Compliments of the Author. COUNTERFEIT SCIENCE. BY A. PALEN POWELSON, M.D., MIDDLETOWN, NEW YORK. REPRINTED FROM THE HAHNEMANNIAN MONTHLY, AUGUST, 1897. COUNTERFEIT SCIENCE. BY A. PALEN POWELSON, M.D., MIDDLETOWN, NEW YORK. Within the past few years the calendars of our courts have become crowded with numerous actions, brought against rail- road corporations to recover damages for personal injuries sustained by reason of real or fancied negligence on the part of these corporations. The necessity for defending such actions as these, and of producing sufficient medical testimony to raise an issue of fact for a jury in reply to the expert evidence usually introduced by injured persons, has resulted in a special phase of medical study, whose main object seems to be to overthrow the generally accepted conclusions of well informed physicians. Those who are really interested in the advancement of medical science will never be disposed to cavil at any genuine contribu- tions to its literature, either in the way of discovery or theory, but everyone will admit that there is a vast difference between the scientific conclusions of experienced surgeons based upon personal diagnosis and pathological treatment, and the crude guesswork of comparative novices, who are solely interested in seeking to evade the force of facts by substituting fancies in their place. It is, of course, perfectly right and proper that railroad companies should employ medical men, and that per- sons seeking to recover money from these companies should submit themselves to examination by their duly accredited physicians. This is fair and just, because such a course dis- closes the actual facts, and affords an equal opportunity to the experts on both sides to apply such usual and satisfactory tests as the common consensus of the profession recognizes as con- clusive. It is, however, a far cry from this sensible and im- partial method of procedure to that which has been recently adopted in the class of works issued by some railway surgeons which seem to be intended as hand-books for those who are 2 employed to get up medical defences in the kind of actions referred to. I allude especially to a publication by Mr. Page, the surgeon of the London and Northwestern Railway Com- pany, which treats of " Injuries to the Spine and Spinal Cord." The principle adopted by the author in question is appar- ently this: to assume in all cases against railroad corpora- tions that the plaintiff is a fraud and a liar, that his medical witnesses are co-conspirators in the fraud, and their conclusions based upon ignorance or old-fashioned and exploded tests; and that, so far as his special thesis is concerned, there is really no such thing as concussion of the brain and spinal cord involving permanent or incurable injury. Mr. Page sees this subject through spectacles of his own, framed in railroad gold and fitted with lenses which magnify infinitesimal defects on the one side and minimize radical errors on the other. The ver- dicts of juries, composed of men of ordinary common sense, sustained in thousands of instances by the decision of judicial tribunals of final resort, afford a tolerably conclusive answer to his suggestions of wholesale malingering on the part of injured suitors. His position on this point also involves the further assumption that the host of reputable and intelligent surgeons who have testified on behalf of such persons in these numerous litigations were either incapable of detecting fraud or eager to act as confederates in its consummation. One can have but little patience with this sort of indiscriminate libel, and it will probably have as little effect upon the profession at large as the barking of a toy terrier would have upon the average elephant. But Mr. Page is very positive about spinal disease, There is, and can be, no such thing, he says, as " molecular disturb- ances of the brain and spinal cord," and he is very severe in his comments upon the authorities who hold otherwise. He "does not comprehend towhat kind of injuries they refer;" he finds " their phraseology ambiguous," " not sufficiently ex- plicit," " lacking in clearness." It never occurs to him that the difficulty of comprehension may be his own, or that the lack of clearness may be in his own receiving medium. They are simply wrong-all of them-and he alone is right, and altogether so. Certainly, if they lack " clearness," he is not wanting either in assurance or self-esteem. Let us make a brief issue. It is the commonly received 3 opinion that a direct blow upon the spine, without injury thereto, frequently produces disease of the spinal cord; it is also believed " that indirect violence, as a sudden twist or a fall upon the feet or buttocks, without actual spinal lesion, may, and often does, produce such a vibratory jar of the central nervous system as leads to molecular change in the finer nerve- elements, resulting either in immediate and complete functional paralysis or forming the commencement of degenerative in- flammation." It has been conclusively demonstrated that re- covery never takes place from the secondary results of concus- sion, which is really the shaking out of nervous force, as magnetism is shaken out of a magnet. It is, further, the uni- versal experience that there is only a slight tendency to recov- ery exhibited in cases of actual concussion. All this Mr. Page denies. lie says, " Urbi et orbi," "Ex nihilo, nihil fit." " Nor are we justified in believing, from the evidence, that the nerv- ous phenomena arising from shakes and jars of, or blows upon, the body, and described as characteristic of concussion of the spine, are in reality due to chronic inflammation of the spinal membranes or cord, or that they are even due to any patho- logical lesion of the spinal cord at all." And he further says, of cases of spinal concussion: " Their tendency is to get perfectly well after a longer or shorter time." He thus enjoys the proud felicity of being " Athanasius contra mundum." He sweeps away, with a con- temptuous wave of the hand, all the received conclusions of able and experienced scientists, while he gives no explanation of the/acfe upon which those conclusions rest. This is a short and easy method of getting rid of evidence which may incon- venience his clients when they are sued, because they have negligently paralyzed a man's spine for life. It furnishes a spurious and counterfeit science which bears a sufficiently simi- lar stamp to the real to confuse and befog a jury, and may pass equally current with the unlearned. It is like the ready-made science of Captain Wragge, in Wilkie Collins's famous novel. That sort of science fooled the shrewd Mrs. Lecount, and, as Mr. Page evidently thinks, is a " good-enough Morgan " for a jury. One can admire the ingenuity of this scheme, but can hardly regard it of permanent value to real science. On the contrary, it may be temporarily injurious. It is, in any event, 4 worth more than a passing notice, because of its practical bearing on future litigation. Henceforth, railway corporations can have on hand, with other office furniture, a copy of Mr. Page's manual, and can always be prepared with a ready-made defence, in cases of alleged spinal concussion, complete in char- acter and decisive, if it be believed. It rests upon these two maxims, for which we have the ex cathedra authority of Mr. Page: Proposition 1.-There is no such thing as spinal concussion. Proposition 2.-If there is such a thing, it is never fatal and always curable. The mere enunciation of these maxims, which form the Apostles' Creed of this new cult, may hereafter be expected to terminate all inconvenient lawsuits in favor of the defendant corporation* " Roma locuta est, causa finita est."