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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    12 October 1912.] 64, Yes ?—There were 25 that had some incapacity out of the 35, and five left the trade on account of the hands. That is out of the 55 in stages 3 or 4. 65. That is out of 1,400 workers you examined ?— Nearly 1,400. These include the five who were in- capacitated and left their trade, whom I did not see at work. I examined 1,400 all at work; but these five were individual members of the union who had left their trade in past years and were receiving compensa- tion from the union and whom Mr. Wardle brought to my attention, and probably represent all or nearly all in Nottingham who have gone on compensation. 66. (Chairman.) As far as your report is concerned, the figures and the facts dealing with the lace workers are the result of your own observation ?—Hntirely. 67. And with regard to the other occupations, they have been supplied to you in the main; is that right ? —The other occupations were extracts taken from various published works which I quoted. 68. (Sir Clifford Allbutt.) I know that anything like definite facts are very difficult to get. There must be a certain amount of surmise, but there is a considerable speculative element in your 69 per cent. For imstance, your six railway porters and the machinists. Does that mean girls making shirts, and so forth ?—You see all I could get was such informa- tion as you get from the hospital notes, and they are so imperfect. 69. There is a considerable speculative element in it ?—There must be. Hospital notes are not always too well kept. inquiry were whether the disease was more prevalent amongst lace workers than other operatives. I under- stand you have no hesitation in saying it is more prevalent ?—No hesitation at all. 71. But any comparison of the percentages between lace workers and other classes I suppose is almost impossible ?—I can do it only in those classes of cases I have given you. I examined the hands of the tin- plate workers and granite cutters myself. They are fairly large numbers in those cases. Over 1,000 granite cutters were examined, and I examined 652 tin plate workers. 72. When you told us that according to your in- quiries the disease took as long as 20 years to develop, IT suppose you were again referring to the ordinary lace workers?—I was referring to the histories I got from the lace workers. 73. Lace workers only?—Yes. You will see from Table I. the distribution in ages of the cases amongst the lace workers. 74. In the case of a wound, a trauma, I suppose it might develop much more quickly >—It might develop much more quickly, although in some cases they were a long time in developing. 75. In some cases that would clearly be so 2.—Yes ; they might be much quicker after an acute injury. 76. I suppose it would be the duty of the certifying surgeon to give a certificate in these cases as in the cases of other diseases ?—Yes. 77. Are there any symptoms by which he could distinguish or might distinguish this disease caused, say, by gout, and caused by pressure ?—No. 78. I have to consider the working of this matter in the courts. Do you think in a given case, assuming the disease existed in a bad form, it would be impossible from any indication of the condition of the hand itself to say whether it was caused by gout or whether it was caused by pressure ?—Personally, I look upon gout as only a predisposing cause. If you ask whether it can occur without the aid of injury, idiopathically, in the case of aman who does not use his hauds at all, and has a gouty diathesis, my answer is no. 79. Then again, there would be no way of deter- mining, except perhaps the balance of probability, as to whether that pressure occurred in work or from ‘ other causes, such as the mam/being a rowing man, or anything of that kind ?—Exactly. 80. There is no way ?—No. In the lace trade in particular, they all join so early that the probability of pressure from any other employment previously [ Continued. followed is extremely small. They are all apprenticed very early as lace minders; it is a closed trade. 81. It might possibly even arise from a relaxation ? —Yes. 82. In a cricketer, for instance ?—I cannot think of any way in which a cricketer would get such a localised pressure. The relation in the special cases we are considering is shown by reference to Table IT. in our report, in which you will see that the annularis or ring finger was proportionately more frequently affected in the lace operatives than in the ordinary individual outside; that is to say, in the cases of in- patients of the three London hospitals, contraction of the little finger occurs proportionately more often, and Arbuthnot Lane says, speaking of the condition, that the disease commences in the little finger. He makes a definite statement that it does. My experience of the cases I saw in the lace trade was that a much larger proportion of them started at the base of the ring finger. You will see this by referring to the plate. If you take No. 6, I think the two hands there show you very definitely this relation to the commence- meot of the trouble. You will see how the contraction is starting in the base of the ring finger rather than in the base of the little finger. 83. What inference do you draw from that ?—That the way handles are manipulated in the lace trade is rather this, if I may show you. If you take Plate I. on one of these machines, and imagine yourself stand- ing in front of this machine, and handling the lever marked P, whichis standing about 5 ft. 6 ins. from the level at which I am, the lever stands so, and there are these several levers along the length of the machine. That thread breaks there. I stopped the machine and turned out the catch bar to mend the thread. The lever has to come down there through a third of a circle. If I took it full and pulled it down, I should be in such a cramped position that I could not get my lever down, so that the habit in the trade is to take the lever thus (explaining), putting the pressure straight into the base of the ring finger. 84. That is why you think it more often commences there with lace workers ?—Yes, and exactly the same with the left hand. They always put it in the position Mr. Hatock has described, that of holding a sword at low guard. 85. There is another thing I want particularly to ask youabout. At what stage of this disease do you think working incapacity ensues ?—Becomes affected ? 86. Yes. I see you describe them as first, second, third, and fourth stages ?—I never found any individual who, as a rule, showed any incapacity short of the third stage. Inthe first stage there would obviously not be any. In the second stage one might have expected a little incapacity ; but the bending of the fingers was so slight, that nobody ever made any complaint to me. There were only a few of those in the third stage who were incapacitated, and even in the fourth stage there were some who were still at work. 87. But do you not think if this were scheduled as a disease under the Compensation Act, many would —Men vary, of course, and always will vary in that respect. 88. That is a matter we can draw our own inference about, I suppose ?—I must say with regard to the old men I saw busy in the lace trade, one man who was working there has a family in which there are a large number affected. He had four sons in the factory, the youngest of whom was 49, and at the factory they told me the father was still as good a workman as anybody they employed in the place. 89. But at present he must work to live or receive no wages. It might be if this disease were scheduled he would have at all events a bare living without work. That might have some effect >—Of course he could have his old age pension now. 90. Do you think it would be possible that the certifying surgeon should give a certificate as a pre- cautionary measure in this disease >—He might find a man in the second stage and say, “ You will very soon * be in the third stage, and you will be incapacitated ; ‘ I will give you a certificate now.’