| HYSTERIA AS AN ASSET |
By PEARCE BAILEY, M.D.
ADJUNCT PROFESSOR OF NEUROLOGY, 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 construction 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 "railway spine" might be. It soon became a best seller. It was indispensable 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 calendars with damage claims. For nearly twenty years it stood unchallenged 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error; and his monograph, once so opportune and never to be stripped of the glory of the pioneer, is nothing now but a historical document.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 Railway, 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 proportion of them recovered. He wrote with candor, but being a corporation 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
