Medical evidence in railway accidents / by John Charles Hall.

  • Hall, John Charles, 1816-1876.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: Medical evidence in railway accidents / by John Charles Hall. Source: Wellcome Collection.

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    If called to a man who has been in a railway colli- sion, and who tells me that he then received a blow on the spine, or a jar, or a twist, or a sprain, or concussion; that he is now quite unable to move his legs, or even to turn himself in bed—(and, especially, if there had been no immediate symptoms after the injury of impaired or altered function of the nerve-centre, but that some weeks or months after the accident, and when it was almost forgotten, these symptoms indica- tive of serious disease are said to have appeared)— when this goes on week after week,—the man still remaining, apparently, without the power of moving in his bed—his lower extremities stated to be without sensation or motion—with a healthy-looking counte- nance—no marked lesion of nutrition—no difference of temperature between the parts said to be paralysed and the rest of the body—perfect command over the bladder and rectum—pulse natural—no bed-sores—no flattening of the nates or calves of the legs—and I am drawing no imaginary picture here—I say, emphatically, there is a total absence of the objective symptoms which I have seen during the last thirty years, in all the numerous cases of serious spinal injuries which I have attended. In all cases, therefore, where the pathognomonic symptoms of the alleged injury are absent, who will venture to say they ought not to be submitted to the most searching, careful, and fearless investigation. I have used the terms objective and subjective. By objective, I mean whatever is exterior to the mind- outward, external; something that we can see. To this, the term subjective is altogether opposed. In the former case I depend on the evidence cognizable to my senses ; in the latter, there is nothing to depend upon, save the statement of the patient. The result of my experience is this. I have never yet seen a case of injury, the result of a collision on a railway, where the symptoms have been subjective onlij, in which the favourable verdict of a jury, and the