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The infantile paralysis epidemic of 1916 lent a new impetus to the creation of organizations for the aid of cripples, and appropriation of time and money for this purpose by national fraternal and social organizations. During the years 1917-1919 all efforts turned to war work, and the post-war rehabilitation of crippled soldiers. But the great International organization was soon to take up its task.

Today six types of social agencies assume the task of aiding their unfortunate little neighbors. There is first the International Society, a group of state and provincial societies which aim to increase non-professional interest in the problem. The central office forms a clearing house for the exchange of information; and a guiding factor to direct the efforts of the state societies toward sponsoring efficient and expedient legislation and operating machinery. A second group is composed of the international social and fraternal societies whose member clubs are making themselves socially valuable by doing individual case work to aid local handicapped children or co-operating with existing agencies to locate the cases. Other such organizations have national programs for this type of work.

A third type of social agency is the national philanthropic organization, which finds the problem of the crippled child a necessary part of its charitable program. A fourth group is the official state or national governmental agencies, whose duty is to promote education throughout their territory, or increase general welfare. A fifth group, the local philanthropic organizations, undertakes to solve the problem in a particular community. In addition to all of these, there are the local groups which select the problem of the crippled child as the object of their energies for a limited period, or to dispose of certain charitably endowed funds.

The state societies of the International Society for Crippled Children are founded on the principle that there are three fundamental divisions of the work for crippled children, "the lacking of any one of which, as we see it, makes impossible the sum total. They are these:

"1. The Professional, which has to do with the hospitals, convalescent homes, orthopedists, the medical profession, the nurse, the Social Service worker and the schools.

"2. The Financial, whereby the price of the cure must be available, which, we believe, should be the duty of the state through legislation, either direct from the state treasury or from charging the cost back to the county from which the child comes. Ninety per cent of the children lack the price of cure.

"3.The Human. After the first two have been provided, there must be some organization, and we are thoroughly convinced that it should be a state organization which has a definite purpose and which has the interest of the crippled child at heart, adding the human touch in connection with the professional and financial, being an originating and policing agency, and seeing to it that the machinery set up should week by week, month by month, and year by year, function."-1-

-1- The Care, Cure and Education of the Crippled Child, a pamphlet published some years ago by the International Society for Crippled Children, p. 4.

Aiming to form the third of these elements, there are at the present time ten state societies, the Illinois, Ohio, Michigan, New York, Ontario, Pennsylvania, Kentucky, Tennessee, Virginia, and West Virginia organizations. Others are in the process of construction. Each of these groups has a president, one or more vice presidents, a secretary-treasurer, or separate officers for these positions, and in several states, "field" or executive secretaries who devote all of their time to surveying the field of action, inciting new enthusiasm, and ascertaining that the work is progressing.

The individual club members pay dues to their local organization, which are in turn sent to the state society headquarters. According to an Ohio estimate, the $4.00 per year Ohio dues are divided in the following manner:

$1.66 to office and executive secretary salaries.
.56 to office expense.
.66 to publicity.
.60 to traveling.
.50 to the International Society for Crippled Children.

The following state society program was outlined in an address by Dr. E. H. Marshall, one of the leaders in the Illinois movement:

1. Surveys of existing conditions in every county.

2. The establishment of as many orthopedic centers scattered throughout the state as may be practical.

3. The promotion of the establishment of special schools for crippled children through the aid of educational bodies.

4. The establishment of a central headquarters bureau, which should act as a clearing house for information and initiate and co-ordinate local movements.

5. To aid in the advancement of the science of orthopedics, the carrying on of necessary research, and the development of preventative measures; the improving of the science of hospital management and equipment pertaining to the care, cure and education of crippled children through affording means of exchange of information and ideas, and financial assistance wherever practical.