568 THE POPULAR SCIENCE MONTHLY 



HYSTEEIA AS AN ASSET 



By PEARCE bailey, M.D. 



adjunct pbofessoe of nedeologt, columbia university, new york 



AT about the time that Commodore Vanderbilt was establishing in 

 America the methods which made railway travel easy, a book 

 was published in London which left untouched all problems of con- 

 struction and management, but nevertheless played an important part 

 in the economics of transportation. This book treated of railway 

 injuries and was written by England's foremost surgeon, John Eric 

 Erichsen. It brought together for the first time, in concrete form, the 

 nervous disturbances from which the victims of railway wrecks suffer 

 so severely; and by chronicling the large sums of money awarded in 

 such cases as were litigated, it showed how important an asset " rail- 

 way spine " might be. It soon became a best seller. It was indis- 

 pensable to physician and attorney alike ; and transportation companies 

 had to have it to protect themselves against the menace of the new. 

 disease. It almost became a court manual at this epoch, when the 

 quickening of railway movement was beginning to crowd court calen- 

 dars with damage claims. For nearly twenty years it stood unchal- 

 lenged and without a rival. Its influence was felt the world over, for 

 it carried with it a money importance such as seldom follows the 

 writings of medical men. 



All this was half a century ago. Since then, new knowledge and 

 new ways of getting it have shown that Erichsen taught mostly error; 

 and his monograph, once so opportune and never to be stripped of the 

 glory of the pioneer, is nothing now but a historical document. It was 

 a costly book for railway companies. The cases it described were 

 serious and " railway spine " brought large verdicts. It was not until 

 1882 that its teachings were seriously questioned. Then Page, surgeon 

 for the London and Northwestern Eailway, took a hand. In vigorous 

 language, he presented new facts as seen by the railway surgeon. He 

 brought forward the after histories of over two hundred cases of railway 

 injuries and showed, contrary to Erichsen's teachings, that a large pro- 

 portion of them recovered. He wrote with candor, but being a cor- 

 poration servant, could not escape the charge of bias. 



But Charcot was not biased, and when, in his studies of hysteria, he 

 began to demonstrate the mental origin of many physical symptoms, 

 the subject received its true illumination. Thoughtful physicians could 

 no longer fail to realize that railway injuries are not essentially different 

 from any others ; that the mutilations are such as surgeons see resulting 

 from a variety of causes, and that the nervous symptoms which so often 



