Minutes of evidence of the departmental committee appointed to inquire and report whether the following diseases can properly by added to those enumerated in the third schedule of the Workmen's Compensation Act, 1906 : namely: (1) cowpox, (2) Dupuytren's Contraction, (3) Clonic spasm of the eyelids, apart from nystagmus, (4) writers' cramp.
- Great Britain. Departmental Committee on Compensation for Industrial Diseases.
- Date:
- 1913
Licence: Public Domain Mark
Credit: Minutes of evidence of the departmental committee appointed to inquire and report whether the following diseases can properly by added to those enumerated in the third schedule of the Workmen's Compensation Act, 1906 : namely: (1) cowpox, (2) Dupuytren's Contraction, (3) Clonic spasm of the eyelids, apart from nystagmus, (4) writers' cramp. Source: Wellcome Collection.
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![12 October 1912.] the hospital cases, all admitted for operation, I found notes of the results of the operations. It is an important point to keep in mind that the hospital cases were practically all in stage 4, and the results of the operations were by no means always successful. There were several cases where fingers had to be amputated, and the application of fomentations and such like at a later stage of the healing of the wound was suggestive that all was not going well. Then another treatment has been introduced, namely, injecting fibrolysin under the skin, but Six Clifford Allbutt would be able to speak better than I can on that. It has been suggested recently, but I have seen no published statistic of the results. 116. (Judge Ruegg.) I gather you regard the disease us not curable ?—Yes. Some operations have had very good results, but the tendency to recur, and the proportion which do not do well, is such that you could not put any responsibility on the man to submit to operation. 117. (Chairman.) Do you mean tendency to recur if the man goes on at work again after the treatment ?— No. 118. Whatever he does ?—Yes, if the wound does not heal cleanly and there is any suppuration. 119. (Sir Clifford Allbutt.) In this case of the precautionary certificate you were asked about, how far in your opinion does the thing progress of its own inertia ? Supposing aman gives up that occupation and turns to something else which does not cause this pressure, how far does it inevitably go on ?—I think when once the fibrous bands have become well established, for instance I should\ say stage 2 on plate 7, if he gave up his trade to-day that case would inevitably goon. With that amount of contraction in the palm of the hand I should say that case is pretty certain to go on. From what the men, some of whom had left the trade, told me it seems to go on inevitably, more rapidly if they stayed in the trade, but to go on inevitably even if they left the trade. 120. Is it easy for a man who has been engaged in this duty to take up any other occupation P— Practically impossible. Of course I mean not to earn the same wages. 121. (Chairman.) At what age, speaking generally, do they become incapacitated by this disease ?—One can only take the ages of those who were incapacitated to ascertain that fact, and there were five of them. The approximate ages of leaving the trade of the five men who had done so on account of their hands were . 67, 58, 49, 64 and 50. is somewhere between 55 and 60 ?—Yes. 123. (Judge Ruegg.) But the result will be that the employer will have to pay compensation for life ?— Yes. 124. (Chairman.) From that age ’—Yes,. 125. Is it possible successfully to malinger ?—I do not think it is possible, because the finger has to be permanently flexed so that it cannot be pulled out. There must be the fibrous bands in the palm of the hand. 126. (Judge Ruegg.) It is much more difficult to malinger than some of the already scheduled diseases ? —I think it is one of the most difficult things. Even if a man is under an anesthetic you cannot press out his hands. 127. (Dr. Legge.) But I think it is necessary to define the degree ?—Yes; I think it would be very valuable to fix the extent if it were possible to do it. 128. (Chairman.) Have you anything more to say as to its occurrence in other trades ?—It is claimed in a report I have from Holland that the disease occurs amongst glass-blowers. The report has been translated, and there is an illustration showing the condition. 129. (Dr. Legge.) That is the result of a succession of slight burns ?—Yes. 130. Do you say this injury corresponds to the disease we are considering *“Yes, it is exactly the same , 131. Not merely analogous, but exactly the same ? —KErxactly the same. The fibrous bands are not shown because the fingers are flexed. [ Continued. 132. (Judge Ruegg.) Would your definition of this disease include or exclude that case ?—My definition would include it unless we get ‘‘chronic pressure” in. There you see there are the effects of * chronic pressure ’’ and burns together. 133. I do not know that that would do. Did you propose in your definition to -put in “chronic pressure ’?—No, I think Dr. Legge’s suggestion is better. 134, (Dr. Legge.) ‘* Localised pressure ”’ —* Local- ised pressure.” 135. (Judge Ruegg.) Do you think that would be better ?—Yes. - 186. Do you think that would include that case ?-— They speak of the way in which it occurred in the text: ‘Continually handle the hot blowing tubes.” It is heat. (Judge Ruegg.) That would exclude it. (Chairman.) It is important to note that in the case ** formation of scars, the flexors (muscles) of the fingers ** contracted.” 137. This information bears on other ways in which 138. (Stir Clifford Allbutt.) With the lace machine handles, you get numbers of infinitely small lesions which scar, and scar, and scar, and the same principle is at work in the Dutch case. There is a very large number of small lesions ?—Yes. . 139. (Chairman.) Could the Dutch case be called one of Dupuytren’s contraction ?—I should say most certainly. : 140. The same general words include both sets of symptoms ?—Yes. 141. (Str Clifford Allbutt.) Except one might go a little further, and ask when there is a series of small injuries, which have developed into a scar, how far this scar will take on any activity of its own, and proceed to farther, and farther, and farther contractions independently of any further lesions ?—I suggest it does. For instance, in the case of my own hand I never set out to ask what started the condition until I was making this inquiry. 142. Whatever produced that, has not been at work since ?—-No. It was when I was making this inquiry that I noticed it, and I had not rowed for 20 years. It has been lying dormant. 143. (Chairman.) With regard to your 20 years point, under Plate 6 you say: “ A. C.;aged 54, who had * worked 37 years in the levers branch. Condition “ first noticed 20 years ago, since when it has not “ advanced.” I suppose Mr. A.C. told you that he had noticed it 20 years ago ?—Yes. 144. And itis exactly the same now as it was 20 years ago. That is the kind of information that is given ?>— Yes, (Str Clifford Allbutt.) Then comes in the speculative question, as to how far gout will accelerate or modify the process. a 145. (Chairman.) It is very wonderful that it should be stationary for 20 years, is it not?—I chose that man to have his hands photographed to exemplify the length of time during which it may remain so. It was not altogether usual. 146. And he was in the first stage ?—Yes. 147. Is there any form of words in which you can say a man is going from the first to the second stage ?— The only way is to put it, “when one or more digits “ become flexed,” but a slight flexion of the digits in no way impairs the working capacity. Using the word * flexion”’ would not be sufficient, and such words as * semi-flexed ” would be no use legally. 148. (Dr. Legge.) ‘* Flexed downwards into the palm.” I think it is possible to find some form of words ?— I think medical men can find some form of words, the question of their legal fitness is for others. (Judge Ruegg.) Might it not be better to leave it as ‘ Dupuytren’s contraction,” and leave the courts to find out. After all, it would have ‘to be not only Dupuytren’s contraction but Dupuyren’s contraction causing incapacity for work. Those would be the things to be proved before compensation would be payable—](https://iiif.wellcomecollection.org/image/b32182028_0010.jp2/full/800%2C/0/default.jpg)
