Reprint from 
Western Medical Review 
Pages 241-243. May. 1912. 
The Industrial Education of the Crippled and 
Deformed. 
There is a growing tendency on the part of those who are. 
engaged in public as well as private philanthropy to direct their 
efforts toward the prevention of dependency rather than simply 
to provide care for those who become dependent. This tendency 
finds expression in many ways which are comparatively new. To 
some of us, at least, none of the newer ways of providing against 
dependency is more interesting or more profitable than the cor- 
rection of deformity in children or the proper care of those 
prospective cripples suffering from chronic disease. A sur- 
prisingly large number of such patients, especially if cared for 
during childhood, may be converted from helplessness to a state 
of complete or comparative independence. 
Those of us who have been engaged for some years m the 
hospital care of these children, however, are having it forced 
upon us that hospital care alone is not sufficient to establish 
the permanent independence of such individuals. A considera- 
ble number of our orthopedic patients are, by reason of the na- 
ture of their disabilities, unable to avail themselves of the or- 
dinary opportunities for acquiring an education. It is not un- 
common, therefore, for such patients at the completion of their 
hospital care to find themselves several years behind normal 
children of the same age in the matter of their school work.. 
Not only this, but many of these patients even at the comple- 2 
tion of hospital care and when all has been done for them that 
can be done, find themselves physically unequal to the perform- 
ance of all the duties of any given trade or occupation. The 
mere statement of the problem suggests the answer, which is 
that such children during their hospital care and afterwards 
should be carried along by means of special methods of instruc- 
tion, so that when the hospital care has been completed they 
may, as rapidly as possible, be provided with such an education 
as will enable them, no matter what their condition, to perform 
some duties by which they can earn a livelihood. 
A number of industrial training schools have already been 
established, but a very small percentage indeed of such patients 
can now be cared for with the educational facilities that are 
available. For example, the Widener Memorial School at 
Philadelphia, which is one of the finest examples in the world of 
the form of philanthropy which I have suggested, has a million 
dollar plant, with an endowment of three millions more, but 
limits itself to the care of less than two hundred children. All 
of these children in the Widener School, however crippled or 
deformed, are being given the best of hospital care and pro- 
vided with such instruction as will render them absolutely inde- 
pendent. This agency is, therefore, doing a tremendous amount 
of good and doing it in as nearly an ideal manner as possible. 
It can readily be seen, however, that many more such agencies, 
even if they must be carried on at less expense of money, must 
be provided for such individuals. 
The Nebraska Orthopedic Hospital has made a beginning 
in this direction, but only a beginning. All of our children, 
both those who are up and the bed patients who are able to do 
so, recite daily to competent teachers in lessons which corre- 
spond as nearly as possible to those which children of the same 
age are having in the grade schools. Cooking, sewing and 
bookbinding are also being taught to those who are able to do 
those kinds of work. Other courses of instruction contemplated 
at the present time are horticulture, picture framing and pho- 
tography. Two of the older girls, formerly patients in our 3 
hospital, are already independent; one is a seamstress and the 
other a telephone operator. 
It is quite important for the institution which provides 
hospital care to supervise the launching of these patients in 
occupations which will make them independent. There is a 
great danger that such patients if returned to their homes, 
either because of lack of means or because of over sympathy 
on the part of parents or friends, even though much improved 
as to their physical condition, will relapse into a state of de- 
pendency. Constant stimulation and intelligent supervision 
are necessary with these children as with others to have them 
use such energy and ability as they have toward proper ends. 
Teachers and equipment must be provided in increasing mea- 
sure to supplement our hospital work if a full realization is to 
be obtained of the plan to make these patients independent. 
The State of Nebraska has been making rapid progress 
along the lines of caring for its orthopedic patients and by do- 
ing just a little more our institution will stand in the very fore- 
front of those which are being devoted to work of this par- 
ticular kind. 
H. Winnett Ore (Lincoln, Neb.)