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sible occupations is limited by his physical disabilities. The ideal must be to train him to become an efficient worker in an industrial process in which his particular handicap will count for the least." (Douglas McMurtrie.)

The Institute now has classes in eight trades, five suited to leg cripples and three to arm cripples. These were selected (1) because of their suitability to cripples; (2) because the training in them is comparatively short; (3) because they afford a good and in some cases an excellent wage; (4) because there is a demand for men in these trades. They are as follows:

Motion picture operating is a growing trade, and the demand for operators is greater than the supply. The wages are good. It can be learned in about three months' time. It is suited to leg cripples who can stand for a considerable length of time.

Typewriter repair work is done seated, and can even be carried on as a home industry. It is suited to a leg cripple, providing he is mechanically inclined and capable of doing careful work. It pays fairly well.

Printing is always a good trade. Linotype and monotype operating are suited to lame men, and there is always a demand for them. They are well paid. They require about six months to learn.

The Institute's artificial limb factory is actually one of the best in the country. It knows and makes all kinds of artificial limbs and also does repair work. All the workmen in the shop are themselves crippled and thus are able to appreciate the finer points in fitting and adjustment. The trade is a good one and well paid. The shop is competent and willing to give advice on the subject and nurses will do well to refer to them patients who are in need of such appliances. Their prices are lower than those of commercial firms.

The jewelry trade, because it is done sitting, and because there is always a demand


for workmen skilled in this line, is a good one for cripples who are not too much disabled to get to their work-place, who have good eyes and deft hands and minds capable of doing painstaking work. It is work quite possible for 'crutch cases." It takes two or three years to learn and is best begun before the age of 20 or 25. At the Institute the class consists almost entirely of young boys who are victims of infantile paralysis, though there are also some spinal cases. The Institute rarely has occasion to give them a full training, for as soon as they have learned the fundamentals of the trade. they usually find positions with manufacturing jewelers, where they may go on learning and at the same time earn ten or twelve dollars a week.

The trades taught to arm cripples are as follows:

Nickel plating can be learned in about. two months. It can be done by a man with one arm disabled or partially amputated. The teacher of this class has himself lost a hand.

Baked-on enamelling is another quickly learned trade that can be done by arm cripples. Both these trades receive good wages.

Oxyacetylene welding is a trade for which there is a great demand and in which excellent wages can be commanded. It takes about six weeks to learn and can be done by a man whose left arm is disabled.

None of these three are strictly onehanded trades, since they require the worker to possess at least a good stump on the injured side. So far, the Institute has not yet found a real trade which is practical for a man with a shoulder amputation. Such men can, of course, do clerical work, learn salesmanship, etc. A man with an entire arm gone is very badly handicapped and must be a person of unusual perseverance and ingenuity in order to make good at manual processes. In such cases the need is for education, since he must make good with his brains rather than his body.

As a general principle, a man is advised

to take training in some occupation into which his previous knowledge and experience fits. It is deemed wrong to throw away any ability he may already possess. Every man is made an individual study. Not only is his physical disability considered, but his personal history, his education or lack of it, family environment, etc. His work history, his tastes, his disposition, are all factors in the case quite as important as his physical condition.

The training at the Institute is given without charge, but a man must be able to maintain himself while he is learning his trade. This limits its field considerably. In an occasional case, a loan, to be repaid in installments, may be arranged.

The Institute is at the present time the only trade school in the country for the adult civilian cripple.

Trained or untrained, the acute need of the crippled man is a job at which he can earn a living. The Employment Department undertakes this task, which is well known to be one of the most difficult pieces of social work there is. In times when there are considerable numbers unemployed it is almost impossible. Just at present the demand for labor being greater than the supply, it is highly successful.

The Institute limits its work to orthopedic cases, or men disabled by rheumatism, paralysis, etc., as the medical cases are taken care of by the Bureau for the Handicapped under the Hospital Social Service Exchange. Last year the employment department had calls for about 1,200 men and placed in positions something over 900. It has new applicants all the time, besides many reapplications from men already on the lists.

Of the nine hundred placed in positions (many more than that were referred to jobs), some were men on crutches, some hemiplegia cases, some with locomotor ataxia, some spinal cases, some arm or hand amputations. Some had two limbs ampu

unplaceable, because of their very great disability, were finally put into positions. There are, of course, a certain number of


In close connection with the placement work is the Department of Industrial Surveys, which finds the jobs. It gets into touch with employers who are needing help, finds if they have positions which cripples can fill, whether or not they will take disabled men, and "analyzes" the job with reference to its suitability. Incidentally, the working conditions are investigated, so that men shall not be placed in unsafe buildings or unhealthy trades.

The Institute also houses the American Association for the Care of Cripples, which works at every phase of the subject continuously. This organization interests itself in men, women and children and endeavors to supply to each of them the thing they specially need. It has a department of home work which undertakes to find paying occupation for those who are too badly disabled to leave their rooms. By this means a considerable number of hopeless dependents are transformed into happy, self-supporting people.

There is a Club for Cripples, run by themselves, which supplies social life and encouragement. It is a live organization of about two hundred members. Its bi-monthly meetings enable the men to get a practical knowledge of how the other fellow overcame his handicap. It publishes a monthly paper containing stories of what cripples have done. Copies of this paper can be had on request by addressing the Institute.

The Institute considers itself a public servant and is glad at all times to give expert and detailed advice in regard to the problems of the handicapped or of individual cases. It has had as long an experience as any organization of the sort in the country and a sufficient volume of work to enable it to know what is practicable, work

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United States Navy Hospitals

BY LOGAN E. RUGGLES, United States Navy

Besides the twenty-three hospitals in the United States the Navy operates four foreign hospitals. This, of course, does not count the twenty-eight temporary hospitals operated by the Navy during the war in England, France, Scotland, Italy and Ireland. We have permanent Naval Hospitals at Canacao-near Manila-P. I.; Honolulu, T. H.; Tutuila, Samoa, and Yokohama, Japan. Although not listed as permanent hospitals, there were operated during the war in the United States about thirty hospitals at temporary Naval Bases.

On board every ship of the Navy provisions are made for the care of the sick. No matter how large or how small the vessel men will be stationed on them to care for and comfort the sick sailors. Very few private hospitals or sanitoriums are better fitted for this important work than are the Navy hospitals of our own proud Navy.

It would take pages of space to tell of the great deeds accomplished by the medical officers of the Navy and their coworkers, the pharmacist's mates, hospital apprentices and the female nurses, not only in the piping times of peace but more especially in the great war. It would likewise take pages of space to tell of the almost unbelievable operations, the excellent facilities and the extreme kindness shown at these great institutions.

We will take the Naval Hospital, Brooklyn, as an example, as it is the oldest of its kind in the country. From a little one-story building it has kept pace with the times and demands of a fast-growing Navy, and at present has within its grounds some thirty buildings. This famous landmark of the Brooklyn Navy Yard the oldest Navy Yard in the United States-was established in 1838,

and is one of the best known hospitals in the country, excepting none. This hospital, like all other Navy Hospitals, has its own post office, laundry, ice machines, power plants, great lawns, moving picture and vaudeville shows, and every modern facility for the care and comfort of the officers and enlisted men of the Navy. Spacious rooms devoted to operations, great white wards, rest rooms, recreation halls, sun porches, and countless easy chairs are features of this great enterprise which is dedicated to humanity.

There are forty medical officers attached to the Brooklyn Hospital under the direction of Captain (MC) C. H. T. Lowndes, U. S. Navy. The officers rank from captain to lieutenant junior grade, and there are eight chief pharmacist's mates, one hundred and fifty-one hospital apprentices and seventy-one female nurses employed. And there are one hundred and seventy-five male civilians and sixtysix female civilians employed in the immediate vicinity of the grounds.

During the war, from April 6th, 1917, to November 11th, 1918, there were admitted to the Brooklyn Hospital alone 26,587 patients-officers, enlisted men of the Navy and officers and enlisted men of the marine corps. To give a slight idea of the expansion of this particular hospital we will take the year 1916, which is considered a typical year, as an example. In 1916 there were admitted 1,669 patients. The demand for more space was soon apparent and twelve new buildings were rushed to completion shortly after war was declared. A call for physicians and trained nurses was broadcasted throughout the nation and it must be said that their response was one of the most patriotic of the World War. Many prom



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inent doctors offered their services to the country-many of them serving for one dollar a year.

It is not generally mentioned, when we speak of the transportation to France of over two million soldiers, that the Navy guarded the health of this gigantic army. In addition to the large Navy personnel on board the cruisers, transports and cargo vessels, from one to twelve thousand army officers and enlisted men were cared for on board these vessels-by the Navy hospital corpsmen.

Special mention might be made of the hospital corpsmen of the Cruiser and Transport Force, probably better known as the "Bridge to France." It was on board these ships that our soldiers were transported to Europe; trip after trip the crews of these ships were only in port long enough to coal, take on provisions and hospital supplies-sailing sometimes in the dead of night for ports unknown.

(The writer went ashore one evening and after going to his home the ship upon which he was serving was ordered to sea at night. The hour for sailing was set for midnight, and as there were a number of officers and chief petty officers on shore, the captain immediately set to work to recall "all hands." It was a standing order to leave one's address and telephone number on board the ship. I went to a show-with my wife-and we left word with the night clerk that we were going to the theatre. Well along in the second act I was tapped on the shoulder by an usher who, after learning my name, told me that an officer was at the door and wanted to see me.

"The ship sails at midnight," he said, "we have just time to catch the last boat." We, my wife and I, took an elevated train to the street where my vessel was lying in the North River, New York, she going home and I to my ship. Nine. days later I was in Portsmouth, Eng

There was a big job confronting the Naval Hospital Corps in converting cargo vessels, passenger ships and other craft into troop ships. Sufficient accommodations for the sick and wounded had to be provided for, and facilities for maintaining sanitary conditions had to be installed. The many expressions of appreciation from men of the Army were very gratifying to the Navy, which was more than pleased to render this service.

During the influenza epidemic our medical officers and hospital corpsmen on the vessels of the Navy worked to the point of physical exhaustion, but they were rewarded in that there were fewer cases, in proportion to the numbers, than there were on land. There were five hundred medical officers assigned to the Cruiser and Transport Force alone. With the sick-bays on converted vessels and transports, the Navy was prepared to handle. 15,000 stretcher cases per month; this was 80 per cent of the total sick-bay accommodation, the remaining 20 per cent being reserved for the casual sick of crews and troops and returning returning sick and wounded of the Navy.

When it is considered that 1,700,000 troops and passengers were brought back on United States transports, that 151,650 sick and wounded were returned to this country, and that, during the period of hostilities, more than two million troops were carried to France, some idea can be gained of the Navy's Medical Department and the task which confronted it. This was in addition to caring for the increased personnel of the Navy and Marine Corps, which expanded to ten times the number in service before the war.

The Medical Department of the Navy saw more service in France than any branch of the Navy. Sixty Medical Officers served with the Marines. And there were twelve dental surgeons and five hundred hospital corpsmen serving in the dif

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