From the very beginning, the triumph of the new railways was linked with the spectacle of violent death. In 1830, during the inaugural running of a train on the Liverpool & Manchester line, William Huskisson, the MP for Liverpool and an avid supporter of the railways, was run over by the Rocket locomotive and killed. This individual death was shocking, but within a few years, large-scale accidents had begun to occur, and in 1841, a parliamentary committee generated the first of many reports entitled "On the Prevention of Accidents on Railways." Railway accidents continued, however, with hundreds of people dying and thousands injured in crashes all over England through the rest of the Victorian era. Public fears about railways--their speed, their violence, their noisiness, their expense, their ability to destroy English values, their ability to ruin the unwary investor--ran high, as these two cartoons suggest:
One of the most famous survivors of a railway crash was Charles Dickens, who crawled out of the Staplehurst disaster in June of 1865, dragging his mistress Ellen Ternan and her mother with him. He then spent several hours assisting other injured passengers, ministering to them with water and brandy, before he retrieved his suitcase with a manuscript for his last completed novel, Our Mutual Friend. (See the illustration above for an imaginative rendering of the scene.) Ten people died and nearly fifty were injured in the crash; and in the following days, Dickens became increasingly anxious and experienced a variety of symptoms including the loss of his voice for two weeks and shaky handwriting. He died five years to the day after the accident.
We would probably attribute symptoms such as these to PTSD, but of course that nomenclature wasn't available back in the 1850s, '60s, '70s, and '80s. Medical men wrestled with how to name the illness and how to cure it; at various times it was called "railway spine" or "railway brain"; some medical men posited that being thrown back and forth around the railway carriage during the accident caused small lesions in the spine, unique to railway accidents; others believed that the injuries sustained were no different than those received from other kinds of accidents (being thrown from a horse or falling off a ladder); and still others maintained that these victims were, for the most part, imagining or concocting the symptoms for notoriety, pity, or money.
It is important to understand that in the mid-1800s the medical profession was struggling to consolidate its public authority. The Medical Act of 1858 had ostensibly united into one profession the university-trained physicians, apprentice-trained surgeons, and apothecaries, but quite often medical men were seen as quacks and charlatans--a belief supported by the fact that quite often medical men would have wildly different views of illnesses and treatments. At mid-century, under existing jurisprudence, a "real" injury was an "organic" injury--one that could be located in a specific organ or limb. So when it came to railway-related injuries, sympathetic medical practitioners located the railway injury in the spine--an "organ" that was wholly inaccessible, of course; as such, the visible bodily symptoms became signs of the invisible injury. Unsympathetic medical men scoffed at the idea and cited cases in which victims became "cured" of their symptoms within hours of receiving financial compensation. These disagreements were played out in open court, for all to see. One of the most famous treatises on the topic was written by John Eric Erichsen, On Railway and Other Injuries of the Nervous System (1866), and quite often it was brought into court and waved around, marshaled as "evidence" for one side or the other. Unlike many diseases, railway-related injuries put a medical man's reputation on the line in two arenas: the private sickroom, where he treated the patient, and the highly public lawcourt where he testified about them.
This is where my novel, A Lady in the Smoke, begins--with a railway disaster involving Lady Elizabeth Fraser and her mother, a medical man named Paul Wilcox, and dozens of patients--one of whom will nearly destroy him.