+-------------+---------------+---------_Dangerous trades

| I. | II. | III. | IV. |

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

| 5.1 | 60 | 58 | 88 |

| 5.2 | 61 | 59 | 88 |

| 5.4 | 62 | 60 | 88 |

| 5.6 | 63 | 61 | 88 |

| 5.8 | 64 | 62 | 88 |

| 6.0 | 65 | 63 | 88 |

| 6.2 | 66 | 64 | 88 |

| 6.4 | 67 | 65 | 88 |

| 6.6 | 68 | 66 | 88 |

| 6.9 | 69 | 67 | 88 |

| 7.1 | 70 | 68 | 88 |

| 7.1 | 71 | 68.5 | 85.5 |

| 7.1 | 72 | 69 | 84 |

| 7.4 | 73 | 70 | 84 |

| 7.4 | 74 | 70.5 | 81.5 |

| 7.65 | 75 | 71.5 | 81.5 |

| 7.7 | 76 | 72 | 79 |

| 8.0 | 77 | 73 | 79 |

| 8.0 | 78 | 73.5 | 77 |

| 8.25 | 79 | 74.5 | 77.5 |

| 8.55 | 80 | 75.5 | 77.5 |

| 8.6 | 81 | 76 | 76 |

| 8.65 | 82 | 76.5 | 74 |

| 8.85 | 83 | 77.5 | 74 |

| 8.9 | 84 | 78 | 72 |

| 9.2 | 85 | 79 | 72 |

| 9.5 | 86 | 80 | 72 |

| 9.55 | 87 | 80.5 | 71 |

| 9.9 | 88 | 81.5 | 71 |

| 10.25 | 89 | 82.5 | 71 |

| 10.3 | 90 | 83 | 69 |

| 10.35 | 91 | 83.5 | 68 |

| 10.7 | 92 | 84.5 | 68 |

| 11.0 | 93 | 85.5 | 68 |

| 11.1 | 94 | 86 | 66 |

| 11.5 | 95 | 87 | 66 |

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

The only other section of much importance was one which made it

necessary to supply 600 cubic feet of fresh air per person per hour.

This Act, although it produced great improvement, did not satisfy

the Weavers’ Associations, and a further attempt was made to bring

about the total abolition of steaming. The Government in consequence

appointed a Committee consisting of Sir H. Roscoe, Sir Wm. Roberts, and

Dr Ransome, to inquire into the working of the Act. A very extensive

inquiry was made, and the resulting report is one of extreme value.

The report was made in 1897, and many of its chief recommendations

were embodied in a Statutory Order of the Home Secretary in the year

1898. This Order, although not altering in any way the amount of

moisture allowed, contained very important provisions with regard to

ventilation, purity of steam, and temperature, etc. It is of such

interest and importance, being in many respects a new departure in

factory legislation, as to be well worth quoting in full here.

_Order of the Secretary of State, dated 2nd February 1898, making

regulations for the protection of health in Cotton Cloth Factories._

(1) In every cotton cloth factory to which the Cotton Cloth

Factories Act, 1889, applies, the occupier or manager or person

for the time being in charge of the factory shall, in addition

to taking the two readings of the thermometers required by

section 7 of that Act, read each of the thermometers every

day between seven o’clock and eight o’clock in the forenoon,

and record the reading of each thermometer in the form and in

accordance with the regulations in Schedule B. of the said Act

as amended by this Order.

(2) Schedules B. and C. of the Act of 1889 shall be altered, and

shall be as set out in the schedule to this Order.

(3) In every such cotton cloth factory, when artificial humidity

is produced, the water used for the purpose shall either be

taken from a public supply of drinking water or other source of

pure water, or shall be effectively purified to the satisfaction

of the Inspector before being introduced in the form of steam

into the factory, and all ducts for the introduction of

humidified air shall be kept clean.

(4) The pipes used for the introduction of steam into a cotton

cloth factory in which the temperature is 70 degrees Fahrenheit

or over shall, so far as they are within the shed, be as small

both in diameter and length as is reasonably practicable, and

shall be effectively covered with non-conducting material to the

satisfaction of the Inspector, so as to minimise the amount of

heat thrown off by them into the shed.

(5) The arrangements for ventilation shall be such that during

working hours in no part of the cotton cloth factory shall the

proportion of carbonic acid (carbon dioxide) in the air be

greater than nine volumes of carbonic acid to every ten thousand

volumes of air.

(6) Unless some other method, certified by the Inspector to

be equally satisfactory, is adopted, the outside of the roof

of every cotton cloth factory shall be whitewashed every

year before the 31st day of May, and such whitewash shall be

effectively maintained until the 31st day of August.

(7) In every cotton cloth factory erected after the date of this

Order, a sufficient and suitable cloak-room, or cloakrooms,

shall be provided for the use of all persons employed therein,

and shall be ventilated and kept at a suitable temperature.

Having briefly described the steps by which the present conditions

have been arrived at, we may now consider these conditions in detail.

The humidity of the air has, rightly or wrongly, been thought to be

the chief factor in the healthiness of weaving-sheds. Moisture is

usually added to the air of sheds by means of a number of steam jets.

Steam introduced in this manner is known in the trade as “live steam.”

The moisture becomes visible almost immediately after escaping from

the pipe, and again disappears at a distance of two or three feet.

Many other methods of moistening the air of weaving-sheds have been

tried. Some of these depend upon the evaporation of water in the shed;

others upon evaporation of water outside the shed, the air so moistened

being forced in; and others again upon steam being mixed with fresh

air, which are forced into the shed together. It is obvious that any

system which depends upon the evaporation of water, if efficient in

other ways, has a distinct advantage in the summer months, in that

it will tend to lower rather than raise the temperature. There are,

however, very distinct drawbacks to most of the methods of humidifying

by evaporation, and the crude method of watering the floor is probably

the most harmful of all forms. The method of humidifying which depends

on evaporating water outside and forcing air so moistened into the shed

has a very limited application, but it might with benefit be extended

in order to lessen the temperature in summer. The way in which moisture

is added to the air of a shed is of little consequence except so far

as it affects the temperature, and this is affected far more by the

length and size of the steam-pipes than by the amount of steam infused.

Previous to the Cotton Cloth Factories Act, 1889, there was no legal

restriction to the amount of humidity. The writer has no personal

knowledge of the condition of the sheds at this time, and he has found

it difficult to form a correct opinion. It is certain, however, that

sometimes steam was introduced to such an extent that it condensed very

freely on the walls, pillars, and floors. The air of the shed became

over-saturated and consequently hazy. This raising of humidity was done

in a very unworkmanlike manner. No attempt was made to find out what

conditions were favourable to weaving. It was known that a very dry air

was unfavourable, and if a dry east wind was blowing, a large amount of

moisture was introduced. When a favourable condition was reached there

was no means of recording what this condition was, for such a thing

as a hygrometer was practically unknown in a weaving-shed. It seems

strange, considering that the degree of dampness of the atmosphere is

so important with regard to weaving, that the use of hygrometers had to

be forced upon the manufacturers by an Act of Parliament.

The introduction of moisture artificially does not necessarily mean

that the relative humidity of the atmosphere of the shed is being

raised above that of the outside air. The temperature of a shed is

usually many degrees above the temperature outside, and consequently

the air of the shed without any addition of moisture would be much

dryer than the air outside. It is not easy to appreciate exactly what

the amount of moisture specified by the Act means. It is quite commonly

said, on the one hand, that the amount of moisture allowed by it is

frequently exceeded under natural conditions in Lancashire, and, on the

other hand, that the moisture allowed is greatly in excess of what can

possibly be healthy. It may give a clearer idea to compare the average

moisture of the air at various temperatures with the moisture allowed

by the schedule. For this purpose the readings taken at the Blackburn

Observatory for the years 1898 and 1899 have been averaged at the

various temperatures.

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

| | |Figures obtained from the Daily Records of the |

| | | Blackburn Observatory for the years 1898 |

| | | and 1899. |

| | +-----------------------+-----------------------+

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

| 50–55 | 86 | 82.1 | 100 |

| 55–60 | 87 | 81.1 | 100 |

| 60–65 | 88 | 77.4 | 97 |

| 65–70 | 88 | 65.1 | 83 |

| 70–75 | 84.6 | 59.9 | 66.5 |

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

For practical purposes temperatures below 60° may be neglected, as

that temperature is generally exceeded in weaving-sheds. At higher

temperatures the moisture allowed in weaving-sheds is considerably in

excess of the average moisture of the atmosphere outside, and above 65°

the legal limit is very considerably in excess of the highest recorded

observation.

It is somewhat difficult to estimate the effect upon health of raising

the amount of moisture in the air one breathes. In the case before

us the problem is complicated by the fact that the humidified air is

only breathed during ten hours of the day, and that the workpeople

frequently pass from the artificial to the natural atmosphere.

Knowledge gained from the distribution of disease in dry and moist

climates must be applied with great caution. The dampness of a

locality is frequently due to the damp and waterlogged condition of

the soil, in which case there are causes of unhealthiness not in the

least comparable with the high humidity of a shed produced by the

introduction of steam. Speaking generally, however, there can be no

doubt that a dry air is invigorating and a moist air enervating.

Probably partly for this reason tubercular diseases, which are

dependent so much in their spread upon the loss of vigour of those

attacked, flourish more in damp climates. The other class of diseases,

which presumably would be increased by excessive humidity, are the

different forms of rheumatism and their complications. In the various

inquiries that have been made into the health of cotton operatives

rheumatism has been complained of as the chief ailment produced by

artificial humidity. Frequent changes from a warm, moist atmosphere

to a dry, cold one without proper precautions are quite sufficient

to account for an excessive amount of rheumatism. This danger is

greatly enhanced by the unsuitable and inadequate clothes worn by

the operatives. There is little or no reason to suppose that working

in an atmosphere which, although moist, is considerably removed from

saturation, would of itself conduce to rheumatism.

One of the chief complaints of the operatives in these sheds is that

their clothes become damp. It is quite impossible that any moisture

can condense on their clothes if the law with regard to steaming is

observed. There is, however, the possibility that clothes which have

been worn for a long time in weaving-sheds may become permeated with

size dust. This dust contains a considerable proportion of deliquescent

salts, and clothes upon which it has been deposited would become

damp on exposure to a moist atmosphere. Whether or not this is a

matter of much practical importance could be settled by a few careful

experiments. If clothes do absorb moisture in this way to any extent,

it is one more argument in favour of cloakrooms. It also suggests the

advisability of the careful brushing of clothes, in order to free them

from shed dust as much as possible. Where no cloak-room is provided,

clothes are usually hung against walls or pillars. If the walls are

outside-walls, and if the pillars act, as they frequently do, as

rain-water pipes, the clothes become wet from the condensation of water

on these walls and pillars. The absorption of moisture by clothes,

due to the hygroscopic nature of wool, is small in amount, and may

probably with safety be left out of account. For all these reasons it

is extremely desirable that all cotton factories in which the air is

artificially moistened should be provided with suitable cloak-room

accommodation. The cloakrooms should of course be of adequate size, and

properly heated and ventilated.

In considering artificial humidity, it must be borne in mind that the

steam is frequently raised from very impure water. It is possible

that this fact accounts to some extent for the strong feeling against

steaming amongst a considerable section of the operatives. Steam raised

from filthy water undoubtedly gives a very disagreeable odour to a

shed, and there can be no doubt that it is injurious to the health of

the workpeople. This matter has, however, been dealt with, so far as

legislation is concerned, by Clause 3 of the Order of 1898, and it only

remains now to enforce the Order.

Closely associated with the humidity of the atmosphere of the shed is

its temperature and impurity. Particularly is it difficult to separate

the effects of high temperatures from those of excessive humidity.

The peculiar construction of a shed, with its roof exposed the whole

day through to the direct rays of the sun, is of itself sufficient in

summer to cause a high temperature. To this must be added the heat

developed by the friction of the machinery. It is not then to be

wondered at that the temperature becomes sometimes almost unbearable

when it is still further raised by the infusion of steam, and by the

heat from steam-pipes. It is very probable that most of the complaints

of steaming have arisen from the excessive temperature that has been

at the same time produced. The effect of the heat of a shed cannot

be gauged absolutely by the temperature, but the temperature and

the humidity must be considered together. The principal reason why

working in a hot, moist atmosphere is uncomfortable and oppressive,

is that evaporation of perspiration is checked, and one of the chief

means of cooling is lessened. What under other conditions would be

insensible perspiration becomes sensible, and general discomfort

ensues. An operative in this condition going out into a dry, cool air

feels a chill at once. It cannot, however, be said that this condition

is brought about solely by excessive humidity, as at the lower

temperatures no discomfort is felt. Whatever conclusion is come to with

regard to the desirability of allowing the introduction of moisture,

there can be no question that every reasonable means should be taken

to prevent the temperature being unduly raised in summer.

Although the agitation against steaming has not led to its abolition,

it has brought about one of the greatest advances in our factories and

workshops legislation of recent years.

The Cotton Cloth Factories Act, 1889, insisted that 600 cubic feet of

fresh air should be supplied for each operative per hour. The fact

that it was made compulsory to supply a definite quantity of fresh air

was in itself an advance, but the amount of air specified by the Act

fell far short of what was necessary. Not only was the amount of air

supplied insufficient, but no adequate steps were taken to ensure that

the fresh air was properly diffused. Moreover, there can be no doubt,

that in the form of ventilation most commonly in use, viz., extraction

by fans through the roof, there is a large amount of short circuiting.

The Committee previously mentioned, which was appointed to inquire

into the working of the Cotton Cloth Factories Act, investigated this

matter very thoroughly. They found that the mechanical ventilation

of sheds under this Act had been productive of some good, although

not to the extent expected. Mr Williams, H.M. Inspector of Factories,

who acted as secretary to the Committee, and to whom I am indebted

for much information, examined seventy-two samples of air taken from

weaving-sheds for the amount of carbonic acid contained in them.

Thirty-four were taken from “dry” sheds, that is, sheds where steam is

not infused, and not as a rule mechanically ventilated; thirty-eight

were taken from “moist” sheds, which were ventilated according to

the Act. The carbonic acid in the air of the dry sheds varied from

.55 to 1.94 parts per thousand, the average being 1.168; that of the

moist sheds varied from .68 to 1.59, the average being 1.021. Many

anemometer tests were also made, and it was found that there was little

correspondence between the amount of air supplied and the purity of the

air of the shed at the breathing level. From these experiments, two

facts were readily deduced, viz., that the amount of air supplied was

too small, and that the anemometer test was not to be relied upon as a

test of ventilation. The Committee consequently took a new departure,

and made a recommendation, that as a measure of respiratory impurity

the carbonic acid gas contained in 10,000 volumes of air in humidified

sheds should not exceed 9 volumes. This recommendation was embodied in

its main feature in the Order previously quoted. It is difficult to

over-estimate the importance of this step. It applies a scientific test

to the ventilation of the factory, and at the same time it allows the

utmost freedom to the manufacturer in selecting means to attain this

standard. Hitherto, openings of certain sizes have been specified for

the purpose of ventilation, or the introduction of a certain amount of

air has been made compulsory, but no legal notice has been taken of

the actual condition of the atmosphere. In this order, then, the most

satisfactory and the only scientific method of estimating ventilation

has been adopted. The difficulties in the way of carrying it out seem

to be gradually being surmounted, and already a standard much higher

than the legal one has been attained in many factories.[154] .9 parts

per thousand may not appear to some a sufficiently high standard. It

certainly is not perfect, but it is probably as high a standard as it

is practicable to adopt at present. It has been found in practice that

it is generally necessary to introduce more than 2000 cubic feet per

head per hour to maintain this standard. On account of considerable

variation in the amount of carbonic acid in the air of towns, the

administration of the Order has been varied to this extent, that .5

parts of carbonic acid are allowed in the air of a shed in excess of

that contained in the air outside at the same time.

Although this regulation with regard to ventilation has only been

applied to weaving-sheds into which moisture is artificially

introduced, there seems to be no good reason why it should not be

applied to all weaving-sheds and to other departments of cotton

manufacture. A regulation of this kind can only be carried out in

buildings where power is available, but in the near future electric

power will be available for every workshop, and then the universal

enforcement of some similar regulation will be possible, and would be

productive of much good. It seems likely that an indirect advantage

will also be gained by the greatly increased knowledge of the

efficiency of the various systems of artificial ventilation. The

useless and inefficient methods of ventilation will be rapidly weeded

out, only the good methods will remain, and a truer perception of the

principles of ventilation will be produced. The stimulus given by

these Acts to ventilating engineers has already brought about great

advances. One extremely ingenious apparatus will deliver enormous

quantities of fresh air (250,000 cubic feet per hour), warmed and

moistened as required, into a room at one single point, and diffuse

it over an area of 8000 square feet without causing a draught. By

this means one of the principal objections to all other methods of

ventilation on the plenum system is overcome, for the air is introduced

directly without the interposition of distributing ducts.

Compared with the workrooms of most other trades, cotton-weaving-sheds

must be considered to be well ventilated, and when the regulations have

been thoroughly enforced, these sheds will have few equals amongst

workrooms judged by the amount of respiratory impurity. There are,

however, other atmospheric impurities that are not dealt with in so

satisfactory a manner. It is found to be quite impossible, with any of

the apparatus at present in use, to keep the amount of carbonic acid

within the legal limits when the shed is lighted with gas. To do this

it would be necessary to increase the amount of fresh air introduced to

an enormous extent. The only practical solution of this difficulty, and

one that is urgently called for, is the substitution of electricity for

gas for lighting purposes. Such a substitution frequently leads to a

positive saving of money.

There is one form of atmospheric contamination that mechanical

ventilation has in some instances made worse. The sanitary conveniences

are frequently built so as to be in direct connection with the shed,

and any system of ventilation depending on extraction increases the

amount of air supplied to the shed through these offices. The remedy in

all such cases is complete disconnection of the sanitary conveniences

by means of an open space.

No ventilation is satisfactory which does not reduce the amount of dust

as well as the gaseous impurities in the atmosphere. The dust floating

in the air of a weaving shed is very variable both in its quantity

and in its composition. In a shed where no size is used (very rare)

the dust consists entirely of cotton fibre. On the other hand, where

size is used, it enters very considerably into the composition of the

dust floating in the atmosphere. Size consists mainly of starch, china

clay, tallow, and various deliquescent salts, the principal one being

magnesium chloride. A certain amount of zinc chloride is put into the

size to delay or prevent the growth of mildew. One would anticipate

that the different constituents of size would vary considerably in the

readiness with which they diffuse through the atmosphere, and this is

so to some extent. For instance, analyses made by Dr Dupré showed that

zinc chloride, although largely used in sizing, is not found in the

dust of sheds. This is of considerable importance, as chloride of zinc

is the only constituent of size which is chemically irritating. On the

other hand, contrary to expectation, it was found that the insoluble

mineral matter (china clay) was present in as large a proportion on

the shafting at considerable heights as in the dust on the floor. The

composition of the dust examined by Dr Dupré varied somewhat, but

roughly speaking, 50 per cent. of the dried dust was insoluble mineral

matter (china clay), 30 per cent. insoluble organic matter (cotton),

15 per cent. soluble organic matter (starch), and 5 per cent. soluble

mineral matter (principally chloride and sulphate of magnesium).

The amount of dust in the atmosphere of a shed is determined partly

by the amount of size used and the quality of the cotton, but also to

a great extent on the efficiency of the ventilation and the degree

of moisture in the air. That the infusion of steam would lessen the

amount of dust in the air was first inferred and afterwards proved by

experiment. A large amount of moisture in the air may cause a more

ready precipitation of dust, but its principal action is probably in

preventing the liberation of dust from the yarn during the process of

weaving. Mr Osborn, in his evidence before the Parliamentary Committee

previously referred to, said that sheds are now freer from dust than

they were, and this he attributed to more careful sizing. Mr Williams

made several comparative tests of the amount of dust in sheds when

moisture was being introduced and when not. He found invariably that

the infusion of steam lessened the amount of dust. The following are

the averages of his experiments:

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

| |No. 1 |No. 2 |No. 3 |No. 4 |No. 5 |

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

|With infusion of steam|26¹¹⁄₁₈ | 25 | 25 | 26½ | 38¼ |

|Without „ „ | 43⅙ | 40⅓ | 36½ | 45½ | 43½ |

+----------------------+---------+---------+---------|---------+---------+

These figures represent the number of particles of dust deposited on

six square millimetres in five minutes.

The dust in the atmosphere is undoubtedly lessened by ventilation,

unless this is of such a nature as to disturb the dust that has already

settled. The most efficient method of ventilation for reducing the

dust in the air would certainly be extraction from beneath the looms.

The dust of a weaving-shed is not, however, of a specially irritating

nature, and although injurious, is not of sufficient importance for the

whole system of ventilation to be devoted to its removal. Apart from

the extraction of air downwards, so that the dust is drawn directly

away from the breathing level, there does not seem much to choose

between the various forms of ventilation in this respect.

The cleanliness of the floors and shed generally must have a

considerable effect upon the amount of floating atmospheric impurity.

As a general rule, the floors are very dirty. They are never washed

(with a few rare but very pleasing exceptions), and are seldom brushed

thoroughly. Such a condition of things lends itself readily to the

spread of infectious diseases. It seems particularly serious with

regard to phthisis. Phthisical sputum must often remain on these floors

undestroyed until much of it has become pulverised, and distributed

in the air of the shed. It would undoubtedly greatly improve the

health conditions of weaving-sheds if proper steps were taken to keep

the floors clean. An improvement of this kind is not limited in its

benefits to the direct results, but it has a very distinct influence

upon the habits of the persons employed.

There is, as the evidence given before the various inquiries shows,

a great difference of opinion as to the healthiness of cotton

manufacture. It is difficult to come to any absolute conclusion from

examination of these opinions, and by examination of the physical

conditions to which the workpeople are subjected. One therefore turns

naturally to the vital statistics bearing on this question, in the hope

that they will afford some absolute and indisputable indications. It

must, however, be acknowledged that when all the available statistics

have been examined, the inferences that can be drawn are not by any

means definite. There are many reasons for looking on trade statistics

with some suspicion. Most of these reasons are very carefully reviewed,

and allowed for as far as possible by Dr Tatham in the supplement to

the Fifty-fifth Annual Report of the Registrar-General. It is only

necessary to see the enormous death-rate of the persons classified as

unemployed to understand how this class is probably greatly swollen

by those who have broken down in their various occupations. It is

very doubtful if under any circumstances trade mortality statistics

can be altogether relied on. There is always the possibility that

the occupation followed at the time of death is not the one that has

really hastened or caused death. A person after some years working

in an unhealthy trade finds it necessary to change his occupation

because his health is failing. At death he is classed in the trade he

was last engaged in, although this trade has had no effect in causing

his death. Again, arduous and unhealthy occupations act as a selective

agency, none but those of a certain physical fitness engaging in them.

It is difficult, too, to separate the influence of a trade from that

of its surroundings. Whether a trade is carried on in crowded, badly

built towns, or in the country, will modify the trade statistics

considerably. These facts make it desirable in gauging the healthiness

of a trade to look outside trade statistics. It is sometimes possible,

where a large proportion of the inhabitants of a district are engaged

in one particular branch of industry, to gauge the healthiness of

this industry by examining the health statistics of the district as a

whole. If the persons employed in this industry have a peculiar age

distribution it is possible to get a more accurate estimate. These

conditions are fulfilled to a peculiar degree in the town of Blackburn.

Out of a population of 120,064 at the 1891 census, no less than 37,755,

or 31 per cent., were employed in the cotton industry. Any marked

unhealthiness of the trade should show itself, although perhaps not

very distinctly, in the general mortality. This of itself would be of

little help but for the peculiar distribution of the cotton operatives

in age periods. The accompanying table illustrates this point clearly:--

DEATH-RATE FOR ENGLAND AND BLACKBURN, 1889–1898.

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

| Age +--------+----------+expressed as+--------+----------+

| | | | | | |

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

| 15–25 | 4.72 | 5.14 | + 8.9 | 4.42 | 4.72 |

| 25–35 | 7.05 | 6.71 | - 4.8 | 6.48 | 6.96 |

| 35–45 | 11.89 | 14.60 | + 23.6 | 10.03 | 13.05 |

| 45–55 | 19.32 | 26.05 | + 34.8 | 14.89 | 18.82 |

| 55–65 | 35.47 | 51.42 | + 44.9 | 28.83 | 43.46 |

| 65 | | | | | |

|& upwards| 98.56 | 117.22 | + 18.9 | 88.88 | 95.08 |

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

| At all }| | | | | |

| Ages }| 20.58 | 23.82 | + 15.7 | 18.20 | 19.51 |

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

Part 2 of table.

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

| |Differences | Percentage of |

| Age +expressed as| population of |

| Period. |percentages.|Blackburn in the|

| | |Cotton Industry.|

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

| 15–25 | + 6.7 | 48.3 | 70.3 |

| 25–35 | + 7.6 | 39.0 | 52.1 |

| 35–45 | + 29.1 | 31.4 | 34.8 |

| 45–55 | + 27.0 | 27.4 | 19.7 |

| 55–65 | + 50.7 | 21.8 | 9.3 |

| 65 | | | |

|& upwards| + 6.9 | 13.2 | 3 |

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

| At all }| | | |

| Ages }| + 7.2 | 26.8 | 33.1 |

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

Any excessive mortality amongst the cotton operatives should show

itself distinctly at those age periods in which the operatives

preponderate. It may be argued that the bad effects are not felt

until the later age periods, but it is difficult to believe that

injurious conditions to which all alike are exposed would produce

increased mortality at the later ages, and not affect the mortality

of the earlier ages. It will be seen that 82 per cent. of the cotton

operatives employed in this town are under the age of thirty-five, and

it is at the age periods below 35 that the mortalities compare most

favourably with those of the country as a whole. The only conclusion,

then, that we can draw from the general mortality figures of Blackburn

is, that the cotton industry has no influence in raising the mortality

of the town as a whole, at any rate as far as the lower age periods are

concerned.

With the reservations previously mentioned the trade statistics may be

profitably considered. The trade mortality statistics in this country

are compiled almost entirely in the office of the Registrar-General

under the supervision of Dr Tatham. Although the statistics published

by the Registrar-General are extremely valuable, there are many local

problems on which little light is thrown. The Medical Officer of Health

and others, to whom these problems are of the greatest importance,

have no chance of investigating them, owing to the meagreness of the

information published in the census returns. The age distribution

of the persons engaged in the various occupations is not given, and

many trades very dissimilar in their working conditions are grouped

together. The necessary information should be forthcoming in one way or

another. If details with regard to the age distribution of the persons

engaged in the various occupations would make the census returns too

bulky, then any local authority should have access to the census

enumeration books, in order to extract whatever information they need.

Fortunately the writer has had access to the enumeration books of the

town of Blackburn, and in consequence he has been able to prepare

special statistics. The following tables have been extracted from the

Supplement to the Fifty-fifth Annual Report of the Registrar-General:--

Mean Annual Mortality of Males for the years 1890, 1891, and

1892, engaged in the Cotton, Flax, and Linen Manufacture of

Lancashire at successive periods of life.

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

| | 15 | 20 | 25 | 35 | 45 | 55 | 65 |

| | to | to | to | to | to | to | and

| | 20. | 25. | 35. | 45. | 55. | 65. | up. |

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

| Lancashire | 3.73 | 5.96 | 7.13 | 13.38| 25.11| 55.06|168.55|

|All Males | 4.14 | 5.55 | 7.67 | 13.01| 21.37| 39.01|103.56|

|All Occupied Males | 2.55 | 5.07 | 7.29 | 12.43| 20.66| 36.66|102.32|

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

Mortality Figures of Males, 25 to 65 years of age, for Certain Diseases

among the following Groups of People, for the years 1890, 1891, and

1892.

Key to table:

A: All Causes.

B: Alcoholism.

C: Rheumatic Fever.

D: Phthisis.

E: Valvular Diseases of Heart.

F: Other Diseases of Circulatory System.

G: Bronchitis.

H: Pneumonia.

I: Diseases of Liver.

J: Other Diseases of Digestive System.

K: Nervous Diseases.

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

| | A | B| C| D | E| F | G | H | I| J| K |

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

|All Males |1000|13| 7|192|24|102| 88|107|29|26|102|

|All Occupied Males | 953|13| 7|185|23| 97| 88|105|27|25| 82|

| London |1147|18| 7|277|28| 97|127|110|30|25| 88|

| Industrial Districts|1248|19| 8|223|27|122|154|178|32|32|108|

| Agricultural „ | 687| 7| 6|135|18| 73| 37| 55|24|21| 63|

| Lancashire |1176| 9|10|200|32|116|159|172|27|35|123|

|Unoccupied Males |2215|23| 2|448|37|191| 84|135|53|39|630|

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

It is at once apparent on examining the tables that the death-rates

of the cotton operatives at the lower age periods is not excessive,

when one considers that the majority of them live in large and crowded

centres. The death-rate from phthisis is little above that of all

males throughout the country, and is much below that of occupied

males in London or in the industrial districts. One striking feature,

however, is the high mortality from bronchitis and pneumonia. The

mortality from rheumatism and heart disease is also considerably

above that of other classes of the population. These are the diseases

which one would expect to be increased in persons subjected to sudden

changes of temperature and humidity. The mortality figures published

by the Registrar-General referring to the two periods, 1880–1882 and

1890–1892, are very instructive when compared. Two of the most striking

features of these figures are the decrease of phthisis and the increase

of bronchitis and pneumonia in the second period as compared with the

first. The phthisis deaths amongst the cotton operatives of Lancashire

were 25 per cent. of the total deaths in the years 1880–1882; the

percentage had decreased to 19.6 in the years 1890–1892. On the other

hand, the percentage of deaths from bronchitis and pneumonia increased

from 25 per cent.] to 29.7 in the same period. The inferences that

one might draw from these figures are rendered less positive by the

fact that a change similar, but not so marked, took place throughout

England. The small amount of phthisis amongst the cotton operatives

in the second period compared with the first is certainly remarkable,

the decrease being much greater than in the whole country. Improved

ventilation following on the 1889 Act may have had some effect, but it

seems likely that there has been some change in death certification,

and that some deaths which formerly were returned as phthisis are now

returned as bronchitis and pneumonia.

DEATH-RATE AMONGST THE DIFFERENT DEPARTMENTS OF THE COTTON TRADE IN

BLACKBURN, _For the Years 1889–1899_.

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

| Weavers. | Spinners. |

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

| Age |Phthisis.| Diseases | All |Phthisis.| Diseases | All |

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

| 15–25 | 1.14 | .48 | 4.2 | 1.65 | .94 | 6.1 |

| 25–35 | 1.72 | .86 | 5.2 | 2.48 | 1.90 | 6.6 |

| 35–45 | 2.11 | 2.59 | 11.0 | 3.09 | 2.90 | 11.8 |

| 45–55 | 1.88 | 5.29 | 16.1 | 2.94 | 11.78 | 31.5 |

| 55–65 | 3.75 | 20.22 | 56.5 | .61 | 21.94 | 43.8 |

| 65 and| | | | | | |

|upwards| 1.45 | 61.81 | 205.8 | 3.95 | 73.12 | 261.2 |

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

Part 2 of table.

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

| Winders and Warpers, etc. | Card-room Hands. |

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

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

| 1.48 | .84 | 5.3 | 1.28 | .52 | 4.7 |

| 2.90 | .65 | 7.4 | 2.03 | .62 | 5.9 |

| 2.30 | 3.05 | 11.2 | 2.96 | 2.47 | 12.3 |

| 1.64 | 7.28 | 23.4 | 3.95 | 10.37 | 21.7 |

| 1.28 | 14.18 | 43.8 | ... | 10.97 | 42.3 |

| | | | | | |

| 5.92 | 53.35 | 201.6 | ... | 69.93 | 181.8 |

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

Part 3 of table.

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

| Whole Borough. |

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

| | Lung | |

|Phthisis.| Diseases | All |

| |other than|Causes.|

| |Phthisis. | |

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

| 1.19 | .80 | 4.8 |

| 1.31 | 1.20 | 6.7 |

| 2.21 | 3.10 | 13.6 |

| 1.76 | 6.32 | 21.6 |

| 1.43 | 14.67 | 45.6 |

| | | |

| .47 | 27.65 | 105.1 |

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

The conclusion to be drawn from the Blackburn figures is that weaving

in that town is somewhat healthier than the other cotton occupations,

and in this connection it must be remembered that “steaming” is

practically confined to weaving-sheds. If one could go more deeply into

this subject, it might probably be shown that some of the disparity

in the death-rates of weavers and spinners in Blackburn is due to the

classes of people from which they are drawn. From all these figures it

may be deduced that the cotton trade has little or no harmful effect

as compared with most other trades at the earlier age periods. After

the age of fifty-five the death-rate becomes enormous. There is,

however, only a very small number of cotton operatives over the age of

fifty-five. Failure of eyesight generally makes it necessary for them

to give up this work and find some other employment before reaching

this age. It seems almost certain that the very large death-rates at

the ages of fifty-five to sixty-five, and sixty-five and upwards, are

due to a great extent to a difference in the manner in which the census

returns and the death returns are made.

As this article shows, much has been done by legislation to make the

cotton trade healthy. There still, however, remains much to be done,

not only by further legislation, but by the operative himself, in

shaping his conduct on reasonably healthy lines. For instance, there

is nothing more desirable than the provision of good cloakrooms,

sufficiently large, well-warmed and ventilated, and constructed in such

a way as to be a real convenience; but these are of little use unless

the operatives make proper use of them, and provide themselves with

clothes sufficiently warm to protect them against the sudden and severe

change of temperature that they are subjected to. The cotton operative

is extremely neglectful in this matter of clothing, and to this fact is

probably due much of the ill effect put down to steaming.

The further improvements that suggest themselves as likely to be most

beneficial are:--

(1) The extension of the regulations with regard to ventilation to all

weaving-sheds and to other departments of the cotton industry.

(2) The substitution of electricity for gas for lighting purposes.

(3) The enforcement of proper cleanliness, particularly with regard to

the floors of weaving-sheds.

(4) The provision of cloakrooms and lavatories.

(5) The complete disconnection of all sanitary conveniences from the

workrooms by means of an open space.

JAMES WHEATLEY.

CHAPTER LIII

RABBIT DOWN

The transformation of rabbit skins into felt hats is one of the most

interesting of the many wonderful metamorphoses brought about by the

manufacturer. Of a long series of acts and processes by which this

transformation is effected, one of the earliest is the removal by the

“fur-puller” of the long, coarse hairs from the rabbit skin. What

is left after these have been removed is the short close fur which,

after it has been separated from the pelt, is alone used by the

felt-hatmaker. The hair plucked off by the fur-puller is the RABBIT

DOWN, a waste product regarded as of little value, sold for 1½d.

to 3d. a pound, to be used principally for stuffing cheap bedding, and

largely bought by mining companies for the miners to lie upon while

working the coal seams.

The fur-puller plucks off these long hairs by means of a special

knife pressed against the thumb, which is protected by an indiarubber

shield. She sits on a low bench before a wooden trough, the rabbit skin

stretched over her knee, held fast at one end between knee and trough,

and grasped at the other by the left hand. A pile of skins is on the

floor on either side of her, and very rapidly she “pulls” each skin in

succession, passing it over from the “unpulled” to the “pulled” heap.

The wooden trough is for the reception of the “down,” and receives

the greater part of it, but it is so light that it flies everywhere,

covering the worker’s hair and clothing till all is one uniform grey;

it floats in the air and rests thickly on every ledge and beam, the

floor too, being carpeted with it.

No description can convey any adequate impression of a fur-pulling

room, whether it be occupied by 1 or 50 workers--the universal grey,

the haze of floating hair, the sickly, disgusting odour of uncleaned

skins--it must be seen, felt, and smelt, to be understood.

Not infrequently the pulling-room in a factory or workshop is used at

the same time as a drying-room and store-room, and the skins hang in

rows suspended from the ceiling, adding an almost overpowering stench

to the other unpleasant conditions. The rabbit skins, when delivered

to the worker, have usually undergone no preparatory or purifying

process, but are as they were received from the dealer. Before they can

be pulled, they must be “opened,” that is, smoothed out and dragged

into shape, scraps of fat or clotted blood cut and scraped off, and the

skin turned fur side out and laid flat. In some of the larger works,

women are employed as “openers” only, and from them the skins pass to

the “pullers.” In most cases the pullers open the skins themselves.

Fur-pullers and openers belong to the poorest class of women. The

dirty and repulsive nature of the work, and the low scale of wages,

attract none but those who, for one reason or another, can get no other

employment. The trade is dying out, very few young women and girls are

found in it, and none will learn it; they go rather to the jam or fancy

box factories, or any of the numerous unskilled occupations open now to

girls. The fur-pullers are chiefly old women, or middle-aged women in

distress. The wages vary according to the class of skins, and according

to whether the puller works at home or in the workshop, and whether she

opens the skins herself; they range from 1s. to 2s. the “turn” of 60

skins. The knife costs 8d., and must be constantly ground: the rubber

shield costs 3d. and 4d., and lasts but a few weeks.

Machines are taking the place of hand-pulling to a certain extent,

but the chief part of the work is done in Belgium, where men do the

pulling for a low wage. The manufacturer here finds it cheaper to pay

the carriage of British rabbit skins to Belgium and back, than to have

them pulled in England. Fur-pullers are, as a class, irregular workers;

and being paid by the piece, the employer has no hold upon them. They

seldom work more than four days in a week; not because there is no

work for them, but because intemperate habits prevail, and home cares

provide other occupations on Monday and Saturday. When the workers in

any industry are drawn only from that class whose standard of life

is the very lowest, when insufficient food and clothing and all the

other sad accompaniments of deep poverty have made their mark upon

them, it is almost impossible to point to any one physical condition

as a result of their occupation. Hoarseness, cough, and a bronchitic

condition are common among fur-pullers; such are also observed in the

old and middle-aged women of the same class who are not fur-pullers.

One would certainly expect to find evidence among them of suffering

caused by inhaling the down present in the air of the workrooms; but,

except for occasional complaints that “it stuffs up the chest,” most of

the workers consider fur-pulling a healthy occupation. It may be that

the fur being so fine and light is not inhaled; the danger is probably

more to be found in swallowing it, and symptoms of ill-health arising

from this are, from their nature, not easily discoverable, and must be

related by the sufferer; but the poor fur-pullers look with suspicion

on any inquiry touching their health, fearing that they may be deprived

of their work, which, although they say it is not worth the doing, is

all they have.

If the occupation is dirty and disgusting even in a factory and

workshop where rooms are specially set apart for it, it is, when

carried on at home in a little living room, indescribably offensive

and horrible. In 1897 the terrible condition of the homes of the

fur-pullers in South London was described in the Press. Since then

matters both inside and outside the factories and workshops have been

improved, although much remains still to be done. In consequence of

recommendations made in 1897 by the Departmental Committee appointed to

inquire into the conditions of work in wool-sorting and other kindred

trades, fur-pulling was added by Order of the Secretary of State in

March 1898 to the Schedule of Trades in which occupiers must keep lists

of out-workers’ names and addresses; and by another Order the taking of

meals in fur-pulling workrooms, or remaining during the time allowed

for meals in such places, was prohibited. By these means greater

control has been exercised by sanitary authorities and the Factory

Department over fur-pulling, both as a home industry and in factories

and workshops, and one of the greatest risks to health, the taking of

meals in the workrooms, removed. In the absence, however, of any legal

obligation upon an employer to provide other accommodation for employés

whom he is bound to exclude from their workroom during their dinner

hour, those poor creatures whose homes are at a distance are turned out

into the streets, and in bad weather run a risk scarcely less than that

from which the legislature sought to preserve them--the risk to health

of cold and wet.

Much more than has yet been attempted might be done to improve, by

specially applied ventilation, the condition of fur-pulling rooms in

factories and workshops. The drawing away of the pulled hair from the

worker in a downward direction by means of a properly constructed

flue under the troughs, and an extracting fan, would seem to be

practicable, and the down could be collected outside in a receptacle

for the purpose. But pulling is not a process that pays; and although

many occupiers have provided better rooms than formerly, and more

attention is paid to general ventilation, to sweeping and cleaning, to

warming in winter, and other matters affecting the health and comfort

of the workers, a pioneer has yet to be found who will revolutionise

the industry by applying to it a really effective dust-extracting

system of ventilation--and this will require some considerable sum

expended on it.[155]

ROSE E. SQUIRE.

CHAPTER LIV

DISEASES DUE TO WORKING IN COMPRESSED AND STAGNANT AIR

_Caisson Disease._

Caisson disease, or compressed air illness, is a product of modern

civilisation. It seizes labourers who are engaged in sinking mines,

in excavating the beds of rivers to obtain a foundation for the piers

of bridges, and in tunnel making. A caisson is a cylinder composed

usually of iron plates riveted together to form a shaft, which, in the

case of bridge building, is sunk into a river, for example, so that

its open mouth shall rest upon the bed of that river. Down this shaft,

when it is properly closed at the top by a perfect fitting diaphragm,

men descend, air having been previously driven in under considerable

pressure to drive the water out at the bottom of the cylinder and to

keep it out. The workmen enter and leave the caisson by a chamber or

“lock” close to the diaphragm at the top. The length of the caisson

shown in the diagram made for me by Mr Huntley, engineer at the

Redheugh Bridge on the Tyne, is 90 feet, and at the time this drawing

was made the men were working 77 feet below high-water level mark. In

building a caisson it is the lower part that is made first. Thirty feet

of circular iron plates are riveted together, care being taken to make

the bottom bell-shaped. Before this unfinished caisson is lowered on to

the bed of the river, there is placed outside of it a larger cylinder,

and the two are united at the rim of the bell-shaped expansion. The

space between the two cylinders is filled with cement. Successive

lengths of twenty feet of cylinders are added, and subsequently the air

lock, or the chamber by means of which men enter and leave the caisson.

Two men work as a rule in each caisson, but this number varies with

its size. In the lock there is an inner as well as an outer air-tight

door, both of which open towards the interior of the caisson. When

a labourer has to enter the cylinder that is filled with compressed

air, he passes into the workman’s part of the lock by the door A (see

Diagram); the other door, B, which opens into the main shaft, is at

this time perfectly closed, and kept thus by the great pressure within

the caisson. Once he is in the lock and door A closed, also the outlet

cock C, the inlet cock D is gradually opened. By degrees the compressed

air of the cylinder escapes into the lock, and when the pressure

inside the lock comes to equal that inside the cylinder, door B opens

of itself. The labourer now enters and descends the internal cylinder

by means of a ladder to his work on the bed of the river. On leaving

the caisson the process is reversed. The men, while working inside the

caisson, shovel the soil and stones into large iron buckets which, when

filled, are raised by a chain wound by an engine outside the cylinder.

This chain passes through the “material” part of the lock, the sliding

doors and cocks of which are moved by men outside who operate very

quickly. As the excavation proceeds, the cylinders sink by their own

weight and require new lengths to be added, bars of pig-iron being

thrown into the space between the external and internal shafts so as to

favour the sinking of the caisson.

[Illustration: FIG. 73.--Section of Caisson used in

rebuilding Redhough Bridge, Newcastle-upon-Tyne.]

It was a French engineer, M. Triger, who first employed caissons in

order to reach a bed of coal that lay underneath the River Loire.

Subsequently he used them for boring wells and fixing piles for

bridges. From the first day on which caissons were used, the workmen

have complained of pains in their ears and joints. In making the

Blackwall Tunnel, several of the men were ill. Dr Snell, the surgeon

to the Blackwall Tunnel, has embodied his experience in an excellent

monograph. It is to MM. Pol and Watelle we are indebted for the

earliest account of the pathological effects of compressed air upon

men working in a mine at Douchy in France. Of 64 workmen exposed to

the influence of compressed air, 47 stood the work well, 25 gave up

their employment, and 2 died. The risks incurred are not so much

when the men are at work in the caisson as on _entering_ or

_leaving_ it, _i.e._, when they are passing through the lock

undergoing _compression_ before entering the cylinder, or coming

out through the lock and undergoing _decompression_. Of these

two, decompression is the more dangerous. If this is not accomplished

slowly, the individual may not only experience very unpleasant

symptoms, he may become the subject of permanent ill-health. It is

because, in our daily life, the ordinary atmospheric air is pressing

upon us _equally all round_ that we are unconscious of the 15-lb.

pressure to the square inch exerted upon our bodies, also that when we

dive under water we are unaware of any superincumbent weight. Engineers

have utilised knowledge of these facts, and have tried to imitate

nature by subjecting men to pressure equal to two, three, or four

atmospheres, or in other words to weights equal to 30, 45, or 60 lbs.

to the square inch.

In this country caissons were first made use of by Hughes in 1851

to make a bridge at Rochester over the Medway. Brunel subsequently

employed them at Chepstow and at Saltash. At Saltash one of the men

died shortly after emerging from the caisson, wherein he had been

working at a depth of 87.5 feet below the surface, and under a maximum

pressure of 40 lbs. During the building of the bridge of Kaffre Azzyat

over the Nile in 1859, five Arabs died from the effects of compressed

air. Blood issued from their mouth, nose, and ears. These men had been

working at a depth of 85 feet below high-water level mark, and under a

pressure of 34 lbs. to the square inch. For several years now, wherever

an important bridge has had to be built, caissons have been used. It

was thus that the foundations were obtained for such structures as the

railway bridge across the Rhine at Strasburg, the Forth Bridge, and the

Suspension Bridge at Brooklyn, New York. Descriptions of the illnesses

that occurred among the workmen engaged at the Forth Bridge, and at

Brooklyn, have been embodied in monographs by Dr James Hunter, in his

M.D. Thesis for Edinburgh University, and by Dr Andrew Smith of New

York. At the Brooklyn Bridge the pressure varied from 18 to 36 lbs. to

the square inch above that of the atmosphere, and the caissons were

lighted by gas. Ventilation of the cylinders was attended to as far

as possible, but, notwithstanding this, the air frequently contained

as much as 0.3 per cent. of carbonic acid as against 0.06, which is

regarded as the maximum for a well-ventilated space. Into the caissons

150,000 cubic feet of air had to be pumped every hour to satisfy the

respiratory requirements of the labourers. The men worked in two

shifts of four hours, separated by a period of rest for two hours, but

as the cylinders sank deeper and deeper the working time had to be

correspondingly diminished. Dr Smith treated 110 cases of compressed

air illness, of which three proved fatal.

In the following brief account of the signs presented, and the

symptoms complained of by one of the patients who was under my care

in the Newcastle Infirmary, will be found a recital of the details of

caisson disease. The man was a sinker, forty-five years of age. He was

working in the caissons at the Redheugh Bridge close to the Infirmary,

77 feet below high-water level mark, at a pressure of 31–35 lbs. to the

square inch. On leaving work one day he felt numb in his legs, became

sick and vomited; shortly afterwards he became giddy and fell to the

ground unconscious. His comrades carried him home, where he lay for

twelve hours in a state of unconsciousness. When he came to himself he

complained of pains all over his body, incomplete loss of power in his

legs, headache, and buzzing in his ears. Next morning on getting out of

bed his nose began to bleed, but as epistaxis is common among sinkers,

he thought lightly of the matter and attempted to go to work. He again

lost consciousness for a brief period, and it was in this condition

that he was brought to the Infirmary. Subsequently he complained of

severe pains all over his body, difficulty of breathing, a feeling

of sickness, and profuse perspiration; the pulse was slow and full,

there were muscular rigidity, loss of power in his legs, and deafness.

The urine was free from albumen and sugar. During the day there was

occasionally delirium of a noisy character. Heart, lungs, liver, and

spleen seemed healthy. When a few days afterwards the symptoms which

have already been detailed had subsided, and the patient attempted to

walk, it was observed that there was considerable staggering, and that

he tended to fall forwards. On examining his blood microscopically,

nothing abnormal was detected beyond the fact that the coloured cells

were slightly paler than usual, and did not form rouleaux properly.

It was several weeks before patient could walk well, also before he

lost the noises complained of in his head, and that his hearing was

perfectly restored. During his stay in the Infirmary he had spitting of

blood on a few occasions.

At the Forth Bridge, Hunter found that several of the men who worked in

the caissons suffered from bleeding at the nose. It is gratifying to

know that not one of his cases of compressed air illness proved fatal.

The men worked under a pressure of from 15 to 34 lbs. above that of

the atmosphere, and from four to six hours at a stretch, but as the

caissons sank this was found to be too long. It was observed that the

men suffered most in their general health when the soft silt in the bed

of the river containing decomposing organic material was being removed.

One of my clinical clerks[156] volunteered to enter a caisson. He

observed that the candles burnt more quickly in compressed air than

in the ordinary atmosphere, and that as a consequence there was much

more smoke. His breathing was at first quickened (40 respirations

instead of 16 to the minute), while in the case of Mr Huntley, the

engineer who accompanied him, and who was accustomed to the position,

the respirations were only 20 to the minute. The pulse-rate was also

quickened. Mr Fawcus experienced very unpleasant sensations in his

ears, which gradually abated when he swallowed air, and thus inflated

the middle-ear through the Eustachian tube. He could speak easily

enough, but he could not whistle. There was no difficulty of breathing,

although the pressure in the cylinder was 41 lbs. to the square inch;

nor was there any sense of fatigue, but rather a feeling of fitness.

Another of my students on emerging from the caisson had bleeding at

the nose, severe earache and faceache. Pain and unpleasant sensations

in the ears are complained of by nearly all on emerging from a caisson

for the first time. The pain is apparently a mechanical effect, and

is the result of the drum of the ear being forcibly driven in by

the compressed air; for when a workman has acquired the faculty of

swallowing air and passing it from his throat up the Eustachian tube

into the middle-ear, so as to equalise the pressure, the sensation

is no longer felt. Under these circumstances, it is unwise for any

person who is suffering from a cold in the head or naso-pharynx to

enter a caisson. The conditions inside the caisson are unnatural. As

the whole body is subjected to an enormous pressure, men can only work

therein for a short period at a time. It is a well-known fact that in

the ordinary affairs of our daily life, some of our best work is done

when we are working under mental pressure; and while the simile does

not actually hold good of comparing mental with physical work, also of

comparing physical work done under normal and abnormal pressure, yet

experience shows that in the caisson the workmen, instead of feeling

any bad effects from the compressed air, are so buoyed up by it, that

in a given time they do far more and much harder work than when they

are on the surface. Besides, as they are unconscious of putting forth

extra effort, they do not feel fatigued, they perspire freely, and are

apt to rub themselves incautiously, thus causing skin eruptions. Just

as candles burn with greater rapidity inside the caissons, so too,

it would appear, are the vital processes in the workmen quickened,

disintegration of their tissues hastened, and the functions of the

eliminating organs heightened. This simply means that all round more

work is done by, and more waste formed in, the human body. Unless a

caisson suddenly ruptures, as occurred a few years ago in France, the

men when working inside run very little danger. It is on emerging

from the cylinder, _i.e._, when he has undergone decompression,

that the workman runs the risk of becoming giddy, and of being unable

to stand, of having temporary paralysis of the legs, of experiencing

muscular pains, called “bends,” all over his body, but particularly

in legs and back, of suffering from bleeding from the nose, ears, and

lungs, or of becoming unconscious.

That pressure _per se_ plays a part in the production of

the symptoms is shown by the fact that as the caisson sinks and

the internal pressure is correspondingly raised, the men suffer

correspondingly. On the Tyne the men always suffered more when the

pressure inside the cylinder was increased so as to keep pace with the

rising tide. The condition of the air inside is also of importance. As

more smoke is given off by the candles, and the men work harder inside

than outside the caissons, the air is rendered very impure. At the

Brooklyn Bridge each man was supplied with 1000 to 3000 cubic feet of

air per hour, and yet the air inside the cylinders contained as much

as 0.3 per cent. of carbonic acid as against 0.06, which is considered

a healthy average. It is desirable that the workmen should have not

less than 6000 cubic feet of air per hour. At the bridge on the Tyne,

where my patients worked, 3000 cubic feet of air per hour were at first

supplied to the workmen, but after their breakdown in health, this

amount was raised to 5000.

It is difficult to say what amount of atmospheric pressure men can

endure with safety. With the object of throwing light upon this

subject, experiments have been conducted by Hersent, a French engineer

at Bordeaux, and also by Dr Lepine. Hersent tried the effects of

compressed air both upon dogs and men. Some of the dogs on leaving the

caisson, others the day after having undergone decompression, became

paralysed in their limbs. Men similarly treated suffered from severe

pains in their limbs and itchiness of their skin. Lepine experimented

with guinea-pigs and rabbits. When these animals had undergone rapid

decompression after exposure to the influence of compressed air, they

became paralysed in their hinder extremities, convulsions supervened,

followed by death in a quarter of an hour. On making a post-mortem

examination of the bodies, the central canal of the spinal cord was

found to be distended by gas which had torn its way into the canal.

There were also gaseous bullæ around the blood-vessels of the spinal

cord. Several of the small arteries were torn and had bled. In one

case where the animal died on the thirteenth day after exposure to

compressed air, followed by rapid decompression, Lepine found foci

of softening in the anterior horns of grey matter of the spinal cord

due to gaseous emboli and to hæmorrhagic infarction or rupture of

blood-vessels.

There is a very great tendency for grave accidents to be produced

in man when the pressure in the caissons exceeds four to five

atmospheres. The greatest risk occurs when the workmen are coming

out of the cylinders and are in the lock undergoing decompression.

If decompression is effected suddenly, harmful or even fatal results

are likely to ensue. One minute for every three pounds of pressure is

the time usually given for decompression, or five minutes for each

atmosphere, but it is obvious that the longer the labourers are in the

caissons and are exposed to very high pressure, the greater is the

probability of a larger amount of gas being dissolved in the blood and

the greater the time therefore required for decompression.

A caisson has been known to burst. This causes the most sudden

decompression possible. It is almost always a fatal accident owing to

the rapid disengagement into the tissues of the nitrogen gas of the

atmosphere which had been dissolved in the blood of the workmen under

very great pressure. Death is often preceded by convulsions. If the

workmen rally, their legs are found to be paralysed; this loss of power

may be temporary or permanent.

Three theories have been brought forward to explain compressed-air

illness: (1) carbonic acid poisoning; (2) mechanical congestion of

internal organs; (3) increased solution by the blood of the gases in

the cylinder and the sudden liberation of these gases from the blood

into the tissues during decompression.

If caisson disease were due to carbonic acid poisoning, we would

naturally expect the symptoms to show themselves during the time the

men are working in the cylinder, and not after they leave it. Dr

Andrew Smith of New York believes that the illness is the result of

mechanical congestion, especially of the brain. In several of the men

who died the membranes of the brain were found to be deeply congested,

a pathological condition that doubtless contributed to the fatal

termination.

My own opinion is that caisson disease is due to an increased solution

of gases in the blood and sudden liberation of them. The amount of

gas capable of being dissolved by a liquid is, as Dalton showed,

proportional to pressure. This law holds good for the workman in

the caisson. Since under the influence of compression more gas is

dissolved in the blood, the excess has to be liberated during the

act of decompression. If this is done quickly there is an escape

of bubbles of gas from the blood as it circulates through the

capillaries in the spinal cord and elsewhere. When Paul Bert, a French

physiologist, exposed animals to the influence of compressed air and

quickly decompressed them, several of them died suddenly, and at the

autopsy free gas was found in the blood and in the right side of the

heart. Other animals were paralysed, and in them bubbles of gas were

found in the spinal cord, while the subcutaneous tissue was at places

emphysematous or filled with air. As to the nature of the gas found

in the blood and tissues it is impossible to speak with certainty.

It is probably nitrogen, for this gas is the largest constituent of

atmospheric air, and it is perfectly passive, so that any effect

produced by it would be purely mechanical. If we regard caisson disease

as due to the liberation of gases dissolved in the blood during too

rapid decompression, we have an explanation of such a circumstance as

that of workmen taking ill shortly after they emerge from the lock,

also the benefit which they receive by being put back into the cylinder

and of undergoing temporary recompression.

_Treatment._--Treatment is preventive and curative. The points

that above all others demand attention are that the acts of compression

and decompression should be very slowly accomplished. Of these two,

decompression is the more important. The workman should not be too

rapidly pushed through the lock or exposed to any sudden increment or

decrement of pressure. One minute for every three pounds of pressure

is regarded as the average period, but this length of time might with

advantage be lengthened especially for decompression, since it is the

more dangerous. At this time too the workman, although he does not feel

fatigued, is perspiring freely, and he is exposed to chill owing to a

falling temperature. The air inside the caisson should be kept as pure

as possible, and the men ought not to work longer than from two to four

hours at a stretch. Even the minimum stated here may require to be

halved as greater depths are reached. Men should be medically selected

for the work, and only healthy men chosen who are free from heart

disease, pulmonary and nasal catarrh, and who are temperate. No man who

is suffering from a discharge from the ear ought to be allowed into a

caisson, for even in healthy men the drum of the ear has been known

to become ruptured. There ought to be a warm shelter or cabin at hand

in which the men could lie down after coming out of the cylinders, and

where hot non-intoxicating drinks can be got if required. If the men on

coming out of the caisson are cold and collapsed, warm bottles should

be applied to their extremities, medical assistance sought, and if the

breathing is impaired a hypodermic injection of liquor strychniæ should

be administered. Stimulants should only be given if there is failure

of the heart’s action. Subsequently, if there is severe muscular

pain morphia may be required. In the view that the symptoms are due

to congestion of the internal organs ergot has been recommended.

When unpleasant and dangerous symptoms have occurred immediately the

workman has emerged from the caisson, good results have been obtained

by subjecting him to recompression. Part of the cabin or shelter

just recommended might be so constructed that recompression could be

carried out therein under careful supervision, with the workman in the

recumbent position.

_Dangers Incidental to the Making of, and Working in, Tunnels._

The making of tunnels has been carried on from remote ages, there

being records of such works as early as six hundred years before

the Christian era. In a paper read by Mr Francis Fox, M.Inst. C.E.,

before the Royal Institution, 25th May 1900, the methods adopted for

making tunnels are described at length, and especially the making of

the great Alpine tunnels. The dangers of tunnelling the Alps have

been considerable, and now that the act has been accomplished, there

has been experienced considerable difficulty in ventilating some

of the tunnels. The _Mont Cenis_ tunnel is 8 miles in length,

and as there is a gradient of 1 in 40 on the French side for the

first 7 kilometres,[157] the trains go through with the regulators

of the engine full open, so that if the wind is blowing in the same

direction, great volumes of smoke practically travel with the train.

For the men who are working in the tunnel there are refuges placed

at every kilometre. Here when the men shut themselves in they can

obtain compressed air, fresh water, and medicines, and by means of the

telephone, extending in both directions, they can make their wants

known outside. The caretakers of the tunnel work in pairs, so that if

one man is affected by want of oxygen or through the density of the

smoke, the other can render assistance, or telephone for relief, or

they can both retire into a refuge and wait for either the air of the

tunnel to clear or for a locomotive to come and remove them.

The _St Gothard_ tunnel is 9.3 miles in length. It is on the

railway from Lucerne to Chiaso on the Italian frontier. The north

portal of the tunnel has an altitude of 3639 feet above the level of

the sea, and the south portal 3757. Ten years were spent in tunnelling

the mountain. The work was accomplished at a great sacrifice of human

life. In constructing the tunnel there were 580 accidents, of which

177 were fatal. The engineer and contractor lost their lives. There

was a great mortality, too, among the horses. This excessive loss of

life was attributed to insufficient ventilation, high temperatures in

the tunnel, exposure of the men to the rigours of an Alpine climate

after leaving their work, carelessness of the men in not changing

their wet clothes, the poor character of the food supplied to the men,

and defective sanitary arrangements. One of the great difficulties as

regards the St Gothard tunnel has been its ventilation. The height of

the mountain prevented the sinking of a shaft, but a large ventilating

fan placed near the mouth of the tunnel blows air through the annular

space between the arch of the tunnel and the gauge of maximum

construction, whereby 210,000 cubic feet of air are thrown into the

tunnel every minute, or 100 cubic metres per second. Before the fan was

brought into operation the temperature used sometimes to be as high as

107° F., with 97 per cent. of moisture, but by artificial ventilation

the temperature fell to 81° F., subsequently to 74.5° F. The tunnel can

now be kept cool and comparatively free from smoke and vapour. Formerly

the engine drivers and passengers were seriously indisposed in going

through the tunnel; to-day they can travel without any inconvenience.

In the St Gothard tunnel the amount of carbonic acid often exceeded 15

per 1000. There resulted from this and other causes such a corrosion

of the rails, that it was necessary at the end of every few years

to entirely replace the rails and their connections. The engineers

estimated that during three and a half years each rail lost on an

average 18 kilos in weight, and at a maximum 28 kilos. Similar metallic

corrosion has been observed in the tunnel between Genoa and Turin, and

is attributed to the sulphurous acid in the smoke of the coal becoming

converted into sulphuric acid. The recent artificial ventilation of

the St Gothard tunnel by the Saccardo system has not only made the air

purer but increased the longevity of the permanent way.

[Illustration: FIG. 74.--The SIMPLON TUNNEL

operations at Iselle, showing hospital and low flat-roofed

workmen’s dwellings in foreground; higher up on right

unmarried men’s barracks, engineers’ hotel, workshops, etc.]

[Illustration: FIG. 75.--Section of Simplon Tunnel,

showing difference in Levels between North and South ends.]

[Illustration: FIG. 76.--Section of Simplon Tunnel,

showing Cross Gallery by means of which air is transmitted

from ventilating passage to head of tunnel where the men are

working.]

The _Simplon_ tunnel is now in course of formation. In the first

eighteen months three miles were made. When finished it will measure

12.26 miles between the north or Swiss portal on the Brigue side of

the Alps and the south or Italian opening at Iselle. Such are the

existing engineering and hygienic arrangements that they are believed

likely to prevent the heavy death-rate that occurred in tunnelling the

St Gothard. Fifty times the amount of atmospheric air is being sent

into the tunnel than was forced into the St Gothard, and there are

means in use whereby the air is cooled by jets of water. The great

difficulty of the enterprise, as Professor Pagliani showed (_Revue

d’Hygiene_, 20 Juin 1900), lies in keeping the temperature low and

in renewing the air, so that the work of excavation and construction

can be conveniently carried on without undue fatigue to the men. In

the centre of the tunnel a temperature of from 107.6° F. to 113° F. is

expected to be met with. The best possible means will be adopted to

cool and ventilate the passages. The effect of high temperatures upon

the men working in the tunnel is to increase the tension of carbonic

acid in their blood and to interfere with respiratory exchanges. The

moist atmosphere, too, tends to induce both pulmonary and circulatory

troubles by preventing elimination of waste material through the

perspiration. It is impossible for hard muscular work to be continued

for any length of time, and to be efficacious in a temperature equal

or superior to that of the human body, and in a close medium saturated

with moisture. At 84° F. we know physiologically that muscular

effort is considerably reduced. An attempt is being made to keep the

temperature of the tunnel at 77° F., and lower when possible.

Two parallel galleries--in other words, two tunnels--are being run

into the mountain 17 metres[158] apart, and are reunited by a small

transverse gallery every 200 metres. As the entrance into the tunnel,

on each side of the mountain, is on a curve, there is at either end a

“gallery of direction” to correct errors of alignment direct from the

two observatories in the axis of the tunnel. Pagliani found that the

amount of carbonic acid at various distances varied from 0.68 to 7.53

per 1000, and the temperature from 75.2° F. to 87.8°, but these amounts

vary with the activity of the ventilation, the number of men working,

the activity of the machinery, and the moisture of the air, which is

nearly always at the point of saturation. It is almost impossible

to have a dry atmosphere; besides it is vitiated by the products of

dynamite explosions.

The chief feature of the Simplon tunnel[159] “is the much lower

altitude of the rails above sea-level than any of the other Alpine

tunnels. This altitude is at its highest point 2314 feet, being 1474

feet lower level than that of the St Gothard, 1934 feet lower than that

of the Mont Cenis....

“The tunnel enters the mountain at the present level of the railway at

Brigue ... but on the Iselle side the connecting line with the existing

railway at Domo d’Ossola necessitates heavy work.... The gradient on

the northern portion of the tunnel will only be that sufficient for

drainage, viz., 1 in 500, but on the southern portion the gradient will

be 7 per 1000, or 1 in 142.”

[Illustration:

FIG. 77.--Interior of Bath-house and Vestiary for the

Miners at the Simplon Tunnel (Iselle), showing the cubicles

provided with hot and cold water douche pipes, also numerous

cords with workmen’s apparel suspended from ceiling.]

In May 1901, I visited the Simplon tunnel, with the object of

inspecting the methods of ventilation, the hospitals, the system

of baths, and the houses erected for the working men, married and

unmarried. Armed with letters of introduction from Mr Francis Fox,

I was received at Iselle, the Italian side of the tunnel, by Mr

Sulser-Ziegler, Director of Messrs Brandt, Brandau & Cie, Zurich;

also by Dr Volante, the resident Medical Officer, who conducted me

over the works, the workmen’s dwellings, and the hospital. From the

elaborate precautions taken, it is clear that the Company has made up

its mind not to repeat the errors of the St Gothard, and to show to the

engineering world and the public generally that tunnel-making can be

conducted without greater risk to life and health than occurs in any

ordinary enterprise. The large number of deaths in the St Gothard was

due to the imperfect system of ventilation, the difficulty of dealing

with excessive temperatures in the mountain, and defective sanitary

arrangements. Before operations at the Simplon were commenced, Mr

Sulser and his colleagues appointed two medical men, one at either

end of the proposed tunnel, viz., Dr Volante at Iselle and Dr Pommata

at Brigue. Both are Italians, and are most capable men. Before

undertaking work the men are all medically examined. By this means,

only healthy men have been employed from the commencement. The most

important problem has been that of ventilation. The Simplon tunnel,

when completed, will be the longest in the world, being upwards of 12

miles in length. So satisfactory have the operations proceeded until

now, that unless some untoward and unexpected event happens, the tunnel

will be completed with the smallest number of deaths on record.[160] A

short description of the work, based upon personal inspection, may well

be added here.

Ventilation, as already stated, is the main difficulty. At the Swiss

end of the mountain a shaft has been sunk into the tunnel, and up

this the foul air is removed by wood fires. Into the tunnel, at each

end, by means of large fans, air is introduced to the extent of 19

million cubic feet per day, or 13,200 cubic feet per minute. The air

is carried in by one of the two parallel tunnels as far as the most

recently constructed cross gallery, thence it is carried to the face by

pipes. It returns by the larger tunnel, _i.e._, the one through

which trains will ultimately travel. By this means fresh air is carried

to the head of the tunnel where the men are working. At Iselle there

are 500 men always at work in the tunnel. There are three shifts of

men, and they work 8 hours each, so that 1500 men, roughly speaking,

are employed at the Italian end, and a much larger number at Brigue.

The average temperature at the head varies from 73° F. upwards. After

firing with dynamite it may be as high as 80° F., or 86° F. The air

is not only ladened with carbonic acid given off from the lungs of

the men and the 15 to 20 horses in the tunnel, but contains materials

given off from the bodies of the men during excessive perspiration,

and is polluted by the products of dynamite and gelatine explosions.

The foul air as it escapes from the mouth of the tunnel is thick and

greyish-white in colour; it contains a good deal of smoke from the

lamps of the workmen, and is very offensive. Small wonder, therefore,

that the men emerge from the tunnel bathed in perspiration, and

disposed to be chilled owing to their clothes being wet, for, although

they work in tarpaulins, there is a good deal of water in the tunnel.

It was, among other things, want of attention to these particular

details in the St Gothard that caused so many deaths and illnesses from

pulmonary disease.

Close to the mouth of the Simplon tunnel at Iselle, where the railway

trucks draw up that bring the men from their work in the interior of

the mountain, are large wooden buildings, one of which internally is

divided off into, among other things, 32 cubicles, each of which is

fitted up with hot and cold water pipes. The railway platform where

the men emerge is covered over, so that the workmen can reach this

building without being exposed to wet or cold. The building alluded to

is not only a bath-house but a vestiary as well. Here the men in going

to work in the tunnel put on their working clothes. At first sight,

part of the interior of the bath-house is not unlike an old-clothes’

shop, for, on looking upwards, the clothes of the workmen can be seen

suspended from the ceiling. There are 2000 strong cords placed 1 foot

6 inches apart. Attached to the free end of each cord are three iron

hooks and a soap dish. Upon the hooks the workman hangs his clothes.

As every cord is provided with a pulley and is numbered, each man,

having had a bath after his day’s work, hangs his wet clothes on the

hooks and draws them up to the ceiling. Next morning he finds his

clothes ready for him, dry, warm, and comfortable. The bath-house is

kept at a warm temperature, and is well ventilated. I was particularly

struck with the excellent system of baths, the vestiary arrangements,

and the cleanliness of the interior, and am of opinion that prevention

of chilling of the workmen after coming out of the hot tunnel has had

much to do with keeping them healthy, and has warded off pulmonary

and bronchial disease. The supply of drinking water is good, and so

far there has been during the three years no case of typhoid fever at

Iselle. The workmen’s dwellings are also good, so, too, is the hospital

and its administration.

In addition to the ill-health caused by working in the vitiated

atmosphere and high temperature of the tunnels, the miners employed

in making the St Gothard tunnel suffered from a peculiar form of

anæmia, which for long was unexplained. The discovery of the cause

of this “maladie des tunnels,” for so it came to be called, was made

by Perroncito of Turin, who showed that the anæmia of the miners was

caused by the presence of a parasite which fixes itself in the upper

part of the small intestine, measures from ¼ to ½ an inch in length,

and possesses a mouth and four long hooklets. By its hooklets the

parasite fixes itself to the lining membrane of the human intestine,

and is thus enabled to suck the blood of its host. The worm is called

“Anchylostomum Duodenale,” and is known to be prevalent in Italy. It

would appear, therefore, that the ova of this parasite escaping by

the fæces of miners who are suffering from anchylostomiasis find in

the heat and moisture of the tunnel a medium favourable for their

transformation into the larval stage; while in the dirty habits of the

miners, and the accidental contamination of their food and drink, lies

the explanation of the means of ingress of the ova into the alimentary

canal. Anchylostomiasis is not therefore necessarily a disease of

tunnels.[161] It was simply introduced into the St Gothard by infected

miners. The malady is endemic in Piedmont and Lombardy. Dubini of

Milan found in one hundred autopsies made upon the peasantry of these

districts, anchylostomiasis present in twenty bodies, so that the

disease had been apparently introduced into the St Gothard by Italian

workmen. The ravages caused by this parasite show the necessity for

miners working in tunnels disinfecting their stools by such means, for

example, as sulphuric acid. It is to the careful medical examination

of the workmen by Drs Volante and Pommata, before being engaged by

the firm, the elimination of all suspected persons, and the repeated

inspection of the closets in the tunnel, that anchylostomiasis has

not appeared at the Simplon. Since much of the pulmonary disease that

affected the miners was consequent upon breathing an overheated and

an excessively moist atmosphere, one also vitiated by the products

of human respiration and dynamite explosions, improved ventilation

in the case of the Simplon tunnel has diminished these evils; while

the opportunities given to the men of changing their wet clothes, of

bathing themselves, and of receiving shelter when tired, have prevented

the acute bronchial and pulmonary catarrhs that were observed in making

the other great Alpine tunnels.

_Underground Railways._

Of the underground railways in this country the only one I need allude

to is the London Metropolitan. In 1897 a Board of Trade Commission

was appointed to inquire into the condition of the air in the “Inner

Circle” of the Metropolitan. The passenger traffic on this line is

enormous. Between Praed Street and Aldgate stations, in one hour, as

many as 38 trains were said to arrive and depart from either side of

the stations. Welsh coal is consumed. Part of the Metropolitan railway

is underground, and part is in the open, so that when the wind is

blowing in certain directions passengers have been inconvenienced

by the smoke and the insufficiency of the ventilation, despite the

numerous escape holes. There has often been an excess of carbonic acid,

sometimes, too, of carbon monoxide, in the air in the tunnels. The

Commission found that the ventilation could not be adequately assured

by the exchange and renewal of the air at the stations and the escape

holes. It recognised the necessity for artificial ventilation, and in

consequence the centrifugal method was adopted.

Vitiation of the air of a tunnel is caused by the gases that come

from the means adopted for illuminating purposes, the products of

respiration, and those due to combustion of coal in the furnace of the

locomotive. Carbonic acid is only dangerous when it is present in large

quantities. Breathed for a very short time at 60 per 1000 it causes

headache, at 100 per 1000 respiration becomes extremely difficult,

while if present in the proportion of 250 per 1000 it will cause rapid

death.[162] It is seldom, however, that carbonic acid is even present

to the extent of 10 per 1000; if present, it is as a rule accidental

and only for a short period, so that danger from this gas is slight.

It is otherwise with carbon monoxide, a gas much more dangerous and

subtle in its influence than carbon dioxide, popularly known as

carbonic acid. Carbon monoxide was found to be present in the air of

the Metropolitan Railway to the extent of 0.66 per 1000. When present

to this amount in air it can, if time is given, paralyse the hæmoglobin

or coloured substance of the blood that carries the oxygen to the

tissues. Harmful effects can occur when carbon monoxide reaches 0.3

per 1000, but as it requires half-an-hour for the blood to absorb

sufficient of this gas to be detrimental to the individual, accidents

do not happen owing to the short length of the tunnels and the good

speed of the trains through them. The risks to health are incurred

mostly by the men who work on the railways. M. Raymond Godfernaux

(_Génie Civil._, Août et Sept. 1899), in reviewing this subject,

remarks that the breathing by an individual in repose for one and a

half hours (less than this if work is being done) of an atmosphere

containing 0.25 of carbon monoxide per 1000 is sufficient to cause

unpleasant symptoms; if the air contains 0.5 per 1000 there will be

debility and vertigo; if 0.9 per 1000 walking becomes impossible,

while death will supervene if there is 1.5 in 1000. To men employed

on underground railways, danger from this source only comes when the

amount of carbon monoxide passes beyond 0.25 per 1000. The passengers

run, practically speaking, no risk.

A heavy sulphurous odour hangs about the tunnels and stations of the

Metropolitan Railway due to the combustion of coal. When sulphurous

acid is present in air to the extent of 0.6 per 1000 it may cause

death. This proportion is never present in the air of the tunnels of

the Metropolitan of London.

The sulphurous acid and carbonic acid are believed to be proportional

to each other. The amount of sulphurous acid is 440 times less than

that of carbonic acid, and as the maximum of carbonic acid was 8.9 per

1000, sulphurous acid is seldom more than 0.02 per 1000.

The Commission established the facts (1) that there was a constant

relation between the deleterious gases in the tunnels, and (2) that the

proportion of carbonic acid present might be taken as the basis for the

aeration of the tunnels. The proportion of carbon monoxide is constant,

and corresponds to one-thirteenth the volume of carbon dioxide, while

that of sulphurous acid is 440 times less than that of carbon dioxide.

The amount of sulphurous acid is regulated by the character of the coal

burnt in the locomotive. Some coals contain more sulphur than others.

A similar remark applies to carbon monoxide. An Italian Commission

charged with a similar function in regard to the composition of the

air in the tunnels of its own country arrived at different chemical

conclusions to the Commission of the Board of Trade, so that it would

be scarcely wise to calculate the purity of the air in all tunnels upon

parallel lines.

The amounts of carbon monoxide and dioxide should be estimated

separately. The composition of the air of the tunnels of the

Metropolitan, accepted for a maximum, is 1.5 of carbonic acid per 1000

(0.3 being regarded as the normal), 0.1 carbon monoxide per 1000, and

0.0027 sulphurous acid per 1000.

It is especially for the sake of the men who are working in the

tunnels, and for the drivers of the locomotives, rather than for the

passengers who spend proportionally a very short time on the railway,

although of course desirable for all, that such artificial means of

ventilation should exist as will quickly disperse the smoke and all

combustion products.

It has been decided to introduce electric traction in the underground

railway. By this means the Metropolitan Railway Company will rid the

atmosphere in the tunnels of the impurities alluded to.

_Divers’ Paralysis._

Men when clad in proper diving suits and wearing air-tight head-gear

can work at very considerable depths under water. At the depth of 33

feet the pressure is about twice that of the atmosphere. It is not

exactly known to what depth men may descend with safety, but 201 feet

have been reached, _i.e._, equivalent to a pressure of 87 lbs. to

the square inch. It is very desirable that the descent should be made

gradually, say about two feet per second. In this country diving is

resorted to for making excavations connected with piers, inspecting

sunken ships, etc., and abroad for sponge, pearl, and coral fishing.

It is not uncommon for the men after having been in the water some

time to complain of weakness of the legs and of impaired sensation. A

patient of Dr Frederick Taylor (_Clin. Jour._, April 27, 1898),

after diving 162 feet felt sick, and when pulled up into the lighter

was found to have lost the power of his legs. Loss of consciousness is

a frequent symptom, and as it often takes a man as much as five minutes

before he can reach the surface of the water, there is considerable

danger attending the occupation. Divers have died without regaining

consciousness. Others when rescued, and on coming to themselves, have

complained of severe cramp-like pains in the muscles of their limbs and

abdomen.

At such depths as 160 to 180 feet men can only stay at the bottom of

the sea a very short time. It is only when men work at very great

depths that paralysis is likely to supervene. The risk to life and

health is regulated by the depth, and particularly is this the case

when there are sudden alterations of pressure. Hauling up divers

too quickly when the air-tube has become foul is a very dangerous

proceeding. Since young men bear the work better than old men, age,

therefore, is a circumstance that should be considered, as well as

temperance in the use of alcohol. The character of the water and the

length of the period of submersion must not be overlooked. Once 150

feet below the surface has been reached, the diver is apt to feel

somewhat inconvenienced, and with every increase of two or three feet

beyond this, the inconvenience becomes rapidly greater. There are

experienced a sense of fulness in the head, buzzing in the ears--often

relieved by filling the mouth with saliva and swallowing the

secretion--also flashes of light before the eyes. Bleeding at the nose,

mouth, and ears occasionally occurs after the men come to the surface;

severe muscular pains, called “bends,” are sometimes complained of,

followed by loss of power in the legs. There is either complete

paraplegia, _i.e._, the lower half of the body is paralysed as

regards motion, and sometimes too as regards sensation, or the loss of

power is limited to groups of muscles affecting the wrists and ankles.

The paralysis may be permanent, or it may last only a few hours or

days, but if a diver has once had paralysis the symptoms are apt to

recur on re-exposure.

The cause of divers’ paralysis, like the disease of caisson workers,

is the sudden liberation of gas that was previously dissolved in

the blood. No hæmorrhages have been found in the central nervous

system, but Van Leyden observed fissures in the spinal cord occupied

by leucocytes, _i.e._, cells like the white corpuscles of the

blood. The appearance of the fissures suggested that they had first

been formed, and that the colourless corpuscles had found their way

thither afterwards. When lesions have been present in the spinal cord

they usually occupy the lowest third of its length, a circumstance

attributed by Moxon to the greater length, tortuosity, and attenuated

condition of the small blood-vessels that are present at this

particular part compared with the arteries in the upper region of the

spinal cord.

Fatal cases of divers’ paralysis fortunately do not occur very

frequently. One of the most recent cases was in November 1900, when

H.M. battleship _Howe_ was cruising in the West of Scotland; the

diver of the ship died after a lengthened immersion in the water.

At the post-mortem examination bubbles of gas were found in the

blood-vessels, the heart, and brain. The morbid conditions found in

this man’s body after death quite confirm the opinion already expressed

as to the pathology of the malady.

In addition to the risks to health already mentioned, there are those

incidental to the fouling of the air-tubes of the diver; also large

stones and other materials occasionally fall upon the tubes, and tend

to cause death by asphyxia.

So far as the operations of diving itself are concerned the three

things to be avoided are: (1) too great depths; (2) sudden alteration

of pressure; and (3) coming up too suddenly. There must necessarily be

increased danger when a man who is working at a depth of 150 feet is

brought to the surface in one minute instead of five.

_Treatment._--If the diver on coming to the surface is found to

be unconscious and not breathing well, artificial respiration should

be resorted to and kept up till breathing becomes automatic. If he is

collapsed, warmth should be applied to the extremities, and, if he

can swallow, hot coffee should be administered. The patient should be

removed to a hospital, or his own home, when sufficiently revived. If

muscular pains are severe, or if there is loss of power, rest in bed,

sinapisms to the spine, and later on galvanism should be tried.

THOMAS OLIVER.

CHAPTER LV

DISEASES DUE TO DIMINISHED ATMOSPHERIC PRESSURE:

PURE AND IMPURE GASES

_Mountain Climbers; Military Balloonists._

Increased atmospheric pressure causes unpleasant and sometimes serious

symptoms in divers and in caisson workers, but to an extremely rarefied

atmosphere can also be traced effects that are nearly equally serious.

It is difficult to say at what height above the ordinary surface level

of the earth man can live with comparative comfort. The Andes and

the Himalayas have been scaled to from 15,000 to 23,000 feet above

the sea level, and men are said to have gone as high as six miles in

balloons. The difficulties of remaining at great altitudes are the

excessive cold and the low barometric and oxygen pressures. In order

to compensate for this low oxygen pressure, nature endows men living

at great heights by increasing the number of the red corpuscles of

their blood. It is these corpuscles that carry oxygen to the tissues.

In ascending a very high mountain the individual experiences not only

great difficulty of breathing and violent palpitation of the heart,

but a sense of great physical fatigue and faintness. A set of symptoms

not unlike those observed in sea-sickness occurs, hence the name given

to the illness, “mal de montagnes,” although vomiting and nausea are

not always present. In climbing mountains people generally put forth a

great amount of muscular effort, and in consequence an increased amount

of chemical change takes place within their body, a circumstance which

reduces the resistance of these individuals to the influences of a

falling barometric pressure. Aeronauts do not experience this sense of

muscular fatigue, because they are not making any muscular effort, but

they ascend to great heights with greater rapidity than climbers, and

to this circumstance must be attributed many of the unpleasant symptoms

they experience.

Since in the act of climbing it is upon the heart and lungs that the

greatest strain is thrown, it is these organs that principally have

their functional activity increased. The palpitation of the heart may

be very distressing. There is throbbing in the head, accompanied by

extreme muscular exhaustion, so that after reaching a great height the

individual may be so overcome that he throws himself on the ground,

unable to proceed further. He lies there for a time panting, trying to

get more oxygen into his system and to rid it of the excess of carbonic

acid. He may bleed at the nose or from the gums. He perspires freely,

and there is great thirst. There may be deafness and earache owing to

the bulging outwards of the drum of the ear. Although it cannot be

stated that in man death has been caused by diminished atmospheric

pressures at great heights, yet it has been shown experimentally in

animals that coma is induced which may end in death. The animal passes

into a state of cadaveric rigidity very shortly after death. It is just

a question how far the sudden supervention of cardiac and cerebral

symptoms in mountain climbers may not be responsible for some of the

fatal accidents that we read of from time to time as occurring on the

Alps.

_Military Balloonists._--In the _Archiv. de Med. Milit._,

February 1900, Dr Maljean reports that in a company of balloonists

belonging to the 1st Regiment of Engineers he found several of the

soldiers suffering from a toxæmic form of jaundice, the nature of which

was obscure. Ultimately he demonstrated that the jaundice was due

to poisoning by inhalation of arseniuretted hydrogen gas mixed with

hydrogen that had been used for filling the balloons. The hydrogen

employed for military balloons is obtained by acting upon granulated

zinc with sulphuric acid. The sulphuric acid is generally obtained from

pyrites, and this is known to contain sometimes as much as from 2 to

5 per cent. of arsenic combined with iron. Commercial zinc also often

contains arsenic. In filling balloons, therefore, it would appear that

not only is there frequently an escape of this impure hydrogen from the

valves of the balloon, but that during the operation of filling the

balloon, the officers and men are in the habit of smelling the tube to

ascertain whether by the garlicky odour of the impure hydrogen this

gas has replaced the ordinary atmospheric air. At a single filling an

officer may smell several times the open tube of the balloon and suffer

in consequence.

According to Maljean the symptoms of poisoning commence with a sense

of great malaise and nausea, followed later on by jaundice, often

of a very pronounced yellow-green tint, urine scanty, and often as

dark as coffee, but not giving the reaction of biliary pigment. The

urine stains the linen like the blood-coloured urine of patients

suffering from hæmoglobinuria, and it may contain both albumen and a

few tube-casts. In a few days these symptoms disappear, but they leave

behind them anæmia and loss of flesh, which persist. It has for long

been known that if animals are given arseniuretted hydrogen gas to

inhale, they rapidly become jaundiced and pass a blood-coloured urine.

A similar set of symptoms has been observed in men working in chemical

and mineral industries in which arsenic is present.

In the balloon service of the French army an endeavour is now being

made to use only pure hydrogen. In most of the military balloons the

valve which allows the gas to escape is placed in the upper part of the

machine. The balloons are filled in the open by hydrogen from metallic

cylinders which have been charged under a pressure equivalent to 120

atmospheric pressures. It is stated by some authorities that under such

very high pressure the impure gas may be decomposed and rendered less

harmful, but this requires confirmation.

Poisoning of aeronauts by arseniuretted hydrogen in connection with

military balloons on the Continent is not confined to the French army

alone. In the _Deutsche Milit. Zeitschrift_, 1900, p. 139, is an

account of two German soldiers, who, after being poisoned by this gas,

died at the end of three days.

Persons ascending in balloons should dress warmly, and they ought to

take with them cylinders filled with compressed oxygen.

THOMAS OLIVER.

CHAPTER LVI

EFFECTS OF CONCUSSION OF THE AIR

_Boilermakers and Riveters._

It may be taken as a fact based upon experience, that artisans who are

exposed to such loud noises as are made in hammering rivets suffer from

deafness. Boilermakers and riveters become deaf at an early age, while

their comrades engaged in other kinds of work in the same shipyard do

not suffer. Several young boilermakers whom I have examined have stated

that they lost their hearing at an early age. Their infirmity dated

back to their ’prentice days, when as boys they were sent into the

boilers to catch the rivets, and were subjected to the intense noise

of hammering inside the cylinder. Workers in sheet-iron factories are

sometimes similarly affected with deafness. It is no uncommon thing,

as people know, for artillerymen when firing large guns to be rendered

temporarily deaf by the noise and force of the explosion, and in some

instances for the drum of the ear to be ruptured. In order to prevent

such an accident, cotton wadding is sometimes placed in the ear. It is

difficult to say exactly what is the cause of deafness in boilermakers,

but the extreme vibration of the tympanum, and the intense agitation of

the ossicles, cannot but be followed either by a thickening of the drum

of the ear, or by a paralytic condition of the minute terminations of

the auditory nerve.

There is nothing I know of that will prevent boilermakers’ deafness,

short of substitution of machine for hand riveting, and once deafness

is established I know of no reliable cure for it.

_Boilermakers, Shipwrights, etc._

Some idea may be formed of the trades included under this heading, by

glancing at the reports of the Boilermakers’ Society, and ascertaining

from what trades the members of the society are drawn. The members

are engaged in the various steel trades, viz., boilermaking,

bridge-building, shipbuilding, also in iron and other structural work

composed of iron and steel. They mostly come from the boilermaking

and shipbuilding industries. As the central office of this Society is

in Newcastle-upon-Tyne, I have, through the kindness of Messrs Robert

Knight and D. C. Cummings, the past and present secretaries, gained

considerable information as to the maladies principally affecting

boilermakers, and their death-rate, etc. The work is hard, and as it

is mostly carried on in the open the workmen are exposed to all kinds

of weather. Under these circumstances, therefore, it would be natural

to expect that boilermakers would show a tendency to suffer from

acute inflammatory affections, especially of the respiratory organs.

Boilermakers as a class are not unhealthy. At the present time there

are 48,000 members in the Society. In 1899 there died 436 members,

a number equal to 9 per 1000, as against 8 per 1000 of the male

population of the country generally. As illustrating the effect of the

occupation upon their working powers, members are eligible to be placed

upon the superannuation fund at the age of fifty-five years. This is

an early age compared with some industries, and yet, at fifty-five

some boilermakers are, comparatively speaking, old, a circumstance

that is attributed to the arduous nature of their calling. The records

of the Society, as of many other trade unions, show that with each

succeeding decade in the working life of a boilermaker he is annually

on the sick-list an increasing number of days. The average age at death

of boilermakers is 46.72 years. Hard and exposed as the work is, it

is interesting to know that the average age at death of boilermakers

is greater than that of the wives of boilermakers, who are leading an

indoor and protected life. The average age at death of members’ wives

is 45.47 years, a circumstance which I attribute to many of the wives

dying during or shortly after their confinement, and also dying at an

earlier age than the members from such other diseases, for example, as

consumption.

In the accompanying statistical tables in their present form I

am indebted to Dr H. E. Armstrong, Medical Officer of Health,

Newcastle-upon-Tyne (see p. 754).

One thousand boilermakers, it will be seen, exhibit a slightly higher

death-rate from all causes than 1000 of the male population of England

and Wales, the numbers being respectively 9 and 8. They have a slightly

higher mean death-rate, too, from all forms of lung diseases, including

pneumonia, viz., 3.0 as against 2.9 of 1000 male persons over twenty

and under sixty-five years of age; but taking tubercular diseases only,

the death-rate from this cause is less, being 1.4 as against 1.6; on

the other hand the death-rate for diseases of the heart and circulatory

organs is slightly higher, 1.2 as against 1.1.

UNITED SOCIETY OF BOILERMAKERS AND IRON SHIPBUILDERS.

_Extracted from the Annual Reports of the Society._

Column headings:

1: YEAR.

2: No. of Members.

3: All Causes.

4: Bronchitis.

5: Pneumonia.

6: Phthisis, not included in cols. 7, 8.

7: Consumption, not included in cols. 6, 8.

8: Tuberculosis, not included in cols. 6, 7.

9: Cancer.

10: Diseases of Heart, Circulatory System.

11: Typhoid Fever.

12: Lung Diseases, including Bronchitis, Pneumonia, Phthisis, etc.

13: Tuberculosis, including Phthisis, and all other forms.

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

| | DEATHS FROM | TOTAL |

| | | DEATHS. |

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

| =1= | =2= | =3= |=4= |=5= |=6= |=7= |=8=|=9= |=10=|=11=|=12= |=13=|

| | | | | | | | | | | | | |

| 1896 | 40,776 | 346 | 27 | 35 | 51 | 8 | | 12 | 48 | 5 | 121 | 51 |

| 1897 | 42,178 | 379 | 32 | 37 | 43 | 12 | 4 | 23 | 52 | 6 | 124 | 47 |

| 1898 | 43,905 | 399 | 25 | 41 | 68 | 6 | 2 | 20 | 53 | 12 | 140 | 70 |

| 1899 | 47,417 | 436 | 30 | 53 | 62 | 3 | 7 | 13 | 56 | 25 | 148 | 69 |

+======+========+=====+====+====+====+====+===+====+====+====+=====+====+

| _Death-Rate per 1000 Members._ |

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

| | 12. | 13. | 9. | 10. | 11. | 3. |

| +--------+--------+--------+--------+--------+--------+

| | =14= | =15= | =16= | =17= | =18= | =19= |

| | | | | | | |

| | 3.0 | 1.3 | 0.3 | 1.2 | 0.1 | 8.9 |

| | 2.9 | 1.1 | 0.5 | 1.2 | 0.1 | 9.0 |

| | 3.2 | 1.6 | 0.4 | 1.2 | 0.3 | 9.1 |

| | 3.1 | 1.5 | 0.3 | 1.2 | 0.5 | 9.2 |

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

| years | 3.0 | 1.4 | 0.4 | 1.2 | 0.2 | 9.0 |

+=================+========+========+========+========+========+========+

| [163]ENGLAND AND WALES.--_Per 1000 population, 1881–90._ |

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

|Mean Annual }| | | | | | |

| Death-Rate of }| | | | | | |

| Male Persons 20}| 2.9 | 1.6 | 0.4 | 1.1 | 0.1 | 8.0 |

| and under 65 }| | | | | | |

| years of age }| | | | | | |

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

It is noteworthy, as already stated, that the average age at death

of the wives of the members of the Boilermaker’s Society is lower

than that of members, viz., 45.47 years for the wives and 46.72 for

the members. Fewer of the wives die from phthisis and tubercular

disease than the members, the numbers being 1 and 1.4 respectively as

against 1.6 of 1000 of the population generally, estimated upon the

returns of the Registrar-General for 1881–90. The wives of members

die at an earlier age from pulmonary consumption than the members,

viz., thirty-four and a half years for the wives, and thirty-nine for

members, a circumstance possibly explained by two facts--that males

show greater resistance to the disease than females, and that during

the early part of the disease at any rate the members spend more of

their time in the open air than do the wives.

Although boilermakers are exposed to such risks as burns from red-hot

rivets, it is surprising how few accidents are traceable to this cause.

When Dr Ogle dealt with the statistics of workers in iron, he concluded

that of the three classes--(1) locksmiths, including bellhangers and

gasfitters; (2) engine and machine-makers, fitters and millwrights; (3)

boilermakers--the engine-makers occupied the most favourable position

from a mortality point of view, the mean mortality rate being 863 as

against 967 for locksmiths, and 994 for boilermakers. According to the

same authority, too, the mean annual death-rate of boilermakers is

greater at all the ages between twenty-five and sixty-five years.

THOMAS OLIVER.

CHAPTER LVII

IRON AND STEEL INDUSTRIES

_Exposure to High Temperatures, and Severe Muscular Strain._

In iron works the _blast furnacemen_ are exposed to very high

temperatures. Passing rapidly from great heat to cold, they are prone

to suffer from bronchial and pulmonary affections and from rheumatism.

They run the risk of burns, also on a windy day of getting particles

of dust or sand into their eyes.[164] Blast furnacemen’s work is hard.

When young the men are, as a class, physically strong. Their wages are

good; they live well, but at an early age they begin to drink freely.

Under the combined influence of their arduous labour, exposure to all

kinds of weather, and their intemperate habits, they break down readily

and become prematurely old.

The men who work at the _puddling_ furnaces are exposed to

excessive heat and to severe muscular strain. Owing to the heat and

excessive perspiration, they often work with the upper half of their

body uncovered. They imbibe many kinds of liquids, so as to replace

what is lost by perspiration. Puddling, which is briefly speaking the

rolling about by means of a rabble the huge balls of molten iron in the

furnaces, is such very hard work that many of the men develop heart

affections, particularly disease of the aortic valves, or aneurismal

dilatation of the aorta, owing to the excessive muscular strain and

intemperate habits. Puddling is justly regarded as one of the most

degrading occupations a man can follow. Fortunately for the workmen it

is now very much on the decrease. Steel is rapidly taking the place of

iron, consequently puddling is not so much required.

Blast furnacemen are occasionally poisoned by the escape of carbonic

oxide from the waste gases used for heating the air of the furnace.

_Blacksmiths and Forgemen._

Beyond the extremely arduous nature of this employment, and which

necessitates the work being undertaken by men of good physique, whose

muscular system develops in proportion to the strain that is imposed

upon it, especially in the early years of manhood, and freedom from

alcoholic excess, the work of the blacksmith and forgeman is healthy.

Formerly a good deal of the heavy work was done by men wielding large

hammers. This threw a strain upon the heart and large blood-vessels,

and was a frequent cause of valvular disease of the heart, dilatation

of the aorta, and possibly too of hernia. Since much of the hard work

previously done by hammermen is now done by machinery, we see less of

aortic disease among forgemen than two decades ago. The workmen are

exposed to heats and colds, to injuries to the eyes, and to burns from

flying scales during hammering. Blacksmiths seem to lead a charmed life

so far as these risks are concerned, for considering their exposure the

percentage of injuries is small. As a consequence of handling the rough

iron tools the skin of the hand becomes thick and hard, and the men run

the risk of catching bronchial and pulmonary catarrhs on emerging from

their heated workshops into the open air. Years ago in Sheffield, when

sledge-hammers were more in use than now, there was observed a form

of paralysis of the muscles of the arms due to overstrain, and known

by the name of hammermen’s paralysis. A considerable percentage of

blacksmiths die from phthisis and diseases of the respiratory organs.

Out of 872 deaths of blacksmiths Dr Ogle found 194 due to consumption,

and 183 caused by other forms of lung disease; while following these

came diseases of the heart and circulation, 108; and, lastly, from

diseases of the nervous system, 85.

_Use of Converters in Steel Works._

This is the proper place to allude to a matter which formed the subject

of a special inquiry by, and report[165] from, the Dangerous Trades

Committee of the Home Office, on account of a fatal accident to four

men in a large iron works in which the Bessemer process of steel

manufacture is in use. The Bessemer converter is a pear-shaped metal

vessel, about nineteen feet long by seven or eight across at its widest

part, into which pig-iron and other ingredients for the manufacture of

steel are run in a liquid condition. In the bottom of the converter are

openings called “tuyere holes,” through which a powerful blast of air

is driven into the molten pig-iron, the object being to burn out such

impurities as carbon, silicon, phosphorus, etc., the means employed to

do this being sufficient to develop at the same time a degree of heat

capable of keeping the purified metal in a liquid state. Before the

blast is turned on, the converter occupies almost an upright position.

The roar that follows the entrance of the blast of air is succeeded

by volumes of coloured smoke and flame, and by myriads of sparks of

molten metal. When the flame has become finally white, the blast is

withdrawn, spiegel iron is added to the seething mass to restore the

proper amount of manganese and carbon required, the converter is

lowered and gently turned over so as to allow of the pouring of the

liquid steel into a ladle, which distributes it into moulds. It is

in the moving of the converter and the ladle into their respective

positions, an act usually accomplished by the aid of hydraulic or steam

power, that accidents have arisen owing to faulty machinery. The moulds

are standing upright in what is called the pit, where there are usually

two or three men employed. Should by chance either the converter or

the ladle spill its contents a fatal accident is almost sure to occur.

It is desirable, therefore, that only experienced men should work the

machinery connected with the lowering and turning over of the converter

and ladle, and that during the act of distributing the steel into

the moulds no men should be present in the pit at all. The Dangerous

Trades Committee, in addition to the above, recommended that where an

automatic safety apparatus has been introduced into the machinery, the

spindle in the valve should be changed every three months, and the

valves examined regularly by a competent engineer. Owing to the fact

that when molten metal falls into water there is an explosion, it was

also recommended that the pits should not be, as they too often are,

open to the sky and exposed to all kinds of weather.

_Nail and Chain Making._

The small iron industries are located in districts where coal is

plentiful, iron close at hand, and labour cheap. It is thus that

chain-making has come to be associated with such places as Cradley

Heath and Dudley, and has grown up to be a family industry, carried on

in these localities by husband, wife, and children in small tenemented

properties and outbuildings under the worst hygienic conditions

possible. A similar remark applies to nail-making at Bromsgrove. In

these trades, as carried on in the Midlands, female labour, assisted

by that of children, prevails, a circumstance that tends to pull down

wages and to render the conditions of life hard.

As an illustration of how the minor iron industries come to be located

in small places, I would mention the manufacture of nails, locks, and

angle iron that has been carried on for many years in Winlaton, a few

miles from Newcastle-on-Tyne. Here also the work has partly assumed

the family type already mentioned. For generations the industry has

been handed on from father to sons. It cannot be said that in Winlaton

the conditions of labour have been, from a financial point of view,

unsatisfactory to the workers or deleterious in its effects upon their

health, as is stated to be the case in the “Black Country,” where

labour has been ill-requited, recourse had to female and child labour

on account of cheapness, the hours of toil long, and the hygienic

conditions under which the work is carried on bad. Dr Arlidge, drawing

his experience from Staffordshire, was of opinion that for the worker

in these trades to earn a living wage, a great amount of physical

labour had to be expended in the forging and hammering of the nails on

the anvil. To put the head on to a nail a suspended hammer has to be

intermittently brought down by pressure of the foot upon a chain. For

spike nails the cold iron has to be cut into proper lengths by means of

an “oliver” or sledge hammer, worked by two or three men by means of a

treddle. In forging a nail a girl works with the hammer on the anvil,

and with her foot a small “oliver.” Apart from the small wages received

it cannot be said that the industry is unhealthy, but the work is hard,

and requires a great amount of physical exertion which ought to be met

by good food and adequate physical rest, the former of which is denied

the workers by their small wages, and the latter by the long hours of

toil required to secure the necessaries of life.

In consequence of the irritation which the palm of the hand is exposed

to in handling the hammer, etc., there occurs a thickening and

contraction of the fascia in the front of the hand whereby the fingers

become crooked and drawn towards the palm. Spinal curvature, too,

is not unknown. It is extremely apt to develop in those who engage

in the work at an early age. Pulmonary disease is said to carry off

the men while still young, and the occupation is one that exposes the

worker to the risk of burns. Attention is drawn to this industry, not

so much because the trades are unhealthy in themselves, as that the

nail-makers at Bromsgrove and Sidemoor, and the chain-makers of Cradley

Heath, scarcely earn wages sufficient to buy the proper food necessary

for the maintenance of the body, while they are obliged to put forth

considerable muscular effort owing to the laborious nature of their

calling.

THOMAS OLIVER.

CHAPTER LVIII

EYE DISEASES AND EYE ACCIDENTS IN RELATION TO

INDUSTRIAL OCCUPATIONS

The subject to be discussed in this article is a very wide one. To

treat all industrial occupations and the relations they bear to eye

diseases and eye accidents would be impossible in the space at my

command. It will, however, be found that the various trades which are

brought under notice cover a considerable part of the whole area.

They may be regarded as perhaps the most important, and some, at all

events, will represent also the dangers arising from cognate or allied

industries. For the most part I have treated of occupations in which I

have myself been particularly interested.

The subjects to be considered may be conveniently arranged under the

following divisions:

_1st._ Diseases due to occupations involving prolonged use

or excessive strain of the eyes, such as nystagmus in miners,

and others.

_2nd._ Diseases due to occupations involving the use of

certain poisonous substances, such as dinitrobenzol, bisulphide

of carbon, tobacco, lead, etc.

_3rd._ Diseases due to occupations involving exposure to

excessive light or heat, or both, such as burnishers, steel

melters, electric welders, etc.

_4th._ Injuries or accidents amongst grinders, iron and

steel workers, masons, coal miners, weavers, etc.

_1. Diseases due to occupations involving prolonged use or excessive

strain of the eyes, such as nystagmus in miners and others._

Coal miners, as a result of their employment, are specially prone

to a peculiar affection of the eyes called “nystagmus,”[166] which

is characterised by oscillations of the eyeball. The sufferer, too,

complains of objects dancing before his eyes. In this disease objects

appear to move either in a circle or an ellipse. Headache is often

present, and especially giddiness, which sometimes causes the miner

so to stumble about that he is compelled to leave his work in the

mine. The movements of the eyeball are chiefly rotatory; to-and-fro

oscillations are sometimes superadded; these are rarely vertical,

but the rotatory are seldom, if ever, absent. The rapidity of the

ocular motions varies greatly: from sixty to one hundred and fifty

motions may be counted in a minute; I have observed them as frequent

as three hundred and fifty. Both eyes are affected, but the rapidity

of movements may vary in the two eyes. The more rapid the oscillations

the less extended is the excursion of the globes. The oscillations are

arrested by turning the gaze downwards below the horizontal line, and

miners often learn to rest their eyes in this way. Looking upwards,

and especially obliquely to one side or the other, rapid movements

of the head, lowering of the head and suddenly raising it, are means

of increasing the rate of movements of the eyeballs, or, in other

cases, of rendering them evident. Placing the patient in the position

he would assume at his work is another method. Tremors of the head

(noticeable to the hand placed on the head), of the eyelids, and of

the muscles of the face or neck, are often associated with nystagmus,

and so is torticollis or “wry-neck” in some cases. Night blindness

has been alleged to be present, but there is some reason to dispute

this; the nystagmus alone is a sufficient cause for any difficulty in

seeing in a failing light. Errors of refraction, myopia, hypermetropia,

and astigmatism are often present, but bear no causal relation to

nystagmus; visual acuity is generally unaffected. Colour perception is

good, and, so far as the movements of the eyeballs permit of testing,

the field of vision is normal. The onset of the disorder is often

brought about by some attack of illness. It is generally met with in

men who have worked in the mine for some years. Ninety per cent. of

cases occur in persons from twenty-five to forty-five years of age.

[Illustration: FIG. 78.--Bottom Holing.

(_Photo. taken in coal mine with Magnesium Flash

Light._)]

[Illustration: FIG. 79.--Bottom Holing. (To show

position of head and eyes.)

(_Photo. taken in coal mine with Magnesium Flash

Light._)]

Nystagmus is found in miners (coal-getters) engaged at the coal face,

who work in a more or less constrained position of body and of eyes.

It is desirable to get coal in as large pieces as possible, and, to

do this, they undercut, or “hole” the seam. A man sits with his legs

crooked up, lying almost on his side, and strikes the coal with a

horizontal swing of his pick at the bottom of the coal seam. He will

cut away the coal to a height of from 18 inches to 2 feet, and then

as he gets deeper in he draws his body under the coal, lying on

one side or the other. The process is called “holing,” and sometimes

the undermining may be continued from 2 or 3 feet to as much as 7 or

8 feet; the distance varies considerably. As he proceeds with his

work the miner applies timber supports to keep the coal from falling.

This just described is called “bottom-holing,” but the seam may be

attacked in the middle (middle-holing) or at the top (top-holing). A

miner engaged at this work will direct his gaze to different parts,

as it becomes necessary for him to strike, for the eyes will follow

the pickpoint, but the tendency will be for the gaze to be directed

upwards (using the ocular elevators) more or less obliquely. He will

lie sometimes on one side and sometimes on the other; his legs will

be crooked up, his head thrown back and flexed more or less on the

shoulder beneath. This position is shown in the photographs, which

were taken in the mine with a magnesium flash-light, of a man whilst

actually at work. Ninety-eight per cent. of all cases of nystagmus

coming under my notice have been in men occupied at the coal face and

more or less engaged at this kind of work. The thickness of the coal

seam varies greatly in different parts, but work of a very similar

nature is done in coal mines in all countries.