Recycling the Disabled: Army, Medicine, and Modernity in WWI Germany by Heather R. Perry (review)

Military historians have studied the causes and consequences of World War I in great detail and in ways that often invoke a great deal of controversy, extending their reach into a broad range of topics, including those typically treated by the history of medicine or disability studies. Heather R. Perry's study examines the practice of orthopedic medicine during the years 1914–1918, and elucidates how three processes converged to render war-disabled men fit to return to German society.

First, specialization made orthopedic physicians uniquely capable of restoring, as fully as possible, the capacity of disabled soldiers, so that they could continue to contribute to the war effort. To accommodate and compensate for a variety of war-related functional impairments, for example, the development of prosthetics was revolutionized during this time, allowing for the creation of more effective artificial limbs. This skill, now much in demand, advanced orthopedic physicians' standing among fellow healthcare professionals. Second, since militarization put the German economy and society on a war footing, orthopedic physicians spearheaded efforts to establish and then enhance institutional structures for the rehabilitation of wounded soldiers and their reintegration into society; bodies were to be effectively "recycled" so that they might subsequently contribute to the war effort in civilian contexts. Finally, medicalization aimed at transforming individuals formerly considered "permanently crippled" into the "temporarily injured." This involved the reeducation of the population so that physically disabled soldiers were no longer perceived solely as objects of pity and charity, and also necessitated shaping the expectations of these soldiers in a way that allowed them to conceive of themselves as (potentially) economically self-sufficient and productive instead of dependent on the state due to their disabilities.

As Perry shows, using the example of the Siemens corporation in Berlin, companies helped promote these ideas not only by employing individuals with physical disabilities but also by finding that they could be more rather than less productive and efficient than nondisabled workers. She also elucidates the activities of the Supreme War Office (Kriegsamt), newly created in 1916, which assumed control over examination policies and funneled injured soldiers through central hospitals throughout their convalescence, conducting inspections and evaluations on-site, with the mission of classifying as few soldiers as possible as no longer fit for war duty. In an excellent microstudy, Perry considers how these policies played out in Saxony.

Apart from a few typographical errors, the scholarship presented in this book is meticulous. Anyone familiar with the disparate nature of topic-related materials dispersed over a variety of archives will appreciate Perry's ability to locate the archival sources and perform a sophisticated, erudite analysis of them. Yet, while the book provides a major contribution to the understanding of the ways in which physical conditions were medicalized and defined as disabilities in Germany during World War I, it is also myopic. For example, occasional exceptions notwithstanding, this book does not venture much beyond Germany during the war for the purpose of comparing and contrasting the developments she describes in the context of other European war powers. Her study ends rather abruptly in 1918: it neither addresses the status of war-induced physical disability in the Weimar Republic nor does it discuss how the policies and innovations she addresses played out in the postwar period. Furthermore, the book does not discuss mental and psychiatric disabilities resulting from the war. A discussion of the similarities and differences of medical approaches to those types of disabilities would have been useful, particularly given extant studies suggesting that many practitioners of military psychiatry during and after World War I were suspicious of claims that the experience of war itself had serious and lasting consequences for mental health. Informed by eugenics and racial hygiene, they tended to blame endogenous factors for the development of psychoses in soldiers. As such, they represented a faction within psychiatry and medicine that began to distinguish between those who...