Show 4 1 I THE AT WORK HK I XV MISCELLANEOUS XV-MISCELLANEOUS FEDERAL ORG ORGANIZATIONS i iBy ri T I T IT 1 By Dy r Frederi J. J J. J Haskin I HE lIE deliberations of few OW learned fl 1 lOI bodies s boar bear bar more directly upon the l' l I. I welfare 10 of tho the traveling public I than those of the American Association Asso Asso- elation caton Q pf Railway Surgeons which Is now nos' in lii II annual session In Chicago While t I the h he great t trunk lines hues lles ca dally daily Iy arc are adopting the most Improved methods for safeguarding 53 a their passengers pa and crews 1 they are arc at the i. saule same time timo making great groat advances along the line lne of alleviation al iii- of suffering suffer ing Ins when through T negligence or 01 unavoidable unavoidable unavoidable un un- un- un avoidable circumstances circum stances atances the tho toll tollof tol p of life Ife and limb Is t taken Today every ever important ra railway I way L system in iii 11 tho the countr country country coun coun- try tr maintains a surgical sur stir department The chief Illet hie 1 surgeon has haR on his staff starr a competent physician In every hamlet MM along all al the lines of 1 the tho system and in some somo of the tho more densely populated sections thero there is a surgeon surgeon sur sur- geon goon within five Oe miles of ot ever every point on the r road ad so that time required In sending aid to o th the tho injured has been re reduced reduced re- re to a minimum As soon as a railroad accident o occurs curs in which an any persons are arc injured a report is telegraphed to tho the chief surgeon But before ho he can f forward ward instructions the same message has carried the call to the nearest physician of at the system The latter lat lal- lat lat- ter leI goes Immediately to tho the wreck armed with his emergency box If the tho number of the Injured Is large tho chief surgeon will wi order additional help to the ace scene no of tho the disaster just as a u general would or order or- or der up reinforcements in a battle batto Usually tho the local surgeons arc are required I by the tho employing road to keep constantly I at hand an au emergency gency box contaInIng bandages and dressings for foi or from containing fifty to two hundred major wounds The Th emergency emer enter gency genc box Is supposed to be sealed and never to l b be used except In cases of railroad railroad rail rail- rl- rl road accidents When once the seal is broken brokon tho the surge surgeon n has Instructions not only to replenish his supply but to sterilize sterilize steril steril- ize afresh all al of tho the bandages romain ro- ro 10 main maui unused I f At the last session of ot congress a bill bi was Introduced by a member of the house which provided that every train engaged in Iii In interstate traffic must be bo equipped with an emergency box The Tho bill bil never was enacted into a a. law as tho the opposition was very keen leen Among the tho arguments advanced against tho the measure was the statement that In case cae of wreck the emergency emergency emergency emer emer- gency box would in nine Ine cases out of ot often often otten ten be bo inaccessible when most needed Tho The most potent argument a against tho tIme box box bo was that it ft i would be bo broken broken broken bro bro- ken open continuously by trainmen to get bandages for minor minol wounds and that when a real emergency arose it J would be bo found that the tho bandages had become in in- in This dangerous fact would be bo overlooked from time to time by quasi quasi- I physicians who in their hasto haste to render aid would use unclean dressings thus producing infection in wounds which might otherwise yield rea readily iy to treatment treatment treatment treat treat- ment The Thc opponents of the emergency box urged that competent physicians al always al- al ways reach the scene of a wreck within a aI short time after the disaster and arid that the I only thing to bo be done don in the meantime Is the of ot the flow fow of blood and that dressings applied during the excitement excite excite- excie- excie ment and confusion of ot the accident are seldom eldorn sa satisfactory In the interest of speed and efficiency the chief surgeon of one one- ono of the largest railway systems in the country recently I issued to his corps of surgeons S along the line Un linea a supply of splints which he had ordered made mado according to his own ideas These splints are thirty inches Incites long and andare andare andare are composed of three strips each three- three fourths of alt all inch wide These strips B are glued to muslin so they ther will wi be Waterproof If I the broken bone is a the mill full ful l length three-piece three splint pUnt is used It i ifa a finger one of f the inch fourth segments Is cut off oc 1 16 tc the desired length I If the tle fracture Is' Is a forearm two of the Segments are are sufficiently wide wide- By having having hayIng hav hay ing the splints splint's made mache in strips they can be rolled together into small smal compass and easly earned carried by straps like hike headless golf sticks When the tile three segments are used they they- can be made to conform to the curvature of tho the limbs as there are in interstices In- In of an eighth of an inch between each of the segments A railroad surgeon never attempts to carry carr many instruments Instruments' in an emergency box a as ac amputation of limbs at the scene of ot a wreck is never imperative One chief surgeon who had been handling wrecks for more than thirty hirty years rears gave gave the tho following isolated case easo of an at a 1 the scene of the accident accident A brakeman had fallen falon between two freight cars while his train was wa going up a mountain side fide The chief surgeon who was a passenger on a passing tr train ln saw th the fall fal and rushed to the mans man's side Both of the latter's laUer's legs had been crushed below the knees and when he was lifted to a stretcher his two feet hung merely by tho the skin skip Tho The only thing to bo done w was s to sto stop the flow fow of blood This was a accomplished by twisting two pairs pair of suspenders around the severed stumps The The feet fet were useless and so 10 the su surgeon eon taking out his pocket knife cut off of tho the thoi i encumbering members Tho The man reeo ered As the element of hU hunan lan fallibility is ismore ismore more and more being reco recognized as physical phy POy- deficiency rather than criminal negI negligence neg- neg I the railroads are making strenuous strenuous ous efforts tc to secure the services of ot only I such men as are sound of at limb clear of ot otere eye ere and mentally alert alett i A decalo decao ago it i was Tiras tho the custom for the prospective engineer or fireman freman to undergo under under- go his examination for distinguishing colors colors colors col col- col- col ors in tho ho railroad yards under the supervision supervision super super- vision of ot the yardmaster If I the date for promotion happened to al a agreen agreen green greet fag flag red a yardmaster has been known to remark Oh Jim Jm knows better better bet bet- ter teI than that Another incompetent would thus be placed In charge of an anen en engine engino en- en gine gino Ino bearing its is human freight to death oath the first time a confusion of ot colors re resulted re- re d in a collision Today the tho testing for color blindness comes under the supervision of or the chief I surgeon Lie Io conducts a rigid examination examination examina examina- i tion of ever every man who apple applies for admission admission sion to the service or who comes up for promotion to a 0 position in which colors have have any bearing upon the safety sateh of pas- pas 1 mongers or Oi The old fashioned I way WiY of testing the eyes was to 10 have lh Ih the s I candidate select from ruin a n rib pile t of assort assorted cd worsteds the colors which the examiner would name namo But it waG was waa discovered red by shrewd surgeons that of the candidates candidates candi candi- i dates dah s were furnished d keys to the woI worsted wor wo I st sted d sk skeins These skeins had small I numbered laga on 01 thorn them thol for fol Lh tho i enco of the thu examiners examiner's classification and I the candidates were furnished keys to I those numbers b by friends in the tho office and aid memorized tho the colors coUrs O UIS UI'S by numbers and not rot h by shades It I is needless to Lo sa say that In InI I all an modern modem examiners examiners' offices the tho numbers numbers numbers num num- bers lia hav Q disappeared surgeons Burgeons offices up to In tho most Is found a complot set aM of or railway signals rigged up exactly as used on the i i lines Jnes These signals aro Installed In a adark I dark room an and the tho lenses are so adjusted as to admit J light ht of varying str strength according according according ac ac- ac- ac cording to the distance at which the eyo eyes eyed aro are being tested For OO feet the distance dis tance at which It I would be necessary tc te distinguish a danger sl signal lal in order to bring a n moving locomotive c to a a. standstill tile the t he gleam lal of the th lamp is ig scarce scarcely more than tau a of t. The candidates must be bo able ablo to distinguish distinguish distin distin- the red green geen white and yellow eno lights and call caU them Instantly if i he Imo hopes to s th the examination n Not No f t only arc the tho eyes eye of ot the employee examined but a now new applicant has to un undergo un un- dergo o a careful physical examination while every evory old employee has to submit to examination rc from timo to time aa IH s often as once ono every over three three years ears on some oron systems Engineers firemen fremen arid and flag flag- fag fag- required to men who wear glasses are In hi undergo ergO ro ro frequently frequently- order ln to guard against their eyes gro n suddenly weaker and Incapacitating them for service Tho The services of railroad surgeons are of course gratuitous as far as Injured passengers are arc concerned It I frequently happens happen that passengers pain gain ain tho the idea dea that inasmuch as the surgeons arc aro paid aI aIb b bv by the road they will wU not give sIve the tho earn Gam careful attention to the injured as would disinterested surgeons The argument to tho the Interest interest in In- seems absurd for it I is naturally in terest of the railroad that t should suffer surfer the tho least possible temporary inconvenience or 01 permanent Injuries n ac by minimizing the results of o a H. wreck the damage suits are all necessarily l lighter Railway surgery holds a unique place Inthe in inthe the he medical world orld It 1 is essentially surgery surgery sur stir dealing gery of emergency and surgery with clean or new wounds For tho the latter latter latter lat lat- lat lat- ter reason the suggestion now being de debated debated de de- bated as to tho the advisability of establishing establish establish- hIng h- h ing two cla classes ses of oC surgeons surgeons familiarly known as the cle clen n and the unclean finds warm favor favo with wIh many railway phy phy- The proposition is based upon the theory that a surgeon who handles an infected theor wound never can be he absolutely absolute absolute- ly Jy certain that ho has completely disinfected disinfected diem diem- his hands his clothing and each of n his Instruments Arguing upon this h hypothesis hy by- It is urged that It would be in infinitely hi- hi finitely better if all infected wounds were beter i al carrl carried d to surgeons who make a specialty o of that class of voll work while 1 th thiv new now r clean wounds cass could be bo treated by surgeons stir sur r f geons cean vho who keep their hands surgically aly clean The agitation has not not as assumed med meder cean butin but butIn butin er very formidable ble proportions as yet et in the opinion of many men who keep 3 a little ahead of the times it I is only a ques question qu s' s ston tion of a few years when the idea obtain ton a strong hold upon tho the medical fraternity S |