THE INDUSTRIAL CLINIC. *
" INDUSTRIAL unrest is a psychological reaction to unfavourable environment ; just as diminishing output is a sign of lack of physical energy," says Professor Collis in his preface to this small but really intensely interesting manual. With its recent experience of strikes on what appear, superficially at least, flimsy pretexts, with the wide prevalence of the " ca.' canny " movement undenied and, indeed, undeniable, the suffering middle class will be inclined to brush aside such a suggestion as senti- mental, partial, and altogether ill-timed. It is true that the present unsettled industrial conditions may not, indeed cannot, be entirely due to the factors on which Professor Collis lays stress. There is to be detected in the movement a political agitation which unfavourable working conditions may have permitted to spread, but which is not directly the result of such conditions This political agitation is hardly concerned with the improvement of the manual labourer's lot in the sense at least of the words quoted. It is not necessary to maintain that the political leaders of the movement have not this ideal before them, but at the present time contentment of the workers would not further their political object, and so they have concentrated on raising the manual labourer's wages. As increase of wages unaccom- panied by increased production only results, during the period of world-shortage of all commodities, in a further rise of prices, the discontent of the proletariat is not allayed by these con- • The Industrial Clinic. Edited by Professor Edgar L. Collis. M.D. " Modern clinic Manuals." London John Bale, Sons, and Danielsson. [10s. Gd. net.]
cessions, but rather enhanced, and only the political agitator is satisfied.
However, the contributors to The Industrial Clinic, each possessing expert knowledge of the particular branch with which he or she deals, give very considerable support to the editor's contention, and the reader must indeed be hard of heart who, studying the manual, does not feel increased sym- pathy with the worker, who, besides suffering from the terrible monotony inseparable from his occupation, has to perform work which may in itself be dangerous, or is of necessity carried out under conditions impoverishing health. The operatives in textile factories may be working in warm humid atmospheres, another class of work may involve the risk of inhaling poisonous fumes or irritating particles of dust, both of which may lead to serious disease of the lungs. It is indeed surprising to learn how many trades are associated with processes dangerous to health. The mortality tables of the workers bring out this point—namely, the relative danger of certain trades—quite clearly, Thus, Dr. Vernon, who contributes a paper on "Industrial Fatigue," mentions that the average duration of life among steel workers was in 1891-99 only 39.3 years. It is true that, probably, as the result of improvement of the conditions of work the average age at death in 1917 reached 49.5 years, yet the average duration of life of steel smelters and pitmen was nine years less than that of labourers in steel works. Dr.
Vernon says : " The fatigue of certain heavy industries is strikingly shown by the mortality records." It is indeed l And it may be truly said that in some industries men have been and are being worked to death. Until such conditions have been as far as possible remedied, contentment of the worker cannot be expected.
But the contributors to this manual are not concerned to show only how the contentment of the worker may be attained.
They insist very strongly that a contented worker is also a more efficient employee and have no difficulty in maintaining this point of view. Large businesses cannot be run even by the most humane employers on a purely philanthropic basis, so that the question whether improved conditions of work will bo accompanied by increased efficiency and greater output is most important. The difficulty, of course, is to convince the employee that the measures taken are as much for his benefit as for that of the employer, and it is here that there is so much room for co-operation between directors and workers. The first stumbling-block is likely to be the selection of the worker for any particular job. The rejected worker will naturally have a grievance, and unless his fellow workers fully understand
the reasons of the rejection, trouble in the works is likely to result. Yet it is obvious that a man is likely to earn more money
and feel more contented in doing work for which he is suited, while if in unsuitable employment, besides experiencing unnecessary strain, he may interfere with the working and earning capacity of his fellow workers and may, indeed, be a positive danger to them. These considerations give particular interest to the papers, "The Medical Examination of the Worker," by W. F. Dearden, and Choosing the Worker," by B. Muscio. The latter paper ends with a section headed " Dangers " which is worthy of careful perusal.
Dr. Vernon's paper on "Industrial Efficiency and Fatigue," from which we have already quoted, will probably attract the most attention, dealing as it does with the effects of the shortening of the hours of work. It is made clear that a very considerable reduction of these hours may be accompanied by a much increased output, but that a point is reached varying with the nature of the particular process when, although the output per hour is increased, the total output is diminished. In certain industries, especially those almost entirely dependent on machinery, reduction of hours is more likely to result in lessened output. " Hence it follows that one cannot lay down a general rule that, so far as output is concerned, an eight-hour day is the best working period; but it will generally be admitted that in all but the very light industries . . . . eight hours a day are as many as can reasonably be expected of the average worker." With this view there will be a large measurement of agreement, it being presupposed that the worker really endeavours to do his best.
The remaining papers maintain the high standard attained by the writers we have mentioned, and the editor is to be con- gratulated on having enlisted the services of such able contributors and on the issue of a manual of so great value to all interested in industrial questions.
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