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
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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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    26 October 1912.] | Continued. 323. But would you recommend a man who is under your care to go back to the work of mining when he has got this symptom ?’—Yes, if I could find no sign of actual nystagmus, 324. There is no treatment for nystagmus except coming out of the mine and working in the open, is there ?—The general health may have something to do with it. 325. Apart from general health ?—No. 326. Do you think, then, that the whole matter can be met by adding nystagmus or its sequele to the schedule? Would that cover it all?—I think I said I should not regard the blinking alone as anything to debar the man from going to work. 327. Perhaps not, but would it cover the disease, or whatever it may be called, if the words of the Act were ‘‘Nystagmus or its sequele ” ’—Yes, it would then bring it into the schedule. 328. But you think it might be dangerous to put it in, because it would give an opportunity of claiming compensation if only this symptom was left which, in your opinion, need not incapacitate for work ?—Yes, it would greatly increase the difficulty. You would have to certify whether a man is fit for work or not before allowing him to go on compensation for a symptom which he can counterfeit. 329. Are you aware that the opinion you hold about this not being a separate disease is not universal ? Others entertain a different opinion ; that it may be a distinct disease —At the hospital here they have the same opinion as I have. 330. Is this a large mining district 2—We are on the south border of a “large mining district. We are south of the Notts Coalfield. 331. And you treat a great’ many miners ?—Yes, we get a great many in the infirmary here. 332. (Sir Cliford Allbutt.) You. would call this blinking of the eyelids rather a habit than a disease ?— Yes, that is my view of it. It is certainly much more pronounced in the nervous individual. 339. (Judge Ruegg.) In your opinicn, in such cases as that, it would bea symptom of incipient nystagmus ? —Or of past nystagmus. 354. If it were past nystagmus, he might have a certificate ?—Yes. 335. (Chairman.) It comes to this really, that it is a sign of past nystagmus P—Yes, I think it is. (Judge Ruegg.) An objective symptom of nystagmus. 336. (Chairman.) Then if he goes back to mining, it wiil probably be followed by, actual nystagmus again ?—Yes. I think any man who has had nystagmus ‘and goes back to mining will have it again in time, but practically they can often work for years. 337. (Judge Ruegg.) It appears that the difficulty arises with the Certifying Surgeon. Would you say that the Certifying Surgeon who finds a man suffering from this spasm, and ‘that alone, would be right in refusing a certificate for nystagmus if he could find nothing else, although the man is a miner ?—Yes, I think he would. Jf I could find no nystagmus, I would let the man go back to work. I should say he was fit for work. 338. Supposing you found the spasm, and no history of past nystagmus, would you say it would he wise as a precautionary measure that he should not continue his work ?—It is difficult to answer that. 339. I mean would you probably say, ‘‘He has got * this symptom, and if he continues to work it will ‘ develop (if that is the correct expression) into * nystagmus ” ?—Yes, I should think he was a man who would be likely to develop nystagmus. I should take it as indicating that he would be more likely than another. 340. This spasm of the eyelids you find existing sometimes in persons who are not engaged in mining, or in fact any manual labour, do you not ?—I have never come across it except in miners. 341. IT only throw it out?—I do not know that I would say that. I think thereare nervous people who blink a good deal. symptom at all at the moment. 342. As far as you know, the mere blinking does not interfere with the man’s power of working as a miner at all, does it?—No. I think many Poe of a nervous type do blink more than others. 343. (Sir Clifford Allbutt.) I want to interpose a little point. The word “spasm,” of course, would be colloquially used ?—Yes. 344. I am not sure that the word “spasm” is correct medically. You are an expert in this matter ; but there is a spasm of the eyelids known as blepharo- spasm ?—Yes. 345. We are excluding that absolutely, are we not ? —Yes. 346. That is involuntary, is it not P—Yes. 347. But there is a voluntary element in this that we are speaking of now ?—Yes, it may be controlled. 348. It is like all habits, it becomes automatic, but in its origin it is voluntary ?—Yes. 349. The ‘blepharospasm i is different. It could not be mistaken for the other affection ; it is quite different, is it not P—Quite different. It has nothing to do with clonic spasm. 350. (Chatirman.) Nor with nystagmus either P—No. 351. (Dr. Legge.) Do you know of wry-neck as associated with nystagmus ?—I know certain move- ments of the head one gets with it, but I have never seen any persistent change. 352. There is no lifting up of the shoulder ?>—I do not think so. One gets movements of the head rather similar to nystagmus—jerking—but not continuous turning of the head to one side. 353. Then I take it you do not believe in a palpebral nystagmus ?—No, I do not regard it as anything apart. 354, And you make it an invariable rule to Bs udc from employment in the mine those whom you find so suffermg from nystagmus P—Yes, but I have no authority for making that statement. 355. There isa general consensus of opinion, whether it isright or wrong, that that is the best course to take ? —No, I would not make myself responsible for anyone else in that. It is only a sort of rough practical rule that I have adopted myself. It is very difficult to say when a man is suffering from nystagmus; and if one has to have a standard—it seems to me that that answers the purpose—that when one can no longer produce any movement of nystagmus by any test one can apply in the consulting room, it is generally a practical thing to let him go back to work. 356. Do you mean in the mine itself ?>—Yes. 357. But is that the generally accepted view? Is it not customary to say that when once a man has had nystagmus he ought never to go back to work in the mine ?—Yes, that has been said, and it is quite true that he will get nystagmus again undoubtedly if he goes on long enough. I think that is quite certain. (Judge Ruegg.) I think I know of several cases in my own district where the men have gone back to work. 358. (Dr. Legge.) I know they do go, but it is stated in all the text-books that once nystagmus is shown they ought not to go back. Iam rather glad to hear you say he need not be kept away ?—It may be a hardship to keep a man from his occupation merely because he may ultimately suffer from nystagmus again. 359. (Judge Ruegg.) It never leads to anything more serious than nystagmus itself; it never leads to blindness ?—No. 360. Repeated attacks would all be cured in the same way—namely, by abstention from work in the mine ? —Yes; but nystagmus may get so bad that it is not cured in the course of his life, and you see men go on working until their eyes are in constant violent move- ment, and they probably do not ever get rid of it. 361. (Dr. Legge.) In your opinion, if clonic spasm is sufficiently serious to call for interference, do you think there would always be nystagmus present ?—Yes, I think so. 362. I mean, sufficiently serious to cause disability ? —Yes. I do not think in itself it ever causes disability. (Judge Ruegg.) That is what I ander stood the witness to say, that in itself he does not think it does cause disability, but it is one of the last symptoms that passes away.