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THE CORRELATION OF NEUROLOGY, PSYCHIATRY,
PSYCHOLOGY AND GENERAL MEDICINE AS
SCIENTIFIC AIDS TO INDUSTRIAL

EFFICIENCY.
BY JAU DON BALL, M.D., OAKLAND, CALIFORNIA,

Captain, Medical Corps, U. S. A.

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I. INTRODUCTION. It is less than a hundred years since organized labor was born. During this time, it has borne the brunt of adjustments to meet ever-changing conditions. Not the lightest of its burden has been the assimilation of the enormous influx of immigrants of many nationalities, races, and languages.

It is unnecessary to go into detail regarding the present signs of industrial unrest; they are only too patent to the thinking individual. The turmoil produced by the I. W. W 's and Bolshevistic teachings, as exemplified in needless strikes, internal strife, excessive and unnecessary turnover, in lowered productivity, and plant inefficiency, is but a handwriting on the wall.

The leaders of industry have kept aloof and the breach between capital and labor has gradually widened until present conditions have awakened the true American to the seriousness of the situation. There should be stimulated a closer relationship between employer and employee and the stabilization of industries by the application of scientific and practical selection of the human material at hand; and the stabilization of the individual by being interested in him, thus creating trust, confidence and cooperation, as well as driving home the principles of good fellowship. To do this, it is absolutely necessary to study the individual as regards his physical, nervous, and mental fitness for a particular job, and to ascertain his special abilities and disabilities.

Undoubtedly a new epoch in the history of labor is at hand, unfolded by the present great necessity, associated with abnormal conditions, and surrounded by unusual circumstances.

Instead of throwing the entire burden of the Americanization of labor upon labor as a class, would it not be more laudable for the normal and unselfish leaders of industry to assume at least a portion of the burden?

We read of this or that leader of industry developing wonderful efficiency in his establishment, but close scrutiny of the industries of this country will reveal conditions absolutely deplorable, unbusinesslike, and certainly unscientific. The turnover in many of our industries is astonishing and absolutely unnecessary.

The prognosis is good, providing proper treatment be applied and continued unhesitatingly, and with deliberate and rational vision.

It is my opinion that the proper treatment consists in the utilization of properly coordinated scientific aids under competent directing heads, and with the sympathetic and untiring cooperation of labor and industrial leaders. Prophylactic measures started now will prevent the disease of inefficiency from making further inroads upon the constitution of capital and labor and will stabilize and unify both.

The plan hereinafter to be discussed is practical, broad, comprehensive, humane, economic, as well as scientific. It must be understood, however, that this article is only preliminary and represents a beginning of industrial research work which the author believes is the first of its kind to be undertaken.

II. SOURCES OF INFORMATION. Information and groundwork for this research was gained by visits to large industrial plants, including one of the large shipbuilding plants on the Pacific coast. Personal interviews were had with managers, superintendents, foremen, and men, and opportunity offered for study of individuals. Careful study was made of the method of employing labor, not only the methods used at the individual plants, but also methods observed at United States employment offices. What particularly impressed the author was the fact that the efficiency of every plant was entirely

*The courtesies extended by the Messrs. Marchant, of Marchant Calculating Machine Co., Oakland, California, made possible a great portion of this work. Also my gratitude is very great for courtesies of Mr. D. M. Rupert, Employment Manager of Union Plant, Bethlehem Shipbuilding Corporation, Ltd., San Francisco, and to Mr. T. H. Jacobs, Manager of Service Department of the same corporation.

dependent upon the methods used in its employment bureau. It is the keystone to the entire arch of industry. True, at the present time, this keystone is a little unstable, but by the proper cooperation of capital and labor and the realization by both of the great necessity for the proper selection and distribution of labor, it will be possible to imbed it the more firmly in the cement of good fellowship and loyalty.

The loss to many industries through the termination of individuals unsuited for a particular job, but having unascertained special abilities, is enormous. The salvage of this human material should be undertaken by a scientifically equipped employment bureau. Such a salvage bureau as a part of the general employment scheme would react not only favorably to the employee, but to the employer as well.

III. METHODS OF PROCEDURE.' Under this head will be given methods used in examinations.

These include: (a) General medical; (b) neurological ; (c) psychiatrical; (d) psychological; (e) social.

All the methods are subject to revision and criticism, but it must be fully appreciated that the foundation for the whole scheme is the proper coordination of all scientific aids in industrial examinations. Without such coordination and a rational interpretation of results, confusion is possible, and erroneous conclusions are liable to be drawn. For example, an individual might have a so-called normal intelligence, and by psychologists be classed as a capable individual, yet a neurological or psychiatrical examination might reveal a serious pathological nervous or

* Many valuable suggestions and much encouragement were given by Mr. Virgil E. Dickson, Chief of Psychological Research Department, Oakland, California, Public Schools.

Mr. A. Vollmer, Chief of Police, Berkeley, California, gave much of his valuable time and experience in assisting at examinations and in freely offering valuable suggestions.

Dr. Paul J. Anderson, psychiatrist, Oakland, California, and Mrs. Grace Hawkins, assistant clinical psychologist, Leland Standford University Medical School, San Francisco, rendered invaluable assistance in the examinations.

My appreciation is keen for the kind encouragement of Prof. Robt. Leonard, Professor of Vocational Education, University of California, Berkeley, California.

mental condition, making such a person a potentially dangerous individual for any industry; or the medical examination might reveal incipient or advanced pulmonary tuberculosis, active syphilis, or some abnormal physical condition or defect, making the individual a menace to his co-workers and a danger to himself. All this, notwithstanding that he possesses normal or above average intelligence, and by psychological tests alone would be passed, demonstrates the great necessity for proper coordination of all scientific aids in industrial examinations.

A scheme involving such a coordination as above explained, could be put into operation in the employment bureaus of industrial organizations, or a general clearing-house could be established for a number of industries. Also such a scheme could be utilized to ascertain the physical, nervous, and mental equipment of individuals already employed, with the end in view of bettering their condition, and possibly ascertaining their special abilities.

Much talent is hidden in modern industry, and many individuals become anti-social because of unfair bosses and foremen (unfair because of some abnormal nervous or mental condition).

As many as 100 at a time could be given the psychiatrical and psychological examinations, but it is preferable to examine in groups of 25, as it gives the examiner greater opportunity to study the individual reactions.

Men and women should be examined separately.

The physical examination should be first, at which time should also be made the neurological examination, and also it is possible during this time to make psychiatrical observations.

The following outline for examination is suggested for the reason that it is simple and covers the necessary points:

A. GENERAL MEDICAL EXAMINATION. 1. General appearance. 2. Vision. 3. Hearing. 4. Heart. 5. Lungs. 6. Skin. 7. Teeth. 8. Venereal diseases.

9. Surgical diseases (especially hernia, flat-feet, deformities). 10. Condition of blood and urine (laboratory examinations, if individual

desires it. Consent can usually be obtained). NOTE.-Author realizes the difficulty involved in obtaining the above, and it might be necessary to confine physical examination to general inspection until labor organizations have been educated as to the value of such examinations to the individual.

B. NEUROLOGICAL EXAMINATION. NOTE.—Can be made at time of general physical examination, and usually presents no difficulties. 1. Principal deep and superficial reflexes :

(a) Knee-kicks.
(b) Tendo Achillis.
(c) Superior tendons.
(d) Abdominal.
(e) Cremasteric.

(f) Pupillary reflexes.
2. Station.
3. Tremors.
4. Neuro-circulatory syndrome (endocrinopathies).
5. Speech disturbances.

C. PSYCHIATRICAL EXAMINATION.

1. Direct observation. 2. Questionnaire. (Most individuals will answer truthfully simple ques

tions if permitted to write the answers. If questions are carefully selected, and are not too numerous, much can be gleaned as to family and personal history, at least enough to justify a special interview

if the answers warrant it.) The following list of questions, most of them answered by either “Yes” or "No," could be used. This list could be made much shorter and less specific, and still would answer the purpose for “ spotting " types :

Form Suggested for Questionnaire. KINDLY ANSWER THE FOLLOWING QUESTIONS TO THE BEST OF YOUR ABILITY. ALL ANSWERS ARE TREATED ABSOLUTELY CONFIDENTIAL AND THE INFORMATION OBTAINED IS TO BE USED FOR SCIENTIFIC PURPOSES ONLY, AND Has No REFERENCE WHATSOEVER TO YOUR PRESENT POSITION OR FUTURE ASSOCIATION WITH THIS OR ANY OTHER COMPANY.

THE INFORMATION GIVEN SHOULD BE AS ACCURATE AS POSSIBLE. YOUR GENEROUS COOPERATION AND ASSISTANCE IS ASKED IN This INVESTIGATION.

Note-Heading for questionnaire could be changed to suit conditions, whether or not it was to be used for research work only, as above, or in course of regular examination of applicants.

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