kept they never showed a loss of all the gain. Tables of weekly weights show slight loss at the beginning of the summer before vacation. This same loss is shown in the controls of healthy children of the public schools."

We have always argued in favor of continuous school work the year around. Not only is the number of hours per day small, but both the children's condition and their progress argue for an uninterrupted school year.

The extent to which Germany has gone ahead of this country is indicated in the article by Dr. McMurtrie previously referred to. In describing some of the institutions, hospital care is simply taken for granted. In each case the training and educational feature of the institution is the thing emphasized. He says regarding one institution, "There is no school, but the boys are taught orthopedic mechanics, key making, saddlery, tailoring, and shoe making." Of another he says, "There is no elementary instruction, although provision is made for advanced training and the making of card board boxes and paper bags." In another institution capable of caring for 24 boys and 20 girls between the ages of 5 and 16 he says, "The single class is conducted by three teachers and a teacher of manual training. The boys are taught bookbinding, paste board work, chair caning, wood working, fret sawing, and tailor's mending; and the girls are instructed in sewing, machine embroidery, mending and the making of artificial flowers."

The great variety of occupations taught in schools for crippled children in Germany serves to illustrate not only the results of the careful study of this problem, but the wide range of usefulness open to crippled individuals if proper training is available.

An essential preliminary to this educational work, as well as to the work of caring for cripples in general, is to ascertain the number and condition of the children requiring special care. The school census should be required to include diseased and crippled children who, instead of being neglected as they are at present, should by all means be provided with the necessary facilities for their care and education. Transportation to the school and return should of course be provided, thus insuring the best attendance and maximum benefit both educationally and physically.

The varieties of crippled conditions which appear as a result of the diseases previously referred to should be taken into consideration. Tuberculosis, for instance, gives us patients with short extremities and stiffened joints, even after the best treatment that can be obtained. Furthermore, there is always the possibility in tuberculosis of a recurrence of the acute symptoms and acute disease. Such patients must be guarded while in school or at work against traumatism caused by standing, walking, or injury in other ways. Infantile paralysis gives us patients with weakened or entirely useless arms or legs. Such children must have an opportunity for employment in a small area with the minimum of physical exertion. The congenital deformities and various traumatic deformities give us a class of people

who must find employment in which they can become proficient and efficient even without the use of one or both feet, legs or arms. All of these problems, which present almost insurmountable difficulties under conditions provided for the care and education of normal individuals, become relatively simple in a special institution. The actual expenditure in caring for a cripple is really but little greater than for a normal individual. It seems larger simply because the money must be diverted into different channels especially for the purpose.

In 1922 we must take account of the great achievements of our Federal Government in the after care and vocational retraining of those who were crippled in our military effort in France. One must say, however, that progress in similar care for crippled children and those disabled in the industries is still relatively slow. Interest is being aroused and better hospital care and more special schools may soon be developed.

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