Heather Perry’s Recycling the Disabled is a welcome and much needed addition to the historiography of Germany’s First World War experience. For a non-expert in the new field of Disability History in specific and medical history in general, this book serves as an excellent entry point and a fine addition to any collection on German society in the grip of Total War. Its intellectual roots are in a debate begun by Roger Cooter, which questions the First World War as the cause of universal advancement in medical science, and the dearth of work on Imperial German medical history (p. 7). Its aim is to ‘examine how the pressures of modern war impacted medical development, military organization and socio-cultural perceptions of the physically disabled body’ (p. 9).
Chapter 1, Healing the Disabled: The Re-Orientation of German Orthopaedics sets the tone of the work with force and clarity. The Imperial German Welfare state, particularly its pension and medical insurance apparatus are briefly scrutinized. Though medical benefits to workers were generous, the doctor-patient relationship was dominated by the interests of the bureaucracies or private firms that paid doctors’ wages (p. 24). When the First World War broke out, orthopaedists seized the chance to prove their patriotism while drawing clear lines between their specialty and other medical disciplines, namely surgery and traumatology (p. 30). Given the heretofore unheard of number of amputees who were surviving the battlefield, orthopaedists promised to cut pension liabilities, restore individual productivity, and reintegrate the severely wounded into their former places in society (p. 39).
Chapter 2, Re-Arming the Disabled: World War I and the Revolution in Artificial Limbs, demonstrates the process by which orthopaedists made themselves the sole experts in prosthetic limbs. This they achieved with the aid of engineers and scientists to analyze the motion of the body at work (pp. 55–56). The result of these experiments was the conclusion that prosthetics should tailored to wearers’ jobs in order to achieve maximum efficiency, but also because attempts at a ‘universal’ arm created ruinously expensive prosthetics. White-collar workers needed fine control resulting in expensive prosthetics more closely resembled natural limbs while blue-collar workers received cheaper, low maintenance mechanical device (p. 71). The central conclusion from prosthetics development was that functionality trumped form; it was more important for war-wounded to rejoin society as productive workers than present the image of body freed from trauma (p. 77).
Chapter 3, Re-habilitation Nation: Re-membering the Disable in Wartime Society, reveals that ‘Rehabilitiation’ is much more than restoring individual’s physical capability; the process was a top-down project of conservative social restoration (p. 85). No government institution existed for directing and facilitating amputee’s reintegration into society so orthopaedists seized their chance. Subsequently they acquired a role in structuring the wartime economy while shoring up the class structure. Specifically, orthopaedists established job counsellors (Berufsberater) who sought to return the disabled to their original professions or a similar career (p. 100). Creating financially independent citizens were paramount, but a shift from a blue-collar to a white-collar occupation, or excessive time spent brooding over one’s injuries were outcomes they prevented whenever possible (pp. 101–103). Indeed, job counsellors played a role in shaping the political order. Disabled from urban centres were sent to the countryside, reducing the number of likely Social Democrats and easing pressure on urban labour markets (p. 108).
Chapter 4: Inventing Disability demonstrates the conversion of ‘war-cripples’ to ‘disabled’ in the public eye by social reformers through a campaign of education. Key are the writings of Konrad Biesalski, who authored a pamphlet arguing that the true stumbling block for soldiers’ reintegration was not their injuries, but public prejudices (p. 119). In fact, the argument went, there was no longer such a thing as ‘crippledness’ but a poisonous ‘pension psychosis’ among the working classes, falsely believing that amputees were entitled to permanent financial aid from the state (p. 125). War wounded instead had a patriotic duty to rehabilitate, restore their families by resuming their old jobs and roles, and so strengthen local communities. Families in turn were to divest themselves of the old falsehoods of ‘crippledness’ as ‘coddling’ a war amputee served only to set back his rehabilitation and impede the awakening of his ‘Will to Work’ (p. 127). On the other hand, ‘Disability’ described a rehabilitated former soldier proceeding with civilian life as he had before entering the army, with the same duties as any member of a society fighting a total war. Since the disabled now had equal ability to perform war work there was no need for pensions or welfare payments. Huge quantities of literature were produced and exhibitions were held to support this campaign, but a sense of who attended and what their impressions were is sadly absent.
Chapter 5, Recycling the Disabled: The Mobilisation of Wounded in Wartime Germany illustrates the depths of war industry’s interest in the disabled, particularly after 1916. Siemens for instance, found that certain categories of disabled veterans were as if not more efficient at certain tasks than present workers, particularly in the case of the war blinded and munitions production (p. 170). Amputees’ prosthetics were fitted out to more easily operate certain machines, yielding increased efficiency, higher piece-wages for disabled workers, and providing an excuse to reduce the number of women in the workplace (p. 175). In order to derive maximum efficiency, the War Office [Kriegsamt], given supreme power over resource coordination in 1916, submitted the disabled to on-site examination so as to determine their potential labour output. The process of physical inspection used on the disabled in 1917 was transferred to all wounded by July 1918. Once again the purpose of care for the disabled was determined by the interests of third parties, in this case the army and state. The military’s system for rehabilitating, remobilizing and redeploying the disabled soldier according to wartime needs defined ‘recycling the disabled’ (p. 179).
Each chapter makes extensive use of end notes, many of which are discursive and carry useful information. The issue of soldiers’ resistance to restrictive, status-quo affirming rehabilitation is dealt with in note 13, p. 153. Here the author states that no evidence of soldiers’ resistance was encountered apart from personal complaints from the Weimar period relating to welfare payments.
As a force in the ordering of the war economy, their belief in their own ability to shape public perception and ‚re-cycle’ war wounded through reintegration with society, Perry’s orthopaedists seem to occupy similar ground to Paul Lerner’s psychiatrists. The author deserves great credit for shedding new light on a neglected and fascinating aspect of German society amidst Total War, even though at points the insights stretch the evidence presented.
 Paul Lerner, Hysterical Men. Psychiatry and the Politics of Trauma in Germany, Ithaca 2003, p. 250.