Amputation; Artificial limbs; Orthopedics; Surgery, Military
This is now understood, and almost everywhere to-day the wounded
soldier can resume work in workshops attached to the centres of
physiotherapy, and thus begin his re-education while continuing his
treatment.
At a certain stage resumption of work becomes the best therapeutic
agent of all.
It is obvious that this resumption of work cannot supply the place
of certain special treatments such as electrical treatment during
the regeneration of a nerve, balneotherapy, or graduated gymnastic
exercises; but is it not true that work with its continual active
movement is infinitely superior to passive mobilisation by means of
apparatus however ingeniously the latter may be contrived? Morover it
is surely a more efficacious course of mechanotherapy when the patient
works for half or all the day than is provided by the special course
occupying only an hour or two.
The tendency to-day is in this direction, as, for example, at the
Grand Palais, thanks to the efforts of J. Camus, and also in the
agricultural centre of the XIIIth district under the direction of
Belot and Privat. At a given moment all treatment may be suspended and
the patient may devote himself exclusively to work with results the
excellence of which Nepper and Vallée have demonstrated.
The workmen are then eligible for work in a town in private workshops,
but so far this freedom has more inconveniences than advantages. A
man whose working capacity is much reduced, and more especially a man
who requires re-education, has no place in an ordinary workshop where
neither the proprietor nor the foreman nor his fellow-workmen are in
truth much inclined to concern themselves about him. Where actual
education is necessary this is best supplied in special workshops
where the patient will be among comrades handicapped like himself,
whose progress he will be able to watch and whose efforts he will
imitate, rather than among able-bodied workmen, by comparing himself
with whom he is bound to be discouraged.
The problem has been solved by the Belgians in a remarkable
establishment opened at Port-Villerz, and by the Austrians at Vienna
under the direction of Spitzy, as Nové-Josserand and Bouget inform
us, by delaying a maimed soldier's discharge from the army until his
re-education is as complete as possible. This method has proved to
be to the interest both of the individual and of the State, but we
do not seem to have considered this solution, and it is still to be
feared that it would accord ill with the independence of our national
character. The actual fact, though it has not been brought into
prominence, is that our usual system of "watertight compartments" has
been applied by adding to the centres of physiotherapy centres of
agricultural or industrial re-education, the results obtained in which
are dependent upon the efficiency of the director of physiotherapy.
Public-domain text, read in full here on John Shaqi.
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