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'This article will show the links between government policy and Stoke Mandeville, how they worked and how they sometimes clashed. It will examine not only the role of rehabilitation in the lives of the spinal injured, what forms it took, how sport and games came to form such an important part of the treatment regime at the Unit, but also how the hospital, its director and government departments worked to turn ‘a severely disabled person into a taxpayer’ [note: 'Apparently this was the main aim of Sir Ludwig Guttmann, Director of the Spinal Unit. Joan Scruton, Stoke Mandeville: Road to the Paralympics (Aylesbury 1998), 19.']. The article will conclude that, for all the positive values that were part of the Stoke Mandeville ethos, central government encouraged schemes of rehabilitation as a way of returning disabled people to the work environment, thereby reducing the welfare bill.' (462)


Suggests that developments in drug and blood transfusion technologies was primary factor in reduction of casualties from urinary tract infection and bedsores: 'While the majority of war-injured, both service and civilian, benefited from this attempt to return them to previous levels of health and reduce residual disability, there was one particular type of injury that defied contemporary notions of rehabilitation. This was paralysis caused by severe damage to the spinal cord. The likelihood of death following a paralysing spinal wound was between 47 and 65 per cent in the first few months, increasing to 80 per cent within three years.[note: 'R.O. Ward, ‘The Management of the Bladder in Spinal Injuries’ in Hamilton Bailey (ed.), Surgery of Modern Warfare (Edinburgh 1944), 661.'] The main factors contributing to early death were complications arising from infection of the urinary tract system and bedsores. [note: 'An awareness of and methods of treatment for bedsores was evident in a report by the Medical Research Council, Injuries of the Spinal Cord and Cauda Equina, 1924.'] As the war progressed, patients’ prognosis improved with the use of penicillin and sulpha drugs, which controlled infection, and blood transfusions, which stabilized the patient and reduced the risk of death from shock. Developments in medicine helped to return the patient from his place of injury to the hospital rather than the morgue.' (464) compare L. Guttmann 'New hope for spinal cord sufferers' Medical Times 73 (1945), pp. 318-326 on pp. 7-10.