Medical College of Virginia - X Ray Yearbook (Richmond, VA)

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stiffness, swelling, or disuse atrophy. In fact, the patient ' s general condition following injury may be allowed to deteriorate to such an extent that he returns home less resistant to the normal hazards of his usual physical work than when he entered the hospital. In the years prior to the war there was manpower enough to compensate easily for the stresses of ordinary living. There was no particular premium on physical fitness, and no real interest in making the disabled employable as quickly as possible. All this changed precipitously with the onset of the war. Manpower shortages in the military services and in industry became the impetus to several significant contributions in the field of physical medicine. They focused attention on two elemental needs previously neglected, the securing of quicker and the securing of better return of function, subsequent to the disabling injury. Because of sheer necessity, bold experiments on the hastening of convalescence were instituted in England and then in this country. A new attack was made on disability evaluation with emphasis on the assessment of residual capacity and the fitting of the physically handi- capped into useful jobs, rather than on the awarding of compensation for residual impairment. The Army demonstrated that enforced leisure due to hospitalization could be constructively utilized to further the technical education of the injured man, so that upon discharge from the hospital he was not only physically fit but returned to duty as a better informed individual. In the aggregate, these experiences have led to a broadened concept of physical medicine, embracing areas which previously attracted little medical attention. Rehabilitation now begins as soon as the patient arrives in the hospital. The concept of keeping the whole man fit following injury is second only in importance to the early institution of physical therapy procedures. The establishment of (12) Using the galvanic current in the treatment of hypertrichosis One of the extremity whirlpools in use at the Medical College of Virginia Hospital

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important to research and education in physical medicine than the establishment of a type of service to the sick which utilizes fundamental advances in knowledge, and applies all available quantitative measures designed to evaluate critically the results achieved. To this end it has significantly expanded the clinical facilities of its Hospital Divisions which serve white and negro patients. By the summer of 1945 both hospital units will be furnished with the latest equipment for the practice of all accepted forms of physical medicine, as well as various precision devices permitting the introduction of quantitative methods. The Clinics are being staffed and organized in a manner which will enable them to take their rightful place in a teaching hospital and maintain it on a high academic plane. The curative and diversional services of occupational therapy are to be incorporated into and integrated with the physical therapy prescription. Thus, the influence and results of the Baruch Center ' s research and educational plan should reflect ultimately in the better use of physical forms of treatment to give solace to the sick, to aid in healing, to expedite the return of function, and to engender healthy and vigorous attitudes toward the responsibilities of everyday living. (Please turn to page 14) The paraffin bath as an effective means of applying thermotherapy Hubbard tank for underwater massage and exercise in the newly equipped physical therapy de- partment of St. Phillip Hospital

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H The occupational therapist provides these patients with activities that are both diversional and curative, thus hastening convalescence convalescent depots in which military discipline is resumed away from the hospital atmosphere has done so much to hasten recovery following incapacitating injury that this divergence from orthodox management may well influence the design and administration of the civilian hospitals of the future. The great benefit attained through the judicious employment of rehabilitation procedures has been one of the outstanding contributions of war medicine to general knowl- edge. It is true that the war has as yet given birth to no dramatic advances by producing hitherto unused tools. Rather, it has utilized established methods in new ways. Since the techniques being elaborated are applicable to the treatment of many diseases, it is to be hoped that well integrated physical therapy, occupational therapy, and rehabilitation departments will become a part of the modern hospital organization serving all types of patients, and that the medical student of the future will be prepared to assume responsibility for the furtherance of this development by virtue of systematic training in a physical medicine program rooted in sound basic and clinical research.