Industrial pneumonoconioses, with special reference to dust-phthisis / by Edgar L. Collis.

  • Collis, Edgar L. (Edgar Leigh), 1870-1957.
Date:
1915
Catalogue details

Licence: In copyright

Credit: Industrial pneumonoconioses, with special reference to dust-phthisis / by Edgar L. Collis. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    14/76 (page 6)
    established the existence of miner's dis- ease, Ihus giving the clue to the mortality figures of Dr. Farr. Peacock, in describing the disease (j2) carefully distinguishes it from ordinary phthisis. The form of the disease in which there is local consolidation in some portion of the lungs, bears a close general resemblance to true consumption, and especially where, as often happens, the voice is husky and the patient expectorates blood. There are, how- ever, features by which it is sufficiently dis- tinguished from that disease. It usually occurs in persons who do not present any hereditary disposition to phthisis — their parents and other relatives often having attained advanced ages and being quite healthy. It commences at a later period of life than phthisis, indeed, in persons who have reached ages at which consumption is by no means of frequent occurrence. It is also much slower and less active in its pro- gress, so that in persons who have been ill for several years the signs often do not indi- cate extensive or advanced disease. The quickness of pulse, the rapid and extreme emaciation, and the night perspirations so characteristic of true phthisis, are also generally absent or only slightly marked, and there is rarely diarrhoea, indeed, the bowels are often obstinately confined. As a source of information the Report of the Commissioners is invaluable, but, not- withstanding the evidence of several wit- nesses, particularly the miners themselves, that the stour or dust was far worse than anything else they had to contend with, the conclusion arrived at, based, I may say, on practically unanimous medical opinion, that the influence of dust was subsidiary to the many other adverse conditions of ventilation, exposure to fumes of explosives, and varia- tions of temperature, which at that time sur- rounded the mining industry, was unfortu- nate. At that time, however, all researches into the causation of phthisis, for example, the writings of Alison {21) and of Chateau- neuf (9), were proving the importance of bad housing, poverty, and lack of ventilation, and, although the prevalence of phthisis in certain dusty industries was noted, the ab- sence of the disease in other dusty industries obscured the issue, and Peacock, influenced by the thought of his day, may be forgiven for ascribing the prevalence of the disease to the imperfect hygienic conditions he saw, rather than to the then disputed point of dust inhalation. Fifty years later a Departmental Committee, of which Dr. J. S. Haldane was a member, was appointed in 1902 to reinves- tigate the causation of the still persistent high phthisis mortality among Cornish tin-miners; and this committee brushed aside every other influence except dust inhalation, deciding (54) that— So far as the Cornish miners are con- cerned it seems evident enough that stone- dust which they inhale produces permanent injury of the lungs—gradually in the case of ordinary miners, and rapidly in the case of machine-drill men—and that this injury, while It is apparently capable of gradually producing by itself great impairment of the respiratory functions, and indirectly of the general health, also predisposes enor- mously to tuberculosis of the lungs, so that a large proportion of miners die from tuber- cular phthisis. That the primary injury to the lungs is due solely to inhalation of stone-dust would seem to be practically certain. In the decade preceding the work of the jNIines' Commissioners of 1862, organised study of public health had commenced; and we find H. Headlam Greenhow appointed to lecture on public health at St. Thomas' Hos- pital. In the elaborate statistical inquiry he carried out in preparing his lectures he im- mediately found that one of the most evi- dent facts brought to light ... is the influ- ence of occupation on health. With this Finlaison's conclusion, arrived at (5/) in 1853, is in close accord, that the real practi- cal difference in the distribution of sickness seems to turn upon the amount of the ex- penditure of the physical force. The density of aggregation, described under terms of city, town, or rural districts, seems to exercise little or no real influence; and this funda- mental point was restated (52) in 1903 by Watson, who said, The proportion of mem- bers sick during any year varies with occu- pation. Greenhow's investigation proved of such importance that Dr., later Sir, John Simon, then medical officer to the General Board of Health, brought it to the attention of the Board, by whom it was published. vShortly after Simon became medical officer to the Privy Council, and he entrusted to Greenliow the duty of pursuing the subject further by visiting the great industrial cen- tres. The reports which followed in 1861