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. (Dr. Legge.) It is voluntary, while the other is involuntary. 363. (Judge Ruegg.) You think it is voluntary ?—I think it is voluntary in its origi. It is a voluntary effort to get over nystagmus, but it becomes a habit. 364. (Chairman.) Have you ever had a_ private patient suffering from this disease, or have you seen anybody at the hospital ?—Yes, some miners come to one privately. 365. Apart from miners, have you ever seen a rich man, a private patient, suffermg from nystagmus ?— There is a nystagmus that is different from miners’ nystagmus, which is due to disease of the eye. 366. (Sir Clifford Allbutt.) What is called idiopathic. Tt is a common sign of nervous affection ?—Yes, that is another type again, and there is a type which is due to eye disease. 367. (Judge Ruegg.) When it is idiopathic, is it sometimes accompanied! by the spasm ?—No; I have never seen it accompanied by the spasm of the lids. 368. The spasm is a peculiarity of miner’s nystag- mus ?—The nystagmus I speak of, due to eye disease, is usually consecutive to some defect in vision. 369. Still, I think itis important if you can answer it. Is what we have been speaking of, clonic spasm, a peculiarity of miner’s nystagmus ?—Yes, I think it is. 370. (Chairman.) AS I understand it, although a man is suffering from clonic spasm, you say he can go back to the mine P—Yes. 371. Although he has the last remaining symptom of having had or having nystagmus ?—Yes. 372. And although you think after he has been there a certain length of time he will get nystagmus ‘again ?—Yes. 373. (Judge Ruegg.) If this is, as well as being one of the symptoms of past nystagmus, one of thesymptoms of approaching nystagmus, I gather you may have it before the other symptoms of nystagmus are defined ?—I do not think so. I do not think it is an early symptom of it. 374. I understood you to say that you found it in the early stages, and you found it after nystagmus had disappeared ?—What I meant was that a man is not always suffering from spasm when he has got nystag- mus. The movements are not always present. If he feels the movement coming on then he would blink. 375. Would you help us on this practical question. I understand the difficulty has arisen where the Certifying Surgeon who finds a man has got this spasm, but has not the other definite symptoms of the disease, refuses a certificate and says: “I cannot give you a certifi- « cate entitling you to compensation.” Supposing this were scheduled as a disease, would it be sufficient (at all events before nystagmus is defined) that the first symptom is present, that is to say, the spasm, and would he get his certificate? What do you say to that ?—I think it would be a bad policy. It would open the way to such easy deceptions and malinger- ing. They already know this symptom of spasm of the lids. 376, Is it your experience that there is much malingering with reference to this disease ?—I do not know what the proportion is. Perhaps, from the cases which are sent to one, one gets an exaggerated idea of the number of malingerers, because the cases which are suspected are sent to one for an opinion. 377. Do you mean since 1907 ?—Yes. 378. Since the Act gave compensation ?— Yes. One gets them mainly from the insurance companies, who have an idea that a man is really able to work. 379. (Chairman.) Have you ever had a ease of a man who has had nystagmus, and had clonic spasm, who has gone back to the mine and come back again suffering from nystagmus ?—I think so. j 380. You have not one in your mind ?—No. 381. That will probably be the cycle according to you ?—Yes, I think that would be. 382. And I take it he would retain the clonic spasm until the nystagmus came back to him. If a man is suffering from clonic spasm and goes to the mine, he is not likely to be cured even of the spasm, is he? It would go on P—No. (Dr. Leqge.) It is very important, and if you would look up your notes and let us know of any such case, it might be valuable.* 383. (Chacrman.) Yes, and how soon he comes back. As I understand it, if a man comes to you, who has had nystagmus, and who at the end of it has clonic spasm, and a fluttering of the eyelids is the only symptom present—if the eyeballs are not moving— then you say, ‘“‘ You have recovered from nystagmus, but you will suffer from spasm ?”—Yes. 384. That is really what it comes to ?—Yes. 385. (Judge Ruegg.) And if it were thought right, that would be covered by “nystagmus or its sequel,” except that you hardly regard it as a sequela. You regard it as largely voluntary ?—No; I only say it can be produced voluntarily. 386. (Chairman.) It is in order to save the eyeballs, as I understand it P—Yes. 387. It is involuntary and automatic at first, and then it is continued after the necessity has passed away ?—Yes. 388. And it becomes a habit really ?—It becomesa habit. 389. But you can at once tell whether there is nystagmus present by going in a dark room and seeing whether there is a movement of the eyeball ?— Yes. 390. (Judge Ruwegg.) Would you say that, with a man who is cured of nystagmus aud has a spasm, the disease was more likely to recur than with a man who had been cured of nystagmus and had not a spasm ? —Yes, I should. (Chairman.) We are much obliged to you. * The witness afterwards wrote :—I have no real evidence to give on this matter ; it would require a long statistical inquiry to get it, and my attention has not previously been specially directed to the point; but my opinion is that he would be likety to have a recurrence sooner than one who had no clonic spasm; not because I think that the clonic spasm in itself predisposes to nystagmus, but that those who present the lid spasm in a marked degree are generally of neryous type and such persons are more prone to nystagmus than others. Mr. Smith first gave evidence :— 391. I do not know which of you gentlemen would like me to ask a few questions of you first ?—I sent the paper along, and was asked to represent the two associations. : : 392. You represent the Levers section specially ?— Yes. 393. Of course, you know the scope of this inquiry —you know, generally speaking, what we are inquiring into, as to whether this Dupuytren’s Contraction should be scheduled or not ?—Yes. ‘ : 394. How long have you been connected with this branch of the trade ?—For 22 or 23 years. 395. In what capacity? Have you ever done any actua] work yourself ?—I have never worked a machine as a twist hand, but I have frequently worked it for half-an-hour or an hour at a time. 396. Just occasionally :—Yes. 397, When did you first know it was suggested that Dupuytren’s Contraction was a disease that was rather common in the trade ?—-[ did not know it was rather common until we got the report. I heard something of this inquiry perhaps a matter of a year ago, when Mr. Wardle took it up. 398. But up to a year ago you had never heard anything about it ’—No.