page_title: Railway surgery
section_title: Great Britain
hierarchical_section_title: Railway surgery / Great Britain
caption_attribution_description: English: Photograph of Dr Thomas Bond (1841-1901). Español: Fotografía del Dr Thomas Bond (1841-1901), sobre todo conocido por ser el primer perfilador criminal de la historia, y por estar vinculado al caso del asesino serial nunca identificado, al que se llamó con el alias de Jack el Destripador.
context_page_description: Railway surgery was a branch of medical practice that flourished in the 19th and early 20th centuries. It concerned itself with the medical requirements of railway companies. Depending on country, it included some or all of: general practice for railway staff, trauma surgery as a result of accidents on the railways, occupational health and safety, medico-legal activities regarding compensation claims against the company, and occupational testing.
  Railway surgery was especially well-developed in the US with formal professional organisations and scholarly journals. One of the reasons for this was that US railways were particularly dangerous with a high number of casualties from crashes and an even higher number of workers hurt in industrial accidents. Another reason was that many US routes passed through areas with little or no existing medical infrastructure. In Europe the railways were safer and infrastructure was generally already in place. The duties of railway surgeons in Europe mostly involved investigations into accidents and the resulting claims arising from passengers.
context_section_description: The first inter-city railway passenger service in the world was the Liverpool and Manchester Railway, opened in 1830.  By 1860, the UK had 10,000 miles of track and employed 180,000 people.  Despite being the pioneer, British railways (and European railways in general) were much safer than American lines and consequently had fewer injuries, although early injury rates were still high by modern standards.  Furthermore, British lines did not pass through vast, thinly populated regions.  Medical infrastructure was already well developed in the country.  Railway companies still employed surgeons.  Page at the London and North Western has already been mentioned.  Another example is Thomas Bond who was retained as surgeon by both the Great Eastern and Great Western Railways.  However, Bond's function for the railways was primarily as medico-legal consultant regarding injury claims rather than practical surgery.  He did, however, treat the injured of an overturned train on which he was himself a passenger.  Bond's last major work for the railways was investigations in connection with the Slough rail accident of 1900.  Bond also wrote a lengthy article on railway injuries for Heath's Dictionary of Practical Surgery.  There is a similar picture with James O. Fletcher, surgeon to the Manchester, Sheffield and Lincolnshire and Great Northern Railways, who wrote the book Railways in Their Medical Aspects.  Fletcher's book discusses numerous cases where he examined or treated patients post-surgery and discusses medico-legal issues at length.  However, he does not cite a single example of his own, or railway colleagues', emergency surgery.
  The first dedicated accident and emergency (A&E) service in Britain was associated with the building of the Manchester Ship Canal, 1887–1894, rather than railways.  However, the civil engineer in charge, Thomas A. Walker, had a background in railway construction around the world, particularly in Canada where he had experience of employing British navvies.  He was also responsible for construction of the District Railway in London.  Walker predicted, correctly, that there would be a high incidence of accidents during the canal construction.  He had a chain of A&E hospitals and first aid stations built and staffed along the route to service the 17,000 workers.  These were linked to the construction sites by purpose built railways.  The service was financed by compulsory worker contributions.  In total, there were 3,000 injuries and 130 deaths during construction.
caption: Thomas Bond, railway surgeon to the Great Western Railway
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