鐵路脊柱症候群

鐵路脊柱症候群（英語：Railway spine）是十九世紀時用來診斷涉及鐵路事故乘客創傷後症狀的術語。

首個針對此病症進行全面醫學研究的是約翰·埃里克·埃里克森的經典著作《關於鐵路及其他神經系統損傷》（On Railway and Other Injuries of the Nervous System）。^[1] 因此，鐵路脊柱症候群通常亦稱為埃里克森氏病（Erichsen's disease）。

在十九世紀初，火車相撞意外頻繁發生。當時的火車車廂結構脆弱，多為木製，對乘客缺乏保護，令問題更為嚴重。

不久後，開始有一群人聲稱他們在火車意外中受傷，但身上卻沒有明顯的受傷證據。鐵路公司拒絕了這些索償，認為是偽造的，有時甚至將傷者的痛苦貶低為訴訟神經症（litigation neurosis），暗示傷者唯一真正的問題是提出法律索償。^[2]

關於「鐵路脊柱症候群」引發的症狀性質，在十九世紀末引起了激烈爭論，尤其是在1886年維也納（奧地利）帝國醫師學會的會議上。德國頂尖的神經學家赫爾曼·奧本海姆主張，所有鐵路脊柱症候群的症狀都是由脊柱或大腦的物理損傷引起；而法國和英國的學者，特別是尚-馬丹·沙爾科和赫伯特·佩奇，則堅持認為部分症狀可能是由歇斯底里症（現稱為轉化症）引起。^[3]^[4]^[5]

埃里克森觀察到，在火車意外中最容易受傷的是那些背對加速度方向坐著的人。這與揮鞭式創傷的受傷機制相同。現已知如同汽車意外一樣，鐵路和飛機意外除了造成身體創傷外，也可能引發創傷後壓力症候群（PTSD）及其他身心症狀。^[6]

參見

註釋

^ Erichsen, JE. On Railway and Other Injuries of the Nervous System. Philadelphia, PA: Henry C. Lea. 1867. On Railway and Other Injuries of the Nervous System.
^ Szalavitz, Maia. Opinion | We're Thinking About Pain All Wrong. The New York Times. 2023-12-24 [2023-12-26]. ISSN 0362-4331 （美国英语）.
^ Ellenberger, Henri. The Discovery of the Unconscious. New York: Basic Books. 1970: 437–39. ISBN 0-465-01673-1.
^ Harrington, Ralph. The railway accident: Trains, trauma and technological crisis in nineteenth-century Britain. Institute of Railway Studies and Transport History. 2003 [2008-08-27].
^ Page, Herbert. Injuries of the Spine and Spinal Column Without Apparent Mechanical Lesion. London: J. A. Churchill. 1885: 25, 62, 69, and 162. page Injuries of the Spine and Spinal Cord Without Apparent Mechanical Lesion.
^ Scaer, Robert. The Body Bears the Burden: Trauma, Dissociation, and Disease, Second Edition. Philadelphia, PA: Haworth Press. 2007: 23–55. ISBN 978-0-7890-3335-2.

[1] Erichsen, JE. On Railway and Other Injuries of the Nervous System. Philadelphia, PA: Henry C. Lea. 1867. On Railway and Other Injuries of the Nervous System.

[2] Szalavitz, Maia. Opinion | We're Thinking About Pain All Wrong. The New York Times. 2023-12-24 [2023-12-26]. ISSN 0362-4331 （美国英语）.

[3] Ellenberger, Henri. The Discovery of the Unconscious. New York: Basic Books. 1970: 437–39. ISBN 0-465-01673-1.

[4] Harrington, Ralph. The railway accident: Trains, trauma and technological crisis in nineteenth-century Britain. Institute of Railway Studies and Transport History. 2003 [2008-08-27].

[5] Page, Herbert. Injuries of the Spine and Spinal Column Without Apparent Mechanical Lesion. London: J. A. Churchill. 1885: 25, 62, 69, and 162. page Injuries of the Spine and Spinal Cord Without Apparent Mechanical Lesion.

[6] Scaer, Robert. The Body Bears the Burden: Trauma, Dissociation, and Disease, Second Edition. Philadelphia, PA: Haworth Press. 2007: 23–55. ISBN 978-0-7890-3335-2.

[1]

[2]

[3]

[4]

[5]

[6]