Document GmoDL7xO15Xrm18zdVJb0gvMq

Sntrrsstate Commerce Commission fcsfnngion, 3B.C. 20423 I, SIDNEY L. STRICKLAND, JR., Secretary of the INTERSTATE COMMERCE COMMISSION, do hereby certify that the attached is a true copy of the Association of American Railroads Proceedings of the Thirty-Seventh Annual Meeting of the Medical and Surgical Section, held at The Greenbrier Hotel, White Sulphur Spring, West VA, March 28-30, 1957, the original of which are now on file and of record in the office of said Commission. IN WITNESS WHEREOF I have hereunto set my hand and affixed the Seal of said 7Commission this 4' day of March, A.D.,, 1993,. 'SECRETARY' OF THE INTERSTATE COMMERCE COMMISSION ^2715 fSS vA*rl n lW ) l w n q-r>r jssssss^wa*. ite^fWL PRO C EE D! K(3'St@M y^jt **?. _ ' '' '- -^Of TH!RTV'-SEVENTH ANNUAL MEETING Or THE 'MEDICAL AND SURGICAL, SECTION- :vv's5t>* >.:^-v*A-<cr'p-a^ -r-j V ^ -V,-J .=: --1 'r',?5Vv2 fsj . ' Si pgpg i>V-sI -.fuJ'.*>. I 'h;\V, ---*>.-s^,';' . WHITE SULPHUR SPRINGS, WEST VIRGINIA . .. _* <* j* .. * *5 f ) I 5: PROCEEDINGS 'K 8 Of THE rj THIRTY-SEVENTH ANNUAL MEETING OF THE r Association of American Railroads MEDICAL AND SURGICAL SECTION 1- r ,-y -r ,, ? -- S? J(* i\lr ~r HELD AT THE GREENBRIER HOTEL WHITE SULPHUR SPRINGS, WEST VIRGINIA MARCH 28-30, 1957 # - -cr j15 W.' ik A v.tfl.A i ' f a ] -j / 3 / ;-- ''" - 7/S As/ -s .Association of American Ran ^Bnnrd of Director?____ - Officers................ ........ ..... Oficratious and Mainter 0 pemt nc-T ran?vonat re Carney. K. A., Adiirr>- by:. Cliaimum It. J. Hennett. Ad Chavez. Dr. icuucio. Addre*. Chirk-. Owen. Addre** hy:._. (. tniuUUf 1 (.'uiiiiiltw **n I *-vnn.:;ciii- Report if.......................... t tutinitcv i.n Disability nnc 1 ; |>.iri <it........ \ :;i-i- mi iir.; A;-i....... ... --.m . t. .;;ii;,:! li'v tti Multi':.. A* !** (. 'ronuttw on AMnuuatious. , on lruu:::a.......... !h'?**rt it......................... Loaned. W. U-. Audrey uy-_ Cushman. Dr. G. I'.. Addre* D-wtuirst. U. i.. Address by I!'.. . Dr. Duncan: prv*vnu:tg Huekncn. liariuu L., Audit.-: Hamilton. U. I'.. Address by Havasu. Dr. L. J.. Address t Itomsethic. Dr. G., Auuruss Lcisii. Dr. Southgate. Jr., Pr Mcrarbnd. Dr. Ro&s A., Ad Medical aud Surgical Sectiec Officers of Srctioa and I Officers oi Section and I Election of Members to i Election of Chairman ai Representative.* nttcndii Rule* of Order.__ Medical Filitt Cummittec___ ML'hivr. Dr. W. id. Address Representative* of Medical t * on Railway Saniuxt j j Sessions of Annual Meeting: j Thursday Mornine. Mai Friday Morning. March Saturday Murnin^. Mar Tuuhv, \Y. J.. Remark* by... INDEX A^ocruion of American Railroads: iioaru hi Directors-------- -------------------------- --- --- _--------------------------- Pose 5 Operations and Maintenance Demrtmeat______ __... h Operation-Transportation Divibon Orife*TM ^ Carney, K. -C. Address by_____ 71-73 Chairman R. J. Bennett, Address byUM7 Cham. Dr. Isnacto. Address by_________ _____ --.... C'-rke. Owen. .C;.:rc by:............................. ............ ................................... (.`mrruttee o< Direi^-m..................................................................................... , C*ru~.;t:oe a Dwi-.otinwnu ilvsuitiax :rom Physical LAammatams.. Cc.~r.uucv *>n uuanuuy ana AvuanuuAV.wu.^__.. r.coor: of_________________ ______ --..... .............. Committee on First Aid.... ......................... Committee ^r. Msxhvui A uccu of A:r Conriilionin< of Cart. C~mm:uoe *:n .W.nunuuoua. Report >f_________ ____ _______ C-mn:uee on trauma_____________ ___ _____ --........... .................. ......... Conned. V>. 3.. Address oy:__ ____________ _______________________ _ TJ-'J C'^nnuia. Dr. G. Address oy:______.-- .................... ............................. 'O-'-i Drrrurrt. K. a.. Acoress nv:.... .................................................................... I3r-12T ve. Dr. Dusi-ua: prcjonttnp Report of Committee on Nominations ... 7 Hayden. Dr. L. -I.. Address by.......... ...................................... ..................... 94-100 Horsiethie. Dr. G.. Address by:_________________ ___ ______ ____ ___ ___123-124 Lciaa. Dr. rivuthrute. Jr.. Paper :>y:__ ___________ ______ ____________ 31-73 Mernriaad. Dr. Rjss .V.. .duress bv:___ __________ ________________ LOl-tll M.-iicai and Surncal >-ction: 0.i:r-r ->f ."j?*-1:**!! and i'< r--t1 CoiutuitriT* R}.V>-iy.)7___ Gtr.cvts *i and iVr-inii-\ .f C*m;rmtU'w U1-Y7-19.V3.........131-133 election *f Members to C-oundut; <*f Dirvruon................ _............ 37 flievuon *f Ci-iir.tiun and Vi-.-.-C-iutrman.................... ...................... Ill Representative-* attendinc Annual Meetimp___ ________ ______ .... 13-13 Rules of Order.............. ...................................... ....................................... 9-13 Medical Klim LAmrr.ittcc..... ....... ......................................................... 3 Mbiiier. Dr. W. LI.. A-Urc-s by:.............................................................. . . 45-50 Representatives of Medsc-ai and .'iurpical Section on Joint Committee on Railway .'armation............................................... ...................... 3 S'vaionj of Annual Meeting: ' Thursday Morninc. March 23______ _____ ___ ___________ _______ Friday Mornine. March 29_____ ......_____________ ________ _______ Saturday M'rnm*. March 30...................... ........ .................. Tunny, W. J.. Remarks by:___ ___ ______ ____ _____ ___ ________ ____ _ 16 57 94 S9-9Q m ASSOCIATION OF AMERICAN RAILROADS (March, 1957) Officers IV. T. I'ancy, President. T. L. Preston. Vins-Preswient and General Counsel i Law Dcnurtmunti. R. G. May. Lieu-President lOpemnoni and Maintenance Denartmenti. Waiter J. Nolly. Vice-President (Traffic D-manmenn. -V. R. sedsr. Vice-President (Finance. Accounting. Taxation and Valuation Department). J. Elmer Monroe. Vice-President and Director (Bureau of Railway Economics}. Robert S. Henry*. Vice-President (Public Relations Department). G. M. Oimooeii. dccretsry-Tn-asurer. Board of Directors W. T. Fancy, Chairman (cx-othcio). C. McD. Davis. President. Atlantic Least Line Railroad. Harry A. DeButts. President, Soutnera Railway -System. r. G. Gurley, President and Chairman oi Executive Committee. Atchison. T-'txr.sai and Santa r'e Ra.ii-A~.iy. . . Clark Kimeenofd, President, St. Luuu-Son Francisco Railway. P. W. Johnston. Chairman oi the Hoard and Chief Executive Officer, Eric Eadftwd. W. a. Johnston. Pr-'-idont. Uiium-s Central Railroad. J. P. Kiley, President. Lhicnso, Milwaukee. St. Paul and Pacific Railroad, il. S. Mael-'arianc. pr-itii-ttt. ii*-rn l'.:-. i::e Railway. Sc. Paul. Minin--*a. A. MarNair.ara, I'r'-.-tdent. Minm-atxliv. .it. Paul and Suult etc. Marie Railroad. Minnrifx'lis -. Minnesota. P. 2. McGinnis. provident. U**ton ik Maine Railroad. P. J. Nn. President. Missouri Pacific Lines. A. E. Perlman. President. New York Central System. D. J. PvU.--eU, President. Southern Pacific Company. H. . Simpson. President, Baltimore ami Ohio Railroad. John W. Smith. President. Seahord Air Line Railroad. R. H. Smith. President. .Norfolk *fc Western Railway. A. E. Stoddard. President, Cuion Panne RailrouiL J. M. Symes*. Praodunt. Pennsylvania Railroad. John E. Tilford. President, Louisville and N'.ishvdlc RaUrnad. L. L White. Chairman of the Board. New York. Qiicaco and St. Louts Railroad. 5 .Ij:u>cmu/r of .immean Rstirn'7'is OPERATIONS AND MAINTENANCE DEPARTMENT H. C. May, X'ico-Presideat OPERATING-TRANSPORTATION DIVISION W. C. linker. Cliaimian K. M. Tnlleson. Vice-Chairman A. I. OUikr. ('h:::rn;sn OFFICERS AND PERSONNEL OF COMMITTEES OF THE MEDICAL AND SURGICAL SECTION FOR THE YEAR 125&-13S7 Dr. I:. J. Ucunett. Chairman Dr. i. Ci*!ow>k>. Va.-.'-OiaiftfUiti f. i';.rk tN-rr.-riry Committee oi Direction Dr. I:. .1. Ben<-t:. Cr:urnv.:v. Or. !. ' Vice-Chairman 'Term extiire* in i0*7i _I>r. Ii. J. Bennett. Chief Surt.*e*>n. iviciu. Juliet ano L-itorr. Uaiiwav. -Ui So'Jt:i l.aCaie- 21.. Cluriiie*, L...vji?. Dr. 2. M. Er.iiij?!!. Mv-neal ami Sitrsicai Director, Baltimore and t.unu Kai> :.sc. Room jJT. li. <ii \j. Centra* Buitini.-iv. Marytaiiu. Dr. i. Guioowsky. Mcdicni Director. Centra, Rm.r.'Uid Conipanv **i Nw Jersey, jersey City, New Jersey. Dr. B. 'V. 5*,jckwftii. Chief Stmreon. Detroit and Toledo ".'lore Line iiaiimau. .7912 John R. St.. Detroit 1. Mieiucan. Term expire? s:: id* > Dr. R. M. Graham. Director, Dcpartaion; of Mi-j:eta.* ana sanitation. The Pullman Company, lG5 North Cmail St.. Chi/airo 0. Illinois. Dr. C. F. Holton. Chief Surceoo. Central o: Geortra Railway. Savanaaa. Georcta. Dr. J- K. Stack. Chief Surgeon. Ckivajo x Nona W*;ern Railway, I'd? Norm Clinton Street. Chicago G. UIini?. *Dr. W. W. Wa>i,i>urn. Chief Sureeun. Souther:: ihe Company. San Francisco 17. California. fTerm expires m I2JL1. Dr. M. B. Clayton. Chief Surceon. Southern Railway System. 15th and K Streets. N. W.. Washiucton. D. C. Dr. Iv. E. Dowd. Chief Medical Officer. Canadian National Railways. Montreal. Ouc.. Canaria. Dr. V. \V. Hullo. Chief Surc->n. Si. Loue-sim I'nineis-co Railway, St. Louis. Missouri. Dr. J. IluU-r Wanner. Chief Surce**n. Be??emer .x Lake Erie Railroad. 52.*. William i'emi dace. I'insi'iircli. IVnnsyivama. *To Retire on St*|Ucmoer l. I'J.iT. t t I tI I i i i i i Dr. James b Railwa\ Dr. J. F. D.i racing i Dr. S. M. La it. c. Dr. J. V. . ii. Tcrunna Dr. R.S. Ku >:. ii..rv x Dr. S. W. St Kaiiruau iv. r.. c. ca R.uhvav Dr. Daman i XtA'l UDr. .1. R. Ga Texas. Dr. C- r. 11 (ieorcia. Dr. 2'jUii<cai Huildimt Dr. W. E- > Cleveian Commit: Dr. W. J. Lc way. 521- Dr. J. j. Brc Hummc Dr. B. I. D Minneso Dr. J. 1C l Massach Dr. J. M. L. CUicaco. Dr. K. C. Wi North C Dr. il. S. " 334 Wes Ep.vRTMErrr .nil .TTZES OF THE -IE VTAR 1966-1957 --. Railway. '20$ South more and Ohio RailMa.-vD.nd. ; > mpa.nv of New ''irf? L.::v Railroad. and Sanitation, The . Illinois. Railway. Savannah. T <<!wny. i27 North ; ` .mamv, San Fran- stem. loth and K Cttion&i Railways, Railway. it. Louis. Ene Railroad, 535 /' and Xurmnd Xvctiofi Committee on Disability tad Rehabilitation Dr. James K- Stack -.Chairman). Chief Surgeon. Qucaeo ,,\; North Wiaoem Railway. 127 North Canton Street, Chicago h. Illinois. Dr. J. f. DePrw*. Chief Surgeon < Lines West). Chicago. Milwaukee. St. Paul A Pacino Railroad. 107 Medical Arts Building. Seattle 1. Washington. Dr. S. M. English. Medical and Surgical Director. Baltimorefc Ohio Railroad. B. fc 0. Central Budding. Room 317, Baltimore 1. Marvland. Dr. J. V\ Houk. Medical Director. New York. Chirac & St. Louis Railroad. Terminal Tower. Cleveland 1. Ohio. Dr. R. S. KhvTrr. t 'hici Surge-in. ?d>:--15:iir<:}. >*. i. 1. Dr. ii-iTY. '.- N*-{~in. Chief >:.*r>n. S*o Line Raiir<:(. ! t.Vi NL-ucai An- R<;d-i;ac. M:Rt;<i:r>`ii 2. '.hnn^^o'r- : Or. '.I. L...-io u;jn:. ( M-.sneai S**rvir. t..;r.adian r.:. k.m.vv.'. oration. Montreal. Oue.. Cortona. Committee on trauma -Dr. li. W. Stockwed .Chairman). ciuet Surgeon. Detroit Toheio r*h<n Line p.aiirtwid. 7r<> Doctors Buh-iing. -*5)19 John iC arreet. Detroit. Mirntgan. Dr. R. C. C.'.trfuhcr?. Chief Surgeon. cuicinnatt. New .means e l'cxaa i'.u-uic iLiilwav. Cincinnati 2. Oiuo. Dr. Du::.-nn Eve. ciuei Surgeon. Xosuvido. Chuitai;<wna Ui nt. Lfu* itoiiwav. ,`nl ::::vn rre-c .\'ash*."..r r. Tvu::oi*. Dr. J. Candy, Ciiu-: Surgeon. T.-vas v NCw i 'rjran.- Uannum. i. Dr. C. F. iloiton. Chief Surgeon. Central of 15-ufgiu Runway. Savannan. Georgia. Dr. Southgate Leigh, Jr.. Chief Surgeon. Seaboard Air Line lloiiromi. S. a. I~ 3t:;!:i:ng. X<r;<dk ill. Virguaa. Dr. W. E. Mishler. < iuof Surr-oit. Erin Raurouu. *fS Ut-jujnh.- DtuLiing. Cleveland io. uiiio. Comnutiee on Developments Resulting from Physical Examinations Dr. W. J. Lonccwny ''Chairman.. Mir-rt-m. Colorado vU Southern Rail- way. .*30 MiUrorv'litan Btul iinc. l)*nv*r, C>'iori<i<>. Dr. J. J. Brandahiir. CUict Mniu-al ivvammor. Oie-ancnke U'lnttr.gton. Virginia. Ohio Railwav. Dr. H. 1. D-rau:. Chief Surgeon. Northern 1`r.ciuo Railway, at. Paul 1. Minnesota, Dr. J. iC Knowles. Chief Surceon. Uoaton vk Maine RailrnMl. ICiMon. Mn<*;:tChUSett.e. Dr. J. M. L. Jeiiien. Chiof Surcwn. Lhicaeo. Rock f.dund Pacific iiaiiro:ul,' Chicaco. liiiaois. Dr. K. C. Malden. Chief Surgeon. Atlantic Coast Line Uaiirnad. Wilmington. North Carolina. Dr. R. S. Westlme. Chief Surgeon. Chicago <a Eastern Illinois Railroad. 5>34 W****t tilled Street. Chicago. Illinois. s Aatoaauon of Ameruan RaihoaAs Committee oq Medical Aspects of Air Conditioning of Cars I>r. I{. M. Graham (Chairman). Director. Department of Medicine sod Sani tation. The Pullman Company. Merchandise Man Plaza. Chicago 5-4, Iliiouia. Hr. M. B. Clayton. Chief Surgeon. Southern Railway System. 15th and K Street-''. X. W.. Wa.-shtnaon 13. D. C. Dr. K. L. Dowd. Chief Medical Ofhcer. Canadian National Railways, Mon treal. Que.. Canada. Committee os First Aid IV. E. C. Chairman. Chief Surccon. Illinois Central Railroad. 55*jy ?wney Island Avenue. Chirac*''. Illinois. I *r. Y. tV. IT-t 'iii<: .'iirce'-::. Frnin-ti Kumvnv. Ft. I...is:. Medical Turn Committee ,n-. x. S irce^a. Mijjour:-ii:i:5?:ur-lvXi? nai.ro-'i. Dr. <j. V,`. Lvsijasun. duei M-.iirui 0dicer. Western Maryland Haimay. Hiiien rvation. uaititnorc 2. Murviasd. IV. (i.4 . Cum.m:u. ' i-tiraeon. Western i'uciTiv iL>uroaa. 52a Mission r're-.'. -:.n i ran< i>-**. v 1 . A. V'."^-1. t iiivt Meduv-i Cxumuu.:. Ci;i aro a: Nona Western llaiiivav. ;_'T N ::t; t..:r.t ;n circ-.t. e. ihinvis. ! v. C. U. C' Dannvii. Mvdicai D.rector. New York Central System. 323 Miduc-ta Cvntrai Pasicna'-.-r atauou. Detroit id. Miriuran. l>r. .*. T.. System ;.ieu.\;-i D.r*-:tor. Atchison. Topeka a Santa Fe ilaiiwav. a-.*4 Wf~i French Avenue. Temple. Texas. Advisory Memoirs :rom Committee o: Direction Dr. R. J. Bennett. ChiefSurrtvn. Elms. Joliet and Eastern Railway. 20SSouth LaSalle Street. Chicago, i'imois. IV. R. M. Graham. Director. Department <:' Medicine and Sanitation. The Pullman lutttpanv. Merciuu.Uise M--'t Plata. Ci-mro 5-?. lliiaou. > V V. W. Chief Snrc-vu. L,..:i.*->a:i rraaciseu Railway. Su Lome, vun. Representatives ot the Mecieai ud Surgical Section on the Joist Committee oa Railway Sanitation IV. R. M. Graham iC'sairman. Joint Committee oa Railway Sanitation). Director. Department : Medicine and Sanitation. The Pullman Compar.v. M-rchasntisr Mart Plain. Chhaao 3 :. Illinois. 1 V. M. ii. Chivt.'n, Ch.vi >::rae.-n Souttiers Railwnv System, loth and K Street?. X. W.. Washmetoa id. D. t. Dr. A. M. W. Hur?h. Asji.-tant Modieu: Director. Pennsvlvanu Railroad, to North 32nd street. Phiia.iehuua 4. Pennsylvania. 1 ] i i i ! !i D. Associatic OPERA ME 1. REPRESENTAT r rc-c::tn::ca <: M- : rrurireniss or nit: in ths* t-cuoe. AFFILIATED * coliai'oratinc or coope ber thereof upoo tne : tioo. An Aiiiiiated ^ Member Roaa reprvse 3. The odteera of ti ana Secretary. (a) As orovided VICE-CHAIRMAN its aemoership. Tl hot succeed himself. (b) The SECRET the Division. His a approval of the Vic (e) The CO MMX' territorially represe England and Ciaac from the West--elec for three years. The terms of oac shall expire at the committee members until the next electic In addition to tf Bureau of Public H him. and a represer and Provincial Hea member* of the Con- r.g of Cars If'iinnc :uui Sani!.izx Cliicaso 34, --item, loth and ;i p,ailways. Mon- .. fl.uirorul. .'09 i.vny. St. -T-.xaj RauroAd. vinr.d Riuiwny. *26 -i*rn iLuiwav. -I System. o'JO r.. 2 >y. -0'?>>;i-:h .station. The ..haois. mv, St. Louis, a 'umtatioo). .liman Corn- loth and K a Railroad. Proceeding* of Medical and Surgical Section 9 ASSOCIATION OF AMERICAN RAILROADS OPERATING--TRANSPORTATION DIVISION MEDICAL AND SURGICAL SECTION s RULES Or ORD'ER 1. REPRESENTATION: As provided ia the Plan of Organization, the representation of Member Roads ia the Medical and Sumcai Section shall he Chief Sarasota or other persons encaged in a similar eaoaeur. The Railway I-press Agency. lac., and the Pullman Company are eligible for memtwshin :a this Section. 2. AFFILIATED MEMBERS: .V representative of aa organization .ahaboratm? or cooperating with the Section may become an Atniiated Mem ber thereof noon the aaoreval of his nsplication by the Committee of Direc tion. Aa Aihiiated Member shaii nave the rights and onviinees acromed a I' : .*u representative. except voting or the howling of oince. Gmcers and Committees 3. The ttfeers of the Seccioa snail consist of & Chairman. Vice-Chainr.ao and Secretary. 'a) As rrovjded ia tat Flan of Organization, the CHAIRMAN and ""ICE-CHAIRMAN mail be selected by *he Committee of Direction from ::s mimcersniD. Their terms of omce shall he one year. A Chairman wiil r.ot sucr^i hmjieif. b: Ti.i SECRETARY wiil he appotnu-u by tiie General Committee of :he Diviy.'n. His saiarv fiiail be named hy that Committee, sublet to the .oorovai o: the V>.;.prijidefit. Onecatior.j v.nd Maintenance Department. :___ Z *' .c) The COMMITTEE OF DIRECTION will consist of twelve members, erritonaily representative as far as nracticable--one each from New England md Canada; four from the East: two from the South and four from the W>jt--eiected as hereinafter prescribed, each of whom shall serve for three y-*ars. The terms of omce of all elective members of the Committee of Direction :hail expire at the conclusion of rhe Annual Meerinj. Vacancies in the oramittee membership snail be tilled by appointment of the Committee until the cext election. lo addition to the above, the Surgeon-General of the United States Bureau of Public Health Service or a representative to be designated by him. and a representative to be designated bv the Conference of State and Provincial Health Authorities of North America shall be honorary memoers of the Committee of Direction. :o Asioctcutart af American KaiiroeAt The Committee of Direction wtil select tram its elective membership i Chairman and Vice-Chairman of the Section, whose terms of otSee sn.iil he one year. A Chairman will not succeed himself. dl The Standing Committees of the Section will be as follows: Committee oo Disability and Rehabilitation Committee on Trauma Committee on Developments Resulting from Physical Examina tions Committee oo Medical Aspects of Air Conditioning of Cars Committee on First Aid Medical Film Committee The representation t( M<*rril*er Road.* m tl.ex* committ<m-. will In*, so fur as is practicable, temtnnaily selected, in approximately the same nr*.* portions as Uifct of the Committee of Dirw.'-n. personnel to le namoi each year hy the Committee of Direction immediately fol!-v.irg adjourn ment of the An'iiiul M*-,,i:-.s Duties o: OScers a 4. Tit CHAIRMAN shall hav* cenerr.l sun^WMoti over the enir. <v > Section and shall preitde nt mmtre? of ?*: Section and at m'-ettmr* ' i ti.-- Comm:::?e of Direction. a. Ti^VTCE-CHAIRJ.IAN, in the absence of the Chairman, sliail perform tie cutte* of the Chairman and such other duties as mav 1m> as-imcd. 'j. .'&> Tr.s SECRETARY shall perform the usual duties of that other and rich other duties as may be assigned to him bv the C:_.:rr.:ai-.. :/ Itc shad receive m\ w<eics in advance of tat- Annual Meeting each year the report of the Committee on Nominations, as eisewnere provided for. cau will aunmit to the raemoersmn at the Annual Meeting the oomiaa"arts contained in that report. to mi tue vacancies tn tiie membership of Committee of Direction. He ahail announce the result of ti*e election rrc.mnriy to toe members. Duties of Committees T. The COMMITTEE OF DIRECTION shall: (nl Exercise general aupermsioo over the interest* and aifairs of the Section. 'b) }> empowered to act on behaif of the Section ir tl.eimcnm i<etwet>n meetings aod snail submit at eaca meeting a report covering us actions. x) Examine and decide what portion o: communication*. papers and reports shall be submitted at ;ne meetings. It shall determine which, if ar.y. of the subjects presented by the various committees, shall be referred to the General Committee of the Division. (dl Appoint two months in advance of the Annual Meeting each year a Committee on Nominations. coasisnne of representatives of live Member Ronds, who shail not be member; r>i the Committee >;' Direction, fe/ Appoint additional committees as required. (f) Submit to tr*e Chairman. General Committee, detail of eon teoeiated unsocial requirements for conducting the wort of the .Section as reputred or os called for by that ornciai. I ! 1 General to eacn r*^juv-*t >. ,<*CC .-hall r.-**** y.i-.c t~*.-1year, ana i> Ti.- tion ut tunc iiuav *r.a ;:;C :a; D (ci Fracture irauar suoj< n. COM resulting repon. with j penodic i warrant, il as the to i 12. O ?t OF AIR its relation partmenu 13. CO' study and for railroad invoiving I i 14. be concern of medical i 'iliicuve mcmairsme : -erm* <: : :.o :--i milo-.vs: . >u >m Phy.Mcal E.trunir.a- . r.ditioniRg of Cara ..-..-.:civ :i;c ?. gr\or.r.vi to he rirsri .:* foilo'.vmc atrourg- the tirTiiira o: tii .1 at r.*v--nr.e3 <:i ;.:nsa. :raii pertem .e assigned. ..-d of that oir.ee a.-. j .:rmun. Aanuai Meeting '%n:~ . -j clsewnere provided --ki Meeting the tsomirai*^in the mecnoershiD v; -r result >jt the ci-.-cti-n rj and aJaifj of the -. '.re iwi-rtm l*-c-.veea ' wermg ::j actions. :.:eation3, papere a.-.-i determine wtuch. ii shall be referre.i Meeting u*n ytr 4 `tives ni five Member - *sf Direction. tee. detail of con : -work of the Section P.-ocr-nnus / Medical and Surgical Section n lg) Call Annual Mootings of the Section. subject to the approval of the General Committee of the Oivistoo. if m its judgment conditions warmat. ,h) Cii meetings o: the Section. upon not less than thirty <uyi' notice to eacn ctemoer. It must call special meetings of the Section upon the request, in writing, of a majority of the Memner lioada. $. The COMMITTEE Olf NOMINATIONS, appointed as above presenoed. shall report to tiie Swrerary at least ix u-eelcs in miv:tm*e if the Annual Meet ing of *ich year, at i-rasi tnro nominations for er.en imo*n*iing vreanev ta re- :uc four memoirs vt tre 1. vir.mittce *i Direction wn.se terms exotre mat year. -la to nil any vr.jsccy. The unties of the nraauir.g Committee? suaii he as sodcss-. 0. COMMITTEE .N't). I--The COMMITTEE ON DISABILITY- AND REHABILITATION saaii study itau report, mta suggestions or recommer.ua*.ior.3, on suen suoitcu ;aa; nave to do svu the osysicai einciencv or msiaiieacy of rouroau es:po*yos. i; suad also constant -.vavs ana means ;.r -rehabilitation of injureu or iscipacstateu employes ana me comsirte rer*ora tion of iuncuoa. ;U. COMMITTEE NO. i--The COMMITTEE OH TRAUMA .-::a study ana moor; oa m.s treatment u.*.d t.~aaspor:at;vu tract-;.*-: ;.-o ir.g <a) Diagnosis fractures. >; Firs: ^.1 .::u ,*-:a-uvf\>;..,:i a.uitj. Fracture report icrms, .as X-ray wor* in connection nua fractures. *cu sisJar subjects. U. COMMITTEE NO. J--The COMMITTEE ON DEVELOPMENTS RESULTING FROM PHYSICAL EICAMINATIONS shad otia^yae and made report. %;ta recommeaas.uaas r :ucget:oos. 0:1 ua:a made avauab-c by tcrtO'.itc e*::inunat;--::s. !: scu-iy ar..; icv-e :. .:t;--r.s n.iv irran;. the i-.-conim-.-nui-J ^:-.acarus -..v<.*r:r.g p;.y-i.-ni t;./.ns ~. -<u as the iorxj used :n connection -Rcro-vitn. 12. COMMUTED NO. 4--the COMMITTEE ON MEDICAL ASPECTS OF AIR CONDITIONING OF CARS idoll study rmi report on this subject ta :ts reiatton to tnc health and coauort ut travelers. .-ytpcratir.< with other dePittmema handling matters relating to air conditionut; of equipment. Id. COMMITTEE NO. >--TUe COMMITTEE ON FIRST AID .hall study nnu rctwrt, with suggestions or reconimcnuations.on tirst aid instntetioas lor railroad employes, a standard am aid packet, etc., and such other matter* involving brat aid aa reiate 10 rauroad ooeratton. U/COMMITTES NO. b--The MEDICAL FILM COMMITTEE b&U be eoocernec with such study as required of matters relating to availability o( medical films for railroad use. Oma&ex*--' of Amnceui kadroaiU 15. VOTDtG AT MEETINGS OF S5CTI02?: (a) Vote may be ukecviva voce, by risinr. by roil call or by ballot. Each Memner Road U*ll b^_ entitled to one vote. The vote of the majority of the Member Roads repre sented shall be required to decide any question,. motion or resolution, unless othenvise ordered, (b) Votioc for candidates for membership on the Com mittee of Direction shall be by ballot, fc) I'nless otherwise dedenated hv it. the rankimr omrer will be re^ocniicti :;? the Vntinc li.crre**r.tative of a mad at any mceunc. 16. LETTER BALLOTS may be taken upon nay subject by order of the Committee of Direction and must be taicen on iu questions a:;ect:r.c physical proper y The *ii* of p-'tv'-r r- :' r-` - i: i- r>.-..:v.r;ioosii- m IT. OP.DER OF SITSIIiESS: ?Vc order x' nu*:nes< a: meetsr.es of tne iestson sunn. Unisys otncrxue ciroctea by a saiortty oi tac members oresent. as it:lu~s: Approval of etsuiea of last cceticc iicacrta of ataacicc Committees Resorts c: 6sicm Committee Rcrvrts o: Toiler* V-.ua'- :-.<sz business Nev* business '.v. .woart's iiuiei of uruer snaii covers tas processors oi sow Sectioo. ..tciuuiac ataeaaaiea; to inaae rimes of Order. 1 : i ;t i j i si i i t j i 1 AS iiaittn H.a:. Bunco Bw'.Jtor British CaaacL Cauac. Centra Centra. Chiat` Chi car* rooa Chicac Rail; Cic*ap Chieuec road.. Colorau DcVawar Uadrc Detroit< Detroit ` Dicta. Ji Erie Uni IVmvar Grand T ii .Mf'KUis i: .'a) Voie may be uicaa . ..irh M'.moef (load ihail be o: the Member Hoads repre. motion or resolution. unless >r membership oo the Com* ithenrte designated by it, ~'C Representative or a road :tay subject by order of the questions snooting physical .ids sbail be proportionate to "'idneri at meetings of the ~.:v r>i :he members present. .'jceeuiazs of this Seetion, -r-'-r'Jir.TT <v' M<*tieal and Susftcal Section 13 ASSOCIATION OF* AMERICAN RAILROAJOS MEDICAL AND SURGICAL SECTION Greenbrier Hotel White Sulphur Springs, West Virginia March 2S-30, 1957 The following were present: Members Represeatmces Atlanta a: St. A.irrewj Bay R.:i!".v:iy....Dr. J. T. Lilia, (.'hurt Surcvoa. .\:...s::o C L.-i ita.iroaii........ ......... Dr. J. M. j*iiuia*a. cAreuttvc As;ttar.:. Ikuttm^rs cc v'hio Radpvui................... .Dr. S. M. En-rin-h. Meaicai k ^ur.r.;.~.u Director. Baltimore c: Onto Chicago Terminal Pvtuiroiii.............................................. ..Dr. S. M. EnrUsh. Medieai d; Surreal Director. Bancor ca Aoistook iLniroad--------.--Dr. J. H. Johnson. Chief Surgeon. 2 .aton cc Maize riahrouu._____________Dr. J. R. Kaowica. Chief Surgeon. British Rauwnya............................... Dr. L. J. Haydon. Chief Medical Oshccr. i.'ian^ia muaju iCiii1ways.-- -- Dr. iL EL Dowd, Chiei Medical Officer. C-mamis Hicii-; R-u-vay-------------------- Dr. G. Earie Wight. Chief of Medwai Servicw. Cciitrut Ce.rgtu H--r.vay...__________Dr. C. r. Uwitoa. Chief Surzeoo. C%;ntriir~ulrtiu.v:Xi-v jersey...........,,Dr. 1. Goulowjky Medical Director. V. hicacy u; W,-vm Rahway____ Dr. J. K. Stack. Cittcf Sufgeou. Chicago. Burlington u: Quincy Rail road..--.............--.................................. Dr. 1C B. Keener. Chief Medical ():ncer. Ciicaco. Mil'.vuuiee. a;. Paulo: Pacific RaiL-oau.................................................... Dr. R. Householder. Chief Surgeon. Linos ELaatl. .. ,c 1 a :.y .......... Dr. !. !. ilrun;ao:jr. C'.ui Mvdi-.ai ' iihrer. Dr. J. M. Emmett. Chief Surgeon. Mr. W. J. Tuohy, President Chicago. Rock Iciand ,t Paeihs Rail road................... Dr. 3. M. L. Jensen. Chief Surgeon. C-.'lorw) 0: S urhi.-m Railway ......... Dr. W. J. Linkway. Chief Surgeon. Delaware. La.-Lawarma u: western RaiDo-iu..........................................,,...0r. J. 0. Mac Lean. Surgeon. Detroit jc Toledo Shore Une RuilroadJ^r. B. W. Stockwetl. Chiei Surgeon. Detroit Terminal Raur-v.vi.......................Dr. U. W. Stocte-xeil. Chief Surgeon. Elan. J.Jiet ,y Eastern Railway.........,,.Df. R. J. B**neett. Jr.. Chief Surgeon. Erie Railroad....................................... .......Dr. W. E. Mishler. Chiei Surgeoa. Ferrorami del Pacttico............................. Dr. I. Chavez. Chief Surgeon. Grand Trunk Western it ..... --_Dr. B. W. Sioekweli. Chief Surgeon. | ; _sCt-*V Members Representaares Illinois Central Railroads._________ ,_.Dr. E. C. Olaon. Chief Surgeon. D.\ H. N. MucKecbrue. Assistant Chief Surgeon. Kansas City Terminal Railway___ ___Dr. G. Owens. Chief Surgeon. LwmsvtiJe <fc Nashville Rniiruoa_____ 1)t. Duncan Eve. Chief 3urv**>>n. M;-v.ur. s`:s'*i!; Rnuro:. : .u<.-nwa ........ . - Dr. J. A. L*-ni!--k. Medical AiMstan; Hfr-.ow.. Dr. T. >; C iii,v:..c. C--ittaiu/vieu ; R.i:.-vay.,,................. Lwu.........Dr. Duncan Eve. Chief Surgeon. .Yew Yuri; Central cysceuL.................._D.\ C. H. O'Donnell. Mouicai Direct'.-/1 N\*rv..l*. : W--uern Rmjwnv......... ......... Or. .\I. P. Moore. Medicoi Directvff. Dr. J. . Hatfield. Associate Meutcal X. r`.:.rr:i i'acme k-;:'a..v ___ . Dr. ii. I. D.Tau:. Chief Surgeon. ;v:nr..*>ivatua Pauiroau............. ............--Dr. J. M. Brewster. Regional Meaicui Omoer. Pittsourira o; Lu*e Er:v u--:roaj........ Dr. J. ii. W&sjier. Chief Surgeon. Dr. A. II. Winters. Chief Surgeon. p..i;>..,i Company............................... _...Dr. R. M. Graham. Director u:' Medicine. Reading Company... ................................ Dr. A. Neupauer. Chief Medical OScer. St. L.-uu-Sun Francisco Railway ______Dr. V. V.'. Iloilo. Chief Surgeon. Mr. R- P. Hamilton, superintendent of safety. Savannah A Atlanta Railroad...............Dr. C. F. Holton. Chief Surceon. Seaooaru Air Line Railroad..................Dr. S. Letch, Jr.. Chief Surgeon. Southern Pacific Company.....................Dr. W. W. Washburn. Chief Surgeon. Southern Railway System........... ........... Dr. M. B. Clayton. Chief Surgeon. State Railway of Thailand...... ............... Dr. G. Homs-thie, Chief Medical Officer. Ti'xa* R:uiw:iv ... ........Dr. \V. R. Powell. Chief Surgeon. Texas o: New Orleans iCaiiroau........... Dr. J. R. Gandy. Chief Surgeon. Texas.O: Pacific Railway......................... Dr. 3. J. Feducia. Chief Surceou. L'aiou Railroad........... . ....................... Dr. Julius Mazer. Medical Director. Dr. J. Huber Wagner, Cbiei Surgeou. Western Marylanc ............Dr. G. W. Benjamin. Chief Medical Officer. Western Pacific Railroad........ ............... Dr. G. F- Cushman. Chief Surgeon. Association of City National I | Interstate Cor C. S. Railroad l i i i j Il i ii l 1 -iae3 S'lnrvou. Assistant Chief "orcoon. ;i Surgeon. Medical Assistant : c*uryeon, r Suryeon. Mvtueai Director .uieai Director. Miociate Medical 'irceoa. -Ayionai Medical ..;et Surycoo. :cei Suryeoo. m. Director of Chief Medical .:et rur;eon. Superintendent of ..ci esuryeon. .virreon. . ( Siirr-i:0 M S'lryt-on. l.iuef M.-dicai -ict .'ircr.fni. of S'lriteon. *vf Suryeon. iicol Dir^tor. Chrf Surycoo. t. Chiei Medical hief Suryeoo. /Vw>j:/i<m of '4{.cal -:n-t S^f'j'cal .y.cfion 15 Alio Present Members Reoreseotaures Association of American Railroads------ Mr. 1C. A- Carney. Executive ViceCh-uraarx. General Claims Division. Director, Claims Uei-'arcn darcau. Mr. i{. S. Dewhursu special Assistant. Mr. F. J. Parser. Secretary. Medical and surgical Section. Mr. R. L. Rose. Assistant to Secretary. Mr. Sr:ee Smith. Secretary and Director i Mnerai Clums i ity X-.unr.ui ii.stiKsc trust uMiuyany Mr. ~h<.tuu Omaris. Interstate Commerce t. /Riioiss*vu......... Mr. v-v-tt t,.arke. '-.-uuuiuioocr. L'.S. R.Mroau Retirement doafsL-........ Dr. 11. 1- iv-iavr. *** Vjrr . .. *5sv-*4V-- - If) Assocuiuon of American RciirotvU TIIt'nSDAY MORNING *E5SION" March 2S. 1957 The Ti*inv->;venth Annuai Meeting. Medical aad Surmcr.l >*<*tioti. A*eciauon ot American Railrn-vis. convened in the Greenbrier Hotel. White Sulphur Jspnnc?. We*t Virginia. at 9:50o'clock, a.m.. Chairman 11. J. Dennett. Chi*! iunwn. Elgin. Joliet <\r Eastern Raiiwnv. Chirac''. ii'in-'!?. *w*'ttr.g. Chairman f'j.xsrrr: Ti.- n.-*-*-tiiic will plea.*** rnme <.-r>i--r. uv a-- certainly ucliciiti-d t*. iiav* you here. We are aL* delighted to be m 'irn a iicautiiul piae,- to hold this tn**-ng. v.iiieh #> het*r is cetnc to I-- -ii*.-f:r:ai to us all. 1 aT/ohsrtJ'r i-.r starring thi* U'*-*-!!Tig :: i:**!e {at- --n-- - - a'*.:. : :: :> ;.* * a: i..tviv~mtrtv w.av. ' \n bi.vsr.rr- V.vnvi- ;; v. ag .utcr-tuic :-:--cram t;.,* n:crr.:r.r. aim -.ve o uac < ect come. Y.'e .-om-.- verv U!.-*t:ngi:ist.oi cue*is tins ve-.tr. .-.t *** are tv-**.- - are vrrv nanny ;*i t-.ave tvm win: u<. \Y- are C 'm_* t > .r :r*>v; .... . ` . :v. :u*.:-r *-a in nr'--.;:.*::!. ih-c:.: :i'*w j a.t<*uM iu:- ;< -tu'-- tu* are tn-rv. ; t.uu voy v.-.a k:k.w men. v.v :-.<;u** v> m. .res t ...hv <-uU <:js<.*u.-- < u: :au;uai yroiit-r.ts wsu; Mt-.v:-.*-, tiuiiiaiw auu u. ar.u ru we have ar.ytainc tn common. Inuouiiie-iiv. tnev ear. ;*-.;rt: ::.;ua: :rna a:.u uuc/UbTvuiv, we can icara .-imt tutuc*: >r**ta uvem. I like ta tntrosuce to you r.r?t. Dr. iunaeio v-.-avez. >>: .< .a*x4Jjara. And we cav* Dr. <j. limftnir. irom Tlutiatm. Aypuiu**-- Vf wouiii like to have our cue?is entc-c into our program. toairc cueition? and ctvmc us their In sure tne wuoic proefum wui oc more mtcreMini: i: they do. they may nclo u? in some ei our nrooiem*. As Item No. 3 on the program, we have -Addree? ut tl'Uairman. ' Anuaiiv. I did not write any aucre.*?. hut iv-r ti-.e ia.*t i**n yt-ar* 1 have n>-n :.:;;n:>tviy asssyrutt.-ni with piit j-icai exannnaii./ii.'-. ai.u 1 .`cl: prij:iiy -- .. parttuc inot. I could say a iew words nix-.ct our exam:nut;-.ti> and r.-.:trr<>: &s u whv!>-. Ac the pres-tiu tune, n: l'*"7. ia<-*- ism- ratn-.-r -\i':;suu:c UH-.Mi-'li'C.-.-a: chanzes. It seem? only y-.-sieriiav ii:.vt tve raw our -..al and oil-burr.u-.u motives going ainns our ru:un lines. ItrU-itiuc out Iunit.- amounts oi black smoke. That was yesterday. Toiiay we have our Diesei*. whicli represent a wonderful ads*anre. They are dome a good joli: tnev arc cheaper, better, iiwter and more quiet. Tomorrow we will proimMv haw- ea! turbines, and atom power. We now have our submarines. Mtnr.rr v**`rc-N anil power stations m some <: our cities. undunl>i<*dlv. -inrc \c f\- nu. we may i.ave an al<im-nuereti kn-omoiiv.' lor oi:r raiiroadr. Ujth all thw is-huoU<u-sl nuvatnv--. u i- ciTiamiv ry i.-f men <> kuow and to Utn-ii ai>n"ast il.<-;n. aoil, theri-forr, w- a |thvieinn> and snrci*ons.`must midcrstan.l tin-**- i-< -v pn'KIcms. \V- must l- ahU* to ir.'.k atoms, uiint (ina-aiuions we mu*t take, uud how these men must work. Yea m-'t men. pronat j r.:rn*ec^rU i 1 th:a. wnerc - i.n r ru: ! 2 have tne y( .-..istii'n t:r* .: t o: \amirt:Umn < uriij'-r.m. ;v.ar on th/ V.>`: r-eni- ari'i muiT.tnei. There ar< -tan::.*- vi: ... ... tr.,, -:!Vrf-a: er.-- n tr.e runn pome ni ro. and sot tcrait--at they hive ystetn. caei laaann ioc this non oes* that wi arnooe our more times we inst into many d:t.v niendinq valuable a. 1 think physical c.u< qq ami give Thank > } We ha\*e i Suruual ~ 1 two vi-.-try Mk. Pa correct y two. I .*>W. V7. -r ; l*..ar - f% -- *2U. -V*r ~ -3t - I(t(rf-- .*** A. . -Hu. i-.mi-It . is^ciJi,0,*rf---- Proceedings of Medical atul Surgical Section You must admit that our railroads, .-vs they are today, our tush ?emonty men. probably to their sixties or seventies. are the ones who are ntnam? our hizrwoeed locomotive on our railroads. Let's iooic at i*tst the nojxvme of this, where ire have the mere Ikivs. let's coil them or younz men. 13. 10. 20. 22. who are nusninz our hizh-jpeed supersonic airplanes. la other wont?, they have the youth, they have the technical advanrazes, they have the quick reaction time where, sometimes, in just a matter of a sniit second, it mean? either the accomplishment of a mission or death. I'm just hhnnnz you that subject of quick reaction time that tec must think about in *lrnz our phvuenl xammations on our employe of today. r :s --tr ;oii. :*>r most nf ; suner.-.-;- oiiy.irrd i-\annt:a* :. -r.s < Tnousands *; -mov-v--* f'ndt.-irnti-div. ;n the :,;:er'nt serfum* ::.?-r-'nt "ti"!'.: i-i!v.,.*i different *h:sz* from our Amoiov*-. ami. ,r.-r'for. *.v h ive c-ruito -von;. ;f>t <<ur p.v-'-ieul r.ndintr? to `hv condition* -m-rcr Th-t '/"c point mat I'm trying to bnr.e out. from a personal standpoint, is th:?.-. are snenomz nudions in budding new mecaamcal shops, drartmz rooms ~c ait -anus of reer.nolomcal advances, to take we of the.** -*w marram.-*. Jlotv much are * tomz for our manpower? T'-vr-t a :-w t -mr railr^aus -and you know exactly where your railroad jtar.es: -.i-here ** haven't hau a onvticai examination cn nm? of * lie r.i*n :-;ace *r.e -my rr.ey started -.vorsc. That may oe rather :sr*ictchen. \V do know ;r.it they ttie eves .-.no cne heannz tests, hut I'm talking about :hr pnv.trit -rmraation f the<A mntovc?. and what an important pan it piay hi .:> rr-nrnz or our rnitro.i.ii. t r:.: empiwcs - ire r.y/cr ready examinee until thev are *,. *in anu :: - T.c-vme? <!<l<-r. { :v'al-unr oi the nnrucru conuition. W* have to -.irr.it--: c.-ait m a :r-x uulanvvs--voen we i** tnese men for the lif*t time, they nave iv.cn oi*>oo pressur**. diabetes, ncr.aia. changes in the respiratory system, -ra.-trointernnat caanxes. zewto-urtnary trouoie. etc. I am a arm f?i.-/*vAr that "A in time <aves mne." I'm ;ust revomnienu- iac thts r-.-v :r*.m a personal ji.iacpmnt nr.u no other. I think it is so**! huu. a:*?? fhat . !-.,< i-;r ni;-.ip.--A.-r. I . -.-.icve that i<ur manpower--/-ertamiv. among our ~\/'A*},i'.,* icim nre 'a-' <i;r v.-1.:.-r- r?r. :n:utv : -! "W. J^-. ...-1 ;... :..< <-r -u- r m.--htn'rv 'vhi.'h ;:* - .* .-> >: r. intL-rv.d.., at nunv . v.any -l:.-. . r.oar.-. zv-'tnz tneni . -r'<i .*wrr.-*;;l.::z. I rwom- r.**nsinz Tr.it. -*r mu.iv. at l<*uk our ni;;iiiK/w.-r. .vuj^h j nr mst vahialde :i**-t. I thimt t liat if tnJ whoa a man <<) - .r T<>. if i-.c.vc ziven him rt'yui.ir ;hv.*ic:d cv.:;:;..*-u.'{>>. i->- wul *>. :r. .lariy-.id niiv-.vai vun.tti*u i>> i-arry n and -ztv** trs.-mv. many nmre ''-.-.ri of .< uvf ervire. Thank y-nu .\ppMii.***i .Vow > '-an zet on with our .-I'zutir orozram. .* We have found r!::-.t on/* of oyr mo>t inmor*-int to thi- .V*/iical ami .-^irzicai pr'Vion is a cood .*/v re*nr\- 'rank Parker ha* ervM u? w-li in th.- year? sm<-e Mr. fh-shur.-t ;?. Ho has done a bang-up job. Fmnk. lo ijGn have jfpmerhiny to *av to the Section today? >.?r Mr. P.tnxCfi: Thank con lo*. Ih-uneU f>r thox* kind r.*mar*i. I uniat i4 A33oaaiurn of /nmmn fiadroou After one year I feci that J am eettmc to know even-one connected with th^ iecuofi and i think everyone knows.me. Many of the cemfemen rre?eru_ here today have stopped m the office when in Chscazo nn*j I do want vou - Lrow now much I appreciate the cUnnr* to talk with you. The** vimc enr r.-.t an opportunity to cet better acquainted with you ir.dmduaiiy. and. in an* -:-.jon. a chance to learn more about the activities or tlc Section, r.r.nr to mv .-`sociatton wun the Office. T.- who have contacted the office for information amt no' x-t :.mn;<.-uiato rvpiv. i want to fay tliat if vrvu wiii be patient v wm (i./cvt-rvir.in r .a our power to net the information to you juft a? ouicidy u* n^'irx.-. V**-i rc-aUae wo must look up rao*t of the information reoueste-t unu. - . m.:u :akc? O'-n.-uundite - * ::./.?.v..vn uunnv.tt: Thame you. rrans. 1: von va::r :o>fy-uK 10 boi* ms: t;.re. ...-.v -v*;..; i::i _r. : vour ::u;iacjs. ? . * uO'.'. r. to nuauie:. 7.. 1 ' oi ijirectwr. anpoiuteu u rommutw :.:>out tu*/ ae'i r;ar:u:ac c'<i;u:irti-vf o: o*tr .'n t.ua. A.- . . v ..* on i.-auioiy unu ;:. i ...om i'l.y-.-ai Lxi^aunatiuiu. Ti.Orv arc _r.: n:uactjj^ :.;:vo ovvfl iuiuuomnc :or many y-a.-.-. 7_v ran:r-;.. i oj i:.c Couur.xUw ou i`uy>icu c\anvuiauon- w.* r/.-.cn m `-1. _r. - t.u.<;c* to Ur. .-:ac*. u:iu t:;<- ii.derent me::ii/vrs o: t.-.c -.:;::;uuer. " ::.aus:;t we u see how we rouiu streumunc it. to urine u up to c:.>. ?o st? to ; to you: ,ttvituoti m the siiyrte-t and sweetest v-ay i:.:au; iviuii. : ir. r?:u:L..:itat:oa. in pny.-icui e.\anu:.ut:oas. ;r_or._. ai.o to ;t ~ZTi mt-irc-itma and ey to dad cveryttn-*:. Therefore. Jnu. wui you niease tell us how lone your co:::::.itlrr wuat .rcisions you Lave corse to. and wnat you would Uke to recommend to thisI I n. K. cr.'.cs Chief iurceon. Chivaco ar.c Xortn tVesierc siaiiway. M.i.Uu. II.:.':-: .M;. Chaimnn and ucntlemcr. ;!.v lia:?-*;: voranutu-c thai 7 r. u'.-v.r.c't v: cvn*>i--i ot Dr. C-il.iowskv. Dr. Hnuisih and ravseii. _r.u joo was. Jir.". :< determine whether we needed ail of tht*e active ;:maittresorr.ot. You will recall that the Medical and Surpcal Section o: the A.A.R. was fee :? m its present form m I'JCO. The first report of the Committee ot Disabimv -nd Rehabilitation was made in 1023. In the intervening years, the persooai- "s o- the committees have ciiansvd. also the Chairmen have chanced. \W i-vr i.aa vi.-e.t cre-.n" with duu-rent iilvti*. anu inevitably, enr.r.icts arose ?.* *> ti- .-iioject-inatter <( tlic two committs. !r. the tm-vn::c 'i the tune of us. the liaison committee, with Use C.*tnmilii-i- . .. i'hvsicai K.\anuua:n*u^. (.`liairmannnl by Dr. Loop/wav. and as*i>tcd in nievtinc yt-'tcroav i>y Dr. Unindabur aiut Dr. Knmvh-*. it was tirtermmvd r. `t to oeree tuc two comnutteef nor to do away ub either committee. It - s felt that mere wa? a place for iioth. and that the apparent contradictions .nncctcri with the ntJemea present ' .Jo want you to Thece visits give i;uly, ami. in aa.*n. prior-to my i not received an I <lo everythin? ' possible. You of course, that ff vrtij. piCirt -'arys name ti aik r:got up to vo months aco . ::ow. of course. : Committee on . Developments .'taut .Standing --.id written m he committee. date, so as to : things *.vhich inl to make it mittee met. what Miumend to this "ern Railway, mmittoe that .,:ul :uv*-U. : (hi--- active V.A.R. was M-t n Disability . -.be personal.hanged. \V mdicta arose ..v Committee l aseisfori m ^determined mroittee. It oQtraoicuona prrxwittm of Medical and Surtpoai Section 10 that you can pick up by a review oi the reports of these committee* could be resolved. and they were resolved. Some were also transferred into the held oi Dr. Olson s Committee on First Aid. That wiU come out in the general com mittee report. I think that about sums up the work oi the Unison committee. Dick. We do not (cel that cither committee should be abolished, and *e` have resolved the contradictions that are evident in the committee reports. Chairman Dennett: Excellent' Is there any discussion on this report of the committee? By that I mean that there was some question about the Disability and Rehabilitation Com mittee. the Physical Examination Committee, or the Committee on Trauma. There is some thought that they somehow might be combined to streamline the sot-up. Dr. .T'.aCci '-.is r.-*coc.:(ucnucu that they be continued, as s. out Or.. it. M. ' Director. Dvcartsfcit oi Moiinac and .'inttatton. the Pullman Company. Chicago. iiimoisi: Was there any delineation as to he held that each womb cover, or wiU that come out in the individual comrsittee report? Dn.hT.vCN: {think that will come out in the individual committee reports. CH.vtnat.vs Sennett: Any other questions, or discussion? Is it necessary to put cnat m the form ot a motion. Jim? I guess we 11 just carry on as is. D?_ .1. IlraER Wagner vChief Surgeon. Bessemer 4c Cake Erie Railroad. Pittsourca. ?a.;; I move tbe acceptance ot tbe report. D?.. I\. ~. D<wo Chief Medical Officer. Canadian National Railways. ?-' >ntr2ai. Outtoec. Canauai: fiecoau the motion. The motion was pul to a vote, and tamed.) Chairman Bennett: Now, Jim. do you want to report separately on dis ability and rehabilitation? We will now hear from Dr. Stack as the Chairman of the Committee on Disability and Rehabilitation. D-:. Stack: Tbs (.`..mmittec cn Disability .mcl CvliahiJitanon w-j formed :n I'.OJ. and charged by t.te Medical anu kurgvral ch-rdon{ the A..V.M. -.vuh he following: "The Gimnuct.i* on Disability and UeiiabiiitatioQ shall study and report with suggestions or recommendations on such subjects' that have ro do with the physical efficiency or inefficiency of railway employes. It shall also uruider ways and means for the rehabilitation of the injured or in capacitated employe, and complete, m so far as po<dhIe. the restoration of function in that emoloye. " Now. that is a broad assignment. The new committee u maue up of Doctors English. Wight. Nelson. Houk. Nieiicr anu DePree. t am the Chairman of that Committee. .Many suojccts have been brnuefit uo in the put 37 years, and they are listed . >n the index of the committee resort to give you some idea of the subject material over the years, and the years uj which changes were made, and these chances put in print. 1r'*"7*"ijf+3*2*** 20 Auodalien of American Rjilrocd* In the column bended. "Years in which previously dienj-s^d hv the ('ommittce under same or related heading"--(hat ty somewhat m error, in that practically all o{ (hose subjects were utscu**e<i each year. However, they were not chanced to the point where they -warranted a change id the printed material that a distributed to you as pan of the proceeding* of this S-rtion each year. I will l'o down the line with the digest and tell you of ike chances that the committee recommends be made this year. On the first subject. "Abrasions with Embedded Cinder>." w* *imniv change*! tiat and added that further operative procedures nuv n"^**arv in #uaiv case*. As you gentlemen know, the tattooing eiieet of cmliodded cinders can be a disability in the sense that it can produce an nn.ig!.tlv : in the event Dial it isn't possible at the time of the initial trc.tiwnt t>> i.rts.-l. away or curette uit all of this v;td**dd<-d t'orngv. mnieriai. > *.-. n:. 1ty.' s-'-.vi.'i s`J-;VCl. ai.imr.u. w<* r.ave anued tnat w-j-,;omu !- i.v t:.* j/w*i. **.;>** or rs*''V*.r.*-i::` hjivStf 1 oo t.<M react me s;i;i;i- to ;:.o u.-.-iitut oi a person " no is univnimc siave :.ss urawn tor aa aicouoi :*-sc: tiiif ntav be assault in vour com- :;;u:utv .mu it ntav not t'e assault m mine, so we snouiu i-e euiced hv that. Ts.v n*-u item. then.: that o: Alergv. Hay Fever ami .\*tlima. U'e have tr.v !.arnerar>ii as u aaa added t::at attention >n<i lw nio to :.e r*u.-:< >!!! eii-cL' o; u.e anuiiisianur.v \irugy. u "die tjnniuvt remains in *tjeru:::tu servve. purtur.tiariy ussoctaten v. itn iumviss? eriiiinisst-m. \r have deleted ttie next subject. Aaierur ivvsentery. ` Tho last renort on that suideet by this committee wta ruaae in I'Jab. following the scare oi :; antc-uic uumreag at tae World s Fair in uu-aco. it is tne committee > leetinc that aaietne dysentery is not at tins tsnie a prooictsi a? far as the etaciency oi ;S;e raiiroao worker is concerneu. or hu rciiabuitauon. On t!;e next subject. "Amputations." we have kept the orst ouraemp:-.. iua. reads. 'Hie end result of amputation at the various levcis u cxtremeiy im portant. and furthermore, the duties of the amputating surgeon arc no; finished until the amputated extremity has oeen fitted with a satisfactory artificial limb &nu the patient has been successfully reiiabiiit.iicd.' M e have deleted tiie next four paragraphs. because we fen tl.ui wo were being .i iiitic too didactic. Ti.i* manual i? no: a ;euci;i:ic manual. and we ivit that v ready had no right to outline now some person wa gome to tarn* out jOiiic *pirritse treatment. Of rourse. we <lo have the right aud the obligation to outline tfir broad principle* which uiterest us as raiirimd doctors. We have kept the lost two paragraphs, deleting the lust sentence of the last paragraph--* At the present time there are several amputation centers which specialize in teaching the amputee to get the maximum use of Ids artificial tnemher.' It wasn't necessary to have that here because tnat is well known to uli of ns. The next subject. Antunoties. has it-rn chanced a lit tie. The first ntence wiil read. "The discovery nd refinement o: antibiotic ntethed4 and therapy has resulted m an increasing number of these bein' made available iur n>e. Many of these hav# nmmti for certain organisms." Tle rest remains. } } l )i We have artphvl*etie tre.-u not undetermiri We kent tne 1 thins we *'ut The next -mioi mow uiKJUt tua We nave tier Uichid-s tl**- et* a n<.;*!.. -aur<- V\ e imve icii -vicr V..v basis A? iar a u. -in*i:r***> us tl . v.:.:.: < m -. wua t u.-ofUL-r. ana u it u>e--. mort o W c have nei diagnosis oi i: used, and is *t jicoos omces. We have m: scntcr.ee. ** U may exist ior only by a toca to''--and this level invoived \\> have * listhesis. or v is called spom Oa the cexi the first sente and himself. We have drugs and the those involved The next. of the feeling purpose of wound*, and closed wound, a closed woui wound, aud The rest is Under the niadc. In pressure, at In the sentence re vamtil valvul; -. . > :-v Cumror. in that they . '!:. printed ::.;i jvvtion :.ges that the v- jimoly i neveisarv ' wMH 'Ey -car :.r. :.ior::sh pLsuc ; .v-cvssary. . ated. - should be : -VI :hat ail unwming ". y ;gr corn el :* that. '''e have >2a to the 'emauu in -:i*t .port -rare m the ' '--'i :'c*siiag eulcieaey -mph. which ' rc.T.oiv t:i. 'n rtf'* not ` ton* :-`l ti.at out some 'ra-irion to "t the last ten wtucn S artihriai h known The tint 'ocdt and ' available *t remains. Procctdtn'ja nf Mca'ica/ and .'iar :uxil Stctian W have dropped the last sentence--"The v-due of antibiotics in the pro phylactic treatment oi wound inietuon is still undetermined." Now. tt is not undetermined. It is very valuable. We kept the sentence. "Antibiotics should i>e employed conservatively." 1 think we would ail agree to that. The next subject. " Back Conditions." is a long one. anti we are going to hear more about that later m the moruing. We have deleted the material oa page 21 ot the book that 1 am using, which includes the opening paraerapns. and have sunpiy said. "Back conditions are a notable cau ot inediricncy and a condition repairing rehabilitation." \V* have i*v-"*d the list : rhnngcs noted on X-rnv *aat *?.: r.-.mic n- -ider t?.*j basis wr - ricctiun. As.iar as^r.e :>:tuiiui uacxs .ire concerned. we nave permittee me rr.~uc:u 'on.iuiims ui me leti-haud .mam unt tne<ictief?inaiuoa* to rer.uun. :>cmie ve want to impress our meoicwi cxauimers aau me uoccors 'nrougiioec our systems with the icca that the painiui one* can oe a rejection oi some Oder disorder, anu does not necessarily arise primarily to me bac*;. itieii. wfcoune. it does, most ui the un:e. but ;r.oe other eoouitioos snouid he (nougat oi. too. >V have kept the two porugrapiis un "bacro-tuae Compiaiuu. ' :.-ecause tne diagnosis oi sacro-i.iac sprain, strain and slip, untenaoie as it is. is itui veiug used, and is stiil being noteu on reports that are sent m to many cctei sur geons' odices. We liave made the following chances in * Spondyiuuathesis ': :u tne secunu sentence." it is commonly associated u ith a congenital detect. This cuii<a:;on may exist ior years without symptoms, It may t very maid and accompanied only bv a iocai oaui. or i: may extreme aau associates vun symptoms uue to --.ind this is tne iuincv--'' i.r*>-ure or irr.t.nttou on avrve routes at tr.e level involved." Ve have auded that "The congentui detect stay exist vvttnuut snonuyio- listhesis. or without displacement.'' ana then, ui brackets. "been a coauiuon i ailed spon<;ylosvliisis or spondylolisthesis. " On the next subject. " Blood Pressure." we have simply added to tne end oi >.e tint sentence tnat tiie mar. may ::c a mons' e 'o other employes, the public and himself. have next V\o .`..iragrapns. ;,r.d ..'.vo uiiiv.i :kac :iyrot-.`"iive drugs .ill*1 tUv :.:-l TnriMaurc:* -houtd s-r ".srl \v>/h `xtreiv.v aUUon t>y hose involve*! ui irkuiir "Un moving L-jiupiavn;. The next subject is " Uuni?. U' have di4ic(r>i a good deal oi this, because it the icehng that 'he second, rather long paragraph was too di.Lictie ior the purpose oi this report. WV -irr.oiy say, "3ums are to be looked upoo us vounus. and arc ;> he created with tiie respect accorded any otner open or clo.ted wound." In other words, a urat-degree burn or second-degree bum is a dosed wound, and is treated as such, ana a third-degree burn is an open wound, and that is treated as <uch. The rest is deleted. t.'uder the subject oi '`C.-vrdioviicuLar-Uenai Disease." minor chauees were made, (a the second senccr.ce. "The examination includes the heart, blood premure. and. next m importance, iundi.'* In the second paragraph we have added the word, "valvular." and the sentence reads. ** Employes in tram, cogue, yard and signal service with ad vanced valvular legions, definite myocarditis, heart bfucic," etc., "should *v> Ajooaauan of American Railroad* be removed from service." Tae other sentences have been deleted. U'e felt that the statement. " Persons with auricular fibrillations have a lush mortality rate." did oot belong ifl this, and "Cerebral and other complications frequently occur" is too didactic. On the oert subject. "Cataract." wehave left this eourcly alone, except that in the second paragraph we hare used "may be" distend of "is." Ti.c sentence- reads. " Post-operative vision, corrected or uncorrected, may be exceedtnciv poor, mid judgment of distance is impaired." The committee ick that the wide variation in the patient's adaptability after cataract opuratmn---just as in the patient with the one eye-- so wide that we did not enre to mate n definite statement. The m*xt subject is "Charcoal Heaters in Refrigerator Cars." There may ou some of these in existence on the smaller roads, and tiierefore -* left \x. al though on most of the larger roads we nave no trouble with charcoal heater* because e don't have them. 'iirn;,v Aru.nv.'"--i-.svc 'tir.r.g1- u::-;- *o - " V. .- entire- vnnp'.-r ,v?*i s:>t::i:y '.ii.rii-i'.., .nc ....................... __ avi-u*-'*- >( tt.i* uLii-iir-.- l.c u-;uv :>eJo;e pro=r trcatRivni ue* given. Manv newer oruca show promise. OtsatiiUv.c* fr*-?. r.nhr-.* _ro freuuvi.tiy improperly yttnqutt-i to injury. C-.-lor Vision"--nave ueieted tut?. because wr- trunk tua:. for :::c mn*; pggt. t:ui^rcioncs to tin* neio of toe Committee on Examinations. "The 'Common Cold' and Coper Respiratory Tract Infections"--w,. have deleted tua: and added the sentences:"The twst nrocnviaxi* asramst sue -or.ir.tor. coia is coo-i general iivatUi. Tiiers i.- no prow mat trie unti:.:-;.ii:.::;;i. crura are elective, out those who nugr.t use tnem or insist on using mem should be waracti oi liieir s;cc erects. The chapter on "Cross Eye--itrsbuntus." has beeo left, because :ha: g:s m weii tntii the cataract group and with toe one-eye croup. ieri la ike "Dermatitis" chapter, we nave ueieusti the first two parusranu* auu adeed the sentence." Protective equipment stiouid be used wnen taere u- uamter of contact with any causative suostance." We have left the last paracrapn as it ij: " It is advtseo that certain workers who may be found to have a marked sensitivity to a material used may require traosier to other types of work oot involving occupational exposure to in* accused irritants." TUe next subject, os "Diabetes." has been chanced. In the first ji-ntvncr we havedeieted"It is agreed that." on-i havesimniy said.".Vo dml-vtic laning insulin shouici be alinweq to continue m any hazardous occupation cusmeeveu with train iervtrv." etc. We liave left the rc*t oi it. anu have made a chance in the iast paragraph* stating that" An employe with diabetes"--twe have deleted the word." nuki," because of the difficulty in distiacuisumg between what is mild, slight, mod erate. moderately seven*, severe, vie..--"< have left that up to the doctor) --" properly controlled by satisfactory diet may be permitted to continue work in certain occupations, but an employe ia a hazardous ordination, panieularlv m connection with train sorviec. mould be removed from such occupation untii the diabetic condition is brought under control without tin* use of insulin. Periodic examinations are muicated to that proper control of the disease is maintained." inext link i-wfi ie :* f-r f'* CTil'.' department "> "Heat cram in t:;e nrst t V..- h;i\The third ..f *--*y tfeutifU-ot < *i 1 er.gggvu in t "Ml'.U.v Dr.. WA< 'y.T-'A. or 2 ("U.MltUA there -tv u accent it o about itic Dn. W. Direction. Cn.uRii report sl.o I)r,, W- my point wormy of Chairs) Carry o Dr. t/ belonc hei of Dr. Ok t l !*'.-* o ''Periodic improvett amonc -- i. W,, :i mortality :r--:*:-n*.iy vifot :.-.at he sentence <rxumeiy :: chic the * -.non--just to make a ** :.;ay :t. a;. - d r.-.'i'.cZf A o have .moment: rc-a'-men' -n .irm.itu * 'he most --%** *^y** hr cc:n- - mg :.*:em -e we i'e-i ^Jiphs and ^Bonr ,.i worker* c.v sentence :ic taking - 'ume'teU .ragraod'"mild." -;at. mod doctor} mue work rticuiorly 'upation ! insulin. ;o disease Pr-icettiinna of .'/Muxl atul Sur/jicaL iYdte/i J3 The next subject. `Dinins Car Employe Instructions; Food Handlers.'" has neon deleted entirely. We have simpiy used the statement that the doctor is to lx* guided bv a iocah state and nrovmcial law when feasible. Local health departments have rontroi over this aspect ot railroad work. ` Diseases Due to Heat '-- e have kept that, ta the last sentence we say "Heat vrnmns may be preveuted by taking sufficient table salt and water," in the lirst paragraph. We have left the second paragraph oi that subject. Tlie third paragraph now reads. " Heat stroke is due to the gradual elevation >n*ody temn-ruturcovera period oi hours or days, due to the hot environment. .::;:*rrrv-r : and ^anriM'-r diet. Tlie most imnortant rvnnt ;n tho :r"-i::::vNt > r-iun* tnt* !-;nr>erarufe ov anv uonronnme mennaj -->._'. a.v.iv t.*c-:n r.e -[jveincicv ot naening ui ice. anu tnc -Occtacilv 4.i;} '.1 1'>4. L: you nave hue. It you nave .; ^,'iauo tree. Halt's nr,*. Ana I'r.i sure ::;at s the wav 1: works out. actualiv. The `injo-'t ot "Electrical Accidents." and the material we nave on that. we !*. belongs to tr.e Committee on first Aid. and we hope chat they wiii accept this. 0:: H:c ruojcct ot " Epd-.-psy ami Epileptic Equivalents." we have kept that with it:* exception 0; the lam sentence ot the third paragraph. wmch no-v rreuis. `D*:.'mg sucri a brief state, r-nous accidents couiii be caused by employes engaged in engine or tram service." (':!atjcman 3".nntt: This 'emncnlly important. E?.. 'A'.-o;.Are y,;u ..-.:m 10 duo:?* ?tus at all. the argumentative point*, or are you going to accept u? L'.iAiitii.v.s iir.nnarr: l t.nink tr.cv auu:d he uiscussed because t think there are intie-rcst pomt3 of .".-.w. and we have to consider them ail. Dk. stack: T:;:s is .-imply a committee recommending thir.es now. Vou accept it v.- reject it. I: you reject it. then we start ail over again and taik about j: again r.s.xt year. ;`!I. ''m'.ser: Would it :wn. -id let d.cm proucr o recommend to the Committee of it'.' ' ffAtn.M.vN BlN'.vKrr: Whnt are your wishes'.' I don't want to cut your port -hort. Jim. Any n.-r idea? **n This? Da. Waoxkr: l think it is very interesting, myself, and I believe from :nv point t vi-"v that it verities a lot of those proposed reports. I think it is wor'tiv >f hinh-r hearing. f `n.vtiaiAN liiSNETT: What are your wishes/ To proceed? (V.rry on. Jim. 11 it. Stack: " I'if.-i Aid :td Emergency Frontment'--that subject docs not belong nvre.auui. a* (he name implies, tliat is also shifted to the broad shoulders <t Dr. Olson and h group. " !'<" of (niocMim'"--we have deleted all but the last paragraph, which reads. 'T.-fifxiic physical examinations with attention to focal infection will aid in the improvement of general health and increased work capacity and cihciency among ratiroad workers." "Vi .-.iJ'xru'Uuin / .inmfcn ffctlroods "Food Poisoning" bis been deleted. "Glasses and Goggles"--we have retained the nrwt and the second para graph*; we have deleted the third, fourth and fifth paragraphs. The final .sentence reads. " Protective glasses or toggles must he worn by empiovr* urine hand tools or operating power machines, and they must be made of shatter proof glass." *A e have deleted the next heading. "Hansen** Disease t Leprosy)." The subject of "Head Injurie*'' hn been transferred to First Aid. "Hearing Defects and Tests"--we liave retained this just us von Invc it there. II* have retained "Hernia" with the exception of the last two sentence*, which are deleted--"Such employe* should be operated upon ii their cenerai condition tnTmits: oth*rwi<r a pmneriy fitted tnts* mnv Ik* :idvi**-d. Th'* ;-ve`*.;.:::i-n* "f :i l.err.;-. -irrf-i- ".* ;'..r :: tii^r.-iugii survev. * i.c hr.-: paracr^;.:. ^i.-::.w-;iurus 01 t;..- m^viiii ;iu:.;g.'uu:i u:,v (x*vr. rev.'itw'i. v Ti.e r'.ti>ject. "laiured Lmniove. iiu* <*-+*n >ieit'<-u. T:.v "Malaria. ' has been evicted. " Maja-radure'1--we have retauted inis. except to auu ttu* worn. "r.uintui. to the fourtn iuie o: trie thtru paracraon--" . . . impaired nuysicm or mer.v*.: vunuw.on ns a rontnhuting cause ui me failure. ' "M^T.tai and Nervous UisnnstTs --a* nave* rctiiumi tne list n.a: given on tr.c?*' two puses, anu ciunsfj tie tiaai nuragraor. to rcuu a.- fui..*u "No **n*.p:oyc who has i*rtn eoa;:ri-ia oimtai institution snnuiu no permit;-; to rn:ur:i to any type yj v.-orx uuu; i* uas received a complete ana satisiactnry reoort front uai institution." ;atnr tnan to be guiucai entirety by tnc writ <ii acjurcauoa. wait:: is ictrui and not socessaniy or caucey mcuuau. The sunject of "Narcotic Haouues --we have rvurneu ou:v inc ur.-i two sentences. TLs rest lias been aeietvu as oetog not pertinent to ;r.is worc, ` Ncis.-enun Infection cGooorrncui" has beeo buitneh. The subject or'obesity" has oeen deleted except ior the lust two paragraph --"TLe Time Table for Reducing and Regulating Weight is available, and it recommended that a man who permits his weight to exceed by 50 per rent the average normal weight should be restricted from duty. The subject of "One live"*--m* have retained tuai paragrapn a> is. The su:>:*.ci >; " rVricuera; Nerve-"--w have deleted tin?- b**vau.4v u.at i- `n-.irfiy a r.iutvr up to the man who u confronted with the peripheral nerve !**ion at i::** urn*.*. Or. :i;s subject of "Physical Medicine." we have deleted this the ex ception of the iast paragraph, which reads, "Occupational therapy is of proven value by prescribing various types of work for bringing into use muscles and joints which need exercise or rehabilitation. One of the best forms of occupa tional therapy i the practical application of the therapy on the man at work on his own job." ~ "PrrumnconioMs"--w.* have retained the first sentence. The next two -cutcuct- arc deleted, ami the final reads." An entrance-vice examination -hotiiti ;:i'iuu<* :i comolete occupational history, a careful physical examina tion. and an X-mv examination oi the lungs for diagno.ns ami further record." And :::m*r ** l " just iv>w that, we aiJ the word. "annually"--" X-ray ex amination oi the lungs mould bo done annually on this group of people." i I "Poison Iw uooer the euoj* * Poisonous i " Repeated 1: "Sick Pawn "Special Die1 The *ubject < "When spraym \\`* feel that The subject "Trooical Di Tubercuio?! nave oe"A: ::*.:*;ivy w i" * a* i -!*t-.i ,.i :,'..:;j.iut tu.u io con i'i.e uext sf ;-.-m.:tti*l to n The next oar returning t*> > vMUilOU. lie. Ti.e last par: and .-nice tin.- v nave come ai>o felt tnat the tn can twat tnat. 'Typhoid F The second pa disease* are stii " Vancos* Ve with treatment We still feel' ` Weed-Killing You may wo deietiou* and : mind how muc how much gooI'm sure. Ken. in the thinkin; Ca.tiBicA.s' 1 group as a wbe subject for all l know wt w also talk over just the things To date, the who l am sure through the n\ have auv spec .'V-xre'lin'f-i .'f'.'iicui ntui Aurmou non "Poison Ivy and Poison Oak "--we luivc <k*iefe<i iiu. iivenu*** that in>w un<ir rtie subject <u dermatitis. * Poisonous pnake Bit*"--'his has bewi transferred to First Aid. " Repeated Injuries (* Accident Prose')"--have retained this just as it is *Sick Passengers"--we have deleted this. "Special Diets on Dining Can" has been deleted. The subject of "Spray Painting" has been allowed to remain. except to add, "When .-praying, protective equipment and ventilation are newfaty." k-1 hat the -ihj<set *i c;-- ad rs^ht, *.-. w v : - The nb;*'i-T *i " T-.-'nnus ' - t *r t*\<r-'rr~! *'> *ru Fir--* V i ' "Tr'spicai Diseases" has r,--;i T'ilMsr'-ilosis" has b^n 1 l.-tr vwr mruon. '{*'. rr*-* *'. .-- ,-rapns nave been deietci on "Tuherruiw.-M. The tnird carnrrann rsmr re-i-is. An emotoye wno has active tuberculosis, and mamtesrs it m ms rvi:um nr nv. other accepted bnbisgs. >houiu oe reueveu from uutv recause w the 'longer of transmitting the disease to n*r. anu nerause tne ebon on tr.e ran or :e nmoioye to continue wors n:av interfere wan nrnner treatment ir.it recovers-. ' T:e next sentence nas <**-n tiangim to r-au. "s*.:cn employe mav ne permuted to resume work omv when." (<*. The next paragrapn has oeea cnangea: `The tuoernuiouj icutvniuaL alter returning to service. ~nuhi i;* n---.cammed at uenmee intervals as a nre- .Mu:;on." The hut oarzgraon has been i-sieie-i. because mat sogg-.-.-o* a <?:' time. ,.n<i .mire '.ins ':m written, great .u'.i-a` *s in management oi "ir-.-rcuioris have come ainmt hrcugii hiimotlttrapy anu larougn tn^ranc mrgery. v*e felt that the umc mould not he mentioi.eu .-pe*-inciuiy. uevause many pop>e can beat that. `Typhoid Fever and Paratyphoid Fever --Ui- dm pamgrapn a deleted. The second paragraph reads. " P-.ratypnmd fever r.r.u om*r reiateu enteric diseases are soil seen, and may appear in endemic iv.*m.' The ro-u is rotrune-u " V-iriro-w* Vins"--we 'nave iv'vtc- the h.-t sentence, -vi.i. n aa :o iOiei.v with treatment. UV feel fhat should r~* left up to the r.-eatmu 'A*- iii ' d. it w:<i "i -i* - '>ii>-r \;c :!.ur.ucr < `imn'Vuii'is.'' -iimud -'rci.o <luy care. Vm may .vondcr. z*n:i'-mcn. as to *.;. w.' have recon:::ivfiJvi .n;e.t t:vse i.iletions and additions, fn *;.o u-e if lias ink. >e simply r^vo ;> keep in it-.ifid how much so**l it will do us and our associates, and. on :hc other hand, how much uood it mii;ht do *vnc other nvioie into whoie hands it r.uuht fall. I'm sure. Ken. you appreciate that point. But ? have to i.ave that io mind in the thinking about these various subicrts. CaxiuiiAN IleNNtrr: Jim. I -vant to thank you personally, -tad tor the ,`roup os a whnl*. for a ma^nideent job of ^<nv over this extretneiy important subject for ad of us. 1 know we will et a lot out of this meettnit u it is being conducted, but we also talk over our problems in the halls outside of the meeting, and these are just the things that we are discussing. To date, there are 4`.t of us registered, and we have several guesu with us who I am sure you would like to meet and know, and say hello to aa we no through the meeting. I'm sure they have something to give to us, so if you have any special problems, don't hesitate about saying hello to them. i CS Association of -> 'ncncan Rauroaii.* One of our guest* is Cuiouei V. i Aa*an. Cucr:d Claim Atom. lor the Elgin. Joiict A Eastern Railroad. Virgil. whl you .-land un and say hello? Mn. V. S- AoKtxs (General Ck.;:n Acenr. Elgin. Joliet .t Eastern Railroad* Cuicaeo. Illinois*: Clad in l>* here. Chairman Hcvnttt: Our ?wond cuest anil I think nrohabiy me*l of us knou'him' if the Executive Vios-Ci.uimsii. Gejiem) Claims Division. A.A.H.. Mr. Ivcci Carney, f Anpiuuse- And then v have Harlan I.. Hackbert. who is a member of the firm of Stevenson. C-vmchan. Velde and flnekhert. which 5rm is the Division Cou**eI mr [>:<' htrite- >tevl (.riKiraimn ~n<: ('.mn'-l for the Elgin. Joliet <fc Eastern I'rdi'-v:.;.- t.'o.-jjnanv. K:.ri:? Mr. HakuaN L. Hackrkut: You il hear front me tomorrow. (Applause- Chairman Bennett: Ami :h*n w> U. have Mr. J..l.i. Small. m-t-w represent a live from rhv {'!.#**.r-riv- v ':'r.. -t"e -t Mr. >- <r. Ma. ./.-I*'. vu-.u. ;lw:Ke tV yuo Hatinem < * (-ntleeaen. I'm m *. !' Mviivai Section for aitout y.-nrr. :a- -an. :.;nj nos'ii.cv alter nnoi-i.-r 'J.t 30 years 1 nuuht tret mv i*cr<--. Lau CuAtcAN Bennett: Nt*e 10 have vou ail. Please take nnrr in <uir nm* vdines. Ami now ie- s vt fa-*; io ta:* extr.-rviv ttraoftasii -omen i-t -ur 1 autt--* oti Uoutmuy ansi l.viiai.iU'.aiior.- I thing mere niimi i-e mmu- rn-nn- of w:om wiiii ii some o; you men n^gat ..nr m nr;::a <m--***r -- so that we cm amend this Di.-uouitv ana iUhauiutution report so 11 w m i.c oi value to aii of us as we ?*-- tit to us* it a:u: u comes out. AU riant, lei's have a general discussion now. Da. E. W. StockTLL t Chief curceon. Detroit v Tuiesio Snort uno Rail road. Detroit. Michiaaui: I wc-uu; .me to bring up me outturn <*1 ;.<-c-i pre?ure. with reference to me oosribuity oi the meuieai uenarimew .> uuuia considered as negligent 11 a man u kept a; wonc wim ulooi pressure aoove me level mentioned here, iviiivli is JQO over IJu in the moon. had arose wnere w> wvresueu for continuing a man at work with .1 pressure over this levoi; we were r*.<iii*d --.<1 1: cost us .j.i.ir.il, iu- iui ;i - oronarv' at work, and we were con.-uv r.-i uvaauvnt in k.-vping i.im at w.irk i-ecau.-v his 1<umk1 pressure wu lvvi.;-s. I just wonder u n is i.v lo reiain m ti.i.* r<-inrt. Dr. \\. J. LuNCnw A v (Chief .'urov-'T!. ( olora-so v aiiiithcrn UaiUvpv. Denver. Coloratloi: U> took up that particular subject in our nieeunc. and we are come to propose a chance when wc make our report, eovcrmp that particular item. CttAiRstAX btNxr.TT: Is there any other 'iLsrussmn. please? Dfc. D-wt>: Mr. Chnirnum. I -'.uii i !:?.< to was it there h;i> in any conM'ieration civi-u to the pLievtiivni of tl.v rutmuic tram s employe m yard serv ice. or in s position an hncimceniun nr -miic other tyte of employment? t the Klein. m Railroad' .* most of us mn. A.A.R.. y<hm. who ..-Tt. whivh ,i C.^unsel Applauset ail. special r Mr. email Railroad) ; = i.i29 of the .other '25 or :n our pro* : <<ur Com* ome pearis -id. sweet-- I.ino Ruil1 of ItilHfll being ::1n>vh the :h :i blood If- H:ul =n at work Railway, .mg. and ring that :ny can* ' irl *rvt' F'fctecinns of Medical nnd Surgical Section U iWa m to me. ta going over the report, that when we refer to high blood pressure, diabetes. et*.. true enough, these men are hazards in road service, but i: does seem to me that in fairness to the can who has given many years of service to the company, it would be fair and reasonable it you took that man--who may be a diabetic on insulin, or who may have a Hypertension beyond the official acures given--and retire him. completely from service if he is 49 or 50. or well under the age of w. T feel that all of you should give .onsiderattoi to the placement of these men in various assignments where th-y .re c=r*. -.-.?..v r.ot iiudiie-i. wnert thev don't e-jrry 'he same type of hazard a: all as *r.*y .o :r road service. Thai r.jv r.e covered n the rertort. Jim. I'm not certain whether ymi rrisrrva *.o d running tracss oeooie. which takes in vara employes, bsegagem-n. .*r *. Dr. dr.vcs: -V* *pent a iong time on that subject. I happen to he Chair* man of -r.t* committee. but I am not the world's greatest expert oa oiood pressure, i'.r* :n ar.otr.er .eoartmeat. However, we have people oa tne -omruttee w-no are. Karie uo you want to answer your countryman here ior a moment ,:.ic t<-:i -rum w *at our taougnts were oa this euojcct? !>:t. G. z. \.?xz iA'jckt -.Chief ot Medical Services. Canadian Pacific Railway. M.ir.tMa:. i. .vt~v: '-Vo .;-.,:jvfAtciy left tins the way it was. This is a rcrnmnveuc^tiwa a:t-a a ruiao. Of nurse, bald litres don't mean soytnmg. You w *r.t a evaluation of ?he nun s carciovoscular system. The figure of J '.d -0 dcr-.-n t mean v.-ry much; at 150/90. the man miht be a lof more sics. TTe left it this w$y for the reason that we con adopt that humanitarian atti tude that you utenti-ned. V.'e can put the mao into yard service. However, if you have arty particular trouble with your labor relations, you have a guide here that gjves yu :r.e upturn to remove him from service, if you wh. but yurhaos ;\j : p-mittinr ram ta xmnuc m yard -ef-fire as a aicniated Hit. r r 0* 1 ..i-iiw'v i* an internist. and he :ii.*o participated in this is.4rti.*si>n y .CrMiu'. Or. 1:*.i l.M.ooW'SV - Mvlwil Director. Cvntrai Railroad Company ot New .I-rs-y. *;> t'.iy v.w .1,-r-ey); I think I go .dong with what Dr. U j-Ht said. ' have " ,ave the main part left in there. It was really the recocnmcr.'iiii.m m Dr. \\ i^ht rh.it we have something to go by when the labor reprcsefitaf..*1!! rr.es m with the man we rake out of service. The general feeling ..: we -:.i have <im:c leeway hare bemuse of the additional thing that we x-Ks-i tor--, stn.iv yf rlie whole cardiovascular system--and that the blood pressure, ner se. ?r.oull not be the deciding factor. As Dr. Wight baa said, a man with 1>0 or even 170 blood pressure, with iliabetea and fundi changes, and -niarged heart, i* a far greater mfc than a nun with perhaps J40 and essential hypertension. where you have no other clinical findings. Dr. Dowd: The diabetic m insulin. You're getting oil and only taking ooe tangent, actually, and that is the hypertension- Let's talk for a moment about the diabetic oa insuUn. 23 .ifoesc:ton f>( Aiwnm Pjiiiroodi Dr. stack: Firt*.. Ben. ooes tiat answer your question about why ** hav the heure of blood pressure n the oaraCTSpn? Dtt- otockwcu.: Yes. However. I would just like to pomt out that it may be used auaiast us tf "e return % man to service who ha* a blood pressure higher than that specified in this paragraph. Cuaip.4SaN Bennett: Mr. Hackbett. you're a lawyer--what is your men on that? Mn. Hackbert: I'u- been sitting here, trying to keep my hie mouth situ: From a logai standpoint. I would snv that to the extent to which. m a rrrr? like this, you can avoid setting arbitrary standards ami making the deeunw test the responsibility of the examining doctor or the chief surgeon. or who ever it may lc. you stand on stronger ground. l>oth as to your h)*or relation* problem and as to your litigated cases. because any surlit deviation ir<m tn- arbitrsry to?'--inv djght fa^'or "r.:ef. is in fivnr of ?*.<- mar. wuom von writ.? ;o place m anotner or :he rdaimitt in ?i- lawsuit --will !. seize*! i:p*??> i -. ::;r- yournc on u-.c o*\cr siu- a? usdscatn.r thL? xuv miviio*> tmt auptv to t:.a: man if you wanttocnaneeht? ioh. or that you ar gtstUvoi n*c*tcenr" *n havw.-* kept the man on tne )oo if r.is condition is a little bu worse than the arrurr.irv standard. From tnc legal standnomt. 1 would say tluit tne safest tnmc to no i* i make your standard the judgment of the examining doctor rattier tnan anv arbitrary figure or any irottrarv matter suen as the diabetic mm conrro; under insulin. or wnatever may be. When we have nau these cases wnere it is left to the judgment of the exam ining doctor as to v. nether tne titan siiuil be transferred from service or r- tumea to service, or re-emoioyed. we have tncre the variable that enaoiee us t give the benefit of the doubt to :i<e man we think is eautied to it. ano to take s*v from the man who is trying to trim us the aovaoiave tnat he woum otnerwwe have in the aroumry standard. Cit*.sitiL.\s Bennett: Thank you very rauen. Bob Graham? Dr. R. M. Graham (Director. Department of Medicine and Sanitation. The Pullman Co.. Chicago 6. Illinois j: I'd like to ask Dr.StocieweU how long ago that case was? U`a it Qve years? Dr. Stocsweel: Four years ago. Mic Hackrert: I have heard o: a similar case just within the last month or so. Those are in tne oooks all the time. Dr. C. F. Holton (Chief Surgeon. Central of Georgia Hailwav. Savannah. G*.): I would be in favor of deleting those figures entirely and just saying. "If. in the opinion of the examining physician, the chief surgeon, the blood pressure is dungeroudv high." etc. Wouldn't that solve that question? Cuajuua.v Bkvvett: Tl.o rurumittec will take that under advisement. Dr. W totiT: I was gome to make a suggestion alone that line. It would probqlily satisfy the legal department; I'm not sure: "an employe in train  a-hv ' have :t out that it -Lood pressure , u your idea mourn *iiut. ;:i .v moort ; the derisive j-o-i. or whouor relations ..ioa irotn the . ;rn you want -.aed upon oy ipoiy to that ::ce in having 'r.e arbitrary e to *io is to -.rt rhnn any ";rh control the exam**rvice or ret enables us to and to take tail he would *.*U now j<iQ^ c lajt month havaon.ih. - just saying. Nn, the blood uvstion? isemeat. 'e. It would oye in train Pmciulintja of .\fcdieai <tn>i Sur^ail Section service should be removed it the blood pressure has reached a dangerous level and <:n brackets) as a guide. 200 systolic to 100 <liastoiic. Just as a miide. Dr. Dowo: It has just been suggested that you tone it down a hit. hut i'.iil quote hgurea. I agree uh Dr. Holtoo that it would he much better ii we left out the racures. Ckaibm.o* Bennett: Lot's hear from Dr. Haydon. from London. Lapland. Ds. L. .1. Havoon t British Railways. Lcndon.-Enriand): l must -ay if we * or<~i oti '.nose iirirvs. we iiiouiu have to c*:t .*0 per tint of our tram s**rvic*\ Luuzr.tef' W- similar tiuures. wept that we use a maatouc of 110 rather man i-'O ..i aa i.MiUtr light. or reu you .ike. V then investigate tne-- ikiiou* v*ry T.oreoauiy indtcU. i mean. we nave tne oovious investigations maue. tr.it i- ur-*ury tract. X-ray of chest for site of the heart and uncoiling of tne aorta. Electrocardiogram. etc., if :r.ese investigations are normal we uucam be bl>t pressure mtocetr.tr. 1 have kept records of 'he biooa pressure of our footoiate scan lEncmcersi for over tea years now. mc.uum^ tr.vn sometimes up to 200 ystoiic. with 110 or 120 diastolic, who are unvtng m futi service, anu--touch wood--w* nave r.ot yet. m those tun years, had any lapse on the anting cao or any troume from those men at ail. They retire at trie ace of Go. but we keep track of them ..'hcrw ims wr.ere possible. ^rs-mady. I gnu : T.e c^:::c .'jailors a damn. It's 'tie patient, ami '-hat he has iwr.ir.J it. I -wii.-in': nave Rcures pubu-iicd a; aii. '*''< merely use them as a guide. CaaiaiiAS Bs.vNr.rr: Thank you. Or. Ilavdon. Or. Chavez, would you like to say a word as to how you fed about puttmq down azures for blood pressure? Drt. IiiNACio Chavez .Chief burgeon, "..rrocarni Del Put:ivo. a. A. do i.'.Jalaiitra. Jalisco. Mexico): Tn Mexico we feel very much as do**- D*. fi.-.y-:-n. fry r.-'. -r to i -.:e hri.'er. for fear we shall ho taimutitatviy rr.ervi. i .-.f'mnten't and try ro p.-riorn irequent metiicai examinations on tlio.-e nipioyes whom we suspect to be aivident-prone. j la Mexico the labor contract does not permit us to change an employe from I .-n.* yn to another. '-V*re we fo attempt to do so. we would be forced either to pay -be employe his pension or indemnity. C.`i.\muAN' Benxctt: Tliaak you. Dr. Chavez. Dr. Homsethie. wonUl you like to say a few words as to how you feel about j dus problem in Thailand? I Dr. C. IIuusethis 'btate Railways of Thailand. Bangkok. Thailand): In | my country we do not have a very hum percentage of high blood prwaure. tt'e j keep in mind that Uie blood pressure has to / considered, of course, but we j- Svlieve it is oot of so much concern in our country. t" i. l Chaibuan Bennett: Is hypertension s problem in Thailand? Should w i all e&t more nee? I. M-fci! -- p*.-. 30 AMOC%atinn of American Railroa/ix Dn. HoiiSETnic: I; is much less than among the wheat-eating peooie. Cuaisxax Be-vvett: Think you. __ All 1 can say is this, that where we have a problem, of blood prcwnJre. dia betes and many other things. I can just tell you that probably we. i&dividu- ally, should not make the decision. I think it always helps us a lot ti we eaJI m our fnenfl. the general claim agent. and give him our story, and let him iook at :t from hi.-* ancle*. Then, let u* call in our lawyer and look at tt from the point of view of whether we should put these figure* down or not. We rpjv even want to rail in someone from the ojonvtsnc division. I think ;f we are to put the?" iscurv.* down, nur-dve*. and <'md Itehind them once m awhile, we'il <<* in trotiblu. Therefore, mini mv tand|Kiint, .ulv personally. 1 would recommend that we take the other department* ot the railroad into con^iueration and call them in frequently to ih-cu** th*** proo- lems vert* fully, and then w can make our decision for the iw*f mi-rc-N *>' overvo:,* cone*-me*i. V.-- ;.<' over ::n :.o;ir on 'a:- ir<ub-:u. an! f ii : :il v-- -- thinx we i n-: .- is.t * ; i.ere :or. to titui out just w;.> rc we 5tan.i. | take a vore as to ;**? -*v*lv how * tar.d. D.'s- C : l move mat we accent im renort as a nrocres? renorr. that it ive p.-mteu as a orotress report. the committee neciucs to onn: i*. with hr.ai uetemunation to tic made at u.e tnecune of the committee ot Direr. tion at a later time. ;The motion wn reuu:ar;v *-conuwi. wa? out to a vote, ami orriro.. C-UAtRsf.v Hevnltt: .ui neat.-we are now at Item No. t. Ih oort or :r on i'rautaa. The uhatrmnn ot trail rommitt*i is b/*n dtocKwrll. from Detroit. Micmcaa. i don't know wnctner ben orougru atone trie key to New Orleans tnai ae aau oreaentru to aim wnen ne was mere, or noc but neverthcirs?. we are count to tura mu report over to een mockwcu. arm he. :n turn, is uomit to tatrouuec Dt. Lcutn. wiionaa seuo>report. . Da. Stocswecl: Mr. Ciiatrmaa anu centiemvu: Prior to 1952 the Comnuuoe was oainco " Commute* on f ractures. ' aau the reports were limited to tnat auojecc Iu 1951 when me Ciiairmao of the Committee was Dr. Duacaa eve. the report consisted of Uiree case iustones oi interesting fractures, and w then supplemented uv an outline of ``The Man agement of Low bark ppruuii." which a presented by Dr. J. Huber tt'acner. In 1952 tin* name oi tr.e Commit tee was chanced to tne (Juiunutice on Trauma, and at that tune tire Committee t.oitart m coordinate tneir report- wuii tho.*oi tin* Cotunuttwon Trauma of the Ac.uiru-.m C'olh-ueoi' burgeon*. Thus ui lio2. this (ilia wu, initiates! by prvsommc a buiieun on "The Care oi Hand in juries" wlucn was prepared by the American Society for the ountcry of the iland and dutnbuted by the Committee on Trauma of the American College of Surgeons tlirouch its recional committees. In 1933 the presentations of the Committee on Trauma of the American CoUc.ce of Surgeons with special emphasis on Surface Injuries, and a bulletin on u Uchabiiiiutmn of tb- ijuadncep'" ''a. nrc*.,*enied. In l',03 lfst* Comnuttt-e prescntml anil en<lor*cd a bulletin prepared bv the Committee on Trauma of tiie American Cuilecc of Surceons vutuleil "The Management of Acute Injuries to the Neck." It is interesting ui reviewing * " ( i | * . t j j ( | Prncttcirujs of Medical and Surgical Seaton 31 this report that one of tbe'prtnciolea ot Fine Aid was: " Do not apply a snug circular bondage wound the neck." In 1956 the Committee endorsed two booklets that were brought out by the Committee on Trauma oi the .American College of Surgeons. and recom mended their use to all members of the Section in an effort to establish a set of sound basic surgical principles for the treatment of all acute injuries. These booklets are the " Early Care of Acute Soft Tissue Injuries." and " An Outline of the Treatment of Fractures." To the report of the Committee for 1957. it is proposed that the booklets recommended to the bection in 1935 be -igoin presented and hcartiiy endorsed fur the use oi the memners ot the Section us well as their staffs. Particular emphasis may be^>iaceuSoo their usefulness in the teaching oi the essential principles of mercency surgery. The booklets seil at -51.09 o5r copy and may be obtained from tne .American College of burgeons. 40 . Erie be.. Chicago. 1U. I might sav that at a bectioaai Meeting ot the .American College of burgeons which was held on Monday oi this week iu Toronto, these booklets were men tioned by Dr. Michael Mason oi Chicago. He told us that their use is oetng extended a great deal torouznout the country, that many hospitals are using them tor the training ot their interns and Residents, ana chat very recently the Catted States N'avy has adorned the use oi the oooiucts ana is making them available in oil oi its centers aau also making them available on ships. I think they are very useful to the chief surgeons in recommending their use to their staffs. This year your committee ta:-cws pleasure m presenting a paper on the sub ject. "The L'se and Toxic Effaces oi Troaoudizing Drugs in Trauma." This will be presented by Dr. ivuthgatc Leigh. Jr.. ?.-ho is one of the members oi the Committee on Trauma- The paper is presented to the Section as a matter of interest, without a specidc recommendation concerning the use ot these drugs. At this time I would like to present Dr. Leigh- (Appiauaej Dr. Soctho.itc Lstoa. Jr. iChiei burgeon, beaboard Air Line Railroad. Norioik. Yu. -: Thank you Dr. brockwc-ll. Mr. Chairman. Duttn-guished Cucsu and Gvotieme-n: T*:tr ataractic or traaoudumg urugs have co recommended for u^c in cany aiiaenu from iiaiutrud worn-* .iirrrvn'ui pruevov. (.V.lh'd " hr.pritrc-^ puis" ly the avenge layman, be has purchased over one hundred million dollars worth of them in the last year i Reader's Digest January 1957) in hopes oi relieving care and tension. Before using these drugs in the treatment oi traumatic conditions, their complications and contraindications should be carefully considered. There is a change in the eodoenne and autonocnic nerve equilibrium of the body whenever trauma occurs, and its reversion to normal is imperative in the re covery from injury. Will the use oi utaraxics impair or improve this reversion? Wluit do we know oi the aettoos and reactions oi these drugsf The ataraxics affect tbe-ccatral nervous system in & different manner from the barbiturates and produce and amelioration of tension without changes in mental performance. Others that are similar are non-specific sedatives that ore thought to block polysynaptic neural transmission in ex cessive muscular tension. Serotonin release from the brain by reseroine, and other Rauwoifia alkaloids, was credited with the traoqudizntioq effect oi that drug, aod is probably re- 32 .4<KWlu>n of Antcnesft Raii^ocdt sponsible for the side effects of iti administration gastrointestinal mouldy and hypersecretion. :vs nivod ("oncvMion. The Rauwoifiu alkaloids. rcserpine and rosemnamino (.'rrnriMl. Modenf. Rauduan. Esksserp, cte.) have been known to produce * marked*3epre<3oo accompanied by &<mety and agitation. The parasympathetic predominance such as miosis, nasal congestion; hypothermia. hypotension or casiTojntftstinal hypermotilitr and hypersecretion is a side effect noted with continued treat ment. Any or these adverse reactions occurring during the treatment of an injury could nave serious effect far outweighing the henents of tranqui:izaton. The Pbenothiarine derivatives, chlorpromatine. nromszm# now-.--ry--,rtn' (Thorazine. panne. Cvntoaiinej have been known to hvmtm~, c;>*t!< tire jaundice and agranulocytosis early in their admuiistrati-in. CTcere the liver and bone marrow is already under a strain from trauma, nm* nrfditi..n:il attain from drug therapy might be very detrimental. Tle-w dry-. |k re- serptne can produce the parasympathetic >! weirriooi -.vii-r ^ r-T--: >: Urv s Park:irn-like syndrom*'. (drug- as ni'*r,ree:,.?v.'.u,v f Kn::;:;i'.. Mil >\v ; - \ - \. .'-.f-'. yv;--;iv' * i r-'Ci'ni**:* have a > ai-tum ir.jtti t:r- um.it v.vm cia-'W. nave J*-** effect nnd^>o'ne.t'lv le-* mn-Mor. "~ ...... . i-.--- r>---n known to pr'.-jucv (lurrunc >kin io>i<>ns aim imea'* omnu>. Tii- sr'.-`r-- iivnemotiiity and hcncrseeretinn txi awo (cen oteyrvou. Ti.,,>. .rnsRuttging types of drugs must ni.-o o used with cauuon m eas-*s of trauma. Tie rr.Usviv reiasinu. meonenesm i Lusennen. Toiserot). aieihvt tironaowiim rvierob. roxarmamme itisxizu ana mcoronamate itouam:. Miitowni r.uvv >.*-<* trar.auuutne effects peruse most ot tttwr action is <<:i the inter- : ugr:.-.i iy--m <; the Praia. These drug* are not tnierstt-a t*y an emorv ..gva'.it r.;g nroaure v.'ver- guatro-intcstmui irritation. la lurrv r.'icv produce tne namsympatucuc sioc reaenons. ana none marrow .-unnressmn. Tl.= oon-i)aro::uruic seoauv*-nvonours uiciuae etacniorvym>i il'mcidvii. .hutamatc 'V&imiai. methyioanuynoi iDormtson/. metuvoryton i\oluari. -ud g:utetaimiac iDondenj. Thar &cuoa is mat of % seaauvc rattier than of a 'raacusiiier. Tli-re are wttnarawsu ouenumena os tea more severe Uuu those iuoiauied with the oarouurwifcs. Lsumiv these occur following lung use of the orug. They must be thougnt of before traumatic cu>as are starttii oo iong time therapy of any tranquiimng drug. With the injured employe upset mvnuUv heeriuac of Ivaa of time from work. ;sibie permanent a^auuay, ami laquinnc tvinmim. uvsgnoors. anu Uwve.*., there is a great temptation u* use a drug mat u<ui pr-.Hiucu ctuoiucss. ihiiipuuity a;u: aninioration i-: ic-nsioa "itr. vut urv`wsiacss or memui e;:*ct. Tmunta has iurtujy upset tue sym.puthetic ncrv*us system ami stu^t of thcav drugs have similar actions. In trauma they shouid l*cusu spnnngiy and with extreme cauuoo. It is not safe for *a employe taking moderate sited doses of utnraxtcs to return to work around moving equipment. The Rauwnlfia alkaloids com bined with euncitomc blocking agents rtre used extensively in the management vf hyperteni.?n. and :t is evtremciy dangerous for one using tbis rvittoJaaiion id y* M.'outui operating tTV-irhiaury. Tie tmnoui:ii:;:gagents are very ctfcetive in mviiud uuu nervous condition*; in comoinauon *iih other drugs they control hypertension; the acute alcoholic  *i<n. -ivril, :`jion .ance .-.mal -.`atf an ...:uc : tie ;ooai .2 re- -1 of -rax) r two "A--a ..-.cro- ;:ua. -:nol -xn) .user.-npty b'lyO, :dur), . n .;tJ L'Ug. ; ::rue -v.irk. "ver*. o;ecu tnese : with .'03 IO -<icn- :neot :iuon . `.ioon; mode prr*>:tdau}3 of MMical find S'-trytcai sVctu>n 33 an bo quieted very quickly; however. they not flic treatment of choi* in iraumu where their possible side rwctsioi ace mote likely u> v:<tur. The tmroducrion of the ataraxie.t was a definite step forward io controlling the diseases of the human miud. Undoubtedly they will bo improved unui their use in trauma without side etfeets can be advocated. When that happens, we will have a treatment for Compensation Neurosis. Some persons react much more vigorously to trauma than others. The patient with moderate trauma wn -hows excessive agitation, increased puUe rate, gitvcsursa wstnout hynefgiy.renua ana tayroid risis facies u uroouoly -uiTencg from excessive pituitary *tr*s. tie is producing aQ excess of ACT1I. the suporo-iiJh of watch wuiJ return mm to normal <imuor:um rauca faster. Thyroid activity can be aioweu. .bong with tne oictauuuc rate, by the au ministration of anti-thyroid drugs. Under these circumstance*. Propylthiouracil. -00 rog per uay m divided doses, acu as an exceiieQt tranguiiizine agent. This drug too must oe watcusu very caretuiiy. Long extended use of it will cause agnaiimcvtosu. The uyputhaisuc-pumtary-adrenai interactiou following trauma is overacuve in these cases, slowing down the thyroid activity shows a marked improvement in the mental and emotional disturo* anees. The Lowering of the genera* metabolism adows tne reparative processes to work more eitecuveiy and produces-a calmness and tranquility comparable to that of the ataractic drugs. ?-?2ENCS iloui. G. Victor, Pi. D-. Director Department >i Pharmacology, Philadelphia College of Pharmacy and scieoce: Personal Communication. Tice. Linwood r., D. sc.. Director Department of Pharmacy, Philadelphia College of Pharmacy arid science: Personal Communication. Martin. Dan A.. M.D.: The Themseutic and Toxic Effect* of Traoauiuring Drugs: Medical Aspects. N. C. Med. Journal. VoL 17. No. 9: 396-401. pt. l.'.'.b, CfuMman. iianry T-. M.D.. .mil Marnieisat. Willard L., M.D.; Adverse Re actions to Mvnronumate. J.A.M.A. 162: bJh-ULiQ. Oct. 12. 1356. Albert. s. N.. .M.LX. spenerr. A. a.. M.D.. Linkcuteio. M., Ph.D.. and Coakley, C. s.. M.D.: `Hie Place of Chiorpromanae in Anesthesia. Cur rent Researches m Anaesthesia and Analgesia. VoL 35 No.. 2:101-114. Chaik-usn 'ds.vjrsrr: Thank you. Dr. stockwcll. Dr. Leigh. Did you Lave some more of your report to give, lien? Or. Stpcxteu.: Duncan Eve. a member of the committee, has just a sew words. I j i t' j: i !X -2 Dr. D cnca.v ve -fChief surgeon. N. C. & St. L Railway, Naahvdle 4. Teno.): Mr. Chairman and gentlemen. I'm sure you all received this from the American Collette of surgeons, (t gives a little history about fractures; I'U hit the highlights on it, It says that io 1909. Lane visited the United states and made talk before the Americansurgical Association in rvysrd to fractures and huw badly they were treated. Dr. Richard Hone of Philadelphia. President of the American Surgical Association, gave his address to the Association in 1911 oq the treat- 34 Asjoctaticn of American Railroads meat of fractures, and ia 1012 a symposium on fracture* was cv.^''. The fracture subject was very active in this Association from 1911 to 1921. Headed by Dr. John B. Roberts fmm 1912 to 1914. Dr. tViiliam L. E.tcv Sr., from 1913 to 1921. ~Z In 1022. Dr. Sruadcr established a Committee oa the Treatment of Frac tures. including three fellows of the Amencan College of Surgeon*. As Chair man. Dr. Scudder. in his first report in 1923. to the Regents, state.! the results of fracture treatment in the L'ntted .States and Canada are had. I had the pleasure of bemc ia Coicaeo (this kind of civ--' my sec u;iv> in 1912. and witnessed Dr. Lane's operation there. U'hat aroused me r.< hi* technic with his snrers. and .'ponces. 1 know my hr.-vrs am v-rv rrntv*-. benauM.- I play cards twim a week. (Laucnter) f think I'd take :: graduate course with my onsors like he did. On a scale of 4. 1 w**M.Vt r-c- i*ter 1. Thank you. iLauci.vr and upnlauH.-) CuaIkMan l`/r.':s>-rrt Thank v.-.u. Dr !.. 1 ' j LJ 'a. t.u.\Vuu. yes. exacnv the sain- *- v...j C;i.ur.n\x Rcnnett: I>r. Kayd-Mi. i.av** t- tratjcu-ir-r- :.*: Dk. HaVjo.n: Nut so f.-savtiy yet, C;i.uiu"..\N Bennett: Dr. Hometrut'.' Du. Kom.'CTUXE: Not >vt. BcvNEtT; lyou *.vry mutn i..r \...... ; -r-. Dr. ct'.ckv.-vii. Dr. Lvicu a:.- Dr. v. Now av ::*.vv the rvi/ort o: tnc Cummutce on i irst A-.:. ay ur. u..- n. Chair* man. Chief aurccuu. iiiiuou cCutnl hauroau. v.iicuso. Dz. K. C. ulsqs tCuici aursvua, iiliaois Central Rauruau. Ctucacs. ibiaois/: N`c matters iiave wra uruuent to me attention of the rir.-t Aid Cotnautu-v iu so far as nr-t md equipment is concerned, iu view of tnv report v.toen Dr. Stack has given, i presume that those items wtucii are not now in me First Aid Manual mil be incorporated in ii. There are some matters in there which refer to processional attention, uuu l presume that since the drst aid i> & matter winch is haadird by inymen. there will jn-ed t .* ur some c.nancw m the ivorctiiu* o: the approach to these variousconditions. Perhaps the commir.ee rouid work on the wj.ruir.r u: the r.rtu-i and sunmit ihut aiunz with the report wiiicii wiii be subr.mtca by Dr. Stack's committr*. Csairma.v Bennett: Any discussion about our report qu First Aid? If not. we will carry on to our Item N'o. S, a report of the Committee oa Develop ments Uesulunc from Physical Examinations. I am come to be & in lie facetious about this, but I was with Dr. Loa;ew&y last nicht for a while, and he made the remark thi? moraine that he was eoioc to toss a com. a.u<l if t: came ik-.hIs. be w:i< qeinc to piny yvlf. If it went tads, he w:v> come to stay m nod. I: :i s?m*d on us edee. he wu> eoruinc to the Eievtinj. (Lauenter) * 1 ) J j j | ) ! } j | J i Coit Rea men AS til >* **_ Mvr *it*.i tlth it r C tri; not we was to. can les r . rac- :ve. ..t- UJ: m i Dr. c Aid .nous vck's : If .lop* :ay .-ting ./.li*. Procee>iin<j3 of S(client anti Sur/jiad Section ZS Da. Loncew.vy (Chief Surgeon. Colorado and Southern Ry., Deader, Colorado i: Voti have received the report of the Committee oo Disability and Rehabilitation, which met in joint session with your Committee on Develop ments Resulting from Physical Examination*. The Committee on Developments Resulting from Physical Examinations, as noted in its circular, shall anaivze end mate a report with recommendation* or rresttoas on made avnulniiie m* r>rv*iic examinations. etc. It shaii -ruoy .;r.c revise. a? ondirajns may '.vnmr.:. *be recommended standards covering isy.^cni e'-iamtnatiuns a.s ivil y_ ^r-.c .'-.rms c-ed in connection there- As a r :i t his -tutiv, your ctirumut-'e has recommended very few chances, due anr.ar.iy to the excellent work ine in previous yars by former com mittees. "A* rviier you o your Circular >'. M. ,u a.--r**). under the Ceaerui Rules, auction puce 3. we have onuued. in line 4. the mores. "1: is recommended that." fiiart a new sentence ana add tee word, "should"*--" - - should be held out of service." In view of the thinga that were said vamer. *.ve snouid probaoiy re-study this section ana consider tne possibility ui .au:t;ng trirtt tvs far a* blood pressures arc coacemcd. Thu idea in what we -im '.in to demand, if we could, that these employes ne and on; of service penuir-g iurtiiur tnve-tiguuoo u the blood pres sure reuened :;ivj ucires. i:i v;w what usa nevn aud here, we could pronabiv re-stnuv met pnmiem. with the i-ivu f pr.^ibiy aot using azures. Continuing uuaer :.;v Central Rules, we have added * jet;ttya oa page -4. vhica cave entitled >fo. 1. Co read, '^"Hen an employe transfer* to an other occupation or clasiihcatioo. he must undergo and pi-** tue required physical examination necessary for that '`.ms." Oa page o. under \he general -ub;.ct of Causes for Rejection, uacer the rjtlc."T'-.-i ay*.'-." in line -1. fo!!:r.r:nr : uv.rci. ":mb,_<mus.`* you w.il see that it reads"' . . . of :n* visual acuitv." TV'e have emitted those Kirns. ''r. rage ;3. vuh " n<t .vi.-onian:- " I*'..-; .\:.d-*iwi.'' ::n Co fi:>; >**.< i th it part ii-vinnisg j-n:ence tcui making aii hormae r.h.-.-r u-r.vn r,n ' i.i: ; -igo. uiulvr " M.-aml .-'.ad Mor.il fr.irmitiea." ivc tcvi we should add or have nut in "refer to the eatira section on "Epilepsy."* which was taken trim page 10 of the report of 'he Committee on Disnotlity and Re habilitation. wns rvr.d by Dr. Stack :.;dav AUo, uavicr the same title in the .-rctioo. add the first two sentences only from the suojret r.uacrmng aarcoura as read by Dr. .Stack today. Because so irviny of our <kxamiaera do not actually study the circular on disability and rehabilitation, we feel 'hat under this same title we ihould mid "refer to mental wnd rvirvous disorders in the report of the Committee on Disability aod Rehabilitation." That is quite a long list, nod there might be somu objection to printing it twice, but you could make the notation " refer to. etc." In an eifort to further promote (he adoption of a standard examination form which will be satisfactory to and adopted by each nulroad. your committee has presented a form which it hope* will at least act as a basis tor a real attempt at wiving this major question. It consists of two sheet* that can lie joined, or it can oc used a* one sheet with the printing on both sidea. The first sheet Is to be filled out by the applicant. It is set up m more or leas of a check-on system. It asks really important questions, including quc> ,j*b Zo Association of .-Immccn Railroads tioos oo uck injuries, bead injunct, sod claims and losses, Since twnv women are worEinc for the railroad.-*, we added a section for females. The second ran, or tbe examiner's renon. at first may seem lone. hut after study you wul see that it is set up in a ume-savtoc way. TV*e have added a section for spine X-ray reports, and also, (or those who are mteresteST a place for alertness or rcacuoo time of applicant We must do more than screen these applicants. \V. <10 have a reaiiv mnt* piste outline oi standard recubuofls. and to make use of them. w- must oo a *tood examination. One important thine, however, i.* that w.* aii--not ji;>t a fcw--<-trr.n:-*harmony, must jermitsty adopt a uniform nr**e*-diire if m?.- t< nw~i (-illu sion. lecai hazards and embarrassments by aeunc on our own. The #uonuii*-t forms are avaiiuhU- at the otereiary .* desk fur your etuev ar.d comment. II:-*!*-' :;u-iv *<ihimttcd. i.'.npi.iu.w :! i not:-v b- tut- *V:i--rr.:.!i!i i.-j I".-- ;;*--r- t?- praeticaiiv lu-v.-r u*t*i anv :t--n. .* Mav I sutT'^t that whe*voti have tons** nnr.t-*s on `tanc.-.rc :\:rm. that V..f-v- ' .xr.vmutc tu<* word. " VVa*it-fmuiui." and juu?U'u\< " * t'ii.vihri.ts iitNSETTt Anv otaer remarxi. succestiun# or cruin-ja#.' *0?.. 0- r. Cfsiiaus iChief surgeon. Western Pacific ii. Ih. dan i'raaewco. Calif.:: Xathtuc is ;:u>i aimut tttc coronary uisoases uUh-t tnait nresectmc *ii:s:_r:orv wua-tice of .-''`very without <K-r.ijicni re*tuuai tiaciaue. r...vv- ii<- a tiuvmc a tot of trouble wnii enciriviiit-n wi;n tv*ritafv uis*nse. i*. 'mt it i in.- wiic to mui:*.-rome vaanc- ::.at: V-u ,-av tr;ai r-::ni-.v-: damage is v-.'iuvncv of vitctroraruiourapnit- cuauce. Much, course, woum r.iiock out a lot of pcoinc. Cuaikuan Bknsctt: Doctor, we have iucut-iieu tr.ai m -the Committee of Direction, auu we went over it from several oificrcnt auiturs a* to just exactly what our criteria sfiouid be for aiio*a*uis these men to return to work again. depenuisc upon their joo. etc. I wonder ii Mr. ilackbert wouiu pive us an idea on that--these men in road service who have had coronary occlusions'.' Mr.- Kacxbert: Acma. the cases arc teams; to hold that ii you put a man back to work who ha* given evidence of ii-r.rt inomutv. either in the way oi acute trouble or viirniiu troui.h-, if ym; put iu:a to work at a ion which may--* in tint opu.iou of some coder. t.*:-' opt;.ion o: the trier of fad---the jury or a cotumu.-io:*.--i-.aw imp--*-b on thal iiaii .- hvart which ho could not bear, liability is itoing to follow. Heart case# constitute a tit-id of particular activity lying ahead of us ia the claim lucid, and in the liticatioo field, and whatever can be done by way of bolstcnnc up the employers' position, and whatever can be done by restricting the re-employment or the return to employment of men who have sustained some kiud of heart damace, which may very possibly cause further trouble ia the future, i# e<nnc to be to the b\*r advamace of the employer and. 1 think, ttuiv be io the l*v*t advantage of tl.- i-nudoyc. Of v"uf#c. it > jn.-t a.* uucumivrtatik- U> die from iiuiiuutfition because of not havtnc a job or bcinc aiiie to uvl yourself as it i# to du- from heart trouble, but I think that the industrial employer, the railroad employer and everyone v* women but aitcr added a i. a place Uy com* must do u . .,tr.ni'.,f jid cuniu* our study \-C W;l4aCr* . a. iClQQurm. tbit ; i'mncisco. . prcevntmu vke. ;ry disease. ; m ,-ay that .. 0( course. * Committee . ;.;it exactly ..r'< -.ar.ui. ..-.".i lil . put a man uc way *i ... jury or .a ... nutici not : of us :n 'he ,,y -.vay "i v restrictmi . . sustained .-her trouble ,.od. t thtok. vnuse o(ol -art trouble* ad everyone Proctmtnqs oj Mfiictit u*vi Snryittd ivaws ci*t has to ua v*.**.vr*>int whw* hwkimr at the nm-hlcm pre sented by the .*ar<iiac pattenc. and rirmiy restrict the area in which he will he permitted to `.eerie or even to be present on the employer'* premises. Cuwmiuax Bsxxett: Thank you. Mr. Hackfeen. Dr. Chavez. do von hare that problem in Mexico--coronary occlusion*, myocardial ir.tsrcts? Vfjut are your procedure* for allowing these men to work, if and when they *o hack .vnr,<? D? *''- . -.`r _*.> -my u-nni'c 'tandurd. [ -In r>o ; .-`lev* ti.it you ,',.-.ere. ~r;,.er. As CI.:*f .`roa v: `he r:>::.*'MU. { mi r~.::.ef asnut tor?upate-.v. w* s^ve seen cases tn wntch w<- hare m.oue nn ri.--iroenraincrsnnir exaraination or an emptovc. the r'-suits of whi-h wre 'hose m a nerrecuy hsiitby man. only to have mm leave the oipce ana drop dewi hair an nour rater. Therefore. I v;ew this examination wnn *-xtremc reserve. { ui.^o reel that greater -.T.oaar!S -nouid re aUced un-in :;.e rmauiiitation of these natients. so as to prevent the tiiupiess. noovicsi iveiins wnicn mrtner ncrsravRtes tneir anxiety. C3.usu.ax SrxxETr: Dr. Ka\`don. would you iike to make a few remark* ns to r.n-v many -A your people !.*** 'nr.anar.* occlusions ana posterior myocur'itii i:i:ar<*ts before tie aue oi 'to! Da. clavaoxt i *'*vnC ;iy ; :t >3 ..v-mnsmy very cunsiueraotv. it ; one of our major proolerra ia tiie survive. tt'e itmpte*i the same rr.etnod. 'S*. try to ot them into jobs. aau. ^<aio. I couida't ayree more that it a impo-smie to forecast wnethc-r you or I are goioe to have a Abrcnary at ,:r.v mesvent. A? fur us ( know. i. no means of estimating `.vhetr.cr that is hxeiv or not. I have f.'ie mas wso .A >. or. ui >:r ',ii**.,naniei snips who has nau tour, and after r--r sd '".I'm-v/u. I .'.av r.llow-i l-.im to co sack :o :::* ;o;i. .* ,v..-... v` -i r. nt * a r,, .11 u. ';r::v !Jr. i; .< f<iur v..vij*~ :.*--r.. .n-i ! .*.***r*-- i <.0 - p*T..*.*n a y-.-.r, his worrr tront ?he puui' :' of :hc :1 ! <;.i him mucker than woul*! his jnh m :rie ' :n. "..i 'utr.c vo-ni -- he n::.n't had ne for ttvo years. nd l think he ntav h* .ai rs^ht. One man in rer.eral nracn-e o'irsi.ic the railway whom [ 'snow had .1 very bail one. t.c wx* .--t mx ;r.jut!;s at aye o: 70. bat he died at tie aye of 02. bavin? i**d a very -.rtr.v lire is between time. I think w* nave to treat a roronarv on its merits, and treat the patieat. and the patient s reaction to this mdafnity. I think ii we overemoharize it. we am oore sot t*f premoitaie sno'r.t.r than ii ie try. with common sense, to let them <o anewi vruh tUeir jon. t.:: CsAXaitA.v BexxTTT: Thank you. Or. Uaydon. Dr. HosistTmE. do you have sum thinys coronary occlusions and myo* cordial infarct* aeons? your employ**? If and when they do come hack to 150 to work, what is your procedure? t :.Vr. ' Dr. HoMstrnuE: There are cases of coronary disease m my country. First. i - _it*ynot to put them into the ruomn* service. They have to he considered *0 individual 3$ t>( American Rniirwdi Ch.iikuaN Bcwett: Thank you. Dr. Uomsethie. Dn. K. C. : I'J lix.4 co submit Uic problem oi the engineer who run & tiah-uved tram, ` ho lias had a coronary occiusmn, who has made a Wjaicai recovery, and *!.- an Vice*.rt>rardioenphic one. It has been my imprvf.*ton that you people have felt that .*uen a man should not be returned to his former job. is that soil the position? ^^ Chairman jcnnktt: Jim btack, do you want to say a few worn.* on thi subject? j Da. dT.tcv: V.Vre all throwing questions at this committee. I wnui.1 like to refer them t.i Oir.-yiar N'.-.. M. cc S--rum. under t!;<* heading. "C::ii*c* P.ejecti.-.n of Apph-nr;:* for Kmi*lyn:mT.'' pace 1" "TheJjpitM-.*' In tk'Mn.n line of this psraurst'i: n-iiMniui: ll.v spine. it is said that a eauv* for rej*-**v.*'n is the "protruded intervertebral <ii*e. operated or unoocmtctl." From a nrarttcjii *:.imir>oinf. of "*uw. yrc.i r.rv t>`-\ point to get the of the utiO'-^ratr-I rri>tru'it-i intervertebral i*i*e. !! in rivtr.-- <' .;? physic;:! esatr.!a.r.,.,'-r v-'" :.* v !.;:......... t:.i*tt:**-:.r N" I ; V. < i-an coon t.-r-rn tr.re ?.nd trveer.y-Tn that ly v.r. ...> v> tr..n :.' ha- a ;rop *>: iitModni *--. in t! < tower ermi-nr rr ;r. i>?t-e:nniny!*:e; X-ray t;.t: r.u-.cy of you take? That's ittst a nj*i!:fr.. Cauast \N hK.wrrr: Xt-n Curnty. can I ask your eepenene* tn s'.ieji ene*. tions as Do you have any cat.'1., hrures or opinion*, on Jur: < questions there. from :-i :::rre rr.2 of material you have amimuiatr-:.' Mit. K. A. CiJtvtv K.veoutive IV'Khmwjn, Genera: i'iiiiu-* i/svii.-.\. A.A.r... CUti-act*. II:. : < '::iv t:.at on ail types of uijuries. the back miun.r arc. by tar. the most not-rtt as far as payments arc concentre, sad rrovutc tt.e greatest vanaoits with restcct to payments pnor to iawruits anti yju:a;ent> renders'.! after iaasu;:5. anu payments jn buck injuries, as sucu. greater than the total of au outer injuries, including amputations anu ueau.s. From that you stay ;-m- into consideration the exaggeration cn u tir#viou.* existing condition acu anp:v i* as a ueouite liability to an accident uaaer u Federal Employers Lnioimy .yet. and make your own construction of what that will be. Cqajrsun Be.v.vett: Ttiunk you. Ken. Dr. tioiiiowskv, our \'u---Ciui*r;uu:t. Dr. Goao-*ii>Kv: UV inv- o-:r ortnopcdic rolicssnit*. but wntn iurt-speei to i;.v won.ierfu: rvsultr ti.vy ct-t with disc operation*, iu our departmem. i: I *w a man v. i;". ^ -car. I U-lp him on with In* hat ami coat so we can uet him out ia>t. ibuchton because t Kate that word. " aggravation." that I hear later m the court?. In reoiv to Dr. OUon. we left hii ouestion unanswered. In the case of u man runtime a hich-?pevd cnetne. despite excellent citnical result* and excellent eiectrocardir^rant. result.*. 1 woui.i txit return him to a hiuh-SfH-ed cnuu.c. Mv'iicaily. ue know t!;ai atiyo-i*- l:;jvn:e one attack i* certainly prone to tt.<* .-"cond. ami we cannot ferct. il when r ;!l oi-cur. t 1 j j ; ; ; i aiiO 1 :-.*yau- l - M?icrv. tn**' i .*" to i I U-tn- omc :ti wt i i.uj :;::e i .-.ta ;.;unmo:i t< cu:i rit K renua' Mark of Zz ijrma Uv "Z" durmc t;u pOSlllOtl Da. Cou attorneys ,.:iV'j::e Ua *n t:.*?e .-.cute t#:iv .jisaliie-1. We ail road indt Da. G an nppucati to Cits, and If you ami if t:.i <ir*p the l r.twer who runs a ..> it.-juo a-clinical ;; my impression . v.i-d to his former .<- words on this --. i .vouii uk<j . "C'JU'v's f*T t:: Jltekist .;:?c i'.*r fcjcvi:->n ii." ) iret the history - course of yj'ir :::>3T *var. Now. ;-*d hjsxa.tr *car v>m iiso comis v*r lumbar some i ;:?t a ov.eittoD. in **u*ri oni'M -.n Jir.t stark'a !aima Di'Tsioo, :he hack injuries .. and provide the '* :ind judiimcnta -ich. are greater .; -Us-;..-. i f - :.rv.i.nj : :vrt M.-icr the ~'.:`t:.vs if ah.it ;t '*i:h ah -ine *. our cJ'oari;->at jo we van -'ictoQ, that I * ease ot a nun i .nxxd oxcedetit ,:j-*peed emtttie. ;y proae to the Prnc^cUnip .-/ Molicai ntvl S-iryieal .vrimn ZO Now.as to where we :irr r<> put {!;** men whim tl:*>* have their ittacic and when hey ume bock to work-tiic commute- :-it 'his part rather broad. I don't think > : rati uetemiine it alone on cieetroeankosrnph re.ndtasa. Certawiy, we uuv find some with residuals, and they may he cumeaily Tine. We nay dud some with perfect eleotnxnrdioyraaai. but with a *ood. careiul history- they have angina, or they hare some other type ot syndrome. I try to help these fellow*. fm a iitrto humane, sometimes soft-hearted, and 1 think that sometimes my brain irets a iittle *oft wh-m t:-.* T-Tfcs-Tvitiv*-' >! in Ai'h these tr/m tn *>v. '' rv * mu: '.it.'. w-.vr --> ! ;:vl V.iv.i r.n ..for*. "-?ni:c .< r*.- *r> .,--3 ;;;-:;i tl v.v.-ver. a: l tt.tnk w** -'' vt ..> >.* -rot ` .vr: l have .t :iotn; -nw.i - hr.'tJMW.vr:* f*i rut ~:n vu "..e -tut a .itus mt. [ may ti--: tiiat I have a job tor t-.ms man :i t:.e .`i.'roun'TC oo:irtment as a :v.n :*;. W.-il. you aii know 'Re problem. the n'lestinn m *nionfv: * rma aa t co tr.ere bemuse he's zoir.z unto a different union. [ leave mat t:o to fhat union ri-nrc^mi.tiivo--' You neopte work it out nmoncst voureeivcs, 1 mn *. :s< nira m certain types oi ;obs. 1 ran use turn n*re it you icuowj u-ut atree upon it. The mairosu wul he maanammoua. anu d cive him a ;oo. out you Tifonie nave to huo ua. ' CitAihM.t.v Ue.v.vtrr: Thank you. l>r. t iuiiu-.* skv. I...I s .irat from Jim rr'ack a<asn. ;>. r f s: I avia say > suure turns; .amuse .Tuviar m tau maienai. This i? ;s-.nz nut^soai tor a iorre payment. The rauroou tucuscrv o: tne t.'sute.i .vales mu Cooaaa uicua more r-wpit*'---rapeeuiiy more uuonne ceoese l --than many otner inuustncs put to^etner. Arc we rom< to ave tnis om- i mumuofl to me outer side and oy." Tins man nbsniuiviy. i.v your own anu- ' ardi. can never as^m ^ct a jyo ou a raxruau. i-w ause ne iias o avor on uur.ovk"? ; It reminds me a iirtie tut of an nUi novel r.mi mutton yteture esuieu ` The Mark of iorro." Zorro waa aripaituh Roi>in Hood, -.vorkuu: s.'i uuthern ` `.h- lie '' *..* :u --.pert -...v he w>;:;:d irk :::< n;tims as*, n a mr.-e of : v.sit-.* i* ;>iu tnv-.-'.i ;::y v-ile:f;uc m of h.-uu: a 4u.*r. f-.r as patients anh mf**rvArr*hrai Do. Uu tvcU that it s "ammunition'* for t:-.e opposing attomuv4 mat this man is n-rmancfiiiy and tuialiy dsjaiiii'u. [ -son't know if .savoiic has h-ren more :'nrt;:aate '.".an 1. and h.-u aot away well any lawsuit i .in i5?.*e '-asn for ( kpo*' t costs us <.*>0.000 or fdo.'"KX). and wery smcle one has been on the basis that the man is permanently and totally \ disahlci. We :di end*,avor to h;Jp tin? uountry and the industry; l (l m t think the rail road industry can afford to fake on a man who has had a dixo oper&uon. Oil Graham: Or. .Stack is makinc a difference between an employe and an appheanu In one rase you're talking about an applicant in your reference to this, and < the other enac we re talkmu about employe*. ! If you use the form (but s recommended, you'll set a history on the back, i and if they deny it and later it develop* that they have a back history, you can t drop tb man. at least. i 1. I >: v --* 40 .iMoaaJwn of .ItaenceR Dk- M. !i. Cj.ayTn tCTiiiei r-urreon. Boutin:": U*...... v .***.'-: ::. M..Men ** T j 13. D. <_Y>: Mr. t tiiitnnan. I ^-ved n numirtr <>i i- i->urt :.-:i r.ne.it Uiis. ami I iuvf these met) on rrroni 35 savtnc that a;i dise c,\hi'-;. come to sorcery miouM Ik* triven at least a tumuitum e; fw-r . m r.*r::sanc:.i di&stnlitv. They so on record further. :< this f\t*::*.. ii..,: . ...........i r:;uv,- disc case should Ik* returned to work which recutre* -:?vm:ou.- :...d I'm um:;c the exact aor*i.-* or lu-nvy lilttnc. Tut* plaintiff'.- .-id<* l:n- /inii"i<-*j!:y i;: wtr.t.c tv-* -...a-: - = into tin* courtroom t* testify tn ito.t *Sft. T:.>-r' \ soractliuur on roeurd to Mpjort tho~i us tan-.i xv;* >.: ... \*. :v.(w nten apply tor return ti duty. a.r raiM* applicator. y. A* far as I'm **iret*rn-l. th* applies nr.* -- j:. --. -- that it 'i-.:*:v :: i **.:*:>. r ; i { t enttsmerme u.e Intimity ; tin* <w:;j\vv ttt iver*. I;:;. A. N.-.v:v. ri a S;<-i A j ih'-:;:;::.,; . .. ; 1 irv.e t.- von? are-ni' o;. u l at:; . '* :;*Ma 7. P.;. ta.tc " r.;.: . *r. i*r nt 4;j (] :*.*. unuer a:.v c*-:n:;t:ot:*. oiTtiii*-- ir iia'oatra s ami **ir ;ro;:i..* - arc puma up nu*r* atm store eacn year "Uii onernimnf. you permit ;i.y matt to wv i<;" to work as aa <;tr4wyv. o; yu H*rmp a.e r.ian to worn as u new aain. tie ruiiac of tUe a-cara. court is ; yo.i .,r.- cnmztuu ot t;.at uisa:<:aty mm >\u u^rrait Lun tv wer>ou ;.av>- r:ni*.:a-i tiis <i;aat>uity. a:a. any ac^ravauou ti.vtvto. or aay -oar-vation ;i.er.-aii*T. you are iiai/if t wi.a.ever Uu* court will aiio'-v tiu- etatna^nt. Soa;c ot vi.c:n have raid JUa: a star j*a't eooac:. to fv;-cl a titan. Or. jtatK mtntJnnen : sintple ianuaertau-.y. Perhaps soruc orrf.rpedis! n..ui [v-r;yrni a ju-!ju at Hit- satin* tiiac. t::arf Xu2. U.<- ,'U craL" t:at:i. t:;> ! !*. 17or ii:.- \V.'r- : -iii.i;:u :a~<il a y-_r< . - ;n iu r;;ioi : -- v >n.-. ]>-r -iir :iv-.*:.e** <>.*:!.oueui.-t : :<.Il you -.at;C t:. v nt'eTa'.i maiiv <>n tne-< ra.M-s. votircnu piw tsuit are ueuvnerated discs, cafes i);:it hapi>eui-i to be disloctdcl from a desvncratHi dL*c pofteriorailv, with pressure oti tiit* ncrvoti? system. Xow. suppose the same ritsc s-nuild Kcrniale ni the tipper portmn 't the Invly. tl-.c v'-nepme. or :i.t* l*uv<r part? You'li set tiO sytr.ptouts: you have no trouble. J.ct's suppo* that herniate.- yntv-rioraxiv. You l;av>* no tri'uMr. > > nhat we priRi:i/::y s;a::::-e tvitii i> ie2encrated - vineh. :n the course <: w>rk. i .i::h*:i to t.*<o;:;r Uu-lm ati-;: <*r iuTtiiate jfw'i*rtor:lh. prlu'iu!; *Tt-ure ami ,iy!uptoutt.`i...*y; ti.eivatb r. ft;ev are op.*rateil. atnl nut tty timer it i* nut a Minnie laminectomy. .Some rtbojK.aRsts say it.ere tuu.-t he jw.'fcrt iu-nin. That is one nt tjo frtHtiiles---e.ue of them only do a lanunertomy. C'ndrf 111Or** eoiiditiuns. I w.mitin t touch ti.etn with a ten-toot Jtnle. rn.str.M.- vsvawr .;..v. TI.: !... w.t 14 : t::e joa i acre :tr :.au : uaca .ii* ` *.:.-<*. ami your bae* Lick?" I M-ray o: b. Wt had a ;p ht-* life, had a back Kajirosd. brioe doten jhOATD? old t hat cafe I thiak i: they ha wry iir.po l tvon' them. VT know th< coronanef 1'ra.aot I think i with the pri-ttv W* has I*.id 1 tiunk i aaf those CaAir i.;m- U\m*iiiigtm inert aini'U **asvs wmeh have r *vni permanent . yu postoperative ,ui I'm unrig -w-disi? o voms ':.* rf.'inid have . ici.iri a ?o.-.*v ;i }..rvictf. I m C l. ' ivivauia U-ulroad. i`l.i.4 applies parM '.hail to the ttuin cyretauou -t the ;rj?y of the'-mpioyc . .i `.vh:U 11 rotues to \> w>rK. , 7. Pa. I : tiattulo un.it i)r. ...i- :i disc fwmtion. because ur - ,u-;j year ivjrh bi.-c or you permit the *lert is *iit jj you art* . . -is :,avc n*l..ni'd ::-.ivviftn ilicwuter, tr. >.....k li'f ..!! r-r:->nu : ;gc, i.aa im herniated times d -a -<?. .-iced that 'nr:i;iy, A'Uh pressure herniate in the . 'Mfc.' Vou'22 gee no rni.:*.'d uotenoruliy. s with id degenerated ..dovalcd or henu&te ; rneceuftcr. they arc .Some orthopedist* juhlcd--some oi them .. tea-foot pole. PriKCOlirujs of Moliral and .Vurytesi Sieiu>n U Chairman Bennett: !Ie mentions teat ihr*e occur durtn; wrfs. Let us remember that Then* are seven days in the u -rk and thre** '-hour "irsj m one liny. Tlrat makes 21 turns n week. l.et's remcmrcr that this mart works five S-hour turns a week, anti he has 5 21 oi a chance oi setting this on the job. Let us also remember chat at home and outside he sometimes uoes much more lifting and heavy work than he ever does on the railroad. Do. TV. TV. Wi.-Miacrix (Chief burgeon. .southern Panne Co...*rnn Fmnnsro. l.'aii;.): I la-v* nnn-,u*.t-<i this !:." '.i-t'*n vrv much. I_>; y--.T. mrvtmg in .' irs cmneisro. I :r.rnton-M matter f ur.i* ;**rni i-iym-n's lnform'itmr. :r.r uii raiiroaus. I ':.e :.-.r::s of i- tr \ Vnuirn-.iis at that time. I found r.;-.:vh "meat ' in those forms. Tr.( re is oue :}iins I mmceit ::i mis A.A.if. physical examination torn which I think :s rather important, .dob Graham and i\ea Carney mentioned the difference i>utv*n an einoioye who was worsting for you anu one aomyme for the'job. Che operating uepanmem eouid tufa a man uoivn tor no particu lar rcjsjfoo at id. warmer it was ncau*e tney uidot like the wav r.e wore ins necktie or anything There are some or iter oueeiions i out mour forms. W* ask." Have you ever had a b;i<*k injury.'" G'-nv, mere arc a lot if people who cave nau huert injurue who didn't know a. \ ou *:<n ascst up :os of people who nad back lajuncs as kids, ami later on y-vt ;<nd <>;<! citunrcssion* there. Tucy never tuiew tr.ev nad those. .:tul '' ih*y <n:crv*#tun?. I also iiiciuae m our ;.*rm. ' Have you ever i.ad an X-ray of your route or of your hac<'.' Have you c.-cr i from iumcauoor sciatica nr neuritis in your back?" I think :t ss ratr.er important to include that--if he das ever hau an X-ray of his back. TV* had a ease just a few years ago of a crfitlemsn who had never been sick (Q las life, never got hurt in lus k;e. fie had .-icneu this form. He has never had a back injury. TV.* found that N- ::.uJ hcvn wording for the ipokanc naiiroaii. un north. rmr claims deoanment ^ot nusy. and we w#re able to i-rng du-vti ~i;:a: X-: v -,f -nr:,- : v.ivfi :r.v years *h:-.t -:uw. *::.>a-ing > I --ir-.-.-'v..-* - . ,r -.vh rmir'vui i--i. ' ;f (.fir*-.*, rnut ra-v v.-.is *' TOW:: ..-u .,f .-riTj.-r. I th:::k .- v 'in!.!- '> .:i;*l <jut. They <sm*w vr.at y ai :r.e:u when you ask if they isave .'r h:td an X-rav : iken of their hack **r sptr.e. I think that is very important. I w.vi t say anytlung more ii>-*ut He* irurutnw. hemu r.o<ke*i on a lot oi them. 5V* have t.cvii ni. e to tnc foiiow#. keeping them nut of service. TV* all know they have ro bid for jobs. We have been hooked on a ;ot of them on roronanet. I'm not a <*an;iolu;:t. I go aiong with Krti Cr.rt:*y about our hack injunea. I think we just about hold a blue rmhon far payments on baric injury rases, with the exception of two or thrrr othrr railroads in the Cr.itel States. We're pretty Irary or tl-.rse bark case?. I do not accept anyone for employment who baa bail a laminectomy or a disc nprraiion or a fusion operation on his back. I think it's & fairly good rule to follow. I hate to have to do it. but that's one of those things. CaAtavA* Bennett: Thank you. Or. Washburn. i I A*W** - -iT^ZU. v.'Cr-ww W Z `"rvy yi|M' i WV^"T'W| FTT t 42 .-tssncvuion f>' .i.-T'i-rvun tlaiiroac* Da- Howtos-. I stronply so alone "*th Dr. GoiJowKy I wdl oot accent anybody who ha? had ft disc operation. \ think Dr. 'Ya-hbum 3 remark.* i>o;: the bar.-; were -- -client. You've ot another chance m the :u: tmmrrtpb. "Y.~p.v did you chaoee occupations?" You've cot tiia: usd-:* forrs;-- sectmn. ! tniak it oucht t* SO aoove there. because some doctors' **"'ud think :h.ti applied only io women. Talkioe about the discs, we sad a railroad Sremso who sustained a due injury and was operated on ia our r.tvpitai. He mode a one hundred per cent complete recovery. He can stand r-it-y-o'ed. bond over r.-.d touch th< t'yor with the palm.* of his hands without d`-.*s:.u;:y. N<> cf.ort :r. the lops, no mm- ful back. He was returned to work, to hi* reruiar job as r.rcmnn. He went to court and cot a .yy\o\i ve.*s:*t whi-H w<- h.st o mv. rivre? *h* fact that wc rr-ttjrrM him t* iuil cuty. Hi- erky i<--t .*>. rv- 1 would nt U-; man with a history di.-*: cr a hud back e> tt> thoopt-iuttr.s department, with tin* section laborer; or anythinc like that for mv nulmnd. Dtt rt.iTMoxo Hr<4Eti<>u>sr. <0 Mi'v.-sukvr. .v f';;. ;r. fh-.iir if.:.* -- ;.i -;r r;.iv:.r . Mi-.. xIacxsert: it isn't a mart*- r- i:-.v.. !:' y..t! hire a man. :: y >*' t. it w'Tvc. y -.j ta.-.v ;.;m von nr.o. ,.;m. us r.e is i: vny injure him 'V.r.r.z "'tr5? ot jj* r-r^.i-riwt. then v<mj imi/ic t<> turn tor the con`'n!:nofrs o- tpat injur-.'. a:;a trie consentient-?-* m tint ::.:ury at the time of trial i* tr>e sum to'a: r.f hi- onor condition ns u has T-e-n r.irmvau-d nv the iniurv. LV-n'rOu-rc-rv. you mv ;->r ?tie- enn result, or you are i:r.r-;e for the end rr-uit. w.-rirmeo s comnensatjon statute? treat the ouestton attierer.tiv. `out *he*e arc -wmi statuton* cxfentmr.* :o tae csr-.eru: ruie. arc tntrv tioo t aopiv :o cue rautoad mausirv except to me exteat taut our Canaotan orotaers are interested tn the pmoiem. because tney are ;tw unaer comoeaation statutes \:p mere. TLe answer to your cuesiton is that it u cot. a matter oi statutes so *r os the raiiroad liability is co&cemed: it's a matter e: woac toe ceaeauy aecenteo ruie iaw roncemuisr aaroactit wui cover. C'haipjja.v Be.vnttt: Thank you. Do. Hocseholdek: i should like to costume my remark*, then. It an employe is injured by virtue detective epuipmeot--tor icitance. a emo iroa that puiis loo.-e--he immediately recovers o:. ;h aa?;? tL^t lv has been t'ur- r.t'ped -si-.ti; improper materui. I ttink that constitute neaaitc liability; the rr.tiroari Has not t'urmihed him with proper i-su;amc-r.*.. ZV th- sam<- tokea. is there not ua contract that u-u-n the empinye a.repts employment, be suouid iumu-ii--ws nii part oi the contract --"equip- mem" that is in eood workmc order? It is my conteatioo that the pre existme condition negravatw the uijury. If be were in cood condition ia the nrs; place, he would not have funt-reo muen. if any, from the traumatic or Accidental assault on his person. I think that most of us have been t<v> w-ji-r-.e to c tvluoc with the plip riainti^"* attorney who. in cro?*--xaniinatica. suies. 'Ti.!-' man tiad a de- itvnenitrd rii.*c. and Ik- has ostvuarttmiii of the spine. Tills blow or tall that Il ls s-M not accept you ciiange ll OUght to ;iiy to Plained a disc .-yired per cent :vh the door m> pain- .y, >he * ir/mtss. 'hjor.rmting *.y railroad. Chicago, -aouid like to utc books that "'O. venerai rules .;m ?.$ y.->*! nad :.ent. then you -oequenceiut .:r:oa as it has ad rr*uit. or :::?erec!iy, but yy don'tapply ,<gtn*brothers are d^eou.statutes .:?* so iarils the . rc'*r>*,^l rule .. then. If an :.e. a grab iroo -.-as bwn iur; liahuity; the n the employe vact--`quip. raac the pren<4iuoo in the traumatic or ; with the glib .xa had & de* :w or fall that i'--rr?<iinQ3 fif Merlt&li ntui Surrpcni .Verien 43 he had, aggravated that condition. didn't it?" I have been cross-examined on 'irminr cz.<+*. and have immediately replied. " Ko " The.plainthFs attorney ha> immcdiaMy perked up and asked. " W*4I. i-n't that what the cenvni opinion is. amt what doctors generally testify to?" My reply to that is that t don't know what the rest of them say, but I think that the shoe is on the other foot, and that the pre-?xi.iag condition aggravates the injury. 1 think that ive, as a body, should start talking in the other direction. It's just as easy to talk in the other direction, rather than to fall in line trith the ciib remarks or the plaintisTs attorney. Chairman b7.NNr.rr: Thank you. Ur. ift.-useii'iider. Du. Hoe.r'istocoER: L rr.ink that the pre-existing condition airerswues the irrjury. rr.d that, hy an imoiiod vnntract wr.<#e the employe has noc furnished 'uitaoie '-.uiomcftt"--ins physical body: that is his equipment--he should be wuiinp. in accepting wages, to furnish "equipment** that is in satisfactory ;>r in ^cod condition, -.vnetner or not it is recognized prior to his employment, just as much as management is required to iurcisn him with equipment in good condition. Cii.urjj.vN Bennett: Thank you. Dr. Housetxoider. I ,-ce Mr. Hackcert w on his icet. Mp.. itAc:3!tT: I think Dr. Householder is still addressing questions to me. Ho tar us tr.c blicntion <t the railroads to fumisn secure trap irons, sate sui :*,v. iv.Tiri-.Ts that iMitomauvuiiy upon impact, and can be uncuupico without necessity -.[ *;avi;:g a man go netwetfi tno ends ot the U3~those -re oil pars *f what are railed safety apmiance acts. There is a companion tatufe related u> locomotive equipment caiied the Boiler Inspecuoo Act. Dy those statutes there u act absolute omicauon imposed upon the railroads to furnish equipment that complice with tnoxe statutes, and there isn't any question <*f n-'giigctive or due care invoic'd. There isn't any question pre sented as to r.r.ether or not the railroad has used us best edorts to provide MUtadie <-quipment. if the equipment doe>a t conform to the statutory .-mndird4. a.':.;;'..*i :r.;u*y r---*sits. tin* ra;io*.:tl is iiaoic. Tat* :..* -?.*:.*:gvnt r.uv >i uabiiitv ' hat atiplivs where y*-u don't have >ne of .ao.-e ..ifcfihc -:atu:<*y vN-iatiocs is just the general duty o u*e reasonable rare -to (iov.de :va.'*>a;*aiy .-.ire equipment and r<-a.-*>naiily -afe places to work. Ho far as me average jury is concerned, the fact that an accident lias oc* curred is conclusive proof of the fact that the quipment wu rictortive. or the ;iiac *>t .v.ir'K >\ :i.- i:>t uc. That t< the test upon which the railroad's liability is determined. -Vow. as to tats question of what Dr. Householder refeta to as an implied contract, or a*.itrance or warranty on the man's part that he is pbvsicallv able to <{o the work--wUf when a man presents tiimseif for employment to the railroad, he is no different i ban the ran of beans on the grocery store shell. If you co in and just buy that without any examination of the label, or without any warranty on the part of the canner or the grocery More as to its fitness, you may oe charged with having taken it just as it is. So it is in the rase of the man whom you accept for employment on the rail road. If you take him as he is. just at face value, you take him and you get just what he is. If you doa't require pre-employment physical examinations. I J 1 ,1 1  . . -ti-- * ' ;- -*.. -is&sryesrJ^r ... 5.*>*."" .-A. 44 .isjocuidOR n/.ien RaiUorui* then, obviously. you don't care wiiai hi* prior pbysnaJ i-oiidumii is. and you take him mem'' lttuie he u avnihude aiul wtUbc' t :?: If you taice him on the lends of u rather pertynenwy pri-vm.ymymem *v- armtuumu. then you ait chanted uuder the law with Lavmc required no more of a warranty or assurance ou uis part as to his phvsical tu do the -erk than will !>c dkscloaed by the kind of examination that you ctvv him. If you dive him a rompiete and Uvmuch pLy.-irnl ejmrr.matioii. aad he r.:.-- represents to the exanuoms physician. r he conrtais from the exsmtainc physician some dc/crt or some phy>icul rendition whiry, if kr:awn. would have prevented his employment, and ymi imve a rvit-y p< that et:vt nr.d ran rn-ve it. and ;i.t* nmu L- su:>'Cquentty injured. u:;l :. WHibj i,.; i.::ve r-c? with injury tf U<* Lid not been employed. <>r ii hv Lm not Kvii ectity ot this mis representation or tins runrealment. th-on y.-u .J* have a ihtWjsc ttt that verv limned ranee w ra-*** hysuotrine that hi*' yn;-t*t i. i*:i : -v ; ru ud. :.v aji-n-r J>r. it phystrru ;>Uin*in::fion. vu rr!><r :V . i>v yrjr * _ .... i;,. .in- stannum.* that the >::dv An:;a..*:'v -vvt aan U.*- i***.i*-f i.\- !'v:Ui-.'i on cue nnir*ai. t:.-:i v-*u ran t:* man u ?,u,:,-5* am;v.-<: cn t imn w them, you . T:u>< -u. there v ;n it Q;a!<!j:a.\' iiK.werr: Titanic you. Alene . we ::v.ve ~ rn`.- .. ..................... . th- ; e a*i L'.;:! :.r. t ;.ur:. :* neat-i as<u tt.c t'-i.e-tiuretTiefi a ui.::i out ttuTe ray4. " YvU r.ris-'tr.r.y-vtr.v: : .-v.\ u ;.ae-. t -...kv \:.vs just : i . * A haw '.mca t:.v static ma; ;ln-sc Ufoie ufe tat emr<au!K-> tvv navi- **n '-u: rayron. Vw n.k- the rtutit t< do a pr.vsir-i exammati'-n, aiwi w- :>. Therctorc. we are sure tiai th-y nti-et t:K*>:atuu.;ur. .-Ninety, u *. <.v.k tuc stati a* u was. or even li we ty:*k the w.r.i o: & <i:ict<T on <>utr.;uv--let s say. ui.* lamny amnor--~j otivn vue.'S tr.rh .'.T.r iiaek trem oeii.c ii.. or sick. tti-v e..iue (ante who it i>rv>cnpt^.a wuca states that toe mao ts now u uijus to wort; ami u in e*>od coaiition. The man pays the donor >3.00. I dm c know whether the uoetvf uai c.* ad over atm to make eer.ava ->r not. or whet re.- iic look the man's wora. E ri'eriil nj.v ttniv heu 1 v.a* tm ihe auu. ii~;:k as-itutiess. i had done ;; t-i.juf-. jtt- p:;y-:rai e*:antita.ts;ii v-Uvre t;.v taw\\-* >n t:.e e;:.er 5;UI- r-.niiy rr.n n.-- ut< and d-i.en t:e ladder ot ;i..- phy-:--.; t i:-.- srnrtvj by re.yiM:. " 1> .'ipr. wa. \h.' man fimpieteix- >::;;:;*-;d wa*:; you *:^rtttl'.*" Then iw rtsried at tuv i't his hftui and :u-: ;c:it titrouuti ?..i the sv>. teas .`itui all the bouy. 1 wa ueiieiu.t tie.i'. I lc.U done a rumptHe phvMeah If we do a penuactory type of examination, wc may or may not come into some cundsct like that in court. Awtti. 1 tiiiuk ii wo co buck to the few remark* that l e.iauo this morntnc upon I'pvuuiq t(;i> session. I think uur emoU'Vesare *ur most valuable assets, and I heie've that. i'r;-rr. turn,* n- unit- niter th'-v sre uv i* siii-uiu & n\rr them with \vTixmic phy.-Kiii tj; ns tu d-s-uie tiseir ahdity i.i carry >n, ar.d ii .*.ime::.;ne i> wr-'-na*. wc sic-uld jh.-k it uy uiy tL.it vinetr.mir COO- druertve can 1m mine, rattier tlun pick tl.ein cu tor the hr.-t tune wfjea thov ;rc ii.j *r 70. w lieu the enmtinn which ., n;ui ,-..Uid ..r miciu L* irr-vcrsihle. Dr Db rema them pone life. ere o Ca l jmpor i on tuc tfxr.m: rvp-irt ID iD \ Ctt vour N pros live peae naut still prese Of what that ques teat this D Mr thai spes Pre far to of rt iirti.jviu r.yioyr.iviic e<-quiiv-o go more i to do the work and h* mis* ':.e vsatuitutig -a. W`>_i have -.r.j .,ar. prove with that . .:y this mis* ;v (hat very m iirwcisreo by *> rc-wnte my s. if, by your _ :r.e equivalent i :he Bouer fn.; '.<} '.hose itaud.*.. it. ' it Coast where .-.ere-ays. "You i :ake (hem just .vs until we liave -ination. aad we <. 'h- -.`rd of a ...-.n -* ;-.ivn --r.j:: v.i,u-h ~.v man :/ :,a '.-ivr him . .::a S" onv.-s. I ':.c 'ber -ide :-n. He started -n you started?" ilia all the sys uiplvtc physical. ./ c.ot come mto ..ade this morning valuable assets. e should go over uity to carry oa, vt somethin? con- time when they ..it he irreversible. Procteainqs of Medical and Surgical Section. Or. Longeway, .-ill y.nj close, pho^v? Da. Lo.ncewav: I have nothing further to add. except to rvitcruc the remark that we just can't screen these applicants. We ready have to give them a physical examination, just as the insurance companies do tor a 5500,00 policy, or a $20,000.00 policy. Here we have a man who may be with us for life. He may cost us a lot of money. We certainly should be sure of what we arc buying. (Applause) Cu.uast.O' Uen.vett: Thank you. Of. lioairewnv. ;,>f argentine tnat vwv important subject. Or. Lonecway and bis committee have put m a lot of time off these reports which have been nut out thuLsmormsa. What should be our comma of oil the members oresent as tar as tne ooysicai examination is concerned / Would you tike to maue a motion, as in tac otner reports, that thu be put out in mimeoeraoned form or sometoinsr. ana oassea around to the members, or sand we leave it up to me Committee of Direc tion as to what should be done/ What are your wishes/ Dr. Wjjhbcrx: Move they be approved. Dr. Wag.vsk: What was the motion' Report of progress/ CilAlhilA.I tfs.VN'ETT: V"3. /The motion was resuiany seeocued. was put t* a vote, and uimed.J Canastas Bennett: Thank you very much. again. Dr. Luogeway, for your .report. Now we have items i) and id. and those are just about the last items on our program. Agsim these are extremely important. Certainly, over the past five or ten years, ur raareads have sained an extreme amount m valuable ex perience ns to the type of (heir pre-employment and periodic X-cay exami nations of the -pine. Some railroads co aU-ut oa '.-.ikir.T these nrc--mpinym.ent X-ray-, nod ;ome till do at do any. ;r.:-rc:oro. have asked i.och .-ides of this question to present their case. Uf cMur?v. we have some people who sav. * Yes, you ought to d> u. This is what we had. and it has paid ott." On he other hand. you have the things that are against taking these X-rays of the spine. We have two sides to the question. Therefore, we thought it would be nice fMuv to bring to your at tention the two `shall we .-ay; ruiulicting views. the'Vons" and tiiCpfua'' on this prooiem of pre-employment X-rays oi the spine. We will have thecons'' first, by Dr. Mishler, of the Erie Railroad. Dr. W. F_ Misiiler (Ciiicf burgeon. Erie Railroad. Cleveland 15, Ohio): Mr. Chairman, memoers of the .Section nod distinguished guests. I want to j thaok the members of the Program Committee for the honor nnd privilege of [ speaking to you today. .Vs Dr. Bennett pointed out. the iuojcct--which is "X-Rays of the bpiae in Pre-Employmeot aod Pcrio>lic Examinations"--is somewhat controversial as XV far as their feasibility in pre-employment examinations is concerned, f want to limit my discussion this morning to only the pre-employment examination, r T^e distinguished surgeon you will hear speaking in favor of the routine uae j /y. oi spinal X-rays will present very forceful arguments for their use and adoption J-6 Asiocuuionof American Raiiro&is in maustry and in particular Uie railroad industry. Mv udk today acaiast ^ their routine use--1 hope no one beiiovt-s that c on our railroad do cot fuliv .A rvalue the vuiuc oi X-rays and I want to make our postuoa dear--we do use ' X-rays primarily as a diagnostic aid in the trialment oi the injured and sick ; if employes. However, we have felt that as a routine procedure and port of the **'* pre-empioyment examination its adoption up to the present was no: justified. The problem of the ``raiiruad spine" or the painful back in general has been present probably from antiquity and will continue to be a challenge to the in dustrial surgeon as lone as men must work for a living. The ever increasing cost to the railroads for injuries to persons i of great concern to munagement and those dejartments dirtily ronctrncb--sad the entire solution has not been found. As pointed out by the study at the csw* os two hundred thousand dniinrs hv the State of New York the ns to iii<iutry fur f--fnicn>aii-.fi in New York turn I risen s-.t alarmingly that : ilK-.-fir.it: a <iv*-rrcr.t i>, CTnansion io T: ra::r. ia:-.r of \ or': .{ <|-.e t;-.V.--.i has uv-hnt-.i .--.uu;..;- :* per the lu^iuios are only nooui J oer cent--'ther s;a;i*i!- further surumr* and a:" in^ni.uvc of an active a:*i eitjcicnt saiciv :r'-r.-..:n--'.wcrtr.clc-f. New York was rciponsiolc for anvut one--iift.f or the eat:'-:-..- pernian':::'. jcirtial r.isw- ano 20 (er cent of the countries permanent :ota> rases. taeastataisy New York's lowest number of serious injuries was recorded ic the peak .tr production oenoo iti42-4o when the prerfunrs of overtime, rmoti' hai iiK-i'.r- and lin- i:h:n\ :' y*mg aii'i <>lu ir.vX;Ti'-.-:--t-d workers were at rite:.* n-nub--in miter words there was little "i-ettvity of worjters. .f i:r:;.er. mjuru- to uc min* nave belied satutv urognims. improvements in medical science ana shorter work week. As cause of totai disability. in -U years, injuries to the truuK iave changed irotn a poor tmra to almost drst rasK. You may wonuer wuy 1 have used New York compensation records'when we are sal concerned with thus* cases under f..L.A. The reasou is dear-- New York is concerned for its economic health--we in the railroad industry are aware that our problem u much mure acute and that uoacr F-E-L-A. we are much more vulnerable. Dr. Howard A. Rusk, Director. Institute of Physical Medicine and Re habilitation. Xew York University. Dciiovue Medical Center, in discussing back oases said as follows: '[ kaow of so greater problem ui rcinibiliutiuti tbaa the back casus. I was ai.>-ut?!y ajCoiiuhtii to read ttw statistics of the Nev.- York et'inpeaiuAuu recurd t: 1049 ana li-^0. iu that period Jd.OOf) back cases were cu'sea. Those that baa just soft tissue injury averaged 42 weeks away from work. Those which had bony injury to the back averaged 246 weeks. That is almost 5 years. These statistics did not even count those who were paraplegic" Dr. Rush coonnuea. "^Yhcn we can truin the average pamplcgic whose cord is severed in 120 cavs. so that he ran go Imck to gainful work, there is something wr>ng.'' Continuing the quotation: '' have neen wericing on an experiment at my imtttutv :if.u tw*of my staff have been .-utinc on the Compensation Bourn reviewing euv* for the Inst coupie of years of >evcrciy disabhd people who get what we ul the big fat 61c. It conies' in :il>out three inches thick. These cases come down to us with a i 1 > {i icmat died doctors. Th living again, mereiv irom :bes pnrnr Our result* h we were able Dr. Ku>k refni-aeute h u*n-uwiurtni than nx Tiw late 1: it-nv::!*--!-* !;:v"...v t!.- in vn ri-rv'.-ijveiv i k:>ow j Ibdujtruu r* Hessntlv ft: home an His doctor wa* it; bed weeks, lie eatatrut sue w-itaout hop wo clums iovoit'ement teotion. and tauoo--w The em patient, cot new, (Laughter) not ov able truth, that efter 72 ' cheat him These erepaucies private T^tday' long bis through nev.-jrjpi ongY mu Tlu-re and that :i R.-alf'sAi ;us*fy. My talk today is against *.v -,r. ;,ur railroad do not fully . .. <.--;r pjaiiion < U'3f--we do use rvatrrcr.; of the injured and -sick ,u:^e procedure and part of the :o the ?:eseat was aot justified. - camfut sock in general had been tmue to be a challenge to the in- - i iivir.*. r :".t;r,v= to persons id of great i concerned--and the r.'izr.r^l thousand. dollars by in .W York has .-rent ;o industrial expansion in that of tae nation has declined .jtiy o per cent--other . an A't;ve and efficient safety ..stoie for about one-halt of the :it vf tie countries permanent rnous '.r.;uries was recorded in :a the pressures of overtime. 1 ,:..xr.r:v::-ed workers were ii;:;e --v activity of workers. r.r prvgrums. improvements in i cause of total disability, in vm a poir third to almost first - rk compensation records when T-L.A. T:io rvrison is clear-- --in *he railroad industry -..'.a under F.U.L.A. vw : ?hyiixii Medicine .nd Uo`.'cuer, is; duuussing a ' hao the buck cases. I was Yurie compvn.-atiou -c'i .ras3 were closed. Those s away iron work. Those . ;o w-eka. That is almost 5 - were paraplegic." Or. `^e paraoiegic whose cord is ;nfui wort, there is something ' institute and two of my start . rovietneg cases (or the Uwt : what *< ceil the big (at file. -** came down to us with a -- v 'J c-u FrnctesLifijji oj ^Igtiicnl nrvl titcrfiml fiction 47 terrific fixed anxiety---they have <*en anywhere from five to twcutv-five doctors. They are .-till in duration. They .ire afraid they ran never make n living again. Their pom is fixed--1-sometimes from mnj muses and many times merely from emotional causes. < we have tried to ee what we mild do with these people with an adequate psychiatric tatf in giving definite treatment. Our results have been discouraging. Out of a group of some 30ft eases l think we jvereeble to get Iws than 10 raxes or about 3 percent IwK t -.v.'rk," Dr, Rusk gmi .vti--" During that >smt period v.< it'O .-rmi-arute hack -v'n that w-.-rr -dri-rH *n u- j.y |-'ir r>hv.'i---::ui. ;> rOc-ir-iu.'.'r.M \:un -ix >( the Iftd we `~,r :**i1 :*~r *vr.t Hack on ;<* ir. !>-- The late Hnrrv t'. >*-.v.Jildin*j?*rsn f'hot*-d;r -urg*.- ;i out nwirc.; 'hr- r-r*or<i har-k ca*-** rn private practice r<mmonreit**Thtf hri'A* h htxrudy 'tie arch of industry. Again it .< the most lir.tfiing of disgnns***. the mo't ur.?Ats;r.tory of treatment, the most promotional in ontrovr-ruo* nnd :ht most GinVi'.lt e>i di,ipo-ition." Hr <-'ntr3!i-**t 'he dl-ahUirie* m indu^tn* with that in pnvnt** prarnco x* ;'..iUws: to oft trant in industry ^0 tveoks am} tho* with b*mv m- ;Ufjei avenging ifT2 weeks--in private pmcrico JW r*e*ks -tri'f .* monh< rc-jpe'-tiv^r." and stated "the indu.*tnnl hack is the people < himlm.'' I know you ;ui agree oath Doctors Rusk and rioamdinc that the imurctt induotrud ca^ w ojn*-r*at rhan the injured Dri*.-3to case. i.ecer.tiy ( ^camtn*') s conductor dO v.-rsr< oll mno had ! fr**m % i.wiocr ; h.-.-me and ;i-?ran*gi a cntnnrrssioo rructure of the fin't iimoar `ttvnmf. HU doctor was a general pmi-tioner w}j> !i<*iOitasizcil and X-ms'ccj im. lie was in bed :>4 *), was *vmotom jm and anxious to return to wot* jo 10 weeks. He had had no mhaoiijtation team of ortnopcuut. neuroirgut. psyefciatrist and rcha'oUjtatmn soeeiaiist--out inere was a <.t>orvrrati'.*e patient, without hope of financial wmdtuil to cushion jsw rettmment. chuvnpctl at his `vn riumsmir-s and a i'oc>r wr.o ferngnrreri a simnie fracture wirh.njt cord iavolv.-ment r.r.d who 'n.-.>i-.e ease >mmy, intelngentiy with pcr*<mal at tention. ana convincing fi'.n.i|p,nr 'o -ni.-i.irrurv -./ ::dj;tluii- --a ::;* :*i .rv^jv i u return to work. T:.e *!)!.(.-.? ".> rr.in ,i I.ulder wluiu ut work fr-nu<jnly is a unVrent ; atie.et. H-': not -u !.< rliim*m >s but U *.smvinrxi (he ladder was ''t new. ri-.v?* .:*.* grea.-e <<\ v,c rung and perhaps someone pushed him. Laughter) The local gr.evw--a real orriiwfKilic authority--- mils him he will got he able to w..-k again, ij-.nt the cokp-ay >r iv>l! not tell him the whole rath, that his -uiK-fior; tr>- n>.t mrretM in inm (frequently w\th Ktmv iruth i"cr 7`- h'-u.-'j :m.i shat unh -i he retains an attorney the riaun ageat will acat him. These factors, primarily i>'V-holrgic. explain. I bdievi*. she ipyullmg di^ cffp.viciea oi *->nv:iles<wnt tone uni (n-rccmuge of euro if you will--between private practice and iulutrial surgery. T.iday'x .social atmosphere which often makm it pruiitahlc fur a man 10 tnv long his disanihty--*hc un`''>osci<uu nnentnmnt t<* iKitov mjurerl--ulwnye through n* fault of ht>--the fantastic promt** of {ilaintiiT*' KUnrneys, the oe*'paper smnes f unbelievably generous injuries ami lhe"brreny" in <wery ooe'x will are prime cause-* fc tt-.e dirtert-nce in industrial and prjvato practice. There is. ( believe, another cause that the medical profession contributes atul that is the difference in the Attitude of the aurgeon doing some industrial 48 Association of Amgnean R&uroada work, are all familiar as chief surgeons with the worker wfa h * simple strain--he is examined briefly, told to apply best snd come bark in 3-d days. The following day he can't get out of bed sad then ts transferred to the boeettai where be is X-rayed and physio-Uierapy is begun. After 10 days or two weeks an orthopedist is called in and because of low back ache a myelogram is ordered to ruie out a disc--really be hopes to And one--when that is found to be neea- tive but some arthritic spurs or perhaps a slightly narrowed disc traction snd more physiotherapy is ordered and the confusion and disability grows like "lop.*y''-snd the lawsuit is in the offing. This patient would bare pawd a physical examination as an applicant even with pre-employment X-rays be cause the changes now seen are those that are normal with advanone rears. I d-m'i Iteiiere routine nre-cmploynvnt spinal X-ray* solve or get to the root- of the problem--eliminating applicant* with anomalies docs not dr away with the iaxy. the accident prone or the neurotic. Here and in laws which provide automatic liability and in free spending jurir- in addition to tlm** factors already mvnf/nK-i lie- cur pr< :!-.t.i. Ti.c-e will f>v:i though :t rci!.*".'td. hv rire-omtiloyn-ent X-mv*. rr?-r. 'ji> *Wi --t util <-; i r. app.irjtf.s still srx-nn.- yjO n head :!< . v. ii.-it industry no-*>S i.- jn-.'.V '.r-'jnif.tM s*irtv"if trjuetl in indu-'.r.r.i nvdivnv.: and surg-rv; n.-r. wiiOse'^.Ttntary interest is in the protwr *election ot applicants and* the nwoc- carref the injured. Thi- mean4 that on tee pre-eropioyment examination the use of those facili ties we as doctor? were trained to use: a critical history: a cotr.nivte examination of the man stripped so that the examination is a proper one: personality evalu ation ar.6 good judgment as to his ability to penorm me job tor which he is applying. liiteso of reitence on w laboratory proccoure. When an emoiove is Injurvd he r.ds a traumatic surgeon in attendance' who i pnmaruy interested in ths: industry and it* eim>l*ye> and who is unstriv aware of its problem.-- aot & surgeon ;> uoes come industrial work because it makes a good supple mentary snd sure income. A surgeon wuu treats the injured employe with the same care ana patience he does ms private cases aoa not as toe poor and un reasoning relative. The cioim agent must be more tiert than the ambulance chaser. He must make prompt contact, give assurance aoa assistance dnancmUy and otaerwise and do everything possible to keep the injured employe from feriing forgotten. I believe the best remedy now available is to make sure we control the result by careful treatment, early rehabilitation and a just settlement made directly as it shouid be between employer and employe. On our raiirvr.d all injury report* ns a rule are received within 1 lours alter the injury: the manner m whicn the injury was received: what the exaauuation includirr X-ray? rcvcaU-.t uiul the estimated dUauiiity in days or wvetfct. For example a brukemnn r.;s' severely comu.-cd m-cr the lumiiar urea. most likely with some tnrr.i-niu.- ui:ir and retcn-{>erii<>neal hemorrhage. There wa- severe pain ami bilateral sciatic radiation. Within 21 hours a myelogram and disc exploration had been proposed. This was vetoed and the man made a rapid and uneventful recovery. n*emtiv f calh'd : man to my ntlicc because his loss of time wits inconsistent with the '.'.'.amivr in which the accident hail occurred. His cmpl:uiit? were typical: 1,-w ci.vk jntn with r.uliaaoti nit** 11* thigh On hi? he kid seen IwtU an crth-medi.-t and a neuro-turgc*n both oi whom had advised an oper ation. A detailed history including his social and economic situation a .* 3 t complete pbv? iimp--no true anmety acate--simple if with remedies woulc hall would aileday. 1 hriieve m study of senou routine X-ray ciaim costa, 1-ct me illu cases for the amount isj \\ were !-* *eno Imiged. 1 *f sit the - These mclud* ano vi-u n:y cases that th positive evj<- There is the use rouunc pro tram service, were tram serv possibly olhee Let us give be a bomcraug Federal rules capital of the effect in litigi off duty injur perfect youth I believe industrial ha plovers and dividuais aco perfect and is against pu Xot only against publ adopted (hi because the} industry' wot is tbe logical The pre-e who will be men X-ray have vvQrkc pre-employ would have ..itlrcada - The worker who has a simple .mcl come lack in 3-5 days. :t is transferred to the hospital :i. Alter 10 tkiys or two weeks k ache a myelogram is ordered . 'ueo that is found to be nega:lv narrowed dttc tmctioti and .- and disability ^roffi like would have nas^d ft . ;;rv--muioymeat X-rays herr_ii wim advancing years. ;i X*myi -oH's <>r get to the - zancrjiiicri does not do away 'a:. Here and in laws which ^ juries in addition to those . -e proo.Vms mil continue to X-rays, r-jccta 'JO to oO per o. No. iviuit industry* aeeds .. medicine and `untery; men. . applicants and the proper :ati.n he use os tho.se faeui.ory: a voir-pL.-te examination ..-oper one: personality evaiu-rm the .'ob ior which he a *--iure. When an employe is -e who is primarily interested rarely aware oi its problems-- "Krause it makes a good supplew'Mhe injured employe with the - and not as the poor and un- .'::buian<'L* chn.icr. Ho must <* nnan-.-hiily and otherwise :yioyo trfRi forgotten. >ure we ofttrol the final :nd a just settlement made ye. ''eived within J4 hours after vivpdt what the examination ..nitty io days nr works. For `~e lumbar urea, most likely morrftage. There was severe :'ura a myelogram and disc : and the man nude a rapid - .* of time wan inconsistent irnxL Hi.< complaints were in. On his own he had seen whom had advised aa oper<d economic situation and a Proceedings of Mediali and Surgical Stdion i-J complete physical revealed in spite of the typical complaint and n marked limp--no true muscle spasm--no lumphy--no neurologic deficit--but a severe anxiety state--primarily with a financial background. Obviously the cure was simple ii with authority 1 could assure him he needed no operation, that simple remedies would cure his physical complaints and that the chum agent across the hall would alleviate the dollar deficit. Actually he went to work the following day. I believe my position in rr<oect to prt--mnioyment X-mv< w .-im-M **v i -turfy er:ou.? rasis which is vniicntemng and rev**nl* *it :!.** oner?** routine X-mys ii actually direrted toward nn almost mxitgtbl* far.r m i-inim costs. - Let me illustrate--f bare n^Sewed the settlements *>t ail the serious baric cases tor rhe past five y*am on the Erie Railroad. Those cases involving an amount less thao $2-500 have been eliminated on the snopomion that thev were less serious and their convalescence normal or at least not unoujv pmloneed. Oi all the serious <rases. -$2,500 and up. the average payment was $7,005. These included fractures. discs, etc. ia none were anomalous detects a factor and you may be surprised to know that the four tartest settlements were in cases that the X-rays were negative and from our examinations snowed no positive evidence of neurologic deficit. Then is the further consideration that most rauroacs ana comcames whieo use routine pre-employment X-rays coonne tneir use to one ctais. l.. those in train *ervice. In this respect this renew of our cases snowea only one-tmrd were train service employes. Back cases occur in ail classes of service except possibly ooce workers and supervision. t Let us give tbougat in passing that toe poiiey of pre-emptoymept X-rays can be a bomeraag in the hands of a piaioaifs attorney and under the present Federal rules of discovery rhere is little douot that he can obtain them or make capital of The met that they were refused. We can all imagine the damaging i effect in liligaiioo to have a current X-ray with time. <tr**.. tnrlamatnry -erf off duty injury changes compared with the normal nre-cmpurytnua X-ray of a perfect youthful back. I believe that .*m -urceons--luHc-wmc the principles of the craincti on industrial health which are '> provide maximum benefits to employes, em l ployers and communities--the emphasis should be on the placement of in dividuals according to their abilities and not simple selection of the physically i perfect and re;--<ion of nil others. I'njust nr queitumahle exclusion imm work is against punlic Aolinre and contrary to sound industrial health principle. Not only must we recognize (bat routine X-ray practice as possibly being against public poiiey hut the beginning of a trend. Assuming all employers adopted this practice, a large pool of willing workers would be unemployable \ because they were not photogenic to X-rays. (Laughter) Aa a result each l industry would b forced to take its proportionate bftre of such workers. This is the logical end remit if the practice became universal. The pro-employment X-ray wdl disqualify many men who have real desire, who will be willing workers and an asset to the railroad industry. On our older men X-rays frequently reveal anomalous and other conditions. These men have worked hard for years and have been loyal and faithful workers. These pre-employment X-rays would have denied them their job and the railroads . would have beeo the losers. Paul Brown, the coach of the Qevdaod Browns S#& 'f&ii f: UZ'f^ ) '-'. ' - i^i^i ji-i -- ~ so AjjociUlion of Aiwncun Railroads football team saya that given a boy with size and speed the most important ingredient tor a championship team L-. desire, football is a rough cootact soon aod contusions and sprains are expected yet the Browns have had no trouble with the "low back syndrome" and they don't ue pre-empinyment spinal X-mya. We should look ior this "desire" also in our applicants. I believe pre-employment X-rays are unnecessary and never take the place of and are not needed to supplement a complete thorough examination by a trained surgeon who is aware of the railroad*' problem and thv many factors involved. Now let us inquire as to whether the use 01 routine ore-employment X-rays has proved its worth. It is an added expense and it t* not fair xu management unless there have been result.- or tndimrir-n that it lias served it* purpose of reducing daim enst*. Let's look at the record--u=mg W51 a base year--the claim payments on the Erie for the past tour years have declined, roushlv T per cent. C.-itic the same I.C.C. tourer :V my fiirun-*--r n.iid u-ir.v* n-citiployment \'-fuv> dwiw*-d -_'tl j. r cons iv-renvj in cissm - -r. for JV.Tlod. In f-ti'iu*:*n. h-i ti' r -- mt- ihr.t t:.v i> '.: >n i- ls-*-J :/ :!: l. j il'Miieic i>r!-<'::::i(.ytiu-iii , A-my-. nte utrtvtwi nsmui-t am amino* hack condition* which our record* `inw1. n prgji~i,> :V;r m ft-io * 1. It is U'Uaiiy in u-e in onlv mic cia-- or rmiy.*s and *** riattn- arc general. 3. U may be used against us m miration 4. The practice i* aeainst the principle- <( mdu-'rnl health ano miniic welfare. 3. It may in* unfair i sppintuii- n<* wotud have U--n sv.vai. v.mmsr vork-.T.* o. The nruetire is unnecessary aim may be a suo-mutc tor a uiurougn examination oy a trained rauroaa surgeon. 7. I: an exjtcnsive program auu 1 have not as yet seen figure* to justity the expenditure. Let me repeat that our problem is a real one but that pre-emuoyrcent X-ray* do not co to the root oi the situation. I believe the remedy can i.e louad oaiv ;q a trained staff of surgeons woo wort hard and ions 10 cuntroi the ultimate result oi the injured employe and alert. claim mea who contact the injured and cultivate theconfidence necessary to settle direct without the costly middleman and expensive miration. C.H.\!l:i!A.v IlRNVr.TT: (icutvim-n. \r i r.vc reached tweiv*--iLsrsv. ? i. e theoretical time ior ts* to have miuic iurtrji. < rr. w hr.tv om- more vi-rv importnni roper l-y Dr. Cushman. >: ::.* of this rol arid our Cutummcv on Nomination- u:.o has in out our ballot? an-, mark them. What arc your wishes? Do you wish to corn- on. or put this off until tomorrow? Curry on? AU in favor? All right, let's parry on. Thank you very much. Dr. Mulder. That show* a lot of thought and harn work. Now lei $ hf.ir from the "pro.-.'' from I )r. Cusiunnu. Cliirf Siiri**. Western PacifJi- Hnilrnuii. Dit-1*. t. b r.-itiiA.v ; t 'iiief Svifu-;ii. Un-rii Paeifu- Kmlrund. S:u 1 rnnnseo. Calif.): Mr. Chairman. Distinguished C.ueMs and Gcntluiicn: No one u~ *x lI It } double that Xupparent on pb from (1) theu- co iidciiuonal time in tunes of labor no or.e can know if he hod been et After five v X-ray program factors have >*u 1. X-ray- c \A x IT hinis.. and this is the ' of expensive cr e\ou4-. - prvsvh'.iy uic;u 2. M'^rv t: ;::c Mvuicnl Deo the C-aum Dcoar o; uies? came of emmoves si i v.ll more r f;/r uu. 'A c i.au -.vfv j>ot car-- wouid not be r.v.a-t uc cue?* they truant ext They ao auc tecien tn dv: occur--tuat vision already menu, but cussed in aars understanding a build-up oi rooocratton Certain listhesis. fi anomalies, operations, becomes a ered. No inee a ce overlooked and yard c 'he met important, . rough coataet sport have had no trouble -employment spinal cants. Tirver rake the place v;:r.:r.a'.i'n by a ...i factors --rv.vir.ynient X-rays :.i.r t- management purpose <>! ; as a aoseyear--the - deciined. rougmy 7 n r.-.iircau uatfig p.-er\ Cvj.i for the .-ame :y.>Q the following: 1 .".gainst anomalous factor in rising riairn nr.a Pars chums are -:d health and pubhc a---.. I-'vnl. willing ituto lot a tijorouau >;::v:nt A-my.ay <an Mural only : cfuitrol *he ultimate -maci -he injured and 'tic <.3ny iniutuemv.n I '.viMie-fhirty. 'he nave .:;e more verv ..is prot'i'*m. and our .lots anu mark them, until tomorrow? of thought and hard r::rf hurgeon. W**t*ro .drood. haft t'ranmrco. .icotlemen: No one ProoctuiMt of .Ifouetd and aurmcai .Section M | ivubts that X-ray examinations do disclose important physical detects not ' :;pp:iront on physical examination. D*bsrc over their practical value arises from ii) their cost, which may oc considerable. <-) aiinunistrntiveditncuUtcs-- I additional time required and particularly utmeuity in ending needed employes 1 in times of labor shortage--and (31 difficulty in estimating tangibleresults, for i no one can know that a given man. rejected, might have become a claim case :v.* i.c.'i: xir.yt.wcu. AlAr live '.poriv:;<e *>n *.:? Ihic-pe uur yrc-riuTMOX'ment ; X-'iv program appeals ; ;.s as avu worw.vo;le. And a- :::nc two main 1 * '..'tors nave yielded this satisfaction;*. r l. X-rays nre iinntcd io train and yarumeQ anu t* me low tiarK--wo j 1-i x 17 Sl::;s. A-1*'ana lateral, of tne iumooiacrai region. These are tnc men i mu this is the region that nave given us in tae past nv tar our largest nurcoer ! ' expensive cioitus. Those are also tne men wno are likciy to remain w:tn its ! ar.i so vxposeu tor a lone time. .:r.k it is uot icasiuie. lor examine. U; j . X-ray :ract iacorers. Mc.aous of hiring u.em ana taiar raotu turnover arc -i:r. that we raa't even give :tiem routine physical examinations. dV arC j -rrsentiy umne 13. a; 13. carpenters anu tunnel workers on a trui hosts. 5 .. M*-rv thun a y.xtr's -tudy of claims xperieuce wus mode n*t tiiy by ; .:. MvucU Department hut inxiepenuetitiy :.v tile hutely. t;.e ('f.*<ini:n aim c.iJ"parT::*.eii(s. h.p>;.*ts vere cxuiiai:gcd oi;U coi.ieicitic-a i.e.a. <;i:l : *r.vs- anted* visions mi only to start a program. t,m uuo aoout ivnat c.as.-e. ; - .r.i'ioyi s suouiu he X-rayed or.u what tue extent ui cvauunotiou suuaui J.e. -'hi more important, this period ot" ir.veattitnuwn was uiutuahy educational far a:i. V.'e hod a preview of some ui the problems that wouiu .<n;rcnt us anu i were not compieteiy unprepared. Management knew in advance that thu \ >'o`ud r.ot ue a ccre-aii. They kiw we couia eliminate some ciaims that ' ! .* aus-rd i;y pre-exiftent 'uncitior.s rather than t*y trauma. in*t that r.ey uuaat vxr.eet some reduction m oroionscu disability irom minor iniunes. hhoy ;.iO .it^.nvrc l that the raaf.acvrir .aui the i.vsteric ...uid nut : .*.-1 . ivvv.ee :,.ey r.-.-..rcu ti.at accidents and injuries wi.uid .-tiil - tir--t!.::fe cwuid lie ::u r.- .jiitiori of :he very in'ensivc safety -lapef- ..li.cr ras. a prnuram involving sevvrai <:cpart- f rr.etits, hut administered by the Medical Department, was thoroughly dis! - ussed ia advance, since we were able, to speak with some intelligence and it. *raii*uis ot vwti oti.cr'- |>roid!iis. a-ij sstnietits came Raturaiiy. r.ot alter i build-up of i.osuiity :uut suspicion. I ain positive that the very complete ; -uopcration ar.d nunmial friction we enjoy could not have been attained with; *,if these oreiimmarv studies and discussions. X-Ray Standards I (`ertain coiuimona are obvious grounds for disqualification: npondylo j listhesis. neoplasm, marked narrowing of intervertebral di.cs, concomtaJ j auumalics. marked arthritic or degenerative changes, evidence of previous | operations, opaque oil in the spinal canal. Beyond there. I believe decision | becomes a matter of personal opinion and of degree of abnormality discov- jcreil. No completely arbitrary standard is possible. I believe this s fortunate j since a certain flexibility is desirable and necessary to minimize a frequently j y. J overlooked accessory expense. In times of heavy tram movement when train and yard crews must he quickly augmented and labor supply becomes short. 22 Auonatian of American Railroads .-s ncid standards result in excessive overtime to keen trams moving. Reason able temporary- relaxation o/ our standards hv minimized lUUjidditional expense. Rejection Rates > - TABLE Number 1932 1933 19.54 1953 1950 examined 629 492 103 334 207 Rejected 2SO 1*3 24 05 35 Per cent 37. S IS 9 14.7 16.9 13.1 Table 1 (.Slide 1 / shows our rejection r:lit by year sim**- " inrtc-i. Ti.:- tiaurc t*r 1952 <37.3 per r-nt) is for out 01 line and wv-ii jn*,,<v ti:-.- iUiKu;ti-s of fialisljra! evaluation. Our thuiai minimum st:t:nl.ir.t wi too strict ui<-i wa# alter a few months' e.vtH-rn-nee. Them v.u.- uisu a r.;gi, ievei of employment and a vpry short labor marici*. that year, la addition. there ua* been a eontmuinc decrease in rejections from ti.e .-t.nrt. aooureatly because trie vast majority of those rejected do not r*-i\npiy in subsequent vu-jsi. There seem to be iesa rejections id yean of lighter demand because tae Personnel Department u able to select youncer appitcanu. Our rejection rate mav still be somewhat hicner man ootimum but i do not Ueiieve it is excessive. Toe cost of pre-empioymcot X-ravj. therefore, can be . kept m rc-^oaiiclc bounds u the program is preaieateo on maximum return for minimum expense. and if me sunthirds are oout reasonable and dcxiblc. 1 I [ I ! Apparent Results Comms to tbe third and final major cause tor dissatisfaction--inaouity to prove definite results 01 pre-employment X-rays--l must confess we are as frustrated as otners. We believe *e are begmatnc to eee a return tor our expenditure of money and effort but the distortion caused by factors otoer than pre-employment selection lone or two major accidents, for example 1 manes tne total claims cost of back inJunes anything out on accurate index of the value of X-rays. Nevertheless the decline in incidence of injunea is impressive. Table II (Slide 2) shows for each year since the program was marled the number of back injuries with disability and also the percentage of employe* sustaining uack injuries resulting in minis. TABLE II 1032 1053 11*34 1055 1956 Number of Back Injuries with Disability (All injuries with claim cost in excess of distance value of $100.00) Per cent of average Trainmen Yardmen Total employment 17 19 33 6.6 1: 1: 24 4.1 10 H) 20 4.0 5 15 2.7 4 6 10 1.5 l . He.von- .*:?i. . ..* : of ;he ...*:; via :oo .* .iiso a i.^a '.i a :u:::;n. ripiresriy . rUOScCUV-H '. '*caus4 '.a* ; '-it I <io not ibre. vaa cs .'i rerun for -tible. jrtjwwe are as -jro for our ' ..ton other .- .xanii>.e: ;* ;n'>s c-f . Tshle U -.yer of back .-.rung tact at of -meet b o Procecttinaa of Mfolieni und S"s<r..-rJ. S'Kum 13 { wish vc could flaim full - r^lit for Mnw>*t -'nttiinc- rrmirtion* m injury incidence hut many things may ni-o have ran riieir "rr.'e*?. -eh a.-* Department activity, modernization of ctiuiarr.ent and the prahtial i reduction in the ranks of "war halucs"--'he physically unit who rained ! i seniority dunng the war yara. la the anal analysis tt is obviously impossible to estimate the number of disabilities that do not occur by reason of pre-employment .<eertson. We do not try to do it for physical r-vaminnnon; why .tvtr.nt it !*t K-r .' ? rhass i 'itucit of *. :>-v * 1 r:is '> )::.. :v..-.v . more per- -uasiv'* man i.*r.r*r<o;;;it . ...:.> war w* r-'TAf,M 33 .*4:n :>r reason i l A.-iat t.i ;ino.Oii!to :or hrst r.c*..si,-.s. They cse n~ air. .isui ;d;i> oy Liicsapeaxe a:m Ohio. and i think that almost eertatniv it must have been tr.e niane tout ::oke them. Then, of course, tsere *3 rae little i matter oi me siiakinr around we find m .'an brznnsc i:.*t Friday taat mient r-i.-.-uuy have e.uu some enr-t on tnem. T..;s i a rw.Ai U..-J1U.1. a.-, von ran -At; un mere, it is .".a ir.eicrr.iai r.ncir.s. M.-tva ;var.Uer into t.vs injury on uuiy" class, in our rase, we nave an huiseut ny not navuic taom us memoers of our nospitai association. i oh.-ici- Thii .-.10.1} ntarxfd nypertroontc chances and scouosis. and. H v.v; I'r.fi .-*f t?.:*. -moirjnai aorta. i uidn t put down tie ace oi mats. o'U :.e vrraimv k ?. ' -y.-ir m-l man re-arolees of rr.?oROa:SieaA uac. iic ic :.i/i a <ui/o 7'...- i- ::: ::;r-Tv.-n-^ type oi uims. We have been tasking About i .'`jeclir.g rwin *a-::o r.ave :iao :;iy<*iocra;ns. l am always suspicious ot a who torucU mat ue '-vent thruu^n me noi-iwonisasant oroceaure oi a myeio- i ;nm when ne aopncii for a joti. This fellow was rejectee, out be actually does not hclontt in this senes >mce ur -v;i.i pi'irn-iiutinc for a nun rejectee three roan ago. T!.o name and .-.ccuruy nunxer m the nseuical -tenartment t iilos !i-i to ro.'iifuriion .vith :..c previous uinu '''wui are compieteiv oi-<uzuiar. filin' Nr.oTTior .*r.y--i`'.'r.ir... : .** "U u i.r -j-xai r;:::al. V.V hdfi'f v,.-iii( l;tm. t Slidet T-.l- -i-.mu.in : l-e :;. re. pf'-rm> on --.it if;\et we iiiink a-e^ in.i<f on --having on.* d.c-tor -:no nut appiicams ana evauune d;a thor oughly before .**nuinc rhem for X-rays. Thu <lor(or in this instance was a little hit tired, .-o he -cm him oi vr first and here we have a smnal fusion. I f.'Iidei t U*ci'r 'S-.nk that v-no ::-.rrnivmt of the lucr.bar-sacral space, in itscii. is mvo:tr:ir nad. hut wh*o u m a.i vs rrme.-u* fnis. aaj when it u aaeoci- atetl with sum m;u*i-:cd arthritic Changes around it. I think that this individual has had. and wiii have, hack trouble. fSlulM As vvi f-.n <*v\ rids -hows an unomaldua v.-nebra. I tiiiin l hrinc alomi the lateral, lie docs have .pondyloisthcsia. I (Slide) Marked hypertropmc arthritis of the snioe in & man of 46 who had new worked ior us we fei is cau.ie for rejection. We don't feel public-spirited enough, if you wiil. to take on the possible expense that will come from this; we would rather he went back to one of his former employers. We can't tell what might have happened if we hired these men. because we didn't hire them. We only rejected .15 last year, and the total cost was *ome i $3,800 to u* in X-ray bills, but I ice) very sure that if these men were on the 1 id v $4 AsjocvJum of Amonenn Railroadt property our Claim Agent would pay *ever:U time?. at least. the cost of the X-ray programs. jun to set them an. Thank you. CiiAiaitA.v Be.yxett: TLatik you very, very much. *~ Gentlemen. that is the er.b o/ our formal proemm. I feel -ure and certain that we would like to go uuo some discussion on this. and if I may. I will make a recommendation that we r ut that part off until tomorrow. prwallv. when we may have a little time. I do believe that we have had a very instructive and wonderful mnmins as far a* our problems in the railroad kniustry are concerned, a.vi. f course, wv particularly feel that Dr. .V.'.e.-~ Dr. Daclisti. Dr. Goiriowskv, trnr VirtrChauman. Dr. .Sioekwell. Dr. Ltish. Dr. Ol#on, Df. Lomrcway xri his emup. Dr. Miehh.-r and Dr. Cusi.mar. should be rommendiM. D-:'s lt.<- them a s'wr hand. (A;|nxus<*i N.Mw v. o:;:v :* <>' u ;.r Krrr.s : ::.n; : r*--<rt ; t .* < **etitr.i*.:* n. V i.;;;:l !..-. 1` f f.Vc. -voul vn-i vr"r May i *ay tin# beiore Df. live get? nr> here"* U'e i;t< iiavr jour vacancy-. *t;re- ve;r# 'n-t,. -tii from rI.*- eastern utvision. I .j.'iji't think it hnopen? wrr rv-n--ne u-uativ have western. south* iW. etc. Dr. Eve wi.i give hts re-ontn'.caaauon# tor the tour racaortcs in tne eastern division. Dk. itrvcw Lvr Tie: -.jriroot.. Nasiivi...-, v iiuiianoocu *v jt. L/mii* liailwnv. N:>-hviih-. Tints.;: Mr. t. :.:::r:nr;:i amt ihv;:;st*,n. t*ur L-.mr.u'.- tcv on Xirut:^ita*a.s met .Mar'l-l. in in-- otixi* w the ."--eretarv. in jm>* with the Ki<-- of Orucr ar.o u..\;r>e irvo wnstaemtvifl iiw >.i noni- iaets mr the Committee oi Dtreruoo. we nave .detected (ne ioumcmr nsomwr; Cor ballot: . ttlC **>st >t tllC -rl jure aad certain f I ."nay. I wiif make '. probably. when vtprhii nturauty ;ia . ui t-ourse. we tv. i>ur Vict-('ii;urT.y ;:ai hu icryep. 'i aive them a ?oou ; ;:`.sd 'hat is the l you aive us your . -.'.tic jiroiwm. in cattern -uvvavon. cm. eastern, south- .r.cica in me eastern it- Lou*--1 :i. Your C'mm:t -.retary. and tn line allocation or nom- oilowms' members yrncLCtiinm n; itnii&zl t>ui SiuiptnL c\cxwn | ASSOCIATION OF AMERICAN RAILROADS I ! medical a:jd surgical section I ANNUAL MEETING--MARCH 2&-30, 1357 I i 3ALLOT TOR MEMBERS 0? COMMITTEE Or DIRECTION ; -ia:;:a:e av ia"X" tie names rered ton i ; "astern Territorr ri V.*ar Terms--fore :or rouri t j :---------------------------------------------------------------------------------------------------------------------------Ji i Dr. R. J. L.:ar.ett. CU:e: iuraees. ! Cain.ar.d Listerr. ;L*l.v:w Dr. .*5. M. Ln-iiih. Mcuicat ana auruicai uerector. ; Uai::;aOfC ana uuiu i '` Dr. I. Oni*5ow-i<v. "' u>:.v::or. L'-:t*rai itaaroau or .W.c Dr. J. vV. D:r-:. N--v VofiC. t-:.j'.aau ..::l .V.. : ; :Dr. A. M. IT. Hursh. .Wi.-rar.t Medical Director, j ! Pennsylvania Uaiiroau } --------- ,----------------------------------------------- ; Dr. .1. H. K;io-AH*j. c >*..-a-.va, :i ! Boiron anil Maine iiahreau !Dr. A. Ilnupuucr. Chief M-**her.l O'fvrr. i j Rirvuna ConuKtnv ; .------------------i---------------------------------------------------------------------------------- jOr. C. H. <> llimr.eil. M--;i>al Dtrpcror. J Xcw York Central .-ryuem Or. K. T. t J Morton Utuiway .'hirxcon. Dr. U. VV. Stnckweil. Cbiri Sorscon. Detroit \c Toledo .Shore Line Railroad Dr. K. i. \V*atltnc. OUiet iurzeon. (.'iiic3i<o umi Eastern Ulinou Radrotul - rjc "=i. , j i A i t -4 I M % 7 > 36 Auodation of American Railroads Chairman* Bennett: Thank you. Dr. Eve. Now, let look at these nominations tliia way--have fo>r c-peume*. ao<j J can aay without any hesitation that they have absolutely picked out i lot of heavyweights as far as the railroad industry is conremed. I think they are to be commended upon their recommendation*. Dr. Howos: These gentlemen are being nominated tor ihe Committee of Direction, aren't they? Chairman Bennett: Right. Dr. Holto.v: Isn't Dr. Goldovsky aummatiraiiv on time committee? ( 'iimrman Bennett: No. In* must i* re-eieetcii. Dr. Holton*: I wanted to get that -iear. Chairman Bennett: A.- y.*i know, you art* <-:,t:u-i to ><> ^'Tordi~u to the miles of rniiro.:d ynur M.*. park.r has the buiiocs and will now only, out o: this croup of twt-h*- tiie-t**.. P. mark voi.t cno'"* * <v iVmr As tellers for the election. I would like to :>rr*-*r;: Dr. Der-.i::', :mti t*.e Northern Pauiiic Railway Chairman, witii i.>r. M. W. Cmci Medical Officer oi the Western Maryland Rstiwav. ami Dr. tr. J. iVuui-ta. Chief Surgeon of the Texas d* Pnrtfie Railway. Those tnre* srntiemen m col lect the ballots after they are marxed nd will return after lunen for tne nur- pose of counting the votes and preparing tneir report. W will now adjourn tor lunch. iThe meetsne recessed at 1:10 p.m. > Proceeding] o I'RIDA' Tim meeting reconvened at 6 ( UAtKMAN itCNvcrr: The iiuhusl to "Cr* ro many out to muni- < hjr nrst order of buxine-* 11* Dr. lK-r:uif. < 'l.ivf Surreon of il r l.r tiller:* ;i' to the result of \> Du. It. 1. lJt'RAi'f Ciiief Mi'!f:*---U:i l: Mr. fl^urucin *w -l'i. 1 i : i ' v ............... ........... 1*:. it. .1 V-. :vf.- f i i i -;u`0'.*kv. AJ.-.ih ..1 1'. ?' >N,rk\veil. ( i:*i <urr-*.t ion in jir. W. 1,, Mi-i.i v::.imuA.N Bennett: Ia*i s -nv uiu atocKweu a mue uanu. Dk. Dowd: Ana now a nine Chairman Bennett: Now him i auure you ti.it'. it u- very. Ycsteroay we had our rccui. c.ttreaieiy iotreiunc. Today w *amr which we do every day on * Cafortunateiv. we are faced w *.ve hive to treat these people an :: and when they are well (or not Most of our legal cases--at 1 to S250.000 a caee. Ic&oaasure your moaey. Therefore, if we got our hou how to care for these employes, step of this program, to attemp lawyers, etc. In this connection, our first sj oi experience m this type of prof this problem, day and night, to t it. and Pm sure w are all goinj Cooperation in an Effective Mec It gives me. indeed, a great deal L Uiickbert, one of my associate Mr. Harlan L. Hackiiert(D tiotr. Counsel. E'.cui, .l.Aict & EI see chat today I am fortunate- Aoyone who doesn't believe t ( ,,vc (our opemnci. and l ./.civ picked out a lot of 'd. I think they are to <i :r :: Committee oi ,.n : .-.at committee? r>js{ to -O r.vmv vo-'*r. of'-raif'i- Mr! Parker --ixn yuur Choiccs oi four U.*. Dcrau!. from :ne .V. U-r.yimm. O.-.ici .r.u Dr- fi- F^ueia. cnticn'-orv wiil coi* iui-.ch w? tr.e par- ? i 0/ in,i S ir^nenl .vv;.u nuD.w uonxrxc. sf:h>ioN March 29. 1957 The rr.eeuns reconvened at 'CW am.. Chairman Bennett presiding. CK.vsastv.s Bf.nvett: The meeting tall please come to order. an de lighted to #ee so many out so early this mormatj. alter being up so cite last nighti Our first order of buswees this mormne u Item No. t& May v hear from l Or. Deraut. Chief Burgeon ot the Northern Pacific Ratlwav. w*h the report ot the tellers as to r-*ui*-* ot y^reni/iv-* i;;:. it i. 7;.;.vrr '(hi.-: .-`iracon. Nr*:>*m ?ir;~r R.uiww. S\ Pmi l. M::;r.---;;i;; M` :.;iir;v.n .to>i mt-mtvr : V - r 'U --!>.- V- Dr. It-'iuimtn * :v--k>-d tr.- ivtilot* mul ri--i-rd- d 'l:v v.:u:.i wear** ' n-rn-rt r-*--i-m m :h* t ummitt^oi Di:-v::r.n w Dr. ri. J. Bennett. ('hat' mtreron. h'nn. J.Ji*-t <c Uaiiwav, Lr. 1. 11 -.hju-V'.kv. M.-tjittu L>ir<ru>r. C*titrru ttailmftrl r New* .fer*ov. Or. lb W. .v-.ekw***!. Chief Detroit -g Toledo ,-horr Lino ihiiimad. ;m<i *!-.v twin <; Dr *.V K. MhjiLt. Clu*f rfutrpjnn. Kr.o iCr-drourt. CiiAt:utAS Bennett: Let's torset Bennett. hut let's tnve Mishier. Goldawskv and fitociiweii a Imle band. < Apmausei Da. Dotror And sow a hand tor Bennett. < Lauenter and aooiausei '.':!.usjjaN Bennett: Now >v* uown to *r.e business at naou touav, aau 1 assure you tr.ai it u very, vert' imoortruat to au ui us. Yestefuay a*e r.-ui *iir rrvuiar committee meetioc. ami the reporu were e.ttrwueiy :atersttnu- D^say we enter s rncercnt Qtuue ot tne ouiiness. some* thine which we uo every iay on our rauroaus. i Cofortunateiv, we are faced with accidents, ann when we do have accidents. | we have to treat these ooonie anu pet mem tveiL n^ntatiy sad payatcady. and 1 it and when tney are weit .or noti wc are faced with thelesjai prooieroa. Most ot onr ::--al --zt. !.*aat ;a me Cuicaco area--run from 4100.000 j to 4250.000 a case. I run x^ure you that the ytr.e* today are very wherai wuh yottr tsccey. Thi-fetom, i: :. cot ur house :n ,>r.Jcr yestvniay from the standpoint of ' how to care tor these vniployos. today we :tre uomu to attempt to tase the ae.ee step of this program. ;.> attempt to protect you a^omat unaenipuioua claims, lawyers, etc. * In this connection, our first sneaker on the program, has had a vast amount of !vpenrnre ;n this type of problem, lo fact, he has spent his Ute working on this problem, day and ruche, co try to ^e; around it. through it. over it or uodcr it. aad I'm sure we are all zome to be very interested to bear "The Doctor's Cooperation in an Effective Medical-Levai Defense of Personal Injun* Cases." ! It gives me. indeed, .i zrest de.il of pleasure to present to you now Mr. fiarUo L. llackbert. one m' my associates m Chicago. (Applause) r -v Mr. Ha8UiO( L Hackaebt (Division Counsel. Cnited Btana Steel Corpora- : tiort; Counsel. F.Imn. Joliet & Distcm Railway Company, Chicago. Illinois); I see that today (-am fortunat^--l have a lady in the audience. \ Anyone who doesn't beiteve that 1 have re-wrttten what l bad to say can \ VV -yVfe 5S .ijsocvi/K?n of Ammccn Railroaaj come and look at mv notes. w-hica art on Greenbrier stationery. 5o you're really gcttmc double value for my appearance here. One oi my favorite stones is about the rooster in the hesyard *h:eb m located near a public playground. One day the youngsters in the playground kicked a football over into the henyard. The rooster came up to it. talked around it. and looked it over irom all sides. Finally he ducked and called the hens around and said. ** Now. look girls. I don't went to complain, but l want to show you- the kind of work that is bear tuiped out in some of the other yards." (Laughter: Well, this morning I'd like to talk to you about som* o; the **errs" that ere being bid in the legal Hcnyard. As l think was pretty Nearly indicated ye*eniav by the trend of the dts- cussion. you gentlemen are familiar with what is koine on m the litigation field. Wl-er. 1 talk lousy. I talk largely about my ecu experiences. I know from yean* of < ontnet with yourbitr.*nee;>and t:* men who.? trv:r.gye**r Janvuit* ia?:d l thtr.K v.-.:h ri*?*"-' -v:. of voi *.* *n v.- :t*j*i;*ra*.**' f cuvis'i :jv t;...; i on** or or t;,f- r--vc wtso in'r.c w vv:r railroati- y,.ur i mine, r.r.-i roNv'**?c?.t;v. wh<v. l talk about my experience*. I m talking aoout thwes mat hannen to a:i of u. A* mc surv-v is gome on m tt.e eounroom. we senow tiia: the r.v..roau? are paving for .r.yjne* wr.ieh existed before the can ever came to worse tor t** raiiro.au. i'r.-.jer trie name or"aggravation." w are payme auuuionm anounu for concenuai or anomalous conumoas. ana ogam, ior tne o.-s--existing injuries which the mar. rad. t'r.ucr :.;:v cui-o oi" acceleration." we are paving for tne orainarv arseases of life, orfor the normal wear ana tear o: norma: ucgenerative ana ucttic oroMsses. When it come? to the question o: daiulity we are paying on piatatuts stories that arc facta^ticaiiy improbable, sac w are paving from tne sianusotnt of raedic.nl causation on .-larms wnere ;:.c causa: rcuittoasuio seems to us to or transparently tr.ir.. but seems to tne jury to oe surncteatiy connect*!--* are paving tor grossiy exaggerate!! uisanmuei. Taming to my own experience tr a ennutr. just a.* v iea lac recora oo appeal in a case tn wuicii there iiad Iweo a ;5J.uOO wrote;. me exunumag neurosurgeon lesiisca mat tne man wou.u never ue sine to benu or iut or carry* or do any kind o: manual labor again. Within a month after tne jury aau returned the 550.000 verdict for taat man. L<* went to worn as a furniture mover's beiper. As I say. just before tne recorc was Sled on nppea:. we teamed that he had beer, kiiii-d m ar autonioruir acciucat on ids way uack from o:. of these turr.tture-tuovirjg ui whici. he and aaotr.cr man uaa moved U.OJO pounds of furt.itur.- r.:o n t\vrw*tory i.cruse, n-riuding an upng.n: pi ..i . re frigerator anC .-"vc. U'c ?ot that ;.;i up by r.mdavu on u uelayed motion ior now trial, and to oo one's surprise, the appellate court reversed, and remanded the case for new trial. *o as to give us an opportunity to present to another jury the story of the extent of the plaintiff's disability. If the jury accepts the plaimur? story of the accident, or if it accepts the medical testimony as to the causal relationship or extent of injuria, the jury s verdict in those case* is wli .'licit conclusive, and our onportumtv* to set it aside or get if rewrH-j. or get a new trial, rome rather rarely. In this contest to win the minds and convictions of the jurors, the railroad company operates under very severe disadvantages. It is not only the natural 1 ' I i ; ; I , : l \ Proc tendency oi the juro.-^ story of how the acetc< disabilities are. as aca. courtroom except. pv we have to face tne i bility of the raiiroao proper equipment. or safe place to work, th of the fact that the ea Again, in our raiir m-er. the contnhuto True, under th<* f'.C but actually, that is - ease. T-.'-i: i:.i- i:w ;r.Ts u.v .'..tn o: c.'-i. i i:.:;t ?r- tionrmo. wnereas. ire l.c-re ct'Citi not r>v.*?i ana t:ic auecc*: V. i;vn you taxe too roonu ana bear, in n* jivnilable aefeases. ah' :o nr.'ive, aac that ::eii 6: hubiiity. virv tedav is to prove tna his story a? to wjien observed, or hts sto highly improbable, the jury that the pi&tn chances of smite chances of wtnoicg Now. that is the defense, and the quei the doctors tuui mec defense against the ft ta this field oi pro . ing his C.*e. i tiiir.k the only source avat plotted. What 1 urn gome examuiattofts, penoi employment--u li the lawsuit, how it lawyer and to the about the question restrict the nvanpo* problem to the ou- lo passiDK, l thuif. operating depanment f*. .'cl vnu r* vard which was * he playground .0 to it. walked i anti {"Ailed the .am. due i want me of 'He oth*tf 'm" that are %*:vi Mt the *itsi.-i'tse (itiaattoa r.eaces. know i r.f trying your < the audience t that for your .-encemiv. wnen .pea *o aii of u*. .at the railroads ' to work for the ;:r:onai amounts --viitius injuries aary disc:toes of i ista; processes ;.istaci:Ti' stones * ae standpoint of -au to us to be -.nccted---w are r^'-T-i -'O ; - ,r Ufr <r _rry : 'h- /try :-.ad :<; a furniture "ai. %vc `.earned ."< irmn no*? **t ; 11 ' right piano, re* rr.U. .aid to no - .-L<e inf new .ne story ot the ' it accept* the .r.c. the jury's tnitica to set it :r*. the railroad ,,niy the natural /Vrfruirt-7* "f '>-tad .Surgical Section 3 'endenry ot the juror? to re rytrtpithi.* tr 'he injured man, and to .wren: his ii torr ot h<>w the accident happesoo. and what his ccmnlr.utt? are and what hi* disabilities are. as itcnir.s: the impersonal corporation whwh is not >*-cri m the courtroom except, rwrtbiy. throuen the rraniie-iarcd claim acent, hut also, we have to tare the fact that whereas were ravine yesterday that the lia bility of the railroad company is predicated cron the failure *o iurm-h Mr*? or \ proper equipment, or th* failure * > r:m:?h. i.< 'he law r-ot::re*. a `j-ib place :o work. v;rv..... "i - .r ;>n :'- nr.^** d.e T.'.-'r.'. -vo*v -.. ; \:sm. :n vir mirimd ir.r.m**' the ordmrtrv run . i "glig^nec <-:'.<c. ir.e <or.trihi;fcu* v ..... :r ;: i r.*,:*.n. i.> no .;..*****. i j Tr:>\ under *:-.c r.l-'.[...\.. I *o go ir.'o rv.fcaunn of damages, i hutactiiaUv. rhat \* a nhcr dim rr<t wih w-wh to und*rrnk n r>rnr> no r.ur i 1 T;:en the law imoos** liahmtv :f m::ro-ui's nepiirenre in whole nr m part" rausci* che injur*,r- *hen-a:r.;;r: .i.nu :.*nm. 'he ?fanmomt of the rciatjon- thip ot the accuient *' d.o :n**:r*.\ ..i **at . n-sOi*<ary from the nlamtiif's ?Mnooouit that someone 'miy -r.rr* m.irctt er cm re a i-.v:ai rrr:a- rionship. -.vhercas. from the -.i'*er:?e s'cnuonuit. >ur burcen is to nrnve tt there couid not norstoiy have r-cen snv r-usai .*eiatton.nto between the ar**j- \\ ' dcru and the alined mjurv. When you '.ike those ii?.v.iv.int:rr? tr.a: we e*wato unucr into tne court i room. ann 'near in trur/.t that tuc '.urtr .ire onrtanttv ro<tnctne the nci.i of iv.nlahle daii-fi-ee. ar.u arc pcrr.ui:.:;c no :a,*rr.irfusiv-f,.touru-<>ut defenees to surviv*. anil rftat they arc. on :r.e r.xr.n. constantly extenumv the fieid of liability, virtually our >:uv - :eci'?.-:ui uetenee in these r .E.L.A. case* I today is to prove that t:.e pisuniitf s vc.'?i*n o; ,-.ow rr.e accuient hanpenea--or his story as to when his injury wns i;r=: - : .i.- mi ` Off.ovaint.i were nrst observed, or bii ?tor.- .;s to tr.c -vtcrt muiraui nr uirnbilutes^tt u hiphly improbable. sv.-v.e* -:. i;.t nucation. uuies.s we prove to the jury that the oiftin'i.f i* ^ -i- ,-r*--.v -xacq-.-r-t'ia': :us ease. o:;r hait-C# ; v.c-iu-ra.iy -r.*akin4. our I j t i'*' .r: V;i:* No-.v. " i* ' > '*< . ri --av-.a . -^c ;urv ijiat thyry *f >:.-n*u--. ;i:*i . ( .. r.-> with you here M-.m morning u what the di<crors and tui-ucal vpartmen's :he raiirnads *an do to help us in the defence airaut.-t the fraud:dent <*>r rh'- .mr-.d -.' taerated ::i i:cd .m-.t'*; 'hat hc ru.ur.t;:; * either lyinq or yrosily Oxaic^Cfit* mq liia Ca.-e. 1 tk '/> rri'siueu w u ::e-< amt *he frtsuieii teMimony ii virtually the only source avaiiabic to us w*u-h r.a.- not vet Keen fully explored and expiotred. Vliut ( am cuimr o .av iru.i .-uorntrs--when l talk about pre-employment examinations. p--rnHiic *r n'hcr 'fanunations during the cmir.*e of the man's employment---** wholly from the standpoint of how it affects the outcome of the lawsuit, how it .'il!.xu iiticatmn. the importance that it bos to the tnnl lawyer and to the locoi department of the railroad. I am not i^oinc to worry about the que.itirm of whether or not pre-employment examinations unilulv restrict the manjower that is available for the railroad, and l will l<-nve that problem to the operating department. fn passing. I think it is pertinent to observe that to the extent that the operating department pays ovmtme to yet the work done, at least it is pay- At3ocu::wn of American RvUroatia in? out the railroAd's money for work that has actually been performed. To the extent that the dun department or the trial lawyer see* money paid out io settlement of claim*, or m satisfaction of judementi, based oo a loss of future earning power, we are paying out the railroad's money for work that never has been and sever will be done for the railroad. Similarly, I am not team? to touch on the question of what is the railroad's obligation to re-emoloy or to take back in employment the man who has been injured and who has made a good or substantially good recovery. There, again, the question of The weight to lie civen to the long years of service--as affecting the obligation of the railroad to offer that nun another job--is a question of policy for management to determine. It is not a question for me. as a lawv*r. to undertake to decide, or perhaps even to expriv* mv views on. But I do want to s:?y fhi-. in that connection: .'{ eaYi rin *.ivr:r suin'*- thine on the** thing*. v-n thong;; 1 knew 1 *ho;:.or. that j^i'.h v cm**-- :;on. I would like to m.iK'* '.hi* iilurtration. that the ':-:e*ttin nor one -g ;4- bc-twiH-j t?;- rg:irn;;.l and the :njureJ rr.u.:;. The `.:on i. not to ui*t*-r- msivu iOwiv on tn* basis of what is the evter^of the cure nr improvement. u> condition of tiic* mdivi-iital nation*. hut miner. :::at the ratiroaa aiso ha* to take mto cnnsiueranon its obligation that u owe? it, the nun s ieiimv employes and to the traveling public not to put a man hack in o position of vuiaemoiiuy. of injury to himscif or causing injury to his fellow emoloyes or to the traveling public, when he is more susceptioic to injury and to sudden aisability than is tme tn the case of the man who has never tiad a heart attack or yr.er injuries trhidt we snake of. i thins no one undertook to snwer fir. OUop's Question vcMcrauv as to the rauroua's obligation to rc-eramoy ano cut back m the operation of nien-soeeu trains nn engineer who has made what is ciintcaiiy aemonstratea to be a com* pl=te recovery irom aeart Attach. tVeil. I think I can answer tnat Question posed by Dr. Olson by putting another question to atm. If be had to go out here to tne Oreenorier airport and catch a oianc oack to Chicago, and he liaa bo caoiee oetween two pianos, one xiowo oy a pilot wno bad a medical history oi a heart attack. presumaoiy completely ronaoiiuateo from a medical stanapoiat. and the other doom oy a mao wno baa ao such previous history, and he bad the opportunity to make a fully informed and otherwise free choice as between the two pilots, I think ;; i? quite cleat thut he wouid take the additional margin of .safety mat was provided hv the piiot "ho had never baa a history m prior heart attack. It is the duty of the railroad to bring that additional margin of saury to its employes and to the traveling public, ami to the otner# who may affected by the injury or the diseased coudmon ot tin* engineer. Cortung to this* question of the preparation of the medical defense for the trial of a lawsuit, no matter how early the plaintiff's lawyer may contact the injured man--even if he is waiting for him oo the hospital steps as the ambu lance pulls up to the door--nevertheless, we still have an advantage in the preparation of our case over that plaintiff's lawyer, m that we have had the man in our employ for some penod of time prior to ;:* occurrence of the Accident, and we have the first chance at the preparation of our medical and our legal defeases. I think it is no exaggeration tu say that tlie effective turn* for the preparation of a persuasive medical-legal defense begins tong before the .i rodent ever occurs. It begin* at the time when the man first come* to the railroad nod sake* application for employment. < } i ; ! i i ; j ; | | j ! | | : There vu a cal examination importance of caaee. There wae m menu and the to you. just fror the applicant w hu lawsuit t**ic Bled. 1 am nequeetio.'i of how wac in the way e di.-ahm::*** in I. investicaut.c t; v r.t.wu.v.; comuarcu with runt t'l.yiiaa ultimate iew*u to tnc man a c ana tfccottter. to demonstrate u**ncc ' these a? ne was at The impor come as a tup They are oae meat, sad tn you as toe Ls interesting u I think I &ad the ant in their chairs of interest At T suppose in kind of uaus pictures unle is rather iotr concerned. When the box for the are all intens Xow. to th X*reys 'bic exaggerated of interest to to them. Somethin? might make taken during accident upot doeeo't *ho ..iy be-tn performed. To *r <?*f money n:ud out -. hired on a less of future for worse that never hi< a'hi; a 'he ratfroad's .: :he rai-o -vno h.14 been .'trover.*. There, warn. * or Jemce--as aSeetinc r ;oo--ri a deration of on ."'or me. as a i.ury*r. -. ; r *:.-t \iviai *oitto on '%a policy <\'te.+* v.on :s no? one juic x< :oa u r.ot to ne deter* j.-e or .morovemcnt io -t :he railroad also has to the man's fellow a back :2 a po-icinn or - j r'v-o-v imp.oy'-s or to ;:rv .mo to sudden his. -ad a r.-.-^n attack or . .n v.-st-rruty aa to trie -'rr.'.'.-.i o: :: ch-ipcM . .neirr-i to be a com* . May*'*? *i;at question catch i plane buck to . j&gafowo.py a pilot who 'Srpietely rehabilitated *So3n who had no .-uch *k rally ;r.;orrn<>l and * vv/* `U'r.r 'ant he -.v:.i- I i*y 'tie ;:* .-._trc*.a >:' *<> q . - vtw may (.>; uifcvtvi .-.'tiral defense for tb** . ever my contact t!v ..I -nj xs the cauu- in advantage m the hat u- have had th<* ' e vr-'.rr*n<ie of th* r <vir neutral and our fur the preparation re the accident vr - to the railroad xad Proceedings of Mtiiseal and Suryiail Section H l------------------------------------------------------------------------------------------------------------------------- i j There wn* a good deal of discussion yesterday about pre-employment physv- ! cal examination, and I think I cannot overemphasize to you gentlemen the i importance of those as they relate to the uccesui defense of our F-E.L..V 1 cases. There wv wme discussion as to the propriety of rejecting a man for employ ment. and the conditions which should lead to his rejection, but let me say this > to you. just from my standpoint, from the trial lawyer's standpoint, that as to j the applicant who is rejected for employment, this touch is dear: 1 have won j his lawsuit before the accident ever occurred, and before the lawsuit is ever filed. I am never going to have to ouality a jury or arcue before a jury -n the ! question u how much there *sj *n *h- way of aggravation. or how much there ii m rh" way of this or that, or rv-v much there ts exaggeration of the *!sia:ed .ii.-jibiiifu'S -.n hi* cnee. Wa re ;:;jt never going to have to -pend any monev m j . ipwstigatmg that man * lawsuit or m li-fending it in the court*. And. peii*ve gentlemen. investigation and mai expenses are very heavy exocnsm as compareu with the cost of pre-employment physical examination, i As to the applicant who is accepted for employment, a careful nre--*mnioy- ment physical examination furnishes the trial lawyer with two mines in the I ultimate lawsuit, i: we have one. One is a record of the doctor's findings a* j to me man s physical condition at the time that he first entered our eraotoy. _ .mu the other, in the form of X-rays, is evidence that we can snow to the jury, to demonstrate to them wnat the piaintio's lawyer* call "demonstrative evi dence" these days. We can show them, in enect. an actual picture of the man 23 he was at the time that he was employed. The importance of X-rays m the trial of a lawsuit u something tsat may v.me as a aurorae to you gentlemen. i'ou accept them as tools of your trade. Thcv are one a; the many things that you reiy upon iq diagnosis and in treat ment. and in -valuation of the extent of uisaoiluy. They are as familiar to you its the ::iw books are--if .-homo oe--co lawyer*. but X-rays are very intefcetmg aim very important to jurors. : I think 1 have never tried a lawsuit in which the shadow box was set up ; and the first X-rays put on me screen nut what the jiirors ail leaned forward 1 in their 'ham or moved to the ccze of t-eir chairs and looked with the greatest ; >>{ interest .-it me pictonal demonstration chat was provi-'-^l by the X-rays. ' f iMPpo-e m rhu day nr.d .\zc. ad us nave had X-rays taken, but i* u n kind of ii.'iii-u -.i srocesr. And m .my hc patient never ^cts to jee hil own pictures nnie-s ne has i `loctor wnom he knows pretty w*il. The. whole tntn; is riiTh*r intriipiiftiz. but it is a i-.oily '.ose*l chanter so f'or tu the patient is ; tfoncemcu. When the juror sits in the jury box and the X-ray films are put m the shadow box for the <:o< tnr to ir.t<*rnrct and vxpiam. ami for the juror to see. the jurors are all intcn.wiv inr-vA-'-'-i in that. . Now. to the '-xtent r)i.u. from the defense standpoint, we caa come up with | X-mvx which demonstrate either the uisences of the plaintiffs story or the 'naciterated enaracter of it. we have seimcihui? there in the X-ray film that is ! >i ir.tfrrsv to ' hr jury, and in many c-a** i think it is of controlling importance to them. ' Something was seed yesterday about the possible use that our adversaria* ! mieht mftke nt the trial of either pre-*mployment X-ray* or possibly X-ray* . takes uuring tho course of the mao'* employment and prior to the time of the : accident upon which he ta relying io bis lawsuit. W<H, let'* ay the X-ray ' doesn't show any disabling condition at the time of the mao'* employment. Then let'* &y that all of his pr-*ectdent X-r*ys. whatever they might be, tre _ Certainly. this is true. I' also negative $o far aa the condition* that ore relied upon m the particular i?.g of what use the pre-c laweuit- There isn't any argument that my adversary can make--based on both standpoints--that those negative X-rays, or baaed on a pre-employment or other physical exam- standpoint--right at the inauoo report--'that can be any more damaging or any harder to meet from env standpoint than the argument that be ran similarly make from the fact that the man was accepted into the railroad's employ and that he worxed for 30 day? or a year or whatever period of time it might have been prior to the time of the aecident upon which he is relying. In other words, unless we are-able to demonstrate by proof what the man's condition was prior to die lime of the accident, the assumption that is going to be argued to the jury in everyone of these case* is that prior to the accident, the man wa* a totally ^r.d physically perfect individual, and that alt of the renditions which are ;'outi<t '.r. the iu:>'"yjont examination.* anti X-ravt nre immuitahle *Wy i ;::0 acrit.efil- Thvrv !'- * v u<v our iL'iv<rv:n*s can tt;akv of our prt-waployntenj, exazain&tiffa. wfietner in the form of nnen report* or tn the form of X-rv* ::;at >.*is go us urv narm. beyond tuat to which we arc already subject. You will rreail that M comprise. by far. the mosi that more money is paid than t* paid mil in the * Certainiy. I know from give us lhe greatest dlv the hack injury mm-, i.j e'.nhuu uu iUggntiv t '.-.ir i--ii;on- ! . ,v v. - : i::-~:%ln:g < tic irgig*.-- I: ' ii tiiui bnmeu m its scoi >:anM>oi.':: a iru.l law f.ons is CMMIHUI rust ns tV. t::e other hr.nd. let's say that the X-ravs do show the conditions which ti.at nrc-eumioyrr.vni ph are charges nv me man. or by his meuieai witnesses. as being the result of or to gw into sun naniiftn attributable to or aggravated by the accident upon which he reite*. If we are ucrnuititi? from the eui*- abie fo show me jury by pre-employment or penodie examinations and X-rays ts-.e vwurr oi i> v.ofK. t;-.kce. rr.ar to the time oi the accident- that the narrowing of the mtcrvertenrrd ha.- just bareiv l*wn twii' roaev--or the arthritic spurs, or tue wear and tear on the vcrteeral bodies, verdicts in somoni i:.o- or tv." curvature *;* i.i'k or curvature oi the spine--were ail coitumons that one against me of any can be sr.otm by the X-rays to have existed before the accident, then we are ctd oi activity that is entitled to argue that to the jury, and to have me jury instructed that it railroads are concerned. eaanot allow tbe piaintm any recovery in this lawsuit except for injuries that are the result of the accident upon which he is reiving, and we've got something to use for comparative purposes to show that the condition did exist, or uie disability was there prior to me time of the accident, tt'e leave'tbe piainufi in a position where he must make ins case solely upon the ground of ag gravation. and if the plaintiff's medical witness or witnesses know that we have ammunition like that in our bttet case, or ui our papers there at the tnai. they'll pull in their horns a lone, lone way. ana they'll stay verv far from cittnbir.g out :o the euges of the limb m their testimony. Almost invariably. gentlemen, in the tnai of these lawsuits, we tind that '-T.cn " ;;::;m'.jf.iuo;i tikv that in our locker, we arc not confronted at an wit:i t:.v s-Nire:::* ;.umiony and the exaggerated finding? and cutupiuims that we are confronted with when we are wholly larking in that kind of previous preparation of our medical defense. I hope the field of pro tended to the question extent oi his loss oi lie: railroad company and is in which there is coasts loss of hearing i one w tee belli* in which we with substantial claims Yes. you can say. it is of the iact that this m: tor us. ayii now hr has number oi years it may a substantial hearing that is due to his emph There was also criticism yesterday over the fact that the pre-employment iet's know it right at examination, at least from the X-rav standpoint, is largely limited in current who has the partial loi practice to trainmen in road onerations. and that the X-rays are limited pn- build up our defense, manly to the hack. Well. that is a valid criticism, but l submit to you that may be our liability fo it is no criticism oi the nre-ernnlovmcnt examination technique, because, after that he is working for all. if 1 i::av com a phrase. iv<* have in learn to walk before e cun ruu. UV work or as a result of have to tackle this problem of nre-emplovment examinations :uui determine we ure dealing with, to what extent it ran be utilized advantageously, both from the standpoint of going to be any worse employment and also oi what value ii can be to us in the trial oi ouf lawsuits record of what the m; in subsequent years. > mrcst he. :trc > h* r-if't<--:!:ir ,'i:tke--M t>**l i>A r nhy*:<ai 'tamr 'o ti-.wc trom AC ifnm the tact '.C h<* worked for 'n prior to me t i u:rv '-\ < <. tf.V'.lv wol 'vr.icr. arc uranic iey to : rC-Tm3i0>' ment 'form <*r .v-rsys ..ibjrct. .->nii'tnr.S wnu'h .: *" re*u;t "i or -lie*, it are ,vi.n r.r.a X.tnterv*ri*rral ertebnu homes. 1 ..xvituor.3 that .at. then we are ..tnicted that it jnjuRea_trvat, .^^jot-scxethm* *?*Kd exist. or the -ve the plaint;:: - *rnuftd that we r.-.wc . :.\r friw. cL7.`h . -.ve ::r.d 'hat * ''`nrr'W-'-i .vt ,:id .nruui.unfj ,ad ni p.*.'V!OUa f'-***v.yloyraent ..:(cd a *nt re limited pn- ::ut to you that . i:**muse. after : cm run. W* and determine > standpoint oi of our lawsuits I I i i i 1 i i ; l 5 i 1 ? i \ t ti /V'v/WtnT* of M'dtC'il nn/i 'ir-.-'.ccl -Section dj Cr-ffamiv ihw i* tnw. that the railroad * 'a.-vimg tin* proUi.'in oi *i.-'ermmu:g ot a ha: m* the pn-empioyuswu nhysi.-ul vsnunattoo* <-nn l>c made imm both .'tanuooiftu--that u. the cmnioytnent *t:utrir.oint and the Urication standpoint--rtpht at the very heart of the problem. You wU reran that Mr. Carney told you vwtenlay that the hark injuries comprise. by far. the most important **-rment oi our personal injury litigation, that :.w>ro money i* paid out in fctticrrv'nt >>r *iti.M:*.non of hark inytrv / -...mi rh.an I'tinl <"it ij: :^A -r ,.ii*:,vi.mi ' n! 'ms '.y:>rr. ` ' .v. n;v -.v--rvu* m *h;*.r 'hi' I'v-f- ,iv . -:r-' c~' .uh<i:!ty. .v* v;m>-h 'tnye u 'he most aamsish. .re i- *-k rv --Ti:-v- are * mo^d::Sn;it r.; ajj r-**.** if .irui v !::: m rh<*. jttr*.*. acm*-m*ntr the jury <>r tue carTe-VT*** of nr ; - a - .in* ii-shr.i: 'hat problem r:-*nt at rhe verv heart of it. not "round at the i ni $r. { it;j a valid rfifictsm that ore--mniovTrtent fT irr.mation '< i n its *-ooe at ;h nre^nc rime. I wane to svy that from mv indnom* u a trial !a-.vver. I hope rent ::;e iiciu ot nre-emotoyment e.tarruna- tair.a i .;.\rer.det yist a* fully as nossioie and i'tt as fast as nossmle. i hone -at r:,'--r.truyv*v.vnt onv.orai e.xanynations. m u very near future, are count j -i'i ::i`o -utu cuvsunns as me latent snsrenttodity of the man to ryataec .rn::i':':` fre~\ i,e -*sf*aneej uatn wtssca ;w u aoma to Aon;e iq ',"unta.:t m >' .-use the ifrmatuw haiuiitv u one 'vuten : :U.-t :a~u coon, and aitnouun we nave nou some nre'ry hie - ,.f,IH ra.vs._i,uji l hmu r;-,y onto nr.non there lor tne mepest tsc :iia:r..*t vi anyone v. no mu* t?j<sa any <rmatms eases yeti tiuit is a H-Ji'i of octiviry 'hat is ^uu:c '-o assume even greater proportions o t:ir aa the radraaiJs are <roncerncu. C hope 'he oid or pre*mpioym*nt cvaniwuiuous is uomc to oe ex- temioti to :;:e question oi `Xierminini: ti:e extent oi rhe mao s hoannp. or *.h v'ent -a !.- ,--a ni i.^;tr:n-4 at ;:.c tur.o dtat i.e u.*st cuntes to work for the ruiroaii romn.nny and is about -i> >;* -.i .umo^oiuirr of an -ro.i ; -,:iitan: :>-- or v:: m'im.i. i.erau't the 3>:ld <*i h.iiniity ior '."a j :> . -x i-vjt l>.sray :, (oiu'aoi upon, out it is or.? oi he m a i.i<-h uoia f to iad 'hat a .; are r*jutro.vs.l ir. f.tture years vuii e;air.;s :'*,r 'Ui-.wwj m the settlement oi those elairns. \ r-a. y.i :m ` v. it is conn? ;o hedL-.ailvantn^eous to us to establish a record I the fact tlait this man s hmrtns wa* d'-O tier i*.-nt before he . ante ro work :<.* atiu iiaa aorVii.t ior u* ior ten or fifteen or t*.vnty or wnatev^r .;umf*-r vf y-nrs it may i*e. .and rum- the hearinc test dis.'lo-ea that he has had a substantial heann? 1m-s. arid the argument is itoioi; to be made that, well, * hat is due *o his rmnioyment by the raiiroaii. UVH. if that is what the fact is. -.t'* know u r.aht at th start. Let * < ut oif from our employment the mao ho has tr.e partial h*s of hearing, before he ever comes to work for u*. Lot's build up iHtr deiefMe. at least, to that extent, and take our chances oo what may i^s jr iiabUity for the main.who loses his limnn? dunnt? the period of time that he is working for the nulroad. whether he loses it as a result of his railroad work or os a nuuit of other conditions. Let's at least know the facts of what we ore dealing with, and let's face the fact, as l said before, that we itreo't going to be any worse od in the trial of a lawsuit when confronted by the actual record of what the man's condition was than we will be with the argument of the piaintiife lawyer that it must be assumed or must be taken for granted t. EtsguF^ \- 64 Association of .imovon Rr.i'.roatLi from the man testimony that he never notwed any difficulty tn heanag at the time he 6f*t come to work for the railroad coraoany. Similarly. I hope that our pre-emoloyment physical examination will l>e exleaded to discover the existence of cardiac defects and all of the other con' ditions of that general kind and character which n*e up to the later years of the man s employment to plague us and to become the basis for the recovery which he hope* to obtain. There is another use of the pre-emoloyment physical examination that was just touched upon very briefly yesterday, and that is the situation where the man misrepresents his physical condition or conceal? what was his physical condition at the time he came to work ior the rndroxd company. I have just finished a three-week* trial in which that question of misrepre sentation and concealment of the truin'* physic::! eor.tfctinn was one of the major issues in the case. Thai hnprencd to )- :< suit ::camst a stenstwiin company by cr.e o: its fCtniov*-*. A* van cnii-m''n whc?- ra:.r-.-a have some overthe-wu'-r opi-ra;:nn< know, rt;< linluiitv unuer *.f.s Jut.--* Act :* precisely t:.:.ii:r. f.- t:.v liability ursm-r t!.- K.K.L.\. As a matte.* of t. 'j; Joaes Act aoopfs provisions of the Federal F.mnioyfts Liability a*** by reference. New. if the man comes to me csnmtmr.t: doctor tr. tr.e pre-employment paysscai examination ami either misrepresents or concsats a physical defect or a rnor injury, ana ii that misrimresentation or concealment it material, if. hoc tee true tacts been known, the man wouid not hav bc*n employed, but if Lis fraud taoo that's what it u u effective. ana heti pernutted toco to woric. sad ho *u: ?eaucntiy meets an ncemenr wtucr. we pvpaoi ut part caused by that coocaaied physical condition, or. m the ultimate outcome, hu physical conciliar. piavs a part--m other woru*. if it w,*e accravsteti or accelerated or whatever term you want to use?--ana you are aole to demonstrate all of those :arts to the jury. tnea. 10 tne worus oi the Supreme Court, that man a*aa aot sc employe as a matter of ncht n toe ume of his accident. He is not entitled to sue under toe Jones Act or the Federal Employers Liability Act. ana he is not entitled to recover for the injury wmch he aa.* sustained- la that respect, the question o; fraud ut ootatamg employment becomes u sicQificar.t sad a very valuable defensive aid. .Mase no mistake about this, gentiemea. You have to prove tint defense right up to the hilt. Tne examin ing doctor can t see a surzicai scar in the rtuoiine of tne hack and then claim later 03 that he just never utw at the ume oi the examination that this man had a surcicai operation for the repair of a ruptured dts*\ He can't see that the man has a class eye and pass him un a physical examination as. having 20-20 vision u; botn eyes. You may say. well, let's nor kid oursoives; that 1*0 1 come to happen. Well. I can quote you--if necessary, to the book and page--where tliat situation happened, with one of the major trunk lines in tlus country, one of whose representatives is sitting here today. To avoid embarrassing him. I won't name the railroad. You can 1 pas? a man as being withro the employable age range--assuming that 4o is your top limit for bin.ec engineers--and accept a cuto who is ob viously no. a.*ic tiien claim inter on that you were deceived oy hint as to Uis ace. There has to iw a rcai anu rnatvruu misrepresentatioa in order to make this defease available to the railroad. Uut when it is available. geoUemen. it is what on* former senior partner used to call a`'sockdoloeer." It's good. boy. to tbe last drop. 1 :. oc-c (vimnwtu man pa*-'ih-t* mini for ih* Mill exaimiiaiio \Mth r-- work, wiio 'xnmmaii* jh-i I'Ntl'lU. A I'm m*t 1 a tr- t-- :!: nspinye a war. o: tr. turn back tremendous If perto1 roncnnipnt raiimaii vs aid a on a panic m 1 he back gesnoti of technique dispensary is to cive conscouen home and anything io the dot doctor iwv In nil j aumv.. ?*> .-imply *w gentlemen doctors, history o If he coi l sucavsi and comoi tile for sue current *ii will do. I to dctrrir 'war .ml 1 v n hcanGk _v.oa will be ex- -r.e other eon,4:er years oi the . recovery which that -.vliere 'he . j cm rmyMOi a c; rr.isreore-ja; he major .-.imp company .-.ve .*ome over:i orectaeiy me Jones Act * *rence. -.wjr'.ploytneat hysieal detect . .i material, --pioyed. but to 20 to work, i part caused his ohyaical .r accelerated - moastrite oil oi that mao was -at. He is not Lability Act. v.aed. : -.-camcs a ->* -.r.owt 8 ms. . H.I rr.-n ' bum tat this man - : --- 'hat the , -savin * ilOLO :0oeo. VTvU. ..it .Mtuation t- ot whose .`.:m. 1 won't :w*3UOU02 .-a wno u od.os to his ace. - to make taws ttlemeo. it is . i <ood. boy. The yv<terl:`.v didn't turn r.ui*-h -m t;.- -m *-riud:c r -- v.tmina.iun ofemploy.-* who ire aircaiiv in you# rtoioy. >- .cv--' *re man pass*# rhe r*?*--moloyment nhvaiml -\.nininiiN.*n. be hr ranks <n employe# who .*# accepted mretv.niovment ami who nave i-?n worfcm :'jr rhe railroad iontt prior to the time ot the installation of the nre--noloi-m.-nt examination routine. What. then. can you duernn do |*ln >:- i-.w-'-1 vjth r*-per* ro *ho-- men who **r* -tir--hv * - 1. [ *! r.*-* t. *.. ' '\r* V* (*.. 'P.Ahl-'e-. ''*T'S*'-'*' : *> v^ir tr.-o, 'Lif .-r^3*lii #\ * >'. ;,- ;> i-..-.-, '... .'>. i : .' Lewie ;'<st iron *h- -f `.ndoonr -ml :-i ;ncartnn. tod . -.t *.' .-.:r.' .:e.-ut what are to h* **:;'.!* -v" n..r.<'di.- ;>hv*!*al -viawn ' V' ** * i At ^ ft *^**;e } fft* #r t * *> f "\f < ' - * - ^*s . :.v.-.Mai *ae ;> '> :inot'i~r "> ;.a * -< - i . .--`r.ij-! hv r--.ar --w*)' < a*. !*-::'oo w:*`i ;--* * r.r w-i t-'.u-ui :f tf f-.ki* r* -i r ,:an f-i .<'* `;v~ ri^nf: ; om.m -m a r--nr/i ;.-.r ^.-n m -.vnat !.* ni>v-,ml M>n'UfKn t- mnoi *<.:a -? '> ' *" Tat ..r f<;>. -.-;i ':-::* v^-.oon ?.t land :-.r ri.-e in u-n irA-m v-'.-n : - .' ;.* . ' * .< t-.*.r-TV.*`:i*.8 **> *.<# tji. '.n Irt !<.-'!, . `\ .i' : t:.?'?.'! tr.women, .ur r-*;r;:;mr .n *-v11; ww :;.v' -tt-'n'wm. ->r m-rrap.'* jwst in ir<:*r < v'-' *~-.r cr*m .a a wartwajinr w.iy. .i :'h ;i *f i*rv havn-ir a : *':> :.i- iw^t-i ur Ii \ n '" ';.'. <( t:>Hen >>r niH (woe * * ;.:< x- -acrtt-'h <i #h.- n<>r.iii:y .-i i injury r ( r.;t. ^ u;;nrv. ( i I-vitriiMile l/wRi the il.aniiotr,t : r-*' ;.*. - -trari r. -ftw a a --r's :h- wt-r u...fiin_'. ,ih-i i; '}>* mart .iiy,,-tt;< ::;rtiu-r l.;.< *r v.a# ,iuv ;::nre tw i- *o irn nai'X 'he {iw.*t>f tn rl;r~e *r (.' >iav<. *.r >.w ih<* ".t ;:: . i'`.litv, :.r mail 'if. <? . iimi. an-l vm\ i*v*r *.a! (tint -- (:? 'i.t- ."-li".-* <.t parti.-n.-.ir trwi.uait ar -'m-erned. .inti if w .'imply ?w-ot ,r.iiv m :'. .-*:rrtTr <w lures, ilot * tins t*i v.u. <vnt..-men. !>:t fhi# ann.*ar.ani-< '< tin* m.in .if v..<jr .ipnofi'afv >r at vo.ir l<-nl iwrtr . y<<*t n <i'f>.irniiiifv :n Kn-.M up the unalicnl file on the history <( that m.livniuat. 1/ !: ^imM tn with a miitiiamt*<i a blow on the Iwail. a i>lw on the b:n*W. I ^`itfcest to you the aUliability >f i.iWm? full umi *-omolc`*' X*rayn. ami iv (till and :r.okte history <*i that mrulwit, puttinc that info the man's mndiml file fur fitch future >i.*e .t* may itUunat-ly fw mad* of if. That to kivp current the r**ol ot the nar*inLr individual, just as periodic rewtammatioos will do. ft also attofils you an otr>orfimty. :udo*a the penmlic f*-etamvnution. to determine wnst is the eimrs* of ihnt man s runditmn. the >-uurAe of his wear and i*r. the course of the development of hie arthritic deposit* m the r,r. .4 Jlociaiu<n of .4ifrvnn Railreatia fl-. . '.'.C ` rpine. and in the other bones and joints of the body. It affords you an ooportunity. if called for. to euceest to that individual that his physical examination demonstrates the desirability of euancuig to a leas hazardous type of workin which he is not exposed to the same hazards of injury that he micht be m the work which he is then doing. Acsun I say, gentlemen, if by a transfer of the man to other work, you avoid tiiC ultimate tier-idem abieh he might have, we have won that lawsuit before it was ever hied, and we have done both a valuable service to the man and rendered a vuiushle service to the railroad. Finally. I s'gggri-t to you gentlemen that even u; the trivial kinds of itiricev.i* such a.** 1 luUt suggested. n full ami rotujdete physical examination, and \-rav exsminatiofi. guards against the possibility of a later asserted claim based uion the incident brought the man into the iiwjwfissry or the tm an; bcritisc. a::*.-' rilt. the m.ri in.* three y*r-.r. from ti;v dm?* <*' the ni*11 vr;.--. vv:.r-:: : .. *;iit rr.m tj.M m*::ic evef.fimi nilvtr:i< r-oii'mi-i-. a m fm:. i y i:n- :r:t o: v.'hv.-n h* e'-mphum : i:t-*o U..-.I xage- \ i>.; ;.i t:.e 1O1 ;>: meuuri: ali'-i.t1 me?- !.. .>> U:v st that time. are rnnjror.tMt m the courtroom wttn u;e xvenin mat " l wept to sec t.'.t- noctor. 1 twiu sum I hurt my t-:tek. Thviie :.r mi-; tr.v u./.e .T.v *r-.:rt c-tT. u::i is*tie?: me :;rounc t:.e hack a iutit? hit. sr.ni.'t * on i.um<- arvu come uavk tr.e next day. aau that s all the attention [ ever cot irntn U.v company. a:ni that is the extent to wnich the company gave me tt*v menu:;*, care anc attention to u men i was enticed, as an employe i:iji;rt-i on ti.e .uo. Our- !*,!' ..' w;::. m ?>. -- . ................ . : .dip of t)i!!*?T indiciums n perfunctory amt -:ir.-ry evauiiuaiioii ; ;yj-.u. Tuc pmimm ? l:'.e<u.:;l wi'.v.s-- wiwi ir. wr... o-1 <r > \-r..v .n;... picks out just tho-e v. iii-ii arc indicative of u,e pmiio.ogv. t;e leiia about u.e comoicte and comprehensive esumination that x.- uus-ue oi :: ::uu. On. safe, he nsy imve made it the cay niter the tnai started, am: hv :nav aennt irasuiy that he never prescribed any treatment lor the man. ami uo?#n t intend ever to treat him for any condition, hut the eoutra*t between the perfunctory ex amination at the time of tl.v acciuent and the cotnori-rtcnss'e :mu cump*cie examination at the time of trial is sometning t:;at damn.- us *n list mines o; every juror kvh*re whom that situation is presented. Well, when it corner to the question of cooperation between die doctors anu the lawyers--:-.t flic time of an actual ::<viH-itt of which you iiave knowiedee. when you icnou tmit accident is oi r-tii- m scrioustic.-s mtu seventy that a i iairn is going to ! made, am: i.-.w^uit may :* the pursiiile wjteuuic--I don t w.uk I - to ted you gir.t:t anything a* t/> :ae :i-<-e'*iiy ir iuil au.i omulcte v.\:;:::u.aiiu::. >. li.e i!rMp:..;\ ! to tt.i- mfurcu ou- pioye tiic fudrsi ami r..i>st adequate treatment that tu.e.iicni science knos. That is part of your job. and I know you do it. and I don't need to teii you. I don't nerd to tell you that in the cooperation between the doctor ami the iavvycr when the lawsuit comes to trial. yo\r function is going to be u> give the lawyer, m caosuiv form, " nat it took you years m medical school to learn, and years tn practice to i*nrn tie experience. Von are going to have to give that nil to him i.n ?eti of luteen minute* of discussion. You're going t" ii:iv g> ari.un.i !>?*>wSii;a i-\;**-rt uitm--sv wii> are specialist? m partu-uiar neUis. atui persuade them to vanod tluir othcc apiKJintineiits--j>efiiai>s mr ttir*c or fmr day? rtmnmc--and to |K>5t|>one tin- nficratiiig s-tieoulc that tiwy luue set tip. m .r.ier to h*Sd tintuseUvs available to come *t the Law-v? defense of your You Know ml of t: I have, ana ym kno f the trial. Sow I WOllhi llfr. eivc.t tp.i ratiH-f < a gtVki one. 1 DSiailll* i u ianino*-to wi.<-u.er mu aud u so. wnen ana * Ti?**^* tv*::rs ::rc e r-m-rt ::: tr* nni r>ct : : t;e uuesiton> a to rttvnirauv f;:: ;,a r rtot ov taamr nao vita " .V,." i: w*s t ;xvp Uie list oi tom answer i< "Xu." l:i <Pcvs wne V>rn:ai." \uetv- tyre, ur.uer a printea uaysicai Lajunvi. ana ; v*VH. the doctor wo was no loacer in thu York aod take bis dept signature, ana ideuudt had no recodeeuoo w all. he examined tbousa of a oavigauoa if irnn On rross-oxamioauo in the decor was one plieaat iu b:nk. and a been typvu in ui iiieoii 11 developed that th made notations as bo on the basis of the hao Oft we went to Clevc win* had custody of the that it was the doctor s tions shout the prewm if the man's answer was only rote on the handw statement which indica "No" or"N*nual cond the tune he made apphe T >mi an upper* : .-viminatioti :vpe of wnfK " mntrit he in rk, you avoid UiWSiiC before . 'he man and - ..i i:. -idei.ti. :i. .-.`..-S X-rr.v based upon .a;i -tation. .-rfj'.iU within . .women was. at Mode visit o or\ the man --rtion that * I -r had me take Ho ou home out from- the :.e the medical -t on the job." --.ird "r n *< the man. ' ray ultra, and -"413 about the -yum. Oh. sure. ^.Slaut frankly - wintend ever to rfim*-rorv e\ and ronjoirie t -ii :.;-tur* and -v.-ritv that a ' iijne-- ( doll t I 1;; -.lilt uri-i n :cm-e know*. -- i to 'ell vou. :.*'u,r an.l the '> lie to cue the bool to icafn. ve to vive that .vilnos*-* who wet their otfice * i !Hipouc the vivr* available PtGCr^titujs of -tn-i d'trytatl .vct:/>n I j j *. ! J | ; i . : | J ) i ; ' j j | | f ' :j ; (j \ ; j ;... j j j'; 1 | i {' to come at the Lawyer's call ant take the witness s' amt and hrar vm .*ic :n :h* defense or your i:v.v<utt. Vou know all of those thinna. Votive *w*n throunn taera. just the .ante .a.* l have, nod you know what ts railed for in the way or 'ooneration at the time of the rrul. Xow l would like to say somethin* about report forme. Vou nave ail re* ceived this rather comprehensive two-pact physical elimination form. It's a uood one. I have one or two -nvccstiona that I aw coir.z *o max* '> **i rr.r.v.tT-.'e. : 'a . .uuaioe -uaucstiuti iv.-n uume -.---lerd.av am "it mim-tinc a ::n:i .* to a rf or not tr.e nt>nnnt hal ever nail an .i-?av :.ti-n n?ev:-riv. *.n*i rt ?>. A-.cn ami vnere. . surny arc cuok umy t> r vterit that tney arc a.-ni;u*v iiniL ^'iu useo ompteteiy mu tuiiv. t:i this iaw-uit mat 1 fold you about, winch we soent tufee '<eu in crvtac. '-mere me nuesuoo was on the matter of concealment at a nre-emorocneot p::y*:r*i e.tr.rr.inuuun. :.nc .-usimsmp company caa a uenecuv r ;js ^f.j; that wmiiii have made * enrapnste udciise to iae awu<t. .v. of * he uuesaofts os to prior history, questions as to *.vaeihef or out tne man sau rres ;:iec:csu.y uUcaarzuvi from the military services, a uuestioo sj to .vr.srvn---r -Trsut ne tutu ever cad any prior oacrc trouole--ail the querttons wereanswered "N >." It was tyr.*u iu there just as bold and ui.i< s x> you p.taue. vr> he rat hi -;::nzs-- Have y.y t-v-f pad any <<i 'tie iwisiRt; -- Tie an.savr tvsts 'he r'a.*ee .vr<cr* tiic answer `'a.ivii lor -.vn> ".hufmai. * :;.e ; ' miai." A *# there. U-'-vn at ii;c raui.tin <>f tuc iave was izt man s 'tire, under a prmicu i:::c whim read. "I have ruiiy <i:s'iosctt an :cv-.'.us pny.-jt-ul iajur.es. ana 1 y that l am ro yood piiy5ui coiwuuoo. ' '.***'*-tJ. :he doctor -vno Iiad ;n:aie tiic pr-.-tmoioymcnt paysivwi e\araa~aua>q was no tomcer in ihis part of the <-outstry. and we hsui to yu down o New \ a;s -icaature. -ir.u :iientia-d its dio-vri thu report, aau ;.e :uetita-u ..a> v.-.iv' ->^r.av.irc. 'Ac .aid ry transiy i.a ..et;n.ii ..:.s<~vir < r<nr;;-s::ar -\aii:i*.a;i-<tt t r*u-.-, ait-r -.il. r.c in.i-.-ivr.-is <u -- \-r.<-n - ;i :r:e ''r-'-it doriaz iir..e "fa r.avw. a -<-*-.on. n sTna--Na:miav'.;.:i it inis t>urTi*-'nr wiii<-U w;w r....wn -o the :t tor aos ..n vmda had bn-n .'iqnc<l 'by both 'hi* doctor ;-.au- 'r.e ap- yltcint 13 '.iauk. :uui ail uf tin: uiiormanon 'hat whs typed in on 'he form :;ad :.vr. -ri t3 at 'UeoifiCC ui the riinio in t .levelnod. ir deveioivu tiiat ti.e .Joe'or fuui iiiucner copy of rhe form on whicri ae nad made nu:a'i**p os he went alone. The typewritten form tiaJ oven made up on the bitsis 'he handwritten iorm. `uf we -vnt to i Icv^iand. take ihc iieoo->ut<u oi '.tie doctor at tUc* -um: who iiou ru.sro.jyof the handwrittea form. Then w* discovered, to our dismay. that it was the doctor's pradie^-fo tnkin* erve history aod in nkimt the oue?*tarns annut 'hi* pri*vw>w oIivskuI mruUUons and diseases--1 i*ave it blnnk if the man's answer was normal, or if the man's answer was *' No." nnd that he - only wrote on the handwritten form those thine* to which the applicant mode a 'latemetit which indicated vimethinc that was departure imm the normal 'No'" or`'Normal conutuoa" answer, tionsepuentiy. althoukh this man. at i he time he made application for work on the vessel, had a tile with the Army `Tr.ri'-S a-aR2f| ^aociei&igsgasneg5 -.4 4 I 1 l tiS ni Ameneon Railromh aud the Veterans .\<immt>tnt(tou tlun U'm out lying; that thick. aoJ lie wa> drawing euni[ivn>attou from thr Veterans Admiauiratujo on the basts of a 30 per coot physical disability. suil, on ine handwritten resort, lac question. "Have you ever be>en discharged for any reason irom the muuarv service?" was btank. sod the quuon. "Are you now receiving compensation irom any* one. based upon phy.-imi disability?" was blank. und the qution.`*Have you hail any pnor back injuries?" wh> blank, although the mao had a history as Kms u> my arm of buck trouble. Oi the ten mourns he had spent in the Arrtv iu ami 1W3. he pul tune months of that time in Army hojoitais for back tmumv. IVeh. 'rtutiatriy f<r u.-. the pimmi*; - In a ..-r. win* wa> * v**rv i.e alio ex* jwrtemvu t'lnimitlV trial man iu I n.emumt-tt his name. I'm quite sure Uiat many oi y-it would kimw ,.f him. and ests-rn'tirr with his ae*er-) made the nn-iuk-- uo.V'ting in* eo-~--v.iuiiumimh tiiui ti,;- ui,..h- thing was ir:r.e. : u;\ ..rid ii.*eyu*:*.>. inat tr.w u* an i>iart!::ir \ '* .*.,;;ivistr:t*'-- r,-:--ft* m::sc :>v t:.> !>? -- ..rv t:,- e.;r. nians. v. ... '.;.e an;..': ti.ni .-r n;.g*u;.. ;tuti*-r.'. r : _r.;:-ui;tr iv.:tm :i> 1 *::v. - .i-m l'/ ecqr.* m n::* t. trouble; i:e dai iu*ve. *u ms pny.*iem t.:.*ior>. " 'i'a.*iis isuv.fld* removed in e;jud:i's*.. ' But i.uu ::li ;ip.<nuiiux *.y UL-Uo:- ;.v way *: comparative rc;s>ns that mi.* wa* tin? uct<r s lecumquc. uuu .i;*et;u*-:;:iy. idler u u:i!: dsy <*i argument. we were aim? *> get Inc pavnvau retsirt m evuiejnx- and sc: in.; donor's te*unionv a.-, t*> want luu a: :.*ie piiysirai examination as r'-ni-eten by ni.* iejx/.*iUoa uuntiUcu a;;-i ulicf a trre*-wi*k.- trail--f.ich. with the mvestiguliou auu rruii exiK'iiM*. i-ru:/am> cu.* the .*uiun.aip cyi:if.-jt>y Mimclt.im: ih lae neica.K-r- h'>Nj s;v).i"JL t.. dete;.d--tiie jury was out U.*> tiian .> r.unut a atd. t;.aha God. retunits! with a "r.ot cuuiv" veruict. But vur waole prnbiem tvouid have been greatly sunuhned u that cxamthihc d*etor had iaken the few minute* <>i extra tmie tievuvd to dli out the iors: aau u> answer an >.' the questions o.irwrtiy aau exjwvvvtiy. iiad he Uvut that, uau he inane the examination that was ludumied ov the ly^-wnuoa repuru e et.uid Lave da-jsi.M-u oi that lawsuit--posfmly by motion tor summary ;ucsiiieot--'w.iiinut any trial whatsoever, and rertainiy in a very snort soace oi tune, much less than the three weeks that- we spent m the trial oi that lawsuit. .*. 1 ?ay >u scnilvn.eu *.:;at when tt fmivs t-. tint mau-ro? theii* physical -\arn!;a.::"u*. wi.ctinT it i* . pr-ciup!oyiu'til piys:ev.i examination report. : :* a Jurii-u:.- e;a:nioaU(>ii made at recular intervaii durtas the mau'i Vii.'.'ir.-tii*-r tho '\:;nmiati<n that y*u make the time the inna ivitu a coiiitiia;::; s-unc trivial or wme vriuu* ineiueii: which nvcum-d v. ntl<- ni work, make die examination fully und completely, and record it in detail upon the form. If you do that, it ha these advantages iu the ulti* mate tr:::i ni me lawsuit: In hr?! piare. :: report made by the examining doctor in the regular . L:. *rk a.* a uncinr. and in the ceguinr cour>c of bis work for the r.-ni -*>:r.r*rt:'> . ........ a. ,.ne ..r the regular records of his ontce. or oi the !:.I'wiy * i.u.uie.'.. madr timtcniiKniiienu-dy with t!ie examination n*eii. ilx- d>Ti..r to he true und tw be nccumte and tn le cumpieic. that ri-.sird then nunnhc* muter the ruleoi the federal courts that is known as '*!* rule, tin* rtiie that is known in most of our state court pro- I < '!:nc> iv* ti a a vs m f.*> f the first -W.'Nif II. ;t( I. .van.* the rc anw.*rr < hieti tfjen thre'- ii.ftmu. a tt I* in r.* ..:;V ! .A_:i.::ini*>*i.- t Hi- .|.--rt i kn rrr.wn ** **r * Mail'- ti.***- ' T" : **\:: csiuie. Ili- u: ini: y ter ph.-ant or to tf :Li* man niaoe yvrtnrmco on t that the result-matters wutvb er*- .Hm'fV.'O. L'n the bxsi.i riTOUeetiou rect A* I say. it tc ;q our particula thick it proved t Finally, tbere amiuiog doctor wbsu you want to tbe courthous been kept in c meittioned. the to the iury. UV hud an m. ably to qualify Mar.ne hospital l might say t counsel, for tbe subsequent to tt the brst operauo and on the sceoni m.v nuestvou abe que*tnut was: du. it tn the Army, o Fortunately, b v-.-u that thick. oaJ he *\ltWa uu tic Ikuu <{ 3 'i reyorc. :h qucatiou. :ic ciiiiafy jcmrei'" `.-cpctLMCioa from any* ..c question, "Hive you ; man bad a history u r-.siU peat ia the Army rmy ngitnc.ils for ict.cC .- 4 wry ;:qiv :u;J c.v- ,:r. l':n uuitt* mre fhst `:i :...- .-..'-I ti.itic -!* t:.y c;tm< ;ts ;mty :-i i'-.T.ytiscru;t.-- . by ;bu >ame doctor-- -v^fyruiuc hank and iy. thu lw**-run*<.UicC ::y.-:ti history. "T .:i.nls : opponutucy q, di-cuye uue'or's itfvtjuiduv. aud to -<*-t Hie ur.yt:ci "121`jcv ^ :g waul had m 'i-y-Mtioa luinuttod a tbo invvstupiuoa ami mcinm* in tile neiyuaor* u Ho misuses and. thank njpiuitrd if that txammiuy i *. nil nut fh*j inrr.i and Hud he <i->ne that, had .vr;t:-n .*.r-n. *- :.* jwilu- :i j v-ry y;rr -oacft **i ir:d *>j r.l;at - flatter f tht-.M* r*tiyicai mi \;u:r:r.atiofi report. :.tvrv::i liuna^ etc muu': at iho Mnw the (pan r.gui incident which <cu - nfnplcioiy. and record - iuivautu<ca iu the ulti- doctor in the regular nurse of hy work for toe ia of uu oifice. ur of the w`y with the exammatioa ;nne and to be complete, 'd courtj dial ia knowo * rt of our ntate court pro* r'K"'-tU>-it 'it .Utitail ,j.vi >'tr.);rni ceedwes a* 'he "`rictn.ii *nfry' rulf. and flat record *.* m sr.rec ways in ?hf* rri-1 ; u hw.-ur.. In 'he brst Wn>. it may b*> iyyii :o refresh the nTiwiccfion <; :im xunuamc doctor if. aitrr h'okinc over 'he ,xaauaton mm*., he l> anle '* *ny flat be recalls tto fnnmaiwn. he recalls the questawu he put to the man. aa<i the answers whirh the man made. he recalls theciixuad testa that facappued to the man. then chat record mav isc used by rhe l**c**r. as u? >ay. o rerr-'h h:. reeoih*ction. He may f<-*niv <.n *.V.c vo-s **< r---'!'-- *:nn as it i.< 'nti ~*rr*^!!*** 1. *i : --n t Nn. .iv . 'i-uni'iitii iiit; -I- nu:.:o- many :: ;nh* r . --u `Ju-* ...........r.ur -Nn-.'.imdi 'n. if'-cn *-v<w r mill* * r iu:ii C uair-.r ane naif at ;ui. mav know n.enjuir if toner that it Aa.i nu umt siev to mas** it rcort oi mas tyrn*. t^at ;.e :runic use reaort.s nftncsriv ::iim r.erufttnsv. ami (tat ue uuwie tnem at tns `ir/.r of i he exanunanon. atus *r.tir. he knows that tne noort ts tn;c anu correct. *Vi;h 'r.i'.t r**fy>rt :n front ( mm. ami on the ::uu yf >tr.a:c\'.-ce of ;li * ifcumcy :tr.d uu knowirssce n< fits usuai ,our^e m cvuninnu/fO ar.i ay usum :>rn>v;ure. i:e mav i-->ntv a matter '( ut-'t. n*t simay to tae p.-.re it-.-it. but re may sesuuy oa a matter *i iuct tnat he put thtf>e tue>U4.*ns to ire at>- fdMint or to ifi" sr.niov*- -.vir** ".me uu 'nuiis.iuuu' l an accutvlif. ".i; fr.v muu maae 're au-wers rc.v.t art* fvr.i'Cfcil on foe .xam:oa:u"i ::iui :: ;.-:r:orn;-ii iiut ..ni;v:uu::i ::ic foy vajt'a are r*>siru'M on iue i<r.*s. u;.o mi rc.'m:j/U;. uiato-'a .v;iu-ti ar* m-i i.iftu ;i.*re. ;h-'-^ 'ere oox.-rv*it. nvft c.euic. "Uui .; *ae f uvtiun- On me ii:c*u* of mat ri t>rt. teco;i>'c'.i->n rti-orjed." may testify r. *.vnat a- d'.syvrs vail "aast .As I say, it f<*k tuvdit tiaif a iay of amunient io *'rder to itt trvi f-enrd in. in *?:r nnrneular !av. .ur, ::ic . ^ ut. e:.d ..:t j*;?l :aat -.auu i thin* it provisi: b- wry Vv..a'iiy. iS--r* -dir.; .. nvn the jun*> `ve pmv>.i -Mir -i.--. ;;j v. ;;.vh tllv r*-rl ti.uy rsc *j**ni. aa;:i.!u-i d,**-,*r ittav >i--\d- Utr -lay h<r ui.d unavauaita: `vhc.n vou a:*tit u-- !n:s'.. '.'.u may uot he a:u** *> imT.M him '.u .t:-i i|.c 1'urfi`Mi'g to '*uy in y..gr uiirtioibr Ua.-uit. Then, if 'h*i rc-r>rd ias Ireeo kept in .ofif/.rmity with the requirements *f thc-sc nilts that f have mentiouwi. the n*.s*rd. i'.-df. may mifnt5*inl in videnre, ami may f.*r rad s-> ti;o jury, Wc mid jtu initafUv <`i 'hui in my b*utt to which I referred when -.ve w*>r- tole t<j qualiiv the v.-o-mns Administration records, and the reeorns of the Marine hospital wh*re 'he man had ?nneiortreatment. I ;:::irht .say rhi.s. ,.;.st hv a-iv u` t.\uim< tuvaclt on the hack, and my co* couRiei. for the reuit <( that iaw-uit. This man had been operated oo twice subsesm^t to the rimmed nertnent oo board ship, for ruptured due. and on the am operation he wn* iound to have a ruptured disc on fhe lumbar-sacral, add <m the second onemtom. at the uutnhand fiith*ntcn*par. >> there misa t noy question nnout the fart rhat rhu man did actuailv have n injury. The question w*u: did he svt it w-orkmq tor the steamship mmpuny, or did he ect it ia tbe Army, or did he qct it pnor to the time uf his Army rxpenenee? Fortunately, hy the u>c of the Veterans Adtaiwnuatiwi records, and the s.ur*x 'V w m*siZ ^ \-rr.7 jacssm IV*'.'. .*SWS5< h.\^,b il w> TO Asioomwm <1/ Amwvon fioiiroo/t* Marine hospital record*. we were ohlc u> put. in lliw: records nod m neut them verbatim. the portions hc wanted. to the jury, so limy rould get the lull bceco-, of the mnn'i history as he recited it in the Anny hospital. o{ these prior hack trounies. the diottuoris by the doctor in the Army and the m thr Veterans Administration.- and the treatment. We tvmr also ahtr t< pr***ent the history ccain as hc pave tt at the Mahno hospital. The last thine read to the jury was the conclusion of the d*etn at the Marine hospital. Th.-re were tour doctors, indudiae a [isycfawtrist, a neuro-iuremn. an orthai^f:,- .ureeen and-the chief of sunfry. When this man rams icick the year after hisfinal examination and mmp'uwvd of the symptoms of which he wn- romplaitimc at the time of trtri?. i: wns ci<ied hy <rh mu* >*f thM* ij>*euirs that the mat* wn* nislmc**niir. !';.? th.v /true we our er***.*. and upon tlat not**, {jvtitleimin---on the r!iVTtve tiw that can hc made t,i carefully kept mtslira) reerris--{ will cite-*. nv remark' here. Thank y-.tt. <Ap:>...;i--' Cji.W!-.:-:.'.v hi *> vr.T ::.n-ti*rru; r-v-.-cJit:.;:-.:; i': -.nv vt vcy :.-:i.*-h. Mr !;%.*- 1 -.v v.--. W.- re t>* <iuf-*.int-:i;j,j-ttnssvir period after the :-.idn--. *-y in the meantime. I wonder if Dr. hmmoir .v.ejid like o mirvv:ev * v-rv jitimtruisi.cd viiit/jr woo i> n itu us today? Dr. Emmett? D.h. .1. M. Essmcj? iChici Surcvon. t hesniwake <k One* Hv . liirr*mri*t 10. % s.;: .Mr. t'hairtua:.. ;t i> a vrrm: pnvji'-w to intmnwe ,r< twi iwi c='i:'t*-rmn -7:0 h.-: v.- r.--vnHe into ' e>- me. ; i.v. I -'ssni iik- t mimca**** itn* President : tin* ( *--V-- .v < kv . PnUA;y. Mr. Wulx-f .1 Tu.-hv. u\;/t;au*et .'ectmdly. I wouin like t* introduce Colonel Mouroe Jooasou. oi Wastunirtoti. Executive Assistant to tnc President of the Atlantic Coast Ue iluu.-*au. formerly Chairmen m tn I.C.C.. *nd an mternatiooauy rccvcuiu-u nuiiH-ntv on transportation. lApiitausci CsAtttiiAN' Bennett: Thant: you very much. Dr. Lmnvm: V..- ;:*a d,^ lighted to have you wuu us. gcouemen. I think that since most of us are assembled here, i would iuso like to mcroducr some other sruests. and some of our speakers. .< we'll just Know ejcartlv whom we are talkiac ;t ami ao- ut. i van tell you. ctntl**r;iru--everyone mciudc<i. luciudine ur viMi-.r---:.`.a; you -u;i tuik {r:snkiv ^uci riant out. oevuusc anytninc that .* .v;:u hen* --r:( y.\ ."jo. ihvmnrc. uv v.re cui::^ in- *ur.- tin.* uviJ *:; in.ii it cw- into the wrong haoun. Uul l thhik our he*; iiefc.*!**.* m y vic*.*fuu> *.ic:.e. v. tbcmore. we must uuk very frankly aiw>ut all our prolilcnt*. Now. I have heco w-ith the Association. Ofl the Committee of Directum and in different johv. for many years now. and I du not recail any lime that w nave fmnkiy about our mutual proVdrnic. \ ears nco, we used tu c**t swuv with 530.000 or J40.000 a clauu. X*w. must >f rur riauns are at l**r.sr lor $100.1**1. nnil many of tlvra arc iMr S'J'Jl.OiV) fu.ti m-vr a- Jjicy arc sent in. :.s a 'nivrvfore. tlie Commuter* of Direction thouent that w<* hinl inner /u<-* tm.* thine squarely ami bring into tbt* meettug all if the l~ heir* them. * -USt rv*l a tin they fit The cent) !r.i**.ire Tie ficv T 1 Usat-ililv :;tiii* Hnnri ; w- a i;.: . v.n.M.* i <i A:.-; v.<-1A'.d last Pal-ic tic.. *\ iu, r " -a . re Mr.. WA5. Ur.i-'.i: f`x.rtXVi fOi5?. we > itsmisf our 'rut o.:scs pay the ni see il it is from the it XOW we ?.*-imirC ui isi tin* Ass a: !;. nv ;.i Manner Ue*.? t. Mk. K. Director, C' Illinois': In tulkii e.a*tty i lion. We hopeiul on <1 l<* H'-ui liu*71 ;t :!* tt*l h*i<``hc . }rt*r 'ack i,,- m th* ,,,;.. n present Ml* -(. tr.imr **'* read t<* .pitaL There were rth"i*,*dic <'ir2**n ma'.-i- .......i '*>111 tbit . -::<t,uvo ti.-c -!;.<# jr;V remarks That 4 the ;v*vt atUicCrs, introduce very 10. ..[ - -.vt> u'ai'Ynien -V Oh:'*- -"n. "i Washington. ;it Line Uailroad. .jri.'rd ai.M.'-rdy : *.c.:ic i.- .-.ua hurc .' :.e -\t- tl-.ut i*. I mjr r*-- t :msikiy asv.ut a;l (, YmrmV.i-e **( not any os. am. N'vsfc-. moat tor 5`10.000 and ;'.i*^-ot Direction : into thus mcetimc |I /4rnc',*tin'jx ni .Mrdimi -mil .Suftiml .'Vrttnn I all of the t>c*tr*ie who piayed a .tv-iioc r.nrt and mhW h*nn *.< Yelp them. \ j;:it want to if.trrehiei? the eentiemeo at tti head rnrde o you wail know alio they are na we ~o through our prO'rram. i The rentleman oa my immediate left is <Vi Clark*. Cwmmjrstoner ot the s i Imemate CYirameree Commission. Waahmiton, D. C. i Applause* TT.e next ^entlcnuft is Mr. W. R. Curmeil. who w <*:.:<' of *ha rWv;*:cn of Disability P-'ertr.tr.ntioes. Rore-rj of ` irn*. H :.`-vr-- ..r.;. * > 11!. * ' Mr. P. !'. li.-nuMon. .-mwr::t...... Ym i-'r:>.;;iway. f M*. M-t-.1:.-!.-- v. -r. Ana a * i:jv w;'h * '::e il.i;!r-sd i ir. Huynn/nd t **ilt*r. a '-.o i* R*arl m O.irnso. HI. 1 Aotls* Ar.<i yjs* ;-r:rr to your attention that we <ion> op .ir *<- .it *`;.* ' .,aT**. and ( ar.a.la. tms im*e we have fcrnusnt m--r.d turn to : >:h a.- >> '"if v?*v -wmiihlv. *vr>*hrr o'* 'an J*nm '.-i:i hi:::, --r re from as--fr. L. J. cfu>*M<.. wno :.4 from Lonion. Hncinr.C. -{'t. Slav.l'in, msi you Mml 'in r.n*i j*isr ?:*v nt.-ii'*'* A.ooiai:-- *'*V - ro five with >:j Ur. (-.sn.irto Chavez, from Mexro. I.r. ("haws? ' Aponnis*1 \r.n a** ".*. Or. flr.n^ethie. from Tl.iaitmii. -Aosnause* M Li*' i-'it n?' *.ve a .; or ih jj V.-i-hinzton. D. .- vrtt:irv **i :*a. Strsve row a ui\ jv: ,.n *.<- ;:fr<::tnu You . . Mr. T.or.v. /:.'f '.ar'iy .* *:a ro -.ore. AY rr ir.o/:; ome rr.onev for .no. M.t. U .1. T*v I 1V-ohit. < 'oi;<.h -'r ralin! :>-ii..- y *; v. < ! *.-:r-j. r:aiX'`"' Mf.vvr.rr: ( -r-iYr.-, ah.:er> ! a.I rh* rail- fne most m'.afifror m -.vmi* ::vl v.a.i :<< ..; I .(..- . ; .;;i,iv V >:| -AIl*r Vakif^ : S*i* ..fvcr' V- ......... T'.::. ..- of " -:C /.:r ...... j;.;u i~ <(.e *;a:-.z y.j :mist r* *- :.. --j: :.<r. :r.* :i:-rcfor-. '.v r- ?o f - ::-y nroi.h-fRi ami - : ;t .............. ..-.`.vi- <*r.coi 'm-^*rloc-*~fttcm-nt.* ami *tcta"nnt tfutity" Jie jury. Y<w m> :t :::a/i '.-iio lii- <iof(e r.n rMr.-*ii*iv la rue atr.i::jt of work isi -aairu ?: ':: o*' <u rr.l*lion a ^rouo. from a uroui* wfiirh a';*.* up , : v /.> . v.--Tttma of an i!aiirauU t< it we muhl romhat this j af S*.*er are .ink 40 from nor -f.iiutrmmt. Our next address will l> A Look i at Management--The M<-iu-al Department--The Enmiovc.'' by Ken Carney. K'>-a.` 'Anniaiw* Mm. K. A. ( AKSfiv (E\fisuwu Vi-<.--<.1i*irman. (.letnrral t.'laima Division, l .: 1 < 'iairtM Research Korean. Assoetatmn of American H.tilronds. Chu ayo, - Illimust: Mr. ('hairmnn. .iKtimpushiii (fiesta. Ladiea nd (;entlemes. ^ k.' In talking to you nvlay. [ ihouebt 1 mi<ht hrta< you up to ilate *ut to put i .-. exactly what wo are iookioc at in the tlenefai Claims Division oi the Assoria| Y~. tin. MY have a rsitier sordid picture in many respects, but still it is * verv | hopetitl >ne tfl other respects. i;-: 1AW11 CR1 rS' v` Among the hopeful Mime a the increasing awerewesa of management.--' including the medical departments and other cieikirtments--as to the neeo for standing up and dome something about something that ought to have ireen done many, many years ago. I have always beiieved that the permit who puir temptation in the wav of another is *yt -.> gtuitv a iiv {x.fson who lakes it- meutev. or whatever u may u--ami wiicn wo jx-riuit traud and things Iim- itmi t< exist on our proper ties without raising our harms to strike hue-*,. 1 f.>v taut we are guilty of u grave mistake in judgment. Of et:r.-e. il if ea>v * say th.~e tame*, hut :t .*.. i:tti- ta-.u- difti'-i::: t* nut 5hem `.tt otwrniiwv l v.u<>: like t<> gi; e v;i a !! :::* a- ! v. mat if p.M-t cuing: :;rst. ** r.'f.i *: *.: n.,-r- is a r~a;h ut tt.c hguic? ; i -.* i.av-- \- awrated to som<- drew tr.** uatiingo thcf.iiav* I--Ml none to u >) a result oi these astronomical voruuis. it's no; <y.*.v as .;>.:.? r i u ua*; i-nuuk:.. bemuse :j we hud mnintytm-i our same accident ?<- u ih.-*: * iinti tmiintaifim from i!?4l to 4:>. in (he iasc Jive years. i:irU-:m oi seenuuig an average oi anoui 595.000.000 a year, we ivomo lave spent an average oi $i7?.0P0.Ut*. a year, and that's no; good. But you naisi s-n.*-iui*er that Part ;.:c t . tm- increasing ievei oi --ng?#. Wages have risen from *.T <,.:> m Cj-i.'. to jl.tn*. in I'.'.Vi. ar.u 1 iv:i t -.now what the `.V-> sarure* :.rc y.-t. i/..t an- mg:.. >0. if we take out of our tsaymctits the mertasv :i wages, and turn take tne Jecrcase in acciuent.-. and balance those two hearts out. we conn- out witi. a zenerai imure tout our cianns touay are. on the avt-rase. costing us ai>out -5 per cent more pgr vase tiuui they were costing us u 1V41 to New. that doesn t soutm t^ impressive, except when I t**ii y*i tuat 'do per cent represents something mat we paid ior ;r.at we >it<>uldsi : !.:m- paid ior. "`hen you take `in per cent oi 505.000,000. you re taking :i pretty good <-:,unk oi money, and that is exactly ivhat I'm talking about. New. where uo these cost* emanate from in the iieitistry? I think we ve go; w locate them in orucr to < iciermine where we ougiit to appiy out remi-jicr. "< are aiway mi arc <j{ the f-.wt ;ht the switchmen. the tr.cn in lug trims;irt:.:.c.n depart::ienl. are engaged m the most hazardous par: *i oi:r ot**-ra- Likewise, we ihink timt they arc pcriiap? Ike recipients oi more money than auyLviy eif\ and they arc. but. since li'4'i. the eLnins paid to tntns* !*>rtatiiii de|irtiin ut enpiluyi-. have mrrcy.-etl 20 ir eeut. The maintenance of equipment account ii up \<0 |>cr cent, and the mainte nance oi way account is up "f> ;>*r cent. .So, when you pentiemen start cun* sidermg tiie impact oi the im-rmse* m those departments, you might further ; cricrt iijkih vntir iie<*i>m:i not to carry vyur X-ray progTsini beyond your trans- |H<rtation emplo> e>. 1 cast mat mil a. ait iimu'uliun oi the nn*d in our mduftrv Unlay nr a crealcr examinauon oi why we art: paying the umuev. to whom we are paying u, In-iorc we make up our mum- as to how far we ought to g\>..or how much we ougnt to limit some of our activities to make it for our lawyers to have some uuttenal on wiucti to uCtciid suceersiully tiim<- ca.-e* that ought to be th-ieutled. I it's** hmk you ougnt t know that in lhe Lmied Slut*-?, v.i.u-it tf iiivUU'd up mu* ditfercnt region? m the raiirouu hu.*ines*. thetc are i wo it-gious that stand out an not 81 been quite & divisions. The eastoi very stodeat The south The nortnThe aoutdl The Pocab Tl.e centrr that is. exccc time that w< winch we mu Ti--is ou; the (.ierveral < do. s^d 1 tlur brine this th period--this out why it u t fault, or does I want to s. approached tt but we are ru the kind of re teUmg a claim that at is jugs didn't psv the we wouldn't like to see the: Unless we can and we still ba position to can that the first 1 think our and our med: tween mamte* are more poop dUVereut. un; developing & know how yoi ought to do fi in our Div time has been with all of you number ol met The Nation excellent medi to see some re a marvelous many of these produced like lacideot&Uy ::uinaemcnt -- r., the need ,of - to have CK*I :t :ti the way of ,tt whatever it . .u our proper;jUy `if s. strive .i::i--c.U ( pul ' * M'.u'-'Oi'.-.c', ' ! The . vi.' have * \- -.a a r**.*uU of ; bad ti'xwh. A maintained .-rsceoi - 't.t* *(> a ywr. vuig wsvei ot und r don't ; take the out wi. a - i. 'ts a***Hit > , miu dial tho have paid --JT' <~L-r<n*l chunk .-;r : .n ! ; or (-'a ; .uOf** uw**y - t.ul to tf;ins- ; ttuuute* i.cn >l;ift row...i-itvt further ..d v-.iinrsn:: our industry <o * hum *>; ucht t* go. or --idle for >ur v those cases * isdisidvd up ns that stnml I'r-jeecfiwas of MUml hm Section 72 otit as not ,`how`ini; any .apjirreudile inm-tse in the last t**n*y*ar?. Th'rr** has i ) .miten *r**;tirt;t5 reduction n .ii-eiditu* dun m the tin* work of our wiety | division*. The eastern territory has not shown a very Ic.r^e nrrease. It Iuj been a very ciouest one. as a mutter of tact. The southwestern region has been just about the same. The northwestern region is way up. The southeastern rrgion is way up. i The P^rahonras r*~ri->ct is way **n. The v---r, i.- :n a little bit. 'A-' hiiv.-n't a:::y*yp vet exactly *'ftv hut .s. h.it know that there were some v.v.wrdirt at. t^e ;-nu* 'hacf.v- txparc'j o:ir h^tres with i.r^vvia-e :nt'orm:ttmn w-h that h.-.cr. we r. vu r.viii back in That :s *ir general nurture. Now. what have been attempting to do in ?he f'l-r.crai Lh-.tnts Division.* I `runic the ftm tninc w* have been tmnr to 1 io. and 1 -.-.ink this season of tli year is rather .an stmfooriate one in wnirn to i hr.r.t - Wj thought into hems;, since tne Lenten period is a ^onl-*-nircninc i pericKi--'r.:s is when you tec roftitv devp down inside yoursett and try to finite nut wny u is that the world dofem't took so pood to you. Is it the other t<siow's :*.u:t. or >:crs u lie m your heart* ; want *> *y tr.is to vnu. mat i don't feel that w in the laduitry have vet umreacne-: '.%at -':>* <-i f^'.neration ivun eacn osr.er tnat we mould liave. af : .mc.iv cettinr to it. "o`>* v.ant '*> produce wr o:ir luanauctnvsu ri v-.:m *..at fr.cy i.uant tu nave, histcud of having a Titan '-'.sns a -.asn :::an ;..a; t-.c :< au anisic, or i n.urn nua teiuns a saietv man `iiat i.e :* ; .cc;mz .-is ..cures, or a memcal mau tetiicp a claim maa teat if oe :..'.n t 5*v tiese c.amu so rya-xiiv. e uouciQ t have so many accuienti. and v< wousdn ; have t>> many n.ramiuy cases, aovi you couid save money. I'd like to see cr.-im ail *t *ioivn r-'cether and tipure out their respeettve prgoiems. Uuii`;j can -in ;:mt. --oeeiauy in n- :;.rL<i ot personal tajury eiamt costs-- 1 au<l -< a?isi r. tvr-n r -i./iie a ihc decree we suuuul--we rc not gomi; to be m a l position So raacc uuctticent r^'imm^mlafir.r.j to our a.ar.:`.;v:ii*nt- c-/ i say .* a 'i;ii--'*:irra;:va. . r;:;a.s :.: r- r-cir.-i -a;,:ty uviolc. our t-iairu Oeupie. uutlawyers, i.cu i*ur -i :t;nl !'* r*ui-c ./? .v.-.-.i :.u,v {., tr-ttt pc. -cal injury ciaimt. There arc tnre p-.-op;-- '--ilij.-c u h-uv t. Uuruil'.-<-l;uins. and cvcry**n-s eils ussoincthiny iii:er**nt. ua:J < are jusc :vorc or lo.s> iicmM.-rcl ir-'m the t;witl;i</int of a -.-.i.r--f. 1'nul ><< aav.1 a .-icar-vat j/di--y. i duti't km*tv .'miv you van itm.'.n.n inn-iiiccndv. Ti.at is iho ba.%is of what 1 think we ouznt to <io tirt, ui a decree liiat we have never before atccmouid. In our Division, we are atreirvpttnc to do th-.t. I thiak a creat deal ot uur time has been .*pcnt '.niii memn--n oi me ."jo-iv Division, wuh you ccauemea. with nil of your medical soneties. and the lawyers. We have attended a great nu mlier of nweimca. Tl:e National Association of ILulw-nv Tnal f.'ounsel is producing another excellent medium, and l commend that to all of you folk, liccause you're going to some real results from that group in the yean to come. They have had a marvelous growth. A defense lw journal is now hems jmblished in which many of there things that we are talking about are some to Ik? documented and produced like N'.A.C.C.A. produces to the N.A.C.C.A. law report*. Incidentally, to demonstrate the weakness of the N.A.C.C.A. positioo in i 1 4 i \ j i i i i *.*'>.;--Vr ........................~ tv'" 74 Is+ocioU'in </ .t mmfin iiuiiro-srin connection with t(ir<- large wnitci*. s'i> have mudcn pnt-vif icnie::; tnve^uca- lion of all of the N.A.C.C-'.A. law journal.-* from the time tii**v i r*tif>iuhec them, ami we have documented ihcilixwonni'K"! appearing rn *:.. N.A.C.C.A. law reports. There i5 a substantial number ot them--airr.o-c iV) per rent. Non*our trial lawyers an.* alft* tou*e that wherever X.A.Ca'.A. arcs that for publication (or the purpt*cnf demonstrating that the verdict i? ore that ourr.t to be upheld liecnusc. (nr instance. in California. a man with a lee vf. n awaroed $125,000 amt it i? upheld. A? a matter of (art. the N.A.C.C.A. *' journal did not ritsHose that in addition to having an amnutaMnn *i the :-2. tie ab** had. peniati?. a a** re* e. n* dfaSdttv u> tlwr **ijs-r n-g. >- m^vm- _ :*ernt:.nt *:t injury to hi> hack. In the trial t<* rtietaui those pmuouiar ..muagvs. tbv titan only has an amputation. ami none *i the outer iac:<B>. so it !<;;* o--ti nu*- leridincts that ro-'rn--t- T*.n*e are i!,,- t:,mgs. r.r Ittsl.- t *'-. v. :*. if trui;. sn-oi<a- t.avi- -.-u. imamm resp^t to r*t*!T e;*--. Vo-i are in SsrvwtTm'i i e**' i:.* **7*yv X-*~\ .-.r give V*U an lit**a entile os tin* ii-mh'.: '>e -i- l.ie\--i I don : t:.j:;k \ve mivr uroumwt anv wnmwnur.mg r--u.is. i *......;:.: achieved s-Wk1 mums that Uavc t-.v.-.iv e.r iwi a'.-.-- goo-v a:-**.:'. . think t:.:* j:as given a mile in-art *.> .*.iaw- u; our t u;w eve-.-. f :..* \>i uur lawyers. a:iu peruaps .-u:nv oi our ;:;:Uia2eui*-!i'. in six vr.tr? time, one s.i<i-~fiu; lawyer m i cwuitio <-..t~*!-*i '.i>wi.ii Svfl!cr..-nt* an<i jimimiviui it--:;* ;;.e raimm-i i;im*trv. : .11 Pcnumg a*, n.e time mat w- t;yg:.i up uiin \ r?. i ur.m. and one ctner #vatv. iiv mdn t wan; anv ir.>u;>u-. u:.u :. .;*#* j i.^ ?ias. He went to :;e uar aSaocialiwU. ;m:i a: *:ir a:a f.v reports in to me airna oruv evcf>` >ix tvee*u so i\v u:uj oui ;.w crttuic aiouz- iie is n very Covm lawyer, a very nice enun m jaauv rr.**:K**-;. a-lnouitu unetuical Li tnv e.wit. lumchtcr: At any rate. ::::re i,e uoi fe..u.i-a auu since he u* ttvu.s tue kuia oi i-.ie um < nope all ia'.vycr* win sia" *.o u-'e- ue hiw acquired ouiy -- cares in two and out-iuai years, coiupareu vita i..c io cases a month that he was formerly Acquiring, Another Cleveland law arm. whose memoers were not sue:-, z'a-aa Wys *s he was--to other iroras. ttieir ethics were just a little i>it worse, ts many re- fpC-CU--has liour :a arul dyne the Mime tiimu m>w wuhm U.c a..*l months. Jioee that time they haven t irotten :uiy eaw. Ih- :::e 10 .*ee just what ueVehip*. r.V my to them. *UVfe not ;;.tcr.--n.*i ; .Mmiia-ul. just want you to live a e***d. ci--:ui. honc.*i life, and lei ;.n wnput- tuuiiy ;i -jo a lair turn lor the tK-nplo who work for u." T;.v_v t:ave *..j<iui.'(ieu tUeifcUaserai" fLauenterj Another thing tiiav we have done: we assisted the state bar association o: West \ iruuua m an injunctive action acaittsi a Ciucuao lawyer. The state bar enjoined this particular lawyer (rom soliciting chums in the slate, and also enjoined r.:s a very ettecuve man. Thi? happened about a vtsr ago in U <-t Vjrcuua. !' ell. t:.- court very i|ue.My manacl'd to get tin? cvniicuuvu ui it? jv.rirdtcuon so tiicy couid serve him. and after titt-y served him. he was inclined to contest the wcuon. out tiiey managed tu get him to commit hmiscii to a continuance oi iiif r;i*e. and ?o he sure cnougn was in court tlicn. and when iie came in to ucit-nd himseii. he deenjod he'd better capitulate, which he did. ILu "a he hful o \ of all u; t volv<*d. " leer*-*- A rtncp that : in the srati We had . that ntnhii: they know, prolilt-nxs tl III Si-tlltlir W:.-* !> 1. >- :< i ;nv to tell ' -.'rtiinerc 5* iuie ie.*< vc nau. Ti. .::ho::ay 1 ar Illinois t . l:*j:trnicr.t o: Mi.uic*f eo mtiief jiuiiai, we nun t nave "Tat-re were cious in i heir i We watched l wr*re (our of tl died before uc fcntniiee. S50<i bargain before As n result . another cum- u would aarec to aside. I saul. * and ie.-tiricni ti* emteful beeau.pumsiiinq you i I just don't thir road company ; sleemig cases ii break up." Their wives " Tlie solicitation ' I hope you re; or anything else conduct- I j /'rv'V.-*'W"/ .\ft-ltml and Cj'ar7if 73 I'-' V--'.Uli- *l*y .-< art" i r.u;-^MUa'4 .rt:.-.* n h- N.A.TA'.A. uir.'f'i. .cl pff .s'.AM'A'.A. lii-rt ton: /or -.eruiet is one inii ouant with ales03 is awarded WAA'.C.A. Uw journal Mtion ill the ied. he also .. urntivyc a yi'rnument :'ut Mr. i. to put ror.vs tcoji ii uis have fo demenstr.v.s. li >vtr-.-i che with uih-rniatvon. v-.iiis, l - fc*hi :v.,<iut urn tv'JOic. a have aod l or our ; <ad rv^cvtoil ->v>.0*^1.000 W-w York. P-sc-yiviniu- -i he tkialiy coftfe-i-.-j hi.* : our s'i;s:esi:ijn r a:..; H*j ;a.J out hove he ti pectins ^rti many respects. uitiioush *T vue <ot frUtpon andhnw .*< will jx^rt :o live, he Has lupirtrd -.viui tue to i- Out -;.;i .';* I :}. .<bit \v<ifs'\ .u __ :.y i<-- :.;U 5 hi* ! :' fifes Illl'IW.l- ire '.vaicUiuc u.eiu to ?vc i.iivttitt-u in p;::ur.iu>.tfnw. mid !-' us have :.:t vt'oor *." They u.ive M.tvii.i.iied ; His "chaser" divided to ti-^ht. however. Vnfommately tor the ``haser.*' i lie had * West Virsinm lawyer. anil the complaint had been dr.ticn tn the name 1 .>t all oi the kiwy'Ts or \V.~t Vtrcrna. so there was a cuntiivt at tntere<t :n| voiced. "llic lawyer w-s not able to represent Him. and he sicced a consent i decree. As a result. He has gotten no business out of the state of West Vircinia since that time, and we have reduced the solicitation of eiainu by these lawyers i-- in the state of West Yirrinia to a substantial decree. }We had u letter from the Attorney General of New Mexico recently, statins l that ambulance chorine in that state by out-of-state lawyers--ntui. so far *j ` . they know, by in-.-'-iio :.*wy.-#--is at an absolute r.'.ini?.v:r.v and ''.:*:** ar** to. i rrobii'Cts tp-rc. hi nf.i.-ni . ' v.*rr ;>d-; lawyer, *! of the i ia :r..tt >*;c.rr-'. Was -1-1*1. Sinn* tv K'w'n Jit l:as been two *>*:?* j v.v irifi- i imn ia [. .* ` `.r.tv --wl ':i'-t ;sV tronnicsona* place--:;a? r.-iur*i | ahout 4' i per rent. }' Another lawyer lias is: ix--n en;oine*i in San Francisco, and he came ui ana ;. mpituHuoiL Th*v :dl c *r.*i m and camtuiate. Tr.cy have various reasons for *. dome it. iw.t th*y oim? tt. and if b--*omcs a noitetne operation, ft u t*v) ; early to (1 *\ imf. is eu:i:c to isaopon to fius sjenttemnn yet. but we re reauy j for another one there. i WHiie dt.-senbinc these successes to you. i must tell you about one defeat we had. That defeat was not .Minteitunc tnat this oncani2ation onutaateo. althov.an l :v.r. the rerson w w> oricmateit the nrat action wnen i was :aen wita i the Illinois i.'mtr:ih The >':nr."uc t 'nn i liiinou has just ruivi aaamst the ; tiisiianiant of a lawy.-r u i.y uli etre'.cm-s! the uaaamation. saoui-.i ue out i of .lm4it;;**s conudet.-ty. v.'.- .* rnu' r. eviin liu. .ituation that ;t is ' rallwr pi::;:d. i.ui >t i yne >jt r:..*e {iii:..*s u::u wni happen to you. aad i hope , we don't ::ave it in our o.-dutii/.auon. j : Tlii'rc w*rv three employes o; a r.uiroad m Indianapolis who were v-ry vi- j i cious in 'heir .-oli'-uatmii actvines tor (. levi-tand lawyers -.usd ChiCaij'u iaivye.-j. We watched tiwtu pr^riv :-acn;dv. ami hnaiiy r.mcfu no atth them. There were s'wnr *! 'hem. .u a r .-<f fact, i-ut. iinfoft-raiteiy :).* us. one of them <. di<*l Iwritrc ivc cnuld bnn-i i;im *a trial; iKv.vcvcr. r!v f.'hcr* uot the ::ia\;nuim 'ft;ii-*i-*' 'ii 1I har-aiii ........ .j.. -.I,.-. i-m: ".-icy T*.vV : i-i f fli:;i<c r.`;vv -re fert*i a. : A.- a r'-!i:i' (' it a.i \.i- ..ikii by the -l.-sVc.-iam j'lawyers in :u<iUii-r i-a.-c ' > uM ut .v;.cti.,-r .%, i.ad .my mercy in our carts, and if we I would aurce *> vacating ;a:l .nirii.--;. -. trim: tiic cintrt to that cart tf it * Aside. 1 .-:ti 1. " i .i famlv. we'll be -had to.'' and l went down there person.dlv s And 5--!t:ii*i (fore me Tv.cv v.rc v--rv ^r:tti*:i:l, and >hc umoiia ..-.*re ; pmtcbil bvcit;;.-.* " * bad n a ii.Tl- ccarf. { .-aid. " UVre not interested in ue sv&te bar aasoeum-ja oi ii*`:ujO lawyer. The sUUi* tuua in tneetate. ana also ' happened about a year ' , puni.liinc >'iM i. duu The :liin-r <.* re interested i-.t is stopping this racket. * ': 1 just limi t think it s rerht that you should work and draw wacei from a rail* '.road, company ami <!n-n. to- the miiw token, take money from a lawyer for - lleenuy ca.-n into Ins hamis. ft just isn't rt;ht- Tliat's what wc want to ^:t,break up." . `ttiieiuua m its jurisdiction he * incUaed to contest t himself to a t'outsuuaucc i. and when he came i 19 * uicit he did. -,,j?s*Their wives were there, and we have had an awfully coo-l n-sult irnin ib.it. :.'.The eolicitatmn in fiiat territory mu been miucesi mthef substaittuliv. 1 ^51 y<u rvalue from this that we don't want to l*e punitive, vindictive, j-jjp? toythinc r>e. We would like to wta people over to a duferent mode of I'i^bnduct- <d*rk|):, J 'I 1 That cels me to Jim Stack. He i; greatly concerned. Naturally, he Is humanitarian. as all doctors ire. fl*e don't want to keep people out of our employ who ought to be employed. We do think we have a right to be seleo tive. When.you cleat applicants through our Division. please do not (and we have told this repeatedly t take the tact that they haw been rejected by somebody else u evidence that you should reject them. That information is given to you merely for the purpose of putting you on cuard that there had been some* tUinc wn*: with that man. Perhaps it lias been corrected since that time. You should inquire as to tl.it. and not depend upon li*c rejection from some body else. It might It interesting te you v> know what kind of rc^or>is v.-r are turning up in this eir-urUiChf -:.-v. rvrorttr.s >? ceiling mcrv.iMnnv important. '>: our :. i ::.r->-yr.:r'-r l:.t y.v.r. t*.e had i.'.li inquiries n'l ra!;rO::*i.\ #c !ur:.c.: 33 r'-eorc- That i; almost couoic the ri owi-.i- <.; :i;v ye::r tciorc. aid quite suustanuai.y more uau tUv trst year.jt course. Or. our claims repeater;, we turned us year, against lo ti.c year t tcre. anu IS the year oetore that. Anu. bear in mine, as we co atone. tnesc figures w,ii crow increasingly important. I don't know that l have sani a smeie thing about what i said I was come to talk about in the title of rr.y talk, which is '.Management. the Doctor ann the Entnloyo." 1 put *;to divi'v in the middle. Iki-iusc that? wuere ne i*. fDaughter) But I'ct coirc to >ro" the ooetor how to cut out of the middle ::na how to chart himseti .**. course so that when he center oui. ne s come to in* imcilinc like a rose. In the hr.*t piaec. I think we ve coi x> u;?sociaie ourselves irom toe apparent need ter bcinc" Partisan." Tne rattroad moustry aoes not want uie oocior to say things that are in favor of the raiiroau company and against me interests of his patient, uniess they art true. Tue railroad industry wants you to give the employe anti the mjurec person tue beaent of even- reasonable Jouut. Now. if you wiii pitxse pursue one goai. and that goal aiout. wmch s rt*acc the truth--and. after you get the truth, if you will not be afraid to proclaim iu whether your organttatior. t< controlled by labor or by management or by any other groutr---and stand steadfastly on that, you will ultimately prevail, unc if you co down, you will least co down with honor. I we n^u that mere t dav than ai any o:hcr ::a-.c in our i.otory. U'c have k*v many uoctor> v :.e are \o x-acii*u:<. ..r.J have . *;;t.sirmu:il irei-'e;n with dficno- ur.is doctor* ivheu they art ov. -i.v wit':*.-.? stand, btce-us* they hvMCito to ic a? posujvc.-ai.eut some tMi.cs as they ouent to I*-. whereas the {iintUTs doctor doesn't have that *u:no degree of hesitancy. That is open to a little argument here and there, in many point*. (Laughter) Now. records are highly important to us. and I think that we would like to have you. the medical denanmom. give us some statistics irom time to time on the rate of recovery and the rate of rcnahilitation of the disc eases and of the hack ea><;. the fracture cases and :!.r amputation r."-e-. I ;!.mk we ouciit to know' n.'ire al.oui tha:. Thru r > do a more otTrrttvc You iux\e a wonderful opportunity to do that. i<y rca>ott uf thv i:ua that you keep these |.-wniv with you all the tune. E would like to sec some stanuards. I would like to compliment Dr. Lonee- w*y. n' you plr.i?e. for hi? preparation of that very good application form. r,`` Ooioed Adkma. he for the eioim departc I think they ought vo have etaadarda. *o th; of StHwiarr} 1.2 or 3. \ Now. it doesn't men. upon thoee standards, mem waats- or no,-*. ; arc tukrna. and what r. standard that even.' o< tion ami srrtiop l*e w k.* y.u v.\n-;v;;l ar:i ! u; th^ : -J Aswl.::oh a?*vir : I l.* ,.:>u .- ov* prouuceu ny tne Hanoi; thv uat.otgiate tfuanu iiiow-s vou a metucal pic l ai*o coxmeno tins t wav Trial Counsel book meuicaidesai prooiema. ta*uv. I wouio like tc uctner the attuuues of c o::r rrcat: neec to tne r*?tre tnat man to bea. tnmes tintotter tnat unt :`.an vmn tend to m.I'ressureM are present froi know that we nave a big r I want to tay very plan that while we have made question oi treating these hind the times in treating I say that we claim mer r.ianaccmcat vs way behini inc otiirer ought to be just rentaiive. He ouclu to m welfare and the welfare of muse I've douo it, and otb< the hands of the lawyer* to sympathetic, honorable poh ality, but not to the point a really concentrate on that p got. and for his benefit, and work within three day* that to fad juit as sure as you ki oucht to da That's theooiy message I heart--1 don't believe that against the smoere interest o 1 Proceedings of Mt'dtcai nnd .iurmcnl Section unify. he i* ..:i wut of Olif :o oeseJec- ,22*i we have . by somebody .;a is civeo to .u ucea fon* a Colonel Adkins. hero--this Yankee colonel--prepared a iocn of Ynninwmn tor the claim eop.-u-rmeftts and the emownn; onieers of the nuirrwl ir.du.urv. 1 think they ought to be uniform ail over the country. 1 think you oust.: :o have standards, so that when one railroad says u rejects an applicant because of Standard 1.2 or 3. you will know what it is talking about. t!i - N'o*. it doesn't mean that you have got to disqualify a man on your rulroad upon those standards. You can accept all of them if that is hat tout manage* meat wants or needs, hut*yo<i ought to know what vu'r *ikmr. whe.u are taking. and what r;.-<s i re running. 3iit. at l;:wt. vm m-rtxt ?a rav* .r;tn::tru *hat every o':1'? r-.:!n>:vi *'.ud have. ar.d then l*t the dtjfvrmni- ion r.i i'h*ct;v* l*; with them. - r.'.softaiit. (.n lines from 40 .i tr.e showing of course, .5 the year ue- luons. that} . I roics: t> v'w-ctof and the ' ' act* iio i?. of ir.e miudie suing to be the oppxreat _^atthe doctor to '^ajytthe interest.* TTaots you to give .-liable doubt. : i rr^'l ^.-tuvnt or ;*y :r.-,v -.iy prevail, .uai :nk *.ve ntru ;i..u f,>o many vlovtur? -ii! -x::h defend' -y ucMiatc to lc -i -:.o nuuunrs ' open to u (tr}<n we wi^uid h!.0 to -a tune to time on ' eases utid >t the `nink c ouent to ,-ob. You have a it you keep these . .meat Dr. Louse* ..icatioo iorm. Malpractice, as you know. * growing hv leaos oho i*ou:uL?. There *< an cxceiieat article in the most recent u-sue oi the Journal of the American Med ical Association uaout mat. umi 1 commcao it to au of you. There w aUo an exceiic.nt study on liitnots workmen's compensation. just produce*! by tiie Illinois Citaraiior of Commerce, wr.icn you can set tv wrrtr.s the Illinois state Chamber oi Commerce, i comment! mat to vou. necausc u shows you.a meuicai picture m mere ivnica is ratner uisturoira. I also comnteau this bulletin to you. aou :ne .vuuooai Association of Railway Trial Counsel book, wbica I think will keep you mforsieu of important medtcai-iegai problems. Lastly, t *.vm;Ui like to >>.ol wun the or.o tr.mg tnat wnl oemans unrig *.v gether me uiutuo.-* oi ManagviimfU. *.:.s employe aou toe uoctor. What s r our greatest nee-i i;i the ireatmctit wi an employe injury first, is :> restore that man to fceuiUi os quu-kiy mu .u coipnieteiy as oo??toie. Tkc V things teat deter that improvement anu taat .iccompusnnvent are mmoiy those J- \ - things which tena to mate rum consider toilora auove ms health. These pressures are present from ieilow worxers. ms union, and from others. 'V- koow that we have a Gig psychological prooiem. \ [ want to say very pi.uniy. very 'iircctly. von- noaestly ^nu very icartesptv. that white we have made Tremendous -uri'W in the jnetiu-al r.ro:***ion in t;.c <{;; -' ion * trealir: r c u::-i .-ur;:;:iilv. we of" way <. iv.r.d '!.* liiv.vs *;..-aluid 'f'-'-n any. I .-.iy ';:at wr ' too. -vov >..'ii:n!, p.syrn*>|o-jica.ly. I -ay rrj.it nianaucr.'.etit is way l.cimn:, psyi-riulugicaiiy. because, lirst of all. the employ- ine oth-vr oijcnt to i<e just as important to the injured man 03 the union repre sentative. iic `'f.uht to numijin an interest in that man. an interest ia his welfare and riiv 'Afiinre >>i iuj family, ['in '.vIHmc ym this can ive don*. b~ cause I've done it. and others are v'.umy it i.xlav. and we c.m keep cases out of . the hanus of the bw-yers to a muen urenter dearer hv a arm, understandable. ' * symnatisetic. honorable policy, even one ctv.a u tmuM with a little bit of li3;cr- aiity. but not to ;oe romt -.vnere vmj -noil it. When we do that, and when we ': really concentrate no that problem and give chat fellow everything that we`ve }: got. and for his benedt. and not to spend more time on getting a maa back to y work within three days than we spend getting bim back to health, we'm going \ _ to fail just os sure as you kuow, atui we're not going to do the kind of job we f-ought to do. r ^t. That's the only message l have. 1 believe this, and 1 believe tt with all my 1; heart--l don't believe that a single employe, a single person, coo stand long t I'tgai&st the sincere interest of the attending doctor, his boss, the guy he works irl . i:Y: * ? 73 .-loetciurt e/ .!.iKn?i /.niiroeus for. if hr t> sincere. lie can't rtnmi t nvvmiie them. Jlc can't "*:2 1<, do swueitunc that is siappinp them n the face. ])r. Hul:n is one I know who Ims ilone a job ji>t like that r*----r.'.lv. Tjt. ML'iilrr is smother nn\ ntiri I *uM name <.th<*r<. Hr. Mi-bb-r ws-n't kbicrr.y you when he said he * paying less money tMfcty titan !- |<iid ten years r-.r--. We had a letter from one of the Erie employer that tee published ir. ouriuh*tsn. desrnbinc what n wondertul rciatiorisiun the'- had there. T!::.t * *:.* - of thing I'm phwtinc tor. l.rt's hutaar.iro thi- hi-n>*--- ni *r*iti*::; ui*n. Lets treat then; at least :> w*it > ut treat damaevi ir.2--..:u<e~. u:.i restore them to health. Jtc sympathetic. kindly. atlemm-. ami !:-.>> *-. them. I tl.ini. : :. :i':.ii. i'i-;il*;i a:i*l l :*:* v.it^ -;i m*........... *. . . f.r I--o. . f.:.i r: <:;t|r II.ole i ru:r'-:*<i in'h'-'n* hnr v.'-v : tfi Jl. i III ..! . . *11 :~ -: - T:.you wrv niuni. Arm:-.*.:-- t"t! HuxN'crr: Thank you. Ken (."r.rnev. Thai w.t a vnr.n-rr"; presentation. i : t.i>uu:;l it '-w.im men. r-enint*. j; ( ninm-: .i.-im-o*! v;:c-v -. pro:;i::.to t>er rrtii o: me iu..<: liu- tiitrre r::;:rua'i s:. . :>*rv l >{:*c< aim .w*v.-n is mrrT;!'ii re ev : - ' i'rexnrknuie reenru. short r<v.$ was taken.! iii.NNr.TT: Ocntiemen. sau we carrv on wun o-jr Very rrr.r.Kiy. -.ve re rtimidtc a utile behind time, and we nave some very, verr i::>.n'rrt-!ri M.i- ee:* y<-i 10 cover. V: are listen neat now tor u ovit-Siioa-aau:i:i.*w*r t-ciou. i v.ouiii hko to is?: your rvoirunenuations .u.u juaci-'iior.i as :.i -ui. r y< u ;mtik it i; bv^t that wc ruouJu go 0:1 witn the on.er ^rc-tmte- tiniv* t!;i. mornne. ami then have our C|uestloa-anu-answer pcrioii at ;i.e eao. o wc ran aii ii i our hair down and tic into each other, to nr< if w can wont ot;f our !'? interests, or wliether wo should have th* oiK.-iioii-jui : ;"tio,i umc. WUat ;o you thihU'.1 All ruiiil. lot's ija. iiei;: i-' . "T;.e rhsjihiiuy Annuity P.'OLT;::a o: ;:.t ::...ir.a> h..Vi.e.-. the, reason v.v are hrmians the ll. ::ie!" Kmk: . i^T.'iJi-* I 'l;inh u is :tu mtearal t>;rt n: o;;t .oof`rra:;.*,n is- twvvti me `Ui'cien! or^.Mittntions tviihin the Association oi Anienr*n i;--i- rorui; which makes our circle complete. You know and I know th.tr tf and when our men are disabled, and if and when they have accidents, ioturte*. ill nesses whien arv outsiuc. the problem often arise*5: is this man ai#ie 10 ca.'rr on in hi- own craft, his own occupation, alone with his HCiioriiv? Or. i: tr.U man '-nunot m, with lus own job. (lyes he have to start .d the bottom c: !(.1 ii-l :a a'Hiti.e* ':tea"ri l Also. < t!;:* ( nay out U.ulrviml Heuremcttl lioar.l bcnHili :'or rr.ef- men. ii:at i A. - some uuwb. l> there ativthin:; left m these men that we -un Use. ;.i taut ti.vv 2vt a hei-eitf livim;. so thai th.eir familiei will earn? C'.a'-;:" \\c..-n- u.t . ''hi.) *!(-' Mr. I 'nnneil tr b, an Uo i.u' ply OP5 Uer I.'l -r' n:. 'our eouu .'issoec suppor ieeti ability rent co: mental and wn aec of i Act furi employe ami me: the eve ami ere; degree c Act also abling lo hia cmploccordaxi' It b oi approach provided pioyera, e applicants accordant-under the You will &1 a busb for h i i. i- i*fKec*tin*!3 </ .!/::c\U `itui :ir-?vcnt .'.(tt'in \ uni t do --ntty. Dr. kiddinc yt*aC$ :tC::: ourbuH*- a the kind ::z !*|in'v*i :Oi*i vc --rt* f .is :tv:;ch trouble up a little :.;re ior the . .vonUcriui v :if>- . iv.iltwtn' *" .'isH'i >ir- :;r prccram. "-,- v**rv. very v-Tiindums us rr premia* -i at fin' u ; "<,r' the Itnilroad .;.-o:nl H.-tirc-..rivi ii\ i'\`* .rfl'-iUt n.m- tlv.lt It ivtld , ui/uri--'. nl.i.l-i to -o-ty Or. i: 'his he bottom ot it3 tor these that "v `J"' -.? Kxactly Me. W. it. ( ;t t <.: 1>.-si;:::y Detenaumtumr. lUtrvsti .i He* } firement C!:uiu>. Ufiilnaul Uelirenvmt Board. l.aiiiujo. UU: Mr. Ouurmon. t' ladies and ^etuiemcn: t [ doeply appreciate the ijracious invitation extended to me by Dr. Bennett i l and .Mr. Parker to meet with you here this momio; tor * discussion ot the Board's disability annuity prormni. I wo*iU be remiss at this time tf I .JM nut review with you some ot the sr-ienuid contributions y#u have made to prodfum and t* ->nv;y f> you < ?tn-*"re ::*nr*-**r.tioit tor v->*;r j crw.iiwn i- :.: :t i:.:> i.et-n ur.v-r* t .*. :>r -> many y '.<. Orrasnlv v.H.-Knit u;ii :ooi*-r.-.tion iuu<n <>t -uci.rr w* ::jvo would not have *'--n pv.-.*iMw'. In p-wwim: your I shall <-maienc* irom the iwmn- uir.i ;j "hen our nrst i:#.ibu:y '--niution rrovt-ami aumttties unon the 1 :iais oi tot.M ami permanent ciiuotutv was *naetel. A: That time the Board v.ms immediately conzroated v-ith the orooiem or evatuaune cuamiitv tn -iO.'/TO cases. Tu add to thu prooieta. we na*i no loetens. no source ot ac- <rvp.at`Je medicai evidenre to "moo.*: <;^bi;itv ciaiau an*t .no eueciac tuuos ;>r aunumstOrtris uisability ic^istation. A* sta-^e. Dr. llarvey dartie of vour .\s$o'*tat;on. wu-s sunuuuceu tor constutatioo and as the resuit ot suen. vunsuitation. the Hoard's meczcai poticiei wore ueciceu unon and a system of nur iievi cooperatiou was estay.mioi. Dr. A. M. vV. liursit aisoot' your Asao iation tvn.i leaned to the HoArci for a f.co y~ars and >mrm< t.iat time Boaru's miMiral stmt -vii or_*a::i:~i -m-.u ; .y.-teni ot ny-ifai vuoccratam ;.as nr ivi-i'rl to mriudv rir.y."o.'auy ot ..e eiuuioyvrs anu claauuye rio*:fita< .'.octalam;. T- date. er */.> per aii r.ui-uvai wiuvnce neeu<rJ : .'iipport cuabmty aiu.uuy :iupueaic.;u u teeviv.-vi irotn tr.cee sources. dccuon 2 la) 4 oi the Act unuer men approxir.uiteiy v) per cent of our ais- abdity claims arc adjudicau.-.!. provides -;nau;;i..-s ;dr individuais iuivia? a cur rent connection with the rauroaa luauscrv. and wio.-e permanent puystcal or * i. uieutai condition is such as to be disabltnc ior v orK m ti-.eir r-<uiar o<:cupatiun. j> . .uid who tviii iavve completed -J v...rs .-i 4<rvire or will iiave attained the f<i `K3 r.ii'i v.iil iiave completed :> ; --rv:,-.-. .-.Litton oi the Act farther pr-jviiiv-v fimt a-iir-;. v->->i-r.i;ioii ut ciurduvcrs and mployes. jlodi secure die vst^i/u.i;:i;efit c: ::;iidar<is deternumru: the physical :ip<l mental conuiti.xis ivhicii :.v-r:vas: .:::y .`.;ua;t:v -mployes for work tn t the several occupations m me raum.id mmistry. mu the Hoard, emplovers. .uni employes shall 'xjf>erate u flic prouiotion os the greatest practicable i decree ot unitoftmty in tiie stau lard-* ;.y .^icra! `Truilovcra. The Act also provides that mi mdr. : . n.v.tioti siudl be dccniol to be dis- ahlins; tor work ia his reyuiar uc^ummon ii ::e mil have been dtwjuaUtUid by lais employer because of dimibuity ior -ennee ia his rctuiar occupation in i accordance 'Mth the upphcable .-t:in<iardi ?o established. ' : It is obvious from the text oi the Act that Congress intended a realistic is*.- approach to the payment or occuoationsi aonuuiea. in the hrst place it tvaa t *' providei that statulards be cetaniuncti by mutuai agreement between era' b' ployera, employes and the Hoard and m the second place. t provided that }^`y applicants lie deemed to be disabled when disqualified by the employers in ^- accordance with such standards. Vou will note that {actual dbijualiOcatioa under the terms ot the Act vested in the employer aod not in tho Hoard. You will also oolc that the Board is required to accept your disqualifications as j.^y* basic (or the payment o( annuities provided your disqualifications arc made * iS? ^SSiteiri \ 'g , '- .' j 1 t .\ I l J I I 1 .. j 80 .43*0041107} cf Amrrxc.m Riiirovis in accordance with tlie standard!. It i. therefore. extremely important in your decisions oi disquiuiGcation that you first consider the permanency ot the disability and secondly. ii the disability is permanent, whether it precluded work in the applicant * particular occupation m accordance with these stan dards. In this connection, you should bear is mind that disability annuities arc not payable upon the basis of temporary disabilities, lu resotvuig the question of permanency, the Board's reflations are suiTicicntiy Wastic to per mit determinations oi permanency where surgery or generally accepted methods of treatment are contraindicated. However, the reason tor contratedicatkin should be dearly stated on your reports so that our mvriicai will uader- >tand the basis for your action. It. the final analysis. you should consider that if your di-quidifinviinns arc pm(>criy based upon permanency of tiie disability, and the standards for the particular oecuoatk-fi. that annuities will net be denied by the Board. Conversely, i: yr-pr findings d<> not warrant ?u**h actro*. the employe should U- apprised of your cip::.i'*o in tin.- rveareiso:hr.: they may return to work m i:r:r re-pe'Miv.' provided t:**-* care to do so. f.'crun:.:" m v.omS'- inic ounnw: ran j-rv*-i by the filir.c .: chdm: by em- .jilwvcs who an- not ei.-.iok-i for work m mvir occupations anu the proper putt to resolve questions of this character is with the doctors w*jo make or cause to he made tlie decisions of disqualification. In this connection, you arc retmsced that disability annuity r.nniicant whom you may uisouaiifv because o: dis ability are not require-i by the Act to rciinquisn their employment neat! until they attain the ace of 65. Tins i.- an imoortant consideration because some employes do recover sufficiently from tl.etr disability to return to work tc tnetr regular occupations. Following the enactment oi hcriion 2 (a - 4 of the A- t on July 3i. .*.? Board called upon Uic employers aau employer tor the cooperation provtaeo for therein anu in rfrs[>on*e tacrcto. a committee on standards was estapusn-a. Tliis committee waa composed of six representatives of the emo.oyerj. sis representatives of the employes ana tsree representatives oi the Board. Doc tors Hursh. .Metz. Miller and Clayton were otuueu to this committee oy the Association of American ILulro--:J. U'e found iforu mis committee that there were no uniform disability sunnard.* m the railroad industry aoo ua their cooperation we commenced to buiid sLiadaros &i nearly as we could to fit the Board's needs in the administration of the Act. N'evdiuss to sav. toe standards agreed upon were not perfect, but they have far exceeded our ex pectations for accuracy. During the ten years we have used the standard*, wc know of no case where they could not he appiiM with rvasonaoie arm equitable results. The committee designed the Board'? disability standards to meet tis our.;:uum requirements for occupations annuities. This does not oevcisardy mean that applicants wi.Q meet the minimum requirements arc disabled ior work in their regular occupations, but it does mean that applicants having leas than the minimum requirements may not qualify for occupational annuities. It was neeessarv to adopt the minimum theory of disability evaluation be cause any other approach to the problem would not conform with the provisions of the A : requiring umfortr.uy of decision?. In adopting this theory of disability *v;:;;;aUori. it wits eicariv rceoinui that many imiivi ji-ais hating the bare Riuumum disability wuuid be able to continue tn their occupations and that ha.- proven to be true m many cases. However, it should be con sidered that tlie standards are for use only in determining annuity rights under Ibe provisions is detcrmimm Having ado Chief Surjtuoo medical earac Tbe reasons ac vtoplows are d tarn of extensi expenditure oi t Form C-MIMT Cbivf ??urgv*ijuU you doctors r information pvi It i- le!i"v.-j invnivv the hea dwn-es of the > 'Tirdt-'crani- cr years exsminatio moat cases in tm rating purpose? complete desenot medical stall doe You may. thereto findings tn tne nr ability decisions c federal courts, it emphaaizca. We disability claims tL 10 but less than 20 they must be adjc showing of total ao for application tu siderably more exa tioo than is called unusual for us in U additional proof of character because t: liave a record of rec Applicants award Art to furnish proof Under recent amenc months in which ea aunt of $100.00 rega: disability annuities i the requirement that disability or if they r **e require ull diabii at ienst mire each > lioth treatment for ti who furou.ii false inft federal courts for fra: Croctviiivja of M&licol and Surtpj&J. o\du>n important in -r.e.hcy Ol ti.e it preclude! * i these sian..:ty annuiuca resolving the -issue to per*'tei ir.tthoos : uea accioQ. it they may .re to do so. hy -m.rroper niaee ,e or cause to ire rerun-led --ause o: -ii*.t r.gatj caul -r.tise ?-;iue *r.i in - '.cir -I. IJ li.the an provi i<svi - estooiUdcd. runloyers. six Hoard. Doc- ut'ee by 'he .nuttoe -nat V<` > - to -*y.'he -doi *vir ..-onaaie and --t ::.c nun- iisabk-d for > having -cm ji annuities. Uuitton oe :tb the pro: this theory iuais hivtn? 'CCUDaUOS* old be coar-Xt.u under the provisions of the Railroad Retirement Act and *vre never :=-i ;-,r csi in dKcrcuning employment ricau as *ich. Having adopted the minimum standard theory of disability \*v3b;ti.-.n. :r.< Chief ourgcoo Members of the committee were of the opinion that a simohS-d medical examination form should be adopted as * companion to the Mowiarcs. The reasons advanced in support of this opinioo was their experience 'hat x' ]\ employes are disqualified because of a -hnsie disability and 'Sit *S- '>remrj *in of extensive medical report* *hv.ving minitiv- rr.di-:- ..>< *. -xp-ridi'umf ?l:ir t:ne and--mid ***rv'tin'vorrh'.vh*!** pur*- V V:: I lul.sn'.wl f<r `.it? :/r.*-r - .r' ; .. Vhipircvons :`;jr their rotne-ien'i and 'Loir iggesti^fi* :ul you ; .tors n*cojni.Te hat it i.* ev. -> m>tvh the form f.h:t' i* -:**' as .*. -: ;. infom-imm liven by you on the form. i It i>` h-ii-vod !cntnfont to point mt that ov**r -JO per *vnt of or >*i*~* involve me iieart and circulation and over "jsi per cent >f nor involve diseases of the skeletal *vxtem. Th" obvious result the n-.-.-i :r *-oor X-my* m nonroxirr.ntciv *i*i ner cent **f our --i--s. In rec.r.t years ican.iaawons received from me Chief surgeons have been suooorted ir. most eases in this respect to the extent that they were adequate tor ab-amiitv > rating purposes. In the completion of your examinations for the Boaro. a complete iwriprion of the nU&bline conditions is mod essentvu nemuse *r mcdicai stan' does not have an opportunity to *-e or examine rac annssesa:*. Voa may. 'hcrefor*. re-t as.-mrot thi' you `-anno? *v-r-.K--enne ui-anuities tir.u . findinss in she prepamtron ot your reports. vVheo it is rws-Merca saat u;saevuity i*msii>ns of the ck^ard are sunject to review on sopcai to tne sevenu ; federal <*oum. the importance of ;uiequate exarmcations cannot oe over- i / emphasized. We might tuid at Uus ooiat that in ooout 10 per cent ot our 1 __ disaiiility claims the applicants are less than 60 years of aceand have compiete'l j' 10 iut lefs than 20 years of service. TVhco **' encounter casei of this character 1L* they must Se adjudicated under .Section 2 (a) 5 *>i the A*-' .vh:.\i recuu-ss .howttig :-/'ai and pernanenc diaauliity for all work. The nMnuarrii are :.<r \f. for nppii-'ati'Vi in thv*** ra>**^ nrul tin di*a:.iiity :--fmtr*n:e.';i.< are .-n- y '-xaning y gen*-nuly r--iutfe more vumoieie i- t:*in ':ia:i i- - -.dv.i i-*r <u uur inciiniiJ i '-rm It :=. 'h^ri-iore. ;;.ii : unu'iid :*ir u n li.v-- eu.ien in nqueat either from you or from other sources add:::i:;ai proof of disability. We dmll not elaborate further on rxi-es of :.bi j. character because they are relatively i'civ in number suui many of them do not 1" have a rwrd t;f rvcvut employment in rbA mdus'rv. Ac-y!i'an:> :v.-sirdtl U.qibiiity :inmnrit-5 arc r^amrai under *he terms of the Act to furrusii nr'**! of c*niinuanee *f di.sahility until they twain the age of ti-v r Under recent r.snendfnents to the Act. di-ahdity nmiuitix are not payable for i**'months in which onrninvs from employment or <eu-emnlnymv*nt exceed :r;e - sum of < UK! y.l r'-gardless of the nature and extent <i their dwibility. When ii disability annuities are npprovM. the recipients thereof are fully informed of ;V-the requirement that they report promptly to the IWrd if they recover from ddiaability or if 'hey earn in exrfi-s f SlOOfV) in any one month. In iwtdition, > we require ail disability annuitants under ace to complete a standard form least once each year which is designed to di.ielo** information r*trarding i^both treatment for their disability and their earning*. Di.<ahility anomtanu :who furnvih false information in this regard are subject to pro.eeuiion in the !?federal courts for fraud where they may on fined s much ns $10,000 or iai. H - 4 i -1 i . .'1 ;J  *C?v yi&e&rjp. S2 Attoaation of American Railroncj prisoned for ss much os one year. It. therefore. follows that our controls against malingering *d fraud arc ndeauatc in most cases. in the final analysis our disability procram has oot reached the stace of per fection but I can state with reasonable accuracy that it is bv far the most advanced disability annuity procram in existence. Again 1 wish to thank you for the privilege oi aridn^-mg your Aw*(cmina and 1 sincerely hope that it wilt .serve in some measure to explain the leeai and administrative concepts of the Railroad Retirement Act relating to daliy annuities. CiiAiEiiAN Dcxsctt: That "a* an *.vtnvr-y valuable presentation. Thank you. Mr. Connell. After Ken pave hU briliiaiit talk on our Claims Division, he was armarentiv afraid, that wv were ceinc to jump turn in this nr.--tin:.-:sn*-.-ir.wer T*enl. :.0 has a^kc-d me if I wo::it;:i t nlra!"* introduce ihe A^ss-turtt DiV-*-'-r of M--- Id*...rc::. jlriv .visit!.. \Vi.cre arc y.iu. ivt: :! N t* have v. In riosme tins ring oi our cooperation ior the AssuCiation oi American roau?. we want to cooperate m anytmne we can tor the help of the <vr.fr divi sions. IVc are wi-.se open to criticism and suggwitoai. "'e know that our n-.vt speaker has ur. extremely important position as ;.r a- tin* Association ei American Railroad- is concerned. and I know that ne has some things on aiminn whir:, might be valuable to u*= aii. It give- r.-.r a crest uv.fi v; pleasure :r> imr-.iu'.i- you thv (.!.airman >:' ific ir.T'v-'r.iv C..t:s::i'Tv \ :nmin.*iwO. Mr. Uweti CiaiKc. tApplati'v; Mr. Owkv Clai;*:: -.Commissioner. ii.tvrstiv- h'omnierce CctamiMioa. Washington. D. CY.: Thank you. Dr. Ue;ws*u. In not being ssatjueu a specific topic for ciicussiou t:us morning. i am re minded oi s certain commencement speaker at Vale L'niverstty, wao iouau himself in the same bout. In searemne for an appropriate subject, ne suuaeniy became inspired by the four letters in the name of ::.i: great s-. r.oo:. so uc ce- cided to taste four subjects as his theme or ten--Youth. Ah::::y. Royalty ua-j Efficiency, having in mmd the letters Y. A. L and E. Then no proceeded to lecture ior at least 30 irunutes on each subject. Needless to say. long before he had finished, one of the smarter students sitting w the back of the room remarked in a loud whisper. "Thank God. we re not graduating from the Ma.snchu.***t:s Ji.stiiutr of Teehnoh'gy." -Laughter* Wc-li. centiemen. don't he aiarr.iC':; 1 i;r.v? r.o intention of emulating tnst particular speaker. I:', fact, my <J:cttisiivi ntm:er.* of i',.r at tl:<- l.cati table. 1]t jc!l you ti.ai lawyers generally a *<yjrteo:is and time-savim: custom of beginning a fi-ngny argument on some fine and beauty point of law by teliing you. at the outset, what they are not point: to talk about. 1 have always thought that was a ven* convenient device, because it enables you to see at a glance that the information you really want will not be covered. fL.-iugtitcrj And o it just isn't nv-essarv to wear out the seats of your trousers, snuirmmc thrnugn it. Wei!. gentlemen, ui t:ie same spin: oi <*mirn**y. 1 think 1 should state nrht now wimt my remark* tins morning are not nn.m. They are not about freight rates or charger: they are not about per bicrn charges; they arc not about freight '~.vr shortages; they are not annul mercers, consolidation*. or any or.e of murtv otner controversial umiur.- wnwh mi.from and confound the Com mission almost daily, instead, ior just a very tew moments. I would like to Procecon. tidk to you atKMit the cenc: fSilwav eunrHm and the I. ( May 1 tirst thank v* jo thv Medical amt bunneol r scaimmc the urw*ri>iic* of usually you itave Insti midr of lawyers. Now. tdtliouci incs. employ your csoienc j do have a great d<t.l in corn fore. I am very tmppv ing. An cneetive tratisjion.-uic u<. llcaith :i<l MiiVtv. of gOan M.s::v *ectio::> of u.<:i cu:sta:.t.v ::: our 11 <ci t ;,c : r<\.. Cov.gtei. You ouctors. as uiUUstna the broau acid of i.uoitfi aa> tiggrei indicate dial almost try ware doomed by vn-tbresoUcd in ceaths. and app p.:e:u. The totui days of di: W.tK?0.t) cam-uays. "'hen the future effect evalubtvu tutu tuidud to u.c work tajurics wifi umoum t This ceruuiuv a war on we Occupational accments ba of America taan ail the war? \Ye know that suustauual effectively witii this problem nauouai concern, uno a cons' in a day when ac-vident veative medicine is iucrensm by more and more families, tunny to help improve the 1 that the ruiiroad industry h. of uiuu:.*i:d medicine m th when the newi tirst arsv. History tells us that Dr. J appointed railway surgeon i< Harper's Ferry, in 1S34. and used exclusively for the care America's first railway surges for the employes and passen of course, that many ncciden well trained workers to fill t found in the experimental eq the country spanned with rr c&iety. :-,at *mf commi* .1 the itaffft ot pcr: hv far the most ;;Uh to thank you hope that it i-lMVtf I'niTO1' .:>ic presentation. : -cij aonarcnJjv .-.ujatver period. so \ Director ot Mei- .Wc to have you . oi American Ra:i> ot the other uivi-.now that our next :u A.-iOciauoa of - <n:e things on ms .Aid of pleasure i 'imuisMuft. --rec CorumtssioQ. -^-morning. 1 am re'.'.erjity. who found :Sject, he suddenly .s svhoul. .-o he tie* .!:ty. r.-iy.tlty :VT-J. : h- ur'K-t-'-'i-'d '< mar-r -ns-l-i:.Hinnk klod. ' , r - ! v;.:f -:i:.'.*.* of ::;v ; a courteous `e fine and deadly ".ot cun? to talk ;-,'v-ire. because it uly want will Tioc -ear out the seats . -houid state right - not anout froicnt .ty arc not about .lions. <r any ot,*" mfotmd the ^ 0(n* -;i. I would like to / Mt-licni nnd Surr/icnl Avciwn :;IU to y.vi .*;e wiuurni .*uijvt of working Twiatioiw rf.e rntiway ami ll.e I-1.\ C. May I hr*' 'hank yiui lor the nnvthi;e ot appearing iM-fore rhi* sneering of the Mediral :mi .-ration t.> niscuis matters of mutual interest'' {a scanning the prorrwlms* ot s>me ot y*tf preetou* annual m<yins!.! find t:.it Usually y<vt hav !.m audre^seil hv eminent Physician!1 hr ,* _*--;r. i..-.-. I > ". :r :.;! ::. v- *' ;.unnv a ;.,* `.ft !:,,* mtlJJit Sos!*-;. T*:vt-'* orovi-i.-d 'l.;* :-.-r : An tt'.on ?viet for the nation ;s a vtf.nl concern *o .; of :s. livii*;h ...n;i of urn of primary inuH<rt.in*e *a a;aier:nr rats 4-.-.-.U M.ry >e*t:nns ><\* l:::er.*'rife i 'o:u;ue:ve Ant anruy to - lictr. n.vi -o jt :a ronstantiv :n our At ?i'-- <'oi;in;.j*ion a- coc.M-;er -.t : i- j'.so .M.-e it on t:.s ' /n^ress. runvrts ot :di the r.*?t:tatO!y .-wer --* :--,rtn n\* V-u >it>t>'r}. oidusirtal ucc v.taiiy xoncernvt. i xiiow. .virn ::.e l.road Uevl of i.cui:a un*i .*.xttv for ail the orx<ira of *ne, Ao-ent hrared iedfate riiat uitiost Amcnean vurxorj m .;u of *."* *v.-re uij.ioiot i y n uuun-.-s in Ivj.V.. ` r ;;-. ::: >.*; rA**;>t*.*i nonro*::: :*-rn'.:;i.ru*. :.::y-.j-ai ;::t';ur* n.eUt. ii.e '..'.at -i^ya of ;o*rsi-:iiry jfiija tniufiet A.-t y*-.ir i:.'*^i '/ '--'is--n t::i future *-.iVcts m tl. mnuu ;::ut pernuiuent imnairrr.enca are -vahiated and adcwl to the immoiiaic :<-s. the tot.d attririutai.i- to ir.c i 'no a-'/fk tnjur.es vtll ,u:*.ount to tii- -t.^ueridi; '.of.d uf lva.'J"ll `i*"* tnan-i::>d. Tills cerramiy :.> a *.var **n wa-ir- v. i.n ii u iiidt ."iiniiot <-oatmue to ;merz*.. f'u'eupationai acid.-ntS Lave it-mk-I more m t;. f A;;;e:;ca id -tie wars. o->uii-- ucami lort-utn. in *.Yi:irii ;ve nafe*--unc'U. ''* e ' v.t --u *-.-.y to..? ,:t:vJiai : r- ur........... u. .< m:i .a '.-.-m. '.i............ ir .o;.a mi.u.-r * t >>n ............. . :r.-itv -.:iou ... :t -.ay ...a-;; ru--.a;; a .* .> .'u in our laiuos. .v;.en Y-nuv; uiiatinne is m.-wa-'iiuiy ponmar. u hen srw.;> jlizaUou is ;i;rr;tfU : y more aau uiorv fii'.u.oi-s. u.c mini.-una! {i;>-ntaii t.iis an unusual -.ppor- tup.ty to i :-*:f> improve !.>>. l!; rv i, f: s-.-uns u*.e .-try i:nh--.|. m pioi.ivnni; t;*c t.eid -[ lU'iUdtn.ti rui'iiune in t.'.i* oiuiiry. Vour vi.-iu.vtry was ri-riamiv' young t wocq the need iifst aru.*e. Kistory teds ns 'hat Dr. Jarun (Juiim. uf .\(:irtuiMiru. W.-t Viremia. au aoouuited ranway j*.iru>*on for die Uaitunorr .v (ifuo from P-nut of llnocs to ; Harper's Kerry, m 1534. and as cam- as l.vih. the tint riiilro.vl liu*nt.al to he i y used e.YCiusivcly lor tfce care ot the su-k ami injured win oponc<L I )r. (Juitin. < Amenta's first railway -urceoti. i:nuouhielK` thought of ins j*i ani.-ly as raring . vf for the employes and passengers involved in nnaueuts. (t s nut .oirpnaing. ; */ of course, that many eceulems incurred in those early days. There were few jy well trained workers to till the jobs of a nw industry. Mauv .icfeots were h^ found in the experimental equipment, and the nation was so anxious to have country spanned wuh raiiro.-un that time seemed more important thao safety. I 4 i ; -;*&?}. ** S4 ,4j*oeario / .itunsn Raiiroais jjal cunc:'.:oiii> have cniflCW. Great amdc* have C"Tfi made. not otiv tn tec'anoiocica: developments but in safety practice?. Through the twrsiMcnt esorte of tr.e officem ana employes in ail brandies oi rniiroad i-.tvicv. it i.a been demonstraied that a naturally hazardous business can be made relatively sue. The prepress that has been made in raiiroaff safety ltas meant a nvir.p oi lives oi railway employes oa veil as oi passescers. j -- -- : * --{ Is the eve years just prior to Worii War II. the annual fatality rate. I am told, averaceu about S.T per million trauwniie?. The 1040 to *44 aversfir 's doom to 4.d. and there w a further d--ime t** 3.0 in rise postwar oert*i of l`.'4a W 1030. Since then. ra;*- has tide between 5.2 an>: 5.0 r>**r million train-miies. 40 it is apparent that & new effort must b* mad---pw.sfly in arw* of sr.fe'y not yet explored-- if v.c an* to achieve funtsc* improvement. T":.<- Inter#;:iJ< t> ,v-rr**-: :;u.::v <\- IT..' :TW" !-?.. '. T....T- . . .'IV *>.**-.:- . :;.! a>:.aixet*vr.;? i..-jr> *i servw* e reporteu: trar-rnortatton of esniorive** and emjov:y r.*~: ! -. v.* C3n;r..^iiirt- sue;. regulations. unit jnv#-?j;:iisor* of rr.:jrr<;:: ameienta. Ti.-r "trv- as a wi.oio. u? u>il a*- a:*i>r. ha? nesm n.on <-*oo.,rativc a:u: beinfui in enccavors oirecieo towaro tne eiirr-ir.ati.'.n <.*: sufetv we;k snot?. That real procrcs; has i*een armeved i= illustrate.: hv urs.z just one cxamtMt-- by tie steajv cerhne m the last ii years ir. the ?*s:mner o: accidents eau^-'i *v failure os sortie oart or ar.punt-nance o: ioeonyittvef. in. tiv year mnti ia?: Juae. only 73 u.auee.i# vausv>i i*y oeimive locomotive* v.**<_ rnon*n. Ti.:.t compare? wi::. i .-ucn acetiients rcrKjne.t tr. lvii. I T-sat to ?-' at tnis Point *:.at -e aaumnatc furtntr croaress an aiumr t;.e itne m raurotui ufv. unu there ni certainly oe oroaress u vpu artu au of u cosceme i witj! tie subject perform co:u*eimuusiy ano coopcrativeiv. j: u co our joy* io :t;e best oi our &um;y. Oat oi the createst temptation? tnat face ar.y man j* tne ocsire to ten another mar. aou to run t.ti jon. 1 chali vieni to tcmntatiuP at ttus point, aau xry to t--il you ir.rte trays in * iucu I Ueheve you can go a oettcr job. Perhaps it seem lee? mconcruou* for a lawyer to L*e tedme a Qoctor how to run its business ii I point out puickly that two of these ideas ready co i*c* yonc ftot only lie mruirai profession nu1. ;;.c- Ivuui t ro;v.i.-:'.:i as wen. Instcau. they f.t-a. wit;: a :::i::..`iTBt;yn ar.n it }<"m? to r.;.* :;.a: you. as metis ."..i o::i'`cr.*o: the ranroi.j.;. have a tromcau- ous',; or..%r.: ..^u :o do m t;:0r:. two Ti.v 2-irra.autrative tnak has !*ccr:. -a u:> you. jn a *e. : y ti:c t ymnussioti. *>VV took a major step iomaru :.i the ran Micty tii-Ul at tl.e bectamoR oi this year when we put toto effect our new atvaiem repornne ruies. I was pleased to cote that von have o discussion oi the application oi these new accident reporting rules on the prorram. Perr.r.ps your ur.-t rcacityfi will be that rules on tne mere rcrordtnc oi acn* *ient thn: r.r.vr turcadv iuippcneii cannot contnhutv mticr. toward a reduettoa :n minder <: ... * :;i the :*:turr. Put they can. Amonc older tnuiCJ. the new r-u.-s v-Ar-.iy ti.e relation the chief raiiraad mectcal officer to the t orntmsoioii. anu tr.ey provide for t much closer wprionc rciationsitip hetweeo ua. Vuu wee net let n>* recall u oi tlc new ru'-< Uie ctrcumstar laciudinc any r tc.^r.fal olficrr* tr.ecical attenti joveni the dv'c ru.es.'* !>V>. >wurv l' troversj* micht r. our revjHsi rule? In k<r. uurmc the 5 iv. ;;? nrm<-.... : a :_ar. s ir -'jri" atirf'rr.e: r.err* wir :r.fuiv-t iOir enn . rr.ysieai mcana - .ay~_,n louio rr: .ar.tr:: uti to anoth :. ;.-r our w.v v *.:-::cr--iae ootn u .*'. iu::v. it is oi v. ...oi'*: to return to -r'.uaav nave rr*-ov \ meed tiu resoou.-iD '.j;owirise. aa<A aieo reinoaiiouue* of ran :,or,j oi rauroao accu ia;urea employes weriztu woric. Txie dc* mea. that is true--tin zot by esanai officers Our *x.'.nunaaons si to service when it as their reedtar dutteacould not perform any their injuries. IVe are awnre of the are tempted not to rep good safety record. O i.ut I'm sure none of ua layman s faulty dtacno? urgent ano important ac l have bevti told tlint responstbuity tor the b  -,i not only to r:.ro-:;n. tne pvcacstcn* '-v.! -vrvicf. it has -.as enact? relatively .v:.y r._i meant a saviog -..tu-ii biahcy rate. I am ~s0 :o '44 average was penod of l*J4b :.......w-n :r.u:wiiiJftj. . *. _r-.:s oi' safety : -rr.r-s with many i. program in* ...---i .*_:i-:y upi/uanctis. ;ri >; TT"-:< e reported; . ?. * insure : ^vt'.xcta. ~ :.-c .-oorvrarive and <: - if*:y weak ?pou. <v*.e example-- ... ..:sr.is crueu by r.-? yvar -fused bit r-porttM. That .if pr-'g:*?* ait aiong tnt j.'t-; it you ana nil of us jsaa -jcsemttvely. if we am :s the desire to tell .tuiion this point, and * :i *>.-cor ::uv redly ;*> bo- l i I l t i \ i > i .iiroiiy. have a trcrr.md- >:rr_'.-.;T"ivc hits '* `Con a major ?tcp r.T.ea we nut into ' to r.nte that you have a * -lies mi the ** :.*e*e recommit oi acci:ru<m to*-am a reduction -i. other thimfs. iU ~ t-ucai otneer to the ' -mz relationship between V'CiV-u.'m ot MniieiL wvi Sid'otn You are probably already familiar with the provision I have m mind. but let mereealt it to von. The orovi.-irn to which l refer is found m S*a?i<in 12.3.14 >f tr.-r r.w mi.-a: \V: .-?i :u?c t< umv.-Tutfity as to theexteat of iinlnlity, oil the '-..runxitafi-va sitfruunuinc an injur.* will be thoroughly investigated, inciuc-r.p any medical attention renuered. which tviU be submitted to the chief meoi'.-i oiaeera of tr.e earner, and in the lijnt oi ail such circamitanees and medieb attention, the professional opinion of the chief Thfjbrfr1 otfieer wall govern the determination and duration of physical incapacitation under these rales." i*c;-.r tv. nvr.d that a"*' are b-.-iiiRi: with those c.t--m where a enn- *.ruv--*.* r:'.: : "> . "..at onst:":?-'* a rraortanlc n^i-ivnc. l.'nder riT :-.-t i r-por: .; !? ient is one winch involves ittii amtn i ..-isn "o ! :::: rremove iutficient to tneanaettate jim from r*er- f'-rncr.r : :ir?.i nv--n*.Y::iy end witho`iextra:v*i9nceau :mi i .nosa* site t.*.? tr.s -luties customarily induced m the asst^ament of the err.t.oyo at the time ci tr.;ury for more than 3 days. 72 hours, in the arrre- ?ite. the 10 days i.T.a:iately fodowtnr; tneaccideot/' Iz ;r nrofvsfior.r.1 .?o-.r.ion. ho" often can a layman determine toe extent <A a nut t injuries *r.u ce sure his ciitunosu u correct! .\nu. iioce we are voncerr.vo here with a procr.osia. as wen. who but a trained and e.xpenenceu v:ncer .an hirveast the course of .i man s recovery, or the duration or his pr.y-: rai mcaontitation.* Isn't it Lkwv that n simple error in jmi'rmeot ov a iaym^.r. .ouid return an injured man to r.w jon too soon, aaa tnus poisiuty coctntu'.e to imothcr acviaer.t or further injury to rhe man. mmscu / LY. cm ;r new pr.>.-~:;;re. you. as chief ruauical omcc. wui 1/C cauoi noun *o d'r'errur.e both ?i.e -Mont t:.c i.uration oi injury wnen there u any ua- een.ainry. It ;s <ii vitui ur.per:ur.ee ui ::;e public interest tr.at employes not at ailo'.viM th .*et>im to peir w<.f .< u;uu lue mwicai u^cer is coovinceu that tiiev actually r.uve recovered sudlvicnti)". in otuer words, the government uas placed respunsimaty upon y.>u. turn :o you i.mrausc of your r.iadi.t^i know.'-Us. anu also i'-.vause of your 'inoersiandinp of the joo functions anu respoRsi: .:*:es o ru:r.Mi :r.p,.oy?.-*. 'Vo turn to you oveause our examina tions of rturojvl accident anu nsuri'-v hies that o:i ?ome *-',asiotw. :r.;!ir>-: < w#,*. --v.irr....; ..cinrv ;?>" wrre pny.-iva.iy :;hi <i<. '.a-tr /.?.:. .i;c '.c.j :r. a.v.-s wor- i.uae nv -luahncd raiifvad cu-.-n. t:.^: true --. ..-:<. i -..us. u:>efvi.o>ry rrr.pioyf"'. *.i.V:y.api::it3~'/Ut nut by ucul oificvrs. Our `ruminations ,-howf~( p,.u:iiv that -ome injured employes were returned to -r.-v-e wn-n :t was ohvmui that the .men could not possibly perform .all of ti.nr r-".~:...r di.tjvs. : .. .a ,-ome la-tancvs. it was round that employes co-.u-i r.- * ; --norm any o: *>?.*:.* *.Mular duties oocause of the senous nature of thtfir ipyc.-i^-i. ..re -iware <u the i.u ; that m -mx mi'inccs. over-tealous .xupervisora are temp*-.i not to rcrort un injury, or to ;maimize one. so as to prusefvc a. good .-nfety r<v:onl. of rfirse. we are all interested in good safety records, but I'm rare none of us wants xo achieve x safety record based in part upon & layman's faulty diagnosis nr nrocnosu. Therefore, as l see it. you have ao urgent and important administrative task ahead of you. I have been told that some 10.000 physicians throughout the country assume responsibility for the health aad safety of railroad employes and passengers. -.birr <!^--ul11"dippw"* N .'.O' S6 Attocsaiion of /Immeon Railroads some of them on a full-time ba*u and some part-time. While that -cems tike 10 awful lot of doctors, f assume that it lias nothing whatever i do with toe fact that *r sometimes hear the railroad industry referred to a -ick in dustry. (Lsucbter) 1 con t lurlieve there is any connection. Cut it i the chief medical officer? of the Class I railroads, throuch this Medical and Surci-"" cal Srction. who are really responsible for the smmiard* of health arm N*mtntton on ail the railroad?. You have unquestionably dm-Hopcti excellent standards. partieuKriv with regard to tin? kind and frequency of physical examination, hut that is enlv pan of the job. ceoth-men. Mtt'i: p.t*<v remain- t I-* 1 l*4fve yen wtii turns.- e.-itL me that it is le:*;:y (.-.-/uei- * up the standc.ffis and tte-n wait coutpiarentiy ir *ac'oocy, .-dueutti-rc. to comjHy with titrn:. Pltc.v- don't m;.-utKler*?a:d n:v. I'm v-t a.-^-uMi.e anyoo** -t '..mr-hi'v-ncy 1 know that v.iu l::v- ?r:-vi tv. v.r. So? ~v r<-- nm'-t,.l*d h. and 1 '. i:._- v. ;; Lr.,- - i;r. :...\b. nici I;:-'.-- n- : a -- e:- : y--:ir r---'t:y; ' 1 am tiiortiucnlv familiar wn kind pr.hl-ni t--*-*:** *i t- mtrai witii (*.i'* tho t '-ma.t-MMi. AY pt-.t^idv-u.- ru.-- non rceujutwn? to the extent that the Oarre-* etrect- us to J-.- hut Uun.i.:. nature jk-ius 'fun it is. ue must .-ees voluntary eompiutner tiv ttt the metjimi- oi Dersuasion e know, and in audition, ue mutt etiiorce wmpnuticv y mean? of nnv**eu* tion. rrUiee voq hick tie to*>U os enforcement. v<.u must rc:y soh-iv m per- sua-ioti. ?> your >,i> is to >ell n-.i.road mantcement on tj.c tn.:or:anec t-l tr.tsr udontinir your reevnimentiatiun- without aceeptunre a* minimum sttaas.ru?. 1 rt-h-r t--{ccuiiiv p: the stunu.ru? v>- physical <juaiincuti-*n- o: per-ottm-i. Csu\>rtuua;eiy. there .* s uisturnuu: lack or uunurmitv aiunu me citterem r-Uroaiic. as 1 know you are weii aware. Thi- iacw <: unbumuic showed up most recently in a survey coudu<-<<-u amuuc ttie Mernm-r tvoao.- of the .V.-e-ution oi .Vinerieun tU.ilroads. Of 11U tliut replied, tin .*i i>orn : xuui they require a physical examinninm as a prcrcoui.-ue ir uppnennti iwiu v.-o; *u work in train and enettic srrvtce. uui only V.' of tlsc liu rmutre pervaic yhvsicai uxaminaunus atu-r eoteruic tUe >ervirt. Ti.o ti a lainy g-oou per- rentage. but ii also mean? that 23 raiiroucU (ana prohaoiy mute, sau-e some oia not even bother to repty to t:.v o.uc-*tionnaire) do not require any turtuer ph^ical exunitnations after the oncmal ehwk-uj*. And of ::.r v2 that do. many ri ;>*neti ttu.t tiny havv n;oatti'ii i:u- r quiretnent.* ..<u rivom- metiaed ior nil jui-.-vournt .''o;nC ' i li.e rusirnuu- ,.,-.;usrvi: pnirioa* i.- i:i'.'lf.<- eri<>. titwi uni t<r tli-.- tr-.is:i m>. rep-.-uvt that \un*ir<uiiou> a;e ^n\u vniy once every 3 yc::r-. betwei-u ti:c ujri-s of 43 und 33. aUJ-oucn tiiey do re quire aunual phyviral cxammaiioUs utter 33. A number of other roads require annual examinations only after the man has reached Co. aod in sorne cases, the periodic e.vanunauuu n cotuc.-nvd oniy with the nusn'a vision. lu.< color sense aod hU iicartac- Tnc ComniU.-inn had no <:trisdtctn.<n over the physical nuaiuirutiuns or the yf*eand freqiji-nry r.| exumtiutt i>>nr n-r rvsiroaii employes, neb 1 wnm t<* arsur? you tiau we want no authority. t_\. ncri ? did Oir.-ri the Cwminiysion. however, to prvscrme extensive rules and rendition* iu this held for motor carriem: and vr* have done s,>. We have presented ripd standards as to ihc physical quali- 6catiori' ttoa N last r*hy tl> Rll-XH or trurK Tiu? r. uu-'.rv. = the panli n:an> i .... m t'inereIr ' uiiivr-T ipparc;:: . nvfc n: r-r-ive act nr measures are vatne ur just uiston-. tie c injuren. At other thinrs. t standarotzeo ; Perhaps tnc very least, ho uniformly ttm believe you re-double your be adopted fu: u.*at thcComn There is one because of it; ; accidents cause-, equipment of ai has to do with o day in nnd day oi many po*stiJ> a pianc rmshiiu: A dtsturliine ti human failureblackout. or a io i r:uit .-oems tike -r v do ivitij the . J Mk'ii Ut il. 2u: it is the ivcu-si and Surgi- -*n<t sututa- ; art:, many with >nly : . -Usvy y<<u .. '..-at. ::;t}tactfP.cy. .-tr.cnt i your . '-`f them .-.-.j.. nave lagged , i.-c - '.deutwal _j ::;,j r.-puiatiotja :u:;:rc being :.i d; oi ver.iust-'ion :.;-dr.5 f nrc^rcu. .; ...;..;y ..!i per- nar.-'C '! their d-.iu.u:*.i .`.aadarxis. . iJu-Rs J operation ;.do.-n-.ity aicics the . - kick of uniformity Mcni.v.-r Hoads of 1. uil r**cNrt<sl tliut piunnts who went ri- uic . : --i ?''r* :.. -. -if- -Ti'-e ..: :.y i-.r-'.wr ; 'hr '.'J that ilo. .* *aat >**u .'o'.om- .y T.iUje cTv'-'>. .:;.::.a:;was are envo -thiusa they do re- :.vr r.-:uis require ^d ta i`ir.e vase*, the -:oo. his color Sense yuaii&cnooQS of the . aod 1 aunt W >urC ' .mmission. however, r motor carriers. :ud toe physical quaii- Srjuion.? f'i- bus and *r: driver*. and me rrquir* an .-tnftisu physical 'amir.v ''n. .'.[.r-.iv-T ." rl::t? *i :**otor*< .*r*!;*r*j. ?ii**mtr.s 5v *f 'he iaal piiy-val. 'w vam-'-i ?ii- driver nr r.ti ':rr.'S. Any fv.inre hy 'he driver t measure up to these r-viirvmetu* means *nnt he r.inv no longer driv a bus i<r truck in interstate rujv.vret. This mntht fm to :v.v.s* a hardship on employes of the motor carrier in dustry, and we reside *n::t in some ra#it.Joe. but the public interest #nd the |>uhUr -ui ]., :.:dh-.':iy>. after a.L are rnmii'-l. ' ..-gr**^- r^^gnim! I . '.if.;.-*? -' .: *;;- *^tn a*.j>i .-n*'.n; :> * -? -u ?> j . --< v*. ;::' :-y .-viiwt.'r ::;o i .-.-iim w- .;;:j ;,:. r urvti liirurtwi rocnae minimum -tAinairi.i ter tr.e nny-irai itiui.iricutmns : -di a.i v.'inc ; .-r.-ufimn. itiui the ttvouenev w .-''vaaminnuou. i.ic ' Vttii v..ui;,i sin it;es :or v:-iati>ss or #i:en regulation*. in wv :X>rn;.-t *::e c--irate inn r-'_i(e aim r**r'.-;d:; . n'.nv.-r.r i ;j ur niun.-a. '.".c nurmuis wore utun*. ante > --t ; up meir own -i:udaf.ts. ihit :: ;j i(-a m tv, ; ?-an>iaru&. They ih.--vine tt:orv apryirent who ait a. u *rna vtuin-'da accident grabs tue m-wuur.c.*. 'u-.-re ...d ..i--vnetd :<r :nv.-*'!in:itm.> anu * *.r- ; .V. Ja ..... ; : .............. i' - ur *----m ait|s<*r::y. , ::.v -:;'.dalc. r--*-ri-w t ,.. . ;.-.~r ... '..:.c :.. T'S'..'. ' > a-*S!I*o au msi.uri.*s are : "f-'-.-ct ::*-vndet-raini rad v:upi'*yvi r.v.d rr.e tvjsu.: : qenvmily, and ;o*{-*rii if/.jrvvr.tion cur.- and reoccurs. U I tame up it:* : tjo f r ne o: :in' ra*t trazic rabrt.ad .ic;:denrs m *ur | htotory, : ;.* :.V t. -m.-i ::: persons used and J-- .v-re iii;f.r*-t. \* ' ; :;:av a .--.'..-'i ; uthertninu*. * -'i::.;:.;-,. .' ur r-;.: .5ui*.-*l i-.v.uv.r'is "nniy . ':n:f'<r*.-?y .:: i :- ali ai.*';;j:u- :d l h-ii*ve y/-i . re-ioiiijlv y.i:t :< '> -.viii'-e rati niairnyvnienc fi;ar :hoe standurds mn-t r.'i " 'h : f:.i"lia--a:*.*n. I v.ant t* a.t.-un' you r(:r\t aH of u.-w ihef :::: :-t ' '.i ` . :npy >> '.v.r:< :.vj V"ti in ;i<'h:ev:r.s tj;!sooj*-tive. T'uerc i> "rit r ' / y'*ur work 'hat 1 want to iou'*h.oa very iiriedy. b*fst.'se of :'s ai.*e f : -.v ':r.oivl'*>i'_'e in 'he inner haute to prevent those accaient*'".iiii' hurnnri :.i:!ur>`. M:iu t::f> rmn :v U>iv; way :n du\t?ifpm''it ; equipment of:: t;.:.< 'ha: '-an '. *?**'ratd Mi;ciy. Ti'.c priniem that remains ^ has to do with iouinefu >: me m:ui who `-an operafe this *puinment .safely, day m an*t iav out. v-i-h'*)* c.'tuns tr*w\v -v oortst. or without makine one of many ;s*--.iilv Inunan "rr- y-nt xaui a tram reartntrvrran umhtitiknifnt. a }*iane>T-..-tiuuc into a mou:::;in-i.h?. ora truck imniin into a imtizu abutment. ir A diifurhinc number of -o-.-nt rail :uvtiJcn<s have resulifil. apparently, from human failure--***me ut:n:.-*-<*so<i physical ailment that -auet a temporary bUcknuu ur a los u coni**eiusuuss. ur mturol frutn some other rouse. a ,g--- - r- i t \ i i -J 4 v.g :S +** 3S $S .iuoaat&n of American Railroads One category of accidents rccularly wvesticatcd by the Commission a the type caused by ft failure to control the speed of a train properly. In six men- dents ot this kind investigated in recent years, it was obvious that thfetStDcer had lost consciousness or control. In 13 similar accidents, the etimneers were kiiled, so their mental and physical condition immediately prior to thF acci dents could not be determined, but those accident' were surpwt. I am sure that no croup has considered thi pnblem merr serv'u.'ly than have you- But much work must Ik* done to had the real answers, and I bdkrve your -Srvuoo Is the logical one to direct thv needed research. For example, try. iir.ie is known of the hypnotic eneet ot rhe constant. prwTrtuKi* mov.-tm-m l: t<t the eyes of an cncio'er. The cancer involv-d in i,vp<~ ti-rr. i-T.*c of a Hat. unbroken buiusrape has lone been rrrveburtl by high way dc-icncrs, and o* a result, trees, shrubbery and other hnvr )x*i added in a varw^y and at location* destco*-i to hp?:k :!. r.-^ -t .nv al-nv <w turt.rik. But me mil: <r.d ttsr::.*--'* :::* *.v 1 j > * r n v* . ' r.i.c r: i.r.c 1j.,*vi i*iC.';., rtvv-. <? :y ?:* Mvnnv. f#w.pjt-;f,vd drone nt it* powenfi:! cneir*"*. A:..j t a:.- .io we know mkmi; the ?ie?t t'.m?v*nturr *'>r tin* ren. i- ;.<>w fr.ivn .-ncinecr newt* remain at* rt ana wute hwsa-V Y.Vnii r-?*mi2c that an or.rmccr must >e r*nstni::iv saerr wnuc at me control.*. At > ruuvs an h'*ur. ne nns.y** a srmn: even* n::at:*e aw* a r.as:. it I - w- -on* hv patent hnd himself swanne c*-wn on ano?i:rr mm. r.r.n r:t > r;C*> an r. ur. :t "..imi take at i^i; :i mi..* *e-:s. .y i? st-ii n brnan jh-w i/>r m*w >msv :sno :::t'.m:v* re..-;r: f r.rp.-cp.nrufc tiau such won; miuuiu i*' mvuvrtawt-n w your avessr.-rt. t*;: :>ehr.i:' >: -,:.c i.ummwio juiu c: the nu.vjc. i smrvmv urev lent you ctv fsvcm :;;v CvOsiacratioO to cuustiuc stuarwi in tots uuiu. Now i om to have taken ouite a bit o; time louav in ttiuac you experts how to ran your 100. Perhaps tnat is symptomatic oi a ot-ire to escape tin- rex:;::-.- < a )*>b as an aojuau-ior. We Cuntmtssioners musi mien every u&y to arcumeoti iratn o(>j*<.Mnc parties. 'Uu eacu siuc tu.itr us exactly t*ow we shouia deesav the cases, so, v-nh a lawyer s usual disreeard tor locxc, I stood here exercismc that same pnvucpc. i itacerety hope that you will and some decree of rr.cnt to tue several recommendations 1 have made this moraine. Ail e: c? a: ire Conmus.^on n no arc cor.:-* rr.iii with radronn fatetv are lookmc onvnr.j iniprovemetit unuer t:.c t.f.v a.'i.utnt riy -r::nc ruivs ana :f;e scc.:r.,..'`.r.'.'nc jt,o mat w- arc n.*ki;:c y<-n N..tur...'.y. -*t- unnri:u,tc a r- ;-.v'i':.irtcc ny .T.vn: .-i' y.-a* nammusn .*::ii^iarc.* for phy?:- r;u,:;i.nvaiif>n.' n-.'. r.-.-ui; <;' y. :;r tK-f.-iut.*><n. and wv Ik* keenly i.m- rv>tcd ir. tiic* hridincs tluu w* in*;v wiil eunsc ironi your rescami into the Lypinnic and other effects oi the Diesel. M:iy I wi-h you conunued success in these ventures. Tli.-ir.se you. '..\p;ilau*e) t'it.uftM.i'- Hsanutt: Tiioiii. you very i p'* r.-.-.ii'f !: - ;u-: Mr. C!:.rkiv. i.r.i ti..- w>r < know. .\.r t. brkv. you have looked over <iur (*ry^ram. and you wiU uoiire that tomorrow we have the sunset of "Human Fartors m the Design aad . c* i r:;*j* nnn : i: i th*i c koo No the ci we bo Mr. meet prohle Mr. if \*ou i Mr. distinct a* a coo man, I : sutamest) This 1 tell you Emmett requirem 1 think whether Each r&a Commission is the -ruperiy. lasixacci: uu that the engineer *s. the engineers were .;iy prior to the &cei- 'USpeCt- . re ?oriusly than ami l r-ik-vo r-*i. For examine. :. neiitious movement ....! ;r. jv^-ihie hypr.o. n t-~* gnued by ruga* objects have been monotony along our ..; haled by unending ..-.ed pities ;u'.iii:r.z by -Asuic.-s that nilgai be ives. or by the steady. : me eao. or now xr.uca ic.` *Vy ail rccr*cniao he m.L-scs one step tram. :md at ?0 r.uiv= ._-ivc research. I: seems ::n by your Section. On urly urge that you give :v in tt'iiint you .\Cefti : a c-.yiro ;< vt-eape t!-.f mu.-: -.i.-rvu every gay xactly ;..>w u-tiM : : ! gn\ i -rand 'bat you w;U end some '*' mane this r.umi:::. -.-.icty nre ;:>-kmg T-'r-v.-.c ruies led :natimuiy, wc acneipau* minimum standards ;or MSi'in. and w* -liail iie me -rent your rv-caren t isrke. doctor ordered, iram. and you wtil uotice cion in the Design ana Proceedia/a of Medical and Surrnail Section J Oneration m Railway Equipment," to be discussed by Dr. McFarland, aod i you wiii also notice item 24. "The Value of Necessity and Method of Examio* ins All Road fMaia Lise) Employes at Reasonable intervals." That .*houid take in the other croups, also. I do boiieve that 1 have failed in keeping tab procram within bounas. but it r has been very interesting. and so valuable to us all. 5usee we meet oniv once i a vc-er. we have to take this back home, digest it. and pass it on to the other doctors who wrk under us and with ns. Wt rt-uiv have a ; o. A: ;r.-~r:r.g# >f the t'-mnuf.e.* ni Direction i have :u.tcct how- .......... ...a get ,r.2;a-.iT.vat in here w:a us. to discuss tiiv-rc oromems. VvV haven : quit- tr.at ruig which maces for enure cooperation among an our <^:aartrovtit*. * As yr.;j know, as we nentioneu prevoiuav. * *tu nave two goalie-men acre v;th u* wdav who are very e:cn in management, i '.urtatray uon t want to embarrass tntm, out l ,usi wonuer wnecher Air. Tuohy wniuo say sometnioz as to how we client approsen this problem, to have maaaccmcnt meet wua us tut with the Interstate Commerce C-mmiassion. or iduircan iiourement - Doaru. ar.a the Claims section, so that we can au?e t;.is rung auu worse t<** gctr.er. ;n harmony, ana procaoiy tick tots prooiem that is lacing us tvttay! C- rtiun of the raurcaus save uirge miivnge. and they not only nave passenger *ra:r.s nut they save -.vr-edertui .stab;ishment3 along tr.cir tine*. i iaiopen to > l-gra.i .*f this section :a;s year, and I zpuiugiae for the fact tr.at tne :::-.it I a:: v.::cr y.-.ij ,3 the canoose. because our -rvices are entirely freight. ;-.r.c I f.i'.vi? teen told via rvvor.u <x.tasions that if I vaotcu to take auvunuigu "hat r::.-a uq war ra.ri.au. 1 aid rt'ic the cai^.-ose any time, i ..a t .-ay r.at witn iwr.y. hut i do rr.cu:; tr.ii. how cao w -vu management cn ti.e iu-.-w <f sitting cows and discussing tt.cse problems very :niu*dy.' I feel that with I 'he soooeration o: our many departments, we can show management, if they know rne preoiems. how sve can prohabiy save them miilions of dollars a vvar. N w. i may be 'diking a iitrle big, out we have to face these problems. When he doctors get tr*ger.er. we talk mcaicin^--mterverteorai aiscs--utiu pernaos ::.::v:g-mcnt wi'h :hai. 'hv.-*' -.re mir '-wn -nocinl Lr.'hlcms. Mr. i'::; -:;g ...-c .f y<n i;:tvc :mv ;.ivas on this, ii-.w - nn we ?::ia nn'Micn: arii'icn:-:.' getting :::i:rtage~:vnt to Mt ;:i with us. to r-*il us 'heir Ms. Ttohy: ('!! :*:*v here. Dr. Bennett, because you won't miss a tiuog yr'u -..-n't i.ear what [ i.av*' io t> 11 you. fljiugnt**r) Mr. Chairman. Mr. Chairman <,f the Interstate Commerce Commission, distinguisr.ed friends and rae?t. (n the first place. I am usually referred to as a i "ai man. not a ornfcssioraii railroad man. If I were a profe*sionai railroad man. i might bo aule oo a nat tr.vi*q Clarke niu done--l <*.>iild make a few lUCgoMioDi ana teil you now co nin your ousintis--tiut I can't do that. This has iwen a very interesting aod educational session for me. i ran only eil you mat so far rts the Chesapeake <k Ohio Railwnv is concenied. Dr. Cmineit runs the snow when it comes to any matter of standard* of medical ' requirements. I think if there is anything for wmch < strive, it is for a cooperative team, whether it'a accounting, coal traiiic. merchandise trathe, research or medical. ! M Each man knows that he has his responsibility. We don't have anv hne Una 00 Aaaocwjfcjn a] .\ntmean Raiimnaa o! demarcation about talking 10 the other fdlow about Jtia i>u-m-?a TV* that. We make fugccstions. But when we come neat down >:ril m,.*oT- ing. Dr. Emmett's word is going to prevail in unv medical neito-r We encourage ond do have frequent etafl meetings. It in'r hard get those boys down here to the CrvenhrwT. t'l.-mcnter) X*t > but Dr Emmett seems to have sort of seasoned us. He *ct5om*d t:.c alt mv <>r -*ver* weeks ago--alter working on me for about a year, he cot mv dw te Force Hospital aud did a little surgical worn, and when he gets vnU there, h,- rosily works on y*u. not only physically bu* fuiiiniaUy ~M ton. (l^uchteri I think. in fi!i HTtousm-js, there a a itml for l^trr uiHicf<t.nilirt* on th* part of top managerm-tit. Certainty. we r-*nmtz- jc v *: lem. and * know 11.*> color'd n mount* it; ctattn- w.. try v. go ; or t .............. t:r.v . wi:. :. *'>i*-^*x'; V . - j , ::.-jog-. k<< ..'!. :;*{ .. replace f>n--i* ami \v* *en r*twn<-.. o*m-* n.v?--~| *<-.. < g-.T:hr. :lw r;;:J:<nd h:; i* ir* i-.. them. i , l think it's a matter os n rinv-n-dnv operatim:. It- m ins tier o rr.- uv- amour t.':*- ihuiartment.*. tin* etaim O'-ttamr.vm. the b-gnl ncrrirmcnt th-nantm-tu. It'.- n matr*r #! tanningano r*ot'-n. mv: 'he more w ran v-'-ogniz*- ittiug.. I mmk 11;- vo*t r*v. w;;> ...jj y.'*;r prr.ntvm. And y;iinr gw i< i*- grKJ ::J<;.mt*n. i >u have t.. rut n us* ~r- !!>' v::y* t'.ur you n::t it iwrv v*tuv. Mnvi*- you j;:i :: t iwen i i^-.i- ntiv acrr-uMVi-un n-iiinc us on it. iw*rsu*c I iuon"*^ < rc outran, and wo re bury, we ttjink #c nave u ht os (tunes to du. anu mavoe wo don't sit down and listen to these tames here. Frankly, I wiil that I bun u conceptKiii j the.sizc. toe tener=?W;. *he s-:npf oi t*nur worse j;ere in tin.- cud of the A.A.U.. ailhoucit we are a mem ber e: the A.A. t<. I'r.: iorr\' that is> a:l that 1 ir.ti tax', but w ore ix*ry oelichted and feei highly honored to have you gentlemen--and uanicuiarsy. vour latitw--**mv oowo So cur iittie hostelry hero to tlw i<aij vi West*. Virginia, and ' liopn you can come back rrenumtlv. f.-\rp!::y>i- ; \.v Ur:.v.\;;7?: Tiiatik y--u. Mr. T'."hy. 1 thiiik-thni throw.* ri;* : ..... to oxvn >> let ...............tin::-- l.-eeUwr. :.:td *-- :: .-!. ii.:- proUen:. Ac..:::, i put H up tu toe nuvtinc :i- :i whole. UV are IteUind time- It s bvc minute? of one. You haven't eaten since sis o'clock this morning, when you ail cm. up. Wo tili have rumihcr iiajser which is extremely important. Alt right, let's curry on. Next on our program is sin informal discus-sum on "T;.v F:-rt tiie D><csor Will Phiy in the P.vjiorp.nu f the 10-lf* Hevi-ion of tiiC le.tcrcu.ii* ('oimr.or/-c Comun--ion'.* Ittt?<--* f-'-v-nin.-: Moi.tp.lv llrpon- .f l;-;:ir**::.! .\i-rnfom.. \V>.- ii lli-aiuv i .:iv' *.svt- >.i; .J;,m:::ry 1. H'.'T." I bvkeve tlnTf no one better anl*- to <'Xp-:isii this to n than Mr. II. I*. Iiaruuton. r?uovntiieiuh*nt of S:if*ty for the >t I.oui-->*.:n hrancwu lUulwav. of St. Luus. Mi--otirt. Mr. ilmuiltuu. iA}i|bu?ei Mu ;L:uoi a LvntuT pr. ::si man'- n k1 :> ' u u -.-i i L shuul. wtts not to fletjnptinc 'harctfj wi: The Mvr ;U't had th' ut uimoraii: ceuonkic rx cuo;prbeno .Mr. W. i Traniportnu caa Uailroac tiie rutes. A Mr. John T selected as a t w*s*sked to 5*on after i Stephens retn active in pre: Jcisuu very fi and roniom ' At a recent etission of the one who was cx be thcooes to ; tattoo under th and the empio) want U* fay tUs for the many ec the new rules all railroads. It must be rer. transportation * W'e do :nl shont- to .jet . hut Dr. or ^ovcn < C'iitnn :;erc, he nruiaUy. /Voeecriitui* / 'f-dicd S':r.;ic-Z .'..V Mb. It. I*. ff.uiti.rnN ;.Siw*nm>-ii.i<-ui .':uc<v. .~t. hrr.-ro {Saiiway. .'st. fatuu-. Mo.): Mr. i. ..urin.-i.n. i'i'tin.riUUeu (oiv-t*. 1 : fo-n'icRHfj: The invitation > :u yur prt>trrun-. -::.,r:-.v -,r- pni-citcd--i-j-fveciiiv x h hen :t rvaiiicd that you halve a {nil pr-aram many lovhna-ul <u!>;ects so di-M-tus. yet tnund time to discus* a ir.nt'*r .. vital ni siie railroads of Arr.enea---*hc proper and uniiorm mwn:mc t-i at*-*: tea:*. irv- My subject i"Tlic Part tfee Doctor VViil PUv in the Ilenortine o: Accidents Coder rhe Xew fluits.** Ftsuiilv. the doctor play a v<*ry ia:r* art. k:mJ i;i ju*t a trw tiMitueut* l will the mi*-* oer*.".i:ii:i^ to *. : -.j u.lV."' - r^-rittir -he ml : :-.fl;::eilS -ration. - .viilil it un .'r r---n :;.a. ami .ivne we a n.<*nv a y..ij . n -.ii : the rrj '.{ K. P. ..awav. ;alt,Tii.^ ivnv *;.ey v.-re Col. I".rst. ns a safety r.utn. t wan* '> .*:ty ttsut ;a rr.y omnimt : most ::r* r*.*.:.; thins iu a sp.-wi surety nri-smai is in prevent *J:c acescent. Ti.c .-.-co::c * -:r.- pioye morale. auu t::e third is tt.c recoru. i: yon are success;ui m t.*.e ":? /! d.-n't have to worry -snout ?:;e tjiirb. f: -hotui :u- uau---r.'t'..'u hy ml cori-crra-ti :aat the purpose n the twi.-.-n was r.ot n mice anv'mns awv :nm savone. mtt to ^'uorav w-,:n :r. A : lh-:vT':ny An; ns russi-c nr c nsrgia w arwi-tit. -.tve ruurouus treat -..-.ns leirrvo with jiiirtrru injuriea srhen no siecsu-.-sst. is mvoiveu. TMi-ajisers ni ti.e ir.'vrs'ate C->i:'.;.`sr-:s vfte .: :. j ju*t i:s<t the ni><ure {' i. -srr.s. Mr. ' v,-n \ i:-.rke. rsmseii . : : ti urtuorr.uty ;a rvyvftst.i ml ;n;::< e<u. *!ivui h<: a . '... a-mnsne nsirr '> arms :;s ....^ urn :;.e .letxirt;:;s A.'. .... : omprchmii cuanites m mnu au oL-.ratn.n v.j;.<-n :.ave . : -jrrea in .*r. v.n: y Mr. >V. II. rsti-piiens. netter known :<> "JJmc. ' Direi'tor ot :r.e Bn.r-.-su Tmn'portauon tccncmu.-d u;ni rotsuv;A-u the .-A-socn-.tion oi A.~er:- K- ran Haurosds t> appoint a cma::v.-.-k v.-nn -;at: iu the r-rv>. a the rules. A eurr.cu:tce of r.vo was app'-inr-.u ; Morse tvtth Df. aieanca*. Mr. i.-hts T. ::::oy .f A--.'.i.-..-; ..... ; ii.h-.iny a.% c-tanannu. i -oh-^'-Nl a fa-rr.ber h<' '-'-rrr..:"'--. : ~ :u:f!ve in ;-rv; r-.nev 'A'.- Ur. atvi.-i.vna ur.a Mr. ./o!-it::a very :'n:r. -nni :tn\t..i:- '> `.-/-.un u ...,-t, vt rules that would he practical and i-r.n:nras wift ran Aei-i-h-nt !h-''Tt::nr A.-: .*.* ratyt'd hy C'< r.vei3. \t a r.-e-.-tit in > i is'.:.;'.- o -..or. ' ir. J. i.-.ani ii.-r ar. :nnr~r.: \i.s vt tin- t.ew rt-.es. he dortors a nice compliment, lie w-. tae 'ssc ufso w;u *:<>ts.-it<'ntiy ;n mvnr or having :;r ihiet jursreona of the rsnrcanj the urn's i<> 'tn-r-rn 'he dvtvrrp.tautrofi and dursita.n .-i ttv phy.-iiai ir.- latinn uutier the new rules, -iiouhl there tie a o-ntroversy hetwevo the evatrany ami the eniphiyv. A- rhun::nu <u' rV <vmmiUce. rcprcrentia? the A.A.IL. I want to .-ay thanks to Mr. hu amj memoers os the O x.*r.^*:oa for the many n/urfo-ie* shown our v'.imimttve. nfid I'm sure we nil hone `hat the new rules will promote accuracy nod unuvrttmy tn rcpi*rtin^ am^jr.^ all railroads. ft must lie nraiizcd that the ratlroaUs are in competition with other terrs ot transportation which are not required by luw to render personai injury rapor.s 92 Auoctatum of American fiaiiroaaa to the Commission as. the railroads must d*. pmeumilv all reports rendered by these competitive forms of tran.'p'rftauoo am k-nt confidential, white the railroad reports are open to aoyonc who dtaircs to ser- them, or who wants to send in for & report. This matteris being handled by the Commis sion. and we hope that it will be corrected. Dunne past years, the milroods have been ehareed with many personal injuries where no accidents were involved, the alleged injury being nothing more than an unfavorable physical condition. For an example, an employe cones to work complaining of his back hurting. After wnrkinc for mi hour nr 50, he states that be started to lift something and hurt hit Ira'vk. He did not slip, trip or fall, nor was there any mishap, and yet a reportable injury was charred to the railroad. However, neither the industries of Arnernn nr the railroad?* competitors had to report an instance tjeh as tins. Ti'-r-- wer many -:::iiisr caw which could discuss, nut time d<.v% n*'t Mr. .i'-'.-n.u. his stati and rrnimoer-' of the _:;0 u .vo 'r.'.o iy correct it a> much a- t>'~*ich\ r-iir>- me miuiuk.i.. As stated before, the doctor? wiil play an important part in uniform report:;.r by the ranroads. Mr. Clarke mentioned a moment ago. tac new rufina which give* responsibility to the chief surgeon as the one woo wouia govern me extermination and duration oi physical mcapaetcauon. ana in m opinion it is one oi the important changes made. At this time I would like to discuss several <.i tne new rules witn you. First. . of an accident--r25,12 lai An accident o an occurrence arising from ? coutsion. duraument. or other happening incurred in the pnystwi opera tion c: a rasimac. Earn of you were iurniiiicd with a act of the new rtues--if you failed to ootain a cony of them. .Mr. Parker wiil be mad to furnish one t<< you uoo9 request- The accident act requires toe reporting of couiuoos. deraumenti. or other accidents resulting to persous. equipment, or roau ued. anting from the operation of a ruuroau. An accment as oenseo in 125.12 (c; is *ometsirr which results in csiernai or internal injury to a person, ana presuppose an occurrence such as a blow, impact of a ifcomouve. car m&cnmery. equipmeat. tool, material, or otner ooject. or a slip, trip or fail, or any misoap usu ally usroreseen, resuiting from an acuon ansinc in the operation of a railroad. 125.12 (d) The Act makes ciear that "accident" and "injury" are not syn onymous terms, and, therefore an injury must be the result of an accident. I. eder rules 125.13 the doctor play* an important part tu uniform ri-jxinmg. Ihss.io--Occurences tiut to.be cias.*nj as "accidents arising from the opera tion of a miiroad." *.a) Ir. the absence oi any mishap the application of physiol exertion alone shall n-n be classed as an accident. fb) Disability through aggravation of an unfavorable physical condition in connection with a mishap as defined in 125.12 (e) shall not be classed as a re portable accident if all the evidence is non-conflicting aiul clearly indicates that *u.mishap of it.-eii would have been tnsuifccicnt to cause rcpormoilitv. D:.-ahuuy resulting uione ironi tin- accentuation of an uniuvorubic physi cal condition, in the absence oi a mishap, shall not be classed as ao accident- Id) Disability resulting from illness or disease shall nt be classed as uu accident. Would In the profess, tion and du We are c the operati requested. The man: possible to r I believe :tv. in oite of tc rutin-ad? wL Mr. Clark Pcrntec in try -kW keep j. rcr-.'rtisg. "t opmiofi wner Cs.Uiui.uv .A general followed.) (The m.eeti rally ail reports confidential. v them, or who . hy the Cucnmis- r. many personal ,'y being nothing . pie. an employe "l tor an hour or ;.-5c He did not "uoie injury wan America nor the -U. There were * oermit. :*e the situation. . unuonn report. the new ruling :.o would govern .id ia his opinion .-.s:h you. Kiist. -rarfsnee arising .: physical upem* he new njiee -if to furnish one to ^eojUsioas, derail' 'road bed. arising 23.12 (t) ia sotne- iad presupposes `n'hjnery. onuip- ny mUlap nu : n of a miir>-nd. are not >yn: an accident. :.::orm reportinif. :'rura the opera- .-.i e.tcrtioo alone *nl condition in - riassed as a re- 'nriy indicates . * reportability. avnrahle physi-. as an accident classed a ao 1: \ ' & Proceeduvja of Medical end Surgical Section 23 fe WntUl like ur you to review nilw 125.14 M). In doing so you will note that the professional opinion t (he chief medical oihcer will govern the determina tion and duration of physical incapacitation under these rules. We are confident that the doctors will assist in every way possible by giving the operating officers the benefit of their professional opinion when it is requested. i: The managements of the railroads are going to continue to do everythin; t* possible to prevent rv.*r*r>r.nf injuria to their employes and to '.he public, and I believe that no one *tin ?*> that a good job. iaiety-wt-e. has not been cose in spite ,i the fact that many aii-g<vi personal injuries liave been enarged to the t railroad? which should not he *hnrsrd. aince there was no accident involved. Mr. Clarke and ali us rhe members of the Coranussioo have certainly co operated in evert* way thev could to assist in the revision of the rules, and I have found Mr. Jeisma and the others fair and square at all times. We deepiy appreciate the interest thev have shown, and we are going to do our best to cry to keep from burdening their unices, and try to have accurate and uniform repornng. You eenuumcn can nvip *os oy giving the bcoefit of your profesiuonai opinion wnen it is requested. H: Cu.uaaiA-s Ue.vnctt: Thank you Mr. Hamilton. > A general discussion on uu the papers presented at this morning's >eSaio& followed. J (Tlie meeting reversed at i ;25 p.m.; f>.V i 9 - *.*< r iSr.- 94 .H-Siocxaxion of .4mmean Railroads SATURDAY MORNING SESSION Murcii 30, 1037 The meeting reconvened at 9:40 o'clock. Chairman Bennett presiding. CuAaa\N UtKSirrr: The meeting will fticxv? come to order. Good mnmint, ladies and cemiemen. VV- an? delighted to see vou here re early. I think at this time we should thank Doctor and Mrs. Emmett and Dr. Clayton fur the very iovoiy party which they cave on Thursdav evrmnc. ii certainly* v a lovely affair, and we are evnatnlv irwi-htv>i to them u*r mi.-:: & nice time. (Applause) Now if we may carry mi with our meeting. I think urobaitly Ken Oann-v would like to make a small announcement strait a mmuie wi.jf-fi wifi b" }5i-it: in Philadelphia. (Ar.isouncement ijy Mi. Larncy.,1 Cha:;;j:.\.\ i'-i:.VM:TT: \<-u. Kin. We will now go on with lue program. ana now we corue to Uie tmcruaitooai rlnvor our procram. ana. m curie. urcdctaruied have our imcniutiotiai visitor.- w-itii us. It i> certain:" a pieasurc. anu an honor, i can assure von that u was quite a joo tor ,-jitn- ui tnesc men u come taese trrtai ufetaitces m order to be with us. so tuat they might pas? on to us some oi their cxuenetuw I ho:w that we. tu turn, eas oe oi value to them. Wc are especially ceiichted tocuv to have with us Dr. L. J. Hayuoa. of use Brttitii Kaiiways, us London. Lsg;au<j. D:. Knydoa.1 (Appiau-ei 1 think you already lave copies of Dr. Hay.i.m's auaress. 1 uuaersiuuu Dr. - Isayc -u wiil ciunorute on that. aad idea you cau ask him nay questions you may oave in mioa. Dr.. Kaydon (British Railways. London. Etigiatidi: Tiiank you. Dr. Ilcrsr.'-:;. Lad.es and ceatiemcu. dr;. I a.iuiu hk to say a very sincere `thank you" for hems asked aau given the high honor o: addressing you today. 1 cur. l find words to express my reui delight in being wuh you once more, uod I caa o&ly hope that it won't be the iast time. I thins: there are two c*cntial differences between railway medicine in mv country and yvurs. r'i.*-;, our nuiway-. a* y->u know, are nationalised. Pc*-* onaiy, we have a National H<-iiin Service. as well. Nau-yiiaiiiatien uf ;:c rtiiw::v- doesn't redly unci't the medical servirc* a great There are -ix region* on tisc Rriioii Railways--the Svc-lta-h. tlsv N\-rtiiea>tern. Midland. Western. Ln.-tens. and the Southern- We are autono mous to A large extent. Above the regions, there is a Body called the British Transport Commission whiou is not oniy responsible for the railroads but tor road transport, for docks, for canals, the hoieis and catering. They are really policymakers: as I said, the regions, themselves, arc autonomous under the direction oi the General Manager. At t:ic Coiumissiou level. tt>-- il re'ivii.Miiic for the dirctioa of the meaical services is cailed the Manpower Advisor. Each of the six regions has a etnef tm-dieul officer, but we have no over-aii Chief metrical officer in tiie (_'-iiutm-.M.n. We meet nan commit tee every month. Procftr and f discuss env proK lives which the Commw own bodv. -nd he hnnemen eacn month. Nationalisation of the child tn Great Britain is both employe* and em muralv SiOO a week b' mntnout- a similar sum I *-hosii. however. sta:nvm. hm at- ull Age : Widows' pensions. The result of lid* is th .::idort:ikv any trvatmvn ":f i;:::r.v:iv j.-rvirv t* i.yraieun*.* ivf rnmioym* i.-r aumi-Mon u emmovvs prior to resum. We si~. : ctiurse piav o me. iigistmc ami water .l.ihn Ambulance men nr Historically. Railway ia 1S47 a burgeon was a .a--* of accident and sic There are also records panics, of individual act and stall, {mine back to A Board minute of the :s desirable that District The same Company is : Employes, and the reeor salary oi something unfit It wiil be appreciated in Great Britain t'other t staff made their contribi 1S57 the Company took Most oi the ikiuway C local practitioners throue birk Fund" and they we The bouthern Railway tion oi a number of small find of the appointment IS67 the bouth Eastern I I think there was some have someone on hand. In 1924 the S<*utherr tioners in various parts They worked nu a partexamination of all applic examination of men and ;tt presiding. -aer. > you here so ::.r.:c:t ::nd Dr. i:iv i-vcnuvr. It ' them Mr ,:.Iv Kc:j Carnev .inch wiii be livid ::c international - ar international ! ran assure you rent distances in 'MD-Tv.-nee:. . lluydou. of the understand Dr. ^j.v questions you fnank you. Dr. * "'l.-U-.k I c:'t re. and { an m-dicmc ui my Mimiued. re*c- .--rv:- e- a e S-otti.-h. I he Vo. are nutono- -rt <*i.mnu-'>ioo :*irt tor ducks, kern- as i said. it the General .irevtioo of the ,ve no over-all o every month. Pr'>ccr'iintt3 Af .'feuieoi *! .vircrenl N-<::> .1 and aw discuss any problems that may hat-** :n any r<mn. Any j*r**o- lives which the Commission make are done rhre'im a laum *tho-r. one ni mir own body, and he hrincs them to this meettr.z. We have .-Utematinit Chair men each month. Xationaliration or the Health Service means that every man. woman and child in Great Britain is entitled to tree medical and <unriml treatment, and both employes and employers amtnbufe a tv-w'kJv sun r>wrd ?h- **-, roMjr.ly n v.v-*x by -vh ynrrv 'r>ntrirre a similar -'im. ;::-;er*f*-:eMt *r --it --mov-v d r-'Tv.i rtmuUi. :sxvvwv**r. <rn*>* that nils nv-xiv levy -'overs not orilv r:>*i!'eti frcafmerif. suit ;i:-o t rid Aav P<n*!f*ns. ir:<l>-rrrrvl f.rurv ami Si^kne-< iv----hrs. -.mi Widows' nensso/i.-. T:it result >i this is that Industrial Medical Officers do r.nf in Great tintrun undertake any treatment, otner than first aw. ana as far os our >m work in the ilaiiway .vn-iw u concerned. we coniine oureeiv** to examination of auniteants for mtnoymeut, routine ;ure examinations of .suetv zrtmes. exami nations for tidmi.'.-ioti <* tue Mirermtimtalimi ruad uuu tno examination .f employes poor *o rtsumnuan of work, -vr.o nave ->in*-reri accident or ickne>s. \V> also uf cuurse iay *ur part m accident prevention, sunerm iivr.ene. ntuti:ic. destine and water problems and toxic Sszarus. aau the training >f ret. John Arr.nyetnre a:en n:m w..rr.cn. Hi.-'orv-sliy. ll:ui.v:iy NUaitai mv-vi'v rr>- a ..c.-ra h'jnureri y.-ars. In 1M7 a ."irr'.-on v.w, upc'.-intai i;y 'iw < 'at VvV-ern i<a:iwav to attend ail n*re o; ;;;d -a .-w -- mtauut-i i`..iu'A.y < rr.*j^>- S at Ti.vrv are m the Dircer-.r-' n::ru;ca of :n old liaua-ay < tranies. of icdivid'sai aoeouiKS oy pruit'e l<u-:ors Mr treatrr.vnt of patients i* and auirf. i^oine oa:k t<i lf.il. r' A Board minute of the - la Midland iMPaav m iNoO -ays " that it is desirable that DL-friet Mcdaul Odi-.*T^ rv- un;i-uit<ti ..v.-r tni v.;..,lc line." The siiiit C*mu:tny in Irud -et up a private a.--u.ia'. at Crv.vc for llailwav F.r.'.n'-'V'-i, a;ti ---->-r i v. - `riaf M .-. i.'i..:r-r>' '-ii in:.r>::,v.xi at a bnrv i.( -r'--,:a:;r :::. .'-t ''.'.tsi a a,-A. [ f.o r.t;nrei.-:a---'t a* lilts iv - [>.-- :::-f!icai 'rc-atiuvnt ::: Ir-ar --.a by '.'tnoi-- Mo and tnv -tuft niiiiie tjicir 'ntrciii'i'in to rl.u e.xs^o'o *! no-ptCiU. However, m l^ir f:.c Comi'iiny .<vvr :uil tinarv-al r-'-Ooii.-nmity. M-x' "f i lie i'.iiii-.vnv :nr.a|ur:::r '.`.:s r> i. 1 f-iA-UrJi). i.miappointed (-at r*fai-:jtioi::rs ffir-tnanou: :h<- timry ::s " Mcdi.id Oifwrrs to the Company hick Kund" anl they were paid mx a per amia The southern Haiiaay i.'.immny -.vns r>rmed in !?J3. from the arr.alcarna tion of a numoer of -maii.-r Com names, and there *s mly '*nc rccyrd that I can find "f rhe appointment of a fuil tttnr Medical u.'hrer prior to this date. In IS*7 the south Eastern Haihmv appointed u Medu-.al Officer for a few months. it'v I think there was some constructional work some nn. and they wanted to have someone on hand. In the ^Southern Uailwav ('ontiiany :if>(untod 12 (General Tractitiooers in various parts of the system as Medivrd Oifirew to the Company. They ivoricoil n a pact-nme lrv*i.s but undcrto.*k the cyecht nod physical examination of all applicants, and on request hy the departmental chief, the examination of men and women already m the Service. 06 Attomalto* of American RcurotuLs In 1938 & full-time Chief Medical OScer was appointed, and it wax intended gradually to recruit a iull-ume staff who could replace the pan-ume practi tioners. L'atonuaately the death of the Chief Medical Officer, and the out break of War put a atop to this development. Id April, 1946. I was appointed Chief Medical OScer of the Southern HiuU way. It was a Directors* appotnunent and I was directly responsible to them and Dot to the Management. My instructions were to survey th* existing set-up and report suggestions for an improvement of the *ervte\ When I took up ray appointment ray medical staff en*wr<ted of one fuff-time Mcdicsl Officer, two pan-time (in Londoni and 12 pan-time in tin- fiemnnH; all e.Tceiieat doctors, but none havine any practical repmenri- *' K.irlwnv working or its attendant hutartK I recommended (nod the Directors agreed; tin: setting up of a tuil-iime Medical Service. Tliv two tiLn-tinu- i^mdon men were taken m iuil time ami five m *.v d*;o*r> iv*rv ryae,^i. 1*: ntanv nai; r-!*irnvi ir*:i -rvi>-v v.*::;i tt- Ar::.-*i ror*-i-> .-mo 1 "uL: :.> very l-eiivr- ;n ray rii,*i'**-. Jn ru! 1 ir s rrur. v. i:h 1 (vvitj: cuaitttca*tor.*: 5 He had had some General Prsctree^nenence. - 2. Hv held a Diploma in Public Heaitn or iu lnau?tr:ul Hygiene i don't think you have these types oi atpiomas over nere. The qututhcuuui:of a practitioner in England are very vtmed. You can go i* a university ann get your M.D.. or you can take what is known as tne conjoint examination < the Rovai College of Surgeons and Physicians. wmen gives you your M.Ii.C.h. or"L.R.C.P., which aiiows you to practice meuicit.\ ii-iicvc- o; phy.-if-eui.- and surgeons &Uo have joint diploma* m public itctuin ana mutistmj mvuit-uie. anesthetics, peoiatrics. and otaer speciuiuw. and u.yv arc gctiertw.y a two- year course for postgraduates. o. He bad had some adaiim-ttrauve experience iu tiie Armvu curec*. fiuch mm were available and were engaged. Id oar Railway we have 3j4 separate graces of empiuyes. Obviously many grades overlap, but ray dr.-.t step was to insure that ail my Medical Officers haa a detailed knowledge oi the working conditions, stresses auo strums of eacn and every grade. During the first year therefore two Medial Officers were out every afternoon gaining this knowledge, and eventually we produced & book giving a medical job analysis for all the main grades. I have it here, if anyone would care to see it afterward. Today a new Medical Officer on appointment iponds hi? first three weeks in tin* Service wjuchmc nu-n at work in ail departments, in company with a !*rni Supervisor. We have three ntaui Works on tac southern--at Ashford, Brighton ami East leigh. Each employ between 2.00(W,000 men and women, and the next step was to appoint a Works doctor for each. In addition to Works duties they were required to cover an adjacent area for the purpose of routine examinations. The general work remained the same, i.e. the examination (eyesight and medical) of all applicants for service, the examination of employes following -icknes- and Occident before resumption of work (we m-v even- man and woman who has had an accident, prior to their resumption of work), and routine examinations at certain ages of those in the safety grades. Rather vrr .Ml 000 sueti 'ii taerc is thr At nrst the . examining staff convenient to his responsible fo Tuts system wo the Medical Offv Brotherhood lea. The routine fi: Department was Mi ftix- docto: examination of established empi. wi-. we lo-e the difficult. We ho ti.v mtiwavs pav r_::.er tna to ci step up the seve applicants Oriure we try to see tha formally in th rush of appueant: by appointment < period can be ctw The other thru? examining. in con hors of the Public Another wits sh< During these vtsi local officials and words, wc try to c the works, secs tii expect you have t one grade to anoth to get the union c heavy to a light jc results, and the rc be dooe. and thn The third, wher particular sp*-ciuli with modern medi interrupted, either investigation has i At the same tu roaio works, i.e. A By now they kno area, as well as U they also have a p men employed in t * intended ; ;C ORlCti- ,-j the out- hetn Rail10 them existing nvinvcs: Hallway full-time i mo and rrtfs in<i with the .d'nimn* :rity and ration >j M.il.C.3. nysiciaos i medicine, ijy a two- i'.jrces. -]y rr.atiy hud mi` -ach ..vrs were : dured u hrr. if - v.--ks in ,;v with a .sid Ka-'tr.ext step hey were -.nons. *vnt and :`.,llu*ing itiin and ,rk). aod iUtbet i'rocetatnjs of ,`f<*iicni end liitrpxal St&ion aw .vO.OtX) suen examinations are arrivd out .viouaily by my sun. I addi tion there is the medico-h-gul work following accidents to Stan aad public. At first the doctors were responsible tor geographical areas, seeing and examining staff from all departments therein, but Utter it was found more convenient to have one doctor in charge of each main department. Thus one is responsible tor the Civil Engineer's aaif. one tor Motive Power start, etc. Tilts system works very w**il and *t**ir*< a wrv ***o*e rtynttmtina b***<**t 'r.v Modic.ii On:.\-r. :::e in-iu n-rnans important. *he local hrithcrh**ud loauers. The routine .cc*ily evolved tor -isaitr.s with day to rlav work of the Med'.- a; Department was as toilow-s: v .Ml five doctors attesaed at Loccon nriaee each moraine for the rouune i-xaminattoa of individual A?p::.`anu. and for me periodic examination v>t established employes, woo as far as ccssioie are seen by appointment. Other wise. we lose them. The iaoor rrcsiem tn Great Britain cas been extrerr.eiv difficult. We have vtrttaiiiy s'uii employment throunaout tee country, ana us the railways pay such ready poor ivaees--*r did uoul just recently--we u:u rather tend to get the dress or me iaoor market. For that reason, we nau to step up the seventy of our applicant examination. We are very severe on applicants before they come mto tpc service, out once they are in the service, ve try to see teat they are ems-oyea suituosy. Xornmiiy in the afternoons oiuy two jters work in the aeporuceat. as uic rush of aapucaats has ceea tagea rare <>i :n tne morning. These two see cases by appointment caiy and can tr.vresore arrange their work so that a longer period can be given to special cases. The other three are employed m various waya One is usually emgvged in examininc, in consultation wjrh the family doctor or specialist, or with mem bers of flu* Public who are making .iaims for compensation iullowing accident. Another vi.-ifs 1 .r.cr T.-taiiations under hu ;unsdiet;ou. n During t.ho-e visits f'lmr::.: -pomai rehabilitation are *:i.feus.<cd with nud >;-o.-.d> :.-ry s-r.-.^uii .-an he nuiuc. :i vTier v... ry :tii r o.-, y-r-->n:tl noTo. TI.c Joctor sr^vs r-> : ir* <*s f:;.* -.lOrk* ii.anngvr. --s unnui oi.irial >hcre. iiecsiuv -v.nd l ; [ iiu w -amc '< tiirtr--.1 ..* -.X' r 'uscly ii:r.<-uit to move a taan frum <mt* grade ?n unotnvr. T;:*ro are -ofti .-f agreements uitout it. and you have o get die union kav. m many before you ran tr.vnfier a man from a heavy ro a i;gn: ; o>. uu: ny - -f'nal utact. .v< do get very satisfactory re.nilii. and d:-.- .* -minilitatioft ta -.jr.e ':.c way 1 think all rehabilitation jhould :> dooe. aiul that is on the man's o-.vn ;n amongst his own work people. The third, where p*-*--u>le. attes.ls a Teaching HwSpual in order to .study a partiruhir -txviaitv in which he u mtcresteil. or at any race to keep up n> date with modern medicine and surgery'. This afternoon routine must he frepueatly interrufiii'd. cither brvause of the number of patients, or because some special investigation has to be made. At the same time the Oivisioosi Medical Otiicen appointed to the three mala works, t.e. .Ashiord, Dnghtoo and Eastleigh, have increased their scope. ** By now they know individually most of the General Practitioners in their area, as well as the star! of the local hospitals. It goes without saying that they q)y> have a personal knowledge of oil the officers and the majority of the :< men employed in the Works. .v:l 1 f f .-A d 1 A .c - 93 Association of Amman keuroads Mure and more they are heme nroucnt into consultation on matters oi lotiu^trui Hveicne tn theWurksand are sow asked to civean ujuaumtin pf>sMole toxic hazards before n new proccxsuig plant is installed. The watchword oi cy department is *' Personal Contact where pvssioie." The closest liaisoo is maintained -with our- employes' Private Doctors. Chest CUnics and HofOttaL. and. where a periodic examination rcvcais moment disease, a full report is feat tn the family doctor. Mrtuaiiy until ten years ago. the medical department was never consulted >a anything. New toxic hazard* could he introduced anywhere, hut ooboae ever told us- Almost the hardest work ban twvn to eiiueaie the head* of f-- panmenu tv -rCving that the doctor wa> a u***tui member of **nt*ty. ra;n**r than a hazard to ins pr-dartiun scWiuic. We maintain very dor? liaison with the private d**rt*r. the Xat*m.-.l H*all: doctor oi our emtiyes. for nnvinu* realms. and w*r ris c-*t the in*t w..n<>r n` --nemti'j;. irui:; them. W- don't oiivr them a i-v. W.. writ*: n U t'.-r ji s-n-i hv-uitui r<-f',rt# rr lull el;:*i*~t not-.-- * i >..i: *::!;.- : r <:r fit Li'-*re w~ nn-.-r ! hi- r--*im ;...>: t: i- r. :\'m ` Mit.-mti *n. I haw three very r'M :r.*.*:id< in L^pbnn in vnrwj* \irt~r.y"' rr-ott:;:* :nfaiii>t' advice (agum. under tn<: he-dt'-i eet.vJtwj l>f rsrmu** :>uf.e!n.s. and gen*r.ii medicine. *'< 5:avc no f*e<`ac it-iistniitaunn iVurksiiona uf fuen. out gPceiaiuis iroin :.-*>tfais adjacent to our fc;c Works trcpuvttUy vim*, tne Works wnn n>v uivitaj Medina 0:hi-r snu advise on upizrautuc : tneir patient* following Atvtit *ir <*t>vruii-$i. I:: many eascr (tuiuethury vi.-u* are made oy my v.u'.i tt> employe- who nave ::-vs: sixit sruin -or* ua i.vtutn grounds tor inure tuan two utoutiuv auu wtv.-rv ;`>.'111:6. tvn.*u:la;n>ii is urn-fuzed witft the family practitioner. Mx.-caii invi-stirafioiis ;.av- own nude throughout the Region mto varioua : "'Xfc fULzarus. The workers in a quarry with a iuiny iuish free smea content r.r- ar.uwa physically ai:u radiui-igieiuly every :u inuntus. The actual stone haa a very ruth free silica content. and we have ooue an L':ve*ttratn>n there. Every employe in the quarry has had uu annual ;uU phyiicui txaotiuauon and a bi-anuuaJ X-ray. A :uil occupational history is taken at tiie srst ex* tsmiustiuc and fo far we have kept free oi siIicosli. Tiie ventuatmn ail our iounuries and sli>|"t where ieftd vorKinc is carried `at b^vii luiiy J nii-i cect-.-ary eMimcsson yiant insl.xheu civiuic n lead tn-e v.ttivs:-:*vre .Ml U-..J workers have si jr.TffHhc hh-ni rxamuutUi.u. < l.:r fucreury nacar.i h:*- uv.*:; riiuilasl*. <teait with. `'fjer v*--1j:j- -ii;nr ivvsi carried out at tlie riiucrit <it. or xa ivi;ua&r.i|iuii ]!: lie-.-am: oodles. Aiimncst there have Ijeen the measure ment of Vi'niiiaufn m trams, at the request oi The Common Cold Research Unit of the Medical Rerearrii Coum-il. and al.-o a trail oi vaporisers in ornces in conjutivtH'n with tiie Public Health Laboratory Service (Air Hygiene Laboratory/. At prci**ni a lo<ie rcr::< t'roi*-c: investicatmc Hyprrttufion in railway wofM-r.- >- oi-ntc i:: i;:irti-<n witli l he Social Mciii'-me iJeM-arcii L*Stt. 1 ;.avt* !*er*<naii\ aiev:i on the Functions oi the Dojeirtmcnt to sma memuers of all our :*! muaj (\iuncua. and l Vive royular talks on Indusifuil ll.-alth to the students w a idiilMiiy Tniimnc Collcee. My a^ustunts also give UiIm at c manvnt " P .,t C.r Mruirir.e course tor Hvcivnc a: fun <*n r.\ Ah 1-ouc: tam t*n \::::;nrr*- :. mftrf~T Vi-ii- hr r.-*: ni-: -- t*:t pitin for very rn- orr t.'jore toil' Old People. ri*-f>n.<i:)iiit ' aamifston u atimasKu. Che com. :>tran counin auspices of 1 Tisereif at Raiitvav*. im you ail ksow We are budo floor of this.; nogeoic facto while buildtn. much fume a exhaust level cr.Uau-t has l at trusf level posed steel, humidity utsi Exposed ro< hardboard frr enee rate. Tl and e ha>*c 6 * water prohof U>- between Retarding t l have with n: ,ti matters of { onion on possible . where p>.Wnle.`" Doctors. Chest : reveals incipient never consulted .ere. Uut nobody h-ids "t -l-v;'i**K,r V. raia-'r .W.ci.mal H.-ul'n : .vAtul-.-riul . l-:;u:r to them. i-ur vmnioyca ; it u u voinj#-.-- j: ai-iatals wnu :.r<uw pacietus. hueviidists troir. - Aiin my Divi uta '.'iiiowimj -viio have ami where .non into various silica content haco done an :< cVna.iaaCoi, r -..i.v n ::-lailed ipvmy i *".3i:iinMiion. "int "i. '( ;:i n n(. r.:i.-.vaur*s" * "id 5!..-.'.'.mrrn i.--r- ;:i "dices - -.Air Hyjicne /u in laiiwnv vcxurcn t'mi. rtmvnt v> start :a on Industrial ;&ms also e>ve Pr*>r+<;tin'll f'f A/'-tnvd -ini .<>tn:;,vil n talks at intervals to such bodies as Mimni Inmmvement Clause? and Per manent Way I.i>ritmr>. Post Graduate *sitden,< >t liv S-hi*l . < Hygiene and Tropical Medicine and ot the tb.ynl Institute Public Health, who are takin; the course tor the Diploma <i Public Health and or he Diploma At Irsdu.trtai Hygiene attend even.- >i.t month tor a liiort course >t lectures and dernoastra- cions on railway medicine. Aitheuch the St. John Ambulance Center is not directly under the iur..`d;r> tiun t the Medical 0* icirraumt. we wrk v.*ry wirh th* n>'';*rni Ambulance S*--n-*ar-*. * '!* --r--art* * sr:-t ." n i.-T- die M.-ih-.u :iv . -mi -.- r*......>:' y. iicanm-r >i vm:in:--: ;v *tr i : r *--*:!?: mo-'ity-n. Vi.ir- hatfc :--ti r*:ud v.i?1' *.1 A>*;*::*~rr .*..***:?. * s r.rsf -.id ?--m 'tiroii^tivu* ri:*- !t b..... m'urn/j-iton-x ? irtnstn^-x:r*5::-i rwm.> up to tin'.'-, ami in .-otne i-asos cr<--.'.m: n*w one* w^or* n<*>,>-.'nrv. ; /; s en made. a:at :ao work L un<--verv ^ittstactnruc. At our ianrest Works r.oieanu un-t*iatv Mtrerr.*** aavr e<--n mjjit an<i !*? are started by trained Xursos who are mrt -i:r Works Mrdt<at t>*inrtrr.-r.:. We have, roushly. 72.(X>1 mnlov*s. :-.mi over -i.uoo ni th*'m have tnetr n:>i w 'lertiticatc. which i think is n wn* even rerord. It's ail voluntary. Thev n *. eet twid tor it. Ail tr^uiine is .'arr.'.si *ut their own time :ui.i it s reaay a very tine organization. Clt.*<r touch is Vent with ihc -"outhern :'.^:iwav < *rt:h;::aiee anu i r OM P'-ipie. ;ut u/th'-u^n a'.'.ua-ai are <; :*; sr-*; or :i r r^poiisuniitv or me Mctia-u D<-oar*.m nt. e o .-aanimv an a:.. ; a;.'- a/tmi^ion t' t;,c :-.r .<.d i\-s:e. '> deterntmt :' r :uimi.-sio(i. Close nuiuict k> tr.uimamcil v.irn i;:uiiv:y .MiiJivsi .'ervues oi oir.ef nur-*- ptsut countries and every two years a Mc.uvui i otuenmi e .* md unuer ::.e auspices /i T;ie International J :.ion i.'aiiaay M<<i;cui Tliere is at present an n*.*icrni/utoi nrt*erani :ir*:i>u-i ;-.r llait'.ve.V'i. m.-iuiun^ i..*.:ue i:.troiu.i;o.j i) 'I 1 .- vi .-urn s;.ai ynn all know n yn*af .h-al t.'''" ,!*n.u r.i- *.......i !:am t . - .`oof of antJ w.- ij.-i I .;:ov\ :i >. -:r-l at ail. <' :: tieTe 1- a < a.*. :- :a>-?><r ia :i:e lu:;-.--. -<tr ' : .Vi::v any - '' 'a:..*, chile i/u:J.innriif :u p-? .-\ir.iu.-i n inoi'd at fin* "urre. -U :r.i:**h lurne :>n*l .xliau.-t uas as |r>.*inlo i- n-mnv/ii at -ourr.* hv ''iT.tctorj at vh:ui.-t level over the oil*, ami a balanc'd -v.ii-m warn air -t;t ,uii .* w r.i-.an*1 i.a- b-**n ;`-*'vn,il ........... j::-. Warm -.ttr t* !** ta::-iu -si at 'ru-s | ;<r>-vcnf r'/mioioatuin and i.-rnianon oi uii/hurt'.' a-'ui on f.\* po-^sl ..*{. tlr.- warm air ;r-un ivinj /nrroiied by temperr.tufrs ar.d humidity tr!*rniaivnr< lo'itic.i r(-.n<v:hout th>* nmliiinc. Kxjm*"d roo( rr:'-miT< an: nro'ia ic-l i>y inanr*-.-?-s and m-niatia^ hnnilKnrl inou .'uinhur liio\id>*. an-t ?hi-> al.-o itivcs 3 J,,w iutif traus-ier- tire me. This work i done w:rh our h/aitme. Uvhliue and wmit "nemrer. and wc have a very clo**t s**p*n\tiftn. We meet once a viek. We have a hit *.{ waiT poiblems in the country, with '.'i'll water, and rvsrrvmrs. The two of us, between iu. Cake complete ciiarse and a-ivune r< >pou>ibUity foe that. a$ Uevardinc the International ("nion *( .Mislued STvicea. the F.unutcwi one. I have with me & letter addre?-^ to Dr. Bennett, extending welcome to <mv "fn c tn s rrs r? 100 Atsoaauon of A mcncan fieilrea/ii of you who would like to tome to our next meeting in Paris. it. Svuicmbcr. If possible. we would like to have an oilicud deit-gntc. Mott even- European country is represented on this body, ana wc have --.me very rrod papers andgood discussions at those meetings. 1 will now hand that to Dr. Bennett. You w Board a: promem take tna: Chairman Bennett: Thank you. Dr. Hayd*n. There ouent to Da. Havdon: Well gentlemen. I think that is my very chef $:ory. I I havejc would be very delighted to answer any questions' 1 could, but that is up to In the you. (Applause) number - CuAt&itAK Bennett: Ladies and gentlemen. that w. reeky worthwhile, can see that, no matter where in the world wc go. tl.c ents.oyes of the rail roads are properly examined, cared for. and the equipment, the ideals of public saicty, hygiene and everything are the aaim* the world art-ur.d. It's just a Thank gi *r interests rvnc tiir eue^'i-.tj of ht*w we apply it. A-, -.-'re \ ! thins: t5u- wonderful invention which Dr. Htiyo-'.:: r.a* -v.^navc v* u i- f- reiiiiy rMRiethias. : :.-.* a r. r As l>r. Haydii inesitiotico. tin-c mvetitiC-: are t.u.si each ~r.z every y-.-^r. I UUUK pome. Pari.*. Berne. London. EdiJ^urch. ail over the r.^rrrean comment. i. v.- r.T O*. Ai: these dtiTervr.t nations got together anti dbcuas tneir mutual problems era- ,kt our r'-rctnr railways. so pitsu-c get your thinking cap- en. auc ;:*. s send several have a <iis ieiecutei. Schooi of Dr. IIolton: Tell us more aoout it. VVhen is it going :< is- His rubje Kquipmen 1'uaIR.v.i.s' Bennett: it u-iii couvit.i? in deptemuer: '*V,'r x<> inform you that the U.I.M-C. will hold ns 7th Annual Congress ta Para from tr.c Dr. Ro.- '23ch to 3utfa, .September. 1957, and we art* thcasoj to invite >ou to eiio an Dr lie ooferver. We tauut. ic tact, that it would *t* of cotiaicemnic i:.:v.i*<t to esutr- M*>saehu: i:*h a liaison between our two organization*, and we nope uut; t.-i srs; contact pi*rksure to estahusii'id ny our uisticguisueo coiieague. Dr. Hayaun. may r< tae begiomaz and Open.' or active collaboration in the future. of acridem "We are happy, on tru occasion, to ask bin*, to give you il Lest b:.v of in the fielc the International L'oion of Itaiiwav Medical g.Tvic--. ar.u to c\n;u:i to you iieve teat somettung aoout our Union and its activities." After yo Signed by the President, Vice President and Secretary Genera:. of your eo There was one item that came to my attention, about two men m me English a better u: ward. One said to the other. " I ye, Alf. did you ceme in to c:r?" The otner the advam replied. " No. I came in yesierdie." (Laughter) Dr. K. E. I don't mean any disrvsoect by tliat. Dr. Havdon. when i sty that. 1 was and my gro tiiasiied when 1 heard n the tr.-t time, aim I ;u-: wondered--ii"i\ frank in my t: ivuid y*u hr'.' :ho operati (There followed a general tfl' the r*cord di.-Tu^ion of Dr. Huydon s faper. also the invttation to the t\ I. M. C. mooting in Paris. France. Septem rpidrmiolo. accidental1 ber 25-30. 1957) ran be effe- Chairman Bennett: For many years we have nut only had the problem the aa ii It is of r ot the prt--employment und periodic physical examination of our employe?, that aoeide hut the ace problem. Now. in our examination of ihr-e employes by ourselves, noci-contac by other doctors and oy a thud aocuir to make this decision. w arc really accidents u oeioc put "o the spot, personally, individually, as a ratirond. Are we.taking an added mk? vehicle acc places, and vta'ser. I: rl'jr*'SCS0 : .;; and : *`ory. I ; i;p ' - <:t U* vi it's yut a .cd to uS :3 r.j to ;a:orm :-.t from the : to strta an ?c to estaiv a^accoQtact ^^oi5ijiir.iC f :f. ' r.iper. 'n'cm- :C prooiem . <mpioy.-s. ourxavw. are ready ve taking Proctcdinof of Moiical and Sunjical Section SOI You will recall that yesterday, both Mr. Connell of the Railroad Retirement Board and *he Chairman of our Interstate Commerce Cosimuuton nut the problem directly up to us. to .aen and every one. individually. H*>v.\ let us take that responsibility, and let's do something about it. There is somethin? else here that has me just a little upset, whieh I think 1 ought to mention rizht now. 1 think it is part of our problem along with what I have iust mentioned. In the back part of our pmgratn tor this meeting you will notn-e a huge mtrr.h*r -t ra*.l?*,t,.*is V>r> that iu-.vc 'heir medical r"nre*enrarivi\ ?hown. LT-anx n*.**-'. ' .nr Mtinmds have medical director*. chief `urgeerc. .-r -'n-.T-'-r.e :n ;r.e mcuicai at:.i Mirsicui rit-iii wno is responsible for me nest inter'-'ts *e -riehmad <*vrv r.i:imsd uuiividuuiiy. I^jm just a little upset *> rad *::? ::zntes .f Vice-Presidents. t.ia:m Agents. Mr. iu-tica-so. and auour- intenoeat co*jtcu-=o. Ac.-urod-.z to me laws and regulations. i do not .*ee how these raiiroaos can be prop-rty representea to tneir ost interests by nawnz someone on nere woo is nut a meeioni reoresentative. who knows exactly treat we are tnuuas about. { -.vniiin ::ke to *ee tms thine prooerty taken care of by next year, some how or otaer. As our r.ext speaker, we are certainly more than delighted and nuoorea :o have a uutvizutsaeb proiessor imiji toe Harvard Medical .School, the Harvard hch'^i ! tleaith. tne Department of Industrial Hygiene. ia Boston. HU sur^ect `.s `'Human Factors in me D*$ign ana vperatian of Hallway Hquirm-V.." Dr. A. .M-:;-ar:an:j. \;;j;:uiaei Dr_ :;/> A. M-.f .p.Lano Harvard b.-hooi <>i Puoiic Health. Boston. Mitssacnufeitsi: Mr. t.-.airman. iauies and gentlemen. it is indeed a great pleasure to come before :ti group t<> t.iik about``Human Factors in the Dusign nod Operation -.( ilaiiioy Equipment." with special reference to the prevention f 7'.r-t <; ad. I -xpiaia that my experience has been largely in the r.vtii o: :-.ir transpnaation. bus. ar.d truck operations. Hr*w.-v.*r, I be- '*ve ic ;;rtr-.-:-.ippiy .'quaily -coll : the .v.ilay held. \i---r i u.. <i nti m -ijvas. \ 'x'vk ?he opportunity :*> r:-1e with a numU-r ... i '..;k -.v-.-n your p-'rauag p*-rsonncl to try to ..oram . ....... i;.~- . i >! your problems. Fortunately, I have had the ailvantr.ze -.vors:r.g eiosciy, for many years, with one of your members. Dr. S\. 11. D./W.j, lie i:as r-ren great inspiration and encouragement to me mu :::y rr< uo zr.d ha'.'** n:;d a r-r.unce Tn Irarfi about your problems from uitrv. In my 1 r.r-t-.-e tc .maiy/c '.he areas of crnciency and safety m the "r:emti<<n < i mi t.vpvs <>t v^bjeuiar equipment, from the point of vtcw of |*ulerr.:oi-'ey. A/t'*r briertv outiinmz some of the problems in the Seld nf -u-fi/HT.tiii trauma. :*.t:d >tannz 'r.e nnruonUoi. ( believe you will see that these < an be e-:ecuv*'iy nnplied to your r.etd. U -eems to me the mndamentnls are the same ui mL held* where ucerators use mecnanued equipment. ft is of zrost importance vc you. as physicians and surgeons, to recozntze t hat accidental deaths ami intunes have reached the epidemic proportions of a non-contamous mas dises.se. Each year there are about Oti.OOO fatalities from accidents in this country. The largest percentage of these come from motor a vehicle accidents: there are about 'Jb.000 in the home, about 16.000 in public c*. places, and aoout M.000 io ditfereot types of industrial activities. Moreover, ;sf T ? X --i .it 1 .i I 1 `- 102 Attodalwn of Amenaan Oauroado accidents have now replaced diseases as the chief threat to health in tarcc rro- portions of our populations. .Accidents now rank ains&d <*: diseases aa the Jeadinc cause of death to |*crsons between the am*s vi 1 umi ;5 year.-, nnd arc surpassed beyond this *k<- ebtcsly by heart disease, casrvr. and certain ce* generative conditions. Tbu you can **x why we o*u>ichrr accidental trauma to Ur s tmnlir hcaith problem, the control of which may in* STiirimbi- to the mett-yd** aevhf****l for the control of ms.-.- disease. In my opinion, the next sicniaeunt ndvniir*' in safety will resuit from eticinecrs. physicians and i.'.hre .Tfa,.i#i< worfcmc together toward a nmrv careful analy-i* if p:v:*hr..* mv*!v**i. U; c*'upmj. such cftiiiitN'RitKiit is not mw in pri*v*-n:iv** tsxijrjjjf. -*,r \- amiuc. the control vi malaria # braueht about ty team study--the mautn- oltiei't. the sanitary rtttrtti-r. and other *;-.-EJi'i'. A *--.. r.imrw-b. m which diih-H-fif diM-iiiiin*-* arc wotkiur . s- *>**v: ...*fv * -:c::r--: i** i-i>- rn>! ::*-'jivssT< it: the u-- of all *yi****. nnr.t'r.ti: Or.-.: ntt.'ui i***iHcii* Hi r*:***i-rr. r--. . i.c i" another. m .-iuc type : unorp.ir* -u*t:;*m;JU now rank- wun and sh-uvr n a i< mir. i :. r- r;- u:vmt truthc dvains aumtnity. l'JU.Oiid i*mn*;::i r.r.j ;"**t ui.<ahv.;;i> -. L-a.-shi on Uiwt trend.* n* i*.r cci.t : l..c r*-- *uc 1:1 r.-.t* rnu:i::v wiii be injured <*r killed in a Derma *i ainuit 15 y*t:r# in :.:r:.w;tv ace-oents aioiic. A'--vtvntai trauma is aiso sn imi*r:2m vn'mem: :r. cur ntttmry *-.-rvi**<*. in :;;o Kenan cunilict more nvn were ktiirM ::i vcr.v.-ua-.r ;-.r \* * ts.ai. u> cornual. "Curr-ii::-*'. trcniutis** an: mv utuitm: cans*: vi u-.m'.i. ..:.*i ::.--.iii- itv.-n*-** au tir.vn. ii*.** : the Ar:ti*u . w*::n v * os:-* raukitsS uii mner types, linen yar about svrvnvaicc are k:ii-o cs motor vcisicsc aecicents. anu tnc tamer proiMirison oi tnesv am teats oveut ivs.ac the men are oil uutv. In audition to military personnel. ti-s >.>rvi!**.* i;.- i..c a..v-*t emt<`yrr> <>i civutattf. Tiiu tney mu't cve s*riuu. vns>ocr3::in prcvrn!:i*n actioem.*. A Conimi*ins on Awiaciitai Traunui ns;* i t: : : in t;.e Aitneu Force< iinsde.TiiuiocH'ai hoard. LV;.ar:mt:i; /.' U^.curv. i nave ;::e honor to serve a? Director of this Coiunusiou. V.'* arc try.as to cvvvop naiir stuuies to reduce the incidence of uccmcuu. vtamcubriv wun rare ;o veuicuiar equipment. A senes of slides wui now ie siioivo to proem **n:eOi our nudities in ihe uiu**.mi and tren*urt rui.i.*. Tui* rirsr >iidc. h:'.**-i <-:i uu::i i;i t:.c uuiU'triu; rioii c*t*e casualty i:i*uni:n-i* c-nsnamc* :r; ilo-i-.u, ..*v. * ac-'*:v;<i fieftiicr.ee n:ir - :*.rv often isiffftt-r its .*.?. -- u.ua m ssitui r < *. T'...* t*:*i':as:>.y r**iii*.,i* tt;\rv"*r :i..j>i~s:*- i::.w* pm :u;.*i.* ami ;m*:: ;;i:o lie* eid of Miiety enemverme and occuntiiinnai imtlieinr. r<r ;::o romrui of acci dents. with a better record ns a roull. .Vi.**-, tl.e safety of operation* depends to some extent on the nature and distribution oi the *5*emr.on-;. Fields such as air tmnsiiort and rauroadiuc have thesr :o*iivitir> spn=i;i out w>r very ex tensive nr<-n*. The hieh milisiiion nf equipment imf*hc* ure**nt ttmc factor*. A!~>. '.here )* n i^tuccRiftituui *: m::r:v --::r:i u.^kin; in clo.-c ;>:.*vir;:ii v. \V)*vi < I H,-*- -**in ; .i*** m*: >. i-ti:ii* v ri:?-i* :i \ rv Id*'*; ueddem rate. tfOiutid oiHTati'ni* in :ivu:ti<*n. i<t *vnnpi-. Wiw .v vvv p<Hr r-'coru. mtinc an*>ut dtlth out of -If) inducin'-* tn the Nni*u;d Asn'ety t,'..uiirii's Ibtine. TUe nulway held is not pywiocnilv mrludod in the N .-i:it**:ncnt. nlthoueii i ii.nc tnat i: :irv-i*c aruu>" wiv Uie aoc;c taius. howevc an;mnvj rr.tv Th^d-taus may *- >'..ur.d ri*'iml H*aJtSi . lut* jr-.-vu-** -'-ivy. ' i..;:noutary c^l The t* :: r*l'l >: . ;:-rrr:. i- lue nr.. .s. *.rir..*a *r: of a x'urietv o: i: Fir*-: ict us es'r T;:c next ic .V'*u:u:*2inr*s i* r-.-rvared ac-cidru avciocots i.* of ert permits be idestif are of ervat uupo safety. The chat 'vdl know froia tof temporary s;a sure*, alcohol, ti and mcdteatiOQS. Tucr" is oalv tir to make a brief at: "i the aceitivtu-re parimeru* reivrt larcc majority ot t Currently there i~ di*eu5sed brieriy Ik There are two a attempt is made to the workers, and t. If one tinds that r> obciotjdv, attempt! is cUoical, and I tvii Ouv of the consul' have repeated aecid. ef any accident proi. repemion brib'd on . ir. large pm"-.iscS tile ars. ui:d are j certain dc- . ;.uuiic i;uth s'ur advance in .v. i`*T \- to *! .:y in tianoc. . d :r-'zu ' ~v:.ka a;:U ;i >. r H) -'MAJ txirtial . <hi.> country - oents alum.*. vrvv>--. .11 c**ii;:-af. - in : viuents .;IJod ia umtor rVijixTur while of : *' V-:: .-I - ij- .. -;'a ri*-y ; .(!> n-;.--.-! . .'D'.-n <11(0 i nc .T-'l <<( Fields .'ii' it ..v/*r very rx* lime factor*. Mfi? in rin.*e iiixh arm lent <m>f r-cord. inrii ii.-fing. "lit. alrnouKii /V.*ccr>i/<./a vf Mfii&ii :td .>-r;icui .vcuon f note tliut the tmtiait ituhe-try r.'.u** unoui the smw -a-s air tTt\n.*i*ri. {{ a orv.'iso miniy.-i -- 1:1 i.arv:;..ir :v:*.t'tric*. it : u-uaiiv * hy tiic accident rates arc high. il-.3rutc*s ' the nature awl ,-uc x *m.x<3- tuma. iiowcwr. ;t>k1 tn'.xiuxd ami misty donanuicnu can ususiiy hnfic about improved mica. The deuuis of the role ot health and safety departmenu id airtraxupunauuu may lie found in my i>ook "Human Fa-tors in Air Traiupiirtatinn--<.w**mpa* d-iaal ilvnitc and r^ucty." .\Hjr.u- lti!i. ly.W. A Mitniar >:nlv t the truck :.? :;v:tua:;: ... .*.* ... - ri--' :r- :; ii.-_'hw:v :I:srv:r*t ? I't .: . .::iii --*t n:::u>-r T:. i* : kmi <i--:i; **.: :.* mil within ?j:ir i-.-.ctiicine r.iui : .iwuc tieiuta. aial '.:.ut an v:>ui::*.m*M>avai .tMorram in <"yiilcoi u< ar-i`'.vnli is nnficai aim u-'x.'lui. .vinatacrnicnts navr ; ::<>u-iM*`in<:vf u/icy.atai<i,.*:a'i:un n.anv icierrvtatcd iaetr<<t ftit*<n*rau*r. :.:s '.`niiji.T.cnt me <-uv:rwnn:-n-'ai .'tune, in :hw <*uu:eiiihm>ca.'ai ap- nronen :n: raaivay ttaameef <r 'ne o;-;vcr u ;ru:K >r mis. r tne uaui t au ..r.'Tiit. U;c aast. L'i.-; a^eat .s ::;c >':u.;:r.;r::T. tne vct:n-*. r liie -ao *ir h:ttevr j;c ::air::u>e of v.,r^pcce auiy m iv:.: .n u man is working, anctner in tratLtp-.rt ::;u<air:n or in u.c :r.-. i"..v .esrtrcaiaeat, ot course, coueuts a virte.y : : tactors innucr.rma n**it amt f:.c mrvni. :r-" Jet M' utJ-.isr liic uu-t'.>!! li-jit J2CJ0rs ::i ' he cau.-ntioii .i acementi. n.-ri.k-uis. '''v erier are :._-.'i.*n;ly -usveunoic to iecjiicjits u *[ mt*rest r<> y ...s y r.-.-r ucid. i *>. ; .xm ueii nervois he identid-'d'.' I:i r.ddi'.j"ii. *av no'-r that ni pcnfotiai uojastmeot v.re ot sr-nt i;:i{*-rt:tn<-*. mid 'I::'.'. .. :-->:aatr mi::.;.,' j.--at si^niRcance t<*r sicty. The -iianuvs ut -'sill v:v::::.-iiiS must ; '-n-idenii. as you v.-ii .xJ. /W v.vp-.-J Jence in r,i ::.;aiy, n.^aence -n-1 : i r.: :t.y :.> ' ! .*. :ii-1 nice sir-t "> ni;*.Ji: a Ji.tet -:i : --s-r-i mi i.roneuess. or thv |;.~hieui t t:v- id-VA-fiKtUvr. Iv. ..v''-.--red r.-.uiizatiniH ihe mnli-ai dc- r-"irr *hr.: t --.*. nnrkiT< are r*Hx>nir*lo ;rr : .r:Jv the ::t . 'i. - .1 einrnviit. *.r dirv'-i :u-:-;dentS. ' "'i.-T'-ntty fiivrc :s rrvv.t iiicviN-cd brk-tly Isvlow. --t t:i .m-a. .:::d -nic irnm riiuiir^s will he There arc wo v.nnrr.-n-hr'i t<> lyv-non. .in: is statistical, when; an titvnim i* r.::nie !< !i:iJ `"it nbnit :!:>.t11tiur: *n ! noxeitcd aefidents among the vriicn*. i;..l to i-.llow it.n-e with .veui-ms tUnush subsequent t'-rvKla. If *me mills *i.at rt'OttiitNi mvidents ::n* oncentratcxl in a few p*x>le then, `rbvimi'iv. alt-nipC' at .untml iimill 'tart with this emop. Another method is cliotCil. ami I will diacu.-s <>ur iin<iing m thu area & little later. One of the 'sinsuirnumns m the -tatistteal appn'ach is that some people will have fep^tuml accidents, just >>u the lasts oi chance alone, and not us a result of any accident pronenoxs. 'Die next slide shows the concentration of accident Tuf rvpotttion basixi on chance alone. If there were ddO accidents in a croup of ft 5 104 Aaioda.tcn of Amervan RziiroaAs ! 500 persons. 275 would have none: 165 would Live l; -?y would have 2: 10 wouid have 3, Md ooe would have 4. Most carefully controlled studies in industry have shows the accidents to follow just sucn n chance distribution. sod there* fore, the influence oi preneneas oo a statistical casts has not been demonstrated. Oae of the difficulties in this approach is that you must have tar^e numbers of accidents before the distributions are meaningful It you studied railroad engineers, switchmen, or brakemeo. the*ee:c*at frequencies would probably not be high enough. Thus you wouldn't be able to ontato a large enougn number oi accidents to do a statistical study. The next slide shows a distribution oi sT-.c-gt; fnr a rarer number oi pilots while in training. Here there seems to be some evidence oi the lodutroce oi a personal factor which might be related to accident proatoess- You wiii note that the theoretical or chance dgure? are compared with the actual accident data. Tbw are considerably more pu'>ts with repeated accident---4. 5. 6 ar.d 7 than would b# *Trv***mi by cbar c T:.u* there scerr.; he v*me hup4: that one might im able u tietitj:v a-_et wn* re reticuiera. in:*.Tv*Tjnc tumc annur ::r-es::g_::- urea > trui*. v.r^.r. L'.z:. acciuent croup is aturned tc suoaeoutuc yc^r.-. :t u not cumuosed oi int same TjiLt ariding suggest* mat trest.r.ta: :-,r various frustrations, <.: overcoming worries nuty dear up taeir c::n.*wti*. Tiu.s iso- us next to a :'justuvRitiun oi the cumcal anprcaca. it has oc*n oroposea that trie cunum auproacr. is ontter suited to reveai tue personal factor? underlying repeated aceiaent.-. uric very succesttve stuoy ir. this ana was mane ny ft Canadian p.-verustr:.--.. or. Vi\ a. Tiilinaaa. wno nas worked -vitu us a: Harvard, xic r.-tr.piireo hr* err-cr- m wtu:ur> io were tT'-v ] .itcinftii- over a certain perwo ui a *:ki gruu:> of i*> wio a:."' had ao acciucuis. uua a uiiru group >i'u tnree or mure iicctuciui earn wjjjsm tne sume penoa. He useu s. iiatp:* cd.ective cictbud to compare the personal sujustmeuts oi these artvers. * i,-- was to iook up the mto ut cue maiviauais iu me aauit court reeoras. me erect; oureau ratings, tnc juvenile court reeoras. the public uealtn ana venereal crease revoros. nu me social survive aeeucie-v nv found that wi pvr cec; oi those wi.o had repeated accidents were known to one or more o; these agencies, against only y per cent oi those who were free oi acciaenu. As a reran oi tuese aaatags, ana itotn intensive psychiatric 6tudy oi accident repeaters, ce concluded that "a man drives as he lives." This is prooabiy jus: as true among your railway workers as ior the drivers. The principle that a man drives. or works, as he iive* sue- gusts wiiat might be done at the time oi seieetic-r.. aoa indicates ms importance oi investigating how the emotiouai ac;cstm?:n oi a person, and his social ao- justment m me community, piny a r-ri- in tits safety o; iu* work. At the Harvard bctioul oi Public Health. applied the same procedure; ui a study oi truck drivers. About 300 drivers wro had serious accidents were matched with accident free men. When the various kinds of records were searched for the names of these drivers, the court records oi automotive of fenses. minor violations ta motor vehicle records, court records oi offenses against persons, court record- oi offenses against self, and unfavorable business inspection report, w ere found to differentiate sigr.iSsaotly between the accident repeaters .and accident free drivers. Then there items were developed into a lest, giving the items weights reflecting their statistical importance, as shown la the next slide. When w-e applied ims test to a new group oi drivers, u " pre dicted" the accident repeaters amortc them in about 85 per cent oi the oi>es. Itccauvr of the m. develop nict.VMt- u or p**yrliialn-t. wlv that the persons tvething. tiuit they L objective methHl> and the one just de; Age is another bo.safety of a man'.- o in varkms &cM-. S are auown in the cc> ui Coativcttcui. Nu have d:-proport;onr. volvtxi in u<--:uv:it -. are me n;Cnv;i-::.*k ; 5 car. ui.d lev*.-: :: CO- Laaemuav tee ehuMiUs. ana are uea f.Tuportionaieiv high in muuitry. it u cii inoaperteuceu worker The eflicieacy uc uu<stf*ii rr.urv ireutic iv^Monoi crouoa such i-dliiw*: li V.i.at ai age? {2; When iu t hi rcactiou time and >kii; that eiucioncv and saf- Aviation is usually i to know that there an { age. The oidvr grot have toed to promote engineers secured--tb: proven to be unht pby; problem. It is hard e: po.-sililc iu submit tLc ineiliud. uud wtf arc ion `biained very gosid dht-.i uce us well a oo a t This next slide sums made id Great Britain cent of the sample in ea time stress, compared t pet older, they cnti curn hand, if the older workc carry out a >t*rie of cor become muddled, make place the worker, as he p More continuous atic railroad engineer than t "1 ..suatry .; there*-:rated. numbers . .~^Jroad r.aibly * -r.ough - its -r..s a .. ante ___ cent j. -i and some *f rs:?n .r same or 'r.tt 10 a . v -Si ise vyzy u: V5 liaj ~rurea in .c xere :as were >::ve oi-'fenses - i*iinea3 - sccaieot eo into & j snowa xt"pre'ae cases. ?: r* .'[-riu-'U nn-i .v;rrim: VJrtioft fh-*-au-- ..t ::ht:~.l i-.nrir.-:;.:* v.-rv dewlnn - .-j.: i; - i~ .u!d as: -;:.::::::i::ssuve **y . gist *r psychiatrist. .*> rr. -i tv. -..mt. r>nlii not rvs-.i into i: many *...r.?s--- that rue :#-r.*rij a*-rv v> attention. that :h*v were rweottu; -.-me- thin?, that they iutd .--presixas. or certain ronzi.:*. We ;*: -^;vvr objective metti^is whim --; zr^tict the persons tvzo may have anti the o:.c juit iescr:r,-~i v-.-v :ntiuiai? its zi < . nnretu-n. in various A .y v:.-= ' zzauiiis m ct.-.m V-> v,ot*r vr:-.-...:- .. ::i Co:.zv:::eu:. yvr.uim ur.vvr--. :a :....irrs. have i;snrwp.-i::C'iatey v.z ziiy accidents. Moreover. *xr.ea tr.ty -** in volved :a awi-s.-st*. taey *. :*a at iaui:. The y-iaudest -irivers. id. are tue hidhest-r-ik zrcuz. Tie rates denine aracus-.-* *tth racn vs-. --c::iz year, auu lev*-: ;z :;.e v, remain iou ,t"a >Uiai thw-zf. ___: 00. *rvn;:a-y `ae .--zvs rhave oeea .-w'ziari :n Iv-i fhusetta. aau arc rrbosciy trie : ;r most other states. iimiiar daatnas .: ;tj- proporiocateiy ci^a uvcicczt rates with youth have seen ixisvrven ia ,-v;i;es in industry. I; : -year `.".a: -ae.au attention must re given to rh* y ;r.:er fallows: .1; -,r-': <: ;.-y.,ad CO a?e? (-) 'Ali-t-a ::.v r.- rr--. . **i uyiaz a.*-,- .:_aa-.-s in seasory : reaction time ana hk-ls r.i . .r.zer .-/ir.p<sQ*ateU by TTMr.? sad c:<prr: . i r. s j that ctacieacy aa-i s.-.i-y.y > .. r..y: to know ;uat are as-.-.: Ivi mriiuc ptsuis ;i;j sre av^ru-z have Ti-jti ` j - .T.r ^^..u:un :i. i .-;r.ta:..i. r__ v?UJt`ers --Th-i: `-y --. .'. ' nu"' :r. vi u:.i - :hr'` re provrn -s .`.c -.7.7.' "... ' .*; -y ;.j -zs-'a;iv. A-s v ; ^;.,<-.v ':.l- ; a "r:; proolom. it is ::sru enouza C j yruzo she ntnoi .jt ymtsscr men. af. ;.>sibic to .tui/nut tiss profsems :a ;ais arias :.i :..e s-Tutiay r....... ~c nietisod. .-;d -e are ivaraaaz - .m: '< --xpev: w:rh *:-jr~:'.i - *....-ve ibtatnvd v'.-ry y."-.1 ; r, ;v*rv --r.-orv : -.-.ru to asre as wii as oa a : :nef npaci::v.->. This next slide sums uo-'-re'ie mot interi'jtm? iadinza. T;:ts i'.zr'-* c-u made m *.<ceat iirt'aia nv u' -iinfd at tCasnhndee. You xiii *-e '.T.-t oer cent oi the .*amoie tn eucn <roun w no were emoioved in avttvuies iav. .via? time stress, comuarvd to me aer rent in jobs without tins iactor. -ks r-rsons i i^et older, tney (.-an carry out xor xuhuut time .-ims ouite xL un taeotner 'n hand, tx tee older worker u : vrcea ro u-xumiiau.- new uuattons rapidly, inu to tv carry out a **;ncs t compses rvacuous within narrow tune limits, he u sot to tj, become muduied.. make errors, sad liave mccuicnts. It thus is oi imcxirtaace u> 5. place the worker, as beipsuoider. m work which does not involve m-n pressures. V More continuous attention u pruoaldy demanded oi the truck driver or the 5 railroad engineer than even ci the airplane pilot, and an even ch.aer rruuny ix. -c. i 1 j i y: ^ -J ..a 'i . :.;] :4 Auoaaiion of American Railroads recturvd oi the ictiutuces which may aSect his ciaercm sensory functions, i.'.i complexity of the decisions that he has to make against tttnt l L-v earned out experiments n this area, and 1 hare found. for uuutnce. that m 10e field of immediate memory, college students perform much better *.deir profvssors. Ii the students are tested in an altitude cliamoer adiustw-i for oxygen a; 12.000 feet, their capacity ior isuaedrue memory drop to about the same lewd as that of their c&Ucee professors. Those enovts are apparent earlier than we usually think. They probably i*xia around 4(>. ra:aer than at 00. The sunjriy f oxr-cn to the nerv*nt tt^ftte i< the mtt.-t! v.ra_a.r and a* tv*.- e-:t oi<l*-r anythin? that rv-iuros the transport or u;d:.*r.ti--n u; osyjcu wu. unpair iuucuou. TLi> euect is cod illustrated by U? vdwi* /f aic.'UvL T : z\`; u> .* w*-ru: oal }<-b aualy.-i.- sir.*ui<i I*" ::::! >f v :* / .. .c v^ur . .^r tt:Mi; arv ttoutm v* a- - t:.'. i* <: i;.:.- s.i:.<i aiisat :.e rew.K:r :u^a;u .-...v r :..u- d. ' 'c........... v. . . * a-.-M i-iistr-tos tc u;-ut:i'.-e wt temporary *v:.a.i:-...- i:. t:..- ft n tus trcfiueiicv ot acciucnts. It utati spenhcuuv wnu u.c cuevt <; mv-.uv. <:* fijfifir.'-y iUtety. \ ou v\ui ijy; that li0 risk of ficcment? me:vaac inanity ; tie a::: tufit wt alcwfivi in tic drivers rdood reaches .12 or .!.* .-ue tivf cent, it . 3 greater tana at me loner concentrations. a:.u a: .even unevc ..j . - in-. ~ j>J times us treat- .\L>* re*x*m nutop-v stuuie- nauv on o.tawny v:v:uns iuttccsi that UO to 70 cent ci tu*v kn**M iiive ait: o: a.i-y;."! i:. ti.*jr blood. tii t-. fia=:::0L ;n*.- reuitiotuhtp between b.-x>u aic.nu. a:.u uraui u.couoi '.j t: . ; - area: tfitpvriaace. Vour c&iuioves ntuv us*. '`WLss can wo co ca mty -iter crxxtfiz' How many pours aoouiu vutpre." iu tr.v ainutes. --j Cv-rfi ret at ia UoUTi. Th? t'jiut is tuai Ui-j curve of alcoooi iu the oiooa &o<i taut tor alcoool ut t-r s: .:.s.i r.uid :;c sr-ia uo aot panoiui eaco other, in me bruin the id^vaoi rmtfiTs - t.tzner .'-nceutrauun nud remains much lufiser. almost twice an ioap. :z tnuiuifi about this subject to various workers. I Lave howu them auch curves :o tn* to bring out the tmponance of refrutrung iroa driakaz for * .-tfifiifics-at period of uae before goiug oo duty. There are many other host factors which o::ch` be auuiyzcd. but the pre- -eaiir <xnfitp.es ^uouid give an uidictutoa of the type of uuaiysii that cao m.oe. in cjunaiifiitn e terms, to relate safety, aao c.iiciency on no cyvaea* her:.-,.; hnsu. TL? :.c.u putsc oi mv t:dk uiii deal with human eajifieenag. or bictecb- ao:s~. fior.tt years aco. I wrote a book ior the airenut uidustry on "Human r actors m .^ir Traaspon Design," (McGraw Hiil, 1^40). Ten years later, l m p;*?ed to say, all the major aircraft manutacturing companies have from 10 to 3> employes in wnst are called human factors teams. In such instances .as p-viwiaa. the pnysuiocsst. the psychologist, the anthropologist and the r.z'-fifi.-r--'.L.-oucn mock-ups uud tUruueh careful studio*--analyte the effect iu::).*aer.; on l.urnnri jen'ormaoi c. Thv end result is a better intepra* :. .a i.; :ae worker nud Lis cgutimivul. iopruach concerns what 1 would cull host-agent rdnuousbips iu ocei- -vai.-. The point is that u trtcu arc to operate equipment ctUrientiy and ;_:w:y. miut be designed m ternis ol bunuu capabilities and limtULtioas. ^*e :c ru roc d:r mo per t-- 1 terr bus. rirb dm* ruilv but eon* Ti nnvii what out r TOO tK tions ificiac In came found exc-nv been t ?-\-:ccainqi ef Mrdizzi cr-i coryient Section .: . v* . ; 'n^vhoi Cl -\e -acobti . vaiccta. -.tticn- . -her: :.t<"CTi.r. acctiy xaa nau W* learned ic tie lost -that machines co ns: iri*. alone; they have ro be or?rste-i by men. wtti zl ef their linrimrirps. F*r instance, wo ri*-4i;:r.od a ""in; rsree finder. sr.fi ::ur>i that the izurzz;mt. as first developed. very accurate-, rut w-fien you put the hurras eyes a this maqe finder. the mama of rrrer try very rreat; imerocular oiitaaee aad a whole series of human factor; were round to be important If the cerizn ef ary kind of machinery involves interference of an established hart: pattern. you w-il have an inadvertent orrmtien of n control. I -n r:v nsry inter:`rirn .."."'rations ef this ir. :.*"itt*a. For in.s:anc*\ >n a fitl-r-'w:-. .z 5-7 airrraft : ;t r-vn*.?:/e ni pilots <vfs:n!rt r.'ivtir :.r \*.e :-tr- _r.J the Innriirn zttir. The `entrain unemtinn tr.nio rro i-;'re v-'-tr:-' ; **. ..T-rnt planes nu.-ur :na;rrr:ent rr.sjnmiiarton nr r-.:~ Mao -- a nctertruiy poor monitor of eminment. You know That from your on-- rua "ay -Keensr.:e. You expect men to wat**a. to look and to see. ar.i v#t they ;:.v.?:eri.iy :z "cat throuah a steam to "-ntca they snouid have reasteo. Thus s :.v.-i#*arv *? monitor men tart-nan tas equipment, or to cave men : '\-.t ~z:~:; refinnnn accidents is to maue an anvaace analysis of eouioner.t to v.*::vAr nr.-; tuntiaate mi possit-.e errr-rs m ccsnra waxen rr.iaat icao : to zacmotfs: ar.u ur-'Ute operations, i -r.-. very r .eased to sav taat one of our itu-.irr.ti r.as :. :-.zz-.-z uv interior *: a suamarme irota ttus point os v:*\v t.z `as vjy y;;rr.tv*.t. -:?r. ;>.-ac iu atfcns: 1 couni ooue tor ra* la tr.-1 t:ar.a:r.r itzzt -here mini ne -a . "rrattonai .*06 analysis 01 wcat >s requur-j : : yersen 'a *ae jon. Ia tae -...icr.a: pna^e. there mut ne ere- iicttra -.: -tr.r.-.T.ry. ur.1 a cn.s^ieration : r.uman .mutations. Then, in tae \ nock-up .-taco.y.u ^a--yzc the lavrreLatitasr.iai revateen itemsu-nich mdueace aeriemua.-e. :.::o 'a:- -..vts <>; various ai not appasent. except t *hn*uca -::rr-.-: `i/'rr.r.v.f.* >; me'-;>err.*t:n. * Th? r.ext : > i..u=s --ustaie types o; uctf.nty esaiysis. earned out to <ie- v *a: . t. yi-.r-s 01 Ti.e hr*: n-ia'os to `inva-.a a -- :rt-.ti:t-r,-y : v. -..Lt-.:ic !.> c<<:i:a. ivr.at lav ; a. . : r...r._:. y-.-s aud are : _su 'uu ttate roquirvtl. Uus :.*:v. a .- - - T.v-v..t: t:y.-a. --.a:.: in -.fee ways shat >f :i;c y :_uv.:.v -i:.<`Pvrafor not a --eat dual most of the rime. *ut hr nas t-i a.-^rt ir.d -.vatra ,-is;:aii,< ana -or.--. out oertatn uitserx-ations Th-r T.a -a * r. 5 .cv r^-c::. .f ::r. --.-ti'.nry .maiysu on the juo of -he '.ivsni'-'-r :r. _;.*;-.-r.rt. r.en you look at -iata ..at taese. you immediately see ; - .".at:: tuiri ; > f men. what nrop>r::.ia a: *r.*:r rime is used in mryinz ;t --. '.l ; nr-".;: a-nects f their -mti-.j. i: not ncce^.'ary *0 rake nt-of.ep ricturri :>.* v.ti kind of an .ituuy?:i. You can make careful yhservn- ;,.-ns -:f man at a--irk. Aee what he is required to do. and note the enticed f incsceats and peer sc~.:enu before the a-tcai accident* occur, r in this ?iide have tn ulustnuion of what an operational anuiysu, or one - earned ou: in a niors-un. mivht reveal, la this trurk. the dimmer switch is r found duretly uadersestb the clutch and brake pedals--and these are at the excessive heicixt of 9 inches from the door. Why should these locations have r> been selected, if case and efficiency in operation are desired? Se . A ' /. mi 4 * .1 108 Assodc:im .i- vransn Railroad* The next few slides deal with hv--- i_^r in relation to the derm 01 equip ment- Our anthropologists have --- r.rj- precue measure--c: all tarts of the body. Then lbee data hsve r-re: used to see how well a particular vehicle accommodates most 0; the tr.i envere. or what per csz: 0: tsc gmup is discommoded. This slide shows the distnbiuers :: tiree body dimensions--*n:nor am reach, knee height, and the f.intc ey* Ifvel. The chief eemr.eer of an auto motive company once said to me. ""wj ^ive often wonecred what the sitting eye level heicht should be ween w -- a ear." It is vbvtous tnat in manv cases such distributions have act :-nt i-rsjiable to the ce*:rr*rt and the en gineer has been working in terns ui average man." The avenge v-iUC. u not adequate: you must dc;~.tm t:* msce in a dutrthuth.a. You can't satisfy everybody in the districts::;:. ;-:ihly, but you sh- the know vnerc tlve cut-off points wouid be i-.r s:y srstrti proportion ci 'f>Ti la tru-.-k mod-.-! shown -- tats i..;- >. per rent 0: ::.e si--:: 4*.*j u-uck driver? vr>uio not ct-v their knre? tt: v.r wneei atm r. ::.t rr-.M-x w-ti; ever t :r. the two ? I wid :i.j a rr*vr t: :u:i~ moute enemtfers in Detroit, aaa taar? yT-e many sautes ;n rec-ai since they .ere aware of certain cvsic: :-- r.: * --.eenng hu--un r t-::s. How about tno operators oi year *- What at.s tie *.*.c^rer nave to reacu or ioou at. or uo. in reisuj: t. "isr* ;.e is attune, i ua; sure ::at improvements ciuiut oc r.iaue 1! .: an analysis were &i,,e. The next slide illustrates tne rr^."tusing shape v"o*nc :: uvsicn v: knobs ana stenches. i<> prever.: -- :sen::iv or :r.u*avr---1: c-peraif'i. The shapes shown can be disungu.?--.. ..m.~ i-set; **t:;cr ry tou r. -- -w;:~ ;; hsen degree of accuracy. I: *: kr. hs are 'k.*v -;.u be distinguished irom each other. :: .ui .. precictou U;-t t:.;e err.r in operation. For example. 1 ^ ;r:eat motor vc::*e aeuttat wt.*: p driver come at 60 mhes an nour a: reuened over to pu- wo:.__: c.ua.*e;:e lighter and mistakenly shut 0: the :ru -.gilts. xic haa ssr;-.u.* accident os a result of improper cesicu. This next slide shows the prut;::^ :: ;re:cninc mstrumeau :cr -:->e of rtau- inc. and to give the operator :^uormauon r.c nevus. .;.-'eau 0: giving a complete scale with cctihri -- ' -- ^ wuea the enttea; a;sas ir.vt.itv only a smaii portioo of the mace. smote the indicator :o show hot. or cold, or safe instead? In our ~t-- of trucks and butts we ioucc no st*sten:rti2ed attempt to oesicn t:: ^"ruments to giv- tr.e :^;rr,.a:ior. :: sinipio wavs, und direftiy be:'o:c x ?s :: the npemti'r. -t.r---~ exf-.r/.^rr may be found in railway encir.v- lo uvaerai. it may i<- said t:^:: ar.y ::^:r:r.iem iiiff.ru'.: :r. rea:. any v-.-r.ttvi unnevessaruy difiicuit to reach "t::;. any seat iuuuwmu r r y-.-sture r discorr.iort or any ur.necessaiy or*Turves to vision may eostr:ru;e <i:rcetiy to ao accident because of the d:u:ru.ry :: proper operation on the para of the driver. In addition, the cumuiati'-e of sucii dimeuitiw are Jure to in duce fatigue, resulting in the 'ver-s_ ifenoration of driver eiricney and perhaos leading to an accident. Tic next few >lidcs may *-,.:r interest to you. s:nrc *.::ey mvoiv the pnr.cit*.-.- f ;:*-v-ii..-:i . ; :r. : _ by viimuti::c --r ;:ymg tho-- features of equipment hu h vau?^ -- ii u. accident.*, f!.^ n_~.:w.*uil u troni the Cvrncil Cra.-h Injury project. -"Lm *v3f onmialiy s-;t up thrruca the Com mission on Accidental Trauma n.cn:> earlier. Vou U dnve ears. .> thi? Pr. ubjcct is very near employe* lor automc The ttrst show; tfar order is at the ertre; the steering wheel chances of \-our beu manuiactunttg compc are le? apt to open cancerous because of uhttun cwd informav. a.'i Klcni* are lwine r able to identify tue t suoMrouent models. T).!- rn-xt jiidc 'ii'"' N--:.e i:.ut :;.c v - ri.1'.: ? '.iov r*-ia`..- t uavuiuriv we oeec ..:..i wtt.er mirt* ot tne : :r.c witr. traumatic sur i the human ooov cat data sauuiu assist tne e W> must nave more c; ni prevent injunrs. 1 *::ry or--, retenmee " 1 -cat vi: ''n a jier~,a l uirne*.*. ti in mt sues-, nam-.-.vi pe vuuui urive -ami: away irotu vt_ la :c c-tferttve m n-oucuig My tiuk wiii be coat envtro&aent taeion m udked about the host or with bis equipment or t nf the host and agent in The comfort, safety, a uy a variety of enviro-. noise and vtoratiOQ. Ti comfort, disconifon.. anc i*i enguicvrs bevause it a; rvcwrdtog biological data \'t the chan represents v. oxide, carbon dioxide, he fort is concerned. This psychological boundary, circle mark the pbvsioioc Iu the fields of air an various engineering grouj the environmental s-nriuh temperature, noise, t-ibra unportam implications K .V.- A i i i Procettiir.f) '/ Mr:,cfii : -.a- gr.un r -:i ^ au:-> :i ..'n ;u .iicieaey tad r.ey iavev* -virr-c '.ao.sf .icrAi d ::vi *vn me Ccco- ira, .-o tzzs subject is very near to you. I know. and you prcaanly treat mere y-'ur employes tor automobile injuries than fvr any otrier '.aue. t The first -*hows the major cause.* <<: injury :n automobile accidents: tr.e ra::.< L order is at the extreme right. Aj you ?ee. a leading cause can be locate*: :.a the steering wheel assembly. secondly. if you are ejected from the car. chances of your being severely or fatally injured are much greater. Tie manufacturing companies have sow put better door lochs on the cars, so they are lota ape to open on impact. Thirdly. h::t:r.a the instrument p-.ir.ei :* iamr.-mus because of all the orotrv:::.a - n:-r.i. Ar. -^temot is b-*:r.r --r.z* * iyx*i information or. .i.l .: injury. .r;.n mra a .. :*i'ioiu-' arc faring rotta-i.-i -.inie m identify j.V th*^< 1: .: -r `r:t-. a iv . n -i.- :rr.:?-r:-.r.r. -> *rvv <-nn :v> rr- ttie-i m lUO-com-nc Tuc next ciiue shows the ireuuency *.t injury m ruation to tne treas. N'otc that the bead is ir.o<t ..wb:;.?. Thee tr.ts iunt *i;.:e :rom tae Cornell study rviatfcs tneuuta tram tr.e prwi.us slices, m terms of :re *ru*- r.ess *f the injury. Oaviously we need to know more aouut :;.s injury tarwnouia ot :a ;u asd other parts oishe body to impact forces, i _uvs*roup oi stuuesi* wor.<- :r.g with traumatic surgeons soa earmeers. *..*v:r.g t<? rsiate wnat au tr.o parts :f the human body cao stana ia terms ut tae anviicm forces of imcnct. auca fata should assist the engineer ;a ueitrzir.c equipment i-.-r naequate protection. **.> must have c.ure kuowiv-iue : ir.ur.-miUiJts .-viAtuusiiips - --'s -..> prevent injuries. Osiy one reference will i;c ruacs in r-fcaro tv uevicer. . u tut a seat belt on a p^r.-iou in a u:. -:.J s.so m. v-.-ment ~ ;ta a .-...u.us.-r harness. (I'ia not sucgestin2 ta-.t t_^ irr'cp --i ever ^.-vr .-.vwes: haroess) be could drive the ;a.' a erica: ~ux lit vJ r -a) mue* an ...ur aa-: cvalk away from it. Ia one crcamury study, itit ne-.ts r..oav nave proven tw he euectit'c iu roduciug injury hy m-.rs tuaa w per .Ti.t. My uik wiil be conciuiiod hy a :ri.-f amtlysy ! 1 :.d hos:- eaviroament factors in this epicetrjCiOi'icsi I p to a<*w . tiiked ab<jut tao best ..r opfruters -r.-i :.V cm:; -:; :.." .rfi his equipment --.r the s?iar. Xjw i-t u.- w.-r..*::i.r -a-.- i::t-.-rremt..:--i..: : fhost and agent in :hv eartrcameaml The .-onuort. .-aic-ty. and -rrr.ou-p- the . r-.m.t":` aro avi.>u.*ty ..n : i iiv a v;tr.ety of envtronrr.t;tai factors, -ucn .ompemturv. uiumuuit:a. i. noise nod vibration. The i.s.xt -Tide -bows in a schematic way the raaues vvmion. discomfort, and luirmrul v.t..-tj :-<r - iTins ;i.us appcui- to enrinc-crs because it :;r,,rr.r` i '-i p'it ..r.ar ~ ::.. < v.-.it they `hcuid .%aow rezarumu biological data ncv-#sary : r the ovsira cf equipment. The renter oi the chart represeots the optimum vaitjes :.? v:hratwa. noise, careen mou- .,xnie. caruoo dioxide, humiutty, v-r.fiation. r.-.-At. .v.d as far ns human com fort is concerned. This rr.-.'i.Ue virtue #how tr.e v.iucs `-orrcepoodiou to the psychological bouudary, or :aut for mco va.-uioie. acd vniues at the outer .Jr circle mark the physiological oouadary, or thresbold of injury. lo the fields of air nod eiuflway cransoortsuoo I have collaborated witn z various engineering groups in providing tbe threshold and tolerance limits for the environmental variables mentioned above. .\s you know, the control of temperature, noise, vibration, and toxic agents such as carbon monoxide has important tmpiic&Uoas for health and safety. It seems reasonable, for ex* * A k1 1 \ ' -- .1 .J < :-A r ~-i i 1 l ) ; Mncrnri/in nf m/nnn ftul'oidj 10 i rrr *.<ers 5: t c-iftcvs ~ raan n--":r-- rr* riiv'^rr. ' .:; -.i <?i imTrr:.*. ~ : ... J-.-ritru ;: :*:: -< ,lv P5 lo know j-'rr.cthtr.s ab^ut the ear apd Its ?e?e?::r:-v ::re m-M !jr-|y c;;<j do H'*t mi*r t"} :cc. I have found that encmeers will dsStca :o -- re: ! nc-e-^ary 'lata arc trrtdv nvsii:th;e to tiert. 7' : sh--;ld b prf-ont**} ir: n'Vis'TrerrA. rr.tr.-'o tzir. .< iv.tcracbt <>{ $** vr.ri:i:*Je ut"*n rsnctr.er. A r-:-.. tfi <:udic> "0 CT!vir'`n.r.*,.*ntfti itiduotufi oi .v ri-f-l* :;: tw* :it* ruiwr.y rrsr.*'-?f*r.tv tt. !i> V" rcrvdm--. ::::!* nr : liutT.tai*. :: i* (i.vioit- ;v u* :-.-r:ry tor tbv ivVvi# to c*r! r~?i with tarn t thrr. Also the r !!; v.-;.'.r.^.v ~mr * .m. . :* t.: mrrr.cui or i;v.'.r:r," ami :n*?rc rvsvnrcti i; aertrd ci tio :c *;:.i-- "ti i.-a sui.srts :a.- . i.'.* *',Lv>iuiv>. liy tr.ut. :.-.-cv?trcys-i *-zz'*"*r . - >-*- ..... rrc .... ;. the ulu:unsr.t:pn provided ia *r.e os.3 ;.i-r . ^ licit its . or ry---. i: is s::r? emeu.: - - ... *.:.. n-.ui vi V5<i.;:. Aue i* >! t.-trir* ir.ee ii . :.f *. . s. t t'..> ; Ifcvnv.-* Tcm-by rr.vrv rrocoin.-.a :;. :r:v.*v-u- : r : V. ra:i r/.:o that v.-jth ar. oquai ar.'.ount oi aatrt. can Or? :.y :iticr or.r c: ?} youac por.^u yf-r.rs iu cco tviii cat zezy the ?aa:e <*tijccrs are made some 17 liases chzitst. `..o sc\t ;: a s:..*v;i partly to dcc.uniirate the chsractcns:;.' curves c :- .--i ir. c. -V. ;. tv.r'Vati. ti -tmli*** nral tf <).< tit-' v.'sv ryf r--rostes r.:7-i . j:.- . p--; A-ii> v.' r.r.a:;:. - fi: .: miptatton ii, :J;v ><---- i *a;.:k. TLt -;ar:y rrr_.a ti.i* httik tLe fzr -i ',l :: 7:. <-r i:::a! !'.:>::t vi *!;e curve, the r*. 'i.'cr '... 7. ; dido i? ;rui:i a .-tuiiy o:i ViUiUUU A CviosCUCV, iuc i can soc -.vitU tlii-. comiititm. one docs not adapt as well. Tie next i'.idf-hows the reiattonship between arc and the ability to pemrre .'. uiidvr . ... Ir :s based oji a study we made ot" CtO suojo:-* rna ire--. :v war.' oi rec. As ynu can >?. the relruion-iio betws r.mi th oi tilur.iimt'f'n n'*od<fi is a stmieht line tuirtioo--it ** i'-r. v. i:-.* .f f'f tin(->).) vci-.n Thi- rrolft*.: :. :< a;>Out ' i ' o*Tfo;r.*.*< yt T>-)<-.rti-*i S,?!! a.*! at:d a o:?'k>c...u ta-n. ootm--mh tho aiw. whai tlio aiToct on a 1*0 ycr.r oid driwr .;.il a :t.'i : - ::*d'wnii4l winch njt: tjt .'0 pvr rt-:-.: ( the Itrr.t betorr it ti,.- .. . Also fcnscRj|-r that accident raos nt tticbl are tnree i:r.ea Proerj u.- i.ra m .iyu,nf. or Study. 1 U'itevr -re tiey c^rum a tsco ..itco w-^dsii^id are t ti'-'-resu variable* sbnu -*rurr-drsu are to *-- i^al utie demo; -_*.:z or ahdity to adap: - 'trandtes. i :e\-d a* ; ' l-riu; :z your bioo :~ttittvu-i;. Thus ii .. :i; curi*r*.-*wmocLc icerr *t 7 ;-..*::uitrd i: tht ` - u.-:-. r.t* to even --Tii -- iinwer the dueas R-t. *< vie m*< ti t'uiriy ruaatitativ I: ts prrposca that the ::ivt. asa study oi o: aretdeatai trac : -se &: the suittptc c . ir r.tr'ni' wav of i ' trr_` c: haams capabiiitie `i ; tie aost-ieeot mat. z inn eirtaee.tat. duca > fzuts 'S- tie deatca oi the uia :: acctdeau. Ii rjneiusion. the physic \i the prevention of ac Aiiei ry carefuuy coatroU rzmrs. and statistical amtrt-aioatsa with other b> Art.'s. Fiuaily. in the wo; At rt-iistj. iuuts followed : tiouiit and acti. iiu tie er.i c; all our ii: * w tie place for the fir TiAiil you. ^Applause) CsaduBtx.vrrr: Tl .l?re tcUowed a general " McFaritnd.) Dinwctt: TTc 11 i : v.ced. we had xneetiac is were still present. We h > `jwii/w*<y. of the Cc i. Ch;y:..io u Vice-Chain | .3 .'Wftiins* of Mi-imi and .>ury:cd h-.Ciw/. ill -.in ?> meet -.*m. Tore * ; r.ua linear r. A ..-rent i v-havDr -!l . .v .'mer.-ity i i At w . v-t-i ,v:: r. -tvd ,-n -i:i t v.hatvv-T t:::s his ..-yes :hv cab was . *di:?:cult to 'an*e in this. ;>r .r.r-'ir.c-.d ::-.re. objects : curve* * n- ariv r<:r*ton u.c -urve .:n:um Dvr r..-.erv:y. and " to piTi '-ivr -0 *uu;Cv:5 tup between vttioa--n.s . j a:>ou: 0.9. : a biological nr old driver Debt before it throe times as bisU a. a: J.-.l**v*is *f hhiu-.uuitiuti. I *.yiutit this pmoi*a for further study. ; . .k.ve enuunvrs should know something ao^ut uutuan viaa.n buore they ersiun a seat ausoroin; windowshietd. It the nod features of the tinted umdshts.u r.re to be used advantageously. all of these human and physical variables should be considered in tbeir interrelationship with each : other ti accidents are to be prevented and operational efficiency increased. 1 The final slide demonstrates the iadueoce of carbon monoxide on sight i vision or ability *-: adapt in darkness. ii a aGD-imokw inhales the >e:oke ..f cr : .::r ..u-z-.f.-.i. i:.i azr.rrar.t^-arijosyj-.vra' eh-bin m bivo<: ruuy .* .i -h as hiss - t. .* -s ;> d t-r -'.-.it. ii th*?re is this :r.y;s sra'jxy- .'.ens'.sii/om :z y.v:r s. f;u ::;e u.cygea iatumewu is the same as at aoout 7.v,,\> :: of ii Wdc. 7__: u a r.r-:;:: vrsun-tte smoker tnhnzes. be has trors 5:05 y-;r cent c:rr , \v _r.t:;S-uOta in za hD-sd. and bis abh:ty to see ui am: itzut i reduced a* if - --r.-e ,`.000 to 9.000 feet altitude. The eiieets are oovtousiy ; greatly accem-zaze-a - -.acre are aaditwasl amounts of CO from ensuse exaaust or upon ascents* *o .-rn m-xicrute altitudes. What oetter xamwe cou.g oe ri'-'^n in show::..*- ;_*ect etiecti of vertain cnvironrr.er.uu muacccw on ue- * r.av.nr, as v.'<u r_- :a; tazcrreuittonsni? between iue host. .:^vuu ana c&virou* tv.rmt in fairly ? torrr.i. It :s :;rnrvi;->i *_: enidesbiionts approach vrlnmaav ucveiuped :or tie control and study ;: mass infectious auestse is also appucaoie to tne stuev saa .cnrrol of -.zzi i.Z'-- :rau~ua .tsmzlur i.;o;n<ic p::ati:..ei arc \r.v.,.Voz. -us .i-ause or :r.c rr.; ;r. .* causes *<i a-.viuvnts. j -tar.-ien . iv r*.** -luircmcnt. One impvrurnt -ay ' improving safery by tav 'ivsicn .f ui terms of human curaauities and lirmtatzans. This iavr,;v-'j cue (.,>cr :r.:>.rrs* tlon of the bost-auta: rjlutioasnips throusa the application o; me pr;ac.'j.ea of human engineehne. Sucaaa approach u.uizes an advance nnaiysa of r-'.sy.sie ; .&uit3 in the c<;irn c: the equipment ami iin aid iubsfantaiiiy :a rs-uuc* ; tiun of accidents. la coaciusion. tbs physician -n U/day uud tue iu'.ure . u.^y m ..... ..".an: .i.le in the prevrr.*: -n *: r*.--tulcnts. The roxt w:.`l * ro- 1 :iu:ed !)V it;*-.;_..y r.tr,c..vil iwnori.'.wf.'ui ;.v-. uv. : c.c : .-'Urvcy-i. and ;tdttstt-^i :inu!y.-:s. ..:.d v.`:*:i `ir: m-.-n 'ii ::c-r z. niiabomuon ::;ef s. ,"Z`.;vo . miiccrs. rimuly. ;c .f the yv ri. T. h. ch.--'. " TL ..-e zr.- :.:u;s j and cuessea. hints followed by cucsscs: ;:nd rise r<-c is prayer. oi>.-'-r'tince. discipline, thou-h: and netion." and acn:n. " - *iu;ll n<;t --use fr*m .vpiom- liua. and the :>! ill *'ir wul le to -.rr.v* re we ....-i. ,mu ,, to snow the pic.ce :.r first time." Thank you. .Aziauiei Cii.vmiiicv Bu.'.'srm Thank y^u Dr. Mcrariaad. that was ir.ucvu most revmiiog. *. (There ioilowea i resend on the record <Iu>cumioq of the paper presented .1 by Dr. McFariand.) 3 CHuauAcc Bssygrr: We are now ready to coatinue wubour mceuug. As you noticed, we nsu a meeting of the Comnuttee of Direction for those members who were still present We have elected a ncr Chairman for next year, and he ** is Dr. Coldowsicy. of the Central Ilauxood of New Jersey. (Applause) Dr. M. B. Dayton ii \lce-CUainnan. -- - *. sm-arte i i .4 i i .'.sytciation of American Jlaiiroaej I u_ ;*- Z. ; would Le nveii Dr. IA-eand Dr. 1 J<*hon would o^ror*. Dr Gol<iv* rirurr.*rif` L'r. zi escorted Dr. >kv to the rostrum.) Bennett: Dr. GoJdo'>ky. are dtuci.v.-'l t> have you. iive anyone oeutr. I'm coin? 10 let you carry on with the rest o; Aii T xi say is, gerfiemen. that 1 lave en?oyed try stay in tin- rvxittor;. I :r-.y L*"i tried to carry t.n with the trust that you have put trt tv.e. It;::*- coin? to turn the Chaga-.afuhip of the Medical t::d Suroeal 5-ci>r. Goidt-wiky. Good luck' fAppiau.ei It- -... <-ty assumed the chair.) <joavowv: Tuank you very much. Zs'r~ K .-ton: I think this ha? been ti.- must oijtstat.*;::.:: r ; '\<- Li..- : -ruSTUm. I SJ.-W r.v:- \ ;... *.-. : --r. o' :.v :.y & r line.- named fc:.:.' : .. *: :.. :: Titir v*t* <v tD. ;;r;. n * ; . ------- : 1 so acrev. T_.- i .-r.ctr sro?e s.-.b appiauued.) 1 T- 2 Ti.ar.2 you. Thauk y<ju very muen. . ... : .-... . Gou^'* sky: V* shaii uroevea wan tv.tr tircrram. vi-- v * l. t if.r ,-!r.'5 imormal ih.?cusiua later. V.e v.u) now r.-.-.r :-on< :: _r : vtsv.cr *>*.:.<, :.vs ovcu wnu us Jor a r*.-w uav.*. ar.a wcvn; v.u . v.a: :a:i: ; , ui <n "TL* ilauwav Mvuicai s-;rvir*3 *. Mvxu'u --- . .aavci. ^Applause) Z l. . .f-rston. Ferrucami Dei Pacibro, h. A. a C. V. Guuua- --. i.ir. Cluotna:i. tame* aa*i cstcvmcu <'waa-uc. o-.- : :: - t: ~5--. yv.u wuu some oi our prumnns. wiii'-r. may or ;:iav au; Pe *>: i. ;i.ay i .-ay a u-w uoru-' auprwauion auo expre.*? my luau*:* .* a-vj : .. privut-u1- c. ;k-uiit nth v.*u and tu;fiymc ;au ucu exavricaw. t"--- - r* aa.v li.t nr^c tune ui ihe history oi your Aaoaauon toat ooe ot our '*.csth r._- ,-j.di tas bees repre*eoti at oae of vour meeuBjja. I tiauk you I'.z.i'izt:'-':. r -- opportunity both for siyseif and ior my country. Ti: r... t.n. rJCi; oi Mexico is ue ro^uit oi the ifevuiuttou oi 101C 7:.. -stu?; c: the country from a compieteiy puiiomi aad apricuitumi - : ir. u:uustr;a;;y modern one. p<K-d vital prahlema on i/ott; ikr V-.~ --: natsc.a) cvei. As & tiation wc Lad bw.-ir.c ro^mzua'. <; *.L-. r.uustrai expausiun. but we puafa] do khitd human resources 'rz ~ z. i' r*'*cru:t a ialr force, lo a few abort years we were obligated to tram ic-= itvrduaJ in skills compievviy oiasumiar to those be had previously acpu-<rd. i^r.eiv the merbaoical skills necessary to our national development. D'umr uu: educational ptocc-rs we were forced to rccocnue the ur.portA&ce it the piyr.rs- wtil-heme oi ihe indindual to industry and the nation, and to *ike mi. .-rtis lu uro'.ect the health of our workers. .U a >vcuvu:e t:e i<i. iaadc-quatv Kt-JcrJ Labor Laws were aban- izne-z ar.: z~-\- ones formulated and protauicated. Tbc present Kwlemi Labor L>wj ; M-v -'j arc among '.sc most advanced in the western world. _ - :9 the ---vt tv viimtna --uoon me -- 'll* v<or lt>. 's""r* '-e first to :?n:rets ha --lail. la vaoii * workers r. :iT:onat reo : mdustr arexoraru.-muntc am medi.-r;: a- Llr L.-w. ,:.un in toe n :*r</vi,ie i .:i*l level. tie^d preoee :-rnnrv of liividuai fuii -i roie .i r.;e .*: `otatty con .r.i moevrn a: ::zz:z.c. aspects .r. 2-- .ir.* a> Ci*ie r__wy sy.-iems tiraadine toed vt ;ii--v trained in ail iv. Mir rtipecttve fields Airiest without exce traiafd tp toreico clinics T.e ?: T'lem Pacific Ra i'- r: 'Tt.Ciiiinply uener : --j^n specialMe i.-' rii--ri u4 to spread t vrv.-*:>e *. the benefit of Our Fvtrrsl Labor Lac it# workers. This law pcx and crr.tm diseases coos obhntioa oa the part of t la tie zrsz Railway Lai bilify vi ittfod all aceider. ;:ut> ar.i incurred ot wix*. w::i lie exception of the latest railway Labor PrvCf.'itnys / .Ucuicot ti'ui.- .'xlwn jy '.029 lii- workers groups had inx\>:nc - .stve and rrsi. Ti.ey .Toned 10 vdroir.ate the servitude io which labor hau hefvtoiufe ix>ec Cesu or.: insist uuvn more humanitarian treatment ior their members. I In this year VXi'J. tee Union of Railway Workers demanded and were con* l cried the dm contracts between this industry and its workers- since then *he contracts have iv--a revised four times. in each distance to the worker? . maai. i:: .ara *t rwi-son. n :.si 4ir.u*nins :mv-- t\"ii ersn'-- : .Vs :r.e w ifkefs u;:;.; ' (>.; ;ac i.e mjiTi; ,i--... `.he r.uc.-'r.ii 's`<itv>;tiv.`v.ie :hk univrvitt .a *.:att .*?ra;:*. _ya.-i:y ::: :u*rv. :--OU;r--d inui M v.:*.r- ;--r ..............nr;..;:., ~ Z.'ti lae.wrauie I.....v-swinn. io educate .a;>or ;> a prac'n-a* rv.i;;a-- : the {m:: rr.ic atm :ai limitations ut the .-untry. .a :.:e r.:-.\i:.ai active:. However, -u; ciimraiiuas to the workers have cv-n rtttr.ttiuiy ' ::ow tb.*rvc thv uacnuincfioii .: *.r.e riuiwav r. " tt5 with .-C-.-r v:: -r::.r more eXleiiMVe tnvu.cal service taaa r.niutrvu t<v *.-.? i'-'icmi L-aor t-v.v; . . r this reason t;-. rauway union* rciiiseu to .i.t r.rticipatioa :.ew .-'viierui Crucial C*cvur::y L-'-c. vkieu : an eXOen:::e:'._. ' attempt to nruviiie r.:r...ai service, bvii.-nuua ;uu compensations J*r an a:.-.r ...t a ballot..*. '. - -viexav "- . n :s a c.-r-.'i.wry :4taiw imirKct. : .-or a-.v:t:i..u;s -~-t ... *rt:::e-r uvitv: ;azi :;;:;c'. :i at ::ie i-vvi vt :-:hc:r*!vv, This . t.'-citru '.r.i r-.-ii [ m u;uuj;rv i- ..aUuuji, 1..- mu*av -v * Mexico are totady *-uc`.r.ieti by tne rVje'ai 'Juwrr.rr.-nt. -.v-i.-n dviuat.--: j eif.cieat and modern aarmach to tne health or-otem. j MEDICAL ASPECTS OF LEGAL AND CON'TP-VCTCAL OBLIGATIONS ' in 'ii ;. :ir. Citie; r ::-c,.--ri <[ i lie r --rr >. urru uei Piemvo. ol :... ' a jrw ^cor .:. .* 'll .. m . :-.v .iii*-u:. i.-eciAsiy "aii'.T'l its an -r-s:. :..:s .! 'heir r -u 'I. X-r.-.v. 'sir .-..ii.-. i : i -ns:..-: v. I ac: .id-umturv. : Almost *.*cr:;! t*::n. tiiv>c 'n.x*nii.*cs anu uvr.ni.-ians have i.i*r. *-.imeti tn i-T-vcti <-::ntr-s and :;o*pn:iis. vsoeviaiiy m 'hose ut ti-.i L'nitdi ctat.-'. T' - '^uti.ern i!.::l-.vav lIi>sonals n:i-i :hc r.-nversirv ,.j Chititci :.av- -fi ".i *':.r.i.;.,i\- c'-n-.-r-'iej in rcceivsna t<ur ;ir<iirj-"."c tnvn tor traminr ..-; ttseir '--:n (/x-iaittes. This nucleus 'tcet:<-r:t!v f ratnod yoiuiff du^terf has ensnl-d js to .-tiroad *itro>ienotit <>ur orc-ntisuon * man concept oi rt:<Nii-'.*i "rtrn-f. *v* iwuetit-'i ixth ftu* worker atui '.he nation. "Wr K-rlerai f^dtor i-a-.v -l.*sriy .iehnes tiic ohinrations ui iudu.*try tmnM - workers. Tt.is law provides tor treaimc.it nf accidents incurred m service ' ami certain dien.*~< nm^tdered as professional. It does not establish any ? ohlieation on the |mrt t industry to tne inmates oi its employ**. J In the drat Railway labor Omtract*. the company accepted the roponsi- hility to attend all accident*, both ihose incurred durm< the penomnuice oi t duty, and those mcumi out of service, arid all illnosea, proir-*slonal or otherj ie. with the exception tho.se oi a venfeal chancier. With the siemne of - the latest Raiiwav labor Contract, the railroad accepted the treatment of t i 3 A i i -4 'i|t * t f^iiaur ZirtL: disease s-r 4 c-*~ture c: bctfirtai *..? :ir zlzzz. ; frereweit; r/T-mioni'al 'tt at t* Mi-i-tai jer.t.'e a.s. intjud-- - * ; t-t:--:.t.'. :::. v-. r.i:t r-rs rnntref- A: `.iis n::rc have a - - r :: ::' :vcr T-vricr:. i.rr.:~*.4-i i"?rex:rr._u.'-* X.;--. :t 1.2''1 rr.:..$. XT- tiv.nii'.c- .'.; crr-Tid'-v..- ' * . -- ::->ye. T:..- * p-srstii :or wL.z; " < meat :* * m-.:^7.. :. r.rcvr c^p;: r... :;.v. *?. jjied * ctt-." jet:.- arc *>* iii.j.rr.xj uaui::.tvrs try ; V c- 'Ji. . -- -- . - .s^r* '; :.:.v .;' **.* " '*r Mettmi sen-: -to *;' Z ~-- -.T-: : * v t;.r :: : : r:.: .t *.? * Zrfl'JT? > itO Xi. .. : w - '.--.a tieUira. iXXvit.: Z XX t Z.'. ' 1 .*t,-t r--y-r v. T -t: :i:f ::: -rp;:-.:.x :i..* x:;e cost <: ".c-uictisw -it r ii? .-x..x..\ v ; :y : -* .- -- - t.v.- ce^axxatig:; o? ::it:zal depaeime.nt in-rr-r.cy .'..xb-Viii it: s ivnnsitty e-riXitH.'C *.o : a_. rrou:r_-.i :; t .: * ;:-:___ : are traa?>crrco Xv :i- _ wr.t-rv y caxn ae ---i-rr---:* :asenvd ccitr-liyi- -l ;;i- . ;:?* . u:::-..-. :ir DtpartSirat aa* .ti'-itj i: r : rr.ji'.i-.. ?; .. : c: t:.y iX.-i; "i' f tv r;-.; :> uu:x- i-'-'r s, r v. .; t 'ravvlinr c...... r.: r.;. "ft__v :t :vr. v-u .iv_i.\uu- ::t..y :risir.;vat c: :..:ic-r i-"..:-;--1 it.; ;tu: obva:iia '-i-. iroesiviy for later hosp:- -a Tir total capacity i- tmh aa additional 50 t^c; isr tu* ' '-r.-iTt. r.cre Tii*sc it::-:.- sjv vtretewi in a modern covers^.*!; sa=j- save a : r '-ur |*aticnt. who arc atteai py y.iric.c. 7I.-.SONNEL :rv.";:vt--.-..vc -::d nv;.. r:.:; a-ittsrs. tac Medurii Donsrtr.rat n^m .Kffis'.-M.: M.-.i'.accr c: tr.e ra .=-ir. Tl*e Hopitai Departn-vit <-ry. -""X :: v. i iive i.;. it; ; --itxi :t X- '-~n: :ur*~: =xs-^" X-ray. f. *t. tau c.-- vJ 4 :: -./ '!liotl tiul '..Lii *.-> `it -av.*.s. meat t zs -xpi-c-z. rata rcierviucns. -rkere. dir.rbuvxJ i tc-ndec: :: r `-s r *Ve kavr -;J i. `..r Macvtlaa 11=:*'^ .. risers.- .. - .Tl : - <1 0 islutil ! i;.: > ::wo* .^A n>*rrmc2uli.T.:>__ _ :.rsv> .;r_; *-.r.v*nne* .1 m the t{fc . :kccs. xted Maoris the ihn-* a: fartsis Oi-iilajarx, r r.r ad`!:?i>*rui . t- :*i `r.e _"?r -f-sctler- .: : ;i:.-i]{hiv . "arsny. -.jia*t:vr_s. :;.t -ita^r/.rts .r ifjja is -ti a ::-r ;::r^;CATio;-T pa;*:,;x:-'T5 '. aont'tr.^i ..cccro..t-r . , > i:. i to ri* <:ap:oy-s zu. doiUw-:::ss ccacue v*r.5* anaqal t ^ ' MEJCT rr*ii t > \-7rJ t Ut ;wvl lir.:: r . ..* v.M :$n ..T.r. .* h-nnl. . . *o :i :. i.-.-sfl. '* 'j- ao cor-tiauu--y ." is truv-itrz -erv* :.or u-;c:*;ct3 actl -t3aiua.tioa, ,:al 50 bei3 tor tu* :. ^ovtmtneat io ore atteaaed by ..vpartmeat reports vnartmeat is cotu- suiary aah iy--. ; --rvi.v. Due to a -- iMi-ri*. *:outrr..*t. -'c : -,ra forrcu ro ti>* total indemnity -r.i T-'.zs: z to ^'ho-* m.vijci:v r-.-iOvS it .~"Ou~.r.i for them to coatiaue the * :c -.a v.-tueh tlwy were e=aioyj tfae ae of the tecideat. iut "r,,se \z at^ ity i.i not i:immin!;.v.' eirh eit?;oyrtiat ia fc aoother branch of *rin justice these cx^e saouixi cov be cuuii 6ed ns totailr incaaaer^tefi. la pro:V**tonsi ch--^se ircidents. empioyes r~.*rtve full rxiarv ter the f- entire pemni -:i t:^:---rat. eoriters abo lusve tfcc r-.zat to two *wxj *iefc bave a vear *itfa :tti aiiary- ia the past, this latter cvatractuai oremUT*. wu theoeciisoa i-jt m*ea louseoo toe part <u` employe*. Vmraentiy ~ ?rder *> - - A 11* .-UMcioiton ef Amcnmn Railroads I I i :o c :.-*aui two vtwki extension of their vacation with pay. they simulated. or attempted to *ituuiu:c*un Other rases oi proiooced noo-nroieaatooal ? iilir?.* wruch invalidated the worker were observed, in which after the lapse of j tie :*o weeks fuu-oay p-riod. the patient and his family were confronted with grave financial problems. In view of the abuse oi this privateer is some cases as c t >>--.d to the actuai ctancai necessity in others, cunae the discussion of t tic last labor contract. ! succesuxl a modification wr.teh va unammousiv accepted. This uow eiause rends as follows: " An employe who has not availed atm--u c-: the two annual sick icaw with pay. rosy accumulate this tint* t-.-tuly cr u*. part. *' tuat -J j;tve*nry l<riw t a non-po!Cs.'i-':.ai uisc^s. i,v wh. : -.-tv.' tail t-.y :*r r. t '>tui i*i 1H days. This modui'-jii--r. *.: the contract wiU tre retroactive tor a r^nou oi 10 years." The benefits of this modification ha*--. uir.-udy pa*er.t. :: v.i- :. r*o'n!vn: ci suit* l*y tii- p;ihiic for tr*uiT;*r'>i *... ". .:::r T\i- ' ti.e rv::r.;:v' ihiv.-ati-T: ::r ;:r s* i::;-,.- j i i. \--r:i tw.-or'-r w:v::-c u \ >. i:hi oi accident tne setUement i hsnetied oy rr.tr insurance com- ; * : .....-i i\ i*;-. c-v.rna:eit :;d i.* entirely oubiuf ti.v .uri-ui'-imti <>: T H ru J r 3 0 IJ.UJUclM lU ildC O M )U I)U < IIT T W U H )0 ".-.-*~r.zarea lewstatistical projections. which i ptiteveare*i-!-xo^inatorv. - flll3 J Pr :'-t>iin':x < %f`-ncii -.\?i N*nion. ....______ ` * ns Auodatien of Amcnccn Reiiroaaa FERROCARRIL DEL PACIFICO. S. A. DE C. V. MEXICO--1966 ANNUAL PAY ROLL . JLM. Total Varies________________ ___ ____________S1C0.$.306 U.S.Cv. 512.S3.L044 ProfessKiaal Accidents and Iiioer.sc;$ 2J)99.15S - $ 167.023 Pert-ratact.............._.... .......................... ..... 1.3% Xon-Pr?*:'t>inal Accident* and Ii:uvs*ea____ S 2.SS..,:2Q $ 231.010 Pcrtrotacc.................................. ...................... I.$% FEPROCARPJL DEL PACIFICO. S. A. DE C. V. 4 r MEXICO-1SS5 -- --tr- TOTAL HOSPITAL DAYS 65.513 Hfapu-tuatiun Cut;. Per Day Fur 7WI:.. L:ra-y. Mental C-*w.................. ...... :2x2S 53. FERROCARRH DEL PACIFICO. S. A. DE C. V. MEXICO--1956 HUMBER OF PROFESSIONAL ACCIDENTS In-Patients............................................................. ....... 7$4 Out-Patten? ______________ ___ __ ______________ 2.764 Tf'.at. ............................. ............................ o.*>4> FERROCARRIL DEL PACIFICO, S. A. DE C. V. MEXICO--196S COST PER CAPITA PROFESSIONAL PATIENT la*Pancut_____________ Gut-Patient....................... M.M. cj02.5j 5 44.23 U.S.Cr. -S>J.4o 5 2.64 COST la*?: Oul- FK fee: HUM. In-Pa: Out-P T FERI COST PE In-Put Out-Pe m / ' ::>r ~~r-i > FERROCARRH DEL PACIFICO. 5. A. DE C. V. COST PER CAPITA OF PROFESSIONAL ACCIDENTS ::.m. c.s.c.7. ___ -____ _ **7." M .'1 T*.nT FERROCARRLL DEL PACIFICO* S. A. DE C. V. o?number professional illnesses 1 ......................... . ..... ........... * FSRROCARRIL DEL PACIFICO. 5- A. DE C. V. number 0? ngn-profe--ional accidents .... ............ ................... ..................... * tul ......... {.i*>3 ferrocarril eel ?ac:fico. s. A- DE c. V. MEE3CO-1S55 COST PER CAPITA. NON-PROFESSIONAL ACCIDENTS fu-Pntu-ui......... ........... Out-PMieat------------------ M.M. j.>Ao.*J3 5 H.23 OS-Cf$44.A0 $ 3.S4 v -v*r*rvf xistion o/Armaxn Railroads 7ER&OCAR3XL DEL PACIHCO, S. A. DE C. V. MEXICO -1956 ?!E.ETTAiZ 0? PROFESSIONAL ACCIDENTS BY DEPARTMENTS E sssrsests ** * . ^ ^ * i1 No. of No. of } Per- Zaptores ! Accidents j eeau*e 1 ^1 4.S-5T. ! i ----------------------------------------------- ' 1.903 |1 1 2iA . ...... ....................... > I .ft;-; 44.7 ._* - 5 - V.i ^ r o o -----------------..-TisMMtiTspawrv. .... - . ::io -S7 -> ; o; V.M :a <y() ............ ................................. FZSROCAFRZ. DEL PACIFICO. S. A D C. V. MEXICO--1956 ::*t:.:ser c? non-professional illnesses 4S.091 ; -- RJv NEMSER RC Li-ritse: RRO -p*:n I? S nf '[i ::<v rot; et:on r.'i I2?-?X>CARRIL DEL PACI7IC0. S. A. DS C. V. MEXICO--135S TJL. LEPROSY AN*D MENTAL PATENTS :s........ .................... .................................... 303 ;i?J>OCARRIL DEL PACIFICO. 5. A. DE C. V. Mexico--i:ss ::iT PEE PATIENT T.B.. LEPROSY AND MENTAL .................. M.M. 1 *-.5X7. is ri.'J'.OC.APJUL DEL PACIHCO. S. A. DE C. V. MEXICO -- 1135 ::iT PER CAPITA NON-PP.OTESSION'AL PATENT c.sxr. ....... : 4VC3 ? 3.31 EP-ROCARRIL DEL PACIFICO. 3. A. DE C. V. MEXICO-1235 ---------------------------- ` '* *;- . - - . - rr <vl > *r *-r- - I: Aiitaciton of American Rs'i'O^ds TEPJIOCARRIL DEL PACIHCO. S. A- DE C. V. MEXICO--1956 NwMSSR OP EMPLOYE'S FAMILIES ATTENDED ......... ..... -- - _______________ lti.3$5 rr?.?.ocA?jL del pacihco. s. a. de c. y. MEXICO--1953 C3E7 PIP. CAPITA E5.S?LOYE'S FAMILIESs M.M. :o.h .v> L\S.Cy'34.33 : 3-5 ; PZ2P.0CA?JJL DEL PACIHCO, S. A. DE C. V. MEXICO--1956 number o? patients attended '1,702 TZRROCARRIL DEL PACIFICO, S. A. DE C. V. MEXICO--1966 AVERAGE HOSPITALIZATION DAYS '.T:'es?:c=ai Accidents.-----____ _______ IS.67 day.-! v rv-Proi'c-'.^otirtl Accidents............................ ; ll.tiidny* n-?.*c:sa>JOHaJ lilnesa...... ...... ............. -........... 11.43 day* rim-iesof Employes.............. ..........-............ --y.In days T.2.. L*sm*y and Mental............................... 02.46 days Cu4J&ma.v jotoresunc ac IVc shftii nknow ius pati< epeei&i coom; our rues'. w-ns At this tunc of Thailand, Thailand-" Du. .0. Hoi Chairmu;:. of lite Assocm .-ayiii~ a lew tv r.;. vnnv Cv:UiC . :....... 'rt:i Gv bur r'jriuuc iron: :.auk:iune. Ti Puciac UctsiuThe popusutio orient t unite: Air Center. 00 land * is erv r East. It is tboueh Thailand suet Admitted that oi the limited general knotric principal lines sidings and y* public both ps acquired oOO lc !0 per cent arc 1957 are ti,500 Prior u> Ju owned and op during World 1 A rapid rcbabl agement were \ government th expeditious at: promulgated tt autonomous in siooers, appoic the State Raiiv tioQ in Thaila 30.000 men an P'nctmr. :t cf Metical end S;.v:cu. csvrvn Cu.UAAi.t-v CouxjwsKr: Thank you very ztuen. Z:. Ciuver. r r..it interesting and informative paper on the mar.-aus e: M:wn. We *hall r.ow proceed -a ::h the next sp'rakcr. . -.ry t maiviuual. 1 know his {uticacc. because wa Wednesday. _uy r~.r?*-'-zr. . _r special committee met ad afternoon aaa from e:d\l 7 m. 13.15 *_m.. -la our truest was right with us. and bore with us tirrugu agi --- At this time 1 would tike to present Dr. G. H::use:a:e. the state RaVseaya of Thailand. who will address us 00 "Tb; 7-idvray Mecirai ier."res :a Thailand." Dit. < I. 1 Rauivnv.* ...f T;;......k. 7........ ! rhe .V.'iocu-.tJ'a ot .\r.:vr:.*asr idiuruads. t .rr.uuy ".r . -tiy;r.s a f-.-.v woto* h-r** - nay at y.ur Thtriv-.- vc::: Annua. M ..:;s :_e _-.ner.ii vivws otiu ruuv.ay .t.-.-ukiu .*erviev <: :... .v ,x. before coin? into detuus. i .-nnuid tike 10 give you descriptions oi fiiodauu. Tkaiinud. the iur_; ay :rv**dum and the popiLaiCns are caked Tim. Vi-: .W-rih bv i>unr.a and L~v. e-juth by iir.tish iC_-.:u: Vietnam and C-ajiboutu-un-; V-3t by tinrma. Vi; ;'jjsr:sc from North to i. u:a haemc Teaaoi-srja - backbone. The netsiniubi ; oouad \V..-st tv Paciac Ocean. The site m tr.c* country as ab^'.: :.;s The pypuiatton is a :;.-ac 3 i.OOO.CcO :C C.'.sutai V iliuzk-.-k I.'.'OiV.tiih havi:^ . Air Center.-'nisi.icrvd t :a.-A:rr * ......4 - rr. ............. iand now is.^rauuaiiy i-H.t-ortunc the'.vi-rM ' :_____.:: . ........ Far Hast. It is thought that some facts aad hrures --t e.~:: : .: Thailand might be oi interest to the partic-.;_-..ar m'-cs _a -_irvjrs. Admitted that the information is not as corcyr-a-nitve ascara-a of the limited time fur this preparation. It is a.-.v-ver :r:raa*i v-.-avry a general kaowiol^c oi the ctate ibid-.vay< fy.- " f \.s rrincinnl lines open to rrattic 13 !;:lomst-r- :a:i:aiia : aale tra.as. o.iiacs and yird tr.n-ks. V.`ith a primary .r;-v . : ...- ...rr. : :: j.r.'.*.? yjidie both 'y.L:isa^vr and r.*ansp>r; ;; ;.'. ,-s. ::,..v.;v _-.s ::roii;re<l im 0:it t:.-.-^. *. ;vr .-.n; . .:. __1 I!) t*r cent are Uie-A vicetric <-n-ri:`.'-s. X'ms-.: :r. `*' ar iOiT are tj.:VX) fnricht "veenas and olti pn-serr/r arn-.-t. Prior t<> .July l. l'.Vl -B.E. the .'a'e :i.axvvs f T..-.aana '-'is o-.vnvd and by the ci*v.:rni:-.-nt, ; .1 r rr- a.- ,a-.r/.aae luring >VorKl vVar II atuch trcn:vn(iou?iy .rr;:.,.! .... , r.;r yrra:. -:a>. A mold rehabilitation vv:is the only soiutuia. i: :> am;*; .: *ie raan- :i?emcnt uere put iu the hands of an autonor.v; ;s amtaorre. r.'-ror^:;ii to tae ^overnmetu ibrouea the minister of cornmuramt: :as. a :a:rnt :.ira;u*.< '.ns expeditious attamrueat of the ultimate aim. r_< rav.-:?.--;.-_*ecuuuy promuJcsted the Untlway Act (I'Jol) B.il. i94. rrsaunj *r.e eui:< ;laiys an xutooomous iadependeot organization under Me iicsra of Ra'i^ay i~~-~r--^- stoners, appointed by the government. With var.ous --.rues or transrortauon the State Idulwsys yet remain the principal a.-.-i oh-.mivc nv.tma 0: traniprna tion in Thailand. At present the State Railway? etsaloy aitccrtner aoout 30.000 men and women. All railway employes and mearners of their facuiiea 4 Aaocxalian of Amtncnn fciiiroadj have ihc advantage oi the iaciliUca provided for their welfare by the Medical service Hurtau. New i*cmus and modem methods of treating curious di-- | have been add-si- A new and modem railway ho.-pua) was cstabiti-bcd recently is tit pronmtty of ^laksssa TVoriahon. and a rii.Mjecsary section at tie Central Headquarters was also put in ierv.ee. At the present time, the aedieei eervtce bureau has acquired 20 physician* and pharmacist.-;. 23 nurses and 35 eanimry i-sr*-nors. The feme* is performed oa a centralized hast*. For medical facilities tr.r system is divided into its division.-, each of which i5 supervised by tie Kcctruai Doctor- All physicians art workiuc on a full-time scaie. Tie erst aid centers with sanitary inspectors have been appointed in various locations aa.i their aeuvitit* are under the control vi the Hvoonal Doctors. Fr-.-r sie-nru.es are provided fur the employes end their iamiiu-s *x*-epi for the eapeUstvt patented medicines. (They ere ciutrgvd at cost prices.} The Pre-fcitr-pioyricat examinations with basic information for proper placement os ali apnii^nat? nave been performed under striri n-pulations. The frequency s:.u evtvr.t::_r rv.-rKirr re-examumthttt- ate rvme.--'vd ar.d depend ._.*r;-ly up.-t ti - --.-ru; y.:---:.? os tUv w.rsa.vu. Due ihe >b'ir;a*.v r. :.uc.r>-.-: oi c;-r r? t:.:- -.-. yenn^n ti.*- - -r:.s;uu;; v -utuus and cve- _-.-vllf*r.s w;t; s*i.r<:Vr; :. yji'jii? 3Tv tf.e uc-.-quntv UCcusuSiu, At the same tirae tie eduxticnai rrvrram has to be avsunbh.- for teuci.:r.r employes in .pemtins servi ;v*. }'_.: i:d ccuirmicn: iia.* oeen provwcu on ait trams tboto lus-encvr sue irnjr.t :x:sj. Thir short tiAf: w;th tvocmpujcui Qescnuuun- .: ti.'.- am:-:- R^-way< M< i:.-ssi serving wi::. i cive v*u r. iwtier view o: Thailand. 1 tains yt-u, C.-iAJRiiA.v C jhaowsf,: Tiaiak you. Dr. com.-vimo. i u.:ss if and when I evar vim; Tiu-iud. I '-ui have to siiiviomcc.- for my lancuacccihicuiue* mare . titan you have aan to opc.ocuv for your.-. There ;oi:ow*n a cKcm ou the recora CL-cusiton of Dr. nofiit-seuues paper the Medical services -- "hauaca.v CilAlRiuu." UohDOWssT: Auy otoef qu-r^tions from Uic hour, i; Lot. we'ii - ct> on with our xeettcc. 1 *2iow the hour is getting t&te. but I hope you wiii Sml bear with us so we can enuu tits session is goon order. j it gives me a crea: ces^ oi pleasure now to csii on our next speaker, one woo has been very rttseiy associated wuii us tor many years as our secretary--our tid tr.end. Steve Dcwnurst. Speech Assptant to the Public Reiations Depart- f xeat of tie A.A.R, ia ^'ayajurioc. Sieve wiii td: w us ob "The Function of F'-.*1;"; neiulioCi iz the A-j-r-tiitwiu o: Atncritfau iuiilroHa.-." (Apphiu>c; Mr. H. S. Dz'-varnsT .Special .Wi.-tun:. A.A.U. I'ui>iic Jhlnaous Dvjart~.e!tt; Mr. (.'uuu'Binc. :au;ei sud gcutlvn-.e;,. Before I say -_rA*thmc cur. ! want to Set you tvaat a crcut pivusure it is for me to be w-;;a you ;ooa> . Mr. Henry, the Vive President of our Public Kdatioos Department, was most plea-ed to have been invited to speuk at this meeting. He wanted very much to joto you on this occasion, but otner com mitments made it impossible for otm to get away from VTasbinctoo at this time. He aaked that I express to you bis siocere rccrcts in not being able -... he bore. .Mi 1 urn sure tuost of y -u ar- awnrv. t!;:.-1 - s croup for which 1 have acquired a ml ioBaats.- over the years. Fir<t f.f all. it meant, while I was your been.- -. c-v .mu rrurcico^*rciy unrw auvteu a ac .-ns cevifi A`Lhv 1 h 1SL.1; \ta\. 1 .r.ei-t a: nice -.; itr:*; cne UviU--- C-" ii i wt*re i .iiCv i.-mr t ljrt:c:*.-aunr 1 . on -e trtzrusi. -PC- -- a sea: ' ii ecu 'riatiii-? io<b '.Zi: t* ere wo-. i-e.-e soar -' `-..ori aco r^?X'l tO br rennmutumt. ''"s":h'.uiiy nc November It) in t 'nr !lno*ga\ cent tutu an A o t^-say 3d or. Having in t ~ ice crcat 'ijtit aepartnv -.5. Acxrtiitur -.br-yi Ua Co Tie Advert! uc .U.K. Coioag tie ns Look. Tit Sat Business Weel Bditor ^ Publi -r.d farm pubi. ':! t tner matt 3V.a respect u tttiotaizuiip T5 -r --2 *n iPer II :li to or -.rti:c -.red -oft- 'nn : woo have alway# r~*er *o ready and uidins to (*o m` .'r ice oorr.r.en a.'-M. ' true thu i*. i.> pf.-leihly . place v ;ry -:..'rt.y .uter ,het.iiiev**t to** Medical .* tnoved trotp New Vr;i : Chicago in lU iO. V* tiad ijr netere vzt nierttarr* tats section m t'htcssu re- ~t^s$ to revt**- etut tr^t up-to-date toe recnrcnsenda- r-rcticn over tr.e years. ;teea wa tr.r Ai?*vat:- n S'me eiehl year*. I must .. vjrprtie-.i * i::u t r.at ceetors mucn uwcffni to . i-merf -a v-- *. r..-Zs ! var: -us *' '--> L.i a .viT\ : r.: rtta?. as:-; -vut-ti the is.s:::t & ;-v rt:-.*; . >a:u:aa -: .-.aj runuc> . -a >: :t '. uv.-e a.rrli:iv< cvr.u'.niv ..vettse arid ...r tauiimu wt ttsu gn*uu uu t. .. -r..-*e. tae nism-au* muivtuu- - -te war i. Ta.-.c.T-.j to the i'uoitc itoaliotii . : ... -.c .* :.u suite tiua privi-vce : tra:::. . . . .r.\y . ::av:?.* .. wry vn.-tnicuve ttsectme. -ii a tittle ^imcuiut to saw ...-as :a tuc ___ tea ?t..:. ? wruu on mutvseuax nturuaus. - : .. :. ,t .is w* :-* u:xn puossc .. a- - ''r-.'-r. it -v.i. ;> expecivu r jea;.v'-i: v.s it:i .r-.-j-rui piussc. i_raie act:'-*:'. ; . er.--.-:a uttta tt .toa -K-e:deu. ^uine li-u. i->i::iie roatiotts -,M r:y .a.;, raiiroadi. r-rs'mai r.uiruad A."-'-."..:'.', D.-xtitrr :mre vt:>? -i 'ho A.A.U.. it -v.-'.-t uj Mi-r.iti ; .! ....3 ;:^eo the '.--'at.iiaiinteui . V,.v--'..r s'.MT. th- Men- . . i-'i iiy Vi--.- .. :`r : -ai:A ;; m-mi-- ticod tor ::a:;atu:e --t ..ti. U' .ateLi u> ^ubiie r-.`:at>Ca re oi vtiiciroey -zi e\Terrrtr#s. the A.A.U. public reia* . :.u T:..*rr are -even 'n'-.re: Advert!** >.v. r.. N-a > iervi'-r, H'jSlic .Section. : -""t ::.- '--ties hander' r-._:'.nsz to tue maca^tneadvertt-sutt; .. . -.peraies in ..u`.iagency :n '.bis runnecturn, r. .e : --- .iniuat:--r.j :i 't-it .-av.-rtisjn* iip(>ears are Life. ;l "i* is.ar-iaT Eveocag P?*t. Ti^s. Nr~s*eelc. fisooa'* Business *ud iiiaa '*"i-en a also rua so ..v??. raw;.' r.d television mniouioea ucn ea _tx a ~--;-~;r ar.d 3rosaciiaa<-1 rlecaiin?. and in various educatiuaal z ;ijrz --a. -t.-.n-i The po>wueUwa ot rusbiu. posters, booklets ud cer- n s-aer ii also the re>tvusistuty oi the .Advertising Seetron. 2. -~crrr < .'-cncuitural s'.elatioc*. thr principal iunction of this ieetioo -i - iii"" - jjoo between t::e marusus and agriculture. It serves to A i Ji \ J I J A \ f i i 125 Auonaitan of American Railroads create & bctv:.* under;tannin;: between the railroads and such weJ-known farm groups as tir American Fare Bureau Federation, the National Grance. and the N&tiaru- Council of Farmer Cooperatives. . The Irk-msuoa Section is cr-marily for the purpose oi brlsasr miormatioo into the xnnusrry. It prepares and distributes to' executives oi ail member roads a we^i-y sews letter ecvering happenings in Wasdinrtii that are t.i particular iresres: to the mi-reads. This Section also puts out ??es* reieaser having to q-. va such matters as caHonriipBv earnings and equipment orders. As the name implies, the New* Service furnishes railroad irucmation to sevspar-rr. mirnziae- radio sni television sources. It prepare* and dinribete* news ann future reinsst-s. I: produces several monitiv rur-l.run -j.* and occasionally pmits radio, teietvicn and motion picture scrip;.'. 1: dcvuivus memoranda cn request by writers for use in stories and articles. In ad<i:::<-n to these nsd :*.her relatedacti*.v.>*. this Stkm Ua the r-*ivv:::.n:l:ry ./uti.i i- it -- - t-^T]. :.*.r..y kit '< r.-iV'TUii s.r c-*`r. :-`j' *. 1n~r-t~c c-.'.jti --i ; ovavia wnti a j^pwnu -. mtcivi. Am'.r.c *.!-; --.tiiy m: t'ur::~v.jns produced thr.*uu:. :i,t* z l.-v Quu cu ?-_ tas end Bmiroisms; Asancan Rajiroaos: Thtir Grows; sac Dereivpmiu;: the Human dint c: Railroawsg: and u SUuroas rum Directc.*?. Ai tcru.; i ^ .xptctvM. tu zcz.i and Coiiece service c-aus setts r-:ucai:&:m aattruui v.r ;aooi ana cuilese use. it dcsiros. prepares ana cu:r:m::es s:>. n_n?. t tviueu. charts. c.sn:&y pieces, sude-mms -tu numerous otner ..crariir turtiruiar putpr .-r Thiat material.- ere in--' v>z~.:,.\z zzz u~-- riput--t : .iventioas oi tc*tn;-rs and iiomrmns. aao ;sv .5 a:.::n:v- .s ,;r?at rutty ua;.o rveuests irom summits ana :n;t.*uct-; :s. Tiv '*rr:tT the noscisi ntuf.es bectiou involve. ;u ;;.c umin. snecuu j-.urtn. tu; tr-purunos oi nrtiufcsivr eucvciopcuias &ou owwus. *su uauuncr a cutu-uutu cu-eb Railway Wisest woicu u useo c.\teus:vc.y -y ipea.er.* ana tu :uroan suicts. Thu election aiso prepares sprvte* on u-.i- ;ion nns asststi ts various oner puimc reiuuons projecu. .Ci in uU. Public P.uuuons Depurunent oi the Assocaiuon c: .^mencsn Z^&uro&os emu.svs neuriy every --.raosoi comsuuicnuon is tue runroau story. It coarimates iu ucttviues with those oi the individual rauruaus asc the restasni muroud orcummuuns. and these eilons are supporteo oy other proups. ruth us the suppliers. ~::z a correspondiap interest m n_i-:u.r known the entirt:_rr. :ne arhievcmeuti sna the problems oi the ruiimuos. As I rr.misr: at the stsn to keep tav remarks briei, I istesu * u just that. Dfctcrc i . u-wc-ver. tnore is cur lurther thouent that I wc-utc iikk to n:c:>;jf-n a; tna* r:zt. A.-iiic tru-r. iurrt-scaie procmninuac :.i the owr-ui. scro.-v oi an iscuitr__puoiic rciatiortf a.-tivity, there is aa element which is every b:t hi important, k not more jo, asa that comprises what might be euied **tbe peraonai touaf" I know there u so oeed to stress to a group ;uca ss this the value o: per?ctai cootact. The impressioa we leave with individuals rerfects not oniy upon turaeives but usos the compitaies and offices we rcpres<*nt. How neat ssq Z"}* rood that imorerSiea is have u great deal to do with the l<*:ig-rus success c: say ruoitc reiatir.e.# erruram. 1 wac: to r.r acaia went a particular pleasure it has been tor me tc Lave this opportunity se with you and to say a few words to you at this meettne. You have my wcv.saeanwl assurance that, if we in the A_A.ll. Public Hvlatinns Depan mea; you to itt v- Tianu ye Cn.sinai.vYou can i 1 sS com eae some w ccir.c t.' re*se*; *s us' may save. Mr. ?urk ew ru'`:r. > coes *nia it. c~ Mr. ?ak Tncre is r acytsmc ar to have him Xethinr. AS *OSg Si ior me to w; have assists that 1 shah Tnnck yc Caulaxa.' am going to TVe go on business at i Our Ccs a*ere three r> I have b*Homsethie. not ouiy lu>\ United Nau to the Greer Our good far away. Our Cum: Mexico City ana. That Juog Hotel > TVe have * rssrf --i & r;ueR3cc* v rpea^rs _.a --=*i ":. -.3 :z.e rvtreu Hjw * -<OC*-~:n > cave rau `^S. You Y-daavaa k i i i I \ I I s *; 'ti'izsci omi Surzial dxttum Dirar:--re: ne c: ijs^usM :> you at any :^:e. ail that is r.`f*sj<ary :'or ---- -- --*~y ?rvM. .Applause) C-iU>owsKT: Trank you. iteve. V:u .r-- j-anys ci-ipicd ttr-rc dtrve. * a-- .- v :: .*..; re zoirz on to tr.-r :***rr. hrre. :z tr :; -.. v- - .. - 1 nt; ..-ra jja. -ad itccr ta-.-rr ; - rrsv i;..-- : ; rr'rrss -vith say uaesuacu tr.: r * tr. " :? -v- uav- iiaisuasd bu^aers briore -re o> ua i-j z- -.-.y ::> r.r.-r. 1 *i:nk curat to ztve rains: u -:z vAyaaius> Aau :.e ;..* --. .t.'.j ''.? zr>;uD. r idtuaeo. at-.a :o zcknotviedqe the pleasure it has area j.z -:? to this mat--Dr. ^rar.ett. I atre l r.v that ae expected. s.ad i do want to say -iktar v) > . j :..< ;. - i v--.- - v .;. - i yea. Mr. VArk-.-r. ar.d i.iv- ;;n worr:*.^. L *' T~- t '' 10^ v:>:r.rsi. ..ad I -mss olc .i the truiic ,:.:rr .1 .*. ? ?rw:r.c cur r.cxt .tirrtir.z place. jr.der r.e* ! ;_. - p"t * i;fJr ntt tv;:a hL'. My ccod trier.a. Cr. M ----rr'-a.;. --u- ' > Tk.uiaaa. -.'atucatcr) I t%-aa atraiu that I r.-n.uJ .t - ^v- "o ;) -r.Tyizz tiv A.A.n.. !;ut p.**:ouoiy cave to end up a ixh tzc . at* iii - -.t..cj. * -r.o-v * r._; irouaic Dick iicacett cad ta <ctt:az him dy.ra tc.e T.'-;ccr.er. -_r ;. *i ;~ead. Dr. Chivrr. iiai mvited uj to .Mrxtco. Tliat u cot too :ir Avay. *-zr d .--ciittee <>t Directt-'O had civea there three places tor your choice: Me&cv di:y. Mexico: ci<i<e*atcr Park. MUsuaippi; nmi New Orleans. Louiai- That would be the cui<ewater Duii Hotel at Edgewater Park sod the f Ezze at New Orleans. --xtr u> decide oa the meeting place, alio, the -- .'x 'W0?l -'y***z ** . *4i- of .1 mtrtean RailnuvU ' *: v_--.; the year there are some eooflictine meeting of _i; I* - y.~z::~ Ar* and the Committee on Trauma. I tfaiak -f nz." keen is ruzi cur :za;e* of place and also the possible weather. This -s_i uzieas-.-sabli eatz.r* ;m. the first two days. I was assured that by the ,-_ir *tiairfts iras tii z.-::? Z ~~ i rr. :vT:Edcewatcr Park. CHArzK.oc Goi3o*'?KV A very strong vmre for Mexico City *'.** ot::vr oothiv:.' ... tv.Uv u: s:< i.rd-.-r. r-.r.cto M**v.rn Ckv--4*-< V *** voitr imntis Ni:ie. :i -r :r. :'av:r c: Nr~ .t.tuds0 Two. T.-.r. ' ;r if*r; -i held at Edrewater Park. Mis.-dasippi. That L- _- ' z:-.: G-; K :r. i' Edrewater Park. Mississippi. It was trie scene ' * tre*.vur ir.r- ur-. I tr.\.L-vr. tr.rve or lour years ac*>. . 7:-'. . tze Golf Coast. i.rar bdoxi. aiul the t<tacv best 7Z-; tv ::.r ttte on Arransemeats. . T 7s.'*'*:.* r: -'-rrz:; Ties i behave :t j your desire u return to u-.e ..* . jzz'.y. ws:r. t:.c i.oici lest to tin.- tYmautiee --z.:z. appointed. .' I : ..a? ?' zsar r c:."merits about the date lor the meetup. Or. 7-r.i.r:.. 1 \z\zZz ;-.u a.*s rz.re :'i3i;&r *vitn some o; the dates of the*? acuve L?.. Co.iiAi:: ~'"z-.z I z.a at the Edccwarer Gulf the last time, the :c was very c'.rr.sYrtnhiv at the end o: March. z.-'~ *-* -: r..e u-.;.rrx.T*: :r,m u.r I. C. Ken Carney will In-*--ur cuvst *7~. ..-.Nrv: 7z_". a r.:-:-rtui of i;.e year. Dz. UioJs.vu: The tr.a c. March. C>: Cozsc^-kt: :z:r.k w< will leave it up to the Arrangements C*-ft'-* iook uo :zt cates, but it will be some time toward the end of Msrrz <: rex: year. Ar.y :.*w r-r.-ir.-rs- h' a:<t. 1 would like to make a lYw rt-r.usrk*. I ~ ' - ; :z-.T : the I .-jv. but I have takt-n punishment r'.' Tr. s.: : ; r. *--izz *.v '--i.* uaua. 1 intent >:iy that this is n<<t a .*|icc-lt. a ru:. .*vf -r. Zrrtnr. mw.ttts. whnh has Ixvn . woinheiui. from whs.z - recrtvf; s.. r - *, iniormation.' :.-.r.r:zr -zr rzest^ r_ t..- l.C C`. I tlntsk viu wtU all ucrw ttAt wben 'e to ;.o-e ra-.-v. x* uke u> speak to the horses nrst, and i certainly ap- pra.t< from y I'm : ic. a r good y, to hanc Sorzr Utlt :-J! dividix. tuilroac the eh-. v. jtr.^u VZ'-'-jl. i:` r.t- iothec: : ssi:r 5o I in our about ' picked know ic matter loiicy brother try to r The: chief siHe mafered u I the recotnc one of raiiroac Atti s tha that vi lot out them c I o\ though would i many c wester: eastert; lhrou. make r We 1 of prts. progra: Of -.ink *he i i * t I | `i r xt h, *n P- [' --Mirths o.` ' .ry-tif Section . Jr. r-r:: `\ ..r.<i -x- heard : :r r: . :r tiromuwe report*. I'-- iuri tiit you arid have a tie*- rim li yvtr hssda before the next rr.ert- c- tTis ter ill the rauroiaa. iiu l i.i**reiy hope that, so matter hc ; i ` ink yvir form may re. yn ik .stick together, or we're i:r.Lie *v <iv a proper r " 7 two <if 4i c\u:.. f.ii.-;:: '..i. .I'.-.c-i nvopie : is_i c;ayu.-nv>l IIV ' %::.:sawn. i " t tl t'lsCU V~cn. 11a >'* rrr. .2 t *h:nk we run expect -a ..as forr.iMue ir. ...; t mxav tmes te >t ... sni urv. civ. vjy tr.at i." ji:ur; 4r .i ti auum-isi::?.*. le-suvra. ''> navr ;... :.*tj ,4i ;.4;uaa u* i4iv::;c a.,i: i ::rvu -a ..u . tr.tr. w- u-.cm. Lv'. a ;r.:tnv instances. a rat:j:s u-.-partniv::; r.ixr. - `:.t *? .iienfut. .;..: . I-- \-r Vi->* Pre^iont ,, i .. . .it .4- t.::.e i .'line tv irv.-Ttt rv-y \? : you .\j a wcwutuce oi o:;c :.> - ;,??. 'r.- : 'n:v4s : t.'.i r, -.--.ic ;-4i-h vour hands. tr.at you ?.* it :.* .'* t :ni< '.:.r "*.:--..r.r:. . '.'..ak *.k.c P.--M<irntS can 4 : . ~r.it L-a on irr? :i *.tr - ; : :ir:-e cays. even if you have to :: ~z .-a a r.;u w.ih an ojectn .4,-...m;a machxe. . 'i-'i ..ste v* \tt:twicu * ' Otr.nii'.'.- T. -i : i . ,1 -io that ancr l xivc c iurta.f _J_4 -a- -nouid '::** rr..r- :.--i.-:a aitj.in .ur own U.-oy. ...<e *> vr.xt happeii iz vir.: u arvaa. UV.i like to knoev Lv'v 14 * '.ivt a :;.iR times to to Oacti to *;.* alter c*rrtam acci'lenu happen oa a -ftera r^.ruau. acd wed prooaoiy to cbw how they hack on the szstz ra^roadi. There *re rruicy itatiitiri. too, that we iiave Rmss*-a-- rrin hi--nnT reeonis--that l f-.-ci are nia? to waste, and l feel we ran ike more active use of that matenal iav c-ard much here of the pt-rsuaaica <A manaecmcat. the persuaswa rmsuiei'-d and senior officers. I 'iiim we *aouid also have a spot on the ~rtm : tr tte per<uaQ of the labor orraauationa. I have had my rare j \ ** i 30 o/ .Hr pinned bac'i cy tit-- t-ssiy oi urr.es. by: ; -- stii c':::c :> V.-.-.t - - si the non;. -- :_- Nothiac arcaiit -y b-sart more t:.as :? -_^c w camsrer * " .** a. coronary and bs*.*e ru spot for bis: os :i? rsbroao. 1 :: waste of masr*:"*-. m oj-oaic waste, tbs: * have to thrrw *--.n: ; pension bears. i;: ?:s;ustf on society, to ecatirttie iiv:=s ::--< reii, his wife ssli bis :*rily. I fvnsbt this rat with ray K-.-ai ..*: .*. sometimes I have s: hesitancy whea taey cna't see the lira: ::: I'm : * be stubborn ass ysr: refute to pat back *be rrrd-rits* -.-.< 1 . m. __ *iaewhe.t:'p--.i iliis v.-tta var -? orssnuu;;. a* tv*'... - .. . top. aoc they. t* %*.. as w*. can essesc- s-.-n.-r.: *;. ry.c* =:.n r.cs--* r these people isto a sroper place is tie ra^raac isda<:ry. 1: i ~ destroy & mss after is year* of service, say--:-- itvrtr^y *-.. 'uS.TM-n. railroad industry sic bis worts to the r--.* _ : ;:.iu*try. -r--- -................................ -- cL-; r.Uistrt4--_ - *r? y .r-.t.r.t*. i Any sex hy-rtur** trim :s-.* :y-r.' : n Cwtr-sstr :_-.:. - There :.>!!.ec * ;-.-sos tat rigors :m.e: ; Dr.. Ooi50" sKT -_s.-: ; -! c--r:;:.-;::.TS . - v. -y ..... . .. I.- taere say tartar: tui.ass* srvuri.: .ri- i..: >.. Hoston: 1 r..vr - - vr'.srs. {The rr.oujs :*ra.*:.y i-.-:os';mj. -n: tut a ii-. n:.n :srr: -s hHAUUUN U-SS ." -rv c?r. bTiCIC tv.- : c. ?. lir. K. . s Sv-utr. L 1>T. i. tv. ri. : i)T. Ii. tt\ 3919 J i>r. Jan:es r. Hr.ywav J. V. IX-r Pa.-ioe H * Arr`sc:*- ; i.; ~;rv:<.r *:`z w a =aa ca :i; -.iu rrsy--bin- :a;w-;o!V : ;c,i :.*c? to v.-rv.u ' > *ec tw 'a "t? t' ,/ 'l-d'.atl end Sutyiaxt Section OFFICERS A.VD PERSCSSSl OF COMMITTEES OF TEX MEDICAL ASD SCRCICAL SECTION FOR THE YEAR iSr-lsts L'r. I. C.liow.-kv. Chairman Or. M. 5. Ch&>~ea. Vice-Chairman F. .1. Farsir. TM-:rv :t Direction :r. i. .. "tv. t.hsirr.iaa : : . 5?- 7 rr. .-\r:rv* in IvoS) *Pr. 0. r. ('::-nr.uin. iitet e- *a. Pactac Raun-ua. ~ r. a. M. i D.;.- O'ntir.if.v. .>.* N . t. 0 f. v .'u.*. O--rc-u. L : .'r. M. Li. S. ~'r. K. F. "V V V.'. -'tetr--* m t'rVji s, .'t.'-utneni u-uway ?yj 7. : M .-;. :-J Of.vrr. Canadian .V .. i...... i L..ui---.S:in Fmr.ri.-VO " T \r::v> m it.-oOl *. .1. r<-:u:rtr, i i. L'^tri. -J*Har*-ra '--ifn L-rn;.- t ..L.a*-:.-:. . 1 . M.i - -fr. (Vuwr.l i'-.:Lr<;a<l ('n: . v. J.-r-.-v (k.v.v. V-v '.v. 'A !.. M:-tik-r, t.-;.: ? a. L'.;ic !U'.ilroau. :<;3 ll-pi:: r. li. 'A `.'Jfj -i>.iin U. t. j.,; i. itad Toledo .Shur** I .. M; htc:m. Commutes oq C.ubuiry and Rebibilitatioo Dr. James K. .'tvc* :avrrr.aD'. Chirr Surecno. Clmaeo Ncr*a a Railway. I J7 Nona Clinioa Street. Cltivuico 6. Uliouiv Dr. J. F. DoPrw. Chief cnirwoo . Lirtt-s V'--O. Chicacu. Miiwauhe*. fp. Pitt, c Faanc Raiir>><i, Iti-xj Mniica;aiuJ Dental Uuiltiintc. Seucd l. Xv-ciacaux. Appointed i<> fill the uflesctryd tern n( Dr \V. W. Wa.ihborn. Z'S&y 'isl&rz .issoeuUum y .1 tut :-i". ,\iuroc-:i Medical and SurrtreJ Dir*;';:.*. cc Or.::- '--"so. 1 Suildicc. R<*o>m U'.T. 3-l'..~'re 1. ."y.ar.; Medical Director, XV.v Y-:rk. J'Licasr*^ I.-:..* - 7. "=tr. Cleveland 1. Ohiu. Caiet* Surceoo. MiSsCur-K'--:i*-Tei- r-iiin-a:.v. L-:a:s :. I >'.l-- >a. Chics Surcaoa. ->- Li:.- Railroad. *4*3 M-.-*. Art* : . ...a.r ' liisea:y*ii 2. Minnt^'U. 7' . Cid-a ot Medical s'.-rw-*. Caaad^iti fV.*. r--.-v:v *.* * - -'.a. Montreal. Oae.. Combines c- Trs i<.':a.:rnussu. Ci. i-- Doth.-:: . : . ry I..: r i rurrec::. Ne^vt ^-ivtanis: 1 ai:-- -i. riTZ***n. TfXi? v .near.i *. lu. Virz'.;:-.:'.. J.sza.";e :a Dereiosssents Rts^sr; ?brs;ci. c.iiri:ia:a; ...... '- . - ",_.Ty..::un r.u-duic. - :.v-r. ..lr.-Ai*-. 1*1 -- -a.r Et 3 ' . - Viraiaiu. Chit: srunreon. Xc.-:r.era "scinr Eaiv.av. i:. >..vi 1 ' I - -i-i t.".: : .vsrc*.-?::. t . 1. 1-1-,. IV \i t. i.<. 3;a=t=ee oa Medical Aspects o: Air Conditiociz; or Cars 1\. 1.7 Jr:.;- '.':.a:rn:nni. Dircrv-'r. Dcrctmpnt o: M-dirir* ar-j c-jm:*. - 7. - . --::i:;n L'i,:::i::iiv. h*"> -r-* . 11.:: . `1 - Cr.:?: Surccit;. rn ...-.dwriy v:.-j K V.'a?utnctii I'i. D. C - - " : Chief Mcdu-.il Orhcer. tVaadiua X-nor.a. 0n:wia. Dr. V. 7/. ?%. a Dr. V M ~ S-t.u 7 Dr. W. Z. .Y 3u3diir Dr. R. i. B>)& L- Dr. I. J-r*ey. Dr. Harrry Buildiat Sb.7 sc uhio . Land. . cl I>^u-s ^uiroad. cl l^uii 1. : 153 A.-** Toledo ci: *r L:."-:Ml.raiar.. .svi o: Texi- tr.z' .iJfuad. i. ..Jxay. civL.-.rair.. '.vpuWic ii"-v.=?- d Ezimtaatiest < i- . . .v. - r .- -n.- p .is i!.v;r' or Cars ar.u sarv.'a- 'iiato ft. .^;r,oy. I At h i.-.j K. itionui iiiL'av*. .----- '. .vaiemufiri \Y. rii'ii-:. Mlsioun. ' :rL=LTtse on Firs: Ail .. . . i.,,: - ..'j.-ii- cl I^uis-s**BB e: > ....Tf.Uj. .W*i nv, .v. 5l* ..........rvja:.-:. .;.;v.v. . ; ,-.-L4**aru. L.LKLCO :raa lc: i r.'.-itir:. : i5. < ;v :z: J-licical .icJ -- oq Rjiixar iiiiiiLjc * Ci." i-L .'-.-..i. CvU'r.crn llauo-n* cv-' Tr.. . i *:i xnu K. n;D. c. Uir>"-'or. T r.:-_sy.v:.:.a --ur-u-i. 15 ._x i. ' ... r ciiroHn. C::.* 1---- K- nm>iir ' :Jdir.c. CP ,-:o. r* r.--r:r-.". C 'L~r3. iClt'in, Joliet a.'.J ''.ub c:-*--KUnou. `-.iay. 20i Dr. i. ` L.JU*v-kV. V:rw*nr, (JcfitnU n_i2r;Li C ::;.*.>* ,c ,NVw ' 'rsev. Ji-r-ey ;*.*. !' .-r^ov. (l\x-0:iieiu> Dr. Harvey NVU a. con lane Railroad. '.<7.1 M*dioal Art* 2<iiidin?. M:caec*oja i '..inseaota.