In a litigious society with so much money at stake, plaintiffs are often portrayed negatively by the media. The Coalition Against Insurance Fraud estimates that fraudulent claims cost $80 billion per year in the U.S. Auto accidents follow a similar trend where the cost of claims is rising while the overall severity of injuries is declining. Her report points to the fact that changing standards put more weight on self-reported pain and discomfort. Veronique de Rugy, a senior research fellow at George Mason University’s Mercatus Center indicated that despite medical advances which allow people to remain on the job, the number of Americans claiming disability has increased more than 6 fold. While causes vary and include falls, auto accidents, assault, occupational accidents, and sports, some of these, such as auto or occupational accidents, result in litigation. These numbers are understated, as they do not include those head injuries which did not involve a trip to the hospital. After World War II, as cars became popular, whiplash injuries multiplied, resulting in similar clusters of symptoms.Īccording to the CDC, there were 2.5 million emergency room visits, hospitalizations, or deaths associated with traumatic brain injury, the majority of which were concussions, or “mild TBI”, in 2010. Pioneering French neurologist Charcot suggested manifestations of hysteria instead.
Later, Oppenheimer moved from the theory of “Railway Spine” to “Railway Brain”, like Erichsen attributing symptoms to an organic cause. Dickens suffered from symptoms including weakness and anxiety and being “not quite right within,” which he attributed to “the railway shaking.” He described “two or three hours work afterwards around the dead and dying surrounded by terrific sights”. Dickens’ carriage did not go over the bridge, but was too close for comfort, dangling. Page proposed that fear and shock played a role, suggesting psychological rather than organic causes in the large number of people who had been in relatively minor accidents yet remained symptomatic afterwards.Īmong the many train crash victims was Charles Dickens, famous author of A Tale of Two Cities, A Christmas Carol, and Great Expectations. This view was challenged in the 1880s by London and Northwest Railway surgeon Herbert Page, who asserted that one of Erichsen’s spinal concussion cases was potentially suffering the effects of syphilis instead, and pointed to a lack of post-mortem data in the majority of spinal concussion cases. The secondary are mostly of an inflammatory character, or are dependent on retrogressive organic changes, such as softening, etc., consequent on interference with its nutrition.” “The primary effects of these concussions or commotions of the spinal cord are probably due to changes in its structure. London surgeon John Eric Erichsen gave famous lectures in 1866, later republished in book format in 1875 as On Concussion of the Spine: nervous shock and other obscure injuries of the nervous system in their clinical and medico-legal aspects, in which he opined: In the late 1800s, the dominant theory involved organic lesions of the spine and brain. With the advent of ‘concussion of the spine’ the situation changed, and the concept that the injured were victims of at best ‘shock’ and at worst spinal anaemia or meningitis became prevalent.” “In the nineteenth century and before, legal cases involved with personal injury were mainly to do with material injuries, such as loss of a limb or an eye, where objective evidence was unmistakable and quantifiable. In his book Post-Traumatic Neurosis, physician Michael Trimble notes that:
With billions of dollars of claims at stake, courtroom adversaries can pick and choose from a range of conflicting studies and theories. Present day conditions of PCS and whiplash present similar symptoms, with etiology that is still the subject of debate.
The present day billboards of personal injury attorneys seeking auto accident victims as clients hark back to the late 19th century, when railways became a popular means of travel. During that time, railway accidents, and the number of physicians reporting on conditions such as “Railway Spine”, increased dramatically. 150 years on, contention still surrounds the lingering symptoms of insomnia, dizziness, irritability, depression, cognitive impairment and so on that affect between 30 and 80 percent of Americans following a mild traumatic brain injury (mTBI), or concussion. Controversy surrounding Postconcussion Syndrome (PCS) dates back to the 1800s.
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