In a paper by Dr. Philip Coombs Knapp entitled "General Paralysis as a Menace to Public Safety in Transportation," which appeared over a year ago,1 it was stated:
There can be little doubt that if men in responsible positions on our railroads were subjected to thorough examination by competent neurologists at regular intervals many of these cases of general paralysis and other brain diseases would be detected and the dangers attendant upon them be averted. Many railroads demand a careful examination of all applicants for employment; but when this examination is once passed, the man is not examined again unless some striking disturbance is noted. The average railway surgeon, however, will inevitably overlook the slight but significant symptoms that reveal grave brain disease to the neurologist, and, even if he were capable of detecting them, it is only by examinations repeated at regular and rather frequent intervals that the
DUNTON WR. THE RESPONSIBILITY OF THE PHYSICIAN IN CASES WHICH ARE A MENACE TO PUBLIC SAFETY. JAMA. 1909;LII(26):2098–2100. doi:10.1001/jama.1909.25420520012002c
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