Bulletin of the History of Medicine 71.3 (1997) 552-553
Klaus-Dieter Thomann. Das behinderte Kind: "Krüppelfürsorge" und Orthopädie in Deutschland, 1886-1920. Forschungen zur neueren Medizin- und Biologiegeschichte, no. 5. Mainz: Akademie der Wissenschaften und der Literatur; and Stuttgart: Gustav Fischer, 1995. 383 pp. Ill. DM 118.00; öS 873.00; Sw. Fr. 113.50.
In Das behinderte Kind (The
... [Show full abstract] handicapped child), K.-D. Thomann presents a thorough study on the development of welfare services for the physically handicapped between 1886 and 1920, with a focus on Prussia. His primary interest lies in the history of the welfare institutions of both the churches and the state, and the establishment of orthopedic medicine in Germany. The social history of the physically handicapped per se and their experiences with welfare institutions and medical measures are not dealt with on a major scale.
Industrialization contributed to the increasing problem of what to do with the physically handicapped, especially those who were children. But neither the local welfare services nor the welfare institutions of the churches were in a position to provide adequate care for them. Most physically handicapped children had to do without any formal schooling. At the end of the nineteenth century, this situation gradually began to change. Orthopedic medicine was more and more able to heal individual patients, or at least to improve their condition, and their situation subsequently became a subject of social policy. The churches began to assume the care for physically handicapped children -- the contemporary expression being "welfare of the crippled" (Krüppelfürsorge)--and established appropriate homes for them. Here, these children received formal schooling so that they could take up an occupation later on, enabling them to provide themselves with a means of living; they also received orthopedic treatment. This welfare policy was to assure that the "crippled" became objects of humanitarian action for whom only the charitable aid of the churches made life in society possible.
Another topic is the institutionalization and professionalization of "welfare for the crippled." Professional societies and journals were established, providing a means of voicing the need for the government and local authorities to assume a greater financial commitment toward the high costs of care. In the course of these campaigns, the discriminating term "cripple" became a sociopolitical battle term intended to mobilize the public. The author clearly illustrates how statistical surveys for registering the number of "crippled" children were used to create a political climate for increasing the number of homes for them. But the children's parents often resisted putting them in such a home and objected to having them called "cripples."
The interest of orthopedic medicine in the welfare of the physically handicapped had a slow start. It began by propagating outpatient treatment, a distinct contrast to the welfare policy of the churches. As the author shows, the orthopedic specialists of those times could not compete against the institutionalized welfare structures that had cropped up and taken hold in the nineteenth century. As a result, the principle of institutional accommodations continued to be the government's preferred concept of welfare service even after World War I. During World War I, orthopedic medicine and the "welfare of the crippled" experienced an upswing because of the vast number of war casualties. As many as possible of those wounded in action had to be assured of medical treatment and rapid subsequent rehabilitation into the work force. Moreover, World War I brought on a dramatic change from another viewpoint, with many families suddenly finding themselves confronted with a physically handicapped husband, father, or son owing to war injuries. The government decreed that the term "cripple" was no longer permitted; instead, people now referred to "war invalids." Once the war was over, however, the old discriminating term came into use again.
After World War I, governmental care for the physically handicapped was statutorily regulated in Prussia as part of its welfare policy. A law passed in 1920 required the public authorities to pay the costs of keeping the physically handicapped in a home. This law marked the final decision against outpatient care. Although...