right to refuse such pupils as seem idle or subversive of order. This generally is discipline enough.

The War Department has a 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 hos- pital 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 complete 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 dis- missed, 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.

DUSSELDORF

The Dusseldorf school, which has issued the fullest report obtainable, offers the following curriculum.^

A. General Education.

1 . Preliminary course. o. Civics.

b. German — writing, grammar, etc.

2. Manual training (as preparation for trade train-

ing).

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 draughtsmen.

6. Commercial course.

7. Course for railway and postal employees and

lower positions in civil service.

a. Office work.

b. Telegraphy.

8. Course for store clerks.

9. Agricultural course.

10. Course in handicraft as preparation for journey- man's and master tests.

' Gotten, Karl, und Herold. Dtlsseldorfer Verwundeten- schule. DUsseldorf, 1916, p. 7-8.

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C. Practical Trade Courses with Shop Work.

1 1 . Electrical work.

12. Metal work.

13. Carpentry and cabinet work.

14. Locksmithing.

15. Stone masonry and carving.

16. Graphic trades (printing, lithography, etc.).

17. Bookbinding, cardboard, and leather work.

18. Painting and plastering.

19. Upholstery and decorating.

20. Dental laboratory work.

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 paying the premium, sometimes they are sent for shorter periods on payment of a small tuition fee. This system is followed for individuals at Dusseldorf and much more at Cochum. Otherwise, it is an expedient 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 Germany of the standard of Nurn- berg and Dusseldorf. Others noted in the appendix are referred to, but full reports of them are not available. 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 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 standard.

SCHOOLS FOR ONE-ARMED

It is recognized in Germany that the one- armed man has the greatest handicap, and spe- cial arrangements are made for his training. Besides exercises and instruction in the hospitals, there are schools for the one-armed at Stras- burg,= Baden Baden, Heidelberg, Munich, Wurz- burg, Kaiserslautern, Ludwigshafen, Nurnberg,

* Korrespondenz jur Kriegswohlfahrtspflege, Berlin, igib- ii- 35-

Erlangen, Frankfurt a. M., Hanover, Dresden, Chemnitz, Dusseldorf.

A school for the one-armed means, as a rule, special courses for one-armed men given in the regular city schools where the men will after- ward be taught a trade. The purpose of these courses is to exercise the stump and the remain- ing members of the one-armed man until he is in a position to take up trade-training beside others less seriously crippled. The course in- cludes instruction in the ordinary acts of life which are made difficult by the loss of a hand, such as eating, washing, dressing, tying knots, using simple tools. Six weeks is said to be enough to put a one-armed man in condition to go on with regular training. A great part of the teacher's duty is to convince the men that these things are all possible and need only a little practice. For this purpose one-armed teachers, preferably industrial cripples who have worked out their methods by long practice are the most useful, though crippled officers have already found employment in this way at Nurnberg, Dusseldorf, and Berlin-Zehlendorf.

An essential part of the course is left-handed writing for those who have lost the right arm. This is necessary, whether or not they are to have a clerical occupation, both for removing the feeling of helplessness and for giving the hand greater flexibility and skill. German teachers have made a scientific study of this question and state that left-handed writing can be made as legible and characteristic as right- handed. Samples of left-handed writing from Nurnberg show excellent script after from twelve to twenty lessons.

Left-handed drawing, designing, and modelling are often added as a matter of functional re-edu- cation. Men with clerical experience are taught to use the typewriter, sometimes using the stump, sometimes a special prosthesis, and sometimes with a shift key worked with the knee. All the schools put great emphasis on physical training. In the school at Heidelberg, under a regular gymnasium instructor, the men do almost all the athletic feats possible to two- armed men.

Dr. Kunssberg, of the Heidelberg school, states that he has made a list of one hundred

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occupations suitable for the one-armed man. He gives the following conclusions drawn from his own experience:

1. One-armed men are, as a rule, able to continue with their old trade. Of those at Heidelberg, only five per cent, were obliged to take up another.

2. The best opportunity for the one-armed man is in narrower specialization within his own trade. For example, the carpenter can take up polishing and wood inlay, the tailor can become a cutter, etc.

3. The most important point is for employers to re- arrange their work so as to reserve for one-armed men the places they are able to fill.

There have been several textbooks written on the subject of the one-armed man and left- handed writing. The best known are: Von Kiinssberg, Einarmfibel (Braun, Karlsruhe); Dahlmann, Ube deine linke Hand (Essen); Graf Gaza Zichy, Das Buck des Einarmigen (Deutsche Verlagsanstalt, Stuttgart and Berlin, 1915).

AGRICULTURAL SCHOOLS

A special efTort is being made to return to the land all who have any connection with it, such as farmers, farm laborers, and even handworkers of country birth. In districts like East Prussia, almost all the wounded come from country dis- tricts, and fifty per cent, from agricultural occu- pations.^ It is felt that to allow these men to be diverted from their original work by the war, would be a serious loss to the country. There- fore, there is wide publicity on the advantages of agricultural life, and it is part of the duty of the care committees to encourage interest in it among the wounded. The suggestion has even been made in Bavaria, that cripples from the country districts should be separated while in hospital from the city men, so that they will run no danger of being estranged from their old interests.*

All the hospitals which have any land give courses in farming and gardening for their in- mates.* It is estimated that there are several hundred such hospital farms, small or large, run by the wounded. In addition to this, there are

* Der Kriegsbeschadigte in der Landwirtschaft. KOnigs- berg i. Pr., 1916, p. 27.

» Zeitschrift fiir Kruppelfursorge, Leipzig, 1916, ix, 157-164. ' Zeilschrift fiir Kruppelfursorge, Leipzig, 1917, x, 235.

definite summer farm courses at agricultural schools and universities, which are free to crip- ples. East Prussia, alone, has eight such special- ized courses in different branches of farming, such as dairying, bee-keeping, forestry, a course for farm overseers, etc' There are in the empire ten regular agricultural schools for war cripples, which are listed in the appendix. The largest appears to be the farm at Struveshof, Berlin, which accommodates 200 and trains cripples as farm teachers. The one of which the fullest description is obtainable is that at Kortau in East Prussia, which accommodates at present only fifteen pupils.

The farm at Kortau is under military disci- pline and serves as part of the reserve hospital at Allenstein, two kilometers away. All patients at Allenstein who come from agricultural occu- pations are immediately transferred to Kortau, that they may be in surroundings which will encourage them to go back to farm work, and that they may have orthopedic exercises and prostheses specially suited to them. The in- struction consists of two courses — a preliminary course of four weeks, and an advanced course, the duration of which is determined by the man's physical condition and the time of his discharge from the army. Work is divided into three classes :

1. Work done primarily with the hands and arms: digging, shovelling, wood-chopping, sowing, planting, mowing, hoeing, raking, threshing, and the care of the necessary tools for these occupations.

2. Work where horses are used : plowing, harrowing, driving, and the operation necessary for the care of horses — harnessing, foddering, etc.

3. Exercises over rough ground and obstacles for men with leg injuries.'

It would appear that the instruction is of the simple type useful for small farms, and that the matter of farm machinery and its adaptation to the war cripple had not been gone into. The chief need is to fit the small peasant farmer to go back to his own holding, where he may, with the help of his wife and children, manage truck-

' Der Kriegsbeschadigte in der Landwirtschaft. KOnigs- berg i. Pr., 1916, p. 12.

» Der Kriegsbeschadigte in der Landwirtschaft. KOnigs- berg i. Pr., 1916, p. 27-41.

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gardening or poultry-raising. Most of the courses serve this sort of purpose. There seem to be few large scale farms in Germany, and though Maier-Bode, in his article, 'Einrichtungen der Kriegskriippelfiirsorge fiir die Landwirt- schaft',' mentions a dozen or more occupations possible for cripples on large estates, very few of these have anything to do with machinery. A publication issued by the provincial govern- ment of East Prussia '" calls attention to the possibility of the use of electric motors by peas- ant farmers, but limits its suggestions to small scale operations. Apparently, the schools aim to give only a background of farming theory and a certain amount of efficiency in the opera- tions performed by hand.

To this smaller field, however, a great deal of inventive thought has been applied. Teachers in the various schools have been very ingenious in contriving tools with modified handles which can be gripped with a prosthesis or a stump, and extra straps and hooks to be attached to the clothing for aid in balancing tools. Friederich Maier-Bode in his book gives examples of ways in which cripples of every kind can manage all the ordinary operations of a farm." The same author strangely urges that crippled farm work- ers shall learn, in addition to farming theory, a handicraft which they can practise at home, thus doubly assuring themselves against helplessness.^^

VI. ATTITUDE OF THOSE CONCERNED TOWARD RE-EDUCATION

TEACHERS

The teaching in all schools is very largely vol- unteer. That does not mean that it is unskilled, for there are a large number of trade and other school teachers, craftsmen, and invalided officers, who are willing to give their services. The National Teachers' Association has passed resolu- tions to this effect. Where the committee has funds enough, as at Diisseldorf, a staff of tech- nical teachers is paid. At other places only one

' Zeitschrift fiir Kriippelf&rsorge, Leipzig, 1916, ix, 157-164.

'■" Der Kriegsbeschadigte in der Landwirtschaft. Konigs- berg, 1916.

" Der Arm- und BeinbeschSdigte in der Landwirtschaft. Leipzig, 1917.

'2 Zeitschrift fiir KriippelfUrsorge, Leipzig, 1916, ix, 157-164.

or two are paid and the others donate their services for half time. Employers often donate the services of a foreman for half the day. The War Department helps by assigning invalided officers and non-commissioned officers who hap- pen to have experience in some particular line, to act as instructors of farming, architecture, etc. The make-up of each school staff is, in this way, a matter of chance depending on the funds of the committee, the suitable volunteers in the locality and the personnel at the command of the local military commander.

This does not seem to make for as much lack of system and training as is usual where an insti- tution relies on volunteers. The fact that the care committees and the volunteers are almost all people who hold public positions, and the military spirit which pervades the empire, seem to make for a rigid system and a high standard of efficiency in the schools. The esprit de corps, the unanimity of the workers as shown in every report, is striking.

ATTITUDE OF MEN

Reports point to very little difficulty met with among the men. This is due to the fact that they are partly under military discipline and also to the very early beginning of schooling before 'pension psychosis' has time to get a foothold. The appeal made to them is a patriotic one, to the effect that no man is a worthy citizen of the Fatherland who has not the will to overcome his handicap. Much literature has been published on the subject, the motto being 'Der Deutsche Wille Siegt!' (The German Will Conquers!) One gathers also, from the reports, that the semi- official position of the volunteer teachers and care committee members, who are mostly from the official and the educated classes, makes the whole system more or less a class matter and causes the wounded soldier to accept the plans of his superiors without question.

ATTITUDE OF EMPLOYERS

The attitude of German employers has always been a very paternal one. The large firms appear to have had, for some time, a benevolent policy toward their employees and have furnished them with a great many material conveniences, such

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as baths, rest rooms, model dwellings, etc. These same large firms have been among the leaders in the war movement and have made many spectacular donations to war relief, to the widows and dependents of soldiers, etc. In the matter of trade training, the large employers have also taken a prominent place. As a matter of fact, the duty of helping the war cripple back to civil life has become a patriotic issue and any employer who did not publicly show his coopera- tion would suffer considerably. Therefore, most of the large firms can be counted on not only for donations to re-education of money, apparatus, and trade teachers, but for an actual share in the work on a large scale.

Many firms have made experiments toward re-training their own crippled employees. The firm of Friedrich Krupp, at Essen, has a hospital on its own grounds to which its former employees are transferred from the military reserve hospital for final orthopedic treatment. While at this hospital, they work as many hours a day as they are able, under medical supervision, in a special shop built for re-education purposes. They re- ceive, while working, a minimum payment of ten marks a month, and anything they make which can be used is paid for at regular piece- work rates. When their training is complete, a place is made for them in the shop. Cripples who were not former employees are also trained whenever there is room for them.^ The Electric Accumulator Works, at Oberschonweide, Berlin, has a similar hospital and shop.^ Most others do not have hospitals, but receive men while at the orthopedic hospitals for training in their works, which thus constitutes a re-education school. These firms are: Phoenix Works, Dus- seldorf; Northwest Group of the Association of German Iron and Steel Industries, Diisseldorf; Siemens-Schiickert, Siemenstadt, Berlin;' Emil Jagenberg, Diisseldorf; Rochlingen Bros., Volk- ingen a. d. Saar.* In all these cases, the men

• Zeitschrift fur Kriippelfiirsorge, Leipzig, 1917, x, 56-60.

' Verhandlungsbericht iiber die Tagung fur Kriegsbeschddig- tenfiirsorge in Koln. Berlin, 1917, p. 113. (Reichsausschuss der Kriegsbeschadigtenfursorge. Sonderschriften, Heft i.)

' Zeitschrift fur Kriippelfiirsorge, Leipzig, 1917, x, 291-299.

• Verhandlungsbericht iiber die Tagung fiir Kriegsbeschadig- tenfursorge in Koln. Berlin, 1917, p. 113. (Reischsausschuss der Kriegsbeschadigtenfursorge. Sonderschriften, Heft i.)

live at the hospital and go daily to the shop, working under the supervision of a doctor fur- nished by the employer. In the case of Siemens- Schiickert, the military authorities place an officer in the factory to take charge of discipline, though this is not always done.

Smaller employers help in different places by taking men as apprentices by arrangement with the local care committee.

INSURANCE ASSOCIATIONS —

The help given to training by state and im- perial insurance offices must be counted as help given by employers since, under the law, it is they who furnish most of the funds for these institutions. By the German social insurance laws, employers in any branch of industry all over the empire are required to form Berufsge- nossenschaften (accident insurance associations), which attend to the payments and the medical care for the men injured in that industry after the first thirteen weeks of invalidity. These Berufsgenossenschaften have large funds obtained by taxation of members, for the care of industrial cripples and the prevention of invalidity. They are supervised in each state by the Landesver- sicherungsanstalt (State insurance office) and in the nation as a whole by the Reichsversicherungs- amt (Imperial insurance office). The insurance officers are allowed, by the law, to spend their funds not only for the care of individual cases, but for any general measures which are for the health of the community. In accordance with this, they have, in different states, voted large sums for orthopedic hospitals, for re-education and even for loans to cripples and for land settle- ment. Money thus contributed by the state insurance office may actually be considered as money contributed by employers.

ATTITUDE OF WORKMEN

The attitude of the workmen toward the re- education of cripples is not so unanimous as that of the employers. This will be taken up more fully under the head of placement. It may be generally stated that the attitude of the handi- craft workers, whose standards are protected by law and who, therefore, have nothing to fear from the inroads of unskilled labor, is cordial;

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that of the unions, consisting of mostly machine workers, is less so.

The representatives of labor who have given the most cooperation to the re-education of cripples have been the Chambers of Handwork. These are a distinctly German institution, in force only since the revision of the Gewerbeord- nung (the industrial code) in 1897. By former provisions of the industrial code, there existed Chambers of Commerce and of Industry {Han- dels- und Gewerbekammern) . They were elected bodies from among the merchants and the indus- trial workers of a locality which were recognized by the state government and acted to it in an advisory capacity wherever the interests of com- merce and industry were concerned. In some districts, the Chambers of Commerce and Indus- try were represented by a single body, in others, where conditions seemed to call for it, by two.

This left the smaller industries, where a man conducted the manufacture and sale of his own goods, unrepresented- Most of these small in- dustries fall under the head of handwork and the men engaged in them are members of hand- workers' guilds.

There still persist in Germany Innungen (handi- craft guilds) which are lineal descendants of the guilds of the middle ages. They are possible in any trade, such as brace making, butchery, bak- ing, which uses only simple tools worked by hand power and where the worker sells his prod- uct straight to the consumer. There is no set line as to which trades have guilds and which have unions; it is a matter of chance development, though the guilds are comparatively few in num- ber and unimportant compared to the unions. The guilds have set rules for membership; they establish a standard length of apprenticeship and tests for the successive stages of journeyman and master workman. A man who passes the master workman's test sets up for himself, is recognized by the guild and has a definite standing before the public.

With the spread of large scale industry, these guild regulations were suffering and it was feared that some useful handicrafts would lapse. Therefore, when the industrial code was revised in 1897, there was included in it the Handwerker- gesetz (Handwork Law), which established the

Handwerkskammern (Chambers of Handwork). Their members are chosen from among the handi- craft workers, both guild members and union members, and their function is principally to regulate apprenticeship and the journeyman's and master's tests. There is now one or more of these chambers in every state and Prussia has thirty-three. The Handwerkskammern, in all parts of Germany, have- been of great help to the re-education schools, and, more than that, they have undertaken an active propaganda to urge cripples to learn a handicraft and to become master workmen. This they do without injury to themselves, since the amount of training nec- essary for the master's test is fixed and there is no danger of a cripple becoming eligible for the guild unless he is perfectly competent to main- tain its standard. Also, handwork is dying out and it would be of advantage to the guilds to recruit their numbers. Beside this, although some master workmen take work as foremen in large establishments, most of them set up for themselves and there is very little danger of wage reduction. However, the Chambers of Handwork have made real concessions. At Diis- seldorf, Bochum, Niirnberg, Liibeck, Hanover, and in Lower Saxony, they have modified the master test so that its requirements will not mean the usual expense and physical labor. At Diisseldorf, the Chamber has ruled that time spent in the cripple school shall count in the necessary time of apprenticeship. The Chamber of Handwork in Prussian Saxony, in cooperation with the provincial care committee, has estab- lished special bureaus of vocational advice for handworkers. Their purpose is to advise a man as to his chances for becoming a master work- man and to see that he gets to the proper re-edu- cational school. Spokesmen for the handicraft workers urge that the crippled worker shall be encouraged to settle on the land where he can combine a handicraft with raising his own food.

ATTITUDE OF UNIONS

The unions have not come out so strongly in favor of re-education. In really well-planned schools, like that at Diisseldorf, there is a union representative on the care committee but the complaint is often that the care is a class affair

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and that labor is not represented nor consulted in the re-education plans. This comes out more strongly when it is actual placement rather than training which is being considered.

VII. VOCATIONAL ADVICE

COOPERATING MILITARY AND VOLUNTEER AGENCIES

Vocational advice is the first of the civilian functions in the care of the war cripple. There has been such wide publicity that every care committee understands that its duty in urging the cripple to a trade begins as soon as the man is well enough to be visited in hospital. This demands a certain amount of cooperation with the local military authorities who censor the visits made to the men. The usual arrangement is that certain men should be appointed by the care committee to serve in a volunteer capacity as advisers and that their appointment should be sanctioned by the local military command. These men make regular visits to the hospitals and take the names and the necessary informa- tion about each new cripple in preparation for advising him as to re-education. Some com- mittees have blanks worked out on which these facts are recorded. (See appendix.) In some places, there is no regular visitor but the hospital doctors and nurses are asked to fill out these blanks. In others, the committees have a large sub-committee consisting of experts in various trades which deal with the whole question of vocational advice.

At the beginning, with such a large body of voluntary workers there was some complaint that many of the advisers did not possess the necessary experience. At present, there has been a good deal written on the subject and the adviser's work has been well defined, so that there seems an improvement. Also schools have been opened in two cities to furnish them with a brief course of training.

As a matter of fact, the principle is fast held to that a man must, if humanly possible, go back to his old trade, or, failing that, to an allied one. This narrows the scope of vocational advice and makes it rather vocational urging. The real requirement would seem to be that the adviser

shall be an enthusiastic and reliable person who would act as a sort of publicity agent for the school and convince the cripple that he will find through it the means of getting back to his old work. Vocational advice, though in point of time it comes before re-education, is so dependent on the re-education possibilities in the different localities, that the description of it here can best follow that of re-education. Vocational advice is almost always the function of the local care committee. The general rule of the military authorities is to send a man for his final, long, orthopedic treatment back to his home district and the committee in this district is, therefore, better acquainted with labor conditions and with the background of the men.

The practice of the committees is to send repre- sentatives to the men in hospital as soon as they are well enough to be visited to get full facts on their experience and their physical condition and then advise them as to re-education or immediate work. The military hospital authori- ties demand that anyone allowed to visit the men be approved by the local military commander. This approval is sometimes given in writing and the visitor receives a regular appointment, at other times it is more informal. The war ofiice has, however, given instructions that district commanders shall cooperate as much as possible. (Kriegserlass.)

Vocational advice is managed with more or less efficiency according to the locality. In some localities, such as those of the eighth and eigh- teenth army corps, the committee requests the doctors to consult with the men in hospital, to fill out blanks and furnish them with the nec- essary advice.'

In others there is a special sub-committee of the care committee, consisting of educators and trade experts, which visits the hospitals in a body or holds sittings there. This is the plan in Freiberg, Breslau, Strasburg, and in Grand Duchy of Hesse. ^ The plan most often followed is that of having, as vocational advisers, indi- vidual men with knowledge of trade conditions

' Zeitsckrift fUr Krilppelfilrsorge, Leipzig, 1916, ix, 98. Korrespondenz fiir Kriegswoldfakrtspflege, Berlin, 1916, ii, 141.

» Zeitschrift fur Krilppelfilrsorge, Leipzig, 191S, viii, 45, 267, 290.

I

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and an ability to win the cripples' confidence. These men are, as a rule, volunteers and from the upper classes, but the realization is growing that they must have special qualifications in order to be efficient. Short courses have been opened in two cities for men who wish to take up this service. There were, in January, 191 7, four hundred vocational advisers serving in Berlin. Individual men are appointed also in the whole province of Brandenburg,^ in West- phalia,* in Bavaria,* and in Baden,* and many places in Saxony. Instructions issued to the vocational advisers in Leipzig (Saxony) by the local committee read as follows:

1. It is the task of the vocational advisers to seek out

such soldiers as are likely, as a result of their wounds, to be hindered in the use of their limbs and to advise them.

2. The vocational advisers will be informed by the

committee in what hospitals, military or associate, such visits are desired. It is desirable, when visit- ing, to get in touch with the physician in charge or the head nurse.

3. The aim which the vocational advisers should hold

before them is: a. To combat the discouragement of the wounded

men by showing them what cripples have

already been able to do. h. To inform themselves as to the cripple's personal

circumstances and his trade experience.

c. To obtain employment for the soldier with his

former employer or at least in his former trade.

d. To arrange for the cure of hindrances to move-

ment of the limbs resulting from wounds by orthopedic or mecano-therapeutic treatment.

e. To arrange, if necessary, for the education of the

wounded man in another trade which is suited to him. /. To place the man in the new trade.

4. As a preparation for this task, the vocational ad-

visers are recomended

a. To read the publications issued by the committee for their instruction.

h. To visit the Home for Crippled Children in Leip- zig.

c. To visit the Zander Institute of the Leipzig Local Sick Benefit Society.

> Zeitschrift fiir Krilppelfiirsorge, Leipzig, 1915, viii, 263. * Zeitschrift fiir KriippelfUrsorge, Leipzig, 191S, viii, 103. ' Zeitschrift fiir KriippelfUrsorge, Leipzig, 1916, ix, 173. ' Zeitschrift fiir Kriippelfiirsorge, Leipzig, 1916, ix, 24.

d. To keep in constant touch with the members and the officers of the Leipzig Committee for the Care of War Cripples.'

VOCATIONAL ADVICE BY MILITARY DEPARTMENT

The war department has recently made some efforts to deal with this question, which was, at first, left entirely to civilian initiative. Each reserve battalion has now a Fiirsorgeabteilung (welfare division) whose primary duty is to assist men about to be dismissed in the settlement of their pensions. In some commands, this de- partment is very active and takes up the matter of vocational advice or even placement with the men under its authority. Where there is an active care committee, the welfare department generally turns most of the actual case work over to it, but in small places, such as a few of those in East Prussia, the welfare department is very active. The war department, in its decree of December 27, 1916, says, in relation to these departments :

In order to avoid confusion, it may be stated that the military bureaus for vocational advice established in certain mihtary districts are expected to work toward the same goal as the civilian agencies and in complete coop- eration with them. It is recognized that, owing to their recent growth, these bureaus are still very faulty; they can best be promoted by a constant exchange of opinion between the military authority and the central care committee.*

VIII. PLACEMENT

PLACEMENT AGENCIES

The problem of placement is much simplified by the German creed that a "man must go back to his former trade and, if possible, to his former position." This makes placement more a matter of re-sorting and fitting a man into the niche reserved for him than of studying possible new combinations. Although the creed is uniform, there is no uniform machinery for putting it into practice. The agencies to which a cripple may turn are five:

1. The care committee.

2. The public employment bureau.

' Zeitschrift fiir KriippelfUrsorge, Leipzig, 1916, ix, 97.

■ Leitsatze iiber Berufsberatung und Berufsausbildung. Berlin, 1917, p. 20. (Reichsausschuss der Kriegsbeschadigten- fUrsorge. Sonderschriften, Heft 2.)

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3. Government service.

4. Employers' and workmen's associations.

5. Miscellaneous charitable and private initiative.

CARE COMMITTEES

The care committee, though the least definitely organized for placement purposes, is generally the agency which comes first in question. To the care committee belongs the routine duty of making connections with the former employer. Many cases are settled in this way without further difficulty. The agent for the care com- mittee is the vocational adviser who interviews the man in hospital. Often he has communicated with the employer before the cripple begins his training and has found exactly what further education is advisable for that particular posi- tion. All committees go as far as this in the matter of placement. If the old employer is unable to make a place for the man, some of the committees immediately turn him over to an- other agency, generally the public employment bureau. Other committees, with more funds and a wider scope, run employment bureaus of their own. The care committee of the Rhine province, an industrial and mining locality, has a system of employment bureaus all over the province, affiliated with the local care commit- tees. The committee of the Province of Silesia has one employment bureau which serves the whole province. In other cases, the care com- mittees do not have separate offices for employ- ment, but attend to it from the regular care committee office for the district, along with vocational advice, pension information, relief, etc. As an example of a care committee employ- ment bureau, that of Heilbronn in Wurtemberg may be cited. This committee, from November, 1915, to March, 1917, had 656 applications, out of which 246 men were placed.' The Dortmund committee, in Westphalia, had 592 applications and placed 165, while seventeen got places for themselves after training provided by the com- mittee.^ Even when the care committees do not place men, a good many duties devolve on them in connection with employment, because many

^ Zeilschrift fur Kruppelfursorge. Leipzig, 1917, x, 126. » Korrespondenz fiir Kriegswohlfahrtspflege, Berlin, 1916, ii, 35.').

public works or government offices will not take on a new man until his local care committee has certified that he is unfit for his old work. This means giving a great deal of responsibility to the care committee. In places which have a repre- sentative and efficient committee, it is a good plan, but in small places where the committee is represented only by one man, there is room for favoritism and unfairness. Complaints in the papers have stated that the decisions are influ- enced by class prejudice and have made this a reason for asking that the whole cripple care system be put under government control.

PUBLIC BUREAUS

Germany has a regular system of public em- ployment bureaus supported by the municipali- ties. The bureaus in each state or province are united under a state or provincial directorate, and the directorates in an imperial federation. Some of these bureaus had, before the war, spe- cial divisions for the handicapped and others are now forming them. It is advised by the Imperial Committee for the Care of War Cripples that the whole matter of placement should be left to these public bureaus and that no new agencies should be established.' This has not yet been done, however, and there is still argument as to whether cripples are best placed by the public bureau or a private one and whether their place- ment should be handled separately from that of the able-bodied.

In a numer of the states, the public bureaus are handling the placement of war cripples, handed over to them by the care committees after placement with the old employer has been found impossible. These states are: Bavaria, Brandenburg, Grand Duchy of Hesse, Hesse Nassau, Baden, Saxony and Anhalt. In Bavaria, where the whole work for cripples is under the state government, each district has a special bureau for cripples, affiliated with the public employment bureau. The other states and provinces handle the work through the regular employment bureau, which keeps a special de- partment, or at least a list of positions, for war cripples.

' Verhandlungsbericht ilber die Tagung filr Kriegsbeschddig- lenfilrsorge in Koln. Berlin, 1917. (Reichsauschuss der KriegsbeschadigtenfUrsorge. Sonderschriften, Heft I.)

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PUBLIC BUREAU REPORT

The report of the public employment bureau of Berlin, Province of Brandenburg, which has a special division for cripples, is as follows:

August I, igis, to December i, jqi6 Applications received . . 2,700 Positions available . . . 2,000 Positions filled 1,400

Of these 1,400, 730 were followed up after they went to work, and the report is not so en- couraging. One hundred and forty-five changed their position eight times before the time came for discharge or renewal of contract; forty-five stayed one week; twenty-nine stayed two weeks; twenty-seven, three weeks; twenty- two, four weeks; forty- two, over a month; twenty- two, two months; and thirty-five, three months. {Norddeutsche Allegemeine Zeitung, February 3, 19170

Work is done here and there by individual bureaus in states and provinces which have not taken over the work as a whole. In East Prussia, an agricultural district, the provincial govern- ment has established a farm employment bureau at Konigsberg. In Strasburg, Alsace, the mu- nicipal bureau takes care of cripples and has an arrangement with the Fifteenth Army Corps commandant by which they can be employed in the military clothing workshops.

GOVERNMENT SERVICE

The Imperial Government has, of course, an enormous number of positions at its disposal, since the railways, as well as all the post office and civil service positions are included. The gov- ernment has already promised that all former employees in any of these lines will be re-em- ployed, if not in their old capacity, in a kindred one. These men, according to instructions from the Imperial Chancellor, are to be paid without consideration of their pensions. This is a new departure, since government pay, in civil service positions, was always subtracted from the amount of the pension.^ The promise, however, decidedly reduces the number of possibilities for the ordinary cripple.

* Korrespondenz fur Kriegswohlfahrtspflege, Berlin, 1916, ii, 157-

The post office department has decided to give all future agencies and sub-agencies in the rural districts to war cripples, provided they are fit for the positions and want to settle on the land.

Germany has the difficulty found in other countries with untrained men who feel them- selves entitled to government positions, and she has taken measures to guard against it. The Imperial Post Office has directed the postal officials in all the states to follow the example set in the Rhine Province and refuse employ- ment to war cripples unless it is certified by their local care committee that they are unfit to go back to their old occupation. In minor civil service posts, no new man is accepted without a certificate, either a Zivilversorgungsschein (civil- ian care certificate) or an Anstellungsschein (place- ment certificate). The Zivilversorgungsschein guarantees a man employment or support in case no position is vacant. It is issued only to men who have had twelve years' honorable ser- vice.^ The Anstellungsschein is given to other non-commissioned officers or privates who are certified by their local care committee as being unable to take other work but it does not guar- antee that they will be accepted and, if not, they have no indemnity payment.'

CITY GOVERNMENTS

The city and other local governments also make every effort to take in cripples, but their possibilities are small. In many places, such as Freiberg, they exercise an indirect influence by refusing to give city contracts to firms which do not re-employ their own injured workmen, or even new crippled men for whom they have room.' In Niirnberg, a foreman is not allowed to discharge a war cripple without bringing the case before a committee of the city, appointed to see that justice is done in such cases.' In general, the city governments also are obliged

^ Korrespondenz fiir Kriegsitiohlfahrtspflege, Berlin, 1916, ii, 89.

89.

' Korrespondenz fUr Kriegswohlfahrtspflege, Berlin, 1916, ii,

' Korrespondenz far Kriegswohlfahrtspflege, Berlin, 1916, ii, 124.

» Verhandlungsbericht ilber die Tagung filr Kriegsbeschddig- tenfiirsorge in Koln. Berlin, 1917. p. 178. (Reichsausschuss der Kriegsbeschadigtenfiirsorge. ISonderschriften, Heft i.)

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to protect themselves. Most of them will not consider an application for work from a war cripple unless the care committee certifies that he cannot resume his old trade.

mittees and government officials all over the country. The Prussian War Ministry publishes a similar bulletin, Anstellungsnachrichten (Em- ployment News).

WAR DEPARTMENT

Aside from these regular government employ- ments, there are special employments due to the war and under the war department. The army workshops at Coblenz' and Kassel '" employ dis- charged crippled soldiers to work on shoes, clothing and saddlery. At Danzig, unskilled men are taken and given regular training as at a re-education school. It has been recommended that the other army corps commanders adopt this plan and employ only war cripples in the workshops under their command.

A military announcement of March 17, 1917, asks that all crippled soldiers should be turned, as much as possible, to civilian work at the rear, such as that of airplane mechanics, blacksmiths, etc. The men formerly employed in these capac- ities were retained under army discipline and given army pay, which is much less than civilian pay. The war office now promises that they will be retained in a civilian capacity and will retain their pensions. '^ It also promises that, after the war, every effort will be made to get these men back to permanent civilian positions.

The war department has recently established a Versorgungsabteilung (welfare department) in every reserve troop where invalided men are sent while awaiting discharge. This department is supposed to facilitate their return to civil life through advice about re-education or employ- ment. In cases where there is no very active local care committee, this department communi- cates with the former employer and even at- tempts some placement activity, but the plan is so new that not much is reported of it so far.

The war office publishes twice a week a jour- nal, Amtliche Milleilungen (official information), which gives the positions open for war cripples. All advertisements from employers are accepted free and the paper is distributed to care com-

* Zeilschrift fur KrUppelfUrsorge, Leipzig, 1916, ix, 332. " Korrespondenz fiir Kriegswoklfahrlpflege, Berlin, 1915, i, 170.

" Zeitschrift fUr KrUppelfUrsorge, Leipzig, 1917, x, 125.

IX. ATTITUDE OF THOSE CONCERNED TOWARD PLACEMENT

ATTITUDE OF EMPLOYER

One of the most active agencies in placement is the employing class. As has already been men- tioned, the re-employing of crippled workmen has been made such a patriotic issue and Cham- bers of Commerce, city governments and news- papers espouse it so violently, that no employer who could possibly make a place for his crippled workmen would dare refuse to do so. Many of the largest firms, such as Krupp and Siemens- Schuckert not only re-employ their former work- men, but retrain them. Krupp guarantees them the full amount of their pension for five years, even though the government should reduce it on account of increased earning capacity.

The large employers' organizations have also put themselves on record in favor of re-employ- ing cripples. Such are the Nordwestliche Gruppe des Vereins deutscher Eisen- und Stahl-Industri- eller; the Verein fur berghauliche Interessen; the Gesamtverband deutscher Metallindustrieller; the Verband deutscher Steindruckereibesitzer; the Deutscher Arbeitgeberverband ftir das Baugewerbe; and the Bayerischer Industriellerverband}

There has recently been formed a national association, the Vereinigung deutscher Arbeit- gebeverbdnde (Union of German Employers' Associations), whose aim is to promote the em- ployment of cripples. This is a federation of seventy-five different trade associations, employ- ing between them two and a half million work- men. This association puts placards in all the hospitals, stating its willingness to employ war cripples and directing them to apply for work to the associations belonging to it.^ The names of these associations representing principally the metal-working trades are listed in the appendix.

The federation states, as its belief, that the reinstatement of crippled workmen is a matter

' Zeitschrift fur KrUppelfUrsorge, Leipzig, 1916, ix, 243. 'KorrespondenzfUr Kriegswohlfahrtspjlege, Berlin, I9i5,i,is.

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which concerns the employer alone and it does not consult the unions in any of its measures.'

These are general measures, but there are smaller associations which take much more definite ones. Many trades have employment bureaus of their own where any workman for- merly employed in that trade may apply and be reinstated if not with his old employer, with another in the same line. Such bureaus are run by the Verband deutscher Diplom-Ingenieure, Deutsche Kraftfahrerdank, Offenbacher Leder- warenindustrie* and the very large steel combin- ation, Rhein-Westfalische Industrie and Nord- westUche Gruppe des Vereins deutscher Eisen- und Stahl-Induslrieller. The former of these last two placed to June, 1916, 5,002 war cripples; the latter, to the same date, 2,200.^

The merchants have not taken such a promi- nent stand as the manufacturers but their rep- resentatives have also expressed themselves pub- licly in favor of reinstating all crippled employ- ees. The problem here is not so much the objection to crippled former employees as to the inrush of new, uneducated employees. Mer- chants are very definite in warning against this and insisting that war cripples must have a thorough commercial course before they can apply for any sort of clerkship.* To this end, the Prussian Chamber of Commerce has directed the commercial schools to work closely with the care committees, so that their courses can be made of real use.

ATTITUDE OF WORKMEN

The attitude of the workmen toward the re- employment of cripples has not been cordial. Here again, we may distinguish between the handworkers proper and the industrial workers. The master guilds among the handworkers have held out every encouragement to cripples to set up for themselves as independent master work- ers. An association has been formed to lend

» Zeitschrifl fiir Kruppelfilrsorge, Leipzig, 1916, ix, 244.

* Zeiischrift fiir Kriippelfiirsorge, Leipzig, 1916, ix, 46.

^ Korrespondenz fur Kriegswohlfahrlspfiege, Berlin, 191 7, iii,

33.

Verhandlungsbericht iiber die Tagung fiir Kriegsbeschadiglenfiir- sorge in Koln. Berlin, 1917, p. 114. (Reichsausschuss der KriegsbeschadigtenfUrsorge. Sonderschriften, Heft i.)

• Zeitschrifl fiir Kriippelfiirsorge, Leipzig, 1916, ix, 595.

money to returned handworkers and to their wives while they are away, so that the small business may be kept up. There is a committee in Wilmersdorf, Berlin, for the care of returning handworkers and small shopkeepers and there are other such committees in the Rhine Province. The Handwerkskammern in Prussian Saxony and Hanover have agreed to try to find work for crippled handworkers. All this is for the advan- tage of the handworkers, since their craft is in danger of dying out and they are glad to strengthen it by new recruits and public interest. They combine their friendly efforts with propa- ganda for keeping up the standard of the master test.

The unions find themselves in a different posi- tion. There are three different types of union in Germany and they will have to be distinguished, since they do not all take the same attitude: (i) The Hirsch Duncker unions are the old con- servative organizations composed of skilled workmen. They have no poHtical affiliations and seldom strike. (2) The Christian unions are Catholic organizations in the nature of benevo- lent societies, who also have very little political interest. They are very systematically organized and maintain advice offices for members all over the country. (3) The socialist unions are of two sorts, the free local unions and the free cen- tral unions. These latter are the newest and are more akin to syndicalist organizations (known popularly as the 'yellow' unions).

The attitude of the Hirsch Duncker union is friendly, if not over cordial. The Christian unions are active in favor of placement of crip- ples. Their union advice offices combine help for war cripples with the regular work ; they have erected schools for the re-education of their own men and others; they accord their wounded members full sick pay and they have subscribed largely to all war relief work.^ The federation of Christian unions has established an employment bureau in Berlin for reinstating their own mem- bers in industry.*

The socialist unions are the ones which have shown the least sympathy. The situation is such

' Korrespondenz fUr Kriegswohlfahrispfiege, Berlin, 1916, ii, 22.

' Zeitschrifl far Kriippelfiirsorge, Leipzig, 1916, ix, 351.

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that any open expression of hostility would lay the objector open to charges of lack of patriot- ism. The socialist unions, therefore, protest their interest in their fellow workmen, but they object to the volunteer organization of the work which, in their opinion, makes it a class matter. Their representatives have demanded in the Reichstag that it be handed over to the Imperial Government, but without result. At a meeting at Cologne, held August, 1916, at which all types of union, except the yellow, were represented, the following resolution was passed:

The workers and employees of Germany take the liveliest interest in sick and crippled soldiers and have always taken part in war cripple welfare work, especially that of the National Committee.

The work for war cripples, which will be of the greatest economic importance, especially after the close of the war, must, first of all, have the confidence of its beneficiaries if it is to be effective. This confidence can only be won if the proper conduct of the work is guar- anteed by an organization established by law. Since the cripple welfare work is still without such an organi- zation, the representatives of the workmen's and em- ployees' organizations of Germany, assembled in Cologne, August 23 to 25, demand its regulation by national law.'

A meeting of the workmen's and employees' unions of Brandenburg came to the same con- clusions. {Vorwdrts, April 12, 1917.)

There is also complaint that the workmen's representatives are not asked to serve on local care committees, or when they are asked that they have no active part in the work. The 'yellow unions' have been loudest in these objec- tions, and it is obvious that there is a distinct attitude of hostility between them and the em- ployers in the whole matter. At the meeting of the National Committee in Cologne, Herr Mijnchrath, factory superintendent, stated:

If employers and workmen are to be active in such care committees, they must be inspired by mutual con- fidence. But confidence between employers and the members of the aggressive type of unions has so far vanished that there can be no further talk of it.'"

' Verhandlungsbericht Uber die Tagung fiir Kriegsbeschddig- tenfursorge in Kbln. Berlin, 191 7, p. 122. (Reichsausschuss der KriegsbeschadigtenfUrsorge. Sonderschriften, Heft 1.)

" Verhandlungsbericht iiber die Tagung fiir Kriegsbeschadig- tenfUrsorge in Kbln. Berlin, 1917, p. 129. (Reichsausschuss der KriegsbeschadigtenfUrsorge. Sonderschriften, Heft I.)

ARBITRATION BOARDS

There has been no open discussion of the possi- bility that wage standards will be reduced by the entry of cripples into industry. The assump- tion has been that this will not occur and the contrary has not been proved. In this matter, however, the unions have made a very sage move. Instead of protesting about the employ- ment of cripples, they have championed the establishment of Arbeitsgemeinschaften arbitra- tion boards in each trade which shall decide on the wages of each cripple on his individual merits.

These boards are to be composed of equal numbers of employers and workmen, sometimes with a neutral president. The unions have been striving to get such arrangement as this for other purposes for a long time. At present, it would seem from their attitude that they consider it the best policy to push the formation of arbitra- tion boards and to strive to make them perma- nent after the war. It would seem likely that their campaign to be represented on local care committees may be in part a political move toward this end.

The arbitration board idea has been very suc- cessful in Berlin, where there are boards in the following industries: woodworking, breweries, stone masonry, building trades, saddlery and leather work, transporting, coal dealing, express companies, textile work.'' The woodworkers and printers ^^ have organized arbitration boards on a national scale.'^ Also the war office has constituted such boards in war industries such as metal work. This is a trade where there was formerly no cooperation at all between employ- ers and employees.

The arbitration board idea has a certain amount of public approval. In a few towns, public contracts are not given to firms which do not abide by their decisions.

ATTITUDE OF CRIPPLES TO EMPLOYMENT

There are no statistics to show to what extent the ideal of the volunteer workers is realized

" Zeitschrift fiir Kriippelfiirsorge, Leipzig, 1916, ix, 244, 191 5, viii, 289. Korrespondenz fiir Kriegswohlfahrtspjlege, Berlin, 1916, ii, 54.

" Liibecker Lazaretl Zeitung, 1916, ii, 5.

" Korrespondenz fiir Kriegswohlfahrtspjlege, Berlin, 1916, ii, III.

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and the cripple is reabsorbed into the mass of the people. Dr. Biesalski states that from ninety per cent, to ninety-five per cent, are thus reabsorbed. The general statement is made by most writers, that the difficulty of getting crip- ples settled in work is lessening very much, owing to the wide publicity employed and the syste- matic way in which the care committees get hold of the men. Figures from the provincial care committee of the Rhine Province, for June, 191 7i give the proportion of cripples who go back to work as follows: "The total number of unemployed cripples dealt with by the 43 local care committees under the provincial committee was 927. Of these, there were: willing to work, 209; work shy, 92; temporarily unfit to work, 395; permanently unfit, 231 {Pensions Gazette, 8)." (Quoted from Soziale Praxis.)

The report of the Rhine committee further gives the reasons for unemployment: "nervous disability, 20.5 per cent. ; tubercular, two-thirds per cent.; blind, 1.8 per cent.; arm amputa- tions, 3 per cent." The majority of unemployed who are willing to work are disabled in arm or leg.

As to the proportion of cripples going back to their old trade, an indication may be had from the statistics published by the committees of Coblenz and the agricultural advice office at Baden. Of the 454 applicants for work at Coblenz in two months, the percentage going back to their old trade was 89 per cent., although only 42 per cent, had so intended. At Baden, out of 204 applicants, 188 went back to their former trade, although only 95 had so intended.

MACHINES FOR CRIPPLES

A subject which may be taken up under place- ment is that of the alteration of machines to suit the use of cripples.

This appears not to have been gone into very widely. Some of the schools use an Underwood typewriter with shift key worked with the knee, and these are installed in some business offices which employ cripples. In Strasburg, the ticket chopping machines are altered so as to be worked with the foot and permit their use by one-armed ticket choppers. There are descrip- tions of a bicycle for cripples and a special

draughting board but it is not stated that these have ever been used.

The field where the most work has been done is that of farm tools. Friederich Maier-Bode, in his book, Der Arm- und Beinbeschddigte in der Landwirtschaft, and the East Prussian Care' Committee, in its publication, Der Kriegsbe- schddigte in der Landwirtschaft, give long lists of simple farm tools which can be altered as to length of handle or general shape so as to be used for cripples. The idea of using electric power for some of these simple operations is only beginning to gain place. Since the war has made fuel and kerosene so scarce, the small towns and country districts are beginning to install electricity. The Province of East Prussia is installing power plants in several places from which all the small farms in the district can be supplied. The committee recommends to peas- ant farmers the use of small electric motors for milking, milk separating, threshing, beet crush- ing, lifting heavy weights, etc. It states that on a few very large estates it is possible to use electric plows and harvesters and recommends that cripples try to get employment in connec- tion with these. It also recommends the electric motor to handicraft workers, such as butchers, locksmiths, wheelwrights, etc."

In order to avoid exploitation of cripples, a proclamation has been issued addressed to them and signed by most of the large workmen's organizations. It directs the cripples, if they find unjust conditions in the labor field, to apply to the signers for redress or placement.

ACCIDENT INSURANCE

Another question which comes up in connec- tion with employment is that of accident insur- ance. The matter of increased number of indus- trial accidents likely to occur where cripples are employed came up for discussion at the meeting of the Vereinigung filr Kriippelfiirsorge, Berlin, February, 1915. At this meeting, Herr Witowski, director of the Reichsversicherungsamt (Imperial insurance office), admitted the difficulty, but the remedy he proposed was simply further watch- fulness on the part of the accident insurance

" Der Kriegsbeschadigte in der Landwirtschaft. Konigs- berg, i. Pr., 1916, p. 108-114.

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associations. These associations, as has been mentioned, already have hospitals and re-educa- tion schools of their own and exert themselves to prevent the occurence of invalidity as far as possible so as to avoid paying the pension re- quired by the insurance law.

The attitude of employers toward war crip- ples, as has been said, must necessarily be a very liberal one and employers have not pressed this question. In a few cases, there have been dif- ficulties. Section 178 of the Reichsversicherungs- ordnung (Imperial Insurance Law) provides that where a man's working capacity is permanently lessened he may work uninsured, if the poor law authorities are caring for him. Some trades have been enforcing this provision with war cripples, but the Prussian Minister of Commerce and Industry has warned against too wide an application.'^

The Prussian War Ministry has decided that where men are discharged from the army and go to work at a trade where insurance is compul- sory, they must be insured under the provisions of the law.'' This apparently applies to all cases except those just mentioned, which are proved to be permanently injured and under the care of the poor law authorities.

There has been a good deal of discussion about the status of men still in hospital and, therefore, under military authority who go out to work in factories, whether for pay or not. The Prussian Ministry of War has decided that such work must be considered part of their medical treat- ment and that they do not come under the provisions of the insurance law, but under the Mannschaftsversorgungsgesetz (provision for troops)," and any injury to them must be the responsibility of the war department. In West- phalia, however, the care committee had so much difficulty with employers, that it arranged with an insurance company to pay the accident com- pensation in these cases.^*

INVESTIGATION OF EMPLOYMENT FOR CRIPPLES

Systematic work is only just beginning in the field of investigation as to possible trades for

'' Korrespondenz fiir Kriegswohlfahrtspjlege, Berlin, 1916, ii,

34-

" Zeilschrift fUr Krilppelfursorge. Leipzig, 1916, ix, 187-188. " Zeitsckrift fiir Kruppelfursorge, Leipzig, 1916, ix, 188. " Zeilschrift fiir KriippelfUrsorge, Leipzig, 1916, ix, 348.

cripples. The Bochum School for the wounded divides the trades taught into: sitting occupa- tions, for men with thigh amputations; half- sitting occupations, for those with amputations just above or below the knee and occupations for the one-armed. The school teaches twelve sitting occupations, nine half-sitting, four for the one-armed and twenty miscellaneous. Fur- ther details are not given.'*

The Deutscher Industrieschutzverband (Ger- man Union for the Protection of Industry), Dresden, has made a report of seventy-nine trades compatible with different injuries. The trade operations, which are not given in great detail, are such general ones as cabinet-maker, locksmith, tailor, etc.^"

The most complete piece of work which has been done in this line, is the report entitled, Lohnende Beschaftigung fiir Kriegsbeschddigte aus dem Metallgewerbe (Gainful Occupation for War Cripples in the Metal Trades), by Franz Alm- stedt (Publisher, Max Janecke, Leipzig, 1916). The author has been a teacher in the city con- tinuation school at Hanover and, since the war, teacher and vocational adviser in the hospital school. He gives a careful description of ninety- two operations in the metal trades, with an exact statement of their compatibility with in- juries from the loss of a finger to loss of both arms or legs.

X. PUBLICITY

HISTORY

Public education on the subject of proper treatment of war cripples has been very effi- ciently managed. There was, at the beginning of the war, the usual outbreak of misguided charity. The newspapers were loud in their demands for Heldenheime (old soldiers' homes), where all cripples could be maintained in idleness for the rest of their lives. Uninformed volunteer societies sprang up everywhere. But the leaders in orthopedic work immediately took up the definite task of educating public opinion.

Dr. Biesalski, the secretary of the federation for the care of cripples, made a tour of the whole

•' Zeilschrift fiir KriippelfUrsorge, Leipzig, 1916, ix, 406. ^'' Zeilschrift fiir KriippelfUrsorge, Leipzig, 1916, ix, 326.

7^

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country under the auspices of the Red Cross, speaking in all the important towns before the social workers and officials, and instructing them in the most modern principles of cripple work. The result was that the new committees, when first formed, were prepared to conduct their work in the most intelligent way, and that there was very little volunteering and subscription of money for undesirable forms of charity.

This tendency was diverted very early to an interest in re-education schools.

PUBLICATIONS

There are several regular publications which keep the social workers informed of the progress and plans of cripple work. The Zeitschrift fiir Kriippelfursorge, the official magazine of the Vereinigung fiir Kriippelfiirsorge has devoted its pages almost entirely since the war to reports on the work for war cripples. There are besides this the regular magazine of the Reichsausschuss and its special reports and pamphlets, the maga- zine of the Brandenburg care committee, Vom Krieg zur Friedensarbeit (From War to Industry) and the reports on general war work in the Korrespondenz fiir Kriegswohlfahrtspflege (Cor- respondence on War Welfare Work). These serve for the technical information of the workers but the various societies have also been at great pains to issue publications for the thorough infor- mation of the public. The Vereinigung fiir Kriippelfiirsorge has published three illustrated pamphlets by its secretary, Dr. Biesalski, in- tended to convince both the cripples and the general public of the truth of his maxim, "There is no such thing as being crippled." The books are full of illustrations and examples of the fact that cripples can and do return to industrial life. They are: Kriegskriippelfiirsorge, Ein Aufkla- rungswort zur Trost und zur Mahnung, (Work for War Cripples, a Word of Comfort and Warning), Die ethische und wirtschaftliche Bedeutung der Kriegskriippelfiirsorge und ihre Organisation in Zusammenhang mil der Gesamte Kriegshilfe, (The Ethical and Economic Significance of the Work for War Cripples and its Organization in Connection with General War Work), 'Die Fiir- sorgefiir unsere heimkehrenden Krieger, insbeson- dere die KriegskrUppel (The Work for Our Home-

coming Soldiers, especially the War Cripples). All three are published by Leopold Voss, Leipzig, 1915-

There are also several pamphlets published in the interests of agriculture, proving the ease and profit with which cripples may return to the land. Such are Der Arm- und Beinbeschddigte in der Landwirtschaft (Agriculture for Men with Arm and Leg Injuries) by Friederich Maier-Bode, vo- cational adviser at Niiremberg-Schafhof, and Der Kriegsbeschddigte in der Landwirtschaft (The War Cripple in Agriculture), published by the East Prussian care committee.^

These books are all as much to provide argu- ments and material for the care committees as for the cripples themselves. One particularly popular appeal aimed directly at the cripple is the pamphlet by Dr. Wiirz of the Oscar-Helene Heim called Der Wille Siegt (Will Conquers). This is meant for distribution in all the hospitals. It is a collection of the histories of succesful crip- ples from Tamburlaine and Frederic of Homburg down to the veterans of the present war. Re- habilitated cripples suffering from all types of injuries tell their own stories and urge their com- rades to similar courage. Its purpose is frankly to provide the stimulus of patriotism, pride and ambition, which will overcome hospital lethargy and pension psychosis. The conclusion may serve as an example of the high dramatic key in which it is couched:

A Rousing Call to War Cripples

You war cripples! Receive these stories and these living examples of the conquering power of the will as good friends into your soulsl When trouble and faintheartedness paint sinister pictures before you, do not believe the terrible spectres. Look upward, toward the victories which cor- ageous war cripples Jmve won. Listen to the message con- tained in these life battles of crippled men. Life is earnest and you have learned how hard it can be for each one of us. But do not let your working power grow rusty. Be good warriors, even on the battlefield of industry. Think not of what you have lost, look not behind you, but stride for- ward, certain of victory. If you believe in yourselves, you are planting many a victorious banner for the future. Let all that you learn become a weapon in your proud fight for independence from the help of others. Be patient as

' Der Arm- und Beinbeschadigte in der Landwirtschaft. Leipzig, 19 1 7. Der Kriegsbeschadigte in der Landwirtsciiaft, Konigsberg i. Pr., 1917.

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you practise your new knowledge. You have stUl, as you have ever had, the joy which lies in every piece of work. With every tiny success, you are building up the strength of the Fatherland. The German people needs you as much as it needs the unwounded. Dare to Will! Will conquersP

There are other pubHcations of this same nature, meant to influence the war cripple while he is in hospital and prepare his mind for the future. One such is the Liibecker Lazarett Zeitung (Liibeck Hospital Journal) published by the Liibeck care committee and distributed free to all cripples in the city. Among short bits of news about trades and pensions, it has inspiring verses and talks on the joy of suffering for the Fatherland, and each month an article on the German nature, featuring such qualities as in- dustry, courage, patience, and patriotism.

EXHIBITIONS

Exhibitions on the subject of cripple care have been held in all parts of the empire. A large ex- hibition on the care of the sick and wounded in war was arranged in December, 1914, stayed a month in the Reichstag building in Berlin and then travelled to Vienna and Buda-Pest and to all the large cities of Germany. In this exhibi- tion, a section arranged by the Vereinigung fiir KrUppelfUrsorge exhibited all the phases of re- education, model workshops, photographs of cripples at work, and samples of the product. The newspapers reported this exhibition as being crowded during the whole course of its progress. The Vereinigung fiir KrUppelfUrsorge plans to establish a permanent museum for cripple wel- fare work which shall be concerned with the care of industrial as well as war cripples.' Smaller exhibitions have been arranged by the care com- mittees in different localities with samples of the work done there, i. e., at Altona, Charlottenburg, Stuttgart, Dusseldorf, Leipzig, Potsdam, Co- logne, and Munich.

The workers in the cripple field are urging that more use be made, even than has yet been made, of slides and moving pictures illustrating the possibilities of work for cripples. These are in use for the lectures given as entertainment at the

« WOrtz, Hans. Der Wille Siegt. Berlin, 1916. > Zeitschriftfiir KrUppelfUrsorge, Leipzig, 1915, viii, Monats- blatt, 25-27.

larger re-education schools and it is urged that more of them be shown before the general public, so that the wives and dependents of cripples will realize the possibilities for them.

Through these publications, the host of volun- teer workers in Germany is kept continually in- formed as to the measures for returning cripples to civil life and is also reminded that one of the first duties of the worker himself is publicity in the instruction of the cripple and his dependents as to the possibility of his returning to industry.

XI. PENSIONS

The source of the pension provisions for non- commissioned officers and privates is the Mann- schaftsversorgungsgeselz (law of provision for troops), passed May 31, 1916. According to this, a pension is granted if a man's working capacity is reduced in any measurable degree, i. e., ten per cent, or more. Injuries which amount to less than ten per cent, are not considered; for injuries which impair the working capacity from ten per cent, to one hundred per cent., the pen- sion is correspondingly increased. Pensions are graded according to military rank. The full pension for complete disablement is, per year:

Private 540 marks

Corporal 600 marks

Sergeant 720 marks

Sergeant Major . . 900 marks

If the degree of disablement is lessened, pen- sions can be accordingly diminished. When the degree of disablement reaches less than ten per cent., pensions can be entirely withdrawn. ^

To the pension proper, there are various addi- tions :

I. Kriegszulage (war allowance), fifteen marks a month. This is paid wherever the pension is paid. If the pension is diminished, the war allow- ance remains the same. If the pension is with- drawn on account of regained working capacity, the war allowance is withdrawn.''

> Verhandlungsbericht iiber die Tagung fur KriegsbeschSdig- tenfUrsorge in Koln. Berlin, 1917, p. 29. (Reichsausschuss der Kriegsbeschadigtenfiirsorge. Sonderschriften, Heft i.) Zeilschrifl fiir KrUppelfUrsorge, Leipzig, 1916, ix, 58.

' Verhandlungsbericht uber die Tagung fur Kriegsbeschadig- tenfUrsorge in Koln. Berlin, 1917, p. 29. (Reichsausschuss der Kriegsbeschadigtenfiirsorge. Sonderschriften, Heft I.) Zeilschrifl fur KrUppelfUrsorge, Leipzig, 1916, ix, 58.

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2. Verstuntmelungszulage (mutilation allow- ance), twenty-seven marks per month. This is paid in case of serious mutilation, such as the loss of an arm, a leg, an eye, etc., or in case these members are rendered useless as by paralysis. For double mutilation, such as the loss of both legs, total blindness, etc., there is double allow- ance. The mutilation allowance cannot be with- drawn so long as mutilation exists, even though working capacity be completely regained (e. g., through the use of prostheses). It can only be withdrawn if mutilation no longer exists, e. g., if the use of a paralyzed limb is regained.'

3. AUerszulage (old age allowance). Paid to men over fifty-five years old whose yearly income does not reach 600 marks. The amount paid is the difference between the man's actual income and 600 marks.*

4. Zusatzrente (supplementary allowance) . This is a later provision not included in the Mann- schaflsversorgungsgesetz; it is paid from a special fund recently set apart by the Imperial Govern- ment for this purpose. According to a report made by the intelligence department of the Eng- Jish local government board, the German gov- ernment has promised to revise the pension sys- tem so as to take into consideration a man's for- mer earnings and not merely his military rank. This cannot be done until after the war, when more funds will be available and the supple- mentary allowance is granted as a temporary measure. The conditions under which it is granted were explained by the Prussian War Ministry, in a decree of June 15, 1917, as follows:

The allowance is granted to those who had a definite income from work before the war and who have lost it as a result of war injuries, or who had such an income in prospect and have lost it in this way. The impair- ment to working capacity must be thirty-three and one- third per cent, or more, and the applicant must show that he has made all possible efforts to get work which will make him self-supporting, and that the local care committee has also been unable to place him. The

• Verhandlungsbericht Uber die Tagung fUr Kriegsbeschadig- tenfiirsorge in Kbln. Berlin, 1917, p. 29. (Reischsausschuss der Kriegsbeschadigtenfiirsorge. Sonderschriften, Heft i.) Zeitschrifl fur Kriippelfiirsorge, Leipzig, 191S. ix. S8.

* Verhandlungsbericht Uber die Tagung fiir Kriegsbeschadig- tenfiirsorge in Koln. Berlin, 1917, p. 29. (Reichsausschuss der Kriegsbeschadigtenfursorge. Sonderschriften, Heft i.)

applicant's total income must be less than 5,000 marks per year, and must be diminished by at least one-fourth as a result of his injuries. In reckoning income, all pension allowances, except mutilation allowance, are counted. The supplementary allowance is granted for only six months at a time and is not renewed if condi- tions improve and put the man outside its provisions. The allowance is graded according to conditions. It may reach forty to forty-five marks a month.'

The authority for the granting and readjust- ment of pensions is the Ministry of War, which can delegate its authority to specially appointed boards. The amount of impairment of working capacity is determined by a military board appointed for this purpose. Its decisions may be appealed from to a higher board and finally to the war office itself. This board meets once a year to consider changes and withdrawals of pensions. No change is made except after regu- lar proceedings where impairment or regaining of working capacity must be proved.

There is great dissatisfaction with the whole pension system, which even the late concession of the supplementary allowance has not reme- died. An investigation conducted in the Rhine Province by cripples themselves revealed, ac- cording to Vorwdrts, great misery and injustice. Pensions were proved in every case to be decid- edly too small. (Vorwdrts, September 24, 1917.) The director of the Bureau for Information and Vocational Advice maintained by war cripples in Berlin makes the same statement. This bureau has complained to the Ministry of War particularly about the way in which the mutila- tion allowance is determined. (Vorwdrts, Octo- ber 26, 191 7.) It has been decided to address to the Reichstag a petition signed by as many cripples as possible and asking an increase in pensions. (Vorwdrts, September 24, 191 7.)

The newspaper Volkswille, Hanover, October 24, 1917, states that the number of cripples dis- charged without pension is so enormous that there is absolute need of some authority to settle disputes between the war department and the pension claimants. Vorwdrts, October 30, 1917, states that there are many thousand pensioned cripples in bitter need. These statements are

' Vom Krieg zur Friedensarbeit, Berlin, 1917, iii, 35. Korre- spondenz fiir Kriegswohlfahrtsflege, Berlin, 1916, 2, 156.

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33

not easily reconciled with those made by the social workers to the effect that ninety per cent, of war cripples are able to return to industrial life. There is evidently a considerable difference of attitude between the volunteer worker class and the socialist element which these papers represent.

The matter of pension revision has come up for discussion before the Hauptausschuss (head committee) of the Reichstag. It was stated at this discussion that the administration of pen- sions is much too bureaucratic and that it is absolutely imperative that the condition of veterans shall be improved. {Frankfurter Zei- tung, October 2, 1917.) It was resolved that the Chancellor shall bring before the Reichstag a proposal for changes in the Mannschaftsversorg- ungsgesetz as soon as possible, at the latest by the beginning of the year 1918. {Frankfurter Zeitung, October 2, 1917.) No report of such a proposal has been received.

The principal changes desired are, as has been intimated, the adjudication of pensions on grounds of a man's age, occupation, and family circumstances instead of military rank, and the granting of permanent pensions irrespective of changed earning capacity. A suggestion made by Dr. Siegfried Kraus, of Frankfurt, is that pensions should not be fixed until a definite time after discharge when a man has had a chance to try out his earning capacity and that, once fixed, they should be inalterable.

The capital settlement law is also criticized on grounds of its discrimination against age. As it now stands, the boy of eighteen has the best chance at a farm, while it is the man of forty who would be best able to conduct a farm, who has sacrificed most in war, and who has the least chance of finding other employment.

SOCIAL INSURANCE FOR WAR CRIPPLES

War cripples, under certain conditions, have a right to payments under the social insurance laws, in addition to their pension payments. The social insurance organization has been briefly sketched under hospital facilities. According to the Reichsversicherungsordnung (Imperial In- surance Law) of June 19, 191 1, there are three kinds of social insurance: sickness, accident, and

invalidity (including old age). The law stipu- lates that accident insurance is paid only in case of injuries occurring while the claimant was at work in one of the insured industries. Acci- dent insurance, therefore, does not come into question for crippled soldiers, but sickness and invalidity do.

SICK BENEFITS

The costs of medical care and sick payments for the first twenty-six weeks of illness are borne by Krankenkassen (sick benefit societies) authorized by the state. To these, the workmen contribute two-thirds and the employers one- third. It is not stipulated that the illness shall be caused by work; therefore, men wounded in war, if still members of sick benefit societies, would have a right to these payments. Since the war department takes charge of all medical treatment for such men, their rights would be limited to the sick payments. Membership in these sick benefit societies is compulsory for workmen engaged in most of the ordinary trades. It is usually allowed to lapse when the man is called to military service unless his family or some charitable society makes the payments for him. However, men injured in war have a right to the payments, if illness set in within three weeks of their leaving the sick benefit society or if they became voluntary members of the society beginning within three weeks of leaving the compulsorily insured trade.*

INVALID INSURANCE

Medical treatment and pension, in case of invalidity and old age, are paid one-half by em- ployers and one-half by employees. A man is entitled to them if he has made two hundred weekly payments. He must accept whatever medical treatment is offered, whether at home or in a sanitarium and must consent to re-education, prostheses, etc., or he loses his rights to a pension. A war cripple who has made the two hundred weekly payments is, therefore, entitled to the invalidity pension in addition to his pension from the war department.' As a rule, medical treat- ment does not come in question because it is

' Zeitschrifl fiir Kriippelfiirsorge, Leipzig, 1916, ix, 169. ^ Zeitschrift fiir Kriippelfiirsorge, Leipzig, 1916, ix, 171.

34

RED CROSS INSTITUTE FOR CRIPPLED AND DISABLED MEN

Series i

attended to by the war department, but, in case of a relapse after discharge or of further expensive treatment, the sanatoria of the insurance socie- ties are very useful.

Even this double possibility does not relieve the poverty among pensioned cripples. At a session of the Hauptausschuss of the Reichstag, October, 1917, it was resolved that all invalidity pensions should be increased fifty per cent, dur- ing the years 191 7 and 191 8. The weekly premi- ums were also to be increased fifty per cent. {Frankfurter Zdtung, October 2, 1917.)

CAPITAL SETTLEMENT LAW

The only important change in the pension laws resulting from the present war, was the Kapital- abfindungsgesetz (capital settlement law), of June 3, 1916. This law was the result of the combined demand for greater generosity in pensions and for some means of keeping the agricultural popula- tion on the land. It provides for commutation of part of the pension into capital payment under certain conditions. The provisions are briefly as follows :

a. Purpose for which settlement may be used: Pur- chase or improvement of real estate property, or build- ing of dwelling houses. This is interpreted to include purchase of farms, market gardens, suburban dwellings, city dwellings, improvement of houses by addition of workshops or stores, purchase of city workingmen's tenements by a number of veterans together. (The only thing definitely excluded is the purchase of build- ing of factories.) The law is intended to benefit prac- tically all the members of the working class. A large number will be induced to buy farms and gardens or to add to those they already own ; handworkers and small shopkeepers can have their own houses in the suburbs or small towns and even city factory workers can combine for improved city dwellings such as already exist in Berlin.'

h. Persons eligible : Veterans and widows of veterans between the ages of twenty-one and fifty-five, who have a right to war payments under the provisions of the law of provision for troops and of the law providing for the widows and orphans of soldiers. Payments which may be commuted, Kriegszulage (war allowance) fifteen marks per month and VerstUmmelungszulage (mutilation allowance), twenty-seven marks per month. For wid- ows, half of total allowance. Those not crippled are, of course, entitled only to war allowance.

• Vom Krieg zur Friedensarbeit, Berlin, 1917, 3, 24.

c. The pension proper may not be commuted but remains as a steady income although it may be reduced or withdrawn with increased earning capacity. The capital payment is supposed to represent the total amount which would accrue to any veteran from pay- ment for life of the two allowances in question. His probable length of life is calculated on the basis of the experience of the Imperial Insurance Office. As a result of this, a man twenty-one years old receives eighteen and one-half times the yearly total of the allowances due him; a man of thirty, sixteen times; of forty, thirteen and three-quarter times; at fifty-five, eight and one-quarter times, etc. The result is that a man of twenty-one, who was entitled to both war and muti- lation allowances would receive 9,324 marks; a man of thirty, with the two allowances, 8,190 marks; one of forty, 6,930, etc. With double mutilation, these would be correspondingly increased.

d. Conditions safeguarding settlement: Each indi- vidual applicant must prove his ability to manage the enterprise for which he proposes to use the money and its practicability. If he purchases land, he must do it through one of the real estate associations authorized by the government. If the applicant is proved later to be unable to manage his enterprise, the total payment must be refunded and he receives his monthly allow- ances instead. Sometimes the government takes a mortgage on his property to insure this.

e. Managing authority: No veteran has an absolute right to capital payment. Each application is decided on its merits by a board appointed by the Ministry of War before which the proper proofs must be brought.

GENERAL CONCLUSIONS

Social workers are extremely hopeful about the results of this law, which was passed after much discussion. Its need was greatly felt but the difficulties were the calculation of a lump sum for men of different ages (dealt with by provisions under 'c') and safeguarding against the total loss of the payment through inefficiency of the recipient (dealt with by provisions under 'c', 'd', and 'e'). The chief difficulty now will be in slowness and formality of administration, since the military boards are notorious for these quali- ties in the matter of deciding pensions.

Great activity has been stimulated among real estate associations. There existed before the war a great many land development associations of a semi-charitable character and, since the pas- sage of the law, many others have been formed with the definite object of assisting veterans

Number 13

RED CROSS INSTITUTE FOR CRIPPLED AND DISABLED MEN

35

under its provisions. Many of the states and provinces, particularly the agricultural ones like Silesia, have formed semi-official associations. There are now thirty or more authorized associa- tions listed in the appendix.

XII. ATTITUDE OF CRIPPLES

One of the most important things to be noted in connection with the re-education of the war cripple is the attitude of the men themselves. The nature of the patriotic appeal made to them and their own published testimony leads one to believe that there is great unanimity and docility among them. The whole spirit of the country would appear to be at such a high patriotic ten- sion that a measure like re-education which is urged on patriotic grounds can be certain of sup- port from every individual.

Since, however, most of the cripples to be re- educated come from the working classes, which are the least in accord with the general spirit, there is evident among them a certain amount of unrest and dissent. Pastor Ulbrich, an experi- enced worker and head of one of the oldest crip- ples homes, stands out against the claim that the injured man will go back to work as though noth- ing had happened. He feels that the idea of recompense for what they have gone through is becoming firmly rooted in the returned cripples, fostered by popular sympathy and that after the war the country must beware of a Helden- partei (hero party) composed of returned soldiers who will insist on concessions from the govern- ment.

Slight indications of something of the sort are already evident. In June, 1916, there was founded at Hamburg the Bund Deutscher Kriegs- beschddigten (German War Cripples' Union). Its object was announced to be merely mutual assistance and fellowship.' Other smaller organi- zations sprang up in different parts of the coun- try and the papers began to accuse them of socialist sympathies. It was these unions which conducted an investigation in the Rhine Province to prove the inadequacy of pensions and which maintain an office in Berlin from which a petition for higher pensions was circulated.

* Zeilschrift fur KrUppdfiirsorge, Leipzig, 1917, x, 238-239.

The interests of these unions have been grow- ing more and more political. In November, 1917, the Berlin union came to an open breach with the Pan-German party over the matter of a negotiated peace. The Pan-German party, in its propaganda for peace by conquest only, had been citing the sufferings of the war cripples and urging the country to fight to the end in order to avenge them and to carry on their work. The Berlin Verband der Kriegsbeschddigten und ehe- mahlige Kriegsteilnehmer (Union of War Crip- ples and War Veterans) called a meeting to pro- test against this action of the Pan-German party.

"The speaker," says Vorwdrts, "stood emphati- cally against the attempt of the Pan-Germans to entrap the veterans and war cripples by promis- ing them a share of the booty. Instead of that, he demanded that the social program of the union of war cripples be adopted and that all veterans should have full voting privileges."

At the close of the meeting, the following reso- lution was adopted :

We, over a thousand war cripples and veterans, in meeting assembled, men who have risked in support of Germany our health and our lives, deny to members of the German 'Fatherland Party' the right to arrogate to themselves a special measure of love for our coun- try. We protest against their quoting the veterans in support of their aims of conquest. We demand an early negotiated peace as soon as this may be done without injury to the nation. We demand that all class privi- leges be laid aside. We demand special provision for those who have sacrificed themselves at the front. (Berlin, Vonvdrts, November 12, 1917.)

APPENDIX

I

Guiding Principles for Vocational Advice and Re-education, Summary of Pamphlet No. 2 of Imperial Committee for Care of War Cripples. Carl Heymans, Berlin, 1917.

VOCATIONAL ADVICE /. General Principles

1. Vocational advice is the duty of civilian

agencies for care of war cripples.

2. These agencies should undertake vocational

advice for each cripple as a regular part of their duties, whether requested or not

36

RED CROSS INSTITUTE FOR CRIPPLED AND DISABLED MEN

Series i

3. Vocational advice must begin as early as

possible. If it has to be delayed until a man is discharged from hospital or from the army, its usefulness is much dimin- ished.

II. Preparatory Measures

4. The hospital staff can assist by preparing the

patient's mind.

5. Vocational advice is best undertaken in a

man's home district. Men should be transferred as soon as possible to the hos- pital of their home district and the local care committee should take up the matter of advice.

6. Within the territory covered by any care

committee, there should be a central office for vocational advice.

7. Trade and agricultural schools for cripples

should be organized in every district and the bureau for vocational advice should work in close cooperation with these.

///. Organization of Bureaus for Vocational Advice

8. The bureau should cover not one trade, but

the whole field.

9. It should have an experienced director with

wide industrial knowledge.

10. Experts in different trades should be called

in for all special cases.

11. Cripples should be directed immediately to

the local care committee but should be advised as to work by the vocational adviser.

12. Vocational advice must always be consid-

ered in its relation to the whole cripple problem, even in consultation with spe- cialists.

13. In large districts, the committee may ap-

point individual men as representatives in different parts of the district.

IV. Aim of Vocational Advice

14. Every cripple must be put back, if possible

in his old position, and, if this is not pos- sible, in his old trade.

15. If a cripple's physical condition is such that

he cannot follow his old trade, he must be placed in some more specialized depart- ment of that trade or educated for such a department.

16. If the cripple cannot follow his old trade or

an allied one,

a. A new trade should be found in which

labor conditions are good or for which the man is specially fitted, or

b. A trade in which a normal man would not

require all his strength or which a cripple can master with the aid of spe- cial apparatus.

17. In advising as to a trade, the effects it will

have on the man's health must be con- sidered.

18. Temporary and unskilled occupations are

to be avoided.

19. The tendency toward civil service positions

is to be opposed, because

a. The state, the municipalities and the public service corporations must keep open the places of their former employ- ees and, like the industries, cannot overload their free places with cripples.

h. Workmen and clerks accustomed to ac- tive competition in wages will not long be content with a position in which a rise in wages is impossible.

20. The hospitals and other agencies must be

prevented from educating war cripples from other trades for commercial pursuits.

21. War cripples from agricultural occupations

or handicraft workers of country birth must be encouraged to return to their old residence and discouraged from settling in the cities.

V. Vocational Advice a Continuous Function

22. Vocational advice should not be confined to

a single act. The adviser, through con- tinued friendly intercourse with the crip- ple, must win his confidence and learn to know him on the human side as well as on the economic side, must take all the factors of the situation into consideration and only then give his advice.

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RED CROSS INSTITUTE FOR CRIPPLED AND DISABLED MEN

37

23. The war cripples must be encouraged, but

their hopes must not be extravagantly raised.

24. Fears and prejudices by which the cripple is

hindered must be investigated and de- stroyed.

25. Vocational advice is advice, not command.

It is, therefore, necessary to consider the cripple's tastes and desires; he should feel that it is he who is responsible for the handling of his own situation.

26. The adviser must enter into friendly rela-

tions with the cripple's dependents or other connections.

27. Vocational advice and the measures conse-

quent upon it must be so planned that, whenever possible, the cripple's entrance into a position follows immediately on his discharge or indefinite leave of absence from the army.

28. Wherever vocational advice and placement

are not under the same management, the adviser must stand in close relation to the placement agency.

29. The scope of vocational advice must extend

beyond the war and beyond the immedi- ate activities of the care committees. Plans must be made so that cripples who need advice again later on may find it to hand.

30. With special types of injury and with spe-

cial trades, there must be special facilities for vocational advice. In any case, the work must not be done according to for- mula but must be adapted in each case to individual needs.

APPLICATION BLANK

FOR WAR CRIPPLES USED BY GERMAN LOCAL CARE COMMITTEES OF FREIBURG IN BADEN

1. Injury and prognosis.

2. Economic prospects of patient.

3. How long probably in hospital.

4. Bed-ridden or not.

(This blank is filled out immediately by the doctor and handed to local care committee which gets other facts later.)

APPLICATION BLANK

FOR WAR CRIPPLES USED BY GERMAN LOCAL

CARE COMMITTEES OF HESSE, HESSE-NASSAU

AND WALDECK

Place date

Office to which application is made

Name (first and surnames)

Born date place

County

Single, married, widower

Of what state a citizen

Place of present residence

Home address

Number of invalid card

Last employment

Name of employer

Address of employer

Length of time employed

Former employment (addresses of employers and length of time employed)

Trade learned

Certificate from re-education school or from former em- ployers

Special training or experience. Special preferences

Diagnosis

Treatment begun or in prospect. Probable duration of treatment . . . .

DECISION

Patient is unfitted for following occupations .

Patient is specially fitted for following occupations.

Will patient need special investigation, care or treatment (e. g. prostheses) and how soon will this be completed?

Doctor's remarks

Remarks on convalescent care due under military provi- sions

Remarks on convalescent care due under provisions of insurance law

Remarks on placement .

38

RED CROSS INSTITUTE FOR CRIPPLED AND DISABLED MEN

Series I

GUIDING PRINCIPLES FOR LOCAL CARE COMMITTEES

Laid down by the Reichsausschuss der Kriegs' heschddigtenfilrsorge (Imperial Committee on Work for War Cripples).

A. Persons to be cared for:

Includes all men connected or formerly connected with German fighting forces who have suffered, because of the war, any physical or mental injury which interferes with earning capacity.

B. Purpose of care committee :

To increase the ability and opportunity of the war cripple for gainful occupation. Means used may include general information, vocational advice, vocational training, placement, temporary or sup- plementary medical treatment, help in settlement on land and, if necessary, to establishing man at work, also financial aid for him and his family. In any other case, such aid is to be asked from public poor funds or charity.

C. Responsibility of care committees:

That committee is responsible for a cripple in whose district he resided before his call to arms; it remains responsible until he is definitely estab- lished in some other district.

II

CLASSIFICATION OF TEACHING FACILITIES

A. Special courses for cripples in city schools, drawing on group of hospitals.

B. Hospitals outfitted with workshops.

C. Hospitals sending men out for instruction,

but to regular schools without special courses.

D. Hospitals with rudimentary shop outfit.

Alsace-Lorraine

A. Strasburg

B. Saarbriiken C.

D.

Baden

A. Freiburg Heidelberg Konstanz

B. Mannheim

C. Pforzheim Karlsruhe Baden-Baden

D.

Bremen
A.	Bremen
B.
C.
D.
Bavaria
A.	Munich
	Augsburg
B.	Munich
	Nurnberg
	Wiirzburg
C.
D.	Passau
Brandenburg
A.	Charlottenburg
	Berlin
■B.	Berlin (3)
	Gorden
C.
D.
Brunswick
A.
B.	Brunswick
C.
D.
East Prussia
A.
B.	Allenstein
	Hindenburghaus
C.
D.
West Prussia
A.
B.	Danzig
C.
D.
Hesse (Grossherzogtum)
A.	Offenbach
B.
C.
D.
Hesse-Nassau
A.	Frankfurt
B.
C.
D.
Hamburg
A.
B.	Hamburg
C.
D.

Number 13

RED CROSS INSTITUTE FOR CRIPPLED AND DISABLED MEN

39

Hanoveb
A.
B.	Hanover
C.
D.
Rheinland
A.	Dusseldorf
	Cologne
B.
C	* Cologne-Deutz
D.
Saxony (	kingdom)
A.	Leipzig
	Dresden
B.
C.	Zwickau
D.	Dresden
Province Saxony
A.	Halle
B.
C.
D.
SCHLESWIG-HOLSTEIN
A.
B.
C.
D.	Altona
	Flensburg
Silesia
A.	Breslau
B.
C.
D.	Glatz
	Neisse
	GSrlitz
	Landshut
	Schweidnitz
	Liegnitz
	Gleiwitz
Westfalia
A.	Bochum
	Dortmund
B.	Bielefeld
C.
D.
WURTTEMBERG
A.	Stuttgart
	Heilbronn
B.
C.
D.
Mecklenburg
A.
B.
C.
D.	Reservelazarett

Totals:

A 15

B 15

C 3

D II

Not classified because of insufficient data 3

Regular cripple homes which have announced readi- ness to take war cripples but are not reported

as doing so 43

Grand total • ^o

III

re-education schools mentioned in german reports

Alsace

Strashurg. Courses for cripples in six dif- ferent city schools under care committee.

Saarbrucken. Instruction in hospitals under care committee.

Baden

Freiburg. All hospitals in city in agreement with city schools where workshops and instruction • provided for inmates for all. Instruction under direction local care committee.

Mannheim. Hospital school of Orthopedic Neurological Hospital with eight work- shops mainly for occupational therapy. Instruction directed by local care com- mittee.

Konstanz. 'Technikum', a private technical school with city subsidy conducts cripple school using its own workshops.

Heidelberg. Locksmiths' and carpenters' workshops in city thrown open for use of cripples.

Baden-Baden. Instruction in city trade schools for hospital inmates under care committee. . Karlsruhe. Under care committee.

Pforzheim. Under care committee.

Ettlingen. Trade school run by Baden state care committee using workshops of re- serve hospital.

Bavaria

All work under state government instead of care committee.

40

RED CROSS INSTITUTE FOR CRIPPLED AND DISABLED MEN

Series I

Munich. Reserve hospital Marfeld, in- struction in hospital, twenty-five work- shops, five hundred beds. Theoretic in- struction at city schools.

Munich. School instruction in building trades for inmates of all hospitals at Royal School of Building, followed by master test. Cripples, if discharged from army, receive subsidy for maintenance from state government.

Niirnberg. Reserve hospital with workshops for fifteen trades, theoretic instruction at city schools.

Augsburg. Hospital with courses in city trade schools.

Wurzhurg. Courses arranged for cripples by the Unterfrankische Ausschuss des baye- rischen Landeshilfvereins and held at dis- trict deaf and dumb institution.

Wiirzburg. Konig Ludwig Haus. Home for crippled children now a Vereinslazarett treating and instructing crippled soldiers. Shops and school in building.

Passau. Small school for crippled soldiers- Few trades.

Ludwigshafen. Instruction in city schools for crippled soldiers in metal and chemical work.

Brunsjvick

Brunswick. Hospital school with eleven shops. Hospital under military authority, instruction under local care committee carried on in hospital shops and in city schools.

Grand Duchy of Hesse

Offenbach. City technical school gives in- struction for surrounding hospitals which accommodate i,6oo. Two hundred and forty severely crippled lodged in technical school itself. Work under care committee.

Mecklenburg-Schwerin

Schwerin. Reservelazarett, basket- weaving and farming as occupational therapy under military discipline.

Hamburg

Hamburg. Marine lazarett, military reserve hospital, has workshops donated by care committee.

Prussia (Province Brandenburg)

Berlin. Brackenlazarett auf dem Tempel- hofer Felde, Workshops in hospital.

Berlin-Zehlendorf. Oscar Helene Heim. Home for crippled children, now a Ve- reinslazarett treating and instructing war cripples.

Berlin. City trade schools give instruction to inmates of all hospitals. Work directed by city.

Berlin. Kriegsbekleidigungsamt des Garde- korps. Clothing factory of Gardekorps gives instruction to discharged war crip- ples in shoemaking, tailoring, and saddlery.

Berlin. Kaiser Wilhelm Haus. Instruction for war cripples in munition work under orthopedic supervision. Private donor, military discipline.

Berlin. Frieda Hempel Heim. Small houses and gardens at cheap rent for war cripples, with instruction in gardening and handicraft.

Prussia (Province Brandenburg)

Charlottenburg. Municipal trade schools give courses either at schools or hospitals. Direction, care committee.

Charlottenburg. Test station for artificial limbs with small workshop where ten cripples can be employed at once. Only expert mechanics taken. Direction, So- ciety Engineers.

Nowawes. Oberlinhaus. Cripple home now acting as Vereinslazarett and taking war cripples. School and workshops on prem- ises.

Garden. Military reserve hospital with special orthopedic department. Twenty- five workshops, eight hundred men. Di- rection, military authorities.

Neukolln. Hospital school.

Prussia (Province East Prussia)

Augeburg. Bethesda, cripple home with eight shops and farming facilities now

Number ij

RED CROSS INSTITUTE FOR CRIPPLED AND DISABLED MEN

41'

acting as Vereinslazarett and taking war cripples for treatment and instruction.

Hindenburghaus. Cripple home with one hundred and twenty beds and five work- shops now reserve hospital taking war cripples. Direction, military authorities.

Allenstein. Military reserve hospital taking war cripples for treatment and instruc- tion. Direction, military authorities.

Konigsherg. Courses for cripples in all city schools. Direction, local care committee.

Prussia (Province Hanover)

Hanover. Annastift and Wilhelm-Augusta- Viktoriastift. Regular cripple homes with shops and school now acting as Vereins- lazarette and taking war cripples.

Prussia (Province Hesse-Nassau)

Fulda. Herz-Jesu-Heim. Cripple home with nine workshops acting as Vereins- lazarett and taking war cripples.

Frankfurt am Main. Friderichsheim. Cripple home now used as reserve hospital and entirely given over to war cripples. Four shops.

Frankfurt am Main. City technical schools give courses for cripples, either in schools or hospitals. Direction, care committee.

Kassel. Local care committee manages in- struction, partly in hospitals and partly in city schools.

Frankfurt. Institut fiir Gemeinwohl, hos- pital turned over to military authorities by local care committee. Instruction in city schools; direction, care committee.

Prussia (Province Pomerania)

Prussia (Province Posen)

Prussia (Province Rhenish Prussia)

Cologne. Courses in city schools for inmates of all hospitals. Direction, care com- mittee. Cologne. Stiftung Dr. Dormagen. Cripple home acting as Vereinslazarett and taking war cripples. Cologne-Deutz. Festungslazarett under mil- ilitary discipline, maintains cripples dur-

ing convalescence while they go out to work in the city. Direction, military authorities.

Diisseldorf. Large school for wounded in school buildings, specially donated by city, taking cripples from fifty hospitals. Direction, care committee.

Coblenz. Orthopedic Hospital School in Barmherziger Briider Hospital. Shops for occupational therapy. Direction, mil- itary authorities.

Prussia (Province Saxony)

Halle. Instruction in City School for Hand- icraft. Direction, care committee.

Prussia (Province Schleswig-Holstein)

Stellingen-Altona. Cripple home with twelve workshops acting as Vereinslazarett and taking war cripples. Flensburg. School for cripples, not de- scribed.

Prussia (Province Silesia)

Breslau. Pestalozzi School, fourteen work- shops and twenty-six business courses. Gives instruction for cripples from all surrounding hospitals; direction, care committee.

Glatz. Hospital school. Neisse. Hospital school. Gorlitz. Hospital school.

Prussia (Province Silesia) Landshut. Hospital school. Schweidnitz. Hospital school. Liegnitz. Hospital school. Gleiwitz. Hospital school.

Prussia (Province Westphalia)

Bochum. Three hospitals with shops built specially for war cripples by local com- mittee. Seven hundred and twenty pa- tients. Instruction at hospital workshops, factories in the town and trade schools. Direction, care committee.

Bigge. Josephs-Kriippelheim. Cripple home with school and shops acting as Vereins- lazarett and taking war cripples.

42

RED CROSS INSTITUTE FOR CRIPPLED AND DISABLED MEN

Series j

Dortmund. Courses in city schools for in- mates all hospitals. Direction, care com- mittee.

Bielefeld. BodelschwinghscheAnstalt. Crip- ple home with twenty-four workshops now acting as Vereinslazarett.

Prussia (Province West Prussia)

Danzig. Kaiser-Wilhelm-Haus fiir Kriegs- beschadigte. Reserve hospital with shops and school. Direction, military authori- ties.

Hakelwerk. Hospital with shops and school.

Saxony

Dresden. Courses for inmates all hospitals in City Business School, Royal School of Handicraft, Royal School of Building, Technical High School. Direction, care committee.

Dresden. Kriippelhilfe, Home for crippled children without shops. Mentioned as taking war cripples.

Leipzig. Courses in city school for manual training. Direction, care committee.

Leipzig. 'Technikum' for printers gives spe- cial courses for war cripples. Direction, care committee.

Zwickau. Courses in city schools for war cripples. Direction, care committee.

Rosswein. School of Locksmiths gives spe- cial courses for cripples. Direction, care committee.

IV. agricultural schools

Baden (2)

Villingen. Course, theoretical and practical, fifty-four men. Instruction and mainte- nance free to needy ones, to others only instruction.'

Bavaria (4)

Instruction for farmers and gardeners at Landsberg am Lech, Weihenstephan, Weitshochheim, Neustadt.^

' Zeitschrift fiir Kriippelfiirsorge, Leipzig, 1916, ix, 380. ' Zeitschrift fiir Kriippelfiirsorge, Leipzig, 1916, ix, 173.

Plankstetten.^ Thirty leg amputations, fif- teen arm.

Brandenburg (2)

Berlin-Dahlem Farm for two hundred pupils run by city at Struveshof Gorden, Re- serve Hospital. All farming authorities and officials interested. Large farm, ten pupils.

West Prussia (i)

Grosstarpen, near Graudenz. Farm gives instruction to men under treatment at Graudenz military hospital.

East Prussia

Hindenburgkaus. Courses in bee-keeping

and gardening; military discipline. Allenstein. Farm school at Kortau under

military discipline.

Hesse (i)

Offenbach . Gardens of city hospital and poor- house used for instruction.

Hanover (i)

Schullazarett, Schwanenburg, under mili- tary authority.

Posen (2)

Gartnerlehranstalt, Koschmin. Kameradenheim free,^ non military.

Prussian Saxony (3)

Bad Lauchstedt. Care station specially established to teach farming by states of Saxony and Anhalt. Has farmland and machinery.

Saxony (Kingdom)

Leipzig. Regular agricultural institute open for cripples.*

Dresden. Four weeks' course started by Landwirtschaftskammer and supported by local care committee.

* Zeitschrift fiir Kriippelfiirsorge, Leipzig, 1917. x, 324.

* Zeitschrift fiir Kriippelfiirsorge, Leipzig, 1916, ix, 41-42. ' Zeitschrift fiir Kriippelfiirsorge, Leipzig, 1915, viii, Monats-

blatter, p. 40.

Number ij

RED CROSS INSTITUTE FOR CRIPPLED AND DISABLED MEN

43

Westfalia (i)

Bielefeld. Bodelschwinghsche Anstalt, with farm and one hundred and sixteen acres of land.

SCHLESWIG-HOLSTEIN

Flensburg, Segeburg, farm schools.

Brandenburg

Konigsberg — Neumark, one year course for farmers. Institute of Chamber of Agri- culture, Brandenburg. Examinations be- fore Royal Examination Board — high school education required.

schools for the one-armed

Alsace (6) Strasburg.

Baden

Baden-Baden. Soldatenheim. Special shoe machinery for one-armed.

Heidelberg. School under Baden state com- mittee. Workshops mentioned for lock- smiths and carpenters.'

Bavaria

Munich. (No further particulars.) (8) Wurzburg. State Deaf and Dumb Institute,

courses and exercises. Kaiserslauiern. Ludwigshafen. Niirnberg. Erlangen.

Hesse-Nassau

Frankfurt-am- Main. (No further particu- lars.)

Hanover

Five masonic lodges have started one-armed school in new institution for blind; it is part of military organization; soldiers sent directly from army corps. Instruc- tion, clerical and commercial.'

35.

« Korrespondenz fur Kriegswohlfahrlspjlege, Berlin, 1916, ii,

' Zeitschrift ftir Kruppelfiirsorge, Leipzig, 1916, ix, 2S, S7S. ' Zeitschrift fiir Kruppelfiirsorge, Leipzig, 1916, ix, 173. • Zeitschrift fur Kruppelfiirsorge, Leipzig, 1916. ix, 44.

Saxony

Dresden.^" Vereinslazarett with forty beds; farm instruction at hospital; trade in- struction in city schools.

Chemnitz ((dist. xix army corps). Free courses arranged by committee in city technical and continuation schools and grammar school, also orthopedic work- shop."

Westphalia. Course at Bochum School for Wounded.^*

EMPLOYERS AND WORKMEN S ASSOCIATIONS ASSISTING IN THE PLACEMENT OF WAR CRIPPLES

I. Employers' Associations, members of the Vereinigung Deutscher Arbeitgeberverbande (Federation of German Employers' Associations) :

Federation of German Metal Manufacturers, Berlin, with twenty-four local associations.

Arbeitgeberverband fur den Bezirk der Nordwest- lichen Gruppe des Vereins Deutscher Eisen und Stahl- industrieller (Employers' Association for the District of the Northwest Group of the Union of German Iron and Steel Manufacturers) ; Headquarters, Diisseldorf, with twelve branch associations. Industrieller Arbeit- geberverband (Industrial Employers' Association), Hanover.

Arbeitgeberschutzverband Deutscher Schlossereien und Verwandter Gewerbe (Employers' Protective Asso- ciation of the German Locksmiths and Allied Trades) ; Headquarters, Berlin, with sixteen branches.

Arbeitgeberverband fiir Handel, Industrie und Ge- werbe (Employers' Association for Commerce, Industry and Trade), Konigsberg.

Ortsgruppe Stettin des Vereins der Industriellen Pommerns und der benachbarten Gebiete (Stettin Local Group of the Manufacturers' Union for Pome- rania and Environs), Stettin.

Arbeitgeberverband der Nadelindustrie von Aachen und Umgegend (Employers' Association of Needle Manufacturers for Aachen and Environs), Aachen.

Arbeitgeberverband der Zentralheizungsindustrie fiir Rheinland and Westfalen (Employers' Association for the Steam Fitters' Trade in Rhineland and Westphalia), Diisseldorf.

" Zeitschrift fUr Kruppelfiirsorge, Leipzig, 191S. Monats- blatter, p. 40. " ibid. " Zeitschrift fUr Kruppelfiirsorge, Leipzig, 1917, x, 77.

44

RED CROSS INSTITUTE FOR CRIPPLED AND DISABLED MEN

Series i

Genossenschaft selbstandiger Gold, Silber und Metallschlager fiir Dresden und Umgegend (Association of Independent Gold, Silver and Metal Workers for Dresden and Environs), Dresden.

Verband Deutscher Zentralheizungsindustrieller (Union of German Steam Fitting Industries), Berlin.

2. Workmen's Associations:

Arbeitsgemeinschaft fiir das einheitliche Angestell- tenrecht.

Soziale Arbeitsgemeinschaft der kaufmannischen Angestellten (Arbitration Board for Mercantile Em- ployees).

Deutscher Werkmeister-Verband (Union of Master Workmen).

Generalkommission der Gewerkschaften Deutsch" lands (General Commission of the German Unions). Socialist.

Gesamtverband der christlichen Gewerkschaften Deutschlands. (Federation of German Christian Unions.)

Verband der deutschen Gewerkvereine Hirsch- Duncker. (Federation of German Unions.)

VI authorized land settlement societies

Alsace-Lorraine

Anhalt

Baden

Bavaria

Landessiedlungsstelle in Ministry of Interior to supervise whole matter.

Brandenburg

Berliner Baugenossenschaft. Furnishes land.

Eigene Scholle. Frankfurt a. Oder.

Berliner Siedlungsgenossenschaft.

Gross Berlin. Ausschuss fiir Ansiedlung Kriegsbeschadigter. Supplies no land of its own, merely acts as go-between in making arrangements. Organized by burgomaster, secretary of state andlandes- direktor.

Brunswick

Free Cities

Hesse (Darmstadt)

Zentralwohnungsverein. . Supplies land and houses.

Hesse-Nassau

Hessische Siedlungsgesellschaft, Kassel. For information.

Hanover

Hannoversche Siedlungsgesellschaft (official for whole province).

Lippe

Mecklenburg

Mecklenburgsche Ansiedlungsgesellschaft. For information.

Oldenburg

Oldenburg. Grossherzogliche Verwaltung des Landeskulturfonds.

Pomerania

Pommersche Landgesellschaft (official for whole province).

Posen

Konigliche Ansiedlungs Kommission fiir Po- sen und West-Preussen. Gutsbetrieb mit Kriegsbeschadigten on estate near Brom- berg. Men trained to agriculture and paid. Supported by care committee, war and agriculture ministries and farm machine industries.

Prussia

Konigsberg. Ostpreussische Landgesellschaft

(information). Gerdau. Gerdauer Siedlungsgesellschaft. Land and houses near Gerdau.

Prussia (West)

Konigliche Ansi^dlungskommission fur Po- sen und West-Preussen.

Rhineland

Siedlungsgesellschaft for whole province to

be founded by Landwirtschaftskammer. Rheinisches-Heim Gesellschaft. Provides

land and houses. Union of many private

societies. Bonn.

Saxe-Altenburg

Saxe-Coburg-Gotha

Saxe-Meiningen

Saxe-Weimar

Weimar. Thuringische Landesversiche- rungsanstalt.

Number 13

RED CROSS INSTITUTE FOR CRIPPLED AND DISABLED MEN

45

Saxony (Province)

Halle. Sachsenland (information).

Saxony

Leipzig. Sachsische Kriegersiedlungsgenos- senschaft. Has bought land and built houses.

Frauendank. Works with Heimatdank look- ing up cases and acting as intermediary agent.

Chemnitz. Chemnitzer Ausschuss f iir Kriegs- beschadigte.

SCHLESWIG-HOLSTEIN

Kiel. Holsteinsche Hofebank,

schwarzburg-sondershausen

Silesia

Schlesische Landgesellschaft. Has bought twenty-one hectares and presented for small holdings. Breslau. Royal supervi- sion.

Landesversicherungsanstalt. Lends money for land purchased to certain classes of in- sured persons.

Neustadt. City government has bought twenty-one hectares to sell as small hold- ings.

Westphalia. Westfalischer Verein zur Forde- rung des Kleinwohnungswesens. Inter- mediary official for whole province. Miinster. Siedlungsgesellschaft Rote Erde.

WiJRTTEMBERG

General Agencies for Whole Nation

Deutscher Verein fiir landliche Wohlfahrts- u. Heimatpflege has information office for land settlement.

Auskunftstelle fiir Ansiedlungswesen. Berlin.

Schutzverband fiir deutschen Grundbesitz.

Royal Prussian 'Ansiedlungskommission', Po- sen. Supervises all work in Prussia and recom- mends societies proper for use.

X

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