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The Care, Cure, And Education Of The Crippled Child

Creator: Henry Edward Abt (author)
Date: 1924
Publisher: International Society for Crippled Children
Source: Available at selected libraries
Figures From This Artifact: Figure 1  Figure 2  Figure 3  Figure 4  Figure 5  Figure 6  Figure 7

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The gateway to the wonderland of these miracles is the clinic or dispensary. The public health nurse, the social service worker, the Rotarian, Kiwanian, Elk, or other good friend, is the gentle guide. In the hospital are the magic wands and potions, and in the convalescent home or sanatorium, recoveries become accomplished facts. A few states have all of these progressive stages to care for their handicapped little ones; many have some; and a few have none of them. But the modern trend is a rapid development toward the completion of the magic pathway in every state and in every locality, for the plan has proved efficient and economical.

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The Clinic

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Professor A. G. Warner, in his standard work on American Charities, stated that "the dispensary or clinic is the most efficient method of hospital extension and forms a link between the sick poor and the professional staff. ....The value of the clinic lies in tying up the social service to the medical treatment."-1- The efficiency of a clinic may well be judged by the degree to which it conforms to this standard of achievement.

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-1- pp. 296-297

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Clinics vary from established institutional dispensaries to temporary investigating centers. Most of the large orthopedic hospitals or general hospitals with orthopedic services have out-patient departments at which are given free examinations and diagnoses. Most social organizations begin their work to aid crippled children by either one of two ways: by individual case-work, in which they bring the children to the nearby institutional clinics; or by conducting a local survey and themselves organizing a clinic, to which they bring the prospective patients.

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At the clinic the child is thoroughly examined. Trained nurses record the history of his disability, all information concerning his general physical condition, and those lesser defects which proper care and treatment may cure. These records may then be classified into five groups:

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A. Urgent and hopeful.

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B. Hopeful but not urgent.

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C. Doubtful but at the same time hopeful of at least some relief.

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D. Hopelessly incurable.

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E. Slight deformities which may be cared for locally. Hospital stay or operation are not necessary for these cases.-1-

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-1- Prepared by The Ohio Department of Health.

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The first group is immediately sent to hospitals for surgical or other necessary treatment. The second group, relatively less important, is given similar treatment upon the disposal of the first. Nurses maintain contact with the families of the third group, which receives attention after the first two. The only solution to the problem presented by the hopelessly incurable is to return them to their families or to commit them to permanent custodial institutions. The decision between these alternatives will depend on the financial situation of the families involved, and the nature of the child's illness.

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The children of Group E are generally communicated with for further treatment at future clinics or at the dispensary headquarters, where braces are fitted, physiotherapy is prescribed or conducted, and general conduct is directed. The best clinics have a well balanced medical staff, a thoroughly competent orthopedist, and above all, an efficient group of social workers who follow up cases to ascertain that the treatment continues and that environmental conditions are favorable to the recovery of the child.

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The value of temporary or periodical clinics, such as are organized by local social organizations, is two-fold: first, they locate the children for treatment under existing laws and by existing facilities, and second, they advertise existing conditions to communities, that public interest may be stimulated toward more stringent enforcement of already enacted legislation, and the enaction of more efficient legislation if necessary. The danger to be avoided is the possibility of unorganized and poorly conducted clinics, resulting in filling hospitals with more cases than they properly can treat, and in a large loss of time and money on children who are not followed up. The experience of most organizations is that without public health nurse co-operation, a large number of cases will be diagnosed, and about fifty per cent never will reappear for treatment. For this reason, clinics always should be held in co-operation with departments of health or agencies existing for the care and cure of crippled children.

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No discussion of clinical facilities would be complete without mention of the famous clinics held under the auspices of the New York City Department of Health, in 1921 and 1922. Dr. Adolph Lorenz, an Austrian orthopedic surgeon, consented to examine a group of cripples, and on November 28th, after several days of publicity, twenty baby stations were thrown open for the examination of crippled children under sixteen years of age. Three cases were to be selected from each station for examination by Dr. Lorenz himself, and he promised to perform several of his operations, known as "bloodless surgery." On the appointed day, 2,113 children from every part of New York State and elsewhere appeared for examination. Although only sixty of this large group could be examined by the visiting surgeon, the registration proved conclusively the existence of a great need for regular clinics of this type, and Dr. Lorenz agreed to conduct three public clinics each week at the Department of Health headquarters. The staff of employees consisted of the following:-1-

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