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conditions existed in man ; that men who resisted re-infectionstill harboured the virus. This opinion was confirmed by thefact that they had not discovered a method of procuring apassive or an active immunity, nor any method of treatmentwith immunising substances.

After the address a number of lantern slides were exhibited,showing preparations of the various spirochaetas and photo-graphs of the lesions in inoculated apes.

INDUSTRIAL DISEASES.

WEDNESDAY, JULY 29TH.

The chair was occupied by Mr. W. F. DEARDEN (Stretford,Manchester), the Vice-President, who said that the sectionwould hear witl( much regret that the President, ProfessorThomas Oliver of Newcastle-on-Tyne, had been detained onbusiness of urgent importance and that he was unable to be

- present that morning. The subject of industrial disease

naturally was one of paramount important in a centre of

industry such as Sheffield and it had aptly been selected forspecial notice by the President of the Association in hisinaugural address.

Dr. S. KING ALCOCK (Burslem), in opening a discussion onThe Granting of Certificates of Titness for Employment, _

said that his paper would be principally concerned withthat section of the Factory Act which dealt with the

age at which children might commence work and with thoseaspects of the subject which affected the examining surgeon.In forming a decision as to the fitness of a child forwork it was of great importance that the conditions of

employment should be thoroughly understood by the

certifying officer. A child when employed in a factory hadto be examined within a week of commencing work, andalthough certificates might be withheld at discretion the

question arose whether the surgeon was to withhold themonly in case of actual disease or whether he should refuse toallow a child to be employed because there was a possibilitythat health might be impaired by his working at someparticular trade. Minor complaints and defects, such as

deafness and errors of vision, must be dealt with on common-sense lines and a judgment formed for each individual casebased on the conditions of work, but affections such as

pediculosis, blepharitis, &c., for instance, should be

rigorously excluded from a factory until they were remedied.Medical examination of school children had recently intro-duced new considerations. As an inspection of each; childat the time of leaving school was suggested it might bethought that that examination would be sufficient forentrance to a factory, and that it would thus render a test

by a certifying surgeon unnecessary. If the latter was

superseded the measure would be a distinct retrogression.The certifying surgeon alone could understand the conditionsof labour and the circumstances in which a particularchild would be placed. But the drastic powers of the

surgeon in stopping the employment of a wage-earnershould be very carefully exercised. Further, there should ’,be repeated examination and more continuous observation. ’,It was possible for a child to be examined at 13 years off age I,on entering a factory, and unless he changed his employmenthe would not be seen again for three years. Children oughtto be examined every year during industrial employment. In

conclusion, he desired to emphasise the following points :(a) there should be better convenience for examination ;(b) the examination ought to take into account and torecord the general health, fitness, age, height, and weight ofthe candidate ; (e) the certifying surgeon ought in everyinstance to have full knowledge of the conditions of employ-

ment ; and (d) the desirability of the abolition of half-timers.Mr. DEARDEN said that for a long time the nation

had paid much attention to the conditions of employ-ment in factories but had only recently concerned itselfabout the equally important sanitary conditions which

prevailed in schools. The recent Act was of very greatimportance as an educational departure. He then brieflytraced the history of industrial legislation, beginning withthe Act of 1833 (by which children under nine years oldwere prohibited from working in workshops and factories)and continuing his review down to the Consolidating Acts of1878 and 1901. By the former of these statutes certificates

ceasea to oe oasea upon age ana were grantea on coinsiclera-tions of health. The Home Secretary also was intrustedwith administration and he drew up rules for the working ofthe department. By the latter Act the age at which achild might be employed as a half-timer was raised to 12years, and it was further made incumbent on the surgeon totake the conditions of employment into account as well as thephysical fitness of the candidate.

Dr. T. F. YOUNG (Liverpool) said that in endeavouring tosave young persons from the danger of suffering from theiremployment they might, unless they were careful, do themreal unkindness. When unemployment was rife the wagesof younger members of the family were often of vital im-portance and the Factory Acts were designed to secure

equal consideration for the interests of employer andemployed alike. In examination each case must be con-sidered absolutely on its own merits. It was the duty of thecertifying surgeon to insist on satisfactory quarters beingprovided for examination. He thoroughly agreed with Dr.King Alcock that the nature of the work should be; takeninto account. Under the new School Examination Act theduties of the factory surgeon would be little affected or hiswork lessened unless different arrangements were made. Inhis own district one man had been appointed to inspect andto give medical supervision to 16,000 children.

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Dr. ALEXANDER SCOTT (Glasgow) said that although theexamination of a factory surgeon could never be replaced bythat of the medical officer of schools he rejoiced thatefficient scholastic examination had now been instituted. Aweak part of the present Factory Act was the lack ofdefinite provision for a child er young person being examinedat 7iiq rrork. In the case of dressmaking and similar employ-ments it was, for instance, most important that the medicalofficer should see the workrooms and the conditions oflabour. In the conditional certificate they had a powerfullever to effect improvement.

Dr. R. PROSSER WHITE (Wigan) said that in his district theclass of candidates for employment -as half-timers was bad.At least 10 per cent. had to be refused. When; a child badbeen passed for a certain employment and afterwards had toabandon it on account of unfitness he considered, that thecertifying surgeon had inadequately performed his, duty.Humanity was the first consideration, and it began andended with the child. It was an imperative obligation oncertifying surgeons to understand exactly the condition ofwork to which a child would be put. In his own district thework of a child of 15 might be to carry a "doffing tin,"

"

which weighed, empty, 15 pounds, and full, 40 pounds.That would be a serious burden for anyone in that room,and as regular employment for a child such work was

unjustifiable.Dr. R. H. CROWLEY (medical omcer of schools, Bradford)

said that much of the distrust which had arisen with_regardtothe employment of children ard half-timers was due to animpression that the examination was perfunctory and in-adequate. He understood that not 1 per cent. of all caiicii-dates were rejected. As a matter of fact, half-timers shouldbe very carefully examined at the time of entry, and heagreed that the examination should be repeated at frequentintervals. The medical officer of schools could never super-sede the certifying surgeon because practical knowledge ofthe work at which the half-timer was to be employed wasnecessary.

Dr. J. A. W. WATTS (Hyde) said that although the system ofhalf-time had been adversely criticised it was a thoroughlygood one. Not the least of its advantages was that childrenemployed in that way were actually healthier than those whopassed the whole of their time in school. As a matter of

fact, the atmosphere of the worst mill was generally betterthan that of the best elementary class-room, and a childmight sometimes be advantageously certified in order to saveit from school. He regretted that on the commission recentlyappointed to inquire into the subject of industrial employ-ment no factory surgeon bad been appointed ; that was amistake. There ought also to be some possibility of

uniformity between certifying surgeons as to the results ofexamination. It was detrimental to efficiency that a childshould be passed, by one surgeon after being rejected byanother. Might not this be avoided by endorsement of abirth certificate or in some other way ?

Dr. R. W. EDGINTON (Birmingham) said that although hedid not think they would be entitled to mark birth certificates,

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uniformity was of the first importance and an attempt shouldbe made to secure it. He regarded the conditional certi-’ficate as a most useful instrument. A child that was quiteunfit for one trade might be well suited for another.

Dr. RALPH P. WILLIAMS (medical inspector of schools,’;Sheffield) said that supposing every facility was given to an<examiner 200 school children might be examined in oneweek ; in other words, during the school year of 40 weeks- about 8000 children were the utmost capacity of a medical’Officer. The atmosphere of elementary schools was admittedlybad but great improvement had been effected and morewould follow. In Sheffield the half-timer had almost beenabolished ; not more than 400 were now employed in that- -city. _

Dr. T. M. LEGGE (His Majesty’s Inspector of Factories)-said that the duties of medical officers of schools and-those of certifying surgeons were allied and could never Ibe in conflict. Each examination had its own purposesand limitations. In the school the child was preparedfor life generally, while the function of the certifying-surgeon was to prevent him from embarking upon employ-ment for which he was unfitted. In the last annual

’report of his department a sample, taken from some 1500cases, of qualifications and conditions had been tabulatedwhich was intended to serve as a standard to guide certifyingsurgeons. In view of the want of uniformity some suchstandard was eminently desirable. Legislators would always-insist on a strong body of authoritative medical opinionbefore passing Acts affecting industrial employment. The

’report of the Committee on Physical Deterioration had

wisely emphasised the necessity of medical supervision foryoung workers between the ages of 13 and 18 years.Without doubt that was the time of life when it was mostnecessary. He thought that factory certification was best,done by men who were thoroughly acquainted with the homeconditions of the child and the nature of the work which hewas to undertake, while re-examination and continuous carewould make the duties of the surgeon more efficient andmore interesting.

Mr. S. BENNETT (one of His Majesty’s inspectors for thedistrict of Sheffield) said that continuity was eminentlydesirable. He would prefer to see the certifying surgeonacting as a visitor and inspector of the conditions of employ-ment rather than as a mere examiner. The bridge whichhad been formed between the functions of medical officers ofschools and factory surgeons would be of great advantagenot only to the individual but to the community.

Mr. DEARDEN said that the discussion had been oneof very great interest and moment. What was of most

importance in their duties was that they should inthe first place insist not only on general but on special

’-fitness for the work at which the candidates were to be

employed; and even more imperative was the obligation tosee that the chief interest considered was that of the children.The fact that rejections for unfitness had doubled within thelast few years showed that the examination as carried out atpresent was by no means inadequate or perfunctory.

Dr. F. SHUFFLEBOTHAM (Newcastle-under-Lyme) read apaper on

Ind2cstrial Dermatitis,in which he described the various forms of eczema andulceration which were set up by irritants used in technical’arts and crafts. Of these, bichromates, aniline, arsenic,Ljnaterials used by potters and laundresses, chrysoidin, flax,"!’3trnng .alkalies, acids, and other chemicals were the mostimportant. The intense skin irritations which were also seenin persons engaged in handling cinchona bark, sugar, lime-juice, and bitter oranges were now appreciable elements inthe list of diseases with which the physician had to deal.In remedying these distressing affections cleanliness was allimportant: in all similar trades frequent and thoroughwashing should be insisted on and regular medical examina-tion of employees should be compulsory.

Dr. LEGGE said that in these industrial complaintsthe lesions in the mucous membranes were even more

important and distressing than those of the skin. Inchrome poisoning the septum of the nose was almost in-

variably involved. Emerald green was especially dangerous,and every worker in a factory where it was used was-liable to a perforated septum. Arsenical green, however,was not now employed in the manufacture of artificial

flowers. It was, indeed, scarcely used at all in any industryin this country.

Dr. EDGINGTON, Dr. PROSSER WHITE, and Dr. ALCOCKalso spoke, and Dr. SHUFFLEBOTHAM briefly replied.

THURSDAY, JULY 30TH.The proceedings on the second day of the meeting of the

Section of Industrial Diseases were opened by the PRESIDENT,Professor T. OLIVER (Newcastle-on-Tyne), who said thatSheffield had long borne an honourable part in the study ofillnesses due to occupation. The subject had not receivedthe attention which it deserved, but it was now becomingrecognised as one of vital importance not only to individualsbut to the nation, and there could be no more appropriateplace for the discussion of economic health problems than thecity in which they were met.

Dr. HAROLD SCURFIELD (medical officer of health ofSheffield) read a paper on

Industrial Diseases caused by Dust.He said that if the mortality tables were consulted itwould be found that of the whole population of Englandover 25 years of age three males died from consumption forevery two females. In Sheffield, however, the proportion ofmales over that age who died from the disease was 6 to

every 2 females. In other words, 120 men annually died inthat city who would presumably not have died were theconditions of work as favourable as those of the rest ofEngland. Similar ratios prevailed with regard to bronchitisand pneumonia, and statistics further proved that most ofthis exceptional mortality was due to the occupation of thevictims. The following table contrasted the death-rate fromphthisis and other diseases of the respiratory organs as

occurring in grinders and cutlers with that from all othercauses in adult males.

Average Mortality in Sheffield from all Oauses and fromPhthius and D2secse of the Respiratory 0,?-gans dwringthe Three Years 1905, 1906, and 1907 in certain DustyTrades and among all Males over 20 Years of &Acirc;ge.

It would be seen from the table that the death-rate ofgrinders from phthisis was more than six times and thedeath-rate from respiratory diseases nearly three times thatof the average male in Sheffield ; also that in the case

of cutlers the death-rate from phthisis was nearly threetimes, and the death-rate from respiratory diseases fourtimes, that of the average male in Sheffield. Theconditions which prevailed in the German Empirewere vastly more favourable to the workers in trades ofwhich dust was an inevitable concomitant. The whole

question had been very carefully studied there by Dr.

Ropke of Solingen-a city which occupied the same positionas a centre of the cutlers’ industry that Sheffield did inEngland-and the effect of the rules and official regulationswhich he drew up had been to improve to an almost in-credible extent the health of the workers. The first directresult of dust inhalation had been shown to be irritation ofthe mucous membranes of the nasal passages with erosionand ulceration of the septum, this condition being afterwardsfollowed by atrophy and loss of smell. The condition at thisstage was curable and many instances had occurred in whichcessation from work had been followed by complete recovery.Atrophy, however, facilitated the entrance of dust into thelungs and fibrotic inflammatory masses forming there ulti-mately broke down and the cavities which were left becameinoculated with tubercle bacilli. The position of theSheffield grinder, who worked on a stone revolving awayfrom him, was less injurious to health than that ofthe German, whose stone revolved towards him, and who had