_Water-gilding._--In the gilding and sil_Dangerous trades

use of mercury has fortunately been almost entirely replaced by the

much less harmful electroplating. The gilding, however, produced by

the amalgam with mercury and subsequent firing (water-gilding) is more

durable than that obtained by electroplating, but such articles as

military buttons are still prepared in the old dangerous way, although

greater precautions are taken to see that the fumes are carried away.

The object to be gilt is treated with a solution of nitrate of mercury,

and the amalgam (previously prepared by heating an alloy of gold with

silver and copper to redness, adding an eighth part by weight of

mercury, subsequently cooling in water and expressing any excess of

mercury) is applied with a brush. Formerly the article was heated over

a charcoal fire, with, necessarily, escape of fumes both of carbonic

oxide and mercury into the room. Now it is done either in a closed

stove or on a gas jet with a good draught.

_Silvering of Mirrors._--The process of silvering of mirrors,

which formerly caused so much suffering, was to spread out on a

perfectly horizontal table of marble or glass a sheet of tinfoil. On to

this a small quantity of mercury was poured to form an amalgam. A large

quantity of the metal was then added, and the carefully polished plate

of glass was slid over it, pushing some of the excess of mercury in

front, which was collected in small channels, but abundance remained in

the cracks and crevices of the tables. Heavy weights were placed on the

glass to press out the mercury, and in a few days the combination of

mercury and tin was found to have adhered firmly to the glass.

It may be well to refer here to the process which has taken its place.

The method is a wet one, and consists in pouring over the cleaned

and dried glass plate a solution of nitrate of silver, containing an

alkaline reducing agent, such as a tartrate, or more commonly ammonia.

A reddish or black precipitate at first falls down, and later on a

shining surface of metallic silver holds close to the glass. The glass

is then carefully wiped dry and backed with a coat of varnish or red

lead. Cases of lead poisoning have occurred from the use of red lead in

this way.

Statistics of Dr Wollner[98] show that in 1885, on an average, 160

persons were engaged in the silvering of mirrors in Fürth. Among

these there were 165 illnesses (103 per cent.) for which sickness

insurance money was paid, and of these 60.6 per cent. were on account

of mercurial poisoning. The percentage among males and females was

practically the same, but the number of sick days was greater in the

case of men than in that of the women--66.7 days as compared with 50.5.

In 21 per cent. symptoms became prominent in from one to two years, in

61 per cent. in two to six years, in 15 per cent. in six to ten years,

and in 3 per cent. in ten to seventeen years.

In 1898 the Factory Inspector for the district of Fürth states in his

report that only seven persons were engaged in the process, and that

their employment was intermittent. As the process has thus become

practically extinct, it is hardly necessary to give the regulations

enforced in Germany since 1889, but they are well worth reading by

those who are anxious to bring to an end particularly dangerous

industries, especially when they are carried on in the homes of the

workers.

_Hatters Furriers’ Processes._--Mercury in the form of a dilute

solution of the nitrate is used in the preliminary process of felt

hat making to increase the felting properties of the rabbit fur. The

industry employs in the mercurial process alone between two and three

hundred men and women. After the longer hairs have been removed by

fur pullers, the rabbit skins are subjected to a process known as

“carotting,” in which they are brushed with the above solution. When

dried they are brushed by machinery to loosen the fur, and then each

rabbit skin is passed through an ingenious machine with rotating knives

so arranged as to cause the skin to be shaved off in strips, leaving

the fur intact.[99]

Few combinations can be imagined more likely to affect detrimentally

the health and more particularly the teeth of workers than that of

mercury and nitric acid. As might be expected, those engaged in

“carotting” show in most marked degree injury to the teeth from the

nitric acid fumes, the typical condition of which has already been

described, while tremor and erythism predominate in those engaged in

the later processes as the result of the inhalation of particles of fur

impregnated with the nitrate of mercury.

The following figures make this clear, giving the result of an

examination made by me of 111 persons in eight different factories, who

had worked for one year and upwards--

+---------------+---------+-----+-----+-----+-----+-------+-----+

+---------------+---------+-----+-----+-----+-----+-------+-----+

|Carotting | 30 | 20 | 66.6| 10 | 33.3| 1 | 3.3|

|Other processes| 81 | 27 | 33.3| 54 | 66.6| 17 | 21.0|

+---------------+---------+-----+-----+-----+-----+-------+-----+

A “fur” as received from the cutting machine, analysed in the

Government Laboratory, was found to contain 1.34 per cent. of nitrate

of mercury. The mercury forms a very insoluble combination with the

keratine in the hair which is not removed in the subsequent processes

of felt hat making. Jungfleish[100] found in a layer of felt which had

been deposited on the revolving cone used in making hats nearly 0.5 per

cent of metallic mercury, and in a felt hat which had been worn for

a long time 0.7 per cent. Nevertheless, mercurial poisoning even of

slight degree does not occur, or at any rate only very exceptionally,

in the later processes of felt hat making.[101]

_Preparation of Mercurial Compounds._--In factories where

mercurial compounds are made, such as calomel, corrosive sublimate,

the red oxide (largely used as an anti-fouling paint for ships’

bottoms), and vermilion, there is considerable evidence of mercurial

poisoning among the workers. For instance, of 27 men so employed, I

found in four (15 per cent.) more or less salivation, and in ten (37

per cent.) tremor, besides such other symptoms as anæmia and gastric

derangement. Danger arises from the volatilisation of the metal in the

subliming operations, and also to some extent from the dust which,

though very heavy, can become scattered, if such processes as mixing,

sifting, and grinding are not carried out with care in closed-in

vessels.

Calomel, subchloride of mercury (HgCl), is made either by intimately

mixing corrosive sublimate with metallic mercury and subsequent

sublimation, or by mixing definite proportions of mercuric sulphate,

metallic mercury, and common salt. The mixture is then heated so

that the calomel may pass off as vapour and be condensed in the cool

subliming chamber. Finally, it is ground wet, dried, and sifted. All

these later stages in the preparation must be carried on in a closed

apparatus, and with observance of great care.

Corrosive sublimate, the bichloride of mercury (HgCl_{2}), is made

by heating two parts by weight of mercury with three parts of strong

sulphuric acid. To the mercuric sulphate so formed when dry, one

and a half parts of common salt are added. The corrosive sublimate

is converted into vapour by heat, and condenses on the upper cooler

portion of the vessel in lustrous colourless masses, leaving a cake of

sulphate of soda below. The sublimate is then scraped out, and usually

undergoes no further treatment such as grinding. The operation of

sublimation requires very constant attention on the part of the worker

to prevent the vessels in which the vapour sublimes being overheated,

and so allowing its escape.

In the preparation of red oxide of mercury, nitrate of mercury is first

made, in which care has to be taken that the fumes so developed are

carried away by ventilating shafts in connection with each vessel. The

crystals formed after evaporation are ground with addition of metallic

mercury, and then heated in an oven. Nitrous fumes are evolved, and the

oxide, black when hot, turns to a brilliant red crystalline powder on

cooling. Finally, it is ground wet, dried, and sifted.

Vermilion, sulphide of mercury (HgS), is made by mixing excess of

sulphur with metallic mercury in closed rotating wooden drums. Black

amorphous sulphide of mercury results,[102] which on heating to 150°

C. becomes converted into a dark violet powder. From this vermilion is

obtained by sublimation, a process attended with risk from escape of

vapour. Finally, it is ground wet, and according to the fineness of the

grinding so is the particular shade of colour obtained.

The manufacture of calomel, corrosive sublimate, and vermilion can be

made by a wet method throughout without danger, provided reasonable

care is taken.

_Preventive Measures._--The conditions to be aimed at in places

where metallic mercury is handled (and for the most part also in places

where salts of mercury are used), are as follows:--

1. The flooring and benches should be smooth, impermeable, and free

from cracks or crevices in which mercury can lodge. Preferably the

floor should be of some kind of asphalt or cement, laid in such a way

that channels all converge towards a receptacle where the scattered

mercury may collect. Wood, although at present in common use, is not

well adapted for the purpose. The receptacles should be covered over,

leaving only a narrow opening for the mercury to run in.

2. There should be ample light, and the windows of all rooms where

mercury vapour may be produced should preferably face the north.

3. Mercurial processes should be carried on in rooms separate and

distinct from the other workrooms.

4. Any unnecessary raising of the temperature above 60° F. is to be

avoided, and consequently there should be no direct heating of the

rooms by open fires or stoves.

5. Mechanical ventilation should be provided, and reliance not be

placed merely on differences of temperature between the outside and

inside air. Inlets for air should be above the level of the heads of

the workers, and the draught of the fan should be a downward suction

one.

6. Workers should wear overalls and head coverings.

7. Shortness of the hair, shortness and cleanliness of the nails, a

proper hygiene of the mouth, and baths, would do much to protect the

workers. Ample washing convenience, including soap, nail brushes, and

towels, should be provided.

8. Meals should be prohibited in any room where mercury is handled.

9. Periodical medical examination, with power to the surgeon appointed

to suspend temporarily or permanently from work.

* * * * *

In two of the largest factories in which mercurial preparations are

made, in addition to the carrying out of all dusty processes such as

mixing and sieving, as far as possible, in a closed-in apparatus, the

following measures have been taken:--

RULES TO BE OBSERVED IN THE MANUFACTURE OF MERCURIAL

PREPARATIONS.

1. The firm will appoint a surgeon to examine all persons

employed in mercurial processes at least once in every month,

and he will undertake any necessary medical treatment of illness

contracted in consequence of such employment. He will have power

to suspend any such person from work in any place or process.

The surgeon will enter in a register the dates and results of

the examination of the person employed as above. No person after

suspension can be employed in any mercurial process without

written sanction from the surgeon.

Every person employed in a mercurial process must present

himself at the appointed time for examination by the surgeon.

2. The firm will provide sufficient and suitable overall suits

for the use of persons engaged in the processes of sifting and

grinding, and every person when so engaged must wear an overall

suit.

3. The firm will provide respirators approved by the surgeon for

persons engaged in processes where there is unavoidable dust,

and every person so employed must wear the respirator.

4. The firm will provide and maintain washing conveniences

in the proportion of one lavatory basin to each five persons

employed, with soap, nail brushes, and towels, and a constant

supply of hot and cold water laid on to each basin.

Every person must, before meals and before leaving the premises,

thoroughly wash in the basins provided, and those who have worn

overalls and respirators must deposit them before leaving the

factory after the day’s work in the place appointed for the

purpose by the firm.

The firm will see that the overalls are washed once a week, and

the respirators renewed or washed every day.

5. The firm will provide and maintain a bath with hot and cold

water laid on, and a sufficient supply of soap and towels. Every

person shall have the opportunity of taking a bath at the

factory once a week, and those whom the surgeon directs must do

so.

Each person taking a bath must sign his name in a register.

6. The firm will provide and maintain a cloak-room in which

workers can deposit clothing put off during working hours,

separate from any portion of the works where mercurial processes

are carried on.

7. No food or tobacco are to be taken into, nor is food to be

eaten in any part of the factory where mercurial processes are

carried on.

8. The foreman must report to the manager any instance coming

under his notice of a workman neglecting to observe these rules.

_Note._--The danger against which the rules are directed is

that of mercurial poisoning, of which the principal symptoms are

soreness of the gums, offensive breath, increase in the amount

of spittle, and trembling of the fingers. Workers are warned of

the danger arising from the chewing of tobacco, and of eating

food with unwashed hands. Mercury has a tendency to destroy the

teeth, and this can be best obviated by the use of a tooth-brush

once every day.

In hatters furriers’ processes the remedial measures required are

rather different, although suggestions (6), (8), (9), and part of

(7) equally apply. It is necessary in this industry to remove the

fumes arising from the solution of nitrate of mercury in carotting,

and to secure the absence of dust at the cutting machines, either by

perfecting the machinery and fittings of the receptacles into which the

bulk of the dust is carried by the revolving knives, or by increasing

this draught by means of a fan. This latter mode has been adopted with

success both as regards removal of dust and economy of work. It is

desirable, too, that the primitive stoves at present in use for drying

the “carotted” skins should be replaced by the kind now commonly to be

found in steam laundries, of “horses” sliding in and out of the heated

chamber on rails.

By the French law of 13th May 1893, the treatment of the skins and fur

of hare and rabbit skins with nitrate of mercury is scheduled, with

others, as an industry in which neither children nor females may be

employed.

T. M. LEGGE.

CHAPTER XXIX

THE LESIONS RESULTING FROM THE MANUFACTURE AND

USES OF POTASSIUM AND SODIUM BICHROMATE

Peculiar lesions--erosion of the septum of the nose and the production

of ulcers on the skin--are caused by bichromate of potassium or sodium.

Erosion of the septum is found only among persons engaged in the

manufacture of the salts, but ulceration of the skin of exposed parts,

principally the hands, although most severe and most frequently met

with among the same class of operatives, may be detected among persons

engaged in the many industries in which the salts are used in solution.

Bichromate of potassium and sodium, commercially known as “bichromes,”

are used largely--

1. In the manufacture of colours, such as the various chrome yellows,

by the interaction of lead acetate and bichromate of potassium.

2. In dyeing and calico-printing. In dying cotton yarn the material

is soaked in lime water, and, after wringing, is transferred to a

vat containing lead acetate. It then passes through a solution of

bichromate which develops the yellow colour on the fibre.

In calico printing potassium bichromate is used in the indigo blue

discharge style, when it may be printed from a paste containing 40 per

cent. of bichromate, which will discharge the colour from the blue

material after suitable treatment. Or it may be used for the production

of chrome lead colours by first printing the desired pattern on the

calico with a paste containing acetate of lead, and subsequently

passing this through a 2 to 5 per cent. solution of bichromate.

Potassium bichromate is the most important mordant for wool. The

mordanting bath is prepared with 2 to 4 per cent. potassium bichromate

(of the weight of the wool) and the necessary quantity of water,

amounting to from 50 to 100 times the weight of wool.[103]

3. In photography. The carbon process depends on the fact that gelatine

and potassium bichromate combine under the influence of light to

form a compound which is insoluble in hot water. The strength of the

bichromate solution for this process does not exceed 5 per cent.

4. As an oxidising agent for the manufacture of coal tar colours, for

the bleaching of oils, etc.

The first full account of the lesions arising in the course of the

manufacture of bichromate was given by Bécourt and Chevallier in

1863.[104] In 1854 Heathcote published in the _Lancet_[105] an

account of obstinate ulceration of the tonsils and pharynx observed in

a worker in a bichromate factory. No such extensive ulceration as he

describes has been recorded since.

A very complete description of the processes and of the clinical

symptoms shown by the persons employed, together with suggestions for

improving the conditions of working, was given in a joint paper by

Delpech and Hillairet[106] in the years 1869 and 1876. They believed

that any part of the skin might become ulcerated if exposed long

enough to the action of the dust. In no case did they find that the

ulcers penetrated into the joints, or that the bones of the nose were

attacked. They believed that the action of the dust set up in some

cases bronchitis and asthma.

In 1893 the effect of bichromate on the health of the workers was

referred to in the Report of a Departmental Committee of the Home

Office on the conditions of labour in chemical works, and, as a result,

special rules prescribing protection of vessels containing bichromate

in solution, respirators, due means for the removal of dust, waterproof

gloves, and lavatory accommodation, were drawn up.[107]

In 1895 the conditions found in the German bichromate factories

was made the subject of an interesting official report by Dr

Wutzdorff,[108] assisted in the chemical part by Dr Heise. Following

upon the recommendations made by Dr Wutzdorff, stringent regulations

were drawn up to govern the industry in Germany.

In 1899 considerable stir was created in Glasgow by the publication

by the _Labour Leader_ of a series of pamphlets directed to

show, among other things, that in certain factories in Scotland the

conditions of work were still unhealthy. In that year I visited all

the factories in this country, and a code of special rules printed

elsewhere in this volume now governs the industry.

Potassium bichromate is made by roasting a mixture of chrome ironstone,

potash and lime, lixiviating the fused mass with water, and adding

enough sulphuric acid to convert the neutral chromate into bichromate.

The reaction may be represented as follows:--

Cr_{2}O_{3} + 3O = 2CrO_{3}

CrO_{3} + K_{2}CO_{3} = K_{2}CrO_{4} + CO_{2}

2K_{2}CrO_{4} + H_{2}SO_{4} = K_{2}SO_{4} + K_{2}Cr_{2}O_{7} + H_{2}O.

Sodium bichromate is made in practically the same way, sodium carbonate

taking naturally the place of potassium carbonate. In the crushing and

grinding of the chrome ironstone much dust permeates the air, but this

mineral dust does not give rise to the peculiar lesions associated with

the bichromate.

After having been ground to a fine impalpable powder the chrome

ironstone, mixed with lime and potash, is introduced into a furnace

and roasted for about three hours. When withdrawn from here the fused

mass or “batch,” as it is called, consisting of neutral chromate of

calcium and potassium, after being allowed to cool, is broken up and

shovelled with evolution of much dust into large vats or “keaves.”

Water and potassium sulphate in solution are added, and at this stage,

owing to the slaking of the uncombined lime, much steam, carrying with

it particles of chromate dust, arises. The solution, when concentrated

by passing through successive keaves, is pumped into evaporating

pans, which are almost invariably entirely covered in and communicate

with the outside air by means of a shaft running through the roof.

Sulphuric acid is next added, forming potassium sulphate and potassium

bichromate. The former is withdrawn, and the latter, when sufficiently

concentrated, is pumped into lead-lined tanks, where crystallisation is

usually completed within three weeks. The crystals form beautiful large

adherent masses on the sides and floor of the tanks. They are broken

up by a pick, removed on barrows to be washed, dried in open stoves by

hot-air or steam-pipes, and finally packed in barrels.

Sodium bichromate does not usually crystallise, but forms a solid cake

which requires to be broken up.

The particular lesions associated with the manufacture are found among

all classes of men employed, from the moment the fused mass is removed

from the furnace, until the crystals are headed up in the barrels.

Inasmuch, however, as all the processes are carried out in one large

common shed, it is a little difficult to determine the relative degree

of danger attaching to each operation.

The rafters immediately above the keaves are coloured a canary yellow,

from the neutral potassium chromate carried up by the steam; a sheet

of cardboard suspended at a height of 2 feet above an evaporating

pan becomes covered in a short time on its _upper_ surface with

innumerable small brown specks of bichromate--a precipitation which

must result from the cooling of the steam; a stranger present for only

a few minutes while the packing is being done has the mucous membrane

of his nose acutely inflamed for hours or even days afterwards. These

facts show how permeated the atmosphere in the shed can become from the

dust and fumes from the bichromate. Breaking the crystals is the source

_par excellence_ for the development of chrome sores.

Dr Heise, in the paper already referred to, estimated quantitatively

the amount of bichromate dust in the air where the different processes

were carried on. Thus he found 1 cubic metre of air near to the place

where three men were breaking up a cake of sodium bichromate contained

6.30 milligrammes. One cubic metre taken during the fifteen minutes

during which packing was done contained 1.57 milligrammes. As regards

the steam, he found 1 cubic metre taken at a height of 45 centimetres

above the level of the evaporating pan contained 0.736 milligrammes of

sodium bichromate. In general, considerably less bichromate was found

in the air over the evaporating pan than where the dusty processes were

carried on.

The following is the result of an examination I made of 176 men exposed

to work at one time or another in the chrome house:

+---------+-------+-----------+----------+--------------+-------------+

+---------+-------+-----------+----------+--------------+-------------+

| 176 | 30 | 126 | 20 | 16 | 39 |

| 100 | 17.0 | 71.6 | 11.3 | 9.9 | 22.1 |

+---------+-------+-----------+----------+--------------+-------------+

In most of the cases where the septum was found ulcerated but not

perforated, the duration of employment had not been sufficiently long

for the ulceration to proceed to perforation.

In none of the 30 men in whom the septum was found to be normal was the

immunity attributable to shortness of employment. Six were connected

with the management, 6 were blacksmiths or coopers, 10 were furnacemen,

4 were engaged at the keaves, and 4 in the crystal house. One-half of

them had been employed for upwards of ten years.

There can be no doubt that the mucous membrane covering the septum is

attacked more readily in some persons than in others, and I incline to

the view that an immunity may be acquired if the first few months are

passed without ulceration taking place.

The rapidity of its onset is remarkable, as is shown by the following

table:--

Duration of Employment where the Ulceration had not

progressed to Perforation.

+------------+------------+---------+--------+----------+

+------------+------------+---------+--------+----------+

| 3 | 7 | 5 | 4 | 1 |

+------------+------------+---------+--------+----------+

Perforation was noted as having already occurred in one instance where

the duration of employment had been seven weeks, and in two others it

had been less than three months. Usually, it appears to take place

between the sixth and twelfth month after commencing work. Most of

the men examined worked in the crystal house, and all except the

four mentioned had either ulceration or perforation of the septum.

The majority of the furnacemen also had perforation, but in them the

septum was found normal more frequently than was the case with the men

employed in the crystal house.

_Nature of the Perforation._--The cartilaginous framework of the

nose consists of five pieces, the two upper and the two lower lateral

cartilages, and the cartilage of the septum. The two upper and the two

lower lateral cartilages give the nose much of its shape, and form the

alæ nasi. The ulcerative process due to bichromate dust never attacks

them. The cartilage of the septum is somewhat triangular in form, and

thicker at its margin than at its centre. Its anterior margin, thickest

above, is connected from above downwards with the nasal bones, the

front part of the two upper lateral cartilages, and the inner portion

of the two lower cartilages. Its posterior margin is connected with

the perpendicular lamella of the ethmoid; its inferior margin with the

vomer and the palate processes of the superior maxillary bones. The

seat of election for the ulceration to commence is a point about a

quarter of an inch from the lower and anterior margin of the septum,

and it extends in a direction upwards and backwards.

The limitation of the perforation to the cartilage of the septum is

accounted for by the fact that the mucous membrane covering it is

adherent, forming the perichondrium, and is far less vascular than the

mucous membrane lining the rest of the nasal fossa. Once the mucous

membrane is destroyed, the blood supply to the cartilage is cut off,

and necrosis ensues. The ulceration having progressed upwards as far

as the junction of the septum with the ethmoid and backwards to the

vomer, becomes arrested. Healing then takes place, the bone not being

attacked, and the cicatrix usually becomes covered with an ecthymatous

crust of mucus.

In no instance was the anterior or lower border of the septum

destroyed. Consequently, the rigidity of the parts is maintained, and

deformity, so prominent in other ulcerative processes attacking the

nose, absent.

The onset of the morbid process is ushered in by sneezing and the

ordinary symptoms of nasal catarrh. The pain accompanying the

ulceration appears to be insignificant. It had never been severe enough

to necessitate absence from work or to call for medical treatment.

Once the perforation is established, the only inconvenience which

results is the formation of plugs of mucus in the nasal passages. The

general health is in no way detrimentally affected by the condition.

Considering the extent of the lesion, the number found with marked

impairment of the sense of smell is not large. Mucous deposits and

white patches were occasionally noted on the pharynx, but definite

ulceration, such as has been described in bichromate workers, was in

no case detected. Asthma, noted by the French writers on the subject,

Delpech and Hillairet, was found in one instance--that of a partner in

one of the works. In his case there was a family predisposition to it,

but the first definite attack dated from contact with bichromate.

_Ulceration of the Skin._--In 39 out of the 176 men engaged in

chrome processes, one or more unhealed ulcers or “chrome holes” were

observed. In these and in several others, numerous scars marking the

site of bygone ulcers were noted.

A chrome hole is a sluggish ulcer. It results from a cut or abrasion of

the skin coming into contact with bichromate in the form of crystals or

solution. The seat of election is either on the knuckles or at the base

of the nail, but they may occur on any part of the hands or forearm. In

two cases they were observed on the neck, once in the groin, and once

on the foot. The tissues around are raised, thickened, and indurated;

the centre is filled by a slough, usually covered by a scab, and the

whole resembles a large boil. When the slough has been removed the

floor of the ulcer is seen to consist of greenish-yellow granulation

tissue. In the majority of cases the central scab is not more than ⅛

inch in diameter, in a few it is ¼ inch, and the largest that I have

seen measured, ¾ by ½ inch. Chrome holes occur principally among men

engaged in the crystal house and at the keaves, and only rarely among

the furnacemen. The amount of pain and inconvenience they cause is

considerable. Sometimes they necessitate absence from work, but they

are never a menace to life. At one works six men were absent during

1898 for periods varying from three to nine weeks, on account of chrome

holes. Even when their severity is not such as to necessitate absence

from work, months may elapse before they heal.

The treatment adopted by the men is of the most elementary description,

and naturally under these circumstances they prove intractable.

The conditions found by Dr Wutzdorff in the German bichromate factories

were very similar. Ulcers of the external skin were found most

frequently on the fingers, hands, and arms, then on the feet and legs;

once an ulcer was found in the external auditory meatus and three times

on the eyelids. The ulcers penetrated deeply into the soft parts, and

required, in consequence, a long time to heal. In no case had they

penetrated as far as the tendons, or into the joints. Ulceration and

perforation of the septum was found in workers in several factories,

and ulceration of the gums and pharynx of slight extent was observed

twice. The general condition of the workpeople was apparently good--at

all events no worse than that of chemical workers generally.

The preventive measures necessary in the manufacture of potassium or

sodium bichromate will be found stated in the regulations printed

elsewhere in this volume. They resolve themselves generally into

removal of dust and fumes, cleanliness, and medical supervision

periodically of the workers, and the covering up of cuts and abrasions

with suitable dressings. When in solution the salt does not attack the

unbroken skin. Indiarubber gloves are sometimes worn by the men in

dye-works who are constantly engaged in processes in which bichromate

is used in dilute solution, but in view of the difficulty of enforcing

their use, and the fact already stated, that unless there is an

abrasion of the skin a chrome hole will not be developed, the wearing

of indiarubber gloves, while a thing to be recommended, can hardly be

made compulsory. It is advisable that in all dye-works the foreman

should be made responsible to report all men suffering from abrasions

of the skin, or from chrome holes, to the manager, in order that they

may have proper treatment, and be put to other work until such time as

healing has taken place.

In photographic processes involving the use of bichromate, if there

is any tendency to the development of eruptions on the hands, careful

washing and subsequent treatment, when thoroughly dried, with lanolin

or glycerine should be tried. If this fails, rubber gloves must be worn.

T. M. LEGGE.

CHAPTER XXX

COPPER AND BRASS

The two substances, the dangers to health attendant on the working

of which form the subject of this chapter, present widely different

features, both as regards their essential natures, their treatment

during the processes of manufacture, and the treatment they

subsequently receive. The one being a metal and the other an alloy,

the primary processes in the first case are those of mining and of

reducing the ore; while in the second, the admixture of metals in such

proportions as the particular alloy requires is the first detail of

treatment. A similar process of casting into ingots follows with both

substances, but the malleable and ductile qualities of copper render

its subsequent treatment, in the various processes of manufacture,

dissimilar to that of brass and its kindred alloys.

There are, moreover, marked features of dissimilarity in the

constituents of brass and of copper ore of especial importance in

any consideration of unhealthy conditions attendant upon working in

these substances. The form of copper ore which is most largely smelted

in England is copper pyrites, an ore which is largely composed of

sulphur, while in various ores arsenic is found. Brass and similar

alloys, on the other hand, are composed of copper and zinc; and as we

shall see later in this chapter, it is to the presence of the latter

ingredient that in our opinion may be attributed the illness known as

“brassfounders’ ague,” or at all events the abnormal amount of ill

health found to exist amongst brass mixers and casters.

Although it might be more natural to discuss the metal in the first

place, and the alloy of which it forms a very important part in the

second, we will reverse that order, owing to the much greater degree

of importance, from a sanitary point of view, which attaches to the

working of brass than to that of copper. Prefacing, therefore, our

remarks on the dangers attending the working in brass by an outline

of the processes involved, it will be sufficient for our purpose to

quote from a Report of a Committee of the Home Office appointed in

1894 to inquire into the conditions of labour in the manufacture of

brass and of kindred amalgams, and of which we had the honour of being

members. It is explained that, in the first instance, an alloy is made

at a very high temperature in crucibles which are plunged into sunken

furnaces, the principal components of the alloy being copper and zinc

(commonly called spelter) mixed in proportions varying in accordance

with the quality of brass required. An example of a deposit resulting

from the pouring of common or yellow brass taken by the Committee is as

follows:--

Moisture 9.64

Organic matter 39.42

Silicious residue 9.14

Oxide of iron 2.78

Copper 1.71

Oxide of zinc 28.82

Other matter 8.49

------

100.00

Other amalgams, such as gun metal, phosphor bronze, and bell metal,

yield different proportions, while in some cases it is found that

old copper and brass scrap, such as discarded locomotive and marine

boiler tubes, are thrown into the mixture. The alloy thus mixed is

poured into iron moulds or ingots, to be remelted when required; or

it is at once poured into moulds which have been already prepared

by patterns to receive the metal, and in which the formation of the

castings takes place. Previously to receiving the metal the mould has

been dusted over with fine dust either of burnt loam, sand, burnt

red brick, charcoal, French chalk, or bean flour, according to the

requirements of the work. The moulds are, roughly speaking, iron rims

clamped together, and filled with very fine sand in which the patterns

have left impressions for the reception of the metal, hence the name of

sand-casting possessed by this process. Should the metal be required

for sheets, tubes, or wire, it is poured into iron moulds or ingots, to

be subsequently rolled or drawn as required, and this process is called

sheet or strip casting. Having procured its shape, the brass article

or casting is subjected to further processes on its way to completion,

such as (1) that of dipping in aqua fortis and in acid solutions of

various strengths for the purpose of removing oxidation and impurities;

(2) that of burnishing or of polishing at a lathe to acquire a smooth

surface; (3) that of finishing or dressing; and finally (4) that of

lacquering, which is an application of a solution of shellac and

other ingredients to the work (specially heated for its reception on a

stove) with a view of securing the colour desired; also (5) a process

of bronzing is also undergone when a particular effect is required

in the appearance of the article. In either of these processes,

which involves the pouring of the molten alloy, the zinc deflagrates

during the pouring, and a dense white smoke is formed, which almost

instantaneously fills the atmosphere of the casting shop. This smoke is

rapidly converted into snow-white flakes and white powder, consisting

of the oxide of zinc, which remains for some time diffused through the

atmosphere of the shop, and in ill-ventilated casting shops collects

upon the rafters and ceiling in the form of a dense white incrustation.

The quantity of these fumes depends, firstly, upon the amount of zinc

employed; secondly, upon the ventilation of the shop; thirdly, upon the

weather--a dull, foggy day preventing their escape. It may be readily

imagined that persons exposed to the alternations of heat and cold in

the casting shop, to the deflagrated zinc inhaled as well as imbibed

with food and drink, and the intense thirst induced by the nature of

the work, would suffer in health. That such is the case the evidence

submitted to the Home Office Committee was ample and conclusive. It

must not, however, be assumed that nothing was previously known upon

the subject, or that no steps had been already taken in the endeavour

to improve the shops or in other ways to ameliorate the condition of

the workers.

The recognition of working in and making brass as causative of disease

is due to Dr Headlam Greenhow, who, in 1862, read before the Royal

Medical and Chirurgical Society a paper on “Brassfounders’ Ague.”

This was based on his experience while paying a brief holiday visit

to Birmingham in 1858, in connection with his investigation of trades

injurious to health. It is curious that he should have selected for

his title the name of a disorder which undoubtedly occurs, but which,

as we shall endeavour to show, is only an acute expression of a

chronic malady, and one which rarely or never comes within the range

or experience of practising physicians. In the out-patient department

of the Birmingham hospitals one meets with an enormous number of

brass-workers complaining of various pulmonary and gastric disorders;

but an experience of many years has never yet produced to us a case of

this so-called ague, although questions will very frequently elicit

the statement of its occurrence. The literature of the subject is

very scanty, but Greenhow quotes Thackrah’s essay on the “Effects

of Arts, Trades, and Professions on Health and Longevity,” published

about 1830, as well as the writings of a few Frenchmen, which have not,

however, materially advanced our knowledge of the disease. Thackrah’s

observations were clearly inaccurate and imperfect, for he mentions

only “ague,” which he speaks of as an intermittent fever, attacking

brass-workers from once a month to once a year, and leaving them in

a state of great debility. Dr Hogben, Physician to out-patients at

the Queen’s Hospital, Birmingham, published a very interesting paper

on this subject in the _Birmingham Medical Review_ in May 1887.

Dr Greenhow refers only to ague and bronchial disorders, and very

cursorily to nervous troubles, as resulting from brass casting; but

Dr Hogben mentions also colic, constipation, and dyspeptic troubles

which result from this occupation. Dr Greenhow, on the one hand, refers

all the symptoms to intoxication by zinc, while Dr Hogben thinks they

should be rather referred to chronic copper poisoning. These two metals

are the principal ingredients in the making of brass, as already

mentioned.

That Thackrah was in error in speaking of brass ague as an intermittent

affection, occurring once a month or once a year, is clearly proved

by the following positive observation, which is supported by all

brass-workers. Ague never occurs among the regular workers, but always

affects those who are new to the work, or who resume work after an

absence of even a month or a fortnight. If a man resumes work, that

is melting or casting, after even so brief an interval, he is sure to

have an attack of ague, but he will have only one attack, and remain

free until after his next holiday. There is most certainly no kind

of regular intermission, and according to brass-workers themselves,

they only suffer till they are inured to the poison. The following

are the symptoms of this so-called ague. After working a few hours,

a man becomes languid, depressed, and feels very cold. He is very

pale and almost in a state of collapse, his face is covered with a

cold perspiration, he shivers, his teeth chatter, and he is restless

and anxious. His head aches, there is much nausea and complaint of

muscular pains. As a rule he goes or is led home, where he drinks

freely of milk and goes to bed. The symptoms continue until he has

vomited, either as the result of taking an emetic or independently of

it. Vomiting is usually followed by sleep or recovery, with more or

less of debility and lassitude on waking. Drs Greenhow and Hogben

speak of a more or less marked hot stage succeeding the cold, while

following the hot stage they mention profuse sweating. The hot stage

may be absent, but the sweating, according to these writers, invariably

occurs. Our own observations, based on inquiry amongst those who have

suffered from this ague, have never elicited a statement of these hot

and sweating stages. Even direct questions as to their occurrence

have always been met with positive negation, though some have spoken

of free perspiration in the stage of collapse. How to reconcile these

statements we do not know. The cycle of events as recorded by Greenhow

is just that of ordinary ague, from which this disease differs,

otherwise than in the suggested sequence, in toto. The inquiries

we have made do not support such a sequence, and certainly not a

relationship to malarial ague. The symptoms are just such as would be

caused by the ingestion of a quantity of irritant metal, sufficiently

large to cause vomiting, and its attendant depression. Such, indeed,

is our opinion of the causation of the symptoms, and therefore the

name “ague” should not be continued, as being wrongly suggestive and

misleading. It will be remembered that it is only when fresh to the

work that brass-workers suffer from “ague,” but, though they do not

suffer from acute metallic poisoning, they do suffer from its chronic

effects, and it is extremely probable that, as with arsenic and opium

eaters, they may become inured to the use of the metals.

As it is not very common for brass-workers to use tooth brushes, the

accumulating tartar is usually found coloured green. Even when an

attempt is made to cleanse the teeth, they still show signs of green

discoloration. This has been proved to be due to the presence of

copper. The white hair of the workmen is often coloured green, and the

underclothing is stained green by the perspiration. The gums may be

slightly blackened at the edges, but there is nothing distinctive as in

the case of the blue line of lead poisoning; nor, indeed, beyond the

green colouring of the hair and teeth, do brass-workers present any

unequivocal evidence of their calling.

Ague is not a disorder for which brass-workers consult a medical man;

they know how to treat it themselves, and also that it is transitory in

its effects; but they come to hospitals in large numbers to be treated

for bronchitis. As regards this there is nothing special. The men

suffer from it in common with all workers in dusty trades, and so far

as we can learn from the Secretary of the Brass-workers’ Organisation,

they usually die from chronic bronchitis or fibroid phthisis, unless

they succumb to some acute malady. The existence of nervous disorders,

especially paralysis agitans, has been said to be common among them,

but we cannot find that a larger percentage of brass-workers than of

the rest of the community suffers from diseases of the nervous system.

It is common, however, to meet with complaints of disturbance of the

digestive function. Brass-casters suffer from dyspepsia, loss of

appetite, gastro-intestinal catarrh, nausea, vomiting, metallic taste,

thirst, colic, constipation, and diarrhœa. They are often nervous and

hypochondriacal, and complain of headache as well as muscular pains.

There is nothing distinctive about any of these disorders, except the

obstinacy with which they resist ordinary methods of treatment, and

the readiness with which they yield to the administration of iodide

of potassium in combination with the other drugs indicated by the

various conditions of ill-health. All the symptoms bear a remarkable

resemblance to those produced by chronic copper poisoning. In Guy and

Ferrier’s _Forensic Medicine_, an outbreak of copper poisoning

from the use of copper vessels in cooking is recorded, in which the

symptoms were almost identical with those here mentioned. The inmates

of a convent suffered severely from obstinate and severe colic,

retching, and bilious vomiting, costiveness, and flatulence, burning

pain in the pit of the stomach and extremities, and paralytic weakness

in the arm. According to Stephenson it is impossible to distinguish

between the symptoms produced by zinc and copper poisoning. These

are just such as brass-workers suffer from, and it is, therefore,

impossible to say which metal--copper or zinc--is most concerned in the

production of these symptoms. Dr Greenhow attributes them all to the

inhalation of the deflagrating zinc. This forms oxide of zinc, which is

only sparingly if at all soluble, and, therefore, is not likely to be

freely absorbed into the stomach. Greenhow pays little or no attention

to the common and chronic gastric and intestinal troubles to which

brass-workers are liable. These affect all who work in the various

processes by which, either in vapour or in minute particles, copper and

zinc--that is, brass--are distributed in the atmosphere. Dr Hogben, on

the other hand, considers copper alone to be the efficient cause of the

symptoms, and advances the following arguments:--

1. We have no evidence that the internal administration of zinc ever

produces the symptoms of brass ague. Enormous doses of the oxide have

been administered without apparently producing the characteristic

febrile reaction of brass ague.

2. The malady is observed in individuals whose work is other than

casting.

3. The malady is not observed in operatives, such as galvanised iron

workers, who work with zinc, and are exposed to its fumes.

4. Zinc is rapidly excreted, and does not, like lead, mercury, or

copper, become fixed in the body, and produce chronic affections.

It seems more probable that, accepting Stephenson’s statement of the

impossibility of distinguishing between the effects of acute copper or

zinc poisoning, the symptoms of ague are due to an admixture of the two

metals; whereas, for the chronic complaints, the copper is responsible.

How the practice of taking milk during an attack of so-called ague has

arisen is not clear; but its wisdom is proved by the fact that in cases

of both copper and zinc poisoning milk is one of the best antidotes,

since it precipitates both these metals into insoluble albuminates.

It is abundantly evident that brass-workers are especially liable

to diseases from the use of the metals employed in its manufacture,

but these are not new disorders; they are either proofs of chronic

poisoning by zinc or copper, or, as in the so-called ague, are due to

intoxication by them. If more proof were wanting of the unhealthiness

of brass-casters, it would be afforded by the fact that a few years

ago, though there were 1200 casters in Birmingham, there were not

more than ten over sixty years of age, and in connection with a

superannuation fund of the Amalgamated Brass-workers’ Association from

which casters could at the age of fifty-five derive benefit, it is an

appalling fact that there were only three men--two in Birmingham and

one in Sheffield--enjoying this benefit.

That such a condition of affairs should be allowed to remain

unremedied, if remedy was possible, was improbable after special power

was vested in the Home Secretary by the Factory Act of 1891 to deal

with processes which he deemed dangerous or even injurious to health.

The desirability of observance of certain general principles, such as

temperance, cleanliness, and care in the matter of taking food, was

obvious not less in the case of brass-workers than of other operatives.

These need not be enlarged upon by us, although their importance

towards securing health and happiness in a man’s declining years are

sadly overlooked among the working classes. But it was felt that there

should be some definite rules officially published for the healthy

conduct of brass-working.

A series of rules designed to that end were tentatively issued with the

approval of the Secretary of State by Mr R. E. Sprague Oram, C.B., then

Chief Inspector of Factories in 1894, but although possessing features

of stringency which appear not unwarrantable under certain conditions

of brass-working, they were generally felt to be unnecessary in the

case of working in alloys in which the percentage of zinc was either

relatively small, or indeed from which it was entirely absent.

Official attention had, however, been thoroughly aroused to the

necessity of action, and in November 1894 a Departmental Committee

was appointed by Mr Asquith, Secretary of State, to report upon

conditions of work, so far as they affected the health of operatives

in the various processes connected with the working of brass, gun

metal, bell metal, and other kindred amalgams. Subsequently too at

Birmingham, which may be regarded as the home of the brass trade,

the Committee held sittings and made inquiries in various parts of

London, in Willenhall, Wolverhampton, Edinburgh, Glasgow, Sheffield,

and Rotherham, and were assisted by the evidence of a large number of

manufacturers, artisans, factory inspectors, physicians, and others,

on which their report to the Home Secretary of State was based. The

report largely deals with matter already given in this chapter, but

drawn as it was immediately after the accumulation of the best evidence

on the subject which could be procured, and for the elicitation of

which no further opportunity is likely to arise for the present, it

is desirable that the conclusions arrived at should be given. Having

stated that during the inquiry the Committee had met with ample

evidence of the existence of such symptoms as have been described

above, the report adds that the attention of the Committee had been, by

personal observation and experience, especially drawn to the causes and

symptoms of the so-called “ague,” of which the members had no reason

to doubt zinc fumes were the efficient cause; that it considered the

danger of working in the several alloys was proportionate to the amount

of zinc contained; that the danger was increased by the use of such

ingredients as discarded locomotive and boiler tubes, and such-like

scrap; also that the symptoms were caused by the inhalation of the

zinc fumes, and by the introduction of the particles of zinc into

the digestive tract with such food as might be eaten in the casting

shop. The conclusion arrived at was that, “Although in brass-casting,

as in all other occupations, the practice of personal cleanliness may

serve to reduce the ill effects incident to the workers’ employment,

yet if a brass-caster is constantly exposed to the influence of these

fumes, it remains almost an impossibility that he should pass unscathed

by them. The most serious efforts, therefore, should be directed by

manufacturers and artisans alike towards the minimising of the ill

effects which must of necessity be caused in the process of casting

by these fumes; and the Committee are convinced, both from personal

experience and from evidence which they have acquired from witnesses

of all classes, that the direction of these efforts should lie towards

securing a proper construction of casting shops, supplemented by a

system of ventilation conducted on scientific principles.”

Shops properly constructed, scientifically ventilated, adequately

provided with washing arrangements for the casters, and licensed by a

competent authority, were the requirements suggested by the Committee

as being absolutely necessary for the casters. The compulsory wearing

of mouth coverings during the process of pouring the metal was felt,

owing to hostile evidence given by the workers themselves, to be

impossible for recommendation. Finding that “a great many witnesses

considered milk to be a desirable thing to take when ill, but as a rule

they preferred to take it at night, finding that it did not agree with

them so well when taken in the shop, and in many cases witnesses did

not think milk suited them personally,” the Committee did not consider

it desirable to recommend the retention of the tentative rule requiring

manufacturers to provide a supply of milk or other sanitary drink.

The drinking of milk, however, as well as the wearing of a covering

to the mouth and nostrils, was recommended for the casters. Further

recommendations were, leaving the shop for the purpose of taking food,

frequent ablution, care in the avoidance of taking cold, and of a

regular and moderate diet.

Apart from the recommendations for optional courses of conduct were

suggestions for specific rules. It was a matter of sincere regret

to the Committee to learn that these were in some instances--such,

for example, as the desired requirement that casting shops should be

licensed--beyond the powers of enforcement vested in the Secretary of

State. The special rules which were issued subsequently to the report

of the Committee underwent a slight modification more recently, and are

now as follows:--

Form 271.

FACTORY AND WORKSHOP ACTS, 1878 TO 1895.

MIXING AND CASTING OF BRASS AND OF CERTAIN OTHER ALLOYS.

_SPECIAL RULES._

Under Section 8 of the Factory and Workshop Act, 1891, and

Section 28 of the Factory and Workshop Act, 1895, for the

processes in the mixing and casting of Brass, Gun Metal, Bell

Metal, White Metal, Delta Metal, Phosphor Bronze, and Manilla

Mixture.

DUTIES OF OCCUPIERS.

1. They shall provide adequate means for facilitating, as far as

possible, the emission or escape from the shop of any noxious

fumes or dust arising from the above-named processes. Such means

shall include the provision of traps or of louvre gratings in

the roof or ceiling of any shop in which such processes, or

either of them, is or are carried on; or in case of a mixing or

casting shop which is situated under any other shop, there shall

be provided an adequate flue or shaft (other than any flue or

shaft in connection with a furnace or fireplace) to carry any

fumes from the mixing or casting shop, by or through any such

shop that may be situated above it.

2. They shall cause all such mixing or casting shops, whether

defined as Factories or as Workshops under the Factory and

Workshop Act, 1878, to be cleaned down and limewashed once at

least within every twelve months, or once within every six

months if so required, by notice in writing from H.M. Inspector

of Factories and Workshops, dating from the time when these were

last thus cleaned down and limewashed; and they shall record the

dates of such cleaning down and lime-washing in a prescribed

form of register.

3. They shall provide a sufficient supply of metal basins,

water, and soap, for the use of all persons employed in such

mixing or casting shops.

4. They shall not employ, or allow within their Factory or

Workshop the employment of, any Woman or Female Young Person,

in any process whatever, in any such mixing or casting shop,

or in any portion thereof which is not entirely separated by a

partition extending from the floor to the ceiling.

DUTIES OF PERSONS EMPLOYED.

5. They shall not partake of, or cook any food in any such

mixing or casting shop, within a period of at least Ten Minutes

after the completion of the last pouring of metal in that shop.

B. A. WHITELEGGE,

_July 10, 1896._ _H.M. Chief Inspector of Factories_.

(_Note._)--WOMEN and PERSONS under 18 YEARS OF AGE are

by the 39th section of the Factory and Workshop Act, 1878,

expressly FORBIDDEN either to TAKE A MEAL or to REMAIN in

any casting shop during the time stated on the Notice

affixed in the factory or workshop as being allowed for

meals; and the obligation of enforcing this section rests

with the occupier.

* * * * *

These Rules are required to be posted up in conspicuous places

in the Factory or Workshop to which they apply, where they may

be conveniently read by the persons employed. Any person who

wilfully injures or defaces them is liable to a penalty not

exceeding five pounds (Factory and Workshop Act, 1891, section

11). Occupiers of factories and workshop, and persons employed

therein, who are bound to observe any special rules, are liable

to penalties for non-compliance with the same (Factory and

Workshop Act, 1891, sections 9 and 11).

These rules will be found to strike at the three principal causes of

illness in the workers, viz.: (1) shops either structurally unfit for

the processes of mixing or casting metal, or equally unfit on account

of their dirty and zinc-coated condition; (2) the want of opportunity

afforded to the casters of washing themselves before taking meals; and

(3) the most pernicious habit, too common hitherto with the workers, of

taking food in an atmosphere of deflagrated zinc. It will be noticed

also that a prohibition is laid upon the employment of females in

casting-shops. Their labour in connection with such work is limited

to the making of cores, small blocks of sand which are used in the

formation of hollow castings. The evidence of the witnesses examined

before the Committee was in favour of this prohibition, also of

core-making being carried on in a separate shop.

With regard to the other processes met with in brass-working, and which

have been enumerated in an earlier part of this chapter, it cannot

be said that they present any causes of illness differing from like

processes in connection with other metals. Workers in the dipping-shop,

and to a less extent in the bronzing process, are exposed to inhalation

of acid fumes, and further, in the former occupation to exposure to the

weather and to being obliged to stand on very wet floors. In a case

brought to our notice, the powder used in bronzing contained lead to an

extent of 7 per cent., a condition which might induce plumbism in the

worker in the absence of due precaution. The dust which is given off

during polishing is partly metallic in character, partly composed of a

mixture of sand and lime, and partly textile fluff worn off the calico

polishing discs by the process of work. Without doubt such dust should,

as in all factories, be removed by fans or other ventilating methods

from the shop. The shops used for lacquering should similarly be freed

from the unpleasant fumes of the lacquer, which cannot, however,

be considered in any particular degree injurious to health. A most

interesting paper read before the Midland Medical Society by Dr William

Murray (subsequently printed in the _British Medical Journal_,

2nd June 1900) on Chronic Brass Poisoning, draws attention to another

rather common form of plumbism caused by the process of “putting

together” gas fittings, it being customary to solder the joints of

these fittings with white lead, and then having closed one end of the

bracket, to suck at the other to ascertain that the work is perfectly

sound. We have recently met with a case of advanced paralysis in a

man of forty-five apparently induced by this branch of brass-work. Dr

Murray deals in detail with his method of treatment of cases of chronic

brass poisoning, of which as Resident Surgeon of the Birmingham General

Dispensary he has had considerable experience.

We hope we have shown that, firstly, the conditions of brass-working

in all its branches require that the shops in which it is carried

on should be well ventilated in order to secure the escape of the

“smother” from the casting-shops, and of the conglomerated dusts from

the polishing rooms; and secondly, these conditions require or rather

demand habits of personal cleanliness and of self-respect on the part

of the workers, habits which prescribe temperance, avoidance of taking

food in the shop, and frequency and regularity of ablution. Such are

now possible of attainment by the persons whose health is concerned,

and it rests with themselves alone to make full use of the improvements

placed within their reach.

Passing from the consideration of brass to that of copper, we find

that there is little to be said regarding the working of that metal

descriptive of any injury to health among its workers. Indeed it may

be doubted whether any traces of such injury can be found. Having

been mined in many quarters of the globe, the ore is subjected to the

process of smelting, which, so far as Great Britain is concerned,

takes place chiefly at Swansea, and also at St Helens and at

Newcastle-on-Tyne. The qualities of the ores from different mining

districts vary greatly, and the reducing processes of the ores vary

correspondingly. Speaking generally, it may be said that the process

consists of six operations conducted in reverbatory furnaces, termed

calcining and melting furnaces. At the conclusion of these processes

the metal, freed from the arsenic, sulphur, and other accessories of

the ore, is melted and cast into ingots, to be sent in that shape to

various centres for manufacturing purposes.

During the smelting processes the sulphurous fumes either are collected

in leaden chambers for purposes of condensation into sulphuric acid,

or escape through the flues into the outside air. In neither case does

the worker at the furnace suffer from these fumes, except, perhaps,

when drawing the furnace he may experience some back draft of sulphur,

an evil which may readily be met by the wearing of a handkerchief over

the mouth while engaged in the operation. During recent years it may

be mentioned that the first of the reducing processes is more commonly

carried on in the vicinity of the mines, and as a consequence the ore

on reaching S. Wales is now usually in the form of regulus. The denuded

state of the country in the neighbourhood of the smelting furnaces

bears witness to the unhealthy character of sulphur fumes. Dr Arlidge,

however, notes an analysis of sickness in the Swansea district which

tends to prove that though the fumes were very productive of acute

pulmonary disease, yet the death-rate in parts of the country subject

to their influence was lower than that in adjacent districts. We are

told by Mr Lewis, who for many years has been the Factory Inspector

in charge of the Swansea district, that although there is a prevalent

impression that the furnacemen suffer exceptionally from chest mischief

owing to the great heat and the fumes, he does not consider that

they suffer in any degree more than the furnacemen in other metal

processes. He forms the same opinion as that held by us in respect

of the brass-workers, namely, that the workers are not sufficiently

careful of themselves between shifts. He reports that the flue and

chamber cleaners, as at other smelting works, rarely wear respirators;

they will not ventilate the flues nor water the dust before commencing

cleaning operations, and consequently the respiratory organs are more

or less affected; he cannot find direct evidence of specific illness

traceable to copper smelting. Mr Lewis attaches considerable importance

to the provision of high and well-constructed stacks and flues, and to

the due preparation of the chambers by ventilation and watering before

the process of their cleaning takes place. No special inquiry having

been ordered concerning this subject, particular importance attaches to

Mr Lewis’ opinion.

On the whole we do not consider that copper-working is in any way as

dangerous an occupation as brass-working, for the pouring of metal

is not accompanied by the same abundant vapours as in brass pouring,

besides such vapour as does arise is mainly due to the presence of

a small quantity of spelter in the mixture. The same precautions as

advised for brass pourers should be taken, but the need is less;

we have seen a pouring shop with a perfectly clear atmosphere five

minutes after the pouring has taken place. A muffler or respirator

should be worn during the operation, and, as far as we have seen, this

is generally done. Apart from the pouring we have been struck by the

excellent health of copper-workers, and as the dust is heavy, and does

not float in the air, there are none of those respiratory troubles

which, as we have seen, are the bane of brass-workers. There is one

danger to which apparently they might be subjected, but we found no

evidence of its having arisen, and that is from the accumulation of

the heavy copper dust on the tables or boards at which the men are

working. It seemed not unreasonable to expect that want of cleanliness

on the part of the workers would entail digestive troubles from the

mixing of copper dust with the food. As we have stated, no evidence of

this is forthcoming. It will be seen that we are unable to confirm Dr

Arlidge’s view of the dangers to copper-workers from the inhalation

of copper dust, nor are we able, though contrary to our expectations,

to assert that men employed in the trade are particularly liable to

suffer from colic. According to Blaudet, this colic is attended by

complete prostration, by vomiting and purging, and it is very probable

that such results would follow, if the men were dirty in their work and

habits, the introduction of copper dust by food taken into the stomach.

Opinions are much divided on this subject, and it is possible that

working in old copper and brass, which are covered with a carbonate

of copper, may be responsible for the ill effects noticed. According

to M. Perron of Besançon, clockmakers, who have to handle copper

freely, suffer from a slow intoxication from it, exhibited by gastric

derangements, diarrhœa, oppression, and some feverishness, but our own

experience among copper-workers and other persons does not confirm

these observations.

The conditions of improvement suggested both for brass and copper

working are those that should be applied to all manufacturing

processes. Shops of good construction, well ventilated, and amply

furnished with lavatory and other sanitary arrangements; these are

desiderata for the workmen.

ROBERT M. SIMON.

SEYMOUR H. KNYVETT.

CHAPTER XXXI

INDIA-RUBBER: DANGERS INCIDENTAL TO THE USE OF

BISULPHIDE OF CARBON AND NAPHTHA

Indiarubber is used in the manufacture of waterproof garments,

door-mats, toys for children, insulators of electric wires, tobacco

pouches, etc. In the production of these articles large numbers of

people find employment. During my visits to indiarubber works in

Manchester and London I had several opportunities of observing some of

the dangers incidental to the trade.

On entering a waterproof garment manufactory one encounters an

extremely pungent vapour, which dries and heats the nose and throat,

and is apt to make the eyes run water. This is the fume that comes from

naphtha, which is used to dissolve the rubber and to form the dough

that is spread as a thin layer by means of a roller machine upon the

cloth about to be waterproofed. Both coal tar and mineral naphtha are

employed. The vapour of naphtha is extremely irritating, and can be

detected over the whole of the factory. The colour of the waterproofed

material depends upon the pigment that is employed. If, for example,

black is wanted, all that has to be added to the dough, composed of

indiarubber and naphtha, is lamp black. The men who feed the roller

machines, and who regulate the distribution of the dough upon the

cloth, are constantly breathing the irritating atmosphere, but I did

not find any special complaint in regard to it from them. It is the

girls who work in the overheated and often overcrowded rooms of the

factory that suffer most. They are usually very anæmic and complain

much of headache. So saturated are they with the fumes of naphtha

that even after they have left the factory they still feel the taste

of naphtha in their food. In the workrooms these girls are employed

rolling and pressing the garments; joining the seams, etc., by rubber

dissolved in naphtha. On a winter’s night, when the gas is full ablaze,

the air of the workroom is extremely pungent, so that girls are often

obliged to leave the room and go into the open air for a short period.

The fumes of naphtha are more unpleasant than really dangerous; still

there is no doubt that the constant inhalation of these fumes during

working hours and the distaste for food thereby created cannot but in

time undermine the health of the female worker, and render her more or

less unfit for duty.

The dangerous process in the manufacture of indiarubber goods is not

that in which naphtha is used, but _bisulphide of carbon_. In

order to render rubber goods capable of withstanding alternations

of heat and cold, and of retaining their elasticity in all kinds of

weather, they must be _vulcanised_. The vulcanising agent is

either the common flowers of sulphur or a compound of sulphur. When

50 to 60 per cent. of sulphur is added to rubber there is obtained a

very hard product known as _ebonite_. Considerable care has to be

taken in using sulphur. If, for example, too much sulphur is added to

rubber, the goods become hard; 5 per cent. gives good elasticity. There

are various ways of bringing indiarubber goods under the influence of

sulphur. It may be done in the primary mixing of the dough, so that

all that is subsequently required in the treatment of the waterproofed

materials is exposure to a great heat, say 260° F. in a closed oven.

Another method is to hang up non-vulcanised waterproofed goods for

several hours in a hot stove in which there is a basin containing

chloride of sulphur heated over a flame. These processes can scarcely

be called dangerous, for they are conducted in closed chambers.

The real danger lies in using as the vulcanising agent bisulphide

of carbon, to which is often added a small quantity of chloride of

sulphur. The bisulphide of carbon has an extremely offensive odour: it

is very volatile and highly inflammable, but it is an excellent solvent

for caoutchouc. To vulcanise indiarubber goods by means of bisulphide

of carbon, the materials are passed through a solution containing

about one thousand parts of bisulphide of carbon and from two to ten

of chloride of sulphur. The indiarubber is dissolved by the carbon

bisulphide and becomes incorporated with the sulphur given up by the

chloride.

It is difficult to prevent the nauseating, offensive, and repellent

vapour given off by carbon bisulphide penetrating the atmosphere of

a workroom even when the room is provided with fans. Fortunately, in

some respects, the work is carried on in the top storey of the factory.

Here the long webs of cloth coated with indiarubber are vulcanised by

being passed through a trough of bisulphide of carbon placed in front

of rollers. Escaping at the distal end of the machine the cloth is

afterwards hung up to dry. All the time the men are at work in this

room they are exposed to the vapour of the bisulphide. Inhalation

of the vapour is liable to induce a subacute inflammatory condition

of the nerves of the limbs known as _peripheral neuritis_, in

consequence of which men lose the power in their arms and legs. Some of

the men whom I examined had been paralysed in their lower extremities,

had been off work for several months, and had only slowly regained

the use of their limbs. Occasionally men may work as long as three or

four years in the bisulphide department without becoming paralysed.

Before actually losing the power in their legs the men suffer from

inco-ordination; they stagger when walking. The workmen complain of the

carbon bisulphide vapour making them drowsy and of their sleep being

heavy. After working for a few hours in the vulcanising department,

they feel tired and sleepy. Thick or foggy weather rather tends to

favour the development of these unpleasant symptoms.

The pernicious effects of bisulphide of carbon are by no means

confined to the men. The women and girls who dip very fine indiarubber

goods--for example, children’s balloons, tobacco pouches, etc.--into

the bisulphide, suffer even more severely than the men. The poisoning

shows itself under two forms. In one the symptoms which are slowly

developed are dizziness, headache, vomiting, lassitude, and not

infrequently paralysis of the arms or legs. Many of the female workers

complain of tasting the nauseous bisulphide in their food. The appetite

thus becomes impaired. In the other form of poisoning, which may be

spoken of as acute, the individual is really intoxicated. Girls have

told me that on leaving the factory at night they have simply staggered

home, they have even fallen as if drunk, or at the end of a day’s work

they have had a splitting headache, and on reaching home have sat down,

tired out, and fallen asleep before touching their evening meal. This

sleep is heavy and non-refreshing. In the morning they drag themselves

to the factory feeling ill and headachy, and, like people who are

accustomed to the intemperate use of alcohol, they only get relief and

recover their nervous equilibrium by renewed inhalation of the vapour

of the bisulphide of carbon. Sad as this state of things is, it is

nothing to the extremely violent maniacal condition into which some

of the workers, both male and female, are known to have been thrown.

Some of them have become the victims of acute insanity, and in their

frenzy have precipitated themselves from the top rooms of the factory

to the ground. In consequence of bisulphide of carbon being extremely

explosive, vulcanisation by means of it has generally to be carried

on in rooms, one side of which is perfectly open. This open front is

usually protected by iron bars.

Bisulphide of carbon, in addition to causing paralysis of the

limbs and an exalted condition of the brain, induces a temporary

form of amblyopia, or blindness. Women often suffer from excessive

menstruation, and, if pregnant, they may abort. Girls sometimes become

hysterical and excited. This form of _toxic hysteria_, like

that in plumbism, often masks a deeper form of bisulphide of carbon

poisoning. The individual becomes extremely loquacious; she shouts or

sings, becomes very irritable, and may, when in this mood, perpetrate

acts that are beyond her control and even beyond her consciousness.

Just as in some people, after the excitement of alcoholic intoxication

has passed off, there comes a stage of depression, physical and mental,

so too after intoxication by bisulphide of carbon there is a period

marked by great weakness of mind and body. Prolonged exposure to the

vapour of bisulphide induces an enfeeblement of the intelligence that

recalls the mental weakness of chronic alcoholic inebriety.

In addition to the risks from naphtha and bisulphide of carbon,

indiarubber workers are said to be liable to consumption. Dr Philip of

Edinburgh states that within a period of eight years he had under his

care in the Hospital for Consumption 70 indiarubber workers, and that

85 per cent. of these suffered from respiratory diseases, the bulk of

which was phthisis. His experience as to pulmonary phthisis has not

been altogether confirmed by that of medical men elsewhere.

_Prevention of Poisoning._--Ventilation of the workrooms is of the

first importance. This cannot be secured by open windows alone. Owing

to the inflammability of carbon bisulphide no fires and no naked lights

are allowed in the workroom. The workpeople complain, therefore, of

the cold, and as a consequence cannot but have their vital resistance

reduced thereby. The air of this particular part of the factory is

redolent of the offensive odour coming from the open troughs and

basins. As carbon bisulphide is heavier than the ordinary atmosphere,

the artificial means of ventilation that are required are such as shall

draw the air of the workroom downwards away from the worker. No young

person should be allowed to work in the vulcanisation of indiarubber

by means of carbon bisulphide, nor should any adult be allowed to work

more than five hours a day--two and a half at a stretch--separated by

at least an hour’s interval, which should be spent in the open air, if

possible, and away from the factory.

This is a kind of work in which there ought to be alternation of

employment. All receptacles containing carbon bisulphide when not

in use should be covered. The machines should be provided with

down-draught suction fans. During the drying of the vulcanised

waterproof goods no person should be allowed to enter the room where

these products are hanging unless on business that is absolutely

necessary. Naphtha receptacles should, when not in use, be kept

covered. No food should be eaten in the bisulphide department, and

it should be discouraged also where naphtha is used. Girls say that

they sometimes can only eat food in the workrooms, because they do

not taste the naphtha there. In the open air the food tastes as

though it contained naphtha. Workers in the bisulphide process should

be medically examined once a month, and the slightest indication of

commencing paralysis or other nervous manifestation should be followed

by suspension from work. Five hundred cubic feet of air space should be

allowed to each worker.

Poisoning by bisulphide of carbon in its minor form generally

disappears on removing the individual from his employment. By many of

the workers, particularly girls who are extremely poor and ill-fed,

suspension from work would be keenly felt, for to them the loss of the

weekly wage is a serious matter. When peripheral neuritis has been

induced and causes paralysis, recovery is usually tedious. The patient

under these circumstances should be taken to a hospital, where under

the influence of good food, rest, electricity, and tonic treatment,

health will in most instances be regained.

In the _Allgm. Medic. Central Zeitung_, 22nd December 1900,

Lazarus, a surgeon-dentist, draws attention to a new malady to which

workers in gutta-percha are liable. In one year he observed twenty

cases of dental caries and necrosis of the jawbone not unlike that met

with in lucifer matchmakers, and known as phosphorus necrosis. Those

workers, who on entering the factory were already the subjects of

decayed teeth and carious stumps, are the most predisposed. With the

exception of a young woman, aged 19 years, and who had worked in the

factory for only two years all the other females who suffered were from

25 to 35 years of age. While Lazarus recommends a dental examination of

the teeth of all the workers before entering a gutta-percha factory, he

offers no suggestion as to the probable causes of the necrosis of the

jaw in the patients who came under his care for treatment.

THOMAS OLIVER.

CHAPTER XXXII

THE EFFECTS OF DINITROBENZINE AND OTHER NITRO-SUBSTITUTION

PRODUCTS OF THE AROMATIC SERIES ON THE WORKMEN EMPLOYED IN THE

MANUFACTURE OF HIGH EXPLOSIVES.

There are about fourteen authorised explosives in use in the United

Kingdom, all of which contain, more or less, naphthalene and the

aromatic nuclei, benzine, toluene, either singly or combined. These

nuclei, when nitrated, form the usual combustible elements in high

explosives.

The dinitro compounds of benzine exist in three varieties, ortho, meta,

and para. The ordinary commercial form consists almost entirely of

metadinitrobenzine, and is generally used in the manufacture of high

explosives. This is in some cases mixed with a chlorinated hydrocarbon.

The metadinitrobenzine is usually commercially pure, it rarely contains

a trace of mononitrobenzine, or the lower oxides of nitrogen. A little

free acid is generally found which colours the crystals yellow, and

stains the hands of the workmen. It is very sensibly volatile at a

temperature of 48° C. At ordinary temperatures it is solid, as are also

its isomerides, para and orthonitrobenzine.

The proportions used in the various explosives differ very largely,

ranging from 5 to 20 per cent. in the finished explosives. In a smaller

number the mono, di, and tri nitrobenzine, toluene, and naphthalene are

employed either alone or in combination.

When comparing the poisonous nature of these substances, naphthalene is

probably not poisonous, whilst some of the toluene compounds are more

poisonous than the benzine.

There is evidence that, generally speaking, the higher the nitration

of the aromatic series, the more dangerous these substances are to

manipulate.

This is borne out by the following investigations, which we

communicated to the _Lancet_, August 31, 1901:--

“We found that mononitrobenzine when given by the mouth to cats was

quite harmless, they seemed rather to thrive and grow fat upon it.

Dinitrobenzine is exceedingly poisonous both to men and animals. 1.2

grammes given to a cat by the mouth proved fatal in about three hours.

The smallest lethal dose for a cat of 6 lb. in weight, given by the

mouth in one dose, was .08 gramme. In another instance .06 gramme given

in the same manner was almost fatal. A lethal dose of .09 gramme of

dinitrobenzine, when given over a consecutive number of days in divided

doses of .04, .02, .01, and .02 gramme, did not cause death.”

“Hypodermically, .04 gramme did not prove fatal to a cat.

“In experimenting upon animals with trinitrobenzine, we found that it

was distinctly but not much more poisonous than dinitrobenzine.

“Coming to the toluene group, the administration of mononitrotoluene

proved, like its homologue mononitrobenzine, quite inert.

“There is great difference of opinion amongst manufacturers as to

whether dinitrotoluene has lethal properties or not. The weight of

evidence rather supports the latter view. We are investigating this

point (_Lancet_, August 31, 1901).

“Trinitrotoluene is not poisonous under ordinary use.

“For comparative purposes we injected 50 minims of a 1 per cent.

solution of dinitrobenzine into a cat, with a fatal result. We then

injected 60 minims of a 1 per cent. solution of trinitrotoluene into

another cat, with the result that the only effect appeared to be some

slight cyanosis.

“Again, 90 minims of a 1 per cent. solution of dinitrobenzine given

hypodermically was quickly fatal to a cat, whilst 90 minims of a 1 per

cent. trinitrotoluene proved perfectly innocuous.”

This is a very important practical point, as the susceptibility of man

and animals seems closely allied. In some factories the trinitrotoluene

has been substituted for dinitrobenzine, with great advantage to the

health of the workmen employed.

The oxidising bodies used are the nitrates of ammonium, potassium, and

barium. These do not appear to affect the workmen injuriously.

The gases produced by the complete detonation of these high explosives,

when well diluted with air, are for all practical purposes harmless.

During the process of the manufacture of these high explosives

an intimate mixture of the organic compound with the oxidising

body results. This is effected in the case of chlorinated

metadinitrobenzine (of which this article chiefly treats), by the

processes of grinding, melting at a temperature of 98.9° C., cooling,

mixing in a closed, heated, jacketed pan at a temperature of 80° C.,

and finally filling in air-tight cartridges.

_Poisonous Dose._--Dinitrobenzine is a potent poison, whether

introduced into the stomach, injected into the circulation, absorbed as

it readily is by the skin, or inhaled in the form of vapour.

The poisonous dose of dinitrobenzine for an animal, cat, or dog of six

pounds in weight averages about .08 gramme; in the same proportion for

a man of ten stones weight, it will be about 1.84 grammes.

Dixon Mann (_Forensic Medicine_, 2nd edition) and T. Oliver

(article in Allbutt’s _System of Medicine_, vol. ii.) do not

mention the poisonous dose, but in all probability a dose of under 1

gramme by the mouth will be lethal.

In fatal cases death takes place within twenty-four hours from a single

dose. If animals live beyond that time, there is a strong probability

of their ultimate recovery.

A marked characteristic of dinitrobenzine is the ease and rapidity with

which, when mixed with fat, it passes through the skin into the system.

We found that a 25 per cent. ointment in lanoline, rubbed into the skin

of a cat, caused death in twenty-four hours, and 400 milligrammes of

lanoline containing .1 gramme of dinitrobenzine, when rubbed into the

groins of a man, produced lividity, cyanosis, and other pathognomonic

symptoms in a few hours. No doubt the secretions of the cutaneous

glands facilitate absorption when the powder settles on the skin. It

is probable that all the nitro derivatives of the aromatic series pass

readily through the skin. In most works, handling any of these crude

compounds for any length of time without gloves is prohibited, being

considered dangerous.

The concentrated vapour is dangerous in small doses, and fatal in

large. A workman breathing for ten minutes the air in a flue through

which pure dinitrobenzine had passed from the mixing pans, died from

the effects eighteen hours later.

Judging from experiments upon animals, the poisonous dose, if injected

hypodermically, is about half that taken by the mouth.

Poisoning divides itself naturally into acute, subacute, and chronic.

_Acute Poisoning._--Fatal acute cases are rare, and have been

noted chiefly on account of their interest from a medico-legal point

of view. The symptoms are nausea and vomiting, intense congestive

headache, faintness and giddiness, loss of control over the limbs,

numbness, tingling in tongue and lips, and other subjective sensations.

A characteristic symptom is deep cyanosis; lips, fingers, and tongue

are deeply cyanosed, nearly black in the early stage. The skin becomes

cold and clammy, the pulse quick and weak, often over 120 a minute.

It is small, thready, and feeble, and shows a very low condition

of arterial tension. The capillaries are freely dilated, and cause

the line of descent in sphygmographic tracings to be very rapid. In

all severe cases the pulse is fully dicrotic, and displays well the

loss of vasomotor tone, which is one of the most marked features in

these cases. The heart’s action is easily excited by exertion, the

breathing is laboured, and the urine darkened. The eyes become bright

and glassy, the features pale and ghastly, and coma supervenes, which

lasts for many hours. Exceptional symptoms are noises in the head, or

dark specks floating before the eyes. When larger doses of the poison

have been absorbed, unconsciousness may become complete. The eyes then

roll slowly from side to side, the pupils are widely dilated, and the

conjunctivæ are insensitive to touch. Both the deep and superficial

reflexes are in abeyance. The respirations are increased to even double

the normal number, become irregular, and Cheyne-Stokes in character.

The limbs become quite flaccid, or one or more of the joints remain

stiff, and when this is the case it is usually those of the upper

limbs. Eventually this stiffness entirely disappears. The hands, feet,

and face become remarkably bloodless. Occasionally there is œdema

of the lips and eyelids, or dropsy of the lower extremities. The

temperature ranges from 99° F. to 102° F. (_Lancet_, November 1,

1902, p. 89).

_Subacute Poisoning._--Subacute attacks may supervene upon

chronic poisoning, in which, besides the usual chronic conditions to

be mentioned later, we find a distinct distaste for food, especially

breakfast. Sometimes there is nausea, or there may be slight vomiting.

This should always be a warning sign, for, if neglected, coma may

follow.

The attacks vary in severity according to the amount of the poison

absorbed. The symptoms noticed are:--Headache, with throbbing of the

temples and forehead, great langour and depression, the urine becomes

darkened in colour, the hands moist; there is drowsiness, with great

tendency to sleep; the men say it is impossible to keep awake. During

the night they sleep soundly unless prevented by an incessant headache.

In the morning they awake unrefreshed and heavy. The tongue is fairly

clean though dark in colour, and develops a yellowish fur; dull, heavy

pains are felt in the back. Breathing is quick and short, and fatigue

follows upon the least exertion. Pricking, tingling, and numbness

in the extremities are complained of when walking; workmen when so

affected may take three hours to cover as many miles; they stagger, do

not know where their legs are, frequently fall, and are unable to pick

themselves up readily. When asked to walk backwards with their eyes

closed, their movements are very unsteady. These symptoms practically

disappear if the men leave work a few days; after such rest they say

they feel in excellent health and spirits.

_Chronic Poisoning._--The more common manifestations may be

denominated chronic, as they are found after prolonged absorption of

small doses of the poison, and many of them persist for a long time,

at least many months, even after the workmen have left this special

occupation. All workers who are brought into intimate contact with this

poison show more or less the following:--

Upon careful examination of the cases, it is found that those employed

suffer from a very severe form of anæmia. The ruddy hue of health

disappears; the skin becomes dirty yellow-greyish in colour. This

duskiness gradually deepens with the amount of poison absorbed,

and decreases as it becomes eliminated. This objective symptom is

especially marked in the mucous membrane. The men appear to be

suffering from partial asphyxia. The conjunctivæ show a jaundiced tinge.

_Muscular System._--The effects of the poison are shown in a

marked manner upon the muscular system. The men have not the appearance

of being employed in manual labour. When stripped the muscles are seen

to be flaccid and the skin loose. The body lacks fullness and firmness.

All movements lose tone and precision. Fatigue quickly follows muscular

exertion.

In long-continued cases the objective symptoms are occasionally

remarkable, such as wasting of the muscles, especially those of

the extremities. This has been particularly pointed out by Dr Ross

(_Medical Chronicle_, May 1889). “The muscles of the hands are

seen to be very much atrophied. The spaces between the metacarpal bones

are more distinctly marked than is normal, and the grooves between them

very noticeable. The muscles of the thenar and hypo-thenar eminences

are soft and distinctly wasted, especially the abductor indices.

Patients cannot, without considerable trouble and difficulty, cause

the tips of the thumb and little finger to meet. Sometimes this is more

observable in one hand than the other. The phalangeal joints must be

bent, otherwise there is inability to flex the thumb strongly into the

palm, and at the same time the power of adduction is feeble.

“All the finer and more delicate movements of the hands are greatly

restricted in severe cases. Small objects such as pins and needles

cannot be readily felt or held. The act of walking loses much of its

elasticity and spring, and in consequence the balance of the body is

with difficulty maintained. The big toe in the advancing foot does not

manifestly drop; it is only slightly flexed into the sole. There is

usually no ankle drop, and the power of raising the toes whilst the

foot is flat on the ground is not lost. The symptoms of weakness and

paresis observed in the muscles of the foot are not so well-marked as

those seen in the hand.”

_Nervous Symptoms._--Pains of a shooting, stabbing, or darting

character are of very frequent occurrence. They are felt in all parts

of the body, a common position being under the heart or in the armpit,

neck, or jaws. The legs are rarely affected. When the pains are in

the locality of the stomach they are of a griping nature. Sometimes

a smarting or burning sensation is described, which is felt in the

cheeks, forehead, and eyes, or restricted to the soles of the feet.

These sensations are not accompanied by tenderness to the touch.

More or less irritation of the peripheral nerves is always present. It

shows itself by tingling and itching of the skin of the fingers, palms,

and backs of the hands, sometimes extending to the wrists. In a certain

proportion of cases they are felt in the feet as well as the hands.

They may be restricted to the feet, and only noticed when the men have

their boots on, or their legs crossed. Whilst sitting, or at rest in

bed, the pains are often acute. They are invariably confined to the

dorsum of the foot, never being felt in the soles, and disappear upon

standing or walking. Occasionally these symptoms are more severe in the

extremity or extremities of one side of the body.

Hyperæsthesia is a most characteristic feature in all these chronic

cases of poisoning. In all cases it is present, but it varies both

in intensity and in the part of the body affected. It may be felt

in one or both feet, restricted to the upper or under surfaces of

the toes. Striking the outside, or dorsum of the foot, causes severe

electric-like pains to run all over the leg. In a well-marked case

there will be exceeding tenderness upon the slightest pressure on any

part of the foot. Drawing the finger very gently over these sensitive

areas sends shooting pains about four inches up the legs. The soles of

the feet are not affected by a light touch, but a sharp blow, tap, or

jar, or a false step in walking causes painful sensations as high as

the knees. These symptoms are usually more acute in the left than the

right leg. The upper extremity is in like manner affected; a gentle

rub on a small part of the cutaneous distribution of the ulnar nerve

will produce general formication and tingling all over the arm. Partial

hemianæsthesia, with a small patch excessively tender, may be present.

This is probably hysterical. Dr Dreschfeld points out that Charcot,

Balmskz, and Marie have found this same symptom in bisulphide of carbon

poisoning, viz., hemianæsthesia with small circumscribed hyperæsthetic

areas. The nerve trunks of the legs or arms are sensitive to pressure

where superficial; and great pain is caused all over the area of

distribution of the occipital nerve by pressure on the nerve trunk.

The muscles are often very tender, especially those of the upper arm.

Touch is often impaired in the fingers and toes. Patients almost

invariably complain that the skin of the hands and soles of the feet

is less sensitive than is usual in the healthy state. The fingers are

numb and act clumsily, while the hands feel as if they were gloved.

The impression of sand or snow is conveyed to the feet when standing

or walking. Heat and cold are with difficulty differentiated. In

one sufferer two test-tubes containing water, differing 10 degrees

in temperature, being applied to the arms and trunk, were readily

distinguished, but from the hips downwards the patient was utterly

unable to discover which of the two tubes was the hotter. If applied

simultaneously about three inches apart, both were experienced as

cold. Generally speaking the skin of the body is more sensitive than

that of the limbs, but in all parts variations occur. Upon using a

Faradic current of a given strength, which was with difficulty borne

by the thighs, arms, and trunk, there was no perceptible impression

produced in the calves or legs. In these situations the compasses must

be separated three inches, to be distinguished as two points. The

transmission of touch and pain are slower than normal, or at any rate

are not as readily responded to as in health. The extremities become

very quickly chilled. On the slightest exposure to a low temperature

the fingers look pale, bloodless, and feel as if they were dead, and

the feet are always cold. Hearing and taste are unaffected. There

is great loss of energy. Feebleness, lassitude, and depression are

invariable concomitants. The sexual appetite is notoriously weakened,

or lost, and erections of the penis rare. The reflexes, superficial and

deep, are very variable; sometimes they are exaggerated; this, however,

is not usual. Generally speaking, they are enfeebled. Dr Reynolds

mentions a case where the patient was comatose and the knee-jerk

persistent. Cremasteric and plantar reflexes are those most commonly

absent. The muscles react readily to a moderate Faradic current, but

different groups of muscles vary in their sensitiveness to the same

strength of current.

_Eye Affections._--Dinitrobenzine produces a distinct toxic defect

of vision similar in many respects to that caused by tobacco, iodoform,

bisulphide of carbon, etc. This amblyopia will be found in a varying

degree in all those who suffer periodically from subacute attacks

of poisoning, or who develop other symptoms due to the continued

absorption of the poison. Susceptibility may aggravate the symptoms,

but no worker can claim perfect immunity. Comparatively few complain

of any impairment to their sight, but probably about one in ten are

unknowingly affected. Dr Neiden (_Edinburgh Medical Journal_,

1889) and Mr Simeon Snell (_British Medical Journal_, 1894) have

described the eye affections. The latter summarises his conclusions as

follows:--“Failure of sight, often to a considerable degree in both

eyes, concentric contraction of the visual field, with in many cases a

central colour scotoma, some blurring, never extensive, of the edges of

the disc, and a varying degree of pallor of its surface.”

In all cases absence from the work removes these symptoms in a varying

length of time: and usually a restricted exposure will alleviate them.

_Urinary Affection._--In cases of long-continued chronic

poisoning, dinitrobenzine will always be found free in the urine

(Dixon Mann). In the urine of animals, tube casts, brown flakes, and

hæmoglobin have been isolated, and in the kidneys much cloudy swelling

of the epithelium lining the tubules can be seen (Strassmann and

Strecker).

We tested the blood, lungs, liver, spleen, and urine from several

cats poisoned by dinitrobenzine. In only one sample, the urine from a

cat which died from chronic poisoning, could any indication be found.

Both sugar and albumen are generally absent. The source of the bile

pigments is the hæmoglobin of the blood, and the excretion of these

pigments points to the existence of some cause at work in the blood

leading to the destruction of hæmoglobin. The large deposit of urates,

high specific gravity and presence of biliary pigments found in the

urine, is strong corroborative evidence of an active destruction of

blood corpuscles.

No experimental evidence has yet proved that reduction takes place

in the body in case of the nitro-compounds of benzine to aniline, or

phenylene-diamine.

In several samples of urine tested, both nitrates and nitrites were

present, so that in the case of phenylene-diamine being present, the

pigment Bismarck brown would be formed, and would give the urine a

brown tint.

The samples of urine were tested for free dinitrobenzine by the

following method: The urine is treated with zinc and hydrochloric acid

for some hours. Any dinitrobenzine that may be present is reduced

by the nascent hydrogen into phenylene-diamine. The urine is then

alkalised with caustic soda, and well shaken up with ether. The ether

is then separated, filtered, and evaporated. The residue is treated

with dilute acetic acid and nitrite of soda, when a yellow or brown

coloration shows the presence of dinitrobenzine in the original sample.

In three cases a slight indication was found.

By ordinary reducing agents in the laboratory, such as nascent

hydrogen, the nitro-substitution compounds of benzine can easily be

reduced as follows:--

Mononitrobenzine to aniline.

Dinitrobenzine to phenylene-diamine.

Trinitrobenzine to triamidobenzine.

The amount of urea is generally high, due to increased metabolism of

the tissues.

The exact chemical changes which take place in the body are extremely

difficult to follow. The nitro-compounds probably pass through the body

without suffering any change, or they may be reduced in the body.

It will be noticed in the subsequent table that all the samples are

acid, many being strongly so. Nearly all are dark-brown in colour

and generally precipitate a red deposit, principally urates. In most

of these urobilin is present, and can be easily recognised by the

following test: 100 c.c. of the urine are acidified with 10 drops of

strong hydrochloric acid, and then shaken with 20 c.c. of chloroform.

The chloroform which falls to the bottom is separated by means of a

separating funnel, and filtered into a test-tube, .4 c.c. of a solution

of 1 gramme of crystallised acetate of zinc dissolved in a litre of 95

per cent. alcohol is then poured gently down the side of the test-tube,

and at the junction where the liquids meet, a green fluorescent ring,

characteristic of urobilin, will appear; the solution on shaking will

become fluorescent, being green by transmitted, and rose-coloured by

reflected light. This pigment can also be detected by means of the

spectroscope.

_Urine._--In severe cases of dinitrobenzine poisoning, the urine

becomes of a dark, tawny, port-wine colour. There is no irritation or

frequency in making water.

The following table represents the examination of the urine from very

mild cases, such as can any day be found amongst men handling, or

breathing the fumes of dinitrobenzine.

_Pathology: The Blood._--Active metabolism takes place at once

upon contact of the blood tissue with dinitrobenzine, and this may

induce a febrile rise of temperature. The blood becomes thin and dark

in colour, varying from chocolate-brown to black. The number of blood

corpuscles is greatly diminished, in some cases less than half the

normal number. The amount of hæmoglobin averages 35 per cent. MacMunn

describes the presence of large coloured megalocytes, 12 µ in diameter;

the ordinary red corpuscles are smaller than normal, about 5 µ or 6 µ

in diameter; many are crenated and broken up.

Haldane (_Journal of Physiology_, vol. xxi., 1897), in carefully

conducted experiments on mice, “finds spectroscopically a feebly-marked

band in the red besides the oxyhæmoglobin bands; but it was not

methæmoglobin. Methæmoglobin is contained in the blood, but some

other pigment is probably present.” In men we were able to obtain

the oxyhæmoglobin band, but it was always blurred. Whether there is

a special dinitro band in the blood is a disputed point; it has been

investigated in animals by Huber and Röhl (_Über akute u. chron.

Intox durch Nitrokorp d. Benzolreihe_, 1890).

_URINARY ANALYSIS_

+---+-------------+----------------+-----------+-----------+

+---+-------------+----------------+-----------+-----------+

+---+-------------+----------------+-----------+-----------+

Part 2 of table.

+---+-------------+---------+--------+---------+-------+---------+--------------+

+---+-------------+---------+--------+---------+-------+---------+--------------+

| 1 | 1029 | 2.6 | Nil | Nil | Nil | Nil | Nil |

| 2 | 1030 | ... | ... | ... |Present| ... | Nil |

| 3 | 1024 | ... | Nil | Nil | Nil | Nil | Nil |

| 4 | 1021 | ... | Nil | Nil | Nil | Nil | Nil |

| 5 | 1025 | ... | Nil | Nil | Nil | Present | Trace |

| 6 | 1027 | 3.3 | Nil | Nil | Nil | Nil | Faint trace |

| 7 | 1026 | 2.9 | Nil | Nil | Nil | Nil | Faint trace |

| 8 | 1026 | 3.1 | Nil | Nil | Nil | Present | Nil |

| 9 | 1022 | 3.0 | Nil | Nil | Nil | Present | Nil |

|10 | 1022 | 2.8 | Nil | Nil | Nil | Nil | Nil |

|11 | 1027 | 3.1 | Trace | Trace | Nil | Present | Nil |

|12 | 1025 | 2.9 | Nil | Nil | Nil | Present | Nil |

|13 | 1024 | 2.8 | Nil | Nil | Nil | Present | Nil |

+---+-------------+---------+--------+---------+-------+---------+--------------+

Dinitrobenzine is a powerful narcotic poison. Death in acute cases

is due to coma in man. Convulsions are frequently and generally

observed in animals. It is a powerful disintegrator of the blood, and

in dogs, cats, and rabbits causes oligocythemia, poikilocytosis, and

hæmoglobinæmia. So great is the destruction of the blood corpuscles

that Haldane attributes all the symptoms to the want of oxygen

consequent on changes in the blood. In chronic poisoning men exhibit

the features of a peripheral neuritis, although this point has not

been confirmed by pathological investigation. Strassmann and Strecker

(Friedreich’s _Blätter für gerichtliche Medizin_, 1896), in dogs,

have obtained, by staining, degeneration of the lateral columns of

the cord. They also found irritation and catarrh of the stomach and

intestines, and after large doses small extravasations of broken-down

blood-clot, with swelling and cloudiness of the mucous membrane of the

stomach. There is also evidence of much tissue degeneration in the

organs, probably fatty. In men, post-mortem, we find that the lividity

entirely disappears, the skin becomes pale, and all the internal

organs, such as the heart, lungs, and liver, are of a pale yellowish

cast, and more friable than usual. The brain is of a dull pink colour,

and the veins of the body, and especially the meninges, are filled with

a thin, characteristically-fluid, black blood.

_Prognosis._--Prognosis in cases of poisoning by dinitrobenzine

depends upon the amount absorbed, the time the men have been exposed

to it, and their previous health. The headache and general malaise

caused by small doses are usually recovered from in the course of a

few days. A week’s absence from work enables the men to regain their

usual energy, the appetite and urine becoming normal. Anæmia is a

very persistent trouble. If the number of blood corpuscles becomes

greatly decreased, it takes months to restore them. The peculiar dusky

colour of the skin can be detected by those who are conversant with

this symptom, even weeks after ceasing work. In cases of coma hours

may elapse before consciousness returns. Recovery has taken place

after insensibility lasting eight to twelve hours. In one fatal case

consciousness returned after nearly sixteen hours’ insensibility, but

death suddenly occurred half-an-hour afterwards, when the man was

being raised quickly and carelessly from the recumbent position. Cases

which are going to terminate fatally usually do so within twenty-four

hours. Some months may elapse before muscular power is fully restored.

The profound anæmia does not leave its mark permanently, it is

eventually entirely recovered from when the workers are removed to

other occupations. Workmen often affirm that after a time they become

accustomed to the effect of the poison. This is not so, any more than

individuals can become habituated to taking alcohol without being

affected by it. In the early stages of employment the workers notice

and complain of the effects of the poison, as it is new and strange

to them; eventually they come to regard the symptoms as necessary to

the work, and if slight, know from their own experience that, by more

care in the manipulation, or absence from work, the symptoms will pass

away. Any natural weakness is liable to be aggravated, and pre-existing

anæmia will be made worse.

_Precautions._--With ordinary care the work is but slightly

harmful, but without care it becomes immediately dangerous. The

higher the percentage of dinitrobenzine used the greater the risk

and the necessity for care. The dinitrobenzine used should be, as

far as possible, chemically pure. We find a small admixture of

mononitrobenzine makes it more dangerous to manipulate (_Lancet_,

August 31, 1901). Commercial dinitrobenzine is a deadly poison, however

introduced into the system. All precautions have for their object the

prevention of poisonous quantities gaining access to the system, by the

dilution of the poison, and the avoidance of personal contact. Works

should be situated in the country. At the erection of the different

houses, much attention should be given to their construction and

arrangement. Each should be well isolated; not opening one into the

other, nor contiguous to another building. Each should be surrounded

by a plentiful air space, and have ample ventilation. Every house

should be provided with a lantern roof, containing rain-proof windows

easily opened and closed. The window space must be ample, and all

windows capable of being freely opened or entirely taken out. It is

often necessary to regulate the draught, and on windy days removing

the windows on the lee side will permit a free current of air, and

ample exit of the fumes, dust, and heat generated. No house should

be overcrowded with machinery, and the different processes should

be conducted as far as possible in separate buildings. All vessels,

melting pots, cooling trays, or pans containing a heated compound

must be provided with efficient and well-fitting covers, with flues

leading from them to the outside air. The floors, tables, covers of

pans, ledges, canisters, etc., in all the houses are to be kept clean

and free from dust, the powdered compound, and manufactured explosive;

and no utensils or useless articles are to be allowed in the houses.

Canisters containing the powder must be kept closed with a well-fitting

lid. No flue through which heated vapour has passed may be entered by

any person. The cleaning of such flues must be done automatically, or

from the outside of the building. Cooling trays should be in a shed

open on all sides to the external air. A house, or other shelter from

the weather, should be provided for the workmen to retire from the

vitiated atmosphere of the house whilst watching the operations.

Wherever possible, the processes of grinding, filling, and emptying

utensils, hoppers, pans, and cartridges should be done automatically.

If done by hand, respirators should be used, and the men should be

careful to stand on the windward side of the pans when the covers

are off. Washing appliances should be freely supplied, preferably

near each house. Towels inside the houses are objectionable; even if

covered up they remain wet. Frequent washing of the hands with soap

and nail-brushes is most desirable. The face, beard, and head should

be kept clean, frequently washed, and free from dust. The beard, hair,

and nails should be cut short. The air in the houses should be kept

as dry as possible. Moisture in the atmosphere is always followed by

an increase in sickness. Low temperature and dry atmosphere cause a

proportionate decrease in the sick-rate. This is accounted for by

the fact, that moisture makes the powder cling to the exposed parts

of the body; perspiration has the same effect, as also some of the

deliquescent salts used. In winter the number of invalids is very

small, but during the hot summer months is greatly increased. In all

houses where there is much dust, respirators are essential. They are

of no use against the vaporised fumes. Cotton respirators fitting

over the nose and mouth, kept very clean and frequently renewed, are

least objected to by the workmen. Dr Snell has suggested a diving-bell

apparatus. Gloves are necessary when handling the material. The

importance of keeping the interior of the gloves scrupulously clean and

tight at the wristbands is self-evident.

Special clothing should be provided, fitting well at the neck, wrists,

and overlapping at the buttons; the caps should fit close. All clothing

should be regularly washed, and never damp when put on. No overalls

should be allowed in the eating place; they should be always removed

before entering, and donned again before going into the working sheds.

Separate dressing and dining rooms should be provided, suitably

arranged with washing appliances.

Medical inspection of the works should be made regularly, preferably at

the end of the week. The difference in the appearance of the employés

at the beginning and end of the week is very noticeable. The number

of visits should be not less than once a fortnight. In hot and damp

muggy weather, where there is extra pressure of work and longer hours,

and in the more dangerous processes, medical inspection should be more

frequent.

The inspection should include the sanitary condition of each house,

ventilation, number of hours worked, composition of the compound,

condition of each employé, sufficiency of washing and drying

requisites, the overalls, gloves, respirators, escape of vapour from

melting pots or flues, dustiness of the air, cleanliness of the houses,

and freedom of tables, floors, etc., from the powder. The surgeon

should warn the management of any peculiarly dangerous process,

suggest the number of hours to be worked, and notify any workman

whom he thinks unfit for it. He may find it necessary to advise an

earlier hour to begin work, on account of the heat, and more frequent

exchange of workers in the different departments of the manufactory.

In selecting men for work, he should choose men of middle age and

strong constitution, and, other things being equal, the less frequently

new hands are taken on the better. Young women, or nursing mothers,

should not be allowed to work, or handle the crude dinitro, the organic

compound, or the finished explosive. Pregnancy or anæmia should entail

dismissal. The medical officer should watch carefully new beginners

at the work, and initiate proper precautions to prevent chronic cases

becoming acute. A written notice of employés off work supposed to be

due to the effects of the poison should be sent to the medical officer

in charge, so that he may investigate the conditions and causes.

All employés should be examined and passed by the medical man, and

their condition noted before being taken on. He may find it necessary

to prescribe short shifts; this may mean either a short continuous

number of hours at the work, as in the filling houses; or frequent

intermission of work, as can be obtained by the mixing house workers.

Sometimes it is necessary to advise very limited spells of work. The

process of grinding and cleaning out of flues are operations attended

with serious risk. About six hours’ work in the mixing and filling

houses daily is as much as an average man can undertake. Headache,

sickness, nausea, and distaste for food in the morning should be looked

upon as warning symptoms, and men so affected should not be allowed to

persist at the work. Heavy muscular exertion is not desirable for those

who suffer from anæmia, or the cyanosis caused by the poison.

Alcohol is contra-indicated, and all oils and fats are solvents of

dinitrobenzine. Lemons, apples, acid fruits and drinks, and milk, are

usually advised; the two latter may be ordered by the medical man with

advantage.

_Treatment._--There is no known antidote. Symptoms must be combated

as they arise. If the poison has been taken into the stomach it must

be immediately removed by the stomach tube. Oxygen freely inhaled

and saline infusion are necessary. Artificial warmth, diffusible

stimulants, and perfect rest must be persisted in until all danger from

syncope is past. Warm, easily-assimilated liquid food per mouth and

rectum must be given. Later the anæmia requires general tonics, fresh

air, and good food.

ROBERT PROSSER WHITE.

CHAPTER XXXIII

DRY CLEANING BY MEANS OF BENZINE

The cleaning of gloves and stained garments by means of benzine is an

occupation which gives employment to large numbers of people. In some

dry-cleaning establishments naphtha alone is used, so that what has

already been said of naphtha in connection with indiarubber trades will

equally apply here. The soiled articles are first washed with naphtha

and soap in an out-building in which no naked lights are allowed, and

then put into a revolving cylinder filled with naphtha. When benzine

is the cleansing agent, two kinds are made use of: (1) a petroleum

spirit obtained from mineral oil, and (2) spirit obtained from coal

tar. In several dry-cleaning establishments fires have suddenly, and

often in a most mysterious and unexplained manner, broken out. They

have been attributed to friction, electric sparks, and to accidental

ignition of the spirit by lucifer matches concealed in the clothes.

One of the first things attended to on the arrival of garments to be

cleaned is a thorough turning inside out of all the pockets, and the

removal particularly of any matches that may have been left therein,

also a stripping-off of all metallic buttons from coats, jackets,

etc. The workmen are not allowed to smoke nor to have in their

pockets any lucifer matches. The work is carried on in outbuildings,

one side of which is quite open, so that the freest ventilation

possible is obtained. No naked, nor artificial, light of any kind is

allowed in these buildings. The garments, after having been examined

on their arrival, and sorted, are placed in a revolving drum that

contains benzine, and which can be hermetically closed, or in a fixed

machine within which there is a revolving cylinder that contains the

spirit. By either of these methods the clothes are brought into the

closest contact with the benzine. After the garments have thus been

sufficiently agitated and cleaned by contact with the benzine, they are

removed and placed in a machine known as a hydro-extractor, whereby

the excess of spirit is removed. This liquid is allowed to settle, the

supernatant clean spirit is decanted off and redistilled. The garments

on being removed from the hydro-extractor are rinsed in clean spirit,

put through the hydro-extractor again, removed, dried, and finished.

The risks incurred by the workpeople are twofold: (1) danger from fire

and explosions; (2) effects of inhalation of the benzine. Fires, as

already mentioned, occur in dry-cleaning establishments under the most

mysterious circumstances. In one establishment that I visited eight

fires and explosions had occurred in fifteen years. In the summer

evenings when the weather is sultry, and perhaps several hours after

the employés have left off working, fires have broken out in these

establishments. The cause of the fire is often unexplainable. It is

believed that benzine has a tendency to undergo spontaneous combustion,

and that this can be prevented by the addition of a small quantity of

oil soap, ¹⁄₁₀ to ¹⁄₁₀₀ per cent., to the benzine, and well mixed with

it. This soap is prepared according to the patent of an Austrian firm,

Messrs L. Schutte, Landsberg, & Co., by dissolving one kilo of caustic

potass, or soda, in four kilos of alcohol. To a litre of this solution

one and three-quarter litres of oleic acid are added and the mixture

heated. In order to keep the salt in solution there should be added

to every 100 parts of the mixture, either before or after heating it,

250 parts of carbon tetrachloride, benzol, benzine, or other suitable

solvent. Experience has shown that too great care cannot be taken in

regard to the manipulation and storage of benzine. Materials that have

just been removed from or cleaned with benzine should on no account

be brought near a fire or naked light. Care has to be exercised, too,

that naphtha and benzine are not poured into the drains in considerable

quantity, for they give off explosive vapours which are dangerous when

workmen enter the large drains in a city with naked lights.

Inhalation of the vapours of benzine affect people differently. Some

persons are more susceptible than others, and are obliged to retire

from the work while others can remain at it. Its effects are more

noticeable in young women than men. Females on the whole are more

readily intoxicated, they become excited and hysterical. The power of

walking is not interfered with. Both men and women complain of headache

and giddiness after working in an atmosphere laden with benzine vapour.

Occasionally they vomit. Although women seem to be more susceptible

than men, yet even the men become intoxicated and feel as if they

were drunk. On a sultry afternoon the effects are more pronounced.

The workpeople are often obliged to leave the rooms and go out into

the fresh air. The vapour of benzine produces in some people a heavy,

sleepy feeling, with a sense of great tiredness, amounting to a loss of

muscular power and followed by a temporary defect of memory. Naphtha

produces similar symptoms. As its vapour is heavier than atmospheric

air, the workmen suffer most in hot, close weather.

_Prevention._--The air of the workroom should be kept as pure

as possible by means of artificial ventilation. In the place where

gloves are cleaned the air should be renewed by the running of a fan.

No food should be allowed to be taken into the workroom. Attached to

each revolving cylinder in which the garments are agitated along with

benzine there ought to be an automatic fire-extinguisher. There should

be plenty of loose sand lying about to put out any accidental fire, and

there ought to be blankets in readiness to throw round any one whose

clothes have caught fire. Woollen outer garments should be worn by the

workpeople. If a dry-cleaning establishment is a few storeys high,

there ought to be fire-escape ladders provided.

Workpeople who have become excited or intoxicated by the benzine

should be taken into the fresh air. It is by the respiratory organs

that the spirit which has been taken into the blood leaves the system.

Anæmic girls who are subject to headache should give up the work, for

experience shows that the inhalation of benzine aggravates headache.

THOMAS OLIVER.

CHAPTER XXXIV

USE OF INFLAMMABLE OR SPIRIT PAINTS

Inflammable paints have only come into use within the last twenty

years. Known in the trade as _quickly drying, composite_ or

_spirit_ paints, they are principally used for painting the

interior of ships that put into dock and which the owners can only

allow to stay there for two or three days. By their use a ship can

be painted and turned out of dock according to the number of men put

on to do the work in from one to three days. To the owners of modern

steam-ships time is money, and consequently there has grown up of

late a considerable demand for these paints. It is in the drying of

the ordinary oil-paint that there occurs delay not only in regard

to the laying on of a second coating, but in the utilisation of the

painted spaces afterwards. With these quickly drying paints it is

quite otherwise. Mr James H. Edwards, formerly of Messrs Edwards,

ship repairers, South Shields, informs me that in half-an-hour or

thereabouts after the first coating of spirit paint has been put on

another layer can be applied. They are used more in the painting of old

than of new boats. Instead of being ground with oil, the colours are

mixed with methylated or petroleum spirit, or with benzine. The paints

may contain lead, but there is less danger from the lead than from the

spirit. It is the spirit which confers upon these paints their quickly

drying properties, but at the same time it renders them extremely

dangerous to the workmen alike from inhalation of the vapour and its

inflammability. In investigating this question along with my colleagues

of the Dangerous Trades Committee of the Home Office, our attention was

specially drawn to the fact that as these paints are generally employed

for coating spaces in ships that are confined and often dark, men have

worked therein with naked lights, and, as a consequence, explosions and

fires have occurred. Too often the workman is alone in the confined

space, and as he may be rendered unconscious not only by the spirituous

vapours rising from the paint, but, in the event of fire, by the

products of combustion, he is quite unable to extricate himself from

his perilous position. I have seen one man with burns nearly over the

whole of his body who had been rescued with difficulty from the bunker

in which he was working. It is not only in the confined spaces in the

interior of ships that fires suddenly break out, they are not unknown

during the painting of the outside of a ship in a dry dock. Momentarily

and without any explanation, unless it be that the wind has fanned a

naked light or blown a spark, the side of a ship may be enveloped in

flame which is just as suddenly extinguished.

It is during the painting of the bunkers, fore and aft peaks, tunnels,

ballast tanks, and the holds of ships that the greatest risk is

incurred, and especially in the former, since only one man as a rule

can work in these confined spaces at a time. Men have been known, after

working in one of these confined spaces, to have become excited as if

intoxicated, and on being removed to the open air they have vomited.

The ejected contents of the stomach have smelt strongly of the spirit

paint they were using. For a short period the men have seemed dazed and

stupid, and would have fallen if unsupported.

Sometimes exposure of an hour or less to the vapours given off by

the paint in a contracted chamber is sufficient to induce unpleasant

symptoms. Men have become unconscious in the bunkers and have had to be

extricated. On being placed on deck in the open air they have looked

pale rather than cyanosed. In some instances where the symptoms have

been less severe, there have been difficulty of breathing and a sense

of suffocation in the chest, but as a rule these are absent. There

is often complaint of a swimming in the head and a feeling of great

uncertainty and want of self-confidence, while in other instances the

individual falls soundly asleep. Now and again, when the men have been

removed from the bunkers bleeding has occurred at the nose. As a rule

the intoxicating and stupefying effects of these spirit paints soon

pass off on exposing the workman to the open air.

In some of the men I observed a well-marked blue line on the gums,

showing that in addition to the danger caused by inhaling spirituous

vapours their system at the same time had been exposed to the risk of

lead poisoning.

_Water-gilding._--In the gilding and silvering of ornaments, the