Library Collections: Document: Full Text


The Disabled Soldier

Creator: Douglas C. McMurtrie (author)
Date: 1919
Publisher: The Macmillan Company, New York
Source: Available at selected libraries
Figures From This Artifact: Figure 2  Figure 3  Figure 4  Figure 5  Figure 6  Figure 7  Figure 8  Figure 9  Figure 10  Figure 11  Figure 12  Figure 13  Figure 14  Figure 15  Figure 16  Figure 17  Figure 18  Figure 19  Figure 20  Figure 21  Figure 22  Figure 23  Figure 24  Figure 25  Figure 26

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426  

It should particularly be noted that many of the most serious disabilities from the point of view of employment are not at first glance apparent. For example, a tour may be made of some Canadian centers of re-education without observing in the classes more than one or two obvious cripples.

427  

It is the crippled soldiers who will be discussed in the present chapter. For convenience the class will be still further subdivided into amputation cases and other disabilities.

428  

The first requirement of the amputation case is an artificial limb. It is worthy of note that there has been a complete revolution in the surgical methods in leg amputations. No longer is a crippled man permitted to drag himself around for months on crutches, learning how to walk on his armpits and forgetting how to walk with his legs. One reason for this practice in the past was that it was impossible to fit the artificial limb until the stump had had a chance to shrink to something resembling its final form. But in the modern anxiety of the surgeons to get the man back on his legs, they do not wait for fitting of the permanent limb, but put on him at once, a few weeks after amputation, a temporary peg leg made of splints and plaster, or papier-mache, or of some other similar material. The soldier then leaves his bed and takes his first steps about the hospital. An appliance of the sort meets in a most satisfactory way all the requirements of transport from overseas.

429  

A peg leg of any kind, however, if worn for some length of time gets a man in a bad habit of walking, for the reason that it must be swung outward in a semi-circular motion to bring the foot of the peg from the end of one step to the beginning of the next. This process is known scientifically as abduction. In providing for leg amputations among men in the American Expeditionary Force, after the cases have been returned to this country, another improvement has therefore been made. Temporary limbs of hollow fiber, made with knee and ankle joints in practically the same manner as the final leg, are made up in standard units in sufficient numbers to meet the probable demand. These are fitted to the men after they have worn the peg leg for a short time, and the fitting can be changed as the stump alters in shape or size. This provisional leg is expected to last from six months to a year and to serve satisfactorily, therefore, until the permanent limb can be fitted with the best results.

430  

France and Great Britain were caught unprepared by the demand for limbs, as their supply had been before the war largely imported from Germany. They have had to make strenuous efforts to meet their needs.

431  

Most of the countries purchase their limbs from private manufacturers. At Roehampton, the great limb-fitting center in England, individual manufacturers have been permitted to erect shops on the grounds of the hospital. Canada led the way in the establishment of a government limb factory, though many of the parts used were, during the first year or two of operation, purchased from outside concerns. More recently Australia has established an artificial limb shop, which is now operated by the Minister of Defense, but is to be handed over at the conclusion of the war to the Repatriation Ministry. In the United States the purchase of permanent artificial limbs, which will be furnished free of charge to crippled soldiers, is in the hands of the Bureau of War Risk Insurance.

432  

The most popular type of limb being made abroad is what is known as the "American leg." This is made up from units of willow, first shaped for outside contour and then hollowed out in similar contour to reduce weight. The units are then covered with rawhide, varnished, and assembled with the joints, stops, and springs necessary to their proper functioning.

433  

In the field of artificial arms an American model has again had preference, though a very satisfactory but elaborate type has recently been worked out in France. These arms permit the performance of practically all the duties of every day life.

434  

In arms of this character movement is attained by linking up the mechanism by cables of wire or rawhide with new muscular combinations. Thus expiration of the chest may open the fingers, and movement of the opposite shoulder may operate the elbow.

435  

A still more modern development, the invention of an Italian surgeon by name Vanghetti, is what is known as kinematic amputation. By this method of operation tendons and muscles are so arranged that attachment may be made to them, and there may thus be caused direct movement of the artificial member. Very often, however, the action of a muscle will cause a different movement from that which it was accustomed to effect under natural conditions, and it then becomes necessary to re-educate the motor reactions in order to attain ordered control. The final value of this method has not yet been determined.

436  

One of the most interesting developments in dealing with cases of arm amputation is the fitting of industrial workers with mechanical appliances, designed to meet the requirements of their particular trades. Thus a bench machinist will be provided with a chuck which will hold interchangeably a file, hammer, chisel, or other tools. A drill press operator will have a hook or ring which will pull down the lever of his machine. An agricultural worker will be equipped with a cylindrical grip or grips which will slip over and hold the handles of various farm tools. A glass worker will have an appliance especially suited to the demands of that calling. Such apparatus do not displace the modern artificial arm which is also furnished to the arm cripple to use in his home on evenings and Sundays. But it has been thought wise for specialized jobs to develop specialized appliances to perform them.

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