Advanced Techniques for Rehabilitation after Total Hip and Knee Arthroplasty: Henry Chase Marble, 1885–Unknown

Henry Chase Marble was born in 1885. He graduated from Clark University with an AB degree in 1906 [12]. He served on the staff at the Massachusetts General Hospital, and for some time was Chief of the Fracture Service. During WWI he served in France at the 6th Base Hospital of the American Expeditionary Force, leaving the military as a major. After the war he participated in the Committee on Fractures of the American College of Surgeons (more than 10 years before the American Academy of Orthopaedic Surgeons was formed) [10]. For 2 years during WWII he was President of The American Association for the Surgery of Trauma and hosted the meeting in Boston in 1942. Owing to the war conditions, they held no meeting in 1943 and he continued as President [11]. He published at least two books: Surgical Treatment of the Motor-Skeletal System [1] (a large work of over 1000 pages in two volumes), and The Hand: A Manual and Atlas for the General Surgeon [8]. In addition to his books, he published a number of papers. Not surprisingly, his early papers covered a wide range of topics in surgery. He developed a particular interest in industrial injuries and published a number of related papers in the 1950s [2‐5, 7, 9].

The paper we reproduce here was published in 1920, shortly after the war [6]. In this article he describes the “ward care” of patients in his hospital in France.

“During the past few months the terms have crept into use; Occupational Therapy, Physio Therapy, as if each were an end unto itself, each the only factor necessary to heal the wounded man. This is a serious mistake. Let us not be led astray from the object of the Medical Corps even in thought and talk of this therapy and that therapy but let us unit them all under a competent surgeon, pool all the resources and make towards a successful whole.”

Marble evidently held strong opinions about rehabilitation, but realized a successful outcome depended upon teamwork.

“At each wounded soldier’s bed the nurse reported upon the progress of the wounds and general condition; the enlisted man was on hand to adjust and rearrange the splinting; the physio aide demonstrated the muscle and joint progress; and the occupational aide showed the progress in her work. The type of occupational work found most suited for bed patients was rug making, toy making, weaving, stenciling, printing, and bead weaving” [6].

Marble’s comments undoubtedly reflect the attitudes and state of the art at the time. We have, however, made great strides in rehabilitation. This month’s symposium highlights the advances in multidisciplinary approaches to quickly rehabilitate patients following joint replacement surgery. Whereas formerly patients spent many days or even weeks in the hospital, they often now are discharged within a few days, or even the same day. It is crucial to emphasize the success depends upon the team working together, just as Marble suggested.

(Editor’s Note: I was unable to identify but little biographical information on Dr. Marble.)