6
CHAPTER 1
estimated at 80 per cent (Thompson-Walker, 1937). Most of those men who managed to
survive dragged out their lives as useless and hopeless cripples, unemployable and
unwanted. They were doomed to spend the rest of their lives as pensioners at home or in
institutions, dependent on other people's assistance and, as a rule, with no incentive
or encouragement to return to a useful life. On the contrary, the existing legislation and
regulations regarding war pensions or workmen's compensation made it quite impossible
for these 100 per cent disabled men to return to remunerative employment, for fear of
losing their pensions and compensation. Indeed, until the Disabled Persons' Act (1944)
was passed in this country, society still adhered to the ancient Greek conception, as
recorded in Lysias' oration
nepl -rov dd-warou
(about 400 BC), that 100 per cent disable–
ment excluded a cripple from remunerative work.
In the inter-war period and even during the Second World War, the defeatist attitude
of most members of the medical profession in this and other countries was still prevalent,
and the general attitude of despondency is revealed in the report of the Medical Research
Council of 1924: 'the paraplegic patient may live for a few years in a state of more or less
ill-health'. Martin (1947) aptly summed up the unsatisfactory situation as follows: 'The
record attained in World War I is not a very enviable one and it is quite apparent that
the methods of treatment of traumatic paraplegia were not improved by the rich experi–
ence of that War.' Gowland (1934, 1941) gave the following account of the conditions of
traumatic paraplegics from the First World War treated at the Star and Garter Home,
founded after the First World War in Richmond, Surrey, for disabled ex-servicemen
'Two or three times a week, the patient is bathed: this means he must be lifted from his
bed to his ward chair and wheeled into the bathroom, where his pyjamas and night-
clothes are removed, and he is placed in a very warm bath and washed by an orderly.'
In discussing the problem of painful, reflex spasms and contractures, he points out:
'The position is often terrible. I suppose there is more morphia, atropine and hyoscine
used in this Home, which I look after, than in any other place of the same size in the
country'. To quote further statements of this author: 'When the vertebral lesion had
consolidated say some eight to twelve months after injury it is well to encourage the
paraplegic to sit up and get about in a wheelchair or hand-propelled or motor tricycle.'
Such views which reflect very well the conception held generally, in these years, that
nothing or very little could be done for these unfortunate people, was hardly designed
to encourage the paramedical professions nurses, physiotherapists, occupational
therapists and society at large, in particular the Ministry of Labour and employers to
help these men to return to a useful life and employment. These victims of war, road and
industrial accidents did not establish a social problem as, in the vast majority of cases,
their life expectancy was very short, as a rule 2-3 years to the utmost, as a result of sepsis
from infection of bladder and kidneys on the one hand and pressure sores on the other
complications which were considered inevitable. Therefore, any attempt to restore
such a person to his former social activities seemed to be out of the question and the
view generally held was the sooner he died the better for all concerned. It is, therefore,
not surprising that, in all discussions on rehabilitation during the years 1939-42, the
subject of rehabilitation of victims of spinal paraplegia was hardly mentioned in spite of
the fact that the modern principles of rehabilitation had been successfully applied for a
