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Another type of treatment to restore function consists in prescribed work in a curative workshop, a method already initiated in the more simple occupational activity. If he has a stiff elbow the soldier is set to work at a machinist's bench and in the interest developed in the work in hand, uses the file so as to give the joint highly effective exercise. In this instance the active exercise with a therapeutic end is unconscious -- just the reverse of the situation in using the registering machines already described. The man hardly realizes, in his interest in the work itself, the curative object in view. One obvious advantage is that the exercise desired can be kept up most of the day, which would be impossible with a more formal system of treatment.

In the words of the officer in charge of one of the British military orthopedic hospitals: "If you give a man a damp rag and set him at work cleaning windows you will see that he is continually working his fingers as though grasping a spring dumb-bell. But while he would tire of the dumb-bell in a few minutes, he will clean windows for several hours without excessive fatigue." The man busy sawing a piece of wood going to make up the framework of a piece of theatrical scenery is really engaged in working an injured elbow back to health. The carpenter planing so vigorously has nothing manifestly the matter with his hands; in matter of fact he has a stiff ankle, but as he works he thrusts forward his right leg with each move in order to get more power into his stroke, and in so doing unconsciously works his lame ankle all the time.

Games and recreation play another important r6Ie in the curative process. They furnish a form of unconscious exercise for stiff joints and muscles. The competition and enjoyment are also factors of positive value, bowling, quoits, badminton, hand-ball, billiards, and tennis have all found place in the program of reconstruction hospitals and convalescent homes.

When physician, nurse, and hospital aid have done everything possible to advance the physical well-being of the wounded soldier, and it becomes evident that in spite of them all he will be permanently handicapped, the attack on his individual problem veers its direction. A plan for his future which will lead to usefulness and self-support must be laid out. More accurately the man himself must determine upon a plan for his own future, though he may be helped and guided to it by friendly counsel.

The first difficulty is encountered in the acute depression and discouragement entailed in the serious disablement of a healthy vigorous man -- for the men on the fighting line are physically the flower of the community. He knows the fate of his friends or fellow-workmen who have in the past been crippled, blinded, or otherwise injured. They have gone down many rungs on the social and economic ladder. The man who was a machinist became a messenger, the electrical worker became a watchman, the skilled baker now peddles pretzels, and the plumber now sells shoestrings on the street corner. Is it any wonder the outlook to the newly disabled man does not look bright?

Again, it seems to him as though life would hold no pleasure in the future, and that he will always feel sensitive regarding his handicap. Besides nobody has much use for the disabled. And these deductions have much basis in precedent and observation.

This state of mind will be encountered in the invalided soldier. It must be met early -- in the base or special hospital abroad -- and overcome. Arguments drawn from the black past history of the disabled must be outweighed by those drawn from the hopeful experience of modern practice. With returning health, initiative must be re-awakened, responsibilities quickened, a heartened ambition must replace discouragement. We can go to him and truthfully say: "If you will help to the best of your ability, we will so train you that your handicap will not prove a serious disadvantage; we will prepare you for a job at which you can earn as much as in your previous position. Meantime your family will be supported and maintained. Finally, we will place you in a desirable job."

To this end it is vital that doctors, nurses, and aids in the military hospitals abroad shall have a full realization of the principles and practice of "reconstruction." They must be able to visualize to the man his future opportunities and possibilities so that, from the first, every contact and influence may operate to encourage rather even than to countenance despair.

During the period of depression the only point of comfort is dependence on the pension which becomes the due of every disabled soldier and sailor. The man begins to figure on how he will manage to exist on the stipend which he will receive. And in most instances a small stipend it is indeed. In the United States the scale is the most generous of any country in the world.

Granted a constructive and effective program for the reconstruction of the disabled soldier and sailor, a low pension scale may be a blessing in disguise, in that it may force the men to make plans for support through their own efforts. Their first reaction, however, when a constructive plan is presented is fear that increasing their earning power may jeopardize their pensions, and a reluctance -- until the pension is determined -- to undertake any instruction which would improve their economic status.