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

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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.

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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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Captain Paul Todera of New York City learns to walk by means of an artificial limb with the help of Apprentice Physiotherapy Aide Catherine Putman of Urbana, III., at Army and Navy General Hospital, Hot Springs, Ark. Photo courtesy U. S. Army Signal Corps Pvt. John Thorburn, Jr., of Jamaica Plain, Mass., wounded twice at Mateur, Tunisia, strengthening his back and shoulder muscles by sanding a table top at Lovell General Hospital, Fort Devens, Mass. Miss Peggy Lind, right, occupational therapy student, from the Boston School of Occupational Therapy, serves as instructor with Miss Marie P. Murphy, Occupational Therapy Aide, supervising the work. Photo courtesy U. S. Army Signal Corps cr r- J Vew fye ' c wective in fUkuHcai yl leJLuiue The two world conflicts of the twentieth century have demonstrated the effectiveness of physical forms of therapy in the immediate care of the injured and have revealed unsuspected vistas of their application to the ultimate prob- lems of rehabilitation. Although the use of physical agents in the treatment of disease dates back to antiquity, it was their help in the salvage of those disabled in the World War of 1914-18 which first aroused widespread in- terest on the part of the medical profession. Unfortunately, skepticism, prejudice, lack of a sustained program of scientific research, coupled with the failure to introduce physical therapy into the medical school curriculum on a high academic plane, inhibited the impetus to growth stimulated by the war. Now a quarter century later, American medicine finds itself inade- quately prepared to meet the urgent physical reconstruction problems suddenly presented by another world conflict. Organized physical medicine is making heroic efforts to meet the current situation and to plan more intelligently for the future. While it has been estimated that (in the normal civilian practice of medicine) from 5 to 10 per cent of all patients hospitalized require some form of physical treatment, the needs of war medicine in this respect are infinitely greater. No sooner had large numbers of selectees been subjected to military training, than it became evident that there was an acute shortage of the type of medical and technical personnel necessary to care adequately for their needs. It was apparent early that a vigorous educational program would hav to be introduced in order to meet the vastly increased demand for physical therapy which would accompany actual participation in hostili- ties. Thus, both the Army and the Navy found (14)