for the Blind took over the plant, and the men have been sent there since that time.

Mr. DALLINGER. So that has been about a year. You mean in May, 1919?

Mr. MOLTER. A number of them; yes.

Mr. DALLINGER. That is, those who have been there longest have been there about a year?

Mr. MOLTER. They have been there about a year.

Mr. DALLINGER. Are you familiar, Mr. Molter, with the way the problem of the blind has been met by Canada. England, France, and the other countries? Have you made any study of it?

Mr. MOLTER. I have done some reading; yes.

Mr. DALLINGER. Do you know what the general policy has been, say, in Canada?

Mr. MOLTER. I know that there is an organization in Canada-the National Institute for the Blind. I know the man who is in charge of the work there, and something about the work which they are doing, and, of course, I know about St. Dunstan's. I have read about the schools in France and in Italy.

Mr. DALLINGER. Do you have a number of schools in those countries, or just one school?

Mr. MOLTER. In France there are several schools.

Mr. DALLINGER. Government schools?

Mr. MOLTER. Some of them are government schools, and some of them are not. In Canada I believe the work is centralized under the National Institute for the Blind. In England, of course, it is at St. Dunstan's.

Mr. DALLINGER. So far as you know, Mr. Molter, at the present time, whatever it may have been in the past, there is no delay in prompt action by the board on applications for training from soldiers who are blind or partially blind?

Mr. MOLTER. There is none. As I said, we have 251 cases. We have established contact with 250. The other one probably we have established contact with now, because we have a representative traveling through the South now personally visiting the homes, and it is our aim to visit each home and to educate the family as well as the man, because that is one of the most important of our activities.

Mr. DALLINGER In your opinion, all the soldiers who are suffering from total blindness, or what you call commercial blindness, which gives them a vocational handicap, are being promptly taken care of? Mr. MOLTER. They are.

Mr. DALLINGER. And the only cases where the men are not actually in training are where they are in the hospital, or where they refuse training, or where they have not quite decided?

Mr. MOLTER. Yes, sir.

Mr. DALLINGER. I think that is all.

The CHAIRMAN. Mr. Molter, before we excuse you, comparatively speaking, is this work more expensive than any other rehabilitation work?

Mr. MOLTER. I consider it more expensive.

The CHAIRMAN. I should think so, having so widely scattered activities all over the country. I wondered just how much follow-up, or how much associate work you can do with one person away off at one point and another away off at another point.

Mr. MOLTER. That is one of our hard problems. We try to solve it in this way, by using the existing institutions for the blind in the country as assistants in the investigation and subsequent follow-up work. That is where we believe the existing institutions can function.

The CHAIRMAN. Is there any let up of the work because of the expense, or are you going to——

Mr. MOLTER. There is not. We are going ahead and doing it.

Mr. DALLINGER. Mr. Molter, will you give us your opinion as to whether or not the United States of America, through the Vocational Board, is doing as much for the blind soldiers as any of the other countries?

Mr. MOLTER. It is my opinion that it is doing as much, if not more, for the blind soldiers.

The CHAIRMAN. You are excused, Mr. Molter.

(The witness was thereupon excused.)

(Whereupon a recess was taken until 2 o'clock p. m.)

AFTER RECESS.

The committee reassembled at 2 o'clock p. m., pursuant to recess, Hon. Horace M. Towner presiding.

Mr. TOWNER. The committee will be in order. Col. Evans, you may take the stand.

STATEMENT OF DR. HORACE MARTIN EVANS, SENIOR SURGEON, UNITED STATES PUBLIC HEALTH SERVICE.

The witness was sworn by Mr. Towner.

Mr. TOWNER. What is your full name, Colonel?
Dr. EVANS. Horace Martin Evans.

Mr. TOWNER. And what is your rank?

Dr. EVANS. Lieutenant colonel-or now senior surgeon in the Public Health Service.

Mr. TOWNER. You are detailed for work at the central office of the Vocational Board?

Dr. EVANS. The Federal Board for Vocational Education; yes, sir. Mr. TOWNER. Of course your work is exclusively with the rehabilitation part of that service?"

Dr. EVANS. Yes, sir.

Mr. TOWNER. In a succinct manner state what the nature of your duties with the board are.

Dr. EVANS. I have only been with the board since February 1st, and am detailed as medical officer in vocational training. As such officer I am to assist in finding out the work in Public Health hospitals and in other institutions, such as private sanatoria; and also to assist in installing the work. There is a committee of three that have it in charge and I am the representative of the medical side of that work. Mr. TOWNER. Who are the other members?

Dr. EVANS. Capt. Smith is in the training section and there is another man-Mr. Taylor from the placement section.

Mr. TOWNER. Do you have anything to do with determining when a man shall be discharged from the service and placed in vocational training?

Dr. EVANS. No, sir.

Mr. TOWNER. That is done exclusively by the officers in the hospitals?

Dr. EVANS. Yes, sir.

Mr. TOWNER. Do you have anything to do with the placing back in the hospitals of the soldiers that have been placed in training but whose training has been discontinued because of their disability?

Dr. EVANS. No, sir; my function is to plan for the training and the personnel in these institutions, and to supervise the work.

Mr. TOWNER. I am coming to that in a minute. Your work, then, is exclusively limited to the vocational work that is possible as part of the treatment in the hospitals before the discharge of the soldier?

Dr. EVANS. Hardly, sir. The treatment is divided into two portions. The Public Health have charge of the occupational therapy, and that part of it that is of a nature of treatment, and we come in under the Federal Board and take charge of the man after he is sufficiently convalescent to take up some prevocational work or vocational work. It is, however, absolutely impossible to make a definite line. of distinction between occupational therapy and vocational, because vocational may have therapeutic value.

Mr. TOWNER. Yes; I understand.

Dr. EVANS. It may be the best thing that could be done.

Mr. TOWNER. Just as the occupation may be part of the treatment of the soldier?

Dr. EVANS. Yes, sir.

Mr. TOWNER. Then you really try to take charge of the soldier, or see that he is taken charge of, as soon as the treatment of the soldier primarily, because he is sick or disabled, is done?

Dr. EVANS. Yes, sir.

Mr. TOWNER. Is this work carried on in the various hospitals by men in the service, by surgeons who are in the service?

Dr. EVANS. Not by surgeons, sir. The work is planned in this manner: We have authority to go into any public health office and make a survey in conjunction with the medical officer in charge or his representative, and if there are those men there who are physically able to undertake some prevocational training, those men are gotten together and they are surveyed and the work then is inaugurated under the direction of an educational director who is an educator and not a physician; and he is assisted by teachers, if possible those who have had Army experience in teaching disabled men. Mr. TOWNER. Ordinarily does this prevocational training have any connection with the vocational training that is to follow?

Dr. EVANS. It is designed to do that, sir; but there are certain things that are fundamental to all successful vocations, and as you know, perhaps, a large percentage of these men need fundamental work-I mean 25 per cent, perchance, are relatively illiterate; 75 per cent have less than a high school education, and for any successful vocation they should have work in a preparatory way.

Mr. TOWNER. That is carried on in the hospitals before they are finally discharged from it, sometimes?

Dr. EVANS. That is our purpose, sir; when a man is capable of going to the schoolroom by the permission of the medical officer, to

utilize his time in this fundamental preparation, or if he does not need that, more purposeful vocational work is given. But the large part of the work would be preparatory.

Mr. TOWNER. Do you have anything to do with manual training at all in this prevocational work?

Dr. EVANS. As it is so understood in high schools and others: yes, sir. There are certain hospitals that will be equipped for a limited amount of manual training work. It is not feasible to attempt to equip each hospital, but if we find a man in one hospital who has developed a particular tendency toward some manual training line, we can transfer him to a place where equipment and opportunities are furnished.

Mr. TOWNER. What is done, if anything, toward what is generally called "building up the system," strengthening the whole physique and resistive capacity of the men?

Dr. EVANS. That would come primarily under the medical jurisdiction. However, in most hospitals there is attention given to the physical training, but it does not come primarily under our direction. Mr. TOWNER. What is the condition of these men with regard to hygienic habits and what is done, if anything, to remedy and establish better conditions in that regard?

Dr. EVANS. I did not get one word there-hygienic habits?
Mr. TOWNER. Yes.

Dr. EVANS. The purpose of this effort to occupy their time is to prevent the degeneracy that absolutely follows indolence, and we find that as long as these men are occupied by the teacher in something that is purposeful, certainly during all that time the tendency is in the right direction, and during the time they are in any preparation for a succeeding lesson, they are properly occupied, and by adjusting the work to meet the physical condition of the man, much of their time can be absolutely controlled by this prevocational training. And it is the greatest aid in morale that the institution can have.

Mr. TOWNER. I agree with you, but I wanted to include in that such matters as personal cleanliness, care of the teeth and eyes, and habits of bathing and other habits of that character. What is your observation and what is done to improve conditions in that regard? Dr. EVANS. This would not come primarily under the jurisdiction of the line of work that I am doing, but my observation is that these men are taught by the hospital authorities and those in direct charge of them physically as to the care of their body in every way, and its relation to their recovery.

Mr. TOWNER. What is your observation as to the response that the men make with regard to those matters?

Dr. EVANS. During the time of the war I think the morale of the men was absolutely all that one could expect, and they did everything to further their physical interests, and so on. I believe that after the armistice there was a general relaxation, and now it is my observation that they must be instructed about these things and have their attention called to it. In other words, they do not seem to be just quite so alert toward their physical condition as they were before.

Mr. TOWNER. For instance, a surgeon who served during the war in one of the large cantonments told me that it was a surprise and a

great disappointment to him to note the number of young men that came into the service without any health habits, and that it was quite difficult to make them see the necessity of it. I was wondering what was the condition when they had been or were about to be discharged from the service?

Dr. EVANS. Well, in the Army hospitals the reconstruction division-as I was chief of that division for seven months-they had a physical director and it was his business to give exercises to those who needed it, and this was done largely under the direction of the department of physiotherapy as a part of their treatment. Then, of course, they engaged in games. Now, there is some of that work done in the hospitals now, but it does not come under the direction or the section with which I have any special relationship.

Mr. TOWNER. Do you come in personal contact with the men at all, Colonel?

Dr. EVANS. Only as I go out initially to survey the place in order to find space and facilities; and then subsequently if I go to inspect the work, to see how they are getting on. In those relations I come in contact with the men.

Mr. TOWNER. I presume you agree with others that one of the most difficult classes of disability is the tubercular patient, the mental patient, and those suffering from epilepsy and diseases of that kind? Dr. EVANS. You have used there three types. There is a difference, in my judgment, as to the different types you have mentioned. Mr. TOWNER. We would be glad to have you

Dr. EVANS (interposing). I would say, sir, that the epileptics present perhaps the hardest problem in rehabilitation; then the mental cases other than epileptics come next. The tuberculous individual does not present such a hard problem, other than that he may die from tuberculosis; but so far as rehabilitating this man, if his resistance is sufficient to overcome the disease, that problem is not so difficult.

Mr. TOWNER. Do you not find, and have you not learned from observation and reports from others, that the tubercular patient is very often apt to become very much despondent and disheartened and not inclined to take an active interest in his work?

Dr. EVANS. That is true, sir; and there is an element of psychosis in most of those cases. In other words, you have to treat the mind as well as the body, in a sense.

Mr. TOWNER. I presume members of the committee as well as others receive a great many letters from men from various parts of the country. I have here a letter from a soldier boy who is now in Denver. He is a tubercular patient and this is an extract from his long letter:

I went to Albuquerque, N. Mex., after I was discharged, to escape the severe weather in the winter, and while there I worked half a day for the United States Public Health Service. I was in charge of the office for the State supervisors, so I had an opportunity to get a good view of the situation. My boss being a doctor, left everything possible for my attention, and so what I say is the real truth. We had soldiers from all parts of the country land in Albuquerque without a cent and with active tuberculosis. They had put in claims for compensation but had not received a cent. They had spent all that they had and all that they could borrow, and most of them were Bolshevists. They can not be blamed. After a year in the hospital these men do not want more hospitalization. Hospitalization is very depressing for the fellow that is