CHAPTER XIX

LEAD AND ITS COMPOUNDS

Of all the metals employed in the arts and industries, none lends itself to such general applicability as lead. In its metallic state it is so plastic that it can be readily moulded. It forms compounds which for colour and persistence have enduring properties superior to most of the metals. There are few articles of manufacture that have not been directly or indirectly brought into contact with lead, and in many of the newer industries the association is extremely close. The census for 1891 showed that there were 132,010 persons employed in lead processes. Of these, 123,829 were painters, 2431 workers in leaden goods, and 5750 were lead-miners. If we add to these the numbers employed in the potteries, electric accumulator works, etc., it will be at once seen that a very large proportion of the artisan class is brought into contact with lead. It is this wide use of the metal, the extremely poisonous character of its compounds, and the peculiarly subtle manner in which they act upon the human organism, that make lead a dangerous substance. Besides, it is frequently present in the water, the aërated beverages, and the wine we drink; the food we eat may be contaminated by having been cooked in common earthenware or in cheap enamelled pots, or by tinning as in canned goods. The acid juices of fruits or foods may dissolve out the lead in the solder. The clothing we wear may have been dyed by lead compounds, and thus not only industrially but in our domestic and personal lives we are daily running the risk of plumbism.

_Lead-mining and the Health and Surroundings of the Miner._

Professor Louis, in his article on Mining, p. 538, has briefly alluded to lead-mining. As in the following pages the subject of lead generally is dealt with, I feel that the reader will have a fuller grasp of all the points relating to lead and its history, if I slightly amplify what he has said by throwing a little side-light upon the medical and social aspects of the lead-miner’s life. Lead-mining in this country is an extremely old industry. Bars of pig-lead have been found in Derbyshire stamped with the imperial arms of Rome, indicating that the Romans worked our mines and smelted the ore. Since 1401 lead-mining has been carried on in the North of England, and has given employment to many families in the remote dales of Cumberland and Durham. It was formerly a source of very great wealth, but the mines have been gradually closing, owing to the importation of cheaper lead and of ores richer in silver than those that exist in this country. To-day it is rather a decaying than a prosperous industry. At present only 15,000 tons of lead are melted annually on Tyneside. Most of it is foreign pig-lead. During 1895 there were 250,000 tons of ore converted into pig-lead in this country. It is perhaps more to the poverty of silver in the native ore than to the cost of production of the raw material that the diminished output of recent years is to be ascribed. It hardly pays the proprietor to extract the silver when it is present in small quantity. English pig-lead contains a very small percentage of silver, seldom more than from 8 to 10 ounces to the ton. Foreign ores vary as regards the amount of silver held. In Spanish ore there may be as much silver as 40 to 80 ounces to the ton, and in Greek 80 ounces. Australian ores show very great variations. In some of the veins the ore contains 60 ounces to the ton, while in other samples there may be 500 ounces or even more.

So far as lead-mining in the North is concerned, the methods adopted for obtaining the ore are antiquated. Owners are apparently afraid to risk money in the enterprise, and as a consequence the means by which lead is mined are much inferior to those for getting coal. Lead mines, too, are not under the same Government regulations as collieries. Their ventilation is bad, the roadways are ill kept, and the mines are often damp, while the means of descent into, and ascent from, the mines, by a series of ladders, are arduous for the workers. So far as the mining of the ore is concerned, there is in this country practically no risk to the miner from lead poisoning, for he is dealing with almost a pure ore, viz., galena, which is a sulphide. Metallic lead is harmless compared with its compounds, the oxide and carbonate. It is this circumstance that explains why lead-miners at Broken Hill in Australia suffer so severely from colic and convulsions, while their confreres in England escape. The ore at Brocken Hill is very largely a carbonate. The English lead-miner runs the ordinary risks to life and limb from accidents, and in a special manner his health is endangered by pulmonary consumption and rheumatism, largely the result of exposure when returning from work heated and fatigued, also of the barrack system in vogue in certain places for housing the miners.

There is not much lead-mining carried on in France, but where it is there is freedom from plumbism among the miners as in our own country, with the exception of an outbreak of colic that occurred among the men who were working in the veins at Asprières (Aveyron), where the mineral was found, like the Australian ore, to be composed mostly of _cerusite_ or carbonate of lead. It is to a similar condition of the ore in the lead mines of Sierra de Gador that are attributed the 400 to 500 cases of colic annually observed by Dr Bayer among 12,000 miners--a malady to which the crushing of the cerusite in the dry state no doubt very largely contributes. (_Poisons Industriels_, Paris, 1901, p. 14.)

The dales of Durham in which lead-mining is carried on are sparsely populated: they are bleak, and swept by cold winds for the greater part of the year. In many instances the miners live a considerable distance from their work, and as railways have not yet penetrated into these remote corners of England, the men have to cover the ground on foot. Lead-miners are brought very little into touch with the outer world. They form a class by themselves, and cling with affection to their homes on the hillsides: they closely intermarry, and thus form not only one family socially but industrially as well. Their wages are small, seldom more than ten to twelve shillings a week, and yet, unless compelled through sheer necessity to renounce their badly paid and not too healthy occupation, they will not leave the district for the more lucrative work of coal-mining. As a class they are thrifty, intelligent, temperate, and religious. They are not long-lived. Pulmonary phthisis is extremely prevalent among lead-miners. In close proximity to some of the mines large “lodging shops” or “barracks” have been erected, where many of the workmen stay during the week. In one district, Dr William Robinson of Sunderland, formerly of Stanhope, found that 166 miners occupied one of these shops during three or four days and nights in the week. Often the barracks are in a filthy condition, for they are badly kept. As the sleeping accommodation is limited, the bedrooms are crowded to excess. In one room, 16 feet by 13½ and 9¾, there were 20 miners accommodated, _i.e._, at the rate of 124 cubic feet of air per man, while the model regulations of the Local Government Board require not less than 400. Most of the rooms have no fireplaces: the windows are fixed, and consequently there is no means of ventilation. As large numbers of men have to be accommodated, the beds are crowded together in two tiers 3 feet 6 inches from each other, so that there is barely space to pass between them. Since the rooms are occupied by different sets of miners working alternate shifts, the beds are hardly cooled before being again occupied, while in consequence of the air of the rooms not being renewed, the stench is overpowering. Bad as the sleeping accommodation is, the day rooms are not any better. The closet accommodation, too, is scanty and often badly placed. In his lodgings as well as at his work many a lead-miner is exposed to the influence of very unwholesome atmospheric conditions, the results of which are seen in his deteriorated constitution and diminished resistance to disease. The air of the lodging-shops is heavy with the effluvia from the bodies of their occupants. Sooner or later lead-miners suffer from asthma and pulmonary catarrh, the end of which is often tubercular consumption, and as the men expectorate upon the floors of the sleeping-room, the tubercle bacilli find in the badly-lit and ill-ventilated rooms the conditions which favour their multiplication. In this manner, and apart from his work, the lead-miner is brought under the influence of the microbe of pulmonary phthisis. The excessive amount of carbonic dioxide in the mines, the unconsumed products given off by the burning candles and those given off by explosion of gunpowder, render the atmosphere of the mine for the greater part of the twenty-four hours unhealthy. By the workman who lives a few miles from the mines, and who has to walk home across a bleak and wind-swept moor, tired and heated after a hard day’s work and wearing wet clothes, colds on the chest are readily caught and not readily got rid of. Out of these repeated pulmonary catarrhs consumption is prone to develop. Commencing work in the open air as a crusher and washer of ore, the son of a lead-miner--for the occupation is largely hereditary--will for health compare most favourably with any young artisan, but he has only to work a few years in the mine when he becomes short-winded. Once this defect is induced it gradually increases, and so at the age of forty to forty-five the lead-miner is old for his years: an asthmatic, he is the subject of wheezing cough and expectoration, and is often obliged to give up work entirely before the age of fifty. Life, however, may be prolonged for years, for the summer months bring abatement of the symptoms; the improvement, however, is only temporary, for the cold winds of winter and spring again light up the chest affection. Since in the mine the air is dusty, and the worker inhales particles of grit, pathological changes in the lungs are established similar to those mentioned in the chapter on Dust and Disease. The lung of one lead-miner that I have is almost solid from excess of fibrous tissue, and it feels as hard as stone, see Fig. 39. On microscopical examination the alveolar structure of the lung is found to be replaced by dense fibro-connective tissue. In the expectoration of some of the lead-miners I have found tubercle bacilli. The pulmonary disease of lead-miners, therefore, like that of workers in dusty trades, may be either a simple form of fibrotic phthisis due to inhalation of grit, or it may be a truly tubercular lesion grafted on to the less formidable fibrosis. The average age at death of lead-miners is about fifty. Nearly 50 per cent. of them die from chest diseases. In the dales around Stanhope, in the county of Durham, the death-rate from phthisis among a secluded population of lead-miners was 4.7, while in another part of the same Union composed of farmers it was only 0.6.

_Lead-smelting._

While the miners in this country do not suffer from lead poisoning, the same cannot be said of the men who smelt the ore. I have seen several smelters die from plumbism. In a few instances I have witnessed son after son in a family thus carried off before the age of thirty. The fume that escapes from the flue of the smelting shop contains oxide and sulphate of lead, and it is the inhalation of this that causes plumbism. Usually the lead fume is conducted into a long flue, 5 feet high and 3 feet wide; in some places the flue is carried up the side of a hill for a mile or two before it terminates in the chimney. This allows of the deposition from the fume of some of the oxide and sulphate of lead which is recoverable. At one large smelting works which I visited along with my colleagues on the White Lead Commission, we found that recovery of the deposited lead by men entering the flues was attended by such serious symptoms that we recommended two hours at a stretch as the maximum time for men to work in cleaning out the flues. Twenty cases of plumbism in lead-smelters were reported to the Home Office in 1900.

Although British galena contains usually but a very small quantity of silver, this can be profitably extracted when present in the ratio of even 2 of silver to 1000 of lead. Frequently the amount of silver present in foreign ores is so large that manufacturers prefer to extract the more valuable metal only. Desilvering of lead ore is generally carried out by the Pattinson process, introduced in 1829. Until that date silver was not extracted from galena. The ore had to be converted into an oxide in order to separate the silver, and the oxide resmelted to recover the lead, but unless the lead contained 8 to 11 ounces of silver to the ton it did not pay to extract it. While its removal has increased the production of silver, its extraction is by some authorities believed to have improved the quality of the lead. On the other hand it is stated that lead pipes made from desilverised ore are, when used for conveying drinking water into our houses, found to be too soft. They are more readily acted upon by water, and become consequently a more frequent cause of plumbism than the harder pipes made from British galena, from which the silver has not been extracted. The introduction of the Pattinson process has caused silver extraction to become a special industry. The process depends upon the formation of an eutectic alloy of silver and lead.[50] It is unnecessary to describe the Pattinson process, since it is detailed in all text-books on metallurgy and chemistry. Suffice it to say that the _desilvering_ plant usually contains five pots made of cast iron and set in masonry, and by a series of melting and skimming, cooling and transferring the separated silver and lead to a series of pots in succession, all the silver, practically speaking, can be removed from the lead. Although I have frequently examined men engaged in desilvering lead I have rarely found them the subjects of plumbism. Two cases of lead poisoning were reported to the Home Office in 1900 as having occurred in silver-smelters.

_Red Lead_; _Lead Oxide_; _Litharge_; _Massicot_; _Minium_.

Lead oxide, the yellow and red, is got by melting metallic lead in a furnace exposed to atmospheric air. By means of a long iron rabble a workman keeps raking the molten liquid so that it is brought into intimate contact with the oxygen of the air. When removed from the furnace and cooled, the product assumes a red or yellowish colour according to the amount of oxygen it contains, and is known as the red oxide of lead and minium, or as massicot. During the operation of melting and raking the lead a certain amount of fume escapes from the open mouth of the furnace. The fume ought to be removed by a strong upward draught through a hooded chimney. Where this is not done and the men approach too near the mouth of the furnace, fume is inhaled, with the result that the workmen suffer from plumbism. A fairly large number of red-lead makers become anæmic and suffer from colic and wrist-drop. Great as is the risk run by the red-lead worker through inhaling the fumes from the molten metal, it is less than that incurred during the crushing and packing of the finished product. The substitution of mechanical agitation of the molten lead in the furnace for that done by hand by the workman would diminish the danger, since it would allow the doors of the furnace to be closed, except during the charging of the interior. The packing of casks with red lead should be conducted in closed spaces provided with a hood and such means as will create an effective draught. The workmen ought to wear overalls, have frequent baths, and be inspected at least every fortnight by a doctor. Men can work longer in red than in white lead without losing their health. There is no truth in the statement that they are _absolutely_ free from the severer forms of plumbism. As a rule, I have found the symptoms of lead poisoning in massicot makers on the average milder than those observed in white-lead workers; but the result depends upon the proximity and length of exposure to lead compounds rather than upon the particular nature of the compound itself--always, of course, remembering that the more soluble the lead compound the greater the danger. Some physicians have had quite other experience. Layet, for example, in a paper read before the Congress of Hygiene at Turin, 1880, stated that minium is more dangerous than white lead, and that the form of poisoning is just as severe, if not more so. He had found red-lead makers more liable to what is known as encephalopathy, _i.e._, the cerebral type of Saturnism, than white-lead workers.

_White Lead_; _Carbonate of Lead_ (_Céruse_, Fr.)

All the soluble salts of lead are capable of inducing plumbism, and of these the carbonate is perhaps the most prolific cause of lead poisoning. In Britain most of the white lead of commerce is made by the _old Dutch_ process. Thin sheets of metallic lead (wickets) are taken to the stacks or blue beds. The floor of the stack is covered by a layer of tan, and on the tan is arranged a series of earthenware pots containing dilute acetic acid. Upon the pots are placed the sheets of lead. Boards are laid over these, and thus the first layer is formed. Tan is thickly strewn over the boards, and when this has reached a sufficient thickness, other rows of pots partially filled with dilute acetic acid and covered over by thin sheets of lead are arranged on the tan, and the whole is covered over by boards. This second layer is followed by others similarly constructed, until by a succession of tiers the ceiling is reached, when the doorway is built up by boards and kept closed for a period varying from ten to fifteen weeks, during which the conversion of blue into white lead by corrosion takes place. The stacks are ventilated by means of a shaft at each corner. Once the “blue” beds are made up and the doorway closed, the tan begins to get warm and evolve carbonic acid. In consequence of this heat the acetic acid becomes volatilised, and through the interaction between the lead and acetic acid on the one hand, and the carbonic acid on the other, chemical changes of a nature not thoroughly understood occur, which ultimately end in the production of the basic carbonate of lead, or what is popularly known as white lead. When this conversion is believed by the manufacturer to have taken place, the stack is opened. It is then no longer spoken of as a “blue” but as a “white” bed. Workpeople enter the white bed to strip it of the corroded lead. What was originally placed in the blue bed as a thin layer of metallic lead has become converted, if the corrosion has been satisfactory, into a much thicker plate made up of a white crisp incrustation of lead carbonate, which often conceals from view very thin pieces of unaltered metallic lead. In stripping the white lead off the unchanged metal a considerable amount of dust is given off, the inhalation of which was previously much more frequently a cause of plumbism in the workpeople than now, owing to the fact that present regulations require that the white beds must be watered by means of a “rose.” The carbonate and unaltered lead removed from the white beds used formerly to be taken direct to the rollers, crushed and washed, so as to separate the two. After washing, the white lead is placed in earthenware vessels and taken to the stoves to be dried. The emptying or drawing of stoves has been the cause of a larger number of severe and fatal cases of lead poisoning than any other department in a white lead factory. Until 1898 the filling and emptying of stoves was very largely done by women, young and middle-aged, but the work was found to be so detrimental to female life that the White Lead Commission recommended that no woman or girl should be allowed to work in the stoves. I have known young women die from plumbism within three months after entering a white lead factory and working in the stoves. It takes from three to five days for the white lead to become thoroughly dried in the old form of stoves, after which it is packed into casks. Since the White Lead Commission published its Report there have been many improvements in stoves. There are many now in use which will tend still to diminish plumbism. In some factories wagons ladened with basins of moist white lead are run on rails into the drying chamber, while in others the white lead is made to fall mechanically on to a series of large revolving discs in a closed chamber heated by air. Packing is often a dusty and dangerous process if it is not conducted in a confined space ventilated by a shaft and fan. The white lead is mixed with oil and converted into paint. When visiting the white lead works in Paris of Messrs Expert-Besançon et Cie., a short while ago, I found that while the old Dutch method of manufacture was in use there was an immunity from plumbism among the employés that created a favourable impression upon me. That freedom I found was in the main due to the following circumstances: (1) no female labour was employed; (2) stoving was practically done away with; (3) the white lead was taken direct from the stacks to the rollers, where it was crushed and washed; then (4) passed through a series of rollers and mixed with oil, which gradually displaced the water,[51] so that a perfectly finished paint escaped from the last roller, practically free from, or containing only a very small percentage of water, and was passed automatically into casks, thus abolishing some of the dusty and dangerous processes as well as the handling of the white lead; (5) careful personal supervision of the workers, and attention to cleanliness; (6) regular medical inspection; and (7) alternation of employment. I reported to the Secretary of State upon these facts, with the result that they were laid before the white lead manufacturers of this country, many of whom adopted in a modified form the practice observed in Besançon’s works. English makers have since then informed me that it not only saves labour and therefore cheapens production (the product itself not suffering in quality), but has materially diminished the number of cases of lead poisoning in their factories.

White lead can be made by other methods. In what is known as the _chamber_ process strips of lead are suspended over parallel bars in a chamber, which is heated by steam, and into which carbonic acid is passed, while acetic acid is present in pans on the floor. The result is the same, viz., formation of white lead by a process of corrosion, only the conversion is much more rapid, being four or five weeks as against the ten to fifteen required by the stack process. The subsequent treatment of the white lead is the same in both cases. Much of the white lead manufactured in Germany is made by the chamber process, and in that country emptying the chamber is regarded as dangerous to health.

By the old Dutch process an excellent and very pure white lead is no doubt produced. The drawbacks to the method are that it is tedious, and that some parts of the process are extremely dusty, and therefore dangerous. There have been various attempts to manufacture lead carbonate by quicker methods, and of these the method of obtaining white lead by the action of acetic acid and glycerine upon the red oxide may be mentioned. In it the first step consists in reducing metallic lead to litharge by placing pig-lead in a furnace and allowing a jet of steam to play upon the vapour of the molten metal. The lead oxide is subsequently crushed into a fine powder. This, as I saw it, can be a very dusty and dangerous process. The red oxide is placed in large revolving barrels along with acetic acid and glycerine, and the churning is allowed to go on for about two hours. A greenish-white liquid is the result, and this is allowed to escape from the barrels into storage vats, from which it is conveyed into large cylinders called _carbonators_. Into these carbonating tanks carbonic dioxide obtained from burning coke and lime is conveyed, and the gas is allowed to bubble through the mass for about an hour, when carbonate or white lead is formed. After running off the supernatant liquid, the deposited lead carbonate is removed through pipes to the _presses_, where it is washed and any acetate that may cling to it is removed. After this it is taken to the stoves, into which it is run on a series of long narrow wagons, the workmen not entering the stove at all. By the third day it is sufficiently dried to be ready for packing or mixing with oil to make paint. This method of manufacture is known as the _precipitation_ process. In it there is no handling of the white lead until it reaches the presses. The dangerous parts of the process are: (1) the grinding of the lead oxide: this is dusty; (2) the pressing: in this the men handle the white lead, and as a consequence I have observed in young workmen marked anæmia, tremor of muscles, colic, and the presence of a deep blue line on the gums; and (3) filling the barrels with the finished white lead, when danger arises from inhalation of dust. In some works ammonia is substituted for glycerine. Conducted as an experiment, white lead manufactured on the lines just detailed is extremely satisfactory, but financially it is not very successful. Although the precipitation process is more rapid it is more costly, and as a consequence factory after factory which has adopted this method has been obliged to close.

In the manufacture of white lead by the _Bischof_ process the first stage consists, after converting metallic lead into litharge, in the reduction of the litharge to suboxide in gas-tight cylinders by means of water gas at a temperature of about 300° C. The suboxide is moistened in mechanical mixers with water, and converted into hydrate. By means of carbonic acid, dilute acetic acid and glycerine, the hydrate is converted into white lead in a gas-tight apparatus, and after separation of the liquid and washing of the sludge, the aqueous white lead is mixed with oil by mechanical means, and becoming thus ordinary white lead paint, it is packed ready for the market. No female labour is employed in the factory. The manufacture of white lead by the Bischof process at the time of writing is still to a large extent experimental, but it gives promise of commercial success. As the work is done by machinery, and is for the most part wet, there is no dust given off. The only possible unhealthy part of the process I observed was the mixing of the suboxide of lead with water, but where this is done mechanically, as I presume it can be in chambers provided with ventilating shafts, all danger can be averted.

In white lead factories the dangerous processes are emptying the white beds, washing the incompletely converted metallic lead plates, crushing, grinding, sifting, filling the pots with white lead for the stoves, emptying the stoves and packing the barrels with the dry white lead. It is the continual absorption into the body of very minute quantities of lead compounds either by the pulmonary or digestive tract that causes plumbism. The skin, too, offers another channel by which it may enter the system. Although it is usually in the form of dust that lead enters the body, it can also enter it in the form of fume, and possibly, too, mixed with steam in which the particles of lead are either dissolved or suspended.

Lead carbonate is an extremely fine white powder, and is largely sought after as a pigment by house painters, by plumbers for searing joints, and by pottery manufacturers for making the glazes in which the ware is dipped. As a pigment it is said by a large number of house decorators to be superior to any other. There is a decided preference in the trade, too, for that made by the stack process. It always commands a higher price, the reason being that it is believed to have much greater covering power than white lead made by some of the other processes. On account of white lead being such a dangerous product, both in its manufacture and manipulation, the question of finding a suitable substitute has often been raised. This subject was carefully gone into by the White Lead Committee a few years ago.

Zinc white, for example, was recommended, but the opinion come to was that while zinc oxide was practically free from the dangers incidental to lead carbonate, and answered well for internal decoration, for covering purposes and endurance in all kinds of weather there was no pigment equal to white lead. It is this widespread belief among house painters generally that makes white lead such a valuable commercial product.

The question of finding a substitute for white lead has not been confined to Britain alone. One hundred and twenty years ago, Courtois presented to the Academy of Dijon some zinc white, which was remarkable on account of its permanence, and in 1783 Guyton de Morveau recommended, from hygienic motives and on account of its chemical properties, zinc oxide for lead carbonate. Ten years ago a small representative committee reported to the Commission des Logements Insalubres of the city of Paris upon zinc white as a likely substitute. As far back as 1849 the Minister of Public Works ordered that all the Government buildings in France were to be painted with zinc oxide instead of lead carbonate, and although in 1852 the Minister of the Interior followed with a similar request to the various prefects, the resolution remained a dead letter. It was indicated to a fresh committee, appointed in 1891, that from an economic and industrial point of view, zinc white was inferior to white lead, that it had no great covering power, little durability, that it cost more, and that therefore the painting of State buildings by it would entail an unjustifiable expense. Some persons, on the other hand, held the belief that zinc white possessed just as good covering properties, so long as it was mixed with a larger proportion of oil and less of turpentine, and that the painter gave a sufficient amount of attention to his work so as to make the coating flat, also that it was not so readily blackened by sulphurous vapours. As for the increased expense, it was to be remembered that if zinc white costs more, it is also less heavy, and therefore weight for weight gives a larger body of material. The Commission, taking into consideration the hygiene of dwellings, the health of the workers, and the interest of landlords, and having the choice of two substances before it, of which one is almost harmless, and the other a strong poison, adopted the following resolutions: (1) the employment of zinc white to the exclusion of white lead will be specified in all the orders for painting; (2) the Commission renews the wish expressed in 1880 in regard to the exclusion of white lead in all public works. No special action followed these recommendations. Within the last few months the question has again been raised in France, and on this occasion more vigorously than before. The operative painters met in congress, and passed resolutions denouncing the use of lead in the manufacture of paint, and demanding that the law for compensation for accidents should be extended to include cases of plumbism. To the painters’ representatives the Minister of Commerce, at a personal interview, while admitting that the law on accidents was imperfect, stated that it was too soon to hope for its amendment. He undertook to do all he could to enforce the decree of 1849, that no more lead should be employed in painting and decorating State buildings. In France zinc sulphide, oxysulphide, and oxide have all been tried as substitutes for white lead, but although there is a belief that these can replace lead carbonate, there is an unwillingness on the part of architects and house-painters to discontinue the use of lead. In Britain other chemical compounds in addition to the above have been tried, _e.g._ sulphate of barium, but although this is a beautifully white substance, it does not mix so well with oil nor has it the covering power of white lead. The surface of the object painted can be seen through the coating of barium sulphate, a circumstance probably due to the fact that the barium salt exists in a more highly developed crystalline form than the lead compound.

In March 1901 the Comité Consultatif d’Hygiène of France reported upon this subject[52] that the manufacture of white lead has become less and less the harmful industry it was owing to the Expert-Besançon process of grinding and mixing the white lead in water, with the subsequent addition of oil as it passes through the rollers, careful medical examination of the workmen employed, and the removal from the works of those who seem to be susceptible to plumbism, or are inclined to the free use of alcohol. The Committee of Hygiene recognises that in house painters, want of cleanliness, also the excessive use of alcohol and absinthe, are responsible for much of the lead poisoning, and therefore, since it is impossible to regulate and control the habits of these men, they ought to be provided with paints which do not contain such an injurious substance as white lead. In zinc white the committee is of opinion that a proper substitute can be found for lead for most purposes. Many architects and builders still object to the use of zinc white, but there are many, on the other hand, who claim for it the same advantages as regards covering power and endurance, and who maintain that when exposed to sulphuretted vapour it forms a sulphide which is white compared with the black sulphide similarly obtained from lead. The zinc coating dries more slowly, and there is therefore some loss of time; the work of laying on, too, may be a little more difficult, and for polishing purposes zinc mastics do not harden so well. Zinc is not so good in calico-printing as white lead. There are some things therefore, the committee admits, that lead may be better for than zinc. It is also admitted that even zinc oxide may be accidentally contaminated by small quantities of arsenic and lead, also that it is slightly more expensive--for example, it costs 0.0152 franc more for each metre of work done. The committee concludes its report by stating that both in the manufacture of zinc white and in its application as a paint it is free from the dangers incidental to lead, and therefore it is worthy of a lengthened trial as forming the basis of colours for house painting, since there is a considerable amount of educated opinion to show that it can be substituted for white lead. The French Government is asked to set the example by having the public buildings painted with oxide of zinc.

No industry, unless, perhaps, it be that of pottery manufacture, has caused so much plumbism as the manufacture of white lead, and yet in none has strict attention to regulations and personal hygiene been so productive of good as in these two industries.[53] The bulk of the work is unskilled labour. In Newcastle and neighbourhood, until the last three years, most of the work in the dangerous processes was performed by women who led rather a casual life, and who took to the trade as a last resource, owing to the idleness, illness, or death of their parents or husbands. They were mostly of the poorest class, and were often ill-fed and ill-clad. After a few weeks or, at the most, a few months of pretty regular employment in a lead factory, particularly if much of the time was spent in stripping the white beds or emptying the stoves, young women would suffer severely from plumbism. As already stated, I have known young women who were strong and healthy when they entered a white lead factory, die from Saturnine poisoning within three months. In one instance a young woman had, to my knowledge, only worked forty days, spread over a period of nine weeks, when she succumbed to lead poisoning. I am firmly convinced that women, especially young women, are much more susceptible to plumbism than men. The predisposition to lead poisoning is in both sexes doubtless spread over all periods of life, but so far as occupation exposure to lead is concerned, my opinion is (1) that women are more susceptible than men; (2) that while female liability is greatest between the ages of eighteen and twenty-three years, that of men is later; and (3) that while females rapidly break down in health under the influence of lead, men can work a longer time in the factory without suffering, their resistance apparently being greater. In addition to a sexual predisposition to plumbism there is also an individual and a family tendency as well. It is difficult to explain this susceptibility of certain persons to lead poisoning. As to the fact, however, there is no doubt. It is partly a constitutional, and it may be partly a temporary and accidental condition. We find illustrations of constitutional predisposition to certain maladies in the greater liability of some people, for instance, to contract infectious diseases than others, in the readiness, for example, with which they catch typhoid fever and suffer severely from it. We have similar illustrations of the influence of age in the early years of adult life being those in which enteric fever is most severe. As an indication of how susceptibility to plumbism may be accidentally and temporarily developed, I would instance the influence of poverty, which, by preventing the purchase of wholesome and abundant food, allows the gastric juice probably to dissolve out more of the lead that has been swallowed. No doubt much of the greater prevalence of plumbism hitherto observed in women who have worked in white lead factories is to be explained by the fact that they have until recently worked in larger numbers than the men in the dangerous processes, for since June 1898, the date in which the Home Office required that male should replace female labour in these processes, the number of cases of plumbism in the men has increased, and correspondingly decreased among the women. Taking for example my own district, the number of cases of plumbism notified to the Home Office from Newcastle-upon-Tyne for the two six months’ periods preceding and succeeding June 1898, the date of the displacement of female by male labour, is as follows:--

NOTIFICATIONS. FATAL CASES. Males. Females. Males. Females. 1st December 1897 to 31st May 1898 19 66 1 4 \ / \ / \ / \ / 85 5 1st June to 30th November 1898 82 12 0 2 \ / \ / \ / \ / 94 2

Between January and October 1898, Dr M. Legge states that there were received at the Home Office from certifying surgeons, 192 reports of plumbism. Of these the stoves supplied 76 patients and the white beds 31. The ages of the workers being--

Under 20 yrs. 20 to 30. 30 to 40. 40 to 50. 50 to 60. Over 60 yrs. 7 84 58 24 15 1

In three instances the patients had worked less than one week in the factory. In four-fifths of the total cases the lead poisoning took the form of colic, in the remaining one-fifth paralysis and cerebral symptoms.

Next to the susceptibility of women generally, and of young women in particular, I would say that all young adult life offers less resistance to plumbism than mature and middle age. In the House of Commons, 17th February 1898, the Home Secretary stated that there had been 37 cases of lead poisoning in factories and lead works among boys under eighteen years of age which had proved fatal.

Looking back upon the tables just presented, it will be observed that when males undertake the work hitherto discharged by females in white lead factories they develop plumbism in a ratio which might raise doubt in the mind of the reader as to the susceptibility of women to plumbism being greater than that of men. Admitting for the moment that the susceptibility is equal in the two sexes, and the fact, too, that in both the illness may be severe, still I unhesitatingly assert that in the main the symptoms are neither so severe in men, nor does the malady run so rapidly to a fatal termination as it does in women. In a word, females contract lead poisoning more readily, the symptoms are usually more acute, they suffer more severely, and they succumb to it more quickly than males. In women acute lead poisoning is more prone to assume the cerebral type than in men. We have, it is true, only the experience of the last three years to enable us to form an opinion as to the abolition of female labour in the dangerous processes of white lead manufacture having been a wise recommendation on the part of the White Lead Commission, but limited as the time is, the records of the Newcastle-upon-Tyne Royal Infirmary are not devoid of interest on this point.

LEAD POISONING.

_In-patients admitted into Royal Infirmary, Newcastle-upon-Tyne._

+------+--------+-------------------+--------------------+-----------+ |Year. | Total. | Recoveries. | Deaths. | Remaining | | | | | | on Books. | +------+--------+--------+----------+--------+-----------+-----------+ | | | Males. | Females. | Males. | Females. | | | 1892 | 44 | 15 | 27 | 2 | 1 | 2 | | 1893 | 32 | 5 | 25 | ... | ... | 2 | | 1894 | 31 | 7 | 20 | ... | ... | 4 | | 1895 | 35 | 11 | 18 | 1 | ... | 5 | | 1896 | 38 | 12 | 22 | ... | 2 | 2 | | 1897 | 21 | 7 | 12 | 1 | 1 | ... | | 1898 | 36 | 22 | 12 | ... | ... | 2 | | 1899 | 20 | 19 | 1 | ... | ... | ... | | 1900 | 14 | 14 | ... | ... | ... | ... | +------+--------+--------+----------+--------+-----------+-----------+

It will be observed that the number of deaths is equal for the two sexes.

A decade ago the Newcastle Infirmary wards were scarcely ever clear of a case or two of lead poisoning. At present weeks or months may pass without one being in the wards. Beyond male labour having been substituted for that of females in the dangerous processes in the factories, and the circumstance that men are believed to do more work than women, I am not aware that there has been any reduction[54] in the number of people engaged in white lead manufacture on Tyneside that will explain the smaller number of cases of plumbism coming into the Infirmary, nor beyond the workhouses is there any other institution in this neighbourhood, other than the Royal Infirmary, to which patients suffering from plumbism could go. During 1898, the year in which men exchanged places with the women in the dangerous departments in white lead factories, the number of cases of plumbism admitted into the Infirmary was slightly greater than for one or two of the previous years, a circumstance possibly explained by the greater irregularity of work on the part both of the men and women, and the fact that the men were of a casual class and had not become accustomed to the work. Immediately after the abolition of female labour, not only is there observed a marked fall in the number of female admissions, but there is this astonishing feature, that while during 1900 only 14 cases, all males, were admitted, for the first time in the history of the Newcastle Infirmary within our memory a whole year passed without even one female being received. During the last three years, as also during 1893–1894, no death from acute lead poisoning took place in the Infirmary. There has been, too, a remarkable absence lately in the Newcastle daily press of announcements of coroner’s inquests having been held upon fatal cases of lead poisoning in the district compared with what there was a few years ago. Nothing could be stronger testimony to the wisdom of the Home Office in having enforced the recommendations than these facts. Although the manufacturers at the time strongly resisted the recommendation of the White Lead Committee, I believe they now admit that it was a proper step, also that work under the present system is better done than formerly, and that there is less sickness among the employés. The difficulty of substituting male for female labour, which manufacturers anticipated and which was their principal objection, has not been realised; the men do more work, and therefore the cost of production has not been increased, although wages have been higher; the men, too, are more cleanly. Improved methods of manufacture and diminished handling of products have doubtless contributed also to this satisfactory result. As the men have come to recognise the dangerous character of their occupation, and have made up their minds to follow it until they can get something better, they have become more careful, and therefore suffer less in proportion from plumbism. Casual work and irregularity of employment certainly play a not unimportant part in causing lead poisoning. The casual labourer is often ignorant and careless. As these pages are passing through the press, a man who had been stripping a white bed in a factory on Tyneside was found eating food with hands unwashed and covered with dust, while his face and beard showed only too plainly the presence of the same material. He stated that he had not been informed of any danger, and that no regulations had been read out to him. How easily, therefore, lead poisoning may be caused and almost as easily prevented. Dr Morison Legge found that of 1463 persons employed off and on in white lead works, the incidence of lead poisoning was 6 per cent. of the average number regularly employed, and in those with casual employment 39 per cent. Taking the whole number of hands passing through white lead factories in a year, the difference between these two, however, is less marked than at first appears, the numbers being 5 per cent. for the employed and 8.3 for the casual workers. Out of thirteen factories with regular employment four of them had no cases of plumbism to report at all, even although in one of these factories 110 persons were employed, whereas from two factories in which there was a large amount of casual employment 50 cases of plumbism were reported. The reasons why casual hands suffer more than those regularly employed are to be found in their carelessness and want of personal cleanliness, intemperate habits as regards alcohol, tobacco-chewing when at work, and unwillingness to wear respirators. During 1900 there were reported to the Home Office 356 cases of plumbism in white lead workers, but Dr Legge says, if two firms, one in Newcastle and the other in London, were excluded from the 18 firms, the total would fall to 175.

I have dwelt at considerable length on female labour and casual employment in lead works, and I hope have shown that the abolition of women’s work in white lead factories has been followed by marked improvement both in the conditions of labour and in the reduced number of cases of plumbism. Female labour, however, is still very largely employed in other trades where lead compounds are used. It may therefore be expected that I should offer some explanation of the attitude I have assumed in regard to this important industrial question. Where the two sexes are as far as possible equally exposed to the influence of lead, women probably suffer more rapidly, certainly more severely than men. To a certain extent the reason is to be found in the fact that lead exercises an injurious influence upon the reproductive functions of women. It deranges menstruation. Usually there is an excessive loss at the monthly periods, which causes women to become anæmic; in a few instances, on the other hand, the loss is scanty. It is upon pregnant women that the metal exercises its worst effects. The ecbolic or abortifacient action of lead is beyond dispute. It is knowledge of this fact that has caused women of the lower classes when pregnant to resort to diachylon pills, which contain a small quantity of lead, for the purpose of producing miscarriage. When a white lead worker becomes pregnant it is almost impossible for her to go to the end of term if she continues to follow her employment. As a rule she mis-carries, but if, perchance, she goes to term, the child is either born dead, or dies shortly after birth from convulsions. In the liver and kidneys of still-born children of female lead workers that I submitted to Professor Bedson for chemical analysis, there were found minute quantities of lead. Chemical analysis, therefore, confirms clinical experience as regards the cause of death in these children. As to the injurious influence of lead upon maternity I shall give a few illustrations taken from my own and others’ experience. Mrs H., aged thirty-five, worked in a white lead factory for six years, before which she had four children born at full time. Since going to the lead works she has had nine miscarriages in succession and no living child. Mrs M., aged thirty, has had seven children and three miscarriages. The last two children were born and all the miscarriages took place after entering the lead factory. Mrs F. has had three miscarriages since taking up lead work. Mrs K., aged thirty-four, had four living children before going into the lead factory, and two living children afterwards. Still following her occupation, she had six miscarriages in succession, became the subject of plumbism, and was under my care in the Infirmary for a few months on account of colic and paralysis; she made a good recovery, but did not return to the lead factory; next pregnancy she went to term and had a living child, which survived. If additional medical testimony were required to support the opinion I have put forward as to the pernicious influence of lead upon maternity, it is to be found in that of M. Constantin Paul, a French physician, who has published in detail his experience of 15 pregnancies of 4 women working in a type foundry. Ten of these pregnancies ended in abortion, 2 in premature labour, 1 in a still-birth, and 1 in a living child, who died a few hours after birth. In another series the facts are just as instructive. Five women before working in lead had borne 9 children without one abortion. After exposure to lead there was a total of 36 pregnancies. Of these, 26 ended in abortion, 1 in premature labour, 2 in still-births, while 5 of the children born at full time died within one year after birth. Constantin Paul, grouping together a large number of pregnancies, viz., 123, found that of these, 64 ended in abortion, 4 in premature confinement, 5 children were born dead, and 20 of the infants died within the first twelve months. Of 1000 pregnancies reported by Tardien, 609 ended in abortion (_Poisons Industriels_, Office du Travail, Paris 1901, p. 5). In the potteries Miss Paterson and Miss Deane, two of H.M. Inspectors of Factories,[55] found that “out of the 77 married women reported as suffering from lead poisoning during this period (the year ended 31st March 1897) 15 have been childless and have had no miscarriages; 8 have had 21 still-born children, 35 have had 90 miscarriages, and of these, 15 have had no child born; 36 have had 101 living children, of whom 61 are still alive, the great majority of the 40 who are dead succumbed to convulsions in infancy.” Dr J. F. Arlidge,[56] Certifying Surgeon for Stoke, has published his experience of 239 married women working in lead processes in the china and earthenware industry. Of the children born before the mothers worked in lead 40.4 per cent. died. Of each 100 pregnancies there were 7.0 miscarriages, while, during or after lead employment, of the children born only 36.5 per cent. died, and the percentage of miscarriages was 11.8. Of the 239 women there were 71 who had had no children prior to working in lead. These 71 women had subsequently 302 children (of whom 114 died) and 38 miscarriages; that is, for every 100 children born 37.7 died, and 11.1 of every 100 pregnancies resulted in miscarriage. Dr J. F. Arlidge’s statistics show that in female pottery workers employed in lead processes the percentage of miscarriages is higher than in those engaged in other departments, but neither is this nor the death-rate of children born under these circumstances so great as M. Paul, Tardien, and I have found.

If lead exercises a prejudicial effect upon the reproductive powers of women it is also capable, although to a less degree, of diminishing the virility of men. Children of female lead workers almost invariably die of convulsions shortly after birth or during the first twelve months. If a child is the offspring of parents, both of whom are lead workers, it is puny and ill-nourished, and is either born dead, or dies a few hours after birth. The power of lead not only to kill the offspring but to destroy for the time being the child-bearing powers of woman is remarkable, and it is this circumstance, along with the fact that women suffer more readily and severely from lead poisoning, that are the main arguments for keeping them out of the dangerous processes in any industry in which lead compounds are used. It is through the intermediary of the temporary structure known as the “after-birth” that the poison is transmitted to the fœtus _in utero_. Roques (_Mouvement Medical_, 1872), is of opinion that a mother working in lead conveys through her milk to the child she is suckling the metallic poison, and that there is produced a slow and progressive deterioration of the infant’s constitution. Prof. Bedson has analysed for me the milk of suckling lead workers without finding any trace of lead therein. Whether or not lead is only occasionally present in the mammary secretion, it is undesirable that women who have an infant at the breast should work in the dangerous processes.

Lead is a subtle poison. Most of its salts have in small doses no unpleasant taste nor odour, they are very soluble, and they produce their baneful effects sometimes in such an insidious manner that the health of the operative becomes so gradually undermined that he is often precipitated into a serious illness without any warning. In most instances, however, there are prodromata, for lead causes colic or severe pain in the abdomen. Usually this is one of the earliest symptoms to cause a lead worker to seek medical advice, while in others, as just mentioned, there is such a gradual deterioration of health that it is not until the system is thoroughly impregnated with lead and pathological changes have been established in the internal organs that the individual comes for relief. Lead poisoning is widespread owing to the large number of industries into which lead in some form or other enters, and the accidental contamination of our food and drink. The metal gains an entrance into the system through the respiratory passages, the digestive canal, and very occasionally through the skin. It has been demonstrated clinically that the injection of acetate of lead up the nostril has resulted in the absorption of the salt by the nasal mucous membrane, and the production of paralysis. How far very fine white lead dust falling upon the eyelids may be dissolved in the lachrymal secretion and be absorbed, I am not at present in a position to state. Inhaled as impalpable dust, it is drawn into the respiratory passages, where it is dissolved and passes into the blood, or it is suspended in the saliva in the mouth and swallowed. On reaching the stomach it is acted upon by the hydrochloric acid of the gastric juice, converted into a soluble salt, and absorbed. Elsewhere[57] I have given in detail a series of experiments showing the solubility of white lead in the juices of different parts of the digestive tract, which, while confirming, at the same time explains the important fact already known to managers of white lead factories, viz., the great danger of employés commencing work in the factory in the morning without having breakfasted. As lead is a direct poison to the system, nature does her best to eliminate it by the fæces and through the kidneys.

The symptoms of plumbism are manifold. Usually easy of recognition, they are sometimes so obscure as to render the malady difficult of detection even by a careful physician. One of the earliest signs is pallor of the countenance. There is developed a degree of anæmia which gradually increases until the features become altered and expressionless, a form of bloodlessness which since it is characteristic of lead poisoning, is spoken of as Saturnine cachexia. This becomes very pronounced, so that it is easy to recognise lead workers by sight. A few weeks’ work will transform a healthy-looking, florid young woman or man into a pallid and listless individual. During the time that pallor is developing, the individual often complains of a disagreeable metallic taste in the mouth, especially on rising in the morning, and of a distaste for food, so that he proceeds to his work in the morning without breaking his fast. There is no more certain way of courting plumbism than for any one to work in a factory where lead compounds are handled without having food in his stomach. This is a fact which the digestive experiments alluded to in my Gulstonian Lectures have placed beyond all question. It was therefore not only a humane action, but it was a wise step, from a white lead manufacturer’s point of view, when the employers gave a free breakfast to their hands before beginning work each morning in the factory, and it was a short-sighted policy that led them to abandon it.

Two forms of lead poisoning are met with, the _acute_ and _chronic_. It is with lead as with many other poisons. One individual may work for several months or years without suffering, while another may succumb to its harmful influence in as many weeks. The manufacture of white lead is one of the industries that will not allow of familiarity breeding contempt. The most careful worker may suffer, so too may the oldest who has passed unscathed for years. Alcoholic excess predisposes to plumbism. Why colic is such a common and early symptom of Saturnine poisoning is because the alimentary canal is one of the principal channels by which lead enters the system, and lead is known to have a special affinity for muscular fibre and nerve tissue, and to induce spasm. Colic is often attended by vomiting and by obstinate constipation. The pain is of varying degrees of severity. Sometimes it is so mild that the individual is able to follow his occupation but in discomfort. At other times it is so severe that he rolls about in agony, and is with difficulty kept in bed. Occasionally relieved by pressure of the hand upon the abdomen, it is under other circumstances often aggravated by it. The pulse is slow, small, and feeble during the attack, although at times it is found to be hard and showing high tension. In severe colic the individual is collapsed--the face wears an anxious expression--there is sleeplessness, and the function of the kidneys is seriously impaired. Notwithstanding the severe nature of the pain in lead colic and the general derangement of internal functions, the symptoms by degrees yield to treatment. After recovery most of those who have been ill return too early to their employment. One attack of plumbism unfortunately predisposes to another. On examining the mouth of a lead worker there is usually to be seen a bluish line along the margin of the gums close to the teeth. The gums are ulcerated, and in the case of old lead workers they are retracted, and thus expose a considerable length of the fang. Although a valuable help in diagnosis, the presence of the blue line on the gums must not be regarded as an indication that the individual possessing it is at the time suffering from lead poisoning, for the line may be present for months without there being either any complaint or any symptom of ill-health. It tells the tale that the individual has been exposed to lead, and that the metal is present in his system, so that when associated with certain other signs and symptoms the presence of the blue line on the gums clenches the diagnosis of plumbism. The line itself is due to a deposit of sulphide of lead in the epithelial cells of the gum or in the large connective tissue cells present along the ulcerated edges. The blue line is met with under two different circumstances. It may be observed on the sound gums of white lead workers who have recently entered a factory, and who have been employed for a few hours in emptying a stove. If the mouth is rinsed with water it disappears, a circumstance which shows that this line is simply a deposit of lead on and not in the gum. The other is much more permanent: it persists for months despite the use of mouth washes and the administration of medicine internally. I know of no mouth wash, tooth paste, or drug that is capable of removing the blue line from the gum under from eight to twelve weeks.

It is upon the nervous system that the worst effects of lead are seen. Usually after having experienced one or more attacks of colic, but sometimes without these, a lead worker suddenly or gradually loses power in his hands and fingers. His hands become paralysed, hang powerless by his side, and the patient is said to be suffering from “wrist drop.” This renders him unable to feed or dress himself. Both hands are usually affected, but not in equal degree. Bilateral paralysis is always suggestive of some form of metallic poisoning. In “wrist drop” the extensor muscles of the fingers and wrists rapidly waste. As a rule the affection is painless, but in some instances the loss of power is preceded by muscular tenderness. The muscles of the shoulders and upper arm, too, may be affected, or the weakness affects the muscles of the foot, and causes “ankle drop.” When the malady is of a more pronounced type the muscles of the trunk become paralysed. In this form the individual is perfectly helpless: he lies like a log, unable to turn or move himself in bed, and for the time being his condition is usually one of danger. It is characteristic of lead paralysis even in such minor forms as “wrist drop,” that it not only completely unfits the individual to earn his living, but to attend to his own personal wants. The paralysis is slow to disappear even when medicine, massage, and electricity are used.

One of the worst forms of acute plumbism is what is known as acute lead _encephalopathy_, and to this women seem to be more predisposed than men. A female lead worker has perhaps been observed by her friends to have been getting paler and paler, and to have lost her appetite. She complains on getting up in the morning of severe headache which prevents her taking food, but notwithstanding these she goes to work, and is probably not more than an hour or two in the lead factory when she is seen to fall on the floor in convulsions. She is unconscious, and the convulsions come and go. In this condition she is taken home or to an infirmary, where within the next two days she dies, never having regained consciousness; or by the third day consciousness returns, but she keeps moaning on account of severe pain in her head. It is now noticed that she is blind; she loathes her food and is often sick. Recovery is slow. The power of vision may be gradually restored, or it remains permanently lost, and thus it happens that, at a comparatively early age, a young woman who has only worked in the dangerous processes of a white lead factory for a few weeks or months, and who has suffered from acute encephalopathy, not only swims for her life during the seizure, but may be rendered permanently blind, and thereby completely unable ever afterwards to earn her living. In the form of lead encephalopathy that I have just portrayed, there is usually some premonitory headache before the individual is struck down in convulsions, but in not a few instances the warning is of another kind, and of such a nature that it may be overlooked even by experienced medical men. I refer to symptoms of hysteria occurring unexpectedly in a young female lead worker. The patient does not seem ill. There is rather an exaltation than depression of her mental faculties and her feelings, and yet out of what appears to be ordinary hysteria the patient may pass into a state of coma, with or without convulsions, and die within three or four days. Under any circumstance it is a very fine line that divides functional from organic disease of the brain, and in lead poisoning this is particularly the case. To _toxic hysteria_, therefore, which often masks a deeper malady and is apt to throw both the friends of the patient and the medical attendant off their guard, I attach considerable importance as a premonition of acute lead encephalopathy. We have seen that after recovery from acute encephalopathy a patient may remain temporarily or permanently blind, and there may or may not be paralysis, but in some instances the mind is so shattered by the illness that complete consciousness is never regained. The patient passes into a state of acute mania, which is usually fatal, or the symptoms are subacute, recovery is incomplete, and the individual passes the remainder of his or her days in an asylum.

The question of insanity in lead workers has been very ably dealt with by Dr Robert Jones,[58] the Medical Superintendent of the London County Asylum, Claybury, Essex. Taking the proportion of 1 lead worker, in the broad sense of the word, to every 58 of the adult population, there ought to be in Claybury 18 male patients belonging to that class. As a matter of fact, however, out of 1050 males in the asylum, there are 35 who have been lead workers, plumbers, painters, and glaziers, but excluding pottery workers and miners. In examining the histories of 3500 male patients admitted into Claybury, Dr Jones found that of these 133 were artisans, who in their trade had possibly become impregnated with lead; their occupation was as follows:--

Painters 75 Decorators 13 Plumbers 18 Gasfitters 13 Labourers in lead works 6 Grainers 3 Gasmeter Makers 2 Colour Grinder 1 File Cutter 1 Tea Lead Roller 1 --- 133 ---

Of these, 19 had signs of lead poisoning upon admission, such as paralysis, colic, and blue line on gums, while in 22 there was a history of convulsions (encephalopathy), headache, giddiness, and paralysis. Of the 133 cases the following is the analysis of their mental condition:--

Mania 37 Melancholia 33 Dementia 19 Dementia with Epilepsy 10 Dementia with General Paralysis 24 (?) General Paralysis 7 Alcoholic Mania 3 --- 133 ---

“The proportion of general paralytics among these possible lead cases is 18 per cent.: the average yearly percentage of general paralytics to the total average number of male patients admitted into asylums for the five years 1893–97 was 13.1, and it appears to me there is a strong presumptive evidence that lead may be a factor in the cause of general paralysis of the insane.” Elsewhere[59] I have drawn attention to the association of lead poisoning and general paralysis, and indicated that as there is in the plumbic form a larger percentage of recoveries than in general paralysis proper, the probability is that the malady is not exactly of the same nature, but is rather a pseudo-general paralysis. Dr Jones summarises his conclusions thus: (1) that lead poisoning is a contributory factor to insanity; (2) that the mental symptoms may be grouped among one or other of the following varieties: (_a_) toxæmia, with sensory disturbances, which tend to get well; (_b_) hallucinations of sight and hearing, usually chronic and irrecoverable; (_c_) general paralysis with tremors, increased knee-jerks, inco-ordination, listlessness, and dementia, which tend to get well.

So far I have depicted the acute rather than the chronic form of lead poisoning. There still remains that form in which the individual, after having been exposed for a lengthened period to the influence of lead, and having experienced one or more attacks of colic, indicating that his system is becoming impregnated with lead, is never well; he is profoundly anæmic, is the subject of frequent headache, imperfect vision, and incomplete wrist drop. Albumen is present in the urine, and there is a slight degree of dropsy of the face, hands, and feet, physical signs that point with these just mentioned to structural alterations having occurred in the kidneys, liver, heart, and blood-vessels, retina, and nervous system. Life drags on from day to day, only to end in a lingering illness, or it is brought to a sudden close either by uræmic convulsions, or in consequence of rupture of a blood-vessel in the brain. At the post-mortem examination in chronic cases the kidneys and liver are found to be hard and their secreting structure replaced by a low form of connective tissue, while in acute lead encephalopathy the brain may be dry on its surface and retracted, on section hard and dry, or watery and pale, the blood-vessels being congested. On microscopic examination very delicate changes have been found in some of the large nerve-cells of the brain and spinal cord, and also in the structure of the liver and kidneys. What, then, is the cause of death in acute lead encephalopathy? In most of my own fatal cases, lead was detected in the liver, kidneys, muscles, and brain, etc. To the fact that lead has been found in the brain, and has probably formed some complex chemical compound with it, may be attributed the convulsive seizures, insanity, and possibly, too, death. At the most it has always been a very minute quantity of lead that has been found in the brain after death. In one of my patients Professor Bedson found on chemical analysis only O.779 grain in a brain and cerebellum that together weighed 51.5 ounces: while from another brain and cerebellum that weighed 48 ounces, he obtained only 0.634 grain of lead. From another brain Professor Bedson removed 4.04 milligrammes of lead, while in a case reported by Mr Wynter Blyth there were 99.7 milligrammes of sulphate of lead found in the brain and 17.4 in the cerebellum. A brain whose nerve-cells have become poisoned by lead cannot functionate as in health, but as in some of the rapidly fatal cases of encephalopathy, occurring in young female lead workers hitherto healthy, no trace of the metal was detected in the brain on careful chemical examination, death must have been caused by some other circumstance than the hypothetical presence of lead in the brain. The human body is a laboratory, wherein even in health animal products are hourly being formed, and which if retained in the system would poison the individual. Were it not for the activity of such eliminating organs as the kidneys and bowels, life would be constantly menaced by this auto-intoxication. Lead in some people rapidly induces structural changes in the liver and kidneys, or it quickly interferes with the functional activity of these organs, so that poisonous materials generated by the individual himself are not removed. It is the circulation of these in the system and their action upon the brain, aided probably by the presence of a soluble compound of lead in the blood, that is the cause of the convulsions and death in some cases of acute lead encephalopathy. Occasionally lead workers are admitted into hospital suffering from convulsions and delirium, which are not due to lead, or at any rate to lead alone. In many of these cases there is a strong alcoholic history, that it is difficult to say how much is due to lead and how much to alcohol. Alcohol we know predisposes to plumbism.

_Treatment--Preventive and Curative._

Of precautionary measures requiring mention I would allude to the avoidance of excess of all kinds on the part of the workpeople, including the use of alcohol; to the need of nutritious food, plenty of milk, and the avoidance of acid fruits; attention to personal cleanliness as secured by frequent washing, change of working clothes, good ventilation of the workrooms, and the wearing of respirators.

A year ago, M. Armand Gautier presented to the Prefect of Police in Paris a report in which he showed that in Paris alone there were upwards of 30,000 persons exposed to the fumes, dust, and combinations of lead, and that the hospital treatment of the working people whose illness was due to lead poisoning cost the municipality a very large amount of money every year. In an earlier report presented to the Council d’Hygiène, and dealing with the admissions into the hospitals between 1870–80, he showed that this expense corresponded to a residence of 11,140 days in these institutions. In 1881 the French Government appointed a Commission to inquire into the prevalence of lead poisoning, and to draw out regulations. The enforcement of the rules was followed by a decided improvement in the number of cases. From 1881 to 1883 the number of patients fell from 552 to 421, and the number of days spent by patients in the hospitals fell one-half. This satisfactory decrease, however, was not maintained, despite the fact that the Clichy white lead works, which used to contribute nearly 50 per cent. of lead cases, was closed, and new methods of production had been introduced. So far as white lead works are concerned, there is not the least doubt that the substitution of the moist for the dry method of dealing with lead carbonate materially diminished the amount of ill-health among the workpeople, and yet, while this improvement was taking place, the number of cases of plumbism rose all over Paris, owing to an increase in the amount of lead used in other trades, which had not attended to hygienic requirements. The number of fatal cases also of lead poisoning in Paris rose. Of 552 patients ill between 1877 and 1880, 5 died; of 248 ill between 1887 and 1889, 16 died; of 302 ill between 1890 and 1893, died; while of 314 ill between 1894 and 1897, 17 died. The fact therefore remains that since 1881, when fresh and more stringent regulations for French white lead workers were introduced, the number of patients suffering from lead poisoning, and dying from it, in Paris, has risen. The explanation of this anomaly is to be found in the fact that the victims of plumbism are no longer supplied by the white lead works in the same proportion as formerly, but that they come from other industries that have not yet been brought under the regulations. Of these industries house painting has contributed the largest number of patients. This trade, along with colour grinding, supplied no less than 223 patients during the years 1894 to 1898. The proof that improvement in methods of manufacture, _e.g._ the substitution of the wet for the dry method, has been satisfactory, is shown by the fact that before the introduction of the regulations of 1881, white lead operatives occupied the second line on the list of dangerous trades, to-day they occupy the sixth. It is in consequence of the increasing prevalence of Saturnine poisoning in house painters that the agitation at present going on in Paris against the use of white lead as a pigment, and alluded to in previous pages, has reached such dimensions.

A few years ago the white lead works at Clichy furnished for a long period nearly one-half of the cases of plumbism admitted into the hospitals of Paris. Demolition of this factory was followed by a rapid diminution in the number of cases of lead poisoning seeking admission. This circumstance shows that in some factories the conditions under which the work is carried on are more unhealthy than in others. On Tyneside we are not without a similar experience. There are some white lead works in which there is always more plumbism than in others, and the explanation is that either the works are older and the ventilation worse, or that the general management is in some way or other not so good. It is the same class, often the same people, who work in all the factories, for they occasionally migrate from one to another, and yet there remains the undesirable fact of a larger amount of sickness among the hands in some of the works than in others. As an illustration, take for example the lead-poisoned patients admitted into the Royal Infirmary, Newcastle-upon-Tyne, from October 1890 to March 1893--

Factory _A_ 52 cases. “ _B_ 15 „ “ _C_ 8 „ “ _D_ 5 „ “ _E_ ... „ Other factories 8 „ ---- 88 ====

Of 88 patients, one factory, not the largest, supplied nearly two-thirds of the total admissions. As illustrating the preventableness of industrial white lead poisoning, it is worth mentioning that in one of the largest and best conducted factories in the Newcastle district, there has only been one fatal case of lead poisoning within the last twenty years, and since the enforcement by the Home Office of the recommendations of the White Lead Committee, the factory that sent 52 out of the 88 cases stated in the preceding table to the Infirmary in two and a half years, at present scarcely sends one patient per annum. Lead-poisoned females are now practically never met with in Newcastle, and male patients are becoming every year rarer. As long ago as 1849, Combe proposed that instead of washing, then drying the white lead in stoves, and subsequently packing it in barrels for sale, it would be safer from a worker’s point of view, since it would rid the atmosphere of dust, if the lead carbonate on its removal from the white beds were ground and washed at once in water, then forced to travel through a series of rollers and washers into oil under rollers. The oil displaces the water, and as a consequence the white lead escapes from the last roller as finished paint.[60] In order to obtain the white lead as a paint, the soft paste as it comes from the grinding stones, and which contains 15 to 20 per cent. of water, can be at once mixed and incorporated as it passes through the rollers with increasing fractions of 10 per cent. of oil. The water is thus gradually eliminated from the paste, so that the product as it escapes from the last roller contains hardly 1 per cent. of water, can be packed, and is ready for the market. Mr T. H. Leathart of Newcastle-on-Tyne, who has adopted this method in his works,[61] informs me that the paint is, practically speaking, free from water, there being not even .5 per cent. of it in the finished product. By the adoption of this method of manufacture there has not only been a saving of labour, but better health among the workmen, owing to the absence of dust. This small change in the method of manufacture has had a wonderful influence on health. The grinding and packing of all dry white lead should be conducted in hermetically-sealed compartments. Even to this there is the drawback that as time goes on, owing to the vibration of the machinery, the joints of the wood and iron become loose and the dust escapes. The defect, however, can be easily remedied.

In 1899 the Chief Inspector of Factories issued special rules for white lead works, which were an advance upon those of previous years, and which have undoubtedly diminished plumbism in this industry. It is unnecessary to reproduce these rules here, but the main points included in them are that plans for new works or structural alteration of old factories must be submitted to the Chief Inspector of Factories; white beds must be watered when being emptied; drying stoves are to be ventilated, and no person is allowed to draw a Dutch stove on more than two days in any week; no women are allowed to work in the white beds, rollers, washbecks or stoves, or in any place where dry white lead is packed, or in other work exposing her to white lead dust; there must be weekly medical examination of every person employed in a lead process, with suspension in the case of illness, and medical re-examination before returning to work; suitable respirators, overalls, and head-coverings must be provided by the occupiers; adequate washing appliances are required, with cessation of work ten minutes before each meal-time and the end of the day’s work for the purpose of washing. The duties of persons employed are similarly defined, and any person obtaining employment under an assumed name or on any false pretence is liable to a penalty. It is enacted, too, (Factory and Workshop Act, 1891, sections 9 and 11) that the rules shall be kept posted up in conspicuous places in the factory, so that they can be conveniently read by the persons employed. Any person who is bound to observe the rules and fails to do so, or acts in contravention of them, is liable to a penalty. In such cases the occupier also is liable to a penalty unless he proves that he has taken all reasonable means by publishing, and to the best of his power, enforcing the rules, to prevent contravention or non-compliance. To extreme temperance in the use of alcohol, and to a weekly or fortnightly alternation of employment for the workpeople in the factory, I attach great importance as preventive agents.

A sanitary drink has to be provided for the workers by the employers. It is usually composed of Epsom salts and lemon juice, or some other acid, dissolved in water. The provision of an acidulated drink for persons employed in white lead works is a subject to which the members of the White Lead Commission gave considerable attention, but I candidly confess that the Committee never attached any great importance to it as a means of preventing plumbism. The theory upon which its administration is based is that the sanitary drink converts any lead which may have been swallowed into the rather insoluble sulphate, and that thereby the risk of plumbism is diminished. When the drink contains a slight excess of acid, then instead of being a safeguard it may become the reverse. Besides, after all, lead sulphate is not very much less insoluble in gastric juice than lead carbonate, and the men who go to the barrel to obtain the sanitary drink are not careful enough to rub their moustache clean before drinking. Within limits, when carefully prepared and not too acid, the sanitary drink possesses certain advantages on account of its being a mild aperient, but beyond this it is only doubtfully a preventive. The workpeople should be given to understand that there is no real antidote to lead poisoning, and that they must be constantly on their guard against it. Personal cleanliness is, I repeat, of the greatest importance. Such drinks as the acid lemonade just described, milk and coffee, etc., however useful they may be of themselves, cannot altogether prevent lead poisoning, and it is unwise therefore to allow the workpeople to shelter themselves under this belief.

_Curative._--During the attack of colic, warm applications to the abdomen, and the administration of a mild aperient, such as magnesium sulphate or castor oil, especially if there is constipation, and there is the prospect of the medicine being retained on the stomach. Occasionally a warm bath may be called for, or if pain is severe, the administration of a hypodermic injection of morphia. In milder cases, or when the immediate urgency of the colic has passed away, iodide of potassium is a good eliminant, but the internal administration of this drug in plumbism requires caution, since it may dissolve out lead that has been deposited in the tissues, flush the blood with a soluble lead salt, and thereby aggravate, and often dangerously too, the symptoms of lead poisoning. For paralysis the internal administration of iodide of potassium with nux vomica, and the use of massage will, in most cases, succeed, but recovery is usually slow and often incomplete. Electricity gives encouraging results, and as practised in the manner suggested by Dr Lewis Jones (see p. 375), has been productive of a great amount of good. For acute lead encephalopathy the subcutaneous injection of pilocarpine and the inhalation of nitrite of amyl have in my hands answered well. Bleeding, and the injection of large quantities (about 500 centimetres) of an artificial serum made from sulphate of soda, 5 grammes; common salt, 1 gramme; corrosive sublimate, 0.05 gramme; and distilled water, 200 centimetres, under the skin of the abdomen, is a line of treatment that finds favour with many French physicians. I need scarcely add that lead poisoning is too serious a malady for its treatment to be undertaken by the laity without the advice of a doctor.

_Chromate of Lead; Dye Works._

The use of chrome dyes has been followed by lead poisoning which in a few instances has ended fatally. Chrome dyeing by means of lead compounds was one of the unhealthy occupations relegated by the Home Secretary to the Dangerous Trades Committee for its opinion. The dye is obtained by mixing a solution of bichromate of soda or potass with sugar of lead, or by acting upon lead carbonate with a solution of bichromate of soda or potass. In the Final Report of the Dangerous Trades Committee, p. 26, it is stated how the different colours may be got. To obtain _deep orange colour_, hanks of yarn are dipped first in a solution of lime, and then in a solution of brown sugar of lead; the dip is again repeated, and after this the hanks are dipped in bichromate of potass or soda, and finally they are boiled in lime water. For _yellow chrome_ colour the treatment is similar, with the exception that the goods are not boiled in lime water, but washed in dilute hydrochloric acid. To obtain _chrome lemon_ colour, the yarn is dipped first in an alkaline lead solution, then in bichromate of soda, and subsequently washed in cold water. _Green chrome_ is got by dipping the lemon-stained yarn in an indigo bath. In all of these processes the bichromate of soda acts upon the lead and produces a chromate. This forms not so much a dye as a coloured coating on the surface of the fibre of the yarn. In the process of dyeing no risk to health is incurred by the workpeople. The danger commences when the goods have become dried and the coloured dust of chromate of lead is given off, as may be seen in the noddling and bundling departments of a factory. In several large dye works, both in England and Scotland, I have seen the girls who handle and pull the yarn covered with yellow dust, found them anæmic, complaining of headache, and showing a well-marked blue line on their gums, while several of them complained that they had suffered from colic, and been off work through it for a time. In some instances more serious symptoms developed. A fatal termination is not unknown. The contents of the stomach when vomited often exhibit the same colour as the yarn the girls handle. In one mill there was quite an epidemic of lead poisoning among the women owing to some of them, on account of the cold weather, having stopped the running of the fan. As a consequence the atmosphere of the carding-room became impregnated with yellow dust, and many of the girls became ill, one of them dying from unmistakable lead poisoning. When the fan was re-started all the illness disappeared. Improved ventilation puts an end to poisoning in chrome dye works. The dust-laden air ought to be drawn down and away from the workers. In the dyeing of cotton, lead compounds are similarly used, but an effort is being made to supplant these by aniline and vegetable dyes. Whether aniline colours are capable of entirely taking the place of lead chromate under all circumstances of climate, etc., still remains to be seen. The opinions of manufacturers are divided upon the point of aniline dyed goods standing exposure to the sun like those coloured by lead chromate. Some maintain that the colours are not so permanent. The subject is therefore not yet ripe for the expression of an absolute opinion. Another danger to which workers in chrome dyeing works are exposed, is the occurrence of chrome holes or scars on the hands of the men who work with the bichromate solution. Perforation of the septum of the nose does not occur.

_Calico Printing._

This subject may be conveniently discussed with that immediately preceding. The pattern is printed on the cotton cloth in lead salts. The cloth is then passed through a solution of bichromate of soda. Only the letters or portions of the pattern that have been printed in lead retain the chrome colour. There is no risk to the operative in the process of printing. The danger resides rather in the dust given off in the drying-room, to which the cloth is taken. Here, owing to the heat of the room and the handling of the calico, a certain amount of dust may be present. The question of aniline substitutes for lead has been discussed by manufacturers, but among them there is no unanimity upon the matter, especially in those engaged in the export trade. In indigo blue dye works where the calico is printed with copper sulphate and lead acetate, the men may suffer as much from the copper as the lead.

_Enamelling of Iron Plates and Hollow Ware._

The enamelling of iron plates is an industry which is mostly confined to Birmingham and Wolverhampton and their immediate neighbourhood. Enamelled iron plates are used for advertising purposes, for announcing the names of railway stations, etc. The process of manufacture consists in first cleansing the iron plate, smearing it with gum-water, and sifting a fine dust on to it, or in allowing to trickle over it powder suspended in water. The powder may contain as much as 25 per cent. of lead, or in some instances no lead at all. The plate having been coated in one of these ways is placed in a furnace and exposed to an intense heat. On removal it is seen on cooling to have received its first coat of enamel. In order to obtain the required red, blue, or brown colours the plate is subsequently swilled. The colours are put on at first roughly with a broad brush, and then a finer one so as to get an even surface, after which it is smoothed by a camel’s hair brush. The plate thus swilled is allowed to dry on hot pipes at a moderate temperature. The process up to this stage is wet, and therefore not dangerous, besides the lead compounds used are often fritted, and these are known to be very insoluble. It is in the subsequent treatment known as stencilling that the danger commences. This part of the work is generally done by women, who by means of a nail-brush rub off the colour on the surface of the plate which is exposed through the openings cut in the stencil, and which correspond to the alphabetical letters, etc., of the advertisement. This is a very dusty process. The atmosphere of the workroom becomes thick from the coloured particles of dust given off from the plate, and these fall upon the hair and clothing of the workpeople. There is often a large percentage of lead in the dust, so that when this is inhaled for several hours, during each working day in the week, it becomes a cause of plumbism occasionally of a severe character, and running to a fatal termination.

Brushing-off through the stencil is usually performed over perforated tables down which there is a strong draught, but if the aspirating force is weak the dust rises and impregnates the atmosphere, so that it is almost impossible to see across the workroom. After the plate has been stencilled it is again placed in the furnace, and the processes of swilling, drying, stencilling, and firing are repeated according to the kind of colours required in the advertisement. These processes may be repeated as many as eight or nine times. Red and other compounds of lead are largely used for enamelling, and may be present to the extent of from 25 to 33 per cent. Formerly arsenic was also used, but such serious consequences followed that its employment has been discontinued.

In this industry, as in white lead works, it is the young female operatives who are the most susceptible to plumbism. A few years ago there was a great amount of ill-health among the hands owing to imperfect ventilation of the workrooms. The White Lead Committee recommended that there should be a medical inspection of all the workers once a month, and that no girl under 20 years of age should be employed as a brusher-off in the stencilling process; that no female should be employed without medical testimony as to her fitness for the work, experience having shown that anæmic, scrofulous, and ill-nourished persons are more predisposed to plumbism than those that are healthy; that after an illness of any kind a medical certificate should be furnished. The Committee would have been glad if the employers could have seen their way to give half a pint of milk every forenoon to each of the workers, for experience has shown, both in this country and abroad, that milk is to some extent a prophylactic against plumbism. Dr Morison Legge,[62] in his report upon the enamelling of iron plates, says that for last year only 10 cases of lead poisoning occurred in 689 persons engaged in the dangerous processes. He attributes the fact of the cases being few to the periodic medical examination, the removal of dust by fans, and the encouraging efforts which are being made by large firms to substitute other things for lead.

_Tinning and enamelling of the hollow ware_ used for culinary and domestic purposes is an industry confined for the most part to Wolverhampton, Bilston, and Dudley. The iron kettle or saucepan about to be tinned is first cleaned or prepared by being swilled in a mixture of dilute hydrochloric acid and chloride of zinc. The process of _tinning_ consists in dipping the utensil into a trough containing molten tin and lead in the proportion sometimes of 60 per cent. of metallic lead and 40 of tin. Owing to tin being the more expensive metal, the cheaper ware is often dipped in a composition of 70 per cent. of lead and 30 of tin. The dangers incidental to tinned hollow ware are twofold: first, if the workman who dips the utensil in the molten lead is not careful, cleanly, and temperate as regards the use of alcohol, he may suffer from lead poisoning; and secondly, the poorer working classes, who buy the cheaper ware, which has been nominally tinned but is in reality leaded, also run the risk of becoming poisoned by the food either having become contaminated by lead in the act of cooking or subsequently. When the cauldrons containing the molten metal, into which the workman plunges the pans, etc., are hooded, the fumes are not so readily inhaled. It is a common belief among these men that the poison enters the system when they are wiping off the metal from the hot sauce-pans, etc., by means of tow. In the white enamelling of iron hollow ware many manufacturers are now using a leadless glaze with every promise of success.

The enamelling of copper letters or tablets is shown by Dr Legge to be a source of plumbism. Four cases were reported to the Home Office in 1900. The danger occurs during the “brushing on” and “wooling off” of a black enamel powder, which was found to contain as much as 67.0 per cent. of lead.

_Electric Accumulator Works and Lead Poisoning._

The manufacture of electric accumulators for telegraph and telephone purposes and for motor cars has become a very important industry, and is likely to become still more important as time goes on. There is one process in the manufacture which is distinctly dangerous. The workmen who rub the red lead, made into a paste by means of dilute sulphuric acid, on to embossed or perforated plates occasionally suffer from plumbism. When the plate leaves the workman its interstices look as if they were filled with red clay. Both sides of the plate have to be treated by the workman, whose hands are generally covered with indiarubber gloves. During the mixing of the dry red lead or litharge with the dilute sulphuric acid a considerable amount of dust is created. The indiarubber gloves which are worn by the men who fill the perforations in the plates with the lead paste become in time thin and worn, or they get torn, and as a result certain parts of the hands of the men become coated with the red composition. By this means, as the work entails a considerable amount of friction, lead poisoning may readily occur. In visiting electric accumulator works, I found several of the workmen, especially the younger men, extremely pale, and suffering from headache; some of them had been laid off with colic, and they presented a well-marked blue line on their gums.

The colic of electricians is not a new disease. In one electric accumulator works in La Hague in 1894, there occurred 37 cases of plumbism in 252 male workers; and in another factory in Wiesbaden 12 cases of lead poisoning occurred in 90 workers. Of 30 patients suffering from lead colic admitted into the Hospital Bichât, Paris, during 1899, Talamon says more than one-half were electricians, the remainder being made up of painters, plumbers, and typographers. So prevalent had lead poisoning become in Germany that the Imperial Health Office directed an inquiry[63] to be made into the conditions of labour in electric accumulator works. In consequence of this, special rules were issued, and as these now govern the industry in Germany, it will not be out of place if I quote at some length from the Report, a translation of which has been kindly placed in my hands by Dr Morison Legge. The information embodied in the Report was collected by a circular letter of the Chancellor, and deals with the extent of the manufacture of accumulators and the dangers of working. From one factory alone the following particulars were received as to the special incidence of plumbism in particular processes.

+------------------+-----------+---------------+-----------+ | | Number | Number of | | | Occupation. | Employed. | Cases of Lead | Per cent. | | | | Poisoning. | | +------------------+-----------+---------------+-----------+ | Casting | 30 | 3 | 10.0 | | Pasting | 30 | 9 | 30.0 | | Soldering | 16 | 6 | 37.5 | | Trimming | 30 | 4 | 13.3 | | Plumbing | 30 | 9 | 30.0 | | Section Building | 60 | 5 | 8.3 | +------------------+-----------+---------------+-----------+

As regards remedial measures, special attention was directed to: (1) casting and preparation of the plate; (2) mixing the paste; (3) actual pasting; (4) the drying and building into batteries of the various segments; (5) forming and changing plates. As regards these various headings the information gathered is as follows:--

(1) Ordinary lead, often containing a trace of antimony, is used for casting the plates. From the surface of the lead in the melting pots fume rises (oxide of lead), so that it is recommended to have the melting pots arranged that they can be provided with an efficient hood and shaft leading either into the open air or into a chimney. The need for these precautions lies in the fact that not only are the fumes of lead and antimony harmful when inhaled, but commercial lead often contains traces of arsenic, varying from 0.1 to 7.9 per cent.

(2) Litharge and red lead are used for making the paste, and as these come to the works in casks, the dry material is transferred from the cask to the worker’s bench by means of a shovel or trowel. Dust thus becomes scattered about in all directions. It is, therefore, desirable to have the floor of the workrooms moistened and swept daily. The mixing of the red lead and sulphuric acid should be done in a closed chamber or under an exhaust shaft.

(3) As regards the wearing of gloves by the men who paste the plates, reference is made to the difficulty of keeping the gloves in good repair. The same difficulty, as I have already mentioned, occurs in Britain. In some of the electric accumulator works the gloves worn are too short. The dry red lead occasionally gets inside the gloves, and as these tend to keep the hands hot and cause them to perspire, plumbism is rather encouraged than prevented, or skin eruptions develop. In order to avoid, therefore, as far as possible absorption of lead by the skin, two alternatives are put forward by the German Committee of Enquiry: (_a_) the work is not to exceed eight hours a day, to be broken by a pause of at least one and a half hours; or (_b_) there is to be one six-hours’ spell of work in the day. The Committee is in favour of the latter. Respirators for the men engaged in pasting are not considered necessary.

(4) In building up the batteries by means of solder, ordinary solder is not used, but a very pure lead instead, in order that the connections made between the plates may not be affected when they are subsequently exposed to the acid. To bind these plates together by solder, the heat from an oxygen or hydrogen blow-pipe flame is used, but frequently the temperature reaches a height sufficient to cause volatilisation of the lead, and statistics show that persons engaged in this occupation run a considerable risk of lead poisoning.

(5) Opinions were found to differ as to the effect of the dilute sulphuric acid vapour in the formation-room upon the workers. There was said to be medical testimony as to its good effects upon workpeople, who are the subjects of chronic bronchitis. Reference is made to the difficulty of providing fans for ventilation of these rooms owing to the deleterious action of the acid upon the metal contained in the fan, and yet some form of artificial ventilation is necessary.

The method adopted in the factory of determining the presence of lead in the air was the simple one of suspending, at the level of the worker’s head, a sheet of blotting paper, 100 centimetres square, previously moistened. Subsequent treatment with dilute acid and exposure to the action of sulphuretted hydrogen showed whether lead was present or not.

_Motor Cars._

In Paris, motor cars are much more in evidence than in this country. There are very few in London compared with the French capital. Dr Proust has reported four cases of lead poisoning in Paris, in women aged eighteen, nineteen, twenty-five, and thirty-nine years respectively, whose work consisted in coating with oxide of lead small leaden rods, and fixing them in position. All of these women entered the electrical department of motor car manufactories in good health. At the end of six weeks to two months they had colic, loss of appetite, constipation, and abdominal pain of such severity that they had to be taken to the hospital, and detained there under treatment for more than a fortnight. In one patient the symptoms of plumbism returned shortly after resuming work. With the dangerous nature of the occupation the employers were quite familiar. They not only paid a doctor to visit the works once a week to examine the workers, but they were in the habit of giving to the female workers honey and sulphur, iron pills, and half a litre of milk daily. Ample provision was made for washing; tooth-brushes were provided, also sulphur baths once a fortnight, and yet, notwithstanding these precautions, four of the women quickly developed symptoms of lead poisoning.

_Electric Tramways._

An accident of rather a peculiar character occurred on 8th Oct. 1901, on a tramway car in Paris. I state the facts for what they are worth. During the course of the evening, nearly a dozen of the travellers were suddenly seized with violent pains in the abdomen and by syncope, and were obliged to be treated at a chemist’s shop _en route_. On an inquiry being instituted, the opinion was expressed that the symptoms were due to poisoning caused by fumes given off by sulphuric acid acting upon the lead in the electric accumulators.

_Recommendations._

It is evident that as electricity will be the motor power of the future and will be turned into numerous channels of application, the number of electric accumulator works in Britain is sure to increase. The necessity for putting into force several of the recommendations mentioned in these pages is almost sure to arise. So far as the hygiene of the works is concerned, the same rules ought to apply to them as are now in force in red lead works.

_Soldering._

Common solder is an alloy of tin and lead, equal parts. Fine solder is composed of 2 parts of tin and 1 of lead; coarse solder, of 2 of lead and 1 of tin. The extensive consumption of tinned meats and fruits is responsible for some cases of plumbism, owing to the acid juices dissolving some of the lead out of the solder, but workmen who solder, _e.g._ tinkers, have been known to suffer from paralysis of the muscles of the fingers and hands, owing to volatilisation of the lead and inhalation of the fume.

_Typefounding_; _Printing_; _Typesetting_; _Linotyping_.

Type metal is an alloy of lead with ⅓ to ¼ of antimony. The antimony is added to harden the alloy, for lead is a soft metal. Occasionally small quantities of tin and copper are added, so that the alloy may be composed of 70 parts of lead, 18 of antimony, 10 of tin, and 2 of copper.

We have already dealt with the smelting of lead ore and the melting of pig-lead. The smelting of antimony ore is not attended with such serious risks to health as is the case with lead. One of the largest antimony works in this country is on Tyneside. I have had the privilege of visiting the works and of examining the workmen. The raw ore or sulphide comes from Japan. It is smelted with iron filings. No constitutional bad effects were noticeable in the men who smelt the ore. To some extent this freedom from illness may be due to the fact that the men are not closely exposed to the fume, and that, owing to good ventilation, the fumes were quickly got rid of. The only trouble the workmen seemed to experience, and it was more of a complaint than an illness, is that as the work is hot they perspire freely, and the skin in consequence becomes extremely irritable and itchy. An eruption appears on the skin. This at first shows itself as a crop of vesicles, which ultimately become pustular. Formerly more than now it was a medical practice in the treatment of disease to apply an ointment composed of tartrate of antimony to the skin in order to bring out a pustular eruption, which acted as a counter irritant. Knowing this to be the local action of antimony, it is easy to understand, therefore, the development of the skin eruption spoken of as “pox” upon the neck and upper part of the abdomen in antimony workers. Eulenburg says that exposure to the fumes of oxide of antimony is followed by pains in the region of the bladder and urethra, and by impotence in the male. My experience does not confirm this statement. Several of the men looked rather pale, probably as the result of exposure to the heat, and a few of them had suffered from gastro-intestinal pains like colic, usually relieved by taking a dose of Epsom salts. A case of industrial antimony poisoning is published in the Report of the Chief Inspector of Factories for 1900, p. 332. It is that of a man who had worked as an extractor of the metal, and who in consequence of having inhaled the fumes suffered from paroxysmal attacks of difficulty of breathing without any physical signs of disease in his lungs. He complained of a sense of constriction in his chest, nausea, a metallic taste in his mouth, backache, weakness in the muscles of his legs, profuse perspiration, headache, and dimness of vision.

It is, however, not so much with antimony as with the presence of lead in the printers’ type that we are here concerned. Printers’ colic was a much more common malady two or three decades ago than now. It is due to handling the type, and to the dust that is given off. Typefounders also suffer from plumbism, but in not a few cases the illness has been caused by the workpeople eating their food without previously washing their hands. Printers as a class are often pale and unhealthy looking. Much of this may be due to the fact that they work in overheated rooms for long spells at a time, and have late hours. H.M. Medical Inspector of Factories reports that during 1900 there were 17 cases of lead poisoning in printers. One of the patients died. Ten of the men were compositors, 4 were linotypists, and 2 stereotypers. Dr Stühler, of Berlin, taking his statistics from the reports of sick benefit societies, states that of 3000 printers in Berlin 313 were annually sick from lead colic, _i.e._, about 10.4 per cent. of printers’ compositors suffer from plumbism, either by absorption through the skin, caused by handling the type that has become oxidised during wear, or by swallowing the dust through eating with unwashed hands. Fromm discusses this subject, and alludes to the analyses of dust of printing-houses made by Stumpf, who found that it contained often as much as 14.43 per cent. of lead. In a report recently presented to the German Board of Health, Faber states that he found in the dust collected from the floor 11.51 per cent. of lead: that the dust taken from a shelf in the room contained 6.59 per cent. of lead, while dust collected in the gangway between the desks in the composing room of a newspaper office contained 4.7 per cent. of lead. In analysing the air of printing shops Keygi[64] found that the dust contained from 10 to 15 per cent. of lead, which came from the wear of the type. Inhalation of the dust of the oxidised metal in all probability, therefore, plays a very important part in the causation of plumbism in printers’ compositors. During 1900, printing was in Britain responsible for 17 cases of lead poisoning. In 2 of the cases there were symptoms of lead encephalopathy, one of which proved fatal, and in another there was paralysis. Ten of the patients were compositors and 4 were linotypists.

It has to be borne in mind that compositors do a great deal of their work in an artificial light. As they are obliged to handle type very freely, the skin on the inner aspect of the last phalanx of the right thumb, forefinger, and midfinger occasionally becomes thick and hard, also the skin of the last phalanx of the left thumb, and the interdigital eminences of the left hand. According to Choquet, typographers suffer from two distinct maladies, one directly due to the mechanical nature of their work, and the other attributable to the medium in which that work is carried on. Standing on their feet for long spells at a time, they run the risk of developing varicose veins, and as the rooms are either too brilliantly lighted, or the reverse, to affections of eyesight. Older compositors frequently show a trembling of the right hand, due to fatigue caused by grasping and distributing the type, but in producing this tremor plumbism no doubt plays a part. Analogous to writers’ palsy, the tremor is sometimes so persistent that it obliges the individual to renounce his work. The channels by which lead dust effects an entrance into the system are the buccal and nasal mucous membranes, the skin, the respiratory passages, and the alimentary canal. So slight are the initial troubles of the typographer, that for a time they are unperceived. Acute plumbism does not occur among compositors, it is always chronic. By degrees the individual begins to look pale; the skin becomes greyish and exhibits a slightly jaundiced tint; the appetite, too, fails, and digestion becomes weak, and obstinate constipation occurs. A blue line, if sought for, will be seen in the gums, and there is complaint of an unpleasant metallic taste in the mouth. The breath becomes fetid, and motor and sensory troubles develop, especially at those parts that have been brought into the closest contact with the type. Often commencing with a sense of fatigue in the muscles, the paresis proceeds to motor paralysis. In female typographers excessive menstrual losses, such as are known to occur in female white lead workers, have been noted.

Whatever tends to interfere with the elimination of lead from the system encourages necessarily the development of plumbism. Alcohol has this tendency. It is said that if the skin of a compositor gets broken, the wound heals slowly and is apt to become erysipelatous, but I have not observed this. Some typographers are more susceptible to plumbism than others. It is largely a question of well or ill ventilated workrooms, and of personal resistance. Tanquerel found in France that the ages between thirty and forty years gave the largest amount of ill health, and that in the hot seasons of the year most cases occurred. Dr Motais, who is a member of the Departmental Council of Hygiene of Paris, in an address recently delivered at a conference of typographers, recited a story of animal life which had been told to him by some of the printers themselves. For twenty years these men had tried to keep cats in the workrooms. The animals were well fed; they received plenty of milk. For a time all would go well with them, and then the same train of symptoms would invariably develop; the eyes would lose their healthy lustre, the limbs become paralysed, and the animals die, presenting the same cerebral symptoms as are observed in the acute lead encephalopathy of man.

_Precautions._--Printing houses should be so situated that free currents of air can get to them, and not, as at present is too frequently the case, shut in by other buildings. Plenty of daylight and, if possible, sunlight are very desirable; daylight if introduced by one side should enter preferably on the left of the compositor, so that no shadow is thrown upon the case that contains his type. Light coming in from the roof obviates all this. So far as artificial lighting of the rooms is concerned, there is an opinion that the electric light is more hurtful than gas, and gas again more harmful than lamps. There should be tinted shades on the gas or lamps, green externally, white internally. The workroom should be well ventilated and without draughts; any dust generated should as far as possible be removed by fans. The type boxes should be kept clean and the floors periodically watered. By young compositors long hours ought to be avoided. No food should be eaten in the workrooms. Compositors should never do any work fasting, and should avoid smoking when at work. Excesses of all kinds ought to be avoided, particularly the immoderate use of alcohol. Milk should be freely taken. On the occurrence of colic, the individual should at once give up his work and be medically treated. Washing the hands and rinsing the mouth before eating are absolutely required, also a bath once a week, and the wearing of overalls when at work.

It is an old opinion attributed to the French physicians Tanquerel and Pidoux, that there exists an antagonism between plumbism and pulmonary tuberculosis. Facts so far as applied to compositors do not support this statement, hence the desirability of printing houses receiving plenty of sunlight, and of the undesirability of persons who are bronchitic or susceptible to lung diseases being allowed to work in printing houses, unless they are careful of how they dispose of their expectoration. One of the great foes of the printer is pulmonary phthisis. Much of this is undoubtedly preventible, since the disease is encouraged by the unhealthy conditions under which the work is carried on. Smith[65] found that the mortality from consumption was 60 per cent. greater than in most of the other trades. Of 799 deaths published by the London Society of Compositors for ten years, 1880–1889 inclusive, Arlidge found phthisis as the cause of death in 296, bronchitis and asthma in 85, pneumonia and pleurisy together were responsible for 67 deaths, paralysis and apoplexy for 61, and Bright’s disease for 21. Pulmonary phthisis caused 37 per cent. of the deaths. The largest number of deaths occurred between the ages of thirty and forty years. Since the statistics given by Dr Arlidge are more than ten years old, and as tabulated are not comparable with the general death-rate all over the country of persons between twenty to sixty-five years of age, I communicated with the Secretaries of the Typographical Association, also the London Society of Compositors, for their annual reports, from which I am able through the kind assistance of Dr Henry Armstrong, the Medical Officer of Health for Newcastle-on-Tyne, and his clerk, Mr Gillinder, to supply more recent information, as indicated in the following table (pp. 329–330).

These statistics unfortunately are not exactly comparable: the time periods are not the same for all three. This is unavoidable, owing to the census returns for later periods not having been published while I write. They are, however, not without value, for they strengthen the suspicion of greater liability of the printer to pulmonary disease.

The figures underlined in column 12 indicate the increased tuberculosis mortality rate of the two associations as compared with the whole of England and Wales. In column 11 it will be observed that in the Society of Compositors there is an increase in tubercular disease, but not great, over the corresponding rate for the entire country. It may be therefore taken as a fact that printers are more liable to tubercular consumption than men engaged in most other trades. In the half-yearly Report of the Typographical Association ending December 1900, there is a list of 74 deaths for the half-year in the Society, whose members number 16,179. Of these 74 deaths, 32 were caused by pulmonary disease, and of these 32 deaths, 22 were caused by tubercular disease, mostly pulmonary phthisis. There is an opinion, but it is erroneous, that smoking tobacco or chewing it is more or less a protection against plumbism, because the men expectorate; but apart from the fact of spitting being a dirty practice, the habit of expectorating upon a printer’s floor is to be discouraged, especially if the workman has a cough and is the subject of lung disease, for it is largely by means of the sputa thrown upon the floor and becoming dried that the bacilli of tubercle disseminate pulmonary consumption.

_MORTALITY TABLES OF TYPOGRAPHICAL ASS0C._

TYPOGRAPHICAL ASSOCIATION.

KEY to headers:

A: All Causes. B: Bronchitis. C: Pneumonia. D: Phthisis. E: Consumption. F: Tuberculosis, etc. G: Lung Diseases, including Bronchitis, Pneumonia, Phthisis, etc. H: Tuberculosis, including Phthisis, and all other forms.

+-----------------------+---------+-----------------------------+---------+----------+ | | | |TOTAL |Death-rate| | | | DEATHS FROM |DEATHS | per 1000 | | | | |FROM | Members. | | | +----+----+---------+----+----+---------+----------+ | | | | | | | | |Per |Per | | | | | | | | | |col.|col. | | | No. of | | | | | | | 9. | 10. | | ||Members.| A | B | C | D | E | F | G | H | I | J | +-----------------------+---------+---------+----+----+----+----+----+----+----+-----+ | 1894. =1= | =2= | =3=| =4=| =5=| =6=| =7=| =8=| =9=|=10=|=11=|=12= | |Half-year ended June 30| 12,417 | 61| 7 | 2 | 21 | ...| 2 | 30 | 23 | ...| ... | | „ „ Dec. 29| 12,544 | 46| 2 | 2 | 11 | ...| 1 | 15 | 12 | ...| ... | | +---------+----+----+----+----+----+----+----+----+----+---- + | Whole year {| 12,480 |}107| 9 | 4 | 32 | ...| 3 | 45 | 35 | 3.6| 2.8 | | {|(average)|} | | | | | | | | | | | +=========+====+====+====+====+====+====+====+====+====+=====+ | 1895. | | | | | | | | | | | |Half-year ended June 29| 13,378 | 78| 6 | 9 | 23 | ...| 6 | 38 | 29 | ...| ... | | „ „ Dec. 28| 13,593 | 65| 6 | 5 | 16 | ...| 3 | 27 | 19 | ...| ... | | +---------+----+----+----+----+---------+----+----+----+-----+ | Whole year {| 13,485 |}143| 12 | 14 | 39 | ...| 9 | 65 | 48 | 4.8| 3.6 | | {|(average)|} | | | | | | | | | | | +=========+====+====+====+====+====+====+====+====+====+=====+ | 1896. | | | | | | | | | | | | |Half-year ended June 27| 13,673 | 75| 5 | 7 | 17 | ...| 2 | 29 | 19 | ...| ... | | „ „ Dec. 26| 13,906 | 68| 2 | 8 | 26 | ...| 1 | 36 | 27 | ...| ... | | +---------+----+----+----+----+----+----+----+----+----+-----+ | Whole year {| 13,784 |}143| 7 | 15 | 43 | ...| 3 | 65 | 46 | 4.7| 3.3 | | {|(average)|} | | | | | | | | | | | +=========+====+====+====+====+====+====+====+====+====+=====+ | 1897. | | | | | | | | | | | | |Half-year ended June 26| 13,862 | 82| 6 | 8 | 19 | ...| 4 | 33 | 23 | ...| ... | | „ „ Dec. 25| 14,405 | 54| 4 | 2 | 21 | ...| 1 | 27 | 22 | ...| ... | | +---------+----+----+----+----+----+----+----+----+----+-----+ | Whole year {| 14,133 |}136| 10 | 10 | 40 | ...| 5 | 60 | 45 | 4.2| 3.2 | | {|(average)|} | | | | | | | | | | | +=========+====+====+====+====+====+====+====+====+====+=====+ | 1898. | | | | | | | | | | | | |Half-year ended June 25| 14,602 | 77| 5 | 3 | 22 | ...| 2 | 30 | 24 | ...| ... | | „ „ Dec. 31| 15,075 | 69| 5 | 1 | 19 | ...| 1 | 25 | 20 | ...| ... | | +---------+----+----+----+----+----+----+----+----+----+-----+ | Whole year {| 14,838 |}146| 10 | 4 | 41 | ...| 3 | 55 | 44 | 3.7| 3.0 | | {|(average)|} | | | | | | | | | | | +=========+====+====+====+====+====+====+====+====+====+=====+ | 1899. | | | | | | | | | | | |Half-year ended June 24| 15,393 | 78| 7 | 6 | 23 | ...| 3 | 36 | 26 | ...| ... | | „ „ Dec. 30| 15,854 | 99| 2 | 13 | 39 | ...| 4 | 54 | 43 | ...| ... | | +---------+----+----+----+----+----+----+----+----+----+-----+ | Whole year {| 15,623 |}177| 9 | 19 | 62 | ...| 7 | 90 | 69 | 5.8| 4.4 | | {|(average)|} | | | | | | | | | | | +=========+====+====+====+====+====+====+====+====+====+=====+ +-----------------------+---------+----+----+----+----+----+----+----+----+----+-----+ | Average for 6 years | 4.5| 3.4 | +=========================================================================+====+=====+

LONDON SOCIETY OF COMPOSITORS.

+----------+--------+-----+----+----+----+-----+----+----+----+-----+-----+ |Year 1897 | 10,780 | 126 | 13 | 10 | 33 | ... | 11 | 56 | 44 | 5.2 | 4.0 | | „ 1898 | 11,079 | 141 | 10 | 5 | 40 | 1 | 11 | 56 | 51 | 5.0 | 4.6 | | „ 1899 | 11,415 | 132 | 11 | 9 | 28 | 1 | 7 | 49 | 35 | 4.3 | 3.0 | +----------+--------+-----+----+----+----+-----+----+----+----+-----+-----+ | Average for 3 years | 4.8 | 3.9 | | | | === | +-------------------------------------------------------------+-----+-----+ | ENGLAND AND WALES.--_Per 1000 Population (1881–90)._ | +-------------------------------------------------------------------+-----+ | Mean Annual Death-rate of male persons, 20–65 years of age 4.5 | 1.8 | | | === | +-------------------------------------------------------------------+-----+

In thus expounding the subject of lead poisoning in printers, I have rather drawn attention to dangers that were more common in the past than exist at present, for, fortunately in this country at least, plumbism among compositors is very much on the wane. It is seldom that we meet with cases of printer’s colic in these days, owing very largely to the change in the method of printing newspapers. Until recently the printing of newspapers was done by ordinary type, the compositor setting the type by touch and not by sight. He quickly picked out the required letters, deftly inserting the nail of his thumb into the groove on one side of the type. It was through these operations that the skin of the fingers became thickened, and lead dust got under his finger nails. Having set and printed the paper, he had to take up, wash the type in lye, and subsequently distribute it, _i.e._, put each type back into its proper place. The distribution of the type required even more care than the setting of it, for a type wrongly distributed became a source of future trouble. Printing by hand type is rapidly on the decline, and is being replaced by stereotyping and linotyping. For newspaper printing there are now several fast printing machines in existence. Stereotyping has made it possible to print from a stamped cylinder without making direct use of the individual type. Endless rolls of paper, too, feed the printing machines. As many as 10,000 thirty-two page periodicals can be thrown off in an hour, but by perfecting the apparatus, as in Hoe’s machine, as many as 24,000 are capable of being thrown off in an hour. It is in typesetting machines with automatic distribution that the greatest progress has been made. The Merganthaler linotype machine, which is used for newspaper printing, produces and gathers in order successive bars of metal, each of the required length and breadth of a line, and bearing on its upper surface the type which prints the line. In the machine are small brass matrices, representing the different letters, etc. When the operator presses a finger-key on the board in front of him a single matrix bearing the required letter falls out of the magazine, and is carried to the assembling block, where the various matrices are set up, side by side, in a line or row. Subsequently these are transported to the face of a vertical mould wheel. Into the face of the mould molten type-metal is pumped, and thus a slug or linotype is produced. As the formation of the slugs is effected automatically, the operator does not handle the metal, consequently plumbism is rare, only two cases of lead poisoning in linotypists appearing in the Annual Report of the Chief Inspector of Factories for 1899, and four in 1900.

The new methods of printing have certainly diminished the numbers of cases of lead poisoning among printers, but the introduction of linotyping is losing us, as a people, an art. No person contends that, for finish, linotyped printing is equal to that obtained by hand-set type. Except for book-printing, in which the letters stand out boldly and clearly, and which as a trade is being relegated to a few towns, stereotyping and linotyping are in our own country rapidly eliminating typography. Since this is unavoidable, it is to be hoped that linotyping will yet further improve, for badly-printed newspapers are trying to the eyes. On the Continent most of the small newspapers are still printed by hand-set type, and consequently lead poisoning among printers is more prevalent there than here.

Compositors working the linotype machine run little risk of lead poisoning if they keep themselves and the workrooms clean. In linotypists the danger is not in handling the metal, for the need of doing this is rare; it is rather through inhalation of the fumes of the molten lead or from oxidation of lead particles that are lying about on the machine and floor. I have met with a few cases of colic in linotypists, but the attacks of pain have been mild and much more quickly got over than in compositors who use the ordinary type. In some, too, I have observed some of the milder derangements of the nervous system, mostly functional, that are the result of plumbism.

_Plumbing._

Plumbers are not a long-lived class. They suffer from lead poisoning in consequence of handling sheet-lead, pipes made from the same metal, also from working with white lead. They often complain of a sweet metallic taste in the mouth during the beating of the lead and the application of solder.

Gasfitters and plumbers run the risk of being poisoned also in another manner, to which allusion may be incidentally made here. When making the necessary connections between the pipes going into the houses and the mains, the gas in the latter is not shut off on account of its requirement by consumers. As a consequence of exposure to coal gas escaping from the main pipes, the workmen occasionally become dizzy and unconscious, lose their eyesight for several minutes, as well as the muscular power of their limbs. They have to be removed by their fellow-workmen, who often administer an emetic of salt and water when consciousness has sufficiently returned to enable them to swallow. The vomited matter smells strongly of coal gas. The symptoms are known as “gassing” by the workmen. In some of the men who have thus suffered I have found that complete muscular power had not returned to the limbs three months after the accident, that the knee-jerks were exaggerated, and that the patients were nervous and the subject of tremor. Albumen or sugar may be temporarily present in the urine.

_House Painting._

House painting is a prolific cause of plumbism. Dr Stühler, of Berlin, who obtained his facts from benefit societies, states that of 3000 painters in Berlin 313 or 10.4 per cent. were annually off work from the effects of lead poisoning. In Paris, Gautier found that out of 14,000 painters and varnishers 250 on an average attended the hospitals on account of plumbism, and that an equal number was treated at home, making a total percentage of 3.5. Of late the admissions into the hospitals of cases of lead poisoning have been increasing notwithstanding the regulations issued by the French Government, and the fact that the patients coming from white lead works have been getting fewer. This circumstance is explained by other industries sending more patients than formerly, and of these industries house painting has contributed the largest number. During the years 1894–98 this trade alone, and colour-grinding, contributed 223 patients, while white lead works only sent 4, and the occupation of plumbing 22. Of 86 fatal cases of lead poisoning in Paris during the five years mentioned, 43 occurred in painters, 2 in plumbers, and only 1 in a white lead worker. In consequence of the large amount of plumbism that prevails among house painters in Paris, it is Gautier’s contention that the occupation should be brought under closer Government supervision. The same remark applies equally to the trade in our own country. Lead poisoning among house painters is much more prevalent than people imagine. Taking a few monthly reports at random, there were 12 cases of plumbism in house painters (with 1 death) reported to the Home Office during the month of June 1900; in the month of November 1900 there were reported 11 cases of lead poisoning (including 2 deaths) among house painters and plumbers, and in the following month 14 cases of lead poisoning (including 4 deaths) in house painters and plumbers. During 1900 there were 199 cases of lead poisoning in house painters and plumbers reported to the Home Office. These figures show that if Saturnine poisoning in house painting was notifiable, both it and plumbing would be found to be trades that are the cause of a great amount of sickness, of which at the present time we hear very little. During the year 1899 upwards of 100 cases of lead poisoning were notified, while from district registrars information was received of 18 fatal cases of plumbism attributed to the occupation of house painting. Notification of lead poisoning in house painters is not compulsorily required by the Home Office. Cases of industrial lead poisoning, also arsenic, phosphorus, mercury, and cases of anthrax, are obliged to be reported to the Chief Inspector of Factories by the medical men who attend the patients, and by employers, but an exception is made in regard to house painting, one of the reasons being that as painters pursue their avocation largely in the open air and in houses away from the employer’s premises, it is difficult to say where the poisoning was contracted. Industrial lead poisoning to be notifiable to the Home Office must have occurred in places that are controlled by the Factory and Workshop Acts. When a painter, who is following his occupation in a factory or workshop and is engaged in grinding or mixing colours, develops lead poisoning, the illness has to be notified. As the Act stands at present, the Home Office cannot deal with certain forms of industrial lead poisoning, nor have the factory inspectors power to enforce improved conditions of labour. In view of house painting being ultimately brought under _Special Rules_, it is very desirable that all cases of sickness in house painters and deaths from plumbism should be reported. To the ordinary medical practitioner, who has been informed that he must report all cases of occupational lead poisoning coming under his care, it is embarrassing for him to draw a distinction between lead poisoning caught by one man filling a barrel with dry lead carbonate in a workroom, and another man who uses this as a paint in decorating the interior of a house or shop, and yet while the former is notifiable, the latter is not, although the same cause is in operation in both. The sphere of Home Office influence ought therefore to be extended so as to include house painting, and this might be done under the Act that allows the Home Secretary on sufficient evidence to schedule a trade as dangerous.

There are several ways in which painters and colour-mixers become the victims of lead poisoning. The men who grind or mix the colours run the risk of inhaling the dust. Unless this process is carried on either in closed spaces or in airy and well-ventilated rooms, the atmosphere becomes thick and can only be cleared by means of a fan. In this country there are, excluding house painters, upwards of 6000 persons employed in the manufacture, mixing, and grinding of paints and colours. Of 48 cases of plumbism that occurred among these persons in 1899, 30 were grinders and 7 of them packers.

For the purposes of house painting, the pigments are generally mixed with oil and a turpentine body. It has sometimes been thought that the lead poisoning of painters is due to the inhalation of the terebinthated vapour that rises from the painted surface. That this is a possible source is shown by the outbreaks of “belly ache,” or _colique sèche_, that occurred a few years ago in the Tropics, and played sad havoc with the sailors of the French Navy. For a long period the nature of the illness was not recognised. It was thought by some to be a neurosis of the abdominal sympathetic nervous system, and due to chill, while other physicians regarded it as a form of malarial disease. Lefèvre, the Director of the Naval Sanitary Board at Brest, ultimately gave it as his opinion that “the _colique sèche_ of the French Navy is nothing more than lead poisoning, and the reason why colic was more frequent among French sailors than those of other countries was due to the fact that lead entered more into the construction of their ships of war. It formed the tanks for holding the drinking water and the pipes for carrying the water; it was present in the paint of the cabins, in the enamel of the drinking-cups, and in the cooking utensils.” Out of this number of possible causes some of the cases of _colique sèche_ might have been due to sleeping in cabins newly painted with lead compounds, although drinking contaminated water would be the more probable cause. A common cause of lead poisoning in house painters is inhalation of the fume evolved during the burning-off of old paint. When engaged for long at this kind of work the men complain of headache, nausea, and occasionally have colicky pains in the abdomen. There is yet another manner in which plumbism may develop, and this occurs in finer work, where several coats of paint have to be applied. After what is called laying-on of the prime colours and puttying with white lead comes the flat colouring. When the coats of paint have become dry the workman is obliged to use sandpaper to rub the surface flat. In doing this a considerable amount of dust is given off which is rich in white lead. It is inhalation of this dust that so frequently induces colic and paralysis of the hands in house painters. Carelessness and ignorance are frequently contributing causes. Men, while laying-on the white paint with a flat knife, have often been observed using the hollow of their left hand as a reservoir for the paint. If there is any erosion of the skin, absorption of the poison is sure to follow. Layers-on are an unhealthy class of men. In Paris alone there occurred 18 deaths during the years 1898 and 1899 in a small union of 200 members, the greatest age at death being 35 years.

A fresh danger has been recently introduced into house painting. A few months ago a house painter, aged 40, was admitted into the Newcastle Infirmary suffering from extreme blueness of the face, lips, ears, hands and fingers, and from colic. He had also a very blue line on his gums. The illness was plumbism, but with something superadded. He had been engaged in removing the varnish and paint from old Venetian blinds, and had been using a dark brown liquid with a pungent, penetrating odour, known in the trade as a special patent. During the process of rubbing and swilling the blinds, and subsequently of sandpapering them, a strong sickening odour arose, which caused him to vomit and to have severe headache. The vapour, too, caused him to become so drowsy that he would almost fall asleep. He would feel giddy, but had no difficulty in walking, nor was his eyesight affected. The man was pale as well as blue, he had a haggard expression, and there was the most marked cyanosis possible. He had colic and constipation. His internal organs were healthy, including the kidneys. He had marked tremor of both hands, but no paralysis. It was quite clear that there was an acute intoxication of some kind or another, over and above lead poisoning. Several examinations of the urine were made by Dr R. A. Bolam, who had charge of the patient, with the view of establishing the nature of the poison. The symptoms reminded me of those observed in men who are employed in painting ships with quickly-drying spirit paints. It was thought at first that the symptoms were due to the presence of aniline oil in the “patent,” or of some chemical akin to the pyridine group of compounds. The case is an illustration of the danger incidental to the use of highly volatile, complex, and unstable chemical compounds whose nature is not quite known, whose effects upon the human body can only be learnt by experience, and which have for their object, from a trade point of view, rapid execution of work.

Painters of ships’ cabins suffer from plumbism as much if not more than house painters, since they are often obliged to work in close, confined spaces; so, too, do the painters of the back of mirrors, from using red lead; also painters of agricultural implements, etc.

It is worthy of mention that shipbuilders have found in the red oxide of iron a cheaper and safer pigment for painting the outside of steel plates than red lead.

The question as to whether any comparatively harmless substitute for white lead can be found for house painting is discussed at p. 293, _q.v._

_Coach Painting._

Lead poisoning in coach and carriage painters is far from being rare. In the painting of carriages there are often as many as eighteen coats of paint and varnish applied. Frequently the work is done in rather close and very ordinarily ventilated places. In Newcastle it is the practice of large firms of coach makers to give a carriage three coats of primary paint, six of filling up, three or four of oil colours, two of varnish colour, _i.e._ oil and varnish mixed, and, finally, about four coats of varnish. The colours used are white lead, dry and ground in oil: lampblack, ultramarine, yellow chromes, zinc white, and others known by particular names in the trade. “Driers” are also used, such as sugar of lead and terebene. Coach painters become the subjects of plumbism chiefly through inhaling the dust when sandpapering to get a good surface. They suffer from colic and wrist-drop. Many of the cases approach in severity the lead poisoning of file cutters. Dr Morison Legge states that the percentage of chronic plumbism among coach painters is greater than among file cutters.

Several cases of plumbism have occurred in the painting of new carriages, also in the breaking-up and burning of the wood of old railway carriages. Thirty-four of the cases of plumbism reported during 1900 as having taken place in coachbuilders. occurred in men engaged in railway shops.

It is almost unnecessary to repeat that in all places where lead paints are being handled and used, as in workshops, factories, ships and dockyards, there should be adequate washing accommodation, with plenty of soap, towels, and nail-brushes, and sufficient time ought to be given to the men to wash before leaving work.

_Glass Polishing._

After glass and crystal have been cut they have to be polished. The polishing is generally conducted on a revolving wheel or table made of wood, and upon which water, containing rouge or putty powder in suspension, is allowed to drip. When the article to be polished is a plane surface, _e.g._ a mirror, the wheel is a horizontal one revolving on a vertical axis. The water containing the rouge or putty powder escapes by a narrow opening from a conical vessel placed above the wheel. When finer work is required, _e.g._ the polishing of wine-glasses, electric-light globes, etc., the water drops on to a hard brush, which is attached to the external rim of a vertical wheel, from four to six inches in diameter, running at a high speed and revolving on a horizontal axis. For this kind of polishing putty powder alone is used. In some factories the liquid putty powder is fed on to the brush by a boy; in others the supply, as already mentioned, is automatic. Several samples of putty powder were sent to the Dangerous Trades Committee, and subjoined is the analysis of two of them:--

A. B.

Oxide of tin 29.72 per cent. 28.96 Oxide of lead 70.28 „ 68.07

In the very free use of this putty powder, rich in lead, the clothes and hands of the workers become bespattered by the thick spray thrown off from the rapidly-revolving wheels. Putty powder administered to animals in their food causes symptoms of Saturnine poisoning almost as quickly as white lead. In the evidence given before the Dangerous Trades Committee there was abundant proof of the extremely harmful effects of the use of putty powder in glass polishing. Many of the workers examined had suffered from colic, while others had been obliged to give up their employment on account of paralysis of the fingers and hands. It was ascertained that several of the male workers had died from acute convulsive seizures due to poisoning by lead. Another point to which attention was drawn was, that plumbism might develop in workmen in a glass-polishing shop who were not engaged in the actual process of polishing, and who had therefore not been directly brought into contact with the putty powder. This was due to the dried liquid on the floor becoming rubbed and trodden upon, rising as dust into the atmosphere, and being inhaled by the workmen in the shop.

Putty powder is a frequent cause of lead poisoning. The master polishers have for years tried to find a substitute for it. In many factories rouge is used. This is considered by many of the employers to be innocuous. On analysing rouge powders for the Dangerous Trades Committee, Professor Thorpe found that they contained commercial oxide of tin: that in one powder 0.13 per cent. of arsenious acid was present, and in another a trace of the same substance. Probably not much danger would follow the use of rouge powders containing such a mere trace of arsenic, but their employment would not be altogether free from risk; besides, since it can be shown that the presence of arsenic is not essential, then it ought to be eliminated altogether. The difficulty in regard to the use of harmless rouge powders is rather a technical or industrial question than medical. Do they answer the purpose as well as putty powder? The Dangerous Trades Committee found that opinions were much divided upon the point. Some of the glass polishers stated that rouge did not give such a fine effect, and that it took a longer time. On the whole, however, the results obtained have been such as to encourage employers to adopt it more freely. Where putty powder has been interdicted by the masters and only rouge used, the health of the workmen has wonderfully improved.

A few years ago M. Geroult proposed to the French glass polishers and crystal manufacturers, metastannic acid as a partial substitute for the putty powders that contained a large percentage of lead, and which had been the cause of several fatal cases of plumbism. The Academy awarded the Montyon prize to Geroult for his discovery. For the last ten years the new method has been followed in the glass works of Baccarat, and has given the most satisfactory results. Dr Schmitt, the surgeon to the works, says, that since 1891, the date of the substitution of the new for the old method, there has not been one single case of lead poisoning among the crystal cutters and glass polishers, nor an acute attack of plumbism in those workers who had previously suffered from lead poisoning. Formerly the putty powder contained 62 per cent. of lead, but in that recommended by Geroult there is only 20 per cent., and even with a smaller percentage of lead good manufacturing results can be obtained.

Glass polishing is one of those trades in which personal cleanliness of the worker can do a very great deal to prevent plumbism, and, knowing this, employers ought to provide ample washing accommodation and appliances; overalls should be worn; no food should be taken into or eaten in the workshop. All polishing should be conducted as far as possible in semi-enclosed cupboards, with draught tubes and fans, and the feeding of the wheels should be done automatically. There ought also to be frequent periodical medical examination of the workers, with power to suspend in case of signs of plumbism. These were the recommendations of the Dangerous Trades Committee, and as one result of their being put into practice the Medical Inspector of Factories, in his Report for 1899, says he is satisfied that the introduction of fans has materially diminished the danger of lead poisoning in the process of glass polishing. It has, practically speaking, abolished the bespattering of the workmen’s clothes and the splashing formerly observed during glass polishing.

_File Cutting._

Hand file cutting, although still giving employment in this country to a fairly large number of people, is generally stated to be a decaying industry. This is controverted by Dr John Robertson, Medical Officer of Health, Sheffield. It is, however, an unhealthy trade. In 1898 there were 46 cases of lead poisoning reported in file cutters, in 1899 the number was 41, and in 1900 there were 40 cases. The centre of the industry is Sheffield, but the manufacture is carried on in London, Glasgow, Rainhill, and Birmingham. There are upwards of 2000 hand file cutters in Sheffield alone. In the Annual Report on the health of the City of Sheffield, 1900, it is stated that there are 2040 persons engaged in 546 hand file cutting shops. Files can be cut both by hand and by machinery, but as file cutting by machinery is usually carried on in modern and well-ventilated factories, this method of manufacture need not detain us, for it is a healthy occupation, there being no lead used in the process. It is otherwise with hand file cutting. Seated on a “stock,” the hand file cutter has in front of him a stone block, into the centre of which a small piece of bar steel called a “stiddy” is inserted, and on this stiddy is placed a piece of metallic lead, which is called the “bed.” The file about to be cut is strapped on to the bed. The lines that are seen on a file are made by means of a chisel and hammer, each line representing a blow. The reason for using the lead bed to strike the file upon is, that while there may be as little recoil as possible, there shall yet be sufficient resistance to develop the line in its entirety as a result of the blow given by the hammer and chisel. As a consequence of constantly striking files of uniform size a groove comes to be formed on the lead bed, into which succeeding files easily fit. When he has cut one face of the file, the workman rubs that side with charcoal, turns it over, and then proceeds to cut the other side, after which both faces are briskly rubbed. The file cutter grips the chisel between the index finger and thumb of the left hand, and in order to get a good grip of the chisel, he often licks his finger. A good deal of strain is experienced by the fingers in a day’s work. The steel hammer used by a cutter generally weighs from 7½ to 9 lbs., and as each line on a file represents one stroke of the hammer, and there are often on large files as many as 3800 lines, it is estimated that in the course of one day a file cutter will lift a weight equal to several tons. A Gateshead file cutter, who consulted me recently, works with a hammer 7 lbs. in weight; he cuts files 16 inches in length. Each file receives 1500 “bats,” and he makes one and a quarter dozen of files daily, working eight to eight and a half hours. In the course of a day’s work he lifts 157,500 lbs. weight.

File cutting by hand is properly regarded as a dangerous industry. Although it claims annually large numbers as the victims of plumbism, it is difficult to say exactly in what form lead enters the system. In Sheffield the work is for the most part carried on in small, badly-ventilated, and overcrowded shops, more like outhouses, often situated in backyards or in the rear of dwellings, and not unfrequently contiguous to privies. Of 546 hand file cutting shops, in only 48 was there any means of ventilation provided, and in many of these “the means of ventilation consisted of a brick taken out of the wall.” Inside, the floor in nearly all of them is the bare earth, or bricks badly placed together. The workers are closely packed together without any consideration of the cubic space of the workroom. Hand file cutters as a class are anything but cleanly. Possibly their sense of indifference to dirt is largely the outcome of the long custom of the men taking their meals in shops totally unprovided with washing appliances. As a consequence of hammering and brushing the files, a considerable amount of dust is created, some of which must be inhaled, as the man or woman--for both sexes follow the occupation--bends closely over the stock. In several samples of dust removed from the stocks and rafters of the shops, lead[66] was found, the other constituents of the dust being particles of iron, charcoal, and chalk. File cutting is a sedentary occupation. In order to get as much light as possible upon their work, the men sit close up to the window, but they object to any part of the window being open on account of the cold and draughts. Owing to the close and dusty atmosphere in which the work is carried on, the general health of the file cutter becomes gradually undermined. As a consequence of this diminished vital resistance, and the practice of eating his food with unwashed hands, the licking of his fingers when at work, and inhalation of dust, the file cutter, in course of time, becomes the victim of lead poisoning. It is metallic lead dust that is given off during the blows with the hammer and chisel upon the file. Lead in this form is certainly much less harmful than when in such a soluble combination as the oxide or carbonate, but oxidation of the surface of the lead is constantly taking place, thereby rendering the metal more or less absorbable.

In addition to the ill-health caused by lead, pulmonary consumption carries off a large number of file cutters. The men work in a stooping position in overcrowded and ill-ventilated shops for long hours daily, with the result that the trade occupies an unenviable position on account of its mortality from phthisis. It is not, therefore, lead _quâ_ lead that is the sole danger, but the unhealthy conditions under which the labour is carried on.

In Sheffield, file cutting has received considerable attention from members of the medical profession. Thirty years ago Dr J. C. Hall denounced the trade as unhealthy, and demonstrated how, with such simple means as the free use of soap and water, much of the suffering and ill-health traceable to lead could be averted. Drs Sinclair White, Porter, and Harvey Littlejohn have in recent times written upon the evils of the trade from different standpoints. Notwithstanding all the attention the subject has received, hand file cutting still remains a most unhealthy industry. All the workers look anæmic. Many whom I examined both in Sheffield and in Rainhill had suffered from colic; several were completely disabled on account of paralysis of the extensor muscles of the fingers and wrists. It is rather in the chronic forms of plumbism, and in those persons in whom the kidneys become affected and health breaks down, that the worst effects of file cutting as an occupation are seen. Out of 100 file cutters examined by Dr Sinclair White, 74 had a blue line on the gums, 28 had had lead colic, and 20 paralysis of the wrists and fingers. The trade is characterised by a high mortality, the figures being 316 against 123 for occupied males in general.

The possibility of finding a substitute for the lead bed upon which the file is cut is, although not a new subject, one to which the Dangerous Trades Committee gave considerable attention. It was felt that if lead could be eliminated, the occupation would be rendered much less harmful. It was ascertained that in Germany pads of paper had been tried for small files, also that clay and sand encased in canvas, bars of wood, copper, vulcanite, and various combinations of indiarubber and gutta-percha had been tried, but each in turn discarded, owing to its unsuitability as a bed. This is a field of inquiry that would well repay any practical file cutter.

File cutters may work at their trade for years without becoming ill. Others again early suffer from colic, and the attacks of abdominal pain keep recurring every few months. Gradually, or suddenly, in those who have been thus afflicted, or even in those who have not had colic, paralysis of the fingers and hands develops. The peculiarity of file makers’ paralysis is, that while the extensor muscles of the fingers and wrists may become affected, so as to constitute a veritable “wrist-drop,” there is observed more frequently paralysis with wasting of the smaller muscles of the fingers and thumb. The loss of power is usually confined to the fingers of the left hand. It is with the left forefinger and thumb that the chisel is grasped, and as a consequence of the workman holding the chisel in this position during a great portion of the day, there is an amount of muscular strain experienced which cannot but play a part in determining the paralysis and its location. It is not the sole explanation, however, for the paralysis also affects at times the muscles of the right hand of the file cutter. This is the hammer hand that really does the hardest work, though not of the same strained character.

While it is to the fact of the work being conducted upon a lead bed, and the want of personal cleanliness on the part of the file cutter, that plumbism is mainly due, there are, as seen in Sheffield, contributory causes in operation which tend to increase the harmfulness of the occupation. One of these is, that file cutting is often a home industry. The work is frequently carried on in the living room or kitchen of a dwelling-house. Domestic and family duties come to be disregarded by the mother, for she, no less than the other members of the family, interruptedly lends a hand to increase the income of the home. Readers of this paper are prepared to learn that work under these circumstances is usually carried on in houses of the poorest description, and that, as a consequence of the dangerous character of the occupation, the unhealthy atmosphere of the workroom, and the constitution of the workers having become undermined through poverty, lead poisoning when it occurs is not only extremely severe, but may affect those who are simply living in the house and not actually engaged in file cutting at all. How to grapple satisfactorily with this most unhealthy trade is one of the many difficult labour problems that have been presented to the Home Office. Both for it and the peculiar tenement conditions under which the industry is carried on in Sheffield, fresh legislation is required.

In file cutting shops generally, the air space ought to be extended to 450 cubic feet at least for each person (it is 600 feet in cotton factories); there should be greater distance between the stocks, say 4 feet; better ventilation; washing appliances, with plenty of soap, water, towels, nail-brushes; wearing of overalls; periodic lime-washing of the workshops; concrete, asphalt, or wooden floors, which can be damped and swept regularly; prohibition of the taking of food into the workshops; and in the event of new buildings being erected, submission of the plans to the Home Office. For ventilation purposes Dr John Robertson recommends an inlet of the type of a Sherringham valve.

The report on the sickness experience of the Society of File Cutters by Hand in Sheffield, by Mr Stuart Uttley, Secretary of the Federated Trades Council, and which is published in the Fourth Interim Report of the Dangerous Trades Committee, 1899, p. 21, shows the extent to which file cutters are thrown off work every year through illness, including lead poisoning. This Society does not contribute any sick benefit, but during the illness of members their contributions to the Society cease. In this way it is readily known how many members are off work. The report deals with adult males only, and the dates chosen are 1891 and 1896, two years when trade was good, when all the members were at work, and malingering was practically beyond question. Out of 1092 members in the Society in 1891, the claims for exemption on account of sickness were equivalent to 1109 weeks, or a fraction of over one week per man per year. It is not maintained that all the sickness was due to plumbism. In 1896, 961 file cutters who were working in Sheffield claimed 951 weeks’ exemption from payment of contributions on account of sickness, or a fraction under one week each per man per year. There were 36 cases of plumbism in file cutters notified in Sheffield from July 1898 to June 1899, and of these 35 were men. A glance at Dr Tatham’s tables of comparative mortality, in an earlier part of this book, will show to what a large extent pulmonary consumption prevails in file cutters.

Dr Harvey Littlejohn found that in twelve years there occurred 91 deaths from plumbism in Sheffield, and that of the 91 people who died, 56 were file cutters. These statistics, however, do not represent the total number of deaths from lead poisoning. Plumbism is sometimes so tardily developed, and the constitution of the workman so gradually undermined, that as pathological changes are very slowly induced in internal organs, such as the kidneys, an individual may die long after he has given up working in lead, and the death be registered as having been caused by chronic disease of the kidneys, which but for lead poisoning would probably not have developed at all. It is thus that many fatal cases of lead poisoning fail to be attributed to their proper cause, owing to the fact that as death is the result of well-defined disease of internal organs, the connection of which with plumbism is overlooked, the occupation of the patient is either not inquired into or is completely ignored by the medical attendant. It was with the view of minimising this error, and of bringing into greater prominence the connection of lead poisoning with industrial occupation, that the Dangerous Trades Committee suggested in its final Report, 1899, p. 6, that if all deaths among workpeople who had been employed at any time within three months immediately preceding death in a trade in which Special Rules are established were compulsorily reported to the coroner, many facts of intrinsic and statistical value would be ascertained, and much light shed upon some of the occupations that give rise to industrial disease. By this means much injury and suffering might be mitigated at an earlier date than at present through alteration of the conditions under which the particular industry is carried on. Possibly six months would be better than the three suggested in the above sentence. Usually lead poisoning is so slowly and insidiously developed in file cutters, that the workpeople become indifferent to the dangers, and yet when symptoms of plumbism occur they can be very severe. Occasionally in female file cutters the malady shows itself at an early date after exposure, and the symptoms are those rather of the acute than the chronic form of plumbism.

Since, doubtless, the tendency to plumbism in file cutters is favoured by the nasty habit indulged in of licking their left thumb in order to get a better grip of the chisel, the application of resin to the finger has been recommended, but the suggestion does not appear to have met with much approval. Allusion has been made at the commencement of this article to the fact that it is only hand made file cutters who suffer from lead poisoning. In the United States all file cutting is done by machinery, and in that country plumbism among file cutters is unknown. In Britain machine-made files are slowly supplanting those cut by hand, but the customs of a trade die hard.

_Use of Lead in Potteries._

Staffordshire is the home of the pottery industry in this country. In Stoke-on-Trent, Burslem, Hanley, Longton, Fenton, and Tunstall, the trade is centred. These towns form what is called the “Potteries,” a district of about ten miles in length and four in breadth. Here nine-tenths of the earthenware produced in the United Kingdom are manufactured. The location of the manufacture of pottery in Staffordshire is an illustration of how industries cling to particular districts. At the present time none of the clay which is used in the manufacture of the finer earthenware is found in the neighbourhood. Originally there was plenty of coarse clay, and there is still abundance of marl, which is used for making saggers and firebricks. Coal, however, is abundant, and cheap fuel is an important item in the manufacture of pottery. In the early part of the seventeenth century there was a good supply of clay and fuel in the locality. The ware produced at that time was made from yellow or red marl, glazed with galena, or crushed raw lead ore brought from the Derbyshire mines; but in 1680, common salt was substituted for galena in the glaze. The articles produced were known as Crouch ware. It was in Burslem that this ware was first made. In 1759, Wedgwood perfected the white cream ware, and introduced many improvements into pottery, especially in the manufacture of green, black Egyptian, and jasper wares. Although England never outrivalled France and Germany, _e.g._ Sèvres or Dresden, in the manufacture of soft china, yet she has produced earthenware on a larger scale and supplied more of the world’s markets than other pottery districts, and is still doing her utmost to maintain her supremacy. In Staffordshire there is plenty of common clay, marl, or fireclay which, as already mentioned, is useful for making saggers, _i.e._ the large vessels in which earthenware is fired. The clays necessary for making the finer earthenware and china are brought from Dorset, Devon, and Cornwall. The clay or felspar used is, roughly speaking, a silicate of alumina in combination with water, potass, soda, lime, or iron. These ingredients act as fluxes on the silicate, and therefore help its vitrification. For earthenware, two kinds of clay may be used, the blue or ball clay and kaolin, but for porcelain only kaolin. It is estimated that upwards of 70,000 tons of ball clay are annually imported into the Potteries from the south of England. Kaolin, the Chinese word for the clay out of which porcelain is made, is in Staffordshire called China or Cornish clay, and is got from granite rocks. Workmen mix this Cornish clay with water in a large tank. The quartz, mica, and undissolved felspar sink to the bottom, while the thick white water in which the fine particles of kaolin are suspended is run off into another tank in which the kaolin is allowed to become precipitated. The precipitate is subsequently removed, dried, and exported from the south of England as a very fine white clay, which contains more alumina but less iron than the untreated clay. Of this material about 130,000 tons are sent to the Potteries every year. In Staffordshire what is called Cornish stone is also used. This is a kind of granite in which the felspar retains its alkaline elements, and is also useful as a vitrifying agent. Ground flints, too, are employed in the manufacture of earthenware. Ball clay forms the foundation of earthenware; flint is simply the whitening material. The addition of Cornish clay makes the body still whiter and less liable to break under a heavy weight and changes of temperature, while Cornish stone renders the ware more compact and of a closer texture. A mixture of these substances when fired would not produce earthenware of a perfectly white colour. The iron contained in them would impart a yellow tinge. This is overcome by adding oxide of cobalt, which neutralises this tendency so completely that white ware is produced.

It is unnecessary to describe at any length the process of manufacture. Once the ware is made it is gently dried by exposure to the ordinary air; afterwards it is placed in saggers and fired in large cylindrical ovens, slowly at first to prevent too sudden evaporation of moisture and to prevent splitting. When the ware has undergone its first firing it is known in the trade as _biscuit_. Common terra-cotta and stoneware only require one firing, but for all English ware it is necessary that it should be placed twice in the oven so as to get a denser texture of the ware, also for the purpose of glazing, or that process whereby the article is dipped in a liquid in which usually raw or ground vitrified lead is suspended. If the ware is to remain white, it is, after it has been biscuited, sent to the dipping department to be glazed, and if it is to be decorated and sold as an inexpensive ware it goes in addition to the printing shop, where by means of thin paper transfers it receives the desired coloured impression. The more expensive ware is painted by hand in the ordinary way by means of small brushes. In underglazed colouring the decorated ware is placed in a kiln and brought to a red heat so as to burn off the oil in the colouring. The earliest glaze used in Staffordshire contained galena or sulphide of lead. The materials used for glazes are the same as those for the body, viz., silica as found in flint, and felspar, to which is often added Cornish stone. These are called the hard materials, and they are vitrified by such fluxes as oxide or carbonate of lead, borax or boric acid, potash, soda, carbonate of lime and barytes. In the Potteries each manufacturer has his own receipt for glazes, and he guards it with a conservatism that to outsiders seems unnecessary in these days of advanced chemical research. The ingredients or the glaze can be rendered very insoluble by vitrifying them in a reverbatory furnace or crucible by exposure to an intense heat, whereby a compound like green glass is obtained, which is called a _fritt_. This is subsequently ground and mixed with water. Into this liquid the ware is dipped, and having been biscuited, the porous ware rapidly absorbs the water, leaving the solid particles of the glaze on the surface. Instead of fritting the lead, many manufacturers until lately simply added raw lead, _i.e._ white lead or carbonate, to the other ingredients in the dipping tub, and it is owing to persistence in this practice that lead poisoning has been so prevalent in the Potteries. After the ware has been dipped in the glaze it is fired for a second time in a manner similar to the first, only in smaller ovens, and with greater care, the individual pieces being better separated from each other. On removal of the ware from the oven it is ready for the market. In most factories the ware, after having been dipped, is dried and _cleaned_ by women, _i.e._ the borders are scraped with a knife to remove any surplus glaze. When this process of cleaning is conducted over a trough that is aspirated there is very little dry glaze dust scattered about the room, but if performed in a room without proper ventilation the atmosphere becomes dusty and dangerous. Ware cleaning ought never to be conducted in the same room as the dipping.

What is called _porcelain_ or _china_ differs slightly from earthenware. There are three kinds of porcelain: (1) that made from kaolin and felspar, with the addition of quartz: this is manufactured in Limoges in France; (2) soft porcelain, which was formerly made at Sèvres, near Paris; and (3) English porcelain, which, like the first, is made from kaolin and Cornish stone, but differs from it in containing calcined bones. For hard porcelain, the glaze is made from felspar, which contains a variable quantity of quartz, while in the glaze used for the other two there is usually some silicate of lead and borates, the presence of which allows of a lower temperature being used for the biscuited ware. Thirty-five firms in the Potteries make china, and 195 earthenware.

The population of the Potteries and of the district immediately round about is probably not less than a quarter of a million. It is estimated that there are from 46,000 to 50,000 people working in the Potteries, of whom 4703--viz., 3123 males and 1580 females--are engaged in what might be called lead or dangerous processes. In his Annual Reports the Chief Inspector of Factories shows that in 1898 there were 457 cases of lead poisoning notified to the Home Office from the Potteries, 249 in 1899, and 200 in 1900, whereas for the same periods the following numbers were reported from all other trades combined, excluding house painters, 1278, 1258, and 1058. The number of persons working “in the lead” in the Potteries in July 1898 was 4703, and were classified as follows:--

NUMBER OF PERSONS employed in Processes where Lead is used in the manufacture of Earthenware and China, North Stafford District, July 1898.

+------------------------+---------------+---------------+---------------+ | Persons Employed. | Under 13. | 13 to 18. | Over 18. | +------------------------+------+--------+------+--------+------+--------+ | |Males.|Females.|Males.|Females.|Males.|Females.| |(_a_) Dippers | ... | ... | 9 | 15 | 486 | 66 | |(_b_) Dippers’ | | | | | | | | Assistants | 7 | ... | 408 | 49 | 103 | 58 | |(_c_) Ware Cleaners | ... | ... | 15 | 76 | 90 | 382 | |(_d_) Glost Placers | ... | ... | 58 | 8 | 1747 | 38 | |(_e_) Majolica | | | | | | | | Paintresses | ... | ... | ... | 62 | ... | 233 | |(_f_) Ground Layers | ... | ... | ... | 9 | 89 | 373 | |(_g_) Colour Dusters | ... | ... | ... | 24 | 7 | 118 | |(_h_) Enamel Colour & | | | | | | | | Glaze Blowers | ... | ... | ... | ... | 9 | 12 | |(_i_) Other persons | | | | | | | | coming in contact| | | | | | | | with lead, not | | | | | | | | enumerated in the| | | | | | | | foregoing list | ... | ... | 19 | 13 | 76 | 44 | +------------------------+------+--------+------+--------+------+--------+ | Totals | 7 | ... | 509 | 256 | 2607 | 1324 | +------------------------+------+--------+------+--------+------+--------+

Males 3123 Females 1580 ---- Total 4703 ====

At the date of the Report on the Use of Lead in Potteries, presented by Professor Thorpe and myself to the Home Secretary (1899), the total number of cases of lead poisoning in the Potteries during the previous three years, _i.e._ since the Act of 1895, as to compulsory notification, came into force, was:--

Males 478 Females 607 ---- Total 1085 ====

These were distributed thus:--

NUMBER OF PERSONS reported as suffering from Lead Poisoning during the years 1896, 1897, and 1898.[67]

+------------------------+-----------------------------------------------+ | | 1896. | 1897. | 1898. | | +-------+-------+-------+-------+-------+-------+ | | 13 to | Over | 13 to | Over | 13 to | Over | | | 18. | 18. | 18. | 18. | 18. | 18. | +------------------------+---+---+---+---+---+---+---+---+---+---+---+---+ | | M.| F.| M.| F.| M.| F.| M.| F.| M.| F.| M.| F.| |Dippers | 3| 1| 50| 14|...|...| 48| 9|...| 1| 41| 6| |Dippers’ Assistants | 9| 6| 3 | 12| 26| 2| 3| 8| 14| 2| 6| 17| |Ware Cleaners |...| 3| 2 | 54|...| 2|...| 66|...| 3| 1| 55| |Glost Placers | 1|...| 57| 1|...|...| 53| 2|...|...| 48| 1| |Majolica Paintresses |...| 1|...| 38|...| 7|...| 41|...| 4|...| 27| |Ground Layers |...|...|16 | 34|...|...| 15| 40|...|...| 10| 45| |Colour Dusters |...| 2|...| 11|...| 9|...| 1|...| 6|...| 9| |Litho. Dusters, or | | | | | | | | | | | | | | Cleaners in making | | | | | | | | | | | | | | Litho. Transfers |...| 10|...| 11|...| 8| 4| 10| 4| 8| 6| 9| |Other persons coming in | | | | | | | | | | | | | | contact with lead, not | | | | | | | | | | | | | | enumerated in the | | | | | | | | | | | | | | foregoing list |...| 1| 10|...|...| 2| 25| 5|...|...| 22| 3| +------------------------+---+---+---+---+---+---+---+---+---+---+---+---+ | Totals | 13| 24|139|175| 26| 30|148|182| 18| 24|134|172| +------------------------+---+---+---+---+---+---+---+---+---+---+---+---+

Age. 1896. 1897. 1898. 13 to 18 { Males 13 26 18 = 57 years. { Females 24 30 24 = 78

Over 18 { Males 139 148 134 = 421 { Females 175 182 172 = 529

Grand total in 3 years { Males 478 { Females 607 ---- 1085 ====

COMPARISON of Number of Persons “Working in Lead” in July 1898, with number of cases of Lead Poisoning reported in year 1898.

+----------------------------+---------------+---------------------------+ | | Workers. | Lead Cases. | | +------+--------+------+-----+--------+-----+ | |Males.|Females.|Males.| Per |Females.|Per | | | | | |cent.| |cent.| +----------------------------+------+--------+------+-----+--------+-----+ |Dippers | 495 | 81 | 41 | 8.2 | 7 | 8.6 | |Dippers’ Assistants | 518 | 107 | 20 | 3.9 | 19 |17.8 | |Ware Cleaners | 105 | 458 | 1 | 1.0 | 58 |12.7 | |Glost Placers | 1805 | 46 | 48 | 2.6 | 1 | 2.0 | |Majolica Paintresses | ... | 295 | ... | ... | 31 |10.5 | |Ground Layers | 89 | 382 | 10 |11.3 | 45 |11.8 | |Colour Dusters and Litho. | | | | | | | | Dusters | 16 | 154 | 10 |62.5 | 32 |20.8 | |Other persons in contact | | | | | | | | with lead | 95 | 57 | 22 |23.2 | 3 | 5.3 | +----------------------------+------+--------+------+-----+--------+-----+ | Totals | 3123 | 1580 | 152 | 4.9 | 196 |12.4 | +----------------------------+------+--------+------+-----+--------+-----+

These statistics were obtained for Professor Thorpe and myself by Mr J. H. Walmsley, H.M. Inspector of Factories, Stoke-on-Trent, and are reproduced from our Conjoint Report to the Home Secretary on Lead Compounds in Pottery. From these figures it is seen that of the total male workers 4.9 per cent. become “leaded,” whereas of the female workers, who form the smaller body, the proportion is as high as 12.4 per cent.; and if the official figures for 1897 had been taken, the results, it is believed, would have been even higher. Before Professor Thorpe and myself commenced our investigation of lead poisoning in the Potteries, _Special Rules_ had been issued by the Chief Inspector of Factories in 1898, the good effects of which were already being felt at the time of our visits to Staffordshire. From the Annual Report of the Chief Inspector of Factories it appears that in 1900, 200 cases of lead poisoning in the Potteries were reported, as against 249 notified in 1899. Dr Morison Legge in alluding to this subject remarks that it is natural to attribute the diminution partly to the new _Special Rules_ (1898), and to the fact that in some factories the use of raw lead has been discontinued. The numbers of cases of both sexes in 1899 are much fewer than in 1898; but of the total persons, it is to be noted that whereas females constituted 55.2 per cent. and males 45.8 per cent. during 1898, the reverse occurs in 1899, viz., 51.4 per cent. males and 48.6 females. The alteration in sex distribution among persons attacked is attributed by Dr Morison Legge to the medical examination, in which adult males did not participate. It would appear, too, that there is a diminution in the number of severe cases reported, a circumstance which is also attributed to the medical examination. The diminution is most observed among ground layers and colour dusters, but not in ware cleaning or dipping operations.

What are called the dangerous processes of pottery manufacture are those in which the worker is brought into contact with lead. The preceding tables show that from lead poisoning a very high percentage of colour and litho-dusters suffer, also that dippers’ assistants, ground layers, ware cleaners, majolica paintresses, and dippers run a considerable risk from plumbism. There are fewer women than men working as dippers, and in this department the incidence of plumbism is nearly equal in the two sexes. With the exception of glost placing, _i.e._ filling the ovens with the ware about to be fired, and which is heavy labour and only fit for men, females predominate in all the other departments. From these figures it is seen that males who are colour dusters suffer in much larger proportion from lead poisoning than do females, but in nearly all the other processes it will be observed that the percentage of lead poisoning is higher in females than males. It is the lead processes that have justly caused pottery manufacture to be regarded as one of the dangerous industries, and whatever may be said to the contrary, women, especially young women from seventeen to thirty years of age, and all _young_ males or females, are especially susceptible to plumbism. Lead poisoning in pottery manufacture has for long been known, but neither had the Home Office, nor employers and the public, any adequate idea of the extent to which the evil prevailed until industrial plumbism became notifiable. It was with the view of throwing light upon this subject that the Secretary of State invited Professor Thorpe and myself, in May 1898, to institute a special inquiry into the hygienic questions involved in the use of lead in pottery processes, and to ascertain--

(1) How far the danger may be diminished or removed by substituting for the carbonate of lead ordinarily used, either (_a_) one or other less soluble compound of lead, _e.g._ a silicate; (_b_) leadless glaze.

(2) How far any substitutes found to be harmless or less dangerous than the carbonate lend themselves to the varied practical requirements of the manufacturer.

(3) What other preventive measures can be adopted.

Professor Thorpe and myself, either singly or together, visited not only the potteries in Staffordshire and in Scotland, but several of the leading manufactories on the Continent, _e.g._ at Delft, La Louvière, Maastricht, Copenhagen, Charlottenburg, Dresden, Limoges, Choisy-le-Roi, etc., and our opinions and recommendations are embodied in a Blue Book which was presented to the Home Secretary, Sir Matthew White Ridley, in February 1899. These, it is to be hoped, will ultimately form the basis of legislation for the trade in this country. At present our recommendations have been challenged by the manufacturers, and are the cause of considerable dispute between the master potters of this country and the Home Office. I therefore reproduce our recommendations:--

(1) That by far the greater amount of earthenware of the class already specified, _i.e. white and cream-coloured ware_, can be glazed without the use of lead in any form. It has been demonstrated, without the slightest doubt, that the ware so made is in no respects inferior to that coated with lead glaze. There seems no reason, therefore, why in the manufacture of this class of goods the operatives should still continue to be exposed to the evils which the use of lead entails.

(2) There are, however, certain branches of the pottery industry in which it would be more difficult to dispense with the use of lead compounds. But there is no reason why, in these cases, the lead so employed should not be in the form of a fritted[68] double silicate. Such a compound, if properly made, is but slightly attacked by even strong hydrochloric, acetic, or lactic acid. There can be little doubt that if lead must be used, the employment of such a compound silicate--if its use could be insured--would greatly diminish the evil of lead poisoning.

(3) The use of raw lead as an ingredient of glazing material, or as an ingredient of colours which have to be subsequently fired, should be absolutely prohibited.

(4) As it would be very difficult to ensure that an innocuous lead glaze shall be employed, we are of opinion that young persons and women should be excluded from employment as dippers, dippers’ assistants, ware cleaners after dippers, and glost placers in factories where lead glaze is used, and that the adult male dippers, dippers’ assistants, ware cleaners, and glost placers should be subjected to systematic medical inspection.

These were our recommendations, and while they received a considerable amount of approval throughout the country, some of them, as might be expected, have been the subject of hostile criticism on the part of the pottery manufacturers. It should be borne in mind that a few years previous to our inquiry a Committee appointed by Mr Asquith, then Home Secretary, and composed of Mr S. W. May, H.M. Superintending Inspector of Factories (Chairman), Dr John T. Arlidge, Mr W. D. Spanton, F.R.C.S.E., Mr A. P. Laurie, M.A., Mr J. H. Walmsley, H.M. Inspector of Factories, and Mr W. D. Cramp, H.M. Superintending Inspector of Factories (Secretary), had reported to the Secretary of State, and made certain recommendations, including one specially by Mr Laurie, in which it is suggested that the manufacturers should be circularised from the Home Office to experiment with and test the uses and the effect upon the health of the workpeople of glazes and colours in which all the lead had been fritted; also the practicability of making a glaze that would be harmless to those employed in the manufacture, and at the same time would not injure the ware. It remains a cause of disappointment that, considering the assistance rendered by the 1893 Committee, the pottery manufacturers did so little to introduce the improvements that were recommended so as to minimize the evils that were yearly increasing. Periodical medical examination of the workers, male as well as female, they certainly encouraged, and they admit that the result was beneficial. There is a feeling that, had the manufacturers bestirred themselves a little more in the direction of using properly fritted lead compounds instead of raw lead in the glaze, and of again experimenting with leadless glazes to see what they could accomplish, plumbism in pottery manufacture would have materially diminished, our inquiry might not have been necessary, and certainly the recommendations made by Professor Thorpe and myself would not have been viewed, as they are by employers, in the light of a menace to the industry and a check to its commercial prosperity.

If there is one thing upon which the British public has made up its mind in regard to some of the important labour and social questions of to-day, it is, that there ought to be fewer cases of lead poisoning in the manufacture of pottery generally, and that plumbism should be practically abolished in the production of certain kinds of earthenware. It would therefore be rather to the advantage of the industry than otherwise, were the Staffordshire employers to meet the wishes of the public in this respect, by making a greater effort to produce ware dipped in leadless glaze. When the Home Secretary published our recommendations, and stated to employers that it was his intention to give effect to them, the pottery manufacturers assumed an attitude partly of agreement and partly of disagreement. They at once stated their willingness to discontinue the use of raw lead in glazes; they asked for a lengthened period to test and experiment with fritted lead, while in regard to leadless glazes they have taken up the position which, up to the time of writing, may be regarded as one of no compromise. The abolition of raw lead, if carried out, would mark a very important stage in the pottery manufacture of this country, and of itself would do much to reduce the number of cases of lead poisoning. The use of fritted lead compounds would also prove helpful; but in order to obviate the risks of plumbism from the use of these substances, the fritting of the lead compounds has to be done carefully, for although less soluble than raw lead, yet plumbism has followed their use. A simple silicate of lead possesses advantages over the carbonate, both in its physical and mechanical characters; it is, for example, less dusty and clammy than either white or red lead, and is more easily removed from the skin by washing. Such an ordinary silicate may contain as much as 70 per cent. of lead oxide, and 25 per cent. of silica, with small quantities of alumina, lime, magnesia, and alkalis, corresponding in fact to a crude mono-silicate, “and this compound, which is generally understood as ‘fritted’ lead, is hardly less soluble in acids than basic lead carbonate,” besides “glazes in which the whole of the lead has been fritted as a properly compound lead silicate--that is, fritted directly with the other components of the glaze, so as to form a double silicate--have been found to possess greater covering power than a glaze containing the same relative amount of lead in the ‘raw’ state, with the further advantage of enhancing the colour.” When the amount of silica is increased the fritt becomes more innocuous, but there is a limit to which silica can be added to litharge, so as to produce a homogeneous silicate. Even bisilicate of lead is not wholly insoluble in acids. Professor Thorpe found in his experiments, conducted in the Government Laboratory, that it was not desirable the fritted lead should be a simple silicate, also that a properly compounded double silicate could be made that would fulfil all the requirements of the potter, and at the same time be practically insoluble in acids. He suggested the following as a suitable constituent of glaze, and as a compound that would be only slightly attacked by hydrochloric acid, viz.--

Lead Monoxide 22.0 Alumina 7.5 Lime 8.3 Alkalis 3.9 Boracic acid 3.5 Silica 54.8 ----- 100.0

This combination can be obtained by “fritting an intimate mixture of litharge, flint, felspar, tincal, and chalk, or an intimate mixture of litharge, flint glass, borax, china clay, and ground flint; or, as is done on the Continent, a portion of the flint may be replaced by white sand, the colour if necessary being corrected by cobalt.” There is a very strong feeling that in Staffordshire the pottery manufacturers have been using more lead than is actually required to make a good glaze. Lead has been used without proper discrimination. As to what the amount of combined lead, calculated as oxide, which the glaze of “glost” ware should contain, the opinion of even practical potters is divided. It has been thought by some that 20 per cent. is required, while others fix the limit at 10. Professor Thorpe found excellent examples of lead-glazed ware in which the monoxide of lead did not exceed 12 per cent. of the total weight of the glazing materials, while on analysing some of the liquid taken from the dipping tubs in the potteries, he found the amount varied from 13 to 24 per cent., and even higher. If, therefore, the use of lead compounds is still to be permitted, and, as has been shown, fritted lead in the form of a simple silicate is not much less soluble than raw lead, it is apparent that, with the view of preventing injurious consequences, their use must be restricted and regulated. It was with this object that the Home Office insisted upon all fritted lead compounds conforming to a certain test of solubility, and it is around this point there is considerable disagreement between the master potters and the Home Office. In a Report on the “Use of Lead in the Manufacture of Pottery,” presented to the Secretary of State by Professor Thorpe (1901), the Government chemist deals, among other things, with the relation between the composition and solubility of lead silicate, as shown in the following table:--

+-------------------------------------------+------------------+--------------+ | | Oxide of Lead | Percentage | | | dissolved by | Composition. | |Fritts arranged in order of Increasing |0.25 per cent. of | ---- | | Solubility. |Hydrochloric Acid.|Oxide of Lead.| +-------------------------------------------+------------------+--------------+ | | Per cent. | | |Preparation from Maastricht fritt (Belgium)| None. | 18.04 | |Preparation from Boch’s fritt (Belgium) | Traces. | 21.83 | |Boch’s fritt | 2.6 | 22.44 | |Ålmström’s fritt (Sweden) | 4.8 | 44.06 | |Maastricht fritt | 5.6 | 18.97 | |Owen’s glaze fritt | 6.6 | 16.23 | |Owen’s fritt | 23.8 | 45.77 | |Doulton’s fritt | 60.4 | 37.92 | |Owen’s lead silicate (No. 2 sample) | 99.6 | 70.40 | +-------------------------------------------+------------------+--------------+

I have not reproduced in the table the percentage composition of the other ingredients of the fritt, but it is maintained that the solubility does not depend upon any of the constituents, nor does any single base or acid increase or decrease continuously as the solubility of the fritt increases. Although in a general sense the solubility increases with the sum of monoxides present in the fritt, yet there is no regular progression. The solubility, according to Thorpe, depends upon the value of the ratio bases/acids which, judging from the results obtained by him, should not exceed 1.45, or thereabouts, if the fritt is to be practically insoluble in 0.25 per cent. hydrochloric acid and be therefore safe. With the view of coming to some understanding upon this question a conference was held between representatives of the pottery industry and the Home Office on 31st October 1899. Two months afterwards the Secretary of State intimated that it was his intention to propose that after a certain interval a standard of insolubility for fritted lead employed in glazes should be observed by the manufacturers--the standard of insolubility being that the glaze should not yield more than 2 per cent. of lead when acted upon by hydrochloric acid, under certain conditions. Permission was granted to manufacturers to submit specimens of fritted lead to Professor Thorpe, so that they might have the necessary chemical assistance if wanted. Several samples were received, and on examination it was found that they could contain amounts of lead ranging from 24 to 53 per cent., and yet be capable of conforming to the standard of solubility required by the Home Office, although generally speaking they yielded slightly larger quantities of lead oxide to dilute hydrochloric acid than the insoluble silicate prepared from Continental fritts. In a short Report by Dr Thorpe, dated 20th November 1900, are published directions for the fritting of lead. The manufacturer, for example, “may, in the first place, fritt together all the materials given in the receipts--that is in one operation. If he chooses to take this course it would, as a matter of economy, be preferable to substitute litharge, if not for the whole of the raw lead, at least for the white lead. It seems absurd to pay for the trouble of putting the carbonic acid and water into the white lead, when these ingredients are expelled by the heat of the kiln. The required alteration in the receipt may easily be calculated from the fact that 1 lb. of litharge contains the same amount of lead oxide as 1.02 lb. of red lead or 1.18 lb. of white lead. Or the manufacturer may make up his fritt by commingling two other fritts. Thus he may fritt together borax, stone and flint, and fritt also the lead oxide, flint and stone, each in such proportions that the two when mixed with the whiting and china clay form a composition containing 18 per cent. of lead oxide.” It was urged by the manufacturers that the 2 per cent. solubility of lead in a glaze would be materially affected by the degree of fineness to which the fritt might be ground, but experiments showed that while within limits increased solubility of the fritt and fineness of grinding were concurrent, yet this question was rather of an academic nature, and had no practical bearing upon the use of fritted lead compounds in pottery. In our Conjoint Report, dated 1889, when discussing the amount of combined lead that might be allowed in glazes, we stated as the opinion of practical potters that it should be from 10 to 20 per cent. We ourselves suggested 12 per cent. Subsequent experience and experiment convinced Professor Thorpe that 12 per cent. is higher than is actually necessary in earthenware and china glaze. Nor does he regard the limit of 2 per cent. of solubility as too hard or stringent a requirement. The manufacturers pressed the Home Office to raise the limit to 5 per cent., but to do this in the face of existing evils was far from helping the object that the Home Office had in view. The stamping out of lead poisoning in pottery manufacture is a most desirable object, and one all must wish to see accomplished without, if possible, any injury to the trade. “If the limit is raised, as suggested, to 5 per cent., it means that the lead in an ordinary earthenware or china glaze, as at present used, may be so soluble that one-third of it may be extracted by very dilute acid at ordinary temperatures in one hour.” More than that, to raise the limit to 5 per cent. would be to throw away all the result of the experience that has been gained by experiments conducted over a period of three years, and would tend to perpetuate the evils that at present exist.[69]

No matter in what form lead is used for glazing pottery, there is always a risk of plumbism. The French pottery manufacturers employ for enamelling purposes a glaze the principal ingredient of which is _calcine_--an alloy of 15 to 20 parts of tin, and 100 parts of lead. An ordinary composition for white glaze for table ware is--

Calcine 44 Minium (lead oxide) 2 Decize sand 44 Sea salt 8 Soda 2

Yellow and green coloured enamels are got by adding to the white glaze a quantity of antimoniate of lead, but for other colours no lead is used. (_Poisons Industriels_, Office du Travail, Paris, 1901, p. 45.)

Since the publication of the Report on Pottery Manufacture in 1899, by Professor Thorpe and myself, in which we recommended the use of leadless glazes for cream and white ware, electrical fittings, sanitary ware, etc., attempts have been made to place leadless glazed earthenware and china on the market. Commercially the thing can be done. The Worcester Porcelain Company, also Messrs Mortlock, Maling & Sons, and others, are willing to supply china finished with a glaze quite free from lead. The Coalport China Company state that they have used a leadless glaze for the past eighty years, and that they have never had a case of lead poisoning in their works. Messrs Maling & Sons, Newcastle-upon-Tyne, regularly produce a large amount of ware dipped in leadless glaze, particularly jam-pots.

In France a circular issued by the Minister of the Interior, and bearing date 19th June 1878, interdicts the manufacture and sale of pottery, either of French or foreign manufacture, glazed by means of oxide of lead which has been incompletely fritted, and which gives up readily oxide of lead to feeble acids. I am not in a position to say how far this has been given effect to.

In potteries where red or brown ware is used plumbism is not unknown. It has generally been traced to the use of red lead. Occasionally lead poisoning from red earthenware potteries, mostly in the form of wrist drop, has come under my notice at the Newcastle Infirmary. Some of the cases have been drawn directly from the immediate district, while others have come from Sunderland. With the view of diminishing plumbism in the manufacture of red and brown earthenware, Professor Thorpe suggested that where employers decline to use fritted lead, on the ground of expense, there would be no practical hardship in adopting the use of ground blue lead or galena, _i.e._ the native ore, instead of red or white lead. It is cheap, but it requires to be ground. The drawback to it is that it gives off sulphur fumes when fired, but the amount of sulphur oxides given off is small to that formed in the combustion of the coal in the oven. It gives a faint yellow or brownish tinge to the glaze, but this does not seem to be objectionable. In visiting potteries in Holland, I found one firm in Gouda which used ground galena for glazing this kind of ware. They had not only every reason to be satisfied with the results, but in the factory plumbism was unknown. Several decades ago galena was similarly used in Staffordshire.

I have dwelt at considerable length upon the question of fritting lead compounds and the use of leadless glazes, both in defence of the attitude which Professor Thorpe and myself have assumed, and to show the reasonableness of our recommendations.

If our recommendations were adopted they would certainly make for better health of the operatives engaged in pottery manufacture. At the time of writing they have not been adopted. Some months ago a statement was issued by a joint committee representing 283 of the 579 manufacturers coming under the Special Rules, challenging our Report. The manufacturers say that it is impossible to glaze the greater part of their ware without lead, and that serious injury will be done to the trade if a radical measure of so sweeping a character is enforced without giving sufficient time to test the products so treated. Employers maintain that from a trade point of view existing regulations are hard enough. They suggest that there should be an extension of the medical examination of all operatives engaged in lead processes quite irrespective of age or sex. The Home Secretary subsequently indicated to the manufacturers the steps he proposed to take with the view of protecting workers from lead poisoning in china and earthenware, viz.--(1) relaxation of the Special Rules for factories or processes in which no lead is used; (2) medical examination of male workers in lead processes; (3) use of fritted lead--six months being allowed before this becomes compulsory; (4) fixing of standard of safety in fritts as regards solubility in acids.

There is everything to show that within the last three or four years the conditions of labour in the Potteries have materially improved, and that there has been a distinct diminution in the number of cases of lead poisoning. The operation of the Special Rules, the periodical medical examinations, and a more restricted use of raw lead have largely contributed to this satisfactory result. A return of cases of lead poisoning reported under the Act 1895, occurring in the manufacture of earthenware and china from 1st January 1899 to 31st December 1900, and presented to the House of Commons by Mr Jesse Collings, 27th February 1901, conveys information upon this particular point. During the year 1899 there were in the Potteries 129 persons suspended from work on account of lead poisoning, and in the following year 95. In 1899, 34 of the 129 persons were ware cleaners, 29 worked in the dipping house, 26 were majolica paintresses, ground layers formed 14 of the total, and 10 were colour dusters, while for 1900 the numbers were respectively 20, 42, 8, 6, 13. The districts of Hanley, Burslem, Tunstall, and Stoke include practically the whole of the North Staffordshire Potteries, where about 46,000 persons are at present employed in the manufacture of china and earthenware, and of whom 4700 are employed in lead processes. Taking, therefore, the cases of lead poisoning in the Potteries for the last four years, they run as follows: in 1897, 446; in 1898, 457; in 1899, 249; and in 1900, 200.[70] Allowing a margin on either side for discrepancies and incompleteness in the statistics, these figures at once show how in a trade that has hitherto been regarded as dangerous the conditions of labour can be materially improved, with a very marked gain in health to the workers. These encouraging results are, it is hoped, only a forecast of others yet to come.

There is considerable discrepancy in the returns of lead poisoning in the Potteries, due to the source from which the statistics have been obtained, and the manner in which the cases have been notified. All the statistics concur in showing a declension of plumbism. From an article in the _Times_, 24th September 1901, the following has been taken:--“That lead poisoning has rapidly diminished among potters and increased among other trades is proved by the following table of cases reported in the last four years, and compiled from the _Labour Gazette_ and other official sources.”

Potters. Other Trades. 1897 469 745 1898 463 954 1899 249 1009 1900 200 1057

It will be thus observed that there has been a progressive diminution in the number of cases of lead poisoning in the pottery trade, a diminution that is still proceeding, judging from the returns of the first half of the year 1901. The cases reported for the six months, January-June, in the last four years are:--

1898 1899 1900 1901 200 165 110 59

“In the course of three years the amount of lead poisoning has been reduced to one-fourth of that reported in 1898.” The manufacturers attribute this result to the monthly medical examination of women and young persons brought into contact with lead.

An accidental delay in the passage of these pages through the press allows me to add a further note upon the attitude of the Home Office and the pottery manufacturers in regard to the use of fritted lead compounds, the suggested standard solubility, and the use of leadless glazes, and thus to bring up to date the history of this important trade inquiry, probably the last of the large industrial conflicts that will be submitted to arbitration. The questions at issue between the Home Office and the manufacturers were referred to arbitration, Lord James of Hereford being chosen as umpire. The Court sat at Stoke-on-Trent on 7th November 1901, and subsequent days. Mr Chester Jones acted as arbitrator for the Home Office, and Mr Llewellyn for the manufacturers; the counsel being, Mr Cripps, K.C., and Mr H. Sutton, for the Home Office; Mr Fletcher Moulton, K.C., for the manufacturers; and Mr Colefax for the operatives. Evidence was given by Professor Thorpe, Mr Wilton Rix; Dr Wilkin, director of large potteries, Dresden; Mr Alström, of the Rorstrand Potteries, Stockholm; Dr T. M. Legge; Miss A. M. Anderson, Principal Lady Inspector of Factories; and myself, on behalf of the Home Office. The principal points urged were: the possibility of using leadless glazes for certain kinds of ware; the greater safety of fritted lead compounds over raw lead; the greater freedom of Continental potteries from plumbism, where most, if not all, of the lead was fritted, than is the case in Staffordshire; and, in a general way, the better structural arrangements in Continental potteries than in those at home. On behalf of the manufacturers, Messrs W. H. Grindley, G. E. Meakin, H. J. Johnson, J. L. Whittaker, and J. Sherwin gave evidence. It was admitted by the witnesses on both sides that there had been since the introduction of the Special Rules 1898 a very notable decline in the number of cases of plumbism in Staffordshire, and that towards this happy circumstance better ventilation, greater personal cleanliness on the part of the workpeople, and systematic medical examination had doubtless contributed. The main part of the inquiry centred round the subject of fritting the lead for the glaze. It was demonstrated by Professor Thorpe that excellent results could be obtained by the use of vitrified lead, which was soluble to the extent of only 2 per cent. in .25 per cent. of hydrochloric acid. The manufacturers having previously intimated to the Home Office their willingness to accept a 5 per cent. standard solubility as the test of lead in their glazes, wished to recede from this position, and at the time the Court was sitting, claimed the right not to be bound by this or any other test of solubility. In fact, it was admitted that many of the manufacturers had returned to the use of 30 to 40 per cent. of raw lead in their glazes. As to the greater safety in the use of fritted lead compounds of the low solubility insisted upon by Professor Thorpe there can be no question. There never will be absolute safety so long as lead in any form is used; a 2 per cent. soluble fritted lead compound must be much less harmful if swallowed than one containing lead which has a solubility of 5 per cent. or more.[71] My contention, like that of Professor Thorpe, was that the .25 per cent. of hydrochloric test was not at all a hard one; that while this was the amount of hydrochloric acid present in the gastric juice, the test proposed was not so severe as that which would be carried on in the human stomach, where there was a higher temperature, greater agitation, and therefore better admixture of the contents.

It is unnecessary here to reproduce the evidence in detail either for or against the recommendations of the Home Office, which were based upon the Thorpe-Oliver Report; but I may mention one or two additional facts. While the Court was sitting, a male dipper of 20 years’ experience, and who had never been ill, requested permission of Lord James to give evidence. This was gladly complied with. The evidence tendered was directed against the proposed monthly examination of males employed in lead processes. The operative simply wished to assert his right to work in lead even if he was the subject of plumbism, to express his unwillingness to submit to periodical medical examination, and to state that he objected to be bound by the arbitrary order of the certifying surgeon either for temporary or permanent suspension. In a word, he stated that he and his comrades knew the risks of their calling, and they were prepared to take them. He appealed against the application of all official restraint, which he regarded as of too coercive a character. When working men, in whose interests well-meant efforts are being made to render their occupation more healthy, prefer to court death and to throw their wives and families upon the ratepayers rather than forego the loss of a few weeks’ wages so that they may regain their health, the difficulty of bringing into line the many conflicting forces is at once apparent.

To the fritting of lead compounds the manufacturers raised many objections. It was stated that, quite apart from the expense, their use was impracticable. Mr W. H. Grindley of Tunstall stated that he had tried fritted lead, but had relinquished it, as its use had involved him in a financial loss of some hundreds of pounds in a few weeks. Mr Henry J. Johnson and other manufacturers gave similar evidence.

Quite unexpectedly, on the fifth day of the sitting of the Court, Lord James announced his intention of not carrying the inquiry further. Balancing the various conflicting issues at stake, and influenced by the reduction in the number of cases of lead poisoning from 12 to 3.5 per cent. in the four years’ operation of the Special Rules, he postponed the arbitration for eighteen months, during which, putting the manufacturers on their honour, he looked to them to rigidly give effect to the Special Rules of 1898; to take a lesson from Continental manufacturers; to try fresh experiments with fritted lead, and to reduce them to the lowest possible solubility consistent with a satisfactory production of their ware; also to come to some understanding with the workpeople in regard to founding a mutual assurance fund. As the whole subject is to be again discussed in eighteen months, it would ill become me to do more than simply state these facts, and to express the hope that by a loyal adherence to the special regulations the amount of lead poisoning in Staffordshire may meanwhile still further decrease.

_Chromo-lithographic Works and Transfer Making._

In the printing of coloured trade advertisements and wrappers there is frequently used metallochrome powder, known under various names, _e.g._ “flake white,” “china white,” etc. Usually the dry powder is dusted on the sheets of paper by hand and dusted off again by young women or lads, an operation that is extremely dusty, and too often carried on in workrooms totally unprovided with any artificial means of ventilation. Practically speaking, the manufacture of transfers for giving coloured impressions to pottery is a similar operation. The coloured impressions are made upon paper which, when applied to china and earthenware about to be fired, allow of the floral design and pictures being transferred to plates, cups, and saucers, etc. Under all circumstances, whether it is the making of transfers for pottery work, covers for fancy tins of biscuits, mustard, tobacco, etc., or coats-of-arms for railway carriages, the occupation is not only dusty but is dangerous, owing to the fact that metallochrome powder often contains as much as from 50 to 60 per cent. of white lead. In the manufacture of transfers the workers, usually girls, throw the powder loosely on the paper and tilt it from side to side, or what is more common, they gently rub the powder all over the paper by means of a soft cloth or a pad of chamois leather, the superfluous powder being removed by shaking. In visiting factories where transfers are made both at home and on the Continent, I have been struck by the extreme pallor of the workers; frequently they have complained of splitting headache and severe abdominal pains. Nearly all the workers presented a deep blue line on their gums. In Limoges, where large quantities of coloured porcelain are made, the introduction of transfers into the industry took place only about twenty years ago, and it was not until several fatal cases of lead poisoning had occurred that the plumbism was traced to its cause, viz., the making of transfers. Many of the girls had succumbed to that extremely severe and often suddenly developed form of Saturnine affection of the brain, which is attended by epileptiform convulsions, and known as lead encephalopathy. It is when metallochrome powder is used in the dry form, and therefore dusty, that there is danger. When mixed and moistened as in coloured printers’ ink, and the printing is done by machinery, there is no danger. Men, however, have suffered from plumbism after mixing “flake white” and varnish. This is not a dusty process, but there is considerable danger when spirituous materials are used along with lead.

Much of the risk to health in this trade can be overcome by diminishing the amount of white lead in the metallochrome powder. Experience shows that this is often present in excess of what is necessary. A less harmful metal, too, might in several instances be substituted for lead. Barium has been suggested, but time and trial alone can tell whether even the use of barium is quite free from danger. Animals can be fed upon barium salts, and apparently thrive when they would die if given the same quantity of lead carbonate. It is a heavier metal than lead, and on the whole may be said to be safer. Magnesia has also been recommended as a substitute for white lead in the metallochrome powders. The trade of transfer making is one in which, fortunately in one sense for the workers, employment is irregular. Under any circumstance it is an occupation in which the workers should have some alternation of employment, and in which no young person should be engaged, no food should be eaten in the workroom, overalls ought to be worn, and before leaving the factory the hands and face of each worker, should be washed. Not only should adequate lavatory accommodation be provided, but sufficient time should be given by the masters before break, for the workers to wash. In this, as in all trades in which lead is used, the individuals should be subjected to periodical medical examination--experience in the potteries, for example, having shown how very beneficial this has been in preventing plumbism. Such an examination often succeeds in eliminating persons who are susceptible to lead before they have worked too long at the trade. In Limoges, so impressed were several of the large porcelain makers by the great susceptibility of young women to plumbism, that they now only employ men in the manufacture of transfers. The work, too, is no longer conducted on open tables, but in closed glass cases, through openings which are guarded by indiarubber, the hands of the workman are thrust, so that the operation of “laying on” is conducted under cover, the dust created being drawn away by strong aspiration on the distal side of the enclosed space. Since the introduction of this method of making transfers, plumbism has disappeared from most of the large porcelain works in Limoges. In Staffordshire a similar method of transfer making has also been adopted, and with equally satisfactory results to the workpeople.

Eleven cases of lead poisoning were notified to the Home Office as having occurred in litho-transfer works during 1899.

_Tile-making and Manufacture of Porcelain Stoves._

The manufacture of tiles for useful and decorative purposes, such as the floor of entrance halls, hearths, sides of fireplaces, and stoves, is a large and increasing industry. The pressing of clay into the form of tiles is done by machinery, and although it is a dusty process, there is usually in operation at the time the pressing is done a strong aspirating draught brought into play, whereby the dust is removed from the face of the worker. The tiles when dried are subsequently dipped in glazes often rich in lead. Usually the lead which enters into the composition of the glaze for majolica tiles is fritted; but some manufacturers have until recently been in the habit of using only raw lead, and it was occasionally in their factories that lead poisoning occurred. The opportunities for a worker becoming leaded are during the dipping, cleaning, or painting. In some of the factories visited by Professor Thorpe and myself, we saw mechanical dippers in use which gave promise of superseding hand-dipping and of abolishing the necessity for cleaning and trimming the edges of the tile. Employment of mechanical dippers and of fritted lead compounds, conforming to the solubility standard required by the Home Office, with enforcement of the Special Rules, would pretty well abolish plumbism in this industry.

During the manufacture, at Velten in Brandenburg, of glazed tiles for making earthenware stoves, there recently occurred a considerable amount of lead poisoning among the operatives,[72] due to the glazing of tiles with oxide of lead. The outbreak is of sufficient importance to be mentioned here. The glazing material is made, first, by firing together lead oxide and tin in the proportion of three to one. To the compound thus obtained there are added felspar, marine salt, and quartz. These are mixed together, and subsequently exposed to a great heat so as to form a fritt. The vitrified material thus obtained is crushed, finely pulverised and mixed with water, while the thick liquid is applied to the surface of the tiles, which are afterwards heated in a special furnace. During these operations there are many opportunities for the workmen to become poisoned by lead. In the act of crushing, a considerable amount of dust rich in lead salts rises into the atmosphere. Rasch caused some of the air to pass through cotton-wool, and he thus arrested the dust. The lead in this he estimated as sulphide. The quantity found by him in 100 litres of air varied between 0.0012 to 0.0066 gramme, which was equivalent to an amount of lead oxide entering into the lungs during the twelve hours’ work in the factory of 0.05 to 0.6 gramme. Upon the clothes of the workmen he obtained as much as 3 to 4.8 grammes. It was found that all the lead in the fritt had not been converted into an insoluble form. There was at least one-hundredth part in the form of lead oxide, a circumstance which rendered the glaze harmful to those who dipped the tiles, and also to those who handled them after dipping. It is needless to say that where this industry is carried on, precautions should be taken similar to those in use in the potteries, care being taken to have the fritting of the lead carried on in well-ventilated places, and the grinding of the fritt done in enclosed machinery.

_Washing of Lead-workers’ and Painters’ Clothes._

In my Gulstonian Lectures on Lead Poisoning, I make mention of the fact that dogs which had slept on the coats or jackets of their masters, who were lead smelters in the vales of Durham, sometimes suffered from colic; also that a peculiar epidemic of Saturnine poisoning occurred in France in women who had simply washed the clothes of their husbands, who were workers in lead factories. One of the main reasons for the White Lead Commission recommending the wearing of overalls when at work was that the Committee ascertained that the clothes of several of the female workers, which were often dust-laden, became the bedclothes of the family at night. Lead dust is always a danger, so, too, may be the bespattered working clothes of house painters. A woman, thirty-six years of age, consulted me at the Newcastle Dispensary on account of anæmia, headache, and double wrist drop. In addition she had a well-marked blue line on her gums. There was no difficulty in diagnosing the case as one of plumbism, the difficulty was rather in tracing the lead poisoning to its source. She was a widow and had never worked in any factory, nor, so far as she knew, had she ever been brought into contact with lead. She simply attended to her domestic duties. On inquiry I found that since her husband’s death, in order to increase her income, she had taken to reside with her two male lodgers--her own brother and a nephew. Both were house painters, and they wore the ordinary white jackets and trousers of the artisan. The patient was in the habit of washing their clothes once a week, which were frequently very much discoloured, especially those of the younger man, the nephew. I asked for a bottleful of the water removed from the washtub when she washed the clothes. This water was dirty brown in colour, and contained a good deal of sediment. I submitted it to Dr Bedson, Professor of Chemistry at the College of Science in Newcastle, who reported the presence of a very large quantity of lead in suspension in the water, and a small quantity in solution. That the woman’s ill-health and paralysis of the hands were due to Saturnine poisoning there was not the least doubt, for under medicinal and electrical treatment and cessation on her part of the weekly washing of the painters’ clothes, health was gradually regained and muscular power restored. It is known that women who wash the overalls, etc., in white lead factories occasionally suffer from plumbism.

_Lead Foil Manufacture._

Makers of lead foil which is to be subsequently used for the tops of bottles or for wrapping round tobacco, snuff, and cheese, occasionally suffer from plumbism; so, too, do those who handle and fix the lead discs over the corks of bottles. On analysis the metallic foil which envelops Roquefort cheese has been found to contain 12 parts of tin and 85 of lead, among other substances, while in that which envelops Angelots cheese there has been found as much as 95 per cent. of lead. Tobacco smokers and chewers have suffered from using tobacco kept in metallic dishes, and I have had professional experience of the very bad effects of the use of snuff wrapped in leaden foil. An attempt is being made to substitute parchment for lead discs for bottles.

_Shoe-finishing and Staining by Lead Compounds._

A few months ago, owing to several shoe finishers in Northampton having been thrown upon their benefit societies, all suffering from the same type of symptoms, ultimately certified to be lead poisoning, the circumstance was necessarily brought under the cognisance of the Factory Inspector for the district. The men worked in the same factory. On investigation it was found that they were in the habit of using, for finishing the bottoms of shoes, certain powders, known in the trade as Chinese red and yellow chrome. These contained lead compounds. In the manipulation of the powders to stain the boots and shoes with, a considerable amount of dust arises. The process is thus described by Mr Wright, H.M. Inspector. Dry China-red powder is by means of a sponge dusted on to the sole of a boot, a piece of fine glass-paper is then used to scour the colour into the leather, a small quantity of grease is subsequently applied, and the sole is polished with a dry cloth. The workman, during the whole of the process, has to bend down closely over the boot, and thereby inhales the coloured dust. Sometimes chrome-yellow is mixed with the China-red. It was found necessary by the Home Office to interdict the use of these powders, less harmful substitutes being suggested.

_Lucifer Matches containing Lead._

In order to make matches strike softly, and in other instances with the view of making matches free from yellow phosphorus, various compounds of lead have been introduced into the paste for heading the lucifers. The mixing of the ingredients and the manipulation of the paste were attended by such an amount of sickness among the workers that their use has been discarded, for it was found that although less painful, lead poisoning was just as serious a malady as that caused by phosphorus.

_Buffing of Brass Cocks and Plumbism._

In buffing brass cocks upon rapidly revolving wheels covered with leather, the surface of which is kept coated with emery powder, several of the men have become ill, and shown signs of lead poisoning. Buffing is done so as to smooth the brass cocks after casting. In what is known as “gun” and “pot” metal, lead is sometimes present to the extent of 5 to 6 per cent.

APPENDIX

NUMBER OF CASES of Lead Poisoning notified to the Home Secretary under Section 29, 1895, during 1898, 1899, and 1900.[73]

+---------------------------+--------------------------+ | | Number of Reported Cases.| | Disease and Industry. +--------+--------+--------+ | | 1900. | 1899. | 1898. | +---------------------------+--------+--------+--------+ |Lead Poisoning | 1058 | 1258 | 1278 | |China and Earthenware | 200 | 249 | 457 | |Litho.-Transfer Works | 10 | 11 | [73] | |Glass Polishing | 7 | 8 | 19 | |Smelting | 34 | 61 | 82 | |Tinning and Enamelling | 16 | 24 | 24 | |File Cutting | 40 | 41 | 46 | |White Lead | 358 | 399 | 332 | |Paints and Colours | 56 | 75 | 59 | |Coachmaking | 70 | 65 | 45 | |Shipbuilding | 32 | 30 | [74] | |Electric Accumulator Works | 33 | 33 | 11 | |Other Industries | 202 | 290 | 103 | +---------------------------+--------+--------+--------+

ANALYSIS OF REPORTS on Lead Poisoning by Certifying Surgeon. Factories and Workshops: Annual Reports for 1899 and 1900 (Dr T. M. Legge).

+----------------------------+---------------------------------------+ | | Total Cases. | | +-------------------+-------------------+ | | 1900. | 1899. | +----------------------------+--------+----------+--------+----------+ | | Males. | Females. | Males. | Females. | |Smelting | 34 | ... | 52 | ... | |Brass | 3 | ... | 11 | 1 | |Sheet Lead | 17 | ... | 26 | ... | |Printing | 17 | ... | 25 | 1 | |File Cutting | 35 | 3 | 39 | 1 | |Plumbing | 8 | 1 | 16 | 1 | |Tinning and Enamelling of | | | | | | Iron Hollow Ware | 2 | 3 | 11 | 4 | |White Lead | 288 | 28 | 340 | 22 | |Red Lead | 19 | ... | 19 | 2 | |Earthenware | 92 | 105 | 119 | 111 | |Litho.-Transfers | 7 | 3 | 6 | 4 | |Glass | 7 | ... | 7 | 1 | |Enamelling of Iron Plates | 8 | 3 | 6 | 4 | |Electric Accumulators | 30 | ... | 31 | 1 | |Paints and Colours | 51 | 5 | 47 | 1 | |Coachpainting | 61 | ... | 58 | ... | |Shipbuilding | 31 | ... | 30 | ... | |Paint in other Industries, | | | | | | excluding House Painters | 46 | ... | 47 | 5 | |Other Industries | 58 | 18 | 64 | 17 | +----------------------------+--------+----------+--------+----------+

Dr T. M. Legge deals with the age, distribution, and duration of employment in persons brought in contact with metallic lead, and with the salts of lead, either in the form of dust or of paint; and in the following table, taken from his annual Report for 1900, shows that in those who handle metallic lead or use it as paint, symptoms of poisoning are more slowly developed than in those employed in industries in which the salts of lead are present in the form of dust.

+--------------------------------+-------------------+-------------------+ | | | Duration of | | | Age. | Employment. | | Source of Poisoning. +---------+---------+---------+---------+ | | Under |30 Years | 1–5 | 5 Years | | | 30. |and over.| Years. |and over.| +--------------------------------+---------+---------+---------+---------+ |Metallic Lead per cent.| 43.0 | 57.0 | 37.4 | 62.6 | |Salts of Lead as Paint „ | 43.6 | 57.4 | 45.8 | 55.2 | |Salts of Lead as Dust „ | 65.4 | 34.6 | 76.0 | 24.0 | +--------------------------------+---------+---------+---------+---------+

The reports bring out the fact that Saturnine palsy is essentially an affection of the male sex, while the symptoms of headache, anæmia, and encephalopathy are more common in the female.

THOMAS OLIVER.