DR. CALVERT HOLLAND ON DISEASES OF THE LUNGS FROM MECHANICAL

CAUSES.

THIS work is a sort of sequel to the Vital Statistics of Sheffield by the same author ; the facts in relation to a certain class of arti- sans being expanded, and the diseases to which the " grinders" are subject being treated both pathologically and medically. The sta- tistical exhibition of the Sheffield grinders in regard to life, death, marriage, and education, are not without interest, although the general results and the facts themselves possess little novelty to those who have perused Dr. CALI/Elm HoLLANn's previous work. The treatise on Diseases of the Lungs from Mechanical Causes is a production of considerable value, new in its facts, clear in its dis- tinctions, sensible in its views, and cautious in its opinions. Con- sidered only as a medical treatise, this part of the book would be entitled to high praise; but when Dr. C. HOLLAND states as a fact established by experiment, and not as a theoretical opinion, that a cheap and easy mode of ventilation can prevent the occurrence of the grinder's disease, the book assumes a general importance which no mere medical work can possess. Without entering into the details of the statistics, we may say that the two most fatal branches of this fatal business are the fork- grinders and the needle-grinders. Of 1,000 persons, the average of deaths in England between the years of twenty and twenty-nine is 160, in the town of Sheffield 184, among fork-grinders 475 ; and by the time the period of fifty years is reached, 399 persons of the 1,000 would be living in Sheffield, 461 in England and Wales, but no fork- grinders would be left. Needle-polishing is still more deadly, though the persons employed are fortunately few; but such is the mortality among them, that thirty years of age is rarely passed, and then the workman has probably discontinued the business for some years : yet the polishers are not allowed to work beyond six hours a day, at least at Hathersage in Derbyshire, the principal seat of needle-grinding. The other branches of dry-grinding—as scissors, razors, and knives—do not exhibit such terrible mortality. It is still, however, greatly disproportioned to any other class ; and few grinders attain more than fifty years, the bulk of them dying much earlier.

And death is scarcely the worst part of their lot. Life to the dry-grinder becomes a long and painful disease ; so that they may be considered the happiest who die the soonest. According to Dr. C. HOLLAND, " diseases of the lungs from mechanical causes " may be arranged into two classes. In one class, the patient displays the general symptoms of common consumption ; emaciation and de- bility exhibiting themselves in an early stage, and gradually increas- ing till death. Among this class, Dr. C. HOLLAND considers the occupation of grinding rather hastens'and aggravates the complaint than positively causes it. Some of these patients would certainly suffer from consumption, and perhaps a large portion of them, un- less placed in more favourable circumstances than their means allow. Dry-grinding only "kills them off" more quickly, and per- haps with increased suffering. Where there is an hereditary or a constitutional predisposition to consumption, the business quickly develops it, and such persons die very early. A natural tendency from delicacy of constitution may struggle longer according to the particular circumstances of the individual ; but here the main features of the disorder are still those of common consumption. This class tills the list of the earlier deaths.

The second class exhibits few spnptoms in common with phthisis, beyond a harassing cough, (which, however, is not always an accompaniment of tuberculous consumption, and with the dry-grinder may continue for years.) The flesh, the appetite, the muscular, and even the constitutional strength, continue till a late

period of disorder, at least such strength and appetite as a dry- grinder can be supposed to possess; for he is fixed all day in a painful position, bending constantly over his work, and inhaling a death-charged atmosphere; he is for the most part grossly ignorant, with low wages, employment often uncertain, and habits dissi- pated and irregular. This class of patients are persons originally strong; and, according to their constitutional strength, they resist the noxious influences; but few survive forty or forty-five, unless they have quitted the business for some time for a more healthy occu- pation : Dr. C. HOLLAND enumerates several who have been in the Army. The longest life, however, is but a long disease. Besides the evils .just indicated, the men are constantly harassed by subacute inflammations of the chest ; the dust inhaled acts upon the lining of the air-passages and lungs, from an incipient disorganization of the coating, to substances varying in size from a currant to that of a bean. The " bronchial glands are frequently enlarged, or, more correctly speaking, are converted into a black, hard, gritty substance, varying in size from half a marble to a large nut. In cutting them, the sound is precisely the same as if the scalpel were directed against a somewhat soft stone ; and when portions are cut away, the surface is black and polished, and in passing the edge of the scalpel over it, grates as if entirely com- posed of such material. * * * In some instances the lungs have presented an appearance as if black currants had been distributed throughout the whole substance of them, and were not accompa- nied with similar bodies of a large size, but, like these, were hard and gritty. They were perceived on the surface of the lungs, as well as in the internal structure."

We might follow out the pathological and medical part in greater detail; but we are not writing to professional men, who, if animated by a liberal curiosity, will refer to the volume, if they have not already perused its substance in the London and Edin- burgh Journal of Medical Science. But we will take from this divi- sion a few extracts of a general kind.

DRY-GRINDERS' INDIFFERENCE.

Adhesions between the lungs and the pleura costalis are generally observed, and are mostly extensive and firm ; which would be anticipated from the great liability of the grinder to inflammatory attacks of the chest, which are often allowed to pursue their course, unchecked by rest, attention to diet, and active remedial measures. The attacks are generally subacute, and though attended with pain and inconvenience, the grinder regards them with comparative indif- ference. The extent to which this feeling is carried, it is scarcely possible to describe. It arises in part from his lamentable ignorance, and also from the impression that such evils are the inevitable accompaniments of his occupa- tion ; and we would further say, that the complicated character of his suffer- ings—severe labour, often miserably low wages, bodily ailments, and insuffi- ciency of food—cause him to look upon life as a questionable good. He forms a mean estimate of the value of it.

So thoroughly reckless is this class of artisans, largely from ignorance, but also from an indifference about it, that it frequently happens, that the first ap- plication is made to the medical practitioner, when extensive structural changes have taken place, which, at most, admit only of slight amelioration. Had we not been observers of the fact, we could not have believed that men living in what is designated an enlightened age and in a civilized country could have dragged on a miserable existence for years without feeling or exciting much solicitude about the results.

Yet, after all, there is some reason in this ; and it would be called philosophy under other circumstances. Dr. C. HOLLAND states that cure is hopeless unless the patient quits his occupation for some more healthy employment. This is out of the question ; and if he applied for relief while he could continue his business, the remedial measures would most probably compel him to discontinue work and wages.

MORAL OF MONEY.

It is a singular fact, but it is nevertheless indisputable, that the more de- structive any of the various departments of grinding, the lower the morals and the remuneration of the workmen.

As previously remarked, grinders may be divided into two classes; the one using the wet, the other the dry-atone. The articles ground by the former are mostly of a large size, such as saws, scithes, files, and edge-tools generally. The articles on which the latter are employed are small, such as razors, scissors, pen and pocket blades, forks, and needles. There is a remarkable difference not only in the longevity of the artisans in these two classes, but also in re- gard to their intelligence and respectability. The wet-grinders, as a body, are greatly superior to the dry in education and pecuniary circumstances. It would naturally be imagined, that the more destructive the pursuit the higher would be the remuneration ; but such is not the case. As a general rule, the remuneration decreases with the increase in the destructive tendency of the branch.

The prevention of the disorder is the great point ; and this Dr. C. HOLLAND states to be possible, by a simple, cheap, and easy process of ventilation. A funnel is placed at the end of each grind- stone opposite to the workman, which communicates with a chan- nel on or under the floor, terminating at the most convenient point in the external wall, for the discharge of the dust. At the mouth • of the channel is placed a fan, which is connected with the grind- ing machinery, whose motion impels its revolution.

" The fan, acting at this point, whatever may be the length of any of the subordinate channels, causes a strong current to flow from the mouth of each funnel, which carries along with it all the gritty and metallic particles evolved, leaving the room in which the operations are pursued free from any per- ceptible dust. When the whole apparatus is perfect and in excellent condition, the atmosphere of the place is almost as healthy as that of a drawing-room. " In one manufactory,* where the apparatus is kept in beautiful order, the dust is thoroughly removed ; and in this case it is conveyed by the general channel into a trough of water on the outside of the building. The quantity which accumulates in it in a few weeks is very great ; and in raising it in a mass, it seems to have almost the specific gravity of metal. The expense in the construction of the apparatus would scarcely exceed the proportion of a sovereign to each grinder. The funnel will cost only a few shillings; and the channel, if the grinder work on the ground-floor, may be formed by the ex- cavation of the earth, placing bricks over it, or it may be formed entirely of bricks. The fan and the pulley may be purchased for a mere trifle.

• That of Messrs. Yeomans and Shaw, spindle-manufacturers of this town. We have authority to state, that these gentlemen will be happy to show and explain to any visitor the system of ventilation %Lich is efficiently carried out in the grinding of spindles. " Were the Legislature to interfere, and make it imperative on the part of the proprietors of wheels to construct such an apparatus, and compel them to keep it in a perfect condition, an immense amount of disease, suffering, and wretchedness, would be prevented ; and the future inquirer into the condition of grinders would not have to record the numerous premature deaths which we shall subsequently bring under consideration. Government has interfered, and very properly, in compelling the mill-owners, in the cotton districts, so to box off the machinery, that accidents, which were once frequent, are now of rare occurrence. The evils arising from the inhalation of gritty and metallic particles are twenty times greater than could possibly be ascribed to unpro- tected machinery. The lives of thousands are shortened and embittered by the baneful occupation which we have described. And the injurious circumstances in the one case are as easily and almost as cheaply corrected as in the other. " The efficacy of the plan is unquestionable. Where the apparatus has been in operation for years, we have not found a single individual labouring under any pulmonary affection; and the branch in which we have observed this im- munity would otherwise have been exceedingly destructive to life."