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There are four stages in the treatment of the disabled soldier: (1) medical treatment; (2) provision of artificial limbs and functional re-education ; (3) vocational advice and vocational re-education; and (4) placement. Of these activities, the first two are controlled by the imperial military authorities and are conducted on uniform lines. With regard to vocational and economic rehabilitation, on the contrary, there is no general direction given by any central authority; the re-education schools are of varying types and most unevenly distributed; the work is in the hands of local and private or semi-private agencies; it is done mostly by volunteers and is not even supervised by the imperial government.

However, in spite of the absence of any general system of organization, there is a complete unity of purpose and the work is everywhere carried on in accordance with certain universally accepted and officially sanctioned principles. These were formulated by Dr. Biesalski in this way:

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

2. Disabled soldiers must be returned to their homes and to their old conditions; as far as possible, to their old work.

3. The disabled soldier 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 subject, first of all among the disabled men themselves.

The possibility of rehabilitation is accepted as a creed by all the institutions 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 attained.

There is a fairly complete network of orthopedic homes distributed all over the empire. Their number has been put at about two hundred. They are all under military discipline. The time of treatment for a man in the orthopedic 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 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.

The best hospitals are excellently equipped. Complaints have been made, however, that the remote hospitals have very incomplete arrangements and that the great demand for orthopedists leaves some places unsupplied.

More and more emphasis is being placed on physical exercise as a means of bringing disabled men 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. Games and outdoor sports are found to have an immense therapeutic value, both psychological and physiological, as compared with medico-mechanical treatment. Thus we find, at the different hospitals, as part of the regular regime, ball playing, spear throwing, bowling, shooting, quoits, hand ball, jumping, club swinging, and swimming. Finally, though the hospitals do not attempt to train a man to a trade, many of them have attached workshops for purposes of functional re-education. There is great emphasis placed on the fact that even this occupational therapy should be really useful and should lead the patient direct to some practical occupation.

All artificial limbs are furnished and kept in repair by the government. The government has prescribed maximum prices for prostheses of different types. Otherwise there is no official supervision. No standard pattern is prescribed, and the matter is left to the doctors and engineers of the country. The result is an immense stimulation of activity. 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 types of artificial legs in actual use.

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 possible.

Re-education in Germany goes on at the same time as the medical treatment. 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 possible moment of convalescence, and second, the fact that, since the government does not pay anything towards 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 maintenance.

The first civilian function in the care of the war cripples is vocational advice. The local care committee usually appoints vocational advisers, which appointments have to be sanctioned by the local military authorities, who control the visits to the men in the hospitals. As soon as a soldier is well enough to be visited, the committee sends a representative to get full data on his experience and his physical condition, and then advise him as to re-education or immediate return to work. 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.