The nineteenth-century medical condition known as "railway spine" has recently received considerable attention from medical historians, particularly historians of psychiatry and related fields. An historical interpretation has developed which traces the origins of "modern" psychodynamic medicine to the responses of nineteenth-century medical practitioners to railway spine. This interpretation characterizes the debates over railway spine as being between adherents of "soma" (i.e. constrained by "traditional" Victorian medical thought) and "psyche" (i.e. looking forward to "modern" psychological approaches). This article argues that this conflict is too sharply drawn and produces a teleologically-driven and misleading impression of the real significance of railway spine. This condition was seen from first to last as an organic disorder, and medical/medico-legal debates over its nature were concerned with the character of the organic processes at work, not with seeking to overturn organic explanations altogether. This has important consequences for historical understanding of the place of railway spine in the emergence of twentieth-century conceptions of traumatic disorder.