normal and abnormal labor, and the various manipulations required in obstetric surgery are all described in detail, and elucidated with numerous practical illustrations.

Since the appearance of the first edition many important advances have been made in the science and art of obstetrics. The results of bacteriologic and of chemicobiologic research as applied to the pathology of midwifery; the wider range of surgery in treating many of the complications of pregnancy, labor, and the puerperal period, embrace new problems in obstetrics, some of which have found their place in obstetric practice. In this new edition, therefore, a thorough and critical revision was required, some of the chapters being entirely rewritten, and others brought up to date by careful scrutiny. A number of new illustrations have been added, and some that appeared in the first edition have been replaced by others of greater excellence.

By reason of the extensive additions the new edition has been presented in two volumes, in order to facilitate ease in handling. The success primarily achieved unquestionably awaits this present edition, as we know of no more commendable work on the subject.

RECOVERY AFTER LIGHTNING STROKE.

BY F. J. BARDWELL.

Accompanying the report of this case is a reproduction of a photograph taken three days after a lightning stroke. The picture shows a mark on the right side of the body beginning at the tip of the right shoulder and extending downward on the side of the trunk as far as the ilium, and then passing inward, terminating in the middle line. This mark, while it appears narrow in the picture, is said to have been from two to three inches wide and blood-red in color along the center, shading off at the edges to the normal skin. So far as the reporter knows, this is the first case of stunning by lightning in which the patient was burned and survived. The patient and three other men were out in a storm. He was under a wagon, twelve feet from the spot where one of his companions stood under a tree. The latter was killed. The remaining two men were at distances of four rods and forty rods respectively. The patient did not hear the report when the lightning struck, but remembers seeing a vivid flash and calling for help. When he regained consciousness he found his two uninjured companions rubbing him. He was conscious for about ten minutes. For a period of two hours after the stroke there was a constant desire to urinate, and for several days there was general muscular weakness.-Medicine.

Traumatic Pneumonia-Pneumonia is but rarely due to traumatism. Of 3,373 cases collected by Stern, only 44, or 1.3 per cent, could be traced directly to trauma. Schild reports the case of a 64-year-old man, who fell on the ice, striking the right side of his chest. During the same evening he was taken with a chill, followed by fever, chest pain, dyspenea, cough, etc. He developed a typical croupous pneumonia of the upper right lobe, which diagnosis was verified by autopsy; there were no other injuries to the chest wall.-Amer. Medicine.

Railway Miscellany.

RAILWAY.BUILDING FOR THE YEAR 1902.

Six months ago, when The Railway Age published its summary of railroad building for the first half of 1902, it appeared evident that the new mileage for the entire year would exceed 6,000 miles, but the incessant rains during July and August, and in some portions of the country during September and October, seriously interfered with grading and tracklaying, and the delays thus encountered, coupled with the difficulty, so widely experienced, of securing rails, have prevented the realization of our expectations. However, the new mileage completed during 1902 exceeds that of 1901, when 5,222 miles of track were laid and is greater than that of any year since 1890, when 5,670 miles were built. The returns for the year just ended are still incomplete and when they are all received it is quite possible that the figures for 1890 will be eclipsed. As the record stands to-day it shows a total of 5,549 miles of track laid on 349 lines in 44 States and Territories from January 1 to December 31, 1902, exclusive of second track and sidings and without taking into consideration many private lines and logging roads which have been built for temporary use. The details are shown in the following table, which gives the mileage by States:

TRACK LAID FROM JANUARY 1 TO DECEMBER 31, 1902.

The year closes with tracklaying in progress, or just about to begin, on many extensions which managers confidently expected to have completed by this time, and the first few months of the year therefore will show large additions to the railway mileage of the country.

Reference to the table will indicate that the Southwest continues to be the scene of greatest activity, and that in the five States and Territories of Arkansas, Texas, Oklahoma, Indian Territory and New Mexico, 2,218 miles have been added in the last twelve months. Indian Territory stands at the head of the list, with 541 miles; Oklahoma is second, with 532 miles; Texas third, with 480 miles; New Mexico fourth, with 358 miles, and Arkansas fifth, with 308 miles.

It is interesting to note that with the exception of 9 miles completed in Oklahoma by the Kansas City Mexico & Orient, all of the new mileage in that territory has been built by or in the interest of the Chicago Rock Island & Pacific, the St. Louis & San Francisco and the Atchison Topeka & Santa Fe. The same companies, with the addition of the Missouri Kansas & Texas, have likewise built the greater portion of the new mileage in Indian Territory, although the Ozark & Cherokee Central and the Fort Smith & Western have built 180 miles in the Territory. A considerable portion of the mileage credited to the Rock Island, however, was completed by the Choctaw Oklahoma & Gulf previous to its absorption. The various companies above named are literally grid-ironing this country with new lines, and further extensions already under way or planned by them exceed their new mileage for 1902.

Considered with reference to grouping of States as ar

The States west of the Mississippi River have built 3,800 miles, which is more than two-thirds of the grand total, and the States south of the Ohio and east of the Mississippi have added 848 miles, leaving only a little over 900 miles to be credited to all of the States north of the Ohio and east of the Mississippi.

The only States reporting no new mileage are: New Jersey, Rhode Island, Delaware, Idaho and Wyoming, although Maryland, Vermont and Massachusetts show only 4 miles each. The addition of 8 miles in Nevada is due to the revision of the Southern Pacific line between Brown and Wadsworth, the old line being abandoned and the new line of easier grades and curves, which is 8.18 miles longer, taking its place.

The greater part of the work of the past year has been carried on by the large systems, which continue to build branch lines into new and undeveloped territory, and there has been little parallel building, one notable exception being the Chicago Great Western, which has completed 661⁄2 miles of its 130-mile extension from Fort Dodge, Ia., to Omaha. The Chicago Rock Island & Pacific system, including the Choctaw Oklahoma & Gulf and other acquired lines, has expanded most by construction and has added 626 miles in Oklahoma, Indian Territory, New Mexico, Texas, Missouri and Arkansas. The St. Louis & San Francisco and allied lines have built 609 miles in Missouri, Arkansas, Texas, Indian Territory and Oklahoma, and the Santa Fe system has completed 185 miles in Arizona, New Mexico, Texas, Indian Territory and Oklahoma. Some of the other large systems have built new lines as follows: Great Northern, 194 miles in Minnesota, North Dakota and Washington, not counting the extensions built in Canada; the Southern Pacific, 165 miles in Louisiana, Texas, Nevada, California and Utah; International & Great Northern, 129 miles in Texas; Chicago Great Western, 112 miles in Minnesota and Iowa; Chicago & Northwestern, including the Chicago St. Paul Minneapolis & Omaha and the Fremont Elkhorn & Missouri Valley, 178 miles in Wisconsin, Minnesota, Nebraska and South Dakota; Chicago Milwaukee & St. Paul, 95 miles in Iowa, Minnesota, North Dakota and South Dakota; Illinois Central, 74 miles in Mississippi, Kentucky and Illinois; Missouri Kansas & Texas, 80 miles in Kansas, Oklahoma, Indian Territory and Missouri; Texas & Pacific, 63 miles in Louisiana; Missouri Pacific, 137 miles in Louisiana, Missouri and Arkansas; Oregon Short Line, 58 miles in Utah.

Important new lines which do not seem to be identified with any of the great systems have laid track as follows: El Paso & Southwestern, 161 miles in New Mexico, Arizona and Texas; Ozark & Cherokee Central, 132 miles in Arkansas and Indian Territory; Fort Smith & Western, 56 miles in Indian Territory; St. Louis Valley, 100 miles in Illinois; Iowa & St. Louis, 60 miles in Iowa and Missouri; Des Moines Iowa Falls & Northern, 53 miles in Iowa.

The two important independent lines which have a large projected mileage each-the San Pedro Los Angeles & Salt Lake and the Kansas City Mexico & Orient-have accomplished but little in the way of tracklaying, the former having completed but 31 miles in California, and the latter but 40 miles in Kansas and Oklahoma and 28 miles in Mexico. However, the Orient line has finished a large percentage of its grading and proposes to push the work of tracklaying early in the year.

The following table indicates new construction by years since 1887, inclusive:

The main line mileage of the United States at the close of 1901 was 198,787 miles, according to Poor's Manual, and the addition of the 5,549 miles completed in 1902 brings the total mileage of the country up to 204,336 miles on January 1, 1903.

A Permanent Home for Disabled Firemen.

The various lodges of the Brotherhood of Railway Firemen are to vote on a proposition for the building and maintenance of a permanent home for disabled members by means of the small contribution of 75 cents per member for the first year and 25 cents thereafter. The home, which has for some time been sustained near Chicago, largely through the exertions of "Father" Coffin, is inadequate for the demands, and Mr. Coffin makes a stirring appeal in the Firemen's Magazine for the co-operation of all members in the enlargement and maintenance of this beneficent work.

Cuban Railways.

According to the Bulletin of the Bureau of American Republics for October, 1902, the entire railways of Cuba aggregate only 2,000 miles, divided among 124 lines, and valued at about $70,000,000. Only 17 lines out of the 124 are devoted to public traffic, while all the rest are used in the transportation of sugar. Passenger rates are about 12 cents and 5 cents per mile for first and second class, respectively. A new line of railway is now under construction which will connect Santa Clara with a line from Havana and Cienfuegos and open communication with Nipe, one of the best harbors on the coast and only 60 hours from New York. This new line will open up an area of about 10,000,000 acres, or approximately one-third of the total area of Cuba.

System of Discipline of the Illinois Central.

Beginning on January 1, 1903, a modified system of discipline by record will be introduced in the transportation department of the Illinois Central. Employes will be divided into two classes, class "A" including those who on December 31, 1902, have clear records and those in service more than two years, with an aggregate of not more than 60 days record of suspensions; class "B" will include those who on the same date have an aggregate of more than 60 days against their records and those in the service less than two years, whose records are not clear. Employes entering the service after December 31, 1903, will enter class "B" and will become eligible to class "A" after two years of service with clear records. Present employes assigned to class "B" may be transferred to class "A" upon clearing their records. An individual account will be kept with each man and entries will be made for every case of neglect of duty, violation of rules or good practice, accidents, improper conduct, etc., with a note of the discipline determined upon. Employes in class "B" will serve actual suspensions, but employes in class "A" will continue at work without loss of time, although reprimands and suspensions will be noted. Records may be improved by the exercise of good judgment in emergencies, acts of heroism, loyalty to the service, and other meritorious conduct. The record will be taken into account when the question of promotion is under consideration. All records will be open to the inspection of the employe interested, but not to others except the division and general officers of the company. Notice will be given every employe of reprimand or suspension noted against him. Suspensions will be made

for periods of not less than five days or more than 60 days, and such records may be extinguished by satisfactory service for various periods, five days being extinguished by clear record of one month, 10 days two months, and so on up to 60 days, which will be extinguished by clear record of one year. An accumulation of records of suspension, showing that the employe is not a desirable one for the service, will justify consideration by the board of inquiry. No change will be made in the existing practice of consideration of offenses. The company expects the system to promote harmony and to stimulate employes to earnest co-operation with its officers in attaining more efficient service.

-

DANIEL G. REID.

The recent election to the chairmanship of the Rock Island board of Mr. Daniel G. Reid, to succeed Mr. R. R. Cable, who has long been desirous of retiring, completes the remarkable series of changes that have placed the management of this old company in new and younger hands. Mr. Reid, who is said to be the largest individual holder of the company, has risen into prominence within a very few years. After a successful career in the banking business at Richmond, Ind., where in 22 years he rose to the vice-presidency, he organized the "tinplate trust" some six years ago and soon acquired a fortune, with which he was able, in connection with the Moore brothers and Mr. W. B. Leeds, to obtain control of the Rock Island some three years ago. At the age of 44 he is now the financial head of a system of over 8,000 miles of railways and has achieved the reputation of being one of the few great financiers of the period. Mr. Reid's residence is in New York, the direct management of the company remaining at Chicago under President

Leeds,

information should fit the place where it is posted. The expectant traveler does not care how much the train was late one or two hundred miles away; he wants to know when it is going to arrive at his station, and if the prospects change after the first announcement he ought to be correspondingly notified. In neglecting to furnish the needed information rail. ways violate a reasonable law, in most States, and fail in an attention which contributes greatly to the comfort and good feeling of their patrons.

British Railways in 1901.

The general report on the railways of the United Kingdom in 1901 to the Board of Trade has been issued as a parliamentary paper. Reserving fuller comments on the report until the document itself arrives, attention is directed to a few facts gathered from press reports. With the ex

ception of compensation to employes and for personal injuries to passengers, all branches of expenditure increased per train mile. The amounts paid for fuel were very large, in spite of the decline in the price of coal, because the contracts at high prices did not terminate until the year was well advanced. The gross receipts amounted to £99,600,000, an increase of £700,000,

or 0.7 per cent. This increase was due to improved passenger business, the freight traffic showing a falling off. The greater part of the increase in passenger traffic fell to the third class, which rose 2.9 per cent; first-class increased but 0.9 per cent, while second class fell off 0.3 per cent. The increase in first-class is appreciably less than the increase in revenues, while the numeral increase of third-class traffic has been greater than the increase in revenues. Both first and second classes owe much of their support to long-distance traveling. The increase in total expenditures is unduly exaggerated by the inclusion on both sides of the account, of figures formerly omitted, such as steamboats, canals, docks, rents, tolls, hotels, etc. The proportion of gross receipts to working expenditures remain practically unaffected, the latter constituing 63 per cent of the former, for the years 1891 to 1901, inclusive. Comparison with the years 1877 to 1891, inclusive, reveals a marked increase in the proportion of working expenditures to total receipts. During these fifteen years this proportion fluctuated between the narrow limits of 51 and 55 per cent. Capitalization was increased by 19% millions sterling, being an increase of 5% millions in the common stock, 81⁄2 millions of guaranteed and preferred stock, and 51⁄2 millions of bonds and debenture stock.

aided by Mr. C. H. Warren, assistant to the president. After 20 years of strenuous and fruitful service with the Rock Island, as general manager, president and chairman of the 'board, Mr. Cable frees himself still further from its burdens, although it is understood that he will continue on the Rock Island board as chairman of the executive committee. The Rock Island will stand as an enduring monument to his remarkable forcefulness and sagacity.

In these days of congested traffic and inclement weather, when passenger train service is liable to some irregularity, the practice of bulletining in the stations the time when trains are expected to arrive, is especially useful. Many roads supply this information promptly and keep waiting passengers notified at frequent intervals in regard to the pros. pects of delayed trains; but on some roads, or at least at some stations, this duty is neglected or imperfectly attended to. Sometimes a train will be bulletined as being an hour late and the announcement, which was based upon the movement of the train perhaps several hours before it was due at the given station, will be allowed to stand, although the train meantime may have made up on lost time materially. The

King Edward of England received from the London & Northwestern Railway Company a remarkable Christmas gift, which was nothing less than a luxuriously furnished special train with a new especially designed engine. The train is perfectly equipped and will be used only for transporting the King and members of the royal family. The cost of the railroad company's present is given as $300,000.

VOL. IX.

No. 9

BY RALPH C. RICHARDS, ESQ., OF CHICAGO, GENERAL CLAIM AGENT, C. & N. W. RY.

Whether any department on a railroad is beneficial to the company depends upon whether it can make or save money for the corporation. A surgical department brings no revenue, so the only question that remains is, does it save any money? And that question has been answered in the affirmative by the managing officials of many of the best operated and most profitable railroads in the country, which for years have had such a department, who certainly would not continue to maintain it had it not proven to be advantageous so to do, as "while we judge ourselves by what we feel capable of doing, others judge us by what we have already done." So the surgical department, like the freight department, the passenger department, or any other department of a railroad, must be and has been judged, not by what the head of that department and his assistants think it is capable of accomplishing, but by what it has actually done.

The last report of the Inter-State Commerce Commission shows that there were employed on the 195,000 miles of railroad operated in this country for the year ending June 30, 1901, 1,071,000 men; that 607,280,000 passengers, almost ten times the population of the country, were carried; that 282 passengers, 2,675 employes and 5,498 outsiders were killed, 4,988 passengers, 41,142 employes and 7,209 outsiders were injured. The figures above given as to the number killed and injured demonstrate that some organized method is necessary (just as it is in the army, where the injuries are not as numerous and probably not so severe), in order that proper care may be given to them, and, what is of equal importance, that such action be taken in the examination of applicants for employment as will prevent physically unfit men from getting into the service; and I shall try to tell as briefly as possible some of the things the surgical department has done, and done well, in the care of that vast army of injured persons, and in the examination of employes, which has, I think, caused the management of the companies who maintain them to render such affirmative judgment, and in so doing shall refer only to the benefits derived by the corporation itself, leaving to you, gentlemen, to decide for yourselves whether it is to your interest, professionally and pecuniarily, to be connected therewith.

First. We know that the corporation is benefited by an inspection of the ties and rails that go into the track,

*Read before the ninth annual meeting of the American Academy of Railway Surgeons, held at Kansas City, October 2-3, 1902

used in the operation of its trains and plants, and that no sane man in charge of the operation of a railroad would think of accepting material, machines, or appliances without such tests and inspection, and no argument is now required to show the importance of examining the human beings who operate the trains and appliances upon which so much skill and money has been expended, and which carry nearly 700,000,000 passengers and merchandise of incalculable value, to determine whether they can see, hear, distinguish colors and are physically able to do the work it is known they will be called upon to perform. So on nearly all roads it is now necessary that a person desiring employment in the operating department must first pass a physical examination to show that he has normal sight and hearing, can distinguish colors, and is physically sound as he ought to be; and, in order that this examination be thorough, and it is of the greatest importance that it should be, it must necessarily be made by someone connected with the surgical department, and under the rules and instructions issued by it, so as to keep disqualified persons out of the service. The result of such examinations on the Northwestern since 1895, when the plan was first adopted, shows that of 21,473 applicants examined, about 13 per cent, or 2,785, were found to be physically disqualified for the work, of whom 1,469 had defective vision, 664 were color blind and 652 had other physical defects (the larger part of whom would probably have gotten into the service but for the examination), demonstrates its importance and the benefit the surgical department is in this one particular, in my opinion more than pays for the whole expense incurred in its maintenance, as certainly the keeping of 2,785, or nearly 400 per year, unfit men out of the service (and who can tell how many more men who were physically disqualified for the work would have applied for positions and gotten into the service but for their knowledge of the fact that they could not pass the required physical examination), in six years has undoubtedly largely reduced the chances of accidents occurring and thereby benefited the corporation by saving the money it would have been obliged to pay in the settlement of claims arising from accidents caused by incompetent men, as well as in giving it a better reputation as the safe road for passengers to use, on account of its having fewer accidents than it would have had if the unfit men had been employed, and thereby increasing its patronage.

Second. Results show that under the general plan

pursued on all railroads having a surgical department the average cost per case for caring for persons injured is,

and must necessarily be, much less than if no such plan were in existence, as it is a self-evident proposition, I think, that if any one and every one were called in to attend and care for the people who were hurt, they not being responsible for the expense, and no regulations in force covering the same, the cost to the corporation would be increased; for instance, during the last year the expense incurred by the Northwestern, including doctors' bills, hospital bills, nurse bills, board bills, and other incidental expenses in the care of injured persons, was $8.73 per case, and I think it does not need any argument to show that the expense would have been much greater but for the fact that the cases were handled in a systematic and careful way, and under direction of the surgical department.

Third. Every adjuster of experience knows that the expense of adjusting claims for causing death averages. more than those for injuries, and therefore, as a matter of dollars and cents, it is to the interest of the corporation that persons injured should receive the promptest as well as the most skilful treatment the locality in which the accident occurs affords. It is therefore essential to have surgeons who are known to the employes and whose names and addresses are printed on the time tables and otherwise published, in order that when a person is injured the employes may know what surgeon to call and that there may be no dispute or delay in doing so, as would inevitably arise if that were not done, and quite frequently result in the least skilful man being sent for, thereby reducing the benefit to the patient and increasing the expense to the company. When the injury is of a serious or complicated nature the case may be immediately reported by the attending surgeon to the chief surgeon, who is generally a man of large experience and skill in his profession and in the treatment of railroad injuries, he consults with the attending surgeon either by mail or personally, and frequently performs the operation if one is called for. The patient thereby receives the benefit of his skill and experience, and where the injury requires hospital treatment, and the patient is able to be transported to one (if there is none at the place where the accident occurs), he is taken there and cared for, as only hospitals can care for the injured, at the expense of the company. Who can say how many more names would have been added to the death roll of 8,455 for the year ending June 30, 1901, but for the adoption of some such plan as this, which increases the chances of the injured making a good, as well as a speedy, recovery, as the more skilful the treatment the quicker the patient will recover, and the less chance of his sustaining any permanent injury or deformity, and at the same time reduces the expense of his care to the company, and the cost of adjusting the claim, which in variably puts in an appearance. For, as Dr. Fairchild. said to you in his address a year ago: "The true way is to secure as perfect and complete recovery as possible, for the final adjustment must be based on this alone; for it must be assumed that the state of mind and willingness to compromise will depend upon the care and attention the patient has received, and his ability to become a useful member of society with comfort to himself."

Fourth. It is also of great benefit to the corporation to obtain prompt and accurate reports of the injury and the

cause of same, as stated by the patient, and this is only practicable when you have a surgical department, so that you may have reliable information as to the extent of the injury, on which the pecuniary damage must be based. Frequently the information given by the patient to the surgeon, and shown in his report, as to how the accident occurred, and who he blames for it, while it cannot and should not be used against him, is of the greatest importance in making the required investigation of the facts to determine the question of liability of the company for the injury. The matter of securing reports as to the length of time the patient is disabled and the extent of permanent disability or deformity, if any suffered, is also of importance and benefit to the corporation, as a large proportion of the claims of employes is for time lost by reason of the injury, and, as skilful treatment will reduce materially the time the injured person will be disabled, it at the same time reduces the expense of caring for the injured, as well as the cost of settling the claim, and gets the patient back into the service, thereby benefiting the corporation as well as the injured man.

Fifth. When the injury is serious, or has resulted in the loss of a limb or some other permanent disability, the fact that the patient has been properly cared for and skilfully treated by the company's surgeon generally renders the matter of adjustment much more easy as well as less expensive, as the patient ordinarily feels under some obligations to the company for the treatment and care he has received and is much more likely to adjust his claim himself, on a reasonable basis, than if he is to put the matter into the hands of an attorney, which, when done, means an additional expense.

Sixth. In the matter of making examinations of persons presenting claims for personal injury, who have been attended by surgeons other than those employed by the company, and reporting the result of such examinations, together with the opinion of the examiner as to the extent of the injury and the length of time the party will be disabled, in order that definite and reliable information may be had upon which to base a proposition of settlement (and I know of no other way in which said information could be obtained that would be satisfactory to the company), in advising with and assisting the legal department in the preparation of the medical testimony in litigated cases, suggesting the experts to be called, and advising and consulting with them, and in assisting in preparing the hypothetical and other questions to be propounded to the expert witnesses for the prosecution, as well as the defense, the benefits derived from the surgical department are almost invaluable.

Seventh. When any contagious disease is raging over the country the advice and assistance of the surgical department is of great benefit to the company in vaccinating the employes, giving directions for the fumigating of cars and buildings, and in other ways assisting the management in preventing the spreading of the disease and keeping the employes in condition for their regular work.

Eighth. In the operation of railroads it is politic to have public opinion favorable to it, and I believe by properly caring for the injured, as is now the custom, the surgical department is a benefit to the corporation by helping to make public opinion in its favor.